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Freddo AM, Jacobsen RM, Yeung E, Stone ML, Kay JD, Khanna AD. Surgical management and outcomes of endocarditis in adolescents and adults with congenital heart disease. International Journal of Cardiology Congenital Heart Disease 2022. [DOI: 10.1016/j.ijcchd.2022.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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2
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Purohit SN, Lee PJ, Strobel AL, Desai AA, Marsala MT, Bull TM, Brieke A, Vargas D, Kay JD, Altman NL. Unusual Case of Acquired Hypoxemia Following Left Ventricular Assist Device Implantation. Circ Heart Fail 2020; 13:e006394. [PMID: 31896269 DOI: 10.1161/circheartfailure.119.006394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Suneet N Purohit
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora
| | - Paul J Lee
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora
| | - Aaron L Strobel
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora
| | - Aken A Desai
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora
| | - Maria T Marsala
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora
| | - Todd M Bull
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora
| | - Andreas Brieke
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora
| | - Daniel Vargas
- Department of Radiology (D.V.), University of Colorado, Aurora
| | - Joseph D Kay
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora.,Department of Pediatrics (J.D.K.), University of Colorado, Aurora
| | - Natasha L Altman
- Department of Medicine (S.N.P., P.J.L., A.L.S., A.A.D., M.T.M., T.M.B., A.B., J.D.K., N.L.A.), University of Colorado, Aurora
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Khanna AD, Duca LM, Kay JD, Shore J, Kelly SL, Crume T. Prevalence of Mental Illness in Adolescents and Adults With Congenital Heart Disease from the Colorado Congenital Heart Defect Surveillance System. Am J Cardiol 2019; 124:618-626. [PMID: 31303246 DOI: 10.1016/j.amjcard.2019.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/29/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
Abstract
The aim of this study was to estimate the prevalence of the full spectrum of mental illness in adolescents (aged 11 to 17) and adults (aged 18 to 64) with congenital heart defects (CHDs) in the population-level Colorado Congenital Heart Disease Surveillance System. Further we sought to investigate whether severity of the defect, frequency of recent cardiac procedures or underlying genetic disorders influence these estimates. The cohort included patients in clinical care for CHDs between January 1, 2011 and December 31, 2013, identified across multiple healthcare systems and insurance claims. Of 2,192 adolescents with CHDs, 20% were diagnosed with a mental illness with the most prevalent categories being developmental disorders (8%), anxiety disorders (6%), attention, conduct, behavior, impulse control disorders (6%), and mood disorders (5%). Of 6,924 adults with CHDs, 33% were diagnosed with a mental illness with the most prevalent categories being mood disorders (13%), anxiety disorders (13%), and substance-related disorders (6%). Greater lesion complexity was associated with a higher likelihood of anxiety and developmental disorders in both adolescents and adults. Adolescents and adults who had ≥2 cardiac procedures in the 3-year surveillance period had a 3- and 4.5-fold higher likelihood of a mental illness diagnosis, respectively, compared with those who had fewer than 2 cardiac procedures. Finally, patients with a genetic syndrome were more likely to have a mental illness diagnosis. In conclusion, mental illness is a prevalent co-morbidity in the adolescent and adult population with CHDs, thus comprehensive care should include mental health care.
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Affiliation(s)
- Amber D Khanna
- Departments of Internal Medicine and Pediatrics, Divisions of Cardiology, University of Colorado | Anschutz Medical Campus, Aurora, Colorado.
| | - Lindsey M Duca
- Department of Epidemiology, Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, Aurora, Colorado
| | - Joseph D Kay
- Departments of Internal Medicine and Pediatrics, Divisions of Cardiology, University of Colorado | Anschutz Medical Campus, Aurora, Colorado
| | - Jay Shore
- Department of Psychiatry and Family Medicine, University of Colorado | Anschutz Medical Campus, Aurora, Colorado
| | - Sarah L Kelly
- Departments of Pediatrics and Psychiatry, University of Colorado | Anschutz Medical Campus, Aurora, Colorado
| | - Tessa Crume
- Department of Epidemiology, Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, Aurora, Colorado
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Wiktor DM, Kay JD, Kim MS. Consecutive percutaneous valve-in-valve replacement late after Ross procedure: A novel approach in an adult with congenital heart disease. Catheter Cardiovasc Interv 2015; 86:1092-6. [PMID: 26356137 DOI: 10.1002/ccd.26114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 07/05/2015] [Indexed: 11/05/2022]
Abstract
The emergence of transcatheter valve technology over the last decade has made significant impact on the treatment of patients with valvular heart disease. There has been increasing experience with both native and valve-in-valve indications with promising results. We present the case of a young woman with congenital heart disease who underwent the Ross procedure for bicuspid aortic valve endocarditis with subsequent reoperation and surgical aortic valve replacement for neo-aortic root dilation who experienced worsening symptoms related to both pulmonary and aortic valve dysfunction. She was successfully treated with percutaneous pulmonary and aortic valve replacement with excellent early term technical results and marked improvement in symptoms.
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Affiliation(s)
- Dominik M Wiktor
- Department of Medicine, University of Colorado, Denver, Aurora, Colorado.,Division of Cardiology, University of Colorado, Denver, Aurora, Colorado
| | - Joseph D Kay
- Department of Medicine, University of Colorado, Denver, Aurora, Colorado.,Division of Cardiology, University of Colorado, Denver, Aurora, Colorado
| | - Michael S Kim
- Department of Medicine, University of Colorado, Denver, Aurora, Colorado.,Division of Cardiology, University of Colorado, Denver, Aurora, Colorado
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Whitaker HC, Shiong LL, Kay JD, Grönberg H, Warren AY, Seipel A, Wiklund F, Thomas B, Wiklund P, Miller JL, Menon S, Ramos-Montoya A, Vowler SL, Massie C, Egevad L, Neal DE. N-acetyl-L-aspartyl-L-glutamate peptidase-like 2 is overexpressed in cancer and promotes a pro-migratory and pro-metastatic phenotype. Oncogene 2014; 33:5274-87. [PMID: 24240687 DOI: 10.1038/onc.2013.464] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/27/2013] [Accepted: 09/16/2013] [Indexed: 02/02/2023]
Abstract
N-acetyl-L-aspartyl-L-glutamate peptidase-like 2 (NAALADL2) is a member of the glutamate carboxypeptidase II family, best characterized by prostate-specific membrane antigen (PSMA/NAALAD1). Using immunohistochemistry (IHC), we have shown overexpression of NAALADL2 in colon and prostate tumours when compared with benign tissue. In prostate cancer, NAALADL2 expression was associated with stage and Grade, as well as circulating mRNA levels of the NAALADL2 gene. Overexpression of NAALADL2 was shown to predict poor survival following radical prostatectomy. In contrast to PSMA/NAALAD1, NAALADL2 was localized at the basal cell surface where it promotes adhesion to extracellular matrix proteins. Using stable knockdown and overexpression cell lines, we have demonstrated NAALADL2-dependent changes in cell migration, invasion and colony-forming potential. Expression arrays of the knockdown and overexpression cell lines have identified nine genes that co-expressed with NAALADL2, which included membrane proteins and genes known to be androgen regulated, including the prostate cancer biomarkers AGR2 and SPON2. Androgen regulation was confirmed in a number of these genes, although NAALADL2 itself was not found to be androgen regulated. NAALADL2 was also found to regulate levels of Ser133 phosphorylated C-AMP-binding protein (CREB), a master regulator of a number of cellular processes involved in cancer development and progression. In combination, these data suggest that changes in expression of NAALADL2 can impact upon a number of pro-oncogenic pathways and processes, making it a useful biomarker for both diagnosis and prognosis.
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Affiliation(s)
- H C Whitaker
- 1] Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK [2] Cancer Research UK Biomarker Initiative, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - L L Shiong
- Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - J D Kay
- Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - H Grönberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - A Y Warren
- 1] Department of Histopathology and ISH Core Facility, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK [2] Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Seipel
- Department of Pathology, Karolinska Institute, Stockholm, Sweden
| | - F Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - B Thomas
- Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - P Wiklund
- Department of Pathology, Karolinska Institute, Stockholm, Sweden
| | - J L Miller
- 1] Department of Histopathology and ISH Core Facility, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK [2] Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - S Menon
- Bioinformatics Core Facility, Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, UK
| | - A Ramos-Montoya
- Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - S L Vowler
- Bioinformatics Core Facility, Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, UK
| | - C Massie
- Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - L Egevad
- Department of Pathology, Karolinska Institute, Stockholm, Sweden
| | - D E Neal
- Uro-Oncology Research Group, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
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Cotts T, Nallamothu BK, Kay JD. GUCH/ACHD: what is required of the newest field in medicine? Eur Heart J 2014; 35:676-677. [PMID: 24772458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Cardiologists from the USA provide information from earlier experiences in this emerging specialty.
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Valente AM, Landzberg MJ, Gianola A, Harmon AJ, Cook S, Ting JG, Stout K, Kuehl K, Khairy P, Kay JD, Earing M, Houser L, Broberg C, Milliren C, Opotowsky AR, Webb G, Verstappen A, Gurvitz M. Improving heart disease knowledge and research participation in adults with congenital heart disease (The Health, Education and Access Research Trial: HEART-ACHD). Int J Cardiol 2013; 168:3236-40. [DOI: 10.1016/j.ijcard.2013.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 03/18/2013] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
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Dorosz JL, Fonseca BM, Kay JD, Graham BB, Salcedo EE, Quaife RA. A Sinus Venosus Atrial Septal Defect Is Diagnosed by Echocardiography with an Unusual Bubble Study. Echocardiography 2013; 30:E182-3. [DOI: 10.1111/echo.12191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jennifer L. Dorosz
- Division of Cardiology; School of Medicine; University of Colorado Denver; Aurora; Colorado
| | - Brian M. Fonseca
- Division of Pediatric Cardiology; School of Medicine; University of Colorado Denver; Aurora; Colorado
| | | | - Brian B. Graham
- Division of Pulmonary - Critical Care Medicine; School of Medicine; University of Colorado Denver; Aurora; Colorado
| | - Ernesto E. Salcedo
- Division of Cardiology; School of Medicine; University of Colorado Denver; Aurora; Colorado
| | - Robert A. Quaife
- Division of Cardiology; School of Medicine; University of Colorado Denver; Aurora; Colorado
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Mongeon FP, Gurvitz MZ, Broberg CS, Aboulhosn J, Opotowsky AR, Kay JD, Valente AM, Earing MG, Lui GK, Fernandes SM, Gersony DR, Cook SC, Ting JG, Nickolaus MJ, Landzberg MJ, Khairy P. Aortic Root Dilatation in Adults with Surgically Repaired Tetralogy of Fallot. Circulation 2013; 127:172-9. [DOI: 10.1161/circulationaha.112.129585] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- François-Pierre Mongeon
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Michelle Z. Gurvitz
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Craig S. Broberg
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Jamil Aboulhosn
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Alexander R. Opotowsky
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Joseph D. Kay
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Anne Marie Valente
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Michael G. Earing
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - George K. Lui
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Susan M. Fernandes
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Deborah R. Gersony
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Stephen C. Cook
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Jennifer Grando Ting
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Michelle J. Nickolaus
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Michael J. Landzberg
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
| | - Paul Khairy
- From the Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children’s Hospital Boston and Brigham and Women’s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M
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Watson RS, Broome TA, Levings PP, Rice BL, Kay JD, Smith AD, Gouze E, Gouze JN, Dacanay EA, Hauswirth WW, Nickerson DM, Dark MJ, Colahan PT, Ghivizzani SC. scAAV-mediated gene transfer of interleukin-1-receptor antagonist to synovium and articular cartilage in large mammalian joints. Gene Ther 2012; 20:670-7. [PMID: 23151520 PMCID: PMC3577988 DOI: 10.1038/gt.2012.81] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
With the long-term goal of developing a gene-based treatment for osteoarthritis (OA), we performed studies to evaluate the equine joint as a model for adeno-associated virus (AAV)-mediated gene transfer to large, weight-bearing human joints. A self-complementary AAV2 vector containing the coding regions for human interleukin-1-receptor antagonist (hIL-1Ra) or green fluorescent protein was packaged in AAV capsid serotypes 1, 2, 5, 8 and 9. Following infection of human and equine synovial fibroblasts in culture, we found that both were only receptive to transduction with AAV1, 2 and 5. For these serotypes, however, transgene expression from the equine cells was consistently at least 10-fold higher. Analyses of AAV surface receptor molecules and intracellular trafficking of vector genomes implicate enhanced viral uptake by the equine cells. Following delivery of 1 × 10(11) vector genomes of serotypes 2, 5 and 8 into the forelimb joints of the horse, all three enabled hIL-1Ra expression at biologically relevant levels and effectively transduced the same cell types, primarily synovial fibroblasts and, to a lesser degree, chondrocytes in articular cartilage. These results provide optimism that AAV vectors can be effectively adapted for gene delivery to large human joints affected by OA.
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Affiliation(s)
- R S Watson
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL 32608-0137, USA
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McCanta AC, Kay JD, Collins KK. Cryoablation of the Slow Atrioventricular Nodal Pathway via a Transbaffle Approach in a Patient with the Mustard Procedure for d-Transposition of the Great Arteries. CONGENIT HEART DIS 2011; 6:479-83. [DOI: 10.1111/j.1747-0803.2011.00515.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Appropriate regimens for anticoagulation in the single ventricle population remain controversial and are usually based on individual practitioners' preferences. We present the case of a patient with a history of hypoplastic left heart syndrome and Norwood palliation who presented at 17 years of age with an acute myocardial infarction and a new diagnosis of antiphospholipid syndrome.
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Affiliation(s)
- Gira S Morchi
- The Children's Hospital Heart Institute-Pediatric Cardiology, Aurora, Colorado, USA
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Klein AJ, Kim MS, Quaife RA, Kay JD. Anomalous Left Anterior Descending Coronary Artery from the Pulmonary Artery, Unroofed Coronary Sinus, Patent Foramen Ovale, and a Persistent Left-sided SVC in a Single Patient: A Harmonious Quartet of Defects. CONGENIT HEART DIS 2009. [DOI: 10.1111/j.1747-0803.2009.00268.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Percutaneous stenting of both native and recurrent coarctation of the aorta has become an acceptable alternative to surgical repair in most centers throughout the world. Severe complications such as aortic rupture, dissection, and late pseudo aneurysm formation are rare but worrisome complications. In many countries, commercially available balloon expandable covered stents designed for intravascular use are used either for primary stenting, or in treating complications once identified. These endovascular stents, however, are not available in the United States. We report the use of a commercially available covered stent, which has been approved by the Food and Drug Administration for tracheal use, to exclude an aortic pseudo aneurysm that was identified late after stenting a native coarctation.
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Affiliation(s)
- Joseph D Kay
- Division of Cardiology, University of Colorado, Denver, Colo., USA.
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Menon S, Berezny KY, Kilaru R, Benjamin DK, Kay JD, Hazan L, Portman R, Hogg R, Deitchman D, Califf RM, Li JS. Racial differences are seen in blood pressure response to fosinopril in hypertensive children. Am Heart J 2006; 152:394-9. [PMID: 16875928 DOI: 10.1016/j.ahj.2005.12.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Accepted: 12/18/2005] [Indexed: 01/05/2023]
Abstract
BACKGROUND Few antihypertensive therapies have been systematically studied in children and dosages for many agents are either extrapolated from adult studies or obtained from small homogenous pediatric populations. It is well established that adult patients of different races show disparate response to angiotensin-converting enzyme (ACE) inhibitors, however no such studies have been performed in children. METHODS Two hundred fifty three children ages 6-16 with hypertension or with high normal blood pressure with an associated medical condition requiring antihypertensive therapy were enrolled at 78 clinical sites in the US, Russia, and Israel in a double blind study to evaluate the efficacy of fosinopril compared to placebo. RESULTS The racial composition of the cohort included 60.1% white (152/253), 20.6% black (52/253), 13.8% Hispanic (35/253), 2.0% Asian (5/253), 0.4% Native American (1/253), and 3.2% (8/253) children classified as other or of mixed race. After adjusting for baseline blood pressure and body surface area (BSA) there was no significant dose response seen in non-black patients. Non-blacks randomized to the low, medium, and high dosages of fosinopril all had a mean decrease of 12 mm Hg in their sequential systolic BP (SBP). Blacks, however, demonstrated a significant dose response to fosinopril; those who received the low dosage had a 5 mm Hg decrease in SBP, and those who received the high dosage had a mean 13 mm Hg decrease in SBP. CONCLUSIONS Fosinopril was effective in treating hypertension, but black children required a higher dose per body weight in order to achieve adequate control. This suggests that black children treated with fosinopril for hypertension on average require higher doses to achieve adequate systolic blood pressure control that non-black children.
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Affiliation(s)
- Sharad Menon
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
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Kay JD, Kilaru R, Berezny K, Deitchman D, Li JS. 1114-205 Racial differences in blood pressure response in children with hypertension treated with fosinopril. J Am Coll Cardiol 2004. [DOI: 10.1016/s0735-1097(04)91638-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND The late outcome of patients treated with atrial septal occluder devices remains incompletely defined. The purpose of this study was to assess the late outcome (range 4-7 years postprocedure) of patients in whom the Das AngelWings septal occluder device was implanted in the atrial septum. We report the clinical and echocardiographic outcome, at an average of 5 years following the procedure, of patients treated with the Das AngelWings device used to close either a secundum atrial septal defect (ASD) or a patent foramen ovale (PFO). METHODS Thirty-two patients underwent successful percutaneous closure of an atrial septal closure, patent foramen ovale, or fenestration in the lateral tunnel of their Fontan with the Das AngelWings device between June 1995 and March 1998 at Duke University Medical Center. Two of the 32 patients were lost to follow-up. The remaining 30 patients were divided into 3 groups based on indication for device implantation. Group 1 consisted of 14 patients with a secundum ASD and predominantly left-to-right atrial shunting. Group 2 consisted of 8 patients who had a PFO and who suffered a thromboembolic event. Group 3 (compassionate use) consisted of 10 patients with multiple comorbid medical problems with predominantly right-to-left shunting at the atrial level causing hypoxemia. Eight of the patients in group 3 were severely ill at the time of device implantation. The 2 remaining patients in group 3 underwent AngelWings implantation for closure of right-to-left shunting through a Fontan fenestration. Mean follow-up was 59 months. RESULTS There was no device embolization. No patient in the ASD or PFO/stroke group had a clinical complication. By radiographic examination, 2 of 27 patients had evidence of fracture of the nitinol framework at 2-year follow-up. Residual shunting was present in 44% at 24 hours, 20% at 1 year, and 18.8% at 2 years by use of Doppler color flow imaging and/or microcavitation echocardiographic studies. Mild mitral regurgitation caused by the AngelWings device occurred in 1 patient. One patient in the compassionate use group had a subsequent neurologic event. Five of the 10 patients in the compassionate use group died of comorbid illnesses in follow-up, none directly related to device complications. CONCLUSION The late clinical outcome of secundum ASD and PFO/stroke patients in this study demonstrates that Das AngelWings closure of the atrial septum is effective and safe. These data are encouraging with respect to the expanding use of other percutaneously implanted ASD occlusion devices, although late clinical safety and efficacy data are needed for the specific devices being implanted.
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Affiliation(s)
- Joseph D Kay
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC 27710, USA
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Dery JP, Hernandez AF, Kay JD, Petersen JL, Rao SV, Rebeiz AG, Singh KP, Donahue MP. Highlights from the American Heart Association annual scientific sessions 2002: November 17 to 20, 2002. Am Heart J 2003; 145:554-62. [PMID: 12660682 DOI: 10.1067/mhj.2003.188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Affiliation(s)
- J D Kay
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA
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Kay JD, Al-Khatib Y, O'Laughlin MP, Sketch MH, Harrison JK. Congenital coarctation and Takayasu's arteritis: aortic stenting employing intravascular ultrasound. J Invasive Cardiol 2001; 13:705-7, discussion 707-9. [PMID: 11581515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- J D Kay
- Division of Cardiology, Duke University Medical Center, Durham, NC, 27710, USA
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Affiliation(s)
- J D Kay
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
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Affiliation(s)
- J D Kay
- Department of Clinical Biochemistry, Oxford Radcliffe Hospitals, UK.
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Affiliation(s)
- P Newton
- Department of General Medicine, John Radcliffe Hospital, Headington, Oxford, UK
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Kay JD, Nurse D. Construction of a virtual EPR and automated contextual linkage to multiple sources of support information on the Oxford Clinical Intranet. Proc AMIA Symp 1999:829-33. [PMID: 10566476 PMCID: PMC2232796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
We have used internet-standard tools to provide access for clinicians to the components of the electronic patient record held on multiple remote disparate systems. Through the same interface we have provided access to multiple knowledgebases, some written locally and others published elsewhere. We have developed linkage between these two types of information which removes the need for the user to drill down into each knowledgebase to search for relevant information. This approach may help in the implementation of evidence-based practice. The major problems appear to be semantic rather than technological. The intranet was developed at low cost and is now in routine use. This approach appears to be transferable across systems and organisations.
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Affiliation(s)
- J D Kay
- Oxford Medical Informatics, Oxford Radcliffe Hospitals NHS Trust, UK
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Taggart DP, Bhattacharya K, Meston N, Standing SJ, Kay JD, Pillai R, Johnssson P, Westaby S. Serum S-100 protein concentration after cardiac surgery: a randomized trial of arterial line filtration. Eur J Cardiothorac Surg 1997; 11:645-9. [PMID: 9151031 DOI: 10.1016/s1010-7940(96)01103-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Embolization of gaseous and particulate matter is incriminated in the neuropsychological morbidity of CPB and can be reduced by membrane oxygenators and arterial line filtration. It is not known if the use of arterial line filtration in conjunction with membrane oxygenators might have an additive effect in reducing cerebral injury. METHODS Forty patients undergoing elective coronary artery surgery were prospectively randomized to a 43 microns heparin coated arterial line filter (Cobe Sentry) or to no filtration (control group). All operations were performed by one surgeon (DPT) using intermittent ischaemia with nonpulsatile CPB, a COBE CML membrane oxygenator and alpha-stat paCO2 management. Flow rates were maintained between 2.0 and 2.4 l-1 m2 per min with a perfusion pressure of 50-80 mmHg and a systemic temperature of 34 degrees C. Cerebral injury was defined by careful neurological examination and serial measurement of the serum concentration of S-100 protein (a highly specific astroglial cell derivative, elevated serum levels of which correlate with proven cerebral injury). RESULTS There was no difference [mean (S.D.)] in the control and filter groups with respect to age [61(9) vs. 62(9) years], ejection fraction, number of grafts [2.8(0.6) vs. 2.6(0.7)] or CPB times [55(19) vs. 57(18) min]. Preoperatively, no patient had detectable S-100. In the postoperative period 23 of 40 patients (58%) showed elevated S-100 levels. At 1, 5 and 24 h the respective number of patients in the control and filter groups with elevated S-100 was (14 vs. 9), (4 vs. 0), (4 vs. 0)) (P < 0.05). No patient had overt cerebral injury. CONCLUSIONS This study suggests that (i) subclinical cerebral injury is common (58% of patients in this study) even after apparently uncomplicated surgery with short CPB times; (ii) serum S-100 protein is a valuable marker for investigating potentially cerebral protective innovations during CPB; and (iii) arterial line filtration significantly reduces but does not eliminate cerebral injury.
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Affiliation(s)
- D P Taggart
- Oxford Heart Centre, John Radcliffe Hospital, UK
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Taggart DP, Mazel JW, Bhattacharya K, Meston N, Standing SJ, Kay JD, Pillai R, Johnssson P, Westaby S. Comparison of serum S-100 beta levels during CABG and intracardiac operations. Ann Thorac Surg 1997; 63:492-6. [PMID: 9033326 DOI: 10.1016/s0003-4975(96)01229-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The risk of overt and subtle cerebral injury may be higher in intracardiac operation (ICO) rather than coronary artery bypass grafting (CABG). S-100 protein is a specific astroglial protein whose serum level increases after cerebral injury. Elevated serum levels of S-100 have been detected after adult cardiac operations and correlated with neurologic injury. METHODS The level of S-100 protein was measured serially over 24 hours in 40 patients (27 undergoing aortic valve replacement, 9 mitral valve replacement, 4 closure of atrial septal defect) undergoing ICO and 20 patients undergoing CABG. RESULTS The groups were similar with respect to age and cardiopulmonary bypass times. The S-100 level was not elevated before operation in any patient. Peak S-100 levels were reached at skin closure, when 35 of the ICO patients (88%) and 13 of the CABG patients (65%) had elevated S-100 levels. At skin closure peak S-100 levels were significantly greater in the ICO group (median [interquartile range], 0.76 [0.44-1.16] versus 0.3 [0-0.55] microgram/L; p < 0.01). At 5 hours S-100 levels were still elevated in 22 patients in the ICO group compared with 1 patient in the CABG group (p < 0.01), and at 24 hours 17 ICO patients had persistently elevated S-100 levels in comparison with 2 in the CABG group (p < 0.01). One valve patient had a stroke 24 hours after operation accompanied by a secondary increase in the S-100 level. There was no significant difference in postoperative S-100 levels between 5 patients in the ICO group with a prior history of stroke and those without. The peak S-100 level correlated with patient age (r = 0.59; p < 0.001) but not with the duration of cardiopulmonary bypass or core temperature during the operation. CONCLUSIONS Intracardiac operation results in a significantly greater elevation in S-100 levels than CABG. Elevated S-100 levels correlate with increasing patient age but not with the duration of cardiopulmonary bypass or intraoperative core temperature. These findings raise the possibility that ICO patients may be more vulnerable to even subtle levels of cerebral injury than CABG patients.
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Affiliation(s)
- D P Taggart
- Oxford Heart Centre, John Radcliffe Hospital, England
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Abstract
OBJECTIVE To compare different screening policies for Down's syndrome across a broad range of outcomes, using decision analysis, with particular reference to the role of maternal serum testing. DESIGN A decision tree was used to combine data from local sources and the medical literature to predict the likely frequency of several outcomes. Sensitivity analyses were used to test the robustness of the conclusions drawn. SETTING Oxfordshire Health Authority. MAIN OUTCOME MEASURES Live births with and without Down's syndrome; miscarriages with Down's syndrome; cases of Down's syndrome detected antenatally; amniocenteses performed (and associated miscarriages); direct NHS screening costs; number of women offered screening. RESULTS Screening policies for Down's syndrome that include serum testing can produce better population outcomes than programmes that do not. Each option for screening for Down's syndrome that we considered had significant drawbacks. In Oxfordshire, offering serum testing to women of all ages would prevent the birth of approximately one more baby with Down's syndrome per year than would a policy of screening for women aged 30 years or more. The cost of preventing this one extra Down's birth would be one or two normal babies lost after amniocentesis, 4500 blood tests for young women (with the associated anxiety and counselling), approximately 200 false positive serum test results and amniocenteses (with the associated anxiety and distress), and 90,000 pounds for the extra tests, counselling, and amniocenteses. Opinions are divided as to which policy is the better option for the population. CONCLUSIONS Decision analysis is a useful tool for determining the likely consequences of different policy options across a broad range of outcomes. This focuses debate and decision making on outcomes of care, which in turn makes it clear that the choice of screening programme for Down's syndrome depends on the relative importance ascribed to the different outcomes. If individuals' values vary widely it may be impossible to find one screening policy that meets the needs of all pregnant women.
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Affiliation(s)
- J Fletcher
- Department of Public Health and Health Policy, Oxfordshire Health Authority
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Phillips PE, Edge JA, Harris DA, Kay JD, Tomlinson P, Hourd P, Dunger DB. Urinary excretion and clearance of insulin in diabetic and normal children and adolescents. Diabet Med 1993; 10:707-14. [PMID: 8261751 DOI: 10.1111/j.1464-5491.1993.tb00152.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Seventy-two diabetic (38 males) and 86 normal (41 males) children provided timed overnight urine collections. Fourteen of the diabetic and 33 of the normal children had concurrent overnight plasma insulin profiles. Urinary insulin clearance in the diabetic subjects was compared with excretion of albumin, growth hormone, retinol-binding protein, and N-acetyl-beta-D-glucosaminidase. In the normal subjects, urinary insulin excretion correlated with mean overnight plasma levels in the boys (r = 0.82, p < 0.001) but not in the girls (r = 0.32), and varied with puberty stage in the boys. Insulin clearance was greater in boys than girls during puberty, and fell in both sexes with advancing puberty. Insulin excretion was greater in diabetic than normal children in both sexes at all puberty stages. Insulin clearance was also greater in diabetic than normal subjects (1.05 +/- 0.1 ml min-1 1.73 m-2 vs 0.48 +/- 0.05 ml min-1 1.73 m-2, p < 0.001). Insulin excretion as a percentage of the filtered load was also greater in diabetic than normal subjects (1.9 +/- 0.27% vs 0.85 +/- 0.09%, p < 0.01). In the diabetic children, there was a correlation between urinary insulin and growth hormone excretion (r = 0.52, p < 0.02), and retinol-binding protein in those (n = 10) with higher retinol binding protein excretion (r = 0.76, p = 0.01). The value of urinary insulin excretion as a measure of free plasma insulin levels in normal and diabetic children may be limited by sex differences in renal insulin clearance, and by proximal renal tubular dysfunction in children with diabetes.
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Affiliation(s)
- P E Phillips
- Department of Paediatrics, John Radcliffe Hospital, Oxford, UK
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Abstract
Of 382 patients undergoing prostatectomy in Oxford in 1985 the prevalence of renal impairment (defined as plasma urea > 14 mmol/l or plasma creatinine > 200 mumol/l) was 8%; prostatectomy patients had significantly higher plasma ureas than age-matched patients undergoing herniorrhaphy and cholecystectomy in the same hospitals in the same year. A review of the case records of men with renal impairment showed that case history could not predict renal impairment. Although few case notes gave follow-up information, it was evident from the information available that recovery of renal function after prostatectomy did not occur invariably. Renal impairment in men undergoing prostatectomy represents substantial and unrecognised morbidity.
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Affiliation(s)
- A M Hill
- Oxfordshire Health Authority, Oxford
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McVittie J, Kay JD. Communication of structured medical information by computers: the Oxford experience. Stud Health Technol Inform 1992; 6:134-7. [PMID: 10163805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- J McVittie
- Department of Clinical Biochemistry, John Radcliffe Hospital, Oxford, England
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Crute BE, Kay JD, Grace ES, Kull FJ. Porcine thyroid cytosolic, latent alkaline ribonuclease: resistance to protein denaturants. Comp Biochem Physiol B 1992; 101:289-97. [PMID: 1499276 DOI: 10.1016/0305-0491(92)90192-t] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
1. A ribonuclease isolated from porcine thyroid cytosol using phenol: sodium dodecylsulfate treatment was associated with RNA and identical to latent alkaline ribonuclease. 2. Distribution of activity between aqueous and phenolic phases depended on pH, RNA, and ribonuclease inhibitor. 3. The ribonuclease was totally resistant to urea, guanidinium: HCl, chloroform:isoamyl alcohol, ethanol, heating at 100 degrees C for 10 min or at 80 degrees C plus 100 mM NaCl. It was highly resistant to hydrolysis by proteinase K except in the presence of detergent. 4. The extreme stability and other properties of latent alkaline ribonuclease could be the result of its association with RNA.
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Affiliation(s)
- B E Crute
- Department of Biological Sciences, State University, Center at Binghamton, NY 13902-6000
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Aparicio SA, Mojiminiyi S, Kay JD, Shepstone BJ, de Ceulaer K, Serjeant GR. Measurement of glomerular filtration rate in homozygous sickle cell disease: a comparison of 51Cr-EDTA clearance, creatinine clearance, serum creatinine and beta 2 microglobulin. J Clin Pathol 1990; 43:370-2. [PMID: 2115049 PMCID: PMC502428 DOI: 10.1136/jcp.43.5.370] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Glomerular filtration rates (GFR) were measured with 51Cr-EDTA in 38 patients (aged 40-75 years) with homozygous sickle cell disease and compared with serum beta 2 microglobulin concentrations in 38 patients and with creatinine clearance in 21 patients. GFR estimated with 51Cr-EDTA was closely correlated with single serum creatinine measurements and the inverse of serum beta 2 microglobulin. Creatinine clearance was also found to be correlated, but values were, on average, 32% below those obtained by the 51Cr-EDTA method, and this difference was significant. It is concluded that measurements of beta 2 microglobulin, single serum creatinine, and creatinine clearance are valuable indicators of GFR in homozygous sickle cell disease. Measurement of beta 2 microglobulin was a useful and reliable method of estimating GFR from single plasma measurements and is therefore a useful means of screening the population.
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Affiliation(s)
- S A Aparicio
- Department of Nuclear Medicine, John Radcliffe Hospital, Oxford
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Magos AL, Lockwood GM, Baumann R, Turnbull AC, Kay JD. Absorption of irrigating solution during transcervical resection of endometrium. BMJ 1990; 300:1079. [PMID: 2344530 PMCID: PMC1662754 DOI: 10.1136/bmj.300.6731.1079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Affiliation(s)
- R Baumann
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital
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Kay JD. Inhibition by salicylates of urea synthesis by isolated rat hepatocytes and citrulline synthesis by isolated rat mitochondria: an effect independent of uncoupling. Horm Metab Res 1988; 20:333-5. [PMID: 3417218 DOI: 10.1055/s-2007-1010829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
1. Acetylsalicylate and salicylate inhibited urea synthesis by isolated rat hepatocytes and citrulline synthesis by isolated rat mitochondria. The effects were dose-dependent and occurred at drug concentrations seen in salicylate induced hepatoxicity. 2. Although ATP concentration was decreased in the hepatocytes the effect of the salicylates on citrulline synthesis remained after treatment with oligomycin and carbonyl cyanide m-chlorophenyl hydrazone. This suggests that the effect is independent of uncoupling of oxidative phosphorylation. 3. This in vitro inhibition of urea synthesis by salicylates is similar to that produced by valproate and endogenous organic acids, which are also associated with hyperammonaemic clinical toxicity, and is a possible mechanism for the action of salicylates in the hyperammonaemia of Reye's syndrome.
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Affiliation(s)
- J D Kay
- Nuffield Department of Clinical Medicine, Radcliffe Infirmary, Oxford, England
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Kay JD, Oberholzer VG, Seakins JW, Hjelm M. Effect of partial ornithine carbamoyltransferase deficiency on urea synthesis and related biochemical events. Clin Sci (Lond) 1987; 72:187-93. [PMID: 3816076 DOI: 10.1042/cs0720187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The biochemical response to an intravenous alanine load of 0.25 g/kg was studied in nine adult female relatives of children with ornithine carbamoyltransferase deficiency. Six were classified as affected by partial deficiency and three as unaffected. The plasma ammonium concentration showed no change after the alanine load in the unaffected group, but marked increases occurred in all but one of the affected groups. The maximum rate of urea synthesis after the alanine load was decreased by 37% (P = 0.02) and delayed by 43% (P = 0.02) in the affected group. In the affected group a low rate of urea synthesis was associated with high urinary orotate excretion, high maximum plasma ammonium concentration and delay in the time taken to reach the maximum rate of urea synthesis (Kendall concordance W = 0.55, P less than 0.05). The effects of a higher dose of alanine and of oral protein were compared. The alanine load of 0.25 g of alanine/kg body weight was shown to provide an adequate stimulus to urea synthesis with a more rapid return of ammonium concentration to the pre-load level than with the protein load. The implication of these results in determining the distribution of flux control of urea synthesis, the discrepancy between them and predicted results and the necessary modifications to quantitative simulations are discussed.
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Kay JD, Seakins JW, Geiseler D, Hjelm M. Validation of a method for measuring the short-term rate of urea synthesis after an amino acid load. Clin Sci (Lond) 1986; 70:31-8. [PMID: 3943275 DOI: 10.1042/cs0700031] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The response of the plasma concentration of urea to the oral and intravenous administration of alanine was studied in healthy adult humans. The instantaneous rate of urea synthesis was calculated by using a model-dependent procedure. The errors in this procedure were calculated and it was shown that analytical precision and sampling frequency, and the estimates of the distribution volume and elimination fluxes, were adequate to determine the synthesis parameters. A direct test of the compartmental model was made by the intravenous injection of exogenous urea. The one-compartment model with first-order elimination gave a good fit to the experimental results at times greater than 8 min after the injection. Both oral and intravenous loads of alanine had dose-dependent effects on the rate of urea synthesis. There was no evidence of a limit to the maximum possible rate of urea synthesis in these experiments and the values obtained were similar to published results for different stimuli and methods of measurement. The rate of synthesis increased more rapidly after intravenous loads and subjective side-effects were less severe. The intravenous administration of alanine appears to be a suitable stimulus for urea synthesis.
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Geiseler D, Kay JD, Oberholzer VG, Seakins JW, Hjelm M. Determination of the rate of urea synthesis from serial measurements of plasma urea concentration after an alanine load: theoretical and methodological aspects. Clin Sci (Lond) 1985; 68:201-8. [PMID: 3967467 DOI: 10.1042/cs0680201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A method is described by which the rate of synthesis of urea can be calculated from the change of plasma concentration of urea after an alanine load. The results can be expressed in terms of f, the maximum increase in the rate of urea synthesis, and t, the time at which urea synthesis reaches its maximum. These parameters are calculated by an algebraic curve-fitting technique which is suitable for a desk computer. The method removes the need for isotopic analysis and urine collections. The effect of various errors and experimental conditions on the calculated synthesis parameters is investigated.
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Hudson GJ, Bailey PA, John PM, Monsalve L, Garcia del Campo AL, Taylor DC, Kay JD. Composition of milk from Ailuropoda melanoleuca, the giant panda. Vet Rec 1984; 115:252. [PMID: 6495573 DOI: 10.1136/vr.115.10.252] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Peel D, Kay JD, Taylor F. Reminder: cresol and phenol preservatives interfere with analysis for glucose with the YSI Analyzer. Clin Chem 1983; 29:1558-9. [PMID: 6872227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Levin M, Hjelm M, Kay JD, Pincott JR, Gould JD, Dinwiddie R, Matthew DJ. Haemorrhagic shock and encephalopathy: a new syndrome with a high mortality in young children. Lancet 1983; 2:64-7. [PMID: 6134958 DOI: 10.1016/s0140-6736(83)90057-0] [Citation(s) in RCA: 86] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In the past year, ten infants have been admitted to hospital with a new or previously unrecognised disorder, characterised by an acute onset of encephalopathy, fever, shock, watery diarrhoea, severe disseminated intravascular coagulation, and renal and hepatic dysfunction. Seven of the infants died. No specific causative agent has been identified, but preliminary studies suggest that the pathophysiology of the disease may involve release of proteolytic enzymes (such as trypsin) into the circulation, with destruction of the microcirculation.
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Jenkins HR, Leonard JV, Kay JD, Pool RW, Sills JA, Isherwood DM. Alpha-1-antitrypsin deficiency, bleeding diathesis, and intracranial haemorrhage. Arch Dis Child 1982; 57:722-3. [PMID: 6982029 PMCID: PMC1627795 DOI: 10.1136/adc.57.9.722-c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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