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Pérez-Gordones MC, Ramírez-Iglesias JR, Benaim G, Mendoza M. Molecular, immunological, and physiological evidences of a sphingosine-activated plasma membrane Ca 2+-channel in Trypanosoma equiperdum. Parasitol Res 2024; 123:166. [PMID: 38506929 DOI: 10.1007/s00436-024-08188-z] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
The hemoparasite Trypanosoma equiperdum belongs to the Trypanozoon subgenus and includes several species that are pathogenic to animals and humans in tropical and subtropical areas across the world. As with all eukaryotic organisms, Ca2+ is essential for these parasites to perform cellular processes thus ensuring their survival across their life cycle. Despite the established paradigm to study proteins related to Ca2+ homeostasis as potential drug targets, so far little is known about Ca2+ entry into trypanosomes. Therefore, in the present study, the presence of a plasma membrane Ca2+-channel in T. equiperdum (TeCC), activated by sphingosine and inhibited by verapamil, is described. The TeCC was cloned and analyzed using bioinformatic resources, which confirmed the presence of several domains, motifs, and a topology similar to the Ca2+ channels found in higher eukaryotes. Biochemical and confocal microscopy assays using antibodies raised against an internal region of human L-type Ca2+ channels indicate the presence of a protein with similar predicted molar mass to the sequence analyzed, located at the plasma membrane of T. equiperdum. Physiological assays based on Fura-2 signals and Mn2+ quenching performed on whole parasites showed a unidirectional Ca2+ entry, which is activated by sphingosine and blocked by verapamil, with the distinctive feature of insensitivity to nifedipine and Bay K 8644. This suggests a second Ca2+ entry for T. equiperdum, different from the store-operated Ca2+ entry (SOCE) previously described. Moreover, the evidence presented here for the TeCC indicates molecular and pharmacological differences with their mammal counterparts, which deserve further studies to evaluate the potential of this channel as a drug target.
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Affiliation(s)
- M C Pérez-Gordones
- Instituto de Biología Experimental (IBE), Universidad Central de Venezuela (UCV), Caracas, Venezuela.
| | - J R Ramírez-Iglesias
- Group of Emerging Diseases, Epidemiology & Biodiversity, Master School of Biomedicine, Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito, Ecuador
| | - G Benaim
- Instituto de Biología Experimental (IBE), Universidad Central de Venezuela (UCV), Caracas, Venezuela
- Instituto de Estudios Avanzados (IDEA), Caracas, Venezuela
| | - M Mendoza
- Centro de Estudios Biomédicos y Veterinarios, Instituto de Estudios Científicos y Tecnológicos (IDECYT), Universidad Nacional Experimental Simón Rodríguez, Caracas, Venezuela
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Mendoza M, Bonacina E, Carreras E, Suy A. Author reply. BJOG 2024; 131:528-529. [PMID: 38225915 DOI: 10.1111/1471-0528.17758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024]
Affiliation(s)
- Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Suy
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
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Cuenca-Gómez D, De Paco Matallana C, Rolle V, Mendoza M, Valiño N, Revello R, Adiego B, Casanova MC, Molina FS, Delgado JL, Wright A, Figueras F, Nicolaides KH, Santacruz B, Gil MM. Comparison of different methods of screening for preterm pre-eclampsia: cohort study. Ultrasound Obstet Gynecol 2024. [PMID: 38411276 DOI: 10.1002/uog.27622] [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] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE To compare the predictive performance for pre-eclampsia (PE) of three different first-trimester mathematical models of screening, which combine maternal risk factors with mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI) and serum placental growth factor (PlGF), and two risk scoring systems, based on NICE and ACOG recommendations. METHODS This was a prospective cohort study performed in eight fetal-medicine units in five different regions of Spain between September 2017 and December 2019. All pregnant women with singleton pregnancies and non-malformed live fetuses attending their routine ultrasound examination at 11+0 to 13+6 weeks' gestation were invited to participate in the study. Maternal characteristics and medical history were recorded and measurements of MAP, UtA-PI, serum PlGF and pregnancy associated plasma protein-A (PAPP-A) were converted into multiples of the median (MoM). Risks for term, preterm-PE (< 37 weeks' gestation) and early-PE (< 34 weeks' gestation) were calculated according to the FMF competing risks model, the Crovetto et al., logistic regression model, and Serra et al., Gaussian model. Patient classification based on NICE and ACOG guidelines was also performed. We estimated detection rates (DR) with their 95% confidence intervals (CIs) at a fixed 10% screen positive rate (SPR), as well as the area under the receiver operating characteristic curve (AUROC) for preterm-PE, early-PE, and all PE for the three mathematical models. For the scoring systems, we calculated DR and SPR. Risk calibration was also assessed. RESULTS The study population comprised of 10,110 singleton pregnancies, including 32 (0.3%) that developed early-PE, 72 (0.7%) that developed preterm-PE and 230 (2.3%) of any PE. At fixed 10% SPR, the FMF, Crovetto et al., and Serra et al., detected 82.7% (95% CI, 69.6 to 95.8%), 73.8% (95% CI, 58.7 to 88.9%), and 79.8% (95% CI, 66.1 to 93.5%) of early-PE; 72.7% (95% CI, 62.9 to 82.6%), 69.2% (95% CI, 58.8 to 79.6%), and 74.1% (95% CI, 64.2 to 83.9%) of preterm-PE and 55.1% (95% CI, 48.8 to 61.4%), 47.1% (95% CI, 40.6 to 53.5%), and 53.9% (95% CI, 47.4 to 60.4%) of all PE, respectively. The best correlation between predicted and observed cases was achieved by the FMF model, with an AUROC of 0.911 (95% CI, 0.879 to 0.943), a slope of 0.983 (95% CI, 0.846-1.120) and an intercept of 0.154 (95% CI, -0.091 to 0.397). The NICE criteria identified 46.7% (95% CI, 35.3 to 58.0%) of preterm-PE at 11% SPR and ACOG criteria identified 65.9% (95% CI, 55.4 to 76.4%) of preterm-PE at 33.8% SPR. CONCLUSIONS The best performance of screening for preterm-PE is achieved by mathematical models that combine maternal factors with MAP, UtA-PI and PlGF, as compared to risk-scoring systems like NICE or ACOG criteria. While all three algorithms show similar results in terms of overall prediction, the FMF model showed the best performance at the individual level. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- D Cuenca-Gómez
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - C De Paco Matallana
- Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain
| | - V Rolle
- Biostatistics and Clinical Research Unit, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - M Mendoza
- Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebrón, Barcelona, Catalonia, Spain
| | - N Valiño
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario A Coruña, A Coruña, Galicia, Spain
| | - R Revello
- Department of Obstetrics and Gynecology, Hospital Universitario Quirón, Pozuelo de Alarcón, Madrid, Spain
| | - B Adiego
- Department of Obstetrics and Gynecology, Hospital Universitario Fundación de Alcorcón, Alcorcón, Madrid, Spain
| | - M C Casanova
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - F S Molina
- Department of Obstetrics and Gynecology, Hospital Universitario San Cecilio, Granada, Spain and Instituto de Investigación Biosanitaria Ibs., Granada, Spain
| | - J L Delgado
- Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - A Wright
- University of Exeter, Exeter, UK
| | - F Figueras
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital San Joan de Deu, Barcelona, Spain
| | - K H Nicolaides
- Fetal Medicine Research Institute, King's College Hospital, London, UK
| | - B Santacruz
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - M M Gil
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
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Maldonado C, Cáceres A, Burgos A, Hinojosa D, Enríquez S, Celi-Erazo M, Vaca F, Ron L, Rodríguez-Hidalgo R, Benítez-Ortiz W, Martínez-Fresneda M, Eleizalde MC, Mendoza M, Navarro JC, Ramírez-Iglesias JR. Seroprevalence of trypanosomosis and associated risk factors in cattle from coast and amazonian provinces of Ecuador. Vet Res Commun 2024:10.1007/s11259-024-10333-z. [PMID: 38369611 DOI: 10.1007/s11259-024-10333-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/14/2024] [Indexed: 02/20/2024]
Abstract
Trypanosomosis is a tropical disease caused by various protozoan haemoparasites, which affects wild and domestic animals, the latter ones related to worldwide livestock production systems. Species such as Trypanosoma vivax and Trypanosoma evansi have been described using serological and molecular tools in several countries from South and Central America. However, Ecuador presents a relevant knowledge gap in the associated general epidemiology and risk factors of the disease. Therefore, the objective of this study was to determine the seroprevalence of trypanosomosis in cattle from different regions of Ecuador. 745 serum samples from 7 Coastal and 3 Amazon provinces were screened for IgG anti-Trypanosoma spp. antibodies, using an in-house indirect ELISA. The seropositivity was explored and associated with several variables such as sex, age, breed, region, management, and province, using statistical tools. The general seroprevalence of trypanosomosis was 19.1% (95% CI: 16.30-22.1%). The Amazonian provinces of Sucumbíos and Napo and the Coastal province of Esmeraldas presented the highest seroprevalence values of 36.7% (95% CI: 27.67-46.47%), 23.64% (95% CI: 16.06-32.68%) and 25% (95% CI: 15.99-35.94%), respectively. Statistical significance was found for the region, province, and management variables, indicating as relevant risk factors the extensive management and Amazon location of the cattle analyzed. Specific actions should be taken to identify the exact species on reservoirs and susceptible hosts, evaluate the implication of farm management and cattle movement as risk factors, and implement surveillance and treatment plans for affected herds.
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Affiliation(s)
- C Maldonado
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
| | - A Cáceres
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
| | - A Burgos
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
| | - D Hinojosa
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
| | - S Enríquez
- Instituto de Investigación en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador
| | - M Celi-Erazo
- Instituto de Investigación en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador
| | - F Vaca
- Instituto de Investigación en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador
| | - L Ron
- Instituto de Investigación en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador
| | - R Rodríguez-Hidalgo
- Instituto de Investigación en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Central del Ecuador, Quito, Ecuador
| | - W Benítez-Ortiz
- Instituto de Investigación en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador
| | - M Martínez-Fresneda
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
- Program of Master in Biomedicine, Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
- Engineering and Applied Sciences Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
| | - M C Eleizalde
- Centro de Estudios Biomédicos y Veterinarios (CEBIV), Instituto de Estudios Científicos y Tecnológicos (IDECYT), Universidad Nacional Experimental Simón Rodríguez (UNESR), Apartado Postal 47925, Caracas, Venezuela
| | - M Mendoza
- Centro de Estudios Biomédicos y Veterinarios (CEBIV), Instituto de Estudios Científicos y Tecnológicos (IDECYT), Universidad Nacional Experimental Simón Rodríguez (UNESR), Apartado Postal 47925, Caracas, Venezuela
| | - J C Navarro
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
- Program of Master in Biomedicine, Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
| | - J R Ramírez-Iglesias
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador.
- Program of Master in Biomedicine, Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador.
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Bonacina E, Garcia-Manau P, López M, Caamiña S, Vives À, Lopez-Quesada E, Ricart M, Maroto A, de Mingo L, Pintado E, Castillo-Ribelles L, Martín L, Rodriguez-Zurita A, Garcia E, Pallarols M, Vidal-Sagnier L, Teixidor M, Orizales-Lago C, Pérez-Gomez A, Ocaña V, Puerto L, Millán P, Alsius M, Diaz S, Maiz N, Carreras E, Suy A, Mendoza M. Mid-trimester uterine artery Doppler for aspirin discontinuation in pregnancies at high risk for preterm pre-eclampsia: Post-hoc analysis of StopPRE trial. BJOG 2024; 131:334-342. [PMID: 37555464 DOI: 10.1111/1471-0528.17631] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/22/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE To assess whether aspirin treatment can be discontinued in pregnancies with normal uterine artery pulsatility index (≤90th percentile) at 24-28 weeks. DESIGN Post-hoc analysis of a clinical trial. SETTING Nine maternity hospitals in Spain. POPULATION OR SAMPLE Pregnant individuals at high risk of pre-eclampsia at 11-13 weeks and normal uterine artery Doppler at 24-28 weeks. METHODS All participants received treatment with daily aspirin at a dose of 150 mg. Participants were randomly assigned, in a 1:1 ratio, either to continue aspirin treatment until 36 weeks (control group) or to discontinue aspirin treatment (intervention group), between September 2019 and September 2021. In this secondary analysis, women with a UtAPI >90th percentile at 24-28 weeks were excluded. The non-inferiority margin was set at a difference of 1.9% for the incidence of preterm pre-eclampsia. MAIN OUTCOME MEASURES Incidence of preterm pre-eclampsia. RESULTS Of the 1611 eligible women, 139 were excluded for UtAPI >90th percentile or if UtAPI was not available. Finally, 804 were included in this post-hoc analysis. Preterm pre-eclampsia occurred in three of 409 (0.7%) women in the aspirin discontinuation group and five of 395 (1.3%) women in the continuation group (-0.53; 95% CI -1.91 to 0.85), indicating non-inferiority of aspirin discontinuation. CONCLUSIONS Discontinuing aspirin treatment at 24-28 weeks in women with a UtAPI ≤90th percentile was non-inferior to continuing aspirin treatment until 36 weeks for preventing preterm pre-eclampsia.
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Affiliation(s)
- Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Monica López
- Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Sara Caamiña
- Department of Obstetrics, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Àngels Vives
- Department of Obstetrics, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Eva Lopez-Quesada
- Department of Obstetrics, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Marta Ricart
- Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Anna Maroto
- Department of Obstetrics, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Laura de Mingo
- Department of Obstetrics, Hospital Universitario Severo Ochoa, Leganés, Spain
| | - Elena Pintado
- Department of Obstetrics, Hospital Universitario de Getafe, Getafe, Spain
| | | | - Lourdes Martín
- Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Alicia Rodriguez-Zurita
- Department of Obstetrics, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Esperanza Garcia
- Department of Obstetrics, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Mar Pallarols
- Department of Obstetrics, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Laia Vidal-Sagnier
- Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Mireia Teixidor
- Department of Obstetrics, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | | | - Adela Pérez-Gomez
- Department of Obstetrics, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Vanesa Ocaña
- Department of Obstetrics, Hospital Universitario de Getafe, Getafe, Spain
| | - Linda Puerto
- Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Pilar Millán
- Department of Obstetrics, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Mercè Alsius
- Department of Biochemistry, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Sonia Diaz
- Department of Obstetrics, Hospital Universitario de Getafe, Getafe, Spain
| | - Nerea Maiz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Suy
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
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6
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Gil MM, Cuenca-Gómez D, Rolle V, Pertegal M, Díaz C, Revello R, Adiego B, Mendoza M, Molina FS, Santacruz B, Ansbacher-Feldman Z, Meiri H, Martin-Alonso R, Louzoun Y, De Paco Matallana C. Validation of machine-learning model for first-trimester prediction of pre-eclampsia using cohort from PREVAL study. Ultrasound Obstet Gynecol 2024; 63:68-74. [PMID: 37698356 DOI: 10.1002/uog.27478] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/28/2023] [Accepted: 08/15/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE Effective first-trimester screening for pre-eclampsia (PE) can be achieved using a competing-risks model that combines risk factors from the maternal history with multiples of the median (MoM) values of biomarkers. A new model using artificial intelligence through machine-learning methods has been shown to achieve similar screening performance without the need for conversion of raw data of biomarkers into MoM. This study aimed to investigate whether this model can be used across populations without specific adaptations. METHODS Previously, a machine-learning model derived with the use of a fully connected neural network for first-trimester prediction of early (< 34 weeks), preterm (< 37 weeks) and all PE was developed and tested in a cohort of pregnant women in the UK. The model was based on maternal risk factors and mean arterial blood pressure (MAP), uterine artery pulsatility index (UtA-PI), placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A). In this study, the model was applied to a dataset of 10 110 singleton pregnancies examined in Spain who participated in the first-trimester PE validation (PREVAL) study, in which first-trimester screening for PE was carried out using the Fetal Medicine Foundation (FMF) competing-risks model. The performance of screening was assessed by examining the area under the receiver-operating-characteristics curve (AUC) and detection rate (DR) at a 10% screen-positive rate (SPR). These indices were compared with those derived from the application of the FMF competing-risks model. The performance of screening was poor if no adjustment was made for the analyzer used to measure PlGF, which was different in the UK and Spain. Therefore, adjustment for the analyzer used was performed using simple linear regression. RESULTS The DRs at 10% SPR for early, preterm and all PE with the machine-learning model were 84.4% (95% CI, 67.2-94.7%), 77.8% (95% CI, 66.4-86.7%) and 55.7% (95% CI, 49.0-62.2%), respectively, with the corresponding AUCs of 0.920 (95% CI, 0.864-0.975), 0.913 (95% CI, 0.882-0.944) and 0.846 (95% CI, 0.820-0.872). This performance was achieved with the use of three of the biomarkers (MAP, UtA-PI and PlGF); inclusion of PAPP-A did not provide significant improvement in DR. The machine-learning model had similar performance to that achieved by the FMF competing-risks model (DR at 10% SPR, 82.7% (95% CI, 69.6-95.8%) for early PE, 72.7% (95% CI, 62.9-82.6%) for preterm PE and 55.1% (95% CI, 48.8-61.4%) for all PE) without requiring specific adaptations to the population. CONCLUSIONS A machine-learning model for first-trimester prediction of PE based on a neural network provides effective screening for PE that can be applied in different populations. However, before doing so, it is essential to make adjustments for the analyzer used for biochemical testing. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M M Gil
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - D Cuenca-Gómez
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - V Rolle
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Clinical Research Unit, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - M Pertegal
- Department of Obstetrics and Gynecology, Hospital Clínico Universitario 'Virgen de la Arrixaca', El Palmar, Murcia, Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain
- Faculty of Medicine, Universidad de Murcia, Murcia, Spain
| | - C Díaz
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario A Coruña, A Coruña, Galicia, Spain
| | - R Revello
- Department of Obstetrics and Gynecology, Hospital Universitario Quirón, Pozuelo de Alarcón, Madrid, Spain
| | - B Adiego
- Obstetrics and Gynecology Department, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M Mendoza
- Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebrón, Barcelona, Catalonia, Spain
| | - F S Molina
- Department of Obstetrics and Gynecology, Hospital Universitario San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria (Ibs.GRANADA), Granada, Spain
| | - B Santacruz
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | | | - H Meiri
- The ASPRE Consortium and TeleMarpe, Tel Aviv, Israel
| | - R Martin-Alonso
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Y Louzoun
- Department of Mathematics, Bar Ilan University, Ramat Gan, Israel
| | - C De Paco Matallana
- Department of Obstetrics and Gynecology, Hospital Clínico Universitario 'Virgen de la Arrixaca', El Palmar, Murcia, Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain
- Faculty of Medicine, Universidad de Murcia, Murcia, Spain
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7
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Mazarico E, Meler E, Mendoza M, Herraiz I, Llurba E, De Diego R, Comas M, Boada D, González A, Bonacina E, Armengol-Alsina M, Moline E, Hurtado I, Torre N, Gomez-Roig MD, Galindo A, Figueras F. Mortality and severe neurological morbidity in extremely preterm growth-restricted fetuses. Ultrasound Obstet Gynecol 2023; 62:788-795. [PMID: 37325877 DOI: 10.1002/uog.26290] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To develop a model for the prediction of adverse perinatal outcome in growth-restricted fetuses requiring delivery before 28 weeks in order to provide individualized patient counseling. METHODS This was a retrospective multicenter cohort study of singleton pregnancies with antenatal suspicion of fetal growth restriction requiring delivery before 28 weeks' gestation between January 2010 and January 2020 in six tertiary public hospitals in the Barcelona area, Spain. Separate predictive models for mortality only and mortality or severe neurological morbidity were created using logistic regression from variables available antenatally. For each model, predictive performance was evaluated using receiver-operating-characteristics (ROC)-curve analysis. Predictive models were validated externally in an additional cohort of growth-restricted fetuses from another public tertiary hospital with the same inclusion and exclusion criteria. RESULTS A total of 110 cases were included. The neonatal mortality rate was 37.3% and, among the survivors, the rate of severe neurological morbidity was 21.7%. The following factors were retained in the multivariate analysis as significant predictors of mortality: magnesium sulfate neuroprotection, gestational age at birth, estimated fetal weight, male sex and Doppler stage. This model had a significantly higher area under the ROC curve (AUC) compared with a model including only gestational age at birth (0.810 (95% CI, 0.730-0.889) vs 0.695 (95% CI, 0.594-0.795); P = 0.016). At a 20% false-positive rate, the model showed a sensitivity, negative predictive value and positive predictive value of 66%, 80% and 66%, respectively. For the prediction of the composite adverse outcome (mortality or severe neurological morbidity), the model included: gestational age at birth, male sex and Doppler stage. This model had a significantly higher AUC compared with a model including only gestational age at birth (0.810 (95% CI, 0.731-0.892) vs 0.689 (95% CI, 0.588-0.799); P = 0.017). At a 20% false-positive rate, the model showed a sensitivity, negative predictive value and positive predictive value of 55%, 63% and 74%, respectively. External validation of both models yielded similar AUCs that did not differ significantly from those obtained in the original sample. CONCLUSIONS Estimated fetal weight, fetal sex and Doppler stage can be combined with gestational age to improve the prediction of death or severe neurological sequelae in growth-restricted fetuses requiring delivery before 28 weeks. This approach may be useful for parental counseling and decision-making. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- E Mazarico
- Hospital Sant Joan de Déu, BCNatal, Barcelona, Spain
- Departament de Ciències Clíniques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0003, Instituto de Salud Carlos III, Madrid, Spain
| | - E Meler
- Hospital Clínic de Barcelona, Seu Maternitat, BCNatal, Barcelona, Spain
| | - M Mendoza
- Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - I Herraiz
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0024, Instituto de Salud Carlos III, Madrid, Spain
| | - E Llurba
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0003, Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - R De Diego
- Hospital Hospital Germans Trias i Pujol, Badalona, Spain
| | - M Comas
- Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (U3PT), Sabadell, Spain
| | - D Boada
- Hospital Clínic de Barcelona, Seu Maternitat, BCNatal, Barcelona, Spain
| | - A González
- Hospital Sant Joan de Déu, BCNatal, Barcelona, Spain
| | - E Bonacina
- Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M Armengol-Alsina
- Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - E Moline
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0003, Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - I Hurtado
- Hospital Hospital Germans Trias i Pujol, Badalona, Spain
| | - N Torre
- Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (U3PT), Sabadell, Spain
| | - M D Gomez-Roig
- Hospital Sant Joan de Déu, BCNatal, Barcelona, Spain
- Departament de Ciències Clíniques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0003, Instituto de Salud Carlos III, Madrid, Spain
| | - A Galindo
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0024, Instituto de Salud Carlos III, Madrid, Spain
| | - F Figueras
- Hospital Clínic de Barcelona, Seu Maternitat, BCNatal, Barcelona, Spain
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Garcia‐Manau P, Bonacina E, Serrano B, Caamiña S, Ricart M, Lopez‐Quesada E, Vives À, Lopez M, Pintado E, Maroto A, Catalan S, Dalmau M, Del Barco E, Hernandez A, Miserachs M, San Jose M, Armengol‐Alsina M, Carreras E, Mendoza M. Clinical effectiveness of routine first-trimester combined screening for pre-eclampsia in Spain with the addition of placental growth factor. Acta Obstet Gynecol Scand 2023; 102:1711-1718. [PMID: 37814344 PMCID: PMC10619612 DOI: 10.1111/aogs.14687] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION Pre-eclampsia affects 2%-8% of pregnancies and is one of the leading causes of maternal and perinatal morbidity and mortality. First-trimester screening using an algorithm that combines maternal characteristics, mean arterial blood pressure, uterine artery pulsatility index and biomarkers (pregnancy-associated plasma protein-A and placental growth factor) is the method that achieves a greater diagnostic accuracy. It has been shown that daily salicylic acid administration before 16 weeks in women at a high risk for pre-eclampsia can reduce the incidence of preterm pre-eclampsia. However, no previous studies have evaluated the impact of routine first-trimester combined screening for pre-eclampsia with placental growth factor after being implemented in the clinical practice. MATERIAL AND METHODS This was a multicenter cohort study conducted in eight different maternities across Spain. Participants in the reference group were prospectively recruited between October 2015 and September 2017. Participants in the study group were retrospectively recruited between March 2019 and May 2021. Pre-eclampsia risk was calculated between 11+0 and 13+6 weeks using the Gaussian algorithm combining maternal characteristics, mean arterial pressure, uterine arteries pulsatility index, pregnancy-associated plasma protein-A and placental growth factor. Patients with a risk greater than 1/170 were prescribed daily salicylic acid 150 mg until 36 weeks. Patients in the reference group did not receive salicylic acid during gestation. RESULTS A significant reduction was observed in preterm pre-eclampsia (OR 0.47; 95% CI: 0.30-0.73), early-onset (<34 weeks) pre-eclampsia (OR 0.35; 95% CI: 0.16-0.77), preterm small for gestational age newborn (OR 0.57; 95% CI: 0.40-0.82), spontaneous preterm birth (OR 0.72; 95% CI: 0.57-0.90), and admission to intensive care unit (OR 0.55; 95% CI: 0.37-0.81). A greater treatment adherence resulted in a significant reduction in adverse outcomes. CONCLUSIONS Routine first-trimester screening for pre-eclampsia with placental growth factor leads to a reduction in preterm pre-eclampsia and other pregnancy complications. Aspirin treatment compliance has a great impact on the effectiveness of this screening program.
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Affiliation(s)
- Pablo Garcia‐Manau
- Universitat Autònoma de BarcelonaBarcelonaSpain
- Department of ObstetricsVall d'Hebron Barcelona Hospital CampusBarcelonaSpain
| | - Erika Bonacina
- Universitat Autònoma de BarcelonaBarcelonaSpain
- Department of ObstetricsVall d'Hebron Barcelona Hospital CampusBarcelonaSpain
| | - Berta Serrano
- Universitat Autònoma de BarcelonaBarcelonaSpain
- Department of ObstetricsVall d'Hebron Barcelona Hospital CampusBarcelonaSpain
| | - Sara Caamiña
- Department of ObstetricsHospital Universitario Nuestra Señora de CandelariaSanta Cruz de TenerifeSpain
| | - Marta Ricart
- Department of ObstetricsHospital Universitari Germans Trias i PujolBadalonaSpain
| | - Eva Lopez‐Quesada
- Department of ObstetricsHospital Universitari Mútua TerrassaTerrassaSpain
| | - Àngels Vives
- Department of ObstetricsConsorci Sanitari de TerrassaTerrassaSpain
| | - Monica Lopez
- Department of ObstetricsHospital Universitari de Tarragona Joan XXIIITarragonaSpain
| | - Elena Pintado
- Department of ObstetricsHospital Universitario de GetafeGetafeSpain
| | - Anna Maroto
- Department of ObstetricsHospital Universitari de Girona Dr. Josep TruetaGironaSpain
| | | | | | | | | | | | | | | | | | - Manel Mendoza
- Universitat Autònoma de BarcelonaBarcelonaSpain
- Department of ObstetricsVall d'Hebron Barcelona Hospital CampusBarcelonaSpain
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9
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Giralt M, Díaz-Troyano N, Comas I, Blanco A, Conesa L, Mendoza M, Zafon C, Goya M, Ferrer R. Reference ranges of thyroid hormones during the first trimester in Catalan women using the Atellica® IM Solution Immunoassay Analyzer. Ann Clin Biochem 2023:45632231219387. [PMID: 37996255 DOI: 10.1177/00045632231219387] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Gestational hypothyroidism has been shown to be associated with adverse pregnancy outcomes as well as adverse outcomes for the child. Thyroid hormones concentrations change in gestation, especially within the first trimester, so the results of thyroid function test often are outside non-pregnant reference ranges. The objective of this study was to establish the first trimester reference ranges for thyroid stimulating hormone (TSH) and free thyroxine (FT4) for pregnant women in Barcelona (Spain). METHODS It was a prospective study in which 673 women were recruited during their first trimester of gestation (8-13 weeks). Serum TSH, FT4 and antithyroid peroxidase antibodies (TPOAb) were measured with Atellica® IM 1600 (Siemens Healthineers). After excluding 418 women, the reference ranges for TSH and FT4 were calculated by the 2.5th and 97.5th percentiles. Potential variables examined in this study were age, body mass index (BMI), ethnicity, iodine supplementation and smoking habit. RESULTS The reference ranges established on the Atellica® IM 1600 for the first trimester pregnancy in our population were 0.111 to 4.291 mIU/L for TSH and 11.45 to 17.76 pmol/L for FT4. No significant differences were found in thyroid hormones concentrations regarding maternal age (≤30 years versus >30 years) (p=0.117), iodine supplementation (p=0.683) and smoking habit (p=0.363). The prevalence of TPOAb was estimated at 10.0%. CONCLUSIONS We found that in our local population the optimal TSH upper reference limit in the first trimester of gestation was 4.3 mIU/L, similar to that proposed by de ATA-2017 guideline (4.0 mIU/L).
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Affiliation(s)
| | | | | | - Albert Blanco
- Department of BiochemistryVall d'Hebron University Hospital
| | - Laura Conesa
- Department of BiochemistryVall d'Hebron University Hospital
| | - Manel Mendoza
- Department of Obstetrics and Reproductive Medicine, Maternal-Fetal Medicine Unit.Vall d'Hebron University Hospital
| | - Carles Zafon
- Diabetes and Metabolism Research Unit (VHIR) and Department of EndocrinologyVall d'Hebron University Hospital
| | - María Goya
- Department of Obstetrics and Reproductive Medicine, Maternal-Fetal Medicine UnitVall d'Hebron University Hospital
| | - Roser Ferrer
- Department of BiochemistryVall d'Hebron University Hospital
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10
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Hurtado I, Bonacina E, Garcia-Manau P, Serrano B, Armengol-Alsina M, Mendoza M, Maiz N, Carreras E. Usefulness of angiogenic factors in prenatal counseling of late-onset fetal growth-restricted and small-for-gestational-age gestations: a prospective observational study. Arch Gynecol Obstet 2023; 308:1485-1495. [PMID: 36401095 DOI: 10.1007/s00404-022-06833-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/19/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To create a predictive model including biomarkers and evaluate its ability to predict adverse perinatal outcomes in late-onset small fetuses, ultimately helping to provide individualized counseling at the time of diagnosis. METHODS This was a prospective observational study, including singleton pregnancies with an estimated fetal weight (EFW) below the 10th percentile, at a gestational age between 32 + 0 and 36 + 6 weeks of gestation (WG). Variables recorded at diagnosis to predict adverse pregnancy outcomes were: soluble fms-like tyrosine-kinase-1 to placental growth factor ratio (sFlt-1/PlGF), fetal Doppler (umbilical artery and middle cerebral artery), uterine artery pulsatility index (UtAPI), EFW percentile, gestational age, and the presence of maternal risk factors for placental insufficiency. Logistic regression models were developed for the prediction of three co-primary outcomes: composite adverse perinatal outcomes (APO), and the need for elective delivery before 35 or 37 WG. RESULTS Sixty (52.2%) fetal growth restricted (FGR) and 55 (47.8%) small for gestational age (SGA) were enrolled. Thirteen (11.3%) women needed elective delivery before 35 WG and 27 (23.5%) women before 37 WG. At least one APO occurred in 43 (37.4%) pregnancies. The best marker in univariate analyses was the sFlt-1/PlGF ratio [AUC = 0.932 (95% CI, 0.864-0.999)]. The multivariate model including sFlt-1/PlGF showed a better predictive performance for APO than the multivariate model without sFlt-1/PlGF (P < 0.024). CONCLUSIONS sFlt-1/PlGF is a good predictor of APO at the time of late-onset FGR/SGA diagnosis. Our predictive models may be useful to provide early individualized prenatal counseling in this group of women. Further studies are needed to validate these preliminary findings in a larger cohort.
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Affiliation(s)
- Ivan Hurtado
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig de La Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Erika Bonacina
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig de La Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Pablo Garcia-Manau
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig de La Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Berta Serrano
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig de La Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Mireia Armengol-Alsina
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig de La Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Manel Mendoza
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig de La Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - Nerea Maiz
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig de La Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Elena Carreras
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig de La Vall d'Hebron, 119-129, 08035, Barcelona, Spain
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11
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Klebaner D, Pollom E, Mendoza M, Kumar KA, Gibbs IC, Chang SD, Hancock SL, Soltys SG. Role of Fractionation in Local Control of Spinal Metastases Treated with Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2023; 117:e117-e118. [PMID: 37784661 DOI: 10.1016/j.ijrobp.2023.06.903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Optimal fractionation of spinal stereotactic radiosurgery (SRS) for spine metastases remains unknown. Retrospective data suggest decreased local failure (LF) with fractionated SRS of brain metastases. We evaluated our institutional outcomes of spinal SRS with the hypothesis that fractionation improves the rate of local failure compared to single-fraction treatment. MATERIALS/METHODS This IRB-approved, retrospective analysis included patients with spine metastases treated with spinal SRS between October 2002 and November 2014 with evaluable follow-up imaging and no prior irradiation to the given segment. The exposure of interest was single- or multi-fraction SRS with a primary endpoint of the cumulative incidence of LF with death as a competing risk. We assessed bivariate associations between fractionation and single-fraction equivalent dose (SFED in Gy10) as well as high-risk features, defined as epidural extension (Bilsky Scale), paraspinous extension, and gastrointestinal (GI) vs non-GI primary. We calculated the rates of LF and vertebral body compression fracture (VCF) at 1-year, and assessed LF by fractionation when limited only to courses receiving SFED>18 Gy. We analyzed the association between fractionation and LF using subdistribution hazard ratios (SHR) estimated from competing risks regression with death as a competing risk and adjusting for lesion-specific characteristics as well as SFED to determine contribution of these variables to the estimated effect of fraction number on LF. We calculated relative attenuation for the contribution of SFED to this association, defined as [SHRfractions-SHRfractions+SFED] ÷ [SHRSFED-1]. RESULTS In 293 patients with 516 spinal segments, lesions treated with single fraction compared to multi-fraction SRS had less epidural (19% vs 36%, p<0.001) and paraspinous (20% vs 35%, p<0.001) extension, more GI histology (17% vs 10%, p = 0.039), received a higher mean SFED (18.3 Gy vs. 16.6 Gy, p<0.001), and had a lower 1-year LF (8% vs 14%, p = 0.02), with no difference in VCF (7% vs. 5%, p = 0.38). After adjusting for high-risk features, single fraction SRS was associated with lower LF (SHR = 0.45, 95% CI 0.24-0.84, p = 0.02). After adjustment for SFED, this association of fractionation was attenuated by 53% and became insignificant (SHR = 0.78, 95% CI 0.44-1.37, p = 0.38). Overall, 1-year LF for SFED>18 Gy was 6% compared to 15% for <18 Gy (p<0.001). When limited to courses with SFED>18 Gy (n = 261), single fraction SRS had no improvement in 1-year LF compared to multi-fraction (6.6% vs 4.6%, p = 0.77). CONCLUSION Single fraction SRS was associated with better local control compared to multi-fraction; however, much of this association was attenuated by SFED but not by high-risk features of treated lesions. To clarify the role of fractionation, we have initiated a prospective, randomized trial of single vs. multi-fraction SRS utilizing the same SFED.
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Affiliation(s)
- D Klebaner
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - E Pollom
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Mendoza
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - K A Kumar
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - I C Gibbs
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - S D Chang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - S L Hancock
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - S G Soltys
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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12
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Zarabi H, Helis CA, Russell G, Huang J, Liu W, Soltys SG, Mendoza M, Braunstein SE, Salans MA, Wang TJC, Gallitto M, Shi W, Cappelli L, Shen C, Young MD, Mignano JE, Halasz LM, Barbour AB, Masters AH, Chan MD. Multi-Institutional Report of Re-Irradiation for Recurrent High-Grade Glioma. Int J Radiat Oncol Biol Phys 2023; 117:S85-S86. [PMID: 37784590 DOI: 10.1016/j.ijrobp.2023.06.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Significant heterogeneity exists with regards to prior published reports of re-irradiation (re-RT) in patients with recurrent high grade glioma (HGG). A multi-institutional database of 10 academic centers across the United States was created to analyze prognostic outcomes for re-RT for recurrent HGG, which included WHO Grade III and Grade IV tumors. MATERIALS/METHODS Patients with HGG who had initially received standard radiotherapy (RT) and were subsequently treated with a course of re-RT at recurrence were included in the study. Factors assessed to delineate a significant association with overall survival (OS) and toxicity included age, KPS, number of relapses, dose, use of bevacizumab (BEV) or temozolomide (TMZ), time from prior RT, histology, RT target, re-RT target> 5cm and extent of resection, and MGMT methylation status. The Kaplan-Meier Method was used to estimate OS. Cox proportional hazards regression models were used to identify factors associated with OS. Toxicity outcomes were assessed using logistic regression. Significance was assumed if p<0.05. Data management and decision management software were used for all analyses. RESULTS Between 2001 and 2022, 280 patients from 10 academic institutions were treated with re-RT for diagnosis of recurrent HGG. 133 patients (71.1%) had a histologic glioblastoma (GBM) at the time of re-RT, with the remainder having Grade 3 gliomas. Median dose delivered at re-RT was 47 Gy BED10 (IQR 47 - 53 Gy BED10), with the most common regimen being 35 Gy in 10 fractions. 83 patients (56%) had GTV greater than 5 cm treated with re-RT. 183 patients (79%) received concurrent systemic therapy, including 95 (41%) who received concurrent TMZ and 86 (45%) who received concurrent BEV. Median OS for the entire cohort was 10 months. Increasing dose at re-RT was associated with improved OS (OR 0.80 95% CI 0.67-0.95, p = 0.10 per 10 Gy BED10), as was dose greater than 47 Gy BED10, which is equivalent to 35 Gy in 10 fractions (OR 0.70, 95% CI 0.54-0.91). Concurrent TMZ was also associated with improved OS (OR 0.68, 95% CI 0.46-0.83, p < 0.01). 32/143 (22%) patients evaluable for toxicity experienced Grade 2 or greater adverse radiation effect (ARE). Use of BEV was associated with decreased toxicity (OR 0.45, 95% CI 0.21-0.98, p = 0.05). Dose at re-RT (OR 1.07 per 10 Gy BED10, p = 0.78), a GTV > 5cm (OR 1.39, p = 0.44), and the use of concurrent TMZ (OR 1.90, p = 0.10) were not associated with Grade 2 or greater ARE. CONCLUSION Higher dose of re-RT and use of concurrent TMZ led to improved OS in recurrent HGG patients without an associated increased rate of ARE. Use of BEV decreased the likelihood of Grade 2 or greater ARE in the re-RT setting for these recurrent HGG patients.
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Affiliation(s)
- H Zarabi
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC
| | - C A Helis
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC
| | - G Russell
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
| | - J Huang
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - W Liu
- University of Iowa, Iowa City, IA
| | - S G Soltys
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Mendoza
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - S E Braunstein
- University of California San Francisco, Department of Radiation Oncology, San Francisco, CA
| | - M A Salans
- University of California San Francisco, San Francisco, CA
| | | | - M Gallitto
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - W Shi
- Thomas Jefferson University Hospital, Philadelphia, PA
| | - L Cappelli
- Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - M D Young
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - J E Mignano
- Tufts Medical Center, Department of Radiation Oncology, Boston, MA
| | - L M Halasz
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | | | | | - M D Chan
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC
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13
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Cuenca-Gómez D, de Paco Matallana C, Rolle V, Valiño N, Revello R, Adiego B, Mendoza M, Molina FS, Carrillo MP, Delgado JL, Wright A, Santacruz B, Gil MM. Performance of first-trimester combined screening for preterm pre-eclampsia: findings from cohort of 10 110 pregnancies in Spain. Ultrasound Obstet Gynecol 2023; 62:522-530. [PMID: 37099759 DOI: 10.1002/uog.26233] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/05/2023] [Accepted: 04/13/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of the Fetal Medicine Foundation (FMF) competing-risks model, incorporating maternal characteristics, mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI) and placental growth factor (PlGF) (the 'triple test'), for the prediction at 11-13 weeks' gestation of preterm pre-eclampsia (PE) in a Spanish population. METHODS This was a prospective cohort study performed in eight fetal medicine units in five different regions of Spain between September 2017 and December 2019. All pregnant women with a singleton pregnancy and a non-malformed live fetus attending a routine ultrasound examination at 11 + 0 to 13 + 6 weeks' gestation were invited to participate. Maternal demographic characteristics and medical history were recorded and MAP, UtA-PI, serum PlGF and pregnancy-associated plasma protein-A (PAPP-A) were measured following standardized protocols. Treatment with aspirin during pregnancy was also recorded. Raw values of biomarkers were converted into multiples of the median (MoM), and audits were performed periodically to provide regular feedback to operators and laboratories. Patient-specific risks for term and preterm PE were calculated according to the FMF competing-risks model, blinded to pregnancy outcome. The performance of screening for PE, taking into account aspirin use, was assessed by calculating the area under the receiver-operating-characteristics curve (AUC) and detection rate (DR) at a 10% fixed screen-positive rate (SPR). Risk calibration of the model was assessed. RESULTS The study population comprised 10 110 singleton pregnancies, including 72 (0.7%) that developed preterm PE. In the preterm PE group, compared to those without PE, median MAP MoM and UtA-PI MoM were significantly higher, and median serum PlGF MoM and PAPP-A MoM were significantly lower. In women with PE, the deviation from normal in all biomarkers was inversely related to gestational age at delivery. Screening for preterm PE by a combination of maternal characteristics and medical history with MAP, UtA-PI and PlGF had a DR, at 10% SPR, of 72.7% (95% CI, 62.9-82.6%). An alternative strategy of replacing PlGF with PAPP-A in the triple test was associated with poorer screening performance for preterm PE, giving a DR of 66.5% (95% CI, 55.8-77.2%). The calibration plot showed good agreement between predicted risk and observed incidence of preterm PE, with a slope of 0.983 (95% CI, 0.846-1.120) and an intercept of 0.154 (95% CI, -0.091 to 0.397). CONCLUSIONS The FMF model is effective in predicting preterm PE in the Spanish population at 11-13 weeks' gestation. This method of screening is feasible to implement in routine clinical practice, but it should be accompanied by a robust audit and monitoring system, in order to maintain high-quality screening. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- D Cuenca-Gómez
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - C de Paco Matallana
- Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, Murcia, Spain
| | - V Rolle
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Biostatistics and Epidemiology Platform, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - N Valiño
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario A Coruña, A Coruña, Galicia, Spain
| | - R Revello
- Department of Obstetrics and Gynecology, Hospital Universitario Quirón, Pozuelo de Alarcón, Madrid, Spain
| | - B Adiego
- Department of Obstetrics and Gynecology, Hospital Universitario Fundación de Alcorcón, Alcorcón, Madrid, Spain
| | - M Mendoza
- Department of Obstetrics and Gynecology, Hospital Universitario Vall d'Hebrón, Barcelona, Catalonia, Spain
| | - F S Molina
- Department of Obstetrics and Gynecology, Hospital Clínico Universitario San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria (Ibs.GRANADA), Granada, Spain
| | - M P Carrillo
- Department of Obstetrics and Gynecology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - J L Delgado
- Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - A Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - B Santacruz
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - M M Gil
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
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Abdulameer NJ, Acharya U, Adare A, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Alfred M, Apadula N, Aramaki Y, Asano H, Atomssa ET, Awes TC, Azmoun B, Babintsev V, Bai M, Bandara NS, Bannier B, Barish KN, Bathe S, Bazilevsky A, Beaumier M, Beckman S, Belmont R, Berdnikov A, Berdnikov Y, Bichon L, Black D, Blankenship B, Bok JS, Borisov V, Boyle K, Brooks ML, Bryslawskyj J, Buesching H, Bumazhnov V, Campbell S, Canoa Roman V, Chen CH, Chiu M, Chi CY, Choi IJ, Choi JB, Chujo T, Citron Z, Connors M, Corliss R, Corrales Morales Y, Csanád M, Csörgő T, Datta A, Daugherity MS, David G, Dean CT, DeBlasio K, Dehmelt K, Denisov A, Deshpande A, Desmond EJ, Ding L, Dion A, Doomra V, Do JH, Drees A, Drees KA, Durham JM, Durum A, En'yo H, Enokizono A, Esha R, Fadem B, Fan W, Feege N, Fields DE, Finger M, Finger M, Firak D, Fitzgerald D, Fokin SL, Frantz JE, Franz A, Frawley AD, Gallus P, Gal C, Garg P, Ge H, Giles M, Giordano F, Glenn A, Goto Y, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guragain H, Gu Y, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hanks J, Han SY, Harvey M, Hasegawa S, Hemmick TK, He X, Hill JC, Hodges A, Hollis RS, Homma K, Hong B, Hoshino T, Huang J, Ikeda Y, Imai K, Imazu Y, Inaba M, Iordanova A, Isenhower D, Ivanishchev D, Jacak BV, Jeon SJ, Jezghani M, Jiang X, Ji Z, Johnson BM, Joo E, Joo KS, Jouan D, Jumper DS, Kang JH, Kang JS, Kawall D, Kazantsev AV, Key JA, Khachatryan V, Khanzadeev A, Khatiwada A, Kihara K, Kim C, Kim DH, Kim DJ, Kim EJ, Kim HJ, Kim M, Kim T, Kim YK, Kincses D, Kingan A, Kistenev E, Klatsky J, Kleinjan D, Kline P, Koblesky T, Kofarago M, Koster J, Kotov D, Kovacs L, Kurgyis B, Kurita K, Kurosawa M, Kwon Y, Lajoie JG, Larionova D, Lebedev A, Lee KB, Lee SH, Leitch MJ, Leitgab M, Lewis NA, Lim SH, Liu MX, Li X, Loomis DA, Lynch D, Lökös S, Majoros T, Makdisi YI, Makek M, Manion A, Manko VI, Mannel E, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Meles A, Mendoza M, Meredith B, Miake Y, Mignerey AC, Miller AJ, Milov A, Mishra DK, Mitchell JT, Mitrankova M, Mitrankov I, Miyasaka S, Mizuno S, Mondal MM, Montuenga P, Moon T, Morrison DP, Moukhanova TV, Muhammad A, Mulilo B, Murakami T, Murata J, Mwai A, Nagamiya S, Nagle JL, Nagy MI, Nakagawa I, Nakagomi H, Nakano K, Nattrass C, Nelson S, Netrakanti PK, Nihashi M, Niida T, Nouicer R, Novitzky N, Nukazuka G, Nyanin AS, O'Brien E, Ogilvie CA, Oh J, Orjuela Koop JD, Orosz M, Osborn JD, Oskarsson A, Ozawa K, Pak R, Pantuev V, Papavassiliou V, Park JS, Park S, Patel L, Patel M, Pate SF, Peng JC, Peng W, Perepelitsa DV, Perera GDN, Peressounko DY, PerezLara CE, Perry J, Petti R, Pinkenburg C, Pinson R, Pisani RP, Potekhin M, Pun A, Purschke ML, Radzevich PV, Rak J, Ramasubramanian N, Ravinovich I, Read KF, Reynolds D, Riabov V, Riabov Y, Richford D, Riveli N, Roach D, Rolnick SD, Rosati M, Rowan Z, Rubin JG, Runchey J, Saito N, Sakaguchi T, Sako H, Samsonov V, Sarsour M, Sato S, Sawada S, Schaefer B, Schmoll BK, Sedgwick K, Seele J, Seidl R, Sen A, Seto R, Sett P, Sexton A, Sharma D, Shein I, Shibata M, Shibata TA, Shigaki K, Shimomura M, Shi Z, Shukla P, Sickles A, Silva CL, Silvermyr D, Singh BK, Singh CP, Singh V, Slunečka M, Smith KL, Soltz RA, Sondheim WE, Sorensen SP, Sourikova IV, Stankus PW, Stepanov M, Stoll SP, Sugitate T, Sukhanov A, Sumita T, Sun J, Sun Z, Sziklai J, Takahama R, Takahara A, Taketani A, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Timilsina A, Todoroki T, Tomášek M, Torii H, Towell M, Towell R, Towell RS, Tserruya I, Ueda Y, Ujvari B, van Hecke HW, Vargyas M, Velkovska J, Virius M, Vrba V, Vznuzdaev E, Wang XR, Wang Z, Watanabe D, Watanabe Y, Watanabe YS, Wei F, Whitaker S, Wolin S, Wong CP, Woody CL, Wysocki M, Xia B, Xue L, Yalcin S, Yamaguchi YL, Yanovich A, Yoon I, Younus I, Yushmanov IE, Zajc WA, Zelenski A, Zou L. Measurement of Direct-Photon Cross Section and Double-Helicity Asymmetry at sqrt[s]=510 GeV in p[over →]+p[over →] Collisions. Phys Rev Lett 2023; 130:251901. [PMID: 37418716 DOI: 10.1103/physrevlett.130.251901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 11/04/2022] [Accepted: 04/28/2023] [Indexed: 07/09/2023]
Abstract
We present measurements of the cross section and double-helicity asymmetry A_{LL} of direct-photon production in p[over →]+p[over →] collisions at sqrt[s]=510 GeV. The measurements have been performed at midrapidity (|η|<0.25) with the PHENIX detector at the Relativistic Heavy Ion Collider. At relativistic energies, direct photons are dominantly produced from the initial quark-gluon hard scattering and do not interact via the strong force at leading order. Therefore, at sqrt[s]=510 GeV, where leading-order-effects dominate, these measurements provide clean and direct access to the gluon helicity in the polarized proton in the gluon-momentum-fraction range 0.02<x<0.08, with direct sensitivity to the sign of the gluon contribution.
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Affiliation(s)
- N J Abdulameer
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - U Acharya
- Georgia State University, Atlanta, Georgia 30303, USA
| | - A Adare
- University of Colorado, Boulder, Colorado 80309, USA
| | - C Aidala
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - N N Ajitanand
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - Y Akiba
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Akimoto
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Alfred
- Department of Physics and Astronomy, Howard University, Washington, D.C. 20059, USA
| | - N Apadula
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y Aramaki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Asano
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - E T Atomssa
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T C Awes
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Azmoun
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Babintsev
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - M Bai
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N S Bandara
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - B Bannier
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K N Barish
- University of California-Riverside, Riverside, California 92521, USA
| | - S Bathe
- Baruch College, City University of New York, New York, New York 10010, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Bazilevsky
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Beaumier
- University of California-Riverside, Riverside, California 92521, USA
| | - S Beckman
- University of Colorado, Boulder, Colorado 80309, USA
| | - R Belmont
- University of Colorado, Boulder, Colorado 80309, USA
- Physics and Astronomy Department, University of North Carolina at Greensboro, Greensboro, North Carolina 27412, USA
| | - A Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - Y Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - L Bichon
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D Black
- University of California-Riverside, Riverside, California 92521, USA
| | - B Blankenship
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - J S Bok
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - V Borisov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - K Boyle
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M L Brooks
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Bryslawskyj
- Baruch College, City University of New York, New York, New York 10010, USA
- University of California-Riverside, Riverside, California 92521, USA
| | - H Buesching
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Bumazhnov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - S Campbell
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
- Iowa State University, Ames, Iowa 50011, USA
| | - V Canoa Roman
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C-H Chen
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Chiu
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C Y Chi
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - I J Choi
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J B Choi
- Jeonbuk National University, Jeonju, 54896, Korea
| | - T Chujo
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - Z Citron
- Weizmann Institute, Rehovot 76100, Israel
| | - M Connors
- Georgia State University, Atlanta, Georgia 30303, USA
| | - R Corliss
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - M Csanád
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Csörgő
- MATE, Laboratory of Femtoscopy, Károly Róbert Campus, H-3200 Gyöngyös, Mátraiút 36, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - A Datta
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | | | - G David
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C T Dean
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K DeBlasio
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - K Dehmelt
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Denisov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - A Deshpande
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E J Desmond
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Ding
- Iowa State University, Ames, Iowa 50011, USA
| | - A Dion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - V Doomra
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J H Do
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - A Drees
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K A Drees
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J M Durham
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Durum
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - H En'yo
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - A Enokizono
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - R Esha
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - B Fadem
- Muhlenberg College, Allentown, Pennsylvania 18104-5586, USA
| | - W Fan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - N Feege
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D E Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M Finger
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - M Finger
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - D Firak
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Fitzgerald
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S L Fokin
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - J E Frantz
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - A Franz
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A D Frawley
- Florida State University, Tallahassee, Florida 32306, USA
| | - P Gallus
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - C Gal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Garg
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - H Ge
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Giles
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - F Giordano
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Glenn
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - Y Goto
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Grau
- Department of Physics, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - S V Greene
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | | | - T Gunji
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Guragain
- Georgia State University, Atlanta, Georgia 30303, USA
| | - Y Gu
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - T Hachiya
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J S Haggerty
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K I Hahn
- Ewha Womans University, Seoul 120-750, Korea
| | - H Hamagaki
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - J Hanks
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S Y Han
- Ewha Womans University, Seoul 120-750, Korea
- Korea University, Seoul 02841, Korea
| | - M Harvey
- Texas Southern University, Houston, Texas 77004, USA
| | - S Hasegawa
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - T K Hemmick
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - X He
- Georgia State University, Atlanta, Georgia 30303, USA
| | - J C Hill
- Iowa State University, Ames, Iowa 50011, USA
| | - A Hodges
- Georgia State University, Atlanta, Georgia 30303, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - R S Hollis
- University of California-Riverside, Riverside, California 92521, USA
| | - K Homma
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Hong
- Korea University, Seoul 02841, Korea
| | - T Hoshino
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - J Huang
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y Ikeda
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - Y Imazu
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - M Inaba
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Iordanova
- University of California-Riverside, Riverside, California 92521, USA
| | - D Isenhower
- Abilene Christian University, Abilene, Texas 79699, USA
| | - D Ivanishchev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - B V Jacak
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S J Jeon
- Myongji University, Yongin, Kyonggido 449-728, Korea
| | - M Jezghani
- Georgia State University, Atlanta, Georgia 30303, USA
| | - X Jiang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Z Ji
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - B M Johnson
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Georgia State University, Atlanta, Georgia 30303, USA
| | - E Joo
- Korea University, Seoul 02841, Korea
| | - K S Joo
- Myongji University, Yongin, Kyonggido 449-728, Korea
| | - D Jouan
- IPN-Orsay, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, BP1, F-91406 Orsay, France
| | - D S Jumper
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J H Kang
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J S Kang
- Hanyang University, Seoul 133-792, Korea
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - A V Kazantsev
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - J A Key
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - V Khachatryan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Khanzadeev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - A Khatiwada
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Kihara
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - C Kim
- Korea University, Seoul 02841, Korea
| | - D H Kim
- Ewha Womans University, Seoul 120-750, Korea
| | - D J Kim
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
| | - E-J Kim
- Jeonbuk National University, Jeonju, 54896, Korea
| | - H-J Kim
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - T Kim
- Ewha Womans University, Seoul 120-750, Korea
| | - Y K Kim
- Hanyang University, Seoul 133-792, Korea
| | - D Kincses
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - A Kingan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E Kistenev
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J Klatsky
- Florida State University, Tallahassee, Florida 32306, USA
| | - D Kleinjan
- University of California-Riverside, Riverside, California 92521, USA
| | - P Kline
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T Koblesky
- University of Colorado, Boulder, Colorado 80309, USA
| | - M Kofarago
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - J Koster
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - D Kotov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - L Kovacs
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - B Kurgyis
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - K Kurita
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - M Kurosawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y Kwon
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J G Lajoie
- Iowa State University, Ames, Iowa 50011, USA
| | - D Larionova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - A Lebedev
- Iowa State University, Ames, Iowa 50011, USA
| | - K B Lee
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S H Lee
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M J Leitch
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Leitgab
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - N A Lewis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S H Lim
- Pusan National University, Pusan 46241, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M X Liu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - X Li
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D A Loomis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - D Lynch
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Lökös
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Majoros
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - Y I Makdisi
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Makek
- Weizmann Institute, Rehovot 76100, Israel
- Department of Physics, Faculty of Science, University of Zagreb, Bijenička c. 32 HR-10002 Zagreb, Croatia
| | - A Manion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - V I Manko
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - E Mannel
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M McCumber
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P L McGaughey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D McGlinchey
- University of Colorado, Boulder, Colorado 80309, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C McKinney
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Meles
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - M Mendoza
- University of California-Riverside, Riverside, California 92521, USA
| | - B Meredith
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - Y Miake
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A C Mignerey
- University of Maryland, College Park, Maryland 20742, USA
| | - A J Miller
- Abilene Christian University, Abilene, Texas 79699, USA
| | - A Milov
- Weizmann Institute, Rehovot 76100, Israel
| | - D K Mishra
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - J T Mitchell
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Mitrankova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - Iu Mitrankov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - S Miyasaka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - S Mizuno
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M M Mondal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Montuenga
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - T Moon
- Korea University, Seoul 02841, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - D P Morrison
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T V Moukhanova
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - A Muhammad
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - B Mulilo
- Korea University, Seoul 02841, Korea
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, School of Natural Sciences, University of Zambia, Great East Road Campus, Box 32379 Lusaka, Zambia
| | - T Murakami
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Murata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - A Mwai
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - S Nagamiya
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J L Nagle
- University of Colorado, Boulder, Colorado 80309, USA
| | - M I Nagy
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - I Nakagawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Nakagomi
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - K Nakano
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - C Nattrass
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Nelson
- Florida A&M University, Tallahassee, Florida 32307, USA
| | | | - M Nihashi
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Niida
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Nouicer
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Novitzky
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - G Nukazuka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A S Nyanin
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - E O'Brien
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C A Ogilvie
- Iowa State University, Ames, Iowa 50011, USA
| | - J Oh
- Pusan National University, Pusan 46241, Korea
| | | | - M Orosz
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J D Osborn
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Oskarsson
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - K Ozawa
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Pak
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Pantuev
- Institute for Nuclear Research of the Russian Academy of Sciences, prospekt 60-letiya Oktyabrya 7a, Moscow 117312, Russia
| | - V Papavassiliou
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J S Park
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - S Park
- Mississippi State University, Mississippi State, Mississippi 39762, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - L Patel
- Georgia State University, Atlanta, Georgia 30303, USA
| | - M Patel
- Iowa State University, Ames, Iowa 50011, USA
| | - S F Pate
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J-C Peng
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - W Peng
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D V Perepelitsa
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Colorado, Boulder, Colorado 80309, USA
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - G D N Perera
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - D Yu Peressounko
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - C E PerezLara
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J Perry
- Iowa State University, Ames, Iowa 50011, USA
| | - R Petti
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C Pinkenburg
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Pinson
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R P Pisani
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Potekhin
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Pun
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - M L Purschke
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P V Radzevich
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - J Rak
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
| | - N Ramasubramanian
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - K F Read
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - D Reynolds
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - V Riabov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - Y Riabov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - D Richford
- Baruch College, City University of New York, New York, New York 10010, USA
| | - N Riveli
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - D Roach
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - S D Rolnick
- University of California-Riverside, Riverside, California 92521, USA
| | - M Rosati
- Iowa State University, Ames, Iowa 50011, USA
| | - Z Rowan
- Baruch College, City University of New York, New York, New York 10010, USA
| | - J G Rubin
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - J Runchey
- Iowa State University, Ames, Iowa 50011, USA
| | - N Saito
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - T Sakaguchi
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Sako
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - V Samsonov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - M Sarsour
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Sato
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - S Sawada
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - B Schaefer
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - B K Schmoll
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K Sedgwick
- University of California-Riverside, Riverside, California 92521, USA
| | - J Seele
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Seidl
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Sen
- Iowa State University, Ames, Iowa 50011, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - R Seto
- University of California-Riverside, Riverside, California 92521, USA
| | - P Sett
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sexton
- University of Maryland, College Park, Maryland 20742, USA
| | - D Sharma
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - I Shein
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - M Shibata
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - T-A Shibata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - K Shigaki
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - M Shimomura
- Iowa State University, Ames, Iowa 50011, USA
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - Z Shi
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P Shukla
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sickles
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C L Silva
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Silvermyr
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B K Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - C P Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - V Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - M Slunečka
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - K L Smith
- Florida State University, Tallahassee, Florida 32306, USA
| | - R A Soltz
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W E Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S P Sorensen
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - I V Sourikova
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P W Stankus
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Stepanov
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - S P Stoll
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sugitate
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - A Sukhanov
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sumita
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Sun
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Z Sun
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J Sziklai
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - R Takahama
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - A Takahara
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - A Taketani
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - M J Tannenbaum
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Tarafdar
- Vanderbilt University, Nashville, Tennessee 37235, USA
- Weizmann Institute, Rehovot 76100, Israel
| | - A Taranenko
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - A Timilsina
- Iowa State University, Ames, Iowa 50011, USA
| | - T Todoroki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M Tomášek
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - H Torii
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R S Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - I Tserruya
- Weizmann Institute, Rehovot 76100, Israel
| | - Y Ueda
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Ujvari
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - H W van Hecke
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Vargyas
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - J Velkovska
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - M Virius
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - V Vrba
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
- Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, 182 21 Prague 8, Czech Republic
| | - E Vznuzdaev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - X R Wang
- New Mexico State University, Las Cruces, New Mexico 88003, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Z Wang
- Baruch College, City University of New York, New York, New York 10010, USA
| | - D Watanabe
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - Y Watanabe
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y S Watanabe
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - F Wei
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - S Whitaker
- Iowa State University, Ames, Iowa 50011, USA
| | - S Wolin
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C P Wong
- Georgia State University, Atlanta, Georgia 30303, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C L Woody
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Wysocki
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Xia
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - L Xue
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Yalcin
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y L Yamaguchi
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Yanovich
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - I Yoon
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - I Younus
- Physics Department, Lahore University of Management Sciences, Lahore 54792, Pakistan
| | - I E Yushmanov
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - W A Zajc
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - A Zelenski
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Zou
- University of California-Riverside, Riverside, California 92521, USA
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15
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Mendoza M, Carreras E, Suy A. Aspirin Discontinuation in Pregnancies at High Risk of Preterm Preeclampsia-Reply. JAMA 2023; 329:1988-1989. [PMID: 37314277 DOI: 10.1001/jama.2023.7398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/15/2023]
Affiliation(s)
- Manel Mendoza
- Department of Obstetrics, Gynecology and Reproductive Sciences, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Elena Carreras
- Department of Obstetrics, Gynecology and Reproductive Sciences, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Anna Suy
- Department of Obstetrics, Gynecology and Reproductive Sciences, Vall d'Hebron University Hospital, Barcelona, Spain
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del Barco E, Franco‐Jarava C, Vargas M, Maíz N, Arevalo S, Sánchez MÁ, Avilés MT, Rodó C, Mendoza M, Goya M, Hernández‐González M, Carreras E. Reference values for interleukin-6 in the amniotic fluid of asymptomatic pregnant women. Acta Obstet Gynecol Scand 2023; 102:480-485. [PMID: 36906815 PMCID: PMC10008271 DOI: 10.1111/aogs.14524] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/18/2023] [Accepted: 01/21/2023] [Indexed: 03/13/2023]
Abstract
INTRODUCTION Nowadays, proinflammatory factors are considered to play an important role in the pathophysiology of threatened preterm labor or chorioamnionitis. The aim of this study was to establish the normal reference range for interleukin-6 (IL-6) levels in the amniotic fluid and to identify factors which may alter this value. MATERIAL AND METHODS Prospective study in a tertiary-level center including asymptomatic pregnant women undergoing amniocentesis for genetic studies from October 2016 to September 2019. IL-6 measurements in amniotic fluid were performed using a fluorescence immunoassay with microfluidic technology (ELLA Proteinsimple, Bio Techne). Maternal history and pregnancy data were also recorded. RESULTS This study included 140 pregnant women. Of those, women who underwent termination of pregnancy were excluded. Therefore, a total of 98 pregnancies were included in the final statistical analysis. The mean gestational age was 21.86 weeks (range: 15-38.7) at the time of amniocentesis, and 38.6 weeks (range: 30.9-41.4) at delivery. No cases of chorioamnionitis were reported. The log10 IL-6 values follow a normal distribution (W = 0.990, p = 0.692). The median, and the 5th, 10th, 90th, and 95th percentiles for IL-6 levels were 573, 105, 130, 1645, and 2260 pg/mL, respectively. The log10 IL-6 values were not affected by gestational age (p = 0.395), maternal age (p = 0.376), body mass index (p = 0.551), ethnicity (p = 0.467), smoking status (p = 0.933), parity (p = 0.557), method of conception (p = 0.322), or diabetes mellitus (p = 0.381). CONCLUSIONS The log10 IL-6 values follow a normal distribution. IL-6 values are independent of gestational age, maternal age, body mass index, ethnicity, smoking status, parity and method of conception. Our study provides a normal reference range for IL-6 levels in the amniotic fluid that can be used in future studies. We also observed that normal IL-6 values were higher in the amniotic fluid than in serum.
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Affiliation(s)
- Ester del Barco
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | | | - Mireia Vargas
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Nerea Maíz
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Silvia Arevalo
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Maria Ángeles Sánchez
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Maria Teresa Avilés
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Carlota Rodó
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Manel Mendoza
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Maria Goya
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
- Maternal and Child Health and Development Network (SAMID)Instituto Salud Carlos IIIMadridSpain
| | | | - Elena Carreras
- Maternal‐Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
- Maternal and Child Health and Development Network (SAMID)Instituto Salud Carlos IIIMadridSpain
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Mendoza M, Bonacina E, Garcia-Manau P, López M, Caamiña S, Vives À, Lopez-Quesada E, Ricart M, Maroto A, de Mingo L, Pintado E, Ferrer-Costa R, Martin L, Rodríguez-Zurita A, Garcia E, Pallarols M, Vidal-Sagnier L, Teixidor M, Orizales-Lago C, Pérez-Gomez A, Ocaña V, Puerto L, Millán P, Alsius M, Diaz S, Maiz N, Carreras E, Suy A. Aspirin Discontinuation at 24 to 28 Weeks' Gestation in Pregnancies at High Risk of Preterm Preeclampsia: A Randomized Clinical Trial. JAMA 2023; 329:542-550. [PMID: 36809321 PMCID: PMC9945069 DOI: 10.1001/jama.2023.0691] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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] [Received: 11/03/2022] [Accepted: 01/18/2023] [Indexed: 02/23/2023]
Abstract
Importance Aspirin reduces the incidence of preterm preeclampsia by 62% in pregnant individuals at high risk of preeclampsia. However, aspirin might be associated with an increased risk of peripartum bleeding, which could be mitigated by discontinuing aspirin before term (37 weeks of gestation) and by an accurate selection of individuals at higher risk of preeclampsia in the first trimester of pregnancy. Objective To determine whether aspirin discontinuation in pregnant individuals with normal soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1:PlGF) ratio between 24 and 28 weeks of gestation was noninferior to aspirin continuation to prevent preterm preeclampsia. Design, Setting, and Participants Multicenter, open-label, randomized, phase 3, noninferiority trial conducted in 9 maternity hospitals across Spain. Pregnant individuals (n = 968) at high risk of preeclampsia during the first-trimester screening and an sFlt-1:PlGF ratio of 38 or less at 24 to 28 weeks of gestation were recruited between August 20, 2019, and September 15, 2021; of those, 936 were analyzed (intervention: n = 473; control: n = 463). Follow-up was until delivery for all participants. Interventions Enrolled patients were randomly assigned in a 1:1 ratio to aspirin discontinuation (intervention group) or aspirin continuation until 36 weeks of gestation (control group). Main Outcomes and Measures Noninferiority was met if the higher 95% CI for the difference in preterm preeclampsia incidences between groups was less than 1.9%. Results Among the 936 participants, the mean (SD) age was 32.4 (5.8) years; 3.4% were Black and 93% were White. The incidence of preterm preeclampsia was 1.48% (7/473) in the intervention group and 1.73% (8/463) in the control group (absolute difference, -0.25% [95% CI, -1.86% to 1.36%]), indicating noninferiority. Conclusions and Relevance Aspirin discontinuation at 24 to 28 weeks of gestation was noninferior to aspirin continuation for preventing preterm preeclampsia in pregnant individuals at high risk of preeclampsia and a normal sFlt-1:PlGF ratio. Trial Registration ClinicalTrials.gov Identifier: NCT03741179 and ClinicalTrialsRegister.eu Identifier: 2018-000811-26.
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Affiliation(s)
- Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Monica López
- Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Sara Caamiña
- Department of Obstetrics, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Àngels Vives
- Department of Obstetrics, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Eva Lopez-Quesada
- Department of Obstetrics, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Marta Ricart
- Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Anna Maroto
- Department of Obstetrics, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Laura de Mingo
- Department of Obstetrics, Hospital Universitario Severo Ochoa, Leganés, Spain
| | - Elena Pintado
- Department of Obstetrics, Hospital Universitario de Getafe, Getafe, Spain
| | - Roser Ferrer-Costa
- Department of Biochemistry, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Lourdes Martin
- Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Alicia Rodríguez-Zurita
- Department of Obstetrics, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Esperanza Garcia
- Department of Obstetrics, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Mar Pallarols
- Department of Obstetrics, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Laia Vidal-Sagnier
- Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Mireia Teixidor
- Department of Obstetrics, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | | | - Adela Pérez-Gomez
- Department of Obstetrics, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Vanesa Ocaña
- Department of Obstetrics, Hospital Universitario de Getafe, Getafe, Spain
| | - Linda Puerto
- Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Pilar Millán
- Department of Obstetrics, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Mercè Alsius
- Department of Biochemistry, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Sonia Diaz
- Department of Obstetrics, Hospital Universitario de Getafe, Getafe, Spain
| | - Nerea Maiz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Suy
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
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González González NL, González Dávila E, González Martín A, Armas M, Tascón L, Farras A, Higueras T, Mendoza M, Carreras E, Goya M. Abnormal Maternal Body Mass Index and Customized Fetal Weight Charts: Improving the Identification of Small for Gestational Age Fetuses and Newborns. Nutrients 2023; 15:nu15030587. [PMID: 36771294 PMCID: PMC9920601 DOI: 10.3390/nu15030587] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/08/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Obesity and thinness are serious diseases, but cases with abnormal maternal weight have not been excluded from the calculations in the construction of customized fetal growth curves (CCs). METHOD To determine if the new CCs, built excluding mothers with an abnormal weight, are better than standard CCs at identifying SGA. A total of 16,122 neonates were identified as SGA, LGA, or AGA, using the two models. Logistic regression and analysis of covariance were used to calculate the OR and CI for adverse outcomes by group. Gestational age was considered as a covariable. RESULTS The SGA rates by the new CCs and by the standard CCs were 11.8% and 9.7%, respectively. The SGA rate only by the new CCs was 18% and the SGA rate only by the standard CCs was 0.01%. Compared to AGA by both models, SGA by the new CCs had increased rates of cesarean section, (OR 1.53 (95% CI 1.19, 1.96)), prematurity (OR 2.84 (95% CI 2.09, 3.85)), NICU admission (OR 5.41 (95% CI 3.47, 8.43), and adverse outcomes (OR 1.76 (95% CI 1.06, 2.60). The strength of these associations decreased with gestational age. CONCLUSION The use of the new CCs allowed for a more accurate identification of SGA at risk of adverse perinatal outcomes as compared to the standard CCs.
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Affiliation(s)
- Nieves Luisa González González
- Department of Obstetrics and Gynecology, University of La Laguna, Hospital Universitario de Canarias, 38200 Tenerife, Spain
- Correspondence: ; Tel.: +34-922678335
| | - Enrique González Dávila
- Department of Mathematics, Statistics and Operations Research, IMAULL, University of La Laguna, 38200 Tenerife, Spain
| | - Agustina González Martín
- Department of Obstetrics and Gynecology, Hospital Universitario Ntra Sra de Candenlaria, 38200 Tenerife, Spain
| | - Marina Armas
- Department of Pediatrics, Evangelisches Krakenhaus König Elisabeth Herzberge, 10365 Berlin, Germany
| | - Laura Tascón
- Department of Obstetrics and Gynecology, University of La Laguna, Hospital Universitario de Canarias, 38200 Tenerife, Spain
| | - Alba Farras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - Teresa Higueras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - Manel Mendoza
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - Elena Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - María Goya
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
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20
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Serrano B, Bonacina E, Rodo C, Garcia-Manau P, Sanchez-Duran MÁ, Pancorbo M, Forcada C, Murcia MT, Perestelo A, Armengol-Alsina M, Mendoza M, Carreras E. First-trimester screening for pre-eclampsia and small for gestational age: A comparison of the gaussian and Fetal Medicine Foundation algorithms. Int J Gynaecol Obstet 2023; 160:150-160. [PMID: 35695395 PMCID: PMC10083925 DOI: 10.1002/ijgo.14306] [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] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Pre-eclampsia (PE) and small for gestational age (SGA) can be predicted from the first trimester. The most widely used algorithm worldwide is the Fetal Medicine Foundation (FMF) algorithm. The recently described Gaussian algorithm has reported excellent results although it is unlikely to be externally validated. Therefore, as an alternative approach, we compared the predictive accuracy for PE and SGA of the Gaussian and FMF algorithms. METHODS Secondary analysis of a prospective cohort study was conducted at Vall d'Hebron University Hospital (Barcelona) with 2641 singleton pregnancies. The areas under the curve for the predictive performance for early-onset and preterm PE and early-onset and preterm SGA were calculated with the Gaussian and FMF algorithms and subsequently compared. RESULTS The FMF and Gaussian algorithms showed a similar predictive performance for most outcomes and marker combinations. Nevertheless, significant differences for early-onset PE prediction favored the Gaussian algorithm in the following combinations: mean arterial blood pressure (MAP) with pregnancy-associated plasma protein A, MAP with placental growth factor, and MAP alone. CONCLUSIONS The first-trimester Gaussian and FMF algorithms have similar performances for PE and SGA prediction when applied with all markers within a routine care setting in a Spanish population, adding evidence to the external validity of the FMF algorithm.
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Affiliation(s)
- Berta Serrano
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlota Rodo
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Ángeles Sanchez-Duran
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Pancorbo
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Forcada
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Teresa Murcia
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Perestelo
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Armengol-Alsina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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21
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Serrano B, Bonacina E, Garcia-Ruiz I, Mendoza M, Garcia-Manau P, Garcia-Aguilar P, Gil J, Armengol-Alsina M, Fernández-Hidalgo N, Sulleiro E, Castillo-Ribelles L, Maiz N, Carreras E, Suy A. Confirmation of preeclampsia-like syndrome induced by severe COVID-19: an observational study. Am J Obstet Gynecol MFM 2023; 5:100760. [PMID: 36195282 PMCID: PMC9526511 DOI: 10.1016/j.ajogmf.2022.100760] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic, some studies have reported an increased preeclampsia incidence in pregnant women with SARS-CoV-2 infection. Several explanations for this association have been proposed, including a preeclampsia-like syndrome induced by severe COVID-19. This syndrome was described in a small case series and has not been confirmed in larger studies, and its effect on perinatal outcomes has not been studied. OBJECTIVE This study aimed to confirm the preeclampsia-like syndrome because of COVID-19 and to investigate its implications on pregnancy outcomes and prognosis. STUDY DESIGN This was a prospective, observational study conducted in a tertiary referral hospital. The inclusion criteria were pregnant women admitted to the intensive care unit for severe pneumonia because of COVID-19. They were classified into 3 groups based on clinical and laboratory findings: preeclampsia, preeclampsia-like syndrome, and women without preeclampsia features. The 3 cohorts were analyzed and compared at 3 different times: before, during, and after severe pneumonia. The main outcomes were incidence of adverse perinatal outcomes and signs and symptoms of PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, and increased angiogenic factors (soluble fms-like tyrosine kinase 1-to-placental growth factor ratio). RESULTS A total of 106 women were admitted to the intensive care unit because of severe pneumonia, and 68 women were included in the study. Of those, 53 (50.0%) did not meet the diagnostic criteria for preeclampsia and remained pregnant after pneumonia (non-preeclampsia); 7 (6.6%) met the diagnostic criteria for preeclampsia, had abnormal (>38) soluble fms-like tyrosine kinase 1-to-placental growth factor ratio (preeclampsia), and delivered during severe pneumonia, and 8 (7.5%) met the diagnostic criteria for preeclampsia, had normal (≤38) soluble fms-like tyrosine kinase 1-to-placental growth factor ratio (preeclampsia like), and did not deliver during pneumonia. Despite not having delivered, most preeclampsia-related features improved after severe pneumonia in women with preeclampsia-like syndrome. Women with preeclampsia had significantly poorer outcomes than women with preeclampsia-like syndrome or without preeclampsia. CONCLUSION More than 50% of women with severe COVID-19 and diagnostic criteria for preeclampsia may not be preeclampsia but a preeclampsia-like syndrome, which may affect up to 7.5% of women with severe COVID-19. Preeclampsia-like syndrome might have similar perinatal outcomes to those of normotensive women with severe pneumonia because of COVID-19. For these reasons, preeclampsia-like syndrome should be excluded by using soluble fms-like tyrosine kinase 1-to-placental growth factor ratio in future research and before making clinical decisions.
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Affiliation(s)
- Berta Serrano
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
| | - Erika Bonacina
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
| | - Itziar Garcia-Ruiz
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
| | - Manel Mendoza
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy); Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy).
| | - Pablo Garcia-Manau
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
| | - Paula Garcia-Aguilar
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
| | - Judit Gil
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
| | - Mireia Armengol-Alsina
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy)
| | - Nuria Fernández-Hidalgo
- Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy),Department of Infectious Diseases, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Fernández-Hidalgo)
| | - Elena Sulleiro
- Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy),Department of Microbiology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Dr Sulleiro),CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Majadahonda, Spain (Dr Sulleiro)
| | - Laura Castillo-Ribelles
- Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy),Department of Biochemistry, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Dr Castillo-Ribelles)
| | - Nerea Maiz
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
| | - Elena Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
| | - Anna Suy
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Armengol-Alsina, Maiz, Carreras, and Suy),Universitat Autònoma de Barcelona, Bellaterra, Spain (Drs Serrano, Bonacina, Garcia-Ruiz, Mendoza, Garcia-Manau, Garcia-Aguilar, Gil, Fernández-Hidalgo, Sulleiro, Castillo-Ribelles, Maiz, Carreras, and Suy)
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22
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De la Cadena E, Camacho M, Vaca F, Enríquez S, Eleizalde MC, Arrivillaga-Henríquez J, Mendoza M, Navarro JC, Ramírez-Iglesias JR. Molecular identification of Trypanosoma theileri in cattle from the Ecuadorian Amazon. Vet Parasitol Reg Stud Reports 2023; 37:100824. [PMID: 36623904 DOI: 10.1016/j.vprsr.2022.100824] [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] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/20/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
Trypanosoma theileri is a cosmopolitan opportunistic haemoparasite described in wild and domestic ruminants, and also in arthropod vectors. The presence of this parasite has been reported in several South American countries, including Amazonian regions. Despite the importance of livestock production, Ecuador possesses scarce studies about trypanosomosis and no T. theileri reports in its territory. Here, we showed molecular evidences of the presence of T. theileri in cattle from a province located in the Ecuadorian Amazon. Bovine blood samples were collected from 2014 to 2019, during campaigns to detect haemoparasites in the Ecuadorian provinces of Orellana and Sucumbíos. DNA was extracted from the buffy coat and used in PCR assays with three different molecular markers, ITS1, 18S and Cathepsin L-like. T. theileri was detected only in the Sucumbíos province, with a specific molecular prevalence of 8.6% (3/35) using the three primers and an additional animal detected as positive (11.4% prevalence) only by the ITS1 marker. DNA sequences derived from the generated amplicons were subjected to phylogenetics maximum parsimony and maximum likelihood analysis, which indicate the presence of TthI and TthII genotypes circulating in the evaluated animals. Molecular surveillance should be continually implemented in Ecuador in order to deepen the epidemiological and evolutionary knowledge about T. theileri as well other haemoparasites in the amazon parts of the country.
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Affiliation(s)
- E De la Cadena
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito 170120, Ecuador; Program of Master in Biomedicine, Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito 170120, Ecuador
| | - M Camacho
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito 170120, Ecuador; Program of Master in Biomedicine, Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito 170120, Ecuador
| | - F Vaca
- Unidad de Entomología Aplicada, Instituto de Investigaciones en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador
| | - S Enríquez
- Unidad de Entomología Aplicada, Instituto de Investigaciones en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador
| | - M C Eleizalde
- Centro de Estudios Biomédicos y Veterinarios (CEBIV), Instituto de Estudios Científicos y Tecnológicos (IDECYT), Universidad Nacional Experimental Simón Rodríguez (UNESR), Apartado Postal 47925, Caracas, Venezuela
| | - J Arrivillaga-Henríquez
- Unidad de Entomología Aplicada, Instituto de Investigaciones en Zoonosis (CIZ), Universidad Central del Ecuador, Quito, Ecuador; Línea de Salud Ambiental, Calidad y Biodiversidad, Área Ambiente y Territorio, THC-FACSO, Universidad Central del Ecuador, Quito, Ecuador
| | - M Mendoza
- Centro de Estudios Biomédicos y Veterinarios (CEBIV), Instituto de Estudios Científicos y Tecnológicos (IDECYT), Universidad Nacional Experimental Simón Rodríguez (UNESR), Apartado Postal 47925, Caracas, Venezuela
| | - J C Navarro
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito 170120, Ecuador; Program of Master in Biomedicine, Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito 170120, Ecuador
| | - J R Ramírez-Iglesias
- Research Group of Emerging and Neglected Diseases, Ecoepidemiology and Biodiversity, Health Science Faculty, Universidad Internacional SEK (UISEK), Quito 170120, Ecuador; Program of Master in Biomedicine, Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito 170120, Ecuador.
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Wang J, Qu V, Hui C, Sandhu N, Mendoza M, Panjwani N, Lin J, Chang Y, Liang C, LU J, Wang L, Kovalchuk N, Gensheimer M, Soltys S, Pollom E. Stratified Assessment of a Commercial Deep Learning Algorithm for Automated Detection and Contouring of Metastatic Brain Tumors in Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2193] [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: 10/31/2022]
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Hui C, Mendoza M, Von Eyben R, Devereaux K, Howitt B, Kidd E. Improved Outcomes with Adjuvant Radiation Therapy in Early-Stage Endometrial Cancer with Abnormal Beta-Catenin Expression. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.598] [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: 10/31/2022]
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Bonacina E, Armengol-Alsina M, Hurtado I, Garcia-Manau P, Ferrer-Oliveras R, Monreal S, Pancorbo M, Mendoza M, Carreras E. sFlt-1 to PlGF ratio cut-offs to predict adverse pregnancy outcomes in early-onset FGR and SGA: a prospective observational study. J OBSTET GYNAECOL 2022; 42:2840-2845. [PMID: 35980876 DOI: 10.1080/01443615.2022.2109956] [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] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This is a prospective, observational study, conducted in a tertiary referral hospital. We enrolled 175 singleton pregnancies with estimated foetal weight below the 10th centile between 20 + 0 and 31 + 6 weeks. Placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and fetoplacental circulation were assessed at the time of diagnosis. Receiver operating characteristic curves were used to assess the performance of sFlt-1/PlGF for predicting adverse perinatal outcomes (APO). The optimal cut-offs to predict each adverse outcome were calculated and the resulting areas under the curve (AUC) were compared to those calculated from the cut-off points of 38, 85 and 110. The need for delivery at <30 and <34 weeks and APO were the main outcome measures. The optimal cut-off points to predict APO, delivery <30 and <34 weeks were 24.9, 116.7 and 97.5, respectively. None of them proved to be superior to 38, 85 or 110 for predicting any adverse pregnancy outcome. Impact StatementWhat is already known on this subject? Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are biomarkers of placental dysfunction. High sFlt-1/PlGF values predict adverse perinatal outcomes in preeclampsia (PE).What do the results of this study add? No specific thresholds have been described to identify early-onset foetal growth restriction (FGR) and small for gestational age (SGA) foetuses at higher risk of adverse outcomes. This study describes these specific cut-offs and compares their predictive capacity to those described for PE.What are the implications of these findings for clinical practice and/or further research? The sFlt-1/PlGF cut-off points of 38, 85 and 110 might be useful for ruling out the occurrence of APO and the need for elective delivery at <30 and at <34 weeks from the moment of diagnosis in early-onset FGR and SGA. These cut-offs could aid Doppler studies in the distinction between FGR and SGA.
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Affiliation(s)
- Erika Bonacina
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Armengol-Alsina
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ivan Hurtado
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raquel Ferrer-Oliveras
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sonia Monreal
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Pancorbo
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Mendoza
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Vargas M, Mendoza M, García I, Farràs A, Maiz N, Carreras E, Goya M. Implications of training for pessary placement and accuracy of cervical length measurements after pessary placement: a prospective, double-blind, randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2022; 279:12-18. [DOI: 10.1016/j.ejogrb.2022.09.024] [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] [Received: 10/25/2021] [Revised: 08/17/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
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Rodo C, de la Calle M, Maroto A, Maiz N, Arévalo S, Garcia-Manau P, Mendoza M, Bartha JL, Carreras E. Gestational age-based reference ranges for cervical length and preterm birth prediction in triplet pregnancies: an observational retrospective study. BMC Pregnancy Childbirth 2022; 22:669. [PMID: 36042432 PMCID: PMC9426284 DOI: 10.1186/s12884-022-04997-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/22/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To develop gestational age-based reference ranges for cervical length in triplet pregnancies. The secondary objective was to assess the performance of cervical length measured between 18 and 20 + 6 days for the prediction of preterm delivery before 28 and 32 weeks, respectively. METHODS Observational retrospective study of triplet pregnancies in three Spanish tertiary-care hospitals between 2001 and 2019. Cervical length measurements were consecutively obtained between 15 and 34 weeks of gestation. Pregnancies undergoing multifetal reduction or fetal surgery were excluded. RESULTS Two hundred and six triplet pregnancies were included in the final analysis. There was a quadratic decrease in cervical length with gestational age. The median and fifth centiles for cervical length at 20 weeks were 35 and 13 mm. In the prediction of preterm birth < 28 weeks, for a false positive rate of 5%, and 10%, the detection rates were 40.9%, and 40.9%, respectively, and the prediction of preterm birth < 32 weeks, 22.0% and 26.0%, respectively. CONCLUSIONS In triplet pregnancies, cervical length decreases with gestational age. The performance of cervical length at 18-20 + 6 in screening for preterm birth before 28 and 32 weeks is poor.
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Affiliation(s)
- Carlota Rodo
- Maternal-Fetal Medicine Research Group, Department of Obstetrics, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - María de la Calle
- Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hospital Universitario La Paz-Carlos III, Madrid, Spain
| | - Anna Maroto
- Maternal-Fetal Medicine, Department of Obstetrics, Hospital Universitari Dr Josep Trueta, Girona, Spain
| | - Nerea Maiz
- Maternal-Fetal Medicine Research Group, Department of Obstetrics, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - Silvia Arévalo
- Maternal-Fetal Medicine Research Group, Department of Obstetrics, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal-Fetal Medicine Research Group, Department of Obstetrics, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Manel Mendoza
- Maternal-Fetal Medicine Research Group, Department of Obstetrics, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - José Luis Bartha
- Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hospital Universitario La Paz-Carlos III, Madrid, Spain
| | - Elena Carreras
- Maternal-Fetal Medicine Research Group, Department of Obstetrics, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain
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Serrano B, Mendoza M, Garcia-Aguilar P, Bonacina E, Garcia-Ruiz I, Garcia-Manau P, Gil J, Armengol-Alsina M, Fernandez-Hidalgo N, Sulleiro E, Lopez-Martinez RM, Ricart M, Martin L, Lopez-Quesada E, Vives A, Maroto A, Maiz N, Suy A, Carreras E. Shared risk factors for COVID-19 and preeclampsia in the first trimester: An observational study. Acta Obstet Gynecol Scand 2022; 101:803-808. [PMID: 35505629 PMCID: PMC9347999 DOI: 10.1111/aogs.14371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The association between preeclampsia and coronavirus disease 2019 (COVID-19) is under study. Previous publications have hypothesized the existence of shared risk factors for both conditions or a deficient trophoblastic invasion as possible explanations for this association. The primary aim of this study was to examine baseline risk factors measured in the first-trimester combined screening for preeclampsia in pregnant women with COVID-19 compared with the general population. A secondary aim of this study was to compare risk factors among patients with mild and severe COVID-19. MATERIAL AND METHODS This was an observational retrospective study conducted at Vall d'Hebron Hospital Campus (Catalonia, Spain). Study patients were 231 pregnant women undergoing the first-trimester screening for preeclampsia and positive for severe acute respiratory syndrome coronavirus 2 between February 2020 and September 2021. The reference cohort were 13 033 women of the general population from six centers across Catalonia from May 2019 to June 2021. Based on the need for hospitalization, patients were classified in two groups: mild and severe COVID-19. First-trimester screening for preeclampsia included maternal history, mean arterial blood pressure, mean uterine artery pulsatility index (UtAPI), placental growth factor (PlGF), and pregnancy-associated plasma protein-A (PAPP-A). RESULTS The proportion of cases at high risk for preeclampsia was significantly higher among the COVID-19 group compared with the general population (19.0% and 13.2%, respectively; p = 0.012). When analyzing risk factors for preeclampsia individually, women with COVID-19 had higher median body mass index (25.2 vs 24.5, p = 0.041), higher UtAPI multiple of the median (MoM) (1.08 vs 1.00, p < 0.001), higher incidence of chronic hypertension (2.8% vs 0.9%, p = 0.015), and there were fewer smokers (5.7% vs 11.6%, p = 0.007). The MoMs of PlGF and PAPP-A did not differ significantly between both groups (0.96 vs 0.97, p = 0.760 and 1.00 vs 1.01, p = 0.432; respectively). CONCLUSIONS In patients with COVID-19, there was a higher proportion of women at high risk for preeclampsia at the first-trimester screening than in the general population, mainly because of maternal risk factors, rather than placental signs of a deficient trophoblastic invasion.
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Affiliation(s)
- Berta Serrano
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paula Garcia-Aguilar
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Itziar Garcia-Ruiz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Judit Gil
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Armengol-Alsina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nuria Fernandez-Hidalgo
- Department of Infectous Diseases, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Rosa Maria Lopez-Martinez
- Biochemistry Department, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Ricart
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lourdes Martin
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | - Eva Lopez-Quesada
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Terrassa, Spain
| | - Angels Vives
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Consorci Sanitari de Terrassa, Universitat Internacional de Catalunya, Terrassa, Spain
| | - Anna Maroto
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari de Girona Doctor Josep Trueta, Universitat de Girona, Girona, Spain
| | - Nerea Maiz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Suy
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
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Morales-Roselló J, Khalil A, Loscalzo G, Buongiorno S, Brik M, Mendoza M, Di Fabrizio C, Scarinci E, Salvi S, Lanzone A, Perales Marín A. Cerebroplacental ratio prediction of intrapartum fetal compromise according to the interval to delivery. Fetal Diagn Ther 2022; 49:196-205. [DOI: 10.1159/000525162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/26/2022] [Indexed: 11/19/2022]
Abstract
Objectives
To evaluate whether the interval to delivery modifies the predictive accuracy of the cerebroplacental ratio (CPR) for the prediction of cesarean section for intrapartum fetal compromise (CS-IFC), either as a single marker or combined with estimated fetal weight centile (EFWc), type of labor onset (TLO) and other clinical variables.
Material and methods
This was a multicenter retrospective study of 5193 women with singleton pregnancies who underwent an ultrasound scan at 35+0- 41+0 weeks and gave birth within one month of examination, at any of the participating hospitals in Spain, UK, and Italy. CS-IFC was diagnosed in case of abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH<7.20, requiring urgent cesarean section. The diagnostic ability of CPR in multiples of the median (CPR MoM) was evaluated at different intervals to delivery, alone and combined with EFWc, TLO, and other pregnancy data such as maternal age, maternal body mass index, parity, and fetal sex, for the prediction of CS-IFC by means of ROC curves and logistic regression analysis.
Results
The predictive ability of CPR MoM for CS-IFC worsened with the interval to delivery. In general, the best prediction was obtained prior to labor, and adding information related with EFWc and TLO [AUC 0.71 (95% CI 0.64-0.79), 0.73 (95% CI 0.66-0.80) and 0.75 (95% CI 0.69-0.81); P<0.0001]. Addition of more clinical data did not improve prediction. In addition, results did not vary when only cases with spontaneous onset of labor were studied.
Conclusion
CPR MoM prediction of CS-IFC at the end of pregnancy worsens with the interval to delivery. Accordingly, it should be done in the short term and considering EFWc and TLO.
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Mendoza M, Bonacina E, Serrano B, Ricart M, Martin L, Lopez-Quesada E, Vives A, Maroto A, Garcia-Manau P, De Antonio C, Tusquets C, Moreano G, Armengol-Alsina M, Carreras E. Implementation of routine first-trimester combined screening for preeclampsia based on the Gaussian algorithm: A clinical effectiveness study. Int J Gynaecol Obstet 2022; 159:803-809. [PMID: 35332556 DOI: 10.1002/ijgo.14192] [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] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/15/2022] [Accepted: 03/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the clinical effectiveness of the routine first-trimester screening for preeclampsia (PE) after being implemented in six Catalan maternities. METHODS Participants in the reference group were recruited prospectively between October 2015 and September 2017. Participants in the study group were recruited retrospectively between November 2018 and May 2019, after implementing the screening program. PE risk was assessed between 11 + 0 and 13 + 6 weeks of gestation using the Gaussian algorithm combining maternal characteristics, mean arterial blood pressure, uterine artery pulsatility index, and maternal serum pregnancy-associated plasma protein-A. Women with a risk ≥1/137 were prescribed daily salicylic acid (150 mg) until 36 weeks of gestation. RESULTS Preterm PE occurred in 30 of 2641 participants (1.14%) in the reference group, as compared with 18 of 2848 participants (0.63%) in the study group (OR: 0.55; 95% CI, 0.31-0.99; P = 0.045). In the reference group, 37 participants (1.40%) were admitted to ICU, as compared with 23 participants (0.81%) in the study group (OR: 0.57; 95% CI, 0.34-0.96; P = 0.035). CONCLUSION The routine first-trimester PE screening can be implemented in a public healthcare setting, leading to a significant reduction in the incidence of preterm PE and of maternal ICU admission.
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Affiliation(s)
- Manel Mendoza
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Berta Serrano
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Ricart
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lourdes Martin
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | - Eva Lopez-Quesada
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Terrassa, Spain
| | - Angels Vives
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Consorci Sanitari de Terrassa, Universitat Internacional de Catalunya, Terrassa, Spain
| | - Anna Maroto
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari de Girona Doctor Josep Trueta, Universitat de Girona, Girona, Spain
| | - Pablo Garcia-Manau
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Clementina De Antonio
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Tusquets
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gabriela Moreano
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Mireia Armengol-Alsina
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Bonacina E, Mendoza M, Farràs A, Garcia-Manau P, Serrano B, Hurtado I, Ferrer-Oliveras R, Illan L, Armengol-Alsina M, Carreras E. Angiogenic factors for planning fetal surveillance in fetal growth restriction and small-for-gestational-age fetuses: A prospective observational study. BJOG 2022; 129:1870-1877. [PMID: 35303394 PMCID: PMC9541486 DOI: 10.1111/1471-0528.17151] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/23/2021] [Accepted: 03/02/2022] [Indexed: 12/13/2022]
Abstract
Objective The aim of this study was to assess the added value of the soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) ratio for adjusting the periodicity of ultrasound examinations in early‐onset fetal growth restriction (FGR) and small for gestational age (SGA). Design A prospective, observational study. Setting Tertiary referral hospital. Population One hundred and thirty‐four single pregnancies with ultrasonographic estimated fetal weight (EFW) below the 10th centile between 20+0 and 31+6 weeks of gestation with antegrade umbilical artery flow. Methods The time from Doppler and sFlt‐1/PlGF assessment to delivery was recorded and classified into four ranges: <1, <2, <3 and <4 weeks. Main outcome measures Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of sFlt‐1/PlGF values to predict the time to delivery. Results In the SGA cohort, the NPV calculated for an sFlt‐1/PlGF cut‐off value of 38 was 100% for delivery before 3 weeks, and 98% for delivery before 4 weeks after diagnosis (95% CI 0.89–1.00). In the FGR cohort, the NPV calculated for an sFlt‐1/PlGF cut‐off value of 38 was 100% for delivery before 2 weeks after diagnosis (95% CI 0.92–1.00). By contrast, more than 50% of cases with an sFlt‐1/PlGF value of >85 required an elective delivery before 1 week. Conclusions sFlt‐1/PlGF values in early‐onset SGA and FGR are predictive of the time to delivery and could be used for planning fetal surveillance, by reducing the frequency of ultrasound in cases with sFlt‐1/PlGF < 38 and by providing closer follow‐up in cases with sFlt‐1/PlGF >85. Tweetable abstract sFlt‐1/PlGF values in early‐onset SGA/FGR could be used in addition to Doppler for planning fetal surveillance. sFlt‐1/PlGF values in early‐onset SGA/FGR could be used in addition to Doppler for planning fetal surveillance. Linked article: This article is commented on by Cecilia Villalaín, pp. 1878 in this issue. To view this minicommentary visit https://doi.org/10.1111/1471‐0528.17172
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Affiliation(s)
- Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Alba Farràs
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Berta Serrano
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Ivan Hurtado
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Raquel Ferrer-Oliveras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Lidia Illan
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Mireia Armengol-Alsina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
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Garcia-Manau P, Mendoza M, Bonacina E, Martin-Alonso R, Martin L, Palacios A, Sanchez ML, Lesmes C, Hurtado I, Perez E, Tubau A, Ibañez P, Alcoz M, Valiño N, Moreno E, Borrero C, Garcia E, Lopez-Quesada E, Diaz S, Broullon JR, Teixidor M, Chulilla C, Gil MM, Lopez M, Candela-Hidalgo A, Salinas-Amoros A, Moreno A, Morra F, Vaquerizo O, Soriano B, Fabre M, Gomez-Valencia E, Cuiña A, Alayon N, Sainz JA, Vives A, Esteve E, Ocaña V, López MÁ, Maroto A, Carreras E. Management of fetal Growth Restriction at term by Angiogenic Factors versus feto-maternal Doppler (GRAFD) to avoid adverse perinatal outcomes: multicenter open-label randomized controlled trial study protocol (Preprint). JMIR Res Protoc 2022; 11:e37452. [PMID: 36222789 PMCID: PMC9597418 DOI: 10.2196/37452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Fetal smallness affects 10% of pregnancies. Small fetuses are at a higher risk of adverse outcomes. Their management using estimated fetal weight and feto-maternal Doppler has a high sensitivity for adverse outcomes; however, more than 60% of fetuses are electively delivered at 37 to 38 weeks. On the other hand, classification using angiogenic factors seems to have a lower false-positive rate. Here, we present a protocol for the Fetal Growth Restriction at Term Managed by Angiogenic Factors Versus Feto-Maternal Doppler (GRAFD) trial, which compares the use of angiogenic factors and Doppler to manage small fetuses at term. Objective The primary objective is to demonstrate that classification based on angiogenic factors is not inferior to estimated fetal weight and Doppler at detecting fetuses at risk of adverse perinatal outcomes. Methods This is a multicenter, open-label, randomized controlled trial conducted in 20 hospitals across Spain. A total of 1030 singleton pregnancies with an estimated fetal weight ≤10th percentile at 36+0 to 37+6 weeks+days will be recruited and randomly allocated to either the control or the intervention group. In the control group, standard Doppler-based management will be used. In the intervention group, cases with a soluble fms-like tyrosine kinase to placental growth factor ratio ≥38 will be classified as having fetal growth restriction; otherwise, they will be classified as being small for gestational age. In both arms, the fetal growth restriction group will be delivered at ≥37 weeks and the small for gestational age group at ≥40 weeks. We will assess differences between the groups by calculating the relative risk, the absolute difference between incidences, and their 95% CIs. Results Recruitment for this study started on September 28, 2020. The study results are expected to be published in peer-reviewed journals and disseminated at international conferences in early 2023. Conclusions The angiogenic factor–based protocol may reduce the number of pregnancies classified as having fetal growth restriction without worsening perinatal outcomes. Moreover, reducing the number of unnecessary labor inductions would reduce costs and the risks derived from possible iatrogenic complications. Additionally, fewer inductions would lower the rate of early-term neonates, thus improving neonatal outcomes and potentially reducing long-term infant morbidities. Trial Registration ClinicalTrials.gov NCT04502823; https://clinicaltrials.gov/ct2/show/NCT04502823 International Registered Report Identifier (IRRID) DERR1-10.2196/37452
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Affiliation(s)
- Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raquel Martin-Alonso
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario de Torrejón, Madrid, Spain
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Lourdes Martin
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | - Ana Palacios
- Department of Obstetrics, Alicante University General Hospital, Miguel Hernandez University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research, Alicante, Spain
| | - Maria Luisa Sanchez
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
| | - Cristina Lesmes
- Maternal Fetal Medicine Unit, Department of Obstetrics, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Ivan Hurtado
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Esther Perez
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario de Cabueñes, Universidad de Oviedo, Gijón, Spain
| | - Albert Tubau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Son Llàtzer, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Patricia Ibañez
- Aragon Institute for Health Research, Department of Obstetrics, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Marina Alcoz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Fundació Althaia, Universitat de Vic, Manresa, Spain
| | - Nuria Valiño
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario de A Coruña, Universidade da Coruña, A Coruña, Spain
| | - Elena Moreno
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Spain
| | - Carlota Borrero
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
| | - Esperanza Garcia
- Maternal Fetal Medicine Unit, Department of Obstetrics, Consorci Sanitari de Terrassa, Universitat Internacional de Catalunya, Terrassa, Spain
| | - Eva Lopez-Quesada
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Terrassa, Spain
| | - Sonia Diaz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario de Getafe, Universidad Europea de Madrid, Getafe, Spain
| | - Jose Roman Broullon
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario Puerta del Mar, Universidad de Cádiz, Cádiz, Spain
| | - Mireia Teixidor
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari de Girona Doctor Josep Trueta, Universitat de Girona, Girona, Spain
| | - Carolina Chulilla
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Maria M Gil
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario de Torrejón, Madrid, Spain
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Monica Lopez
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | - Amparo Candela-Hidalgo
- Department of Obstetrics, Alicante University General Hospital, Miguel Hernandez University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research, Alicante, Spain
| | - Andrea Salinas-Amoros
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain
| | - Anna Moreno
- Maternal Fetal Medicine Unit, Department of Obstetrics, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Francesca Morra
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Oscar Vaquerizo
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario de Cabueñes, Universidad de Oviedo, Gijón, Spain
| | - Beatriz Soriano
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Son Llàtzer, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Marta Fabre
- Aragon Institute for Health Research, Department of Obstetrics, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Elena Gomez-Valencia
- Maternal Fetal Medicine Unit, Department of Obstetrics, Fundació Althaia, Universitat de Vic, Manresa, Spain
| | - Ana Cuiña
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario de A Coruña, Universidade da Coruña, A Coruña, Spain
| | - Nicolas Alayon
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Spain
| | - Jose Antonio Sainz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
| | - Angels Vives
- Maternal Fetal Medicine Unit, Department of Obstetrics, Consorci Sanitari de Terrassa, Universitat Internacional de Catalunya, Terrassa, Spain
| | - Esther Esteve
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Terrassa, Spain
| | - Vanesa Ocaña
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario de Getafe, Universidad Europea de Madrid, Getafe, Spain
| | - Miguel Ángel López
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitario Puerta del Mar, Universidad de Cádiz, Cádiz, Spain
| | - Anna Maroto
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari de Girona Doctor Josep Trueta, Universitat de Girona, Girona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
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Acharya U, Aidala C, Akiba Y, Alfred M, Andrieux V, Apadula N, Asano H, Azmoun B, Babintsev V, Bandara N, Barish K, Bathe S, Bazilevsky A, Beaumier M, Belmont R, Berdnikov A, Berdnikov Y, Bichon L, Blankenship B, Blau D, Bok J, Borisov V, Brooks M, Bryslawskyj J, Bumazhnov V, Campbell S, Canoa Roman V, Cervantes R, Chiu M, Chi C, Choi I, Choi J, Citron Z, Connors M, Corliss R, Cronin N, Csörgő T, Csanád M, Danley T, Daugherity M, David G, DeBlasio K, Dehmelt K, Denisov A, Deshpande A, Desmond E, Dion A, Dixit D, Do J, Drees A, Drees K, Durham J, Durum A, En’yo H, Enokizono A, Esha R, Esumi S, Fadem B, Fan W, Feege N, Fields D, Finger M, Finger M, Fitzgerald D, Fokin S, Frantz J, Franz A, Frawley A, Fukuda Y, Gallus P, Gal C, Garg P, Ge H, Giles M, Giordano F, Goto Y, Grau N, Greene S, Grosse Perdekamp M, Gunji T, Guragain H, Hachiya T, Haggerty J, Hahn K, Hamagaki H, Hamilton H, Hanks J, Han S, Harvey M, Hasegawa S, Haseler T, Hemmick T, He X, Hill J, Hill K, Hodges A, Hollis R, Homma K, Hong B, Hoshino T, Hotvedt N, Huang J, Imai K, Inaba M, Iordanova A, Isenhower D, Ivanishchev D, Jacak B, Jezghani M, Jiang X, Ji Z, Johnson B, Jouan D, Jumper D, Kang J, Kapukchyan D, Karthas S, Kawall D, Kazantsev A, Khachatryan V, Khanzadeev A, Khatiwada A, Kim C, Kim EJ, Kim M, Kim T, Kincses D, Kingan A, Kistenev E, Klatsky J, Kline P, Koblesky T, Kotov D, Kovacs L, Kudo S, Kurita K, Kwon Y, Lajoie J, Larionova D, Lebedev A, Lee S, Lee S, Leitch M, Leung Y, Lewis N, Lim S, Liu M, Li X, Loggins VR, Loomis D, Lovasz K, Lynch D, Lökös S, Majoros T, Makdisi Y, Makek M, Manko V, Mannel E, McCumber M, McGaughey P, McGlinchey D, McKinney C, Mendoza M, Mignerey A, Milov A, Mishra D, Mitchell J, Mitrankova M, Mitrankov I, Mitrankov I, Mitsuka G, Miyasaka S, Mizuno S, Mondal M, Montuenga P, Moon T, Morrison D, Mulilo B, Murakami T, Murata J, Nagai K, Nagashima K, Nagashima T, Nagle J, Nagy M, Nakagawa I, Nakano K, Nattrass C, Nelson S, Niida T, Nouicer R, Novák T, Novitzky N, Nukazuka G, Nyanin A, O’Brien E, Ogilvie C, Orjuela Koop J, Osborn J, Oskarsson A, Ottino G, Ozawa K, Pantuev V, Papavassiliou V, Park J, Park S, Patel M, Pate S, Peng W, Perepelitsa D, Perera G, Peressounko D, PerezLara C, Perry J, Petti R, Phipps M, Pinkenburg C, Pisani R, Potekhin M, Pun A, Purschke M, Radzevich P, Ramasubramanian N, Read K, Reynolds D, Riabov V, Riabov Y, Richford D, Rinn T, Rolnick S, Rosati M, Rowan Z, Runchey J, Safonov A, Sakaguchi T, Sako H, Samsonov V, Sarsour M, Sato S, Schaefer B, Schmoll B, Sedgwick K, Seidl R, Sen A, Seto R, Sexton A, Sharma D, Shein I, Shibata TA, Shigaki K, Shimomura M, Shioya T, Shukla P, Sickles A, Silva C, Silvermyr D, Singh B, Singh C, Singh V, Slunečka M, Smith K, Snowball M, Soltz R, Sondheim W, Sorensen S, Sourikova I, Stankus P, Stoll S, Sugitate T, Sukhanov A, Sumita T, Sun J, Sun Z, Sziklai J, Tanida K, Tannenbaum M, Tarafdar S, Taranenko A, Tarnai G, Tieulent R, Timilsina A, Todoroki T, Tomášek M, Towell C, Towell R, Tserruya I, Ueda Y, Ujvari B, van Hecke H, Velkovska J, Virius M, Vrba V, Vukman N, Wang X, Watanabe Y, Wong C, Woody C, Xue L, Xu C, Xu Q, Yalcin S, Yamaguchi Y, Yamamoto H, Yanovich A, Yoon I, Yoo J, Yushmanov I, Yu H, Zajc W, Zelenski A, Zharko S, Zou L. Transverse-single-spin asymmetries of charged pions at midrapidity in transversely polarized
p+p
collisions at
s=200 GeV. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.032003] [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: 11/07/2022]
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Hamoy-Jimenez G, Elahmar HA, Mendoza M, Kim RH, Bril V, Barnett C. A cross-sectional study of gender differences in quality of life domains in patients with neurofibromatosis type 1. Orphanet J Rare Dis 2022; 17:40. [PMID: 35135568 PMCID: PMC8822866 DOI: 10.1186/s13023-022-02195-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited data regarding gender differences in quality of life between women and men with Neurofibromatosis type 1. We aimed to study differences in quality of life domains between women and men with Neurofibromatosis type 1 living in Canada. METHODS This is a cross sectional study of adults with Neurofibromatosis type 1 attending a tertiary NF centre at Toronto General Hospital between January 2016 to December 2017. Demographic and clinical data were collected. We compared scores of generic measures (SF-36, EQ-5D-5L, pain interference) and a disease-specific measure (PedsQL-NF1 module) between women and men. We also assessed the relationship between disease visibility scored by an examiner (Ablon's visibility index) and self-reported perceived physical appearance, stratified by gender. RESULTS One hundred and sixty-two participants were enrolled, 92 females and 70 males. Ablon's index score 1 was in 43% and score 2 in 44%, while only 13% of patients had a score 3. Women had worse scores on the total PedsQL-NF1 scales, and also in the perceived physical appearance, anxiety and emotional health domains. In women, there was a low but significant correlation between Ablon's index and perceived physical appearance (r = - 0.27, p = 0.01, ANOVA p < 0.001). In men, there was no difference in self-reported physical appearance by Ablon's index. There were no differences between men and women in the SF-36 or EQ-5D-5L scores. CONCLUSION Women with NF1 reported worse NF1-related quality of life than men, with worse perceived physical appearance, anxiety, and mental health. Perceived physical appearance does not always correlate to disease visibility; therefore, healthcare providers should inquire about body image, physical appearance concerns, and mental health, especially among women with NF1.
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Affiliation(s)
- G Hamoy-Jimenez
- Elisabeth Raab Neurofibromatosis Clinic, University Health Network, 200 Elizabeth ST, 5EC Room 334, Toronto, ON, M5G 2C4, Canada
| | | | - M Mendoza
- Elisabeth Raab Neurofibromatosis Clinic, University Health Network, 200 Elizabeth ST, 5EC Room 334, Toronto, ON, M5G 2C4, Canada
| | - R H Kim
- Elisabeth Raab Neurofibromatosis Clinic, University Health Network, 200 Elizabeth ST, 5EC Room 334, Toronto, ON, M5G 2C4, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - V Bril
- Elisabeth Raab Neurofibromatosis Clinic, University Health Network, 200 Elizabeth ST, 5EC Room 334, Toronto, ON, M5G 2C4, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - C Barnett
- Elisabeth Raab Neurofibromatosis Clinic, University Health Network, 200 Elizabeth ST, 5EC Room 334, Toronto, ON, M5G 2C4, Canada. .,Department of Medicine, University of Toronto, Toronto, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
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Mendoza M, Ferrer-Oliveras R, Bonacina E, Garcia-Manau P, Rodo C, Carreras E, Alijotas-Reig J. Evaluating the Effect of Pravastatin in Early-Onset Fetal Growth Restriction: A Nonrandomized and Historically Controlled Pilot Study. Am J Perinatol 2021; 38:1472-1479. [PMID: 32615618 DOI: 10.1055/s-0040-1713651] [Citation(s) in RCA: 9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study aimed to analyze the effect of pravastatin on angiogenic factors, feto-maternal Doppler findings and pregnancy outcomes in women with early-onset fetal growth restriction (FGR) treated with pravastatin compared with nontreated controls. STUDY DESIGN This was a pilot study conducted between March 2016 and September 2017. Women with single pregnancies and FGR diagnosed at ≤ 28 weeks of gestation were offered 40 mg of pravastatin daily. Doppler progression, soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) values, and pregnancy outcomes were assessed and compared with consecutive historical controls. Controls were matched to treated women for gestational age, maternal characteristics, maternal and obstetric history, Doppler severity classification, and angiogenic factors at diagnosis. The sFlt-1/PlGF was measured in maternal serum at two different times: before pravastatin was started (ratio M0) and during pravastatin treatment (ratio M1). Doppler severity was classified into four categories: normal, mild, moderate, and severe. RESULTS A total of 38 women were enrolled in this study. No differences were observed in baseline characteristics between groups. However, when compared with the ratio M0, M1 was increased by a median (interquartile range) of 67.0 (-34.8 to 197.3) in the control group but decreased by a median (interquartile range) of -10.1 (-53.1 to -0.07) in the pravastatin treated group (p < 0.001). No significant differences were observed in Doppler progression throughout pregnancy. Median interval from diagnosis to delivery was extended by 16.5 days, the median newborn birthweight was increased from 1,040 to 1,300 g, and the number of women with preeclampsia decreased from 9 (47.4%) to 6 (31.6%) in treated women; however, these trends were not statistically significant. CONCLUSION In women with early-onset FGR, treatment with pravastatin 40 mg daily was associated with significant improvement in the angiogenic profile. Additionally, median pregnancy duration and median birthweight increased and the incidence of PE was reduced in treated women. Nevertheless, since this pilot study was underpowered, none of these differences were statistically significant. KEY POINTS · Pravastatin improves sFlt-1/PlGF in FGR.. · Pregnancy duration tended to be greater in treated women.. · Birthweight tended to be greater in treated women..
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Affiliation(s)
- Manel Mendoza
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raquel Ferrer-Oliveras
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlota Rodo
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Department of Obstetrics, Maternal Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaume Alijotas-Reig
- Department of Medicine, Systemic Autoimmune Diseases Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Eid R, Mounzer C, Mendoza M, Middleton J, Barnes B, McGowan E. A079 DETERMINANTS OF ESOPHAGEAL EOSINOPHILIA AND EOSINOPHILIC ESOPHAGITIS IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.418] [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: 11/16/2022]
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Alzamil H, Wu T, van Wijngaarden E, Mendoza M, Malmstrom H, Fiscella K, Kopycka-Kedzierawski D, Billings R, Xiao J. Removable Denture Wearing as a Risk Predictor for Pneumonia Incidence and Time to Event in Older Adults. JDR Clin Trans Res 2021; 8:23800844211049406. [PMID: 34693793 PMCID: PMC9772962 DOI: 10.1177/23800844211049406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Older adults are more susceptible to a common respiratory infection: pneumonia. Nearly 1 million older adults per year are hospitalized for community-acquired pneumonia in the United States. OBJECTIVE To examine whether wearing removable dentures are associated with an increased risk of pneumonia incidence in a geriatric population. METHODS We conducted a retrospective cohort study among patients >65 y of age within a large academic health system (University of Rochester Medical Center). The medical and dental electronic records from 2010 to 2018 were reviewed and used for data collection. The exposure was removable denture wearing. The main outcome variables were the incidence of pneumonia and time to event of pneumonia. A Cox proportional hazards regression was used to examine the association between pneumonia onset and wearing removable dentures, adjusting for demographics, socioeconomic status, and medical and dental conditions. RESULTS A total of 2,364 patients were included, with 1,189 (50.29%) in the denture-wearing group and 1,175 (49.70%) in the non-denture wearing group. The annual pneumonia incidence rate per 100,000 persons was 1,191 in the denture-wearing group and 128 per 100,000 persons in the non-denture wearing group, with a crude incidence rate ratio of 9.33 (95% CI, 5.41 to 18.81; P < 0.0001). The mean ± SD age of the pneumonia onset was 78.0 ± 10.0 and 78.6 ± 9.0 y among denture-wearing and nonwearing groups (P = 0.84). The time to event of pneumonia was associated with removable denture wearing (yes/no; hazard ratio, 7.68 [95% CI, 3.91 to 15.08]; P < 0.001) after adjusting for covariates. CONCLUSIONS Wearing removable dentures was found to be a risk predictor for pneumonia incidence among the geriatric population even after accounting for other risk factors. KNOWLEDGE TRANSFER STATEMENT Wearing removable dentures was found to be a risk predictor of pneumonia incidence among older adults. Although the current study does not imply a causal relationship between denture wearing and pneumonia, clinicians and older patients could reference the study results when choosing dental prostheses to restore missing teeth.
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Affiliation(s)
- H. Alzamil
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - T.T. Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - E. van Wijngaarden
- Department of Public Health, University of Rochester Medical Center, Rochester, NY, USA
| | - M. Mendoza
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health, Monroe County, Rochester, NY, USA
| | - H. Malmstrom
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - K. Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | | | - R.J. Billings
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - J. Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
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Acharya UA, Aidala C, Akiba Y, Alfred M, Andrieux V, Apadula N, Asano H, Azmoun B, Babintsev V, Bandara NS, Barish KN, Bathe S, Bazilevsky A, Beaumier M, Belmont R, Berdnikov A, Berdnikov Y, Bichon L, Blankenship B, Blau DS, Bok JS, Brooks ML, Bryslawskyj J, Bumazhnov V, Campbell S, Canoa Roman V, Cervantes R, Chi CY, Chiu M, Choi IJ, Choi JB, Citron Z, Connors M, Corliss R, Corrales Morales Y, Cronin N, Csanád M, Csörgő T, Danley TW, Daugherity MS, David G, DeBlasio K, Dehmelt K, Denisov A, Deshpande A, Desmond EJ, Dion A, Dixit D, Do JH, Drees A, Drees KA, Durham JM, Durum A, Enokizono A, En'yo H, Esha R, Esumi S, Fadem B, Fan W, Feege N, Fields DE, Finger M, Finger M, Fitzgerald D, Fokin SL, Frantz JE, Franz A, Frawley AD, Fukuda Y, Gal C, Gallus P, Garg P, Ge H, Giles M, Giordano F, Goto Y, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guragain H, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hamilton HF, Han SY, Hanks J, Harvey M, Hasegawa S, Haseler TOS, He X, Hemmick TK, Hill JC, Hill K, Hodges A, Hollis RS, Homma K, Hong B, Hoshino T, Hotvedt N, Huang J, Huang S, Imai K, Inaba M, Iordanova A, Isenhower D, Ivanishchev D, Jacak BV, Jezghani M, Ji Z, Jiang X, Johnson BM, Jouan D, Jumper DS, Kang JH, Kapukchyan D, Karthas S, Kawall D, Kazantsev AV, Khachatryan V, Khanzadeev A, Khatiwada A, Kim C, Kim EJ, Kim M, Kincses D, Kingan A, Kistenev E, Klatsky J, Kline P, Koblesky T, Kotov D, Kudo S, Kurgyis B, Kurita K, Kwon Y, Lajoie JG, Larionova D, Lebedev A, Lee S, Lee SH, Leitch MJ, Leung YH, Lewis NA, Li X, Lim SH, Liu MX, Loggins VR, Lökös S, Loomis DA, Lovasz K, Lynch D, Majoros T, Makdisi YI, Makek M, Manko VI, Mannel E, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Mendoza M, Mignerey AC, Milov A, Mishra DK, Mitchell JT, Mitrankov I, Mitrankova M, Mitsuka G, Miyasaka S, Mizuno S, Mondal MM, Montuenga P, Moon T, Morrison DP, Mulilo B, Murakami T, Murata J, Nagai K, Nagashima K, Nagashima T, Nagle JL, Nagy MI, Nakagawa I, Nakano K, Nattrass C, Nelson S, Niida T, Nouicer R, Novák T, Novitzky N, Nukazuka G, Nyanin AS, O'Brien E, Ogilvie CA, Orjuela Koop JD, Osborn JD, Oskarsson A, Ottino GJ, Ozawa K, Pantuev V, Papavassiliou V, Park JS, Park S, Pate SF, Patel M, Peng W, Perepelitsa DV, Perera GDN, Peressounko DY, PerezLara CE, Perry J, Petti R, Phipps M, Pinkenburg C, Pisani RP, Potekhin M, Pun A, Purschke ML, Radzevich PV, Ramasubramanian N, Read KF, Reynolds D, Riabov V, Riabov Y, Richford D, Rinn T, Rolnick SD, Rosati M, Rowan Z, Runchey J, Safonov AS, Sakaguchi T, Sako H, Samsonov V, Sarsour M, Sato S, Schaefer B, Schmoll BK, Sedgwick K, Seidl R, Sen A, Seto R, Sexton A, Sharma D, Sharma D, Shein I, Shibata TA, Shigaki K, Shimomura M, Shioya T, Shukla P, Sickles A, Silva CL, Silvermyr D, Singh BK, Singh CP, Singh V, Slunečka M, Smith KL, Snowball M, Soltz RA, Sondheim WE, Sorensen SP, Sourikova IV, Stankus PW, Stoll SP, Sugitate T, Sukhanov A, Sumita T, Sun J, Sun Z, Sziklai J, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Tarnai G, Tieulent R, Timilsina A, Todoroki T, Tomášek M, Towell CL, Towell RS, Tserruya I, Ueda Y, Ujvari B, van Hecke HW, Velkovska J, Virius M, Vrba V, Vukman N, Wang XR, Watanabe YS, Wong CP, Woody CL, Xu C, Xu Q, Xue L, Yalcin S, Yamaguchi YL, Yamamoto H, Yanovich A, Yoo JH, Yoon I, Yu H, Yushmanov IE, Zajc WA, Zelenski A, Zharko S, Zou L. Probing Gluon Spin-Momentum Correlations in Transversely Polarized Protons through Midrapidity Isolated Direct Photons in p^{↑}+p Collisions at sqrt[s]=200 GeV. Phys Rev Lett 2021; 127:162001. [PMID: 34723614 DOI: 10.1103/physrevlett.127.162001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/26/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
Studying spin-momentum correlations in hadronic collisions offers a glimpse into a three-dimensional picture of proton structure. The transverse single-spin asymmetry for midrapidity isolated direct photons in p^{↑}+p collisions at sqrt[s]=200 GeV is measured with the PHENIX detector at the Relativistic Heavy Ion Collider (RHIC). Because direct photons in particular are produced from the hard scattering and do not interact via the strong force, this measurement is a clean probe of initial-state spin-momentum correlations inside the proton and is in particular sensitive to gluon interference effects within the proton. This is the first time direct photons have been used as a probe of spin-momentum correlations at RHIC. The uncertainties on the results are a 50-fold improvement with respect to those of the one prior measurement for the same observable, from the Fermilab E704 experiment. These results constrain gluon spin-momentum correlations in transversely polarized protons.
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Affiliation(s)
- U A Acharya
- Georgia State University, Atlanta, Georgia 30303, USA
| | - C Aidala
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - Y Akiba
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Alfred
- Department of Physics and Astronomy, Howard University, Washington, D.C. 20059, USA
| | - V Andrieux
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - N Apadula
- Iowa State University, Ames, Iowa 50011, USA
| | - H Asano
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - B Azmoun
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Babintsev
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - N S Bandara
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - K N Barish
- University of California-Riverside, Riverside, California 92521, USA
| | - S Bathe
- Baruch College, City University of New York, New York, New York 10010, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Bazilevsky
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Beaumier
- University of California-Riverside, Riverside, California 92521, USA
| | - R Belmont
- University of Colorado, Boulder, Colorado 80309, USA
- Physics and Astronomy Department, University of North Carolina at Greensboro, Greensboro, North Carolina 27412, USA
| | - A Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - Y Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - L Bichon
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - B Blankenship
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D S Blau
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
| | - J S Bok
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - M L Brooks
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Bryslawskyj
- Baruch College, City University of New York, New York, New York 10010, USA
- University of California-Riverside, Riverside, California 92521, USA
| | - V Bumazhnov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - S Campbell
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - V Canoa Roman
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - R Cervantes
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C Y Chi
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - M Chiu
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - I J Choi
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J B Choi
- Jeonbuk National University, Jeonju 54896, Korea
| | - Z Citron
- Weizmann Institute, Rehovot 76100, Israel
| | - M Connors
- Georgia State University, Atlanta, Georgia 30303, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Corliss
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - N Cronin
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Csanád
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Csörgő
- Eszterházy Károly University, Károly Róbert Campus, H-3200 Gyöngyös, Mátrai út 36, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - T W Danley
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | | | - G David
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K DeBlasio
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - K Dehmelt
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Denisov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - A Deshpande
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E J Desmond
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Dion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Dixit
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J H Do
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - A Drees
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K A Drees
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J M Durham
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Durum
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - A Enokizono
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - H En'yo
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - R Esha
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S Esumi
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - B Fadem
- Muhlenberg College, Allentown, Pennsylvania 18104-5586, USA
| | - W Fan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - N Feege
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D E Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M Finger
- Charles University, Ovocný trh 5, Praha 1, 116 36 Prague, Czech Republic
| | - M Finger
- Charles University, Ovocný trh 5, Praha 1, 116 36 Prague, Czech Republic
| | - D Fitzgerald
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S L Fokin
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - J E Frantz
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - A Franz
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A D Frawley
- Florida State University, Tallahassee, Florida 32306, USA
| | - Y Fukuda
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - C Gal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Gallus
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - P Garg
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - H Ge
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Giles
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - F Giordano
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - Y Goto
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Grau
- Department of Physics, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - S V Greene
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | | | - T Gunji
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Guragain
- Georgia State University, Atlanta, Georgia 30303, USA
| | - T Hachiya
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J S Haggerty
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K I Hahn
- Ewha Womans University, Seoul 120-750, Korea
| | - H Hamagaki
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H F Hamilton
- Abilene Christian University, Abilene, Texas 79699, USA
| | - S Y Han
- Ewha Womans University, Seoul 120-750, Korea
- Korea University, Seoul 02841, Korea
| | - J Hanks
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Harvey
- Texas Southern University, Houston, Texas 77004, USA
| | - S Hasegawa
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - T O S Haseler
- Georgia State University, Atlanta, Georgia 30303, USA
| | - X He
- Georgia State University, Atlanta, Georgia 30303, USA
| | - T K Hemmick
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J C Hill
- Iowa State University, Ames, Iowa 50011, USA
| | - K Hill
- University of Colorado, Boulder, Colorado 80309, USA
| | - A Hodges
- Georgia State University, Atlanta, Georgia 30303, USA
| | - R S Hollis
- University of California-Riverside, Riverside, California 92521, USA
| | - K Homma
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Hong
- Korea University, Seoul 02841, Korea
| | - T Hoshino
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - N Hotvedt
- Iowa State University, Ames, Iowa 50011, USA
| | - J Huang
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Huang
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - M Inaba
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Iordanova
- University of California-Riverside, Riverside, California 92521, USA
| | - D Isenhower
- Abilene Christian University, Abilene, Texas 79699, USA
| | - D Ivanishchev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - B V Jacak
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Jezghani
- Georgia State University, Atlanta, Georgia 30303, USA
| | - Z Ji
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - X Jiang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - B M Johnson
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Georgia State University, Atlanta, Georgia 30303, USA
| | - D Jouan
- IPN-Orsay, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, BP1, F-91406 Orsay, France
| | - D S Jumper
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J H Kang
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - D Kapukchyan
- University of California-Riverside, Riverside, California 92521, USA
| | - S Karthas
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - A V Kazantsev
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - V Khachatryan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Khanzadeev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - A Khatiwada
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C Kim
- University of California-Riverside, Riverside, California 92521, USA
- Korea University, Seoul 02841, Korea
| | - E-J Kim
- Jeonbuk National University, Jeonju 54896, Korea
| | - M Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - D Kincses
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - A Kingan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E Kistenev
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J Klatsky
- Florida State University, Tallahassee, Florida 32306, USA
| | - P Kline
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T Koblesky
- University of Colorado, Boulder, Colorado 80309, USA
| | - D Kotov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - S Kudo
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - B Kurgyis
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - K Kurita
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - Y Kwon
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J G Lajoie
- Iowa State University, Ames, Iowa 50011, USA
| | - D Larionova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - A Lebedev
- Iowa State University, Ames, Iowa 50011, USA
| | - S Lee
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - S H Lee
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M J Leitch
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y H Leung
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - N A Lewis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - X Li
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S H Lim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
- Pusan National University, Pusan 46241, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M X Liu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - V-R Loggins
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - S Lökös
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - D A Loomis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - K Lovasz
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - D Lynch
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Majoros
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - Y I Makdisi
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Makek
- Department of Physics, Faculty of Science, University of Zagreb, Bijenička c. 32 HR-10002 Zagreb, Croatia
| | - V I Manko
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - E Mannel
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M McCumber
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P L McGaughey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D McGlinchey
- University of Colorado, Boulder, Colorado 80309, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C McKinney
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - M Mendoza
- University of California-Riverside, Riverside, California 92521, USA
| | - A C Mignerey
- University of Maryland, College Park, Maryland 20742, USA
| | - A Milov
- Weizmann Institute, Rehovot 76100, Israel
| | - D K Mishra
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - J T Mitchell
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Iu Mitrankov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - M Mitrankova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - G Mitsuka
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Miyasaka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - S Mizuno
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M M Mondal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Montuenga
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - T Moon
- Korea University, Seoul 02841, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - D P Morrison
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - B Mulilo
- Korea University, Seoul 02841, Korea
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Murakami
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Murata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - K Nagai
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - K Nagashima
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - T Nagashima
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - J L Nagle
- University of Colorado, Boulder, Colorado 80309, USA
| | - M I Nagy
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - I Nakagawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K Nakano
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - C Nattrass
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Nelson
- Florida A&M University, Tallahassee, Florida 32307, USA
| | - T Niida
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Nouicer
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Novák
- Eszterházy Károly University, Károly Róbert Campus, H-3200 Gyöngyös, Mátrai út 36, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - N Novitzky
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - G Nukazuka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A S Nyanin
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - E O'Brien
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C A Ogilvie
- Iowa State University, Ames, Iowa 50011, USA
| | | | - J D Osborn
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Oskarsson
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - G J Ottino
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - K Ozawa
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - V Pantuev
- Institute for Nuclear Research of the Russian Academy of Sciences, prospekt 60-letiya Oktyabrya 7a, Moscow 117312, Russia
| | - V Papavassiliou
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J S Park
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - S Park
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S F Pate
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - M Patel
- Iowa State University, Ames, Iowa 50011, USA
| | - W Peng
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D V Perepelitsa
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Colorado, Boulder, Colorado 80309, USA
| | - G D N Perera
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - D Yu Peressounko
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - C E PerezLara
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J Perry
- Iowa State University, Ames, Iowa 50011, USA
| | - R Petti
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Phipps
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C Pinkenburg
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R P Pisani
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Potekhin
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Pun
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - M L Purschke
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P V Radzevich
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - N Ramasubramanian
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K F Read
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - D Reynolds
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - V Riabov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - Y Riabov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - D Richford
- Baruch College, City University of New York, New York, New York 10010, USA
| | - T Rinn
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- Iowa State University, Ames, Iowa 50011, USA
| | - S D Rolnick
- University of California-Riverside, Riverside, California 92521, USA
| | - M Rosati
- Iowa State University, Ames, Iowa 50011, USA
| | - Z Rowan
- Baruch College, City University of New York, New York, New York 10010, USA
| | - J Runchey
- Iowa State University, Ames, Iowa 50011, USA
| | - A S Safonov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - T Sakaguchi
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Sako
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - V Samsonov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - M Sarsour
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Sato
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - B Schaefer
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - B K Schmoll
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K Sedgwick
- University of California-Riverside, Riverside, California 92521, USA
| | - R Seidl
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Sen
- Iowa State University, Ames, Iowa 50011, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - R Seto
- University of California-Riverside, Riverside, California 92521, USA
| | - A Sexton
- University of Maryland, College Park, Maryland 20742, USA
| | - D Sharma
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Sharma
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - I Shein
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - T-A Shibata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - K Shigaki
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - M Shimomura
- Iowa State University, Ames, Iowa 50011, USA
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - T Shioya
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - P Shukla
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sickles
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C L Silva
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Silvermyr
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - B K Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - C P Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - V Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - M Slunečka
- Charles University, Ovocný trh 5, Praha 1, 116 36 Prague, Czech Republic
| | - K L Smith
- Florida State University, Tallahassee, Florida 32306, USA
| | - M Snowball
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R A Soltz
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W E Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S P Sorensen
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - I V Sourikova
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P W Stankus
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S P Stoll
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sugitate
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - A Sukhanov
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sumita
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Sun
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Z Sun
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J Sziklai
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - M J Tannenbaum
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Tarafdar
- Vanderbilt University, Nashville, Tennessee 37235, USA
- Weizmann Institute, Rehovot 76100, Israel
| | - A Taranenko
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
| | - G Tarnai
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - R Tieulent
- Georgia State University, Atlanta, Georgia 30303, USA
- IPNL, CNRS/IN2P3, Univ Lyon, Universit Lyon 1, F-69622 Villeurbanne, France
| | - A Timilsina
- Iowa State University, Ames, Iowa 50011, USA
| | - T Todoroki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M Tomášek
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - C L Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R S Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - I Tserruya
- Weizmann Institute, Rehovot 76100, Israel
| | - Y Ueda
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Ujvari
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - H W van Hecke
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Velkovska
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - M Virius
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - V Vrba
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
- Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, 182 21 Prague 8, Czech Republic
| | - N Vukman
- Department of Physics, Faculty of Science, University of Zagreb, Bijenička c. 32 HR-10002 Zagreb, Croatia
| | - X R Wang
- New Mexico State University, Las Cruces, New Mexico 88003, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y S Watanabe
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - C P Wong
- Georgia State University, Atlanta, Georgia 30303, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C L Woody
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C Xu
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - Q Xu
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - L Xue
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Yalcin
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y L Yamaguchi
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - H Yamamoto
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Yanovich
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - J H Yoo
- Korea University, Seoul 02841, Korea
| | - I Yoon
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - H Yu
- New Mexico State University, Las Cruces, New Mexico 88003, USA
- Peking University, Beijing 100871, People's Republic of China
| | - I E Yushmanov
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - W A Zajc
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - A Zelenski
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Zharko
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - L Zou
- University of California-Riverside, Riverside, California 92521, USA
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Eleizalde MC, Gómez-Piñeres E, Ramírez-Iglesias JR, Mendoza M. Evaluation of five primer sets for molecular detection of Trypanosoma vivax by polymerase chain reaction (PCR) and their implementation for diagnosis in naturally infected ruminants from Venezuela. Vet Parasitol Reg Stud Reports 2021; 25:100594. [PMID: 34474787 DOI: 10.1016/j.vprsr.2021.100594] [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] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 03/28/2021] [Accepted: 05/23/2021] [Indexed: 11/16/2022]
Abstract
Trypanosoma vivax is a protozoan parasite that causes trypanosomosis in ruminants and is widely distributed in tropical areas in the world. The control of this disease depends on the sensitivity and specificity of the diagnostic tests implemented for naturally infected samples, where parasitaemias are usually low. This study aimed to evaluate the analytical sensitivity and specificity of several primers for T. vivax detection in experimental infections and their implementation for the diagnosis of trypanosomosis in naturally infected bovine and ovine samples. Using a T. vivax Venezuelan isolate, five sets of primers were evaluated: TviSL1/2, ITS1CF/BR, TVMF/R, ILO1264/1265, TVWA/B. Additionally, we tested the PCR protocols using different DNA quantities. The best set of primers (ILO1264/1265) was used to detect T. vivax DNA from whole blood and buffy coat samples of 12 sheep (ovine) and 45 cattle (bovine) of small farms from Venezuela, and compared to the micro-haematocrite centrifugation technique (MHCT). The highest sensitivity was 0.0001 ng for ILO1264/1265 and TVWA/B primers. Using 100 ng of DNA extracted from the buffy coat and the ILO1264/1265 primers for trypanosomosis diagnosis from naturally infected samples, yielded 66.7% (8/12) and 35.7% (16/45) positives in ovine and bovine respectively. The percentage of positives samples increased to 83.3% (10/12) and 64.4% (29/45), with 300 ng in the assays. Contrary, using 300 ng of DNA extracted from the whole blood yielded only 50% (6/12) and 28.9% (13/45) of positives samples for T. vivax respectively. MHCT only detected the parasite in bovine samples with 17.8% (8/45) of positives. Based on our results, we recommend the use of the ILO1264/1265 primers and 300 ng of DNA extracted from the buffy coat for epidemiological studies of naturally infected animals. Moreover, detection of the parasite in ovine herds highlights a possible role of this host in the epidemiology of trypanosomosis in Venezuela.
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Affiliation(s)
- M C Eleizalde
- Centro de Estudios Biomédicos y Veterinarios (CEBIV), Instituto de Estudios Científicos y Tecnológicos (IDECYT), Universidad Nacional Experimental Simón Rodríguez, Apartado Postal 47925, Caracas, Venezuela
| | - E Gómez-Piñeres
- Núcleo Monagas, Escuela de Zootecnia, Departamento de Biología y Sanidad Animal, Universidad de Oriente, Maturín, Venezuela
| | - J R Ramírez-Iglesias
- Group for Neglected-Emerging Diseases, Eco-Epidemiology and Biodiversity, Health Sciences Faculty, Universidad Internacional SEK, Quito, Ecuador
| | - M Mendoza
- Centro de Estudios Biomédicos y Veterinarios (CEBIV), Instituto de Estudios Científicos y Tecnológicos (IDECYT), Universidad Nacional Experimental Simón Rodríguez, Apartado Postal 47925, Caracas, Venezuela.
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Otero A, Mendoza M, Carreras R, Fernández B. Biogas production from slaughterhouse waste: Effect of blood content and fat saponification. Waste Manag 2021; 133:119-126. [PMID: 34391987 DOI: 10.1016/j.wasman.2021.07.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/02/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
The effect of fat saponification and the inclusion or exclusion of blood in slaughterhouse mixtures were assessed in terms of anaerobic digestion performance. Mixtures of animal by-products (ABP) were collected for 1 year, whereby following the daily activity and waste generation at a slaughterhouse facility, seasonal fluctuations were found. The blood content of ABP mixtures was variable, affecting both the methane yield and the production rate (287.8-320.5 NLCH4 kgCOD-1 and 80.3-94.7 and NLCH4 kgCOD-1 d-1, respectively). The saponification of fatty ABP materials was studied to assess the methane production rate, singularly or combined, with and without the addition of blood. Data showed that saponification significantly reduced the lag phase, from 2.2 to 1.5 days in winter mixtures and from 1.5 to 0.9 days in summer mixtures (all with blood), and from 0.3 to 0.1 days in summer mixtures without blood. Finally, the percentage of energy demand at the slaughterhouse potentially covered by net biogas energy was estimated, finding that the facility could be 100% energy self-sufficient in winter, whereas this would be reduced to 85% in the summer due to different methane yields of ABP mixtures based on season.
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Affiliation(s)
- A Otero
- IRTA, Sustainability in Biosystems Program. Torre Marimon, 08140, Caldes de Montbui, Barcelona, Spain; Enginyeria i Ciències Aplicades, Universitat de Barcelona, Carrer de Martí i Franquès, 1-11, 08028 Barcelona, Spain; Mafrica S.A., Paratge Can Canals Nou, S/N, 08250 Sant Joan de Vilatorrada, Spain.
| | - M Mendoza
- IRTA, Sustainability in Biosystems Program. Torre Marimon, 08140, Caldes de Montbui, Barcelona, Spain; Enginyeria i Ciències Aplicades, Universitat de Barcelona, Carrer de Martí i Franquès, 1-11, 08028 Barcelona, Spain
| | - R Carreras
- Mafrica S.A., Paratge Can Canals Nou, S/N, 08250 Sant Joan de Vilatorrada, Spain
| | - B Fernández
- IRTA, Sustainability in Biosystems Program. Torre Marimon, 08140, Caldes de Montbui, Barcelona, Spain
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Ferrer-Oliveras R, Mendoza M, Capote S, Pratcorona L, Esteve-Valverde E, Cabero-Roura L, Alijotas-Reig J. Immunological and physiopathological approach of COVID-19 in pregnancy. Arch Gynecol Obstet 2021; 304:39-57. [PMID: 33945026 PMCID: PMC8093597 DOI: 10.1007/s00404-021-06061-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/31/2021] [Indexed: 12/18/2022]
Abstract
Coronavirus disease-2019 (COVID-19) related to Coronavirus-2 (SARS-CoV-2) is a worldwide health concern. Despite the majority of patients will evolve asymptomatic or mild-moderate upper respiratory tract infections, 20% will develop severe disease. Based on current pathogenetic knowledge, a severe COVID-19 form is mainly a hyperinflammatory, immune-mediated disorder, triggered by a viral infection. Due to their particular immunological features, pregnant women are supposed to be particularly susceptible to complicate by intracellular infections as well as immunological disturbances. As an example, immune-thrombosis has been identified as a common immune-mediated and pathogenic phenomenon both in COVID-19, in obstetric diseases and in COVID-19 pregnant women. According to extensive published clinical data, is rationale to expect an interference with the normal development of pregnancy in selected SARS-CoV-2-infected cases, mainly during third trimester.This manuscript provides insights of research to elucidate the potential harmful responses to SARS-CoV-2 and /or other coronavirus infections, as well as bidirectional interactions between COVID-19 and pregnancy to improve their respective management.
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Affiliation(s)
- Raquel Ferrer-Oliveras
- Department of Obstetrics and Gynaecology, Hospital Universitari Quironsalud Barcelona, Barcelona, Catalonia, Spain.
| | - Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Sira Capote
- Department of Obstetrics and Gynaecology, Hospital Universitari Quironsalud Barcelona, Barcelona, Catalonia, Spain
| | - Laia Pratcorona
- Department of Obstetrics, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Enrique Esteve-Valverde
- Department of Internal Medicine, Althaia Network Health. Manresa, Barcelona, Spain
- Universitat Central de Catalunya, Barcelona, Catalonia, Spain
| | - Lluis Cabero-Roura
- Department of Obstetrics and Gynaecology, Hospital Universitari Quironsalud Barcelona, Barcelona, Catalonia, Spain
- Prof. Emeritus of Obsterics and Gynaecology, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Jaume Alijotas-Reig
- Systemic Autoimmune Diseases Unit. Department of Internal Medicine-1, Vall d' Hebron University Hospital, Barcelona, Spain.
- Systemic Autoimmune Research Unit, Vall d'Hebron Reseacrh Institute, Barcelona, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Coit J, Wong M, Galea JT, Mendoza M, Marin H, Tovar M, Chiang SS, Lecca L, Franke MF. Uncovering reasons for treatment initiation delays among children with TB in Lima, Peru. Int J Tuberc Lung Dis 2021; 24:1254-1260. [PMID: 33317668 DOI: 10.5588/ijtld.20.0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND: Timely diagnosis and treatment of pediatric tuberculosis (TB) is critical to reducing mortality but remains challenging in the absence of adequate diagnostic tools. Even once a TB diagnosis is made, delays in treatment initiation are common, but for reasons that are not well understood.METHODS: To examine reasons for delay post-diagnosis, we conducted semi-structured interviews with Ministry of Health (MoH) physicians and field workers affiliated with a pediatric TB diagnostic study, and caregivers of children aged 0-14 years who were diagnosed with pulmonary TB in Lima, Peru. Interviews were analyzed using systematic comparative and descriptive content analysis.RESULTS: We interviewed five physicians, five field workers and 26 caregivers with children who initiated TB treatment < 7 days after diagnosis (n = 15) or who experienced a delay of ≥7 days (n = 11). Median time in delay from diagnosis to treatment initiation was 26 days (range 7-117). Reasons for delay included: health systems challenges (administrative hurdles, medication stock, clinic hours), burden of care on families and caregiver perceptions of disease severity.CONCLUSION: Reasons for delay in treatment initiation are complex. Interventions to streamline administrative processes and tools to identify and support families at risk for delays in treatment initiation are urgently needed.
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Affiliation(s)
- J Coit
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - M Wong
- Socios En Salud Sucursal, Lima, Peru
| | - J T Galea
- School of Social Work, University of South Florida, Tampa, FL, College of Public Health, University of South Florida, Tampa, FL
| | - M Mendoza
- Socios En Salud Sucursal, Lima, Peru
| | - H Marin
- Socios En Salud Sucursal, Lima, Peru
| | - M Tovar
- Socios En Salud Sucursal, Lima, Peru
| | - S S Chiang
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, Center for International Health Research, Rhode Island Hospital, Providence, RI, USA
| | - L Lecca
- Socios En Salud Sucursal, Lima, Peru
| | - M F Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Mendoza M, Serrano B, Bonacina E, Capote S, Garcia-Manau P, Regincós L, Murcia MT, Barberan L, Míguez M, Carreras E. Diagnostic accuracy of the Gaussian first-trimester combined screening for pre-eclampsia to predict small-for-gestational-age neonates. Int J Gynaecol Obstet 2021; 156:322-330. [PMID: 33724448 DOI: 10.1002/ijgo.13673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Pre-eclampsia and delivery of small-for-gestational-age (SGA) neonates can be predicted from the first trimester. A Gaussian model for prediction of PE has recently been described, although its capacity to predict SGA is still unknown. METHODS This was a secondary analysis of a prospective cohort study conducted at Vall d'Hebron University Hospital (Barcelona) in 2483 single pregnancies from October 2015 to September 2017. Mean arterial blood pressure and mean uterine artery pulsatility index were recorded at the first-trimester scan. Serum concentrations of placental growth factor and pregnancy-associated plasma protein-A were assessed between 8+0 and 13+6 weeks. The predictive capacities of early (<32 weeks) and preterm (<37 weeks) SGA were tested. RESULTS For SGA without pre-eclampsia, detection rates of 25.0% (95% confidence interval [CI] 0-75.0) for early SGA and 14.3% (95% CI 3.6-28.6) for preterm SGA were achieved. For SGA with pre-eclampsia, the algorithm showed detection rates of 100.0% (95% CI 25.0-100.0) for early SGA and 56.3% (95% CI 31.3-81.3) for preterm SGA. CONCLUSION This algorithm identifies 62.5% of early SGA and 27.3% of preterm SGA. Combined screening for predicting both pre-eclampsia and SGA by using the Gaussian algorithm is feasible and would simplify clinical practice.
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Affiliation(s)
- Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Berta Serrano
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sira Capote
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laia Regincós
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Teresa Murcia
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lidia Barberan
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Míguez
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Greenberg DC, Kamara D, Tatsugawa Z, Mendoza M, Pineda E, Holschneider CH, Zakhour M. The role of the genetic testing industry in patient education of hereditary cancer: An observational study assessing the quality of patient education videos. Gynecol Oncol 2021; 161:516-520. [PMID: 33618842 DOI: 10.1016/j.ygyno.2021.02.013] [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] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/07/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Genetic testing (GT) companies have developed patient education videos to supplement or replace pre-test genetic counseling (GC) by certified genetic counselors (CGC). The aim of this study was to assess the quality of these videos compared to the standard of care (SOC). METHODS Videos from four major GT companies were selected from an internet search identifying pre-test patient education videos. A scoring rubric with 22 questions and 36 total points was devised to assess quality metrics, as described by the National Cancer Institute and National Society of Genetic Counselors. Twenty-two individuals with varying genetics expertise (3 gynecologic oncologists, 3 academic generalists, 4 CGC, a genetics community health worker, 3 cancer care navigators, and 8 medical students) scored each video. Scorers were blinded to others' assessments. RESULTS Invitae had the highest median score (26/36), followed by Myriad (22/36), Ambry (17.5/36), and Color (15/36). All videos scored highly in explaining DNA basics, cancer development, and hereditary cancer predisposition. All addressed benefits of GT but failed to address potential disadvantages. All scored poorly in explaining medical terms and different GT options. There was variability in addressing patient concerns including cost, privacy, and procedure. CONCLUSIONS There is significant variation in the content of pre-test patient education videos between GT companies. None of the videos met the SOC for pre-test GC, and none addressed disadvantages of GT, possibly due to a conflict of interest. With improvement in content, accessibility, and use of interactive platforms, these videos may serve as an adjunct to in-person pre-test GC.
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Affiliation(s)
- D C Greenberg
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; UC Irvine Department of Obstetrics and Gynecology, Orange, CA, USA
| | - D Kamara
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; UCLA Department of Obstetrics and Gynecology, Los Angeles, CA, USA
| | - Z Tatsugawa
- Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - M Mendoza
- Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - E Pineda
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - C H Holschneider
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; UCLA Department of Obstetrics and Gynecology, Los Angeles, CA, USA; Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - M Zakhour
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA; UCLA Department of Obstetrics and Gynecology, Los Angeles, CA, USA; Olive View-UCLA Medical Center, Sylmar, CA, USA.
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Mendoza M, Garcia‐Manau P, Arévalo S, Avilés M, Serrano B, Sánchez‐Durán MÁ, Garcia‐Ruiz I, Bonacina E, Carreras E. Diagnostic accuracy of first-trimester combined screening for early-onset and preterm pre-eclampsia at 8-10 compared with 11-13 weeks' gestation. Ultrasound Obstet Gynecol 2021; 57:84-90. [PMID: 32388877 PMCID: PMC7839448 DOI: 10.1002/uog.22071] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/07/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To compare the ability of first-trimester combined screening for pre-eclampsia (PE) to predict early-onset and preterm PE when pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PlGF) were assessed before vs after 11 weeks' gestation. METHODS This was a secondary analysis of a prospective cohort study of singleton pregnancies undergoing routine first-trimester screening conducted at Vall d'Hebron University Hospital, Barcelona, Spain, between October 2015 and September 2017. Demographic characteristics, obstetric history, maternal history and biophysical markers (mean uterine artery pulsatility index and mean arterial blood pressure (MAP)) were recorded at the first-trimester scan (at 11 + 0 to 13 + 6 weeks' gestation). Maternal serum concentrations of PAPP-A and PlGF were assessed from the routine first-trimester blood test (at 8 + 0 to 13 + 6 weeks). Women were classified into two groups depending on whether serum biomarkers were assessed at 8 + 0 to 10 + 6 weeks or at 11 + 0 to 13 + 6 weeks. Probability scores for early-onset and preterm PE were calculated by using two different algorithms: the multivariate Gaussian-distribution model and The Fetal Medicine Foundation (FMF) competing-risks model. Receiver-operating-characteristics (ROC) curves were produced and detection rates at fixed 5% and 10% false-positive rates were computed to compare the performance of these algorithms when PAPP-A and PlGF were assessed before vs after 11 weeks. RESULTS Of the 2641 women included, serum biomarkers were assessed before 11 weeks in 1675 (63.4%) and at or after 11 weeks in 966 (36.6%). Of these, 90 (3.4%) women developed PE, including 11 (0.4%) cases of early-onset PE and 30 (1.1%) of preterm PE. Five (45.5%) cases of early-onset and 16 (53.3%) of preterm PE were identified in the group in which serum biomarkers were assessed at 8 + 0 to 10 + 6 weeks and six (54.5%) cases of early-onset and 14 (46.7%) of preterm PE in the group in which serum biomarkers were assessed at 11 + 0 to 13 + 6 weeks. In the prediction of early-onset and preterm PE using the Gaussian algorithm, no differences were observed between the areas under the ROC curves (AUCs) when PAPP-A and PlGF were measured before or after 11 weeks. In the prediction of early-onset and preterm PE using the FMF algorithm, no differences were observed between AUCs for any of the combinations used for risk calculation when the serum biomarkers were obtained before vs after 11 weeks, except for the combination of PAPP-A and MAP, which showed a greater AUC for the prediction of early-onset PE when PAPP-A was measured at or after 11 weeks. CONCLUSIONS The prediction of early-onset and preterm PE is similar when serum biomarkers are measured before or after 11 weeks. This allows the use of a two-step approach for PE risk assessment that permits immediate risk calculation at the time of the first-trimester scan. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M. Mendoza
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - P. Garcia‐Manau
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - S. Arévalo
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - M. Avilés
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - B. Serrano
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - M. á. Sánchez‐Durán
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - I. Garcia‐Ruiz
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - E. Bonacina
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - E. Carreras
- Maternal Fetal Medicine Unit, Department of ObstetricsHospital Universitari Vall d'Hebron, Universitat Autònoma de BarcelonaBarcelonaSpain
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Garrido-Gimenez C, Mendoza M, Cruz-Lemini M, Galian-Gay L, Sanchez-Garcia O, Granato C, Rodriguez-Sureda V, Rodriguez-Palomares J, Carreras-Moratonas E, Cabero-Roura L, Llurba E, Alijotas-Reig J. Angiogenic Factors and Long-Term Cardiovascular Risk in Women That Developed Preeclampsia During Pregnancy. Hypertension 2020; 76:1808-1816. [PMID: 33012203 DOI: 10.1161/hypertensionaha.120.15830] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Preeclampsia is caused by placental impairment with increased expression of sFlt-1 (soluble fms-like tyrosine kinase 1) and decreased PlGF (placental growth factor); it has been associated with cardiovascular morbidity and mortality later in life, but the underlying mechanism remains unknown. The aim of this study was to determine whether sFlt-1 and PlGF levels during preeclampsia are associated to long-term cardiovascular risk. We prospectively recruited 43 women with previous preeclampsia and 21 controls with uncomplicated pregnancies. Cardiovascular risk assessment ≈12 years later included maternal hemodynamic, cardiac function and structure, biomarker analysis, and carotid-intima thickness evaluation. Women with previous preeclampsia had higher prevalence of hypertensive disorders and dyslipidemia than controls. In addition, they had worse global longitudinal strain, thicker left ventricular septal and posterior walls, more myocardial mass and increased carotid intima-media thickness compared with controls. PlGF during pregnancy correlated positively with high-density lipoprotein (r=0.341; P=0.006), and negatively with global longitudinal strain (r=-0.581; P<0.001), carotid intima-media thickness (r=-0.251; P=0.045), and mean arterial blood pressure (r=-0.252; P=0.045), when adjusted by study group. sFlt correlated negatively with high-density lipoprotein (r=-0.372; P=0.002) and apolipoprotein A-1 (r=-0.257; P=0.040), and positively with carotid intima-media thickness (r=0.269; P=0.032) and left ventricular posterior wall thickness (r=0.368; P=0.003). The antiangiogenic state present in preeclampsia is related to greater prevalence of cardiovascular risk factors ≈12 years after delivery. The knowledge of altered angiogenic factors may help detect women with a higher risk for premature cardiovascular disease, who will require earlier follow-up after delivery.
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Affiliation(s)
- Carmen Garrido-Gimenez
- From the Maternal-Fetal Medicine Unit, Sant Pau University Hospital (C.G.-G., M.C.-L., E.L.), Universitat Autònoma de Barcelona, Spain.,Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Spain (C.G.-G., O.S.-G., E.L.).,Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.)
| | - Manel Mendoza
- Maternal-Fetal Medicine Unit Vall d'Hebron University Hospital (M.M., E.C.-M.), Universitat Autònoma de Barcelona, Spain
| | - Monica Cruz-Lemini
- From the Maternal-Fetal Medicine Unit, Sant Pau University Hospital (C.G.-G., M.C.-L., E.L.), Universitat Autònoma de Barcelona, Spain.,Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.)
| | - Laura Galian-Gay
- Cardiology Department (L.G.-G., C.G., J.R.-P.) Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain.,Centro de Investigación Biomédica en Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Spain (L.G.-G., J.R.-P.)
| | - Olga Sanchez-Garcia
- Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Spain (C.G.-G., O.S.-G., E.L.).,Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.)
| | - Chiara Granato
- Cardiology Department (L.G.-G., C.G., J.R.-P.) Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain
| | - Victor Rodriguez-Sureda
- Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.).,Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Spain (V.R.-S.).,Biochemistry and Molecular Biology Research Centre for Nanomedicine, Vall d'Hebron University Hospital, Barcelona, Spain (V.R.-S.)
| | - Jose Rodriguez-Palomares
- Cardiology Department (L.G.-G., C.G., J.R.-P.) Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain.,Centro de Investigación Biomédica en Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Spain (L.G.-G., J.R.-P.)
| | - Elena Carreras-Moratonas
- Maternal-Fetal Medicine Unit Vall d'Hebron University Hospital (M.M., E.C.-M.), Universitat Autònoma de Barcelona, Spain
| | - Lluis Cabero-Roura
- Chairman Obstetrics and Gynecology, Universitat Autònoma de Barcelona, Department of Obstetrics and Gynecology, Quironsalud Hospital Barcelona (L.C.-R.)
| | - Elisa Llurba
- From the Maternal-Fetal Medicine Unit, Sant Pau University Hospital (C.G.-G., M.C.-L., E.L.), Universitat Autònoma de Barcelona, Spain.,Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Spain (C.G.-G., O.S.-G., E.L.).,Women and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain (C.G.-G., M.C.-L., O.S.-G., V.R.-S., E.L.)
| | - Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Internal Medicine Department, and Vall d'Hebron Research Institute (J.A.-R.), Universitat Autònoma de Barcelona, Spain
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Mendoza M, Garcia-Ruiz I, Carreras E, Suy A. Authors' reply re: Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. BJOG 2020; 128:618. [PMID: 33225590 PMCID: PMC7753544 DOI: 10.1111/1471-0528.16583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 01/31/2023]
Affiliation(s)
- M Mendoza
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - I Garcia-Ruiz
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - E Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - A Suy
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
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Mendoza M, Hurtado I, Bonacina E, Garcia-Manau P, Serrano B, Tur H, Rodo C, Maiz N, Carreras E. Individual risk assessment for prenatal counseling in early-onset growth-restricted and small-for-gestational-age fetuses. Acta Obstet Gynecol Scand 2020; 100:504-512. [PMID: 33098097 DOI: 10.1111/aogs.14032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/01/2020] [Accepted: 10/16/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Early-onset fetal growth restriction and small-for-gestational age of fetuses lead to an increased risk of adverse pregnancy outcomes. Doppler abnormalities can predict the occurrence of complications in the short term, but normal fetal Doppler values at the time of diagnosis do not exclude their occurrence in the long term. The objective of this study was to investigate the capacity of a predictive model to assess individual risks for prenatal counseling at the time of diagnosis. MATERIAL AND METHODS This was a prospective observational study of singleton pregnancies with estimated fetal weight below the 10th centile between 20+0 and 31+6 weeks of gestational age. Placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) levels, estimated fetal weight centile, uterine artery pulsatility index, fetal Doppler and maternal risk factors for placental disease were assessed at the time of enrollment. The occurrence of adverse perinatal outcomes or the need for elective delivery at <30, <34 or <37 weeks was considered an adverse pregnancy outcomes. Univariable logistic regression analysis was used to examine the association between each predictive variable and the adverse outcomes. A multivariable logistic regression-based model was constructed with the combination of all variables. An additional model without sFlt-1/PlGF was also created. Both models, and the sFlt-1/PlGF alone, were used to develop the different formulas to assess individual risks. Receiver operating characteristic curves were constructed to assess and compare their performance of screening. RESULTS Forty-nine small-for-gestational-age fetuses and 124 with fetal growth restriction were enrolled at a median gestational age of 23.6 weeks. Elective delivery was needed in 77 (44.5%) women at <37 weeks, 53 (30.6%) women at <34 weeks and 30 (17.3%) at <30 weeks. Adverse perinatal outcomes occurred in 81 (55.9%) pregnancies. When areas under the curve were compared among models, no statistically significant differences were observed between the model with sFlt-1/PlGF and sFlt-1/PlGF alone; however, the model without sFlt-1/PlGF yielded an overall poorer performance. CONCLUSIONS Individual risk assessment can be made at the time of early-onset fetal growth restriction/small-for-gestational-age diagnosis, which permits accurate counseling of parents with an affected fetus. Two formulas could be used: one combining maternal characteristics and ultrasound findings and the other with a single sFlt-1/PlGF measurement.
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Affiliation(s)
- Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ivan Hurtado
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Berta Serrano
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Helena Tur
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlota Rodo
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nerea Maiz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Mendoza M, Garcia‐Ruiz I, Maiz N, Rodo C, Garcia‐Manau P, Serrano B, Lopez‐Martinez RM, Balcells J, Fernandez‐Hidalgo N, Carreras E, Suy A. Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. BJOG 2020; 127:1374-1380. [PMID: 32479682 PMCID: PMC7300912 DOI: 10.1111/1471-0528.16339] [Citation(s) in RCA: 199] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate the incidence of clinical, ultrasonographic and biochemical findings related to pre-eclampsia (PE) in pregnancies with COVID-19, and to assess their accuracy to differentiate between PE and the PE-like features associated with COVID-19. DESIGN A prospective, observational study. SETTING Tertiary referral hospital. PARTICIPANTS Singleton pregnancies with COVID-19 at >20+0 weeks. METHODS Forty-two consecutive pregnancies were recruited and classified into two groups: severe and non-severe COVID-19, according to the occurrence of severe pneumonia. Uterine artery pulsatility index (UtAPI) and angiogenic factors (soluble fms-like tyrosine kinase-1/placental growth factor [sFlt-1/PlGF]) were assessed in women with suspected PE. MAIN OUTCOME MEASURES Incidence of signs and symptoms related to PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, abnormal UtAPI and increased sFlt-1/PlGF. RESULTS Thirty-four cases were classified as non-severe and 8 as severe COVID-19. Five (11.9%) women presented signs and symptoms of PE, all five being among the severe COVID-19 cases (62.5%). However, abnormal sFlt-1/PlGF and UtAPI could only be demonstrated in one case. One case remained pregnant after recovery from severe pneumonia and had a spontaneous resolution of the PE-like syndrome. CONCLUSIONS Pregnant women with severe COVID-19 can develop a PE-like syndrome that might be distinguished from actual PE by sFlt-1/PlGF, LDH and UtAPI assessment. Healthcare providers should be aware of its existence and monitor pregnancies with suspected pre-eclampsia with caution. TWEETABLE ABSTRACT This study shows that a pre-eclampsia-like syndrome could be present in some pregnancies with severe COVID-19.
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Affiliation(s)
- M Mendoza
- Maternal‐Fetal Medicine UnitDepartment of ObstetricsHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - I Garcia‐Ruiz
- Maternal‐Fetal Medicine UnitDepartment of ObstetricsHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - N Maiz
- Maternal‐Fetal Medicine UnitDepartment of ObstetricsHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - C Rodo
- Maternal‐Fetal Medicine UnitDepartment of ObstetricsHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - P Garcia‐Manau
- Maternal‐Fetal Medicine UnitDepartment of ObstetricsHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - B Serrano
- Maternal‐Fetal Medicine UnitDepartment of ObstetricsHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - RM Lopez‐Martinez
- Biochemistry DepartmentHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - J Balcells
- Paediatric Critical Care DepartmentHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - N Fernandez‐Hidalgo
- Department of Infectous DiseasesHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
- Red Española de Investigación en Patología Infecciosa (REIPI)Instituto de Salud Carlos IIIMadridSpain
| | - E Carreras
- Maternal‐Fetal Medicine UnitDepartment of ObstetricsHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - A Suy
- Maternal‐Fetal Medicine UnitDepartment of ObstetricsHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
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Garcia-Manau P, Mendoza M, Bonacina E, Garrido-Gimenez C, Fernandez-Oliva A, Zanini J, Catalan M, Tur H, Serrano B, Carreras E. Soluble fms-like tyrosine kinase to placental growth factor ratio in different stages of early-onset fetal growth restriction and small for gestational age. Acta Obstet Gynecol Scand 2020; 100:119-128. [PMID: 32860218 DOI: 10.1111/aogs.13978] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/31/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Increased soluble fms-like tyrosine kinase to placental growth factor ratio (sFlt-1/PlGF) has been demonstrated in early-onset fetal growth restriction (FGR) and small for gestational age (SGA). sFlt-1/PlGF cut-offs have been described to assess preeclampsia severity; however, sFlt-1/PlGF values present in early-onset SGA and different FGR severity stages remain unknown. Hence, the objective of this study was to describe and compare the sFlt-1/PlGF values and pregnancy outcomes among early-onset SGA/FGR stages. MATERIAL AND METHODS This is a prospective case-control study conducted at Vall d'Hebron University Hospital. Singleton pregnancies with estimated fetal weight <10th centile and a control group of uncomplicated pregnancies between 20+0 and 31+6 weeks of gestation were enrolled. Study women were classified at diagnosis into different stages, according to estimated fetal weight centile and Doppler ultrasound. sFlt-1/PlGF serum concentrations were measured at diagnosis and, together with pregnancy outcomes, were compared among FGR severity stages, SGA, and controls. Finally, correlations between sFlt-1/PlGF values and time to delivery, gestational age at delivery, days of neonatal admission, and birthweight z-scores were investigated. RESULTS Among the 207 women enrolled, 32 (15.4%) had uncomplicated pregnancies, 49 (23.7%) pregnancies showed SGA, and 126 (60.9%) involved FGR (92 being stage I, 17 stage II, and 17 stage III). SGA and controls had similar median sFlt-1/PlGF values (25.7 vs 27.1, P > .05) and pregnancy outcomes. However, all FGR stages had significantly poorer outcomes and greater sFlt-1/PlGF values than those of SGA and controls. Furthermore, median values differed significantly among all FGR severity stages (9.76 for stage I; 284.3 for stage II, and 625.02 for stage III, P < .05) increasing with FGR severity as well as the frequency of adverse pregnancy outcomes. Additionally, a significant correlation was found between greater sFlt-1/PlGF ratio values and gestational age at delivery, time from diagnosis to delivery, birthweight z-scores, and time in neonatal intensive care unit (r = -.637, r = -.576, r = -.161, and r = .311, respectively). CONCLUSIONS Values of sFlt-1/PlGF at diagnosis permit early-onset FGR/SGA severity classification with good correlation with Doppler ultrasound findings and the occurrence of adverse outcomes. Thus, sFlt-1/PlGF could aid in early-onset FGR/SGA severity classification and clinical management when Doppler assessment is not feasible.
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Affiliation(s)
- Pablo Garcia-Manau
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Mendoza
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Erika Bonacina
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carmen Garrido-Gimenez
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Fernandez-Oliva
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julia Zanini
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marina Catalan
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Helena Tur
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Berta Serrano
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Valld'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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