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Linder A, Ullrich S, Linder N, Gößmann H, Denecke T, Ebel S. Interventionelle Bergung eines abgerissenen und durch ein
persistierendes Foramen ovale in beide Vorhöfe migrierten
Portkatheters. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1756576] [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] [Indexed: 11/05/2022]
Affiliation(s)
- A Linder
- Universitätsklinikum Leipzig, Klinik u. Poliklinik für
Diagnostische u. Interv. Radiologie, Leipzig
| | - S Ullrich
- Klinik und Poliklinik für Diagnostische und Interventionelle
Radiologie, Universitätsklinikum Leipzig, Leipzig
| | - N Linder
- Klinik und Poliklinik für Diagnostische und Interventionelle
Radiologie, Universitätsklinikum Leipzig, Leipzig
| | - H Gößmann
- Klinik und Poliklinik für Diagnostische und Interventionelle
Radiologie, Universitätsklinikum Leipzig, Leipzig
| | - T Denecke
- Klinik und Poliklinik für Diagnostische und Interventionelle
Radiologie, Universitätsklinikum Leipzig, Leipzig
| | - S Ebel
- Klinik und Poliklinik für Diagnostische und Interventionelle
Radiologie, Universitätsklinikum Leipzig, Leipzig
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Hacker UT, Hasenclever D, Baber R, Linder N, Busse H, Obermannova R, Zdrazilova-Dubska L, Valik D, Lordick F. Modified Glasgow prognostic score (mGPS) is correlated with sarcopenia and dominates the prognostic role of baseline body composition parameters in advanced gastric and esophagogastric junction cancer patients undergoing first-line treatment from the phase III EXPAND trial. Ann Oncol 2022; 33:685-692. [PMID: 35395383 DOI: 10.1016/j.annonc.2022.03.274] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [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: 12/06/2021] [Revised: 03/26/2022] [Accepted: 03/31/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Sarcopenia represents an established adverse prognostic factor in cancer patients. Consequently, different means to counteract sarcopenia have been proposed to improve cancer treatment. Computed tomography (CT) based measurements, also labor intensive, are well validated for the analysis of sarcopenia. As inflammation plays a key role in the development of sarcopenia, we here studied the role of the modified Glasgow prognostic score (mGPS), consisting of inflammation parameters plasma C-reactive protein and albumin, to predicting sarcopenia and adipose tissue related body composition (BC) parameters at baseline and their changes during treatment and to analyze its prognostic role in conjunction with BC parameters. PATIENTS AND METHODS CT measurements of body composition parameters were performed at baseline and week 12 in patients with advanced gastric or esophago-gastric junction (EGJ) cancer from the phase III EXPAND trial, undergoing first-line platinum-fluoropyrimidine chemotherapy. mGPS was calculated from baseline CRP and albumin plasma levels. Pearson correlation and Cox regression analyses were performed. RESULTS mGPS is strongly prognostic for overall survival (OS). Baseline mGPS is significantly correlated with baseline mean muscle attenuation (MA), P<0.0001. Baseline mGPS did not predict a decline in muscle or adipose tissue parameters during 12 weeks of treatment and a decline in muscle or adipose tissue parameters was not prognostic for OS. MA lost its prognostic role for OS when mGPS or CRP was entered into the COX models. ECOG performance status together with CRP or mGPS remained as sole baseline prognostic factors for OS. CONCLUSIONS Our findings support a model where tumor-mediated inflammatory response represents a strong prognostic factor, which is causally related to sarcopenia, but with no direct causal path from sarcopenia to survival. Therefore, therapeutic targeting of systemic inflammation should be further explored as a promising strategy to improve both sarcopenia and the efficacy and tolerability of cancer treatment.
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Affiliation(s)
- U T Hacker
- Department of Medicine II, University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany.
| | - D Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Medical Faculty of the University Leipzig, Leipzig, Germany
| | - R Baber
- Leipzig Medical Biobank, University Leipzig, Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - N Linder
- Department of Radiology, University Medicine Leipzig, Leipzig, Germany
| | - H Busse
- Department of Radiology, University Medicine Leipzig, Leipzig, Germany
| | - R Obermannova
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk, University, Brno, Czech Republic; Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - L Zdrazilova-Dubska
- Department of Laboratory Medicine and Department of Laboratory Methods, Faculty of Medicine and University Hospital Brno, Masaryk University, Czech Republic; Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - D Valik
- Department of Laboratory Medicine and Department of Laboratory Methods, Faculty of Medicine and University Hospital Brno, Masaryk University, Czech Republic; Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - F Lordick
- Department of Medicine II, University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany
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Linder N, Shapiro S, Moser A, Roitman J, Engelhard D. Treatment of Neonatal Immune Thrombocytopenia with
High Dose Intravenous γ-Globulin. ACTA ACUST UNITED AC 2019. [DOI: 10.1159/000480899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Linder N, Rakete T, Stange R, Solty K, Kahn T, Busse H. In-vitro
validation of MR-based fat quantification at 1.5 T. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aae646] [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: 11/11/2022]
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Schaudinn A, Linder N, Hudak A, Stange R, Garnov N, Stocker G, Hacker U, Kahn T, Busse H. Semi-automatische Software zur zeiteffizienten CT-basierten Quantifizierung des abdominellen Fettgewebes. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600184] [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] [Indexed: 10/19/2022]
Affiliation(s)
- A Schaudinn
- Universitätsklinikum Leipzig, Klinik für Diagnostische und Interventionelle Radiologie, Leipzig
| | - N Linder
- Universitätsklinikum Leipzig, Klinik für Diagnostische und Interventionelle Radiologie, Leipzig
| | - A Hudak
- Universitätsklinikum Leipzig, Klinik für Diagnostische und Interventionelle Radiologie, Leipzig
| | - R Stange
- Universitätsklinikum Leipzig, Klinik für Diagnostische und Interventionelle Radiologie, Leipzig
| | - N Garnov
- Universitätsklinikum Leipzig, Klinik für Diagnostische und Interventionelle Radiologie, Leipzig
| | - G Stocker
- Universitätsklinikum Leipzig, Universitäts Krebszentrum Leipzig, Leipzig
| | - U Hacker
- Universitätsklinikum Leipzig, Universitäts Krebszentrum Leipzig, Leipzig
| | - T Kahn
- Universitätsklinikum Leipzig, Klinik für Diagnostische und Interventionelle Radiologie, Leipzig
| | - H Busse
- Universitätsklinikum Leipzig, Klinik für Diagnostische und Interventionelle Radiologie, Leipzig
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Brück O, Blom S, Turkki R, Kovanen P, Ribeiro A, Linder N, Lundin J, Kallioniemi O, Pellinen T, Mustjoki S. Immune cell profiling in CML bone marrow by multiplex IHC. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw525.43] [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: 11/13/2022] Open
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Schaudinn A, Linder N, Garnov N, Blüher M, Schütz T, Karlas T, Dietrich A, Kahn T, Busse H. Hochrechnung des viszeralen Fettvolumens auf der Basis weniger MRT-Einzelbilder: Abhängigkeit von Geschlecht, Alter und Adipositas-Grad. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581324] [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: 10/22/2022]
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Garnov N, Linder N, Schaudinn A, Dietrich A, Lehmann S, Retschlag U, Oberbach A, Kahn T, Busse H. Einfluss einer bariatrischen OP auf das Fettgewebe: Follow-up-Charakterisierung mittels MRT. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581323] [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: 10/22/2022]
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Otto J, Schaudinn A, Linder N, Ganzer R, Stolzenburg J, Horn L, Garnov N, Kahn T, Moche M, Busse H. MR-gesteuerte Interventionen an der Prostata. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581876] [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: 10/22/2022]
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Schaudinn A, Linder N, Garnov N, Blüher M, Dietrich A, Schütz T, Karlas T, Kahn T, Busse H. Effiziente MRT-gestützte Quantifizierung des viszeralen Fettgewebes bei adipösen Patienten. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550906] [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: 10/23/2022]
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Otto J, Schaudinn A, Linder N, Garnov N, Stolzenburg J, Moche M, Kahn T, Busse H. Prostatakarzinom: Radiologische Intervention. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551446] [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: 10/23/2022]
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Vassilev L, Ranki T, Joensuu T, Jäger E, Karbach J, Wahle C, Partanen K, Kairemo K, Alanko T, Turkki R, Linder N, Lundin J, Ristimäki A, Kankainen M, Hemminki A, Backman C, Dienel K, von Euler M, Haavisto E, Hakonen T, Juhila J, Jäderberg M, Priha P, Vuolanto A, Pesonen S. Repeated intratumoral administration of ONCOS-102 leads to systemic antitumor CD8 + T-cell response and robust cellular and transcriptional immune activation at tumor site in a patient with ovarian cancer. Oncoimmunology 2015; 4:e1017702. [PMID: 26140248 PMCID: PMC4485730 DOI: 10.1080/2162402x.2015.1017702] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [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: 12/19/2014] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 12/04/2022] Open
Abstract
Adenoviruses are excellent immunotherapeutic agents with a unique ability to prime and boost immune responses. Recombinant adenoviruses cause immunogenic cancer cell death and subsequent release of tumor antigens for antigen presenting cells, resulting in the priming of potent tumor-specific immunity. This effect may be further enhanced by immune-stimulating transgenes expressed by the virus. We report a case of a 38-year-old female with Stage 3 metastatic micropapillary serous carcinoma of the ovary. She was treated in a Phase I study with a granulocyte-macrophage colony stimulating factor (GMCSF)-expressing oncolytic adenovirus, Ad5/3-D24-GMCSF (ONCOS-102). The treatment resulted in progressive infiltration of CD8+ lymphocytes into the tumor and concomitant systemic induction of several tumor-specific CD8+ T-cell populations. The patient was alive at the latest follow up more than 20 months after initiation of the study.
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Affiliation(s)
| | - T Ranki
- Oncos Therapeutics ; Helsinki, Finland
| | - T Joensuu
- Docrates Cancer Center ; Helsinki, Finland
| | - E Jäger
- Hämatologie-Onkologie; Krankenhaus Nordwest ; Frankfurt, Germany
| | - J Karbach
- Hämatologie-Onkologie; Krankenhaus Nordwest ; Frankfurt, Germany
| | - C Wahle
- Hämatologie-Onkologie; Krankenhaus Nordwest ; Frankfurt, Germany
| | - K Partanen
- Docrates Cancer Center ; Helsinki, Finland
| | - K Kairemo
- Docrates Cancer Center ; Helsinki, Finland
| | - T Alanko
- Docrates Cancer Center ; Helsinki, Finland
| | - R Turkki
- Institute for Molecular Medicine Finland (FIMM) ; Helsinki, Finland
| | - N Linder
- Institute for Molecular Medicine Finland (FIMM) ; Helsinki, Finland
| | - J Lundin
- Institute for Molecular Medicine Finland (FIMM) ; Helsinki, Finland
| | - A Ristimäki
- Division of Pathology; HUSLAB and Haartman Institute; Helsinki University Central Hospital ; Helsinki, Finland ; Genome-Scale Biology; Research Programs Unit; University of Helsinki ; Helsinki, Finland
| | - M Kankainen
- Institute for Molecular Medicine Finland (FIMM) ; Helsinki, Finland
| | - A Hemminki
- University of Helsinki and Helsinki University Central Hospital; Cancer Gene Therapy Group ; Helsinki, Finland
| | - C Backman
- Oncos Therapeutics ; Helsinki, Finland
| | - K Dienel
- Oncos Therapeutics ; Helsinki, Finland
| | | | | | - T Hakonen
- Oncos Therapeutics ; Helsinki, Finland
| | - J Juhila
- Oncos Therapeutics ; Helsinki, Finland
| | | | - P Priha
- Oncos Therapeutics ; Helsinki, Finland
| | | | - S Pesonen
- Oncos Therapeutics ; Helsinki, Finland
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Linder N, Lahat Y, Kogan A, Fridman E, Kouadio F, Melamed N, Yogev Y, Klinger G. Macrosomic newborns of non-diabetic mothers: anthropometric measurements and neonatal complications. Arch Dis Child Fetal Neonatal Ed 2014; 99:F353-8. [PMID: 24792775 DOI: 10.1136/archdischild-2013-305032] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess the association of anthropometric measurements with neonatal complications in macrosomic newborns of non-diabetic mothers. DESIGN Retrospective cohort study. PATIENTS All liveborn, singleton, full term newborns with birth weight ≥4000 g born to non-diabetic mothers at a tertiary medical centre in 1995-2005 (n=2766, study group) were matched to the next born, healthy, full term infant with a birth weight of 3000-4000 g (control group). Exclusion criteria were multiple birth, congenital infection, major malformations and pregnancy complications. INTERVENTION Data collection by file review. OUTCOME MEASURES Complication rates were compared between study and control groups and between symmetric and asymmetric macrosomic newborns, defined by weight/length ratio (WLR), Body Mass Index and Ponderal Index. RESULTS The 2766 non-diabetic macrosomic infants identified were matched to 2766 control infants. The macrosomic group had higher rates of hypoglycaemia (1.2% vs 0.5%, p=0.008), transient tachypnoea of the newborn (1.5% vs 0.5%, p<0.001), hyperthermia (0.6% vs 0.1%, p=0.012), and birth trauma (2% vs 0.7%, p<0.001), with no cases of symptomatic polycythaemia, and only one case of hypoglycaemia. Hypoglycaemia was positively associated with birth weight. It was significantly higher in the asymmetric than the symmetric macrosomic newborns, defined by WLR (1.7% vs 0.3%, p<0.001). CONCLUSIONS Macrosomic infants of non-diabetic mothers are at increased risk of neonatal complications. However, routine measurements of haematocrit and calcium may not be necessary. Symmetric macrosomic infants (by WLR) have a similar rate of hypoglycaemia as normal-weight infants. Thus, repeat glucose measurements in symmetric macrosomic infants are not justified.
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Affiliation(s)
- N Linder
- Department of Neonatology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Lahat
- Department of Neonatology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - A Kogan
- Department of Neonatology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - E Fridman
- Department of Neonatology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - F Kouadio
- Department of Neonatology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - N Melamed
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Departments of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - Y Yogev
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Departments of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - G Klinger
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Neonatal Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
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Linder N, Tauscher A, Borte G. [Sacculation of the uterus - a rare but ominous complication in pregnancy]. ROFO-FORTSCHR RONTG 2014; 187:57-8. [PMID: 25171503 DOI: 10.1055/s-0034-1366598] [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: 10/24/2022]
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Linder N, Hiersch L, Fridman E, Lubin D, Kouadio F, Berkowicz N, Merlob P, Melamed N. The effect of gestational age on neonatal outcome in low-risk singleton term deliveries. J Matern Fetal Neonatal Med 2014; 28:297-302. [DOI: 10.3109/14767058.2014.916266] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Linder N. Quantitative Analyse des Leberfettgehalts mittels MR-Techniken. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373546] [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: 10/25/2022]
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Garnov N, Schaudinn A, Linder N, Kahn T, Busse H. Experimentelle Untersuchungen zur Genauigkeit einer automatisierten, MR-basierten Fettvolumetrie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373565] [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: 10/25/2022]
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Otto J, Thörmer G, Garnov N, Hoang Do M, Stolzenburg JU, Linder N, Schaudinn A, Kahn T, Moche M, Busse H. Transrektale Prostatabiopsien in einem konventionellen 3-T MRT – erste klinische Erfahrungen mit einer Navigationsoption. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373464] [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: 10/25/2022]
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Skog M, Bono P, Lundin M, Lundin J, Louhimo J, Linder N, Petrova TV, Andersson LC, Joensuu H, Alitalo K, Haglund CH. Expression and prognostic value of transcription factor PROX1 in colorectal cancer. Br J Cancer 2011; 105:1346-51. [PMID: 21970873 PMCID: PMC3241535 DOI: 10.1038/bjc.2011.297] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background: PROX1 is a specific target of the β-catenin/TCF pathway in the intestinal epithelium. It acts as a regulator of progression from a benign to a highly dysplastic phenotype in colorectal tumours. However, the clinical significance of PROX1 expression is not known. Methods: We studied the prognostic value of immunohistochemical expression of PROX1 in a series of 517 patients with colorectal cancer (CRC). Results: The majority of the tumour samples expressed PROX1 (91%, 471 out of 517). High PROX1 expression was associated with a poor grade of tumour differentiation (P<0.0001). In the subgroup of patients with colon cancer, high PROX1 expression was associated with unfavourable colorectal cancer-specific survival (CCSS) as compared with low PROX1 expression (CCSS 47% vs 62% P=0.045; RR 1.47). The association between high PROX1 and poor outcome was further strengthened in female colon cancer patients (CCSS 38% vs 63% P=0.007; RR 2.02). Nonetheless, in multivariate survival analysis PROX1 expression was not retained as an independent prognostic factor. Conclusion: High PROX1 expression is associated with a poor grade of tumour differentiation, and, in colon cancer patients, also with less favourable patient outcome. Our results strengthen the previous preclinical observations that PROX1 has a role in tumour progression in CRC.
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Affiliation(s)
- M Skog
- Department of Oncology, Helsinki University Central Hospital, Helsinki FIN-00029 HUS, Finland
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Klinger G, Frankenthal D, Merlob P, Diamond G, Sirota L, Levinson-Castiel R, Linder N, Stahl B, Inbar D. Long-term outcome following selective serotonin reuptake inhibitor induced neonatal abstinence syndrome. J Perinatol 2011; 31:615-20. [PMID: 21311497 DOI: 10.1038/jp.2010.211] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [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: 11/09/2022]
Abstract
OBJECTIVE To assess the long-term neurodevelopment of children exposed in utero to selective serotonin reuptake inhibitors (SSRIs) that developed a neonatal abstinence syndrome (NAS). STUDY DESIGN Neurodevelopmental evaluation was performed at the age of 2 to 6 years. Children who developed NAS were compared with those who did not using univariate and logistic regression analyses. RESULT Thirty children with NAS and 52 without NAS participated in the study. Both groups were similar in mean cognitive ability (106.9±14.0 vs 100.5±14.6, P=0.12) and developmental scores (98.9±11.4 vs 95.7±9.9, P=0.21). However, there was a trend towards small head circumference in the NAS group (20 vs 6%, P=0.068). NAS was associated with an increased risk of social-behavior abnormalities (odds ratio (OR) 3.03, 95% confidence interval (CI) 1.07 to 8.60, P=0.04) and advanced maternal age (OR 1.12, 95% CI 1.00 to 1.25, P=0.04). CONCLUSION Infants who developed NAS had normal cognitive ability, but were at an increased risk for social-behavioral abnormalities. Follow-up evaluation of symptomatic neonates should be considered.
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Affiliation(s)
- G Klinger
- Neonatal Intensive Care Unit, Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel.
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Bergbauer W, Strassburg M, Kölper C, Linder N, Roder C, Lähnemann J, Trampert A, Fündling S, Li SF, Wehmann HH, Waag A. Continuous-flux MOVPE growth of position-controlled N-face GaN nanorods and embedded InGaN quantum wells. Nanotechnology 2010; 21:305201. [PMID: 20603534 DOI: 10.1088/0957-4484/21/30/305201] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We demonstrate the fabrication of N-face GaN nanorods by metal organic vapour phase epitaxy (MOVPE), using continuous-flux conditions. This is in contrast to other approaches reported so far, which have been based on growth modes far off the conventional growth regimes. For position control of nanorods an SiO(2) masking layer with a dense hole pattern on a c-plane sapphire substrate was used. Nanorods with InGaN/GaN heterostructures have been grown catalyst-free. High growth rates up to 25 microm h(-1) were observed and a well-adjusted carrier gas mixture between hydrogen and nitrogen enabled homogeneous nanorod diameters down to 220 nm with aspect ratios of approximately 8:1. The structural quality and defect progression within nanorods were determined by transmission electron microscopy (TEM). Different emission energies for InGaN quantum wells (QWs) could be assigned to different side facets by room temperature cathodoluminescence (CL) measurements.
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Affiliation(s)
- W Bergbauer
- Osram Opto Semiconductors GmbH, Regensburg, Germany.
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Abstract
BACKGROUND Measurements at the end of puberty of neonates short for gestational age (SGA-L) are scant. OBJECTIVE To determine the correlation between birth length and weight in neonates, with height and weight at age 17 years. SUBJECTS AND METHODS 385 full-term neonates, measuring less than 48 cm (SGA-L) and 585 full-term neonates, measuring 48 cm or greater (adequate birth length for gestational age; AGA-L) were included. 234 SGA-L and 359 AGA-L were identified at age 17 years. RESULTS Comparison of the two groups revealed that both sexes born SGA-L were also shorter at age 17 years than those born AGA-L (girls 158.9 cm (SD 7.6) vs 164.2 cm (SD 64) (p<0.001) and boys 167.3 cm (SD 8.7) vs 173.8 cm (SD 7.1) (p<0.001)). The subjects born SGA-L also weighed significantly less than those born AGA-L (p<0.001) both at birth and at age 17 years. CONCLUSIONS Children born SGA-L become short adults and weigh less at age 17 years than children with a normal birth length.
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Affiliation(s)
- A Farfel
- Endocrinology and Diabetes Research Unit, Schneider Children's Medical Center, Petah Tikva, Israel
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Pasenow B, Koch SW, Hader J, Moloney JV, Sabathil M, Linder N, Lutgen S. Auger losses in GaN-based quantum wells: Microscopic theory. ACTA ACUST UNITED AC 2009. [DOI: 10.1002/pssc.200880865] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
OBJECTIVE The neonatal mortality rate is disproportionately influenced by preterm infants and does not reflect the rate in full-term infants. Our objectives were to estimate the full-term neonatal mortality rate and to identify causes of death in full-term infants during the first month of life. STUDY DESIGN A retrospective study of full-term infant deaths during a 6-year period from 2000 to 2005, in a tertiary medical center. RESULT During the study period there were 44,703 full-term births and 31 deaths, representing a mortality rate of 0.69 per 1,000 live births. The main cause of death was congenital anomalies (64.5%), specifically cardiac anomalies. Other causes were chromosomal anomalies or syndromes (12.9%), labor complications (12.9%), infections (3.2%), congenital diseases (3.2%) and metabolic disorders (3.2%). CONCLUSION The mortality rate of full-term infants may be lower than previous estimates. Efforts aimed at decreasing mortality among full-term infants should focus on prenatal diagnosis.
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Affiliation(s)
- A Amir
- Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel
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26
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Linder N, Haglund C, Lundin M, Nordling S, Ristimäki A, Kokkola A, Mrena J, Wiksten JP, Lundin J. Decreased xanthine oxidoreductase is a predictor of poor prognosis in early-stage gastric cancer. J Clin Pathol 2006; 59:965-71. [PMID: 16935971 PMCID: PMC1860491 DOI: 10.1136/jcp.2005.032524] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Xanthine oxidoreductase (XOR) is a key enzyme in the degradation of DNA, RNA and high-energy phosphates. About half of the patients with breast cancer have a decrease in XOR expression. Patients with breast cancer with unfavourable prognosis are independently identified by the loss of XOR. AIM To assess the clinical relevance of XOR expression in gastric cancer. METHODS XOR levels were studied by immunohistochemistry in tissue microarray specimens of 337 patients with gastric cancer and the relation between XOR expression and a series of clinicopathological variables, as well as disease-specific survival, was assessed. RESULTS XOR was moderately decreased in 41% and was undetectable in another 14% of the tumours compared with the corresponding normal tissue. Decreased XOR was associated with advanced stage, deep tumour penetration, diffusely spread tumour location, positive lymph node status, large tumour size, non-curative disease, cellular aneuploidy, high S-phase fraction and high cyclooxygenase-2 expression, but not with p53 expression or Borrmann classification. Down regulation of XOR was associated with unfavourable outcome, and the cumulative 5-year gastric cancer-specific survival in patients with strong XOR expression was 47%, compared with 22% in those with moderate to negative expression (p<0.001). This was also true in patients with stage I-II (p = 0.01) and lymph node-negative (p = 0.02) disease, as well as in patients with smaller (< or =5 cm) tumours (p = 0.02). CONCLUSION XOR expression in gastric cancer may be a new marker for a more aggressive gastric cancer biology, similar to that previously reported for breast cancer.
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Affiliation(s)
- N Linder
- Developmental and Reproductive Biology and Hospital for Children and Adolescents, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland.
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27
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Punke M, Hoos F, Karnutsch C, Lemmer U, Linder N, Streubel K. High-repetition-rate white-light pump-probe spectroscopy with a tapered fiber. Opt Lett 2006; 31:1157-9. [PMID: 16625935 DOI: 10.1364/ol.31.001157] [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] [Indexed: 05/08/2023]
Abstract
We have realized a 76 MHz white-light differential transmission spectroscopy system. The technique employs a Ti:sapphire laser oscillator and a tapered fiber to generate a white-light continuum spanning almost the full visible to near-infrared spectral range. Using acousto-optical modulation and subsequent lock-in detection, transient relative transmission changes as small as 10(-5) are detected. The method is applied to study the ultrafast gain dynamics of the active layer of a vertical-external-cavity surface-emitting laser based on a multiple-quantum-well structure.
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Affiliation(s)
- M Punke
- Light Technology Institute and Center for Functional Nanostructures (CFN), Universität Karlsruhe (TH), Kaiserstrasse 12, D-76131 Karlsruhe, Germany.
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Linder N, Levit O, Klinger G, Kogan I, Levy I, Shalit I, Ashkenazi S, Sirota L. Risk factors associated with candidaemia in the neonatal intensive care unit: a case–control study. J Hosp Infect 2004; 57:321-4. [PMID: 15262393 DOI: 10.1016/j.jhin.2004.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2003] [Accepted: 04/15/2004] [Indexed: 10/26/2022]
Abstract
The incidence of candidaemia is steadily increasing in neonatal intensive care units (NICUs). Several neonatal risk factors for candidaemia have been identified, however, the number of cases in controlled studies is small and knowledge concerning maternal and perinatal risk factors is limited. The present study attempted to identify modifiable, independent maternal, perinatal and neonatal risk factors for candidaemia using a retrospective case-control study in the NICU of a tertiary-care paediatric medical centre. The study group consisted of 56 neonates admitted to the NICU between 1996 and 2000 who acquired candidaemia. The control group comprised the first infant admitted immediately after each study infant matched for gestational age (+/-10 days) and birthweight (+/-200 g). Potential maternal, perinatal and neonatal risk factors were compared between the groups using statistical methods and analysed by univariate and multivariate stepwise logistic regression models. The independent risk factors found to be significantly associated with increased risk of candidaemia were duration of ventilation and presence of bacteraemia before candidaemia. Maternal steroids had a significant protective effect. The positive predictive value using these three parameters was 78.38%. Maximizing in-utero steroid treatment in high-risk pregnancies, minimizing the days of mechanical ventilation and investment of efforts in prevention of bacteraemia may help to reduce the incidence of candidaemia in the NICU.
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Affiliation(s)
- N Linder
- Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva 49202, Israel.
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29
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Linder N, Prince S, Barzilai A, Keller N, Klinger G, Shalit I, Prince T, Sirota L. Disinfection with 10% povidone-iodine versus 0.5% chlorhexidine gluconate in 70% isopropanol in the neonatal intensive care unit. Acta Paediatr 2004. [PMID: 15046275 DOI: 10.1111/j.1651-2227.2004.tb00707.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM The finding that 10% povidone-iodine skin disinfectant may compromise thyroid function in premature infants prompted its replacement with 0.5% chlorhexidine gluconate solution in 70% isopropanol. The objective of this study was to compare the incidence rates of true infection and contamination associated with the use of these two disinfectants in the neonatal intensive care unit. METHODS The study population comprised two cohorts of infants admitted to our neonatal intensive care unit: 1) in 1992-1993 when only 10% povidone-iodine was used as a skin disinfectant, and 2) in 1995-1996 when only 0.5% chlorhexidine gluconate solution in 70% isopropanol was used. A retrospective chart review was conducted to determine whether all documented positive blood, CSF and suprapubic aspirate cultures indicated true infection or contamination. True infection was defined as clinical symptoms and/or laboratory abnormalities suggestive of sepsis, with positive blood, CSF or suprapubic aspirate cultures. RESULTS 1146 infants were admitted during the study periods, 507 during the first period and 639 during the second. In the early group, 17.6% of infants had major malformations, 72.0% were premature and 25.2% had weights of < 1500 g. Corresponding percentages for the latter group were 16.0%, 80.6% and 32.9%, respectively. No statistically significant differences were found between the two research periods in rate of infants with positive blood cultures, true infections, or contamination. CONCLUSION The use of 0.5% chlorhexidine gluconate solution in 70% isopropanol as a skin disinfectant is justified in neonatal intensive care units because it is not associated with an increased incidence of infections as opposed to 10% povidone-iodine and is devoid of detrimental effects.
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Affiliation(s)
- N Linder
- Department of Neonatology, Schneider Children's Medical Center of Israel, 14 Kaplan St., Petah Tiqwa 49202, Israel.
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30
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Linder N, Prince S, Barzilai A, Keller N, Klinger G, Shalit I, Prince T, Sirota L. Disinfection with 10% povidone-iodine versus 0.5% chlorhexidine gluconate in 70% isopropanol in the neonatal intensive care unit. Acta Paediatr 2004; 93:205-10. [PMID: 15046275 DOI: 10.1080/08035250310008159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
AIM The finding that 10% povidone-iodine skin disinfectant may compromise thyroid function in premature infants prompted its replacement with 0.5% chlorhexidine gluconate solution in 70% isopropanol. The objective of this study was to compare the incidence rates of true infection and contamination associated with the use of these two disinfectants in the neonatal intensive care unit. METHODS The study population comprised two cohorts of infants admitted to our neonatal intensive care unit: 1) in 1992-1993 when only 10% povidone-iodine was used as a skin disinfectant, and 2) in 1995-1996 when only 0.5% chlorhexidine gluconate solution in 70% isopropanol was used. A retrospective chart review was conducted to determine whether all documented positive blood, CSF and suprapubic aspirate cultures indicated true infection or contamination. True infection was defined as clinical symptoms and/or laboratory abnormalities suggestive of sepsis, with positive blood, CSF or suprapubic aspirate cultures. RESULTS 1146 infants were admitted during the study periods, 507 during the first period and 639 during the second. In the early group, 17.6% of infants had major malformations, 72.0% were premature and 25.2% had weights of < 1500 g. Corresponding percentages for the latter group were 16.0%, 80.6% and 32.9%, respectively. No statistically significant differences were found between the two research periods in rate of infants with positive blood cultures, true infections, or contamination. CONCLUSION The use of 0.5% chlorhexidine gluconate solution in 70% isopropanol as a skin disinfectant is justified in neonatal intensive care units because it is not associated with an increased incidence of infections as opposed to 10% povidone-iodine and is devoid of detrimental effects.
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Affiliation(s)
- N Linder
- Department of Neonatology, Schneider Children's Medical Center of Israel, 14 Kaplan St., Petah Tiqwa 49202, Israel.
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31
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Kopylov U, Sirota L, Linder N. [Retinopathy of prematurity--risk factors]. Harefuah 2002; 141:1066-9, 1089. [PMID: 12534206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Retinopathy of prematurity (ROP) was first described by Terry in 1942. ROP is considered a multifactorial disease. Low gestational age, low birth weight and oxygen therapy are recognized as risk factors for this condition. Other risk factors including multigestational pregnancy, white race, sepsis, NEC, BPD, intraventricular hemorrhage, lung maturation, steroid treatment, blood transfusions and light exposure were identified by multiple studies. We aim to review these studies in order to identify the independent risk factors for the development of ROP. The reviewed studies confirm that low birth weight, low gestational age, prolonged oxygen treatment and blood transfusions are statistically significant risk factors for the development of ROP. The incidence of all stages of ROP is similar for Caucasian and black infants, although the occurrence of threshold ROP was found higher in the Caucasian group. No relationship was demonstrated between light exposure and the development of ROP. The studies reviewed show decreased frequency and severity of ROP in neonates of mothers who had received antenatal steroid therapy. The findings concerning the influence of postnatal steroid treatment on the incidence of ROP are controversial.
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Affiliation(s)
- U Kopylov
- Schneider Childrens Medical Center, Sackler Faculty of Medicine, Tel Aviv
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Linder N, Vishne TH, Levin E, Handsher R, Fink-Kremer I, Waldman D, Levine A, Ashkenazi S, Sirota L. Hepatitis B vaccination: long-term follow-up of the immune response of preterm infants and comparison of two vaccination protocols. Infection 2002; 30:136-9. [PMID: 12120937 DOI: 10.1007/s15010-002-2068-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND We conducted a 3-year follow-up study of long-term antibody persistence following vaccination of low-risk preterm infants with recombinant hepatitis B vaccine (HBV). Two three-dose protocols were compared: vaccination beginning within 24 h of birth to initial vaccination delayed until a weight of 2,000 g was reached. SUBJECTS AND METHODS The study population included 136 children, divided into three groups: children born prematurely (< or = 35 weeks, n = 57), children born at term (> or = 37 weeks, n = 39), both groups receiving the first dose of HBV within 24 h of birth, and children born prematurely (< or = 35 weeks, n = 40), who received the first dose of HBV when a weight of 2,000 g was reached. All infants received the second hepatitis vaccination 1 month after the first, and the third dose 6 months after the first. Hepatitis B surface antibody (AntiHBs) was measured at an age of 3-3.5 years (at least 2.5 years after completion of the three-dose HBV series). An AntiHBs level of > or = 10 IU/l was considered positive. RESULTS At 3-3.5 years of age, a higher percentage of the premature-delayed vaccination group had a positive AntiHBs level (92.5%) compared to both the premature (54.4%, p < 0.001) and full-term groups (71.8%, p < 0.05) vaccinated soon after birth. The premature-delayed vaccination group also had a significantly higher geometric mean concentration (GMC) (119 vs 14.2 IU/l, p < 0.001 and 119 vs 32.7 IU/l, p < 0.005, respectively). CONCLUSION Delaying vaccination of premature infants against hepatitis B until a weight of 2,000 g was reached resulted in both a significantly higher percentage of children with positive antibody levels and a significantly higher GMC at 3-3.5 years of age as compared to early-vaccinated preterm and full-term infants. The known short-term advantage of delayed vaccination of preterm infants was shown to persist for at least the first 3 years of life.
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Affiliation(s)
- N Linder
- Dept. of Neonatology, Schneider Children's Medical Center of Israel, Petah Tiqva.
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Linder N, Shenkman B, Levin E, Sirota L, Vishne TH, Tamarin I, Dardik R, Lubin D, Savion N, Varon D. Deposition of whole blood platelets on extracellular matrix under flow conditions in preterm infants. Arch Dis Child Fetal Neonatal Ed 2002; 86:F127-30. [PMID: 11882557 PMCID: PMC1721386 DOI: 10.1136/fn.86.2.f127] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A previous study showed greater adhesion by platelets of healthy full term infants to subendothelial extracellular matrix (ECM) under flow conditions compared with healthy adult platelets. AIM To investigate the adhesion and aggregation of platelets from preterm infants on ECM under defined shear conditions. METHODS In vitro platelet function was investigated in 106 preterm infants, 74 full term infants, and 26 healthy adults. Blood samples were obtained from all infants within 24 hours of birth, and weekly until discharge from preterm infants only. Citrated whole blood was placed in ECM precoated tissue culture plates and subjected to shear stress (1300 s-1) for two minutes using a rotating Teflon cone. Platelet adhesion (surface coverage) and aggregation (average size) to ECM were assayed using an image analyser. Assays for von Willebrand factor (vWF) antigen, ristocetin cofactor, and vWF collagen-binding activity were performed on samples from an additional 70 preterm infants, 23 healthy full term infants, and 24 healthy adults. Preterm infants with hyaline membrane disease (HMD) were analysed separately in both cohorts. RESULTS Platelets from preterm infants displayed significantly less platelet adhesion than those from full term infants but similar aggregation and levels of vWF antigen, ristocetin cofactor, and collagen binding activity. Mean surface coverage was 22.0 (8.4)% for preterm infants with HMD, 28.7 (8.0)% for healthy preterm infants, and 35.7 (7.9)% for full term infants. Surface coverage in the preterm infants correlated with gestational age during the first 24 hours only, and did not reach full term levels during 10 weeks of follow up. CONCLUSION Platelet adhesion to ECM is significantly poorer in preterm than in full term infants, and poorer in preterm infants with HMD than in healthy preterm infants. Intrinsic platelet properties rather than the concentration or activity of vWF may be responsible for this difference.
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Affiliation(s)
- N Linder
- Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tivkah, Israel.
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Abstract
A preterm infant, with posterior urethral valves had a mycetoma of the renal pelvis caused by Fusarium species. Prolonged treatment with amphotericin B alone or with flucytosine failed. Combined surgical drainage and medical therapy resulted in full resolution.
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Affiliation(s)
- C Nakar
- Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
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35
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Linder N, Ferber A, Kopilov U, Smetana Z, Barzilai A, Mendelson E, Sirota L. Reported exposure to chickenpox: a predictor of positive anti-varicella-zoster antibodies in parturient women. Fetal Diagn Ther 2001; 16:423-6. [PMID: 11694750 DOI: 10.1159/000053952] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the positive and negative predictive values of recalled exposure to chickenpox for identifying anti-varicella-zoster virus (VZV) seropositive parturient women. METHODS Blood samples were taken from laboring women during February 1998: All women completed questionnaires concerning a history of chickenpox in themselves and their children. Anti-VZV antibodies were determined by the immunofluorescent antibodies to membrane antigen (IFAMA) technique. RESULTS Three hundred and twenty-seven women formed the study population; 239 women (73.1%) recalled chickenpox in themselves or their children, of which 229 (95.8%) were seropositive for anti-VZV antibodies. Of the 88 women who gave a negative/uncertain history of chickenpox 82 (93.2%) were seropositive and 6 (6.8%) were seronegative. All 87 mothers who were certain their children had had chickenpox were seropositive, including all 16 mothers who had a negative personal history. Thus, a woman with a history of chickenpox had a positive predictive value of 95.8%, and a woman with a lack of history had a negative predictive value of 6.8% (sensitivity 73.6%, specificity 37.5%), while a positive history of chickenpox in a child had a positive predictive value of 100%. CONCLUSIONS Most women with no known history of VZV infection have evidence of prior exposure by serologic testing. Moreover, 100% of women with a negative history who were exposed to VZV in their children were protected from the disease. Therefore, mothers exposed to VZV during pregnancy can be reassured that most likely they are protected. However, the practice of testing all pregnant women exposed to the disease should be continued.
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Affiliation(s)
- N Linder
- Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
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36
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Zucker I, Sirota L, Linder N. [Complications of blood transfusion in neonates and prematures]. Harefuah 2001; 140:67-71. [PMID: 11242905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Linder N, Handsher R, German B, Sirota L, Bachman M, Zinger S, Mendelson E, Barzilai A. Controlled trial of immune response of preterm infants to recombinant hepatitis B and inactivated poliovirus vaccines administered simultaneously shortly after birth. Arch Dis Child Fetal Neonatal Ed 2000; 83:F24-7. [PMID: 10873167 PMCID: PMC1721105 DOI: 10.1136/fn.83.1.f24] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM The study was conducted to evaluate the immunogenicity of an early, extra dose of enhanced inactivated poliovirus vaccine (IPV) administered simultaneously with recombinant hepatitis B vaccine (HBV) to preterm infants shortly after birth. METHODS Three groups were studied. Fifty preterm infants received IPV intramuscularly within 24 hours of birth, in addition to routine recommended childhood immunisations. Fifty two preterm infants and 35 full term infants received routine immunisations only (routine vaccination timing: HBV at birth, 1 and 6 months of age; IPV at 2 and 4 months; oral polio vaccine (OPV) at 4 and 6 months; diphtheria-tetanus-pertussis (DTP) at 2, 4, and 6 months; and Haemophilus influenzae B vaccine at 2 and 4 months). Blood samples were taken at birth, 3 and 7 months of age from all infants, and at 1 month of age from preterm infants only. RESULTS At birth, a lower percentage of both study and control preterm infants had antipoliovirus type 3 titres >/= 1:8 than full term infants. At 1 and 3 months of age significantly more early IPV infants had antipoliovirus type 3 titres >/= 1:8 than routinely vaccinated preterm infants (p < 0.05). At 7 months of age there were no significant differences in percentage of antipoliovirus titres >/= 1:8 or geometric mean times (GMTs) between the early IPV group and the routinely vaccinated preterm group. At 3 and 7 months of age, the percentage of positive antihepatitis B titres (>/= 1:10) and the GMT of the early IPV preterm group did not differ significantly from those of preterm controls. There was no significant difference in percentage of positive antihepatitis B titres between the early IPV group and full term controls at any time. GMTs for hepatitis B antibodies were significantly lower in the early IPV preterm group than in full term controls at 3 and 7 months of age. CONCLUSIONS Administration of an additional dose of IPV simultaneously with routine HBV to preterm infants shortly after birth provides early protection from poliovirus and hepatitis B infection, and does not interfere with poliovirus antibody production at the age of 7 months.
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Affiliation(s)
- N Linder
- Department of Neonatology, Schneider Children's Medical Center of Israel, 14 Kaplan St, Petah Tikva 49202, Israel.
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Juster-Reicher A, Leibovitz E, Linder N, Amitay M, Flidel-Rimon O, Even-Tov S, Mogilner B, Barzilai A. Liposomal amphotericin B (AmBisome) in the treatment of neonatal candidiasis in very low birth weight infants. Infection 2000; 28:223-6. [PMID: 10961528 DOI: 10.1007/s150100070040] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED AmBisome (2.5-7 mg/kg/day as a continuous 1 h infusion) was evaluated prospectively from September 1994 to January 1998 in 24 very low birth weight infants (mean birth weight 847+/-244 g, mean gestational age 26 weeks) with systemic candidiasis. Mean age at onset of candidemia was 17 days. One patient had two episodes of candidiasis. Thirteen infants failed previous antifungal therapy with amphotericin B (with or without 5-flucytosine). Candida spp. were isolated from the blood in all 25 episodes and from skin abscesses and urine in four infants each, respectively. There were 13 isolates of Candida albicans, ten of Candida parapsilosis, two of Candida tropicalis and one of Candida glabrata. One infant had a mixed infection with C. albicans and C. parapsilosis. The mean duration of therapy was 21 days; the cumulative AmBisome dose was 94 mg/kg. Fungal eradication was achieved in 92% of the episodes; mean duration of AmBisome therapy until achieving eradication was 9 days. Twenty (83%) infants were considered clinically cured at the end of treatment. No major adverse effects were recorded; one infant developed increased bilirubin and hepatic transaminases levels during therapy. Four (17%) infants died; in two of them (8%) the cause of death was directly attributed to systemic candidiasis. CONCLUSION AmBisome represents an effective, safe and convenient antifungal agent in the therapy of systemic fungal infections in very low birth weight infants.
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Abstract
OBJECTIVES To compare the placental transfer of maternal varicella-zoster (VZV) antibodies to preterm and term infants and to investigate antibody decay during the first 6 months of life in the preterm infants. STUDY DESIGN Maternal and umbilical cord blood samples were taken from 113 healthy mother-newborn pairs: 64 term (gestational age > or =37 weeks) and 49 preterm (gestational age < or =35 weeks). Premature infants were further tested at 1, 2, and 6 months. Anti-VZV antibody to membrane antigen was measured with the immunofluorescent technique. RESULTS Preterm infants of gestational age < or =28 weeks had positive cord antibody and a geometric mean titer significantly lower than those in preterm infants of gestational age 29 to 35 weeks and term infants (25% vs 95% and 95%, respectively, P <.001 for each, and 2.5 +/- 2.2 vs 10.5 +/- 2.4 and 12.6 +/- 2.4, respectively, P <.001 for each). There was no difference between the preterm 29 to 35 weeks of gestation and term groups. Fetal-maternal ratios for both preterm groups were <1 and were significantly less than the fetal-maternal ratio in the term infants. The transfer of maternal antibodies to term infants was significantly greater than to the 29- to 35-week preterm infants (P =.01). At 2 months of age, 25% of 29- to 35-week preterm infants and no preterm infant < or =28 weeks had a positive titer. At 6 months of age, all preterm infants were seronegative, and the geometric mean titer in both groups declined to undetectable levels. CONCLUSION Transplacental transfer of maternal VZV antibodies is diminished in preterm infants. VZV antibody levels are significantly lower in preterm infants born at < or =28 weeks' gestational age compared with those in preterm infants 29 to 35 weeks' gestational age and term infants. Anti-VZV titers decrease to undetectable levels in preterm infants by 6 months of age or earlier; thus these infants appear to be susceptible to chickenpox before the scheduled 12-month vaccination.
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Affiliation(s)
- N Linder
- Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tikva
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40
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Affiliation(s)
- N Linder
- Department of Neonatology, Pediatric Ophthalmology Unit, Schneider Children's Medical Center, Petach Tikva, Israel
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41
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Maayan-Metzger A, Linder N, Marom D, Vishne T, Ashkenazi S, Sirota L. Clinical and laboratory impact of coagulase-negative staphylococci bacteremia in preterm infants. Acta Paediatr 2000; 89:690-3. [PMID: 10914964 DOI: 10.1080/080352500750044016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
UNLABELLED A retrospective evaluation of the clinical and laboratory impact of coagulase-negative staphylococci (CONS) bacteremia in preterm infants was carried out. The study population included all preterm infants (n = 31) in whom two or more blood cultures were positive for CONS within a period of 4 d, with negative blood cultures 1 wk before and 1 wk after the CONS bacteremia. Clinical manifestations and the results of laboratory tests 7 d before and after the positive blood cultures, and on the first day of sepsis, were recorded and compared. During CONS bacteremia, the infants demonstrated apnoea and bradycardia (88%) and a need for oxygen (59%) and ventilatory support (69%). Significant laboratory findings were leukopenia below 5,000 cells/mm3 (12%), leukocytosis above 30,000 cells/mm3 (39%), and thrombocytopenia below 150,000/mm3 (25%). These clinical and laboratory manifestations differed significantly during the bacteremia infection compared with the week before and after. CONCLUSION CONS bacteremia is a clinically significant infection in preterm infants, causing episodes of apnoea and bradycardia, and a need for ventilatory support.
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Affiliation(s)
- A Maayan-Metzger
- Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tiqva
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Linder N, Raz M, Sirota L, Reichman B, Lubin D, Kuint J, Cohen AH, Barzilai A. Unexplained fever in neonates may be associated with hepatitis B vaccine. Arch Dis Child Fetal Neonatal Ed 1999; 81:F206-7. [PMID: 10525025 PMCID: PMC1721007 DOI: 10.1136/fn.81.3.f206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To investigate whether hepatitis B vaccination has increased the number of cases of unexplained neonatal fever. METHOD The files of all infants born from 1 January 1991 to 31 December 1992, in whom a diagnosis of "injected antibiotic" or "disease of temperature regulation" was recorded, were reviewed. Those who had unexplained fever of 38 degrees C or higher during the first three days of life were divided into two groups: infants who did not receive the hepatitis B vaccine (1991) and infants who did (1992). RESULTS In 1992 the incidence of unexplained fever in hepatitis B vaccinated neonates was significantly higher than in the 1991 group of pre-vaccination neonates (35 out of 5819 (0.6%) vs 14 out of 5010 neonates (0.28%) respectively, p=0.013). CONCLUSIONS The increase in the number of cases of unexplained neonatal fever seems to be associated with the introduction of routine hepatitis B vaccination on the first day of life. The possibility that an excess number of neonates will undergo unnecessary procedures and treatment to diagnose unexplained fever justifies planning a controlled study to determine whether these preliminary findings point to a significant problem.
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Affiliation(s)
- N Linder
- Department of Neonatology, Schneider Children's Medical Center of Israel, 14 Kaplan St, Petah Tikva 49202, Israel
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Linder N, Sirota L, Snapir A, Eisen I, Davidovitch N, Kaplan G, Barzilai A. Parental knowledge of the treatment of fever in children. Isr Med Assoc J 1999; 1:158-60. [PMID: 10731324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Although the onset of fever in children often prompts parents to seek immediate treatment, the general level of parental knowledge on pediatric fever and administration of antipyretic medications is unknown. Parents without a basic understanding of treatment principles may give their children incorrect doses of medication. Overdosing may cause drug toxicity, while underdosing may lead to unnecessary, repeated clinic and/or emergency room visits. OBJECTIVES To assess parental decision-making with regard to treating fever in children, and its effectiveness, and to suggest methods for improving the level of treatment. METHODS In this cross-sectional self-reported survey, questionnaires were completed by 650 parents who sought medical assistance for a child under the age of 10 years. Parents represented various socioeconomic levels, educational backgrounds and religious affiliations. RESULTS Ninety-six percent of parents treated fevers that reached 38.5 degrees C, and 77.6% treated fevers of only 38 degrees C. Acetaminophen was the treatment of choice for 96% and dipyrone for 4%. Parental sources of information for managing and administering antipyretic drugs were medical personnel (40.7%), mother's or grandmother's experience (30%), and the enclosed leaflet or instructions on the bottle (29.3%). Forty-three percent of the parents administered the recommended dosage (10-20 mg/kg), whereas 24.3% used less and 32.7% used more; 11% exceeded a daily dosage of 120 mg/kg. CONCLUSIONS A total of 57% of parents treated children with incorrect doses of antipyretic drugs. In 11% of the children treated, the daily dose was at a level that could cause severe toxicity. Parental knowledge of the treatment of fever must be improved.
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Affiliation(s)
- N Linder
- Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
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Linder N, Davidovitch N, Kogan A, Barzilai A, Kuint J, Mazkeret R, Sack J. Longitudinal measurements of 17alpha-hydroxyprogesterone in premature infants during the first three months of life. Arch Dis Child Fetal Neonatal Ed 1999; 81:F175-8. [PMID: 10525018 PMCID: PMC1721005 DOI: 10.1136/fn.81.3.f175] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To determine normal concentrations of 17alpha-hydroxyprogesterone (17OHP) for premature infants. METHODS 17OHP was measured in 66 consecutive premature infants once a week during the first month, and once every two weeks thereafter, until the age of 3 months. The 17OHP values in 100 full term healthy neonates on the third day of life served as controls. Blood was sampled on filter paper using a neonatal radioimmunoassay kit. Findings were correlated with gestational age, birthweight, mode of delivery, Apgar scores, presence of respiratory distress syndrome and intake of maternal steroids. RESULTS Mean 17OHP was raised at 7 days of age (138.9, 46.3, 53.3, 29.9 nmol/l, respectively, for infants whose gestational age was under 29 weeks, 29 to 30 weeks, 31 to 32 weeks, and 33 weeks and above). It fell sharply in the first two weeks after which it gradually decreased further, reaching 32.7, 23.6, 16.9, and 13.0 nmol/l, respectively, by the age of 90 days. The mean (SEM) 17OHP concentration in full term infants on day 3 of life was 17.8 (8.9) nmol/l. These values were independent of the presence and severity of respiratory distress syndrome and of prenatal maternal steroids. CONCLUSIONS The increased 17OHP concentrations found at birth fell to those found in term infants during the first three months of life in infants over 31 weeks of gestation. Postconceptional age is the most important factor determining 17OHP concentration.
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Affiliation(s)
- N Linder
- Department of Neonatology, Chaim Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Tel Aviv
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Linder N, Rapola J, Raivio KO. Cellular expression of xanthine oxidoreductase protein in normal human tissues. J Transl Med 1999; 79:967-74. [PMID: 10462034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
Xanthine oxidoreductase is an important cytoplasmic source of reactive oxygen species, and has been implicated in the pathogenesis of ischemia-reperfusion damage. Because the cellular localization of this protein remains unclear, our aim was to study its distribution in fresh normal human tissue obtained at surgery. For immunohistochemical studies we purified the protein from human milk and raised a polyclonal antibody in rabbits. In the liver the protein was preferentially localized to the periportal hepatocytes and it was absent from the perivenous region. In the proximal intestine, the protein was expressed in epithelial cells and goblet cells. Lactating mammary gland acinar cells showed intense staining. Small vessel vascular endothelial cells of the intestine, mammary gland, and skeletal muscle showed immunoreactivity, but in the kidney, glomerular endothelial cells were negative. No cells in the heart, brain, or lung expressed the enzyme protein. The observed localization of the xanthine oxidoreductase protein is consistent with previously observed enzyme activities in the organs studied. The widely assumed exclusive localization to capillary endothelium obviously does not apply to humans.
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Affiliation(s)
- N Linder
- Research Laboratory, Hospital for Children and Adolescents, University of Helsinki, Finland.
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Halevy A, Linder N, Sirota L. [Neonatal diabetes]. Harefuah 1999; 137:138-40. [PMID: 10959305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Linder N, Sirota L, Aboudy Y, German B, Lifshits T, Barnea BS, Lieberman B, Mendelson E, Barzilai A. Placental transfer of maternal rubella antibodies to full-term and preterm infants. Infection 1999; 27:203-7. [PMID: 10378133 DOI: 10.1007/bf02561529] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Premature infants are vulnerable to infections, partly because of the low transplacental transfer of maternal antibodies. The present study investigated the placental transfer of maternal rubella-specific antibodies to full-term and preterm infants. The study group consisted of 133 healthy, native Israeli mothers and their 159 newborns. Of these, 69 were full-term infants (gestational age > 37 weeks) of 69 mothers, and 90 were preterm infants (gestational age < 35 weeks) of 64 mothers. Antibody titers against rubella were measured in maternal and umbilical cord blood samples by hemagglutination inhibition and microneutralization techniques. There was no significant difference in the level of protection and in geometrical mean titers by hemagglutination between the full-term and preterm groups. Conversely, significant differences in geometric mean titers of neutralizing antibodies were found between full-term and preterm infants, e.g., 65.9 and 39.8, respectively (P < 0.001). Very low birth weight preterm infants are at greater risk of rubella infection during the first year of life, due to the diminished transfer of neutralizing maternal antibodies. Therefore, earlier vaccination of this group may be beneficial.
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Affiliation(s)
- N Linder
- Dept. of Neonatology, Schneider Children's Medical Center of Israel, I-Petah Tikva, Israel
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Linder N, Karetnyi Y, Gidony Y, Dagan R, Ohel G, Levin E, Mendelson E, Barzilai A. Decline of hepatitis A antibodies during the first 7 months of life in full-term and preterm infants. Infection 1999; 27:128-31. [PMID: 10219645 DOI: 10.1007/bf02560513] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In a previous study we have shown that transplacental transfer of hepatitis A antibodies to preterm infants does not differ from that observed in full-term infants. This follow-up study was designed to investigate the decline of hepatitis A virus (HAV) antibodies during the first 7 months of life in full-term and preterm infants, in an endemic region for hepatitis A. Two hundred and fifty newborn infants--147 full-term and 103 preterm infants--were enrolled. Blood samples from the infants were taken at birth, and at 3 and 7 months of age. Anti-HAV titers were determined by ELISA. A concentration of > or = 1:20 mlU/ml was considered protective. Protective hepatitis A antibodies were present at birth in 48.3% of all full-term and 49.5% of all premature infants. By the age of 7 months only 13% of full-term and 21.7% of preterm infants still had protective titers. For the seropositive full-term infants the geometric mean titers (GMT) were 15,698, 6,107 and 345 at birth, 3 months and 7 months, respectively, and for preterm infants, 10,378, 2,307 and 225 at birth, 3 months and 7 months, respectively. Significant differences in GMT between preterm and full-term infants were found at birth and at 3 months of age (P < 0.05). In a region endemic for hepatitis A, low levels of anti-HAV at 7 months of age may justify trials on infant vaccination since this is the most effective way to eliminate hepatitis A from circulation.
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Affiliation(s)
- N Linder
- Dept. of Neonatology, Schneider Children's Medical Center, Petach-Tikva, Israel
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Shenkman B, Linder N, Savion N, Tamarin I, Dardik R, Kennet G, German B, Varon D. Increased neonatal platelet deposition on subendothelium under flow conditions: the role of plasma von Willebrand factor. Pediatr Res 1999; 45:270-5. [PMID: 10022601 DOI: 10.1203/00006450-199902000-00019] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In vitro platelet function of umbilical cord blood and neonatal peripheral vein blood from full-term newborns was compared with that of adults. Citrated whole blood was subjected to shear stress (1300 s(-1)) on subendothelial extracellular matrix (ECM)-coated wells in a cone and plate(let) analyzer. Adhered platelets on the ECM were quantitated by image analyzer. Both umbilical cord and neonatal peripheral blood platelets demonstrated more extensive adhesion than adult platelets, and similar aggregate formation on ECM. The ability of neonatal platelets to form aggregates on ECM was confirmed by scanning electron microscopy. Similar activation of neonatal and adult platelets after subjection to shear stress, in the suspension phase, was established by flow cytometry, which showed an increase in fibrinogen binding and a decrease in glycoprotein Ib expression on platelet membrane. The difference in adhesion rates between neonatal and adult platelets was preserved even when the hematocrit level of the neonatal blood was adjusted to that of adults. Reconstitution of neonatal or adult platelet-rich plasma with autologous or heterologous red packed cells yielded no change in adhesion and aggregation. When von Willebrand factor-covered plates were used to prevent deposition of plasma von Willebrand factor on the surface, no difference in platelet adhesion was seen between neonatal and adult blood. In conventional aggregometry assay, the response to ristocetin of washed platelets of either neonatal or adult source was higher on addition of plasma from neonates than from adults. Our data suggest that the extensive neonatal platelet deposition on ECM is mediated by plasma von Willebrand factor, which is known to be more multimerized and, therefore, more active in neonates than in adults. This mechanism may provide balanced primary hemostasis in neonates despite the platelet hyporeactivity to agonists without application of shear stress.
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Affiliation(s)
- B Shenkman
- Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer, Israel
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Blondheim O, Bader D, Abend M, Peniakov M, Reich D, Potesman I, Handsher R, Gidoni I, Linder N. Immunogenicity of hepatitis B vaccine in preterm infants. Arch Dis Child Fetal Neonatal Ed 1998; 79:F206-8. [PMID: 10194993 PMCID: PMC1720866 DOI: 10.1136/fn.79.3.f206] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To assess the immunogenicity of hepatitis B vaccine in preterm and term infants, given in a sequence of three doses beginning soon after birth. METHOD The immunogenicity of hepatitis B vaccine was assessed in 176 preterm infants (< 35 weeks of gestation), immunised soon after birth, and compared with that in 46 term infants. Titres of hepatitis B antibodies were determined one to two months after the third vaccine. The significance of the differences between the term and preterm groups was determined using Student's t test. RESULTS A similar proportion of infants in both preterm and term groups attained protective titres of hepatitis B antibodies (88.7% vs 93.4%, respectively; p = NS). However, the term infants had a higher geometric mean titre of antibodies after the third vaccine than did the preterm infants (701.2 (745.0) vs 469.1 (486.2) mU/ml, respectively; p < 0.03). CONCLUSION Hepatitis B vaccine is effective in most preterm infants when given soon after birth. It may be advisable to determine the immune response at 12-24 months of age to booster the non-responders.
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Affiliation(s)
- O Blondheim
- Department of Neonatology, Haemek Medical Center, Afula, Israel.
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