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Großpötzl M, Kloeckl L, Guttmann A, Kruger M, Gran J, Hoeflechner L, Brandner M, Gaugl H, Ivastinovic D, Lindner M, Riedl R, Wedrich A, Lindner E. Protective Effect of Amblyopia on Age-Related Macular Degeneration. Am J Ophthalmol 2024; 259:1-6. [PMID: 37437833 DOI: 10.1016/j.ajo.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/24/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE Our aim was to evaluate whether patients with age-related macular degeneration (AMD) and cooccurrent amblyopia are more likely to have diseases diagnosed on both the ipsilateral and the contralateral side in a large Austrian database. DESIGN Retrospective cross-sectional study. METHODS Setting: Institutional practice. PATIENT POPULATION Medical records of all patients who visited the Department of Ophthalmology of the Medical University of Graz between December 1996 and June 2021 were searched for the co-occurrence of AMD and amblyopia. MAIN OUTCOME MEASURES Data from patients with AMD diagnosed on 1 eye side were used for further analysis. Spectral-domain optical coherence tomography images were analyzed to confirm the lateral asymmetry of AMD. RESULTS A total of 327,443 patients were screened for the co-occurrence of AMD and amblyopia. Of them, 8742 patients had AMD diagnosed on 1 eye side and 5051 patients had unilateral amblyopia. In total, 163 patients were found to have AMD diagnosed on 1 side and unilateral amblyopia in combination. Of these, 126 patients had AMD and amblyopia on contralateral sides and 37 had AMD and amblyopia on the ipsilateral side (P < .001). CONCLUSIONS Less amblyopic patients had AMD diagnosed on the amblyopic eye compared with the nonamblyopic eye. In cases of lateral asymmetry, the nonamblyopic eye is more likely to have the more advanced form of AMD.
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Affiliation(s)
- Manuel Großpötzl
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Lorenz Kloeckl
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Andreas Guttmann
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Michael Kruger
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Jakob Gran
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Lukas Hoeflechner
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Martina Brandner
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Heike Gaugl
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Domagoj Ivastinovic
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | | | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation (R.R.), Medical University of Graz, Graz, Austria
| | - Andreas Wedrich
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.)
| | - Ewald Lindner
- From the Department of Ophthalmology (M.G., L.K., A.G., M.K., J.G., L.H., M.B., H.G., D.I., A.W., E.L.).
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Van Niekerk JP, Cluver P, Hertzog E, Kruger M, Moodley K, Myers J, Ncayiyana D, Snyman J. Decriminalising and legalising medical assistance in dying. S Afr Med J 2024; 114:e1857. [PMID: 38525568 DOI: 10.7196/samj.2024.v114i2.1857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Indexed: 03/26/2024] Open
Affiliation(s)
| | - P Cluver
- Neurosurgeon, former chair of the Stellenbosch University Council, companies' director, environmentalist.
| | - E Hertzog
- Anaesthesiologist, founder and past chairman of Mediclinic International.
| | - M Kruger
- Emeritus professor Stellenbosch, former Executive Head Paediatrics and Child Health, Stellenbosch, Paediatric oncologist, ethicist.
| | - K Moodley
- Distinguished Professor WHO Collaborating Centre of Bioethics Division of Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University.
| | - J Myers
- Emeritus professor, University of Cape Town (former head of School of Public Health and Family Medicine).
| | - Dan Ncayiyana
- Emeritus professor, University of Cape Town, obstetrician and gynaecologist, emeritus editor SAMJ.
| | - J Snyman
- Family practice in Uitenhage; advisor in the medical insurance/ managed care industry; chairman of SAMA East Cape branch; SAMA federal councillor; elected member of the HPCSA.
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Motchon YD, Sack KL, Sirry MS, Kruger M, Pauwels E, Van Loo D, De Muynck A, Van Hoorebeke L, Davies NH, Franz T. Effect of biomaterial stiffness on cardiac mechanics in a biventricular infarcted rat heart model with microstructural representation of in situ intramyocardial injectate. Int J Numer Method Biomed Eng 2023; 39:e3693. [PMID: 36864599 PMCID: PMC10909490 DOI: 10.1002/cnm.3693] [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: 05/23/2022] [Revised: 11/19/2022] [Accepted: 01/29/2023] [Indexed: 05/13/2023]
Abstract
Intramyocardial delivery of biomaterials is a promising concept for treating myocardial infarction. The delivered biomaterial provides mechanical support and attenuates wall thinning and elevated wall stress in the infarct region. This study aimed at developing a biventricular finite element model of an infarcted rat heart with a microstructural representation of an in situ biomaterial injectate, and a parametric investigation of the effect of the injectate stiffness on the cardiac mechanics. A three-dimensional subject-specific biventricular finite element model of a rat heart with left ventricular infarct and microstructurally dispersed biomaterial delivered 1 week after infarct induction was developed from ex vivo microcomputed tomography data. The volumetric mesh density varied between 303 mm-3 in the myocardium and 3852 mm-3 in the injectate region due to the microstructural intramyocardial dispersion. Parametric simulations were conducted with the injectate's elastic modulus varying from 4.1 to 405,900 kPa, and myocardial and injectate strains were recorded. With increasing injectate stiffness, the end-diastolic median myocardial fibre and cross-fibre strain decreased in magnitude from 3.6% to 1.1% and from -6.0% to -2.9%, respectively. At end-systole, the myocardial fibre and cross-fibre strain decreased in magnitude from -20.4% to -11.8% and from 6.5% to 4.6%, respectively. In the injectate, the maximum and minimum principal strains decreased in magnitude from 5.4% to 0.001% and from -5.4% to -0.001%, respectively, at end-diastole and from 38.5% to 0.06% and from -39.0% to -0.06%, respectively, at end-systole. With the microstructural injectate geometry, the developed subject-specific cardiac finite element model offers potential for extension to cellular injectates and in silico studies of mechanotransduction and therapeutic signalling in the infarcted heart with an infarct animal model extensively used in preclinical research.
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Affiliation(s)
- Y. D. Motchon
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human BiologyUniversity of Cape TownCape TownSouth Africa
| | - Kevin L. Sack
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human BiologyUniversity of Cape TownCape TownSouth Africa
- Department of SurgeryUniversity of California at San FranciscoSan FranciscoCaliforniaUSA
| | - M. S. Sirry
- Department of Biomedical Engineering, School of Engineering and ComputingAmerican International UniversityAl JahraKuwait
| | - M. Kruger
- Cardiovascular Research Unit, MRC IUCHRUUniversity of Cape TownCape TownSouth Africa
| | - E. Pauwels
- Centre for X‐ray Tomography, Department of Physics and AstronomyGhent UniversityGhentBelgium
- Nuclear MedicineUniversity Hospitals LeuvenLeuvenBelgium
| | - D. Van Loo
- Centre for X‐ray Tomography, Department of Physics and AstronomyGhent UniversityGhentBelgium
- XRE nv, Bollebergen 2B box 1, 9052GhentBelgium
| | - A. De Muynck
- Centre for X‐ray Tomography, Department of Physics and AstronomyGhent UniversityGhentBelgium
| | - L. Van Hoorebeke
- Centre for X‐ray Tomography, Department of Physics and AstronomyGhent UniversityGhentBelgium
| | - Neil H. Davies
- Cardiovascular Research Unit, MRC IUCHRUUniversity of Cape TownCape TownSouth Africa
| | - Thomas Franz
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human BiologyUniversity of Cape TownCape TownSouth Africa
- Bioengineering Science Research Group, Faculty of Engineering and Physical SciencesUniversity of SouthamptonSouthamptonUK
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Kellerman I, Blaauw R, Schoeman J, Kruger M. Changes in anthropometrical status and body composition in children with cancer during initial chemotherapy. Pediatr Hematol Oncol 2023; 40:659-672. [PMID: 37092844 DOI: 10.1080/08880018.2023.2201299] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 04/25/2023]
Abstract
Children with cancer require adequate nutritional support to prevent malnutrition. This study investigated the impact of chemotherapy on anthropometrical status and body composition during the first six months of treatment. Anthropometrical status and body composition were measured at diagnosis, utilizing standardized protocols and validated S10 InBody bio-electrical impedance (BIA) measurements and compared to subsequent consecutive monthly follow-up measurements to plot changes over time during the first six months. Statistical significance was defined as p < 0.05. Forty-three newly diagnosed children (median age 4 years, IQR: 2.0-7.6; male-female ratio 1:0.9; 53% haematological malignancies and 47% solid tumors) were included. Prevalence of malnutrition varied, with under-nutrition 14% (mid-upper arm circumference (MUAC)/body mass index (BMI)), over-nutrition 9.3% (BMI) and stunting 7% at diagnosis. MUAC (14%) identified fewer participants with underlying muscle store depletion than BIA (41.8%). Chemotherapy exposure acutely exacerbated existing nutritional depletion during the first two months after diagnosis for all variables except fat mass (FM), with contrary effects on cancer type. Haematological malignancies had rapid increases in weight, BMI and FM. All patients had an acute loss of skeletal muscle mass. Nutritional improvement experienced by all cancer types during month two to three of treatment resulted in catch-up growth, with a significant increase in weight (chi2=40.43, p < 0.001), height (chi2=53.79, p < 0.001), BMI (chi2=16.32, p < 0.005), fat free mass (chi2=23.69, p < 0.003) and skeletal muscle mass (chi2=24.19, p < 0.001) after six months. Monthly nutritional assessments, including advanced body composition measurements, are essential to provide timely nutritional interventions to overcome the acute decline in nutritional reserves observed during the first two months of chemotherapy exposure.
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Affiliation(s)
- I Kellerman
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - R Blaauw
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - J Schoeman
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - M Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Kruger M, Sommer M, Singer C, Seidel G. Self-Made Sleeve for Chandelier Light Simulation. Retina 2023; 43:531-532. [PMID: 32404845 DOI: 10.1097/iae.0000000000002847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To develop a quick and cost-effective alternative to a chandelier light for vitrectomy. METHODS The surgical material available in an ophthalmologic operating room was used to create a sleeve for the vitrectomy light probe and tested on 30 consecutive retinal detachment cases for feasibility. RESULTS A 64 × 5-mm cotton swab stick was cut into the length of the light probe minus the length of the trocar and subsequently pierced by a blunt needle. With this sleeve, the light probe could be safely handled similar to a chandelier light during surgery. CONCLUSION A sleeve for the light probe can serve as a substitute for a chandelier light during scleral depression in retinal detachment surgery.
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Affiliation(s)
- Michael Kruger
- Department of Ophthalmology, Medical University of Graz/Austria, Graz, Austria
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Neumann EM, Vogel-Heuser B, Haben F, Kruger M, Wieringa T. Introduction of an Assistance System to Support Domain Experts in Programming Low-code to Leverage Industry 5.0. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3193728] [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: 01/10/2023]
Affiliation(s)
- E.-M. Neumann
- Institute of Automation and Information Systems, Department of Mechanical Engineering, School of Engineering and Design, Technical University of Munich, Germany
| | - B. Vogel-Heuser
- Institute of Automation and Information Systems, Department of Mechanical Engineering, School of Engineering and Design, Technical University of Munich, Germany
| | - F. Haben
- Institute of Automation and Information Systems, Department of Mechanical Engineering, School of Engineering and Design, Technical University of Munich, Germany
| | - M. Kruger
- Institute of Automation and Information Systems, Department of Mechanical Engineering, School of Engineering and Design, Technical University of Munich, Germany
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7
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van Heerden J, Esterhuizen TM, Hendricks M, Poole J, Büchner A, Naidu G, du Plessis J, van Emmenes B, van Zyl A, Mathews E, Kruger M. The Association of Clinical Characteristics and Tumour Markers With Image-Defined Risk Factors in the Management of Neuroblastoma in South Africa. Clin Oncol (R Coll Radiol) 2021; 34:e149-e159. [PMID: 34750056 DOI: 10.1016/j.clon.2021.10.014] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/04/2021] [Accepted: 10/22/2021] [Indexed: 12/18/2022]
Abstract
AIMS Image-defined risk factors (IDRFs) in neuroblastoma predict surgical complications and management outcomes. As there is a lack of data regarding the association of IDRFs with clinical and pathological factors, this study evaluated the prognostic value of IDRFs to predict neuroblastoma survival outcomes. MATERIALS AND METHODS This was a retrospective study including 345 patients and reviewed diagnostic imaging for 20 IDRFs, pleural effusions and ascites. The IDRFs were grouped into five 'primary IDRFs' cohorts with vascular encasement, involvement of multiple body compartments, organ infiltration, airway obstruction and intraspinal extension. The association between clinical, histopathological and biological characteristics of neuroblastoma and management was evaluated. RESULTS More patients without IDRFs had operations compared with patients with IDRFs, with a trend towards significance (64.4% versus 35.6%, P = 0.082). Patients with multiple compartment tumour involvement (P = 0.003) and organ infiltration (P < 0.001) had a higher risk of surgical complications. The 5-year overall survival of the group with more than one IDRF was 0.0% and those with pleural effusions or ascites 6.7%, associated with the worst outcome (P = 0.005). The total number of IDRFs was not predictive of the metastatic remission rate (P = 0.585) or overall survival (P = 0.142), with no conclusive association found between IDRF groups and clinical or biological markers. CONCLUSIONS Patients with more than one IDRF had the shortest survival time, whereas those with pleural effusions and ascites at diagnosis had a poor outcome. Standardised reporting of IDRFs is crucial for predicting prognosis.
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Affiliation(s)
- J van Heerden
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa; Paediatric Haematology and Oncology, Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium.
| | - T M Esterhuizen
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - M Hendricks
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Paediatric Haematology and Oncology Service, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - J Poole
- Faculty of Health Sciences, Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - A Büchner
- Paediatric Haematology and Oncology, Department of Paediatrics, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa
| | - G Naidu
- Faculty of Health Sciences, Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - J du Plessis
- Department of Paediatrics, Faculty of Health Sciences, University of the Free State, Division of Paediatric Haematology and Oncology, Universitas Hospital, Bloemfontein, South Africa
| | - B van Emmenes
- Division of Paediatric Haematology and Oncology Hospital, Department of Paediatrics, Frere Hospital, East London, South Africa
| | - A van Zyl
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - E Mathews
- Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Port Elizabeth Provincial Hospital, Walter Sisulu University, Port Elizabeth, South Africa
| | - M Kruger
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
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8
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Van Heerden J, Kruger M, Esterhuizen TM, Hendricks M, Du Plessis J, Engelbrecht G, Janse van Vuuren M, van Emmenes B, Uys R, Burger C, Nyakale N, More S, Brink A. The Association between Tumour Markers and Meta-iodobenzylguanidine Scans in South African Children with High-risk Neuroblastoma. Clin Oncol (R Coll Radiol) 2021; 33:517-526. [PMID: 33781675 DOI: 10.1016/j.clon.2021.03.003] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/04/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022]
Abstract
AIMS Diagnostic and post-induction 123I-meta-iodobenzylguanidine (123I-mIBG) scans have prognostic significance in the treatment of neuroblastoma, but data from low- and middle-income countries are limited due to resource constraints. The aim of this study was to determine the association between neuroblastoma-associated tumour markers (lactate dehydrogenase [LDH], ferritin and MYCN amplification) and 123I-mIBG scans (modified Curie scores and metastatic disease patterns) in predicting complete metastatic response rates (mCR) and overall survival. MATERIALS AND METHODS Two hundred and ninety patients diagnosed with high-risk neuroblastoma in South Africa between January 2000 and May 2018 and a subanalysis of 78 patients with diagnostic 123I-mIBG scans were included. Data collection included LDH, ferritin and MYCN amplification at diagnosis. Two nuclear physicians independently determined the modified Curie scores and pattern of distribution for each diagnostic and post-induction 123I-mIBG scans with high inter-rater agreement (r = 0.952) and reliability (K = 0.805). The cut-off values for the diagnostic and post-induction modified Curie scores of ≥7.0 (P = 0.026) and 3 (P = 0.009), respectively, were generated. The association between the tumour markers and the modified Curie score of the 123I-mIBG scans was determined using post-induction mCR and 2-year overall survival. RESULTS Diagnostic LDH (P < 0.001), ferritin (P < 0.001) and the diagnostic modified Curie scores (P = 0.019) significantly predicted mCR. Only ferritin correlated with diagnostic modified Curie scores (P = 0.003) but had a low correlation coefficient of 0.353. On multivariable analysis, the only significant covariate for 2-year overall survival at diagnosis was LDH <750 U/l (P = 0.024). A post-induction chemotherapy modified Curie score ≤3.0 had a 2-year overall survival of 46.2% compared with 30.8% for a score >3.0 (P = 0.484). CONCLUSION LDH, ferritin and the diagnostic 123I-mIBG scans significantly predicted mCR, but only LDH predicted 2-year overall survival. Ferritin and the modified Curie scores correlated with each other. MYCN amplification neither correlated with any aspect of the 123I-mIBG scans nor significantly predicted mCR or 2-year overall survival. LDH and ferritin are therefore appropriate neuroblastoma tumour markers to be used in low- and middle-income countries with limited or no access to mIBG scans and/or MYCN amplification studies.
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Affiliation(s)
- J Van Heerden
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa; Paediatric Haematology and Oncology, Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium.
| | - M Kruger
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - T M Esterhuizen
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - M Hendricks
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Paediatric Haematology and Oncology Service, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - J Du Plessis
- Department of Paediatrics, Faculty of Health Sciences, University of the Free State, Division of Paediatric Haematology and Oncology, Universitas Hospital, Bloemfontein, South Africa
| | - G Engelbrecht
- Department of Nuclear Medicine, University of the Free State, Universitas Hospital, Bloemfontein, South Africa
| | - M Janse van Vuuren
- Drs B Vorster and M Janse van Vuuren Incorporated, Nuclear Physicians, Bloemfontein, South Africa
| | - B van Emmenes
- Division of Paediatric Haematology and Oncology Hospital, Department of Paediatrics, Frere Hospital, East London, South Africa
| | - R Uys
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - C Burger
- Department of Nuclear Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - N Nyakale
- Department of Nuclear Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Inkosi Albert Luthuli Academic Hospital, Durban, South Africa
| | - S More
- Department of Paediatrics and Child Health, Division of Nuclear Medicine, Faculty of Health Sciences, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - A Brink
- Department of Paediatrics and Child Health, Division of Nuclear Medicine, Faculty of Health Sciences, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
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Springer PE, Slogrove AL, Kidd M, Kalk E, Bettinger JA, Esser MM, Cotton MF, Zunza M, Molteno CD, Kruger M. Neurodevelopmental and behavioural outcomes of HIV-exposed uninfected and HIV-unexposed children at 2-3 years of age in Cape Town, South Africa. AIDS Care 2019; 32:411-419. [PMID: 31280587 DOI: 10.1080/09540121.2019.1637506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 01/24/2023]
Abstract
Successful vertical HIV transmission prevention programmes (VTP) have resulted in an expanding population of HIV-exposed uninfected (HEU) infants whose growth, health and neurodevelopmental outcomes could have consequences for future resource allocation. We compared neurodevelopmental and behavioural outcomes in a prospective cohort of 2-3 year old HEU and HIV-unexposed uninfected (HU) children.Women living with and without HIV and their infants were enrolled within three days of birth from a low-risk midwife obstetric unit in Cape Town, South Africa during 2012 and 2013, under WHO Option A VTP guidelines. HIV-uninfected children aged 30-42 months were assessed using the Bayley scales of Infant Development-Third edition (BSID) and Strengths and Difficulties questionnaire (SDQ).Thirty-two HEU and 27 HU children (mean birth weight 3048g vs 3096g) were assessed. HEU children performed as well as HU children on BSID cognitive, language and motor domains. Mean scores fell within the low average range. Mothers of HEU children reported fewer conduct problems but stunting was associated with increased total difficulties on the SDQ.HEU and HU children's performance on the BSID was similar. In this low-risk cohort, HIV exposure did not confer additional risk. Stunting was associated with increased behavioural problems irrespective of HIV exposure.
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Affiliation(s)
- P E Springer
- Department of Paediatrics and Child Health and Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - A L Slogrove
- Department of Paediatrics and Child Health and Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Ukwanda Centre for Rural Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - M Kidd
- Centre for Statistical Consultation, Stellenbosch University, Stellenbosch, South Africa
| | - E Kalk
- Centre for Infectious Diseases Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - J A Bettinger
- Vaccine Evaluation Center, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - M M Esser
- Immunology Unit, Medical Microbiology, National Health Laboratory Service Tygerberg, Department of Pathology, Stellenbosch University, Cape Town, South Africa
| | - M F Cotton
- Department of Paediatrics and Child Health and Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Family Clinical Research Unit, Tygerberg Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - M Zunza
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - C D Molteno
- Department of Psychiatry, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - M Kruger
- Department of Paediatrics and Child Health and Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Abstract
Poice agents have beg to use hair analysis as a drug-screening tool in both officer recruitment and officer monitoring. This has been controversial because of a putative racial bias associated with human hair specimens, especially focused on cocaine. However, little empirical evidence has been offered to substantiate this claim. To asses this issue, Hoffin (1999, p. 613) analyzed recruitment cohort data from a major metropolitan police department ( N - 1,80) for cocaine ad marijuana hair assays, contrasting recruits by race. Hoffman's conclusion, based on comparison of odds ratios and relative rates for positive assy outcomes, was that there was "no evidence that one group (i.e., race) was more adversely affected by hair testing compared to urine testing." This article reports on research seekig to replicate Hoffman's results concerning hair analysis by utilizing a similar analytic approach with a much larger data set ( N - 40,000) and examining a different major metropolitan police department. This research is disnct form the Hoffman study in two ways: The assessment was exclusively of cocaine prevalence, and the subjects were who job applicants but sworn police officers. The findings reported here support Hoffman's conclusion that there is no statically significant race bias attributable to hair analysis, at least as applied to cocaine.
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Fayrer-Hosken RA, Kruger M, Vandenplas M, Giguere S, Buss P. 115 CHARACTERIZING NEUTROPHIL PROFILES IN HORSES FOR RHINOCEROS CAPTURE. Reprod Fertil Dev 2016. [DOI: 10.1071/rdv28n2ab115] [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] [Indexed: 11/23/2022] Open
Abstract
Conservation of several African species is becoming essential, and efforts to move threatened animals are causing physiological and reproductive problems. To save these species, a more comprehensive knowledge of their biology and response to stressors is required. Capture stress of rhinoceroses has been quantified (Kruger et al. 2011 Reprod. Fertil. Dev. 23, 181–182) by evaluating leucocyte coping capacity (LCC). LCC is the measurement of the fluorescence of circulating active neutrophils, then expressed as optical density (OD)/1000 neutrophils. The LCC then provides a standardized value between species as we used identical conditions and reagents. To quantify the role of LCC in rhinoceros conservation, it is essential to characterize normal LCC profiles of healthy unstressed rhinoceroses. Horse neutrophils are very similar to rhinoceros neutrophils in their biological activity. The objective of the study was to characterize normal LCC profiles in stallions, geldings, nonpregnant mares, pregnant mares, as well as fillies and colts of various ages as a benchmark for adult and juvenile rhinoceroses. The LCC profiles are shown in Figures 1 to 3. For the colts (days, weeks, and months old) there was little difference in their LCC profile over time. For the fillies (days, weeks, and months old) the LCC response for fillies only days old was significantly (P < 0.05) greater when compared to fillies that were weeks and months old. For the adult horses, the stallions had the lowest overall LCC and were very similar to nonpregnant mares. The LCC of pregnant mares was of significantly (P < 0.5) greater magnitude than that of stallions and nonpregnant mares. The LCC response of gelding was significantly (P < 0.5) greater than that of stallions and nonpregnant mares, but significantly (P < 0.5) lower than that of pregnant mares. The stallion and pregnant mare responses mirrored the quantitative responses of breeding rhinoceros bulls and pregnant rhinoceros cows. From the data (Figure 4) we suggest that breeding males (stallions, elephants, and rhinoceros bulls) have the lowest LCC activity curves, as their breeding activities result in higher daily stresses. We hypothesized that the stressed bulls have their neutrophil activity down regulated by circulating corticosteroids. The converse is true for pregnant females (mares and cows), as they may have more vigorous neutrophils and therefore the highest LCC curves. These basic studies support and validate the role of rapid LCC in stress evaluation of wild caught rhinoceroses and horses could be applicable for captured elephant.
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Vilchez G, Hoyos LR, Maldonado MC, Lagos M, Kruger M, Bahado-Singh R. Risk of neonatal mortality according to gestational age after elective repeat cesarean delivery. Arch Gynecol Obstet 2015; 294:77-81. [DOI: 10.1007/s00404-015-3955-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
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Mehta SH, Kruger M, Sokol RJ. Institute of Medicine Guidelines for Appropiate Pregnancy Weight Gain for Obese Women May Be Too High. J Reprod Med 2015; 60:324-328. [PMID: 26380491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate how the 2009 Institute of Medicine (IOM) guidelines for pregnancy weight gain for obese women relate to the longer-term outcome of childhood obesity. STUDY DESIGN Maternal, neonatal, soioeconomic, and nutritional histories were collected for mothers with children age 2-5 years old. Women in each body mass index (BMI) category were categorized based on under, appropriate (AG), and over weight gain per IOM guidelines and compared with rates of childhood obesity in each category. RESULTS A total of 502 mother-child pairs were enrolled; 36.4% of women were obese at the start of pregnancy. Obese women who were AG by IOM guidelines were more likely than underweight, normal weight, and overweight women to have obese offspring (29.5% vs. 14.2%, p = 0.04). The BMI percentiles of the offspring of obese AG women were 10 percentile points higher than the 55th percentile of the other groups. CONCLUSION The 2009 IOM pregnancy weight gain guidelines for obese women may still be too high when considering longer-term outcomes such as childhood obesity. Further studies are needed.
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Kruger M, Strydom NA. Plankton dynamics associated with the convergence zone of a shear front in the permanently open Kowie Estuary, South Africa. African Zoology 2015. [DOI: 10.1080/15627020.2011.11407478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kruger M, Hendricks M, Davidson A, Stefan D, Van Eyssen A, Uys R, Van Zyl A, Hesseling P. Letter to the editor. Pediatr Blood Cancer 2014; 61:1525. [PMID: 25045774 DOI: 10.1002/pbc.24973] [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: 11/09/2022]
Affiliation(s)
- M. Kruger
- Department of Paediatrics and Child Health; Tygerberg Hospital, University of Stellenbosch; Cape Town South Africa
| | - M. Hendricks
- Haematology-Oncology Service; Red Cross War Memorial Children's Hospital, Department of Paediatrics and Child Health, University of Cape Town; Cape Town South Africa
| | - A. Davidson
- Haematology-Oncology Service; Red Cross War Memorial Children's Hospital, Department of Paediatrics and Child Health, University of Cape Town; Cape Town South Africa
| | - D.C. Stefan
- Department of Paediatrics and Child Health; Tygerberg Hospital, University of Stellenbosch; Cape Town South Africa
| | - A.L. Van Eyssen
- Haematology-Oncology Service; Red Cross War Memorial Children's Hospital, Department of Paediatrics and Child Health, University of Cape Town; Cape Town South Africa
| | - R. Uys
- Department of Paediatrics and Child Health; Tygerberg Hospital, University of Stellenbosch; Cape Town South Africa
| | - A. Van Zyl
- Department of Paediatrics and Child Health; Tygerberg Hospital, University of Stellenbosch; Cape Town South Africa
| | - P.B. Hesseling
- Department of Paediatrics and Child Health; Tygerberg Hospital, University of Stellenbosch; Cape Town South Africa
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Zaglia T, Milan G, Ruhs A, Franzoso M, Bertaggia E, Pianca N, Catalucci D, Kruger M, Mongillo M, Sandri M. 17Inhibition of the ubiquitin ligase atrogin-1 impairs chmp2b turnover, blocks autophagy flux and causes cardiomyopathy. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu076.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wynberg JB, Paik LJ, Odom BD, Kruger M, Atalla CS. Body mass index predicts outcome of ureteroscopy-assisted retrograde nephrostomy for percutaneous nephrolithotomy. J Endourol 2014; 28:1071-7. [PMID: 24779944 DOI: 10.1089/end.2014.0204] [Citation(s) in RCA: 3] [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: 11/12/2022] Open
Abstract
INTRODUCTION Several clinical series of retrograde nephrostomy for percutaneous nephrolithotomy (PCNL) have been published over the past 30 years demonstrating good outcomes and safety. We previously reported our adaptation of the Lawson technique, wherein we deploy the puncture wire through a flexible ureteroscope. We herein aim to clarify the performance characteristics of this nephrostomy creation technique. MATERIALS AND METHODS Institutional Review Board approval and informed consent were obtained. A ureteroscopy-assisted retrograde nephrostomy (UARN) procedure was performed as described previously. Data were collected prospectively. Multiple patient and operative factors were evaluated for association with UARN success and nephrostomy creation time: body mass index (BMI), skin-to-stone distance, Guy's score, Clinical Research of the Endourological Society nephrolithometric score, hydronephrosis, stone burden, location of nephrostomy, exit from a stone-bearing calix, and use of holmium laser to access calix. RESULTS Nephrostomy was successful in 49/52 UARN procedures (94%). Only single access was placed: upper-18, mid-27, and lower-7. Median BMI was 29 kg/m(2) and median time for nephrostomy creation was 39 minutes. Fluoroscopy time for the entire PCNL including nephrostomy creation was 84 and 16 seconds for case numbers 1-25 and 26-52, respectively. By stepwise linear regression, variables correlating with nephrostomy creation time were BMI (r(2)=0.219), stone burden (r(2)=0.094), use of holmium laser to access calix (r(2)=0.104), and total r(2) linear=0.416. CONCLUSIONS UARN is an intuitive safe procedure that offers dramatic reductions in fluoroscopy times. UARN is best suited to cases requiring only one nephrostomy tract. Upper pole access is commonly performed with a subcostal technique to navigate the puncture wire below the ribs. Increasing BMI best predicts longer nephrostomy creation times; procedure failure was associated with BMI exceeding 40 kg/m(2). UARN is a robust technique for nephrostomy creation in appropriately selected patients.
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Affiliation(s)
- Jason B Wynberg
- 1 Department of Urology, Detroit Medical Center , Detroit, Michigan
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Vilchez G, Brantley E, Leon-Peters J, Chelliah A, Kruger M, Bahado-Singh R. 673: Effect of Asian race on adverse neonatal outcomes after elective repeat cesarean delivery. Am J Obstet Gynecol 2014. [DOI: 10.1016/j.ajog.2013.10.706] [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: 11/26/2022]
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Guirgis GA, Klaassen JJ, Pate BH, Seifert NA, Darkhalil ID, Deodhar BS, Wyatt JK, Dukes HW, Kruger M, Durig JR. Microwave, infrared, and Raman spectra, structural parameters, vibrational assignments and theoretical calculations of 1,3-disilacyclopentane. J Mol Struct 2013. [DOI: 10.1016/j.molstruc.2013.06.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bahado-Singh RO, Akolekar R, Chelliah A, Mandal R, Dong E, Kruger M, Wishart DS, Nicolaides K. Metabolomic analysis for first-trimester trisomy 18 detection. Am J Obstet Gynecol 2013; 209:65.e1-9. [PMID: 23535240 DOI: 10.1016/j.ajog.2013.03.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 02/28/2013] [Accepted: 03/21/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether nuclear magnetic resonance-based metabolomic markers in first-trimester maternal serum can detect fetuses with trisomy 18. STUDY DESIGN This was a study of pregnancies between 11 weeks and 13 weeks 6 days' gestation. We analyzed 30 cases of trisomy 18 and a total of 114 euploid cases. Nuclear magnetic resonance-based metabolomic analysis was performed. A further analysis was performed that compared 30 cases with trisomy 18 and 30 trisomy 21 (T21) cases. RESULTS Metabolomic markers were sensitive for trisomy 18 detection. A combination of 2-hydroxybutyrate, glycerol and maternal age had a 73.3% sensitivity and 96.6% specificity for trisomy 18 detection, with an area under the receiver operating curve: 0.92 (P < .001). Other metabolite markers, which include trimethylamine, were sensitive for distinguishing trisomy 18 from T21 cases. CONCLUSION This is the first report of prenatal trisomy 18 detection that has been based on metabolomic analysis. Preliminary results suggest that such markers are sensitive not only for the detection of fetal trisomy 18 but also for distinguishing this aneuploidy from T21.
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Bahado-Singh RO, Akolekar R, Mandal R, Dong E, Xia J, Kruger M, Wishart DS, Nicolaides K. Metabolomic analysis for first-trimester Down syndrome prediction. Am J Obstet Gynecol 2013; 208:371.e1-8. [PMID: 23313728 DOI: 10.1016/j.ajog.2012.12.035] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [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: 06/29/2012] [Revised: 11/07/2012] [Accepted: 12/27/2012] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The objective of the study was to perform first-trimester maternal serum metabolomic analysis and compare the results in aneuploid vs Down syndrome (DS) pregnancies. STUDY DESIGN This was a case-control study of pregnancies between 11+0 and 13+6 weeks. There were 30 DS cases and 60 controls in which first-trimester maternal serum was analyzed. Nuclear magnetic resonance-based metabolomic analysis was performed for DS prediction. RESULTS Concentrations of 11 metabolites were significantly different in the serum of DS pregnancies. The combination of 3-hydroxyisovalerate, 3-hydroxybuterate, and maternal age had a 51.9% sensitivity at 1.9% false-positive rate for DS detection. One multimarker algorithm had 70% sensitivity at 1.7% false-positive rate. Novel markers such as 3-hydroxybutyrate, involved in brain growth and myelination, and 2-hydroxybutyrate, involved in the defense against oxidative stress, were found to be abnormal. CONCLUSION The study reports novel metabolomic markers for the first-trimester prediction of fetal DS. Metabolomics provided insights into the cellular dysfunction in DS.
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Affiliation(s)
- Ray O Bahado-Singh
- Department of Obstetrics and Gynecology, Oakland University -William Beaumont School of Medicine, Royal Oak, MI, USA
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Bajaj R, Chhabra L, Kruger M, Kumar D. Mobile complex atherosclerotic aortic plaque. Case Reports 2013; 2013:bcr-2013-009542. [DOI: 10.1136/bcr-2013-009542] [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: 11/04/2022] Open
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Arnetz B, Drutchas A, Sokol R, Kruger M, Jamil H. 1991 Gulf War exposures and adverse birth outcomes. US Army Med Dep J 2013:58-65. [PMID: 23584910 PMCID: PMC3930470] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We studied 1991 Gulf War (GW)-related environmental exposures and adverse birth outcomes in Iraqis. A random cross-sectional sample of 307 Iraqi families that immigrated to the United States responded to a structured interview covering socioeconomics, lifestyle, environmental exposures, and birth outcome. Data per each family was collected either from the man or the woman in the respective family. The respondents were divided into those that resided in Iraq during and following the GW (post-GW, n=185) and those that had left before (pre-GW, n=122). The primary outcome was lifetime prevalence of adverse birth outcomes, ie, congenital anomalies, stillbirth, low birth weight, and preterm delivery and its relationship to GW exposures. Mean number of adverse birth outcomes increased from 3.43 (SD=2.11) in the pre-GW to 4.63 (SD=2.63) in the post-GW group (P<.001). Mean chemical (Ch) and nonchemical (NCh) environmental exposure scores increased from pre-GW scores of 0.38 units (SD=1.76) and 0.43 (SD=1.86), respectively, to post-GW scores of 5.65 units (SD=6.23) and 7.26 (SD=5.67), P<.001 between groups for both exposures. There was a significant dose-response relationship between Ch environmental exposure (P=.001), but not NCh exposure, and number of adverse birth outcomes. Exposure to burning oil pits and mustard gas increased the risks for specific adverse birth outcomes by 2 to 4 times. Results indicate that Gulf War Ch, but not NCh exposures are related to adverse birth outcomes. Pregnancies in women with a history of war exposures might benefit from more intensive observation.
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Affiliation(s)
- Bengt Arnetz
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
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Bahado-Singh RO, Akolekar R, Mandal R, Dong E, Xia J, Kruger M, Wishart DS, Nicolaides K. First-trimester metabolomic detection of late-onset preeclampsia. Am J Obstet Gynecol 2013; 208:58.e1-7. [PMID: 23159745 DOI: 10.1016/j.ajog.2012.11.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 11/04/2012] [Accepted: 11/08/2012] [Indexed: 12/17/2022]
Abstract
OBJECTIVE We sought to identify first-trimester maternal serum biomarkers for the prediction of late-onset preeclampsia (PE) using metabolomic analysis. STUDY DESIGN In a case-control study, nuclear magnetic resonance-based metabolomic analysis was performed on first-trimester maternal serum between 11(+0)-13(+6) weeks of gestation. There were 30 cases of late-onset PE, i.e., requiring delivery ≥37 weeks, and 59 unaffected controls. The concentrations of 40 metabolites were compared between the 2 groups. We also compared 30 early-onset cases to the late-onset group. RESULTS A total of 14 metabolites were significantly elevated and 3 significantly reduced in first-trimester serum of late-onset PE patients. A complex model consisting of multiple metabolites and maternal demographic characteristics had a 76.6% sensitivity at 100% specificity for PE detection. A simplified model using fewer predictors yielded 60% sensitivity at 96.6% specificity. Strong separation of late- vs early-onset PE groups was achieved. CONCLUSION Significant differences in the first-trimester metabolites were noted in women who went on to developed late-onset PE and between early- and late-onset PE.
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Vilchez G, Chelliah A, Argoti P, Kruger M, Bahado-Singh R. 795: Optimal gestational age for elective repeat cesarean delivery in Hispanics. Am J Obstet Gynecol 2013. [DOI: 10.1016/j.ajog.2012.10.133] [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: 10/27/2022]
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Bahado-Singh RO, Akolekar R, Mandal R, Dong E, Xia J, Kruger M, Wishart DS, Nicolaides K. Metabolomics and first-trimester prediction of early-onset preeclampsia. J Matern Fetal Neonatal Med 2012; 25:1840-7. [PMID: 22494326 DOI: 10.3109/14767058.2012.680254] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To evaluate the use of metabolomics for the first-trimester detection of maternal metabolic dysfunction and prediction of subsequent development of early-onset preeclampsia (PE). STUDY DESIGN This was a case-control study of maternal plasma samples collected at 11-13 weeks' gestation from 30 women who had subsequently developed PE requiring delivery before 34 weeks and 60 unaffected controls. Nuclear magnetic Resonance (NMR) spectroscopy was used to identify and quantify metabolomic changes in cases versus controls. Both genetic computing and standard statistical analyses were performed to predict the development of PE from the metabolite concentrations alone as well as the combination of metabolite concentrations with maternal characteristics and first-trimester uterine artery Doppler pulsatility index (PI). RESULTS Significant differences between cases and controls were found for 20 metabolites. A combination of four of these metabolites (citrate, glycerol, hydroxyisovalerate, and methionine) appeared highly predictive of PE with an estimated detection rate of 75.9%, at a false-positive rate (FPR) of 4.9%. The predictive performance was improved by the addition of uterine artery Doppler PI and fetal crown-rump length (CRL) and with an estimated detection rate of 82.6%, at a FPR of 1.6%. CONCLUSION A profound change in the first-trimester metabolite profile was noted in women who had subsequently developed early-onset PE. Preliminary algorithms appeared highly sensitive for first trimester prediction of early onset PE.
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Affiliation(s)
- Ray O Bahado-Singh
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI 48226, USA.
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Aguin E, Aguin T, Cordoba M, Aguin V, Roberts R, Albayrak S, Kruger M, Bahado-Singh R. Amniotic fluid inflammation with negative culture and outcome after cervical cerclage. J Matern Fetal Neonatal Med 2012; 25:1990-4. [PMID: 22372938 DOI: 10.3109/14767058.2012.667177] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine whether amniotic fluid (AF) inflammation, in the absence of infection, is associated with adverse pregnancy outcomes in nonelective cervical cerclage patients. METHODS A retrospective case-control study was carried out. The patient population included 82 singleton pregnancies with negative AF cultures. The variables used to define AF inflammation were white blood cell count (WBC) >50 cell/mm(3), glucose <14 mg/dl or interleukin-6 (IL-6) >11.3 ng/ml. The study group consisted of cases with intra-amniotic inflammation. Sub-analysis was performed for the groups in which IL-6 concentrations were measured. Adverse outcomes were evaluated with variables such as gestational age at delivery, interval from cerclage to delivery, chorioamnionitis and cumulative neonatal morbidity. RESULTS Elevated AF WBC was correlated with severe and extreme preterm delivery (p < 0.05). Decreased AF glucose was associated with histological chorioamnionitis and a decreased cerclage to delivery interval (p < 0.05). Elevated AF IL-6 correlated significantly with decreased gestational age at delivery (p < 0.012) and decreased cerclage to delivery interval (p < 0.001). Elevated IL-6 concentrations were associated with severe, extreme preterm delivery (p < 0.001) and neonatal death (p < 0.001). CONCLUSION Elevated AF IL-6, elevated WBC and low AF glucose, in the absence of a positive AF culture, are significantly associated with adverse pregnancy outcomes in patients undergoing nonelective cerclage.
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Affiliation(s)
- Eduardo Aguin
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan 48201, USA.
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Mieczkowski T, Kruger M. The Informational Yield of Paired Samples from a Large Sample: Hair Analysis and Urinalysis for Cocaine and Cannabinoids. J Addict Nurs 2012; 23:30-9. [DOI: 10.3109/10884602.2011.645254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Leach RE, Jessmon P, Coutifaris C, Kruger M, Myers ER, Ali-Fehmi R, Carson SA, Legro RS, Schlaff WD, Carr BR, Steinkampf MP, Silva S, Leppert PC, Giudice L, Diamond MP, Armant DR. High throughput, cell type-specific analysis of key proteins in human endometrial biopsies of women from fertile and infertile couples. Hum Reprod 2012; 27:814-28. [PMID: 22215622 PMCID: PMC3279126 DOI: 10.1093/humrep/der436] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [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: 04/14/2011] [Revised: 08/17/2011] [Accepted: 10/17/2011] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although histological dating of endometrial biopsies provides little help for prediction or diagnosis of infertility, analysis of individual endometrial proteins, proteomic profiling and transcriptome analysis have suggested several biomarkers with altered expression arising from intrinsic abnormalities, inadequate stimulation by or in response to gonadal steroids or altered function due to systemic disorders. The objective of this study was to delineate the developmental dynamics of potentially important proteins in the secretory phase of the menstrual cycle, utilizing a collection of endometrial biopsies from women of fertile (n = 89) and infertile (n = 89) couples. METHODS AND RESULTS Progesterone receptor-B (PGR-B), leukemia inhibitory factor, glycodelin/progestagen-associated endometrial protein (PAEP), homeobox A10, heparin-binding EGF-like growth factor, calcitonin and chemokine ligand 14 (CXCL14) were measured using a high-throughput, quantitative immunohistochemical method. Significant cyclic and tissue-specific regulation was documented for each protein, as well as their dysregulation in women of infertile couples. Infertile patients demonstrated a delay early in the secretory phase in the decline of PGR-B (P < 0.05) and premature mid-secretory increases in PAEP (P < 0.05) and CXCL14 (P < 0.05), suggesting that the implantation interval could be closing early. Correlation analysis identified potential interactions among certain proteins that were disrupted by infertility. CONCLUSIONS This approach overcomes the limitations of a small sample number. Protein expression and localization provided important insights into the potential roles of these proteins in normal and pathological development of the endometrium that is not attainable from transcriptome analysis, establishing a basis for biomarker, diagnostic and targeted drug development for women with infertility.
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Affiliation(s)
- Richard E. Leach
- Michigan State University-Spectrum Health Medical Group, Grand Rapids, MI, USA
| | - Philip Jessmon
- Wayne State University, Detroit, MI, USA
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | | | | | | | | | | | | | | | - Bruce R. Carr
- University of Texas-Southwestern Medical Center, Dallas, TX, USA
| | | | - Susan Silva
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | | | - Linda Giudice
- University of California San Francisco, San Francisco, CA, USA
| | | | - D. Randall Armant
- Wayne State University, Detroit, MI, USA
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
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Bahado-Singh RO, Bolinjkar R, Allen L, Vilchez G, Zeid L, Albayarak S, Kruger M. 22: Folate dysregulation and the development of hypoplastic left heart syndrome. Am J Obstet Gynecol 2012. [DOI: 10.1016/j.ajog.2011.10.048] [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: 11/17/2022]
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Abstract
OBJECTIVE Our objective is to determine if there is a relationship between diabetes during pregnancy and childhood obesity, in our inner-city, African-American population. METHODS Pertinent child, neonatal and maternal pregnancy and delivery data were collected from mothers of children age 2-5 years old. Outcome variable definition was based on children's body mass index (BMI) subgroups; independent variable definition on birthweight subgroups based on customized growth percentiles. Covariates included pre and postnatal factors. Those covariates marginally related to diabetes (p < 0.2) by bivariate analyses, were allowed to compete in logistic regression, with p < 0.05 significant. RESULTS Four hundred and ninety-three patients were enrolled, of which 35 (7.1%) had diabetes during pregnancy. Children of diabetic mothers were more likely to be obese at age 2-5 years than those of non-diabetics (p = 0.004). Five of 20 covariates had p < 0.2 in bivariate setting. Following stepwise logistic regression, diabetes and maternal prepregnancy BMI were significant determinants of childhood obesity. When large-for-gestational age (LGA) was added into the model, diabetes was no longer significant (p = 0.105); only LGA (p = 0.008) and maternal prepregnancy BMI (p = 0.032) were significantly associated with childhood obesity. CONCLUSIONS In our inner-city, primarily African-American population, diabetes in pregnancy is significantly related to childhood obesity at age 2-5 years. Well-controlled diabetes during pregnancy that avoids macrosomia may lead to prevention of future childhood obesity as well.
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Affiliation(s)
- Shobha H Mehta
- Department of Obstetrics, Gynecology and Women's Health, Henry Ford Health System, Detroit, MI, USA.
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Londra L, Shavell V, Vilchez G, Kruger M, Berman J, Diamond M. The Use of Intrauterine Devices for Birth Control in a Minority, Inner-City Patient Population: A Review of Outcomes. J Minim Invasive Gynecol 2011. [DOI: 10.1016/j.jmig.2011.08.161] [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: 11/25/2022]
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Bahado-Singh RO, Schenone M, Cordoba M, Shieh WS, Maulik D, Kruger M, Reece EA. Male gender significantly increases risk of oxidative stress related congenital anomalies in the non-diabetic population. J Matern Fetal Neonatal Med 2011; 24:687-91. [PMID: 21381882 DOI: 10.3109/14767058.2010.529970] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Oxidative stress (OS) is an important mechanism of teratogenesis. Recent work suggests increased OS in males. We evaluated whether male gender increased the risk of cyanotic congenital heart defects (CCHD) whose development is linked to OS and other common congenital anomalies (CA) in non-diabetic pregnancies. METHODS CDC-National Center for Health Statistics data for 19 states in 2006 were reviewed. CCHD, anencephaly, spina bifida, congenial diaphragmatic hernia (CDH), omphalocele, gastroschisis, limb defects, cleft lip with or without cleft palate (CL/P) and isolated cleft palate were evaluated. Adjusted odds ratio (OR) (95% CI) were calculated for CA in males with females as the reference group. RESULTS Of 1,194, 581, cases analyzed after exclusions, 3037 (0.25%) had major CA. Males had elevated adjusted OR (95% CI) for CCHD: 1.198 (1.027, 1.397), CDH: 1.487 (1.078, 2.051), and CL/P: 1.431 (1.24, 1.651). There was a significant interaction between cigarette use and (male) fetal gender and also with maternal age in the CL/P group. CONCLUSIONS In non-diabetic pregnancies, male gender appears to be an independent risk factor for some types of CA believed to be associated with OS. Cigarette smoking, a well recognized source of OS only increased the risk of CL/P in males.
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Affiliation(s)
- Ray O Bahado-Singh
- Department of OB/GYN, Wayne State University School of Medicine, Detroit, Michigan, USA.
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Mehta SH, Kruger M, Sokol RJ. Being too large for gestational age precedes childhood obesity in African Americans. Am J Obstet Gynecol 2011; 204:265.e1-5. [PMID: 21376166 PMCID: PMC3055169 DOI: 10.1016/j.ajog.2010.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [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: 07/29/2010] [Revised: 11/23/2010] [Accepted: 12/07/2010] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the association between large-for-gestational-age (LGA) infants and the development of childhood obesity in an inner-city primarily African American population. STUDY DESIGN Maternal, neonatal, socioeconomic, and nutritional histories were collected for mothers with children who were 2-5 years old. Associations between Alexander and customized birthweight percentiles and body mass index for the age of the child were examined. RESULTS One hundred ninety-five mother-child pairs were enrolled; the childhood obesity rate was 18%. Increasing Alexander and customized birthweight percentiles were related to increasing obesity. LGA newborn infants were 2.5 times more likely to be obese in childhood than average size newborn infants. Maternal smoking was also associated with childhood obesity. CONCLUSION LGA infants have the highest likelihood of childhood obesity in this inner-city predominantly African American population. Customized growth percentiles perform best in the identification of the highest risk population.
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Affiliation(s)
- Shobha H Mehta
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
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Kruger M, Loggenberg E. Complications, disease profile and histological yield from percutaneous renal biopsy under real-time US guidance: A retrospective analysis. SA J Radiol 2011. [DOI: 10.4102/sajr.v15i1.342] [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] [Indexed: 11/01/2022] Open
Abstract
Objective. The objective of the study was to evaluate (i) the technique used at Universitas Hospital in comparison with other international centres also performing renal biopsies, (ii) the disease profile in patients undergoing renal biopsies, (iii) the complications experienced during and/or after the procedure, and (iv) the histological yield of the biopsies (amount of nephrons per biopsy taken) using this technique.
Design. A retrospective descriptive analysis of all patients who underwent percutaneous renal biopsy under ultrasound (US) guidance at the Interventional Radiology Unit, Universitas Hospital, Bloemfontein, was undertaken for the period 1 January 2003 - 31 December 2008. Data obtained from the patients’ files and histology reports were statistically analysed.
Results. A total of 112 patients qualified for inclusion in the study, all of whom had proof of renal failure and then had percutaneous renal biopsy performed under US guidance. The histology was diagnostic in 111 (99.1%) of the cases, with more than 5 nephrons present in 105 (93.5%) of the cases. Minor complications were found in 29 (25.8%) of the patients, but no major complications were noted. Primary renal disease was found in 67 (59.8%) of patients, and the renal pathology and failure in 45 (40.2%) of the patients were shown histologically to be owing to systemic disease.
Conclusion. The technique utilised for performing percutaneous renal biopsy under US guidance at the Interventional Radiology Unit was shown to be safe, with a diagnostic histological yield comparable with international standards. A small majority or patients suffered primary renal disease in comparison with renal failure owing to systemic illness.
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Argoti P, Allen L, Kruger M, Bahado-Singh RO. 788: Mean platelet volume for intrapartum prediction of preeclampsia. Am J Obstet Gynecol 2011. [DOI: 10.1016/j.ajog.2010.10.810] [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: 11/28/2022]
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Kruger M, Pitts NI, Virgo J, Betts E, Delk K, Fayrer-Hosken RA. 158 DEVELOPMENT OF FIELD ASSAY FOR EVALUATION OF WHITE RHINOCEROS NEUTROPHIL FUNCTION AS A STRESS MARKER. Reprod Fertil Dev 2011. [DOI: 10.1071/rdv23n1ab158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Kruger National Park (KNP) is the primary source of translocated white rhinoceroses (Ceratotherium simum) in South Africa. Capture and transport of the rhinoceroses is a highly successful procedure. However, some relocated rhinoceroses present with fertility problems in the 1–2 years post capture. Novel research has shown that one can assess stress using respiratory neutrophil burst levels in several species (Huber et al. 2006 Protoplasma 229, 221–224; Weyts et al. 1998 Dev. Comp. Immunol. 22, 563–572). The hypothesis is that some rhinoceroses respond poorly to stress. The response to stress might be measurable by a neutrophil function (NF) assay, and NF depression might identify adversely stressed animals. The aim was to develop an in-the-bush test for NF and evaluate the changes in neutrophil activity during capture and loading into transportation crates. Neutrophil function was assayed using a portable luminometer (3M Clean-Trace™, 3M, St. Paul, MN, USA) while driving from one capture to the next. For the reaction mixture, 500 μL of PBS was incubated with 10 μL of fresh heparinized blood at 37.6°C. The incubator unit was power by a 230 V convertor in the vehicle. After 5 min of incubation, 100 μL of luminol was added. This sample was read in the luminometer as a blank and then to the sample, 100 μL of 12-O-tetradecanoylphorbol-13-acetate (TPA), also commonly known as phorbol 12-myristate 13-acetate (PMA), a diester of phorbol, was added. The luminescence readings or relative light units (RLU) were read at 2.5 min and then 5 min after PMA addition. All samples were prepared in triplicate. The readings were then taken every 5 min for 65 min. Two samples of blood were evaluated for each rhinoceros: the first sample at capture (anaesthetic induction) and then a second sample after loading of the rhinoceros into the transport crate, 20 to 30 min later. Two response curves were produced for each rhinoceros using the means of the triplicate readings. The curves were then transformed with a trend line and the area under the curve (AUC) was calculated. The 2 AUC for rhinoceros were then compared statistically using Wilcoxon rank regression, with P < 0.05 considered statistically different. Three distinct response curve patters were seen. Sixty-two percent (16/26) of the rhinoceroses had no statistical (P < 0.05) difference between capture and loading samples. In 5 of 26 (19%), the loading AUC was statistically greater than the capture sample, and in 5 of 26 (19%), the capture AUC was statistically greater than the loading sample. In conclusion, NF can be assayed in the field using the blood of wild caught rhinoceroses. The assay is repeatable and can distinguish 3 populations of wild caught rhinoceroses. The hope is that future research will allow us to identify rhinoceroses that have negative stress reactions and to change the capture conditions to make the process less stressful.
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Adams A, Bahado-Singh RO, Maulik D, Kruger M. 276: Male gender and the risk of oxidative stress related birth defects. Am J Obstet Gynecol 2011. [DOI: 10.1016/j.ajog.2010.10.294] [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: 11/24/2022]
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Kruger M, Strydom N. Spatial and Temporal Variability in the Larval Fish Assemblage of a Warm Temperate South African Estuary, with Notes on the Effects of Artificial Channelling. African Zoology 2010. [DOI: 10.3377/004.045.0221] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kudish B, Mehta S, Kruger M, Russell E, Sokol RJ. Delivery route preferences of urban women of low socioeconomic status. Int J Gynaecol Obstet 2010; 111:28-31. [PMID: 20579999 DOI: 10.1016/j.ijgo.2010.04.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 04/19/2010] [Accepted: 05/24/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify the main determinants of mode of delivery preference among urban dwelling women of lower socioeconomic status (SES). METHODS Over a 12-month period, a self-completion 36-item questionnaire was administered to a convenience sample of 308 women within the first 3 postpartum days. Non-parametric tests were used for analysis. RESULTS Study participants were mostly African American (>85%), single mothers (>75%), and unemployed (≥55%). Among the women, 85.7% had vaginal delivery (VD) and 14.3% had cesarean delivery (CD). Women who preferred CD (10%) were more likely to be concerned about a vaginal tear/episiotomy during VD, forceps, and a "big" baby compared with women who preferred VD, for whom "pushing the baby out myself" and "fear of cesarean" were the most important factors. In the final model of 7 factors, the 3 main factors found to positively impact maternal preference for CD were a vaginal cut during VD (P<0.001), higher mean BMI (P=0.001), and cesarean as the most recent delivery type (P<0.001). The total explained variance by this model was 46%. CONCLUSIONS Short-term complications of a VD, higher BMI, and a previous cesarean delivery are the most significant factors that impact the preferences of women of lower SES for future mode of delivery.
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Affiliation(s)
- Bela Kudish
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington Hospital Center, Washington DC 20010-2975, USA.
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Schenone MH, Aguin E, Li Y, Lee C, Kruger M, Bahado-singh RO. Prenatal prediction of neonatal survival at the borderline viability. J Matern Fetal Neonatal Med 2010; 23:1413-8. [DOI: 10.3109/14767058.2010.481318] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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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Kruger M. The ethical approach to evidence-based medicine. South African Journal of Clinical Nutrition 2010. [DOI: 10.1080/16070658.2010.11734276] [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: 10/21/2022]
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Bahado-Singh R, Argoti P, Hauff N, Jones T, Kruger M, Sorokin Y. 491: Multiple vs last cervical length measurement for prediction of spontaneous preterm birth. Am J Obstet Gynecol 2009. [DOI: 10.1016/j.ajog.2009.10.657] [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: 11/27/2022]
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Bahado-Singh R, Argoti P, Allen L, Jodicke C, Kruger M, Reece EA. 715: Increased risk of congenital anomalies in male fetuses in diabetes diagnosed in pregnancy. Am J Obstet Gynecol 2009. [DOI: 10.1016/j.ajog.2009.10.732] [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: 11/25/2022]
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Bahado-Singh R, Kruger M, Imudia A, Schenone M, Jones T, Sorokin Y. 492: Cervical length measurement for prediction of spontaneous preterm birth. Am J Obstet Gynecol 2009. [DOI: 10.1016/j.ajog.2009.10.658] [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: 11/26/2022]
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Ward C, Thakur P, Kruger M, Christensen C. 138: Postpartum methadone requirements remain increased after maintenance therapy in pregnancy: a 6-month follow-up study. Am J Obstet Gynecol 2009. [DOI: 10.1016/j.ajog.2009.10.153] [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: 11/25/2022]
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Barbu D, Mert I, Kruger M, Bahado-Singh RO. Evidence of fetal central nervous system injury in isolated congenital heart defects: microcephaly at birth. Am J Obstet Gynecol 2009; 201:43.e1-7. [PMID: 19446786 DOI: 10.1016/j.ajog.2009.03.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Revised: 02/28/2009] [Accepted: 03/06/2009] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We sought to ascertain the risk of reduced fetal brain growth in cases of isolated congenital heart defect (CHD) based on microcephaly at birth. STUDY DESIGN In a case-control study, head circumference was compared in 401 newborns with isolated CHD with 401 control subjects. Microcephaly was defined as head circumference below third percentile. The rates of microcephaly in multiple different categories of major CHD were ascertained along with logistic regression analyses to determine the specific types of cardiac defects that were significantly associated with microcephaly. RESULTS Isolated CHD in the fetus was associated with an increased risk of microcephaly as were tetralogy of Fallot, coarctation/aortic arch hypoplasia, and hypoplastic left ventricle syndrome. Tetralogy of Fallot odds ratio, 2.6; 95% confidence interval, 1.1-6.3; P < .04 and coarctation/aortic arch hypoplasia, odds ratio, 2.8; 95% confidence interval, 1.5-5.1; P < .001 were significant independent predictors of microcephaly. CONCLUSION The finding of microcephaly at birth in nonsyndromic CHD provides strong evidence in support of intrauterine hypoxic central nervous system damage. Potential changes in prenatal management including aggressive antepartum surveillance and earlier delivery warrant urgent consideration.
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Bandyopadhyay S, Nahleh Z, Ali Fehmi R, Arabi H, Sakr W, Munkarah A, Kruger M. Enhancer of zeste homologue 2 ( EZH-2) expression in breast cancer: a novel marker and potential target. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e22154] [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: 11/20/2022] Open
Abstract
e22154 Background: EZH-2 is a protein involved in cell cycle regulation; it belongs to the Polycomb group of proteins and has been suggested to be associated with aggressive breast cancer. In hormone receptor negative (HR-) breast carcinomas, novel therapeutic targets are needed. Few markers have achieved the success of Her-2/neu as targeted therapy making the search for novel treatment strategies imperative. In our study we investigate the expression of EZH2 in a cohort of hormone receptor negative breast carcinomas. Methods: We identified a consecutive cohort of 84 cases of HR- breast carcinoma in 2005–2006, from the Pathology department archives. Tumor grade, size, presence or absence of DCIS, lymph node status and Her2/neu expression were documented. The race of the patients was also noted. Immunohistochemical staining for EZH2 was performed on paraffin embedded sections. Nuclear expression of EZH2 was considered as positive and the percentage of cells staining positive was estimated. Using the Mann-Whitney U test, the expression of EZH2 was correlated with the tumor characteristics listed above. Results: The mean expression of EZH2 in HR- tumors was estimated at 74% with a median of 80% (0–90). Most of these cases (n= 61) were triple negative; 23 cases were HER-2/neu positive by established criteria. Increasing expression of EZH2 was correlated with increase in tumor size (>2 cm) and increased incidence of lymph node metastasis. No correlation was seen with tumor grade, the presence or absence of DCIS and Her2/neu expression. Race did not appear to have an impact on EZH2 expression. Conclusions: Our findings suggest that EZH2 is expressed in the majority of HR - breast cancer and is associated with aggressive breast carcinomas. EZH2 could be an important therapeutic target in this patient population. The study is ongoing to further characterize EZH2‘s role and its association with survival. No significant financial relationships to disclose.
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Affiliation(s)
- S. Bandyopadhyay
- Wayne State University/Detoit Medical Center, Detroit, MI; Wayne State University/Karmanos Cancer Institute, Detroit, MI; Wayne State University/Detroit Medical Center, Detroit, MI; Henry Ford Medical Center, Detroit, MI
| | - Z. Nahleh
- Wayne State University/Detoit Medical Center, Detroit, MI; Wayne State University/Karmanos Cancer Institute, Detroit, MI; Wayne State University/Detroit Medical Center, Detroit, MI; Henry Ford Medical Center, Detroit, MI
| | - R. Ali Fehmi
- Wayne State University/Detoit Medical Center, Detroit, MI; Wayne State University/Karmanos Cancer Institute, Detroit, MI; Wayne State University/Detroit Medical Center, Detroit, MI; Henry Ford Medical Center, Detroit, MI
| | - H. Arabi
- Wayne State University/Detoit Medical Center, Detroit, MI; Wayne State University/Karmanos Cancer Institute, Detroit, MI; Wayne State University/Detroit Medical Center, Detroit, MI; Henry Ford Medical Center, Detroit, MI
| | - W. Sakr
- Wayne State University/Detoit Medical Center, Detroit, MI; Wayne State University/Karmanos Cancer Institute, Detroit, MI; Wayne State University/Detroit Medical Center, Detroit, MI; Henry Ford Medical Center, Detroit, MI
| | - A. Munkarah
- Wayne State University/Detoit Medical Center, Detroit, MI; Wayne State University/Karmanos Cancer Institute, Detroit, MI; Wayne State University/Detroit Medical Center, Detroit, MI; Henry Ford Medical Center, Detroit, MI
| | - M. Kruger
- Wayne State University/Detoit Medical Center, Detroit, MI; Wayne State University/Karmanos Cancer Institute, Detroit, MI; Wayne State University/Detroit Medical Center, Detroit, MI; Henry Ford Medical Center, Detroit, MI
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Claassen N, Snyman J, Koorts A, Nolte H, Wagenaar B, Kruger M, Becker PJ, Viljoen M. Cyclooxygenase inhibitors and the exercise-induced stress response. S Afr J SM 2009. [DOI: 10.17159/2413-3108/2006/v18i1a245] [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] [Indexed: 11/05/2022] Open
Abstract
Objective. This study investigated the effects of single dosages of the non-steroidal anti-inflammatory drug (NSAID) naproxen, and of the coxib, rofecoxib, on the exercise-induced stress response. Design. Eight subjects (age 20.9 ± 1.1 years, weight 70.4 ± 3.9 kg, height 170.9 ± 6.7 cm, body surface area 1.82 ± 0.09 m2, body mass index 24.1 ± 1.3 kg.m-2) took part in a double-blind, drug-placebo, cross-over design study. The experimental procedures were performed on 3 occasions on each volunteer, i.e. once on placebo, once on naproxen (single dose of 1 000 mg) and once on rofecoxib (single dose of 50 mg). Results. Mean post-exercise cortisol values were significantly higher than pre-exercise values with the subjects on placebo (p = 0.0365) and rofecoxib (p = 0.0208), but not on naproxen (p = 0.0732). Post-exercise oral temperatures were significantly higher than pre-exercise temperature values on placebo (p = 0.0153) and rofecoxib (p = 0.0424), but not on naproxen (p = 0.5444). Conclusion. The results of this study suggest a role for cyclooxygenase-1 (COX-1) in the exercise-induced cortisol and temperature response to exercise. South African Journal of Sports Medicine Vol. 18 (1) 2006: pp. 4-8
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Bahado-Singh R, Mert I, Barbu D, Kruger M. 186: Evidence of fetal hypoxic brain injury in isolated congenital heart defect (CHD) as determined by newborn microcephaly. Am J Obstet Gynecol 2008. [DOI: 10.1016/j.ajog.2008.09.213] [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: 10/21/2022]
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