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Ragunanthan NW, Lamb J, Hauspurg A, Beck S. Assessment of Racial Disparities in Aspirin Prophylaxis for Preeclampsia Prevention. Am J Perinatol 2024; 41:635-640. [PMID: 35189651 PMCID: PMC9900494 DOI: 10.1055/s-0042-1743142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Low-dose aspirin is recommended for preeclampsia prevention among women with high-risk conditions, including chronic hypertension. Black women have higher rates of hypertensive disorders of pregnancy, and whether this is related to disparities in aspirin prophylaxis is unknown. We investigated the relationship between race and counseling/prescription and uptake of aspirin among a cohort of women with chronic hypertension. STUDY DESIGN This is a single-institution, retrospective cohort study of women with chronic hypertension who delivered between 2016 and 2018. Medical record review was performed to assess counseling/prescription of aspirin prophylaxis and self-reported uptake. Self-reported uptake was determined by mention in the provider's notes or by inclusion in the medication reconciliation system. Demographic and obstetric outcome data were compared by self-reported race (Black vs. all other races) in univariate analysis. Multivariable logistic regression analysis was performed to evaluate the association between race and aspirin adherence. RESULTS We included 872 women: 361 (41.4%) Black women and 511 (58.6%) white or other race women. Overall, 567 (65.0%) women were counseled and/or given a prescription for aspirin, and 411 (72.4%) of those women reported uptake. Black women were equally likely to be counseled and/or prescribed aspirin compared with all other races (67.3 vs. 63.4%; p = 0.7). However, Black women were less likely to report uptake of aspirin (63.8 vs. 79.0%; p < 0.001). After adjustment for total prenatal visits and tobacco use, Black race was associated with an adjusted odds ratio of 0.53 (95% confidence interval: 0.36-0.78) for uptake of aspirin. CONCLUSION In our cohort, recommendation for aspirin prophylaxis was suboptimal in all groups, reaching only 65% of eligible women. Black women were equally likely as women of other races to receive counseling about aspirin, but rates of uptake were lower. Our findings suggest that counseling and prescription of aspirin alone in high-risk Black women are not sufficient for utilization of this intervention. KEY POINTS · Rates of counseling about aspirin prophylaxis for preeclampsia did not vary by race.. · Black women had lower rates of uptake of aspirin compared with women of other races.. · Counseling about aspirin was inadequate in general, reaching only 65% of eligible women..
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Affiliation(s)
- Nina W. Ragunanthan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jordan Lamb
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alisse Hauspurg
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Stacy Beck
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Gopalan P, Spada ML, Shenai N, Kratzer I, Nichols N, Kucherer S, Chou S, Hovis E, Beck S, Glance J. An Overview for the General Psychiatrist Evaluating Patients With Obstetric and Neonatal Complications and Perinatal Loss. Focus (Am Psychiatr Publ) 2024; 22:35-43. [PMID: 38694157 PMCID: PMC11058915 DOI: 10.1176/appi.focus.20230021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
When neonatal and obstetrical complications occur, the identification and management of mood and anxiety disorders become complex with an ever-expanding array of psychiatric needs that include the management of grief- and trauma-related disorders. With high rates of maternal morbidity and mortality in the United States and laws in many states restricting reproductive health access, psychiatrists must be proficient in managing psychiatric sequelae in this context. High-risk groups for peripartum mood and anxiety disorders, posttraumatic stress disorder, and complicated grief include those with neonatal intensive care unit (NICU) stays and those who have experienced infertility and recurrent pregnancy loss. Groups who have been historically marginalized by the medical system (e.g., Black, Indigenous, people of color) and those from LGBTQ+ communities are at similarly high risk, and more interventions are needed to support these groups. Strategies emphasizing trauma-informed care, psychotherapeutic approaches, and using patient-centered language are recommended.
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Affiliation(s)
- Priya Gopalan
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Meredith L Spada
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Neeta Shenai
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Isabella Kratzer
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Nona Nichols
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Shelly Kucherer
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Shinnyi Chou
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Elizabeth Hovis
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Stacy Beck
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
| | - Jody Glance
- Department of Psychiatry, University of Pittsburgh Medical Center Western Psychiatric Hospital (Gopalan, Spada, Kratzer, Kucherer, Chou, Glance); Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio (Nichols); Department of Obstetrics, Gynecology, and Reproductive Services, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh (Beck); Department of Psychiatry, University of Wisconsin-Madison (Shenai); Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee (Hovis)
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3
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Hunter A, Beck S, Cappelli E, Margot F, Straub M, Alexanian Y, Gatti G, Watson MD, Kim TK, Cacho C, Plumb NC, Shi M, Radović M, Sokolov DA, Mackenzie AP, Zingl M, Mravlje J, Georges A, Baumberger F, Tamai A. Fate of Quasiparticles at High Temperature in the Correlated Metal Sr_{2}RuO_{4}. Phys Rev Lett 2023; 131:236502. [PMID: 38134803 DOI: 10.1103/physrevlett.131.236502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/08/2023] [Indexed: 12/24/2023]
Abstract
We study the temperature evolution of quasiparticles in the correlated metal Sr_{2}RuO_{4}. Our angle resolved photoemission data show that quasiparticles persist up to temperatures above 200 K, far beyond the Fermi liquid regime. Extracting the quasiparticle self-energy, we demonstrate that the quasiparticle residue Z increases with increasing temperature. Quasiparticles eventually disappear on approaching the bad metal state of Sr_{2}RuO_{4} not by losing weight but via excessive broadening from super-Planckian scattering. We further show that the Fermi surface of Sr_{2}RuO_{4}-defined as the loci where the spectral function peaks-deflates with increasing temperature. These findings are in semiquantitative agreement with dynamical mean field theory calculations.
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Affiliation(s)
- A Hunter
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - S Beck
- Center for Computational Quantum Physics, Flatiron Institute, 162 Fifth Avenue, New York, New York 10010, USA
| | - E Cappelli
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - F Margot
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - M Straub
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - Y Alexanian
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - G Gatti
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - M D Watson
- Diamond Light Source, Harwell Campus, Didcot, OX11 0DE, United Kingdom
| | - T K Kim
- Diamond Light Source, Harwell Campus, Didcot, OX11 0DE, United Kingdom
| | - C Cacho
- Diamond Light Source, Harwell Campus, Didcot, OX11 0DE, United Kingdom
| | - N C Plumb
- Swiss Light Source, Paul Scherrer Institut, CH-5232 Villigen PSI, Switzerland
| | - M Shi
- Swiss Light Source, Paul Scherrer Institut, CH-5232 Villigen PSI, Switzerland
| | - M Radović
- Swiss Light Source, Paul Scherrer Institut, CH-5232 Villigen PSI, Switzerland
| | - D A Sokolov
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - A P Mackenzie
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
- Scottish Universities Physics Alliance, School of Physics and Astronomy, University of St. Andrews, St. Andrews KY16 9SS, United Kingdom
| | - M Zingl
- Center for Computational Quantum Physics, Flatiron Institute, 162 Fifth Avenue, New York, New York 10010, USA
| | - J Mravlje
- Department of Theoretical Physics, Institute Jozef Stefan, Jamova 39, SI-1001 Ljubljana, Slovenia
- Faculty of Mathematics and Physics, University of Ljubljana, Jadranska 19, SI-1000 Ljubljana
| | - A Georges
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
- Center for Computational Quantum Physics, Flatiron Institute, 162 Fifth Avenue, New York, New York 10010, USA
- Collège de France, 11 Place Marcelin Berthelot, 75005 Paris, France
- Centre de Physique Théorique, Ecole Polytechnique, CNRS, Institut Polytechnique de Paris, 91128 Palaiseau Cedex, France
| | - F Baumberger
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
- Swiss Light Source, Paul Scherrer Institut, CH-5232 Villigen PSI, Switzerland
| | - A Tamai
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
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4
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Katheria A, Szychowski J, Carlo WA, Subramaniam A, Reister F, Essers J, Vora F, Martin C, Schmölzer GM, Law B, Dempsey E, O'Donoghue K, Kaempf J, Tomlinson M, Fulford K, Folsom B, Karam S, Morris R, Yanowitz T, Beck S, Clark E, DuPont T, Biniwale M, Ramanathan R, Bhat S, Hoffman M, Chouthai N, Bany-Mohammed F, Mydam J, Narendran V, Wertheimer F, Gollin Y, Vaucher Y, Arnell K, Varner M, Cutter G, Wilson N, Rich W, Finer N. Umbilical Cord Milking Versus Delayed Cord Clamping in Infants 28 to 32 Weeks: A Randomized Trial. Pediatrics 2023; 152:e2023063113. [PMID: 37941523 DOI: 10.1542/peds.2023-063113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVES To determine whether rate of severe intraventricular hemorrhage (IVH) or death among preterm infants receiving placental transfusion with UCM is noninferior to delayed cord clamping (DCC). METHODS Noninferiority randomized controlled trial comparing UCM versus DCC in preterm infants born 28 to 32 weeks recruited between June 2017 through September 2022 from 19 university and private medical centers in 4 countries. The primary outcome was Grade III/IV IVH or death evaluated at a 1% noninferiority margin. RESULTS Among 1019 infants (UCM n = 511 and DCC n = 508), all completed the trial from birth through initial hospitalization (mean gestational age 31 weeks, 44% female). For the primary outcome, 7 of 511 (1.4%) infants randomized to UCM developed severe IVH or died compared to 7 of 508 (1.4%) infants randomized to DCC (rate difference 0.01%, 95% confidence interval: (-1.4% to 1.4%), P = .99). CONCLUSIONS In this randomized controlled trial of UCM versus DCC among preterm infants born between 28 and 32 weeks' gestation, there was no difference in the rates of severe IVH or death. UCM may be a safe alternative to DCC in premature infants born at 28 to 32 weeks who require resuscitation.
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Affiliation(s)
- Anup Katheria
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
| | | | | | | | - Frank Reister
- Department of Pediatrics and Obstetrics, University of Ulm, Ulm, Germany
| | - Jochen Essers
- Department of Pediatrics and Obstetrics, University of Ulm, Ulm, Germany
| | - Farha Vora
- Department of Pediatrics and Obstetrics, Loma Linda University, Loma Linda, California
| | - Courtney Martin
- Department of Pediatrics and Obstetrics, Loma Linda University, Loma Linda, California
| | - Georg M Schmölzer
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Brenda Law
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Eugene Dempsey
- Department of Pediatrics and Obstetrics, University College Cork, Cork, Ireland
| | - Keelin O'Donoghue
- Department of Pediatrics and Obstetrics, University College Cork, Cork, Ireland
| | - Joseph Kaempf
- Women and Children's Services, Providence St Vincent Medical Center, Portland, Oregon
| | - Mark Tomlinson
- Women and Children's Services, Providence St Vincent Medical Center, Portland, Oregon
| | - Kevin Fulford
- Department of Pediatrics and Obstetrics, Sharp Grossmont Hospital, La Mesa, California
| | - Bergen Folsom
- Department of Pediatrics and Obstetrics, Sharp Grossmont Hospital, La Mesa, California
| | - Simon Karam
- Department of Pediatrics and Obstetrics, University of Mississippi Medical CenterJackson, Mississippi
| | - Rachael Morris
- Department of Pediatrics and Obstetrics, University of Mississippi Medical CenterJackson, Mississippi
| | - Toby Yanowitz
- Department of Pediatrics and Obstetrics, Magee Women's Hospital of UPMC, Pittsburgh, Pennsylvania
| | - Stacy Beck
- Department of Pediatrics and Obstetrics, Magee Women's Hospital of UPMC, Pittsburgh, Pennsylvania
| | - Erin Clark
- University of Utah, Department of Pediatrics and Obstetrics, Salt Lake City, Utah
| | - Tara DuPont
- University of Utah, Department of Pediatrics and Obstetrics, Salt Lake City, Utah
| | - Manoj Biniwale
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Rangasamy Ramanathan
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Shazia Bhat
- Department of Pediatrics and Obstetrics, Christiana Care Health System, Newark, Delaware
| | - Matthew Hoffman
- Department of Pediatrics and Obstetrics, Christiana Care Health System, Newark, Delaware
| | - Nitin Chouthai
- Department of Pediatrics, Saint Louis University School of Medicine, St Louis, Missouri
| | - Fayez Bany-Mohammed
- Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, California
| | - Janardhan Mydam
- Department of Pediatrics, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois
| | - Vivek Narendran
- Department of Pediatrics and Obstetrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Fiona Wertheimer
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Yvonne Gollin
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
| | - Yvonne Vaucher
- Department of Pediatrics, University of California at San Diego, San Diego, California
| | - Kathy Arnell
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
| | - Michael Varner
- University of Utah, Department of Pediatrics and Obstetrics, Salt Lake City, Utah
| | - Gary Cutter
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Nicole Wilson
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Neil Finer
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
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Roberts JM, King TL, Barton JR, Beck S, Bernstein IM, Buck TE, Forgues-Lackie MA, Facco FL, Gernand AD, Graves CR, Jeyabalan A, Hauspurg A, Manuck TA, Myers JE, Powell TM, Sutton EF, Tinker E, Tsigas E, Myatt L. Care plan for individuals at risk for preeclampsia: shared approach to education, strategies for prevention, surveillance, and follow-up. Am J Obstet Gynecol 2023; 229:193-213. [PMID: 37120055 DOI: 10.1016/j.ajog.2023.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/01/2023]
Abstract
Preeclampsia is a multisystemic disorder of pregnancy that affects 250,000 pregnant individuals in the United States and approximately 10 million worldwide per annum. Preeclampsia is associated with substantial immediate morbidity and mortality but also long-term morbidity for both mother and offspring. It is now clearly established that a low dose of aspirin given daily, beginning early in pregnancy modestly reduces the occurrence of preeclampsia. Low-dose aspirin seems safe, but because there is a paucity of information about long-term effects on the infant, it is not recommended for all pregnant individuals. Thus, several expert groups have identified clinical factors that indicate sufficient risk to recommend low-dose aspirin preventive therapy. These risk factors may be complemented by biochemical and/or biophysical tests that either indicate increased probability of preeclampsia in individuals with clinical risk factors, or more importantly, identify increased likelihood in those without other evident risk. In addition, the opportunity exists to provide this population with additional care that may prevent or mitigate the short- and long-term effects of preeclampsia. Patient and provider education, increased surveillance, behavioral modification, and other approaches to improve outcomes in these individuals can improve the chance of a healthy outcome. We assembled a group with diverse, relevant expertise (clinicians, investigators, advocates, and public and private stakeholders) to develop a care plan in which providers and pregnant individuals at risk can work together to reduce the risk of preeclampsia and associated morbidities. The plan is for care of individuals at moderate to high risk for developing preeclampsia, sufficient to receive low-dose aspirin therapy, as identified by clinical and/or laboratory findings. The recommendations are presented using the GRADE methodology with the quality of evidence upon which each is based. In addition, printable appendices with concise summaries of the care plan's recommendations for patients and healthcare providers are provided. We believe that this shared approach to care will facilitate prevention of preeclampsia and its attendant short- and long-term morbidity in patients identified as at risk for development of this disorder.
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Affiliation(s)
- James M Roberts
- Magee-Womens Research Institute and Clinical and Translational Science Institute, Department of Obstetrics, Gynecology and Reproductive Sciences and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.
| | - Tekoa L King
- School of Nursing, University of California, San Francisco, Oakland, CA
| | - John R Barton
- Maternal-Fetal Medicine, Baptist Health, Lexington, KY
| | - Stacy Beck
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Ira M Bernstein
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont, Burlington, VT
| | | | | | - Francesca L Facco
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Alison D Gernand
- Nutritional Sciences, Pennsylvania State University, University Park, PA
| | - Cornelia R Graves
- Division of Maternal-Fetal Medicine, University of Tennessee College of Medicine, Nashville, TN
| | - Arundhati Jeyabalan
- Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Alisse Hauspurg
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Tracy A Manuck
- Obstetrics and Gynecology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jenny E Myers
- Division of Developmental Biology and Medicine, University of Manchester, Manchester, United Kingdom
| | - Trashaun M Powell
- National Racial Disparity Taskforce, Preeclampsia Foundation and New Jersey Family Planning League, Somerset, NJ
| | | | | | | | - Leslie Myatt
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
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Gumprich A, Liedtke J, Beck S, Chirca I, Potočnik T, Alexander-Webber JA, Hofmann S, Tappertzhofen S. Buried graphene heterostructures for electrostatic doping of low-dimensional materials. Nanotechnology 2023; 34:265203. [PMID: 36758234 DOI: 10.1088/1361-6528/acbaa2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
The fabrication and characterization of steep slope transistor devices based on low-dimensional materials requires precise electrostatic doping profiles with steep spatial gradients in order to maintain maximum control over the channel. In this proof-of-concept study we present a versatile graphene heterostructure platform with three buried individually addressable gate electrodes. The platform is based on a vertical stack of embedded titanium and graphene separated by an intermediate oxide to provide an almost planar surface. We demonstrate the functionality and advantages of the platform by exploring transfer and output characteristics at different temperatures of carbon nanotube field-effect transistors with different electrostatic doping configurations. Furthermore, we back up the concept with finite element simulations to investigate the surface potential. The presented heterostructure is an ideal platform for analysis of electrostatic doping of low-dimensional materials for novel low-power transistor devices.
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Affiliation(s)
- A Gumprich
- Chair for Micro- and Nanoelectronics, Department of Electrical Engineering and Information Technology, TU Dortmund University, Martin-Schmeisser-Weg 4-6, D-44227, Dortmund, Germany
| | - J Liedtke
- Chair for Micro- and Nanoelectronics, Department of Electrical Engineering and Information Technology, TU Dortmund University, Martin-Schmeisser-Weg 4-6, D-44227, Dortmund, Germany
| | - S Beck
- Chair for Micro- and Nanoelectronics, Department of Electrical Engineering and Information Technology, TU Dortmund University, Martin-Schmeisser-Weg 4-6, D-44227, Dortmund, Germany
| | - I Chirca
- Department of Engineering, University of Cambridge, 9 JJ Thompson Avenue, Cambridge CB3 0FA, United Kingdom
| | - T Potočnik
- Department of Engineering, University of Cambridge, 9 JJ Thompson Avenue, Cambridge CB3 0FA, United Kingdom
| | - J A Alexander-Webber
- Department of Engineering, University of Cambridge, 9 JJ Thompson Avenue, Cambridge CB3 0FA, United Kingdom
| | - S Hofmann
- Department of Engineering, University of Cambridge, 9 JJ Thompson Avenue, Cambridge CB3 0FA, United Kingdom
| | - S Tappertzhofen
- Chair for Micro- and Nanoelectronics, Department of Electrical Engineering and Information Technology, TU Dortmund University, Martin-Schmeisser-Weg 4-6, D-44227, Dortmund, Germany
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7
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Beck S, Dittrich F, Busch A, Jäger M, Theysohn JM, Lazik-Palm A, Haubold J. Unloader bracing in osteoarthritis of the knee - Is there a direct effect on the damaged cartilage? Knee 2023; 40:16-23. [PMID: 36403395 DOI: 10.1016/j.knee.2022.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 08/26/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Unloading knee braces represent a conservative treatment option for non-pharmalogical management of unicompartmental osteoarthritis of the knee. Though there is consensus on the clinical effectiveness of unloading, the effect mechanism of bracing remains part of a debate. Our study was designed to assess the effect of unloader bracing on damaged cartilage via MRI cartilage mappings. METHODS Fourteen patients (7 female, 7 male, mean age 43.1 ± 9.4 years) with unicompartmental cartilage wear in knees with varus or valgus malalignment were enrolled. Clinical scores, radiographs and MR-graphic properties (T2/T2* mapping, T1 Delayed Gadolinium Enhanced MRI of the cartilage (dGEMRIC) mapping, high-resolution PDw sequences) of knee cartilage were recorded before and three months after brace use. RESULTS Bracing the knees for a mean of 14.4 ± 2.0 weeks (range 11 to 18 weeks) resulted in significant pain reduction (VAS changed from 5.9 ± 2.0 to 2.0 ± 1.3, p < 0.001) and improvement in knee function (KOOS increased from 42.1 ± 22.7 to 64.8 ± 18.7, p < 0.001). In the affected cartilage regions T2 relaxation times significantly decreased from 56.1 ± 11.4 ms to 46.5 ± 11.2 ms (p < 0.05). No changes in T1-dGEMRIC and T2* relaxation times, thickness or the extent of the damaged cartilage area could be detected. CONCLUSIONS Our results suggest, that unloader bracing improves the biochemical properties of the damaged cartilage by increasing collagen and proteoglycan concentration as well as decreasing the cartilage edema.
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Affiliation(s)
- S Beck
- Sportsclinic Hellersen, Paulmannshoeher Strasse 17, 58515 Luedenscheid, Germany; Department of Orthopedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
| | - F Dittrich
- Department of Orthopedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; Gelenkzentrum Bergisch Land, Freiheitsstrasse 203, 42853 Remscheid, Germany
| | - A Busch
- Department of Orthopedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; Department of Orthopedics, Trauma and Reconstructive Surgery, St. Marien Hospital Muelheim, Contilia Gruppe, Kaiserstrasse 50, 45468 Muelheim an der Ruhr, Germany
| | - M Jäger
- Department of Orthopedics, Trauma and Reconstructive Surgery, St. Marien Hospital Muelheim, Contilia Gruppe, Kaiserstrasse 50, 45468 Muelheim an der Ruhr, Germany; Chair of Orthopedics and Trauma Surgery, University of Duisburg-Essen, Essen, Germany
| | - J M Theysohn
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - A Lazik-Palm
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany
| | - J Haubold
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany.
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8
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Bergomi V, Beck S, Dobromylskyj M, Davison LJ, Wills JW, Hughes K. Insulin expression in β cells is reduced within islets before islet loss in diabetic cats. J Small Anim Pract 2022; 63:809-815. [PMID: 35986507 DOI: 10.1111/jsap.13541] [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] [Received: 12/03/2021] [Revised: 05/02/2022] [Accepted: 07/07/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Diabetes mellitus is a common condition that requires intensive treatment and markedly impacts the welfare of affected cats. The aim of this study was to identify diabetes mellitus-associated perturbations in the feline pancreatic islet microenvironment. The utility of "clear, unobstructed brain/body imaging cocktails and computational analysis" (CUBIC) for three-dimensional pancreatic analysis was investigated. METHODS Formalin-fixed paraffin-embedded tissues from cats with diabetes mellitus, or control cats without pancreatic pathology, were retrospectively identified. Immunohistochemistry for synaptophysin and ionised calcium binding adaptor molecule 1, and immunofluorescence for insulin and synaptophysin, were used to assess changes in islets. An image analysis pipeline was developed to analyse images acquired from two-dimensional immunofluorescence. CUBIC was used to optically clear selected pancreas samples before immunofluorescence and deep three-dimensional confocal microscopy. RESULTS Diabetic cats have a significant reduction in synaptophysin-positive islet area. Whilst islets from diabetic patients have similar numbers of β cells to islets from control cats, significantly lower intensity of insulin expression can be observed in the former. CUBIC facilitates clear visualisation of pancreatic islets in three dimensions. CLINICAL SIGNIFICANCE The data presented support the theory that there is a decrease in function of β cells before their destruction, suggesting a potentially significant step in the pathogenesis of feline diabetes mellitus. In parallel, we demonstrate CUBIC as a valuable new tool to visualise the shape of feline pancreatic islets and to interrogate pathology occurring in the islets of diabetic pets.
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Affiliation(s)
- V Bergomi
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK.,Mercer & Hughes Veterinary Surgeons, Saffron Walden, CB11 3JB, UK
| | - S Beck
- VPG Histology, Horner Court, Bristol, BS7 0BJ, UK.,Independent Anatomic Pathology Ltd, Bath, UK
| | | | - L J Davison
- Department of Clinical Sciences and Services, Royal Veterinary College, Hatfield, UK.,Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - J W Wills
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - K Hughes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
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9
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Lim G, Nowakowski E, LaSorda KR, Altamirano V, Morgan M, Makeen M, Beck S, Krans E, Chelly JE. NSS-Bridge Device for Post-Cesarean Delivery Analgesia: A Randomized Controlled Trial. Obstet Gynecol Res 2022; 5:210-218. [PMID: 36276260 PMCID: PMC9581440 DOI: 10.26502/ogr094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction Percutaneous auricular nerve stimulation has been used for the treatment of symptoms associated with opioid withdrawal, including abdominal pain, nausea, and general discomfort. However, its potential utility for pain management and opioid minimization after surgery has not been investigated. The purpose of this study was to test the feasibility and acceptability of a trial protocol designed to assess the effectiveness of the NSS2-Bridge device as a non-pharmacologic alternative to opioids after cesarean delivery. Methods In a randomized control design, healthy women receiving cesarean delivery were randomized to receive the active device, placebo device, or no device. Devices were placed on the ear following cesarean delivery and left in place for 5 days. Feasibility and acceptability of the device was assessed by patient reports of device tolerability (rated on a 100mm visual analog scale where 0 is not tolerable at all and 100 is the most tolerable) as well as qualitative reporting. Additional outcomes assessed included proportion of patients not using opioids in hospital, as well as pain at rest, pain with movement, and total opioid consumption in the hospital and for the first 5 days after surgery. Results There were 60 patients included in the final analysis. Device tolerability was rated highly, with an average daily score of >75 mm on the visual analog scale. The trial retention rate was 89.7% with most exclusions (42.9%) occurring due to unanticipated development of care complexity (e.g., hemorrhage and additional surgical procedures), with only 1 exclusion (14.3%) due to device discomfort. The active device group achieved the highest proportion of opioid-free hospitalizations (40%) compared to placebo (20%) and no device groups (30%). Pain at rest and with movement was similar between treatment groups. Conclusions This trial protocol designed to test the efficacy of NSS2-Bridge device for post-cesarean pain management is feasible and acceptable. Larger proportions of patients not using opioids in the active device group justifies additional investigation on device effectiveness in pregnant and postpartum people at highest risk for pain.
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Affiliation(s)
- Grace Lim
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for Innovation in Pain Medicine, Center for Complementary and Alternative Pain Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Emma Nowakowski
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kelsea R LaSorda
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Valeria Altamirano
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Madison Morgan
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Mutasim Makeen
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Stacy Beck
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Elizabeth Krans
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jacques E Chelly
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Orthopedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for Innovation in Pain Medicine, Center for Complementary and Alternative Pain Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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10
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Castignani C, Gimeno-Valiente F, Larose Cadieux E, Chen K, Mensah N, Chervova O, Watkins T, Dhami P, Vaikkinen H, Saghafinia S, Karasaki T, Hiley C, Feber A, TRACERx C, Demeulemeester J, Tanic M, Beck S, van Loo P, Swanton C, Kanu N. 28P Identification of convergent gene repression mechanisms through integrative genomic and DNA methylation analysis in NSCLC. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.055] [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: 11/01/2022] Open
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11
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Malyutina S, Chervova O, Tillmann T, Maksimov V, Gafarov V, Ryabikov A, Hubacek J, Pikhart H, Beck S, Bobak M. The relationship between epigenetic age and myocardial infarction in a population based case-control study. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.320] [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: 11/02/2022]
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12
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Rempel E, Kluck K, Beck S, Ourailidis I, Kazdal D, Neumann O, Volckmar AL, Kirchner M, Goldschmid H, Pfarr N, Weichert W, Hübschmann D, Fröhling S, Sutter C, Schaaf CP, Schirmacher P, Endris V, Stenzinger A, Budczies J. Pan-cancer analysis of genomic scar patterns caused by homologous repair deficiency (HRD). NPJ Precis Oncol 2022; 6:36. [PMID: 35681079 PMCID: PMC9184602 DOI: 10.1038/s41698-022-00276-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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] [Received: 07/01/2021] [Accepted: 04/15/2022] [Indexed: 12/12/2022] Open
Abstract
Homologous repair deficiency (HRD) is present in many cancer types at variable prevalence and can indicate response to platinum-based chemotherapy and PARP inhibition. We developed a tumor classification system based on the loss of function of genes in the homologous recombination repair (HRR) pathway. To this end, somatic and germline alterations in BRCA1/2 and 140 other HRR genes were included and assessed for the impact on gene function. Additionally, information on the allelic hit type and on BRCA1 promoter hypermethylation was included. The HRDsum score including LOH, LST, and TAI was calculated for 8847 tumors of the TCGA cohort starting from genotyping data and for the subcohort of ovarian cancer also starting from WES data. Pan-cancer, deleterious BRCA1/2 alterations were detected in 4% of the tumors, while 18% of the tumors were HRD-positive (HRDsum ≥ 42). Across 33 cancer types, both BRCA1/2 alterations and HRD-positivity were most prevalent in ovarian cancer (20% and 69%). Pan-cancer, tumors with biallelic deleterious alterations in BRCA1/2 were separated strongly from tumors without relevant alterations (AUC = 0.89), while separation for tumors with monoallelic deleterious BRCA1/2 alterations was weak (AUC = 0.53). Tumors with biallelic deleterious alterations in other HHR genes were separated moderately from tumors without relevant alterations (AUC = 0.63), while separation for tumors with such monoallelic alterations was weaker (AUC = 0.57). In ovarian cancer, HRDsum scores calculated from WES data correlated strongly with HRDsum scores calculated from genotyping data (R = 0.87) and were slightly (4%) higher. We comprehensively analyzed HRD scores and their association with mutations in HRR genes in common cancer types. Our study identifies important parameters influencing HRD measurement and argues for an integration of HRDsum score with specific mutational profiles.
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Affiliation(s)
- E Rempel
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - K Kluck
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - S Beck
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany.,Center for Personalized Medicine (ZPM) Heidelberg, 69120, Heidelberg, Germany
| | - I Ourailidis
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - D Kazdal
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany.,German Center for Lung Research (DZL), Heidelberg site, 69120, Heidelberg, Germany
| | - O Neumann
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - A L Volckmar
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - M Kirchner
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - H Goldschmid
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - N Pfarr
- Institute of Pathology, TUM School of Medicine, Technical University of Munich, 81675, Munich, Germany
| | - W Weichert
- Institute of Pathology, TUM School of Medicine, Technical University of Munich, 81675, Munich, Germany.,German Cancer Consortium (DKTK), 69120, Heidelberg, Germany
| | - D Hübschmann
- German Cancer Consortium (DKTK), 69120, Heidelberg, Germany.,Division of Translational Medical Oncology, NCT Heidelberg and DKFZ, 69120, Heidelberg, Germany.,NCT Molecular Diagnostics Program, NCT Heidelberg and DKFZ, 69120, Heidelberg, Germany
| | - S Fröhling
- Center for Personalized Medicine (ZPM) Heidelberg, 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK), 69120, Heidelberg, Germany.,Division of Translational Medical Oncology, NCT Heidelberg and DKFZ, 69120, Heidelberg, Germany.,NCT Molecular Diagnostics Program, NCT Heidelberg and DKFZ, 69120, Heidelberg, Germany
| | - C Sutter
- Institute of Human Genetics, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - C P Schaaf
- Center for Personalized Medicine (ZPM) Heidelberg, 69120, Heidelberg, Germany.,Institute of Human Genetics, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - P Schirmacher
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK), 69120, Heidelberg, Germany
| | - V Endris
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - A Stenzinger
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany. .,Center for Personalized Medicine (ZPM) Heidelberg, 69120, Heidelberg, Germany. .,German Center for Lung Research (DZL), Heidelberg site, 69120, Heidelberg, Germany. .,German Cancer Consortium (DKTK), 69120, Heidelberg, Germany.
| | - J Budczies
- Institute of Pathology, Heidelberg University Hospital, 69120, Heidelberg, Germany. .,Center for Personalized Medicine (ZPM) Heidelberg, 69120, Heidelberg, Germany. .,German Center for Lung Research (DZL), Heidelberg site, 69120, Heidelberg, Germany. .,German Cancer Consortium (DKTK), 69120, Heidelberg, Germany.
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13
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Malyutina S, Chervova O, Tillmann T, Maximov V, Ryabikov A, Gafarov V, Pikhart H, Beck S, Bobak M. The relationship between epigenetic age and myocardial infarction/acute coronary syndrome and in a population based nested case-control study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3199] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The measure of “epigenetic age” (EA) derived from DNA methylation (DNAm) is considered as biomarker of ageing.
Objective
We investigated the relationship between EA and Myocardial Infarction (MI) /Acute coronary syndrome (ACS) in a nested case-control study of the elderly population.
Methods
A random population sample was examined at baseline (2003/05, n=9360, age 45–69, the Russian arm of the HAPIEE Project), re-examined in 2006/08, 2015/17, and followed up for an average 15 years for fatal and non-fatal events. Using a nested case-control study design, we selected participants with incident MI/ACS (cases) and age-and sex-stratified controls among those free from baseline CVD. We performed DNAm profiling of the whole blood samples (using Illumina EPIC arrays) collected at baseline. After quality control, 135 cases and 185 controls were included in the analysis. Baseline EA was calculated using Horvath, Hannum, PhenoAge and Skin and Blood DNAm clocks; the differences between EA and chronological age (CA) were denoted as DAHr, DAHn, DAPh, DASB, respectively.
Results
DNAm ages calculated with Horvath's, Hannum's and Skin and Blood clocks were close to the CA; the corresponding median absolute differences (MAD) were 3.38, 3.64 and 2.79 years, and mean (SD) −0.85 (5.37), 1.96 (5.18) and 2.10 (3.94) for DAHr, DAHn and DASB respectively. As expected, PhenoAge's predictions were less precise with MAD=9.41 and DAPh mean (SD) 8.94 (6.38). The mean DAHr and DAHn were significantly higher in MI/ACS compared to controls (0.99 (5.38) vs. −1.55 (5.27), p=0.007, and 2.89 (6.37) vs. 1.28 (4.95), p=0.006 correspondingly), DASB was borderline higher in MI/ACS vs controls and DAPh was similar in cases and controls. After controlling for sex, the risk of MI/ACS was higher in DAHr terciles 2 and 3 vs. tercile 1 (OR=1.08 [95% CI 0.61–1.89], p=0.799 and OR=2.09 [1.19–3.66], p=0.010); the association was independent of smoking but it was largely explained (or mediated) by metabolic factors (blood pressure, body mass index, total and LDL-cholesterol). Similarly, the risk of MI/ACS was increased in terciles 2 and 3 of DAHn; compared with lowest tercile, the OR were 1.52 [0.86–2.71], p=0.152 and 2.41 [1.34–4.34], p=0.003), respectively; again, the association was largely explained by metabolic factors. There was no association found between baseline DAPh or DASB and the risk of MI/ACS.
Conclusion
In this case-control study nested in a prospective population-based cohort, we found an association between acceleration of epigenetic age and increased risk of MI/ACS independent of sex and smoking. The risk of MI/ACS was about 2-fold higher in the top tercile of difference between epigenetic and chronological age. The excess risk is appeared to be modulated by metabolic factors.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Russian Science Foundation; Russian Academy of Sciences, Sate Assignment
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Affiliation(s)
- S Malyutina
- Research Institute of Internal and Preventive Medicine - Branch of IC&G SB RAS, Novosibirsk, Russian Federation
| | - O Chervova
- University College London, UCL Cancer Institute, London, United Kingdom
| | - T Tillmann
- University College London, Institute for Global Health, London, United Kingdom
| | - V Maximov
- Research Institute of Internal and Preventive Medicine - Branch of IC&G SB RAS, Novosibirsk, Russian Federation
| | - A Ryabikov
- Research Institute of Internal and Preventive Medicine - Branch of IC&G SB RAS, Novosibirsk, Russian Federation
| | - V Gafarov
- Research Institute of Internal and Preventive Medicine - Branch of IC&G SB RAS, Novosibirsk, Russian Federation
| | - H Pikhart
- University College London, Institute of Epidemiology and Health Care, London, United Kingdom
| | - S Beck
- University College London, UCL Cancer Institute, London, United Kingdom
| | - M Bobak
- University College London, Institute of Epidemiology and Health Care, London, United Kingdom
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14
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Chen K, Kang G, Zhang Z, Lizaso A, Beck S, Lyskjær I, Chervova O, Li B, Shen H, Wang C, Li B, Zhao H, Chuai S, Yang F, Kanu N, Wang J. 1159P Individualized methylation-based dynamic analysis of cell-free DNA in postoperative monitoring of resected lung cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1762] [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] Open
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15
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Schnitzer K, AhnAllen C, Beck S, Oliveira Y, Fromson J, Evins A. Multidisciplinary barriers to addressing tobacco cessation during an inpatient psychiatric hospitalization. Addict Behav 2021; 120:106988. [PMID: 34051645 DOI: 10.1016/j.addbeh.2021.106988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/03/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
Tobacco use and resultant health complications disproportionately impact individuals with psychiatric disorders. Inpatient psychiatric hospitalizations provide an opportunity to initiate tobacco treatment. In this study, electronic medical record review identified demographic and clinical information, smoking status, and tobacco cessation treatment offered for adults hospitalized on two acute, non-smoking psychiatric units in Massachusetts from January 2016 to March 2018. We additionally conducted semi-structured interviews with 15 inpatient nursing, psychiatry, psychology and social work providers regarding their tobacco cessation treatment practices and perceived facilitators and barriers to addressing tobacco use on psychiatric inpatient units. Chart review identified 1099 of 3140 (35%) people admitted reporting daily tobacco smoking. On discharge, 5 (0.005%) of inpatient smokers received a prescription for varenicline, 43 (0.04%) for dual-nicotine replacement therapy, 211 (19.2%) for nicotine patch, and 5 (0.005%) for bupropion. Barriers to inpatient smoking cessation treatment initiation identified in qualitative interviews included: 1) smoking cessation as low priority, 2) smoking cessation as the responsibility of outpatient providers, 3) lack of education about tobacco treatment, and 4) treatment discussions framed as preventing withdrawal. Given the potential to impact a large percentage of psychiatric tobacco users, future interventions should investigate provision of tobacco cessation counseling and pharmacotherapy in inpatient settings, with interventions that take into account the barriers and opportunities presented in this study.
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Gannon JM, Gopalan P, Solai LK, Lim G, Phillips JM, Beck S, Moses‐Kolko E, Miller D, Chengappa KR. ECT for a pregnant patient with bipolar disorder in the COVID-19 Era: A clinical conundrum. Bipolar Disord 2021; 23:524-527. [PMID: 33590703 PMCID: PMC8013649 DOI: 10.1111/bdi.13061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/24/2020] [Accepted: 01/08/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Jessica M. Gannon
- Department of PsychiatryUniversity of Pittsburgh Medical Center Western Psychiatric HospitalUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Priya Gopalan
- Department of PsychiatryUniversity of Pittsburgh Medical Center Western Psychiatric HospitalUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - LalithKumar K. Solai
- Department of PsychiatryUniversity of Pittsburgh Medical Center Western Psychiatric HospitalUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Grace Lim
- Department of Anesthesiology & Perioperative MedicineDivision of Obstetric AnesthesiologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Jaclyn M. Phillips
- Department of Obstetrics, Gynecology and Reproductive SciencesDivision of Maternal Fetal MedicineUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Stacy Beck
- Department of Obstetrics, Gynecology and Reproductive SciencesDivision of Maternal Fetal MedicineUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Eydie Moses‐Kolko
- Department of PsychiatryUniversity of Pittsburgh Medical Center Western Psychiatric HospitalUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Donald Miller
- Department of Anesthesiology & Perioperative MedicineDivision of Obstetric AnesthesiologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - K.N. Roy Chengappa
- Department of PsychiatryUniversity of Pittsburgh Medical Center Western Psychiatric HospitalUniversity of Pittsburgh School of MedicinePittsburghPAUSA
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17
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Cook A, Faustini S, Williams L, Cunningham A, Drayson M, Shields A, Kay D, Taylor L, Plant T, Huissoon A, Wallis G, Beck S, Jossi S, Perez-Toledo M, Newby M, Allen J, Crispin M, Harding S, Richter A. Validation of a combined ELISA to detect IgG, IgA and IgM antibody responses to SARS-CoV-2 in mild or moderate non-hospitalised patients. J Immunol Methods 2021; 494:113046. [PMID: 33775672 PMCID: PMC7997147 DOI: 10.1016/j.jim.2021.113046] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 11/17/2020] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Frequently SARS-CoV-2 results in mild or moderate disease with potentially lower concentrations of antibodies compared to those that are hospitalised. Here, we validated an ELISA using SARS-CoV-2 trimeric spike glycoprotein, with targeted detection of IgG, IgA and IgM (IgGAM) using serum and dried blood spots (DBS) from adults with mild or moderate disease. METHODS Targeting the SARS-CoV-2 trimeric spike, a combined anti-IgG, IgA and IgM serology ELISA assay was developed using 62 PCR-confirmed non-hospitalised, mild or moderate COVID-19 samples, ≥14 days post symptom onset and 624 COVID-19 negative samples. The assay was validated using 73 PCR-confirmed non-hospitalised, mild or moderate COVID-19 samples, ≥14 days post symptom onset and 359 COVID-19 negative serum samples with an additional 81 DBSs. The assay was further validated in 226 PCR-confirmed non-hospitalised, mild or moderate COVID-19 samples, ≥14 days post symptom onset and 426 COVID-19 negative clinical samples. RESULTS A sensitivity and specificity of 98.6% (95% CI, 92.6-100.0), 98.3% (95% CI, 96.4-99.4), respectively, was observed following validation of the SARS-CoV-2 ELISA. No cross-reactivities with endemic coronaviruses or other human viruses were observed, and no change in results were recorded for interfering substances. The assay was stable at temperature extremes and components were stable for 15 days once opened. A matrix comparison showed DBS to correlate with serum results. Clinical validation of the assay reported a sensitivity of 94.7% (95% CI, 90.9-97.2%) and a specificity of 98.4% (95% CI, 96.6-99.3%). CONCLUSIONS The human anti-IgGAM SARS-CoV-2 ELISA provides accurate and sensitive detection of SARS-CoV-2 antibodies in non-hospitalised adults with mild or moderate disease. The use of dried blood spots makes the assay accessible to the wider community.
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Affiliation(s)
- A.M. Cook
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - S.E. Faustini
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK
| | - L.J. Williams
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK,Corresponding author at: The Binding Site Group, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - A.F. Cunningham
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - M.T. Drayson
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK
| | - A.M. Shields
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK,University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK
| | - D. Kay
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - L. Taylor
- The Royal Wolverhampton NHS Trust, Wolverhampton Road, Wolverhampton, West Midlands WV10 0QP, UK
| | - T. Plant
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK
| | - A. Huissoon
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK,University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK
| | - G. Wallis
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - S. Beck
- University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK
| | - S.E. Jossi
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - M. Perez-Toledo
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - M.L. Newby
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - J.D. Allen
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - M. Crispin
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - S. Harding
- The Binding Site Group Ltd, 8 Calthorpe Road, Birmingham B15 1QT, UK
| | - A.G. Richter
- Clinical Immunology Service, University of Birmingham College of Medical and Dental Sciences, Birmingham B15 2TT, UK,University Hospitals Birmingham, NHS Foundation Trust, Birmingham B15 2GW, UK
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Graage R, Beck S, Koch M, Dolezal M, Schwarz L, Hennig-Pauka I. [Comparison between oral fluid samples and pooled serum samples for the detection of antibodies against Porcine Reproductive and Respiratory Syndrome Virus in weaning pig herds]. SCHWEIZ ARCH TIERH 2021; 162:531-538. [PMID: 32855120 DOI: 10.17236/sat00270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Monitoring of Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) in pig farms is performed usually by testing for antibodies against PRRSV in serum samples. A new method is the detection of PRRSV antibodies in porcine saliva. In this study serum samples and saliva were collected in nine farms suspicious for PRRSV and tested for the presence of PRRSV antibodies. In total 220 serum and 41 saliva samples were taken from pigs at the age of 8 weeks (± 1 week). One saliva and one pooled serum sample (1:5) were tested from each pen. In total 11 (Cut-off 0.4/0.3) or 14 (Cut-off 0.2) serum samples and 23 saliva out of 41 pens were positive for PRRSV antibodies. Cohen`s Kappa testing showed a moderate agreement (κ = 0.446). Saliva samples compared to pooled serum samples were very sensitive, the specificity was 60 and 67, respectively.
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Affiliation(s)
- R Graage
- Departement für Nutztiere, Abteilung Schweinemedizin, Vetsuisse-Fakultät, Universität Zürich
| | - S Beck
- Universitätsklinik für Schweine, Department für Nutztiere und öffentliches Veterinärwesen in der Veterinärmedizin, Veterinärmedizinische Universität Wien
| | - M Koch
- Universitätsklinik für Schweine, Department für Nutztiere und öffentliches Veterinärwesen in der Veterinärmedizin, Veterinärmedizinische Universität Wien
| | - M Dolezal
- Plattform Bioinformatik und Biostatistik, Veterinärmedizinische Universität Wien
| | - L Schwarz
- Universitätsklinik für Schweine, Department für Nutztiere und öffentliches Veterinärwesen in der Veterinärmedizin, Veterinärmedizinische Universität Wien
| | - I Hennig-Pauka
- Universitätsklinik für Schweine, Department für Nutztiere und öffentliches Veterinärwesen in der Veterinärmedizin, Veterinärmedizinische Universität Wien
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Yatsenko SA, Quesada-Candela C, Saller DN, Beck S, Jaffe R, Kostadinov S, Yanowitz J, Rajkovic A. Cytogenetic signatures of recurrent pregnancy losses. Prenat Diagn 2020; 41:70-78. [PMID: 33015842 DOI: 10.1002/pd.5838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/31/2020] [Accepted: 10/01/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To investigate the incidence of chromosomal abnormalities in the products of conception (POC) of patients with spontaneous miscarriages (SM) and with recurrent pregnancy losses (RPL) and to determine biological mechanisms contributing to RPL. METHODS During a 20-year period, 12 096 POC samples underwent classical chromosome analysis. Cytogenetic findings were compared between the SM and RPL cohorts. RESULTS Analysis of RPL cohort has identified an increased incidence of inherited and de novo structural chromosome abnormalities, recurrent polyploid conceptions, and complex mosaic alterations. These abnormalities are the signature of genomic instability, posing a high risk of genetic abnormalities to offspring independent of maternal age. Predominance of male conceptions in the RPL cohort points toward an X-linked etiology and gender-specific intolerance for certain genetic abnormalities. CONCLUSIONS Our study showed several possible genetic etiologies of RPL, including parental structural chromosome rearrangements, predisposition to meiotic nondisjunction, and genomic instability. Loss of karyotypically normal fetuses might be attributed to defects in genes essential for fetal development, as well as aberrations affecting the X chromosome. Molecular studies of parental and POC genomes will help to identify inherited defects in genes involved in meiotic divisions and DNA repair to confirm our hypotheses, and to discover novel fetal-essential genes.
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Affiliation(s)
- Svetlana A Yatsenko
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA.,Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Cristina Quesada-Candela
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | - Devereux N Saller
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stacy Beck
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ronald Jaffe
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stefan Kostadinov
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Judith Yanowitz
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | - Aleksandar Rajkovic
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Pathology, University of California San Francisco, San Francisco, California, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.,Institute of Human Genetics, University of California San Francisco, San Francisco, California, USA
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20
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Gimeno-Valiente F, Chen K, Cadieux E, Watkins T, Chervova O, Dhami P, Vaikkinen H, Feber A, Demeulemeester J, Tanic M, Beck S, Van Loo P, Kanu N, Swanton C. 1228P Integrated analysis of gene expression and chromosomal aberrations to determine the global patterns of DNA methylation heterogeneity in the TRACERx lung study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1430] [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] Open
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21
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Beck S, Zins L, Holthusen C, Rademacher C, Von Breunig F, Knipper S, Tennstedt P, Haese A, Graefen M, Zöllner C, Fischer M. Comparison of cognitive function after robot-assisted prostatectomy and open retropubic radical prostatectomy: A prospective observational single-center study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34025-8] [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] Open
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22
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Cabrera C, Radolec M, Prescott A, De La Cruz C, Beck S. Interdisciplinary Approach for the Medical Management of Gestational Gigantomastia. AJP Rep 2020; 10:e304-e308. [PMID: 33094019 PMCID: PMC7571560 DOI: 10.1055/s-0040-1715174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/08/2020] [Indexed: 11/25/2022] Open
Abstract
Background Gestational gigantomastia is a rare and debilitating condition that is thought to result from hormone hypersensitivity. Several definitions have been proposed using breast weight and change in body mass index, but the breast growth is best summarized as rapid, diffuse, and excessive. Case We report a case of a 31-year-old woman with a history of infertility and cystic fibrosis that developed pathologic breast growth during hormonal preparation for in vitro fertilization. Her serum laboratories were unremarkable, and she was medically managed until 31 weeks of gestation. After delivery, she experienced rapid decrease in breast size and was followed by plastic surgery with plan to allow spontaneous regression with interval breast reduction Conclusion We highlight a successful interdisciplinary medical management approach, which helped to avoid a morbid, intrapartum breast reduction.
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Affiliation(s)
- Camila Cabrera
- Department of Obstetrics and Gynecology, UPMC, Pittsburgh, Pennsylvania
| | - Mackenzy Radolec
- Department of Obstetrics and Gynecology, UPMC, Pittsburgh, Pennsylvania
| | - Angela Prescott
- Department of Plastic Surgery, UPMC, Pittsburgh, Pennsylvania
| | | | - Stacy Beck
- Department of Obstetrics and Gynecology, UPMC, Pittsburgh, Pennsylvania
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23
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Beck S, Hoop D, Ragab H, Rademacher C, Meßner-Schmitt A, Von Breunig F, Knipper S, Haese A, Graefen M, Zöllner C, Fischer M. Post-anesthesia care unit delirium following robot-assisted versus open retropubic radical prostatectomy – a prospective observational study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34026-x] [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] Open
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24
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Ragunanthan NW, Lamb JE, Hauspurg A, Beck S. 741: Assessment of racial disparities in aspirin prophylaxis for preeclampsia prevention. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.11.755] [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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25
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Katheria A, Reister F, Essers J, Mendler M, Hummler H, Subramaniam A, Carlo W, Tita A, Truong G, Davis-Nelson S, Schmölzer G, Chari R, Kaempf J, Tomlinson M, Yanowitz T, Beck S, Simhan H, Dempsey E, O’Donoghue K, Bhat S, Hoffman M, Faksh A, Arnell K, Rich W, Finer N, Vaucher Y, Khanna P, Meyers M, Varner M, Allman P, Szychowski J, Cutter G. Association of Umbilical Cord Milking vs Delayed Umbilical Cord Clamping With Death or Severe Intraventricular Hemorrhage Among Preterm Infants. JAMA 2019; 322:1877-1886. [PMID: 31742630 PMCID: PMC6865839 DOI: 10.1001/jama.2019.16004] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Umbilical cord milking as an alternative to delayed umbilical cord clamping may provide equivalent benefits to preterm infants, but without delaying resuscitation. OBJECTIVE To determine whether the rates of death or severe intraventricular hemorrhage differ among preterm infants receiving placental transfusion with umbilical cord milking vs delayed umbilical cord clamping. DESIGN, SETTING, AND PARTICIPANTS Noninferiority randomized clinical trial of preterm infants (born at 23-31 weeks' gestation) from 9 university and private medical centers in 4 countries were recruited and enrolled between June 2017 and September 2018. Planned enrollment was 750 per group. However, a safety signal comprising an imbalance in the number of severe intraventricular hemorrhage events by study group was observed at the first interim analysis; enrollment was stopped based on recommendations from the data and safety monitoring board. The planned noninferiority analysis could not be conducted and a post hoc comparison was performed instead. Final date of follow-up was December 2018. INTERVENTIONS Participants were randomized to umbilical cord milking (n = 236) or delayed umbilical cord clamping (n = 238). MAIN OUTCOMES AND MEASURES The primary outcome was a composite of death or severe intraventricular hemorrhage to determine noninferiority of umbilical cord milking with a 1% noninferiority margin. RESULTS Among 540 infants randomized, 474 (88%) were enrolled and completed the trial (mean gestational age of 28 weeks; 46% female). Twelve percent (29/236) of the umbilical cord milking group died or developed severe intraventricular hemorrhage compared with 8% (20/238) of the delayed umbilical cord clamping group (risk difference, 4% [95% CI, -2% to 9%]; P = .16). Although there was no statistically significant difference in death, severe intraventricular hemorrhage was statistically significantly higher in the umbilical cord milking group than in the delayed umbilical cord clamping group (8% [20/236] vs 3% [8/238], respectively; risk difference, 5% [95% CI, 1% to 9%]; P = .02). The test for interaction between gestational age strata and treatment group was significant for severe intraventricular hemorrhage only (P = .003); among infants born at 23 to 27 weeks' gestation, severe intraventricular hemorrhage was statistically significantly higher with umbilical cord milking than with delayed umbilical cord clamping (22% [20/93] vs 6% [5/89], respectively; risk difference, 16% [95% CI, 6% to 26%]; P = .002). CONCLUSIONS AND RELEVANCE In this post hoc analysis of a prematurely terminated randomized clinical trial of umbilical cord milking vs delayed umbilical cord clamping among preterm infants born at less than 32 weeks' gestation, there was no statistically significant difference in the rate of a composite outcome of death or severe intraventricular hemorrhage, but there was a statistically significantly higher rate of severe intraventricular hemorrhage in the umbilical cord milking group. The early study termination and resulting post hoc nature of the analyses preclude definitive conclusions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03019367.
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Affiliation(s)
- Anup Katheria
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
| | - Frank Reister
- Department of Obstetrics, University of Ulm, Ulm, Germany
| | - Jochen Essers
- Department of Pediatrics, University of Ulm, Ulm, Germany
| | - Marc Mendler
- Department of Pediatrics, University of Ulm, Ulm, Germany
| | - Helmut Hummler
- Division of Neonatology, Department of Pediatrics, Sidra Medicine, Doha, Qatar
| | | | - Waldemar Carlo
- Department of Pediatrics, University of Alabama at Birmingham
| | - Alan Tita
- Department of Obstetrics, University of Alabama at Birmingham
| | - Giang Truong
- Department of Pediatrics, Loma Linda University, Loma Linda, California
| | | | - Georg Schmölzer
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Radha Chari
- Department of Obstetrics, University of Alberta, Edmonton, Canada
| | - Joseph Kaempf
- Women and Children’s Services, Providence St Vincent Medical Center, Portland, Oregon
| | - Mark Tomlinson
- Women and Children’s Services, Providence St Vincent Medical Center, Portland, Oregon
| | - Toby Yanowitz
- Department of Pediatrics, Magee Women’s Hospital of UPMC, Pittsburgh, Pennsylvania
| | - Stacy Beck
- Department of Obstetrics, Magee Women’s Hospital of UPMC, Pittsburgh, Pennsylvania
| | - Hyagriv Simhan
- Department of Obstetrics, Magee Women’s Hospital of UPMC, Pittsburgh, Pennsylvania
| | - Eugene Dempsey
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | | | - Shazia Bhat
- Department of Pediatrics, Christiana Care Health System, Newark, Delaware
| | - Matthew Hoffman
- Department of Obstetrics, Christiana Care Health System, Newark, Delaware
| | - Arij Faksh
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
| | - Kathy Arnell
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
| | - Wade Rich
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
| | - Neil Finer
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California
| | - Yvonne Vaucher
- Department of Radiology, Children’s Hospital Colorado, University of Colorado School of Medicine, Denver
| | - Paritosh Khanna
- Department of Radiology, Rady Children’s Hospital, San Diego, California
| | - Mariana Meyers
- Department of Radiology, Children’s Hospital Colorado, University of Colorado School of Medicine, Denver
| | - Michael Varner
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City
| | - Phillip Allman
- Department of Biostatistics, University of Alabama at Birmingham
| | - Jeff Szychowski
- Department of Biostatistics, University of Alabama at Birmingham
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham
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Reinke N, Arndt S, Bakalov I, Band S, Beck S, Nowack H, Iliev D, Spengler C, Klein-Hessling W, Sonnenkalb M. Validation and Application of the AC2 Code COCOSYS. KERNTECHNIK 2019. [DOI: 10.3139/124.190066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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]
Abstract
AbstractThe GRS program package AC2 with its codes ATHLET/ATHLET-CD and COCOSYS aims for the reliable computational simulation of significant phenomena occurring during normal operation, design basis accidents, and severe accidents in the cooling circuit and containment of a nuclear power plant. To keep the modelling at the state-of-the-art, continuous development and validation is required. This is accomplished through participation in several national and international experimental research programs, where AC2 or one of its codes are assessed against both separate effect tests and integral tests. This paper exemplifies the status of validation and application of COCOSYS by means of calculations of iodine chemistry and molten corium/concrete interaction after reactor pressure vessel rupture. Further, calculations using the external 3D module CoPool coupled to COCOSYS on thermal stratification in large water pools are discussed. The examples given demonstrate the progress of the COCOSYS development and the capability to simulate phenomena in the containment during incidents and accidents with good results. Future applications comprise the entire spectrum of incidents and accidents for Generation III/III+ systems with just one program package.
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Affiliation(s)
- N. Reinke
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - S. Arndt
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - I. Bakalov
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - S. Band
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - S. Beck
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - H. Nowack
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - D. Iliev
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - C. Spengler
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - W. Klein-Hessling
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
| | - M. Sonnenkalb
- 1Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Safety Research Division, Schwertnergasse 1, 60677 Köln
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Dittrich F, Busch A, Harren K, Jäger M, Landgraeber S, Reinecke F, Beck S. [Apps in clinical use in orthopedics and trauma surgery : The status quo in Germany]. Unfallchirurg 2019; 122:690-696. [PMID: 31127352 DOI: 10.1007/s00113-019-0675-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the course of digitalization the smartphone is penetrating more and more areas of life giving the user mobile and almost ubiquitous access to the internet and other web applications. The advantages of mHealth are an integral part in some areas of patient care but in contrast to other disciplines, routine integration of mobile devices into orthopedics and trauma surgery is still in its infancy. A survey among German orthopedists and trauma surgeons revealed which kind of apps have become established in everyday clinical practice to date. Apps published by representative institutions such as the AO Foundation demonstrated the highest usage rates. In summary, the number of regularly used apps is low; however, the causes of this lack of acceptance have not yet been conclusively clarified. The authors of this study proclaim a significant increase in the use of mHealth and mobile devices in daily clinical practice in the future.
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Affiliation(s)
- F Dittrich
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Gebäude 37, Kirrberger Straße, 66421, Homburg, Deutschland.
| | - A Busch
- Universitätsklinik für Orthopädie und Unfallchirurgie, Universitätsmedizin Essen, Essen, Deutschland
| | - K Harren
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, Deutschland
| | - M Jäger
- Universitätsklinik für Orthopädie und Unfallchirurgie, Universitätsmedizin Essen, Essen, Deutschland
| | - S Landgraeber
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Gebäude 37, Kirrberger Straße, 66421, Homburg, Deutschland
| | - F Reinecke
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, Deutschland
| | - S Beck
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Gebäude 37, Kirrberger Straße, 66421, Homburg, Deutschland
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Essen, Essen, Deutschland
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28
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Waters JH, Beck S, Yazer MH. How do I perform cell salvage in obstetrics? Transfusion 2019; 59:2199-2202. [PMID: 31145473 DOI: 10.1111/trf.15352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 11/30/2022]
Abstract
Maternal mortality in the United States is increasing. The leading cause of death is hemorrhage. Maternal hemorrhage can be profound, with entire blood volumes being lost. In most major blood loss surgery, autotranfusion (also known as cell salvage, cell saving, and intraoperative blood collection and readministration) is a technique that has been used to minimize allogeneic transfusion. Historically, autotransfusion has been considered contraindicated in the face of maternal hemorrhage because of a fear of incorporating amniotic fluid in the salvaged blood. Recent data suggests that this fear is unfounded, with several medical societies now recommending that autotransfusion be used during maternal hemorrhage. In this review, autotransfusion during maternal hemorrhage is discussed, and suggestions are made for how to make it most successful.
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Affiliation(s)
- Jonathan H Waters
- Departments of Anesthesiology & Bioengineering, University of Pittsburgh, McGowan Institute for Regenerative Medicine, Pittsburgh, Pennsylvania
| | - Stacy Beck
- Department of Obstetrics & Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mark H Yazer
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Rijsbergen M, Niemeyer‐van der Kolk T, Hogendoorn G, Kouwenhoven S, Lemoine C, Klaassen E, de Koning M, Beck S, Bouwes Bavinck J, Feiss G, Burggraaf J, Rissmann R. Digoxin with furosemide is efficacious in cutaneous warts. Br J Dermatol 2019. [DOI: 10.1111/bjd.17803] [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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Rijsbergen M, Niemeyer‐van der Kolk T, Hogendoorn G, Kouwenhoven S, Lemoine C, Klaassen E, Koning M, Beck S, Bouwes Bavinck J, Feiss G, Burggraaf J, Rissmann R. 地高辛联合呋塞米对于皮肤疣有效. Br J Dermatol 2019. [DOI: 10.1111/bjd.17815] [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: 11/29/2022]
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Rijsbergen M, Niemeyer-van der Kolk T, Hogendoorn G, Kouwenhoven S, Lemoine C, Klaassen ES, de Koning M, Beck S, Bouwes Bavinck JN, Feiss G, Burggraaf J, Rissmann R. A randomized controlled proof-of-concept trial of digoxin and furosemide in adults with cutaneous warts. Br J Dermatol 2019; 180:1058-1068. [PMID: 30580460 PMCID: PMC6850412 DOI: 10.1111/bjd.17583] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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] [Accepted: 12/19/2018] [Indexed: 12/13/2022]
Abstract
Background Topical ionic contraviral therapy (ICVT) with digoxin and furosemide inhibits the potassium influx on which DNA viruses rely for replication. Therefore, ICVT was hypothesized to be a potential novel treatment for cutaneous warts. Objectives To assess the clinical efficacy, safety and tolerability of ICVT in adults with cutaneous warts. The secondary objective was to gain insight into the underlying working mechanism of ICVT. Methods Treatment with ICVT was assessed for efficacy, safety and tolerability in a single‐ centre, randomized, double‐blind, placebo‐controlled phase IIA trial. Eighty adult patients with at least two cutaneous warts (plantar or common) were randomized to one of four treatments: digoxin + furosemide (0·125%), digoxin (0·125%), furosemide (0·125%) or placebo. The gel was administered once daily for 42 consecutive days. Predefined statistical analysis was performed with a mixed‐model ancova. The trial was registered at ClinicalTrials.gov with number NCT02333643. Results Wart size and human papillomavirus (HPV) load reduction was achieved in all active treatment groups. A statistically significant reduction in wart diameter of all treated warts was shown in the digoxin + furosemide treatment group vs. placebo (−3·0 mm, 95% confidence interval −4·9 to −1·1, P = 0·002). There was a statistically significant reduction in the HPV load of all treated warts in the digoxin + furosemide group vs. placebo (−94%, 95% confidence interval −100 to −19, P = 0·03). With wart size reduction, histologically and immunohistochemically defined viral characteristics disappeared from partial and total responding warts. Conclusions This study demonstrates the proof of concept for the efficacy of topical ICVT in adults with cutaneous warts. What's already known about this topic? Cutaneous warts are caused by the human papillomavirus (HPV). Ionic contraviral therapy (ICVT) might be a potential treatment for cutaneous warts. A previous phase I/II open‐label study demonstrated the safety and efficacy of ICVT.
What does this study add? Proof of concept for the efficacy of topical ICVT in adults with cutaneous warts. Topical ICVT demonstrates a favourable safety profile, with the effects most pronounced when it is combined in a formulation for common warts. Wart size reduction was related to HPV load reduction measured by quantitative polymerase chain reaction (qPCR) in swabs. qPCR is a valuable disease biomarker for drug development in cutaneous warts.
https://doi.org/10.1111/bjd.17803 available online https://www.bjdonline.com/article/
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Affiliation(s)
- M Rijsbergen
- Center for Human Drug Research, Leiden, the Netherlands
| | | | - G Hogendoorn
- Center for Human Drug Research, Leiden, the Netherlands
| | - S Kouwenhoven
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - C Lemoine
- Center for Human Drug Research, Leiden, the Netherlands
| | - E S Klaassen
- Center for Human Drug Research, Leiden, the Netherlands
| | - M de Koning
- DDL Diagnostic Laboratory, Rijswijk, the Netherlands
| | - S Beck
- DDL Diagnostic Laboratory, Rijswijk, the Netherlands
| | - J N Bouwes Bavinck
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - G Feiss
- Cutanea Life Science, Wayne, PA, U.S.A
| | - J Burggraaf
- Center for Human Drug Research, Leiden, the Netherlands
| | - R Rissmann
- Center for Human Drug Research, Leiden, the Netherlands
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Beck S, Buhimschi IA, Summerfield TL, Ackerman WE, Guzeloglu-Kayisli O, Kayisli UA, Zhao G, Schatz F, Lockwood CJ, Buhimschi CS. Toll-like receptor 9, maternal cell-free DNA and myometrial cell response to CpG oligodeoxynucleotide stimulation. Am J Reprod Immunol 2019; 81:e13100. [PMID: 30758898 DOI: 10.1111/aji.13100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/01/2019] [Accepted: 02/08/2019] [Indexed: 01/05/2023] Open
Abstract
PROBLEM Among mechanisms triggering onset of parturition, it has been recently postulated that Toll-Like Receptor (TLR)9 engagement by cell-free DNA (cfDNA) triggers inflammation, myometrial contractions, and labor in absence of infection. The current study evaluated whether direct (myometrial) or indirect (decidual) TLR9 engagement enhances human myometrial contractility. METHOD OF STUDY Toll-like receptor 9 expression and cellular localization were surveyed by immunohistochemistry of placenta, fetal membranes, and myometrium in term (gestational age [GA]: >37 weeks) labor (TL, n = 7) or term non-labor (TNL, n = 7) tissues. Non-pregnant myometrium (n = 4) served as reference. TLR9 mRNA expression relative to other TLRs was evaluated through the mining of an RNA-seq dataset and confirmed by RT-PCR. Immortalized human myometrial cells (hTERT-HM) were treated with incremental concentrations of TLR9 agonist ODN2395, TNF-α, or LPS. Secreted cytokines were quantified by multiplex immunoassay, and contractility was assessed by an in-gel cell contraction assay (n = 9). Induction of hTERT-HM contractility was also evaluated indirectly following exposure to conditioned media from primary term decidual cells (n = 4) previously stimulated with ODN2395. RESULTS Toll-like receptor 9 immunostaining in placenta and amniochorion was strongest in decidual cells, but unrelated to labor. TLR9 staining intensity was significantly decreased in TL compared with TNL myometrium (P = 0.002). Although total cfDNA in maternal circulation increased in TL (P = 0.025 vs TNL), difference in cffDNA was non-significant. Myometrial TLR9 mRNA levels were unaffected by contractile status and far less abundant than other pro-inflammatory TLRs. hTERT-HM contractility was enhanced by LPS (P = 0.002) and TNF-α (P = 0.003), but not by ODN2395 (P = 0.345) or supernatant of TLR9-stimulated decidual cells. CONCLUSION Myometrial and decidual TLR9 are unlikely to directly regulate human parturition.
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Affiliation(s)
- Stacy Beck
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Irina A Buhimschi
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.,Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
| | - Taryn L Summerfield
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
| | - William E Ackerman
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Ozlem Guzeloglu-Kayisli
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Umit A Kayisli
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Guomao Zhao
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Frederick Schatz
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Charles J Lockwood
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Catalin S Buhimschi
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
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Katheria AC, Reister F, Hummler H, Essers J, Mendler M, Truong G, Davis-Nelson S, Subramaniam A, Carlo W, Yankowitz TD, Simhan H, Beck S, Kaempf J, Tomlinson M, Schmolzer G, Chari R, Dempsey E, O’Donoghue K, Bhat S, Hoffman M, Faksh A, Vaucher Y, Szychowski J, Cutter G, Varner M, Finer N. LB 1: Premature Infants Receiving Cord Milking or Delayed Cord Clamping: A Randomized Controlled Non-inferiority Trial. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2018.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Beck S, Darsow U, Chocano P, Schmid R, Lehmann S, Klaghofer R, Spies L, Bischoff-Ferrari HA. 75PREDICTION ACCURACY OF CLINICAL ASSESSMENT FOR CONVERSION TO ALZHEIMER’S DISEASE DEMENTIA IN SUBJECTS WITH SUBJECTIVE AND MILD COGNITIVE IMPAIRMENT: A LONGITUDINAL STUDY. Age Ageing 2018. [DOI: 10.1093/ageing/afy118.07] [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: 11/13/2022] Open
Affiliation(s)
- S Beck
- Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich Switzerland
- University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland
| | - U Darsow
- Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich Switzerland
- University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland
| | - P Chocano
- Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich Switzerland
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich
| | - R Schmid
- University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland
| | - S Lehmann
- University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland
| | - R Klaghofer
- University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Switzerland
| | - L Spies
- Jung Diagnostics GmbH, Hamburg, Germany
| | - H A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich Switzerland
- University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Switzerland
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Affiliation(s)
- M. Freitag
- Becker Technologies GmbH, Rahmannstr. 11, Eschborn 65760, Germany
| | - S. Gupta
- Becker Technologies GmbH, Rahmannstr. 11, Eschborn 65760, Germany
| | - S. Beck
- Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Reactor Safety Research Division, Schwertnergasse 1, Köln 50667, Germany
| | - M. Sonnenkalb
- Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, Reactor Safety Research Division, Schwertnergasse 1, Köln 50667, Germany
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Cadieux EL, Wilson G, Tanic M, Demeulemeester J, Barrett J, Birkbak N, Swanton C, Beck S, Loo PV. PO-342 Integrating copy number analysis and tumour DNA methylation profiling. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.854] [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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Baretto RL, Beck S, Heslegrave J, Melchior C, Mohamed O, Ekbote A, Huissoon AP, Krishna MT. Validation of international consensus equation for acute serum total tryptase in mast cell activation: A perioperative perspective. Allergy 2017; 72:2031-2034. [PMID: 28609557 DOI: 10.1111/all.13226] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2017] [Indexed: 11/30/2022]
Abstract
There is no standardized method for assessing serum total mast cell tryptase (MCT) in anaphylaxis. The consensus equation (peak MCT should be>1.2× baseline tryptase+2 mg/L) has been proposed to interpret acute MCT in mast cell activation syndrome (MCAS). To validate consensus equation in a perioperative setting analyses of cases of suspected perioperative anaphylaxis during general anaesthesia (GA) were performed. Anaphylaxis was defined as per World Allergy Organisation (WAO) criteria. Timed serial MCT measurements were mapped against the consensus equation and receiver operating characteristic (ROC) curves produced. A total of 82 patients (60 females, mean age 56.5 years±SD17.2) underwent investigation. Sixty (73%) patients fulfilled WAO criteria for anaphylaxis, and 22 patients did not. Aetiology included 59% IgE-mediated anaphylaxis, 2% non-IgE-mediated anaphylaxis, 12% anaphylaxis of unknown cause and 27% deemed non-anaphylaxis. IgE-mediated anaphylaxis included the following: NMBA (35%), antibiotics (46%), chlorhexidine (8%), patent blue dye (8%) and others (8%). An acute MCT with a comparable baseline was available in 71 of 82 (87%) patients (60 anaphylaxis and 11 controls). The median interquartile range (IQR) time from reaction to peak MCT was 1.34 (0.82-2.51) hours. Analyses confirmed that a rise in acute MCT greater than that defined by the equation had a sensitivity, specificity, positive predictive value (PPV) and negative (N) PV of 78%, 91%, 98% and 44%, respectively. The magnitude of increase in acute MCT above the threshold predicted by consensus equation was higher in the anaphylaxis group compared to controls (P=.0001). This equation has a high specificity, PPV with a moderate NPV and sensitivity in perioperative anaphylaxis.
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Affiliation(s)
- R. L. Baretto
- Department of Allergy & Immunology; Heart of England NHS Foundation Trust; Birmingham UK
- Department of Immunology; Kettering General Hospital NHS Foundation Trust; Kettering UK
- Department of Biochemistry & Immunology; University Hospitals of Coventry and Warwickshire; Coventry UK
| | - S. Beck
- Department of Allergy & Immunology; Heart of England NHS Foundation Trust; Birmingham UK
| | - J. Heslegrave
- Department of Allergy & Immunology; Heart of England NHS Foundation Trust; Birmingham UK
| | - C. Melchior
- Department of Allergy & Immunology; Heart of England NHS Foundation Trust; Birmingham UK
| | - O. Mohamed
- Department of Allergy & Immunology; Heart of England NHS Foundation Trust; Birmingham UK
| | - A. Ekbote
- Department of Allergy & Immunology; Heart of England NHS Foundation Trust; Birmingham UK
| | - A. P. Huissoon
- Department of Allergy & Immunology; Heart of England NHS Foundation Trust; Birmingham UK
- Institute of Immunology & Immunotherapy; University of Birmingham; Birmingham UK
| | - M. T. Krishna
- Department of Allergy & Immunology; Heart of England NHS Foundation Trust; Birmingham UK
- Institute of Immunology & Immunotherapy; University of Birmingham; Birmingham UK
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Bell K, Wilding C, Beck S, Pfeiffer N, Grus F. Neurotrophins involved in neuroprotective antibody effect. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03522] [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: 11/28/2022]
Affiliation(s)
- K. Bell
- Department of Ophthalmology; Experimental Ophthalmology; Mainz Germany
| | - C. Wilding
- Department of Ophthalmology; Experimental Ophthalmology; Mainz Germany
| | - S. Beck
- Department of Ophthalmology; Experimental Ophthalmology; Mainz Germany
| | - N. Pfeiffer
- Department of Ophthalmology; Experimental Ophthalmology; Mainz Germany
| | - F.H. Grus
- Department of Ophthalmology; Experimental Ophthalmology; Mainz Germany
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Teister J, Anders F, Beck S, Funke S, von Pein H, Prokosch V, Pfeiffer N, Grus F. Decelerated neurodegeneration after intravitreal injection of α-synuclein antibodies in a glaucoma animal model. Sci Rep 2017; 7:6260. [PMID: 28740252 PMCID: PMC5524683 DOI: 10.1038/s41598-017-06702-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Received: 08/18/2016] [Accepted: 06/19/2017] [Indexed: 01/02/2023] Open
Abstract
Although elevated intraocular pressure (IOP) remains the major risk factor in glaucoma, neurodegenerative processes continue despite effective IOP lowering. Altered α-synuclein antibody (Abs) levels have been reported to play a crucial role. This study aimed at identifying whether α-synuclein Abs are capable to decelerate neuronal decay while providing insights into proteomic changes. Four groups of Sprague Dawley rats received episcleral vein occlusion: (1) CTRL, no intravitreal injection, n = 6, (2) CTRL IgG, intravitreal injection of unspecific IgG, n = 5, (3) Buffer, intravitreal injection of buffer, n = 6, (4), α-synuclein Ab, intravitreal injection of α-synuclein Ab, n = 5. IOP and retinal nerve fiber layer thickness (RNFLT) were monitored and immunohistochemistry, microarray and proteomic analysis were performed. RNFLT was reduced in CTRL, CTRL IgG and Buffer group (all p < 0.01) and α-synuclein Ab group (p = 0.17). Axon and RGC density showed an increased neurodegeneration in CTRL, CTRL IgG and Buffer group (all p < 0.01) and increased neuronal survival in α-synuclein Ab group (p = 0.38 and 0.06, respectively) compared with fellow eyes. Proteomic analysis revealed alterations of cofilin 1 and superoxide dismutase 1 expression. This data indicate that α-synuclein Ab might indirectly modulate the actin cytoskeleton organization and negatively regulate apoptotic processes via cofilin 1 and superoxide dismutase 1.
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Affiliation(s)
- J Teister
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - F Anders
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - S Beck
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - S Funke
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - H von Pein
- Institute of Neuropathology, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - V Prokosch
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - N Pfeiffer
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - F Grus
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany.
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Beck S, Trog S, Knizia S, Linscheid MW. Fragmentation behavior of DOTA complexes under different activation conditions. J Mass Spectrom 2017; 52:442-451. [PMID: 28455851 DOI: 10.1002/jms.3942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/25/2017] [Accepted: 04/25/2017] [Indexed: 06/07/2023]
Abstract
We have investigated the fragmentation behavior of a number of DOTA-metal complexes under collision-induced dissociation, infrared-multiphoton dissociation and higher-energy collisional dissociation activation conditions. Both, positive and negative ion mode electrospray ionization was applied. The results show that characteristic fragmentations were obtained for the metal-complexes under the investigated conditions. All elemental compositions of fragment ions have been unambiguously identified by high resolution-accurate mass measurements. Certain trends, for instance eliminations of carbon dioxide, alkyl and amine residues, were observed that coincide with the size of the metal and its location within the periodic table. Additionally, lanthanide, aluminium and indium species with even oxidation state or containing a radical have been detected. To further investigate the observed water capture during activation, deuterium labeling experiments have also been carried out. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- S Beck
- Department of Chemistry, Humboldt-Universität zu Berlin, Brook-Taylor Str. 2, 12489, Berlin, Germany
| | - S Trog
- Department of Chemistry, Humboldt-Universität zu Berlin, Brook-Taylor Str. 2, 12489, Berlin, Germany
| | - S Knizia
- Department of Chemistry, Humboldt-Universität zu Berlin, Brook-Taylor Str. 2, 12489, Berlin, Germany
| | - M W Linscheid
- Department of Chemistry, Humboldt-Universität zu Berlin, Brook-Taylor Str. 2, 12489, Berlin, Germany
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Beck S, Gunawardena P, Horton DL, Hicks DJ, Marston DA, Ortiz-Pelaez A, Fooks AR, Núñez A. Pathobiological investigation of naturally infected canine rabies cases from Sri Lanka. BMC Vet Res 2017; 13:99. [PMID: 28403882 PMCID: PMC5389160 DOI: 10.1186/s12917-017-1024-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 02/03/2016] [Accepted: 04/03/2017] [Indexed: 12/25/2022] Open
Abstract
Background The recommended screening of rabies in ‘suspect’ animal cases involves testing fresh brain tissue. The preservation of fresh tissue however can be difficult under field conditions and formalin fixation provides a simple alternative that may allow a confirmatory diagnosis. The occurrence and location of histopathological changes and immunohistochemical (IHC) labelling for rabies in formalin fixed paraffin embedded (FFPE) canine brain is described in samples from 57 rabies suspect cases from Sri-Lanka. The presence of Negri bodies and immunohistochemical detection of rabies virus antigen were evaluated in the cortex, hippocampus, cerebellum and brainstem. The effect of autolysis and artefactual degeneration of the tissue was also assessed. Results Rabies was confirmed in 53 of 57 (93%) cases by IHC. IHC labelling was statistically more abundant in the brainstem. Negri bodies were observed in 32 of 53 (60.4%) of the positive cases. Although tissue degradation had no effect on IHC diagnosis, it was associated with an inability to detect Negri bodies. In 13 cases, a confirmatory Polymerase chain reaction (PCR) testing for rabies virus RNA was undertaken by extracting RNA from fresh frozen tissue, and also attempted using FFPE samples. PCR detection using fresh frozen samples was in agreement with the IHC results. The PCR method from FFPE tissues was suitable for control material but unsuccessful in our field cases. Conclusions Histopathological examination of the brain is essential to define the differential diagnoses of behaviour modifying conditions in rabies virus negative cases, but it is unreliable as the sole method for rabies diagnosis, particularly where artefactual change has occurred. Formalin fixation and paraffin embedding does not prevent detection of rabies virus via IHC labelling even where artefactual degeneration has occurred. This could represent a pragmatic secondary assay for rabies diagnosis in the field because formalin fixation can prevent sample degeneration. The brain stem was shown to be the site with most viral immunoreactivity; supporting recommended sampling protocols in favour of improved necropsy safety in the field. PCR testing of formalin fixed tissue may be successful in certain circumstances as an alternative test.
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Affiliation(s)
- S Beck
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK.
| | - P Gunawardena
- Department of Veterinary Pathobiology, University of Peradeniya, Peradeniya, Sri Lanka
| | - D L Horton
- Wildlife Zoonoses and Vector Borne Diseases Research Group, Animal and Plant Health Agency, Weybridge, UK
| | - D J Hicks
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK
| | - D A Marston
- Wildlife Zoonoses and Vector Borne Diseases Research Group, Animal and Plant Health Agency, Weybridge, UK
| | | | - A R Fooks
- Wildlife Zoonoses and Vector Borne Diseases Research Group, Animal and Plant Health Agency, Weybridge, UK
| | - A Núñez
- Pathology Department, Animal and Plant Health Agency, Weybridge, UK
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Mooney K, Beck S, Echeverria C, Donaldson G. The impact of an automated, telephone-based coaching module on the adoption of an exercise program for cancer chemotherapy patients experiencing symptoms. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30595-6] [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: 10/20/2022]
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Beck S, Buhimschi IA, Summerfield T, Guzeloglu-Kayisli O, Kayisli U, Schatz F, Lockwood CJ, Buhimschi CS. 893: Myometrial and decidual toll-like receptor 9 (TLR9) and onset of human parturition. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.11.802] [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: 11/28/2022]
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Rood KM, Buhimschi IA, Zhao G, Beck S, Cackovic M, Bahtyiar MO, Summerfield T, Locke M, Buhimschi CS. 396: Presence and regulation of the soluble death receptor-3 in the amniotic fluid of pregnancies complicated by intra-amniotic infection/inflammation. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.11.654] [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: 10/20/2022]
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Ibrahim W, Abunga Y, Mamo J, Beck S, Brij SO. P113 Indeterminate IGRA results prior to anti-tnf therapy: stable state testing may be important for immune-mediated inflammatory disorders. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.256] [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: 11/03/2022]
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Funke S, Perumal N, Schmelter C, Teister J, Markowitsch S, Beck S, Pfeiffer N, Grus F. Retina proteomics provide new insights in glaucoma. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0128] [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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Siegenbeek van Heukelom ML, Richel O, de Vries HJC, van de Sandt MM, Beck S, van den Munckhof HAM, Pirog EC, de Koning MNC, Prins JM, Quint KD. Low- and high-risk human papillomavirus genotype infections in intra-anal warts in HIV-positive men who have sex with men. Br J Dermatol 2016; 175:735-43. [PMID: 26994411 DOI: 10.1111/bjd.14567] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Anogenital warts are often presumed to represent nondysplastic or low-grade anal intraepithelial neoplasia (LGAIN). We previously demonstrated that up to 20% of intra-anal warts in HIV-positive men who have sex with men (MSM) contain regions of high-grade AIN (HGAIN). OBJECTIVES To determine the causative human papillomavirus (HPV) types of low- and high- grade dysplastic areas in warts from HIV-positive MSM. METHODS A total of 42 intra-anal warts from 41 HIV-positive MSM were graded as nondysplastic, LGAIN or HGAIN. Whole-tissue sections (WTS) were analysed with the SPF10 polymerase chain reaction/LiPA25 HPV genotyping system. If the WTS contained multiple HPV types, dysplastic regions were isolated by laser capture microdissection (LCM) for HPV genotyping. RESULTS Overall, 38 of 42 (91%) WTS tested positive for HPV DNA. Of these, 23 (61%) contained a single HPV type and 15 (39%) contained multiple HPV types. All LCM-selected regions contained no more than one HPV type. Ten of 42 (24%) WTS contained HGAIN disease, of which six (60%) were associated with a high-risk HPV (hrHPV) genotype. Twenty-three of 42 WTS contained LGAIN disease, of which two (9%) were associated with hrHPV. AIN lesions containing hrHPV types were identified using p16 staining. CONCLUSIONS LGAIN lesions can be caused by high-risk HPV genotypes and vice versa. We therefore recommend routine follow-up and treatment of all dysplastic intra-anal warts for HIV-positive MSM.
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Affiliation(s)
- M L Siegenbeek van Heukelom
- Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands. .,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands. .,Department of Dermatology, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.
| | - O Richel
- Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands
| | - H J C de Vries
- Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.,Department of Dermatology, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.,STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), 1018 WT, Amsterdam, the Netherlands
| | | | - S Beck
- DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands
| | | | - E C Pirog
- Department of Pathology, Weill Medical College of Cornell University, New York, NY, 10065, U.S.A
| | - M N C de Koning
- DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands
| | - J M Prins
- Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands
| | - K D Quint
- DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands.,Department of Dermatology, The Leiden University Medical Center, 2300 RC, Leiden, the Netherlands.,Department of Dermatology, Roosevelt Clinics, 2321 BL, Leiden, the Netherlands
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Nast S, Fassbender M, Bormann N, Beck S, Montali A, Lucke M, Schmidmaier G, Wildemann B. In vivo quantification of gentamicin released from an implant coating. J Biomater Appl 2016; 31:45-54. [PMID: 26865659 DOI: 10.1177/0885328216630912] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Drug-releasing implants are gaining increasing interest. The present study reports a detailed physicochemical analysis of a polymeric coating based on poly(D,L-lactide) and the incorporated gentamicin combined with an in vitro and in vivo study of the gentamicin release. Differential scanning calorimeter, Fourier transform infrared spectroscopy, gel permeation chromatography and high-performance liquid chromatography showed no effect of the gamma sterilisation on the coating components or an interaction of the polymer and the gentamicin. Microbiological analysis revealed an inhibition of bacterial growth on the implant surface. For the in vivo study, gentamicin-coated wires were implanted into the tibiae of rats and harvested at different time points up to day 42. To monitor the release in vivo, gentamicin was quantified in serum, bone, endosteum, kidney, and on the explanted wires. Gentamicin was detectable over a time period of 42 days in the endosteum, up to seven days in the kidney, up to 4 h in the bone and at the end of the experiment on one of eight wires. The locally released gentamicin caused no histological changes of the kidney. Microbiologically active concentrations of released gentamicin were found in the endosteum up to 4 h after implantation. The combination of different methods supports the individual results, where quantification is complemented by visualisation or antimicrobial activity. This work demonstrates that the coating procedure results in no substantial alteration of the incorporated drug and that the in vitro burst release occurs also in vivo.
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Affiliation(s)
- S Nast
- Berlin-Brandenburg Center for Regenerative Therapies and Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M Fassbender
- Excellence Cluster Cardio-Pulmonary System, Giessen, Germany
| | - N Bormann
- Berlin-Brandenburg Center for Regenerative Therapies and Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - S Beck
- Synthes GmbH, Oberdorf, Switzerland
| | | | - M Lucke
- Chirurgische Klinik Dr. Rinecker, München, Germany
| | - G Schmidmaier
- Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - B Wildemann
- Berlin-Brandenburg Center for Regenerative Therapies and Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Rieck R, Beck S, Jones M, Zhao G, Rood K, Berryman K, Buhimschi IA, Buhimschi CS. 836: Comprehensive screening for presence and localization of TLR4 immunoreactivity in placenta and fetal membranes. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2015.10.886] [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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Beck S, Buhimschi IA, Zhao G, Ackerman W, Summerfield T, Buhimschi CS. 235: Toll-like receptor (TLR-9), a link between maternal cell-free DNA and human parturition. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2015.10.273] [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: 11/29/2022]
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