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1.
Ultrasound Obstet Gynecol ; 52(2): 186-195, 2018 08.
Article in English | MEDLINE | ID: mdl-29896812

ABSTRACT

OBJECTIVE: To examine the performance of screening for early, preterm and term pre-eclampsia (PE) at 11-13 weeks' gestation by maternal factors and combinations of mean arterial pressure (MAP), uterine artery (UtA) pulsatility index (PI), serum placental growth factor (PlGF) and serum pregnancy-associated plasma protein-A (PAPP-A). METHODS: The data for this study were derived from three previously reported prospective non-intervention screening studies at 11 + 0 to 13 + 6 weeks' gestation in a combined total of 61 174 singleton pregnancies, including 1770 (2.9%) that developed PE. Bayes' theorem was used to combine the prior distribution of gestational age at delivery with PE, obtained from maternal characteristics, with various combinations of biomarker multiples of the median (MoM) values to derive patient-specific risks of delivery with PE at < 37 weeks' gestation. The performance of such screening was estimated. RESULTS: In pregnancies that developed PE, compared to those without PE, the MoM values of UtA-PI and MAP were increased and those of PAPP-A and PlGF were decreased, and the deviation from normal was greater for early than late PE for all four biomarkers. Combined screening by maternal factors, UtA-PI, MAP and PlGF predicted 90% of early PE, 75% of preterm PE and 41% of term PE, at a screen-positive rate of 10%; inclusion of PAPP-A did not improve the performance of screening. The performance of screening depended on the racial origin of the women; on screening by a combination of maternal factors, MAP, UtA-PI and PlGF and using a risk cut-off of 1 in 100 for PE at < 37 weeks in Caucasian women, the screen-positive rate was 10% and detection rates for early, preterm and term PE were 88%, 69% and 40%, respectively. With the same method of screening and risk cut-off in women of Afro-Caribbean racial origin, the screen-positive rate was 34% and detection rates for early, preterm and term PE were 100%, 92% and 75%, respectively. CONCLUSION: Screening by maternal factors and biomarkers at 11-13 weeks' gestation can identify a high proportion of pregnancies that develop early and preterm PE. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.


Subject(s)
Placenta Growth Factor/blood , Pre-Eclampsia/diagnosis , Pregnancy Trimester, First , Pregnancy-Associated Plasma Protein-A/metabolism , Risk Assessment/methods , Uterine Artery/physiopathology , Vascular Endothelial Growth Factor Receptor-1/blood , Adult , Arterial Pressure/physiology , Bayes Theorem , Biomarkers/blood , Female , Gestational Age , Humans , Pregnancy , Prospective Studies , Pulsatile Flow/physiology
2.
Zhonghua Shao Shang Za Zhi ; 34(4): 219-224, 2018 Apr 20.
Article in Chinese | MEDLINE | ID: mdl-29690740

ABSTRACT

Objective: To observe effects of exogenous high mobility group protein box 1 (HMGB1) on angiogenesis in ischemic zone of early scald wounds of rats. Methods: Thirty-six Sprague-Dawley rats were divided into HMGB1 group and simple scald (SS) group according to the random number table, with 18 rats in each group. Comb-like copper mould was placed on the back of rats for 20 s after being immersed in 100 ℃ hot water for 3 to 5 min to make three ischemic zones of wound. Immediately after scald, rats in HMGB1 group were subcutaneously injected with 0.4 µg HMGB1 and 0.1 mL phosphate buffer solution (PBS), and rats in SS group were subcutaneously injected with 0.1 mL PBS from boarders of ischemic zone of scald wound. At post scald hour (PSH) 24, 48, and 72, 6 rats in each group were collected. Protein expressions of vascular endothelial growth factor (VEGF) in ischemic zone of wound at PSH 24, 48, and 72 and protein expressions of CD31 in ischemic zone of wound at PSH 48 and 72 were detected by immunohistochemistry. The number of microvessel in CD31 immunohistochemical sections of ischemic zone of wound at PSH 48 and 72 was calculated after observing by the microscope. The mRNA expressions of VEGF and CD31 in ischemic zone of wound were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction at PSH 24, 48, and 72. Data were processed with analysis of variance of factorial design, t test, and Bonferroni correction. Results: (1) At PSH 24, 48, and 72, protein expressions of VEGF in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=7.496, 4.437, 5.402, P<0.05 or P<0.01). At PSH 48 and 72, protein expressions of CD31 in ischemic zone of wound of rats in HMGB1 group were 0.038 8±0.007 9 and 0.057 7±0.001 2 respectively, significantly higher than 0.013 4±0.004 9 and 0.030 3±0.004 0 of rats in SS group (t=10.257, 15.055, P<0.01). (2) At PSH 48 and 72, the number of microvessel in ischemic zone of wound of rats in HMGB1 group was obviously more than that of rats in SS group (t=3.536, 4.000, P<0.05). (3) At PSH 24, 48, and 72, mRNA expressions of VEGF in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=4.406, 3.821, 3.356, P<0.05). At PSH 24 and 48, mRNA expressions of CD31 in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=4.113, 3.466, P<0.05). At PSH 72, mRNA expressions of CD31 in ischemic zone of wound of rats in 2 groups were close (t=0.010, P>0.05). Conclusions: Exogenous HMGB1 can promote angiogenesis in ischemic zone of early scald wounds of rats by increasing expressions of VEGF and CD31.


Subject(s)
Burns/metabolism , HMGB1 Protein/metabolism , Vascular Endothelial Growth Factor A/metabolism , Animals , Burns/pathology , Neovascularization, Pathologic , Rats , Rats, Sprague-Dawley
3.
Ultrasound Obstet Gynecol ; 52(1): 52-59, 2018 07.
Article in English | MEDLINE | ID: mdl-29704277

ABSTRACT

OBJECTIVES: To examine the effect of first-trimester screening for pre-eclampsia (PE) on the prediction of delivering a small-for-gestational-age (SGA) neonate and the effect of prophylactic use of aspirin on the prevention of SGA. METHODS: The data for this study were derived from two multicenter studies. In SPREE, we investigated the performance of screening for PE by a combination of maternal characteristics and biomarkers at 11-13 weeks' gestation. In ASPRE, women with a singleton pregnancy identified by combined screening as being at high risk for preterm PE (> 1 in 100) participated in a trial of aspirin (150 mg/day from 11-14 until 36 weeks' gestation) compared to placebo. In this study, we used the data from the ASPRE trial to estimate the effect of aspirin on the incidence of SGA with birth weight < 10th , < 5th and < 3rd percentile for gestational age. We also used the data from SPREE to estimate the proportion of SGA in the pregnancies with a risk for preterm PE of > 1 in 100. RESULTS: In SPREE, screening for preterm PE by a combination of maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor identified a high-risk group that contained about 46% of SGA neonates < 10th percentile born at < 37 weeks' gestation (preterm) and 56% of those born at < 32 weeks (early); the overall screen-positive rate was 12.2% (2014 of 16 451 pregnancies). In the ASPRE trial, use of aspirin reduced the overall incidence of SGA < 10th percentile by about 40% in babies born at < 37 weeks' gestation and by about 70% in babies born at < 32 weeks; in babies born at ≥ 37 weeks, aspirin did not have a significant effect on incidence of SGA. The aspirin-related decrease in incidence of SGA was mainly due to its incidence decreasing in pregnancies with PE, for which the decrease was about 70% in babies born at < 37 weeks' gestation and about 90% in babies born at < 32 weeks. On the basis of these results, it was estimated that first-trimester screening for preterm PE and use of aspirin in the high-risk group would potentially reduce the incidence of preterm and early SGA by about 20% and 40%, respectively. CONCLUSION: First-trimester screening for PE by the combined test identifies a high proportion of cases of preterm SGA that can be prevented by the prophylactic use of aspirin. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.


Subject(s)
Aspirin/therapeutic use , Fetal Growth Retardation/prevention & control , Placenta Growth Factor/blood , Platelet Aggregation Inhibitors/therapeutic use , Pre-Eclampsia/prevention & control , Pregnancy-Associated Plasma Protein-A/metabolism , Uterine Artery/diagnostic imaging , Adult , Biomarkers/blood , Female , Fetal Growth Retardation/diagnosis , Gestational Age , Humans , Infant, Newborn , Infant, Small for Gestational Age , Mass Screening , Pre-Eclampsia/diagnosis , Predictive Value of Tests , Pregnancy , Pregnancy Trimester, First , Prenatal Diagnosis
4.
Ultrasound Obstet Gynecol ; 51(6): 743-750, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29536574

ABSTRACT

OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016. Singleton pregnancies at 11-13 weeks' gestation had recording of maternal characteristics and medical history and measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum placental growth factor (PlGF) and serum pregnancy-associated plasma protein-A (PAPP-A). The performance of screening for PE by the Bayes' theorem-based method was compared with that of the NICE method. Primary comparison was detection rate (DR) using NICE method vs mini-combined test (maternal factors, MAP and PAPP-A) in the prediction of PE at any gestational age (all-PE) for the same screen-positive rate determined by the NICE method. Key secondary comparisons were DR of screening recommended by the NICE guidelines vs three Bayes' theorem-based methods (maternal factors, MAP and PAPP-A; maternal factors, MAP and PlGF; and maternal factors, MAP, UtA-PI and PlGF) in the prediction of preterm PE, defined as that requiring delivery < 37 weeks. RESULTS: All-PE developed in 473 (2.8%) of the 16 747 pregnancies and preterm PE developed in 142 (0.8%). The screen-positive rate by the NICE method was 10.3% and the DR for all-PE was 30.4% and for preterm PE it was 40.8%. Compliance with the NICE recommendation that women at high risk for PE should be treated with aspirin from the first trimester to the end of pregnancy was only 23%. The DR of the mini-combined test for all-PE was 42.5%, which was superior to that of the NICE method by 12.1% (95% CI, 7.9-16.2%). In screening for preterm PE by a combination of maternal factors, MAP and PlGF, the DR was 69.0%, which was superior to that of the NICE method by 28.2% (95% CI, 19.4-37.0%) and with the addition of UtA-PI the DR was 82.4%, which was higher than that of the NICE method by 41.6% (95% CI, 33.2-49.9%). CONCLUSIONS: The performance of screening for PE as currently recommended by NICE guidelines is poor and compliance with these guidelines is low. The performance of screening is substantially improved by a method combining maternal factors with biomarkers. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.


Subject(s)
Pre-Eclampsia/diagnosis , Prenatal Diagnosis , Adult , Arterial Pressure , Bayes Theorem , Biomarkers/blood , Female , Humans , Practice Guidelines as Topic , Pre-Eclampsia/blood , Pre-Eclampsia/diagnostic imaging , Predictive Value of Tests , Pregnancy , Pregnancy Trimester, First , Pulsatile Flow , Risk Factors , Uterine Artery/physiology
5.
Ultrasound Obstet Gynecol ; 51(6): 738-742, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29380918

ABSTRACT

OBJECTIVE: To report the incidence of preterm pre-eclampsia (PE) in women who are screen positive according to the criteria of the National Institute for Health and Care Excellence (NICE) and the American College of Obstetricians and Gynecologists (ACOG), and compare the incidence with that in those who are screen positive or screen negative by The Fetal Medicine Foundation (FMF) algorithm. METHODS: This was a secondary analysis of data from the ASPRE study. The study population consisted of women with singleton pregnancy who underwent prospective screening for preterm PE by means of the FMF algorithm, which combines maternal factors and biomarkers at 11-13 weeks' gestation. The incidence of preterm PE in women fulfilling the NICE and ACOG criteria was estimated; in these patients the incidence of preterm PE was then calculated in those who were screen negative relative to those who were screen positive by the FMF algorithm. RESULTS: A total of 34 573 women with singleton pregnancy delivering at ≥ 24 weeks' gestation underwent prospective screening for preterm PE, of which 239 (0.7%) cases developed preterm PE. At least one of the ACOG criteria was fulfilled in 22 287 (64.5%) pregnancies and the incidence of preterm PE was 0.97% (95% CI, 0.85-1.11%); in the subgroup that was screen positive by the FMF algorithm the incidence of preterm PE was 4.80% (95% CI, 4.14-5.55%), and in those that were screen negative it was 0.25% (95% CI, 0.18-0.33%), with a relative incidence in FMF screen negative to FMF screen positive of 0.051 (95% CI, 0.037-0.071). In 1392 (4.0%) pregnancies, at least one of the NICE high-risk criteria was fulfilled, and in this group the incidence of preterm PE was 5.17% (95% CI, 4.13-6.46%); in the subgroups of screen positive and screen negative by the FMF algorithm, the incidence of preterm PE was 8.71% (95% CI, 6.93-10.89%) and 0.65% (95% CI, 0.25-1.67%), respectively, and the relative incidence was 0.075 (95% CI, 0.028-0.205). In 2360 (6.8%) pregnancies fulfilling at least two of the NICE moderate-risk criteria, the incidence of preterm PE was 1.74% (95% CI, 1.28-2.35%); in the subgroups of screen positive and screen negative by the FMF algorithm the incidence was 4.91% (95% CI, 3.54-6.79%) and 0.42% (95% CI, 0.20-0.86%), respectively, and the relative incidence was 0.085 (95% CI, 0.038-0.192). CONCLUSION: In women who are screen positive for preterm PE by the ACOG or NICE criteria but screen negative by the FMF algorithm, the risk of preterm PE is reduced to within or below background levels. The results provide further evidence to support the personalized risk-based screening method that combines maternal factors and biomarkers. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.


Subject(s)
Pre-Eclampsia/epidemiology , Prenatal Diagnosis , Adult , Algorithms , Clinical Trials as Topic , Europe/epidemiology , Female , Humans , Incidence , Practice Guidelines as Topic , Pre-Eclampsia/diagnosis , Pregnancy , Pregnancy Trimester, First , Prospective Studies , Risk Factors
6.
Zhonghua Er Ke Za Zhi ; 55(3): 210-214, 2017 Mar 02.
Article in Chinese | MEDLINE | ID: mdl-28273705

ABSTRACT

Objective: To explore the TPO, DUOX2 and DUOXA2 genotypes and phenotypes of children with permanent congenital hypothyroidism(PCH) suspected dyshormonogenesis in Guangzhou, identified and treated at Guangzhou Newborn Screening Center. Six of them were born between 2011 and 2012. Method: Retrospectively analyzed the clinical data of 9 children with PCH suspected dyshormonogenesis. Genetic analysis of TPO, DUOX2 and DUOXA2 genes were performed with Sanger sequencing. Result: Of the 9 patients, four were identified variants in TPO gene including three cases with biallelic variants and one case with monoallelic variant. Novel c. 1784G>C( p. R595T) variant in TPO was predicted to be damaging by SIFT and PolyPhen-2. Four patients harbored monoallelic known variants in DUOX2 gene and the other one harbored heterozygous known mutation c. 738C>G(p.Y246X) in DUOXA2 gene.Two adolescent patients with biallelic variants in TPO gene showed classical PCH phenotypes with thyroid goiter or nodules. The six patients with monoallelic variant in TPO, DUOX2 or DUOXA2 presented variable phenotypes. Among the 433 578 newborns in the 2011-2012 cohort, there were 156 cases of CH. Six of these cases were PCH suspected dyshormonogenesis, among which 1 case was confirmed TPO biallelic variants and 5 cases were monoallelic variants of TPO, DUOX2, or DUOXA2 genes. Conclusion: TPO and DUOX2 variants are the common molecular pathogenesis in children with PCH suspected dyshormonogenesis. Monoallelic variants in TPO, DUOX2 or DUOXA2 are associated with PCH and showed wide variability in their phenotypes. The novel variant p. R595T in TPO is probably a pathologic variant. The prevalence of PCH caused by TPO gene defects is rare in Guangzhou.


Subject(s)
Congenital Hypothyroidism/genetics , Genetic Testing , Membrane Glycoproteins , Membrane Proteins , NADPH Oxidases , Dual Oxidases , Genotype , Goiter , Heterozygote , Humans , Infant, Newborn , Mutation , Neonatal Screening , Phenotype , Prevalence , RNA, Long Noncoding , Retrospective Studies
7.
Ultrasound Obstet Gynecol ; 50(2): 175-179, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28295773

ABSTRACT

Pre-eclampsia (PE), which affects about 2% of pregnancies, is a major cause of maternal and perinatal morbidity and mortality. Early detection of PE can improve pregnancy outcome by providing timely intervention and closer monitoring. The current guideline from the UK National Institute for Health and Care Excellence (NICE) recommends that, at the booking visit, women identified with one major risk factor or more than one moderate risk factor for PE should be advised to take low-dose aspirin daily from 12 weeks until delivery. However, performance of the current method of screening is poor and identifies only about 35% of PE. Extensive studies in the last decade have established that the best performance for early prediction of PE can be achieved by using a novel Bayes' theorem-based method that combines maternal characteristics and medical history together with measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) at 11-13 weeks' gestation. This forms the 'combined test', which could be simplified to the 'mini combined test' when only maternal factors, MAP and PAPP-A are taken into consideration. We present the protocol (version 3.1, 14 November 2016) for the 'Screening programme for pre-eclampsia' (SPREE) study, a prospective multicenter cohort study that will be carried out in seven National Health Service maternity hospitals in England. Eligible pregnant women attending their routine scan at 11-13 weeks' gestation will be invited to participate in this study. Maternal characteristics and history and measurements of MAP, UtA-PI, serum PAPP-A and PlGF will be recorded according to standardized protocols. The patient-specific risk for PE will be calculated and data on pregnancy outcomes collected. We hypothesize that the first-trimester mini combined test and combined test for PE screening, using the Bayes' theorem-based method, are likely to be superior to the current method recommended by NICE that is based on maternal demographics and history alone. Enrollment for the study commenced in April 2016. The study is registered on the International Standard Randomised Controlled Trial Number (ISRCTN) registry. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.


Subject(s)
Pre-Eclampsia/diagnosis , Prenatal Diagnosis , Female , Humans , Pregnancy , Pregnancy Trimester, First , Prospective Studies , Research Design , State Medicine , United Kingdom , Validation Studies as Topic
8.
Ultrasound Obstet Gynecol ; 49(2): 201-208, 2017 Feb.
Article in English | MEDLINE | ID: mdl-27671370

ABSTRACT

OBJECTIVE: To estimate the patient-specific risk of pre-eclampsia (PE) at 31-34 weeks' gestation by a combination of maternal characteristics and medical history with multiples of the median (MoM) values of serum placental growth factor (PlGF) and serum soluble fms-like tyrosine kinase-1 (sFlt-1) and to compare the performance of screening to that achieved by the sFlt-1/PlGF ratio. METHODS: This was a prospective observational study in women attending a third-trimester ultrasound scan at 31-34 weeks as part of routine pregnancy care. We estimated the performance of screening for PE with delivery within 4 weeks of assessment and PE with delivery from 4 weeks after assessment up to 40 weeks' gestation by the sFlt-1/PlGF ratio and by a method utilizing Bayes' theorem that combines maternal factors and MoM values of sFlt-1 and PlGF. The significance of the difference in screening performance between the two methods was assessed by comparison of the areas under the receiver-operating characteristics curves (AUC). RESULTS: The study population of 8063 singleton pregnancies included 231 (2.9%) that subsequently developed PE. In the prediction of delivery with PE at < 4 weeks from assessment, the performance of the method utilizing Bayes' theorem was similar to that using the sFlt-1/PlGF ratio (AUC, 0.987 (95% CI, 0.979-0.995) vs 0.988 (95% CI, 0.981-0.994); P = 0.961). In contrast, the performance of screening for delivery with PE at ≥ 4 weeks after assessment up to 40 weeks' gestation was better with the method utilizing Bayes' theorem than that with the sFlt-1/PlGF ratio (AUC, 0.884 (95% CI, 0.854-0.914) vs 0.818 (95% CI, 0.775-0.860); P < 0.0001). CONCLUSION: At 31-34 weeks' gestation the performance of screening for PE delivering at < 4 weeks from assessment by the method utilizing Bayes' theorem is similar to that using the sFlt-1/PlGF ratio, but the former is superior to the latter in prediction of PE delivering ≥ 4 weeks from assessment. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.


Subject(s)
Placenta Growth Factor/blood , Pre-Eclampsia/diagnostic imaging , Pregnancy Trimester, Third/blood , Vascular Endothelial Growth Factor Receptor-1/blood , Adult , Female , Humans , Pre-Eclampsia/metabolism , Pregnancy , Prospective Studies , Ultrasonography, Doppler , Ultrasonography, Prenatal
9.
Pediatr Transplant ; 21(1)2017 Feb.
Article in English | MEDLINE | ID: mdl-27774707

ABSTRACT

HBoV is an emergent virus, which is frequently detected as a co-infective agent. However, it can cause disease on its own. It is associated with respiratory and diarrhoeal illness in children and adults, whether immunocompetent or immunocompromised. We report HBoV infection in a child post-liver transplantation, who presented with persistent fever and mild tachypnea, 3 weeks after a successful transplant. She recovered spontaneously with no graft dysfunction.


Subject(s)
Liver Failure/surgery , Liver Transplantation/adverse effects , Parvoviridae Infections/complications , Cytomegalovirus , Female , Human bocavirus , Humans , Immunosuppression Therapy/adverse effects , Immunosuppressive Agents/therapeutic use , Infant , Liver Failure/complications , Parvoviridae Infections/etiology , Polymerase Chain Reaction
10.
Ultrasound Obstet Gynecol ; 48(5): 602-606, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27854393

ABSTRACT

OBJECTIVE: To establish a normal range of birth weights for gestational age at delivery and to compare the proportion of live births and stillbirths that are classified as small-for-gestational age (SGA) according to our normal range vs that of the INTERGROWTH-21st standard. METHODS: The study population comprised 113 019 live births and 437 (0.4%) stillbirths. The inclusion criterion for establishing a normal range of birth weights for gestational age was the live birth of a phenotypically normal neonate ≥ 24 weeks' gestation and the exclusion criteria were smoking and prepregnancy hypertension, diabetes mellitus, systemic lupus erythematosus or antiphospholipid syndrome, pre-eclampsia, gestational hypertension, gestational diabetes mellitus or iatrogenic preterm birth for fetal growth restriction in the current pregnancy. Inclusion criteria were met by 92 018 live births. The proportions of live births and stillbirths with birth weights < 5th and < 10th percentiles of our normal range and those according to the INTERGROWTH-21st standard were determined and compared by the chi-square test and McNemar test. RESULTS: The proportions of live births and stillbirths with a birth weight < 5th percentile according to our standard were significantly higher than and discordant with the proportion according to the INTERGROWTH-21st standard (live birth: 5.6% vs 3.4%; stillbirth: 37.2% vs 22.7%). Similarly, the proportion of live births and stillbirths with a birth weight < 10th percentile according to our standard were significantly higher than and discordant with those according to the INTERGROWTH-21st standard (live birth: 11.2% vs 6.9%; stillbirth: 44.3% vs 32.6%). CONCLUSION: The INTERGROWTH-21st standard underestimates the proportion of SGA live births and stillbirths in our population. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.


Subject(s)
Live Birth/epidemiology , Stillbirth/epidemiology , Birth Weight , Female , Gestational Age , Humans , Infant, Newborn , Infant, Small for Gestational Age , Live Birth/ethnology , Pregnancy , Stillbirth/ethnology , United Kingdom/ethnology
11.
Br J Surg ; 101(4): 383-9; discussion 389, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24492989

ABSTRACT

BACKGROUND: Most previous studies have reported superior results when blue dye and radiocolloids were used together for sentinel lymph node (SLN) biopsy in early breast cancer. Blue dye was reported to perform poorly when used alone, although more recent studies have found otherwise. This study reviewed the authors' practice of performing SLN biopsy with blue dye alone. METHODS: This was a retrospective review of patients who underwent SLN biopsy using blue dye alone from 2001 to 2005, when SLN biopsy was performed selectively and always followed by axillary lymph node dissection (ALND), and from 2006 to 2010, when SLN biopsy was offered to all suitable patients and ALND done only when the SLN was not identified or positive for metastasis. RESULTS: Between 2001 and 2005, 170 patients underwent SLN biopsy with blue dye alone. The overall SLN non-identification rate was 8·4 per cent. The overall false-negative rate was 34 per cent, but decreased with each subsequent year to 13 per cent in 2005. From 2006 to 2010, 610 patients underwent SLN biopsy with blue dye alone. The SLN was not identified in 12 patients (2·0 per cent) and no significant contributing factor was identified. A median of 2 (range 1-11) SLNs were identified. A non-SLN was found to be positive for metastasis in two patients with negative SLNs. Axillary nodal recurrence developed in one patient; none developed internal mammary nodal recurrence. Anaphylaxis occurred in one patient. CONCLUSION: Blue dye performed well as a single modality for SLN biopsy. Non-identification, axillary nodal recurrence and serious allergic reactions were uncommon.


Subject(s)
Breast Neoplasms/pathology , Coloring Agents , Lymph Nodes/pathology , Rosaniline Dyes , Adult , Aged , Aged, 80 and over , Axilla , Coloring Agents/adverse effects , Female , Humans , Lymphatic Metastasis , Middle Aged , Neoplasm Recurrence, Local/pathology , Retrospective Studies , Rosaniline Dyes/adverse effects , Sentinel Lymph Node Biopsy , Tumor Burden , Young Adult
12.
Plant Dis ; 97(12): 1544-1548, 2013 Dec.
Article in English | MEDLINE | ID: mdl-30716866

ABSTRACT

Here, we report the screening of 332 new accessions of 11 different wild oat (Avena) species from the United States Department of Agriculture National Small Grains Collection in Aberdeen, ID, for resistance to crown rust disease, caused by Puccinia coronata f. sp. avenae. This collection originated from Morocco and includes Avena agadiriana, A. atlantica, A. barbata, A. damascena, A. eriantha, A. hirtula, A. longiglumis, A. magna, A. murphyi, A. sterilis, and A. wiestii. After screening this collection with a highly diverse population of P. coronata f. sp. avenae, 164 accessions (49%) were rated moderately resistant to resistant in the preliminary screen at the seedling stage and 181 accessions (55%) rated moderately resistant to highly resistant in the adult plant stage. Although none of the accessions showed a highly resistant response consistently in the seedling stage, 20 accessions did display a highly resistant response in the adult plant stage. Both seedling as well as adult plant resistance was found in 150 (45%) of the accessions. Virulence in P. coronata has been reported to all resistance genes currently being used in North American oat cultivars. The new resistance sources presented here are potentially new sources for future breeding. The resistance found in 52 accessions of A. magna and A. murphyi with the AACC genome is especially valuable because these should be relatively easy to transfer into hexaploid A. sativa.

13.
Health Educ Res ; 26(5): 896-907, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21715653

ABSTRACT

We assessed the effectiveness of a brief structured diabetes education programme based on the concept of self-efficacy on self-care and glycaemic control using single-blind study design. One hundred and sixty-four participants with poorly controlled diabetes from two settings were randomized using computer-generated list into control (n = 82) and intervention (n = 82) groups, of which 151 completed the study. Monthly interventions over 12 weeks addressed the self-care practices of diet, physical activity, medication adherence and self-monitoring of blood glucose (SMBG). These self-care practices were assessed at Weeks 0 and 12 using pre- and post-questionnaires in both groups together with glycated haemoglobin A1c (HbA1c) and diabetes knowledge. In the intention-to-treat analysis (n = 164), the intervention group improved their SMBG (P = <0.001), physical activity (P = 0.001), HbA1c (P = 0.03), diabetes knowledge (P = <0.001) and medication adherence. At Week 12, HbA1c difference adjusted for SMBG frequency, medication adherence and weight change remained significant (P = 0.03) compared with control group. For within group comparisons, diabetes knowledge (P = <0.001), HbA1c level (P = <0.001), SMBG (P = <0.001) and medication adherence (P = 0.008) improved from baseline in the intervention group. In the control group, only diabetes knowledge improved (P = <0.001). These findings can contribute to the development of self-management diabetes education in Malaysia.


Subject(s)
Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 2/therapy , Glycated Hemoglobin/analysis , Health Knowledge, Attitudes, Practice , Self Care/methods , Blood Glucose Self-Monitoring , Diet, Diabetic/standards , Female , Humans , Malaysia , Male , Medication Adherence , Middle Aged , Motor Activity , Outcome and Process Assessment, Health Care , Patient Education as Topic/methods , Self Efficacy , Single-Blind Method
14.
Vet Parasitol ; 173(1-2): 152-6, 2010 Oct 11.
Article in English | MEDLINE | ID: mdl-20609520

ABSTRACT

The prevalence of spargana infection in frogs (Rana nigromaculata) was investigated in China's central Hunan Province, from March 2007 to October 2009. 59 of 292 (20.2%) wild-caught frogs were found to be infected with plerocercoids (spargana) of the genus Spirometra. Spargana were recovered from the skeletal muscle of the hind limb. The infection rate ranged from 4.5% to 27.4%, and the infection intensity was 1-15 spargana per frog. To identify the species identity of the collected spargana, a portion of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified, sequenced, and analyzed. Sequence variations for cox1 among all the examined spargana were 0.0-3.1%, with 14 variable sites being identified in sequences obtained (3.1%, 14/446), representing 6 different cox1 sequences. Phylogenetic analysis showed that all the spargana isolates in Hunan province represented Spirometra erinaceieuropaei. This is the first report of S. erinaceieuropaei infection in frogs in Hunan province, China.


Subject(s)
Cestode Infections/veterinary , Ranidae , Spirometra/isolation & purification , Animals , Cestode Infections/epidemiology , China/epidemiology , Cytochromes c/classification , Cytochromes c/genetics , Phylogeny , Spirometra/classification , Spirometra/genetics
15.
Theor Appl Genet ; 121(1): 117-25, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20204320

ABSTRACT

Despite efforts to control late blight in potatoes by introducing R(pi)-genes from wild species into cultivated potato, there are still concerns regarding the durability and level of resistance. Pyramiding R(pi)-genes can be a solution to increase both durability and level of resistance. In this study, two resistance genes, R(Pi-mcd1) and R(Pi-ber), introgressed from the wild tuber-bearing potato species Solanum microdontum and S. berthaultii were combined in a diploid S. tuberosum population. Individual genotypes from this population were classified after four groups, carrying no R(pi)-gene, with only R (Pi-mcd1), with only R(Pi-ber), and a group with the pyramided R(Pi-mcd1) and R (Pi-ber) by means of tightly linked molecular markers. The levels of resistance between the groups were compared in a field experiment in 2007. The group with R(Pi-mcd1) showed a significant delay to reach 50% infection of the leaf area of 3 days. The group with R ( Pi-ber ) showed a delay of 3 weeks. The resistance level in the pyramid group suggested an additive effect of R (Pi-mcd1) with R(Pi-ber). This suggests that potato breeding can benefit from combining individual R(pi)-genes, irrespective of the weak effect of R(Pi-mcd1) or the strong effect of R(Pi-ber).


Subject(s)
Genes, Plant , Immunity, Innate/genetics , Phytophthora infestans/immunology , Plant Diseases , Solanum tuberosum , Breeding , Crops, Agricultural/genetics , Crops, Agricultural/microbiology , DNA, Plant/genetics , Genetic Linkage , Genetic Markers , Molecular Sequence Data , Phytophthora infestans/pathogenicity , Plant Diseases/genetics , Plant Diseases/immunology , Plant Diseases/microbiology , Solanum tuberosum/genetics , Solanum tuberosum/microbiology
16.
Theor Appl Genet ; 119(8): 1477-87, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19816672

ABSTRACT

Resistance to Globodera pallida Rookmaker (Pa3), originating from wild species Solanum tarijense was identified by QTL analysis and can be largely ascribed to one major QTL. GpaXI ( tar ) ( l ) explained 81.3% of the phenotypic variance in the disease test. GpaXI ( tar ) ( l ) is mapped to the long arm of chromosome 11. Another minor QTL explained 5.3% of the phenotypic variance and mapped to the long arm of chromosome 9. Clones containing both QTL showed no lower cyst counts than clones with only GpaXI ( tar ) ( l ) . After Mendelising the phenotypic data, GpaXI ( tar ) ( l ) could be more precisely mapped near markers GP163 and FEN427, thus anchoring GpaXI ( tar ) ( l ) to a region with a known R-gene cluster containing virus and nematode resistance genes.


Subject(s)
Chromosomes, Plant , Nematoda/physiology , Solanum/genetics , Animals , Chromosome Mapping , Multigene Family , Quantitative Trait Loci
17.
Vet Parasitol ; 160(3-4): 348-50, 2009 Mar 23.
Article in English | MEDLINE | ID: mdl-19091472

ABSTRACT

The prevalence of helminths in adult dogs was investigated in Hunan Province, the People's Republic of China between June 2006 and December 2007. A total of 438 adult farm dogs slaughtered in local abattoirs from 9 representative administrative regions in Hunan Province were examined for the presence of helminths using a helminthological approach. All collected worms were counted and identified to species according to existing keys and descriptions. A total of 11 helminth species were found in the dogs, and they represented 2 phyla, 3 classes, 6 families and 8 genera. All dogs were infected by more than one helminth species. Clonorchis sinensis (29.4%) was the only trematode species found, Dipylidium caninum (42.3%) was the most common cestode species, and Toxocara canis (45.2%) the most common nematode species. 6 of the 11 dog helminths are also transmissible to humans (i.e., zoonotic), and can cause severe clinical human diseases, posing significant public health threats. The results of the present investigation have implications for the ongoing control of helminth infections in dogs and humans in Hunan Province, China.


Subject(s)
Dog Diseases/epidemiology , Helminthiasis, Animal/epidemiology , Helminths/classification , Intestinal Diseases, Parasitic/veterinary , Public Health , Abattoirs , Animals , China/epidemiology , Dog Diseases/transmission , Dogs , Female , Helminthiasis, Animal/transmission , Helminths/isolation & purification , Humans , Intestinal Diseases, Parasitic/epidemiology , Intestinal Diseases, Parasitic/transmission , Male , Phylogeny , Prevalence , Zoonoses
18.
Mol Plant Microbe Interact ; 21(7): 909-18, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18533831

ABSTRACT

The distinction between field resistance and resistance based on resistance (R) genes has been proven valid for many plant-pathogen interactions. This distinction does not seem to be valid for the interaction between potato and late blight. In this study, a locus involved in late blight resistance, derived from Solanum microdontum, provides additional evidence for this lack of distinction. The resistance is associated with a hypersensitive response and results in a delay of infection of approximately 1 to 2 weeks. Both a quantitative as well as a qualitative genetic approach were used, based on data from a field assay. Quantitative trait locus (QTL) analysis identified a QTL on chromosome 4 after correction of the resistance data for plant maturity. A qualitative genetic analysis resulted in the positioning of this locus on the short arm of chromosome 4 in between amplified fragment length polymorphism marker pCTmACG_310 and cleaved amplified polymorphic sequence markers TG339 and T0703. This position coincides with a conserved Phytophthora R gene cluster which includes R2, R(2-like), R(Pi-blb3), and R(Pi-abpt). This implies that R(Pi-mcd1) is the fifth R gene of this nucleotide-binding site leucine-rich repeat cluster. The implications of our results on R-gene-based and field resistance are discussed.


Subject(s)
Genes, Plant , Phytophthora/pathogenicity , Solanum tuberosum/genetics , Solanum/genetics , Solanum/microbiology , Base Sequence , Chromosome Mapping , Chromosomes, Plant/genetics , DNA, Plant/genetics , Genetic Markers , Host-Pathogen Interactions/genetics , Models, Genetic , Multigene Family , Plant Diseases/genetics , Plant Diseases/microbiology , Quantitative Trait Loci
19.
Plant Physiol ; 126(3): 1012-23, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11457952

ABSTRACT

We have studied the mechanism of UV protection in two duckweed species (Lemnaceae) by exploiting the UV sensitivity of photosystem II as an in situ sensor for radiation stress. A UV-tolerant Spirodela punctata G.F.W. Meyer ecotype had significantly higher indole-3-acetic acid (IAA) levels than a UV-sensitive ecotype. Parallel work on Lemna gibba mutants suggested that UV tolerance is linked to IAA degradation rather than to levels of free or conjugated IAA. This linkage is consistent with a role for class III phenolic peroxidases, which have been implicated both in the degradation of IAA and the cross-linking of various UV-absorbing phenolics. Biochemical analysis revealed increased activity of a specific peroxidase isozyme in both UV-tolerant duckweed lines. The hypothesis that peroxidases play a role in UV protection was tested in a direct manner using genetically modified tobacco (Nicotiana sylvestris). It was found that increased activity of the anionic peroxidase correlated with increased tolerance to UV radiation as well as decreased levels of free auxin. We conclude that phenol-oxidizing peroxidases concurrently contribute to UV protection as well as the control of leaf and plant architecture.


Subject(s)
Magnoliopsida/radiation effects , Peroxidases/metabolism , Ultraviolet Rays , Indoleacetic Acids/metabolism , Phenols/metabolism , Photosynthesis , Plants, Toxic , Radiation Tolerance , Nicotiana/radiation effects
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