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Bhavsar SM, Clouser KN, Connolly H, Gadhavi J, Kaur R, Lozy T, Naganathan S, Pierre M, Riollano Cruz M, Shah P, Siu A, Swenson C, Ballance C. Characteristics and Presentations of Hospitalized Children Due to 3 Predominate COVID-19 Variants Within a Health Care Network. Clin Pediatr (Phila) 2024; 63:66-72. [PMID: 37872729 DOI: 10.1177/00099228231207314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objective of this article is to describe differences in the demographic and clinical characteristics, severity of illness, and outcomes in pediatric patients with different SARS-CoV-2 variants. We conducted a retrospective study of pediatric patients admitted with COVID-19 during the 3 large waves of infection within a health network in New Jersey. We included demographic characteristics, clinical features, and outcomes and compared the data with respect to the different variants. Of 351 total patients included in this study, 74 were admitted during wave 1, 94 during wave 2, and 181 during wave 3. The median age of patients decreased from wave 1 (11.5 years) to wave 3 (3 years) (P = .0034). 87.7% of the patients were unvaccinated. The overall incidence of admissions due to pneumonia related to COVID-19 decreased in wave 3. COVID-19 bronchiolitis or croup admissions occurred mostly in wave 3. There was no significant difference in the number of patients requiring intensive care in any particular wave. Length of stay decreased across the waves (P < .0001). Treatments required did not vary between the waves except for a decrease in antibiotic use with each subsequent wave (P < .0001). The impact of COVID-19 on the pediatric population differs from the adult population, and the overall number of hospitalized children has mirrored the peak in cases observed during each infection wave. Our study illustrates the changes in clinical presentation and severity observed with the different coronavirus variants.
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Affiliation(s)
- Sejal M Bhavsar
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
- Hackensack Meridian School of Medicine, Edison, NJ, USA
| | - Katharine N Clouser
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
- Hackensack Meridian School of Medicine, Edison, NJ, USA
| | - Hailey Connolly
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Jasmine Gadhavi
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
- Hackensack Meridian School of Medicine, Edison, NJ, USA
| | - Ranbir Kaur
- Hackensack Meridian School of Medicine, Edison, NJ, USA
- Department of Pediatrics, JFK University Medical Center, Edison, NJ, USA
| | - Tara Lozy
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
- Center for Discovery & Innovation, Member of Hackensack Meridian Health, Hackensack, NJ, USA
| | - Srividya Naganathan
- Hackensack Meridian School of Medicine, Edison, NJ, USA
- Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune Township, NJ, USA
| | - Margarette Pierre
- Hackensack Meridian School of Medicine, Edison, NJ, USA
- Department of Pediatrics, JFK University Medical Center, Edison, NJ, USA
| | - Mariawy Riollano Cruz
- Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune Township, NJ, USA
| | - Pooja Shah
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
- Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Anita Siu
- Hackensack Meridian School of Medicine, Edison, NJ, USA
- Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune Township, NJ, USA
- Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Carly Swenson
- Hackensack Meridian School of Medicine, Edison, NJ, USA
| | - Cathleen Ballance
- Hackensack Meridian School of Medicine, Edison, NJ, USA
- Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune Township, NJ, USA
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Fernandes DM, Oliveira CR, Guerguis S, Eisenberg R, Choi J, Kim M, Abdelhemid A, Agha R, Agarwal S, Aschner JL, Avner JR, Ballance C, Bock J, Bhavsar SM, Campbell M, Clouser KN, Gesner M, Goldman DL, Hammerschlag MR, Hymes S, Howard A, Jung HJ, Kohlhoff S, Kojaoghlanian T, Lewis R, Nachman S, Naganathan S, Paintsil E, Pall H, Sy S, Wadowski S, Zirinsky E, Cabana MD, Herold BC. Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth. J Pediatr 2021; 230:23-31.e10. [PMID: 33197493 PMCID: PMC7666535 DOI: 10.1016/j.jpeds.2020.11.016] [Citation(s) in RCA: 119] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity. STUDY DESIGN We conducted a multicenter, retrospective, and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at 8 sites in New York, New Jersey, and Connecticut. RESULTS We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into 3 groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% vs 18%, P = .02). Seven patients (2%) died and 114 (41%) were admitted to the intensive care unit. In multivariable analyses, obesity (OR 3.39, 95% CI 1.26-9.10, P = .02) and hypoxia on admission (OR 4.01; 95% CI 1.14-14.15; P = .03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR 8.33 per unit decrease in 109 cells/L, 95% CI 2.32-33.33, P = .001) and greater C-reactive protein (OR 1.06 per unit increase in mg/dL, 95% CI 1.01-1.12, P = .017) were predictive of severe MIS-C. Race/ethnicity or socioeconomic status were not predictive of disease severity. CONCLUSIONS We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.
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Affiliation(s)
- Danielle M Fernandes
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY.
| | | | - Sandra Guerguis
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
| | - Ruth Eisenberg
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
| | - Jaeun Choi
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
| | - Mimi Kim
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
| | - Ashraf Abdelhemid
- Department of Pediatrics, Kings County Hospital Center, Brooklyn, NY
| | - Rabia Agha
- Department of Pediatrics, Maimonides Children's Hospital, Brooklyn, NY
| | - Saranga Agarwal
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack, NJ
| | - Judy L Aschner
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack, NJ
| | - Jeffrey R Avner
- Department of Pediatrics, Maimonides Children's Hospital, Brooklyn, NY
| | - Cathleen Ballance
- Department of Pediatrics, K. Hovnanian Children's Hospital, Neptune City, NJ
| | - Joshua Bock
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
| | - Sejal M Bhavsar
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack, NJ
| | - Melissa Campbell
- Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | - Katharine N Clouser
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack, NJ
| | - Matthew Gesner
- Department of Pediatrics, Kings County Hospital Center, Brooklyn, NY
| | - David L Goldman
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
| | | | - Saul Hymes
- Department of Pediatrics, Stony Brook University Renaissance Hospital, Stony Brook, NY
| | - Ashley Howard
- Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | - Hee-Jin Jung
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack, NJ
| | - Stephan Kohlhoff
- Department of Pediatrics, SUNY Downstate Medical Center University Hospital, Brooklyn, NY
| | | | - Rachel Lewis
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack, NJ
| | - Sharon Nachman
- Department of Pediatrics, Stony Brook University Renaissance Hospital, Stony Brook, NY
| | - Srividya Naganathan
- Department of Pediatrics, K. Hovnanian Children's Hospital, Neptune City, NJ
| | - Elijah Paintsil
- Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | - Harpreet Pall
- Department of Pediatrics, K. Hovnanian Children's Hospital, Neptune City, NJ
| | - Sharlene Sy
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
| | - Stephen Wadowski
- Department of Pediatrics, SUNY Downstate Medical Center University Hospital, Brooklyn, NY
| | - Elissa Zirinsky
- Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | - Michael D Cabana
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
| | - Betsy C Herold
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY
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Bhavsar SM, Clouser KN, Gadhavi J, Anene O, Kaur R, Lewis R, Naganathan S, Michalak Z, Chen CQ, Shah P, Siu A, Ballance C. COVID-19 in Pediatrics: Characteristics of Hospitalized Children in New Jersey. Hosp Pediatr 2021; 11:79-87. [PMID: 33386296 DOI: 10.1542/hpeds.2020-001719] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Understanding the risk factors, predictors, and clinical presentation of coronavirus disease 2019 (COVID-19) in pediatric patients with severe disease. METHODS We conducted a retrospective chart review of pediatric patients admitted between March 1, 2020, and May 31, 2020, to a large health network in New Jersey with positive test results for severe acute respiratory syndrome coronavirus 2 on reverse transcriptase polymerase chain reaction, rapid testing, or serum immunoglobulin G testing; we included demographic characteristics, clinical features, and outcomes. RESULTS A total of 81 patients ≤21 years old were admitted with positive test results for severe acute respiratory syndrome coronavirus 2 on reverse transcriptase polymerase chain reaction and/or serum immunoglobulin testing. Sixty-seven patients (82.7%) were admitted for management of acute COVID-19 infection, whereas 14 (17.3%) were admitted for management of multisystem inflammatory syndrome in children (MIS-C). Of the 81 hospitalized patients, 28 (34.6%) required intensive care. A majority of patients (42 [51.9%]) admitted for both acute COVID-19 infection and MIS-C were Hispanic. Underlying chronic health conditions were not present in most patients. Obesity (mean BMI of 41.1) was noted in the patients with MIS-C requiring ICU care, although not statistically significant. Absolute lymphopenia and elevated levels of inflammatory markers were statistically significant in the patients with MIS-C treated in the ICU. CONCLUSIONS This study adds to the growing literature of potential risk factors for severe disease in pediatric patients due to COVID-19 infection and MIS-C. Patients of Hispanic ethnicity represented the majority of patients with both acute COVID-19 infection and MIS-C, despite only representing 10% to 20% of the population our hospitals serve. Infants and patients with chronic health conditions were not at increased risk for severe disease. Absolute lymphopenia and elevated levels of inflammatory markers were associated with more severe disease.
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Affiliation(s)
- Sejal M Bhavsar
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey; .,Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Katharine N Clouser
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey.,Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Jasmine Gadhavi
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey
| | - Okechukwu Anene
- Hackensack Meridian School of Medicine, Nutley, New Jersey.,Department of Pediatrics, John F. Kennedy Medical Center, Edison, New Jersey
| | - Ranbir Kaur
- Hackensack Meridian School of Medicine, Nutley, New Jersey.,Department of Pediatrics, John F. Kennedy Medical Center, Edison, New Jersey
| | - Rachel Lewis
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey.,Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Srividya Naganathan
- Hackensack Meridian School of Medicine, Nutley, New Jersey.,Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune City, New Jersey; and
| | - Zuzanna Michalak
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey
| | - Clara Q Chen
- Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Pooja Shah
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey.,Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Anita Siu
- Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune City, New Jersey; and.,Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Cathleen Ballance
- Hackensack Meridian School of Medicine, Nutley, New Jersey.,Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune City, New Jersey; and
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Clouser KN, Gadhavi J, Bhavsar SM, Lewis R, Ballance C, Michalak Z, Baer A, Kriegel M, Pall H, Piwoz J, Slavin K, Siegel ME, Tozzi ME, Tozzi R, Walker DM, Lapidus S, Aschner J. Short-Term Outcomes After Multisystem Inflammatory Syndrome in Children Treatment. J Pediatric Infect Dis Soc 2020; 10:52-56. [PMID: 33211859 PMCID: PMC7798945 DOI: 10.1093/jpids/piaa151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/26/2020] [Accepted: 11/17/2020] [Indexed: 01/10/2023]
Abstract
This is a retrospective chart review of 20 patients treated with a consensus-driven treatment algorithm in multisystem inflammatory syndrome in children patients across a wide clinical spectrum. Their treatments and clinical status are described as well as their favorable return to functional baseline by 30 days post presentation.
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Affiliation(s)
- Katharine N Clouser
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA,Corresponding Author: Katharine Clouser, MD, Department of Pediatrics, Hackensack University Medical Center, 30 Prospect Avenue, Hackensack, NJ 07601, USA. E-mail:
| | - Jasmine Gadhavi
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Sejal M Bhavsar
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Rachel Lewis
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Cathleen Ballance
- Department of Pediatrics, K. Hovnanian Children’s Hospital, Jersey Shore University Medical Center and Hackensack Meridian School of Medicine, Neptune, New Jersey, USA
| | - Zuzanna Michalak
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Aryeh Baer
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Marni Kriegel
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Harpreet Pall
- Department of Pediatrics, K. Hovnanian Children’s Hospital, Jersey Shore University Medical Center and Hackensack Meridian School of Medicine, Neptune, New Jersey, USA
| | - Julia Piwoz
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Kevin Slavin
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Mark E Siegel
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Meghan E Tozzi
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Robert Tozzi
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - David M Walker
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Sivia Lapidus
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Judy Aschner
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
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Das T, Bartschat K, Bray I, Fursa D, Zatsarinny O, Ballance C, Chung HK, Ralchenko Y. Recommended electron-impact excitation and ionization cross sections for Be I. At Data Nucl Data Tables 2019; 127-128:10.1016/j.adt.2018.11.001. [PMID: 32116394 PMCID: PMC7047829 DOI: 10.1016/j.adt.2018.11.001] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Analytic fits to the recommended electron-impact excitation and ionization cross sections for Be I are presented. The lowest 19 terms of configurations 2snl (n ≤ 4) and 2p 2 terms below the first ionization limit are considered. The fits are based on the accurate calculations with the convergent close coupling (CCC) method as well as the B-spline R-matrix (BSR) approach. The fitted cross sections provide rate coefficients that are believed to approximate the original data within 10% with very few exceptions. The oscillator strengths for the dipole-allowed transitions between all the considered states are calculated with the relativistic multi-configuration Dirac-Hartree-Fock (MCDHF) approach and compared with the CCC and BSR results. This comparison shows a very good agreement except for a handful of cases with likely strong cancellations.
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Affiliation(s)
- T. Das
- International Atomic Energy Agency, A-1400 Vienna,
Austria
| | - K. Bartschat
- Department of Physics and Astronomy, Drake University, Des
Moines, IA 50311, USA
| | - I. Bray
- Curtin Institute for Computation and Department of Physics,
Astronomy and Medical Radiation Science,Curtin University, GPO Box U1987, Perth, WA
6845, Australia
| | - D.V. Fursa
- Curtin Institute for Computation and Department of Physics,
Astronomy and Medical Radiation Science,Curtin University, GPO Box U1987, Perth, WA
6845, Australia
| | - O. Zatsarinny
- Department of Physics and Astronomy, Drake University, Des
Moines, IA 50311, USA
| | - C. Ballance
- School of Mathematics and Physics, Queen’s
University Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom
| | - H.-K. Chung
- International Atomic Energy Agency, A-1400 Vienna,
Austria
| | - Yu. Ralchenko
- National Institute of Standards and Technology,
Gaithersburg, MD 20899, USA
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Hızarcioglu-Gulsen H, Aydemir Y, Gucer S, Berberoglu-Ates B, Hizal G, Peynircioglu B, Saltik-Temizel IN, Chawla H, Schwartzberg P, Nakhleh N, Loveridge-Lenza B, Ballance C, Sultan R, Naganathan S, Ngido F, Misra S. Index of suspicion. Pediatr Rev 2014; 35:531-7. [PMID: 25452662 DOI: 10.1542/pir.35-12-531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Yusuf Aydemir
- Department of Pediatric Gastroenterology, Hepatology and Nutrition
| | | | | | - Gulin Hizal
- Department of Pediatric Gastroenterology, Hepatology and Nutrition
| | - Bora Peynircioglu
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | | | - Paul Schwartzberg
- Department of Pediatrics, K. Hovnanian Children's Hospital, Neptune, NJ
| | - Nader Nakhleh
- Department of Pediatrics, K. Hovnanian Children's Hospital, Neptune, NJ
| | | | - Cathleen Ballance
- Department of Pediatrics, K. Hovnanian Children's Hospital, Neptune, NJ
| | - Richard Sultan
- Department of Pediatrics, K. Hovnanian Children's Hospital, Neptune, NJ
| | | | - Fabian Ngido
- Department of Pediatrics, East Carolina University-Brody School of Medicine, Greeneville, NC
| | - Sudipta Misra
- Department of Pediatrics, East Carolina University-Brody School of Medicine, Greeneville, NC
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Colledge L, Ballance C. THE SURGICAL TREATMENT OF PARALYSIS OF THE VOCAL CORD AND OF PARALYSIS OF THE DIAPHRAGM. Br Med J 2011; 1:553-9. [PMID: 20773096 DOI: 10.1136/bmj.1.3455.553] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ballance C. An Address ON THE RESULTS OBTAINED IN SOME EXPERIMENTS IN WHICH THE FACIAL AND RECURRENT LARYNGEAL NERVES WERE ANASTOMOSED WITH OTHER NERVES. Br Med J 2011; 2:349-54. [PMID: 20771704 DOI: 10.1136/bmj.2.3322.349] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ballance C. Ocular injuries in squash competitors. Nurs Stand 1992; 6:25-7. [PMID: 1642981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Squash players are liable to suffer serious eye injuries if they do not take appropriate protective measures. The author presents a short case study which illustrates the type of injury that can be sustained, and argues that nurses and interested associations must become involved in health education activities to reduce the high incidence of injuries during squash matches.
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Sharkey RM, Goldenberg DM, Goldenberg H, Lee RE, Ballance C, Pawlyk D, Varga D, Hansen HJ. Murine monoclonal antibodies against carcinoembryonic antigen: immunological, pharmacokinetic, and targeting properties in humans. Cancer Res 1990; 50:2823-31. [PMID: 2328505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We have examined three 131I-labeled murine monoclonal antibodies (MAbs) against carcinoembryonic antigen (CEA), NP-2, NP-3, and NP-4, after i.v. injection in patients with diverse cancers. Although the MAbs had a similar tumor-targeting ability, several important features were discovered that have led us to the selection of one of these MAbs for further clinical evaluation. We found that it is important to evaluate MAbs with a high immunoreactivity. For example, the MAb NP-2 was used initially in patients with an immunoreactivity between 35 and 50%. Although the tumor-imaging properties of this MAb compared favorably with the affinity-purified, goat anti-CEA antibody that we used previously, further purification of NP-2 to an immunoreactivity greater than 70% uncovered a previously unknown cross-reactivity with human granulocytes. It was also discovered that the MAbs differed in their ability to complex with CEA in the blood. Plasma samples were analyzed by gel filtration at 1 or 24 h after injection. The formation of complexes with circulating CEA was dependent on the CEA:MAb ratio in the blood. NP-3 complexed to a greater degree with CEA than NP-4, but NP-2 did not complex with CEA even at CEA:NP-2 ratios of 55 to 1. NP-3 commonly showed enhanced uptake in the colon by external scintigraphy, and examination of the radioactivity in the stool showed that most of the radioactivity was associated with whole IgG and large-sized fragments of NP-3. We also compared the rate of elimination of radioactivity from the blood for all of the MAbs and compared the clearance of NP-3 to NP-4 at three different ranges of MAb protein doses (less than 1.0 mg, 1 to 5 mg, and 5 to 20 mg). The blood clearance rate for NP-3 was fastest among the other MAbs at protein doses exceeding 1.0 mg. Patients given less than 1.0 mg of NP-4 had a significantly (P less than 0.005) shorter elimination half-life than patients given more than 1.0 mg of NP-4. By virtue of NP-4's good targeting properties in patients and its limited complexation with circulating CEA, it was selected as the MAb of choice for CEA tumor imaging.
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Affiliation(s)
- R M Sharkey
- Center for Molecular Medicine and Immunology, University of Medicine and Dentistry of New Jersey, Newark 07103
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Sharkey RM, Gold DV, Aninipot R, Vagg R, Ballance C, Newman ES, Ostella F, Hansen HJ, Goldenberg DM. Comparison of tumor targeting in nude mice by murine monoclonal antibodies directed against different human colorectal cancer antigens. Cancer Res 1990; 50:828s-834s. [PMID: 2297729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Tumor targeting of five radioiodinated murine monoclonal antibodies (MAbs) directed against human colorectal cancer were studied in nude mice bearing the GW-39 human colonic tumor xenograft. All of the MAbs are of the IgG1 isotype. Two of the MAbs (NP-4 and MN-14) are directed against a Class III carcinoembryonic antigen-specific epitope, but they differ 10-fold in their affinity. The other three MAbs recognize mucins found in colonic cancer. Mu-9 recognizes a peptide determinant similar to that described previously for a polyclonal goat anti-colon-specific antigen p. G9 identifies an organ-specific, tumor-associated carbohydrate epitope. The tumor targeting of these MAbs was compared to that of B72.3, another anti-mucin MAb. The tumor uptake of all the MAbs were similar on days 1, 3, and 7, with an average maximum accretion of between 30 and 40%/g tumor occurring by day 3. This tumor uptake was maintained for 14 days with the anti-mucin MAbs, whereas the percentage of injected dose/g in the tumor for 2 anti-carcinoembryonic antigen MAbs decreased 2-fold by day 14. Although no statistical difference could be found between the percentage of injected dose/g in the tumor for NP-4 and MN-14 (carcinoembryonic antigen MAbs), in a paired-labeled study using 131I-MN-14 and 125I-NP-4, MN-14 uptake in the tumor was consistently 1.3 times higher than that of NP-4 on all days tested. F(ab')2 fragments showed lower tumor uptake (maximum uptake for NP-4 and Mu-9 was 11% on day 1), but the faster clearance resulted in a 4- to 40-fold increase in tumor/blood ratios on day 3 in comparison to the whole IgGs. Fab' fragments had the lowest tumor uptake of the 3 forms of immunoglobulin, with a maximum of only 5%/g 6 h after injection. However, tumor/blood ratios on day 1 for the Fab' fragments were improved 3-fold over that of F(ab')2. All of these MAbs, except Mu-9, identify epitopes that can be detected in plasma, but none of the MAbs complexed appreciably when mixed in vitro with plasma containing antigen at antigen/MAb ratios anticipated to be encountered most frequently in imaging or therapy applications in humans. However, complexation of the MAbs will occur if antigen in the plasma is markedly elevated. These studies suggest that if used clinically, tumor targeting of colorectal cancer with any of these MAb IgG may be similar if these antigens are present at relatively similar concentrations in tumor.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- R M Sharkey
- Center for Molecular Medicine and Immunology, University of Medicine and Dentistry of New Jersey, Newark
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Ballance C. The Operative Treatment of Facial Palsy: with Observations on the prepared Nerve-Graft and on Facial Spasm: (Section of Otology and Section of Laryngology). Proc R Soc Med 1934; 27:1367-1372. [PMID: 19989926 PMCID: PMC2205494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Beattie J, Duel AB, Ballance C. The Effects of Stimulation of the Hypothalamic Pupillo-Dilator Centre after Successful Anastomoses Between the Cervical Sympathetic and Certain Motor Nerves. J Anat 1932; 66:283-99. [PMID: 17104375 PMCID: PMC1248935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
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Barlow T, Ballance C. THE WAR EMERGENCY FUND. West J Med 1928. [DOI: 10.1136/bmj.1.3519.1045] [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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Colledge L, Ballance C. ANASTOMOSES BETWEEN THE RECURRENT LARYNGEAL AND PHRENIC NERVES: THE CONDITION OF THE INTRINSIC MUSCLES AND NERVES OF THE LARYNX OF A RHESUS MONKEY MORE THAN THREE YEARS, AND TWO YEARS, AFTER OPERATION. Br Med J 1928; 1:746-7. [PMID: 20773861 DOI: 10.1136/bmj.1.3513.746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Colledge L, Ballance C. THE SURGICAL TREATMENT OF PARALYSIS OF THE VOCAL CORD AND OF PARALYSIS OF THE DIAPHRAGM. Br Med J 1927; 1:609-12. [PMID: 20773104 DOI: 10.1136/bmj.1.3456.609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ballance C, Colledge L. Cinematograph Demonstration: Effects of Nerve Anastomosis on the Movements of the Vocal Cords and Diaphragm. Proc R Soc Med 1927; 20:217-218. [PMID: 19985485 PMCID: PMC2100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Ballance C. DISCUSSION ON FRACTURE OF THE BASE OF THE SKULL; AND THE EAR, NOSE AND THROAT SURGEON. Proc R Soc Med 1926; 19:12-13. [PMID: 19985121 PMCID: PMC1948190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Ballance C. Radiogram of Cerebello-pontine Region in a Case of Suspected Auditory Nerve Tumour. Proc R Soc Med 1921; 14:18. [PMID: 19981920 PMCID: PMC2152140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Ballance C. Gunshot Wound of Temporal Bone. Proc R Soc Med 1921; 14:16-17. [PMID: 19981918 PMCID: PMC2152143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Ballance C. Introductory Remarks. Proc R Soc Med 1921; 14:1-2. [PMID: 19981915 PMCID: PMC2152152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Ballance C, Dundas-Grant J. Gunshot Wound of Temporal Bone. Proc R Soc Med 1921; 14:17-18. [PMID: 19981919 PMCID: PMC2152139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Ballance C, Stewart P. Clinical and Experimental Observations introducing a Discussion on the Regeneration of Peripheral Nerves; an Address. Med Chir Trans 1902; 85:283-304. [PMID: 20896983 PMCID: PMC2036368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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