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Chen FS, Chen CC, Tsai CC, Lu JH, You HL, Chen CM, Huang WT, Tsai KF, Cheng FJ, Kung CT, Li SH, Wang CC, Ou YC, Lee WC, Chang YT, Hashim F, Chao HR, Wang LJ. Urinary levels of organophosphate flame retardants metabolites in a young population from Southern Taiwan and potential health effects. Front Endocrinol (Lausanne) 2023; 14:1173449. [PMID: 37334296 PMCID: PMC10272846 DOI: 10.3389/fendo.2023.1173449] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023] Open
Abstract
Background Organophosphate flame retardants (OPFRs) are widely distributed in the environment and their metabolites are observed in urine, but little is known regarding OPFRs in a broad-spectrum young population from newborns to those aged 18 years. Objectives Investigate urinary levels of OPFRs and OPFR metabolites in Taiwanese infants, young children, schoolchildren, and adolescents within the general population. Methods Different age groups of subjects (n=136) were recruited from southern Taiwan to detect 10 OPFR metabolites in urine samples. Associations between urinary OPFRs and their corresponding metabolites and potential health status were also examined. Results The mean level of urinary Σ10 OPFR in this broad-spectrum young population is 2.25 μg/L (standard deviation (SD) of 1.91 μg/L). Σ10 OPFR metabolites in urine are 3.25 ± 2.84, 3.06 ± 2.21, 1.75 ± 1.10, and 2.32 ± 2.29 μg/L in the age groups comprising of newborns, 1-5 year-olds, 6-10 year-olds, and 11-18 year-olds, respectively, and borderline significant differences were found in the different age groups (p=0.125). The OPFR metabolites of TCEP, BCEP, DPHP, TBEP, DBEP, and BDCPP predominate in urine and comprise more than 90% of the total. TBEP was highly correlated with DBEP in this population (r=0.845, p<0.001). The estimated daily intake (EDI) of Σ5OPFRs (TDCPP, TCEP, TBEP, TNBP, and TPHP) was 2,230, 461, 130, and 184 ng/kg bw/day for newborns, 1-5 yr children, 6-10 yr children, and 11-17 yr adolescents, respectively. The EDI of Σ5OPFRs for newborns was 4.83-17.2 times higher than the other age groups. Urinary OPFR metabolites are significantly correlated with birth length and chest circumference in newborns. Conclusion To our knowledge, this is the first investigation of urinary OPFR metabolite levels in a broad-spectrum young population. There tended to be higher exposure rates in both newborns and pre-schoolers, though little is known about their exposure levels or factors leading to exposure in the young population. Further studies should clarify the exposure levels and factor relationships.
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Affiliation(s)
- Feng-Shun Chen
- Section of Neonatology, Department of Pediatrics, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chih-Cheng Chen
- Section of Neonatology, Department of Pediatrics, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Early Childhood Care and Education, Cheng-Shiu University, Kaohsiung, Taiwan
| | - Ching-Chang Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jian-He Lu
- Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Neipu, Taiwan
| | - Huey-Ling You
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Mei Chen
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wan-Ting Huang
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kai-Fan Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Jen Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chia-Te Kung
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chin-Chou Wang
- Department of Occupational Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Che Ou
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Chin Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ting Chang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fahimah Hashim
- Universiti Malaysia Terengganu, Kuala Terengganu, Malaysia
| | - How-Ran Chao
- Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Neipu, Taiwan
- Institute of Food Safety Management, College of Agriculture, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Forslin Y, Bergendal Å, Hashim F, Martola J, Shams S, Wiberg MK, Fredrikson S, Granberg T. Detection of Leukocortical Lesions in Multiple Sclerosis and Their Association with Physical and Cognitive Impairment: A Comparison of Conventional and Synthetic Phase-Sensitive Inversion Recovery MRI. AJNR Am J Neuroradiol 2018; 39:1995-2000. [PMID: 30262646 DOI: 10.3174/ajnr.a5815] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 08/02/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Cortical lesions are common in multiple sclerosis and are included in the latest diagnostic criteria. The limited sensitivity of cortical MS lesions on conventional MR imaging can be improved by phase-sensitive inversion recovery. Synthetic MR imaging could provide phase-sensitive inversion recovery without additional scanning, but the use of synthetic phase-sensitive inversion recovery remains to be validated. We aimed to compare the ability and clinical value of detecting leukocortical lesions with conventional and synthetic phase-sensitive inversion recovery in MS. MATERIALS AND METHODS Twenty-one patients with MS prospectively underwent conventional and synthetic phase-sensitive inversion recovery, 3D T1-weighted, and T2 FLAIR imaging. Two neuroradiologists independently performed blinded phase-sensitive inversion recovery lesion assessments; a consensus rating with all sequences was considered the criterion standard. Lesion volumes were segmented. All participants underwent standardized cognitive and physical examinations and Fatigue Severity Scale assessment. Results were analyzed with multiple linear regressions. RESULTS Interrater and criterion standard agreement for leukocortical lesions was excellent for both conventional and synthetic phase-sensitive inversion recovery (intraclass correlation coefficient = 0.79-0.97). Leukocortical lesion volumes for both sequences were associated with lower information-processing speed (P ≤ .01) and verbal fluency (P ≤ .02). Both phase-sensitive inversion recovery sequences showed a positive effect on the association when combining volumes of leukocortical lesions and white matter lesions with information-processing speed (P ≤ .005) and verbal fluency (P ≤ .03). No associations were found between leukocortical lesion volumes and physical disability or fatigue. CONCLUSIONS Synthetic and conventional phase-sensitive inversion recovery have a sensitivity similar to that of leukocortical MS lesions. The detected leukocortical lesions are associated with cognitive dysfunction and thus provide clinically relevant information, which encourages assessment of cortical MS involvement at conventional field strengths.
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Affiliation(s)
- Y Forslin
- From the Departments of Clinical Science, Intervention and Technology (Y.F., Å.B., F.H., J.M., S.S., M.K.W., T.G.) .,Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden
| | - Å Bergendal
- From the Departments of Clinical Science, Intervention and Technology (Y.F., Å.B., F.H., J.M., S.S., M.K.W., T.G.)
| | - F Hashim
- From the Departments of Clinical Science, Intervention and Technology (Y.F., Å.B., F.H., J.M., S.S., M.K.W., T.G.).,Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden
| | - J Martola
- From the Departments of Clinical Science, Intervention and Technology (Y.F., Å.B., F.H., J.M., S.S., M.K.W., T.G.).,Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden
| | - S Shams
- From the Departments of Clinical Science, Intervention and Technology (Y.F., Å.B., F.H., J.M., S.S., M.K.W., T.G.).,Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden
| | - M K Wiberg
- From the Departments of Clinical Science, Intervention and Technology (Y.F., Å.B., F.H., J.M., S.S., M.K.W., T.G.).,Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden
| | - S Fredrikson
- Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden.,Neurology (S.F.), Karolinska University Hospital, Stockholm, Sweden
| | - T Granberg
- From the Departments of Clinical Science, Intervention and Technology (Y.F., Å.B., F.H., J.M., S.S., M.K.W., T.G.).,Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden
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3
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Forslin Y, Shams S, Hashim F, Aspelin P, Bergendal G, Martola J, Fredrikson S, Kristoffersen-Wiberg M, Granberg T. Retention of Gadolinium-Based Contrast Agents in Multiple Sclerosis: Retrospective Analysis of an 18-Year Longitudinal Study. AJNR Am J Neuroradiol 2017; 38:1311-1316. [PMID: 28495943 DOI: 10.3174/ajnr.a5211] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 03/03/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE Gadolinium-based contrast agents have been associated with lasting high T1-weighted signal intensity in the dentate nucleus and globus pallidus, with histopathologically confirmed gadolinium retention. We aimed to longitudinally investigate the relationship of multiple gadolinium-based contrast agent administrations to the Signal Intensity Index in the dentate nucleus and globus pallidus and any associations with cognitive function in multiple sclerosis. MATERIALS AND METHODS The Signal Intensity Index in the dentate nucleus and globus pallidus was retrospectively evaluated on T1-weighted MR imaging in an 18-year longitudinal cohort study of 23 patients with MS receiving multiple gadolinium-based contrast agent administrations and 23 healthy age- and sex-matched controls. Participants also underwent comprehensive neuropsychological testing. RESULTS Patients with MS had a higher Signal Intensity Index in the dentate nucleus (P < .001), but not in the globus pallidus (P = .19), compared with non-gadolinium-based contrast agent-exposed healthy controls by an unpaired t test. Increasing numbers of gadolinium-based contrast agent administrations were associated with an increased Signal Intensity Index in the dentate nucleus (β = 0.45, P < .001) and globus pallidus (β = 0.60, P < .001). This association remained stable with corrections for the age, disease duration, and physical disability for both the dentate nucleus (β = 0.43, P = .001) and globus pallidus (β = 0.58, P < .001). An increased Signal Intensity Index in the dentate nucleus among patients with MS was associated with lower verbal fluency scores, which remained significant after correction for several aspects of disease severity (β = -0.40 P = .013). CONCLUSIONS Our data corroborate previous reports of lasting gadolinium retention in brain tissues. An increased Signal Intensity Index in the dentate nucleus and globus pallidus was associated with lower verbal fluency, which does not prove causality but encourages further studies on cognition and gadolinium-based contrast agent administration.
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Affiliation(s)
- Y Forslin
- From the Departments of Clinical Science Intervention and Technology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.) .,Radiology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.)
| | - S Shams
- From the Departments of Clinical Science Intervention and Technology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.).,Radiology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.)
| | - F Hashim
- From the Departments of Clinical Science Intervention and Technology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.).,Radiology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.)
| | - P Aspelin
- From the Departments of Clinical Science Intervention and Technology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.).,Radiology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.)
| | - G Bergendal
- From the Departments of Clinical Science Intervention and Technology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.).,Radiology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.).,Neurology (G.B., S.F.)
| | - J Martola
- From the Departments of Clinical Science Intervention and Technology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.).,Radiology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.)
| | - S Fredrikson
- Neurology (G.B., S.F.).,Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden
| | - M Kristoffersen-Wiberg
- From the Departments of Clinical Science Intervention and Technology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.).,Radiology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.)
| | - T Granberg
- From the Departments of Clinical Science Intervention and Technology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.).,Radiology (Y.F., S.S., F.H., P.A., G.B., J.M., M.K.-W., T.G.)
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4
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Granberg T, Uppman M, Hashim F, Cananau C, Nordin LE, Shams S, Berglund J, Forslin Y, Aspelin P, Fredrikson S, Kristoffersen-Wiberg M. Clinical Feasibility of Synthetic MRI in Multiple Sclerosis: A Diagnostic and Volumetric Validation Study. AJNR Am J Neuroradiol 2016; 37:1023-9. [PMID: 26797137 DOI: 10.3174/ajnr.a4665] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 11/24/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Quantitative MR imaging techniques are gaining interest as methods of reducing acquisition times while additionally providing robust measurements. This study aimed to implement a synthetic MR imaging method on a new scanner type and to compare its diagnostic accuracy and volumetry with conventional MR imaging in patients with MS and controls. MATERIALS AND METHODS Twenty patients with MS and 20 healthy controls were enrolled after ethics approval and written informed consent. Synthetic MR imaging was implemented on a Siemens 3T scanner. Comparable conventional and synthetic proton-density-, T1-, and T2-weighted, and FLAIR images were acquired. Diagnostic accuracy, lesion detection, and artifacts were assessed by blinded neuroradiologic evaluation, and contrast-to-noise ratios, by manual tracing. Volumetry was performed with synthetic MR imaging, FreeSurfer, FMRIB Software Library, and Statistical Parametric Mapping. Repeatability was quantified by using the coefficient of variance. RESULTS Synthetic proton-density-, T1-, and T2-weighted images were of sufficient or good quality and were acquired in 7% less time than with conventional MR imaging. Synthetic FLAIR images were degraded by artifacts. Lesion counts and volumes were higher in synthetic MR imaging due to differences in the contrast of dirty-appearing WM but did not affect the radiologic diagnostic classification or lesion topography (P = .50-.77). Synthetic MR imaging provided segmentations with the shortest processing time (16 seconds) and the lowest repeatability error for brain volume (0.14%), intracranial volume (0.12%), brain parenchymal fraction (0.14%), and GM fraction (0.56%). CONCLUSIONS Synthetic MR imaging can be an alternative to conventional MR imaging for generating diagnostic proton-density-, T1-, and T2-weighted images in patients with MS and controls while additionally delivering fast and robust volumetric measurements suitable for MS studies.
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Affiliation(s)
- T Granberg
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - M Uppman
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Diagnostic Medical Physics (M.U., L.E.N., J.B.)
| | - F Hashim
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - C Cananau
- Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - L E Nordin
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Diagnostic Medical Physics (M.U., L.E.N., J.B.)
| | - S Shams
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - J Berglund
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Diagnostic Medical Physics (M.U., L.E.N., J.B.)
| | - Y Forslin
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - P Aspelin
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
| | - S Fredrikson
- Clinical Neuroscience (S.F.), Karolinska Institutet, Stockholm, Sweden Neurology (S.F.), Karolinska University Hospital, Stockholm, Sweden
| | - M Kristoffersen-Wiberg
- From the Departments of Clinical Science, Intervention and Technology (T.G., M.U., F.H., L.E.N., S.S., J.B., Y.F., P.A., M.K.-W.) Departments of Radiology (T.G., F.H., C.C., S.S., Y.F., P.A., M.K.-W)
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Granberg T, Hashim F, Andersen O, Sundal C, Karrenbauer VD. Hereditary diffuse leukoencephalopathy with spheroids - a volumetric and radiological comparison with multiple sclerosis patients and healthy controls. Eur J Neurol 2016; 23:817-22. [DOI: 10.1111/ene.12948] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 11/13/2015] [Indexed: 02/02/2023]
Affiliation(s)
- T. Granberg
- Division of Medical Imaging and Technology; Department of Clinical Science; Intervention and Technology; Karolinska Institutet; Stockholm Sweden
- Department of Radiology; Karolinska University Hospital; Stockholm Sweden
| | - F. Hashim
- Division of Medical Imaging and Technology; Department of Clinical Science; Intervention and Technology; Karolinska Institutet; Stockholm Sweden
- Department of Radiology; Karolinska University Hospital; Stockholm Sweden
| | - O. Andersen
- The Sahlgrenska Academy; Department of Neuroscience and Physiology; Section of Clinical Neuroscience and Rehabilitation; University of Gothenburg; Gothenburg Sweden
| | - C. Sundal
- The Sahlgrenska Academy; Department of Neuroscience and Physiology; Section of Clinical Neuroscience and Rehabilitation; University of Gothenburg; Gothenburg Sweden
- Department of Neurology; Haukeland University Hospital; Bergen Norway
| | - V. D. Karrenbauer
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Department of Neurology; Karolinska University Hospital; Stockholm Sweden
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El-Naggar N, Almansari A, Khudada K, Salman S, Mariswamy N, Abdelfattah W, Hashim F. The A1 chieve study - an observational non-interventional study of patients with type 2 diabetes mellitus initiating or switched to insulin analogue therapy: subgroup analysis of the Gulf population. Int J Clin Pract 2013; 67:128-38. [PMID: 23305475 DOI: 10.1111/ijcp.12078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
AIM To evaluate the safety and effectiveness of insulin analogues (insulin aspart, insulin detemir and biphasic insulin aspart 30, alone or in combination) in type 2 diabetes mellitus (T2DM) patients in routine clinical practice in the Gulf as a subgroup of the A(1) chieve multi-national study. METHODS A total of 10,704 T2DM Gulf patients with uncontrolled T2DM on oral antidiabetics ± insulins other than insulin aspart, insulin detemir or biphasic insulin aspart 30, who initiated or switched to study insulins were included and followed up for 24 weeks in the context of the A(1) chieve study. RESULTS Baseline HbA(1c) (± SD) was poor: 9.7 ± 1.7%. At Week 24, an improvement in HbA(1c) of -2.3 ± 1.6% was observed in the entire cohort, and -2.4 ± 1.5% and -2.1 ± 1.7% for insulin-naïve patients and prior insulin users respectively. Overall, rates of hypoglycaemia increased in those new to insulin therapy, whereas a reduction was observed in those switching from other insulins. A marginal reduction in body weight (-0.8 ± 4.4 kg) was noted in the entire cohort, whereas the overall lipid profile and systolic blood pressure (-6.2 ± 15.3 mmHg) improved. CONCLUSIONS Initiating or switching to insulin analogues was well tolerated and resulted in significant improvements in glycaemic control in T2DM patients in the Gulf.
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Affiliation(s)
- N El-Naggar
- Hai AlJamea Hospital, Jeddah, Kingdom of Saudi Arabia.
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Khalil SI, Kamal A, Hashim F, Olaish MO. Study of Left Ventricular Diastolic Function in Patients with Diabetes Mellitus. Sud Jnl Med Sci 2008. [DOI: 10.4314/sjms.v2i2.38469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Zeidan Z, Kojal H, Habour A, Nowary K, Hashim F, Awadelkarim M. Clinical and epidemiological features of severe malaria in children in four hospitals in Sudan. East Mediterr Health J 2006; 12:783-91. [PMID: 17333823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We assessed the clinical and epidemiological features of severe malaria cases before admission, management in hospital and outcome and associated factors in 4 hospitals in different areas of Sudan over a 5-month period in 2000. There were 543 children admitted representing 21% of all paediatric admissions. Median age was 36 months. Treatment at home was the first action taken by 57.5% of families. Case fatality rate was 5/1000 and 93% of the children who died were under 9 years. Highest risk of death was associated with delay in seeking treatment and severity of illness before admission. Omdurman Hospital in Khartoum had the best case-management performance index compared to the other hospitals.
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MESH Headings
- Age Distribution
- Case Management/standards
- Cause of Death
- Child
- Child, Hospitalized/statistics & numerical data
- Child, Preschool
- Cross-Sectional Studies
- Endemic Diseases/statistics & numerical data
- Epidemiologic Studies
- Female
- Hospital Mortality
- Hospitals, District
- Hospitals, Pediatric
- Humans
- Infant
- Malaria, Cerebral/epidemiology
- Malaria, Cerebral/parasitology
- Malaria, Falciparum/complications
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/therapy
- Male
- Outcome Assessment, Health Care
- Parents/education
- Patient Admission/statistics & numerical data
- Risk Factors
- Seasons
- Severity of Illness Index
- Sudan/epidemiology
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Affiliation(s)
- Z Zeidan
- Department of Community Medicine, University of Khartoum, Khartoum, Sudan.
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Abstract
Donor site morbidity for free fibula microvascular flaps is generally reported to be low and considered to be minor. We describe a case where the major complication of compartment syndrome occurred in a 15-year-old boy when the donor site defect was closed primarily after taking a skin paddle with a width of 4 cm. We recommend that when harvesting free fibula flaps in children, skin grafting of donor site should be considered irrespective of the width of the flap, if there is any doubt about the tightness of the closure.
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Affiliation(s)
- M Saleem
- Section of Otolaryngology-Head and Neck Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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10
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Hashim F, Sakr FM, el Din EZ. In vitro release and in vivo absorption of nitrofurantoin and nalidixic acid from ethylcellulose microcapsules. Pharmazie 1987; 42:315-7. [PMID: 3671441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Ethylcellulose was used as an efficient retarding material to prepare nitrofurantoin or nalidixic acid microcapsules. The dissolution rates of the different preparations have found to increase in alkaline rather than in acidic media. Considerable retardation in the rate and extent of release from 2:1, 1:1 and 1:2 drug-polymer ratios were observed as compared with those of the plain drugs. Absorption study in man proved that formulations containing 2:1 ratios have delayed urinary excretion rates by 2 h, however, the total cumulative amounts excreted from all samples remained almost constant. Man volunteers administered the 2:1 drug-polymer microcapsules did not suffer gastric irritation, usually produced after three consecutive d from taking the plain drugs. Experiments in male albino rats showed that the coated drugs did not produce gastric hemorrhage seen with the same doses of the uncoated ones.
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Affiliation(s)
- F Hashim
- Faculty of Pharmacy, Pharmaceutics Department, Mansoura University, A. R. E
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Creagh F, Teece M, Williams S, Didcote S, Perkins W, Hashim F, Rees Smith B. An analysis of thyrotrophin receptor binding and thyroid stimulating activities in a series of Graves' sera. Clin Endocrinol (Oxf) 1985; 23:395-404. [PMID: 2998648 DOI: 10.1111/j.1365-2265.1985.tb01097.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Improved receptor and bioassays have been used to compare TSH receptor binding and thyroid stimulating activities in unextracted sera from 110 patients with Graves' disease. The two parameters showed a significant correlation (r = 0.65; P less than 0.001) although there were some clear discrepancies. Dose-response studies in 17 sera showed that both receptor binding and thyroid stimulating responses always increased with increasing doses of serum. In patients who were in relapse or remission following antithyroid drug treatment, the results of both bio- and receptor assays correlated well with disease activity with only one clear discrepancy which could have been attributable to the coexistence of autoimmune stimulation and destruction of the thyroid.
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Abstract
The TSH receptor binding and thyroid stimulating properties of (Fab)2 and Fab fragments of Graves' IgG have been investigated. (Fab)2 fragments were prepared by pepsin digestion of IgG and Fab fragments by reduction of (Fab)2 or papain digestion of IgG. (Fab)2 and Fab were effective in inhibiting TSH binding to its receptor with all five patients' sera studied and both preparations stimulated cyclic AMP release from isolated thyroid cells. However Fab fragments were less active thyroid stimulators than their parent (Fab)2 in all five cases. These studies indicate that antibody divalency is not essential for thyroid stimulation by TSH receptor antibodies.
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Rees Smith B, Rickards CR, Davies Jones E, Kajita Y, Buckland PR, Creagh FM, Howells RD, Hashim F, Parkes AB, Petersen VB. The thyrotropin receptor and its role in Graves' disease. J Endocrinol Invest 1985; 8:175-82. [PMID: 2993404 DOI: 10.1007/bf03350678] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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