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Low S, Maldonado-Howell C, Vescio R, Darrah J, Merin N, Flores J, Federizo Y, Uy L, Guerrero M, Lua M, Daskivich T, Paquette R. Stepping up: A Pilot Study Explores the Mobility Trajectory for Myeloma Patients Undergoing Autologous Stem Cell Transplantation. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00106-9] [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: 02/07/2023]
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Figueiredo JC, Ihenacho U, Merin NM, Hamid O, Darrah J, Gong J, Paquette R, Mita AC, Vescio R, Mehmi I, Basho R, Salvy SJ, Shirazipour CH, Caceres N, Finster LJ, Coleman B, Arnow HU, Florindez L, Sobhani K, Prostko JC, Frias EC, Stewart JL, Merchant A, Reckamp KL. SARS-CoV-2 vaccine uptake, perspectives, and adverse reactions following vaccination in patients with cancer undergoing treatment. Ann Oncol 2022; 33:109-111. [PMID: 34687893 PMCID: PMC8527840 DOI: 10.1016/j.annonc.2021.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/02/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- J C Figueiredo
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA.
| | - U Ihenacho
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA; Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - N M Merin
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - O Hamid
- The Angeles Clinic and Research Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - J Darrah
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - J Gong
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - R Paquette
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - A C Mita
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - R Vescio
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - I Mehmi
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - R Basho
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - S J Salvy
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - C H Shirazipour
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA; Department of Medicine, University of California Los Angeles, Los Angeles, USA
| | - N Caceres
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - L J Finster
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - B Coleman
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, USA
| | - H U Arnow
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, USA
| | - L Florindez
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, USA
| | - K Sobhani
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | | | - E C Frias
- Abbott Diagnostics, Abbott Park, USA
| | | | - A Merchant
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
| | - K L Reckamp
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA.
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Figueiredo JC, Merin NM, Hamid O, Choi SY, Lemos T, Cozen W, Nguyen N, Finster LJ, Foley J, Darrah J, Gong J, Paquette R, Mita AC, Vescio R, Mehmi I, Basho R, Tourtellotte WG, Huynh CA, Melmed GY, Braun J, McGovern DPB, Mengesha E, Botwin G, Prostko JC, Frias EC, Stewart JL, Joung S, Van Eyk J, Ebinger JE, Cheng S, Sobhani K, Reckamp KL, Merchant A. Longitudinal SARS-CoV-2 mRNA Vaccine-Induced Humoral Immune Responses in Patients with Cancer. Cancer Res 2021; 81:6273-6280. [PMID: 34759001 PMCID: PMC9060668 DOI: 10.1158/0008-5472.can-21-3554] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022]
Abstract
Longitudinal studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-induced immune responses in patients with cancer are needed to optimize clinical care. In a prospective cohort study of 366 (291 vaccinated) patients, we measured antibody levels [anti-spike (IgG-(S-RBD) and anti-nucleocapsid immunoglobulin] at three time points. Antibody level trajectories and frequency of breakthrough infections were evaluated by tumor type and timing of treatment relative to vaccination. IgG-(S-RBD) at peak response (median = 42 days after dose 2) was higher (P = 0.002) and remained higher after 4 to 6 months (P = 0.003) in patients receiving mRNA-1273 compared with BNT162b2. Patients with solid tumors attained higher peak levels (P = 0.001) and sustained levels after 4 to 6 months (P < 0.001) compared with those with hematologic malignancies. B-cell targeted treatment reduced peak (P = 0.001) and sustained antibody responses (P = 0.003). Solid tumor patients receiving immune checkpoint inhibitors before vaccination had lower sustained antibody levels than those who received treatment after vaccination (P = 0.043). Two (0.69%) vaccinated and one (1.9%) unvaccinated patient had severe COVID-19 illness during follow-up. Our study shows variation in sustained antibody responses across cancer populations receiving various therapeutic modalities, with important implications for vaccine booster timing and patient selection. SIGNIFICANCE: Long-term studies of immunogenicity of SARS-CoV-2 vaccines in patients with cancer are needed to inform evidence-based guidelines for booster vaccinations and to tailor sequence and timing of vaccinations to elicit improved humoral responses.
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Affiliation(s)
- Jane C Figueiredo
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California.
| | - Noah M Merin
- Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Omid Hamid
- The Angeles Clinic and Research Institute, A Cedars-Sinai Affiliate, Los Angeles, California
| | - So Yung Choi
- Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California
| | - Tucker Lemos
- Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Wendy Cozen
- Division of Hematology/Oncology, Department of Medicine, Department of Pathology, School of Medicine, University of California Irvine, Orange, California
| | - Nathalie Nguyen
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Laurel J Finster
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Joslyn Foley
- Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Justin Darrah
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jun Gong
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Ronald Paquette
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Alain C Mita
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Robert Vescio
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Inderjit Mehmi
- The Angeles Clinic and Research Institute, A Cedars-Sinai Affiliate, Los Angeles, California
| | - Reva Basho
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Warren G Tourtellotte
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Carissa A Huynh
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Gil Y Melmed
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Los Angeles, California
| | - Jonathan Braun
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Los Angeles, California
| | - Dermot P B McGovern
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Los Angeles, California
| | - Emebet Mengesha
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Los Angeles, California
| | - Greg Botwin
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Los Angeles, California
| | | | | | | | - Sandy Joung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jennifer Van Eyk
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Joseph E Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Kimia Sobhani
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Karen L Reckamp
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California.
| | - Akil Merchant
- Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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Kharfan-Dabaja MA, Al Malki MM, Deotare U, Raj RV, El-Jurdi N, Majhail N, Cherry MA, Bashir Q, Darrah J, Nishihori T, Sibai H, Hamadani M, de Lima M, Gerds AT, Selby G, Qazilbash MH, Forman SJ, Ayala E, Lipton JH, Hari PN, Muzzafar T, Zhang L, Olteanu H, Perkins J, Sokol L, Kumar A, Ahmed S. Haematopoietic cell transplantation for blastic plasmacytoid dendritic cell neoplasm: a North American multicentre collaborative study. Br J Haematol 2017; 179:781-789. [PMID: 28980314 DOI: 10.1111/bjh.14954] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/14/2017] [Indexed: 12/22/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is incurable with conventional therapies. Limited retrospective data have shown durable remissions after haematopoietic cell transplantation (HCT) [allogeneic (allo) or autologous (auto)]. We conducted a multicentre retrospective study in BPDCN patients treated with allo-HCT and auto-HCT at 8 centres in the United States and Canada. Primary endpoint was overall survival (OS). The population consisted of 45 consecutive patients who received an allo-HCT (n = 37) or an auto-HCT (n = 8) regardless of age, pre-transplant therapies, or remission status at transplantation. Allo-HCT recipients were younger (50 (14-74) vs. 67 (45-72) years, P = 0·01) and had 1-year and 3-year OS of 68% [95% confidence interval (CI) = 49-81%] and 58% (95% CI = 38-75%), respectively. Allo-HCT in first complete remission (CR1) yielded superior 3-year OS (versus not in CR1) [74% (95% CI = 48-89%) vs. 0, P < 0·0001]. Allo-HCT outcomes were not impacted by regimen intensity [3-year OS for myeloablative conditioning = 61% (95% CI = 28-83%) vs. reduced-intensity conditioning = 55% (95% CI = 28-76%)]. One-year OS for auto-HCT recipients was 11% (95% CI = 8-50%). These results demonstrate efficacy of allo-HCT in BPDCN, especially in patients in CR1. Pertaining to auto-HCT, our results suggest lack of efficacy against BPDCN, but this observation is limited by the small sample size. Larger prospective studies are needed to better define the role of HCT in BPDCN.
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Affiliation(s)
- Mohamed A Kharfan-Dabaja
- Deptartment of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Monzr M Al Malki
- Deptartment of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Uday Deotare
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Renju V Raj
- Deptartment of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Najla El-Jurdi
- Div. of Hematology-Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Navneet Majhail
- Deptartment of Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH, USA
| | - Mohamad A Cherry
- Section of Hematology-Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Qaiser Bashir
- Division of Cancer Medicine, Deptartment of Stem Cell Transplantation and Cellular Therapy, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Justin Darrah
- Deptartment of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Taiga Nishihori
- Deptartment of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Hassan Sibai
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Mehdi Hamadani
- Deptartment of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Marcos de Lima
- Div. of Hematology-Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Aaron T Gerds
- Deptartment of Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH, USA
| | - George Selby
- Section of Hematology-Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Muzaffar H Qazilbash
- Division of Cancer Medicine, Deptartment of Stem Cell Transplantation and Cellular Therapy, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen J Forman
- Deptartment of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Ernesto Ayala
- Deptartment of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Jeffrey H Lipton
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Parameswaran N Hari
- Deptartment of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Tariq Muzzafar
- Deptartment of Hematopathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Ling Zhang
- Deptartment of Hematopathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Horatiu Olteanu
- Deptartment of Hematopathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Janelle Perkins
- College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Lubomir Sokol
- Deptartment of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA
| | - Ambuj Kumar
- Program for Comparative Effectiveness Research, University of South Florida College of Medicine, Tampa, FL, USA
| | - Sairah Ahmed
- Division of Cancer Medicine, Deptartment of Stem Cell Transplantation and Cellular Therapy, UT MD Anderson Cancer Center, Houston, TX, USA
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Behbod F, Limback D, Hong Y, Elsarraj H, Berger J, Heddens E, Valdez K, Smith WP, Inciardi M, Reddick M, Gatewood J, Darrah J, Winblad O, Meierotto R, Ricci L, Wagner J, Amin A, May L, Cusick T, Mammen J, Fields T, Godwin AK, Fabian C, Kaufman C, Tawfik O, Fan F. Abstract P4-06-01: Patient derived DCIS mouse-intraductal (MIND) models recapitulate the full spectrum of human patient pathology and histologic features including progression to invasion in a subset of cases. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-06-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: The 20-year breast cancer mortality rate following a DCIS diagnosis is ∼3%. Radiation and anti-hormonal therapy of DCIS has not resulted in improved overall survival, which argues against the non-selective use of such therapies in DCIS management. However, some DCIS cases do progress to invasive cancer, and these patients may benefit from treatment. A study of 80 DCIS patients followed for up to 30 years reported a 43% progression rate. Notably, progression was not predicted by grade, as 39% of even low-grade DCIS ultimately progressed to invasive cancer. Clearly, there is a need to identify which DCIS lesions are likely to progress. We have developed a novel mouse xenograft model (mouse-intraductal; MIND) to study the molecular basis of DCIS progression and enable identification of suitable biomarkers that predict invasive progression.
Methods: MIND involves injection of epithelial cells derived from patient breast lesions into the mammary ducts of immunocompromised mice. Serial sections of mouse mammary glands containing DCIS xenograft lesions were examined at time intervals of 3-14 months post-engraftment by histology using hematoxylin and eosin (H&E) and immunohistochemistry using anti-human cytokeratin 5/19, smooth muscle actin, ER, PR, p53, Ki67 and HER-2.
Results: Intraductal injection of cells derived from breast lesions of 28 patients into 133 mice resulted in a successful engraftment rate of 60%. Among these, 12 pure DCIS samples were injected into 35 different mice to create MIND xenografts. As early as three months post-engraftment, the DCIS xenograft cells showed multilayered in situ growth consisting of atypical neoplastic cells with prominent and vesicular nuclei. DCIS MIND xenografts exhibited the full spectrum of human DCIS histologic features, including similar biomarker expression (ER, PR, Ki67, HER-2 and p53) at long-term follow-up after engraftment (up to 12 months). Most remarkably, a subset of xenografts representing 5 patients (5/12; 42%) showed progression to invasion 6-12 months post-engraftment in the absence of any external genetic manipulations. This rate is very similar to that reported for human DCIS progression in untreated patients. MIND DCIS xenograft lesions that progressed showed disruption of basement membrane and myoepithelial layer by the invasive cells, retraction of basement membrane, and micro-invasion. MIND DCIS lesions were enriched in small capillaries, and in some cases clusters of invasive cells appeared inside nearby blood vessels.
Conclusion: The MIND xenograft is a viable model for human DCIS progression that recapitulates histologic features of human DCIS, as well as reported rates of progression to invasion. The availability of this innovative model provides a valuable tool for the discovery of new biomarkers to identify DCIS with invasive potential. The identification of high risk DCIS will ultimately help patients and clinicians choose the best course of therapy and avoid the morbidity and costs associated with unnecessary treatment.
Citation Format: Behbod F, Limback D, Hong Y, Elsarraj H, Berger J, Heddens E, Valdez K, Smith WP, Inciardi M, Reddick M, Gatewood J, Darrah J, Winblad O, Meierotto R, Ricci L, Wagner J, Amin A, May L, Cusick T, Mammen J, Fields T, Godwin AK, Fabian C, Kaufman C, Tawfik O, Fan F. Patient derived DCIS mouse-intraductal (MIND) models recapitulate the full spectrum of human patient pathology and histologic features including progression to invasion in a subset of cases [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-06-01.
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Affiliation(s)
- F Behbod
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - D Limback
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - Y Hong
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - H Elsarraj
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - J Berger
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - E Heddens
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - K Valdez
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - WP Smith
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - M Inciardi
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - M Reddick
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - J Gatewood
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - J Darrah
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - O Winblad
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - R Meierotto
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - L Ricci
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - J Wagner
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - A Amin
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - L May
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - T Cusick
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - J Mammen
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - T Fields
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - AK Godwin
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - C Fabian
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - C Kaufman
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - O Tawfik
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
| | - F Fan
- University of Kansas Medical Center, Kansas City, KS; Truman Hospital, Kansas City, MO; St. Luke's Hospital, Kansas City, MO; Wichita School of Medicine, Wichita, KS
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Do H, Vintch J, Carter Y, Yeh J, Darrah J. Angiosarcoma After Treatment of Primary Mediastinal Yolk Sac Tumor. Chest 2016. [DOI: 10.1016/j.chest.2016.08.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Darrah J, Wiart L, Magill-Evans J, Ray L, Andersen J. Are family-centred principles, functional goal setting and transition planning evident in therapy services for children with cerebral palsy? Child Care Health Dev 2012; 38:41-7. [PMID: 21083684 DOI: 10.1111/j.1365-2214.2010.01160.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada. METHODS Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes. RESULTS All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports. CONCLUSION Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite attending the same programme. Standardized programme processes and policies may provide a starting point to ensure that all families have equitable opportunities to participate in their child's rehabilitation programme.
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Affiliation(s)
- J Darrah
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada T6G 2G4.
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Karachristos A, Herrera A, Sifontis NM, Darrah J, Baribault C, Lee I, Leech SH, Constantinescu S, Gaughan J, Jain A, Silva P, Daller JA. Outcomes of Renal Transplantation in Older High Risk Recipients: Is There an Age Effect? J Surg Res 2010; 161:173-8. [DOI: 10.1016/j.jss.2009.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Revised: 10/02/2009] [Accepted: 11/05/2009] [Indexed: 10/20/2022]
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9
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Darrah J, Magil-Evans J, Adkins R. How well are we doing? Families of adolescents or young adults with cerebral palsy share their perceptions of service delivery. Disabil Rehabil 2002; 24:542-9. [PMID: 12171644 DOI: 10.1080/09638280210121359] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE The satisfaction of families of adolescents and young adults with a diagnosis of cerebral palsy with the service delivery they had experienced in the areas of health, education, recreation, employment, housing and transportation was examined. Common themes across the six service areas were identified. METHOD Forty-nine adolescents (13-15 years) and 39 young adults (19-23 years) and their families rated their satisfaction with services and then participated in semi-structured interviews to discuss their experiences. RESULTS Using a constant comparative method of analysis, common themes were identified from the transcribed interviews. Four themes were identified and named: caring and supportive people; fighting and fatigue; communication/information; and disability awareness. CONCLUSIONS Families continue to experience dissatisfaction and frustration with service delivery in the six areas examined. Both bureaucratic structure and attitudes of service providers contribute to their dissatisfaction.
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Affiliation(s)
- J Darrah
- Faculty of Rehabilitation Medicine, 3-50 Corbett Hall, University of Alberta, Edmonton, AB, Canada T6G 2G4.
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10
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Wiart L, Darrah J. Changing philosophical perspectives on the management of children with physical disabilities--their effect on the use of powered mobility. Disabil Rehabil 2002; 24:492-8. [PMID: 12097218 DOI: 10.1080/09638280110105240] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE Over the past decade, the emergence of a new philosophical framework has influenced approaches to service delivery in paediatric rehabilitation. Traditional approaches focused on the attainment of typical movement patterns as the ultimate goal of intervention. By contrast, contemporary approaches to intervention encourage children with physical disabilities to use their most efficient movement strategies to explore their environment and participate in meaningful activities. METHODS/RESULTS Factors that facilitated this change in approaches to intervention are explored and include: the disability movement; the evolution of models of disablement; the shift from a medical model to a family-centred model of health care service provision; the emergence of a new theory to explain motor development and increased availability and quality of assistive technology. CONCLUSION The clinical implications of this philosophical shift for the use of powered mobility with children with physical disabilities are explored. A collaborative approach to working with families throughout the process of selecting mobility options for their children is discussed.
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Affiliation(s)
- Lesley Wiart
- Consulting Services, Edmonton Public Schools, Belvedere Office, 13359 62nd Street, Edmonton, Alberta T5A OV5, Canada.
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11
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12
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Abstract
This study compared adolescents with cerebral palsy (CP) and their families to adolescents without physical disabilities and their families as the child enters and leaves adolescence (age ranges 13 to 15 years and 19 to 23 years). Families of 90 individuals with CP (42 females, 48 males) and 75 individuals without physical disabilities (34 females, 41 males) participated. They completed the Family Assessment Device, Life Situation Survey, Multidimensional Scale of Perceived Social Support, and Future Questionnaire. There were few differences in family functioning, life satisfaction, or perceived social support between the groups. Expectations of young adults with CP and parents of both adolescents and young adults regarding future independence and success were lower than the expectations of the control group. While the group results emphasize similarities between families during the two stages of adolescence, individual families and individual family members report specific challenges.
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13
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Affiliation(s)
- L Wiart
- Consulting Services, Edmonton Public School Board, Canada.
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14
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Abstract
The primary objective of this study was to determine the inter-rater reliability of the revised version of the Edmonton Functional Assessment Tool (EFAT-2). A second objective was to determine whether both formally trained and self-trained therapists had an acceptable level of inter-rater reliability. The EFAT-2 was administered to consenting palliative care patients by one of two independent physical therapist rater pairs; one pair self-trained (R1, R2) and the other formally trained (R3, R4). The intraclass correlation [ICC (1,1)] for R1, R2 was 0.97 [95% confidence interval (CI) 0.94-0.99] and for R3, R4 was 0.95 (95% CI 0.90-0.98). The standard error of measurement was 1.09 and 1.44, respectively. The Kappa statistic for the rater pairs on individual EFAT items ranged from 0.17 to 0.96. The results suggest that both formally trained and self-trained therapists obtain an acceptable level of inter-rater reliability when using the EFAT-2.
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Affiliation(s)
- T Kaasa
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
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15
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16
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Butler C, Chambers H, Goldstein M, Harris S, Leach J, Campbell S, Adams R, Darrah J. Evaluating research in developmental disabilities: a conceptual framework for reviewing treatment outcomes. Dev Med Child Neurol 1999; 41:55-9. [PMID: 10068052 DOI: 10.1017/s0012162299000110] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- C Butler
- Treatment Outcomes Committee, American Academy for Cerebral Palsy and Developmental Medicine, Rosemont, IL, USA.
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17
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Abstract
The purpose of this study was to evaluate the intra-individual stability of gross motor scores obtained by normally developing full-term infants on the Alberta Infant Motor Scale (AIMS). The gross motor skills of 47 infants were assessed monthly in their homes by pairs of physical therapists. Infants were followed from two weeks of age until they achieved independent walking. A developmental pediatrician assessed each infant at 18 months of age, and classified the infant's gross motor skills as normal, suspicious or abnormal. Only the data of infants receiving a normal classification at 18 months were included in the analyses (n = 45). Individual infants' percentile ranks varied considerably from month to month, with no systematic pattern of change noted across infants. As a group, the mean percentile range over 13 assessments was 66.78 (S.D. 13.47). Fourteen infants (31.1%) received a score below the 10th percentile on at least one occasion. The results suggest that normally developing infants are not stable in the rate of emergence of gross motor skills. This instability has implications for infant screening programs, and supports the premise of serial assessments to identify accurately those infants with a motor delay.
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Affiliation(s)
- J Darrah
- Dept of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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18
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Abstract
The Alberta Infant Motor Scale (AIMS) is a norm-referenced measure of infant gross motor development. The objectives of this study were: (1) to establish the best cut-off scores on the AIMS for predictive purposes, and (2) to compare the predictive abilities of the AIMS with those of the Movement Assessment of Infants (MAI) and the Peabody Developmental Gross Motor Scale (PDGMS). One hundred and sixty-four infants were assessed at 4 and 8 months adjusted ages on the three measures. A pediatrician assessed each infant's gross motor development at 18 months as normal, suspicious, or abnormal. For the AIMS, two different cut-off points were identified: the 10th centile at 4 months and the 5th centile at 8 months. The MAI provided the best specificity rates at 4 months while the AIMS was superior in specificity at 8 months. Sensitivity rates were comparable between the two tests. The PDGMS in general demonstrated poor predictive abilities.
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Affiliation(s)
- J Darrah
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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19
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Abstract
One hundred and seven infants aged < 32 weeks of gestation were stratified according to birthweight and randomly assigned to either a waterbed group (N = 53) or a mattress group (N = 54). All the infants were assessed on removal from the surface: 68 infants at 40 weeks gestation and 52 infants at four, eight, 12 and 18 months adjusted age. At the 18-month assessment, outcome was classified as normal, suspicious or abnormal. There were no significant differences between the groups at any age. The results suggest that the use of the waterbed as a positional surface in the neonatal intensive-care unit has no influence on the motor development of very low-birthweight infants.
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Affiliation(s)
- J Darrah
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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20
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Levey JM, Banner B, Darrah J, Bonkovsky HL. Inflammatory cloacogenic polyp: three cases and literature review. Am J Gastroenterol 1994; 89:438-41. [PMID: 8122661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- J M Levey
- Department of Medicine, University of Massachusetts Medical Center, Worcester
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21
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Piper MC, Pinnell LE, Darrah J, Maguire T, Byrne PJ. Construction and validation of the Alberta Infant Motor Scale (AIMS). Can J Public Health 1992; 83 Suppl 2:S46-50. [PMID: 1468050] [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: 12/27/2022]
Abstract
The Alberta Infant Motor Scale (AIMS), an observational assessment scale, was constructed to measure gross motor maturation in infants from birth through independent walking. Based upon the literature, 58 items were generated and organized into four positions: prone, supine, sitting and standing. Each item describes three aspects of motor performance--weight-bearing, posture and antigravity movements. Content validation of the instrument was accomplished through a mail survey of Canadian pediatric physical therapists and consultation with an international panel of experts. Five hundred and six infants, age-stratified from birth through 18 months, participated in the reliability and validity testing of the AIMS. In addition, 20 infants who were experiencing abnormal motor development and 50 infants at risk for motor disorders were assessed and compared with the results of the full-term sample. Results to be presented include: 1) test-retest and inter-rater reliability estimates; 2) correlations between the AIMS and the Bayley and Peabody motor scores; and 3) scaling of the items along the age continuum for normal motor development.
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Affiliation(s)
- M C Piper
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton
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22
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Abstract
The motor development of 75 preterm infants was assessed at 4 months chronological and 4 months adjusted ages using the Movement Assessment of Infants (MAI). Infants were followed until 18 months old when neurological and motor outcomes were assessed by a developmental pediatrician, and outcomes were classified as normal, suspicious, or abnormal. Sensitivity, specificity, and positive and negative predictive values were calculated at the two points in time using a variety of cutoff MAI scores. At 4 months, the practice of adjusting for prematurity resulted in the better combination of screening rates for the detection of both neurologically abnormal and neurologically abnormal/suspicious children. To obtain comparable rates, different cutoff MAI scores were used to identify the neurologically abnormal versus the neurologically abnormal/suspicious children. The optimal combination of sensitivity, specificity, positive and negative predictive values varies according to the age of assessment, the disorders being identified, and the cutoff scores employed.
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Affiliation(s)
- M C Piper
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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23
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Abstract
We prospectively performed magnetic resonance imaging (MRI) studies during the neonatal period, and at 4 and 8 months of age, on 15 term infants with hypoxic-ischemic encephalopathy, and compared the results with their neurodevelopmental outcome at 18 months of age. Cerebral palsy developed in nine infants, two infants were classified as having abnormalities of tone and delayed motor milestones that were suggestive of cerebral palsy, and four infants were normal. Structural abnormalities, delayed myelination, or a combination of the two were detected with MRI at 8 months of age in all nine infants with later development of cerebral palsy. Three of the four normal infants and one infant with suggestive abnormalities had normal serial MRI findings. Each of the remaining two infants (one normal, one with suggestive abnormalities) had isolated persistent ventricular dilation on all three MRI studies. Our results suggest that 8 months appears to be the earliest time at which MRI findings correlate well with later adverse neurodevelopmental outcome in this population.
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Affiliation(s)
- P Byrne
- Department of Pediatrics, University of Alberta, Edmonton, Canada
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24
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Piper MC, Pinnell L, Welch B, Darrah J, Byrne P. Calculation of sensitivity and specificity. Am J Dis Child 1990; 144:958-9. [PMID: 1697734 DOI: 10.1001/archpedi.1990.02150330016010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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25
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Abstract
Forty-five neurologically normal preterm infants were allocated to one of two groups according to their gestational age at birth (less than 32 weeks; 32 to 36 weeks). Their gross and fine motor development was assessed at eight and 12 months chronological age and eight and 12 months adjusted age. At eight months chronological age the two groups differed significantly in both gross and fine motor development, but at eight and 12 months adjusted age and 12 months chronological age they differed significantly only in fine motor development.
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Affiliation(s)
- M C Piper
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton
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26
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Byrne PJ, Piper MC, Darrah J. Motor development at term of very low birthweight infants with bronchopulmonary dysplasia. J Perinatol 1989; 9:301-6. [PMID: 2809783] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Forty-one preterm infants weighing less than 1500 g and less than 32 weeks' gestation at birth had a Dubowitz neurological assessment performed at 40 weeks postconceptional age. The infants were classified into three groups. Eight infants had bronchopulmonary dysplasia and severe central nervous system abnormalities, 11 infants had bronchopulmonary dysplasia alone, and 22 infants had neither bronchopulmonary dysplasia nor severe central nervous system abnormalities. The neuromotor performance of these three groups of infants was similar on all the Dubowitz assessment items at 40 weeks postconceptional age. Neuromotor development of very low birthweight infants with severe bronchopulmonary dysplasia appears to be no different from that of infants without bronchopulmonary dysplasia at 40 weeks postconceptional age utilizing the Dubowitz neurological assessment.
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Affiliation(s)
- P J Byrne
- Department of Pediatrics, University of Alberta, Edmonton
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27
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Abstract
A cohort of 62 low-risk preterm infants was identified and followed prospectively through the first 4 months of life to assess whether motor development is determined by biological maturity or the duration of the extrauterine experience. After identification, the cohort was subdivided into two groups according to gestational age at birth: less than 32 weeks gestation (n = 23) and greater than or equal to 32 weeks gestation (n = 39). Neuromotor assessments were performed on every infant at both 4 months chronological and 4 months adjusted ages. Analyses revealed that (1) the two groups of infants differed significantly at 4 months chronological age in terms of tone, primitive reflexes and volitional movement, but not in automatic reactions, and (2) the two groups of infants differed significantly at 4 months adjusted age in terms of primitive reflexes, but not in tone, automatic reactions or volitional movement. These findings suggest that the development of volitional movement and tone appear to evolve according to biological maturity alone. In contrast, primitive reflexes and automatic reactions in the preterm infant may be influenced by both biological maturation and environmental experience.
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Affiliation(s)
- M C Piper
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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28
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Purtilo DT, Geelhoed GW, Li FP, Yang JP, Thurber WA, Darrah J, Cassel C. Mucinous colon carcinoma in a black family. Cancer Genet Cytogenet 1987; 24:11-5. [PMID: 3024808 DOI: 10.1016/0165-4608(87)90079-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Carcinoma of the large bowel developed in an autosomal dominant pattern in 13 members of a black-American family. Seven members were affected prior to initial ascertainment of the family in 1976. Thereafter, the remaining six were affected while 0.2 cases were expected (p less than 0.001). Median age at diagnosis of colon cancer was 39 years (range, 22-62 years) in this family, compared with 65 years among black-Americans, in general. Histologic review of surgical specimens from six patients and medical record data for a seventh patient showed mucinous adenocarcinoma of the colon, an uncommon histologic variant. Studies of several family members a decade ago had revealed no biologic markers of cancer susceptibility.
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29
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Darrah J. Diagnostic practices and special classes for the educable mentally retarded--a layman's critical view. Except Child 1967; 33:523-527. [PMID: 6045532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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