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Wiggins LD, Rubenstein E, Windham G, Barger B, Croen L, Dowling N, Giarelli E, Levy S, Moody E, Soke G, Fields V, Schieve L. Evaluation of sex differences in preschool children with and without autism spectrum disorder enrolled in the study to explore early development. Res Dev Disabil 2021; 112:103897. [PMID: 33610079 PMCID: PMC8215620 DOI: 10.1016/j.ridd.2021.103897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 01/30/2021] [Accepted: 02/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND AIMS Research in school-aged children, adolescents, and adults with autism spectrum disorder (ASD) has found sex-based differences in behavioral, developmental, and diagnostic outcomes. These findings have not been consistently replicated in preschool-aged children. We examined sex-based differences in a large sample of 2-5-year-old children with ASD symptoms in a multi-site community-based study. METHODS AND PROCEDURES Based on a comprehensive evaluation, children were classified as having ASD (n = 1480, 81.55 % male) or subthreshold ASD characteristics (n = 593, 70.15 % male). Outcomes were behavior problems, developmental abilities, performance on ASD screening and diagnostic tests, and parent-reported developmental conditions diagnosed before study enrollment. OUTCOMES AND RESULTS We found no statistically significant sex differences in behavioral functioning, developmental functioning, performance on an ASD screening test, and developmental conditions diagnosed before study enrollment among children with ASD or subthreshold ASD characteristics. Males in both study groups had more parent reported restricted interests and repetitive behaviors than females, but these differences were small in magnitude and not clinically meaningful. CONCLUSIONS AND IMPLICATIONS Preschool males and females who showed risk for ASD were more similar than different in the outcomes assessed in our study. Future research could examine sex-based differences in ASD phenotypes as children age.
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Affiliation(s)
- Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Eric Rubenstein
- Boston University, Department of Epidemiology, Boston, MA, United States
| | - Gayle Windham
- California Department of Public Health, Environmental Health Investigations Branch, Richmond, CA, United States
| | - Brian Barger
- Georgia State University, School of Public Health, Atlanta, GA, United States
| | - Lisa Croen
- Kaiser Permanente Northern California, Division of Research, Autism Research Program, Oakland, CA, United States
| | - Nicole Dowling
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ellen Giarelli
- College of Nursing and Health Professionals, Drexel University, Philadelphia, PA, United States
| | - Susan Levy
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Eric Moody
- University of Wyoming, Wyoming Institute for Disabilities College of Health Sciences, Laramie, WY, United States
| | - Gnakub Soke
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Victoria Fields
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laura Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Schieve LA, Tian L, Dowling N, Croen L, Hoover-Fong J, Alexander A, Shapira SK. Associations Between the 2nd to 4th Digit Ratio and Autism Spectrum Disorder in Population-Based Samples of Boys and Girls: Findings from the Study to Explore Early Development. J Autism Dev Disord 2019; 48:2379-2395. [PMID: 29450837 DOI: 10.1007/s10803-018-3495-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The ratio of the index (2nd) finger to ring (4th) finger lengths (2D:4D) is a proxy for fetal testosterone and estradiol. Studies suggesting 2D:4D is inversely associated with autism spectrum disorder (ASD) in males were limited by lack of confounder and subgroup assessments. Studies of females are sparse. We examined associations between ASD and 2D:4D among children in the Study to Explore Early Development; we considered case subgroups and numerous potential demographic and maternal-perinatal health confounders. We observed a modest inverse association between ASD and right-hand 2D:4D in males; subgroup analyses indicated associations were limited to ASD cases with birth defects/genetic syndromes or dysmorphic features. We observed a positive association between ASD and left-hand 2D:4D in females, overall and within most case subgroups.
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Affiliation(s)
- Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mailstop E-86, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA.
| | - Lin Tian
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mailstop E-86, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Nicole Dowling
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mailstop E-86, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Lisa Croen
- Kaiser Permanente Division of Research, Oakland, CA, USA
| | - Julie Hoover-Fong
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aimee Alexander
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mailstop E-86, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Stuart K Shapira
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mailstop E-86, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
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Willige SUD, Pyle M, Vos H, de Visser M, Lally C, Dowling N, Hooper WC, Bertina R, Austin H. Fibrinogen gamma gene 3’-end polymorphisms and risk of venous thromboembolism in the African-American and Caucasian population. Thromb Haemost 2017. [DOI: 10.1160/th08-12-0813] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryGenetic determinants of venous thromboembolism (VTE) in the African-American population are poorly characterised. It was recently shown that fibrinogen gamma gene (FGG) polymorphisms 10034C>T and 9340T>C influence VTE risk in the Caucasian population. In the African-American population these polymorphisms are common, with allele frequencies above 25%. Here we evaluated whether these and other FGG 3’-end polymorphisms were associated with VTE risk in the African-American population and aimed to replicate the association in the Caucasian population. We examined 557 Caucasian patients and 678 Caucasian controls, and 537 African-American patients and 586 African-American controls from the ‘Genetic Attributes and Thrombosis Epidemiology’ (GATE) study. In the African-American population, 10034C>T and 9340T>C marginally influenced VTE-risk, with a 20% increase in risk for 10034TT carriers and a 20% reduction in risk for 9340CC carriers. In the Caucasian population, 10034TT was associated with a 1.7-fold increase in risk, which increased to 2.1-fold for idiopathic VTE patients. 9340CC significantly reduced VTE risk approximately two-fold. In conclusion, both FGG polymorphisms 10034C>T and 9340T>C influence VTE-risk, with the strongest effects observed in the Caucasian population, confirming previous data on these polymorphisms in this population.
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Ng CH, Bousman C, Smith DJ, Dowling N, Byron K, King J, Sarris J. A Prospective Study of Serotonin and Norepinephrine Transporter Genes and the Response to Desvenlafaxine Over 8 Weeks in Major Depressive Disorder. Pharmacopsychiatry 2016; 49:210-212. [PMID: 27023264 DOI: 10.1055/s-0042-103968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
No studies to date have evaluated SLC6A2 and SLC6A4 genetic polymorphisms influencing antidepressant response to desvenlafaxine. We conducted an 8-week, open-label, prospective pilot study in 35 patients with major depressive disorder to assess the effects of genetic variations in SLC6A2 and SLC6A4 on both efficacy and side effect profile of desvenlafaxine. Results revealed that homozygotes for the SLC6A4 HTTLPR S allele showed a 33% HDRS reduction compared to a 58% reduction for L allele carriers (p=0.037). No results survived adjustments for covariates or multiple comparisons. While these results need to be interpreted cautiously, they provide preliminary support for the SLC6A4 HTTLPR polymorphism as potential modifier of desvenlafaxine efficacy.
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Affiliation(s)
- C H Ng
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne
| | - C Bousman
- Florey Institute for Neuroscience and Mental Health, Parkville, Australia
| | - D J Smith
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne
| | - N Dowling
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne
| | - K Byron
- Healthscope Advanced Pathology, Melbourne, Victoria, Australia
| | - J King
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne
| | - J Sarris
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne
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Yucel M, Braganza L, Murawski C, Lorenzetti V, Youssef G, Fontenelle L, Dowling N, Larsen T, O'Doherty J, Harrison B. SY38-3 * SIMILARITIES AND DIFFERENCES IN REWARD AND AVOIDANCE LEARNING IN OCD AND PROBLEM GAMBLERS. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu052.159] [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: 11/14/2022] Open
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Janssens ACJW, Ioannidis JPA, Bedrosian S, Boffetta P, Dolan SM, Dowling N, Fortier I, Freedman AN, Grimshaw JM, Gulcher J, Gwinn M, Hlatky MA, Janes H, Kraft P, Melillo S, O'Donnell CJ, Pencina MJ, Ransohoff D, Schully SD, Seminara D, Winn DM, Wright CF, van Duijn CM, Little J, Khoury MJ. Strengthening the reporting of genetic risk prediction studies (GRIPS): explanation and elaboration. Eur J Clin Invest 2011; 41:1010-35. [PMID: 21434890 DOI: 10.1111/j.1365-2362.2011.02493.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
• The rapid and continuing progress in gene discovery for complex diseases is fuelling interest in the potential application of genetic risk models for clinical and public health practice. • The number of studies assessing the predictive ability is steadily increasing, but they vary widely in completeness of reporting and apparent quality. • Transparent reporting of the strengths and weaknesses of these studies is important to facilitate the accumulation of evidence on genetic risk prediction. • A multidisciplinary workshop sponsored by the Human Genome Epidemiology Network developed a checklist of 25 items recommended for strengthening the reporting of Genetic RIsk Prediction Studies (GRIPS), building on the principles established by prior reporting guidelines. • These recommendations aim to enhance the transparency, quality and completeness of study reporting and thereby to improve the synthesis and application of information from multiple studies that might differ in design, conduct or analysis.
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Affiliation(s)
- A Cecile J W Janssens
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Lin J, Lee J, Wu C, Caffrey JL, Chang M, Hwang J, Dowling N, Lin Y. Metabolic Syndrome, Testosterone, and Cardiovascular Mortality in Men. J Sex Med 2011; 8:2350-60. [DOI: 10.1111/j.1743-6109.2011.02343.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Scinicariello F, Yesuprya A, Fowler B, Chang M, Dowling N. The modifying effect of NOS3 variants on the association between blood lead and hypertension. Toxicol Lett 2011. [DOI: 10.1016/j.toxlet.2011.05.676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Janssens ACJW, Ioannidis JPA, Bedrosian S, Boffetta P, Dolan SM, Dowling N, Fortier I, Freedman AN, Grimshaw JM, Gulcher J, Gwinn M, Hlatky MA, Janes H, Kraft P, Melillo S, O'Donnell CJ, Pencina MJ, Ransohoff D, Schully SD, Seminara D, Winn DM, Wright CF, van Duijn CM, Little J, Khoury MJ. Strengthening the reporting of Genetic RIsk Prediction Studies (GRIPS): explanation and elaboration. J Clin Epidemiol 2011; 64:e1-e22. [PMID: 21414753 DOI: 10.1016/j.jclinepi.2011.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The rapid and continuing progress in gene discovery for complex diseases is fuelling interest in the potential application of genetic risk models for clinical and public health practice. The number of studies assessing the predictive ability is steadily increasing, but they vary widely in completeness of reporting and apparent quality. Transparent reporting of the strengths and weaknesses of these studies is important to facilitate the accumulation of evidence on genetic risk prediction. A multidisciplinary workshop sponsored by the Human Genome Epidemiology Network developed a checklist of 25 items recommended for strengthening the reporting of Genetic RIsk Prediction Studies (GRIPS), building on the principles established by prior reporting guidelines. These recommendations aim to enhance the transparency, quality and completeness of study reporting, and thereby to improve the synthesis and application of information from multiple studies that might differ in design, conduct or analysis.
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Affiliation(s)
- A Cecile J W Janssens
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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10
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Lin YS, Caffrey JL, Chang MH, Dowling N, Lin JW. Cigarette smoking, cadmium exposure, and zinc intake on obstructive lung disorder. Respir Res 2010; 11:53. [PMID: 20459696 PMCID: PMC2881897 DOI: 10.1186/1465-9921-11-53] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Accepted: 05/09/2010] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVE This study examined whether zinc intake was associated with lower risk of smoking-induced obstructive lung disorder through interplay with cadmium, one of major toxicants in cigarette smoke. METHODS Data were obtained from a sample of 6,726 subjects aged 40+ from the Third National Health and Nutrition Examination Survey. The forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured using spirometry. Gender-, ethnicity-, and age-specific equations were used to calculate the lower limit of normal (LLN) to define obstructive lung disorder as: observed FEV1/FVC ratio and FEV1 below respective LLN. Zinc intake was assessed by questionnaire. Logistic regression analysis was applied to investigate the associations of interest. RESULTS The analyses showed that an increased prevalence of obstructive lung disorder was observed among individuals with low zinc intake regardless of smoking status. The adjusted odds of lung disorder are approximately 1.9 times greater for subjects in the lowest zinc-intake tertile than those in the highest tertile (odds ratio = 1.89, 95% confidence interval = 1.22-2.93). The effect of smoking on lung function decreased considerably after adjusting for urinary cadmium. Protective association between the zinc-to-cadmium ratio (log-transformed) and respiratory risk suggests that zinc may play a role in smoking-associated lung disorder by modifying the influence of cadmium. CONCLUSIONS While zinc intake is associated with lower risk of obstructive lung disorder, the role of smoking cession and/or prevention are likely to be more important given their far greater effect on respiratory risk. Future research is warranted to explore the mechanisms by which zinc could modify smoking-associated lung disease.
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Affiliation(s)
- Yu-Sheng Lin
- Department of Environmental and Occupational Health, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - James L Caffrey
- Department of Integrative Physiology and Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Man-Huei Chang
- National Office of Public Health Genomics, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE MS: E-61, Atlanta, GA 30333, USA
| | - Nicole Dowling
- National Office of Public Health Genomics, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE MS: E-61, Atlanta, GA 30333, USA
| | - Jou-Wei Lin
- Cardiovascular Center and Health Management Center, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Taiwan
- Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Krieg EF, Butler MA, Chang MH, Liu T, Yesupriya A, Dowling N, Lindegren ML. Lead and cognitive function in VDR genotypes in the third National Health and Nutrition Examination Survey. Neurotoxicol Teratol 2009; 32:262-72. [PMID: 20006704 DOI: 10.1016/j.ntt.2009.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 11/10/2009] [Accepted: 12/07/2009] [Indexed: 01/08/2023]
Abstract
The relationship between the blood lead concentration and cognitive function in children and adults with different VDR genotypes who participated in the third National Health and Nutrition Examination Survey was investigated. The relationship between blood lead and serum homocysteine concentrations was also investigated. In children 12 to 16 years old, performance on the digit span and arithmetic tests as a function of the blood lead concentration varied by VDR rs2239185 and VDR rs731236 genotypes. Decreases in performance occurred in some genotypes, but not in others. In adults 20 to 59 years old, performance on the symbol-digit substitution test as a function of the blood lead concentration varied by VDR rs2239185-rs731236 haplotype. In the 12 to 16 year old children and adults 60 or more years old, the relationship between the serum homocysteine and blood lead concentrations varied by VDR genotype. The mean blood lead concentrations of the children and adults did not vary by VDR genotype.
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Affiliation(s)
- Edward F Krieg
- National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, USA.
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12
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Krieg EF, Butler MA, Chang MH, Liu T, Yesupriya A, Lindegren ML, Dowling N. Lead and cognitive function in ALAD genotypes in the third National Health and Nutrition Examination Survey. Neurotoxicol Teratol 2009; 31:364-71. [PMID: 19686844 DOI: 10.1016/j.ntt.2009.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Revised: 07/23/2009] [Accepted: 08/07/2009] [Indexed: 11/25/2022]
Abstract
The relationship between the blood lead concentration and cognitive function in children and adults with different ALAD genotypes who participated in the third National Health and Nutrition Examination Survey was investigated. The relationship between blood lead and serum homocysteine concentrations was also investigated. In children 12 to 16 years old, no difference in the relationship between cognitive function and blood lead concentration between genotypes was found. In adults 20 to 59 years old, mean reaction time decreased as the blood lead concentration increased in the ALAD rs1800435 CC/CG group. This represents an improvement in performance. In adults 60 years and older, no difference in the relationship between cognitive function and blood lead concentration between genotypes was found. The serum homocysteine concentration increased as the blood lead concentration increased in adults 20 to 59 years old and 60 years and older, but there were no differences between genotypes. The mean blood lead concentration of children with the ALAD rs1800435 CC/CG genotype was less than that of children with the GG genotype.
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Affiliation(s)
- Edward F Krieg
- National Institute for Occupational Safety and Health, Robert A. Taft Laboratories, Cincinnati, Ohio 45226, USA.
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13
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Dowling N, Smith D, Proeve M, Lee JK. The multiphasic sex inventory: A comparison of american and Australian samples of sexual offenders. Australian Psychologist 2007. [DOI: 10.1080/00050060008257486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Austin H, Lally C, Benson J, Dowling N, Hooper C. VENOUS THROMBOEMBOLISM, FACTOR V LEIDEN, AND PROTHROMBIN 20210 AMONG AMERICAN CAUCASIANS IN THE GATE STUDY. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb00671.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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De Staercke C, Lally C, Austin H, Winston C, Dowling N, Williams B, Hooper WC. The lack of association between four point mutations in the promoter region of the toll-like 4 receptor gene and myocardial infarction. Thromb Res 2007; 119:105-10. [PMID: 16469362 DOI: 10.1016/j.thromres.2005.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Revised: 11/19/2005] [Accepted: 12/16/2005] [Indexed: 11/24/2022]
Abstract
The toll-like receptor 4 gene product (TLR4) has been implicated in the pathogen recognition response mechanism because it plays a central role in the transcriptional activation of the host defense system. Activation of TLR4 initiates an intracellular signaling cascade, via the adapter protein MyD88 (myeloid differentiation factor 88), which leads to the activation of NF-kappaB transcriptional factor, and ultimately to the induction of a pro-inflammatory response. This inflammatory response has been increasingly associated with atherosclerosis. Recent analyses on two polymorphisms of TLR4, which affect the extracellular domain of the receptor, have been shown to give rise to an attenuated innate immune defense which may contribute to disease susceptibility. We have investigated the significance of four new substitutions found by re-sequencing in the 5'-proximal promoter region of the TLR4 gene in a case-control study of acute myocardial infarction. Our results found no statistically significant association between these genetic variants and MI.
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Affiliation(s)
- Christine De Staercke
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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16
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Philipp CS, Miller CH, Faiz A, Dilley A, Michaels LA, Ayers C, Bachmann G, Dowling N, Saidi P. Screening women with menorrhagia for underlying bleeding disorders: the utility of the platelet function analyser and bleeding time. Haemophilia 2006; 11:497-503. [PMID: 16128894 DOI: 10.1111/j.1365-2516.2005.01129.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [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: 12/28/2022]
Abstract
Menorrhagia is a very common clinical problem among women of reproductive age and recent studies have suggested that underlying bleeding disorders, particularly von Willebrand's deficiency and platelet function defects, are prevalent in women presenting with menorrhagia. The objective of this study was to determine the utility of the platelet function analyser (PFA-100) and bleeding time (BT) as initial screening tests for underlying bleeding disorders in women with menorrhagia. In this study, 81 women with a physician diagnosis of menorrhagia underwent PFA-100 testing, BT and comprehensive haemostatic testing. The effectiveness of the PFA-100 and BT as screening tools in women with menorrhagia was assessed using results of haemostatic testing for von Willebrand's disease (VWD) and platelet dysfunction. In women presenting with menorrhagia, the PFA-100 had a sensitivity 80%, specificity 89%, positive predictive value (PPV) 33%, negative predictive value (NPV) 98% and efficiency 88% for VWD. For platelet aggregation defects, the PFA-100 closure time had a sensitivity 23%, specificity 92%, PPV of 75%, NPV of 52% and efficiency 55%. The data suggest that the PFA-100 may be useful in stratifying women with menorrhagia for further von Willebrand testing; however, neither the PFA-100 nor the BT tests are effective for purposes of classifying women for standard platelet aggregometry testing in women presenting with menorrhagia.
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Affiliation(s)
- C S Philipp
- Division of Hematology, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA.
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Hooper WC, Roberts S, Dowling N, Austin H, Lally C, Whitsett C. The prevalence of the prothrombin gene variant C20209T in African-Americans and Caucasians and lack of association with venous thromboembolism. Thromb Res 2006; 118:767-8. [PMID: 16469364 DOI: 10.1016/j.thromres.2005.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Revised: 11/23/2005] [Accepted: 12/01/2005] [Indexed: 11/22/2022]
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18
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Philipp CS, Faiz A, Dowling N, Dilley A, Michaels LA, Ayers C, Miller CH, Bachmann G, Evatt B, Saidi P. Age and the Prevalence of Bleeding Disorders in Women With Menorrhagia. Obstet Gynecol 2005; 105:61-6. [PMID: 15625143 DOI: 10.1097/01.aog.0000148889.15061.fb] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [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] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A study was conducted to evaluate the frequency and types of hemostatic defects occurring in adolescent and perimenopausal-age women diagnosed with menorrhagia. METHODS A total of 115 women with a physician diagnosis of menorrhagia, including 25 adolescent women, 25 perimenopausal-age women, and 65 women between the ages of 20 and 44, underwent comprehensive hemostatic testing for possible bleeding disorders. Frequencies of bleeding disorders were calculated and compared. RESULTS Forty-seven percent of women were found to have hemostatic abnormalities, including platelet dysfunction, von Willebrand's disease, and coagulation factor deficiencies. Adolescents and perimenopausal-age women with menorrhagia were just as likely to have hemostatic abnormalities as were women aged 20 to 44. CONCLUSION These results demonstrate that underlying bleeding disorders are frequently found in adolescent, postadolescent reproductive age, and perimenopausal-age women presenting with menorrhagia and suggest that women with menorrhagia should be considered for further hemostatic evaluation.
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Affiliation(s)
- Claire S Philipp
- Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
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Stevens M, Patel H, Walters A, Burch K, Jay A, Dowling N, Mitchell CJ, Swann RA, Willis AT, Shanson DC. Comparison of Sentinel and Bactec blood culture systems. J Clin Pathol 1992; 45:815-8. [PMID: 1401215 PMCID: PMC495112 DOI: 10.1136/jcp.45.9.815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 12/26/2022]
Abstract
AIMS To evaluate the Sentinel automated blood culture system and to compare its performance with that of Bactec. METHODS The Sentinel blood culture system was evaluated in three centres. The performance of the system was assessed in comparison with the routine blood culture method used in these centres, the Bactec system. RESULTS Blood culture sets (n = 2180) consisting of Sentinel aerobic and anaerobic, and Bactec aerobic and anaerobic bottles yielded 218 (10%) clinically important isolates. One hundred and fifty five (71%) of the isolates were detected by both systems; 35 (16%) were detected by Sentinel only; and 28 (13%) by Bactec only. For the duration of the evaluation, the Sentinel system was deliberately configured so that it was impossible to detect positive results during the first 12 hours. The times to positivity after the first 12 hours were similar. Data gathered during and subsequent to the evaluation have been used by the manufacturer to refine the algorithm so that positive results can be detected at a minimum of 2.25 hours. CONCLUSIONS After a period of familiarization the Sentinel system was considered easy to use. Sentinel is a useful addition to the methods available for the detection of bacteria in blood cultures.
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Affiliation(s)
- M Stevens
- Department of Health Evaluation Unit, Royal Infirmary, Leicester
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Mori S, Wolfinbarger JB, Dowling N, Wei W, Bloom ME. Simultaneous identification of viral proteins and nucleic acids in cells infected with Aleutian mink disease parvovirus. Microb Pathog 1990; 9:243-53. [PMID: 1965846 DOI: 10.1016/0882-4010(90)90013-g] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [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: 12/29/2022]
Abstract
A method combining in situ hybridization and immunohistochemistry was used to characterize cells infected with Aleutian mink disease parvovirus (ADV). Single-stranded RNA hybridization probes specific for obligate replicative intermediates and antisera specific for virion or non-structural proteins were employed. Crandell feline kidney cells in which the ADV-G strain of ADV was permissively replicating contained virion and non-structural proteins, large amounts of single stranded virion DNA, duplex replicative form (RF) DNA, and mRNA. Late in the infectious cycle, however, cells containing non-structural proteins but little nucleic acid were observed, probably representing cells in the end stage of viral cytopathology. Sections of lung prepared from mink kits infected with the ADV-Utah 1 strain were then examined. Alveolar type II cells permissively replicating ADV contained viral nucleic acids and proteins in patterns nearly identical to CRFK cells, suggesting that permissive ADV replication was similar in vitro and in vivo. Another population of ADV containing cells that had cytoplasmic virion antigen, but undetectable levels of non-structural protein was found in vivo. Furthermore, although virion DNA was present in the cytoplasm of these cells, RF DNA or mRNA could not be detected. These cells may have been alveolar macrophages sequestering viral particles.
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Affiliation(s)
- S Mori
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana 59840
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McFadden ER, Pichurko BM, Bowman HF, Ingenito E, Burns S, Dowling N, Solway J. Thermal mapping of the airways in humans. J Appl Physiol (1985) 1985. [PMID: 3980358 DOI: 10.1063/1.335663] [Citation(s) in RCA: 68] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
To characterize the intrathoracic thermal events that occur during breathing in humans, we developed a flexible probe (OD 1.4 mm) containing multiple thermistors evenly spaced over 30.2 cm, that could be inserted into the tracheobronchial tree with a fiberoptic bronchoscope. With this device we simultaneously recorded the airstream temperature at six points from the trachea to beyond the subsegmental bronchi in six normal subjects while they breathed ambient and frigid air at multiple levels of ventilation (VE). During quiet breathing of room air the average temperature ranged from 32.0 +/- 0.05 degrees C in the upper trachea to 35.5 +/- 0.3 degrees C in the subsegmental bronchi. As ventilation was increased, the temperature along the airways progressively decreased, and at a VE of 100+ 1/min the temperature at the above two sites fell to 29.2 +/- 0.5 and 33.9 +/- 0.8 degrees C, respectively. Interval points were intermediate between these extremes. With cold air, the changes were considerably more profound. During quiet breathing, local temperatures approximated those recorded in the maximum VE room-air trial, and at maximum VE, the temperatures in the proximal and distal airways were 20.5 +/- 0.6 and 31.6 +/- 1.2 degrees C, respectively. During expiration, the temperature along the airways progressively decreased as the air flowed from the periphery of the lung to the mouth: the more the cooling during inspiration, the lower the temperature during expiration. These data demonstrate that in the course of conditioning inspired air the intrathoracic and intrapulmonic airways undergo profound thermal changes that extend well into the periphery of the lung.
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Abstract
To characterize the intrathoracic thermal events that occur during breathing in humans, we developed a flexible probe (OD 1.4 mm) containing multiple thermistors evenly spaced over 30.2 cm, that could be inserted into the tracheobronchial tree with a fiberoptic bronchoscope. With this device we simultaneously recorded the airstream temperature at six points from the trachea to beyond the subsegmental bronchi in six normal subjects while they breathed ambient and frigid air at multiple levels of ventilation (VE). During quiet breathing of room air the average temperature ranged from 32.0 +/- 0.05 degrees C in the upper trachea to 35.5 +/- 0.3 degrees C in the subsegmental bronchi. As ventilation was increased, the temperature along the airways progressively decreased, and at a VE of 100+ 1/min the temperature at the above two sites fell to 29.2 +/- 0.5 and 33.9 +/- 0.8 degrees C, respectively. Interval points were intermediate between these extremes. With cold air, the changes were considerably more profound. During quiet breathing, local temperatures approximated those recorded in the maximum VE room-air trial, and at maximum VE, the temperatures in the proximal and distal airways were 20.5 +/- 0.6 and 31.6 +/- 1.2 degrees C, respectively. During expiration, the temperature along the airways progressively decreased as the air flowed from the periphery of the lung to the mouth: the more the cooling during inspiration, the lower the temperature during expiration. These data demonstrate that in the course of conditioning inspired air the intrathoracic and intrapulmonic airways undergo profound thermal changes that extend well into the periphery of the lung.
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Pichurko BM, McFadden ER, Bowman HF, Solway J, Burns S, Dowling N. Influence of cromolyn sodium on airway temperature in normal subjects. Am Rev Respir Dis 1984; 130:1002-5. [PMID: 6439086 DOI: 10.1164/arrd.1984.130.6.1002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
It is well established that cromolyn sodium attenuates the bronchoconstriction induced by airway cooling in both normal and asthmatic subjects. To determine whether this protection derives from a modification of the thermal events that transpire during the conditioning of inspired air, we first recorded the effect of cromolyn on the bronchoconstrictor response to hyperventilation with frigid air in 7 normal subjects. On a separate occasion, we imposed the same thermal burden and measured the temperature at multiple sites within the airways before and after pretreatment with cromolyn. The first cold air challenge produced a significant decrease in forced expiratory volume in one second (FEV1) of 5.5 +/- 0.9% (SEM) and these changes were significantly reduced by cromolyn (FEV1 = 2.8 +/- 0.9%; p less than 0.05). In concert with the improvement in mechanics, the temperatures (T) within the trachea (tr) and the anterior segment of the right lower lobe (AS-RLL) were significantly higher after cromolyn (Ttr = 1.3 +/- 0.2 degrees C; p less than 0.01; TAS-RLL = 1.0 +/- 0.4 degrees C; p = 0.05), and there was a direct positive relationship between the mechanical protection offered by the drug and the increase in airway temperature (Spearman's rank correlation coefficient = 0.83; p = 0.05). These data suggest that cromolyn modifies respiratory heat exchange in such a fashion as to limit airway cooling. The mechanism of this action is not presently known but may reflect a direct or indirect influence on the bronchial vasculature.
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