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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, 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Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa 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Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Pitt J, Pandya A, Miller C, Dowling P. M006 DELAYED-ONSET ANAPHYLACTIC REACTION WITH HIGH FEVER AFTER AMOXICILLIN ORAL CHALLENGE AND NEGATIVE PENICILLIN SKIN TESTING. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abdenur JE, Sowa M, Simon M, Steenari M, Skaar J, Eftekharian S, Chang R, Ferdinandusse S, Pitt J. Medical nutrition therapy in patients with HIBCH and ECHS1 defects: Clinical and biochemical response to low valine diet. Mol Genet Metab Rep 2020; 24:100617. [PMID: 32642440 PMCID: PMC7334802 DOI: 10.1016/j.ymgmr.2020.100617] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/13/2020] [Accepted: 06/14/2020] [Indexed: 01/30/2023] Open
Affiliation(s)
- J E Abdenur
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA.,Department of Pediatrics, University of California Irvine, Orange, CA. USA
| | - M Sowa
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA
| | - M Simon
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA
| | - M Steenari
- Division of Neurology, CHOC Children's. Orange, CA, USA.,Department of Pediatrics, University of California Irvine, Orange, CA. USA
| | - J Skaar
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA
| | - S Eftekharian
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA
| | - R Chang
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA.,Department of Pediatrics, University of California Irvine, Orange, CA. USA
| | - S Ferdinandusse
- Departments of Clinical Chemistry and Pediatrics, Laboratory Genetic Metabolic Diseases, Amsterdam, the Netherlands
| | - J Pitt
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, AU, Australia
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Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Pitt J, Chan M, Gibson C, Hasselwander O, Lim A, Mukerji P, Mukherjea R, Myhre A, Sarela P, Tenning P, Himmelstein MW, Roper JM. Safety assessment of the biotechnologically produced human-identical milk oligosaccharide 3-Fucosyllactose (3-FL). Food Chem Toxicol 2019; 134:110818. [PMID: 31533061 DOI: 10.1016/j.fct.2019.110818] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 06/06/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 10/26/2022]
Abstract
3-Fucosyllactose (3-FL), a highly abundant complex carbohydrate in human breast milk, functions as a prebiotic promoting early microbial colonization of the gut, increasing pathogen resistance and modulating immune responses. To investigate potential health benefits, 3-FL was produced by fermentation using a genetically modified E. coli K12 strain. The safety assessment of 3-FL included acute oral toxicity, in vitro and in vivo assessment of genetic toxicity, and a subchronic rodent feeding study. 3-FL was not acutely toxic at 5000 mg/kg bw, and there was no evidence of genetic toxicity in the bacterial reverse mutation test and chromosomal aberration assay. There was a repeatable statistically-significant trend in the 4-h S9-activated test conditions in the in vitro micronucleus assay; the confirmatory in vivo mouse micronucleus study was negative at all doses. Dietary subchronic exposure of rats to 3-FL (5% and 10%) did not produce any statistical or biologically-relevant differences in growth, food intake or efficiency, clinical observations, or clinical or anatomic pathology changes at average daily intakes of 5.98 and 7.27 g/kg bw/day for males and females, respectively. The weight of evidence from these studies support the safe use of 3-FL produced using biotechnology as a nutritional ingredient in foods.
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Affiliation(s)
- J Pitt
- DuPont Nutrition and Biosciences, 1801 Larkin Center Drive, Midland, MI, 48674, USA.
| | - M Chan
- Corteva™, Agriscience™, P.O. Box 30, Newark, DE, 19714, USA
| | - C Gibson
- Total Pathology Solutions, LLC, Kennett Square, PA, 19348, USA
| | - O Hasselwander
- DuPont Nutrition and Biosciences, 43 London Road, Reigate, Surrey, RH2 9PW, UK
| | - A Lim
- DuPont Nutrition and Biosciences, 200 Powder Mill Road, Wilmington, DE, 19803, USA
| | - P Mukerji
- Corteva™, Agriscience™, P.O. Box 30, Newark, DE, 19714, USA
| | - R Mukherjea
- DuPont Nutrition and Biosciences, 4300 Duncan Ave, St. Louis MO, 63110, USA
| | - A Myhre
- Corteva™, Agriscience™, P.O. Box 30, Newark, DE, 19714, USA
| | - P Sarela
- DuPont Nutrition and Biosciences, Sokeritehtaanti 20, FI- 02460, Kantvik, FI, USA
| | - P Tenning
- DuPont Nutrition and Biosciences, Langebrogade 1, DK-1411, Copenhagen K, DE, USA
| | | | - J M Roper
- Corteva™, Agriscience™, P.O. Box 30, Newark, DE, 19714, USA
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Riddick SN, Hancock BR, Robinson AD, Connors S, Davies S, Allen G, Pitt J, Harris NRP. Development of a low-maintenance measurement approach to continuously estimate methane emissions: A case study. Waste Manag 2018; 73:210-219. [PMID: 28003116 DOI: 10.1016/j.wasman.2016.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/02/2016] [Accepted: 12/04/2016] [Indexed: 06/06/2023]
Abstract
The chemical breakdown of organic matter in landfills represents a significant source of methane gas (CH4). Current estimates suggest that landfills are responsible for between 3% and 19% of global anthropogenic emissions. The net CH4 emissions resulting from biogeochemical processes and their modulation by microbes in landfills are poorly constrained by imprecise knowledge of environmental constraints. The uncertainty in absolute CH4 emissions from landfills is therefore considerable. This study investigates a new method to estimate the temporal variability of CH4 emissions using meteorological and CH4 concentration measurements downwind of a landfill site in Suffolk, UK from July to September 2014, taking advantage of the statistics that such a measurement approach offers versus shorter-term, but more complex and instantaneously accurate, flux snapshots. Methane emissions were calculated from CH4 concentrations measured 700m from the perimeter of the landfill with observed concentrations ranging from background to 46.4ppm. Using an atmospheric dispersion model, we estimate a mean emission flux of 709μgm-2s-1 over this period, with a maximum value of 6.21mgm-2s-1, reflecting the wide natural variability in biogeochemical and other environmental controls on net site emission. The emissions calculated suggest that meteorological conditions have an influence on the magnitude of CH4 emissions. We also investigate the factors responsible for the large variability observed in the estimated CH4 emissions, and suggest that the largest component arises from uncertainty in the spatial distribution of CH4 emissions within the landfill area. The results determined using the low-maintenance approach discussed in this paper suggest that a network of cheaper, less precise CH4 sensors could be used to measure a continuous CH4 emission time series from a landfill site, something that is not practical using far-field approaches such as tracer release methods. Even though there are limitations to the approach described here, this easy, low-maintenance, low-cost method could be used by landfill operators to estimate time-averaged CH4 emissions and their impact downwind by simultaneously monitoring plume advection and CH4 concentrations.
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Affiliation(s)
- S N Riddick
- Centre for Atmospheric Science, Dept. of Chemistry, University of Cambridge, United Kingdom.
| | - B R Hancock
- Centre for Atmospheric Science, Dept. of Chemistry, University of Cambridge, United Kingdom
| | - A D Robinson
- Centre for Atmospheric Science, Dept. of Chemistry, University of Cambridge, United Kingdom
| | - S Connors
- Centre for Atmospheric Science, Dept. of Chemistry, University of Cambridge, United Kingdom
| | - S Davies
- Viridor Waste Management Limited, Peninsula House, Rydon Lane, Exeter, United Kingdom
| | - G Allen
- Centre for Atmospheric Science, University of Manchester, United Kingdom
| | - J Pitt
- Centre for Atmospheric Science, University of Manchester, United Kingdom
| | - N R P Harris
- Centre for Atmospheric Science, Dept. of Chemistry, University of Cambridge, United Kingdom
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El-Beialy H, Venn ML, Gangadharan S, Pitt J, Driver I, Malik A. TAMIS-ESD/EMR excision of a circumferential LST-G polyp in the mid and upper rectum - a video vignette. Colorectal Dis 2017; 19:947-948. [PMID: 28795773 DOI: 10.1111/codi.13845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 08/01/2017] [Indexed: 02/08/2023]
Affiliation(s)
- H El-Beialy
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - M L Venn
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - S Gangadharan
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - J Pitt
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - I Driver
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - A Malik
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
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Hettiarachchi TS, Askari A, Donelly E, Driver I, Pitt J, Malik A. Total mesorectal excision with Denonvilliers' fascia in anterior rectal tumours using taTME technique - a video vignette. Colorectal Dis 2017; 19:597-598. [PMID: 28419673 DOI: 10.1111/codi.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/23/2017] [Indexed: 02/08/2023]
Affiliation(s)
- T S Hettiarachchi
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - A Askari
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - E Donelly
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - I Driver
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - J Pitt
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
| | - A Malik
- Department of Colorectal Surgery, Ipswich Hospital NHS Trust, Ipswich, UK
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Olopade OI, Pitt JJ, Riester M, Odetunde A, Yoshimatsu T, Labrot E, Ademola A, Sanni A, Okedere B, Mahan S, Nwosu I, Leary R, Ajani M, Johnson RS, Sveen E, Zheng Y, Wang S, Fitzgerald DJ, Grundstad J, Tuteja J, Clayton W, Khramtsova G, Oludara M, Omodele F, Benson O, Adeoye A, Morhason-Bello O, Ogundiran T, Babalola C, Popoola A, Morrissey M, Chen L, Huo D, Falusi A, Winckler W, Obafunwa J, Papoutsakis D, Ojengbede O, White KP, Ibrahim N, Oluwasola O, Barretina J. Abstract PD8-05: Comparative analysis of the genomic landscape of breast cancers from women of African and European ancestry. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-pd8-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Objectives: Paucity of data on populations of African Ancestry in clinical trials continues to limit our ability to design and implement innovative solutions to narrow the breast cancer survival gap amongst Africans, African Americans, and European Americans. We have developed a cross-continent research infrastructure to examine the spectrum of genomic alterations in breast tumors from West Africa and subsequently, to compare them to tumors from African American women and women of European Ancestry in The Cancer Genome Atlas (TCGA) database.
Methods: Consecutive women with breast cancer presenting for treatment at the University College Hospital, Ibadan and at Lagos State University Teaching Hospital, Lagos, Nigeria gave informed consent and were recruited to the West African Breast Cancer Study (WABCS) between 2013-2016. Tumor-normal pairs were subjected to exome and/or high-depth (90x) genome sequencing. High confidence somatic mutations (substitutions, insertions/deletions and structural variants) were obtained by using multiple variant callers. Furthermore, 1,089 exomic and 80 genomic breast tumor-normal pairs from TCGA were harmonized with WABCS samples, resulting in a cohort of 147 West Africans (147 exome; 40 genome), 154 African Americans (154 exome; 31 genome), and 776 Caucasians (776 exome; 43 genome).
Results: Across the exomes, genes commonly altered in breast cancer in TCGA are also altered in women of African ancestry, but the mutational spectrum is quite different, demonstrating overrepresentation of tumors with aggressive phenotypes. Overall, TP53 (65%), ERBB2 (27%), and GATA3 (17%) showed statistically significant higher alteration frequencies in West Africans and African Americans. In contrast, PIK3CA (24%) was less frequently mutated. Of note, GATA3 mutation was statistically significantly more frequent in Nigerians (39%) and African Americans (16.7%) compared to Caucasians (10.5%), in ER-positive cancers. Analysis on Structural Variants (SV), on the other hand, has shown that the genome-wide SV counts among three populations are comparable in ER-negative cancers, while Nigerians have significantly more SV counts compared to African Americans (P=0.0013) or European Americans (P=2.9x10-5) in ER-positive cancers. Similarly, genome-wide substitution patterns in ER+ and ER- cancers varied widely by race/ethnicity. In ER- cases, West Africans carried the highest proportion of canonical APOBEC-associated substitutions, particularly C>T transitions. Conversely, European Americans with ER+ disease showed a higher proportion of C>T than both West Africans (Welch t-test P = 0.044) and African Americans (Welch t-test P = 0.011). Mutation signature analyses highlighted multiple APOBEC signatures, with notable contribution differences across ancestry and ER status. A signature likely corresponding to DNA damage repair correlated with the proportion of genetic ancestry, being most prevalent in European Americans and least common in Nigerians, particularly in ER-negative cancers, with African Americans showing a degree of this signature's contribution in between the two populations (linear model adjusted for age, P=1.0x10-10).
Conclusions: Overall, our data suggests mutation spectra differences in across race/ethnicity and geography. Identification of molecular characteristics such as higher rates of HER2 enriched tumors and higher rates of GATA3 mutations in ER positive tumors are beginning to reveal the genomic basis of race-associated phenotypes and outcomes in breast cancer. Population differences in frequency and spectrum of mutations should now inform the design of innovative clinical trials that improve health equity and accelerate Precision Oncology care in diverse populations.
Citation Format: Olopade OI, Pitt JJ, Riester M, Odetunde A, Yoshimatsu T, Labrot E, Ademola A, Sanni A, Okedere B, Mahan S, Nwosu I, Leary R, Ajani M, Johnson RS, Sveen E, Zheng Y, Wang S, Fitzgerald DJ, Grundstad J, Tuteja J, Clayton W, Khramtsova G, Oludara M, Omodele F, Benson O, Adeoye A, Morhason-Bello O, Ogundiran T, Babalola C, Popoola A, Morrissey M, Chen L, Huo D, Falusi A, Winckler W, Obafunwa J, Papoutsakis D, Ojengbede O, White KP, Ibrahim N, Oluwasola O, Barretina J. Comparative analysis of the genomic landscape of breast cancers from women of African and European ancestry [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 PD8-05.
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Affiliation(s)
- OI Olopade
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - JJ Pitt
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - M Riester
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - A Odetunde
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - T Yoshimatsu
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - E Labrot
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - A Ademola
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - A Sanni
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - B Okedere
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - S Mahan
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - I Nwosu
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - R Leary
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - M Ajani
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - RS Johnson
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - E Sveen
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Y Zheng
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - S Wang
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - DJ Fitzgerald
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - J Grundstad
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - J Tuteja
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - W Clayton
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - G Khramtsova
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - M Oludara
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - F Omodele
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - O Benson
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - A Adeoye
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - O Morhason-Bello
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - T Ogundiran
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - C Babalola
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - A Popoola
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - M Morrissey
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - L Chen
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - D Huo
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - A Falusi
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - W Winckler
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - J Obafunwa
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - D Papoutsakis
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - O Ojengbede
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - KP White
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - N Ibrahim
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - O Oluwasola
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - J Barretina
- Center for Global Health, The University of Chicago, Chicago, IL; Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL; Novartis Institutes for BioMedical Research, Cambridge, MA; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; University of Ibadan, Ibadan, Oyo, Nigeria; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; Oncology Unit, Lagos State University, Ikeja, Lagos, Nigeria; The University of Chicago, Chicago, IL, Nigeria; Centre for Population & Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
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Huo D, Hu H, Rhie SK, Gamazon ER, Cherniack AD, Liu J, Yoshimatsu TF, Pitt JJ, Hoadley KA, Troester M, Ru Y, Lichtenberg T, Sturtz LA, Shelley CS, Mills GB, Laird PW, Shriver CD, Perou CM, Olopade OI. Abstract P1-05-11: Comprehensive comparison of breast cancer molecular portraits by African and European ancestry in the cancer genome atlas. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-05-11] [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
Background: African American breast cancer patients have worse survival rates than European American patients. Although racial differences in the distribution of breast cancer intrinsic subtype are known, it is unclear if there are other inherent genomic differences contributing to this racial outcome disparity.
Methods: We defined patient race based on genomic ancestry and compared multiple molecular features of breast cancer between 154 black and 776 white patients in The Cancer Genome Atlas (TCGA). We examined the contribution of these molecular features to survival outcomes using Cox proportional hazards models. We also estimated the heritability of breast cancer subtypes using a mixed effect model.
Results: Compared to whites, black patients had higher odds of basal-like (odds ratio=3.80, p<0.001) and HER2-enriched (odds ratio=2.22, p=0.027) breast cancers in reference to luminal A subtype. Beyond differences in relative frequency of intrinsic subtypes, black and white patients had distinct gene expression, protein expression, and somatic mutation landscapes. However, the majority of these molecular differences were eliminated after adjusting for subtype; in the subtype-adjusted models, we found 142 genes, 16 methylation probes, 4 copy number segments, 1 protein, and no somatic mutation were differentially expressed or present between black and white patients. Using the top 40 differentially expressed genes, we built a race-enriched gene signature, which had excellent capacity of distinguishing breast tumors from black versus white patients (c-index=0.852 in the validation dataset). We also estimated the heritability of breast cancer subtype (basal vs. non-basal) to be 0.436 (p=1.5x10-14) and showed that two genetic variants (rs1078806 in FGFR2, rs34084277 in BABAM1) were associated with intrinsic subtype and can partially explain racial differences in subtype frequencies.
Conclusion: On the molecular level, once intrinsic subtype frequency differences are accounted for, there are few genomic or proteomic differences observed between blacks and whites. More than 40% of breast cancer subtype frequency differences may be due to genetic ancestry. These results suggest that future studies are warranted to investigate genetic and non-genetic factors that contribute to the development and progression of breast cancer subtypes in order to reduce racial disparity.
Citation Format: Huo D, Hu H, Rhie SK, Gamazon ER, Cherniack AD, Liu J, Yoshimatsu TF, Pitt JJ, Hoadley KA, Troester M, Ru Y, Lichtenberg T, Sturtz LA, Shelley CS, Mills GB, Laird PW, Shriver CD, Perou CM, Olopade OI. Comprehensive comparison of breast cancer molecular portraits by African and European ancestry in the cancer genome atlas [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 P1-05-11.
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Affiliation(s)
- D Huo
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - H Hu
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - SK Rhie
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - ER Gamazon
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - AD Cherniack
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - J Liu
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - TF Yoshimatsu
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - JJ Pitt
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - KA Hoadley
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - M Troester
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - Y Ru
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - T Lichtenberg
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - LA Sturtz
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - CS Shelley
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - GB Mills
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - PW Laird
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - CD Shriver
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - CM Perou
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
| | - OI Olopade
- University of Chicago; Chan Soon-Shiong Institute of Molecular Medicine at Windber; University of Southern California; Vanderbilt University; The Eli and Edythe L. Broad Institute of MIT and Harvard; University of North Carolina at Chapel Hill; Nationwide Children's Hospital, Columbus; University of Wisconsin; University of Texas MD Anderson Cancer Center; Van Andel Research Institute; Walter Reed National Military Medical Center
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Pisso I, Myhre CL, Platt SM, Eckhardt S, Hermansen O, Schmidbauer N, Mienert J, Vadakkepuliyambatta S, Bauguitte S, Pitt J, Allen G, Bower KN, O'Shea S, Gallagher MW, Percival CJ, Pyle J, Cain M, Stohl A. Constraints on oceanic methane emissions west of Svalbard from atmospheric in situ measurements and Lagrangian transport modeling. J Geophys Res Atmos 2016; 121:14188-14200. [PMID: 28261536 PMCID: PMC5310218 DOI: 10.1002/2016jd025590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/08/2016] [Accepted: 11/13/2016] [Indexed: 06/06/2023]
Abstract
Methane stored in seabed reservoirs such as methane hydrates can reach the atmosphere in the form of bubbles or dissolved in water. Hydrates could destabilize with rising temperature further increasing greenhouse gas emissions in a warming climate. To assess the impact of oceanic emissions from the area west of Svalbard, where methane hydrates are abundant, we used measurements collected with a research aircraft (Facility for Airborne Atmospheric Measurements) and a ship (Helmer Hansen) during the Summer 2014 and for Zeppelin Observatory for the full year. We present a model-supported analysis of the atmospheric CH4 mixing ratios measured by the different platforms. To address uncertainty about where CH4 emissions actually occur, we explored three scenarios: areas with known seeps, a hydrate stability model, and an ocean depth criterion. We then used a budget analysis and a Lagrangian particle dispersion model to compare measurements taken upwind and downwind of the potential CH4 emission areas. We found small differences between the CH4 mixing ratios measured upwind and downwind of the potential emission areas during the campaign. By taking into account measurement and sampling uncertainties and by determining the sensitivity of the measured mixing ratios to potential oceanic emissions, we provide upper limits for the CH4 fluxes. The CH4 flux during the campaign was small, with an upper limit of 2.5 nmol m-2 s-1 in the stability model scenario. The Zeppelin Observatory data for 2014 suggest CH4 fluxes from the Svalbard continental platform below 0.2 Tg yr-1. All estimates are in the lower range of values previously reported.
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Affiliation(s)
- I. Pisso
- NILU‐Norwegian Institute for Air ResearchKjellerNorway
| | - C. Lund Myhre
- NILU‐Norwegian Institute for Air ResearchKjellerNorway
| | - S. M. Platt
- NILU‐Norwegian Institute for Air ResearchKjellerNorway
| | - S. Eckhardt
- NILU‐Norwegian Institute for Air ResearchKjellerNorway
| | - O. Hermansen
- NILU‐Norwegian Institute for Air ResearchKjellerNorway
| | | | - J. Mienert
- Centre for Arctic Gas Hydrate, Environment and Climate, Department of GeologyUiT‐The Arctic University of NorwayTromsøNorway
| | - S. Vadakkepuliyambatta
- Centre for Arctic Gas Hydrate, Environment and Climate, Department of GeologyUiT‐The Arctic University of NorwayTromsøNorway
| | - S. Bauguitte
- FAAMNatural Environment Research CouncilCranfieldUK
| | - J. Pitt
- School of Earth, Atmospheric and Environmental SciencesUniversity of ManchesterManchesterUK
| | - G. Allen
- School of Earth, Atmospheric and Environmental SciencesUniversity of ManchesterManchesterUK
| | - K. N. Bower
- School of Earth, Atmospheric and Environmental SciencesUniversity of ManchesterManchesterUK
| | - S. O'Shea
- School of Earth, Atmospheric and Environmental SciencesUniversity of ManchesterManchesterUK
| | - M. W. Gallagher
- School of Earth, Atmospheric and Environmental SciencesUniversity of ManchesterManchesterUK
- National Centre for Atmospheric ScienceUK
| | - C. J. Percival
- School of Earth, Atmospheric and Environmental SciencesUniversity of ManchesterManchesterUK
| | - J. Pyle
- National Centre for Atmospheric ScienceUK
- Department of ChemistryUniversity of CambridgeCambridgeUK
| | - M. Cain
- National Centre for Atmospheric ScienceUK
- Department of ChemistryUniversity of CambridgeCambridgeUK
| | - A. Stohl
- NILU‐Norwegian Institute for Air ResearchKjellerNorway
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Bauquier J, Stent A, Gibney J, Jerrett I, White J, Tennent-Brown B, Pearce A, Pitt J. Evidence for marsh mallow (Malva parviflora
) toxicosis causing myocardial disease and myopathy in four horses. Equine Vet J 2016; 49:307-313. [DOI: 10.1111/evj.12604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/21/2016] [Indexed: 12/31/2022]
Affiliation(s)
- J. Bauquier
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - A. Stent
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - J. Gibney
- Victorian Department of Environment and Primary Industries; Bundoora Victoria Australia
| | - I. Jerrett
- Victorian Department of Environment and Primary Industries; Bundoora Victoria Australia
| | - J. White
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Parkville Victoria Australia
| | - B. Tennent-Brown
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - A. Pearce
- Golden Plains Equine; Bannockburn Victoria Australia
| | - J. Pitt
- Victorian Clinical Genetics Services; Royal Children's Hospital; Melbourne Victoria Australia
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Barends M, Pitt J, Morrissy S, Tzanakos N, Boneh A. Biochemical and molecular characteristics of patients with organic acidaemias and urea cycle disorders identified through newborn screening. Mol Genet Metab 2014; 113:46-52. [PMID: 25047749 DOI: 10.1016/j.ymgme.2014.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 07/03/2014] [Accepted: 07/03/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND In recent years it has become clear that newborn screening (NBS) programmes using tandem mass spectrometry identify "patients" with "classical" inborn errors of metabolism who are asymptomatic. This observation raises issues regarding medicalization of "non-diseases," potentially unnecessary treatment and unnecessary anxiety to parents. AIMS This study aims to identify possible markers that may assist in predicting the need for treatment of infants with "classical" organic acidaemias (OA) and urea cycle disorders (UCD) diagnosed through NBS. METHODS Medical records of all patients with classical OA and UCD detected through the Victorian NBS programme from February 2002 to January 2014, or diagnosed clinically between 1990 and January 2002 were retrospectively reviewed. RESULTS Neonatal presentation did not always predict the need for on-going strict treatment. Blood concentrations of amino acids and acyl-carnitines and the changes thereof in follow-up samples correlated with severity in citrullinaemia-I, possibly isovaleric acidaemia but not in argininosuccinic aciduria or propionic acidaemia. Some specific mutations correlate with "attenuated" citrullinaemia-I. Gender may affect clinical outcome in propionic acidaemia. CONCLUSIONS Changes in blood concentration of certain metabolites (amino acids, acyl-carnitines) in the first weeks of life may be predictive of the need for treatment in some disorders but not in others. Mutation analysis may be predictive in some disorders but whether or not this should be considered as second-tier testing in NBS should be discussed separately.
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Affiliation(s)
- M Barends
- Metabolic Research, Murdoch Childrens Research Institute, and Victorian Clinical Genetics Services, Royal Children's Hospital, Melbourne, Australia; Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J Pitt
- Metabolic Research, Murdoch Childrens Research Institute, and Victorian Clinical Genetics Services, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - S Morrissy
- Metabolic Research, Murdoch Childrens Research Institute, and Victorian Clinical Genetics Services, Royal Children's Hospital, Melbourne, Australia
| | - N Tzanakos
- Metabolic Research, Murdoch Childrens Research Institute, and Victorian Clinical Genetics Services, Royal Children's Hospital, Melbourne, Australia
| | - A Boneh
- Metabolic Research, Murdoch Childrens Research Institute, and Victorian Clinical Genetics Services, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Pitt J, Becker AB, Kozyrskyj A. Characteristics of atopic asthma and non-atopic asthma in the Study of Asthma, Genes and the Environment (SAGE) Cohort at 11-13 years. Allergy Asthma Clin Immunol 2010. [PMCID: PMC3353463 DOI: 10.1186/1710-1492-6-s3-p6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yaplito-Lee J, Pitt J, Meijer J, Zoetekouw L, Meinsma R, van Kuilenburg ABP. Beta-ureidopropionase deficiency presenting with congenital anomalies of the urogenital and colorectal systems. Mol Genet Metab 2008; 93:190-4. [PMID: 17964839 DOI: 10.1016/j.ymgme.2007.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 09/13/2007] [Accepted: 09/13/2007] [Indexed: 10/22/2022]
Abstract
Beta-ureidopropionase deficiency (McKusick 606673) is an autosomal recessive condition caused by mutations in the UPB1 gene. To date, five patients have been reported, including one putative case detected through newborn screening. Clinical presentation includes neurological and developmental problems. Here, we report another case of beta-ureidopropionase deficiency who presented with congenital anomalies of the urogenital and colorectal systems and with normal neurodevelopmental milestones. Analysis of a urine sample, because of the suspicion of renal stones on ultrasound, showed strongly elevated levels of the characteristic metabolites, N-carbamyl-beta-amino acids. Subsequent analysis of UPB1 identified a novel mutation 209 G>C (R70P) in exon 2 and a previously reported splice receptor mutation IVS1-2A>G. Expression studies of the R70P mutant enzyme showed that the mutant enzyme did not possess any residual activity. Long-term follow-up is required to determine the clinical significance of the beta-ureidopropionase deficiency in our patient.
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Affiliation(s)
- J Yaplito-Lee
- Metabolic Service, Genetic Health Services Victoria, Royal Children's Hospital, Melbourne, Vic. 3052, Australia.
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16
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Pitt J, Myer L, Wood R. Quality of life of HIV-infected individuals in a community-based antiretroviral programme. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p159] [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: 11/10/2022] Open
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17
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Boneh A, Andresen BS, Gregersen N, Ibrahim M, Tzanakos N, Peters H, Yaplito-Lee J, Pitt JJ. VLCAD deficiency: pitfalls in newborn screening and confirmation of diagnosis by mutation analysis. Mol Genet Metab 2006; 88:166-70. [PMID: 16488171 DOI: 10.1016/j.ymgme.2005.12.012] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2005] [Revised: 12/21/2005] [Accepted: 12/21/2005] [Indexed: 11/15/2022]
Abstract
We diagnosed six newborn babies with very long-chain acyl-CoA dehydrogenase deficiency (VLCADD) through newborn screening in three years in Victoria (prevalence rate: 1:31,500). We identified seven known and two new mutations in our patients (2/6 homozygotes; 4/6 compound heterozygotes). Blood samples taken at age 48-72 h were diagnostic whereas repeat samples at an older age were normal in 4/6 babies. Urine analysis was normal in 5/5. We conclude that the timing of blood sampling for newborn screening is important and that it is important to perform mutation analysis to avoid false-negative diagnoses of VLCADD in asymptomatic newborn babies. In view of the emerging genotype-phenotype correlation in this disorder, the information derived from mutational analysis can be helpful in designing the appropriate follow-up and therapeutic regime for these patients.
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Affiliation(s)
- A Boneh
- Metabolic Service and Newborn Screening Laboratory, Genetic Health Services Victoria, Melbourne, Australia.
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Abstract
BACKGROUND This study aimed to determine the reasons for dentists' choice of materials, in particular amalgam and resin composite, in Australia. METHOD A questionnaire was developed to elicit this information. The names and addresses of 1000 dentists in Australia were selected at random. The questionnaire was mailed to these dentists with an explanatory letter and reply-paid envelope. RESULTS A total of 560 replies were received. Regarding choice of material, 99 per cent of respondents cited clinical indication as an influencing factor, although patients' aesthetic demands (99 per cent of respondents), patients' wish (96 per cent), patients' financial situation (82 per cent), and lecturers' suggestions (72 per cent) were also reported to influence respondents' choice of materials. Twelve per cent of respondents used composite 'always', 29 per cent 'often', 32 per cent 'sometimes', 23 per cent 'seldom' and 4 per cent 'never' in extensive load-bearing cavities in molar teeth. For composite restorations in posterior teeth, 84 per cent 'always', 'often' or 'sometimes' used the total etch technique, 84 per cent used a thick glass-ionomer layer and 36 per cent never used rubber dam. Fifty-nine per cent of respondents reported a decreased use of amalgam over the previous five years. Sixty-eight per cent of respondents agreed with the statement 'discontinuation of amalgam restricts a dentist's ability to adequately treat patients'. Seventy-five per cent considered that the growth in the use of composites increased the total cost of oral health care. CONCLUSIONS Of the respondents from Australia 73 per cent place large composite restorations in molar teeth and their choice of material is influenced greatly by clinical indications, and patients' aesthetic demands.
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Affiliation(s)
- F J T Burke
- Primary Dental Care Research Group, School of Dentistry, The University of Birmingham, Birmingham, UK.
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Abstract
As well as characteristic increases in C(8) carnitine, dried blood spot samples from 11 newborns with medium-chain acyl-CoA dehydrogenase deficiency detected by tandem mass spectrometry screening using butyl esters showed apparent increases in glutarylcarnitine (m / z 388 signals). In four of the newborns in which it was measured, apparent increases in malonylcarnitine (m / z 360) were also detected. It was shown that the apparent increases were caused by interfering acylcarnitines, putatively identified as hydroxyoctanoylcarnitine and hydroxydecanoylcarnitine, respectively, using alternative derivatives for tandem mass spectrometry. Levels of the two abnormal carnitines correlated with C(8) carnitine levels and normalized with repeat testing in 10 cases. These results indicated that the abnormal carnitines were significantly elevated only during periods of increased fatty acid catabolism, as may occur in the immediate postnatal period.
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Affiliation(s)
- N Napolitano
- Genetic Health Services Victoria, Murdoch Children's Research Institute, Parkville, Vic. 3052, Australia
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Pitt J, Carpenter K, Wilcken B, Boneh A. 3-Hydroxyglutarate excretion is increased in ketotic patients: implications for glutaryl-CoA dehydrogenase deficiency testing. J Inherit Metab Dis 2002; 25:83-8. [PMID: 12118531 DOI: 10.1023/a:1015654608166] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Three patients with ketosis had increased excretion of 3-hydroxyglutarate (21.8-37.9 micromol/mmol creatinine; controls 2.3 +/- 1.6), an indicator of glutaryl-CoA dehydrogenase deficiency (GDHD), which normalized when the patients were nonketotic. Clinical assessment of all three patients and enzyme studies in one patient were not consistent with GDHD. These findings were compared with those of other ketotic patients, who showed statistically significant increases in 3-hydroxyglutarate excretion (9.4 +/- 5.0 micromol/mmol creatinine; p < 0.01), and with those of a child with confirmed GDHD when she was both ketotic and nonketotic. Secondary increase in 3-hydroxyglutarate excretion during ketosis is a potential confounder in the diagnosis of GDHD.
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Affiliation(s)
- J Pitt
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Parkville, Australia.
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Abstract
OBJECTIVE: Diltiazem is a calcium channel blocker that has shown potential to heal chronic anal fissures. We have prospectively evaluated the treatment of patients with anal fissure with diltiazem gel (SLA Pharma, UK). PATIENTS AND METHODS: All patients with chronic anal fissure from September 1999 to May 2000 were treated topically with 8 mg 2% diltiazem hydrochloride gel (equivalent to 2 cm of gel supplied by SLA Pharma) three times daily. The 23 patients (12 female), median age 45 (range 22-80) years had a 2-36 month (median 6 months) history of fissure. These were associated with a sentinel tag in 9 (39%) patients. RESULTS: The fissure healed in 11 (48%) of 23 patients, including 6 (75%) of 8 patients who previously failed to heal with GTN ointment. There were no recurrences at 3 months and no adverse effects. Of the 12 patients who did not respond to diltiazem, 4 have undergone sphincterotomy. CONCLUSION: Diltiazem gel has a healing rate similar to that observed with GTN ointment but there were no adverse effects, the recurrence rate was lower, and diltiazem was effective in 75% of patients previously treated unsuccessfully with GTN ointment.
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Affiliation(s)
- R. DasGupta
- Department of Colorectal Surgery, West Middlesex University Hospital, Isleworth, UK, Chelsea and Westminster Hospital NHS Trust, Suffolk, UK, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK
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Abstract
Molybdenum cofactor deficiency is a rare inborn error of metabolism with generally severe symptoms, most often including neonatal seizures and severe developmental delay. We describe a patient with an unusually mild form of the disease. Two mutations in MOCS2A (molybdenum cofactor synthesis enzyme 2A) were identified: a single base change, 16C > T, that predicts a Q6X substitution on one allele and a 19G > T transversion that predicts a valine to phenylalanine substitution, V7F, on the second. It is postulated that the milder clinical symptoms result from a low level of residual molybdopterin synthase activity derived from the 19G > T allele.
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Affiliation(s)
- J L Johnson
- Department of Biochemistry, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Wallis TP, Pitt JJ, Gorman JJ. Identification of disulfide-linked peptides by isotope profiles produced by peptic digestion of proteins in 50% (18)O water. Protein Sci 2001; 10:2251-71. [PMID: 11604532 PMCID: PMC2374058 DOI: 10.1110/ps.15401] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Determination of the disulfide-bond arrangement of a protein by characterization of disulfide-linked peptides in proteolytic digests may be complicated by resistance of the protein to specific proteases, disulfide interchange, and/or production of extremely complex mixtures by less specific proteolysis. In this study, mass spectrometry has been used to show that incorporation of (18)O into peptides during peptic digestion of disulfide-linked proteins in 50% (18)O water resulted in isotope patterns and increases in average masses that facilitated identification and characterization of disulfide-linked peptides even in complex mixtures, without the need for reference digests in 100% (16)O water. This is exemplified by analysis of peptic digests of model proteins lysozyme and ribonuclease A (RNaseA) by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) and electrospray ionization (ESI) mass spectrometry (MS). Distinct isotope profiles were evident when two peptide chains were linked by disulfide bonds, provided one of the chains did not contain the C terminus of the protein. This latter class of peptide, and single-chain peptides containing an intrachain disulfide bond, could be identified and characterized by mass shifts produced by reduction. Reduction also served to confirm other assignments. Isotope profiling of peptic digests showed that disulfide-linked peptides were often enriched in the high molecular weight fractions produced by size exclusion chromatography (SEC) of the digests. Applicability of these procedures to analysis of a more complex disulfide-bond arrangement was shown with the hemagglutinin/neuraminidase of Newcastle disease virus.
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Affiliation(s)
- T P Wallis
- Biomolecular Research Institute, Parkville VIC 3052, Australia
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Acosta EP, Zorrilla C, Van Dyke R, Bardeguez A, Smith E, Hughes M, Huang S, Pitt J, Watts H, Mofenson L. Pharmacokinetics of saquinavir-SGC in HIV-infected pregnant women. HIV Clin Trials 2001; 2:460-5. [PMID: 11742433 DOI: 10.1310/puy3-5jwl-fx2b-98vu] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate saquinavir (SQV) pharmacokinetics, tolerance, and safety in 10 HIV-infected pregnant women between 14-32 weeks gestation. METHOD This was a phase I, prospective, area-under-the-curve (AUC) targeted study. Antepartum treatment consisted of SQV 1200 mg tid, lamivudine 150 mg bid, and zidovudine 200 mg tid. The SQV targeted exposure was an 8-hour AUC (AUC(8)) of 3000 ng. h/mL; the study was to be halted if the first 4 participants did not achieve this AUC(8). Cord blood and plasma samples were collected in neonates at birth. RESULTS Four women completed the SQV pharmacokinetic assessments. Exposure in all 4 patients was below the target AUC(8). Median (range) AUC(8) and trough (C8H) were 1672 (738-2614) ng. h/mL and 60 (<15-332) ng/mL, respectively. Oral clearance (CL/F) was 9.3 (5.1-16.6) L/h/kg and C(max) was 599 (177-953) ng/mL. Cord and neonate plasma concentrations were mostly undetectable; 1 of 5 infants was HIV-infected at 24 weeks. CONCLUSION These data suggest highly variable SQV pharmacokinetics in pregnant women, and exposure at 1200 mg tid may not be adequate for longer term therapy; both the AUC(8) and C8H were considerably below average. Because ritonavir has been shown to significantly increase SQV concentrations, this combination should be further explored in this population.
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Affiliation(s)
- E P Acosta
- Division of Clinical Pharmacology, University of Alabama at Birmingham, 35294-0019, USA.
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25
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Newton JT, Thorogood N, Bhavnani V, Pitt J, Gibbons DE, Gelbier S. Barriers to the use of dental services by individuals from minority ethnic communities living in the United Kingdom: findings from focus groups. Prim Dent Care 2001; 8:157-61. [PMID: 11799714 DOI: 10.1308/135576101322462228] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe the barriers identified by individuals from minority ethnic communities resident in the United Kingdom to their use of dental services. METHOD Focus group discussions were held with individuals from minority ethnic groups. Data were analysed using the technique of content analysis on the basis of categories defined by the researchers. FINDINGS Barriers to regular attendance identified by participants included: language, a mistrust of dentists, cost, anxiety, cultural misunderstandings, concern about standards of hygiene. The type of barrier identified differed between ethnic groups, though mistrust of dentists was common to all groups. CONCLUSIONS The findings confirm previous research identifying barriers to the use of dental services. However, for the first time in the United Kingdom, it has been suggested that the nature of the perceived barriers varies across ethnic groups. These findings have implications for attempts to increase use of dental services among individuals from minority ethnic communities.
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Affiliation(s)
- J T Newton
- Division of Dental Public Health & Oral Health Services Research, GKT Dental Institute, London.
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26
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Abstract
PURPOSE Although glyceryl trinitrate ointment has become the first-line treatment for chronic anal fissure, healing rates are lower than after lateral internal sphincterotomy. The purpose of this study was to identify which factors are associated with treatment failure of glyceryl trinitrate ointment. METHODS All patients who presented with chronic anal fissure from March 1997 to November 1998 were treated with 0.2 percent glyceryl trinitrate ointment. They were prospectively evaluated until healing or lateral internal sphincterotomy occurred, and long-term follow-up was obtained by standardized telephone questionnaire. A Cox model multivariate analysis was used with seven variables to determine significant factors related to healing. RESULTS Sixty-four patients (42 men and 22 women; mean age, 37.5 years) with chronic fissure-in-ano were treated with 0.2 percent glyceryl trinitrate ointment. Sentinel piles were observed in 19 patients (29.7 percent). Twenty-six patients (40.6 percent) were healed initially, but 12 (46.2 percent) experienced recurrence. Mean follow-up time was 15.6 (+/-5.5) months. Twenty-nine patients (45.3 percent) had known risk factors for anal fissure, including constipation (n = 21; 32.8 percent), recent childbirth (n = 6; 9.3 percent), colonoscopy (n = 1; 1.6 percent), and anoreceptive intercourse (n = 1; 1.6 percent). Fissures were significantly less likely to heal initially (P < 0.05), more likely to recur (P < 0.05), and more likely to remain unhealed in the long term (P < 0.05) in the presence of a sentinel pile. Fissures with a history of more than six months were less likely to heal initially (P < 0.05). CONCLUSION The presence of a sentinel pile adversely affects the outcome of treatment of chronic anal fissures with glyceryl trinitrate ointment, and a long history of the fissure reduces the rate of initial healing. Reasons for these findings are discussed.
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Affiliation(s)
- J Pitt
- Colorectal Surgical Unit, West Middlesex University Hospital NHS Trust, Isleworth, Middlesex, United Kingdom
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27
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Abstract
BACKGROUND Indoramin is an alpha1-adrenoceptor antagonist and has been shown to reduce anal resting pressure. Its therapeutic potential has not been explored. The aim of this study was to determine the outcome of treatment with oral indoramin on patients with chronic anal fissure in the setting of a double-blind randomized placebo-controlled trial. METHODS Twenty-three patients with chronic anal fissure were computer randomized to receive a 6-week course of oral indoramin (20 mg) or placebo in identical capsules, twice daily and with bulk-forming laxatives. Pain was assessed by a visual analogue scale from 0 to 10. Anal resting pressure, heart rate and blood pressure were recorded. Patients were reviewed 1 h after taking the capsule and at 2, 6 and 12 weeks thereafter. RESULTS Fourteen patients were randomized to indoramin and 9 to placebo. Maximum anal resting pressure was reduced from a mean of 96.4 cm H2O (+/- 32) to 67.6 cm H2O (+/- 26), 1 h after indoramin (P=0.02) and there was no significant change after placebo. There were no significant changes in heart rate or blood pressure. Pain was reduced in the placebo group from a score of 4.9 to 2.0 after 6 weeks (P < 0.01) but not in the indoramin group. After 6 weeks, healing had occurred in one (7%) patient in the indoramin group and in 2 (22%) in the placebo group (P > 0.1). After 3 months, the chronic anal fissure in the indoramin group had recurred. The trial was terminated early because of poor healing rates. CONCLUSION An oral dose of indoramin (20 mg) administered twice daily reduced anal resting pressure by 30% compared with pretreatment levels but was ineffective in healing chronic anal fissures.
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Affiliation(s)
- J Pitt
- Department of Surgery, West Middlesex University Hospital, Isleworth, UK
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28
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Schofield A, Pitt J, Biring G, Dawson PM. Oophorectomy in primary colorectal cancer. Ann R Coll Surg Engl 2001; 83:81-4. [PMID: 11320934 PMCID: PMC2503332] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Colorectal cancer is a common cancer affecting women which may metastasize to the ovaries. We present five cases of ovarian metastases requiring surgery and review the debate regarding oophorectomy at the primary resection for colorectal cancer. Although prophylactic oophorectomy has not been proven to affect survival, further surgery for symptomatic ovarian metastases may be avoided and the increased risk of developing primary ovarian cancer is abolished.
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Affiliation(s)
- A Schofield
- Colorectal Surgical Unit, West Middlesex University Hospital NHS Trust, Twickenham Road, Isleworth, Middlesex TW7 6AF, UK
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29
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Abstract
Medium chain acyl-coenzyme A dehydrogenase (MCAD) deficiency classically presents as hypoketotic hypoglycemia. Under-production of ketones has been presumed to be the cause of hypoketosis, but this has never been proven. Stable isotope dilution studies of ketone kinetics were performed on three well children with homozygous 985G MCAD deficiency using 1,3-13C2 sodium acetoacetate and 1,2,3,4-13C4 sodium 3-hydroxybutyrate to ascertain the rates of ketone production, interconversion, and use. All children were fasted for 9 to 11.5 hours before the beginning of the study period. Euglycemia was maintained in all cases. Ketone kinetics were calculated using a two-accessible pool model and showed normal ketone production in all three children compared with published control data from children fasted for a similar length of time. There is no evidence for underproduction or overuse of ketones in these MCAD-deficient children, at least when they are well. We propose that another factor, such as fever, may be required to reduce ketone production and result in the biochemical phenotype recognized in unwell children.
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Affiliation(s)
- J M Fletcher
- Murdoch Institute and Department of Clinical Biochemistry, Royal Children's Hospital, Parkville, Victoria, Australia
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30
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Daar ES, Little S, Pitt J, Santangelo J, Ho P, Harawa N, Kerndt P, Glorgi JV, Bai J, Gaut P, Richman DD, Mandel S, Nichols S. Diagnosis of primary HIV-1 infection. Los Angeles County Primary HIV Infection Recruitment Network. Ann Intern Med 2001; 134:25-9. [PMID: 11187417 DOI: 10.7326/0003-4819-134-1-200101020-00010] [Citation(s) in RCA: 149] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The optimal approach for diagnosing primary HIV-1 infection has not been defined. OBJECTIVE To determine the usefulness of symptoms and virologic tests for diagnosing primary HIV-1 infection. DESIGN Prospective cohort study. SETTING A teaching hospital in Los Angeles and a university research center in San Diego, California. PATIENTS 436 patients who had symptoms consistent with primary HIV infection. MEASUREMENTS Clinical information and levels of HIV antibody, HIV RNA, and p24 antigen. RESULTS Primary infection was diagnosed in 54 patients (12.4%). The sensitivity and specificity of the p24 antigen assay were 88.7% (95% CI, 77.0% to 95.7%) and 100% (CI, 99.3% to 100%), respectively. For the HIV RNA assay, sensitivity was 100% and specificity was 97.4% (CI, 94.9% to 98.9%). Fever, myalgia, rash, night sweats, and arthralgia occurred more frequently in patients with primary infection (P < 0.05). CONCLUSIONS No sign or symptom allows targeted screening for primary infection. Although assays for HIV RNA are more sensitive than those for p24 antigen in diagnosing primary infection, they are more expensive and are more likely to yield false-positive results.
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Affiliation(s)
- E S Daar
- Cedars-Sinai Burns & Allen Research Institute, University of California, Los Angeles, USA.
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Abstract
OBJECTIVE To determine the self-assessed oral health status of individuals from minority ethnic communities living in South London. METHOD A sample of 1,057 individuals from minority ethnic communities (as defined by Office of Censuses and Surveys categories) resident in South London were asked to complete measures of their oral and facial symptoms, the impact of their oral health on their daily functioning and of their satisfaction with the appearance of their teeth and gums. MEASURES Self-assessed oral health status was determined by means of two short scales addressing oral symptoms and the impact of oral health on activities of daily living. Satisfaction with the appearance of the teeth and gums was also assessed. FINDINGS No significant differences were found between minority ethnic communities in the number of symptoms reported, in the level of impact which such symptoms cause, or in their dissatisfaction with the appearance of their teeth and gums. Reporting of symptoms and impact were mildly though significantly correlated with dissatisfaction. CONCLUSIONS There appears to be little difference between ethnic communities in their reporting of oral and facial symptoms, though these groups report higher levels of dissatisfaction with the appearance of their teeth and gums. Social and demographic factors play an important role in determining perceptions of oral health. The findings should be interpreted with caution given the difficulty of sampling minority ethnic communities and the subsequent limited representativeness of the sample.
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Affiliation(s)
- J T Newton
- Division of Dental Public Health & Oral Health Services Research, Guy's Hospital, Guy's King's & St. Thomas' Dental Institute, London, UK.
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32
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Schubert C, Schisa J, Pitt J, Priess J. ABSTRACT Germline/soma asymmetry in Caenorhabditis elegans. Biochem Cell Biol 2000. [DOI: 10.1139/o00-045] [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: 11/22/2022] Open
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33
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Pitt J, Henrard D, FitzGerald G, Mofenson L, Lew J, Hillyer G, Mendez H, Cooper E, Hanson C, Rich KC. Human immunodeficiency virus (HIV) type 1 antibodies in perinatal HIV-1 infection: association with human HIV-1 transmission, infection, and disease progression. For the Women and Infants Transmission Study. J Infect Dis 2000; 182:1243-6. [PMID: 10979926 DOI: 10.1086/315809] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 01/27/2000] [Revised: 06/22/2000] [Indexed: 11/03/2022] Open
Abstract
Anti -human immunodeficiency virus (HIV) type 1 antibodies in 242 pregnant women and 238 infants were measured at birth and at 1, 2, 4, and 6 months after birth, to estimate their association with perinatal transmission and infant disease progression. Maternal anti-p24 (P=.01) and anti-gp120 (P=.04) antibodies were inversely associated with vertical transmission rates, independent of maternal percentage of CD4 cells, hard drug use, duration of ruptured membranes, serum albumin levels, serum vitamin A levels, and quantitative HIV-1 peripheral mononuclear blood cell culture, but not with maternal plasma immune complex dissociated p24 or HIV-1 RNA copy number, both of which were highly correlated with antibodies. From ages 1-2 months, anti-gp120, -gp41, -p31, and -p66 decayed to a greater extent in infected than in uninfected infants. Infected infants produced anti-p24 antibody by age 2 months, anti-p17 by 4 months, and anti-p41 and anti-gp120 by 6 months. As early as birth, infants with rapid disease progression had lower levels of anti-p24 than did infants whose disease did not rapidly progress, but not independently of HIV-1 RNA levels.
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Affiliation(s)
- J Pitt
- Columbia University College of Physicians and Surgeons, Dept. of Pediatrics, Division of Infectious Diseases, New York, NY 10032, USA.
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34
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Abstract
PURPOSE Patients with chronic anal fissures are known to have high resting anal pressures that return to normal after successful surgical treatment. Internal anal sphincter activity is increased by sympathetic excitatory innervation via alpha adrenoceptors. The objective of this study was to determine the effect of alpha-1 adrenoceptor blockade on anal sphincter pressure in patients with and without chronic anal fissures. METHODS The effect on the anal canal pressure profile of a single oral 20 mg dose of indoramin, an alpha-1 adrenoceptor antagonist, on seven patients with chronic anal fissure and six healthy patients without a fissure was investigated. RESULTS Indoramin reduced anal resting pressures in those with anal fissure by a mean of 35.8 percent, from 106.9 +/- 22.15 cm H2O to 68.6 +/- 20.35 cm H2O, and in those without anal fissure by a mean of 39.9 percent, from 84.17 +/- 27.46 cm H2O to 52.17 +/- 24.78 cm H2O, after one hour. This pressure reduction persisted at three hours, and its magnitude is comparable to that obtained after internal sphincterotomy. The pressure reduction occurred over the whole length of the anal canal. CONCLUSION It is proposed that alpha-1 adrenoceptor antagonists could be a suitable treatment for chronic anal fissure and other painful conditions where reduction in anal pressure is warranted.
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Affiliation(s)
- J Pitt
- University College London Medical School, United Kingdom
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35
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Affiliation(s)
- A A Riaz
- Department of Surgery, Chase Farm Hospital, Enfield, UK
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36
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Pitt JJ, Da Silva E, Gorman JJ. Determination of the disulfide bond arrangement of Newcastle disease virus hemagglutinin neuraminidase. Correlation with a beta-sheet propeller structural fold predicted for paramyxoviridae attachment proteins. J Biol Chem 2000; 275:6469-78. [PMID: 10692451 DOI: 10.1074/jbc.275.9.6469] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [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: 11/06/2022] Open
Abstract
Disulfide bonds stabilize the structure and functions of the hemagglutinin neuraminidase attachment glycoprotein (HN) of Newcastle disease virus. Until this study, the disulfide linkages of this HN and structurally similar attachment proteins of other members of the paramyxoviridae family were undefined. To define these linkages, disulfide-linked peptides were produced by peptic digestion of purified HN ectodomains of the Queensland strain of Newcastle disease virus, isolated by reverse phase high performance liquid chromatography, and analyzed by mass spectrometry. Analysis of peptides containing a single disulfide bond revealed Cys(531)-Cys(542) and Cys(172)-Cys(196) linkages and that HN ectodomains dimerize via Cys(123). Another peptide, with a chain containing Cys(186) linked to a chain containing Cys(238), Cys(247), and Cys(251), was cleaved at Met(249) with cyanogen bromide. Subsequent tandem mass spectrometry established Cys(186)-Cys(247) and Cys(238)-Cys(251) linkages. A glycopeptide with a chain containing Cys(344) linked to a chain containing Cys(455), Cys(461), and Cys(465) was treated sequentially with peptide-N-glycosidase F and trypsin. Further treatment of this peptide by one round of manual Edman degradation or tandem mass spectrometry established Cys(344)-Cys(461) and Cys(455)-Cys(465) linkages. These data, establishing the disulfide linkages of all thirteen cysteines of this protein, are consistent with published predictions that the paramyxoviridae HN forms a beta-propeller structural fold.
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Affiliation(s)
- J J Pitt
- Biomolecular Research Institute, Parkville, Victoria 3052, Australia
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37
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Robinson PG, Bhavnani V, Khan FA, Newton T, Pitt J, Thorogood N, Gelbier S, Gibbons D. Dental caries and treatment experience of adults from minority ethnic communities living in the South Thames Region, UK. Community Dent Health 2000; 17:41-7. [PMID: 11039630] [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: 02/18/2023]
Abstract
OBJECTIVE To describe the dental caries and treatment experience of groups of adults from minority ethnic communities living in the South Thames Region of England. DESIGN Cross-sectional clinical study. SETTINGS Community, religious and educational centres for adults from minority ethnic communities. PARTICIPANTS Snowball sample of 928 adults from 44 ethnic groups including: Black Caribbean (141), Black African (134); Pakistani (123); Indian (190); Bangladeshi (78); Chinese/Vietnamese (143) and 119 from other groups. RESULTS More participants were dentate or had 18 or more sound and untreated teeth than adults living in the same area (Todd and Lader, 1991). Duration of residence in the United Kingdom predicted caries or treatment experience in the sample as a whole and in Chinese/Vietnamese people. Increased DMFT was predicted by age and by history of visiting a UK dentist in the sample as a whole and in the Black African group. CONCLUSIONS Effect of duration of UK residence on presence and extent of caries suggests that oral health may be better among adults from these ethnic minority groups than among the general population. However, the differences can also be attributed to sampling bias and old comparison data. Better sampling strategies are required for research of this type.
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Affiliation(s)
- P G Robinson
- Division of Dental Public Health and Oral Health Services Research, Guy's, King's and St. Thomas' Dental Institute, King's College London, UK.
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Welles SL, Pitt J, Colgrove R, McIntosh K, Chung PH, Colson A, Lockman S, Fowler MG, Hanson C, Landesman S, Moye J, Rich KC, Zorrilla C, Japour AJ. HIV-1 genotypic zidovudine drug resistance and the risk of maternal--infant transmission in the women and infants transmission study. The Women and Infants Transmission Study Group. AIDS 2000; 14:263-71. [PMID: 10716502 DOI: 10.1097/00002030-200002180-00008] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [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: 11/27/2022]
Abstract
OBJECTIVES Although the treatment of pregnant women and their infants with zidovudine (ZDV) has been remarkably effective in preventing the perinatal transmission of human HIV-1, many potentially preventable infections still occur. To examine whether the risk of perinatal infection is increased among women who carry ZDV-resistant HIV-1, the role of genotypic ZDV resistance in perinatal transmission was evaluated. METHODS The reverse transcriptase (RT) region of clinical isolates from culture supernatants of 142 HIV-1-infected women enrolled in the Women and Infants Transmission Study (WITS), who had been treated with ZDV during pregnancy was sequenced. Results from genotypic sequencing were linked to demographic, laboratory, and obstetrical databases, and the magnitude of association of having consensus drug-resistant HIV-1 RT mutations with transmission was estimated. RESULTS Twenty-five per cent (34/142) of maternal isolates had at least one ZDV-associated resistance mutation. A lower CD4 cell percentage and count (P= 0.0001) and higher plasma HIV-1 RNA (P=0.006) were associated with having any ZDV resistance mutation at delivery. Having any RT resistance mutation [odds ratio (OR): 5.16; 95% confidence interval (CI): 1.40, 18.97; P=0 0.01], duration of ruptured membranes [OR: 1.13 (1.02, 1.26) per 4 h duration; P= 0.02], and total lymphocyte count [OR: 1.06 (1.01, 1.10) per 50 cells higher level; P=0.009] were independently associated with transmission in multivariate analysis. CONCLUSION Maternal ZDV resistant virus was predictive of transmission, independent of viral load, in these mothers with moderately advanced HIV-1 disease, many of whom had been treated with ZDV before pregnancy.
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Affiliation(s)
- S L Welles
- Division of Epidemiology, University of Minnesota, School of Public Health, Minneapolis 55454, USA.
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Nachman SA, Stanley K, Yogev R, Pelton S, Wiznia A, Lee S, Mofenson L, Fiscus S, Rathore M, Jimenez E, Borkowsky W, Pitt J, Smith ME, Wells B, McIntosh K. Nucleoside analogs plus ritonavir in stable antiretroviral therapy-experienced HIV-infected children: a randomized controlled trial. Pediatric AIDS Clinical Trials Group 338 Study Team. JAMA 2000; 283:492-8. [PMID: 10659875 DOI: 10.1001/jama.283.4.492] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Although protease inhibitors are used routinely in adults with human immunodeficiency virus (HIV) infection, the role of these drugs in the treatment of clinically stable HIV-infected children is not clear. OBJECTIVE To evaluate the safety, tolerance, and virologic response produced by a change in antiretroviral therapy in HIV-infected children who were clinically and immunologically stable while receiving previous therapy. DESIGN The Pediatric AIDS Clinical Trials Group 338, a multicenter, phase 2, randomized, open-label controlled trial conducted from February 6 to April 30, 1997 (patient entry period); patients were followed up for 48 weeks. SETTING Pediatric HIV research clinics in the United States and Puerto Rico. PATIENTS Two hundred ninety-seven antiretroviral-experienced, protease inhibitor-naive, clinically stable HIV-infected children aged 2 to 17 years. INTERVENTIONS Children were randomized to receive zidovudine, 160 mg/m2 3 times per day, plus lamivudine, 4 mg/kg 2 times per day (n = 100); the same regimen plus ritonavir, 350 mg/m2 2 times per day (n = 100); or ritonavir, 350 mg/m2 2 times per day, and stavudine, 4 mg/kg 2 times per day (n = 97). MAIN OUTCOME MEASURE Plasma HIV-1 RNA levels at study weeks 12 and 48, compared among the 3 treatment groups. RESULTS At study week 12, 12% of patients in the zidovudine-lamivudine group had undetectable plasma HIV RNA levels (<400 copies/mL) compared with 52% and 54% of patients in the 2- and 3-drug ritonavir-containing groups, respectively (P<.001). Through study week 48, 70% of children continued receiving their ritonavir-containing regimen. At study week 48, 42% of children receiving ritonavir plus 2 nucleosides compared with 27% of those receiving ritonavir and a single nucleoside had undetectable HIV RNA levels (P = .04); however, similar proportions in each group continuing initial therapy had HIV RNA levels of less than 10000 copies/mL (58% vs 48%, respectively; P = .19). CONCLUSIONS In our study, change in antiretroviral therapy to a ritonavir-containing regimen was associated with superior virologic response at study week 12 compared with change to a dual nucleoside analog regimen. More children receiving ritonavir in combination with 2 compared with 1 nucleoside analog had undetectable HIV RNA levels at study week 48.
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Affiliation(s)
- S A Nachman
- Department of Pediatrics, State University of New York at Stony Brook, 11794-8111, USA.
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40
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Shearer WT, Lipshultz SE, Easley KA, McIntosh K, Pitt J, Quinn TC, Kattan M, Goldfarb J, Cooper E, Bryson Y, Kovacs A, Bricker JT, Peavy H, Mellins RB, Heart N, Institute LB. Alterations in cardiac and pulmonary function in pediatric rapid human immunodeficiency virus type 1 disease progressors. Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted Human Immunodeficiency Virus Study Group. Pediatrics 2000; 105:e9. [PMID: 10617746 PMCID: PMC4331103 DOI: 10.1542/peds.105.1.e9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Infants with human immunodeficiency virus type 1 (HIV-1) can be divided into rapid progressors (RPs) and non-rapid progressors (non-RPs) based on symptoms and immunologic status, but detailed information about cardiac and pulmonary function in RP and non-RP children needs to be adequately described. METHODOLOGY Cardiac, pulmonary, and immunologic data and HIV-1 RNA burden were periodically measured in 3 groups: group I, 205 vertically infected children enrolled from 1990 to 1994 and followed through 1996; group II, a prospectively studied cohort enrolled at birth that included 93 infected (group IIa); and 463 noninfected infants (group IIb). RESULTS Mean respiratory rates were generally higher in group IIa RP than non-RP children throughout the period of follow-up, achieving statistical signifance at 1 month, 12 months, 24 months, 30 months, and 48 months of follow-up. Non-RP and group IIb (HIV-uninfected children) had similar mean respiratory rates from birth to 5 years of age. Significant differences in mean respiratory rates were found between group I RP and non-RP at 7 age intervals over the first 6 years of life. Mean respiratory rates were higher in RP than in non-RP at <1 year, 2.0 years, 2.5 years, 3.0 years, 3. 5 years, 4.0 years, and 6.0 years of age. Mean heart rates in group IIa RP, non-RP, and group IIb differed at every age. Rapid progressors had higher mean heart rates than non-RP at all ages through 24 months. Mean heart rates at 30 months through 60 months of age were similar for RP and non-RP children. Non-RP children had higher mean heart rates than did group IIb at 8 months, 24 months, 36 months, 42 months, 48 months, 54 months, and 60 months of age. In group I, RP had higher mean heart rates than non-RP at 2.0 years, 2.5 years, 3.0 years, and 4.0 years of age. After 4 years of age, the non-RP and RP had similar mean heart rates. Mean fractional shortening differed between the 3 group II subsets (RP, non-RP, and IIb) at 4, 8, 12, 16, and 20 months of age. Although mean fractional shortening was lower in RP than in non-RP in group II at all time points between 1 and 20 months, the mean fractional shortening was significantly lower in RP only at 8 months when restricting the statistical comparisons to the 2 HIV-infected groups (RP and non-RP). Mean fractional shortening increased in the first 8 months of life followed by a gradual decline through 5 years of age among group IIb children. No significant differences among the 3 groups in mean fractional shortening were detected after 20 months of age. In group I, differences between RP and non-RP in mean fractional shortening were detected at 1.5, 2.0, 2.5, and 3.0 years of age. After 3 years of age, group means for fractional shortening in RP and non-RP did not differ. Because of the limited data from the first months of the group I patients, it could not be determined whether this group experienced the gradual early rise in mean fractional shortening seen in the group II infants. In group IIa, RP had more clinical (eg, oxygen saturation <96%) and chest radiographic abnormalities (eg, cardiomegaly) at 18 months of life. RP also had significantly higher 5-year cumulative mortality than non-RP, higher HIV-1 viral burdens than non-RP, and lower CD8(+) T-cell counts. CONCLUSIONS Rapid disease progression in HIV-1- infected infants is associated with significant alterations in heart and lung function: increased respiratory rate, increased heart rate, and decreased fractional shortening. The same children exhibited the anticipated significantly increased 5-year cumulative mortality, increased serum HIV-1 RNA load, and decreased CD8(+) (cytotoxic) T-cell counts. Measurements of cardiopulmonary function in HIV-1-infected children seem to be useful in the total assessment of HIV-1 disease progression.
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Affiliation(s)
- W T Shearer
- Baylor College of Medicine, Houston, Texas, USA.
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Rich KC, Fowler MG, Mofenson LM, Abboud R, Pitt J, Diaz C, Hanson IC, Cooper E, Mendez H. Maternal and infant factors predicting disease progression in human immunodeficiency virus type 1-infected infants. Women and Infants Transmission Study Group. Pediatrics 2000; 105:e8. [PMID: 10617745 DOI: 10.1542/peds.105.1.e8] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Infants with perinatally acquired human immunodeficiency virus type 1 (HIV-1) infection have widely variable courses. Previous studies showed that a number of maternal and infant factors, when analyzed separately, are associated with infant HIV-1 disease progression. In this study, clincal, virologic, and immunologic characteristics in the mothers and infants were examined together to determine the predictors of disease progression by 18 months of age and the associations with rapid progression during the first 6 months of life. METHODS One hundred twenty-two HIV-1-infected women whose infants were HIV-1 infected were identified from the Women and Infants Transmission Study (WITS) cohort. WITS is a longitudinal natural history study of perinatal HIV-1 infection carried out in 6 sites in the continental United States and in Puerto Rico. The women were enrolled during pregnancy and their infants were enrolled at the time of delivery and followed prospectively by a standardized protocol. Virologic and immunologic studies were performed in laboratories certified by National Institutes of Health-sponsored quality assurance programs. Maternal factors in pregnancy were used as potential predictors of infant disease progression (progression to Centers for Disease Control and Prevention [CDC] Clinical Class C disease or death by 18 months of age) or as correlates of progression at <6 months of age. Infant factors defined during the first 6 months of life were used as potential predictors of progression during 6 to 18 months of age and as correlates of progression at <6 months of age. RESULTS Progression by 18 months of age occurred in 32% of infants and by 6 months of age in 15%. Maternal characteristics that, by univariate analysis, were significant predictors of infant disease progression by 18 months of age were elevated viral load, depressed CD4(+)%, and depressed vitamin A. CD8(+)%, CD8(+) activation markers, zidovudine (ZDV) use, hard drug use, and gestational age at delivery were not. When examined in a combined multivariate analysis of maternal characteristics, only vitamin A concentration independently predicted infant progression. Infant characteristics during the first 6 months of life that, by univariate analysis, were associated with disease progression included elevated mean viral load at 1 to 6 months of age, depressed CD4(+)%, CDC Clinical Disease Category B, and growth delay. Early HIV-1 culture positivity (<48 hours), CD8(+)%, CD8(+) activation markers, and ZDV use during the first month of life did not predict progression. Multivariate analysis of infant characteristics showed that the only independent predictors were progression to CDC Category B by 6 months of age (odds ratio [OR], 5.80) and mean viral load from 1 to 6 months of age (OR, 1.99). The final combined maternal and infant analysis included the significant maternal and infant characteristics in a multivariate analysis. It showed that factors independently predicting infant progression by 18 months of age were progression to CDC Category B by 6 months of age (OR, 5.80) and elevated mean HIV-1 RNA copy number at 1 to 6 months of age (OR, 1.99). The characteristics associated with rapid progression to CDC Category C disease or death by 6 months of age were also examined. The only maternal characteristic associated with progression by 6 months in multivariate analysis was low maternal CD4(+)%. The infant characteristics associated with progression by 6 months of age in multivariate analysis were depressed mean CD4(+)% from birth through 2 months and the presence of lymphadenopathy, hepatomegaly, or splenomegaly by 3 months. Infant ZDV use was not assocciated with rapid progression. CONCLUSION The strongest predictors of progression by 18 months are the presence of moderate clinical symptoms and elevated RNA copy number in the infants in the first 6 months of life. In contrast, progression by 6 months is associated with maternal and infant immun
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Affiliation(s)
- K C Rich
- Department of Pediatrics, University of Illinois at Chicago, Illinois, USA.
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Schubert C, Schisa J, Pitt J, Priess J. ABSTRACT Germline/soma asymmetry in <I>Caenorhabditis elegans</I>. Biochem Cell Biol 2000. [DOI: 10.1139/bcb-78-5-649] [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: 11/22/2022] Open
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Keerasuntonpong A, Pitt J, Gaut PL, Daar ES. Primary human immunodeficiency virus type 1 infection in pregnancy. Obstet Gynecol 1999; 94:844. [PMID: 10546755 DOI: 10.1016/s0029-7844(99)00517-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- A Keerasuntonpong
- Burns and Allen Research Institute, Cedars-Sinai Medical Center, Department of Medicine, University of California at Los Angeles, USA
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Kalish LA, McIntosh K, Read JS, Diaz C, Landesman SH, Pitt J, Rich KC, Shearer WT, Davenny K, Lew JF. Evaluation of human immunodeficiency virus (HIV) type 1 load, CD4 T cell level, and clinical class as time-fixed and time-varying markers of disease progression in HIV-1-infected children. J Infect Dis 1999; 180:1514-20. [PMID: 10515810 DOI: 10.1086/315064] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 11/03/2022] Open
Abstract
Human immunodeficiency virus (HIV) type 1 RNA load, CD4 T cell level, and Centers for Disease Control and Prevention (CDC) clinical class history were measured as potential correlates of a CDC class C diagnosis or death in 165 HIV-1-infected children followed from birth. These covariates were assessed at fixed "landmark" ages from 6 to 24 months and were also assessed as time-varying values. Virus load was associated with progression in all analyses, even after adjusting for immunologic and clinical status. This confirms its importance for monitoring pediatric disease progression. CD4 T cell level was associated with disease progression in time-varying but not in adjusted landmark analysis, suggesting that CD4 cells reflects immediate risk more than long-term risk. The distinction between clinical class B and lower classes is prognostic during the first 18 months of life; class C versus classes N/A/B becomes more important as the patient ages. Virologic, immunologic, and clinical status all provide information regarding disease progression risk.
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Affiliation(s)
- L A Kalish
- New England Research Institutes, Watertown, MA 02472, USA. lesk@neri. org
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Garcia PM, Kalish LA, Pitt J, Minkoff H, Quinn TC, Burchett SK, Kornegay J, Jackson B, Moye J, Hanson C, Zorrilla C, Lew JF. Maternal levels of plasma human immunodeficiency virus type 1 RNA and the risk of perinatal transmission. Women and Infants Transmission Study Group. N Engl J Med 1999; 341:394-402. [PMID: 10432324 DOI: 10.1056/nejm199908053410602] [Citation(s) in RCA: 597] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The importance of plasma levels of human immunodeficiency virus type 1 (HIV-1) RNA in pregnant women in relation to the other factors known to influence the risk of transmission of infection to their infants is incompletely defined. We studied the relation of maternal plasma HIV-1 RNA levels to the risk of perinatal transmission and the timing of transmission. METHODS We measured plasma HIV-1 RNA serially in 552 women with HIV-1 infection who had singleton pregnancies. The status of infection in their infants was assessed by culture of blood and further classified as early (if a culture of blood obtained within the first two days of life was positive) or late (if a culture of blood obtained in the first seven days of life was negative but subsequent cultures were positive). The rates of transmission at various levels of maternal plasma HIV-1 RNA were analyzed by tests for trend, with adjustment for covariates by stratification and logistic regression. RESULTS Increasing geometric mean levels of plasma HIV-1 RNA were associated with increasing rates of transmission: the rate was 0 percent among women with less than 1000 copies per milliliter (0 of 57), 16.6 percent among women with 1000 to 10,000 copies per milliliter (32 of 193), 21.3 percent among women with 10,001 to 50,000 copies per milliliter (39 of 183), 30.9 percent among women with 50,001 to 100,000 copies per milliliter (17 of 55), and 40.6 percent among women with more than 100,000 copies per milliliter (26 of 64) (P<0.001). The treatment status of one woman was unknown. The highest rate of transmission was among women whose plasma HIV-1 RNA levels exceeded 100,000 copies per milliliter and who had not received zidovudine (19 of 30 women, 63.3 percent). Neither higher HIV-1 RNA levels early in pregnancy nor higher levels late in pregnancy were associated with the timing of infection in the infants. CONCLUSIONS In pregnant women with HIV-1 infection the level of plasma HIV-1 RNA predicts the risk but not the timing of transmission of HIV-1 to their infants.
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Affiliation(s)
- P M Garcia
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, USA.
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Burns DN, FitzGerald G, Semba R, Hershow R, Zorrilla C, Pitt J, Hammill H, Cooper ER, Fowler MG, Landesman S. Vitamin A deficiency and other nutritional indices during pregnancy in human immunodeficiency virus infection: prevalence, clinical correlates, and outcome. Women and Infants Transmission Study Group. Clin Infect Dis 1999; 29:328-34. [PMID: 10476737 DOI: 10.1086/520210] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [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: 11/04/2022] Open
Abstract
Vitamin A levels in plasma and other nutritional indices were measured during pregnancy for 449 women enrolled in a multicenter cohort study of mother-to-infant transmission of human immunodeficiency virus type 1 (HIV-1). During the third trimester, 29.6% of the women had low (20 to <30 microg/dL) and 11.1% had very low (<20 microg/dL) vitamin A levels. Vitamin A and body mass index, serum albumin levels, and hemoglobin levels were weakly correlated. After adjustment for other covariates, women with low and very low vitamin A levels before the third trimester were more likely to deliver infants with low birth weight (<2500 g) than were those with higher levels (odds ratio [OR], 4.58; 95% confidence interval [CI], 1.57-13.4; and OR, 6.99; 95% CI, 1.09-45.0, respectively). However, there was no statistically significant association between vitamin A level and mother-to-infant transmission of HIV-1. Anemia and low body mass index before the third trimester were associated with an increased risk of transmission in univariate analyses but not in multivariate analyses.
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Affiliation(s)
- D N Burns
- Pediatric, Adolescent, and Maternal AIDS Branch, Center for Research for Mothers and Children, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892-7510, USA.
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Affiliation(s)
- J Pitt
- Colorectal Surgical Unit, West Middlesex University Hospital NHS Trust, Twickenham Road, Isleworth, Middlesex, TW7 6AF, UK
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Kovacs A, Schluchter M, Easley K, Demmler G, Shearer W, La Russa P, Pitt J, Cooper E, Goldfarb J, Hodes D, Kattan M, McIntosh K. Cytomegalovirus infection and HIV-1 disease progression in infants born to HIV-1-infected women. Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection Study Group. N Engl J Med 1999; 341:77-84. [PMID: 10395631 PMCID: PMC4280563 DOI: 10.1056/nejm199907083410203] [Citation(s) in RCA: 211] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND METHODS Cytomegalovirus (CMV) has been implicated as a cofactor in the progression of human immunodeficiency virus type 1 (HIV-1) disease. We assessed 440 infants (75 of whom were HIV-1-infected and 365 of whom were not) who had known CMV status and were born to HIV-1-infected women and who were followed prospectively. HIV-1 disease progression was defined as the presence of class C symptoms (according to the criteria of the Centers for Disease Control and Prevention [CDC]) or CD4 counts of less than 750 cells per cubic millimeter by 1 year of age and less than 500 cells per cubic millimeter by 18 months of age. RESULTS At birth the frequency of CMV infection was similar in the HIV-1-infected and HIV-1-uninfected infants (4.3 percent and 4.5 percent, respectively), but the HIV-1-infected infants had a higher rate of CMV infection at six months of age (39.9 percent vs. 15.3 percent, P=0.001) and continued to have a higher rate of CMV infection through four years of age (P=0.04). By 18 months of age, the infants with both infections had higher rates of HIV-1 disease progression (70.0 percent vs. 30.4 percent, P=0.001), CDC class C symptoms or death (52.5 percent vs. 21.7 percent, P=0.008), and impaired brain growth or progressive motor deficits (35.6 percent vs. 8.7 percent, P=0.005) than infants infected only with HIV-1. In a Cox regression analysis, CMV infection was associated with an increased risk of HIV-1 disease progression (relative risk, 2.59; 95 percent confidence interval, 1.13 to 5.95). Among children infected with HIV-1 alone, but not among those infected with both viruses, children with rapid progression of HIV-1 disease had higher mean levels of HIV-1 RNA than those with slower or no progression of disease. CONCLUSIONS HIV-1-infected infants who acquire CMV infection in the first 18 months of life have a significantly higher rate of disease progression and central nervous system disease than those infected with HIV-1 alone.
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Affiliation(s)
- A Kovacs
- Maternal-Child HIV Management and Research Center, Los Angeles County and University of Southern California Medical Center, Los Angeles, USA.
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Fletcher JM, Pitt JJ. Pitfalls in the use of 2-octynoic acid as an in vivo model of medium-chain acyl-coenzyme A dehydrogenase deficiency: ketone turnover and metabolite studies in the rat. Metabolism 1999; 48:685-8. [PMID: 10381140 DOI: 10.1016/s0026-0495(99)90165-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
2-Octynoic acid was administered by intraperitoneal injection to fasted Sprague-Dawley rats in an attempt to simulate medium-chain acyl-coenzyme A dehydrogenase (MCAD) deficiency. The resultant urine organic acid profile showed a mild dicarboxylic aciduria but lacked the glycine conjugates characteristic of MCAD deficiency. Further studies with infused 13C(4)-3-hydroxybutyrate and 13C(2)-acetoacetate demonstrated reduced ketone production in treated rats compared with control animals. Although plasma ketone body concentrations were low in treated rats, plasma free fatty acids were also low, thereby providing diminished substrate for ketone production. This is the reverse of the finding in children with MCAD deficiency, who have low levels of plasma ketones despite elevated free fatty acids. These animal studies were therefore not helpful in improving our understanding of ketone body kinetics in children with MCAD deficiency.
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Affiliation(s)
- J M Fletcher
- Murdoch Institute and Department of Clinical Biochemistry, Royal Children's Hospital, Parkville, Victoria, Australia
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Jenson H, McIntosh K, Pitt J, Husak S, Tan M, Bryson Y, Easley K, Shearer W. Natural history of primary Epstein-Barr virus infection in children of mothers infected with human immunodeficiency virus type 1. J Infect Dis 1999; 179:1395-404. [PMID: 10228060 PMCID: PMC4360073 DOI: 10.1086/314764] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [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: 11/03/2022] Open
Abstract
The natural history of Epstein-Barr virus (EBV) infection in 556 infants born to 517 human immunodeficiency virus (HIV) type 1-infected mothers was studied in a prospective, multicenter, cohort study. HIV-1-infected children had a cumulative EBV infection rate similar to HIV-1-uninfected children at age 3 years (77.8% vs. 84. 9%) but had more frequent oropharyngeal EBV shedding (50.4% vs. 28. 2%; P<.001). The probability of shedding decreased with longer time from EBV seroconversion and was similar to that of HIV-1-uninfected children 3 years after seroconversion. HIV-1-infected children identified as rapid progressors shed EBV more frequently than nonrapid progressors (69.4% vs.41.0%; P=.01). HIV-1-infected children with EBV infection had higher mean CD8 cell counts. EBV infection did not have an independent effect on mean CD4 cell counts, percent CD4, IgG levels, HIV-1 RNA levels, lymphadenopathy, hepatomegaly, or splenomegaly. Early EBV infection is common in children born to HIV-1-infected mothers. Children with rapidly progressive HIV-1 disease have more frequent EBV shedding.
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Affiliation(s)
- H Jenson
- Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX 78284-7811, USA.
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