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Adam K, Wiley L, Glaser L. 8880 Recurrent Endometriosis-Associated Massive Hemorrhagic Ascites: A Case Report and Literature Review. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.501] [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: 11/27/2022]
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Farrow L, Brasnic L, Martin C, Ward K, Adam K, Hall AJ, Clement ND, MacLullich AMJ. A nationwide study of blood transfusion in hip fracture patients. Bone Joint J 2022; 104-B:1266-1272. [DOI: 10.1302/0301-620x.104b11.bjj-2022-0450.r1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to examine perioperative blood transfusion practice, and associations with clinical outcomes, in a national cohort of hip fracture patients. Methods A retrospective cohort study was undertaken using linked data from the Scottish Hip Fracture Audit and the Scottish National Blood Transfusion Service between May 2016 and December 2020. All patients aged ≥ 50 years admitted to a Scottish hospital with a hip fracture were included. Assessment of the factors independently associated with red blood cell transfusion (RBCT) during admission was performed, alongside determination of the association between RBCT and hip fracture outcomes. Results A total of 23,266 individual patient records from 18 hospitals were included. The overall rate of blood transfusion during admission was 28.7% (n = 6,685). There was inter-hospital variation in transfusion rate, ranging from 16.6% to 37.4%. Independent perioperative factors significantly associated with RBCT included older age (90 to 94 years, odds ratio (OR) 3.04 (95% confidence interval (CI) 2.28 to 4.04); p < 0.001), intramedullary fixation (OR 7.15 (95% CI 6.50 to 7.86); p < 0.001), and sliding hip screw constructs (OR 2.34 (95% CI 2.19 to 2.50); p < 0.001). Blood transfusion during admission was significantly associated with higher rates of 30-day mortality (OR 1.35 (95% CI 1.19 to 1.53); p < 0.001) and 60-day mortality (OR 1.54 (95% CI 1.43 to 1.67); p < 0.001), as well as delays to postoperative mobilization, higher likelihood of not returning to their home, and longer length of stay. Conclusion Blood transfusion after hip fracture was common, although practice varied nationally. RBCT is associated with adverse outcomes, which is most likely a reflection of perioperative anaemia, rather than any causal effect. Use of RBCT does not appear to reverse this effect, highlighting the importance of perioperative blood loss reduction. Cite this article: Bone Joint J 2022;104-B(11):1266–1272.
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Affiliation(s)
- Luke Farrow
- Institute of Applied Health Sciences, University of Aberdeen College of Life Sciences and Medicine, Aberdeen, UK
- Grampian Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, UK
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
| | - Lorena Brasnic
- Institute of Applied Health Sciences, University of Aberdeen College of Life Sciences and Medicine, Aberdeen, UK
| | - Caroline Martin
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
| | - Kirsty Ward
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
| | - Karen Adam
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
| | - Andrew J. Hall
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
- Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK
| | - Nick D. Clement
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Alasdair M. J. MacLullich
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, UK
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Brasnic L, Martin C, Ward K, Adam K, MacLullich A, Farrow L. 807 The Association between Blood Transfusion and Outcome in Hip Fracture Patients. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.474] [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: 11/05/2022]
Abstract
Abstract
Aim
Hip Fractures are endemic in older adults across Europe, with potential increases in incidence expected as the population ages. Management of blood loss and anaemia is a mainstay of care for these patients, but there is still significant debate regarding balance between benefit and risk of liberal versus restrictive transfusion policies. Understanding the association between providing blood products and adverse healthcare outcomes in hip fracture patients is a key component in the transfusion decision-making process.
Method
This retrospective cohort study uses national audit data from the Scottish Hip Fracture Audit (SHFA) and the Scottish National Blood Transfusion Service (SNBTS) to examine the association between blood transfusion and important hip fracture process of care measures and healthcare outcomes.
Results
A total of 28 461 patient records were included for assessment across 19 acute hospitals. Blood transfusion during admission was associated with a small but statistically significant decrease in survival at both 30 and 60 days. Those receiving blood transfusion during admission were less likely to be mobilised by the end of the 1st post-operative day, less likely to have a length of stay below the average and had far lower probability of discharge.
Conclusion
This study found that blood transfusion is associated with poor healthcare outcomes following hip fracture, even when adjusted for potential confounding factors. This likely reflects the potential harm of perioperative anaemia rather than any direct impact from transfusion. Further work to reduce perioperative blood loss is therefore key to improving important hip fracture outcomes.
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Affiliation(s)
- L Brasnic
- University of Aberdeen , Aberdeen , United Kingdom
| | - C Martin
- Scottish Hip Fracture Audit, Public Health Scotland , Edinburgh, Edinburgh , United Kingdom
| | - K Ward
- Scottish Hip Fracture Audit, Public Health Scotland , Edinburgh, Edinburgh , United Kingdom
| | - K Adam
- Scottish Hip Fracture Audit, Public Health Scotland , Edinburgh, Edinburgh , United Kingdom
| | - A MacLullich
- Scottish Hip Fracture Audit, Public Health Scotland , Edinburgh, Edinburgh , United Kingdom
| | - L Farrow
- University of Aberdeen , Aberdeen , United Kingdom
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Hall AJ, Clement ND, Ojeda-Thies C, MacLullich AMJ, Toro G, Johansen A, White TO, Duckworth AD, Abdul-Jabar H, Abu-Rajab R, Abugarja A, Adam K, Aguado Hernández HJ, Améstica Lazcano G, Anderson S, Ansar M, Antrobus J, Aragón Achig EJ, Archunan M, Arrieta Salinas M, Ashford-Wilson S, Assens Gibert C, Athanasopoulou K, Awadelkarim M, Baird S, Bajada S, Balakrishnan S, Balasubramanian S, Ballantyne JA, Bárcena Goitiandia L, Barkham B, Barmpagianni C, Barres-Carsi M, Barrett S, Baskaran D, Bell J, Bell K, Bell S, Bellelli G, Benchimol JA, Boietti BR, Boswell S, Braile A, Brennan C, Brent L, Brooke B, Bruno G, Burahee A, Burns S, Calabrò G, Campbell L, Carabelli GS, Carnegie C, Carretero Cristobal G, Caruana E, Cassinello Ogea MC, Castellanos Robles J, Castillon P, Chakrabarti A, Cecere AB, Chen P, Clarke JV, Collins G, Corrales Cardenal JE, Corsi M, Cózar Adelantado GM, Craxford S, Crooks M, Cuarental-García J, Cuthbert R, Dall G, Daskalakis I, De Cicco A, Diana DLFDD, Demaria P, Dereix J, Díaz Jiménez J, Dinamarca Montecinos JL, Do Le HP, Donoso Coppa JP, Drosos G, Duffy A, East J, Eastwood D, Elbahari H, Elias de Molins Peña C, Elmamoun M, Emmerson B, Escobar Sánchez D, Faimali M, Farré-Mercadé MV, Farrow L, Fayez A, Fell A, Fenner C, Ferguson D, Finlayson L, Flores Gómez A, Freeman N, French J, Gabardo Calvo S, Gagliardo N, Garcia Albiñana J, García Cruz G, García de Cortázar Antolín U, García Virto V, Gealy S, Gil Caballero SM, Gill M, González González MS, Gopireddy R, Guntley D, Gurung B, Guzmán Rosales G, Haddad N, Hafeez M, Haller P, Halligan E, Hardie J, Hawker I, Helal A, Herrera Cruz M, Herreros Ruiz-Valdepeñas R, Horton J, Howells S, Howieson A, Hughes L, Hünicken Torrez FL, Hurtado Ortega A, Huxley P, Hamid HK, Ilahi N, Iliadis A, Inman D, Jadhao P, Jandoo R, Jawad L, Jayatilaka MLT, Jenkins PJ, Jeyapalan R, Johnson D, Johnston A, Joseph S, Kapoor S, Karagiannidis G, Karanam KS, Kattakayam F, Konarski A, Kontakis G, Labrador Hernández G, Lancaster V, Landi G, Le B, Liew I, Logishetty K, Lopez Marquez ACD, Lopez J, Lum J, Macpherson GJ, Madan S, Mahroof S, Malik-Tabassum K, Mallina R, Maqsood A, Marson B, Martin Legorburo MJ, Martin-Perez E, Martínez Jiménez T, Martinez Martin J, Mayne A, Mayor A, McAlinden G, McLean L, McDonald L, McIntyre J, McKay P, McKean G, McShane H, Medici A, Meeke C, Meldrum E, Mendez M, Mercer S, Merino Perez J, Mesa-Lampré MP, Mighton S, Milne K, Mohamed Yaseen M, Moppett I, Mora J, Morales-Zumel S, Moreno Fenoll IB, Mousa A, Murray AW, Murray EV, Nair R, Neary F, Negri G, Negus O, Newham-Harvey F, Ng N, Nightingale J, Noor Mohamed Anver S, Nunag P, O'Hare M, Ollivere B, Ortés Gómez R, Owens A, Page S, Palloni V, Panagiotopoulos A, Panagiotopoulos E, Panesar P, Papadopoulos A, Spyridon P, Pareja Sierra T, Park C, Parwaiz H, Paterson-Byrne P, Patton S, Pearce J, Porter M, Pellegrino A, Pèrez Cuellar A, Pezzella R, Phadnis A, Pinder C, Piper D, Powell-Bowns M, Prieto Martín R, Probert A, Ramesh A, Ramírez de Arellano MVM, Renton D, Rickman S, Robertson A, Roche Albero A, Rodrigo Verguizas JA, Rodríguez Couso M, Rooney J, Sáez-López P, Saldaña-Díaz A, Santulli A, Sanz Pérez MI, Sarraf KM, Scarsbrook C, Scott CE, Scott J, Shah S, Sharaf S, Sharma S, Shirley D, Siano A, Simpson J, Singh A, Singh A, Sinnett T, Sisodia G, Smith P, Sophena Bert E, Steel M, Stewart A, Stewart C, Sugand K, Sullivan N, Sweeting L, Symes M, Tan DJH, Tancredi F, Tatani I, Thomas P, Thomson F, Toner NS, Tong A, Toro A, Tosounidis T, Tottas S, Trinidad Leo A, Tucker D, Vemulapalli K, Ventura Garces D, Vernon OK, Viveros Garcia JC, Ward A, Ward K, Watson K, Weerasuriya T, Wickramanayake U, Wilkinson H, Windley J, Wood J, Wynell-Mayow W, Zatti G, Zeiton M, Zurrón Lobato M. IMPACT-Global Hip Fracture Audit: Nosocomial infection, risk prediction and prognostication, minimum reporting standards and global collaborative audit. Lessons from an international multicentre study of 7,090 patients conducted in 14 nations during the COVID-19 pandemic. Surgeon 2022; 20:e429-e446. [PMID: 35430111 PMCID: PMC8958101 DOI: 10.1016/j.surge.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/06/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022]
Abstract
Aims This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods A multicentre collaboration among 112 centres in 14 countries collected data on all patients presenting with a hip fracture between 1st March-31st May 2020. Demographics, residence, place of injury, presentation blood tests, Nottingham Hip Fracture Score, time to surgery, management, ASA grade, length of stay, COVID-19 and 30-day mortality status were recorded. Results A total of 7090 patients were included, with a mean age of 82.2 (range 50–104) years and 4959 (69.9%) being female. Of 651 (9.2%) patients diagnosed with COVID-19, 225 (34.6%) were positive at presentation and 426 (65.4%) were positive postoperatively. Positive COVID-19 status was independently associated with male sex (odds ratio (OR) 1.38, p = 0.001), residential care (OR 2.15, p < 0.001), inpatient fall (OR 2.23, p = 0.003), cancer (OR 0.63, p = 0.009), ASA grades 4 (OR 1.59, p = 0.008) or 5 (OR 8.28, p < 0.001), and longer admission (OR 1.06 for each increasing day, p < 0.001). Patients with COVID-19 at any time had a significantly lower chance of 30-day survival versus those without COVID-19 (72.7% versus 92.6%, p < 0.001). COVID-19 was independently associated with an increased 30-day mortality risk (hazard ratio (HR) 2.83, p < 0.001). Increasing age (HR 1.03, p = 0.028), male sex (HR 2.35, p < 0.001), renal disease (HR 1.53, p = 0.017), and pulmonary disease (HR 1.45, p = 0.039) were independently associated with a higher 30-day mortality risk in patients with COVID-19 when adjusting for confounders. Conclusion The prevalence of COVID-19 in hip fracture patients during the first wave of the pandemic was 9%, and was independently associated with a three-fold increased 30-day mortality risk. Among COVID-19-positive patients, those who were older, male, with renal or pulmonary disease had a significantly higher 30-day mortality risk.
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Brown SE, Bycroft KA, Adam K, Collett MG. Acute fibrinous pleuropneumonia and septicaemia caused by Bibersteinia trehalosi in neonatal calves in New Zealand. N Z Vet J 2020; 69:51-57. [PMID: 32646323 DOI: 10.1080/00480169.2020.1792372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Case history: In July and August 2019, 15/40, ≤48-hour-old calves became acutely ill. The calves were all born on-farm, transferred to pens soon after birth, and fed with "gold" colostrum. The hygiene, biosecurity and ventilation in the pens were poor. Of the 15 calves, 11 died or were euthanised and four calves, ≤48-hour-old, that became acutely ill later in the outbreak were treated with cefquinome, a fourth-generation cephalosporin, and recovered. Clinical findings: The affected calves presented with acute recumbency, lethargy, tachypnoea, tachycardia, increased lung sounds, inability to stand or feed, and dehydration without pyrexia. Pathological findings: Gross findings in a calf that died naturally included fibrinous pleuropneumonia, marked oedematous expansion of the interlobular septa, especially in the ventral lung lobes, fibrinous polyserositis and fibrinous polyarthritis. A second calf that was euthanised had strikingly similar lung lesions. Histologically, the pulmonary interlobular septa of both calves were prominently expanded by oedema, dilated lymphatics and the infiltration of numerous neutrophils and macrophages interspersed with small Gram-negative rod bacteria. Likewise, the visceral pleura showed fibrinopurulent inflammation with numerous small Gram-negative rods. Microbiological findings: Microbial culture and matrix-assisted laser desorption ionisation time-of-flight (MALDI-TOF) mass spectrometry identified Bibersteinia trehalosi in the lung, stifle joint and peritoneal cavity of the first calf and lung of the second. Diagnosis: B. trehalosi acute fibrinous pleuropneumonia and septicaemia. Clinical relevance: This is the first report of the clinical findings and histological lesions of B. trehalosi pleuropneumonia and septicaemia in calves in New Zealand. The pathogen is isolated with increasing frequency from cases of bovine respiratory disease in dairy cows, feedlot cattle and calves in the United Kingdom and North America. The importance of microbial culture in cases such as this with unusual lung lesions in calves <48 hours of age, cannot be over emphasised. Cefquinome was administered to all remaining heifer calves and four calves that became ill later in the outbreak recovered after cefquinome treatment.
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Affiliation(s)
- S E Brown
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - K A Bycroft
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - K Adam
- IDEXX New Zealand Veterinary Pathology, Palmerston North, New Zealand
| | - M G Collett
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Strazza M, Adam K, Smrcka AV, Lerrer S, Mor A. PLCε1 suppresses tumor growth by regulating murine T cell mobilization. Clin Exp Immunol 2019; 200:53-60. [PMID: 31867717 DOI: 10.1111/cei.13409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 01/01/2023] Open
Abstract
Phospholipase C epsilon 1 (PLCε1) is a unique member of the phospholipase family, in that it also functions as a guanine nucleotide exchange factor (GEF) for the small GTPase Rap1. It is this function as a Rap1 GEF that gives PLCε1 an essential role in chemokine-mediated T cell adhesion. We have utilized a syngeneic tumor model, MC38 cells in C57BL/6 mice, and observed that tumors grow larger and more quickly in the absence of PLCε1. Single-cell analysis revealed an increased CD4+ /CD8+ ratio in the spleens, lymph nodes and tumors of PLCε1 knock-out tumor-bearing mice. T cells isolated from PLCε1 knock-out mice were less activated by multiple phenotypical parameters than those from wild-type mice. We additionally noted a decrease in expression of the chemokine receptors C-X-C chemokine receptor type 4 (CXCR4) and C-C motif chemokine receptor 4 (CCR4) on CD4+ T cells from the spleens, lymph nodes and tumors of PLCε1 knock-out mice compared to wild-type mice, and diminished migration of PLCε1-depleted CD3+ T cells towards stromal cell-derived factor (SDF)-1α. Based on these results, we conclude that PLCε1 is a potential regulator of tumor-infiltrating lymphocytes, functioning, at least in part, at the level of T cell trafficking and recruitment.
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Affiliation(s)
- M Strazza
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - K Adam
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - A V Smrcka
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - S Lerrer
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - A Mor
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
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Affiliation(s)
- K. Adam
- Royal Veterinary College; Hawkshead Lane Hatfield Hertfordshire AL9 7TA UK
| | - S. Baillie
- University of Bristol School of Veterinary Sciences; Langford House Langford Bristol BS40 5DU UK
| | - J. Rushton
- Royal Veterinary College; Hawkshead Lane Hatfield Hertfordshire AL9 7TA UK
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Gaweco A, Matthews K, Palmer S, Shamilov R, Adam K, Elia A, Clybouw C, Windsor W, Nomeir A, Stouch T, Ginzler E, Tilley J. OP0137 Complete Survival and Disease Amelioration in MRL/LPR Mice Following Therapeutic Administration of an Oral Retinoic Acid Receptor-Related Orphan Receptor Gamma T [RORGT] Inverse Agonist INV-17: A Promising Safe & Efficacious Novel Lupus Treatment. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2002] [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: 11/04/2022]
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Dommisch H, Staufenbiel I, Schulze K, Stiesch M, Winkel A, Fimmers R, Dommisch J, Jepsen S, Miosge N, Adam K, Eberhard J. Expression of antimicrobial peptides and interleukin-8 during early stages of inflammation: An experimental gingivitis study. J Periodontal Res 2015; 50:836-45. [DOI: 10.1111/jre.12271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/28/2022]
Affiliation(s)
- H. Dommisch
- Department of Periodontology and Synoptic Dentistry; Charité - University Medicine Berlin; Berlin Germany
- Department of Oral Health Sciences; Health Science Center; University of Washington; Seattle WA USA
- Department of Periodontology, Operative and Preventive Dentistry; University Hospital Bonn; Bonn Germany
| | - I. Staufenbiel
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry; Hannover Medical School; Hannover Germany
| | - K. Schulze
- Clinic for Dental Prosthetics and Biomedical Materials Science; Hannover Medical School; Hannover Germany
| | - M. Stiesch
- Clinic for Dental Prosthetics and Biomedical Materials Science; Hannover Medical School; Hannover Germany
| | - A. Winkel
- Clinic for Dental Prosthetics and Biomedical Materials Science; Hannover Medical School; Hannover Germany
| | - R. Fimmers
- Institute of Medical Biometry; Informatics and Epidemiology; University of Bonn; Bonn Germany
| | - J. Dommisch
- Department of Periodontology, Operative and Preventive Dentistry; University Hospital Bonn; Bonn Germany
| | - S. Jepsen
- Department of Periodontology, Operative and Preventive Dentistry; University Hospital Bonn; Bonn Germany
| | - N. Miosge
- Research Group for Oral Biology and Tissue Regeneration; Department of Prosthetic Dentistry; University Hospital Göttingen; Göttingen Germany
| | - K. Adam
- Clinic for Dental Prosthetics and Biomedical Materials Science; Hannover Medical School; Hannover Germany
| | - J. Eberhard
- Clinic for Dental Prosthetics and Biomedical Materials Science; Hannover Medical School; Hannover Germany
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Mance I, Adam K, Fukuda K, Vogel E. The contribution of attentional lapses to estimates of individual differences in working memory capacity. J Vis 2014. [DOI: 10.1167/14.10.40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Adam K, Mance I, Fukuda K, Vogel E. Trial-by-trial fluctuations in working memory performance predict individual differences in working memory capacity. J Vis 2014. [DOI: 10.1167/14.10.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kollias K, Mylona E, Adam K, Papassiopi N, Papassiopi N, Xenidis A. Suppression of Pyrite Oxidation by Surface Silica Coating. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/gep.2014.24006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Adam K, Mance I, Awh E, Vogel E. Whole-report procedures reveal bimodal distribution of visual memory precision within a single array. J Vis 2013. [DOI: 10.1167/13.9.1362] [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: 11/24/2022] Open
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Rashid MH, Pan S, Hong TM, Sheng LFS, Sittampalam K, Sairi A, Adam K, Chin F, Teo M, Quek R. Undifferentiated Pleomorphic Sarcoma (UPS): An Analysis of 135 Patients (PTS) with this Clinically Unique Subtype of High-Grade Soft Tissue Sarcoma (HG-STS). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34045-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Adam K, Farid M, Sairi A, Widayana H, Manaf A, Soh L, Quek R. AOS12 Efficacy and safety of trabectedin versus gemcitabine/docetaxel in patients with sarcoma after failure of anthracycline and/or ifosfamide. Eur J Cancer 2012. [DOI: 10.1016/j.ejca.2012.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tang AW, Alfirevic Z, Turner MA, Drury J, Topping J, Dawood F, Farquharson R, Quenby S, Adam K, Entwisle M, O'Toole K, Bhima G, Palep-Singh M, Edi-Osagie E, Abediasl Z, Moini M, Jansen E, Stoop D, Ermini B, Haentjens P, De Vos M, Polyzos N, Verheyen G, Devroey P, Cabar FR, P. Pereira P, Francisco RP, Zugaib M, Horiuchi R, Miyaji S, Haruki A, Fukuda A, Morimoto Y. SELECTED ORAL COMMUNICATION SESSION, SESSION 34: EARLY PREGNANCY LOSS PROGNOSIS AND TREATMENT, Tuesday 5 July 2011 10:00 - 11:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Grundey J, Thirugnanasambandam N, Drees A, Adam K, Paulus W, Nitsche M. Effects of nicotine on PAS-induced neuroplasticity in the healthy human. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Panagopoulos I, Karayannis A, Adam K, Aravossis K. Application of risk management techniques for the remediation of an old mining site in Greece. Waste Manag 2009; 29:1739-1746. [PMID: 19136246 DOI: 10.1016/j.wasman.2008.11.017] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Accepted: 11/13/2008] [Indexed: 05/27/2023]
Abstract
This article summarizes the project and risk management of a remediation/reclamation project in Lavrion, Greece. In Thoricos the disposal of mining and metallurgical wastes in the past resulted in the contamination with heavy metals and acid mine drainage. The objective of this reclamation project was to transform this coastal zone from a contaminated site to an area suitable for recreation purposes. A separate risk assessment study was performed to provide the basis of determining the relevant environmental contamination and to rate the alternative remedial schemes involved. The study used both existing data available from comprehensive studies, as well as newly collected field data. For considering environmental risk, the isolation and minimization of risk option was selected, and a reclamation scheme, based on environmental criteria, was applied which was comprised of in situ neutralization, stabilization and cover of the potentially acid generating wastes and contaminated soils with a low permeability geochemical barrier. Additional measures were specifically applied in the areas where highly sulphidic wastes existed constituting active acid generation sources, which included the encapsulation of wastes in HDPE liners installed on clay layers.
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Affiliation(s)
- I Panagopoulos
- Sybilla Ltd., 16 Ipsilantou, Maroussi, 151 22 Maroussi, Athens, Greece.
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Amawi S, Adam K, Kellner G, Holzgartner N, Weitzel S, Vielhaber H. Iatrogene Hyperchlorämie als Ursache einer protrahierten, scheinbar insulinresistenten Azidose bei Diabetes mellitus Erstmanifestation. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1079034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Amawi S, Adam K, Kellner G, Holzgartner N, Weitzel S, Vielhaber H. Vital bedrohliche Hypokaliämie bei Erstmanfestation eines Diabetes mellitus mit schwerer diabetischer Ketoazidose. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1079031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Brecht M, Schreier S, Adam K, Vielhaber H. Isolierte ausgedehnte familiäre Aplasia cutis des Schädels. Monatsschr Kinderheilkd 2007. [DOI: 10.1007/s00112-007-1637-z] [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: 11/25/2022]
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Albert MH, Becker B, Schuster FR, Klein B, Binder V, Adam K, Nienhoff C, Führer M, Borkhardt A. Oral graft vs. host disease in children--treatment with topical tacrolimus ointment. Pediatr Transplant 2007; 11:306-11. [PMID: 17430488 DOI: 10.1111/j.1399-3046.2006.00666.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Oral chronic graft vs. host disease (GVHD) frequently presents in patients with sclerotic features of skin GVHD and is often associated with considerable limitations of oral food intake and decreased quality of life. Systemic tacrolimus is efficacious for prophylaxis and treatment of acute and chronic GVHD and topical tacrolimus has shown activity in chronic GVHD skin lesions. We therefore initiated a pilot study to investigate the safety and efficacy of topical tacrolimus ointment in children with oral GVHD. Six patients suffering from oral GVHD (five chronic and one acute) were included in the study. Tacrolimus ointment 0.1% was applied twice daily using sterile gauze. The only side-effects observed were a slight burning discomfort after the first application in one patient and after food intake in another patient. Tacrolimus was absorbed systemically in four of six patients. Of six patients, we observed a complete response in two, a very good partial response (VGPR) in two, and a PR in two patients, respectively. We conclude that topical application of tacrolimus ointment holds promise as a safe and efficacious treatment for oral GVHD in children. The Food and Drug Administration has recently issued a health advisory about a potential cancer risk associated with topical tacrolimus treatment of the skin; therefore, its benefits should be weighed against its potential risks and diligent long-term follow-up should be carried out especially in children.
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Affiliation(s)
- Michael H Albert
- Department of Pediatric Hematology/Oncology, Dr von Haunersches Kinderspital, Ludwig Maximilians University, Munich, Germany.
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El Sony A, Slama K, Salieh M, Elhaj H, Adam K, Hassan A, Enarson DA. Feasibility of brief tobacco cessation advice for tuberculosis patients: a study from Sudan. Int J Tuberc Lung Dis 2007; 11:150-5. [PMID: 17263284] [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: 05/13/2023] Open
Abstract
SETTING Twenty-four health care centres in Sudan. OBJECTIVE To examine the feasibility of introducing a tobacco cessation intervention into tuberculosis (TB) treatment programmes. DESIGN A feasibility study of a tobacco cessation intervention for new cases of pulmonary tuberculosis (PTB) in men compared survey centres (controls) and tobacco cessation intervention centres. Feasibility was evaluated by examining 1) acceptance by health staff and 2) the impact of additional tasks on TB treatment outcomes. A secondary assessment looked at rate of stopping tobacco use among those enrolled in the intervention condition. RESULTS Staff members did not differ in personal use of tobacco, in enforcing rules banning the use of tobacco at health centres or in rates of recruitment into the study. A total of 513 patients (44% of those eligible) were enrolled. Differences in TB treatment success were found between patients who were enrolled and those who were not: respectively 83% and 59% were cured or completed treatment. Of identified tobacco users undergoing the cessation intervention, 66% reported abstinence at the end of their TB treatment. CONCLUSION Although differences existed between patients enrolled or not enrolled, the intervention was demonstrated to be feasible to implement and effective for those enrolled within routine TB services.
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Saussele S, Adam K, Hochhaus A, Béné MC, Büchner T, Burnett A, Finazzi G, Fonatsch C, Gluckman E, Gökbuget N, Grimwade DJ, Haferlach T, Hallek M, Hasford J, Hoelzer D, Ljungman P, Niederwieser D, Serve H, Simonsson B, de Witte TJ, Hehlmann R. Klinische Forschung im „European LeukemiaNet”. Dtsch Med Wochenschr 2006; 131:2423-6. [PMID: 17054061 DOI: 10.1055/s-2006-955027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S Saussele
- III. Medizinische Universitätsklinik, Klinikum Mannheim der Universität Heidelberg, 68305 Mannheim.
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Parapanissiou E, Papastavrou T, Deligiannidis A, Adam K, Kanakoudi F, Daniilidis M, Polymenidis Z. HLA antigens in Greek children with allergic bronchial asthma. ACTA ACUST UNITED AC 2005; 65:481-4. [PMID: 15853903 DOI: 10.1111/j.1399-0039.2005.00392.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of our study was to investigate the genetic linkage between mite allergic bronchial asthma and HLA class I and II antigens and haplotypes. Sixty Greek children with allergic bronchial asthma due to mite sensitivity (Dermatophagoides pteronyssinus and Dermatophagoides farinae) and their family members were typed for HLA class I and II antigens (total 263 subjects). One hundred and twenty-five healthy, unrelated Greek children without medical history of atopy were also typed as control group. Major histocompatibility complex class I and II gene analysis revealed that only HLA-DRB1*04 and HLA-DQA1*0301 alleles are possibly important factors in the development of atopic asthma in Greek children with sensitivity to mites. No significant differences among the HLA-DRB1*04 subtypes have been established. Transmission disequilibrium test revealed that no specific HLA-A, -B, -DRB1, -DQA1 and -DQB1 alleles were transmitted preferentially to the affected children. HLA-DQB1*0301-4 alleles were associated with high levels of total serum immunoglobulin E in affected children. The study of the HLA haplotypes failed to demonstrate any significant association between any extended or natural selection haplotype and mite allergic bronchial asthma in Greek children.
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Affiliation(s)
- E Parapanissiou
- Histocompatibility Center and Department of Immunology, Hippokration General Hospital, Vislis-Visadas 17-54636, Thessaloniki, Greece
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Brohn S, Kullmer U, Knoblauch B, Adam K, Münstedt K. Prognosefaktoren des Endometriumkarzinoms - Ein Vergleich klinischer und immunhistochemisch bestimmter Parameter. Geburtshilfe Frauenheilkd 2004. [DOI: 10.1055/s-2004-820973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Abstract
OBJECTIVE To examine the association of unresolved and unclassifiable attachment with dissociative symptomatology in a sample of 133 adolescents in psychiatric treatment. METHOD The study compared 69 adolescents who were unresolved and unclassifiable with 64 adolescents who were not unresolved and unclassifiable. Attachment organization was assessed using the Adult Attachment Interview (AAI). Dissociative symptomatology was assessed using a scale derived from the Youth Self Report (YSR) behaviour checklist. RESULTS A continuing unresolved and unclassifiable response to attachment-related trauma was correlated with dissociative symptomatology for both male and female adolescents. CONCLUSIONS Cognitive disorganization may be an important variable mediating between the effects of earlier traumatic caregiving experiences and later dissociative symptoms.
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Affiliation(s)
- M West
- Department of Psychiatry, University of Calgary, Calgary, Alberta.
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Adam K, Vavatsi N, Mytilineos J, Kouidou S, Polymenidis Z, Trakatellis A, Opelz G. HLA class II DNA-RFLP typing in 102 individuals from Northern Greece. Transpl Int 2001; 7 Suppl 1:S522-6. [PMID: 11271298 DOI: 10.1111/j.1432-2277.1994.tb01434.x] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The serological identification of HLA class II alleles is often doubtful. Since accurate HLA typing is essential for the matching of donor-recipient pairs in allogeneic transplantation, an effort was made to establish DNA restriction fragment length polymorphism (RFLP) typing and to assess the correlation between the serological and RFLP techniques in the population of Northern Greece. One hundred and two healthy individuals (204 HLA-DR alleles) from Northern Greece were HLA-DR, DQ typed with both the microcytotoxicity and the Taq I RFLP method, using three exon-specific probes. DNA-RFLP typing revealed (1) concordant results with serology in 69.9% (142/204) of the alleles and (2) at least one HLA-DR allele discrepant to serology in 30.4% (62/204) of the alleles. Incorrect serological DR types (weak reactions or inability to distinguish between two alleles with a common epitope) were identified in 54 alleles (26.5%), while 3.9% (8/204) of serological "blank" alleles turned out to be definable alleles by RFPL. Of the individuals tested, 10.8% (11/102) were DR-homozygous by RFLP. This comparison of results obtained by serology and RFLP demonstrated the necessity of the clinical application of DNA typing, especially for organ transplantation where accurate HLA typing has an important influence on graft survival.
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Affiliation(s)
- K Adam
- Immunology Department, Thessaloniki, Greece
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Kakas PK, Adam K, Lazidou P, Papakyriazi H, Parapanisiou E, Polymenides Z. Selection of the most compatible graft recipient by computer program, used in regional tissue typing laboratory of Hellas (R.T.T.L.). Transpl Int 2001; 7 Suppl 1:S532-5. [PMID: 11271300 DOI: 10.1111/j.1432-2277.1994.tb01436.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to present the new computer program that we developed in the regional tissue typing laboratory (R.T.T.L.) and use for the selection of the most suitable recipient for cadaveric allografts in a more efficient way. This new program was written and compiled in TURBO PASCAL 6.0, sorts all possible recipients to the HLA type of a donor, checks for the existence of splits and utilises them, and when requested, gives out results to more specific inquiries, i.e. all compatible recipients from 2DR2B2A to 1DR0B0A matching. It can also forecast success percentages according to different factors, i.e. combination of donor's and recipient's ages, HLA matching etc. The material used for this study were the patients who are registered in the formal cadaveric transplantation list of R.T.T.L. We have used this program since 2 January 1992 together with the old one. Since then we found that the new program is faster in sorting all the possible recipients of cadaveric renal allografts according to the criteria already mentioned. The total selection time, with all the criteria activated, averages a few seconds, whereas with the old program it took approximately 2 min just for the sorting of HLA matching, without any other criteria activated. In the printout of the final result of each inquiry are all the possible recipients in the sorted order together with relevant data (telephone number, address etc.). As a result, the laboratory personnel has been free from the tedious task of this sorting which was initially done by hand and the possibility of error has been eliminated. The program was developed exclusively by doctors and all the updates needed are done by the users. More important, however, is the fact that in many cases the time of cold ischaemia was reduced by more than 30 min with all the obvious advantages for the longevity of the graft's life.
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Affiliation(s)
- P K Kakas
- Immunology Department, Thessaloniki, Greece
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Fleva A, Daniilidis M, Sidiropoulos J, Adam K, Tourkantonis A, Daniilidis J, Hadzipetrou L. Can HLA typing predict the outcome of grass pollen immunotherapy? Exp Clin Immunogenet 2001; 18:13-23. [PMID: 11150849 DOI: 10.1159/000049083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between HLA molecules and the positive or negative response of atopic patients to specific immunotherapy (SIT). METHODS We studied 42 atopic multisensitive patients undergoing grass pollen immunotherapy, 42 parents of patients (30 mothers and 12 fathers) and 173 control individuals. HLA class I and class II antigens were typed by a microlymphocytotoxicity test. The typing of DRB1* alleles for atopic patients and their parents was based on the reverse hybridization principle, while for the control group, DNA-RFLP and PCR-SSP methods were used. RESULTS The frequency of B14 and DRB1*1101-4 antigens/alleles, as well as the A2B5DR11 haplotype, showed a statistically significant difference in those patients who responded to immunotherapy. On the other hand, HLA-A28, B8 and DRB1*0301 antigens/alleles, as well as the frequency of the A1B8 and A1B8DR3 haplotypes, were found to be significantly higher in patients who responded poorly to SIT. DISCUSSION Our findings support the hypothesis that treatment responsiveness may show an association to HLA molecules, which could thus play a role in the immunological selection and monitoring of atopic patient candidacy for SIT.
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Affiliation(s)
- A Fleva
- First Department of Internal Medicine, Hippokration General Hospital, Thessaloniki, Greece
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West M, Rose S, Spreng S, Adam K. The Adolescent Unresolved Attachment Questionnaire: the assessment of perceptions of parental abdication of caregiving behavior. J Genet Psychol 2000; 161:493-503. [PMID: 11117104 DOI: 10.1080/00221320009596727] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article reports on the Adolescent Unresolved Attachment Questionnaire (AUAQ), a brief questionnaire that assesses the caregiving experiences of unresolved adolescents (as recipients of caregiving). The AUAQ was developed and validated in a large normative sample (n = 691) and a sample of 133 adolescents in psychiatric treatment. It is a self-report questionnaire consisting of 3 scales with Likert-type responses ranging from strongly disagree to strongly agree. The Aloneness/Failed Protection Scale assesses the adolescent's perception of the care provided by the attachment figure. The Fear Scale taps the fear generated by the adolescent's appraisal of failed attachment figure care. The Anger/Dysregulation Scale assesses negative affective responses to the perceived lack of care from the attachment figure. All scales demonstrated satisfactory internal reliability and agreement between scores for adolescents (n = 91) from the normative sample who completed the AUAQ twice. Adolescents in the clinical sample also completed the Adult Attachment Interview (AAI; C. George, N. Kaplan, & M. Main, 1984/1985/1996); the AUAQ demonstrated high convergent validity with the AAI.
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Affiliation(s)
- M West
- Department of Psychiatry, University of Calgary, Alberta, Canada
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Kirshon B, Reiter A, Adam K, Cheung SW. Confirmation of paternal disomy in a twin molar pregnancy. A case report. J Reprod Med 2000; 45:39-41. [PMID: 10664946] [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: 02/15/2023]
Abstract
BACKGROUND Paternal dispermy can be the pathogenesis of complete molar pregnancy. CASE A 23-year-old, white woman, gravida 4, para 1, was pregnant with a twin gestation by ovulation induction with metrodin. Ultrasound evaluation confirmed an intrauterine pregnancy in conjunction with what appeared to be a hydatidiform mole. The karyotype in the molar pregnancy, obtained from chorionic villus sampling, showed a pair of paternally derived inverted chromosomes 9, confirming the diagnosis of a complete mole. Uncontrollable hemorrhage with a rapid rise in the beta-human chorionic gonadotropin titer necessitated evacuation of the uterus. The patient was followed with beta-human chorionic gonadotropin titers for a year, with no evidence of recurrence. CONCLUSION This case illustrates paternal disomy in a complete molar pregnancy documented by a paternal chromosome 9 inversion.
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Affiliation(s)
- B Kirshon
- Houston Perinatal Associates and Laboratories for Genetic Services, Inc., Texas 77054, USA
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Pratsidou-Gertsi P, Kanakoudi-Tsakalidou F, Spyropoulou M, Germenis A, Adam K, Taparkou A, Siamopoulou A, Drakou C, Konstantinidis T, Prieur AM, Stavropoulos-Giokas C. Nationwide collaborative study of HLA class II associations with distinct types of juvenile chronic arthritis (JCA) in Greece. Eur J Immunogenet 1999; 26:299-310. [PMID: 10457895 DOI: 10.1046/j.1365-2370.1999.00156.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The aim of this study was to investigate the association of different groups and subgroups of juvenile chronic arthritis (JCA) with HLA class II (DR, DP, DQ) alleles and/or haplotypes. Groups and subgroups were mainly distinguished on the basis of the type of onset, the course and complications of the disease, and some predefined disease markers according to the criteria proposed by the ILAR Standing Committee (Chile, 1994). On the basis of these criteria the following five JCA groups and their subgroups were included in the study: (1) define systemic onset (n = 25) and systemic progressing to persistent arthritis (n = 14); (2) JCA of oligoarthritis onset (O-JCA, n = 124) and of oligoarthritis onset and course (n = 98), O-JCA of early (< 6 years) or late (> 6 years) onset (EOO-JCA n = 71 and LOO-JCA n = 44), O-JCA with ANA positive (n = 69) or negative (n = 55) and O-JCA progressing to extended arthritis (n = 22); (3) JCA of polyarthritis onset (P-JCA) with rheumatic factor (RF) negative (n = 29), and P-JCA RF negative with antinuclear antibodies (ANA) positive (n = 13) or negative (n = 16); (4) JCA complicated with chronic anterior uveitis (CAU, n = 32); (5) juvenile psoriatic arthritis (n = 20). To assess the HLA allele frequencies in the above 223 Greek children with JCA, these frequencies were compared to those of 98 age-matched and 250 adult controls. The main findings were the following. A common HLA-DRB1* allele was not involved in the JCA groups and subgroups studied; on the other hand, the DQA1*0501 allele was found to be associated with different JCA groups/subgroups (O-JCA, P-JCA RF-negative ANA-positive, JCA with CAU), probably suggesting a closer relationship of this locus with the immunogenetic background of JCA. The DPB1*0201 allele was associated with the development of either EOO-JCA or CAU. Susceptibility to CAU was stronger when the DPB1*0201 was combined with the presence of DRB1*13. Another allele, DQB1*0301, was also associated with O-JCA and CAU. Finally, no specific HLA class II allele was found to be related to the presence of ANA or psoriatic lesions or to the severity of the arthritis. Our findings suggest that the wide clinical and laboratory spectrum of JCA is associated with an immunogenetic background that is linked with HLA alleles of more than one locus. Some of them, such as the DPB1*0201 allele, confer susceptibility to certain clinical onsets and courses or complications of the disease. The rapidly advancing techniques of typing of DNA profiles may lead to more definite conclusions.
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Affiliation(s)
- P Pratsidou-Gertsi
- 1st Department of Pediatrics, Aristotle University, Thessaloniki, Greece
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Abstract
Aortic stenosis in pregnancy can be a life-threatening condition, but fortunately it is rare. In the modern era, careful obstetric and cardiologic monitoring, particularly through echocardiography, have improved fetal and maternal outcomes. However, a test that could predict outcome has not been available for patients with aortic stenosis who seek prepregnancy counseling. We report a case in which exercise Doppler echocardiography was used to predict cardiac function and maximal gradients in a woman with a bicuspid aortic valve who wished to become pregnant.
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Affiliation(s)
- S Wilansky
- Department of Cardiology, Texas Heart Institute/St Luke's Episcopal Hospital, Houston 77030, USA
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Abstract
BACKGROUND Little information is available about changes in left ventricular diastolic function during pregnancy. We used mitral inflow and pulmonary venous flow profiles to evaluate left ventricular diastolic function in 37 healthy pregnant women 26 to 41 years old (mean, 32 years). METHODS AND RESULTS Echocardiographic studies were performed at the end of each trimester. Eight subjects (control group) underwent similar testing 1 to 3.5 months (mean, 1.7 months) postpartum. During pregnancy, the cardiac output increased significantly as a result of an increased heart rate and, to a lesser degree, stroke volume. Significantly decreased systemic vascular resistance and increased left ventricular mass were also noted. Peak mitral flow velocity in early diastole (E) increased 13. 3% during the first trimester and remained at the high end of normal throughout pregnancy. Peak A-wave velocity (A) increased maximally in the third trimester. Compared with control subjects, first-trimester subjects had a significantly increased E/A ratio. The ratio subsequently decreased, reflecting the augmented A-wave velocity. Pulmonary venous peak systolic forward flow velocity increased, peaking in the second trimester (nonsignificant), but returned to baseline levels postpartum. The pulmonary venous diastolic time-velocity integral decreased significantly from the first to the third trimester. Peak pulmonary venous reverse flow velocity at atrial contraction increased significantly, without being markedly changed in duration. CONCLUSIONS Pregnancy, a chronic, natural volume-overload state, has important effects on hemodynamic and echocardiographic variables. Based on pulmonary venous flow and left ventricular inflow velocities, our results provide a standard reference concerning diastolic filling dynamics by trimester.
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Affiliation(s)
- A Mesa
- Department of Cardiology, St Luke's Episcopal Hospital and Baylor College of Medicine, Texas Heart Institute, Houston, USA
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Kontopoulos A, Harsoulis P, Adam K, Papadopoulos G, Polymenidis Z, Boudoulas H. Frequency of HLA antigens in Graves' hyperthyroidism and mitral valve prolapse. J Heart Valve Dis 1996; 5:543-7. [PMID: 8894996] [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: 02/02/2023]
Abstract
BACKGROUND AND AIMS OF THE STUDY An association between Graves' hyperthyroidism (G) and mitral valve prolapse (MVP) has been reported, but possible genetic linkage between the two disorders has not. METHODS One hundred and five patients (pts) with G were studied after therapy, in a euthyroid state. MVP (auscultatory plus echocardiographic findings) was present in 33 pts (31%). Frequency of human lymphocyte antigens (HLA) in pts with G and in pts with G plus MVP was compared to 170 normal subjects (NL). There was no difference in HLA-A antigens among the three groups. RESULTS The frequency of HLA B-15 was greater in pts with G plus MVP (18.9%) compared to NL (3%) and to G without MVP (4.2), p < 0.01. The frequency of HLA-B39 was greater in G without MVP (13.8%) compared to NL (4.1%), p < 0.01. The HLA DRB1*1601-2 was more frequent in G with (30.3%) or without (29.2%) MVP compared to NL (13.5%), p < 0.01. The frequency of HLA DRB1*1401-10 and DQA1*0104 were greater in NL (16.5%) compared to G with (3.0%) or without (4.2%) MVP, p < 0.01. CONCLUSIONS The data confirmed previous observations that the frequency of MVP is high in pts with G. Further, the data indicated a possible genetic linkage between the two abnormalities.
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Affiliation(s)
- A Kontopoulos
- Propedentic Department of Medicine, Aristotelian University of Thessaloniki, Greece
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Polymenidis Z, Gakis D, Adam K, Parapanissiou E, Koukoudis P, Papakyriazi E, Antoniadis A, Papadimitriou M. Importance of natural selection haplotypes in renal transplantation from haploidentical living related donors (LRD). Hum Immunol 1996. [DOI: 10.1016/0198-8859(96)85306-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lazidou G, Adam K, Parapanissiou E, Rimenidou K, Persidou H, Papakyriazi H, Polymenidis Z. Distribution of HLA-A, B, DRB1*, DQB1* and DQA1* antigens and natural selection haplotypes (NSH) in the greeks. Hum Immunol 1996. [DOI: 10.1016/0198-8859(96)85262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Harsoulis F, Adam K, Lazidou P, Lalanga S, Polymenidis Z. Class I and II HLA antigens and natural selection haplotypes in greek patients males and females with graves' disease. Hum Immunol 1996. [DOI: 10.1016/0198-8859(96)84841-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Montgomery LD, Belfort MA, Adam K. Massive fetomaternal hemorrhage treated with serial combined intravascular and intraperitoneal fetal transfusions. Am J Obstet Gynecol 1995; 173:234-5. [PMID: 7631692 DOI: 10.1016/0002-9378(95)90201-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
One of the many causes of fetal hydrops is fetomaternal hemorrhage. This report presents a pregnancy with fetomaternal hemorrhage that was treated with serial combined intravascular and intraperitoneal fetal transfusions, resulting in a good outcome. A 26-year-old woman seen for ultrasonographic evaluation was found to have a fetus with hydrops fetalis. Fetal blood sampling demonstrated severe fetal anemia (hematocrit 16.4%). The initial Kleihauer-Betke test result on maternal blood was 6% fetal cells. The fetus was transfused five times over a 24-day period by means of a combined intravascular and intraperitoneal route. The fetus also received one platelet transfusion for thrombocytopenia. The pregnancy resulted in a good fetal outcome without the need for postpartum transfusion. This case represents successful treatment of fetal anemia and nonimmune hydrops with a serial combined intravascular and intraperitoneal transfusion technique.
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Affiliation(s)
- L D Montgomery
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA
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Rokey R, Hsu HW, Moise KJ, Adam K, Wasserstrum N. Inaccurate noninvasive mitral valve area calculation during pregnancy. Obstet Gynecol 1994; 84:950-5. [PMID: 7970475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To compare two different Doppler echocardiographic techniques for the assessment of the transmitral area in pregnant patients with native mitral valve stenosis or prosthetic mitral valves. METHODS Eight consecutive gravid women with prosthetic mitral valves or obstructive native mitral valve disease were evaluated using both the pressure half-time and the continuity equation Doppler echocardiographic methods. Heart rate, cardiac output, and transmitral valve gradient and area were calculated. These studies were repeated postpartum in five women. Differences between the two methods were assessed by characterizing the absolute differences between the mean and standard deviation and by paired t tests. Linear regression analysis was also applied. RESULTS For the five women who also had postpartum studies, antepartum data were similar to those of the full set of eight patients. Postpartum heart rate, cardiac output, and transvalvular gradient were lower than antepartum measurements. Calculations using the continuity equation yielded comparable antepartum and postpartum estimates of transmitral areas (1.31 +/- 0.41 versus 1.32 +/- 0.44 cm2, respectively, r = 0.96). These estimates were also consistent with the initial clinical presentation. In contrast, antepartum transmitral valve areas calculated using the pressure half-time technique (2.67 +/- 0.61 cm2) were markedly higher than postpartum (1.94 +/- 0.58 cm2). The correlation between the estimates of antepartum valve area given by the two methods was not statistically significant (r = 0.02). In contrast, there was excellent postpartum correlation of transmitral area between the methods (r = 0.99), despite a significant difference (P < .001) in the transmitral area calculated with each technique. CONCLUSIONS The results indicate that Doppler echocardiographic estimates of the transvalvular area using the continuity equation technique during pregnancy are valid. In contrast, estimates of area using the pressure half-time technique in pregnant patients are dubious and could result in life-threatening consequences.
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Affiliation(s)
- R Rokey
- Department of Internal Medicine and Pediatrics, Baylor College of Medicine, Houston, Texas
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Abstract
OBJECTIVE Our purpose was to determine the effects of orally administered nimodipine on selected maternal and fetal parameters in patients with preeclampsia. STUDY DESIGN Ten consecutive patients were given 30 mg of nimodipine orally every 4 hours from admission until 24 hours after delivery. Maternal and fetal cerebral blood velocity, umbilical artery blood velocity, fetal heart rate variability, maternal blood pressure and heart rate, and transplacental passage of the drug were studied. All 10 patients were delivered within 24 hours of the first dose of nimodipine. RESULTS There was an acute and significant reduction in the pulsatility index in the smaller diameter maternal cerebral arteries (ophthalmic and central retinal) and in the fetal middle cerebral artery. The umbilical artery systolic/diastolic ratio was also significantly reduced. Maternal blood pressure was controlled without the need for other antihypertensive medication, and although there was an increase in heart rate after administration of the drug, it was well tolerated. Nimodipine reached significant maternal and fetal levels within 2 hours. CONCLUSIONS Nimodipine is rapidly absorbed after oral administration and has significant maternal and fetal cerebral vasodilator activity. It is an effective, easily administered antihypertensive agent when used in patients with preeclampsia.
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Affiliation(s)
- M A Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
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Adam K, Oswald I. Triazolam. Small studies miss the difference. BMJ 1993; 307:626. [PMID: 8401034 PMCID: PMC1678927 DOI: 10.1136/bmj.307.6904.626-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
The short- and long-term effects of simultaneous administration of terbutaline and betamethasone were investigated in 8 gravidas treated for preterm labor. Their plasma concentrations of glucose, insulin, glucagon, C-peptide, lactate and potassium were compared to a control group receiving intravenous magnesium sulfate and betamethasone. The patients on terbutaline therapy had a marked hyperglycemia at 11 h which remained elevated for 48 h. There was a simultaneous rise in plasma insulin and C-peptide, and a fall in plasma glucagon. Lactate levels were markedly elevated. Only 1 of the 8 patients had an abnormal glucose tolerance test at 1 week of therapy. The metabolic changes of control patients were minimal in comparison and there was no lacticacidemia. This suggests that glucocorticoids potentiate the hyperglycemic response of terbutaline.
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Affiliation(s)
- K Adam
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Tex. 77030
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Jessurun CR, Adam K, Moise KJ, Wilansky S. Pheochromocytoma-induced myocardial infarction in pregnancy. A case report and literature review. Tex Heart Inst J 1993; 20:120-2. [PMID: 8334363 PMCID: PMC325074] [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: 01/29/2023]
Abstract
We present the case of a 30-year-old woman, 33 weeks pregnant, whose pregnancy was complicated with the rare condition of pheochromocytoma-induced myocardial infarction. Alpha- and beta-adrenergic blockade was instituted immediately for control of hypertension and arrhythmias. Two weeks after myocardial infarction, fetal maturity was documented, and the patient underwent cesarean section delivery of a 6-lb, 6-oz baby girl. The delivery was followed immediately by excision of a 7- x 6- x 4.5-cm tumor, which was confirmed to be a pheochromocytoma by histologic examination. Her post-operative course was uneventful. Our case study and a review of the literature show that the key to successful fetal and maternal outcome is early diagnosis, which can be confirmed by 24-hour urine testing of catecholamine and metanephrine levels. If the tumor is diagnosed before 20 weeks' gestation, we recommend immediate surgical removal of the tumor and continuation of the pregnancy to term. The management of the patient who presents between 20 and 24 weeks' gestation will depend on the uterine size in terms of tumor access. After 24 weeks, the pregnancy should be carried to term, at which time delivery by cesarean section will be followed by tumor excision. Postoperative care should include appropriate cardiovascular investigation and ongoing serial measurements of urinary catecholamines.
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Affiliation(s)
- C R Jessurun
- Department of Adult Cardiology, Texas Heart Institute, Houston
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Adam K, Polymenidis Z, Papakyriazi L, Alexopoulos E, Parapanissiou E, Antoniadis A, Papadimitriou M. HLA-A, B, DR antigens and renal transplantation from cadaveric donors and living-related donors in Greek patients. Transplant Proc 1992; 24:2449-50. [PMID: 1465825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- K Adam
- Department of Immunology, Hippokration Hospital of Thessaloniki, Aristotelian University of Thessaloniki, Greece
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Polymenidis Z, Adam K, Parapanissiou E, Sakellariou G, Papakyriazi E, Antoniadis A, Papadimitriou M. Importance of certain HLA-A,B haplotypes for the survival of renal grafts from living-related donors. Transplant Proc 1992; 24:2458-60. [PMID: 1465830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Z Polymenidis
- Department of Immunology, Hippokration Hospital of Thessaloniki, Aristotelian University of Thessaloniki, Hellas, Greece
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Adam K, Oswald I. [Triazolam is different: it is a PAF antagonist]. Anaesthesist 1992; 41:103-6; author reply 106-7. [PMID: 1562092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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