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Bombarde M, Chau K, Droz D, Hernandez M. Comparative study of the dental health of 4-year-old children in north-eastern France between 2001 and 2018. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00893-8. [PMID: 38743213 DOI: 10.1007/s40368-024-00893-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 03/07/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE To analyse the evolution of the oral health of 4-year-old children in nursery school between 2001 and 2018 as well as the early predictor and associated risk factors, in different school areas. METHODS We compared (1) the prevalence of ECC (4 ≥ dmft ≥ 1) and S-ECC (dmft ≥ 5) of 4-year-old children and (2) data obtained by a structured questionnaire completed by their parents from two studies performed in 2001 and 2018. Data were analysed using the Chi2 test and odds ratio (OR). RESULTS A total of 322 children and of 425 children randomly selected among Moselle's public nursery schools in north-eastern France were, respectively, included in the study in 2001 and 2018. The prevalence of ECC was respectively 40.70% and 21.65% in 2001 and 2018 (p < 0.001; OR = 2.48; 95% CI = 1.78-3.47). We also observed a decrease of S-ECC prevalence (10.56% in 2001 vs 5.90% in 2018, p < 0.05, OR = 1.89; 95% CI = 1.07-3.38). The intake of cariogenic food (sweet drink, biscuits, candies, milk, baby bottle) decreased but the knowledge of parents concerning cariogenic food did not improve. The proportion of parents helping their child has not changed in 17 years (82.33% vs 86.52%, p > 0.1) but tooth brushing was initiated earlier in 2018 than in 2001 (p < 0.01). Prescription of systemic fluoride decreased (39.14% vs 3.62%; p < 0.001). CONCLUSION The identification of the food consumption habits and the knowledge of parents concerning oral health should enable strengthening of preventive measures and the initiation of an oral health education programme for children and their family.
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Affiliation(s)
- M Bombarde
- Odontology Faculty, University of Lorraine, Nancy, France
| | - K Chau
- Maternal and Child Protection Department and Health Direction, Metz, France
- General Medicine Department, University of Lorraine, Nancy, France
- INSERM, Plurithematic Clinical Investigation Center 1433, UMR 1116, University of Lorraine, CHRU Nancy, Nancy, France
| | - D Droz
- Odontology Faculty, University of Lorraine, Nancy, France
| | - M Hernandez
- Pediatric Dentistry Department, CHRU Nancy, Nancy, France.
- Odontology Faculty, University of Lorraine, Nancy, France.
- Laboratory of Stress, Immunity, Pathogens (EA7300), Medicine Faculty, University of Lorraine, Nancy, France.
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Lambert K, Ryan M, Flanagan J, Broinowski G, Nicdao M, Stanford J, Chau K. Dietary Patterns, Dietary Adequacy and Nutrient Intake in Adults Commencing Peritoneal Dialysis: Outcomes from a Longitudinal Cohort Study. Nutrients 2024; 16:663. [PMID: 38474791 DOI: 10.3390/nu16050663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
(1) Background: Optimal dietary intake is integral to good health in people receiving peritoneal dialysis (PD). We investigated how dietary patterns, dietary adequacy and nutrient intake may change over time in people commencing PD. (2) Methods: Participants were attending the PD training unit for the commencement of peritoneal dialysis, aged ≥18 years and willing to complete food records. Misreporters were excluded from the analysis. Dietary intake was compared at PD commencement and at 12 months. Intake was also compared to reference standards. Dietary patterns were derived using principal component analysis. (3) Results: There were no significant changes between baseline and 12 months for grains, fruit, vegetables and meat. Dairy and added sugar intake was significantly lower (p = 0.01). The intake of energy and protein was adequate and did not change. There was a significant reduction in dietary phosphorus and calcium, and increased vitamin C intake. Three dietary patterns were identified: the 'Bread and Cereal' pattern; 'Milk and Potatoes' pattern; and the 'Semi Vegetarian' pattern. (4) Conclusions: In this longitudinal cohort study, the diet quality was suboptimal and there were limited changes in intake after the commencement of PD. Further exploration of how dietary patterns may impact outcomes and quality of life is warranted.
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Affiliation(s)
- Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Michele Ryan
- Western Renal Service, Blacktown Hospital, Blacktown, NSW 2148, Australia
| | - Jade Flanagan
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Georgie Broinowski
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Maryann Nicdao
- Western Renal Service, Blacktown Hospital, Blacktown, NSW 2148, Australia
| | - Jordan Stanford
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Katrina Chau
- Western Renal Service, Blacktown Hospital, Blacktown, NSW 2148, Australia
- Blacktown Clinical School, School of Medicine, Western Sydney University, Blacktown, NSW 2148, Australia
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Xu C, Tsihlis G, Chau K, Trinh K, Rogers NM, Julovi SM. Novel Perspectives in Chronic Kidney Disease-Specific Cardiovascular Disease. Int J Mol Sci 2024; 25:2658. [PMID: 38473905 DOI: 10.3390/ijms25052658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Chronic kidney disease (CKD) affects > 10% of the global adult population and significantly increases the risk of cardiovascular disease (CVD), which remains the leading cause of death in this population. The development and progression of CVD-compared to the general population-is premature and accelerated, manifesting as coronary artery disease, heart failure, arrhythmias, and sudden cardiac death. CKD and CV disease combine to cause multimorbid cardiorenal syndrome (CRS) due to contributions from shared risk factors, including systolic hypertension, diabetes mellitus, obesity, and dyslipidemia. Additional neurohormonal activation, innate immunity, and inflammation contribute to progressive cardiac and renal deterioration, reflecting the strong bidirectional interaction between these organ systems. A shared molecular pathophysiology-including inflammation, oxidative stress, senescence, and hemodynamic fluctuations characterise all types of CRS. This review highlights the evolving paradigm and recent advances in our understanding of the molecular biology of CRS, outlining the potential for disease-specific therapies and biomarker disease detection.
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Affiliation(s)
- Cuicui Xu
- Kidney Injury Group, Centre for Transplant and Renal Research, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia
| | - George Tsihlis
- Renal and Transplantation Medicine, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Katrina Chau
- Department of Renal Services, Blacktown Hospital, Blacktown, NSW 2148, Australia
- Blacktown Clinical School, School of Medicine, Western Sydney University, Sydney, NSW 2148, Australia
| | - Katie Trinh
- Kidney Injury Group, Centre for Transplant and Renal Research, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia
- Department of Renal Services, Blacktown Hospital, Blacktown, NSW 2148, Australia
| | - Natasha M Rogers
- Kidney Injury Group, Centre for Transplant and Renal Research, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia
- Renal and Transplantation Medicine, Westmead Hospital, Westmead, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
| | - Sohel M Julovi
- Kidney Injury Group, Centre for Transplant and Renal Research, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
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Rodger G, Chau K, Aranega-Bou P, Roohi A, Moore G, Hopkins KL, Hopkins S, Walker AS, Stoesser N. A workflow for the detection of antibiotic residues, measurement of water chemistry and preservation of hospital sink drain samples for metagenomic sequencing. J Hosp Infect 2024; 144:128-136. [PMID: 38145816 DOI: 10.1016/j.jhin.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Hospital sinks are environmental reservoirs that harbour healthcare-associated (HCA) pathogens. Selective pressures in sink environments, such as antibiotic residues, nutrient waste and hardness ions, may promote antibiotic resistance gene (ARG) exchange between bacteria. However, cheap and accurate sampling methods to characterize these factors are lacking. AIMS To validate a workflow to detect antibiotic residues and evaluate water chemistry using dipsticks. Secondarily, to validate boric acid to preserve the taxonomic and ARG ('resistome') composition of sink trap samples for metagenomic sequencing. METHODS Antibiotic residue dipsticks were validated against serial dilutions of ampicillin, doxycycline, sulfamethoxazole and ciprofloxacin, and water chemistry dipsticks against serial dilutions of chemical calibration standards. Sink trap aspirates were used for a 'real-world' pilot evaluation of dipsticks. To assess boric acid as a preservative of microbial diversity, the impact of incubation with and without boric acid at ∼22 °C on metagenomic sequencing outputs was evaluated at Day 2 and Day 5 compared with baseline (Day 0). FINDINGS The limits of detection for each antibiotic were: 3 μg/L (ampicillin), 10 μg/L (doxycycline), 20 μg/L (sulfamethoxazole) and 8 μg/L (ciprofloxacin). The best performing water chemistry dipstick correctly characterized 34/40 (85%) standards in a concentration-dependent manner. One trap sample tested positive for the presence of tetracyclines and sulphonamides. Taxonomic and resistome composition were largely maintained after storage with boric acid at ∼22 °C for up to five days. CONCLUSIONS Dipsticks can be used to detect antibiotic residues and characterize water chemistry in sink trap samples. Boric acid was an effective preservative of trap sample composition, representing a low-cost alternative to cold-chain transport.
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Affiliation(s)
- G Rodger
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; NIHR Health Protection Unit in Antimicrobial Resistance and Healthcare-associated Infection, University of Oxford, Oxford, UK
| | - K Chau
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; NIHR Health Protection Unit in Antimicrobial Resistance and Healthcare-associated Infection, University of Oxford, Oxford, UK
| | - P Aranega-Bou
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, UK
| | - A Roohi
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; NIHR Health Protection Unit in Antimicrobial Resistance and Healthcare-associated Infection, University of Oxford, Oxford, UK
| | - G Moore
- Biosafety, Air and Water Microbiology Group, UK Health Security Agency, Porton Down, UK
| | | | - S Hopkins
- UK Health Security Agency, Colindale, UK
| | - A S Walker
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; NIHR Health Protection Unit in Antimicrobial Resistance and Healthcare-associated Infection, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - N Stoesser
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; NIHR Health Protection Unit in Antimicrobial Resistance and Healthcare-associated Infection, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK.
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Sagar PS, Munt A, Saravanabavan S, Vahedi FA, Elhindi J, Nguyen B, Chau K, Harris DC, Lee V, Sud K, Wong N, Rangan GK. Efficacy of beetroot juice on reducing blood pressure in hypertensive adults with autosomal dominant polycystic kidney disease (BEET-PKD): study protocol for a double-blind, randomised, placebo-controlled trial. Trials 2023; 24:482. [PMID: 37507763 PMCID: PMC10386227 DOI: 10.1186/s13063-023-07519-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND In autosomal dominant polycystic kidney disease (ADPKD) impaired nitric oxide (NO) synthesis, in part, contributes to early-onset hypertension. Beetroot juice (BRJ) reduces blood pressure (BP) by increasing NO-mediated vasodilation. The aim of this double-blind, randomised, placebo-controlled study is to test the hypothesis that BRJ reduces systolic and diastolic clinic BP in hypertensive adults with ADPKD. METHODS Participants with ADPKD and treated hypertension (n = 60) will be randomly allocated (1:1) to receive a daily dose of either nitrate-replete (400 mg nitrate/day) or nitrate-deplete BRJ for 4 weeks. The co-primary outcomes are change in mean systolic and diastolic clinic BP before and after 4 weeks of treatment with daily BRJ. Secondary outcomes are changes in daily home BP, urinary albumin to creatinine ratio, serum and salivary nitrate/nitrite levels and serum asymmetric dimethylarginine levels before and after 4 weeks of BRJ. DISCUSSION The effect of BRJ in ADPKD has not been previously tested. BRJ is an accessible, natural dietary supplement that, if effective, will provide a novel adjunctive approach for treating hypertension in ADPKD. TRIAL REGISTRATION ClinicalTrials.gov NCT05401409. Retrospectively registered on 27th May 2022.
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Affiliation(s)
- Priyanka S Sagar
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, 2145, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - Alexandra Munt
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, 2145, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - Sayanthooran Saravanabavan
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, 2145, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - Farnoosh Asghar Vahedi
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, 2145, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - James Elhindi
- Research and Education Network, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - Beatrice Nguyen
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, 2145, Australia
| | - Katrina Chau
- Department of Renal Medicine, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, 2148, Australia
- Blacktown Clinical School, Western Sydney University, Blacktown, NSW, 2148, Australia
| | - David C Harris
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, 2145, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
| | - Vincent Lee
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2145, Australia
| | - Kamal Sud
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2145, Australia
- Department of Renal Medicine, Nepean Hospital, Nepean Blue Mountains Local Health District, Sydney, NSW, 2750, Australia
| | - Nikki Wong
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2145, Australia
- Department of Renal Medicine, Nepean Hospital, Nepean Blue Mountains Local Health District, Sydney, NSW, 2750, Australia
| | - Gopala K Rangan
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, 2145, Australia.
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, 2145, Australia.
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Hansen MS, Tesfaye W, Sud K, Sewlal B, Mehta B, Kairaitis L, Tarafdar S, Chau K, Razi Zaidi ST, Castelino R. Psychosocial factors in patients with kidney failure and role for social worker: A secondary data audit. J Ren Care 2022; 49:75-83. [PMID: 35526147 DOI: 10.1111/jorc.12424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with kidney failure face a multitude of psychosocial stressors that affect disease trajectory and health outcomes. OBJECTIVES To investigate psychosocial factors affecting people with kidney failure before or at start of kidney replacement therapy (KRT) and kidney supportive and palliative care (KSPC) phases of illness and to explore role of social worker during the illness trajectory. METHODS We conducted a secondary data audit of patients either before or at start of KRT (Phase 1) and at the KSPC (Phase 2) of illness and had psychosocial assessments between March 2012 and March 2020 in an Australian setting. RESULTS Seventy-nine individuals, aged 70 ± 12 years, had at least two psychosocial assessments, one in each of the two phases of illness. The median time between social worker evaluations in Phase 1 and Phase 2 was 522 (116-943) days. Adjustment to illness and treatment (90%) was the most prevalent psychosocial issue identified in Phase 1, which declined to 39% in Phase 2. Need for aged care assistance (7.6%-63%; p < 0.001) and carer support (7.6%-42%; p < 0.001) increased significantly from Phase 1 to Phase 2. There was a significant increase in psychosocial interventions by the social worker in Phase 2, including supportive counselling (53%-73%; p < 0.05), provision of education and information (43%-65%; p < 0.01), and referrals (28%-62%; p < 0.01). CONCLUSION Adults nearing or at the start of KRT experience immense psychosocial burden and adaptive demands that recognisably change during the course of illness. The positive role played by the nephrology social worker warrants further investigation.
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Affiliation(s)
- Micaella Sotera Hansen
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Wubshet Tesfaye
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia.,Health Research Institute, University of Canberra, Canberra, Australia
| | - Kamal Sud
- Department of Renal Medicine, Nepean Hospital, Nepean and Blue Mountains Local Health District, Penrith, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Beena Sewlal
- Social Worker, Blacktown Hospital Western Sydney Local Health District (WSLHD), Blacktown, New South Wales, Australia
| | - Bharati Mehta
- Social Worker, Blacktown Hospital Western Sydney Local Health District (WSLHD), Blacktown, New South Wales, Australia
| | - Lukas Kairaitis
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Surjit Tarafdar
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Katrina Chau
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Syed Tabish Razi Zaidi
- School of Healthcare, University of Leeds, Leeds, West Yorkshire, England.,HPS Pharmacies, Institutional Care, Dockland, Melbourne, Australia
| | - Ronald Castelino
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia.,Pharmacy Department, Blacktown Hospital, WSLHD, Blacktown, New South Wales, Australia
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Swinnen J“J, Baker L, Burgess D, Allen R, O’Grady A, Chau K. Changing the peritoneal dialysis access algorithm with a precise technique of percutaneous Seldinger PD catheter placement. J Vasc Access 2022; 23:615-623. [DOI: 10.1177/11297298221077607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: In 1953, Swedish radiologist Sven Seldinger introduced a technique for blood vessel or hollow organ access using a needle, guide wire and catheter. Over the last two decades, this technique has been used for Peritoneal Dialysis (PD) catheter placement, “Seldinger PD” (SPD). To improve the safety and accuracy of SPD, ultrasound, X-ray guidance, contrast imaging and micropuncture techniques have been incorporated to a greater or lesser extent. Methods: This manuscript describes a new and rigorous technique of SPD developed at our unit and results in the first 64 cases. One of our goals was to replace emergency Central Vein Catheter Hemodialysis with “Urgent-Start” PD. We therefore sought to develop a procedure that was ultra-safe, minimally invasive and readily done on the sickest patients under Local Anesthetic. As the technique was new to our unit, and because of progressive modifications of the technique, some of the results reflect our “learning curve.” In addition, 55% of the patients referred to our program had “crashed” into renal failure, 32% were deemed “unfit for General Anaesthesia” by the Anaesthetists and 53% were moderately to severely obese, resulting in a very morbid and vulnerable cohort. Results: Despite this, we had no procedure related mortality, no organ injury and no significant bleeding. Technical success was 97% (intention-to-treat). Urgent Start PD was used in 36%; overall, 3/61 catheters placed experienced PD fluid leak. Correct catheter tip placement – in the Pelvic Pouch – was documented in all cases; significant catheter migration was seen in 18% of those with imaging follow-up, only two requiring revision. Most catheter migrations occurred early in our series before our low peritoneal puncture technique became standard. Conclusions: We believe this SPD technique is safe, precise, clinically and financially cost-effective and can replace other forms of PD placement in most situations.
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Affiliation(s)
- Jan “John” Swinnen
- Vascular Surgery, Westmead Hospital, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Luke Baker
- Radiology Department, Westmead Hospital, Sydney, NSW, Australia
- Notre Dame University, Darlinghurst, NSW, Australia
| | - David Burgess
- Cardiology, Blacktown Hospital, Blacktown, NSW, Australia
- Western Sydney University, Penrith, NSW, Australia
| | - Richard Allen
- Vascular Surgery, Westmead Hospital, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Allan O’Grady
- Radiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - Katrina Chau
- Western Sydney University, Penrith, NSW, Australia
- Nephrology, Blacktown Hospital, Blacktown, NSW, Australia
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Chau K, Welsh M, Makris A, Hennessy A. Progress in preeclampsia: the contribution of animal models. J Hum Hypertens 2022; 36:705-710. [PMID: 34837033 PMCID: PMC8617007 DOI: 10.1038/s41371-021-00637-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 11/02/2021] [Accepted: 11/09/2021] [Indexed: 11/09/2022]
Abstract
Recent advances have been made in understanding the nature of placental dysfunction causing preeclampsia, and other hypertensive disorders of pregnancy. The contribution of animal studies in the understanding of the effects of inadequate placentation on blood pressure and other target organs will be explored in this review. This will include technical aspects of animal studies in pregnancy, as well as the translation of data regarding newly discovered pathological pathways, in particular the angiogenic pathway, into targets in clinical practice.
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Affiliation(s)
- Katrina Chau
- grid.460687.b0000 0004 0572 7882Department of Renal Medicine, Blacktown Hospital, Blacktown, NSW Australia ,grid.1029.a0000 0000 9939 5719School of Medicine, Western Sydney University, Campbelltown, NSW Australia ,grid.1013.30000 0004 1936 834XHeart Research Institute, University of Sydney, Sydney, NSW Australia
| | - Mikala Welsh
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia. .,Heart Research Institute, University of Sydney, Sydney, NSW, Australia. .,Sydney Local Health District, Camperdown, NSW, Australia.
| | - Angela Makris
- grid.1029.a0000 0000 9939 5719School of Medicine, Western Sydney University, Campbelltown, NSW Australia ,grid.1013.30000 0004 1936 834XHeart Research Institute, University of Sydney, Sydney, NSW Australia ,grid.1005.40000 0004 4902 0432South Western Sydney Clinical School, UNSW, Sydney, NSW Australia
| | - Annemarie Hennessy
- grid.1029.a0000 0000 9939 5719School of Medicine, Western Sydney University, Campbelltown, NSW Australia ,grid.1013.30000 0004 1936 834XHeart Research Institute, University of Sydney, Sydney, NSW Australia ,grid.482212.f0000 0004 0495 2383Sydney Local Health District, Camperdown, NSW Australia ,grid.460708.d0000 0004 0640 3353Campbelltown Hospital, South Western Sydney Local Health District, Campbelltown, NSW Australia
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9
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Hansen MS, Tesfaye W, Sewlal B, Mehta B, Sud K, Kairaitis L, Tarafdar S, Chau K, Zaidi ST, Castelino RL. Psychosocial factors affecting patients with end-stage kidney disease and the impact of the social worker. J Nephrol 2021; 35:43-58. [PMID: 34181197 DOI: 10.1007/s40620-021-01098-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 03/14/2021] [Accepted: 06/10/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND End-stage kidney disease (ESKD) incidence has been increasing over time, contributing significantly to morbidity and mortality. However, there is limited data examining the psychosocial factors affecting people with ESKD and how the social worker fits within the multidisciplinary CKD care. This integrative systematic review aims to summarise the existing evidence on psychosocial determinants of outcomes in ESKD and the role of the social worker in nephrology care. METHOD The literature search was conducted using PubMed and MEDLINE, targeting articles published from database inception until May 2021. This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Joanna Briggs Institute tools were employed to assess the quality of included studies. RESULTS Of the 397 citations, 13 studies applicable to 1465 patients met the inclusion criteria. The studies were of cross-sectional, experimental, and exploratory qualitative design in nature. The findings of the studies were summarised into three major themes-psychosocial factors, role of the renal social worker, and impact of the renal social worker. The studies demonstrated that concerns related to adjustment, death and dying, family and social functioning, and loss were common amongst participants of the included studies indicating the need for a social worker. Three studies explored the impact of social workers in ESKD, revealing that people who received support from social workers had an improved quality of life, lower depression scores, and reduced hospitalisations and emergency room visits. CONCLUSION This review summarizes the multitude of physical and psychological stressors that patients with ESRD face, and highlights the positive role social workers can play in improving the psychosocial stressors in this patient group, and the need for large-scale randomised trials to understand the role of social workers as part of a multidisciplinary nephrology care.
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Affiliation(s)
- Micaella Sotera Hansen
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Wubshet Tesfaye
- Health Research Institute, University of Canberra, Canberra, Australia.
| | - Beena Sewlal
- Blacktown Hospital Western Sydney Local Health District (WSLHD), Blacktown, Australia
| | - Bharati Mehta
- Blacktown Hospital Western Sydney Local Health District (WSLHD), Blacktown, Australia
- Westmead and Blacktown Hospitals, Western Sydney, Local Health District (WSLHD), Blacktown, Australia
| | - Kamal Sud
- Department of Renal Medicine, Nepean Hospital, Nepean and Blue Mountains Local Health District, Kingswood, Australia
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lukas Kairaitis
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Surjit Tarafdar
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Katrina Chau
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | | | - Ronald Lynel Castelino
- School of Pharmacy, University of Sydney, Sydney, Australia
- Pharmacy Department, Blacktown Hospital, WSLHD, Blacktown, Australia
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10
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Zhang JQJ, Saravanabavan S, Cheng KM, Raghubanshi A, Chandra AN, Munt A, Rayner B, Zhang Y, Chau K, Wong ATY, Rangan GK. Long-term dietary nitrate supplementation does not reduce renal cyst growth in experimental autosomal dominant polycystic kidney disease. PLoS One 2021; 16:e0248400. [PMID: 33886581 PMCID: PMC8061912 DOI: 10.1371/journal.pone.0248400] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/26/2021] [Indexed: 11/18/2022] Open
Abstract
Augmentation of endogenous nitric oxide (NO) synthesis, either by the classical L-arginine-NO synthase pathway, or the recently discovered entero-salivary nitrate-nitrite-NO system, may slow the progression of autosomal dominant polycystic kidney disease (ADPKD). To test this hypothesis, the expression of NO in human ADPKD cell lines (WT 9–7, WT 9–12), and the effect of L-arginine on an in vitro model of three-dimensional cyst growth using MDCK cells, was examined. In addition, groups of homozygous Pkd1RC/RC mice (a hypomorphic genetic ortholog of ADPKD) received either low, moderate or high dose sodium nitrate (0.1, 1 or 10 mmol/kg/day), or sodium chloride (vehicle; 10 mmol/kg/day), supplemented drinking water from postnatal month 1 to 9 (n = 12 per group). In vitro, intracellular NO, as assessed by DAF-2/DA fluorescence, was reduced by >70% in human ADPKD cell lines, and L-arginine and the NO donor, sodium nitroprusside, both attenuated in vitro cyst growth by up to 18%. In contrast, in Pkd1RC/RC mice, sodium nitrate supplementation increased serum nitrate/nitrite levels by ~25-fold in the high dose group (P<0.001), but kidney enlargement and percentage cyst area was not altered, regardless of dose. In conclusion, L-arginine has mild direct efficacy on reducing renal cyst growth in vitro, whereas long-term sodium nitrate supplementation was ineffective in vivo. These data suggest that the bioconversion of dietary nitrate to NO by the entero-salivary pathway may not be sufficient to influence the progression of renal cyst growth in ADPKD.
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Affiliation(s)
- Jennifer Q. J. Zhang
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sayanthooran Saravanabavan
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Kai Man Cheng
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Aarya Raghubanshi
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Ashley N. Chandra
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Alexandra Munt
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Benjamin Rayner
- Heart Research Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Yunjia Zhang
- Heart Research Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Katrina Chau
- Department of Renal Medicine and School of Medicine, Western Sydney University at Blacktown Hospital, Sydney, New South Wales, Australia
| | - Annette T. Y. Wong
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Gopala K. Rangan
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
- * E-mail:
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11
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Alessi S, Merkling T, Girerd N, Boivin JM, Chau K, Lopez-Sublet M, Laville M, Zannad F, Rossignol P, Wagner S. Étude de trajectoires d’indice de masse corporelle et de tour de taille sur 18 ans et leur impact sur les marqueurs de la fonction et atteinte rénale dans la cohorte STANISLAS. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2020.11.006] [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: 10/22/2022] Open
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12
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Xu B, Shanmugalingam R, Chau K, Makris A, Hennessy A. Galectin-1-Related Modulation of Trophoblast Endothelial Interactions by Integrins α1 and β1. Reprod Sci 2020; 27:1097-1109. [PMID: 32253734 DOI: 10.1007/s43032-019-00046-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 12/19/2018] [Accepted: 04/15/2019] [Indexed: 10/24/2022]
Abstract
During normal trophoblast invasion, integrins α6β4 are downregulated, and α1β1 are upregulated in invasive cytotrophoblast cells. In preeclampsia both interstitial and endovascular invasion are shallow and cytotrophoblasts fail to upregulate α1β1 and downregulate α6β4. This study aims to investigate the role of integrins α1β1 and α6β4 on cellular pathways influencing trophoblast integration into endothelial cellular networks in vitro. Red fluorescent-labeled human uterine myometrial microvascular endothelial cells (UtMVECs) were seeded on Matrigel to form endothelial networks. Green fluorescent-labeled trophoblastic HTR-8/SVneo cells pre-incubated with 20 μg/ml of neutralizing antibodies (anti-α1, β1, α6, β4, α1 + β1, or α6 + β4) for 1 h were then co-cultured with endothelial networks with the neutralizing antibodies for 24 h. Fluorescent images were captured, and quantified utilizing Image J. Cells were retrieved to analyze mRNA expression of galectin-1, TIMP-1, and PAI-1 by quantitative PCR. MMP-2, MMP-9, free sFlt-1, and PlGF from conditioned media were measured by ELISA. The integration of trophoblast cells into endothelial cellular networks was inhibited by anti-β1(- 28 ± 3%, p < 0.0001), and increased by anti-α6(+ 19 ± 5%, p < 0.01). Galectin-1 mRNA expression was decreased by anti-α1(- 35 ± 7%, p < 0.001), anti-β1(- 23 ± 5%, p < 0.05), and anti-α1+β1(- 35 ± 5%, p < 0.001). The mRNA expression of TIMP-1 was inhibited by anti-α1(- 59 ± 9%, p < 0.01) and anti-β1(- 63 ± 7%, p < 0.001) while PAI-1 mRNA expression was increased by anti-α1 + β1(+ 285 ± 70%, p < 0.0001). In the conditioned medium, anti-α1 reduced MMP-2(-28 ± 1%, p < 0.001), MMP-9(-27 ± 8%, p < 0.01), and sFlt-1(-27 ± 5%, p < 0.001) production. Anti-β1 reduced MMP-2(- 15 ± 2%, p < 0.05) production. There were no changes in PlGF. Appropriate integrins α1β1 modulate trophoblast cell integration into endothelial cellular networks in vitro through invasive pathways including galectin-1, TIMP-1, PAI-1, MMP-2, and MMP-9 production.
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Affiliation(s)
- Bei Xu
- Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, 7 Eliza St., Newtown, NSW, 2042, Australia.
| | - Renuka Shanmugalingam
- Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, 7 Eliza St., Newtown, NSW, 2042, Australia.,School of Medicine, Western Sydney University, Sydney, Australia.,Renal Unit, Liverpool Hospital, Sydney, Australia
| | - Katrina Chau
- Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, 7 Eliza St., Newtown, NSW, 2042, Australia
| | - Angela Makris
- Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, 7 Eliza St., Newtown, NSW, 2042, Australia.,School of Medicine, Western Sydney University, Sydney, Australia.,Renal Unit, Liverpool Hospital, Sydney, Australia
| | - Annemarie Hennessy
- Vascular Immunology Research Laboratory, The Heart Research Institute, University of Sydney, 7 Eliza St., Newtown, NSW, 2042, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
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13
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Chau K, Xu B, Hennessy A, Makris A. Effect of Placental Growth Factor on Trophoblast-Endothelial Cell Interactions In Vitro. Reprod Sci 2020; 27:1285-1292. [PMID: 32016802 DOI: 10.1007/s43032-019-00103-7] [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] [Received: 05/28/2019] [Accepted: 11/10/2019] [Indexed: 12/26/2022]
Abstract
Placental growth factor (PlGF) is an important angiogenic factor which has an emerging role in the clinical management of suspected preeclampsia. The role of PlGF in normal placental development is not completely understood and it is uncertain whether PlGF influences trophoblast and endothelial cell interactions central to uterine spiral artery remodelling, especially in variable oxygen conditions. A two-cell model of endovascular invasion was used. Tissue culture plates were coated with Matrigel™, on which fluorescent-labelled uterine microvascular endothelial cells (1 × 105/well) and HTR8/SVNeo cells were co-cultured (1 × 105/well) for 20 h. Co-cultures were treated with recombinant human PlGF (rhPlGF) (10 or 100 ng/mL) and incubated at either 21% O2 or 2% O2. Images were captured by fluorescence microscopy and analysed using ImageJ (n = 7). Data was analysed using SPSSv24. Treatment with rhPlGF did not improve integration in co-cultures irrespective of oxygen conditions but increased proliferation in 2% O2 of both trophoblast and endothelial cells. Expression of angiogenic factors VEGF, sFLT-1, PlGF and CXCL12 in both co-cultures and in isolated trophoblast cells was not altered by rhPlGF treatment. Expression of TLR-3 mRNA in co-cultures was increased by rhPlGF 100 ng/mL at 21% O2 (p = 0.03). PlGF contributes to trophoblast and endothelial cell proliferation in the setting of physiological hypoxia but does not influence trophoblast and endothelial cell interactions in an in vitro model of spiral artery remodelling. Upregulation of TLR-3 expression in co-cultures may indicate a role for PlGF in the placental inflammatory response.
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Affiliation(s)
- K Chau
- Vascular Immunology Group, Heart Research Institute, Sydney, Australia. .,School of Medicine, Western Sydney University, Sydney, Australia. .,Regional Dialysis Centre, Blacktown Hospital, Blacktown, Australia.
| | - B Xu
- Vascular Immunology Group, Heart Research Institute, Sydney, Australia
| | - A Hennessy
- Vascular Immunology Group, Heart Research Institute, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
| | - A Makris
- Vascular Immunology Group, Heart Research Institute, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia.,Renal Department, Liverpool Hospital, Liverpool, Australia
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14
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Chau K, Bobek G, Xu B, Stait-Gardner T, Price W, Hennessy A, Makris A. Effect of placental growth factor in models of experimental pre-eclampsia and trophoblast invasion. Clin Exp Pharmacol Physiol 2019; 47:49-59. [PMID: 31452230 DOI: 10.1111/1440-1681.13169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/14/2019] [Accepted: 08/22/2019] [Indexed: 12/18/2022]
Abstract
Placental growth factor (PlGF) is decreased in early gestation of pregnant women who subsequently develop pre-eclampsia. In this study, pre-emptive treatment with PlGF to prevent pre-eclampsia was evaluated in an in vivo rodent model of experimental pre-eclampsia (EPE) induced by TNF-α and in an in vitro model of human first-trimester trophoblast invasion. Pregnant C57/BL6 mice were treated with recombinant mouse placental growth factor-2 (rmPlGF-2) 100 μg/kg/day IP from gestational day (gd) 10. Animals had EPE induced by continuous TNF-α infusion on gd 13 and were subject to either continuous blood pressure monitoring by radiotelemetry throughout pregnancy or live placenta T2 -weighted magnetic resonance imaging (MRI) to demonstrate placental function on gd 17. There was no difference in BP (P > .99), proteinuria (P = .9) or T2 values on MRI (P = .9) between control and rmPlGF-2-treated animals. On gd 13, animals treated with rmPlGF-2 demonstrated increased placenta PlGF (P = .01) and Toll-like receptor-3 (P = .03) mRNA expression as compared with controls. Fluorescent-labelled human uterine microvascular endothelial cells and HTR8/SVNeo cells were co-cultured on Matrigel™ and treated with recombinant human PlGF (rhPlGF) (10 ng/mL) and/or TNF-α (0.5 ng/mL). Trophoblast integration into endothelial networks was reduced by added TNF-α (P = .006), as was rhPlGF concentration in conditioned media (P < .0001). Cell integration was not ameliorated by addition of rhPlGF (P > .9). Although TNF-α-induced EPE was not reversed with pre-emptive rmPlGF-2, a further trial of pre-emptive rhPlGF in vivo is required to determine whether the absence of effect of rhPlGF demonstrated in vitro precludes PlGF as a preventative therapy for pre-eclampsia.
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Affiliation(s)
- Katrina Chau
- Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia.,Vascular Immunology Group, Heart Research Institute, University of Sydney, Newtown, New South Wales, Australia.,School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Gabriele Bobek
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Bei Xu
- Vascular Immunology Group, Heart Research Institute, University of Sydney, Newtown, New South Wales, Australia
| | - Timothy Stait-Gardner
- Nanoscale Organisation and Dynamics Group, Western Sydney University, Campbelltown, New South Wales, Australia
| | - William Price
- Nanoscale Organisation and Dynamics Group, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Annemarie Hennessy
- Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia.,Vascular Immunology Group, Heart Research Institute, University of Sydney, Newtown, New South Wales, Australia.,School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Angela Makris
- Vascular Immunology Group, Heart Research Institute, University of Sydney, Newtown, New South Wales, Australia.,School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.,Renal Department, Liverpool Hospital, Liverpool, New South Wales, Australia
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15
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Shanmugalingam R, Wang X, Münch G, Fulcher I, Lee G, Chau K, Xu B, Kumar R, Hennessy A, Makris A. A pharmacokinetic assessment of optimal dosing, preparation, and chronotherapy of aspirin in pregnancy. Am J Obstet Gynecol 2019; 221:255.e1-255.e9. [PMID: 31051121 DOI: 10.1016/j.ajog.2019.04.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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] [Received: 01/08/2019] [Revised: 04/16/2019] [Accepted: 04/24/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND The benefit of aspirin in preventing preeclampsia is well established; however, studies over the years have demonstrated variability in outcomes with its use. Potential contributing factors to this variation in efficacy include dosing, time of dosing, and preparation of aspirin. OBJECTIVE We aimed to compare the difference in pharmacokinetics of aspirin, through its major active metabolite, salicylic acid, in pregnant women and nonpregnant women, and to examine the effect of dose (100 mg vs 150 mg), preparation (enteric coated vs non-enteric-coated), and chronotherapy of aspirin (morning vs evening) between the 2 groups. MATERIALS AND METHODS Twelve high-risk pregnant women and 3 nonpregnant women were enrolled in this study. Pregnant women were in 1 of 4 groups (100 mg enteric coated, 100 mg non-enteric-coated, 150 mg non-enteric-coated morning dosing, and 150 mg non-enteric-coated evening dosing), whereas nonpregnant women undertook each of the 4 dosing schedules with at least a 30-day washout period. Blood samples were collected at baseline (before ingestion) and at 1, 2, 4, 6, 12, and 24 hours after ingestion of aspirin. Plasma obtained was analyzed for salicylic acid levels by means of liquid chromatography-mass spectrometry. Pharmacokinetic values of area under the curve from time point 0 to 24 hours point of maximum concentration, time of maximum concentration, volume of distribution, clearance, and elimination half-life were analyzed for statistical significance with SPSS v25 software. RESULTS Pregnant women had a 40% ± 4% reduction in area under the curve from time point 0 to 24 hours (P < .01) and 29% ± 3% reduction in point of maximum concentration (P < .01) with a 44% ± 8% increase in clearance (P < .01) in comparison to that in nonpregnant women when 100 mg aspirin was administered. The reduction in the area under the curve from time point 0 to 24 hours, however, was minimized with the use of 150 mg aspirin in pregnant women, with which the area under the curve from time point 0 to 24 hours was closer to that achieved with the use of 100 mg aspirin in nonpregnant women. There was a 4-hour delay (P < .01) in the time of maximum concentration, a 47% ± 3% reduction in point of maximum concentration (P < .01) and a 48% ± 1% increase in volume of distribution (P < .01) with the use of 100 mg enteric-coated aspirin compared to non-enteric-coated aspirin, with no difference in the overall area under the curve. There was no difference in the pharmacokinetics of aspirin between morning and evening dosing. CONCLUSION There is a reduction in the total drug metabolite concentration of aspirin in pregnancy, and therefore a dose adjustment is potentially required in pregnant women. This is likely due to the altered pharmacokinetics of aspirin in pregnancy, with an increase in clearance. There was no difference in the total drug metabolite concentration of aspirin between enteric-coated and non-enteric-coated aspirin and between morning and evening dosing of aspirin. Further pharmacodynamic and clinical studies are required to examine the clinical relevance of these pharmacokinetic findings.
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Affiliation(s)
- Renuka Shanmugalingam
- School of Medicine, Western Sydney University, NSW, Australia; Department of Renal Medicine, South Western Sydney Local Health District, NSW, Australia; Heart Research Institute, University of Sydney, NSW, Australia; Women's Health Initiative Translational Unit (WHITU), South Western Sydney Local Health District, NSW, Australia.
| | - XiaoSuo Wang
- Bosch Mass Spectrometry Facility, Bosch Institute, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Gerald Münch
- Pharmacology Unit, School of Medicine, Western Sydney University, NSW, Australia
| | - Ian Fulcher
- Department of Obstetrics and Gynaecology, Liverpool Hospital, NSW, Australia
| | - Gaksoo Lee
- Department of Renal Medicine, South Western Sydney Local Health District, NSW, Australia; Women's Health Initiative Translational Unit (WHITU), South Western Sydney Local Health District, NSW, Australia
| | - Katrina Chau
- Heart Research Institute, University of Sydney, NSW, Australia
| | - Bei Xu
- Heart Research Institute, University of Sydney, NSW, Australia
| | - Roshika Kumar
- Department of Obstetrics and Gynaecology, Liverpool Hospital, NSW, Australia
| | - Annemarie Hennessy
- School of Medicine, Western Sydney University, NSW, Australia; Department of Renal Medicine, South Western Sydney Local Health District, NSW, Australia; Heart Research Institute, University of Sydney, NSW, Australia; Women's Health Initiative Translational Unit (WHITU), South Western Sydney Local Health District, NSW, Australia
| | - Angela Makris
- School of Medicine, Western Sydney University, NSW, Australia; Department of Renal Medicine, South Western Sydney Local Health District, NSW, Australia; Heart Research Institute, University of Sydney, NSW, Australia; Women's Health Initiative Translational Unit (WHITU), South Western Sydney Local Health District, NSW, Australia
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16
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THEIVENDRAN T, Sharma A, Hennessy A, Chau K. MON-250 THE MANAGEMENT OF NEPHROTOXIC MEDICATIONS IN COLONOSCOPY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1052] [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: 10/26/2022] Open
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17
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THEIVENDRAN T, Sharma A, Hennessy A, Chau K. SUN-180 THE INCIDENCE OF ACUTE KIDNEY INJURY FOLLOWING INPATIENT COLONOSCOPY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.582] [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: 11/26/2022] Open
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18
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Imber B, Chau K, Goldberg E, Joffe E, Yahalom J. GRADE 3A FOLLICULAR LYMPHOMA CAN BE EFFECTIVELY CONTROLLED WITH VERY LOW DOSE RADIATION THERAPY. Hematol Oncol 2019. [DOI: 10.1002/hon.60_2631] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- B.S. Imber
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - K. Chau
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - E. Goldberg
- School of Medicine; Mount Sinai; New York United States
| | - E. Joffe
- Lymphoma Service; Memorial Sloan Kettering Cancer Center; New York United States
| | - J. Yahalom
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York United States
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19
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Goldberg E, Imber B, Chau K, Joffe E, Yahalom J. Radiotherapy is an Effective Definitive Treatment for Limited Stage Grade 3A Follicular Lymphoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2018.11.057] [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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20
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Kang K, Hanson J, Chau K. The Temporospatial Epidemiology of Rheumatic Heart Disease in Far North Queensland (1997–2017). Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.521] [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: 10/26/2022]
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21
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Chelius M, Chau K, Yang J, Yahalom J. Low Grade, Indolent Lymphomas of the Head and Neck: Comparative Toxicity of Standard Versus Very Low Dose Radiation Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.703] [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: 11/15/2022]
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22
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Yang J, Chau K, Scordo M, Sauter C, Yahalom J. Patients with Relapsed/Refractory Large Cell Lymphoma Who Were Also Refractory to Salvage Chemotherapy: Outcome with Salvage Radiation Therapy Followed by Autologous Stem Cell Transplant. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Chau K, Yang J, Hajj C, Chelius M, Yahalom J. Response Rates of Nodal Versus Extranodal Follicular and Marginal Zone Lymphomas to Very Low Dose Radiation Therapy of Only 4 Gy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.794] [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: 11/16/2022]
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24
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Beckham T, Yang J, Chau K, Noy A, Yahalom J. Local Therapy in the Definitive Management of Castleman Disease. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.782] [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: 11/15/2022]
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25
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Chau K, Xu B, Hennessy A, Makris A. 97. Effect of placental growth factor on trophoblast integration into endothelial cell networks in the presence of inflammation. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.065] [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: 11/15/2022]
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26
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Shanmugalingam R, Wang XS, Chau K, Xu B, Lee G, Kumar R, Hennessy A, Makris A. 262. A pharmacokinetic assessment of aspirin through timed analysis of plasma salicylate acid level: An analysis of difference in gender, dose and preparation of aspirin. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Laird J, Ma J, Chau K, Chelius M, Bell A, Lok B, Yahalom J. Local Recurrence After Radiation Therapy for Langerhans Cell Histiocytosis: Risk Stratification by Site of Disease. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.324] [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: 11/26/2022]
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28
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Ma J, Laird J, Chau K, Chelius M, Bell A, Zhang Z, Lok B, Yahalom J. LANGERHANS CELL HISTIOCYTOSIS IN ADULTS IS ASSOCIATED WITH INCREASED HEMATOLOGIC AND SOLID MALIGNANCIES. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_200] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J. Ma
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - J. Laird
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - K. Chau
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - M. Chelius
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - A.C. Bell
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - Z. Zhang
- Department of Epidemiology-Biostatistics; Memorial Sloan Kettering Cancer Center; New York USA
| | - B.H. Lok
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - J. Yahalom
- Radiation Oncology; Memorial Sloan Kettering Cancer Center; New York USA
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Pears S, Pilowsky P, Aggarwal S, Sunderland N, Lim S, Chau K, Heffernan S, Ogle R, Iliopoulos J, Thompson J, Dennis A, Hennessy A, Makris A. 10 Acute blood pressure variability response to antihypertensive drugs in an experimental model of preeclampsia. Pregnancy Hypertens 2016. [DOI: 10.1016/j.preghy.2016.08.011] [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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Chau K, Er L, Djurdjev O, Levin A. SP638NON-CALCIUM BASED PHOSPHATE BINDERS CONFER SURVIVAL BENEFIT INDEPENDENT OF PHOSPHATE REDUCTION. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv199.04] [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: 11/14/2022] Open
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Abstract
There is a growing body of evidence supporting a bidirectional relationship between parathyroid hormone (PTH) and aldosterone (Aldo). We report a case of secondary hypertension due to concomitant Aldo-producing adenoma (APA) and parathyroid adenoma (PA) requiring both unilateral adrenalectomy and parathyroidectomy.
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Affiliation(s)
- Katrina Chau
- Division of Nephrology, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Holmes
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Adrienne Melck
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Clifford Chan-Yan
- Division of Nephrology, University of British Columbia, Vancouver, BC, Canada;
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Pears SJ, Hennessy A, Lim S, Chau K, Yeung K, Heffernan S, Makris A. [104-POS]. Pregnancy Hypertens 2015. [DOI: 10.1016/j.preghy.2014.10.110] [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: 10/24/2022]
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Cocker R, Chau K, Gimenez C, Khalbuss WE. Role of FNA cytology with cell block in the diagnosis of papillary squamous cell carcinoma of the upper aero-digestive tract: case report. Cytopathology 2014; 26:390-1. [PMID: 25303677 DOI: 10.1111/cyt.12209] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R Cocker
- North Shore-Long Island Jewish Health System, Lake Success, NY, USA
| | - K Chau
- North Shore-Long Island Jewish Health System, Lake Success, NY, USA
| | - C Gimenez
- North Shore-Long Island Jewish Health System, Lake Success, NY, USA
| | - W E Khalbuss
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Chau K, Schisler T, Er L, Jaswal D, Cheung C, Israel A, Bowering J, Levin A. Fluid balance, change in serum creatinine and urine output as markers of acute kidney injury post cardiac surgery: an observational study. Can J Kidney Health Dis 2014; 1:19. [PMID: 25960885 PMCID: PMC4424577 DOI: 10.1186/s40697-014-0019-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/08/2014] [Indexed: 12/20/2022] Open
Abstract
Background Acute kidney injury (AKI) is defined as oliguria or rise in serum creatinine but oliguria alone as a diagnostic criterion may over-diagnose AKI. Objectives Given the association between fluid overload and AKI, we aimed to determine if positive fluid balance can complement the known parameters in assessing outcomes of AKI. Design Prospective observational study. Setting Teaching hospital in Vancouver, Canada. Patients 111 consecutive patients undergoing elective cardiac surgery from January to April 2012. Measurements Outcomes of cardiac surgery intensive care unit (CSICU) and hospital length of stay (LOS) in relation to fluid balance, urine output and serum creatinine. Methods All fluid input and output was recorded for 72 hours post-operatively. Positive fluid balance was defined as >6.5 cc/kg. Daily serum creatinine and hourly urine output were recorded and patients were defined as having AKI according to the AKIN criteria. Results Of the patients who were oliguric, those with fluid overload trended towards longer LOS than those without fluid overload [CSICU LOS: 62 and 39 hours (unadjusted p-value 0.02, adjusted p-value 0.58); hospital LOS: 13 and 9 days (unadjusted p-value: 0.05, adjusted p-value: 0.16)]. Patients with oliguria who were fluid overloaded had similar LOS to patients with overt AKI (change in serum creatinine ≥ 26.5 µmol/L), [CSICU LOS: 62 and 69 hours (adjusted p value: 0.32) and hospital LOS: 13 and 14 days (adjusted p value: 0.19)]. Patients with oliguria regardless of fluid balance had longer CSICU LOS (adjusted p value: 0.001) and patients who were fluid overloaded in the absence of AKI had longer hospital LOS (adjusted p value: 0.02). Limitations Single centre, small sample, LOS as outcome. Conclusions Oliguria and positive fluid balance is associated with a trend towards longer LOS as compared to oliguria alone. Fluid balance may therefore be a useful marker of AKI, in addition to urine output and serum creatinine.
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Affiliation(s)
- Katrina Chau
- Division of Nephrology, Faculty of Medicine, The University of British Columbia, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z1Y6 Canada
| | - Travis Schisler
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z1Y6 Canada
| | - Lee Er
- Division of Nephrology, Faculty of Medicine, The University of British Columbia, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z1Y6 Canada
| | - Dharmvir Jaswal
- Division of Nephrology, Faculty of Medicine, The University of British Columbia, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z1Y6 Canada
| | - Christopher Cheung
- Faculty of Medicine, The University of British Columbia, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z1Y6 Canada
| | - Amanda Israel
- Faculty of Medicine, The University of British Columbia, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z1Y6 Canada
| | - John Bowering
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z1Y6 Canada
| | - Adeera Levin
- Division of Nephrology, Faculty of Medicine, The University of British Columbia, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z1Y6 Canada
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Chau K, Martinez G, Elder GJ. Vascular calcification in patients undergoing kidney and simultaneous pancreas-kidney transplantation. Nephrology (Carlton) 2014; 19:275-81. [DOI: 10.1111/nep.12212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Katrina Chau
- Department of Renal Medicine; Westmead Hospital; Sydney New South Wales Australia
| | - Gabriela Martinez
- Department of Renal Medicine; Westmead Hospital; Sydney New South Wales Australia
| | - Grahame J Elder
- Department of Renal Medicine; Westmead Hospital; Sydney New South Wales Australia
- Osteoporosis and Bone Biology Division; Garvan Institute of Medical Research; Sydney New South Wales Australia
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Chau K, Henderson C, Adno A, Spicer T, Cleland B, Makris A. A case of recurrent severe pre-eclampsia associated with essential cryofibrinogenaemia. Obstet Med 2013; 6:136-137. [PMID: 27708708 DOI: 10.1258/om.2012.120005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Essential cryofibrinogenaemia is a rare disorder characterized by cryofibrinogens without cryoglobulins. Connective tissue disorders and thrombophilia are known to increase risk of pre-eclampsia, but pre-eclampsia has not previously been reported in association with cryofibrinogenaemia. We report the case of a 32-year-old woman with recurrent severe pre-eclampsia diagnosed with essential cryofibrinogenaemia.
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Affiliation(s)
| | | | - Alan Adno
- Department of Obstetrics and Gynaecology, Liverpool Hospital , Elizabeth Street, Liverpool, Sydney, New South Wales 2170 , Australia
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37
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Chau K, Yong J, Ismail K, Griffith N, Liu M, Makris A. Levetiracetam-induced severe acute granulomatous interstitial nephritis. Clin Kidney J 2012; 5:234-6. [PMID: 26069773 PMCID: PMC4400501 DOI: 10.1093/ckj/sfs023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 02/16/2012] [Indexed: 11/13/2022] Open
Abstract
Granulomatous interstitial nephritis (GIN) is an uncommon cause of renal failure, which may be caused by drugs. Levetiracetam is an increasingly used anti-epileptic medication that is not known to cause renal toxicity in adults. To our knowledge, levetiracetam has not previously been reported as a cause of GIN. We report the case of a 69-year-old woman who developed haemodialysis-requiring acute renal failure after commencement of treatment with levetiracetam, which was shown to be GIN by renal biopsy. She made a complete recovery with cessation of levetiracetam and treatment with steroids.
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Affiliation(s)
- Katrina Chau
- Renal Unit, Liverpool Hospital, Sydney, Australia
| | - Jim Yong
- Department of Anatomical Pathology, South Western Area Pathology Service, Sydney, Australia
| | - Kasim Ismail
- Department of Anatomical Pathology, South Western Area Pathology Service, Sydney, Australia
| | - Neil Griffith
- Department of Neurology, Liverpool Hospital, Sydney, Australia
| | - Michael Liu
- Department of Dermatology, Liverpool Hospital, Sydney, Australia
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Turek P, Burnett A, Sigman M, Perreault S, Cornwall G, Chau K, Smith J, Prins G, Trasler J, Walsh T, Lamb D. 2008 Annual Meeting of the American Society of Andrology. Meeting summary. ACTA ACUST UNITED AC 2009; 30:e2-9. [PMID: 19269933 DOI: 10.2164/jandrol.109.007872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
BACKGROUND Different types of coils have been designed for transcatheter closure of persistent arterial ducts. We compared the efficacy and safety of three types of coils: Gianturco coils (Cook), Cook detachable coils (Cook), and Duct Occlud devices (pfm). METHODS Sixty-three patients underwent coil occlusion of arterial ducts between April 1995 and July 2000. The mean age and weight were 4.8+/-3.4 years and 16.5+/-7.6 kg, respectively. The results and complications of ductal occlusion among the three types of coils were compared. Kaplan-Meier analysis was used to assess reduction in the prevalence of residual shunt with time, and multiple regression analysis was performed to identify predictors of complete occlusion. RESULTS Coil occlusion of persistent arterial ducts that measured 2. 2 +/- 0.8 mm was feasible in 90% (57/63) of patients. Gianturco coils were used in 29, Duct Occlud devices in 16, and Cook detachable coils in 12 patients. The prevalence of residual shunt at 24 hours, 6 months, 12 months, and 24 months was 42%, 20%, 18%, and 14%, respectively. The reduction in prevalence of residual shunt with time tended to be greater when Gianturco coils were used (P =. 067). Logistic regression identified the use of Gianturco coils to be a significant predictor of complete ductal occlusion on follow-up (P =.04). Pull-through of coils occurred in 4.8% (3/63) and coil embolization in 6.3% (4/63). There was no association between the type of coil and the risk of embolization (P = 1.00). CONCLUSIONS Transcatheter occlusion of small persistent arterial ducts with coils is safe and effective. There is no advantage of detachable coils (Cook detachable coils and Duct Occlud devices) over nondetachable Gianturco coils in reducing the risk of embolization. Our findings are in favor of the inexpensive, but more effective, Gianturco coils for occluding small arterial ducts of 3 mm or less.
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Affiliation(s)
- Y Cheung
- Division of Pediatric Cardiology, Department of Pediatrics, Grantham Hospital, University of Hong Kong, Hong Kong, People's Republic of China.
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40
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Ng DK, Chau K. Management of Acute Asthma in Children. J R Coll Physicians Edinb 2000. [DOI: 10.1177/147827150003000404] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- D. K. Ng
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong
| | - K Chau
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong
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41
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Chau K, Arlotta P, Patel UA, Crane-Robinson C, Manfioletti G, Ono SJ. A novel downstream positive regulatory element mediating transcription of the human high mobility group (HMG) I-C gene. FEBS Lett 1999. [PMID: 10471823 DOI: 10.1016/bbr.2011.03.031] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The high mobility group (HMG) I proteins are small, non-histone chromosomal proteins that promote gene activation during development and within rapidly dividing cells. They do so by facilitating enhanceosome formation on inducible genes, via both protein/DNA and protein/protein interactions. The HMG I-C gene is tightly regulated, normally being expressed exclusively during embryonic development. However, HMG I-C expression is also observed frequently in a number of tumor types, and this expression has been shown to contribute to the malignant transformation process. With the aim of dissecting pathways that lead to aberrant expression of HMG I-C in tumor cells, we have analyzed HMG I-C gene regulation in the human hepatoma cell line PLC/PRF/5. One of the two HMG I-C transcripts detected in this cell line originates from a novel downstream initiation site at nucleotide -161 relative to the first methionine. Transcription from the downstream initiation site is mediated by a PRE located between nt -222 and -217. We show here that the Sp1 and Sp3 transcription factors interact with the PRE and transactivate the HMG I-C promoter in a cooperative fashion. This study provides the first characterization of this downstream HMG I-C promoter.
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Affiliation(s)
- K Chau
- The Schepens Eye Research Institute, Brigham and Women's Hospital, and Committee on Immunology, Harvard University, 20 Staniford St., Boston, MA 02114, USA
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Chau K, Arlotta P, Patel UA, Crane-Robinson C, Manfioletti G, Ono SJ. A novel downstream positive regulatory element mediating transcription of the human high mobility group (HMG) I-C gene. FEBS Lett 1999; 457:429-36. [PMID: 10471823 DOI: 10.1016/s0014-5793(99)01100-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [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: 10/18/2022]
Abstract
The high mobility group (HMG) I proteins are small, non-histone chromosomal proteins that promote gene activation during development and within rapidly dividing cells. They do so by facilitating enhanceosome formation on inducible genes, via both protein/DNA and protein/protein interactions. The HMG I-C gene is tightly regulated, normally being expressed exclusively during embryonic development. However, HMG I-C expression is also observed frequently in a number of tumor types, and this expression has been shown to contribute to the malignant transformation process. With the aim of dissecting pathways that lead to aberrant expression of HMG I-C in tumor cells, we have analyzed HMG I-C gene regulation in the human hepatoma cell line PLC/PRF/5. One of the two HMG I-C transcripts detected in this cell line originates from a novel downstream initiation site at nucleotide -161 relative to the first methionine. Transcription from the downstream initiation site is mediated by a PRE located between nt -222 and -217. We show here that the Sp1 and Sp3 transcription factors interact with the PRE and transactivate the HMG I-C promoter in a cooperative fashion. This study provides the first characterization of this downstream HMG I-C promoter.
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Affiliation(s)
- K Chau
- The Schepens Eye Research Institute, Brigham and Women's Hospital, and Committee on Immunology, Harvard University, 20 Staniford St., Boston, MA 02114, USA
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43
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Tai AK, Zhou G, Chau K, Ono SJ. Cis-element dependence and occupancy of the human invariant chain promoter in CIITA-dependent and -independent transcription. Mol Immunol 1999; 36:447-60. [PMID: 10449097 DOI: 10.1016/s0161-5890(99)00061-9] [Citation(s) in RCA: 13] [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] [Indexed: 11/27/2022]
Abstract
The major histocompatibility complex (MHC)-associated invariant chain (Ii) associates with the class II alpha/beta heterodimer during its biosynthesis, inhibiting association of endogenous peptides with the peptide-binding cleft. It is therefore not surprising that there are significant similarities in regulatory mechanisms controlling the expression of the structural class II MHC and Ii genes. One important similarity is that both classes of genes can be expressed via CIITA-dependent or -independent mechanisms. In this report, we have dissected CIITA-dependent and -independent transcription of the Ii gene using an isogenic B-LCL cell pair (Jijoye and clone-13) which do or do not express the class II MHC transactivator (CIITA), respectively. Experiments using mutant or deletion constructs of the Ii gene promoter indicate that while both the X-box and li-kappaB1 elements are critical for CIITA-dependent transcription in B lymphocytes, the Ii-kappaBI element is of greater importance for CIITA-independent Ii gene transcription, with the X-box playing a secondary role. Despite these clear differences in cis-element dependence of CIITA-dependent and -independent Ii transcription, there are only subtle differences in the occupancy of these elements in vivo as assessed by genomic footprinting. These differences are restricted to occupancy of the X-box and Y-box, with which the RF-X and NF-Y complexes interact in Ii-positive cells. This difference in the occupancy of the X-box and Y-box in this cell pair indicates that while protein/protein interactions between CIITA and promoter-bound factors stabilize promoter occupancy, these interactions are not absolutely required for occupancy and transcription of the invariant chain gene.
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MESH Headings
- Antigens, Differentiation, B-Lymphocyte/genetics
- Antigens, Differentiation, B-Lymphocyte/immunology
- Base Sequence
- Cell Line
- Chloramphenicol O-Acetyltransferase/metabolism
- Enhancer Elements, Genetic
- Gene Deletion
- Genes, Reporter
- Histocompatibility Antigens Class II/genetics
- Histocompatibility Antigens Class II/immunology
- Humans
- Models, Biological
- Models, Genetic
- Models, Molecular
- Molecular Sequence Data
- NF-kappa B/genetics
- Nuclear Proteins
- Promoter Regions, Genetic
- RNA/analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Trans-Activators/genetics
- Trans-Activators/immunology
- Transcription, Genetic
- Transfection
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Affiliation(s)
- A K Tai
- The Schepens Eye Research Institute, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02114, USA
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44
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Rochling FA, Jones WF, Chau K, DuCharme L, Mimms LT, Moore B, Scheffel J, Cuthbert JA, Thiele DL. Acute sporadic non-A, non-B, non-C, non-D, non-D, non-E hepatitis. Hepatology 1997; 25:478-83. [PMID: 9021967 DOI: 10.1002/hep.510250237] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [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: 02/03/2023]
Abstract
Patients presenting with clinical and laboratory features consistent with a diagnosis of acute non-A, non-B hepatitis were evaluated for evidence of hepatitis C or hepatitis E infection and for evidence of severe or prolonged disease. Antibody to hepatitis C virus (anti-HCV) was detected in 75 of 108 (69%) patients, antibody to hepatitis E virus (anti-HEV) in three patients (3%), and neither antibody in 31 (29%) patients. One patient had both anti-HCV and anti-HEV. HCV RNA was not detected in sera from any of 20 patients with seronegative (non-ABCDE) hepatitis, but in all 10 patients with anti-HCV who were tested by polymerase chain reaction (PCR). Compared with patients with acute hepatitis C, those with non-ABCDE hepatitis had a lower incidence of parenteral risk factors (6% vs. 70%; P < .001), higher peak serum bilirubin levels (45% vs. 5% with peak levels > 15 mg/dL; P < .001), more prolonged jaundice (25% vs. 0% with peak bilirubin >5 weeks after onset; P < .01), more severe prothrombin time abnormalities (26% vs. 0% with >3 second prolongation; P < .001), more severe hypoalbuminemia (39% vs. 9% with albumin <3 g/dL; P < .01), and more frequent major clinical complications (13% vs. 0% with encephalopathy; P < .01; 10% vs. 0% with death or transplant; P = .024). Patients with acute non-ABCDE hepatitis were less likely to develop chronic hepatitis than those with acute hepatitis C (23% vs. 68%; P < .05). Thus, patients with acute non-ABCDE hepatitis are epidemiologically distinct from those with acute hepatitis C and have a significantly more severe acute illness.
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Affiliation(s)
- F A Rochling
- The University of Texas Southwestern Medical Center at Dallas, Department of Internal Medicine, 75235-9151, USA
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46
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Clemens JM, Taskar S, Chau K, Vallari D, Shih JW, Alter HJ, Schleicher JB, Mimms LT. IgM antibody response in acute hepatitis C viral infection. Blood 1992; 79:169-72. [PMID: 1309424] [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: 12/26/2022] Open
Abstract
IgM antibody against hepatitis C virus (IgM anti-HCV) was measured in serial samples from 15 transfusion recipients in whom posttransfusion chronic non-A, non-B hepatitis (NANBH) developed and three plasmapheresis donors during acute HCV infection using recombinant proteins derived from three immunodominant regions: core, NS-3, and NS-4 (c100). IgM anti-HCV core was detected in 13 of 15 posttransfusion patients. Nine of these patients had transient, acute-phase IgM anti-HCV core detected coincidentally or earlier than active IgG anti-HCV core response. The average duration of IgM anti-HCV core reactivity was 8.1 +/- 3.7 weeks. One patient lacking an IgM anti-HCV core response had detectable IgM anti-HCV NS-3 during the acute phase. Passive transfer of IgM anti-HCV was not observed in these posttransfusion cases, in contrast to the high frequency observed for IgG anti-HCV. Late IgM anti-HCV was detectable against core, c100, and NS-3 in three, two, and one posttransfusion patients, respectively. These data indicate that IgM anti-HCV core is a useful acute-phase marker in HCV infection.
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Abstract
We investigated the amount of fasting steady-state systemic glucose production utilized by the neonatal canine cerebral cortex. The relationship of systemic glucose production and cerebral glucose utilization were analyzed as functions of cerebral blood flow, cerebral oxygen uptake, and indirect measures of alternate fuel utilization. Fasting arterial blood glucose was 3.36 mM and glucose production was 49.6 mumol/kg/min. Average cerebral blood flow was 0.83 ml/g/min, and cerebral glucose uptake was 0.60 +/- 0.15 mumol/g/min. 36.6% of systemic glucose production was utilized by the cerebral cortex. There were no correlations between systemic glucose production, cerebral blood flow, or cerebral glucose uptake with blood glucose concentration. Furthermore, total cerebral glucose uptake was static across a wide range of glucose levels. Nonetheless, the percent of glucose production used by the brain was an inverse function of systemic glucose production (r = -0.71, p less than 0.001). The cerebral extraction of glucose (27.6 +/- 4.1%) decreased as a function of increasing blood glucose levels (r = -0.51, p less than 0.05), while brain uptake index correlated with increasing systemic glucose production (r = 0.61, p less than 0.02). We can conclude that the canine neonatal cerebral cortex may utilize only 37% of systemic glucose production. At low rates of glucose turnover, a larger proportion of systemic glucose production is allotted to the brain. Mechanisms that may regulate total cerebral glucose influx may be glucose permeability, or the increased extraction of glucose at lower blood glucose levels.
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Affiliation(s)
- M M Huang
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio
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48
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Feinman SV, Overby LR, Berris B, Chau K, Schable CA, Maynard JE. The significance of IgM antibodies to hepatitis B core antigen in hepatitis B carriers and hepatitis B-associated chronic liver disease. Hepatology 1982; 2:795-9. [PMID: 7141390 DOI: 10.1002/hep.1840020609] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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