Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 16 de 16
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
País de afiliação
Intervalo de ano de publicação
1.
Genome Res ; 34(1): 145-159, 2024 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-38290977

RESUMO

Hundreds of inbred mouse strains and intercross populations have been used to characterize the function of genetic variants that contribute to disease. Thousands of disease-relevant traits have been characterized in mice and made publicly available. New strains and populations including consomics, the collaborative cross, expanded BXD, and inbred wild-derived strains add to existing complex disease mouse models, mapping populations, and sensitized backgrounds for engineered mutations. The genome sequences of inbred strains, along with dense genotypes from others, enable integrated analysis of trait-variant associations across populations, but these analyses are hampered by the sparsity of genotypes available. Moreover, the data are not readily interoperable with other resources. To address these limitations, we created a uniformly dense variant resource by harmonizing multiple data sets. Missing genotypes were imputed using the Viterbi algorithm with a data-driven technique that incorporates local phylogenetic information, an approach that is extendable to other model organisms. The result is a web- and programmatically accessible data service called GenomeMUSter, comprising single-nucleotide variants covering 657 strains at 106.8 million segregating sites. Interoperation with phenotype databases, analytic tools, and other resources enable a wealth of applications, including multitrait, multipopulation meta-analysis. We show this in cross-species comparisons of type 2 diabetes and substance use disorder meta-analyses, leveraging mouse data to characterize the likely role of human variant effects in disease. Other applications include refinement of mapped loci and prioritization of strain backgrounds for disease modeling to further unlock extant mouse diversity for genetic and genomic studies in health and disease.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Camundongos , Animais , Filogenia , Genótipo , Camundongos Endogâmicos , Fenótipo , Mutação , Variação Genética
2.
Osteoarthritis Cartilage ; 32(3): 287-298, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38072172

RESUMO

OBJECTIVE: The crosstalk of joint pathology with local lymph nodes in osteoarthritis (OA) is poorly understood. We characterized the change in T cells in lymph nodes following load-induced OA and established the association of the presence and migration of T cells to the onset and progression of OA. METHODS: We used an in vivo model of OA to induce mechanical load-induced joint damage. After cyclic tibial compression of mice, we analyzed lymph nodes for T cells using flow cytometry and joint pathology using histology and microcomputed tomography. The role of T-cell migration and the presence of T-cell type was examined using T-cell receptor (TCR)α-/- mice and an immunomodulatory drug, Sphingosine-1-phosphate (S1P) receptor inhibitor-treated mice, respectively. RESULTS: We demonstrated a significant increase in T-cell populations in local lymph nodes in response to joint injury in 10, 16, and 26-week-old mice, and as a function of load duration, 1, 2, and 6 weeks. T-cell expression of inflammatory cytokine markers increased in the local lymph nodes and was associated with load-induced OA progression in the mouse knee. Joint loading in TCRα-/- mice reduced both cartilage degeneration (Osteoarthritis Research Society International (OARSI) scores: TCRα 0.568, 0.981-0.329 confidence interval (CI); wild type (WT) 1.328, 2.353-0.749 CI) and osteophyte formation. Inhibition of T-cell egress from lymph nodes attenuated load-induced cartilage degradation (OARSI scores: Fingolimod: 0.509, 1.821-0.142 CI; Saline 1.210, 1.932-0.758 CI) and decreased localization of T cells in the synovium. CONCLUSIONS: These results establish the association of lymph node-resident T cells in joint damage and suggest that the S1P receptor modulators and T-cell immunotherapies could be used to treat OA.


Assuntos
Cartilagem Articular , Osteoartrite , Animais , Camundongos , Microtomografia por Raio-X , Linfócitos T , Osteoartrite/metabolismo , Cartilagem/patologia , Articulação do Joelho/patologia , Modelos Animais de Doenças , Cartilagem Articular/patologia
3.
Med Phys ; 51(7): 4827-4837, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38377383

RESUMO

BACKGROUND: Dynamic contrast-enhanced ultrasound (DCE-US) is highly susceptible to motion artifacts arising from patient movement, respiration, and operator handling and experience. Motion artifacts can be especially problematic in the context of perfusion quantification. In conventional 2D DCE-US, motion correction (MC) algorithms take advantage of accompanying side-by-side anatomical B-Mode images that contain time-stable features. However, current commercial models of 3D DCE-US do not provide side-by-side B-Mode images, which makes MC challenging. PURPOSE: This work introduces a novel MC algorithm for 3D DCE-US and assesses its efficacy when handling clinical data sets. METHODS: In brief, the algorithm uses a pyramidal approach whereby short temporal windows consisting of three consecutive frames are created to perform local registrations, which are then registered to a master reference derived from a weighted average of all frames. We applied the algorithm to imaging studies from eight patients with metastatic lesions in the liver and assessed improvements in original versus motion corrected 3D DCE-US cine using: (i) frame-to-frame volumetric overlap of segmented lesions, (ii) normalized correlation coefficient (NCC) between frames (similarity analysis), and (iii) sum of squared errors (SSE), root-mean-squared error (RMSE), and r-squared (R2) quality-of-fit from fitted time-intensity curves (TIC) extracted from a segmented lesion. RESULTS: We noted improvements in frame-to-frame lesion overlap across all patients, from 68% ± 13% without correction to 83% ± 3% with MC (p = 0.023). Frame-to-frame similarity as assessed by NCC also improved on two different sets of time points from 0.694 ± 0.057 (original cine) to 0.862 ± 0.049 (corresponding MC cine) and 0.723 ± 0.066 to 0.886 ± 0.036 (p ≤ 0.001 for both). TIC analysis displayed a significant decrease in RMSE (p = 0.018) and a significant increase in R2 goodness-of-fit (p = 0.029) for the patient cohort. CONCLUSIONS: Overall, results suggest decreases in 3D DCE-US motion after applying the proposed algorithm.


Assuntos
Algoritmos , Meios de Contraste , Imageamento Tridimensional , Ultrassonografia , Humanos , Imageamento Tridimensional/métodos , Projetos Piloto , Movimento , Artefatos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Hepáticas/diagnóstico por imagem
4.
JCI Insight ; 8(5)2023 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-36692956

RESUMO

Bone metastases are a common complication of breast cancer. We have demonstrated that intermittent administration of parathyroid hormone (PTH[1-34]) reduces the incidence of bone metastases in murine models of breast cancer by acting on osteoblasts to alter the bone microenvironment. Here, we examined the role of signaling mediated by PTH 1 receptor (PTH1R) in both osteoblasts and breast cancer cells in influencing bone metastases. In mice with impaired PTH1R signaling in osteoblasts, intermittent PTH did not reduce bone metastasis. Intermittent PTH also did not reduce bone metastasis when expression of PTH1R was knocked down in 4T1 murine breast cancer cells by shRNA. In 4T1 breast cancer cells, PTH decreased expression of PTH-related protein (PTHrP), implicated in the vicious cycle of bone metastases. Knockdown of PTHrP in 4T1 cells significantly reduced migration toward MC3T3-E1 osteoblasts, and migration was further inhibited by treatment with intermittent PTH. Conversely, overexpression of PTHrP in 4T1 cells increased migration toward MC3T3-E1 osteoblasts, and this was not inhibited by PTH. In conclusion, PTH1R expression is crucial in both osteoblasts and breast cancer cells for PTH to reduce bone metastases, and in breast cancer cells, this may be mediated in part by suppression of PTHrP.


Assuntos
Melanoma , Neoplasias Cutâneas , Animais , Camundongos , Hormônio Paratireóideo , Proteína Relacionada ao Hormônio Paratireóideo/genética , Microambiente Tumoral , Receptor Tipo 1 de Hormônio Paratireóideo/metabolismo , Melanoma Maligno Cutâneo
5.
J Bone Miner Res ; 37(10): 1823-1842, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35983701

RESUMO

In mammals, hematopoiesis migrates to the bone marrow during embryogenesis coincident with the appearance of mineralized bone, where hematopoietic stem cells (HSCs) and their progeny are maintained by the surrounding microenvironment or niche, and sustain the entirety of the hematopoietic system. Genetic manipulation of niche factors and advances in cell lineage tracing techniques have implicated cells of both hematopoietic and nonhematopoietic origin as important regulators of hematopoiesis in health and disease. Among them, cells of the osteoblast lineage, from stromal skeletal stem cells to matrix-embedded osteocytes, are vital niche residents with varying capacities for hematopoietic support depending on stage of differentiation. Here, we review populations of osteoblasts at differing stages of differentiation and summarize the current understanding of the role of the osteoblast lineage in supporting hematopoiesis. © 2022 American Society for Bone and Mineral Research (ASBMR).


Assuntos
Hematopoese , Células-Tronco Hematopoéticas , Animais , Osteoblastos , Medula Óssea , Diferenciação Celular , Nicho de Células-Tronco , Células da Medula Óssea , Mamíferos
6.
JBMR Plus ; 6(12): e10695, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36530190

RESUMO

Teriparatide, recombinant parathyroid hormone (PTH[1-34]), and abaloparatide, an analogue of PTH related-peptide (PTHrP[1-34]), are both anabolic medications for osteoporosis that target the PTH receptor PTH1R. PTH1R is a G protein-coupled receptor, and the stimulatory Gs protein is an important mediator of the anabolic actions of PTH1R activation in bone. We have published that mice lacking the α subunit of Gs in osteoprogenitors do not increase bone mass in response to PTH(1-34). Unexpectedly, however, PTH(1-34) still increases osteoblast numbers and bone formation rate in male mice, suggesting that PTH1R may have both Gs-dependent and -independent actions in bone. Here we examine the role of Gs signaling in the anabolic actions of abaloparatide. We find that abaloparatide increases bone formation in male mice with postnatal deletion of Gsα in Osx-expressing osteoprogenitors (P-GsαOsxKO mice) but not in female P-GsαOsxKO mice. Therefore, abaloparatide has anabolic effects on bone in male but not female mice that appear to be independent of Gs-mediated signaling. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

7.
Am J Obstet Gynecol ; 204(5): 448.e1-4, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21333965

RESUMO

OBJECTIVE: The objective of the study was to evaluate the impact on resident forceps experience by a single proactive teacher. STUDY DESIGN: A study was performed to assess the impact on delivery statistics and outcome following the assignment of a single attending to teach forceps to residents. A 2 year period immediately preceding and 2 years following the study was compared using χ(2) and Student t tests. RESULTS: After appointment of the specific teaching attending, forceps deliveries increased by 59% (8% of all births), whereas vacuum procedures decreased to 3% of births (P < .0001) compared with the prior 2 years. The overall percentage of operative vaginal deliveries remained unchanged (11%). Cesarean section rates were unchanged during the study period at 27% of all births. Perineal laceration, 5 minute Apgar less than 7, and birth injuries were also not statistically different. There were fewer fetal pH events less than 7.1 in the teaching period (P = .003). CONCLUSION: In the population studied, there was an association between increasing resident forceps use and a positive impact on birth outcomes from the designation of a full-time, experienced, and proactive faculty member to obstetrics teaching duty.


Assuntos
Internato e Residência , Forceps Obstétrico , Obstetrícia/educação , Ensino/métodos , Parto Obstétrico , Feminino , Humanos , Gravidez
8.
J Ultrasound Med ; 30(12): 1643-7, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22123999

RESUMO

OBJECTIVES: The purpose of this study was to examine the efficacy of nonvisualization of the fourth ventricle for first-trimester detection of spina bifida. METHODS: A total of 250 digitally stored sonographic examinations at gestational ages of 11 weeks to 13 weeks 6 days (245 normal and 5 randomly interspersed spina bifida cases) were retrospectively analyzed by 4 blinded reviewers for the presence or absence of the fourth ventricle followed by an anteroposterior ventricular dimension measurement. The ventricle size was related to the crown-rump length and gestational age by linear regression analysis and Pearson correlation. RESULTS: The fourth ventricle was identified in 971 of 1000 image readings (97.1%). False-negative and false-positive readings occurred in 11 of 20 (55.0%) and 20 of 980 (2.0%) cases, respectively (sensitivity, 0.45; specificity, 0.98.). False-negative and false-positive readings were evenly distributed throughout the gestational age range. When the ventricular size was measurable, its mean dimensions increased linearly with gestational age and were below the fifth percentile in 10 of 245 (4.0%) normal and 0 of 4 spina bifida cases, respectively. Intraclass correlation coefficient estimates were calculated based on the 2-way analysis of variance model and found to be 0.30 for a single rater and 0.64 for the mean of 4 raters. CONCLUSIONS: Nonvisualization of the first-trimester fourth ventricle is a less robust screening parameter for spina bifida than previously published.


Assuntos
Quarto Ventrículo/diagnóstico por imagem , Disrafismo Espinal/diagnóstico por imagem , Disrafismo Espinal/epidemiologia , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Pré-Natal/estatística & dados numéricos , Adulto , California/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Prevalência , Reprodutibilidade dos Testes , Medição de Risco , Sensibilidade e Especificidade
9.
Harefuah ; 150(5): 484-8, 2011 May.
Artigo em Hebraico | MEDLINE | ID: mdl-21678649

RESUMO

The complex microbial populations that colonize the human body form the human microbiome. The human microbiota may contain 1014) cells, an order of magnitude greater than the number of the human cells, and can express 100 times more genes than the human genome. The metagenome is the collective genomes of the human and its microbial flora. Major international colLaborative efforts currently explore the diverse human microbiomes from five different body areas: the nasopharyngeal, gastrointestinal and female urogenital tracts, the oral cavity and the skin. Defining the complexity of the human microbiome in health and disease will enhance the understanding of multiple pathological mechanisms and facilitate the development of novel diagnostic tools and therapeutic interventions.


Assuntos
Metagenoma , Metagenômica/métodos , Feminino , Trato Gastrointestinal/microbiologia , Humanos , Boca/microbiologia , Nasofaringe/microbiologia , Pele/microbiologia , Sistema Urogenital/microbiologia
10.
J Ultrasound Med ; 29(10): 1439-43, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20876897

RESUMO

OBJECTIVE: The purpose of this study was to determine the association between discordant crown-rump length (CRL) measurements in structurally normal euploid dichorionic twins and adverse pregnancy outcomes. METHODS: This retrospective cohort study included women with dichorionic twins who underwent chorionic villus sampling and delivered in our facility from January 2000 to September 2007. Only pregnancies with viable twin fetuses and normal karyotypes were included. The association between CRL discordance, defined as a CRL discrepancy of 9% or greater, and adverse pregnancy outcomes was evaluated. RESULTS: Seventy-eight women met inclusion criteria and included 24 discordant twins (group 1) and 54 concordant twins (group 2). Maternal ages were similar: mean ± SD, 38.2 ± 3.1 years in group 1 versus 39.2 ± 3.9 years in group 2 (P = not significant). The median gestational ages at delivery were 35.6 ± 3.1 weeks in group 1 and 37.3 ± 2.0 weeks in group 2 (P < .01). At least 1 major complication occurred in 19 women (79%) in group 1 and 25 (46%) in group 2 (P = .01). Group 1 had significantly more major complications overall (P = .0008). Preterm premature rupture of membranes occurred in 10 women (42%) in group 1 and 6 (11%) in group 2 (P = .005). Delivery before 37 weeks' gestation occurred in 19 of 24 women (79%) in group 1 and 24 of 54 (44%) in group 2 (P = .006). There was a significant difference for younger gestational age at delivery in the discordant group (P < .01). CONCLUSIONS: Our data suggest that there is an increased risk of adverse pregnancy outcomes in chromosomally normal dichorionic twins with first-trimester discordant CRL measurements. These results may be clinically useful for counseling, management, and antenatal surveillance.


Assuntos
Estatura Cabeça-Cóccix , Resultado da Gravidez , Gêmeos , Adulto , Peso ao Nascer , Feminino , Ruptura Prematura de Membranas Fetais , Idade Gestacional , Humanos , Modelos Logísticos , Gravidez , Primeiro Trimestre da Gravidez , Estudos Retrospectivos
11.
Lab Chip ; 19(14): 2340-2345, 2019 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-31209452

RESUMO

Direct laser writing (DLW) is a three-dimensional (3D) manufacturing technology that offers vast architectural control at submicron scales, yet remains limited in cases that demand microstructures comprising more than one material. Here we present an accessible microfluidic multi-material DLW (µFMM-DLW) strategy that enables 3D nanostructured components to be printed with average material registration accuracies of 100 ± 70 nm (ΔX) and 190 ± 170 nm (ΔY) - a significant improvement versus conventional multi-material DLW methods. Results for printing 3D microstructures with up to five materials suggest that µFMM-DLW can be utilized in applications that demand geometrically complex, multi-material microsystems, such as for photonics, meta-materials, and 3D cell biology.


Assuntos
Lasers , Impressão/métodos
12.
PLoS Biol ; 2(10): e288, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15328538

RESUMO

The physiological flux of oxygen is extreme in exercising skeletal muscle. Hypoxia is thus a critical parameter in muscle function, influencing production of ATP, utilization of energy-producing substrates, and manufacture of exhaustion-inducing metabolites. Glycolysis is the central source of anaerobic energy in animals, and this metabolic pathway is regulated under low-oxygen conditions by the transcription factor hypoxia-inducible factor 1alpha (HIF-1alpha). To determine the role of HIF-1alpha in regulating skeletal muscle function, we tissue-specifically deleted the gene encoding the factor in skeletal muscle. Significant exercise-induced changes in expression of genes are decreased or absent in the skeletal-muscle HIF-1alpha knockout mice (HIF-1alpha KOs); changes in activities of glycolytic enzymes are seen as well. There is an increase in activity of rate-limiting enzymes of the mitochondria in the muscles of HIF-1alpha KOs, indicating that the citric acid cycle and increased fatty acid oxidation may be compensating for decreased flow through the glycolytic pathway. This is corroborated by a finding of no significant decreases in muscle ATP, but significantly decreased amounts of lactate in the serum of exercising HIF-1alpha KOs. This metabolic shift away from glycolysis and toward oxidation has the consequence of increasing exercise times in the HIF-1alpha KOs. However, repeated exercise trials give rise to extensive muscle damage in HIF-1alpha KOs, ultimately resulting in greatly reduced exercise times relative to wild-type animals. The muscle damage seen is similar to that detected in humans in diseases caused by deficiencies in skeletal muscle glycogenolysis and glycolysis. Thus, these results demonstrate an important role for the HIF-1 pathway in the metabolic control of muscle function.


Assuntos
Regulação da Expressão Gênica , Subunidade alfa do Fator 1 Induzível por Hipóxia/biossíntese , Subunidade alfa do Fator 1 Induzível por Hipóxia/fisiologia , Músculo Esquelético/metabolismo , Condicionamento Físico Animal/fisiologia , Trifosfato de Adenosina/química , Trifosfato de Adenosina/metabolismo , Alelos , Animais , Creatina Quinase/metabolismo , Cruzamentos Genéticos , Deleção de Genes , Genótipo , Glucose/metabolismo , Glicogênio/metabolismo , Glicólise , Hematócrito , Hemoglobinas/metabolismo , Hipóxia , Ácido Láctico/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Microscopia Eletrônica , Oxigênio/metabolismo , Esforço Físico , Reação em Cadeia da Polimerase , Regiões Promotoras Genéticas , Reação em Cadeia da Polimerase Via Transcriptase Reversa
14.
Obstet Gynecol ; 99(6): 1049-52, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12052598

RESUMO

OBJECTIVE: To measure the rate of hepatitis B (HBV) transmission from chronic HBV carriers to breast-fed infants after immunoprophylaxis. METHODS: Since 1992, information on women with HBV during pregnancy has been collected in a prospective longitudinal study. Those HBV carriers and their infants participating in a county HBV immunoprophylaxis program were identified. Infants were followed for up to 15 months and examined for hepatitis B infection by hepatitis B surface antigen (HBsAg). RESULTS: A total of 369 infants born to women with chronic HBV met the inclusion criteria and received hepatitis B immune globulin at birth and the full course of the hepatitis B vaccine series. We compared 101 breast-fed infants with 268 formula-fed infants. There was no significant difference between the two groups with respect to the number of women who were positive for hepatitis B e antigen (HBeAg) (22% versus 26%, P =.51). Three women in the breast-feeding group had liver transaminase abnormalities, compared with six women in the formula-feeding group (P =.29). Overall, there were nine cases of HBV infection transmission (2.4%). None of the 101 breast-fed infants and nine formula-fed infants (3%) were positive for HBsAg after the initial vaccination series (P =.063). The mean length of time for breast-feeding was 4.9 months (range 2 weeks to 1 year). CONCLUSION: With appropriate immunoprophylaxis, including hepatitis B immune globulin and hepatitis B vaccine, breast-feeding of infants of chronic HBV carriers poses no additional risk for the transmission of the hepatitis B virus.


Assuntos
Aleitamento Materno/efeitos adversos , Hepatite B/prevenção & controle , Hepatite B/transmissão , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Adolescente , Adulto , Doença Crônica , Estudos de Coortes , Feminino , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B , Humanos , Imunização Passiva , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Estudos Longitudinais , Gravidez , Estudos Prospectivos , Fatores de Risco , Texas/epidemiologia
15.
J Matern Fetal Neonatal Med ; 24(6): 837-41, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21142756

RESUMO

OBJECTIVE: Three-dimensional ultrasound has become an integral mode of fetal imaging. However, unclear but foundational concepts such as 'rotational axes' and 'sectional planes' are key to obtaining, manipulating, and understanding 3d volumes. This randomized study utilized 'analogical transfer', as a novel method of teaching three-dimensional ultrasound. We hypothesized that the cognitive processing of medical professionals dealing with medical imaging is less structure-based and more intuitive. METHODS: Ninety-four ultrasound education naïve subjects (50 conventional vs 44 experimental) were randomly assigned to using one of two teaching instruments to determine whether there was a difference in learning three-dimensional concepts. One instrument used the conventional approach (prose description of concepts) while the second teaching instrument used visual descriptors. Time to complete the instrument (self-learning + quiz) was recorded and quiz results were analyzed. RESULTS: One hundred potential subjects were offered participation and 94 accepted. The mean score (scale 0-8) using the analogical transfer approach was 5.32 ± 1.64 (n = 44) and using the traditional approach was 3.42 ± 1.93 (n = 50). Using an unpaired t-test, (α = 0.05), the calculated p value was 0.0001 (95% CI 1.16-2.64). CONCLUSIONS: Those subjects exposed to the analogical transfer method were more likely to better comprehend three-dimensional ultrasound concepts as represented by higher quiz scores.


Assuntos
Obstetrícia/educação , Ultrassonografia Pré-Natal/métodos , Adolescente , Adulto , Educação Médica Continuada/métodos , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Modelos Biológicos , Gravidez , Ensino , Adulto Jovem
16.
Obstet Gynecol ; 116(2 Pt 1): 330-334, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20664393

RESUMO

OBJECTIVE: To report the demographic characteristics and clinical morbidity of methamphetamine-exposed pregnancies compared with control patients in a tertiary care, urban, academic medical center. METHODS: A single-site chart review from 2000 to 2006 was conducted. International Classification of Diseases, 9th Revision code 648.3x was used to identify potential study participants. Specific inclusion criteria required either a positive urine drug screen for methamphetamine use or by patient statement of methamphetamine use during pregnancy. Data from 276 identified patients were then compared with the 34,055 in the general obstetric population during the same period for various demographic factors and perinatal outcomes. RESULTS: Two hundred seventy-six patients responsible for 273 live births were identified between 2000 and 2006. Factors that were significantly associated with methamphetamine use were age younger than 20 years (9% methamphetamine compared with 16% control patients), non-Hispanic white ethnicity (55% compared with 71%), married (12% compared with 46%), preterm delivery (52% compared with 17%), low Apgar scores (6% compared with 1-2%), cesarean delivery (29% compared with 23%), and neonatal mortality (4% compared with 1%). Additionally, the maternal demographic characteristics suggested that these women were more likely to be unemployed, use other abusive substances, and have higher rates of domestic violence and adoption when compared with the control population. CONCLUSION: Methamphetamine use in pregnancy is complicated by more morbid maternal and neonatal outcomes when compared with the general obstetric population. Because the patients in this study were in a variety of ways demographically distinct, attempts to identify these patients early and intervene in an effort to improve pregnancy-related outcomes appears possible and warranted. LEVEL OF EVIDENCE: II.


Assuntos
Estimulantes do Sistema Nervoso Central/efeitos adversos , Metanfetamina/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/complicações , Centros Médicos Acadêmicos/estatística & dados numéricos , California , Feminino , Humanos , Mortalidade Infantil , Recém-Nascido , Gravidez , Resultado da Gravidez , Gravidez de Alto Risco , Estudos Retrospectivos , População Urbana/estatística & dados numéricos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA