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Gabriella Pridjian

Publications and source records attributed to Gabriella Pridjian.

13 recordsLinked to original sources
PubMed2006

Birth weight and infant growth: optimal infant weight gain versus optimal infant weight.

OBJECTIVE: Infant growth assessment often focuses on "optimal" infant weights and lengths at specific ages, while de-emphasizing infant weight gain. Objective of this study was to examine infant growth patterns by measuring infant weight gain relative to birth weight. METHODS: We conducted this study based on data collected in a prospective cohort study including 3,302 births with follow up examinations of infants between the ages of 8 and 18 months. All infants were participants in the Louisiana State Women, Infant and Children Supplemental Food Program between 1999 and 2001. Growth was assessed by infant weight gain percentage (IWG%, defined as infant weight gain divided by birth weight) as well as by mean z-scores and percentiles for weight-for-age, length-for-age, and weight-for-length calculated based on growth charts published by the U.S. Centers for Disease Control (CDC). RESULTS: An inverse relationship was noted between birth weight category and IWG% (from 613.9% for infants with birth weights <1500 g to 151.3% for infants with birth weights of 4000 g or more). In contrast, low birth weight infants had lower weight-for-age, weight-for-length z-scores and percentiles compared to normal birth weight infants according to CDC growth charts. CONCLUSIONS: Although low birth weight infants had lower anthropometric measures compared to a national reference population, they had significant catch-up growth; High birth weight infants had significant slow-down growth. We suggest that growth assessments should compare infants' anthropometric data to their own previous growth measures as well as to a reference population. Further studies are needed to identify optimal ranges of infant weight gain.

Aid to Families with Dependent Children↗
PubMed2006

Eighty hour work reform: faculty and resident perceptions.

OBJECTIVE: The purpose of the study was to describe resident and faculty perceptions on the impact of the 80 hour work reform on residency training. STUDY DESIGN: Surveys were distributed to resident and faculty at a major university-based teaching institution. All responses were anonymous. Information abstracted from the survey included: demographic characteristics and resident and faculty perceptions on resident education, patient care, resident work environment, and quality of life after the institution of new regulations on resident duty hours. Descriptive and comparison analyses were performed. RESULTS: Ninety-four residents and 56 faculty members responded. Significant differences were detected in resident and faculty perceptions that work reform improved resident education (52.3% vs 20.8%, respectively, P < .01), and worsened quality of patient care (8.8% vs 45.3%, respectively, P < .01). Both residents (84.4%) and faculty (90.7%) agreed that work reform improved resident quality of life. CONCLUSION: Faculty and resident perceptions differed on the impact of the work reform on patient care and resident education but agreed that it improved resident quality of life.

Adult↗
PubMed2006

Periodontal disease and gestational diabetes mellitus.

OBJECTIVE: We examined the relationship between periodontal disease and different types of diabetes in pregnant and nonpregnant women. STUDY DESIGN: This study was based on the data from the third National Health and Nutrition Examination Survey (NHANES III), including 256 pregnant and 4234 nonpregnant women. Women were classified into those with gestational diabetes mellitus (GDM) in current pregnancy, with GDM in previous pregnancy, and with type 1 or 2 diabetes. RESULTS: In pregnant women, the prevalence of periodontitis was 44.8% in women with GDM and 13.2% in nondiabetic women, with adjusted odds ratio (aOR) of 9.11 (95% confidence interval [CI] 1.11-74.9). In nonpregnant women, the prevalence of periodontitis was 40.3% in women with type 1 or 2 diabetes, 25.0% in women with previous history of GDM, and 13.9% in nondiabetic women, with aOR of 2.76 (1.03-7.35) for women with type 1 or 2 diabetes. CONCLUSION: We found an association between periodontal disease and GDM.

Adolescent↗
PubMed2006

Beneficial effects of metolazone in a rat model of preeclampsia.

Preeclampsia is a disorder that continues to exact a significant toll with respect to maternal morbidity and mortality as well as fetal wastage. Furthermore, the treatment of this disorder has not changed significantly in 50 years and is unsatisfactory. The use of diuretics in this syndrome is controversial because there is a concern related to potential baleful effects of volume contraction leading to a possible further decrement in the perfusion of the maternal-fetal unit. Metolazone is a diuretic/antihypertensive agent, which has a therapeutic effect on blood pressure (BP) in human essential hypertension without causing a natriuresis. We administered the drug in nondiuretic doses in a rat model of preeclampsia previously developed in this laboratory. The drug reduced BP without an accompanying natriuresis. Although there was a trend toward an improvement in intrauterine growth restriction, as determined by litter size and the number of pups demonstrating malformations, the values did not reach statistical significance. We conclude that metolazone, in low dosage, is an effective antihypertensive in this rat model. These studies have implications for the treatment of the human disorder.

Animals↗
PubMed2006

Predisposition to atypical teratoid/rhabdoid tumor due to an inherited INI1 mutation.

BACKGROUND: Germline mutations of the INI1 gene predispose children to the development of rhabdoid tumors. Reports of familial cases, however, are extremely rare. PROCEDURE: We have identified a three-generation family in which two half-brothers were diagnosed with central nervous system atypical teratoid/rhabdoid tumors (AT/RT). The two boys, diagnosed at 2 months and 17 months of age, had a germline insertion mutation in exon 4 of the INI1 gene that was inherited from their healthy mother. A maternal uncle died in childhood from a brain tumor and a malignant rhabdoid tumor of the kidney, and presumably carried the same germline mutation. As the mother and uncle had different fathers, the grandmother is also an obligate carrier of the mutation. CONCLUSION: The identification of two unaffected carriers in a family segregating a germline mutation and rhabdoid tumor supports the hypothesis that there may be variable risks of development of rhabdoid tumor in the context of a germline mutation. There may be a developmental window in which most rhabdoid tumors occur. This family highlights the importance of mutation analysis in all patients with a suspected rhabdoid tumor.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

Phenotypic characteristics shared by preeclamptic patients and an animal model of the syndrome: report of a pilot study.

BACKGROUND: Preeclampsia is a disorder that affects between 3% and 10% of all pregnancies. Progress in the understanding of the etiology (or etiologies) of this disorder has been impeded by the lack of suitable animal models of its early pathogenesis. Etiologic possibilities abound, and there are a number of considerations that suggest that preeclampsia is not one disease but rather a group of diseases with similar phenotypic characteristics. A rat model of this syndrome has been developed by inducing excessive volume expansion using desoxycorticosterone acetate and by replacing the drinking water with 0.9% saline. These animals develop hypertension, proteinuria, and intrauterine growth restriction (IUGR). However, they do not develop glomerular endotheliosis or a reduced glomerular filtration rate (GFR). We therefore surveyed the charts of patients with a discharge diagnosis of preeclampsia. We addressed the question of whether there was a group of such patients with the characteristics of our rat model. These include hypertension, proteinuria, IUGR, and either normal or only mildly abnormal GFR. METHODS: We performed a retrospective chart review of 630 consecutive patients discharged with a diagnosis of preeclampsia. Of the patients, 1290 had all data available to allow appropriate analysis. RESULTS: A total of 29 patients demonstrated hypertension (>140/90 mm Hg), proteinuria (>300 mg/ 24 h), and IUGR and did not have any confounding comorbid conditions. Of these 29 patients, 18 had GFR that were within the range expected for gestational age or only slightly reduced. CONCLUSIONS: There is a group of patients that mirror the characteristics of our animal model. Accordingly, at least one etiology of preeclampsia is related to excessive expansion of the extracellular fluid volume.

Adolescent↗
PubMed2005

Involvement of marinobufagenin in a rat model of human preeclampsia.

BACKGROUND: Preeclampsia is a potentially devastating disorder of hypertension in pregnancy for which there is currently no definitive treatment short of delivery. The bufadienolide, marinobufagenin (MBG), an inhibitor of Na(+)/K(+) ATPase, has been found to be elevated in extracellular fluid volume-expanded hypertensive patients, a condition similar to preeclampsia. Thus, these studies sought to examine the role of MBG in our rat model of preeclampsia. METHODS AND RESULTS: Pregnant female rats were injected intraperitoneally with deoxycorticosterone acetate (DOCA) and given 0.9% saline as drinking water for the duration of their pregnancy. Urinary MBG was measured using a DELFIA immunoassay. Blood pressure was measured via the tail-cuff method. Injections of anti-MBG antibody were given intraperitoneally or intravenously to hypertensive pregnant rats. MBG was given intraperitoneally to pregnant rats. Uterine arterioles were dissected free and their diameters were measured before and after perfusion of MBG, ouabain, or digoxin. MBG was found to be elevated in the pregnant + DOCA + saline (PDS) rats compared to normal pregnant animals. In addition, when PDS rats were injected with anti-MBG antibody, there was a subsequent reduction in blood pressure. Administration of MBG in normal pregnant rats caused an elevation in blood pressure equivalent to the PDS model. Also, uterine vessel measurements showed an increased vasoconstrictive reactivity to MBG in the PDS animals vs. the normal pregnant controls; while no changes were observed with perfusion of digoxin or ouabain at the same concentration. CONCLUSION: These results suggest a relationship between MBG and a syndrome in rats resembling preeclampsia. Armed with these promising results, it would seem logical to further examine the role of MBG in human preeclampsia.

Animals↗
PubMed2005

A rat model of preeclampsia.

Preeclampsia/eclampsia is a disorder of human pregnancy that continues to exact significant maternal morbidity and mortality and fetal wastage. Therapy of these disorders has not changed in over 50 years and there are no proven preventive measures. We describe a model of the development of a syndrome in the pregnant rat that resembles preeclampsia, which results from the imposition of excessive volume expansion early in gestation. We administered desoxycorticosterone acetate (DOCA) to pregnant animals whose drinking water had been replaced with saline. We compared the results obtained in these animals with those resulting from the study of control, virgin animals, virgin animals receiving DOCA and saline, and normal pregnant (NP) animals. The virgin animals given DOCA and saline did not become hypertensive. The experimental paradigm in the DOCA plus saline pregnant (PDS) animals provides many of the phenotypic characteristics of the human disorder including the development of hypertension, proteinuria, and intrauterine growth restriction. In addition, the mean blood nitrite/nitrate concentration was reduced in the PDS rats compared with their NP counterparts. We propose that this model may prove to be useful in the study of the human condition.

Animals↗
PubMed2005

Racial differences in cesareans: an analysis of U.S. 2001 National Inpatient Sample Data.

OBJECTIVE: To evaluate racial differences in potentially unnecessary cesareans in the United States. METHODS: The 2001 Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to analyze various maternal demographic and clinical parameters among women having cesarean deliveries. For the purpose of our study, if there were no diagnoses related to cesarean delivery on the discharge certificate, the cesarean was classified as potentially unnecessary RESULTS: Using our methodology, 11% of 540,174 primary and 65% of 371,863 repeat cesareans for the year 2001 in the United States were classified as potentially unnecessary. After controlling for age, payment source, ZIP income, admission day, region of the country, and hospital size, location, and teaching status, black women had a higher likelihood of having potentially unnecessary primary cesareans when compared with white (P < .001) or Hispanic women (P < .001). White women had a higher likelihood of having potentially unnecessary repeat cesareans than black women (P < .001), although the magnitude of the odds ratio for race was not as striking as in primary cesarean. Potentially unnecessary primary cesareans were also more likely to occur in women aged 35 years or older, Medicare patients, weekend admissions, or those residing in the South or Northeast. Potentially unnecessary repeat cesareans were more likely to occur in women younger than 35 years, in rural hospitals, and in weekday admissions. CONCLUSION: In the United States, racial differences exist in the proportion of cesarean deliveries that are potentially unnecessary. Further exploration of these differences is warranted. LEVEL OF EVIDENCE: III.

Adult↗
PubMed2003

Preeclampsia and eclampsia revisited.

Hypertensive disorders during pregnancy, which account for approximately 15% of pregnancy-related deaths, represent the second-leading cause of morbidity and mortality in the United States. New classifications recommended by the National Institutes of Health's Working Group on High Blood Pressure in Pregnancy have decreased the confusion often associated with these disorders. The cause of preeclampsia-eclampsia still remains elusive, but continued research has provided hope with regard to screening, improved diagnosis, and management. Risk factors that have recently gained attention include inherited thrombophilias, inherited metabolic disorders, and lipid disorders. Treatment and management of the hypertensive disorders of pregnancy have not changed substantially in the past 50 years. Prevention of preeclampsia-eclampsia has been unsuccessful, and recurrence risks remain high. Careful diagnosis, classification, and further investigation of the causes of hypertensive disorders in pregnancy are needed to achieve optimal management of affected women and their fetuses.

Eclampsia↗
PubMed2002

Preeclampsia. Part 1: clinical and pathophysiologic considerations.

Preeclampsia-eclampsia is still one of the leading causes of maternal and fetal morbidity and mortality. Despite active research for many years, the etiology of this disorder exclusive to human pregnancy is an enigma. Recent evidence suggests there may be several underlying causes or predispositions leading to the signs of hypertension, proteinuria, and edema, findings that allow us to make the diagnosis of the "syndrome" of preeclampsia. Despite improved prenatal care, severe preeclampsia and eclampsia still occur. Although understanding of the pathophysiology of these disorders has improved, treatment has not changed significantly in over 50 years. Although postponement of delivery in selected women with severe preeclampsia improves fetal outcome to a degree, this is not done without risk to the mother. In the United States, magnesium sulfate and hydralazine are the most commonly used medications for seizure prophylaxis and hypertension in the intrapartum period. The search for the underlying cause of this disorder and for a clinical marker to predict those women who will develop preeclampsia-eclampsia is ongoing, with its prevention the ultimate goal. This review begins with the clinical and pathophysiologic aspects of preeclampsia-eclampsia (Part 1). In Part 2, the experimental observations, the search for predictive factors, and the genetics of this disorder will be reviewed.

Diagnosis, Differential↗
PubMed2002

Preeclampsia. Part 2: experimental and genetic considerations.

Preeclampsia-eclampsia is still one of the leading causes of maternal and fetal morbidity and mortality. Despite active research for many years, the etiology of this disorder exclusive to human pregnancy is an enigma. Recent evidence suggests there may be several underlying causes or predispositions leading to the signs of hypertension, proteinuria, and edema, findings that allow us to make the diagnosis of the "syndrome" of preeclampsia. Despite improved prenatal care, severe preeclampsia and eclampsia still occur. Although understanding of the pathophysiology of these disorders has improved, treatment has not changed significantly in over 50 years. Although postponement of delivery in selected women with severe preeclampsia improves fetal outcome to a degree, this is not done without risk to the mother. In the United States, magnesium sulfate and hydralazine are the most commonly used medications for seizure prophylaxis and hypertension in the intrapartum period. The search for the underlying cause of this disorder and for a clinical marker to predict those women who will develop preeclampsia-eclampsia is ongoing, with its prevention the ultimate goal. This review began with the clinical and pathophysiologic aspects of preeclampsia-eclampsia (Part 1). Now, in Part 2, the experimental observations, the search for predictive factors, and the genetics of this disorder are reviewed.

Amino Acid Sequence↗