126 results on '"Robert E. Meyer"'
Search Results
2. Cancer diagnostic profile in children with structural birth defects: An assessment in 15,000 childhood cancer cases
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Philip J. Lupo, Sonja A. Rasmussen, Tania A Desrosiers, Tiffany M. Chambers, Jeremy M. Schraw, Wendy N. Nembhard, Peter H. Langlois, Robert E. Meyer, Mark A. Canfield, Sharon E. Plon, and Logan G. Spector
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Hepatoblastoma ,Male ,Ependymoma ,Cancer Research ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Population ,Article ,Congenital Abnormalities ,Causes of cancer ,Neuroblastoma ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Neoplasms ,Epidemiology of cancer ,Epidemiology ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Child ,education ,education.field_of_study ,business.industry ,Liver Neoplasms ,Infant, Newborn ,Infant ,Cancer ,medicine.disease ,United States ,Oncology ,Child, Preschool ,Hematologic Neoplasms ,030220 oncology & carcinogenesis ,Female ,Germ cell tumors ,business - Abstract
BACKGROUND Birth defects are established risk factors for childhood cancer. Nonetheless, cancer epidemiology in children with birth defects is not well characterized. METHODS Using data from population-based registries in 4 US states, this study compared children with cancer but no birth defects (n = 13,111) with children with cancer and 1 or more nonsyndromic birth defects (n = 1616). The objective was to evaluate cancer diagnostic characteristics, including tumor type, age at diagnosis, and stage at diagnosis. RESULTS Compared with the general population of children with cancer, children with birth defects were diagnosed with more embryonal tumors (26.6% vs 18.7%; q
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- 2020
3. Maternal diet as a risk factor for primary congenital glaucoma and defects of the anterior segment of the eye in the<scp>National Birth Defects Prevention Study</scp>
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Kari E. North, Tania A Desrosiers, Sharon F. Freedman, Nina E. Forestieri, KJ Moore, Robert E. Meyer, Suzan L. Carmichael, and Andrew F. Olshan
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0301 basic medicine ,Embryology ,Pediatrics ,medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,030105 genetics & heredity ,Toxicology ,Logistic regression ,Odds ,03 medical and health sciences ,Pregnancy ,Risk Factors ,Odds Ratio ,medicine ,Humans ,Risk factor ,business.industry ,Infant ,Glaucoma ,Odds ratio ,medicine.disease ,United States ,Latent class model ,Confidence interval ,Diet ,030104 developmental biology ,Quartile ,Case-Control Studies ,Pediatrics, Perinatology and Child Health ,Female ,business ,Developmental Biology - Abstract
Primary congenital glaucoma (PCG) and anterior segment defects (ASDs) are rare ocular malformations diagnosed early in life which can cause blindness. Pathogenic variants in several genes have been linked to these conditions, but little is known about nongenetic risk factors. We investigated the association between maternal nutrition and PCG and ASDs in the National Birth Defects Prevention Study, a large population-based, multicenter case-control study of major birth defects in the United States. Mothers of cases (n = 152) and control infants without a birth defect (n = 9,178) completed an interview which included a food frequency questionnaire capturing usual dietary intake in the year before pregnancy. Maternal nutrition was assessed through individual nutrient intake, calculating a Diet Quality Index for Pregnancy (DQI-P) score for each mother, and using latent class analysis to empirically derive four dietary patterns. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (CI) using logistic regression. The results for individual nutrients varied, with some having an inverse or U-shaped pattern of association with increasing intake. The DQI-P was not associated with risk of PCG and ASDs (aOR 0.91; CI 0.49-1.66, highest vs. lowest quartile). The dietary pattern analysis suggested lower odds among women with a Prudent and Mexican dietary pattern (aOR 0.82, 95% CI 0.52-1.29; aOR 0.80, 95% CI 0.36-1.78, respectively) compared to those with a Western dietary pattern. We found that higher intake of some nutrients and certain dietary patterns may be inversely associated with PCG and ASDs, though caution is urged due to imprecision of estimates.
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- 2020
4. Academic Achievement Among Children With Nonsyndromic Orofacial Clefts : A Population-Based Study
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Luiz André Freire Pimenta, Robert E. Meyer, Robert J. Lipinski, Arthur S. Aylsworth, Jeffrey R. Marcus, Stephanie Watkins, Ronald P. Strauss, and Alexander C. Allori
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business.industry ,030206 dentistry ,Academic achievement ,Population based study ,03 medical and health sciences ,Poor reading ,0302 clinical medicine ,School performance ,Otorhinolaryngology ,030225 pediatrics ,Learning disability ,Medicine ,Oral Surgery ,medicine.symptom ,Association (psychology) ,business ,Clinical psychology - Abstract
Objective:Children with orofacial clefts (OFCs) may experience poor reading proficiency, learning disabilities, and academic underachievement. We examined the association between nonsyndromic (NS) OFCs and end-of-grade (EOG) performance in reading and math from third through eighth grade in a sample subgroup.Participants:We identified a cohort of 559 children with NS-OFCs and 6822 children without birth defects, classifying cleft type by cleft lip alone, with or without cleft alveolar ridge (CL); cleft lip with cleft palate (CL+P); and cleft palate only (CP).Main Outcome Measures:Using logistic regression, we estimated the odds of not meeting grade-level standards among children with NS-OFCs compared to unaffected peers. Using longitudinal analyses, we estimated the odds of not meeting grade-level standards and average change in test scores through eighth grade.Results:Children with NS-OFCs were 1.22 (95% CI: 0.96, 1.83) times as likely not to meet grade-level standards in reading compared to unaffected peers. The effect was similar for math (OR: 1.17; 95% CI: 0.92, 1.48). Children with CL+P were 1.33 (95% CI: 0.86, 1.83) and 1.74 (95% CI: 1.19, 2.56) times as likely not to meet grade-level standard in reading and in both subjects, respectively, compared to unaffected peers. The average rate of change in both scores was similar for children with and without OFCs.Conclusions:Poor academic performance appears greatest for children with CL+P, a finding compatible with previous observations and hypothesized mechanisms associating orofacial clefts with subtle abnormalities in brain development. Academic performance monitoring and referral for academic assistance is warranted.
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- 2021
5. Prevalence and descriptive epidemiology of infantile hypertrophic pyloric stenosis in the United States: A multistate, population‐based retrospective study, 1999–2010
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Russell S. Kirby, Renuka Kapoor, Vijaya Kancherla, Jonathan Suhl, Paul A. Romitti, Mark A. Canfield, Robert E. Meyer, Jacob Oleson, Yanyan Cao, and Charlotte M. Druschel
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Adult ,Male ,0301 basic medicine ,Embryology ,medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,Birth weight ,Population ,Pyloric Stenosis, Hypertrophic ,030105 genetics & heredity ,Toxicology ,Logistic regression ,Article ,03 medical and health sciences ,symbols.namesake ,Pregnancy ,Risk Factors ,Epidemiology ,Prevalence ,Birth Weight ,Humans ,Medicine ,Poisson regression ,education ,Retrospective Studies ,education.field_of_study ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Infant ,Retrospective cohort study ,United States ,Confidence interval ,Parity ,Logistic Models ,030104 developmental biology ,Population Surveillance ,Pediatrics, Perinatology and Child Health ,symbols ,Female ,business ,Developmental Biology ,Demography - Abstract
BACKGROUND: Antecedents for infantile hypertrophic pyloric stenosis (IHPS) vary across studies; therefore, we conducted a multistate, population-based retrospective study of the prevalence and descriptive epidemiology of IHPS in the United States (US). METHODS: Data for IHPS cases (n = 29,554) delivered from 1999–2010 and enumerated from 11 US population-based birth defect surveillance programs, along with data for live births (n = 14,707,418) delivered within the same birth period and jurisdictions, were analyzed using Poisson regression to estimate IHPS prevalence per 10,000 live births. Additional data on deliveries from 1999–2005 from seven of these programs were analyzed using multivariable logistic regression to estimate adjusted prevalence ratios (aPR)s and 95% confidence intervals (CI)s for selected infant and parental characteristics. RESULTS: Overall, IHPS prevalence from 1999–2010 was 20.09 (95% CI = 19.87, 20.32) per 10,000 live births, with statistically significant increases from 2003–2006 and decreases from 2007–2010. Compared to their respective referents, aPRs were higher in magnitude for males, preterm births, and multiple births, but lower for birth weights
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- 2018
6. Pharmacokinetics and pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses
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Heather K Knych, William S. Denney, Vernon C. Langston, Robert E. Meyer, Claudio Correa Natalini, Robin L. Fontenot, Sarah E. Shane, and Robert W. Wills
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040301 veterinary sciences ,Sedation ,Im injections ,0403 veterinary science ,03 medical and health sciences ,0302 clinical medicine ,Bolus (medicine) ,Pharmacokinetics ,030202 anesthesiology ,medicine ,Animals ,Horses ,Dexmedetomidine ,Infusions, Intravenous ,Standing sedation ,Pharmacology ,Cross-Over Studies ,General Veterinary ,business.industry ,04 agricultural and veterinary sciences ,Crossover study ,Anesthesia ,Injections, Intravenous ,Administration, Intravenous ,Female ,medicine.symptom ,business ,medicine.drug ,Pressure threshold - Abstract
An ideal dexmedetomidine protocol has yet to be determined for standing sedation in horses. It was hypothesized that an IV bolus followed by CRI dexmedetomidine would have a quicker increase in plasma concentrations compared with repeated IM injections. In a crossover design, eight adult, female horses were randomly placed into two groups: the CRI group (IV bolus dexmedetomidine at 0.005 mg/kg followed by a CRI at 0.01 mg/kg/h for 15 min then 0.005 mg/kg/h for 60 min) and the IM group (dexmedetomidine at 0.01 mg/kg, followed by 0.005 mg/kg in 30-min intervals for 60 min). Clearance and elimination half-life were 134 ± 67.4 ml/kg/min and 44.3 ± 26.3 min, respectively, in the CRI group, and apparent clearance and half-life were 412 ± 306 ml/kg/min (Cl/F) and 38.9 ± 18.6 min, respectively, in the IM group. Analgesia was evaluated using mechanical pressure threshold. Intravenous dexmedetomidine produced faster onset of sedation and increased pressure threshold compared with IM administration. Individual horses had a large variability in dexmedetomidine plasma concentrations between CRI and IM administration. The odds of a decreased GI motility following IV administration was 12.34 times greater compared with IM administration.
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- 2021
7. Causes of Death and Cardiovascular Comorbidities in Adults With Congenital Heart Disease
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Joseph Paolillo, Charlie J. Sang, Richard A. Krasuski, Robert J. Hartman, Robert E. Meyer, Alex R. Kemper, Timothy M. Hoffman, Tracy Spears, Karen Chiswell, Jennifer S. Li, Alfred D’Ottavio, Michael J. Walsh, and Sarah A. Goldstein
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Heart Defects, Congenital ,Male ,Pediatrics ,medicine.medical_specialty ,Heart disease ,Comorbidity ,Cohort Studies ,Risk Factors ,death ,Cardiovascular Disease ,Cause of Death ,North Carolina ,medicine ,Humans ,cardiovascular diseases ,Original Research ,Aged ,Aged, 80 and over ,business.industry ,aging ,Congenital Heart Disease ,Age at death ,medicine.disease ,Female ,Mortality/Survival ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Little is known about the contemporary mortality experience among adults with congenital heart disease (CHD). The objectives of this study were to assess the age at death, presence of cardiovascular comorbidities, and most common causes of death among adults with CHD in a contemporary cohort within the United States. Methods and Results Patients with CHD who had a healthcare encounter between 2008 and 2013 at 1 of 5 comprehensive CHD centers in North Carolina were identified by International Classification of Diseases, Ninth Revision ( ICD‐9 ), code. Only patients who could be linked to a North Carolina death certificate between 2008 and 2016 and with age at death ≥20 years were included. Median age at death and underlying cause of death based on death certificate data were analyzed. The prevalence of acquired cardiovascular risk factors was determined from electronic medical record data. Among the 629 included patients, the median age at death was 64.2 years. Those with severe CHD (n=157, 25%), shunts (n=202, 32%), and valvular lesions (n=174, 28%) had a median age at death of 46.0, 65.0, and 73.3 years, respectively. Cardiovascular death was most common in adults with severe CHD (60%), with 40% of those deaths caused by CHD. Malignancy and ischemic heart disease were the most common causes of death in adults with nonsevere CHD. Hypertension and hyperlipidemia were common comorbidities among all CHD severity groups. Conclusions The most common underlying causes of death differed by lesion severity. Those with severe lesions most commonly died from underlying CHD, whereas those with nonsevere disease more commonly died from non‐CHD causes.
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- 2020
8. Male Sex and the Risk of Childhood Cancer: The Mediating Effect of Birth Defects
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Sharon E. Plon, Peter H. Langlois, Tania A Desrosiers, Robert E. Meyer, Jeremy M. Schraw, Philip J. Lupo, Wendy N. Nembhard, Erin L. Marcotte, and Mark A. Canfield
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Cancer Research ,education.field_of_study ,business.industry ,Confounding ,Population ,Ethnic group ,Cancer ,medicine.disease ,Article ,Oncology ,Neuroblastoma ,medicine ,Risk factor ,AcademicSubjects/MED00010 ,business ,education ,Birth Year ,Sex ratio ,Demography - Abstract
Background There is a persistent, unexplained disparity in sex ratio among childhood cancer cases, whereby males are more likely to develop most cancers. This male predominance is also seen for most birth defects, which are strongly associated with risk of childhood cancer. We conducted mediation analysis to estimate whether the increased risk of cancer among males is partially explained by birth defect status. Methods We used a population-based birth cohort with linked data from birth certificates, birth defects registries, and cancer registries from Arkansas, Michigan, North Carolina, and Texas. We conducted counterfactual mediation analysis to estimate the natural direct and indirect effects of sex on cancer risk, modeling birth defect status as mediator. State; birth year; plurality; and maternal race and ethnicity, age, and education were considered confounders. We conducted separate analyses limited to cancers diagnosed younger than 1 year of age. Results Our dataset included 10 181 074 children: 15 110 diagnosed with cancer, 539 567 diagnosed with birth defects, and 2124 co-occurring cases. Birth defect status mediated 38% of the association between sex and cancer overall. The proportion mediated varied by cancer type, including acute myeloid leukemia (93%), neuroblastoma (35%), and non-Hodgkin lymphoma (6%). Among children younger than 1 year of age at cancer diagnosis, the proportion mediated was substantially higher (82%). Conclusions Our results suggest that birth defects mediate a statistically significant proportion of the relationship between sex and childhood cancer. The proportion mediated varied by cancer type and diagnosis age. These findings improve our understanding of the causal pathway underlying male sex as a risk factor for childhood cancer.
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- 2020
9. The Science of Transitional States of Consciousness and Euthanasia
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Robert E. Meyer
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Loss of righting reflex ,Unconscious mind ,Consciousness ,040301 veterinary sciences ,business.industry ,media_common.quotation_subject ,Companion animal ,Unconsciousness ,0402 animal and dairy science ,04 agricultural and veterinary sciences ,040201 dairy & animal science ,0403 veterinary science ,Euthanasia, Animal ,medicine ,Animals ,medicine.symptom ,Small Animals ,business ,media_common ,Cognitive psychology - Abstract
The science of transitional states of consciousness is reviewed. Despite intensive study, determining the subjective experience of animals during transitional states of consciousness remains inherently limited. Until better assessment tools become available, behavior-based observations, such as loss of righting reflex/loss of posture, remain among our most useful guides to the onset of unconsciousness in animals. To minimize potential animal suffering and to ensure a truly unconscious state is unambiguously achieved, a state of general anesthesia relying on gamma amino butyric acid type A agonists or N-methyl-d-aspartate antagonist agents continues to be a necessary component of the companion animal euthanasia process.
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- 2020
10. Effect of Concomitant Birth Defects and Genetic Anomalies on Infant Mortality in Tetralogy of Fallot
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Paula D. Strassle, Rebecca C. Stebbins, Eric G. Jernigan, Robert E. Meyer, and Jennifer S. Nelson
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0301 basic medicine ,Embryology ,Pediatrics ,medicine.medical_specialty ,business.industry ,Health, Toxicology and Mutagenesis ,Odds ratio ,030204 cardiovascular system & hematology ,030105 genetics & heredity ,Toxicology ,medicine.disease ,Monitoring program ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,Concomitant ,Pediatrics, Perinatology and Child Health ,Risk of mortality ,Medicine ,business ,Trisomy ,Survival analysis ,Developmental Biology ,Tetralogy of Fallot - Abstract
Background A substantial proportion of infants born with tetralogy of Fallot (TOF) die in infancy. A better understanding of the heterogeneity associated with TOF, including extracardiac malformations and chromosomal anomalies is vital to stratifying risk and optimizing outcomes during infancy. Methods Using the North Carolina Birth Defects Monitoring Program, infants diagnosed with TOF and born between 2003 and 2012 were included. Kaplan-Meier survival curves were used to estimate cumulative 1-year mortality, stratified by the presence of concomitant birth defects (BDs) and chromosomal anomalies. Multivariable logistic regression was used to estimate the direct effect of each concomitant BD, after adjusting for all others. Results A total of 496 infants with TOF were included, and 15% (n = 76) died. The number of concomitant BD systems was significantly associated with the risk of death at 1-year, p
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- 2017
11. Population-based microcephaly surveillance in the United States, 2009 to 2013: An analysis of potential sources of variation
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Philip J. Lupo, Russell S. Kirby, Jennifer Isenburg, Amy Nance, Glenn Copeland, Deborah J. Fox, Jennifer S. Liu, Rebecca F. Liberman, Marlene Anderka, Cara T. Mai, C.J. Alverson, Jane Fornoff, Sook Ja Cho, Amanda Seagroves, Rachel E. Rutkowski, Marilyn L. Browne, Amy Steele, Samantha E. Parker, Erin B. Stallings, Janet D. Cragan, Robert E. Meyer, Paul A. Romitti, Mary K. Ethen, and MaryAnn Evans
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Embryology ,Pediatrics ,medicine.medical_specialty ,Percentile ,Microcephaly ,Birth weight ,Population ,Zika virus ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Medicine ,030212 general & internal medicine ,education ,education.field_of_study ,biology ,business.industry ,Gestational age ,Retrospective cohort study ,General Medicine ,biology.organism_classification ,medicine.disease ,Pediatrics, Perinatology and Child Health ,Gestation ,business ,Developmental Biology - Abstract
Background Congenital microcephaly has been linked to maternal Zika virus infection. However, ascertaining infants diagnosed with microcephaly can be challenging. Methods Thirty birth defects surveillance programs provided data on infants diagnosed with microcephaly born 2009 to 2013. The pooled prevalence of microcephaly per 10,000 live births was estimated overall and by maternal/infant characteristics. Variation in prevalence was examined across case finding methods. Nine programs provided data on head circumference and conditions potentially contributing to microcephaly. Results The pooled prevalence of microcephaly was 8.7 per 10,000 live births. Median prevalence (per 10,000 live births) was similar among programs using active (6.7) and passive (6.6) methods; the interdecile range of prevalence estimates was wider among programs using passive methods for all race/ethnicity categories except Hispanic. Prevalence (per 10,000 live births) was lowest among non-Hispanic Whites (6.5) and highest among non-Hispanic Blacks and Hispanics (11.2 and 11.9, respectively); estimates followed a U-shaped distribution by maternal age with the highest prevalence among mothers
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- 2016
12. Geographic distribution of live births with tetralogy of Fallot in North Carolina 2003 to 2012
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Robert E. Meyer, Rebecca C. Stebbins, Jennifer S. Nelson, and Paula D. Strassle
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Embryology ,medicine.medical_specialty ,Spatial epidemiology ,Geographic variation ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Disease cluster ,Monitoring program ,Zip code ,Travel time ,Geographic distribution ,03 medical and health sciences ,0302 clinical medicine ,Geography ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Cardiology ,medicine ,030212 general & internal medicine ,Developmental Biology ,Tetralogy of Fallot ,Demography - Abstract
Background Geographic variation in congenital heart disease is not well-described. This study uses geographic information systems (GIS) to describe the spatial epidemiology of tetralogy of Fallot (TOF), in North Carolina (NC) and to compare travel time for cases to congenital heart centers in NC. Methods Using the NC Birth Defects Monitoring Program database, live births with TOF born between 2003 and 2012 were identified. Birth certificates provided demographic variables. A denominator of live births/zip code was obtained from the NC live births database. ArcGIS® software was used to illustrate TOF prevalence by zip code, and SatScanTM was used to identify spatial clusters of TOF cases and to identify changes in cluster location over time. Driving time to each of five NC congenital heart centers was predicted based on road systems information. Results A total of 496 infants were born with TOF between 2003 and 2012. The prevalence was 4.2/10,000 live births. A large cluster (330 zip codes, 306 cases) was identified in northeastern NC. Average driving time for each case to closest congenital heart center was: University of North Carolina 37 min, Vident Medical Center 64 min, Duke University 58 min, Carolina's Medical Center 89 min, and Wake Forest Baptist Health 57 min. Overall, average predicted driving time to the nearest congenital heart center was 61 min. Conclusion Approximately 50 infants/year were born with TOF in NC. One cluster was identified. Further study is necessary to explore potential explanations for the observed case cluster. As interest in regionalization of congenital heart surgery grows, GIS and spatial analysis can become increasingly useful tools for health care planning. Birth Defects Research (Part A) 106:881-887, 2016. © 2016 Wiley Periodicals, Inc.
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- 2016
13. National population-based estimates for major birth defects, 2010-2014
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Russell S. Kirby, Deepa Aggarwal, Mark A. Canfield, Tiffany Riehle-Colarusso, C.J. Alverson, Cara T. Mai, Robert E. Meyer, Adolfo Correa, Jennifer Isenburg, Sook Ja Cho, and Philip J. Lupo
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0301 basic medicine ,Adult ,Heart Defects, Congenital ,Embryology ,Down syndrome ,Eye Diseases ,Health, Toxicology and Mutagenesis ,Population ,Cardiovascular Abnormalities ,Prevalence ,030105 genetics & heredity ,Toxicology ,Article ,Congenital Abnormalities ,03 medical and health sciences ,Young Adult ,Central Nervous System Diseases ,Pregnancy ,Anencephaly ,medicine ,Humans ,Musculoskeletal Diseases ,Registries ,education ,education.field_of_study ,Omphalocele ,business.industry ,Gastroschisis ,Genetic Diseases, Inborn ,Infant, Newborn ,Infant ,Middle Aged ,medicine.disease ,United States ,030104 developmental biology ,Population Surveillance ,Pediatrics, Perinatology and Child Health ,Female ,Trisomy ,business ,Live birth ,Developmental Biology ,Demography - Abstract
Background Using the National Birth Defects Prevention Network (NBDPN) annual data report, U.S. national prevalence estimates for major birth defects are developed based on birth cohort 2010-2014. Methods Data from 39 U.S. population-based birth defects surveillance programs (16 active case-finding, 10 passive case-finding with case confirmation, and 13 passive without case confirmation) were used to calculate pooled prevalence estimates for major defects by case-finding approach. Fourteen active case-finding programs including at least live birth and stillbirth pregnancy outcomes monitoring approximately one million births annually were used to develop national prevalence estimates, adjusted for maternal race/ethnicity (for all conditions examined) and maternal age (trisomies and gastroschisis). These calculations used a similar methodology to the previous estimates to examine changes over time. Results The adjusted national birth prevalence estimates per 10,000 live births ranged from 0.62 for interrupted aortic arch to 16.87 for clubfoot, and 19.93 for the 12 critical congenital heart defects combined. While the birth prevalence of most birth defects studied remained relatively stable over 15 years, an increasing prevalence was observed for gastroschisis and Down syndrome. Additionally, the prevalence for atrioventricular septal defect, tetralogy of Fallot, omphalocele, and trisomy 18 increased in this period compared to the previous periods. Active case-finding programs generally had higher prevalence rates for most defects examined, most notably for anencephaly, anophthalmia/microphthalmia, trisomy 13, and trisomy 18. Conclusion National estimates of birth defects prevalence provide data for monitoring trends and understanding the impact of these conditions. Increasing prevalence rates observed for selected conditions warrant further examination.
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- 2019
14. Humanely Ending the Life of Animals: Research Priorities to Identify Alternatives to Carbon Dioxide
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Tobias Schnitzer, Aline R Steiner, Thomas C. Gent, Patricia V. Turner, Regula Bettschart-Wolfensberger, Huw D. R. Golledge, Daniel M. Weary, Charlotte Berg, Shannon Axiak Flammer, Rebeca García Pinillos, Robert E. Meyer, Ngaio J. Beausoleil, Michael J. Toscano, Michael Marahrens, University of Zurich, and Gent, Thomas C
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medicine.medical_specialty ,media_common.quotation_subject ,medicine.medical_treatment ,Compromise ,3400 General Veterinary ,killing ,animal welfare, carbon dioxide, stunning, killing, euthanasia, rodents, poultry, pigs, aversion, air hunger ,Animal-assisted therapy ,610 Medicine & health ,Animal welfare ,lcsh:Zoology ,medicine ,aversion ,air hunger ,lcsh:QL1-991 ,Intensive care medicine ,media_common ,lcsh:Veterinary medicine ,General Veterinary ,630 Agriculture ,stunning ,poultry ,Stunning ,Unconsciousness ,carbon dioxide ,pigs ,euthanasia ,Distress ,rodents ,Commentary ,11404 Department of Clinical Diagnostics and Services ,Anxiety ,lcsh:SF600-1100 ,590 Animals (Zoology) ,Animal Science and Zoology ,medicine.symptom ,1103 Animal Science and Zoology ,Psychology ,Welfare - Abstract
Simple Summary Carbon dioxide is commonly used for stunning animals prior to killing. It allows several animals to be killed at once, reduces the need for handling, and is a reliable method. However, research in laboratory rodents, poultry, and pigs has indicated that it causes considerable aversion at concentrations above ambient conditions. Currently, there are no available alternatives with desirable characteristics. This manuscript describes a list of research priorities to find and implement the use of alternative methods or agents to improve animal welfare. Abstract The use of carbon dioxide (CO2) for stunning and killing animals is considered to compromise welfare due to air hunger, anxiety, fear, and pain. Despite decades of research, no alternatives have so far been found that provide a safe and reliable way to induce unconsciousness in groups of animals, and also cause less distress than CO2. Here, we revisit the current and historical literature to identify key research questions that may lead to the identification and implementation of more humane alternatives to induce unconsciousness in mice, rats, poultry, and pigs. In addition to the evaluation of novel methods and agents, we identify the need to standardise the terminology and behavioural assays within the field. We further reason that more accurate measurements of consciousness state are needed and serve as a central component in the assessment of suffering. Therefore, we propose a roadmap toward improving animal welfare during end-of-life procedures.
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- 2019
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15. Survival of infants with spina bifida and the role of maternal prepregnancy body mass index
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Robert E. Meyer, Tania A Desrosiers, Stephen R. Cole, Mark A. Canfield, Nancy C. Chescheir, Nelson D Pace, Sarah C. Tinker, Andrew F. Olshan, Anna Maria Siega-Riz, Suzan L. Carmichael, and Adrienne T. Hoyt
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0301 basic medicine ,Adult ,Male ,Embryology ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Health, Toxicology and Mutagenesis ,Mothers ,Kaplan-Meier Estimate ,030105 genetics & heredity ,Overweight ,Toxicology ,Article ,Body Mass Index ,Cohort Studies ,03 medical and health sciences ,Pregnancy ,Risk Factors ,Infant Mortality ,medicine ,Odds Ratio ,Humans ,Obesity ,Maternal Behavior ,Spinal Dysraphism ,Proportional Hazards Models ,Retrospective Studies ,Obstetrics ,Proportional hazards model ,Spina bifida ,business.industry ,Hazard ratio ,Infant, Newborn ,Infant ,medicine.disease ,Infant mortality ,030104 developmental biology ,Case-Control Studies ,Pediatrics, Perinatology and Child Health ,Female ,Underweight ,medicine.symptom ,business ,Body mass index ,Developmental Biology - Abstract
OBJECTIVE: To investigate first-year survival of infants born with spina bifida, and examine the association of maternal prepregnancy body mass index (BMI) with infant mortality. METHODS: This is a retrospective cohort study of 1,533 liveborn infants with nonsyndromic spina bifida with estimated dates of delivery from 1998 to 2011 whose mothers were eligible for the National Birth Defects Prevention Study (NBDPS). NBDPS data were linked to death records to conduct survival analyses. Kaplan–Meier survival functions estimated mortality risk over the first year of life. Cox proportional hazards models estimated hazard ratios (HRs) for maternal prepregnancy BMI categorized as underweight (
- Published
- 2018
16. Maternal residential exposure to agricultural pesticides and birth defects in a 2003 to 2005 North Carolina birth cohort
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Joshua L. Warren, Amy H. Herring, Robert E. Meyer, Alison P. Sanders, Naomi C. Brownstein, Thomas J. Luben, and Kristen M. Rappazzo
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Embryology ,Pregnancy ,Pediatrics ,medicine.medical_specialty ,business.industry ,General Medicine ,Odds ratio ,010501 environmental sciences ,medicine.disease ,01 natural sciences ,Monitoring program ,Infant mortality ,Atrial septal defects ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Gestation ,030212 general & internal medicine ,Live birth ,business ,0105 earth and related environmental sciences ,Developmental Biology ,Demography - Abstract
Background Birth defects are responsible for a large proportion of disability and infant mortality. Exposure to a variety of pesticides have been linked to increased risk of birth defects. Methods We conducted a case–control study to estimate the associations between a residence-based metric of agricultural pesticide exposure and birth defects. We linked singleton live birth records for 2003 to 2005 from the North Carolina (NC) State Center for Health Statistics to data from the NC Birth Defects Monitoring Program. Included women had residence at delivery inside NC and infants with gestational ages from 20 to 44 weeks (n = 304,906). Pesticide exposure was assigned using a previously constructed metric, estimating total chemical exposure (pounds of active ingredient) based on crops within 500 meters of maternal residence, specific dates of pregnancy, and chemical application dates based on the planting/harvesting dates of each crop. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals for four categories of exposure ( 90th percentiles) compared with unexposed. Models were adjusted for maternal race, age at delivery, education, marital status, and smoking status. Results We observed elevated ORs for congenital heart defects and certain structural defects affecting the gastrointestinal, genitourinary and musculoskeletal systems (e.g., OR [95% confidence interval] [highest exposure vs. unexposed] for tracheal esophageal fistula/esophageal atresia = 1.98 [0.69, 5.66], and OR for atrial septal defects: 1.70 [1.34, 2.14]). Conclusion Our results provide some evidence of associations between residential exposure to agricultural pesticides and several birth defects phenotypes. Birth Defects Research (Part A) 106:240–249, 2016. © 2016 Wiley Periodicals, Inc.
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- 2016
17. Abstract PR03: Sex ratio disparities and the risk of childhood cancer: Evaluating the mediating effect of birth defects among 15,000 childhood cancer cases
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Philip J. Lupo, Peter H. Langlois, Sharon E. Plon, Wendy N. Nembhard, Mark A. Canfield, Robert E. Meyer, Erin L. Marcotte, Tania A Desrosiers, and Jeremy M. Schraw
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Cancer Research ,education.field_of_study ,business.industry ,Birth weight ,Population ,Confounding ,Gestational age ,Cancer ,medicine.disease ,Pediatric cancer ,Oncology ,medicine ,Risk factor ,education ,business ,Sex ratio ,Demography - Abstract
Background: There is a persistent yet unexplained disparity in the sex ratio among childhood cancer cases, whereby males are more likely to develop several cancers. These patterns are also seen for most birth defects, which are strongly associated with the risk of childhood cancer. We conducted a mediation analysis to estimate whether birth defect status mediates the association between sex and childhood cancer risk. Methods: We linked data from birth, birth defects, and cancer registries to obtain a population-based birth cohort including births from 1992-2013 in Arkansas, Michigan, North Carolina, and Texas. We obtained birth defects diagnoses, including chromosomal and nonchromosomal defects, from statewide, population-based birth defects registries. We focused on “major” defects as defined by the National Birth Defects Prevention Network and the National Birth Defects Prevention Study. Cancer diagnoses that occurred prior to age 18 years were obtained from state cancer registries. We obtained data on child’s sex, birth weight, gestational age, maternal race/ethnicity, maternal age, and plurality from birth records. We conducted counterfactual mediation analysis to estimate the direct and indirect effects of sex on risk of childhood cancer, modeling sex as the exposure, birth defect status as the mediator, and cancer type as the outcome. State, maternal race/ethnicity (white, black, other), maternal age (continuous), and plurality (singleton vs. multiple) were considered potential mediator-outcome confounders. Due to lower success rates of linkage to birth records among adolescent cancer cases, we conducted a sensitivity analysis limiting to cancers diagnosed at age < 5 years. Results: Our dataset included 10,181,074 children (5,208,379 males; 4,972,695 females), including 15,110 with cancer diagnoses (8044 males; 7066 females), 539,567 children with birth defects diagnoses (320,666 males; 218,901 females), and 2,124 co-occurring cases (children with both cancer and one or more birth defect diagnosis: 1,186 males; 938 females). We observed mediation of the association between sex and childhood cancer overall by birth defect status (proportion mediated [PM]: 38%). In analyses of specific cancer types, we observed variation of the estimated proportion mediated among several cancers, including hepatoblastoma (PM: 33%), neuroblastoma (PM: 35%), non-Hodgkin lymphoma (PM: 6%), and soft tissue sarcomas (PM: 25%). In analysis of children age < 5 years at cancer diagnosis, we observed similar results. Conclusions: Our results suggest that birth defects mediate a significant proportion of the overall relationship between sex and childhood cancer. While approximately 60% of the male excess in childhood cancer cases remains unexplained, these findings add to our understanding of the causal pathway of male sex as a risk factor for childhood cancer. Additional studies are under way to characterize the biology underlying these observations. This abstract is also being presented as Poster A66. Citation Format: Erin L. Marcotte, Jeremy M. Schraw, Tania A. Desrosiers, Wendy N. Nembhard, Peter H. Langlois, Mark A. Canfield, Robert E. Meyer, Sharon E. Plon, Philip Lupo. Sex ratio disparities and the risk of childhood cancer: Evaluating the mediating effect of birth defects among 15,000 childhood cancer cases [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr PR03.
- Published
- 2020
18. Assessment of humaneness using gunshot targeting the brain and cervical spine for cervid depopulation under field conditions
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Jennifer M. Gambino, David Miller, Robert E. Meyer, Vickie L. DeNicola, and Anthony J. DeNicola
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0106 biological sciences ,Epidemiology ,Ballistics ,Wildlife ,01 natural sciences ,0403 veterinary science ,Reflexes ,Medicine and Health Sciences ,Medicine ,Public and Occupational Health ,Musculoskeletal System ,Rusa marianna ,Mammals ,Multidisciplinary ,Physics ,Traumatic Injury Risk Factors ,Eukaryota ,Classical Mechanics ,04 agricultural and veterinary sciences ,Ruminants ,010601 ecology ,medicine.anatomical_structure ,Target site ,Vertebrates ,Physical Sciences ,Cervical Vertebrae ,Guam ,Engineering and Technology ,Weapons ,Anatomy ,Cervical vertebrae ,Research Article ,medicine.medical_specialty ,Firearms ,040301 veterinary sciences ,Science ,Animal Types ,Equipment ,Animal Welfare ,Physical medicine and rehabilitation ,Euthanasia, Animal ,Animal welfare ,Animals ,Humans ,Rifle ,Ecosystem ,Skeleton ,business.industry ,Euthanasia ,Deer ,Skull ,Organisms ,Biology and Life Sciences ,Chronic wasting disease ,medicine.disease ,Cervical spine ,Spine ,Brain Injuries ,Medical Risk Factors ,Amniotes ,Wounds, Gunshot ,Cranium ,business ,Introduced Species ,Zoology ,Field conditions ,Neuroscience - Abstract
Population reduction or eradication of domestic or non-domestic species may be required to address their impacts on the environment, other species, or human interests. Firearms are often used to accomplish these practical management objectives, and there is increased concern that the methods used may compromise animal welfare. We document the accuracy and humaneness of gunshot placement to the brain and cervical vertebrae of Philippine deer (Rusa marianna) on Guam during depopulation activities as a model for meeting AVMA standards of euthanasia under field conditions (e.g., animal is not in hand). Deer were shot with a .223 caliber rifle from 10-125 m and approached immediately (
- Published
- 2018
19. Sociodemographic Factors and Survival of Infants With Congenital Heart Defects
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Matthew E. Oster, Jessica H. Knight, Dianne Enright, Robert E. Meyer, Nina E Forestieri, and Nelson D Pace
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Heart Defects, Congenital ,Male ,Pediatrics ,medicine.medical_specialty ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Infant Death ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,030225 pediatrics ,Infant Mortality ,Humans ,Medicine ,Socioeconomic status ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Proportional hazards model ,Hazard ratio ,Infant, Newborn ,Infant ,Retrospective cohort study ,Monitoring program ,Confidence interval ,Infant mortality ,Socioeconomic Factors ,Pediatrics, Perinatology and Child Health ,Marital status ,Female ,business - Abstract
OBJECTIVES: To examine the first-year survival of infants with congenital heart defects (CHDs) and investigate the potential role of socioeconomic and demographic factors on survival. METHODS: Subjects included 15 533 infants with CHDs born between 2004 and 2013 ascertained by the NC Birth Defects Monitoring Program. We classified CHDs into the following 3 groups: critical univentricular (n = 575), critical biventricular (n = 1494), and noncritical biventricular (n = 13 345). We determined vital status and age at death through linkage to state vital records and used geocoded maternal residence at birth to obtain census information for study subjects. We calculated Kaplan–Meier survival estimates by maternal and infant characteristics and derived hazard ratios from Cox proportional hazard models for selected exposures. RESULTS: Among all infants with CHDs, there were 1289 deaths (8.3%) in the first year. Among infants with univentricular defects, 61.6% (95% confidence interval [CI]: 57.7%–65.7%) survived. Survival among infants with univentricular defects was considerably better for those whose fathers were ≥35 years old (71.6%; 95% CI: 63.8%–80.3%) compared with those whose fathers were younger (59.7%; 95% CI: 54.6%–65.2%). Factors associated with survival among infants with any biventricular defect included maternal education, race and/or ethnicity, marital status, and delivery at a heart center. The hazard of infant mortality was greatest among non-Hispanic African American mothers. CONCLUSIONS: Survival among infants with critical univentricular CHDs was less variable across sociodemographic categories compared with survival among infants with biventricular CHDs. Sociodemographic differences in survival among infants with less severe CHDs reinforces the importance of ensuring culturally effective pediatric care for at-risk infants and their families.
- Published
- 2018
20. Pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses
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Robert E. Meyer, Claudio Correa Natalini, Robin L. Fontenot, Robert W. Wills, and S. Shane
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General Veterinary ,business.industry ,Pharmacodynamics ,Anesthesia ,Medicine ,Dexmedetomidine ,business ,Administration (government) ,medicine.drug - Published
- 2019
21. Special education use in elementary school by children with nonsyndromic orofacial clefts
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Ronald P. Strauss, Robert E. Meyer, Stephanie Watkins, Jeffrey R. Marcus, Alexander C. Allori, and Arthur S. Aylsworth
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0301 basic medicine ,Male ,Embryology ,Health, Toxicology and Mutagenesis ,Cleft Lip ,Ethnic group ,Service use ,030105 genetics & heredity ,Toxicology ,Special education ,Logistic regression ,White People ,Odds ,03 medical and health sciences ,Odds Ratio ,Prevalence ,Medicine ,Humans ,Child ,African american ,Schools ,business.industry ,Grade retention ,Black or African American ,Cleft Palate ,030104 developmental biology ,School performance ,Logistic Models ,Education, Special ,Pediatrics, Perinatology and Child Health ,Female ,business ,Facilities and Services Utilization ,Developmental Biology ,Demography - Abstract
BACKGROUND Children with nonsyndromic orofacial clefts (NS OFCs) may require exceptional children's (EC) services for academic delays. We examined EC service use of children with and without NS OFCs in NC in elementary school. METHODS We included 559 children with NS OFCs and 6,822 children without birth defects who had NC educational records. We estimated prevalence ratios, trends in enrollment, and characteristics of eligibility classification using descriptive statistics and logistic regression by cleft subtype and race/ethnicity. We estimated the odds of third grade retention by EC enrollment using logistic regression with inverse probability of treatment weights. RESULTS Children with NS OFCs were 3.02 (95% CI: 2.50, 3.64) times as likely to receive third grade special education (SE) services compared to unaffected peers. The prevalence odds was highest among children with CL+P (OR: 4.61, 95% CI: 3.49, 6.09) declining by 54% by fifth grade. The prevalence odds of SE for white children was approximately 1.50 times that for African American children in fourth and fifth grades. Approximately 33% of children with NS OFCs within each racial/ethnic group received SE in third grade. African American children were twice as likely to receive services under specific learning disability. Children with NS OFCs receiving EC services were 44% (OR: 0.56; 95% CI: 0.13, 2.38) less likely to be retained in third grade compared to children with NS OFCs who were not receiving services. CONCLUSIONS Children with NS OFCs are more likely to receive SE services in elementary school compared to their unaffected peers. The eligibility category differed by racial/ethnic group.
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- 2018
22. Sharp transection of the suspensory ligament as an alternative to digital strumming during canine ovariohysterectomy
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Jodi M. Richardson, David R. Smith, Kimberly A. Woodruff, Wilson C Brookshire, Robert E. Meyer, and Jacob M Shivley
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040301 veterinary sciences ,Ovariectomy ,Hysterectomy ,law.invention ,0403 veterinary science ,03 medical and health sciences ,0302 clinical medicine ,Dogs ,Randomized controlled trial ,law ,Heart rate ,Medicine ,Animals ,Clinical significance ,Student training ,Ligaments ,General Veterinary ,Adult female ,business.industry ,Suspensory ligament ,04 agricultural and veterinary sciences ,Pain scale ,Nociception ,030220 oncology & carcinogenesis ,Anesthesia ,Female ,business - Abstract
OBJECTIVE To compare time efficiency and nociceptive input between digital strumming (DS) and sharp transection (ST) of the suspensory ligament during ovariohysterectomy (OVH). STUDY DESIGN Randomized controlled trial. ANIMALS 30 adult female dogs. METHODS Dogs were randomly assigned to ST or DS procedures. Measures of nociception were assessed through measurements of preoperative and intraoperative heart rate during manipulation of the suspensory ligament. Measures of pain were assessed through preoperative and postoperative pain scores by using the short form Glasgow Composite Pain Scale. Time efficiency was measured through total surgical time and the time to release each suspensory ligament. RESULTS After body weight was accounted for, the total surgical time was 1.1 minutes (P = .06) faster for ST than for DS, and each additional kilogram of body weight increased total surgical time by 0.1 minutes (P = .02). Digital strumming had 30.6-fold greater odds of taking greater than 1 minute compared with ST (P = .001). The heart rate from baseline to peak was 7.4 beats per minute lower in the ST group than in the DS group (P = .06). No complications were observed, and there was no difference in postoperative pain scores between treatments. CONCLUSION Sharp transection was faster and generated less intraoperative acceleration in heart rate but did not differ in postoperative outcomes compared with DS. CLINICAL SIGNIFICANCE Sharp transection is a viable alternative to DS for breakdown of the suspensory ligament during canine OVH. Sharp transection may improve surgical efficiency, especially when performing large volumes in the spay/neuter setting and could influence veterinary student training.
- Published
- 2018
23. Study of selected birth defects among American Indian/Alaska Native population: A multi-state population-based retrospective study, 1999-2007
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Tom Anderson, Del Yazzie, Robert E. Meyer, Russell S. Kirby, Mark A. Canfield, Julie Dunn, Sarah C. Fisher, Cara T. Mai, Glenn Copeland, Lisa Marengo, Timothy J. Flood, and Mary K. Ethen
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0301 basic medicine ,Male ,Embryology ,medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,Native population ,Population ,Population health ,030105 genetics & heredity ,Toxicology ,White People ,Article ,Congenital Abnormalities ,03 medical and health sciences ,0302 clinical medicine ,Fetus ,Risk Factors ,medicine ,Ethnicity ,Prevalence ,Humans ,030212 general & internal medicine ,education ,Retrospective Studies ,education.field_of_study ,Multi state ,business.industry ,Public health ,Microtia ,Infant, Newborn ,Infant ,Retrospective cohort study ,medicine.disease ,Alaskan Natives ,United States ,Anotia ,Population Surveillance ,Pediatrics, Perinatology and Child Health ,Epidemiological Monitoring ,Indians, North American ,Female ,Public Health ,business ,Developmental Biology ,Demography - Abstract
Background Higher prevalence of selected birth defects has been reported among American Indian/Alaska Native (AI/AN) newborns. We examine whether known risk factors for birth defects explain the higher prevalence observed for selected birth defects among this population. Methods Data from 12 population-based birth defects surveillance systems, covering a birth population of 11 million from 1999 to 2007, were used to examine prevalence of birth defects that have previously been reported to have elevated prevalence among AI/ANs. Prevalence ratios (PRs) were calculated for non-Hispanic AI/ANs and any AI/ANs (regardless of Hispanic ethnicity), adjusting for maternal age, education, diabetes, and smoking, as well as type of case-finding ascertainment surveillance system. Results After adjustment, the birth prevalence of two of seven birth defects remained significantly elevated among AI/ANs compared to non-Hispanic whites (NHWs): anotia/microtia was almost threefold higher, and cleft lip +/- cleft palate was almost 70% higher compared to NHWs. Excluding AI/AN subjects who were also Hispanic had only a negligible impact on adjusted PRs. Conclusions Additional covariates accounted for some of the elevated birth defect prevalences among AI/ANs compared to NHWs. Exclusion of Hispanic ethnicity from the AI/AN category had little impact on birth defects prevalences in AI/ANs. NHWs serve as a viable comparison group for analysis. Birth defects among AI/ANs require additional scrutiny to identify modifiable risk and protective factors.
- Published
- 2018
24. Response to Harcombe
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Bridget Mosley, Tania A Desrosiers, Robert E. Meyer, and Anna Maria Siega-Riz
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0301 basic medicine ,Embryology ,business.industry ,Health, Toxicology and Mutagenesis ,030105 genetics & heredity ,Toxicology ,computer.software_genre ,Diet, Carbohydrate-Restricted ,03 medical and health sciences ,Text mining ,Pediatrics, Perinatology and Child Health ,Humans ,Medicine ,Neural Tube Defects ,Artificial intelligence ,business ,computer ,Natural language processing ,Developmental Biology - Abstract
The crux of Dr. Harcombe’s critique is her assertion that our study design was inappropriate for our research objective, which was to investigate whether maternal carbohydrate restriction before conception was associated with neural tube defects (NTDs) in the National Birth Defects Prevention Study (NBDPS), a population-based case-control study of birth defects (Desrosiers, Siega-Riz, Mosley, Meyer, & The National Birth Defects Prevention Study, 2018). In her Letter, Dr. Harcombe claims that our study is fundamentally flawed because “cases should have been women who restrict carbohydrates and the controls should have been women who don’t and the outcome measure should have been NTD-affected pregnancies.” Despite her confusing (mis)use of the terms case and control, what Dr. Harcombe appears to be describing is a cohort study.
- Published
- 2018
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25. Response to Camacho
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Tania A Desrosiers, Robert E. Meyer, Bridget Mosley, and Anna Maria Siega-Riz
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0301 basic medicine ,Embryology ,medicine.medical_specialty ,business.industry ,Health, Toxicology and Mutagenesis ,MEDLINE ,030105 genetics & heredity ,Toxicology ,03 medical and health sciences ,0302 clinical medicine ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,medicine ,030212 general & internal medicine ,business ,Developmental Biology - Abstract
We appreciate Dr. Camacho’s interest in our article (Desrosiers, Siega-Riz, Mosley, Meyer, & National Birth Defects Prevention Study, 2018), and welcome the opportunity to respond. As Dr. Camacho emphasizes, the association between folic acid and neural tube defects (NTDs) is well established (Viswanathan et al., 2017). What is less certain are factors potentially related to folate insufficiency among women of reproductive age, and even more so, among women who meet the U.S. Preventative Health Task Force’s recommendation of 0.4–0.8 mg/day of supplemental folic acid (Tinker, Hamner, Qi, & Crider, 2015; US Preventive Services Task Force, 2017). Understanding the reasons for folate insufficiency could help prevent some cases of birth defects in the future and is thus a worthy research pursuit. One theory expressed in the literature is whether avoidance of carbohydrate-rich foods such as enriched grains (fortified with folic acid) and beans (high in natural folate) could lead to meaningful reductions in folate status, which could in turn lead to an increased risk for some women of having an NTD-affected pregnancy (Mills, 2017; Quinlivan & Gregory, 2007).
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- 2018
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26. Low carbohydrate diets may increase risk of neural tube defects
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Anna Maria Siega-Riz, Robert E. Meyer, Tania A Desrosiers, and Bridget Mosley
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0301 basic medicine ,Adult ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,Embryology ,Health, Toxicology and Mutagenesis ,Physiology ,030105 genetics & heredity ,Toxicology ,Logistic regression ,03 medical and health sciences ,Diet, Carbohydrate-Restricted ,Young Adult ,0302 clinical medicine ,Risk Factors ,Anencephaly ,medicine ,Humans ,030212 general & internal medicine ,Neural Tube Defects ,Young adult ,Fortified Food ,business.industry ,Spina bifida ,Neural tube ,Odds ratio ,medicine.disease ,medicine.anatomical_structure ,Folic acid ,Pediatrics, Perinatology and Child Health ,Female ,business ,Developmental Biology - Abstract
BACKGROUND Folic acid fortification significantly reduced the prevalence of neural tube defects (NTDs) in the United States. The popularity of "low carb" diets raises concern that women who intentionally avoid carbohydrates, thereby consuming fewer fortified foods, may not have adequate dietary intake of folic acid. METHODS To assess the association between carbohydrate intake and NTDs, we analyzed data from the National Birth Defects Prevention Study from 1,740 mothers of infants, stillbirths, and terminations with anencephaly or spina bifida (cases), and 9,545 mothers of live born infants without a birth defect (controls) conceived between 1998 and 2011. Carbohydrate and folic acid intake before conception were estimated from food frequency questionnaire responses. Restricted carbohydrate intake was defined as ≤5th percentile among controls. Odds ratios were estimated with logistic regression and adjusted for maternal race/ethnicity, education, alcohol use, folic acid supplement use, study center, and caloric intake. RESULTS Mean dietary intake of folic acid among women with restricted carbohydrate intake was less than half that of other women (p
- Published
- 2017
27. Issues involved in the phenotypic classification of orofacial clefts ascertained through a state birth defects registry for the north carolina cleft outcomes study
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Luiz André Freire Pimenta, Alexander C. Allori, Barry L. Ramsey, Katherine G. Harmsen, Jeffrey R. Marcus, Arthur S. Aylsworth, Stephanie Watkins, Robert E. Meyer, and Ronald P. Strauss
- Subjects
Embryology ,Robin Sequence ,Pediatrics ,medicine.medical_specialty ,business.industry ,Medical record ,Dentistry ,General Medicine ,Case review ,Premaxillary agenesis ,Pediatrics, Perinatology and Child Health ,Cohort ,medicine ,Review process ,Medical diagnosis ,business ,Median cleft lip ,Developmental Biology - Abstract
Background: Epidemiologic studies involving birth defects are extremely sensitive to phenotype accuracy and precision. We devised a case review and classification protocol for a project to study school achievement in children with idiopathic, nonsyndromic orofacial clefts to improve the reliability of phenotypic classification from the statewide birth defects registry. Methods: Surveillance-program abstraction data and medical records at the birth or treating hospitals were used when available. Exclusion criteria included: median cleft lip; Tessier cleft; premaxillary agenesis; presence of a recognizable syndrome, phenotype, association, or sequence (other than Robin sequence); clefts with other malformations not considered to be normal or common variants in the newborn; and cases with documented or suspected genetic or teratogenic causes. Results: Of 712 children identified with orofacial clefts, 153 were excluded, leaving 559 nonsyndromic orofacial cleft cases of unknown cause in the final study. These cases were grouped into the following clinically meaningful types: cleft lip with or without cleft alveolus; cleft lip and cleft palate; and cleft palate only. This review and classification process resulted in the elimination of 21.5% of the original cohort of identified cases, with most exclusions being due to suspected syndromic associations. Conclusion: Verbatim descriptions of the clinical findings are critical for accurate classification of diagnoses. This review process improved the precision of orofacial cleft phenotype classification for our study. Precision would have been further improved if all of the cases had verbatim descriptions of diagnoses and all medical records could have been reviewed by the classification team. Birth Defects Research (Part A) 103:899–903, 2015. © 2015 Wiley Periodicals, Inc.
- Published
- 2015
28. Physiologic Measures of Animal Stress during Transitional States of Consciousness
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Robert E. Meyer
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c-fos ,Sympathetic nervous system ,Pathology ,medicine.medical_specialty ,media_common.quotation_subject ,Review ,Electroencephalography ,anesthesia ,consciousness ,Heart rate ,Stress (linguistics) ,lcsh:Zoology ,medicine ,heart rate ,stress markers ,lcsh:QL1-991 ,EEG ,media_common ,lcsh:Veterinary medicine ,General Veterinary ,medicine.diagnostic_test ,Unconscious States ,business.industry ,ECG ,Unconsciousness ,euthanasia ,Distress ,medicine.anatomical_structure ,lcsh:SF600-1100 ,Animal Science and Zoology ,medicine.symptom ,Consciousness ,BOLD MRI ,business ,Cognitive psychology - Abstract
Simple Summary The humaneness, and therefore suitability, of any particular agent or method used to produce unconsciousness in animals, whether for anesthesia, euthanasia, humane slaughter, or depopulation, depends on the experience of pain or distress prior to loss of consciousness. Commonly reported physiologic measures of animal stress, including physical movement and vocalization, heart rate and ECG, electroencephalographic activity, and plasma and neuronal stress markers are discussed within this context. Abstract Determination of the humaneness of methods used to produce unconsciousness in animals, whether for anesthesia, euthanasia, humane slaughter, or depopulation, relies on our ability to assess stress, pain, and consciousness within the contexts of method and application. Determining the subjective experience of animals during transitional states of consciousness, however, can be quite difficult; further, loss of consciousness with different agents or methods may occur at substantially different rates. Stress and distress may manifest behaviorally (e.g., overt escape behaviors, approach-avoidance preferences [aversion]) or physiologically (e.g., movement, vocalization, changes in electroencephalographic activity, heart rate, sympathetic nervous system [SNS] activity, hypothalamic-pituitary axis [HPA] activity), such that a one-size-fits-all approach cannot be easily applied to evaluate methods or determine specific species applications. The purpose of this review is to discuss methods of evaluating stress in animals using physiologic methods, with emphasis on the transition between the conscious and unconscious states.
- Published
- 2015
29. What we don't know can hurt us: Nonresponse bias assessment in birth defects research
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Scott D. Grosse, Robert E. Meyer, Sarah C. Tinker, Cynthia H. Cassell, Paula D. Strassle, and Stuart K. Shapira
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Embryology ,medicine.medical_specialty ,education.field_of_study ,business.industry ,Population ,Alternative medicine ,Survey research ,General Medicine ,Birth certificate ,Survey methodology ,Phone ,Pediatrics, Perinatology and Child Health ,Marital status ,Medicine ,Non-response bias ,business ,education ,Developmental Biology ,Demography - Abstract
BACKGROUND Nonresponse bias assessment is an important and underutilized tool in survey research to assess potential bias due to incomplete participation. This study illustrates a nonresponse bias sensitivity assessment using a survey on perceived barriers to care for children with orofacial clefts in North Carolina. METHODS Children born in North Carolina between 2001 and 2004 with an orofacial cleft were eligible for inclusion. Vital statistics data, including maternal and child characteristics, were available on all eligible subjects. Missing ‘responses’ from nonparticipants were imputed using assumptions based on the distribution of responses, survey method (mail or phone), and participant maternal demographics. RESULTS Overall, 245 of 475 subjects (51.6%) responded to either a mail or phone survey. Cost as a barrier to care was reported by 25.0% of participants. When stratified by survey type, 28.3% of mail respondents and 17.2% of phone respondents reported cost as a barrier. Under various assumptions, the bias-adjusted estimated prevalence of cost as barrier to care ranged from 16.1% to 30.0%. Maternal age, education, race, and marital status at time of birth were not associated with subjects reporting cost as a barrier. CONCLUSION As survey response rates continue to decline, the importance of assessing the potential impact of nonresponse bias has become more critical. Birth defects research is particularly conducive to nonresponse bias analysis, especially when birth defect registries and birth certificate records are used. Future birth defect studies which use population-based surveillance data and have incomplete participation could benefit from this type of nonresponse bias assessment. Birth Defects Research (Part A) 103:603–609, 2015. © 2015 Wiley Periodicals, Inc.
- Published
- 2015
30. Assessed occupational exposure to chlorinated, aromatic and Stoddard solvents during pregnancy and risk of fetal growth restriction
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Adolfo Correa, Patricia A. Stewart, Robert E. Meyer, Christina C. Lawson, Martha A. Waters, Tania A Desrosiers, and Andrew F. Olshan
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Adult ,Male ,medicine.medical_specialty ,Halogenation ,Birth weight ,Population ,Gestational Age ,Article ,Young Adult ,chemistry.chemical_compound ,Pregnancy ,Risk Factors ,Occupational Exposure ,Epidemiology ,medicine ,Birth Weight ,Humans ,education ,education.field_of_study ,Fetal Growth Retardation ,business.industry ,Obstetrics ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Case-control study ,Gestational age ,medicine.disease ,Hydrocarbons ,Pregnancy Complications ,Logistic Models ,chemistry ,Maternal Exposure ,Case-Control Studies ,Infant, Small for Gestational Age ,Solvents ,Small for gestational age ,Female ,Solvent exposure ,business ,Maternal Age - Abstract
Previous experimental and epidemiological research suggests that maternal exposure to some organic solvents during pregnancy may increase the risk of fetal growth restriction (FGR). We evaluated the association between expert-assessed occupational solvent exposure and risk of small for gestational age (SGA) infants in a population-based sample of women in the National Birth Defects Prevention Study.We analysed data from 2886 mothers and their infants born between 1997 and 2002. Job histories were self-reported. Probability of exposure to six chlorinated, three aromatic and one petroleum solvent was assessed by industrial hygienists. SGA was defined as birthweight10th centile of birthweight-by-gestational age in a national reference. Logistic regression was used to estimate ORs and 95% CIs to assess the association between SGA and exposure to any solvent(s) or specific solvent classes, adjusting for maternal age and education.Approximately 8% of infants were SGA. Exposure prevalence to any solvent was 10% and 8% among mothers of SGA and non-SGA infants, respectively. Among women with ≥ 50% probability of exposure, we observed elevated but imprecise associations between SGA and exposure to any solvent(s) (1.71; 0.86 to 3.40), chlorinated solvents (1.70; 0.69 to 4.01) and aromatic solvents (1.87; 0.78 to 4.50).This is the first population-based study in the USA to investigate the potential association between FGR and assessed maternal occupational exposure to distinct classes of organic solvents during pregnancy. The potential associations observed between SGA and exposure to chlorinated and aromatic solvents are based on small numbers and merit further investigation.
- Published
- 2015
31. Next steps for birth defects research and prevention: The birth defects study to evaluate pregnancy exposures (BD-STEPS)
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Richard S. Olney, Sarah C. Tinker, Suzan L. Carmichael, Marlene Anderka, Jennita Reefhuis, Marilyn L. Browne, Wendy N. Nembhard, Kristin M Conway, and Robert E. Meyer
- Subjects
Embryology ,Pediatrics ,medicine.medical_specialty ,Pregnancy ,Prevention Study ,Obstetrics ,business.industry ,Pediatrics, Perinatology and Child Health ,medicine ,General Medicine ,medicine.disease ,business ,Developmental Biology - Abstract
Background The Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS) is a population-based, multi-Center case-control study of modifiable risk factors for selected birth defects in the United States. BD-STEPS is the second major research effort of the Centers for Birth Defects Research and Prevention, which extends and expands the initial research effort, the National Birth Defects Prevention Study (NBDPS).
- Published
- 2015
32. Pharmacokinetics and pharmacodynamics comparison between subcutaneous and intravenous butorphanol administration in horses
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Matthew K. Ross, Andrew Claude, Ludovica Chiavaccini, Vernon C. Langston, J. H. Lee, and Robert E. Meyer
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Male ,Butorphanol ,Injections, Subcutaneous ,Statistics as Topic ,Biological Availability ,Absorption (skin) ,Subcutaneous injection ,Pharmacokinetics ,Animals ,Medicine ,Horses ,Pharmacology ,Volume of distribution ,Cross-Over Studies ,General Veterinary ,business.industry ,Half-life ,Crossover study ,Bioavailability ,Analgesics, Opioid ,Anesthesia ,Injections, Intravenous ,Female ,business ,Half-Life ,medicine.drug - Abstract
The study objective was to compare butorphanol pharmacokinetics and physiologic effects following intravenous and subcutaneous administration in horses. Ten adult horses received 0.1 mg/kg butorphanol by either intravenous or subcutaneous injections, in a randomized crossover design. Plasma concentrations of butorphanol were measured at predetermined time points using highly sensitive liquid chromatography-tandem mass spectrometry assay (LC-MS/MS). Demeanor and physiologic variables were recorded. Data were analyzed with multivariate mixed-effect model on ranks (P ≤ 0.05). For subcutaneous injection, absorption half-life and peak plasma concentration of butorphanol were 0.10 ± 0.07 h and 88 ± 37.4 ng/mL (mean ± SD), respectively. Bioavailability was 87%. After intravenous injection, mean ± SD butorphanol steady-state volume of distribution and clearance was 1.2 ± 0.96 L/kg and 0.65 ± 0.20 L/kg/h, respectively. Terminal half-lives for butorphanol were 2.31 ± 1.74 h and 5.29 ± 1.72 h after intravenous and subcutaneous administrations. Subcutaneous butorphanol reached and maintained target plasma concentrations >10 ng/mL for 2 ± 0.87 h (Mean ± SD), with less marked physiologic and behavioral effects compared to intravenous injection. Subcutaneous butorphanol administration is an acceptable alternative to the intravenous route in adult horses.
- Published
- 2014
33. Maternal Cigarette, Alcohol, and Coffee Consumption in Relation to Risk of Clubfoot
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Allen A. Mitchell, Martha M. Werler, James R. Kasser, Mahsa M. Yazdy, Susan T. Mahan, Marlene Anderka, Robert E. Meyer, and Charlotte M. Druschel
- Subjects
Smoke ,Pregnancy ,medicine.medical_specialty ,education.field_of_study ,Clubfoot ,Epidemiology ,Offspring ,business.industry ,Population ,Odds ratio ,medicine.disease ,Obesity ,Surgery ,Pediatrics, Perinatology and Child Health ,medicine ,Parity (mathematics) ,business ,education ,Demography - Abstract
Background Clubfoot is associated with maternal cigarette smoking in several studies, but it is not clear if this association is confined to women who smoke throughout the at-risk period. Maternal alcohol and coffee drinking have not been well studied in relation to clubfoot. Methods The present study used data from a population-based case–control study of clubfoot conducted in Massachusetts, New York, and North Carolina from 2007 to 2011. Mothers of 646 isolated clubfoot cases and 2037 controls were interviewed about pregnancy events and exposures, including the timing and frequency of cigarette smoking, alcohol intake, and coffee drinking. Results More mothers of cases than controls reported smoking during early pregnancy (28.9% vs. 19.1%). Of women who smoked when they became pregnant, those who quit in the month after a first missed period had a 40% increase in clubfoot risk and those who continued to smoke during the next 3 months had more than a doubling in risk, after controlling for demographic factors, parity, obesity, and specific medication exposures. Adjusted odds ratios for women who drank >3 servings of alcohol or coffee per day throughout early pregnancy were 2.38 and 1.77, respectively, but the numbers of exposed women were small and odds ratios were unstable. Conclusions Clubfoot risk appears to be increased for offspring of women who smoke cigarettes, particularly those who continue smoking after pregnancy is recognisable, regardless of amount. For alcohol and coffee drinkers, suggested increased risks were only observed in higher levels of intake.
- Published
- 2014
34. Birth defects data from population-based birth defects surveillance programs in the United States, 2007 to 2011: Highlighting orofacial clefts
- Author
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S. Shahrukh Hashmi, Jennifer Isenburg, Russell S. Kirby, Richard S. Olney, Meredith Beck, Cara T. Mai, Russel Rickard, Mark A. Canfield, Sook Ja Cho, Cynthia H. Cassell, Erin B. Stallings, and Robert E. Meyer
- Subjects
Embryology ,Pediatrics ,medicine.medical_specialty ,business.industry ,fungi ,Pediatrics, Perinatology and Child Health ,medicine ,General Medicine ,Population based ,business ,Teratology ,Developmental Biology - Abstract
© 2014 The Authors Birth Defects Research Part A: Clinical and Molecular Teratology Published by Wiley Periodicals, Inc.
- Published
- 2014
35. Estimated Maternal Pesticide Exposure from Drinking Water and Heart Defects in Offspring
- Author
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Jihye Kim, Michael D. Swartz, Peter H. Langlois, Paul A. Romitti, Peter Weyer, Laura E. Mitchell, Thomas J. Luben, Anushuya Ramakrishnan, Sadia Malik, Philip J. Lupo, Marcia L. Feldkamp, Robert E. Meyer, Jennifer J. Winston, Jennita Reefhuis, Sarah J. Blossom, Erin Bell, A. J. Agopian, and the National Birth Defects Prevention Study
- Subjects
0301 basic medicine ,Adult ,Heart Defects, Congenital ,Male ,Public drinking ,Offspring ,Health, Toxicology and Mutagenesis ,public drinking water ,lcsh:Medicine ,Water supply ,030105 genetics & heredity ,Logistic regression ,Article ,congenital heart defect ,03 medical and health sciences ,chemistry.chemical_compound ,Water Supply ,Environmental health ,pesticide ,Texas ,birth defects ,Medicine ,Humans ,Atrazine ,Pesticides ,Water pollution ,2. Zero hunger ,business.industry ,Drinking Water ,lcsh:R ,Water Pollution ,Public Health, Environmental and Occupational Health ,Case-control study ,Pesticide ,3. Good health ,Logistic Models ,chemistry ,Maternal Exposure ,Case-Control Studies ,Female ,business - Abstract
Our objective was to examine the relationship between estimated maternal exposure to pesticides in public drinking water and the risk of congenital heart defects (CHD). We used mixed-effects logistic regression to analyze data from 18,291 nonsyndromic cases with heart defects from the Texas Birth Defects Registry and 4414 randomly-selected controls delivered in Texas from 1999 through 2005. Water district-level pesticide exposure was estimated by linking each maternal residential address to the corresponding public water supply district’s measured atrazine levels. We repeated analyses among independent subjects from the National Birth Defects Prevention Study (NBDPS) (1620 nonsyndromic cases with heart defects and 1335 controls delivered from 1999 through 2005). No positive associations were observed between high versus low atrazine level and eight CHD subtypes or all included heart defects combined. These findings should be interpreted with caution, in light of potential misclassification and relatively large proportions of subjects with missing atrazine data. Thus, more consistent and complete monitoring and reporting of drinking water contaminants will aid in better understanding the relationships between pesticide water contaminants and birth defects.
- Published
- 2017
36. A Population-Based Exploration of the Social Implications Associated with Cleft Lip and/or Palate
- Author
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Anna R. Carlson, Stephanie Watkins, Arthur S. Aylsworth, Jeffrey R. Marcus, Robert E. Meyer, Luiz André Freire Pimenta, Ronnie L. Shammas, Adam D. Glener, Irene J. Pien, Alexander C. Allori, and Ronald P. Strauss
- Subjects
Social stigma ,business.industry ,4. Education ,MEDLINE ,030206 dentistry ,Population based ,03 medical and health sciences ,0302 clinical medicine ,Psychosocial stress ,Medicine ,Surgery ,Original Article ,030223 otorhinolaryngology ,business ,Psychosocial ,Clinical psychology - Abstract
Background: Clefts of the lip and/or palate (CL/P) carry a social stigma that often causes psychosocial stress. The purpose of this study was to consider the association of cleft phenotype and age with self-reported aspects of psychosocial stress. Methods: Children with nonsyndromic CL/P and unaffected children born between 1997 and 2003 were identified through the North Carolina Birth Defects Monitoring Program and North Carolina birth records, respectively. The psychosocial concerns of children with CL/P were assessed via a 29-question subset of a larger survey. Responses were analyzed according to school age and cleft phenotype (cleft lip with/without cleft alveolus, CL ± A; cleft palate only, CP; or cleft lip with cleft palate, CL + P). Results: Surveys were returned for 176 children with CL/P and 333 unaffected children. When compared with unaffected children, responses differed for CL ± A in 4/29 questions, for CP in 7/29 questions, and for CL + P in 8/29 questions (P < 0.05). When stratified by school age, children with CL/P in elementary, middle, and high school differed from unaffected children by 1/29, 7/29, and 2/29 questions, respectively. Middle school–aged children with CL/P were more affected by aesthetic concerns, bullying, and difficulties with friendship, and social interaction. Children with CL + P reported more severe aesthetic-related concerns than children with CL ± A or CP but experienced similar speech-related distress as children with CP only. Conclusion: Social implications associated with CL/P are most pronounced during middle school, and less so during elementary and high school. This information identifies areas of social improvement aimed at reducing the stigma of CL/P.
- Published
- 2017
37. Euthanasia and Humane Killing
- Author
-
Robert E. Meyer
- Subjects
03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Anesthesia ,Unconsciousness ,medicine ,Bispectral analysis ,Visual evoked potentials ,medicine.symptom ,Psychology ,030217 neurology & neurosurgery - Published
- 2017
38. Nitroprusside improves tumor perfusion during local 42°C hyperthermia
- Author
-
Mark W. Dewhirst, Gary L. Rosner, R. D. Braun, and Robert E. Meyer
- Subjects
Hyperthermia ,Text mining ,General Veterinary ,business.industry ,Anesthesia ,Tumor perfusion ,MEDLINE ,Medicine ,business ,medicine.disease - Published
- 2017
39. Comparison of Morphine, Morphine-Lidocaine, and Morphine-Lidocaine-Ketamine Infusions in Dogs Using an Incision-Induced Pain Model
- Author
-
Ludovica Chiavaccini, Andrew Claude, and Robert E. Meyer
- Subjects
Male ,Lidocaine ,040301 veterinary sciences ,medicine.medical_treatment ,Analgesic ,Surgical Wound ,Pain ,0403 veterinary science ,03 medical and health sciences ,0302 clinical medicine ,Dogs ,030202 anesthesiology ,Medicine ,Animals ,Ketamine ,Dog Diseases ,Dexmedetomidine ,Small Animals ,Saline ,Morphine ,business.industry ,Surgical wound ,04 agricultural and veterinary sciences ,Pain scale ,Anesthesia ,Female ,business ,medicine.drug - Abstract
We aimed to compare antinociceptive effects of IV infusions of morphine (M), morphine-lidocaine (ML), or morphine-lidocaine-ketamine (MLK) combined, in a mild-to-moderate pain model in dogs. Eighteen adult hounds were heavily sedated with IV morphine (0.2 mg/kg) and dexmedetomidine to undergo thoracic skin incisions. After reversal, dogs were randomly assigned to receive loading doses of lidocaine and ketamine (MLK), lidocaine and saline (ML), or equivalent volume of saline (M), followed by 18 hr constant infusions of morphine (0.12 mg/kg/hr), lidocaine (3 mg/kg/hr) and ketamine (0.6 mg/kg/hr); morphine (0.12 mg/kg/hr) and lidocaine (3 mg/kg/hr); or morphine (0.12 mg/kg/hr), respectively. Pain was assessed with Short Form Glasgow Composite Measure Pain Scale and mechanical nociception with von Frey filaments (VFFS). Data were analyzed with linear mixed model on ranks. Independently of treatment, Short Form Glasgow Composite Measure Pain Scale was significantly higher than baseline for 24 hr (p < .0001), while VFFS was significantly lower than baseline for 48 hr post-recovery (p < .0001), with no difference between MLK and M groups. The ML group recorded significantly lower VFFS (p = .02) than the M group for the entire study. In conclusion, there was no significant analgesic difference between MLK and M alone.
- Published
- 2017
40. Baseline Prevalence of Birth Defects Associated with Congenital Zika Virus Infection - Massachusetts, North Carolina, and Atlanta, Georgia, 2013-2014
- Author
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Rebecca F. Liberman, Margaret A. Honein, Tonya R Williams, April L. Dawson, Dana Meaney-Delman, Augustina Delaney, Coleen A. Boyle, Megan R. Reynolds, Cynthia A. Moore, Alissa C. Stevens, Jennifer Isenburg, Kara N. D. Polen, Kim Newsome, Janet D. Cragan, Robert E. Meyer, Julie Dunn, Cara T. Mai, Emily E. Petersen, Sascha R. Ellington, Suzanne M. Gilboa, Carrie K. Shapiro-Mendoza, Nina E Forestieri, and Cathleen A. Higgins
- Subjects
0301 basic medicine ,Gerontology ,Adult ,Pediatrics ,medicine.medical_specialty ,Microcephaly ,Health (social science) ,Georgia ,Epidemiology ,Health, Toxicology and Mutagenesis ,Population ,World health ,Zika virus ,Congenital Abnormalities ,03 medical and health sciences ,0302 clinical medicine ,Health Information Management ,Pregnancy ,medicine ,North Carolina ,Prevalence ,Humans ,030212 general & internal medicine ,Full Report ,Pregnancy Complications, Infectious ,education ,Retrospective Studies ,Fetus ,education.field_of_study ,biology ,business.industry ,Zika Virus Infection ,Infant, Newborn ,Infant ,Retrospective cohort study ,General Medicine ,biology.organism_classification ,medicine.disease ,030104 developmental biology ,Massachusetts ,Population Surveillance ,Female ,Abnormality ,business - Abstract
Zika virus infection during pregnancy can cause serious brain abnormalities, but the full range of adverse outcomes is unknown (1). To better understand the impact of birth defects resulting from Zika virus infection, the CDC surveillance case definition established in 2016 for birth defects potentially related to Zika virus infection* (2) was retrospectively applied to population-based birth defects surveillance data collected during 2013-2014 in three areas before the introduction of Zika virus (the pre-Zika years) into the World Health Organization's Region of the Americas (Americas) (3). These data, from Massachusetts (2013), North Carolina (2013), and Atlanta, Georgia (2013-2014), included 747 infants and fetuses with one or more of the birth defects meeting the case definition (pre-Zika prevalence = 2.86 per 1,000 live births). Brain abnormalities or microcephaly were the most frequently recorded (1.50 per 1,000), followed by neural tube defects and other early brain malformations† (0.88), eye abnormalities without mention of a brain abnormality (0.31), and other consequences of central nervous system (CNS) dysfunction without mention of brain or eye abnormalities (0.17). During January 15-September 22, 2016, the U.S. Zika Pregnancy Registry (USZPR) reported 26 infants and fetuses with these same defects among 442 completed pregnancies (58.8 per 1,000) born to mothers with laboratory evidence of possible Zika virus infection during pregnancy (2). Although the ascertainment methods differed, this finding was approximately 20 times higher than the proportion of one or more of the same birth defects among pregnancies during the pre-Zika years. These data demonstrate the importance of population-based surveillance for interpreting data about birth defects potentially related to Zika virus infection.
- Published
- 2017
41. Academic Outcomes in Children with Congenital Heart Defects: A Population-based Cohort Study
- Author
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Stephanie Watkins, Robert E. Meyer, Jessica H. Knight, Kevin D. Hill, and Matthew E. Oster
- Subjects
Heart Defects, Congenital ,Male ,Pediatrics ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Article ,03 medical and health sciences ,Population based cohort ,0302 clinical medicine ,Child Development ,Cognition ,Risk Factors ,030225 pediatrics ,North Carolina ,Medicine ,Humans ,Registries ,Child ,Retrospective Studies ,business.industry ,Age Factors ,Gestational age ,Brain ,Logistic Models ,Treatment Outcome ,Birth Certificates ,Educational Status ,Female ,Educational Measurement ,Cardiology and Cardiovascular Medicine ,business ,Neurocognitive - Abstract
Background— Most studies evaluating neurocognitive outcomes in children with congenital heart defects (CHD) have focused on high-risk patients or used specialized, resource-intensive testing. To determine the association of CHD with academic outcomes and compare outcomes according to the severity of CHD, we linked state educational records with a birth defects registry and birth certificates. Methods and Results— We performed a retrospective cohort study using data from the North Carolina Birth Defects Monitoring Program, North Carolina Department of Public Instruction, and North Carolina Department of Health and Human Services vital records. We performed logistic regression, adjusting for maternal education, race/ethnicity, enrollment in public pre-Kindergarten, and gestational age, to determine the association of CHD with not meeting standards on reading and math end-of-grade examinations in third grade in 2006 to 2012. Of 5624 subjects with CHD and 10 832 with no structural birth defects, 2807 (50%) and 6355 (59%) were linked, respectively. Children with CHD had 1.24× the odds of not meeting standards in either reading or math (95% confidence interval, 1.12–1.37), with 44.6% of children with CHD not meeting standards in at least one of these areas compared with 37.5% without CHD. Although children with both critical and noncritical CHD had poorer outcomes, those with critical CHD were significantly more likely to receive exceptional services compared with the noncritical group (adjusted odds ratio, 1.46; 95% confidence interval, 1.15–1.86). Conclusions— Children with all types of CHD have poorer academic outcomes compared with their peers. Evaluation for exceptional services should be considered in children with any type of CHD.
- Published
- 2017
42. Obstructive sleep apnea in children with cleft lip and/or palate: Results of an epidemiologic study
- Author
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Irene J. Pien, Anna R. Carlson, Jeffrey R. Marcus, Alexander C. Allori, Stephanie Watkins, Ronald P. Strauss, Arthur S. Aylsworth, Robert E. Meyer, Eileen M. Raynor, Barry L. Ramsey, Luiz André Freire Pimenta, and Danielle L. Sobol
- Subjects
Obstructive sleep apnea ,Pediatrics ,medicine.medical_specialty ,Epidemiologic study ,business.industry ,medicine ,medicine.disease ,business - Published
- 2017
43. Barriers to care for children with orofacial clefts in North Carolina
- Author
-
Kyung A. Lee, Dara D. Mendez, Paula D. Strassle, Cynthia H. Cassell, Anne Krohmer, Robert E. Meyer, and Ronald P. Strauss
- Subjects
Embryology ,Pediatrics ,medicine.medical_specialty ,business.industry ,Family medicine ,Pediatrics, Perinatology and Child Health ,Health care ,medicine ,Retrospective cohort study ,General Medicine ,business ,Developmental Biology - Abstract
Background Little is known about the barriers faced by families of children with birth defects in obtaining healthcare. We examined reported perceived barriers to care and satisfaction with care among mothers of children with orofacial clefts.
- Published
- 2014
44. The Association Between Race/Ethnicity and Major Birth Defects in the United States, 1999–2007
- Author
-
Russell S. Kirby, Ying Wang, Christopher L. Borger, Joseph Sweatlock, C.J. Alverson, Russel Rickard, Glenn Copeland, Robert E. Meyer, Mark A. Canfield, Richard S. Olney, Lisa Marengo, Nila Irwin, Cara T. Mai, Rachel E. Rutkowski, Jane Fornoff, Timothy J. Flood, and Alissa O’Halloran
- Subjects
genetic structures ,Population ,Ethnic group ,Congenital Abnormalities ,Encephalocele ,Online Research and Practice ,symbols.namesake ,Risk Factors ,Ethnicity ,Prevalence ,medicine ,Humans ,Poisson regression ,education ,education.field_of_study ,business.industry ,Racial Groups ,Microtia ,Public Health, Environmental and Occupational Health ,medicine.disease ,United States ,Confidence interval ,Anotia ,Birth Certificates ,Population Surveillance ,symbols ,business ,Trisomy ,Demography - Abstract
Objectives. We investigated the relationship between race/ethnicity and 27 major birth defects. Methods. We pooled data from 12 population-based birth defects surveillance systems in the United States that included 13.5 million live births (1 of 3 of US births) from 1999 to 2007. Using Poisson regression, we calculated prevalence estimates for each birth defect and 13 racial/ethnic groupings, along with crude and adjusted prevalence ratios (aPRs). Non-Hispanic Whites served as the referent group. Results. American Indians/Alaska Natives had a significantly higher and 50% or greater prevalence for 7 conditions (aPR = 3.97; 95% confidence interval [CI] = 2.89, 5.44 for anotia or microtia); aPRs of 1.5 to 2.1 for cleft lip, trisomy 18, and encephalocele, and lower, upper, and any limb deficiency). Cubans and Asians, especially Chinese and Asian Indians, had either significantly lower or similar prevalences of these defects compared with non-Hispanic Whites, with the exception of anotia or microtia among Chinese (aPR = 2.08; 95% CI = 1.30, 3.33) and Filipinos (aPR = 1.90; 95% CI = 1.10, 3.30) and tetralogy of Fallot among Vietnamese (aPR = 1.60; 95% CI = 1.11, 2.32). Conclusions. This is the largest population-based study to our knowledge to systematically examine the prevalence of a range of major birth defects across many racial/ethnic groups, including Asian and Hispanic subgroups. The relatively high prevalence of birth defects in American Indians/Alaska Natives warrants further attention.
- Published
- 2014
45. Associations between prenatal exposure to air pollution, small for gestational age, and term low birthweight in a state-wide birth cohort
- Author
-
Thomas J. Luben, J. Allen Davis, Lynne C. Messer, Lisa Vinikoor-Imler, and Robert E. Meyer
- Subjects
Adult ,Male ,Adolescent ,Binomial regression ,Biochemistry ,Cohort Studies ,Young Adult ,Ozone ,Pregnancy ,Interquartile range ,Air Pollution ,Environmental health ,North Carolina ,Birth Weight ,Humans ,Medicine ,Air quality index ,General Environmental Science ,Fetal Growth Retardation ,business.industry ,Confounding ,Infant, Newborn ,Middle Aged ,medicine.disease ,Maternal Exposure ,Relative risk ,Infant, Small for Gestational Age ,Educational Status ,Small for gestational age ,Female ,Particulate Matter ,business ,CMAQ - Abstract
A range of health effects, including adverse pregnancy outcomes, have been associated with exposure to ambient concentrations of particulate matter (PM) and ozone (O3). The objective of this study was to determine whether maternal exposure to fine particulate matter (PM2.5) and O3 during pregnancy is associated with the risk of term low birthweight and small for gestational age infants in both single and co-pollutant models. Term low birthweight and small for gestational age were determined using all birth certificates from North Carolina from 2003 to 2005. Ambient air concentrations of PM2.5 and O3 were predicted using a hierarchical Bayesian model of air pollution that combined modeled air pollution estimates from the EPA׳s Community Multi-Scale Air Quality (CMAQ) model with air monitor data measured by the EPA׳s Air Quality System. Binomial regression, adjusted for multiple potential confounders, was performed. In adjusted single-pollutant models for the third trimester, O3 concentration was positively associated with small for gestational age and term low birthweight births [risk ratios for an interquartile range increase in O3: 1.16 (95% CI 1.11, 1.22) for small for gestational age and 2.03 (95% CI 1.80, 2.30) for term low birthweight]; however, inverse or null associations were observed for PM2.5 [risk ratios for an interquartile range increase in PM2.5: 0.97 (95% CI 0.95, 0.99) for small for gestational age and 1.01 (95% CI 0.97, 1.06) for term low birthweight]. Findings were similar in co-pollutant models and linear models of birthweight. These results suggest that O3 concentrations in both urban and rural areas may be associated with an increased risk of term low birthweight and small for gestational age births.
- Published
- 2014
46. Medication Use in Pregnancy in Relation to the Risk of Isolated Clubfoot in Offspring
- Author
-
Charlotte M. Druschel, Martha M. Werler, Robert E. Meyer, Allen A. Mitchell, Mahsa M. Yazdy, Marlene Anderka, Susan T. Mahan, and James R. Kasser
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Clubfoot ,Drug-Related Side Effects and Adverse Reactions ,Epidemiology ,Original Contributions ,New York ,Young Adult ,Pregnancy ,Risk Factors ,North Carolina ,medicine ,Humans ,Registries ,Family history ,business.industry ,Case-control study ,Odds ratio ,medicine.disease ,Confidence interval ,Massachusetts ,Case-Control Studies ,Prenatal Exposure Delayed Effects ,Gestation ,Female ,business ,Body mass index ,Maternal Age - Abstract
Clubfoot, a common major structural malformation, develops early in gestation. Epidemiologic studies have identified higher risks among boys, first-born children, and babies with a family history of clubfoot, but studies of risks associated with maternal exposures are lacking. We conducted the first large-scale, population-based, case-control study of clubfoot with detailed information on maternal medication use in pregnancy. Study subjects were ascertained from birth defect registries in Massachusetts, New York, and North Carolina during 2007-2011. Cases were 646 mothers of children with clubfoot without other major structural malformations (i.e., isolated clubfoot); controls were mothers of 2,037 children born without major malformations. Mothers were interviewed within 12 months of delivery about medication use, including product, timing, and frequency. Odds ratios were estimated for exposure to 27 medications in pregnancy months 2-4 after adjustment for study site, infant sex, first-born status, body mass index (weight (kg)/height (m)(2)), and smoking. Odds ratios were less than 1.20 for 14 of the medications; of the remainder, most odds ratios were only slightly elevated (range, 1.21-1.66), with wide confidence intervals. The use of antiviral drugs was more common in clubfoot cases than in controls (odds ratio = 4.22, 95% confidence interval: 1.52, 11.73). Most of these results are new findings and require confirmation in other studies.
- Published
- 2014
47. Risk of cancer in children with birth defects and effect of IVF conception
- Author
-
M. Browne, Mary K. Ethen, Ethan Wantman, Mark A. Canfield, Mahsa M. Yazdy, S.C. Fisher, Morton B. Brown, Stephanie Watkins, Barbara Luke, Hazel B. Nichols, Sergio Oehninger, Nina E Forestieri, Maria J. Schymura, Kevin J. Doody, and Robert E. Meyer
- Subjects
medicine.medical_specialty ,Reproductive Medicine ,Obstetrics ,business.industry ,medicine ,Obstetrics and Gynecology ,Cancer ,medicine.disease ,business - Published
- 2018
48. Association Between Birth Defects and Cancer Risk Among Children and Adolescents in a Population-Based Assessment of 10 Million Live Births
- Author
-
Wendy N. Nembhard, Mark A. Canfield, Sharon E. Plon, Tiffany M. Chambers, Philip J. Lupo, Chunqiao Luo, Amir Mian, Sonja A. Rasmussen, Beth A. Mueller, Austin L. Brown, Glenn Copeland, Tania A Desrosiers, Angela E. Scheuerle, Robert E. Meyer, Joshua D. Schiffman, Matthew E. Oster, Jeremy M. Schraw, Susan E. Carozza, Peter H. Langlois, Chad D. Huff, Pagna Sok, Amanda E. Janitz, Saumya D. Sisoudiya, Michael E. Scheurer, Heather E. Danysh, and Susan G. Hilsenbeck
- Subjects
Cancer Research ,medicine.medical_specialty ,education.field_of_study ,Acute leukemia ,business.industry ,Proportional hazards model ,Obstetrics ,Hazard ratio ,Population ,Cancer ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Medicine ,030212 general & internal medicine ,Live birth ,business ,Cancer risk ,Trisomy ,education - Abstract
Importance Birth defects affect approximately 1 in 33 children. Some birth defects are known to be strongly associated with childhood cancer (eg, trisomy 21 and acute leukemia). However, comprehensive evaluations of childhood cancer risk in those with birth defects have been limited in previous studies by insufficient sample sizes. Objectives To identify specific birth defect–childhood cancer (BD-CC) associations and characterize cancer risk in children by increasing number of nonchromosomal birth defects. Design, Setting, and Participants This multistate, population-based registry linkage study pooled statewide data on births, birth defects, and cancer from Texas, Arkansas, Michigan, and North Carolina on 10 181 074 children born from January 1, 1992, to December 31, 2013. Children were followed up to 18 years of age for a diagnosis of cancer. Data were retrieved between September 26, 2016, and September 21, 2017, and data analysis was performed from September 2, 2017, to March 21, 2019. Exposures Birth defects diagnoses (chromosomal anomalies and nonchromosomal birth defects) recorded by statewide, population-based birth defects registries. Main Outcomes and Measures Cancer diagnosis before age 18 years, as recorded in state cancer registries. Cox regression models were used to generate hazard ratios (HRs) and 95% CIs to evaluate BD-CC associations and the association between number of nonchromosomal defects and cancer risk. Results Compared with children without any birth defects, children with chromosomal anomalies were 11.6 (95% CI, 10.4-12.9) times more likely to be diagnosed with cancer, whereas children with nonchromosomal birth defects were 2.5 (95% CI, 2.4-2.6) times more likely to be diagnosed with cancer before 18 years of age. An increasing number of nonchromosomal birth defects was associated with a corresponding increase in the risk of cancer. Children with 4 or more major birth defects were 5.9 (95% CI, 5.3-6.4) times more likely to be diagnosed with cancer compared with those without a birth defect. In the analysis of 72 specific BD-CC patterns, 40 HRs were statistically significant (adjustedP Conclusions and Relevance Several significant and novel associations were observed between specific birth defects and cancers. Among children with nonchromosomal birth defects, the number of major birth defects diagnosed was significantly and directly associated with cancer risk. These findings could inform clinical treatment for children with birth defects and may elucidate mechanisms that lead to these complex outcomes.
- Published
- 2019
49. Factors associated with distance and time traveled to cleft and craniofacial care
- Author
-
Dara D. Mendez, Ronald P. Strauss, Robert E. Meyer, Anne Krohmer, Cynthia H. Cassell, and Kyung A. Lee
- Subjects
Background information ,Embryology ,education.field_of_study ,Pediatrics ,medicine.medical_specialty ,business.industry ,Population ,General Medicine ,Logistic regression ,Health outcomes ,Travel time ,Maternal education ,Pediatrics, Perinatology and Child Health ,Health insurance ,Medicine ,Craniofacial ,business ,education ,human activities ,Developmental Biology ,Demography - Abstract
BACKGROUND Information on travel distance and time to care for children with birth defects is lacking. We examined factors associated with travel distance and time to cleft care among children with orofacial clefts. METHODS In 2006, a mail/phone survey was administered in English and Spanish to all resident mothers of children with orofacial clefts born 2001 to 2004 and identified by the North Carolina birth defects registry. We analyzed one-way travel distance and time and the extent to which taking a child to care was a problem. We used multivariable logistic regression to examine the association between selected sociodemographic factors and travel distance (≤60 miles and >60 miles) and time (≤60 min and >60 min) to cleft care. RESULTS Of 475 eligible participants, 51.6% (n = 245) responded. Of the respondents, 97.1% (n = 238) were the child's biological mother. Approximately 83% (n = 204) of respondents were non-Hispanic White; 33.3% (n = 81) were college educated; and 50.0% (n = 115) had private health insurance. One-way mean and median travel distances were 80 and 50 miles, respectively (range, 0–1058 miles). One-way mean and median travel times were 92 and 60 min, respectively (range, 5 min to 8 hr). After adjusting for selected sociodemographics, travel distance varied significantly by maternal education, child's age, and cleft type. Travel time varied significantly by child's age. Approximately 67% (n = 162) reported taking their child to receive care was not a problem. CONCLUSION Approximately 48% of respondents traveled > 1 hr to receive cleft care. Increasing access to care may be important for improving health outcomes among this population Birth Defects Research (Part A) 97:685–695, 2013. © 2013 Wiley Periodicals, Inc.
- Published
- 2013
50. Prevalence and Correlates of Gastroschisis in 15 States, 1995 to 2005
- Author
-
Russell S. Kirby, Marcia L. Feldkamp, Jennifer Marshall, Jason L. Salemi, Russel Rickard, Lisa K. Marengo, James E. Kucik, Charlotte M. Druschel, Jean Tanner, and Robert E. Meyer
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Ethnic group ,Article ,Abdominal wall ,Young Adult ,Pregnancy ,Prevalence ,Humans ,Medicine ,Mass index ,Young adult ,Gastroschisis ,business.industry ,Infant, Newborn ,Obstetrics and Gynecology ,medicine.disease ,United States ,medicine.anatomical_structure ,Regression Analysis ,Gestation ,Female ,business ,Live birth ,Maternal Age ,Demography - Abstract
Gastroschisis, a congenital malformation causing the herniation of intestines and other abdominal organs outside of the fetal abdominal wall, continues to capture the attention of epidemiologists because of ongoing reports of the as-yet-unexplained increase in prevalence. Gastroschisis typically results in term or near-term live birth, with few comorbid congenital disorders.1–4 Whereas the cause of gastroschisis is unknown, identified risk factors include young maternal age with a lower body mass index (calculated as weight (kg)/[height (m)]2)5 and maternal race and ethnicity.6–8 Compared with foreign-born mothers, mothers born in the United States have a higher risk of having a neonate born with gastroschisis.9 Whereas estimates of prevalence of gastroschisis range from 2 to 3 cases per 10,000 live births, numerous reports indicate an increasing prevalence both in the United States and worldwide.1,8,10–15 Previous United States studies evaluating the trends and correlates of gastroschisis have been limited by the relatively rare occurrence. Small case counts may have prevented recognition of social, demographic, and clinical factors that might have provided information for prevention or intervention efforts. We therefore leveraged interstate collaboration within the National Birth Defects Prevention Network to pool data from a large, population-based, and nationally representative sample of gastroschisis cases over the course of 11 years to address the following research questions: What is the prevalence of gastroschisis in the United States?; Is there evidence to show that the prevalence has been increasing in the past two decades?; Are there subgroups of women at higher risk for having a neonate born with gastroschisis (eg, maternal age, racial, or ethnic groups)?; and Are there demographic (eg, sex of the newborn) or reproductive (eg, multiple gestations) characteristics associated with the occurrence of gastroschisis?
- Published
- 2013
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