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2. The role of β-2-microglobulin and cystatin C as urinary biomarkers of focal segmental glomerulosclerosis in the setting of paediatric HIV infection

Author

Persad, K, Nandlal, L, Bhimma, R, and Naicker, T

Subjects
FSGS, paediatric, HIV, Biomarkers, urinary proteins
Abstract

BACKGROUND. Africa has the highest rate of HIV infection, and HIV-associated nephropathy (HIVAN) is one of the most frequent kidney diseases observed in children. HIVAN in children usually presents as a form of nephrotic syndrome, predominantly focal segmental glomerulosclerosis (FSGS) on histopathology, that often leads to chronic kidney failure. OBJECTIVE. This study determined the urinary concentrations of β-2-microglobulin (β2M) and cystatin C proteins in children with HIVAN and primary FSGS. METHODS. The study group comprised 34 children; 14 with HIVAN and 20 with primary FSGS. The control groups were 20 HIV-positive and 20 HIV-negative children with no kidney disease. Urine samples collected from these 74 children were stored at -80°C. Bio-Plex technology was used to analyse the urinary protein concentration of cystatin C and β2M. RESULTS. A significant increase in urinary β2M levels was observed in the HIVAN group compared with the HIV-negative group (p=0.0240). No other statistically significant differences in urinary β2M concentrations were noted across the study groups. Urinary cystatin C levels were significantly increased in primary FSGS children compared with both HIV-negative (p=0.0041) and HIV-positive controls (p=0.0256). Urinary cystatin C displayed a significant increase in the primary FSGS compared with the HIVAN group (p=0.0150). No significant differences in urinary cystatin C levels were noted in the HIVAN group compared with the HIV-negative and HIV-positive control groups. CONCLUSION. Urinary cystatin C has promising prognostic value to predict primary FSGS from HIVAN.

Published
2023

3. The role of ß-2-microglobulin and cystatin C as urinary biomarkers of focal segmental glomerulosclerosis in the setting of paediatric HIV infection.

Author

Persad, K., Nandlal, L., Bhimma, R., and Naicker, T.

Subjects
*CYSTATIN C, *FOCAL segmental glomerulosclerosis, *HIV infections, *PEDIATRIC nephrology, *CHRONIC kidney failure
Abstract

Background. Africa has the highest rate of HIV infection, and HIV-associated nephropathy (HIVAN) is one of the most frequent kidney diseases observed in children. HIVAN in children usually presents as a form of nephrotic syndrome, predominantly focal segmental glomerulosclerosis (FSGS) on histopathology, that often leads to chronic kidney failure. Objective. This study determined the urinary concentrations of ß-2-microglobulin (ß2M) and cystatin C proteins in children with HIVAN and primary FSGS. Methods. The study group comprised 34 children; 14 with HIVAN and 20 with primary FSGS. The control groups were 20 HIV-positive and 20 HIV-negative children with no kidney disease. Urine samples collected from these 74 children were stored at -80°C. Bio-Plex technology was used to analyse the urinary protein concentration of cystatin C and ß2M. Results. A significant increase in urinary ß2M levels was observed in the HIVAN group compared with the HIV-negative group (p=0.0240). No other statistically significant differences in urinary ß2M concentrations were noted across the study groups. Urinary cystatin C levels were significantly increased in primary FSGS children compared with both HIV-negative (p=0.0041) and HIV-positive controls (p=0.0256). Urinary cystatin C displayed a significant increase in the primary FSGS compared with the HIVAN group (p=0.0150). No significant differences in urinary cystatin C levels were noted in the HIVAN group compared with the HIV-negative and HIV-positive control groups. Conclusion. Urinary cystatin C has promising prognostic value to predict primary FSGS from HIVAN. [ABSTRACT FROM AUTHOR]

Published
2023
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4. CLASP - A RANDOMIZED TRIAL OF LOW-DOSE ASPIRIN FOR THE PREVENTION AND TREATMENT OF PREECLAMPSIA AMONG 9364 PREGNANT-WOMEN

Author

BEROYZ, G, CASALE, R, FARREIROS, A, PALERMO, M, MARGULIES, M, VOTO, L, FABREGUES, G, RAMALINGAM, R, DAVIES, T, BRYCE, R, BOYD, W, CARMODY, F, KING, J, VACCA, A, FAY, R, WALTERS, W, ANTONAS, B, BENNETT, P, BROOM, T, CROWTHER, C, DERHAM, R, GEORGE, K, HAGUE, W, HASENHOHR, G, HEYSEN, D, KORNMAN, L, OLOUGHLIN, S, MORRIS, D, PRIDMORE, B, ROBINSON, J, SVIGOS, D, SWEET, R, BEALE, M, BENNETT, M, BOSCH, E, FISHER, C, HORRAUTZ, S, SYMINGTON, I, SZIRT, A, FORBES, K, FREEMAN, A, POPPER, E, WILSON, J, PERMEZEL, M, BOWDITCH, J, REYNOLDS, G, MOULINASSE, R, BIETLOT, Y, KIRKPATRICK, C, COULON, R, DELVOYE, P, DEMATOS, C, SIMONINI, S, LEJEUNE, B, NEERDAELS, C, ALEXANDER, S, GOESSENS, L, HANSSENS, M, SPITZ, B, VANASSCHE, A, WECKHUYSEN, R, PARBOOSINGH, J, HARMAN, C, REY, E, BURROWS, R, BELCHER, J, GARNER, P, SYLVAIN, J, NIMROD, C, THOMAS, B, DEININGER, F, LAO, T, LI, C, FRIEDMAN, S, BORNSTEIN, J, SHALIT, A, MATZKEL, A, POMERANZ, M, GELSNER, M, MANKUTA, D, WIZNITZER, A, LEVINE, S, ADEEB, N, CHANDRAN, R, NASRI, N, SHARIFF, J, ANSELL, D, LAKE, Y, GOROCHOVA, L, MERIAKRI, V, ROMANUGA, N, DOTZ, I, SHEUV, B, VIKHLYAEVA, E, ANDREEV, K, GOLUBEVA, L, GORODCOV, V, ADELANTADO, J, SANTONJA, J, HOLMBERG, H, BUCHHAVE, P, LEANDERSSON, U, LILJESTRAND, J, RYDHSTROEM, H, SWEDIN, G, BJORKLUND, A, GENNSER, G, SANDEN, M, DAHLGREN, S, HAMMARBACK, S, SMEDS, A, SIDENVALL, M, ENEROTH, E, SZABOLCS, A, DANIELSSON, I, LINDQVIST, P, HOGSTEDT, S, WALLENBURG, H, BREMER, H, BRIET, J, DEBIEMEYERINK, A, DONKERS, B, LAMPING, P, SCHIERBEEK, J, VANDERLEEUWHARMSEN, L, THE, H, VANBODEGOM, F, VANEGMONDLINDEN, A, FLU, P, KUIJKEN, J, MORREL, B, STRAUB, M, VIERHOUT, M, KEIRSE, M, VANROOSMALEN, J, HOHNER, C, HUTTEN, J, BENNEN, J, ROEX, A, WIJFFELS, T, OOSTERHOFF, H, OTTEN, J, VANDERKLEI, T, RAMONDT, J, VANDERMOER, P, DEGRAAFF, J, SIJSMA, E, DEGREVE, O, SMIT, D, SMULDERS, P, NIJHUIS, J, ZONDERVAN, H, LIND, J, SCHOOT, B, MONKHORST, M, STUT, J, VANDAM, L, VANOTTERLO, L, VLAANDEREN, W, EGGENS, J, SANTEMA, J, VERHOEFF, A, HAMID, S, JOHN, I, KHAN, G, SHAH, S, SHEIKH, E, SINHA, C, ABRAMOVICH, D, CAMPBELL, D, FISHER, P, GALL, S, HALL, M, JANDIAL, V, PARKIN, D, SMITH, N, SUTHERLAND, H, SWAPP, G, TEMPLETON, A, TERRY, P, KALAM, A, MAGEE, S, MARTIN, D, SPEARING, G, ALDERMAN, B, MURRAY, A, SUTHERST, J, HYATT, D, SAUNDERS, P, BURGESS, S, COCHRANE, G, WHITE, A, ARMSTRONG, M, MCNICHOL, E, OSBOURNE, G, PRICE, J, CRICHTON, J, EVANS, D, ANDERSON, R, HULL, M, JAMES, D, NIVEN, P, STIRRAT, G, WARDLE, P, GARDNER, P, PADGETT, L, ALAILY, A, NASH, G, GINZ, B, SMITH, M, RICHARDS, C, ARMAR, A, ARMSTRONG, N, MANNING, E, PERSAD, K, COLLINGWOOD, M, COLLINS, R, CROWTHER, J, FARRELL, B, HAFNER, B, HANDOLL, H, HEINEMAN, J, KNIGHT, S, MEAD, G, RADLEY, A, SPENCE, S, REID, W, TREHARNE, I, HEASLEY, R, LOWRY, D, MYLES, T, WALLACE, R, GEALS, M, GORDON, G, TRAIN, T, HUTCHON, D, MACDONALD, J, STOREY, R, ANDERSON, G, WORTH, R, ERIAN, J, MCQUEEN, J, TATFORD, E, TERRY, M, NEALE, R, HOWAT, R, KENNEDY, J, MACNAUGHTON, M, MCEWAN, H, WALKER, J, HUTCHESON, R, KEMP, V, READ, M, SIMMS, M, SWINGLER, G, HUSEMEYER, R, CHAPMAN, M, MAXWELL, D, ELDER, M, FUSI, L, HAWKINS, D, NICOLINI, U, WINSTON, R, BURTON, E, FAIRBANK, J, SIMMONS, S, SPING, J, TRICKEY, N, GILLARD, M, HUDSON, C, SETCHELL, M, WATHEN, N, CANTY, S, WHITELEY, P, CAMPBELL, J, FEENEY, J, HAY, D, IMRIE, A, PALMER, A, PURDIE, D, SPECK, E, TYRRELL, S, MCLEAN, J, BROWN, V, DUNCAN, S, JOHNSON, D, MILLAR, D, BUCKLEY, D, CHARNOCK, M, DOVE, P, ELLIS, J, GILLMER, M, MCVITTIE, J, MANNION, V, REDMAN, C, SELLERS, S, TURNBULL, A, NEWMAN, M, CAMPBELL, S, CARDOSO, L, GIBB, D, HARRINGTON, K, PARSONS, J, NICOLAIDES, K, STUDD, J, DIXON, R, GIE, C, PICKLES, C, SEAR, R, GRAHAM, R, KIRWAN, P, SMITH, G, ANWAR, M, ALAZZAWI, F, DAVIDSON, A, DECHAZEL, R, DRIFE, J, GILL, F, LANG, G, MACAFEE, J, MACVICAR, J, NAFTALIN, N, NEUBERG, R, TAYLOR, D, LEAVER, E, TIMOTHY, I, BREESON, A, LAMB, M, VELACOTT, I, VERNER, V, HORWELL, D, LOBB, M, SELIGMAN, S, SCOTT, A, HALL, S, MACKENZIE, W, SMITH, E, VETHANAVAGAN, S, VERZIN, J, WEIR, P, WHITE, R, CLARK, H, FAWDRY, R, LYNCH, C, MCCUNE, G, BOWENSIMPKINS, P, CALVERT, J, EMERY, S, JACKSON, W, STOKES, I, WARD, A, BROWNING, A, COX, C, LITTLE, D, STIBBE, H, MCINTOSH, A, SNODGRASS, C, WAGSTAFF, T, HOWIE, P, BIBBY, J, DAVIES, W, ELLIOTT, B, SHAXTED, E, MCGARRY, J, DAW, E, BAKER, K, CLUBB, A, GOUGH, J, GRANT, M, MENON, V, OBHARI, M, OBRIEN, P, BROWN, R, RYALL, A, WALTON, S, BAKER, J, BRUCE, J, LIU, D, JOHNSON, I, TYACK, A, COWIE, D, NYSENBAUM, A, BAMFORD, P, GARRIOCH, D, HILL, J, GRANT, A, FELTON, D, HACKMAN, B, FALCONER, A, FREEMAN, F, GREENE, K, JACKSON, J, HUNTER, G, GRATTON, D, MAULIK, T, YOUSSEF, H, BANWELL, G, HARTWELL, R, WILSON, P, BOND, A, FORBESSMITH, P, BARRON, L, DAVISON, J, DUNLOP, W, LIND, T, TACCHI, D, BALFOUR, R, MUTCH, L, COLTART, T, DESWIET, M, EDMONDS, D, LOEFFLER, F, MALVERN, J, OSBOURNE, J, RODECK, C, SIMS, C, SPENCER, J, BONE, C, MACDONALD, A, DREW, N, BALLARD, R, THONET, R, HANNA, L, MORCOS, S, HOLT, E, COOPER, J, CALLEN, P, FOZZARD, C, GRUNDY, M, STANLEY, S, DANIEL, D, GOLDING, R, WIENER, J, BUCKINGHAM, M, HEARD, M, LETCHWORTH, A, BOOMLA, K, CLARK, A, GRUDZINSKAS, J, HARTGILL, J, ORAM, D, ROBSON, J, SAVAGE, W, BLUNT, V, LANE, J, OWEN, A, REDFORD, D, BEARD, R, BOSTOCK, J, MEASDAY, B, MELVILLE, H, DORNAN, J, TRAUB, A, UTIDJIAN, M, AULD, A, KRASZEWSKI, A, MACK, D, MCDOUGALL, N, MOWAT, J, DOCHERTY, P, MCKENNA, D, SMEDLEY, G, WILDE, J, SMITH, R, WATNEY, P, MCDONNELL, J, TROMAMS, P, CALDER, A, GLASIER, A, GREER, I, JOHNSTONE, F, LISTON, W, LIVINGSTONE, J, NEILSON, J, SMITH, S, WEST, C, BULLOUGH, C, JONES, A, MACKAY, G, COOPER, K, RUOSS, C, JOYCE, D, MCCOY, D, MCLEOD, F, SAVAGE, P, SMITH, P, TURNER, G, KANE, L, ROSENBERG, D, SHANNON, R, BROMHAM, D, BUCHAN, P, CROMPTON, A, JARVIS, G, LILFORD, R, MACDONALD, H, THORNTON, J, PINKER, G, BEVAN, J, FRANCIS, J, KETTLE, M, HOLMES, H, KERRWILSON, R, SUTTON, M, BEYNON, J, HOOKER, J, FERGUSSON, I, MORTON, K, TAYLOR, R, DAVIS, J, LOW, R, STEWART, J, ASHWORTH, F, SOONAWALLA, K, TEBBUTT, I, USHERWOOD, M, VOIGT, J, COHEN, S, GODFREY, K, MCNAB, G, MURRAY, B, GUDGEON, D, FOULKES, J, STANNARD, P, JAMSHIDI, R, MULHOLLAND, J, BOND, E, DUNLOP, J, FOGARTY, P, BRANT, H, LACHELIN, L, LLOYDJONES, R, SIDDLE, N, SILVERSTONE, A, STEELE, S, WARD, R, EDDIE, D, VERNONPARRY, J, CIETAK, K, KENNEDY, C, REED, M, SANTCASSIA, L, BEGG, H, FRAMPTON, J, GRIFFIN, D, LEWIS, B, NESTROP, A, SHERIDAN, R, TIPTON, R, BOBER, S, BROUGH, F, STAFFORD, J, HOUSE, M, PAWSON, M, REES, D, VENN, R, ANDERSON, T, HUGHES, J, REGINALD, P, HENSON, G, MORGAN, H, ALLEN, I, HANNAY, W, LENNOX, C, CALLENDER, R, MCLEAN, R, GOLDKRAND, J, and FIDALGO, C

Subjects
medicine.medical_specialty, Randomized controlled trial, law, business.industry, Internal medicine, medicine, General Medicine, medicine.disease, business, law.invention, Preeclampsia, Low dose aspirin
Published
2016
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7. Evaluation of the characteristics of primary iridociliary cysts using ultrasound biomicroscopy at a tertiary care centre.

Author

Liu D, Lutchman CR, Persad K, and Simpson ER

Subjects
Humans, Male, Female, Microscopy, Acoustic, Retrospective Studies, Tertiary Care Centers, Canada, Ciliary Body diagnostic imaging, Iris Diseases diagnosis, Cysts diagnostic imaging, Eye Abnormalities
Abstract

Objective: To evaluate the ultrasound biomicroscopic characteristics of primary iridociliary cysts presenting to a Canadian tertiary care centre., Design: Retrospective study., Participants: A total of 189 patients (212 eyes) referred to the Sinai Health System (Toronto) for suspected iris abnormalities., Methods: Clinical records of patients referred between March 2016 and October 2019 were reviewed. All patients were evaluated and received a diagnosis of an iridociliary cyst using ultrasound biomicroscopy (UBM). Data were collected for age, sex, involvement (iris vs ciliary body), laterality, size, and location on initial examination and subsequent follow-up., Results: Of the 189 patients (212 eyes) with iridociliary cysts, more were female (65.1%) versus male (34.9%). The highest incidence occurred in females aged 21-30 years (13.2%). The iris pigment epithelium was involved in 84.4%, and only the ciliary body was involved in 3.8%. Both the iris pigment epithelium and the ciliary body were involved in 10.8%. The size of the cysts ranged between 0.5 and 4.41 mm in diameter. Cysts greater than 1 mm in diameter occurred in 78.7%, and 86.8% of cysts occurred unilaterally. Twelve percent were multicystic, and 8.5% were multiloculated, with 1% exhibiting both features. Twenty-three eyes (12.2%) were reviewed at 1 year of follow-up with UBM. Stable iridociliary cysts with no appreciable change in size were seen in 73.9% (n = 17). Iridociliary cyst growth was noted at 4 months in 1 patient., Conclusion: Information regarding iridociliary cysts is not easily available in the literature. UBM is a helpful clinical tool in the evaluation of iris abnormalities. Iridociliary cysts tend to be stable and compatible with a low rate of complications., (Copyright © 2022 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)

Published
2023
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8. Treatment outcomes in stage IIIA non-small-cell lung cancer in a community cancer center.

Author

Hanson S, Persad K, Qiao X, Guarino M, and Petrelli N

Abstract

Background: Treatment outcomes for non-small-cell lung cancer (NSCLC) patients diagnosed at stage IIIA have been analyzed in many studies, which generally involve patients younger and healthier than the average patient with this disease., Objective: To analyze demographics and treatment outcomes in patients with stage IIIA NSCLC at a community cancer center., Methods: We reviewed charts of 226 patients diagnosed with stage IIIA NSCLC from January 2003 to December 2008 treated at our community cancer center. Results Median overall survival for all patients and sequentially and concurrently treated chemoradiation patients were 18 months, and 18 months, and 20 months, respectively. Median overall survival for women and men was 24 months and 16 months, respectively., Results: Median overall survival for all patients and sequentially and concurrently treated chemoradiation patients were 18 months, and 18 months, and 20 months, respectively. Median overall survival for women and men was 24 months and 16 months, respectively., Limitations: Study design was retrospective and some medical records were not available. However, this population is likely representative of patients treated in similar settings., Conclusions: In our population, advanced age and male gender were associated with lower median survival. Responses to concurrent and sequential chemoradiation seemed to differ based on age group, which may be useful as a prognostic guideline for similar populations., (©2015 Frontline Medical Communications.)

Published
2015
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9. Acute poisoning in children. Cases hospitalized during a three-year period in Trinidad.

Author

Pillai GK, Boland K, Jagdeo S, and Persad K

Subjects
Acute Disease, Adolescent, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Kerosene poisoning, Pesticides poisoning, Poisoning diagnosis, Retrospective Studies, Suicide, Attempted, Trinidad and Tobago epidemiology, Poisoning epidemiology
Abstract

The aim of this study is to describe the epidemiological features of acute poisoning in children less than 16 years old who were admitted to a paediatric hospital in north Trinidad. The specific objectives included the determination of the age range most susceptible to poisoning, which agents are mainly responsible, an examination of the need for preventive strategies and educational programmes as well as to evaluate the need for a poison control centre in the country. Data were extracted from the medical records of 169 patients (83 males (49%) and 86 females (51%) with acute poisoning during the period of January 1998 to December 2000. The results revealed that the majority of cases of poisoning were accidental (84.6%), suicide (11.2%) and forced poisoning (4.1%). The largest category of poisoning was a miscellaneous group (24.8%) followed by the drug category (21.8%), kerosene (19.5%), pesticides (15.9%) and bleach (9.4%). Paraquat ingestion constituted 5.3% of cases. The highest prevalence of acute poisoning occurred within the age group of 0-4 years (69.2%), followed by the age group of 10-13 years (13.6%), 5-9 years (9.4%) and the age group with the lowest incidence was 14-16 years (7.6%). The only fatality was a female (10-13 year-group) and this was due to suicidal ingestion of paraquat. All other cases were treated and subsequently discharged. The frequency of accidental poisoning in Trinidad merits more widespread public education aimed at preventing exposure to toxic substances while increasing the use of deterrents such as child-resistant containers.

Published
2004

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