RESUMEN
OBJECTIVE: To investigate whether differences between early preeclampsia and early fetal growth restriction can be explained by differential placental expression patterns of sFlt-1, Flt-1, and PlGF. METHODS: Placental tissues and maternal blood samples from six cases of preeclampsia, seven IUGR, and six age-matched controls were studied for mRNA and protein levels as well as protein localization and expression intensity. RESULTS: Neither placental PlGF mRNA and protein expression nor placental villous trophoblast expression intensity of PlGF was altered by placental dysfunction. CONCLUSION: High sFlt-1 concentrations may account for diminished maternal serum PlGF levels.
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Retardo del Crecimiento Fetal/metabolismo , Factor de Crecimiento Placentario/metabolismo , Placenta/metabolismo , Preeclampsia/metabolismo , Receptor 1 de Factores de Crecimiento Endotelial Vascular/metabolismo , Adulto , Estudios de Casos y Controles , Femenino , Humanos , EmbarazoRESUMEN
OBJECTIVE: We aimed to characterize the diagnostic accuracy of the Kryptor® assay for sFlt-1 and PlGF in maternal serum samples of uneventful singleton pregnancies and subjects with preeclampsia (PE) and PE-related outcomes such as fetal growth restriction (FGR). Longitudinal reference ranges of the sFlt-1 and PlGF level in the course of normal pregnancies were generated. METHODS: A cohort of subjects with PE and PE-related outcomes including FGR in the third trimester was compared to a cohort of women with uneventful outcome. Serum levels of sFlt-1, PlGF level as well as the sFlt-1/PlGF ratio was analysed with the Kryptor® assay and compared between the case- and control groups. Cut-off values were generated and diagnostic accuracy examined. RESULTS: Longitudinal reference ranges of the sFlt-1 and PlGF level in healthy pregnancies were in line with those levels measured with other immunoassays. Comparison of the sFlt-1/PlGF ratio between PE-related outcomes including FGR or PE and healthy controls showed a high diagnostic accuracy with an area under the curve (AUC) of 0.917 for PE-related outcomes and 0.919 for PE.
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Retardo del Crecimiento Fetal/sangre , Retardo del Crecimiento Fetal/diagnóstico , Inmunoensayo/métodos , Factor de Crecimiento Placentario/sangre , Preeclampsia/sangre , Preeclampsia/diagnóstico , Receptor 1 de Factores de Crecimiento Endotelial Vascular/sangre , Adulto , Área Bajo la Curva , Automatización de Laboratorios , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Inmunoensayo/normas , Valor Predictivo de las Pruebas , Embarazo , Tercer Trimestre del Embarazo/sangre , Curva ROC , Estándares de Referencia , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
OBJECTIVE: To investigate whether differences between late-onset preeclampsia (PE) and intrauterine growth restriction (IUGR) can be explained by differential placental expression patters of sFlt-1, Flt-1, and placental growth factor (PlGF). METHODS: Placental tissues and maternal blood samples from seven patients with PE, five IUGR, and seven age-matched controls were studied for mRNA and protein levels as well as protein localization and expression intensity. RESULTS: Placental PlGF mRNA and protein expression were not altered by placental dysfunction while placental villous trophoblast expression intensity of PlGF was increased. CONCLUSION: High sFlt-1 concentrations may account for diminished maternal serum PlGF levels.
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Retardo del Crecimiento Fetal/sangre , Factor de Crecimiento Placentario/sangre , Placenta/metabolismo , Preeclampsia/sangre , Receptor 1 de Factores de Crecimiento Endotelial Vascular/sangre , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Embarazo , Adulto JovenRESUMEN
BACKGROUND: Since the onset of the Somali civil war in 1991, more than 1 million Somalis have been displaced from Somalia. Minnesota has the largest Somali population in the U.S. Informal tobacco prevalence estimates among Somali populations in the U.S. and the United Kingdom range from 13% to 37%, respectively. Little research has been conducted to determine the extent of Somali tobacco use. PURPOSE: This paper reports the results from a knowledge, attitudes, and practices (KAP) survey conducted and analyzed in 2009 that explores tobacco use and estimates prevalence among Somali adults aged ≥ 18 years in Minnesota. METHODS: Modeled after validated state and national tobacco use surveys, the survey was adapted for Somalis and administered to ethnically Somali adults (N=392) from 25 neighborhood clusters in Minnesota. Participants were chosen through probability proportional to size and multistage random sampling methods. RESULTS: Estimated prevalence for cigarette use among Somalis was 24% (44% among men, 4% among women). Ever users were significantly more likely to be men, have attended college, and have friends who used cigarettes (p<0.0001). Belief in Islamic prohibition of tobacco was protective and affected current use and future intention to use tobacco (p<0.0001). The majority of Somali smokers were unwilling to use current cessation programs. CONCLUSIONS: Estimated cigarette use prevalence was lower than perceived prevalence (37%). Contrary to typical results, greater smoking prevalence was found among Somalis with higher education levels. Positive peer pressure and religion are protective factors from tobacco use and should be integrated into prevention and cessation programs.
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Conocimientos, Actitudes y Práctica en Salud , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Escolaridad , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Minnesota/epidemiología , Grupo Paritario , Prevalencia , Religión , Factores Sexuales , Somalia/etnología , Adulto JovenRESUMEN
BACKGROUND: Somalis compose the largest African refugee group in the U.S., with more than 55,000 primary arrivals since 2000. Minnesota has the largest Somali population in the U.S. Despite its size, little research has been conducted to determine the extent of tobacco use among Somali youth. PURPOSE: This paper reports the results from a knowledge, attitudes, and practices (KAP) survey designed to explore factors related to tobacco-use prevention, initiation, and cessation, and to reliably estimate tobacco-use prevalence among Somali youth in grades 9 through 12 in Minnesota. METHODS: A KAP survey, modeled after validated state and national youth tobacco-use surveys, was adapted for Somali youth and administered to ethnically Somali youth (N = 302) from seven high schools in Minnesota in 2008. Participants were chosen through probability-proportional-to-size and multi-stage random sampling methods, and the results were analyzed in 2009. RESULTS: Somali high school students' estimated prevalence for "ever-users" of cigarettes was 12.8%, and current use was 4.7%. This is one quarter of the reported statewide smoking prevalence for Minnesota high school students (19.1%) and half of the nationwide prevalence for blacks/African Americans (11.6%). Ever-users were more likely to have close friends or live with someone who smoked cigarettes (p < 0.01). Belief in the Islamic prohibition of tobacco affected future intention to use tobacco (p < 0.01), as did the belief that using hookah/sheisha is less risky than smoking cigarettes (p < 0.01). CONCLUSIONS: Estimated cigarette use prevalence (4.7%) for Somali youth was substantially lower than among Minnesota high school students and also lower than perceived prevalence among Somalis. Positive peer pressure and religion appear to be protective factors in tobacco use and should be integrated into future Somali tobacco prevention and cessation programs, along with education on the risks of hookah/sheisha use.
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Conocimientos, Actitudes y Práctica en Salud , Fumar/etnología , Adolescente , Estudios Transversales , Familia , Femenino , Humanos , Islamismo , Masculino , Minnesota/epidemiología , Grupo Paritario , Prevalencia , Investigación Cualitativa , Factores Sexuales , Somalia/etnología , Adulto JovenRESUMEN
BACKGROUND: Somalis compose the largest African refugee group living in the U.S., with more than 10,330 primary arrivals in fiscal year 2006 alone. Half of all Somalis in the U.S. live in Minnesota. Although tobacco use is a considerable problem among Somalis, especially among men, little research has examined factors affecting tobacco use and cessation. METHODS: A sequential exploratory design informed the overall study methodology. Key informant interviews (n=20) and focus group discussions (13 groups; n=91) were conducted with Somali adults and youth in the fall of 2006 and the summer of 2007, respectively. Participants were asked about tobacco-use prevalence, prevention, and cessation, and the marketing of tobacco. RESULTS: Perceived prevalence of tobacco use by Somalis is high at 50%. The main reason for initiating tobacco use was the influence of friends or peer pressure and included other social factors. Prevention and cessation messages suggested by participants include medical advice, education on the negative health effects of tobacco use, religion, and the support of family and friends. Barriers to cessation include lack of insurance coverage, lack of knowledge on where to find assistance, and lack of cessation support groups. Severe social stigma for Somali female smokers poses specific challenges to prevention and intervention efforts. Water-pipe smoking is perceived to be prevalent, particularly among female youth. CONCLUSIONS: Somalis view tobacco use as an important issue in their community. Religious and social support and demographically targeted approaches should be key factors in creating effective prevention and cessation programs and must address water-pipe smoking.
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Fumar/epidemiología , Adulto , Anciano , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Minnesota/epidemiología , Cese del Hábito de Fumar/métodos , Somalia/etnología , Población Urbana , Adulto JovenRESUMEN
The objective of this study was to evaluate the effects of an innovative, multicomponent, theory-based educational intervention for pediatric residents on prevention of tobacco use counseling for cessation. Before and 3 months after intervention residents in a large urban midwestern pediatric residency program completed a self-assessment of measures of their attitudes and counseling behaviors. The intervention was a 3-hour multicomponent program including presentations, case discussions, role-plays and support material based on concepts from Motivational Interviewing (MI). Participants reported increased confidence in their ability to counsel, as well as greater frequency of counseling (standardized effect size (d) = 0.57). Residents also reported an increased use of principal components of MI, assessing how important quitting is to patients (d = .66), and how confident patients are in their ability to quit (d = .78). This brief educational intervention taught theory-based counseling techniques to pediatric residents. After the study, participants reported significant increases in their frequency of counseling as well as greater use of the MI principles.