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Fredrik Dahl, Olle Ericsson, Olof Karlberg, Filip Karlsson, Mathias Howell, Fredrik Persson, Fredrik Roos, Johan Stenberg, Tarja Ahola, Ida Alftrén, Björn Andersson, Emelie Barkenäs, Birgit Brandner, Jenny Dahlberg, Sara Elfman, Magnus Eriksson, Per-Ola Forsgren, Niels Francois, Anna Gousseva, Faizan Hakamali, Åsa Janfalk-Carlsson, Henrik Johansson, Johanna Lundgren, Atefeh Mohsenchian, Linus Olausson, Simon Olofsson, Atif Qureshi, Björn Skarpås, Anna Sävneby, Eva Åström, Ove Öhman, Magnus Westgren, Helena Kopp-Kallner, Aino Fianu-Jonasson, Argyro Syngelaki, Kypros Nicolaides
Cell-free DNA analysis is becoming adopted for first line aneuploidy screening, however for most healthcare programs, cost and workflow complexity is limiting adoption of the test. We report a novel cost effective method, the Vanadis NIPT assay, designed for high precision digitally-enabled measurement of chromosomal aneuploidies in maternal plasma. Reducing NIPT assay complexity is achieved by using novel molecular probe technology that specifically label target chromosomes combined with a new readout format using a nanofilter to enrich single molecules for imaging and counting without DNA amplification, microarrays or sequencing...
March 14, 2018: Scientific Reports
M Y Tan, D Wright, A Syngelaki, R Akolekar, S Cicero, D Janga, M Singh, E Greco, A Wright, K Maclagan, L C Poon, K H Nicolaides
OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Athanasios Tyraskis, Spyros Bakalis, Carolina Scala, Argyro Syngelaki, Stefano Giuliani, Mark Davenport, Anna L David, Kypros Nicolaides, Simon Eaton, Paolo De Coppi
AIM: We investigated the natural history of fetal ovarian cysts to estimate the risk of torsion according to size. METHODS: Cases were identified from 1/1/2000 until 1/1/2015. Data were collected pre- and postnatally on cyst size and sonographic features until an outcome of surgery, torsion, or resolution. Fisher's exact test for categorical data and logistic regression for continuous data were used to test the significance of size on torsion; P value <0.05 was considered significant...
February 12, 2018: Journal of Pediatric Surgery
David Wright, Daniel L Rolnik, Argyro Syngelaki, Catalina de Paco Matallana, Mirian Machuca, Mercedes de Alvarado, Sofia Mastrodima, Min Yi Tan, Siobhan Shearing, Nicola Persico, Jacques C Jani, Walter Plasencia, George Papaioannou, Francisca S Molina, Liona C Poon, Kypros H Nicolaides
BACKGROUND: Preeclampsia is a major pregnancy complication with adverse short- and long-term implications for both the mother and baby. Screening for preeclampsia at 11-13 weeks' gestation by a combination of maternal demographic characteristics and medical history with measurements of biomarkers can identify about 75% of women that develop preterm-preeclampsia with delivery at <37 weeks' gestation and 90% of those with early-preeclampsia at <32 weeks, at a screen positive rate of 10%...
March 2, 2018: American Journal of Obstetrics and Gynecology
Keerthana Sankar, Wade Kyono, Corey Raffel, Theodore Nicolaides
Slipped capital femoral epiphysis (SCFE) is a fracture that results from displacement of the proximal femoral epiphysis from the femoral neck. SCFE can be caused by various endocrinopathies that lead to bone weakening in both adult and pediatric patients. We report a rare case of suprasellar germinoma presenting with SCFE in an 11-year-old female patient. The findings of this case further support the need to consider pituitary lesions as the underlying cause of endocrine deficiences leading to SCFE.
December 16, 2017: Curēus
Liron Yoffe, Avital Gilam, Orly Yaron, Avital Polsky, Luba Farberov, Argyro Syngelaki, Kypros Nicolaides, Moshe Hod, Noam Shomron
Preeclampsia is one of the most dangerous pregnancy complications, and the leading cause of maternal and perinatal mortality and morbidity. Although the clinical symptoms appear late, its origin is early, and hence detection is feasible already at the first trimester. In the current study, we investigated the abundance of circulating small non-coding RNAs in the plasma of pregnant women in their first trimester, seeking transcripts that best separate the preeclampsia samples from those of healthy pregnant women...
February 21, 2018: Scientific Reports
Suzanne Demers, Amelie Boutin, Regina Dembickaja, Mercedes Campanero, Kypros Nicolaides
OBJECTIVE: Preeclampsia is associated with placental vascularization disorders. Ultrasonographic sphere biopsy (USSB) of the placenta can estimate the vascularization of the placenta and potentially the risk of preeclampsia. We aimed to explore the factors related to placental vascularization measured with USSB in the first trimester. STUDY DESIGN: A prospective cohort was conducted in women recruited at 11 to 14 weeks. Three-dimensional acquisition of the placenta with power Doppler was undertaken along with crown-rump length (CRL)...
February 19, 2018: American Journal of Perinatology
Iakovos Theodoulou, Marios Nicolaides, Thanos Athanasiou, Apostolos Papalois, Michail Sideris
OBJECTIVE: We aimed to identify and critically appraise all literature surrounding simulation-based learning (SBL) courses, to assess their relevance as tools for undergraduate surgical education, and create a design framework targeted at standardizing future SBL. METHODS: We performed a systematic review of the literature using a specific keyword strategy to search at MEDLINE database. RESULTS: Of the 2371 potentially eligible titles, 472 were shortlisted and only 40 explored active interventions in undergraduate medical education...
February 16, 2018: Journal of Surgical Education
Stavros Kakkos, Andrew Nicolaides
INTRODUCTION: The use of a venoactive drug is considered an important component of medical treatment of chronic venous disease (CVD), although the efficacy of certain VADs on one or more individual leg symptoms or signs may have not been extensively studied to justify a strong recommendation in guidelines on CVD. The aim of this systematic review and metaanalysis was to study the effectiveness of the micronized purified flavonoid fraction (MPFF, Daflon®) across the spectrum of defined venous symptoms, signs, quality of life (QoL) and treatment assessment by the physician...
January 31, 2018: International Angiology: a Journal of the International Union of Angiology
Liona C Poon, Daniel L Rolnik, Min Yi Tan, Juan Luis Delgado, Theodora Tsokaki, Ranjit Akolekar, Mandeep Singh, Walkyria Andrade, Tunay Efeturk, Jacques C Jani, Walter Plasencia, George Papaioannou, Ana Rosa Blazquez, Ilma Floriana Carbone, David Wright, Kypros H Nicolaides
OBJECTIVE: To report the incidence of preterm preeclampsia (PE) in women that fulfil the screening criteria of the National Institute for Health and Clinical Excellence (NICE) and American Congress of Obstetricians and Gynecologists (ACOG) and compare the incidence in those that are screen positive and screen negative by the Fetal Medicine Foundation (FMF) algorithm. STUDY DESIGN: This was a secondary analysis of data from the ASPRE study. The study population consisted of women with singleton pregnancies who had prospective screening for preterm-PE by means of the FMF algorithm that combines maternal factors and biomarkers at 11-13 weeks' gestation...
January 30, 2018: Ultrasound in Obstetrics & Gynecology
Carolina Ferreira, Ana Lidia Rouxinol-Dias, Teresa Loureiro, Kypros Nicolaides
OBJECTIVES: To examine the subarachnoid space diameters in chromosomally abnormal fetuses at 11-13 weeks' gestation. METHODS: Stored three-dimensional (3D) ultrasound volumes of the fetal head at 11-13 weeks' gestation from 407 euploid and 88 chromosomally abnormal fetuses (trisomy 21, n = 40; trisomy 18, n = 19; trisomy 13, n = 7; triploidy, n = 14; Turner syndrome, n = 8) were analyzed. The subarachnoid space diameters, measured in the sagittal and transverse planes of the fetal head, in relation to biparietal diameter (BPD) in each group of aneuploidies was compared to that in euploid fetuses...
January 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
Kypros H Nicolaides
No abstract text is available yet for this article.
December 14, 2017: New England Journal of Medicine
Nijole Bernaitis, Tony Badrick, Shailendra Anoopkumar-Dukie
BACKGROUND: Warfarin is used to prevent stroke in patients with atrial fibrillation (AF). Ongoing monitoring of International normalised ratio (INR) and time in therapeutic range (TTR) commonly used to assess the quality of warfarin management are required. Anticoagulant clinics have demonstrated improved TTRs, particularly in countries with poorer control in primary care settings. Reported TTR in Australia has been relatively high; so, it is unknown if benefit would be seen from dedicated warfarin clinics in Australia...
January 9, 2018: International Journal of Clinical Practice
Stephanie Roberge, Emmanuel Bujold, Kypros H Nicolaides
OBJECTIVE DATA: Impaired placentation in the first 16 weeks of pregnancy is associated with increased risk of subsequent development of preeclampsia, birth of small-for-gestational-age neonates, and placental abruption. Previous studies reported that prophylactic use of aspirin reduces the risk of preeclampsia and small-for-gestational-age neonates with no significant effect on placental abruption. However, meta-analyses of randomized controlled trials that examined the effect of aspirin in relation to gestational age at onset of therapy and dosage of the drug reported that significant reduction in the risk of preeclampsia and small-for-gestational-age neonates is achieved only if the onset of treatment is at ≤16 weeks of gestation and the daily dosage of the drug is ≥100 mg...
January 3, 2018: American Journal of Obstetrics and Gynecology
Diane Nzelu, Dan Dumitrascu-Biris, Kypros H Nicolaides, Nikos A Kametas
BACKGROUND: There is extensive evidence that pre-pregnancy chronic hypertension is associated with high risk of development of severe hypertension and preeclampsia and birth of small for gestational age neonates. However, previous studies have not reported whether anti-hypertensive use, blood pressure control or normalization of blood pressure during early pregnancy influence the rates of these pregnancy complications. OBJECTIVE: To stratify women with pre-pregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first-trimester of pregnancy and examine the rates of severe hypertension, preeclampsia and birth of small for gestational age neonates according to such stratification...
January 2, 2018: American Journal of Obstetrics and Gynecology
Jyoti Balani, Steve Hyer, Argyro Syngelaki, Ranjit Akolekar, Kypros H Nicolaides, Antoinette Johnson, Hassan Shehata
Objectives: To examine whether the reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is mediated by changes in insulin resistance. Methods: This was a secondary analysis of obese pregnant women in a randomised trial (MOP trial). Fasting plasma glucose and insulin were measured in 384 of the 400 women who participated in the MOP trial. Homeostasis model assessment of insulin resistance (HOMA-IR) was compared in the metformin and placebo groups and in those that developed preeclampsia versus those that did not develop preeclampsia...
December 2017: Obstetric Medicine
Ray Bahado-Singh, Liona C Poon, Ali Yilmaz, Argyro Syngelaki, Onur Turkoglu, Praveen Kumar, Joseph Kirma, Matthew Allos, Veronica Accurti, Jiansheng Li, Peng Zhao, Stewart F Graham, David R Cool, Kypros Nicolaides
Term preeclampsia (tPE), ≥37 weeks, is the most common form of PE and the most difficult to predict. Little is known about its pathogenesis. This study aims to elucidate the pathogenesis and assess early prediction of tPE using serial integrated metabolomic and proteomic systems biology approaches. Serial first- (11-14 weeks) and third-trimester (30-34 weeks) serum samples were analyzed using targeted metabolomic (1 H NMR and DI-LC-MS/MS) and proteomic (MALDI-TOF/TOF-MS) platforms. We analyzed 35 tPE cases and 63 controls...
November 23, 2017: Scientific Reports
Roberto Romero, Agustin Conde-Agudelo, Eduardo Da Fonseca, John M O'Brien, Elcin Cetingoz, George W Creasy, Sonia S Hassan, Kypros H Nicolaides
BACKGROUND: The efficacy of vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix has been questioned after publication of the OPPTIMUM study. OBJECTIVE: To determine whether vaginal progesterone prevents preterm birth and improves perinatal outcomes in asymptomatic women with a singleton gestation and a midtrimester sonographic short cervix. DATA SOURCES: MEDLINE, EMBASE, LILACS, and CINAHL (from their inception to September 2017), Cochrane databases, bibliographies, and conference proceedings...
November 16, 2017: American Journal of Obstetrics and Gynecology
Llinos Roberts, Piya Chaemsaithong, Daljit S Sahota, Kypros H Nicolaides, Liona C Y Poon
The study aimed to identify the simplest protocol for the measurement of mean arterial pressure (MAP) across 10-40weeks' gestation. 2726 women with uncomplicated singleton pregnancy attending for their routine hospital visit between 10 and 40weeks' gestation were recruited prospectively. The blood pressure (BP) was measured according to the National Heart Foundation of Australia (NHFA) protocol using automated devices. Linearizing regression models were determined for MAP derived from single, repeat and average measurements taken in the left and right arms using the same polynomial power of the best fit model determined using the NHFA protocol...
October 2017: Pregnancy Hypertension
Stephanie Roberge, Emmanuel Bujold, Kypros H Nicolaides
OBJECTIVE DATA: Metaanalyses of randomized controlled trials have reported contradictory results about the effect of aspirin in the prevention of preeclampsia, both in terms of the gestational age at the onset of treatment and the dose of the drug. The controversy may be resolved by a metaanalysis that includes several recently published trials and particularly the large Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-based Preeclampsia Prevention trial and by examination of whether there is a difference of the effect of aspirin on preterm vs term preeclampsia...
November 11, 2017: American Journal of Obstetrics and Gynecology
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