8 Impact of Intrauterine Growth Restriction on Extrauterine Growth Rate of Very Low Birth Weight Infants.

Abstract

history of angina, myocardial infarction, heart failure, stroke, peripheral vascular disease) in this predominantly African American patient population. We conducted a cross-sectional study involving 41 African American patients (14 M, 27 F; 60 Ϯ 16 years) who were on hemodialysis Ն 3 months. Patient demographics and medical histories were obtained. Predialysis serum PAI-1 (ELISA) and serum carnitine levels (spectrophotometry) were measured. Other markers of inflammation and oxidative stress, including C-reactive protein (CRP), IL-6, IL-10, and TNF-␣, were also measured (ELISA). The subjects were divided into two groups: group 1 (n = 36) -low total serum carnitine (< 31 µmol/L for women and < 42 µmol/L for men) and group 2 (n = 5) -normal total serum carnitine (Ն 31 µmol/L for women and Ն 42 µmol/L for men). There were no significant differences in mean age (60 Ϯ 16 years vs 64 Ϯ 13 years; p = ns), gender, presence of hypertension or diabetes, etiology of CKD or serum levels of CRP, IL-6, IL-10, or TNF-␣ between the groups. PAI-1 levels were significantly higher in subjects in group 1 as compared to group 2 (62 Ϯ 24 IU/mL vs 37 Ϯ 21 IU/mL; p = .03). Nine subjects in group 1 had a composite cardiovascular end point as compared to none in group 2. In this population, patients with low carnitine levels had higher levels of PAI-1 as compared to patients with normal carnitine levels. This study was limited by small sample size and the high prevalence of low carnitine levels in hemodialysis patients. More studies are needed to further clarify this observation and the association with cardiovascular disease. Purpose: ASPECTS is a robust method for quantifying acute stroke hypodensity on noncontrast CT (NCCT) and helps predict clinical outcome. Whole brain source images obtained with CT angiography (CTA-SI) may increase ischemic brain conspicuity. We sought to determine if CTA-SI is more sensitive than NCCT in detecting acute middle cerebral artery (MCA) infarction and in predicting final infarct size using a modified ASPECT score for lesion delineation. Materials and Methods: After informed consent, we reviewed NCCT and CTA-SI scans of 51 patients with suspected MCA stroke, imaged within 12 hours of symptoms onset, enrolled in a dual-center cohort study. Two blinded neuroimagers rated presence and extent of NCCT and CTA-SI hypodensity using modified ASPECTS. Level of certainty for hypodensity detection was graded on admission and follow-up images using a 5-point scale (5 = definitely present; 1 = definitely absent). Linear regression and receiver operator characteristic (ROC) analyses were performed. Results: Thirty-three patients had confirmed infarction at follow-up (mean 6.5 days). Using certainty levels Ն 4 (probable/definite) for ischemic hypodensity, sensitivity for acute stroke detection was 49% with NCCT and 70% with CTA-SI (p = .04, ROC analysis); specificity was 100% for both. Linear regression showed R 2 = .42 (p < .0001) for the correlation between acute NCCT modified ASPECTS and follow-up modified ASPECTS, ...