Publications (7) View all
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Article: Somatic and reproductive outcomes in mice treated with cyclophosphamide in pre-pubertal age.
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ABSTRACT: Disruption in the normal timing of female puberty, such as in pre-pubertal cancer treatments, can cause abnormal somatic development. We sought to evaluate the impact of cyclophosphamide (CTX) on the somatic, uterine, and ovarian, development of pre-pubertal mice. Pre-pubertal (day 18 of life) C57BL/6J female mice were randomized to receive placebo (group 1A and 1B), 200 mg/kg CTX (group 2A), or 120 mg/kg CTX (group 2B). Mice were euthanized on day 56 (A groups) or 95 (B groups) of life. Body weight and length, uterine and ovarian weight and right femur length and weight were measured, and ovarian insufficiency was assessed. Data were analyzed using ANOVA and t-test. Body weight and length did not differ among groups at time of euthanasia. The femur was shorter and weighed less in mice treated with CTX than in controls. Uterine weight was lower in group 2B than 1B (46.1 mg, 95% CI: 42.9-49.4, vs. 62.2 mg, 95% CI: 58.5-65.8, respectively; p = 0.005) and was lower in mice that developed ovarian insufficiency than in mice that did not (p < 0.05). Ovarian weight was lower in mice treated with CTX, regardless of whether they developed ovarian insufficiency. Even with no observable effect on adult body length and weight, CTX treatment in pre-pubertal mice appears to negatively affect femur, uterine, and ovarian development. However, uterine development seems to be dependent on the hormonal status created by CTX more than on its direct effect.Systems biology in reproductive medicine 01/2013; · 0.80 Impact Factor -
Article: Fetal transfusion: the spectrum of clinical research in the past year.
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ABSTRACT: Our goal is to review recent articles that examine the current state of fetal transfusion therapy from technique to education. Even as technology facilitates physicians' diagnosis and treatment of rare disorders requiring fetal transfusion therapy, longstanding questions remain such as the use of intravascular versus intraperitoneal transfusion sites. However, the recent progress seen with molecular techniques, disease markers, and mathematical models demonstrates that despite unanswered questions, there is much to be hopeful about in improving our understanding of fetal transfusions and their application to a variety of diseases. Systematic and collaborative approaches to studying low-frequency disorders treatable by fetal transfusions are necessary. Continued refinement of techniques should improve the timeliness and accuracy of diagnosis, as well as assist in determining the appropriate timing, site, and duration of treatments.Current opinion in obstetrics & gynecology 02/2010; 22(2):155-8. · 2.49 Impact Factor -
Article: Deliberative assessment of surrogate consent in dementia research.
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ABSTRACT: Research involving incapacitated persons with dementia entails complex scientific, legal, and ethical issues, making traditional surveys of layperson views on the ethics of such research challenging. We therefore assessed the impact of democratic deliberation (DD), involving balanced, detailed education and peer deliberation, on the views of those responsible for persons with dementia. One hundred and seventy-eight community-recruited caregivers or primary decision-makers for persons with dementia were randomly assigned to either an all-day DD session group or a control group. Educational materials used for the DD session were vetted for balance and accuracy by an interdisciplinary advisory panel. We assessed the acceptability of family-surrogate consent for dementia research ("surrogate-based research") from a societal policy perspective as well as from the more personal perspectives of deciding for a loved one or for oneself (surrogate and self-perspectives), assessed at baseline, immediately post-DD session, and 1 month after DD date, for four research scenarios of varying risk-benefit profiles. At baseline, a majority in both the DD and control groups supported a policy of family consent for dementia research in all research scenarios. The support for a policy of family consent for surrogate-based research increased in the DD group, but not in the control group. The change in the DD group was maintained 1 month later. In the DD group, there were transient changes in attitudes from surrogate or self-perspectives. In the control group, there were no changes from baseline in attitude toward surrogate consent from any perspective. Intensive, balanced, and accurate education, along with peer deliberation provided by democratic deliberation, led to a sustained increase in support for a societal policy of family consent in dementia research among those responsible for dementia patients.Alzheimer's & dementia: the journal of the Alzheimer's Association 02/2010; 6(4):342-50. · 5.90 Impact Factor -
Article: Assessing the quality of democratic deliberation: a case study of public deliberation on the ethics of surrogate consent for research.
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ABSTRACT: "Deliberative democracy" is an increasingly popular method for soliciting public input on health care policies. There are a number of ways of organizing deliberative democracy (DD) sessions, but they generally involve gathering a group of citizens, supplying them with information relevant to the policy in question, giving them time to interact with each other and with experts in the policy area, and collecting their informed and considered opinions. As the method has become more widely used, some have questioned the quality of the public input it generates. Although theorists of DD agree that "good" input - i.e., input that is the product of careful and thorough reflection - is an essential aspect of useful and effective deliberation, few have actually measured the quality of deliberative sessions. As part of a DD project organized to help guide policies on the morally complex question of allowing surrogate permission to enroll persons with dementia in medical research, we developed and tested measures of "quality of deliberation." After a brief discussion of the substantive results of our research - survey data from participants in the DD sessions and control groups showed a significant change in participants' attitudes toward surrogate consent - we examine the process by which this change occurred, describing and assessing the characteristics of our DD sessions. We use both quantitative and qualitative data from our DD sessions, conducted in southeastern Michigan, United States, to examine four dimensions of the quality of deliberation: 1) equal participation by all members of the session, 2) respect for the opinions of others, 3) a willingness to adopt a societal perspective on the issue in question (rather than a focus on what is best for participants as individuals), and 4) reasoned justification of one's positions. We demonstrate that DD can be reliably used to elicit opinions of the public and show how analysis of the quality of deliberations can offer insight into the ways opinions about ethical dilemmas are formed and changed.Social Science [?] Medicine 03/2010; 70(12):1896-903. · 2.70 Impact Factor -
Article: Effect of the ABO blood group on the proliferative and clonogenic capacity of umbilical cord stem cells.
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ABSTRACT: Possible effects of the ABO blood group on the proliferative and self-renewal capacity of umbilical cord CD34+ cells were evaluated. A, B and O (all Rh D+) CD34+ cells isolated from three placental blood samples were cultured in four platforms with hematopoietic growth factors on a 3-dimensional biocompatible matrix. Results from this study suggest that proliferation of CD34+ cells with the O phenotype may be greater than that of cells with the A or B phenotypes. Further ex vivo studies are required to confirm this finding and to determine the effect of the number and type of other genetically determined cell surface antigens on the capacity of hematopoietic stem cells to respond to cytokines. In addition, clinical studies aimed at determining if the CD34+ donor blood group affects the time to functional hematological reconstitution are recommended.Transfusion and Apheresis Science 11/2006; 35(2):119-23. · 1.25 Impact Factor
