Last data update: May 20, 2024. (Total: 46824 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Wang RY[original query] |
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Case diagnosis and characterization of suspected paralytic shellfish poisoning in Alaska.
Knaack JS , Porter KA , Jacob JT , Sullivan K , Forester M , Wang RY , Trainer VL , Morton S , Eckert G , McGahee E , Thomas J , McLaughlin J , Johnson RC . Harmful Algae 2016 57 45-50 Clinical cases of paralytic shellfish poisoning (PSP) are common in Alaska, and result from human consumption of shellfish contaminated with saxitoxin (STX) and its analogues. Diagnosis of PSP is presumptive and based on recent ingestion of shellfish and presence of manifestations consistent with symptoms of PSP; diagnosis is confirmed by detection of paralytic shellfish toxins in a clinical specimen or food sample. A clinical diagnostic analytical method using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was used to evaluate the diagnosis of saxitoxin-induced PSP (STX-PSP) in 11 Alaskan patients using urine specimens collected between June 2010 and November 2011. Concentrations of urinary STX were corrected for creatinine concentrations to account for dilution or concentration of urine from water intake or restriction, respectively. Of the 11 patients with suspected PSP, four patients were confirmed to have STX-PSP by urine testing (24-364 ng STX/g creatinine). Five patients had clinical manifestations of PSP though no STX was detected in their urine. Two patients were ruled out for STX-PSP based on non-detected urinary STX and the absence of clinical findings. Results revealed that dysphagia and dysarthria may be stronger indicators of PSP than paresthesia and nausea, which are commonly used to clinically diagnose patients with PSP. PSP can also occur from exposure to a number of STX congeners, such as gonyautoxins, however their presence in urine was not assessed in this investigation. In addition, meal remnants obtained from six presumptive PSP cases were analyzed using the Association of Official Analytical Chemists' mouse bioassay. All six samples tested positive for PSP toxins. In the future, the clinical diagnostic method can be used in conjunction with the mouse bioassay or HPLC-MS/MS to assess the extent of STX-PSP in Alaska where it has been suggested that PSP is underreported. |
Analytical considerations in the clinical laboratory assessment of metals
Wang RY , Caldwell KL , Jones RL . J Med Toxicol 2014 10 (2) 232-9 The presence of metals in the environment is ubiquitous and humans are constantly being exposed to them. As such, a general concern exists about potential health consequences that result from the exposure to metals. The continued efforts of environmental scientists to measure metals in clinical specimens are important for defining the extent of human exposure to these chemicals. Laboratory methods to measure the concentration of metals in human blood or urine are available, and they can be used to assess the extent of human exposure to these chemicals. However, several considerations should be reviewed when requesting a laboratory measurement of metals because some factors can affect the test result or its interpretation. These considerations are discussed in this article and include pre-analytical, analytical, and post-analytical factors. Clinicians with this knowledge will be able to request these laboratory tests for their patients with enhanced confidence. |
Antidotes and rescue therapies
Wang RY . Curr Pharm Biotechnol 2012 13 (10) 1914-6 In this issue of Current Pharmaceutical Biotechnology, we present a series of articles on the clinical use of antidotes and rescue therapies. Our goal is to heighten awareness in the scientific community about the benefits of and challenges to research and development for these agents. The intention is to stimulate further interest in this area, leading to new and improved antidotes. Antidotes are medications that limit the progression of adverse health outcomes that result from exposure to exogenous agents: drugs, metals, and toxins. Antidotes are commonly used to treat poisoned patients and, in select situations, patients receiving chemotherapy. | The use of antidotes depends on the clinical indication and the availability of the product. The National Poison Data System (NPDS) reports the annual occurrence use of selected antidotes and rescue therapies available for poisoned patients [1]. These reports, compiled from calls made by the public to Poison Control Centers throughout the United States, likely under represent the actual figures because calls are made on a voluntary basis. Since the 2004 Food and Drug Administration (FDA) approval of the intravenous formulation of N-acetylcysteine (IV NAC) for human acetaminophen poisonings in the United States, annual use of IV NAC increased by approximately 13 fold. Average annual use during 1999–2003 was 1,279; in 2009, the number was 16,260 [1–11]. Similarly, the use of fomepizole (4-methyl pyrazole) for ethylene glycol and methanol poisonings increased from 305 in 2000 to 1,743 in 2009 [1, 3–11]. Fomepizole was FDA approved for use in patients poisoned with ethylene glycol in 1997 and methanol in 2000. Prior to the availability of fomepizole, ethanol was used to treat these patients. Its annual use decreased from 576 during 1992 to 1996 to 96 in 2009—largely because of its unfavorable safety and efficacy profiles compared to fomepizole [1–19]. These examples indicate the clinical need for antidotes and the demand for antidotes when they become available. |
Association of caffeine consumption and smoking status with the serum concentrations of polychlorinated biphenyls, dioxins, and furans in the general U.S. population: NHANES 2003-2004
Jain RB , Wang RY . J Toxicol Environ Health A 2011 74 (18) 1225-39 Smoking appears to enhance the body's clearance of dioxins and dioxin-like polychlorinated biphenyls (PCB) by inducing CYP1A2 activity based on studies with a limited number of participants. This hypothesis was evaluated by using data from National Health and Nutrition Examination Survey. Specifically, adult participants were identified and the sums of their serum lipid-adjusted concentrations of 12 polychlorinated dibenzo-p-dioxins/polychlorinated dibenzofurans (PCDD/PCDF) congeners, 33 PCB (total), 26 non-dioxin-like PCB, and 6 mono-ortho (dioxin-like) PCB were determined. In addition to evaluating the association of smoking, the association of caffeine consumption and the interaction between them was evaluated. Data analysis included regression models that were fitted with age, gender, race/ethnicity, and body mass index (BMI). R(2) varied from 34.8 to 66%. Smokers had significantly lower concentrations of total PCDD/PCDF than nonsmokers. New to this study, a siginificant interaction between caffeine consumption and smoking for total PCB was found. When caffeine was consumed less than once a day, smokers had higher concentrations of total PCB than nonsmokers. However, when caffeine was consumed at least once a day, smokers had lower concentrations than nonsmokers. A significant interaction between age and caffeine consumption frequency for each of the PCB groups was also observed. The differences in concentration between younger and older age groups were greater when caffeine was consumed at least once a day than when caffeine was consumed less frequently. Smoking and caffeine consumption need to be considered in the interpretation of human biomonitoring data because they appear to affect the serum concentrations of these chemicals. |
Iodine status of the U.S. population, National Health and Nutrition Examination Survey, 2005-2006 and 2007-2008
Caldwell KL , Makhmudov A , Ely E , Jones RL , Wang RY . Thyroid 2011 21 (4) 419-27 BACKGROUND: This report presents urinary iodine (UI) concentrations for the general U.S. population during 2005-2006 and 2007-2008. These findings are the fourth and fifth assessments of the population since National Health and Nutrition Examination Survey (NHANES) III (1988-1994), when the median UI concentration for the population decreased from NHANES I (1971-1974). METHODS: During 2005-2006 and 2007-2008, approximately 5000 participants per year were selected to participate in NHANES. The participants were interviewed and examined. UI concentration was measured on a random one third subsample of 2649 participants, aged 6 years and older in 2005-2006, and in all participants in 2007-2008. These urine iodine concentrations are representative of the general U.S. population by age, sex, and race/ethnicity. RESULTS: (i) The median UI concentrations for the general U.S. population in 2005-2006 and 2007-2008 were 164 mug/L (95% confidence interval [CI] 154-174) and 164 mug/L (95% CI 154-173), respectively. Also, the proportions of the population with a UI concentration of <50 mug/L during these survey periods were 9.8% +/- 1.3% and 8.8% +/- 0.4%, respectively. The median UI concentration and prevalence of ≥200 mug/L appeared to be higher in children and persons ≥70 years than in other age groups. (ii) In both surveys, children aged 6-11 years had median UI concentrations of ≥200 mug/L, and about 5% of them had a UI concentration of <50 mug/L. (iii) All pregnant women (sample size 184) surveyed during 2005-2008 had a median UI concentration of 125 mug/L (95% CI 86-198), and 56.9% +/- 7.9% of this group had a UI concentration of <150 mug/L. UI concentrations were lower among non-Hispanic black survey participants than non-Hispanic white and Mexican-American participants. CONCLUSIONS: These findings affirm the stabilization of UI concentration and adequate iodine nutrition in the general U.S. population since 2000. However, certain groups likely do not achieve a sufficient dietary iodine intake according to the World Health Organization. The needs of these vulnerable groups and the inadequacy of their dietary iodine intake should be addressed in future efforts. |
Prenatal exposure to PBDEs and neurodevelopment
Herbstman JB , Sjodin A , Kurzon M , Lederman SA , Jones RS , Rauh V , Needham LL , Tang D , Niedzwiecki M , Wang RY , Perera F . Environ Health Perspect 2010 118 (5) 712-9 BACKGROUND: Polybrominated diphenyl ethers (PBDEs) are widely used flame retardant compounds that are persistent and bioaccumulative and therefore have become ubiquitous environment contaminants. Animal studies suggest that prenatal PBDE exposure may result in adverse neurodevelopmental effects. OBJECTIVE: In a longitudinal cohort initiated after 11 September 2001, including 329 mothers who delivered in one of three hospitals in lower Manhattan, New York, we examined prenatal PBDE exposure and neurodevelopment when their children were 12-48 and 72 months of age. METHODS: We analyzed 210 cord blood specimens for selected PBDE congeners and assessed neurodevelopmental effects in the children at 12-48 and 72 months of age; 118, 117, 114, 104, and 96 children with available cord PBDE measurements were assessed at 12, 24, 36, 48, and 72 months, respectively. We used multivariate regression analyses to evaluate the associations between concentrations of individual PBDE congeners and neurodevelopmental indices. RESULTS: Median cord blood concentrations of PBDE congeners 47, 99, and 100 were 11.2, 3.2, and 1.4 ng/g lipid, respectively. After adjustment for potential confounders, children with higher concentrations of BDEs 47, 99, or 100 scored lower on tests of mental and physical development at 12-48 and 72 months. Associations were significant for 12-month Psychomotor Development Index (BDE-47), 24-month Mental Development Index (MDI) (BDE-47, 99, and 100), 36-month MDI (BDE-100), 48-month full-scale and verbal IQ (BDE-47, 99, and 100) and performance IQ (BDE-100), and 72-month performance IQ (BDE-100). CONCLUSIONS: This epidemiologic study demonstrates neurodevelopmental effects in relation to cord blood PBDE concentrations. Confirmation is needed in other longitudinal studies. EDITOR'S SUMMARY: Polybrominated diphenyl ethers (PBDEs) are widely used flame retardant compounds that are persistent and bioaccumulative. Animal studies suggest that prenatal PBDE exposure may result in adverse neurodevelopmental effects. Herbstman et al. (p. 712) initiated a longitudinal cohort following the World Trade Center attack on 11 September 2001 to evaluate associations between concentrations of individual PBDE congeners and neurodevelopmental indices. Outcomes were evaluated in approximately 100 children with PBDE concentrations measured in cord blood samples. After adjustment for potential confounders, higher concentrations of BDEs 47, 99, or 100 were associated with lower scores on tests of mental and physical development at 12-48 and 72 months. The authors conclude that developmental exposure to flame retardants following the World Trade Center disaster was associated with altered neurodevelopment of children up to 72 months of age. |
Regression models to estimate total polychlorinated biphenyls in the general US population: 2001-2002 and 2003-2004
Jain RB , Wang RY . Chemosphere 2010 79 (3) 243-52 Certain polychlorinated biphenyls (PCB) have long half-lives and, despite the regulatory bans on the industrial pollutants that expose humans to PCB, are detectable in human serum. However, many of them are not detectable because of the small quantities that may be present in body fluids. For this reason, attempts have been made to estimate the total concentration of PCB (SigmaPCB) using the relationship between SigmaPCB and the concentrations of a few of the PCB congeners which can be reliably measured at detectable levels. PCB 153 or a combination of PCB 153,138, and 180 have previously been used for this purpose. However, because of the unique populations investigated in these studies, the results are not necessarily applicable to the racially/ethnically heterogeneous US population. We defined SigmaPCB as the sum of the concentrations of 12 PCB congeners, and sum of 33 PCB congeners for NHANES 2001-2002 and 2003-2004 respectively. We built regression models in a step-wise fashion using SigmaPCB as the dependent variable and age, race/ethnicity, and gender as the covariates for both whole-weight and lipid-adjusted data. In addition, concentration of PCB 153 was used as the continuous independent variable for 2001-2002 models, and PCB 153 and PCB 180 for 2003-2004 models respectively. R(2) for both models for NHANES 2001-2002 was >86%. The R(2) for both NHANES 2003-2004 models was >81%. Thus, the estimate of SigmaPCB for the general US population can be improved by considering common demographic variables, such as race/ethnicity, and selected congeners. |
A public health focus on infertility prevention, detection, and management
Macaluso M , Wright-Schnapp TJ , Chandra A , Johnson R , Satterwhite CL , Pulver A , Berman SM , Wang RY , Farr SL , Pollack LA . Fertil Steril 2010 93 (1) 16 e1-10 In 2002, 2 million American women of reproductive age were infertile. Infertility is also common among men. The Centers for Disease Control and Prevention (CDC) conducts surveillance and research on the causes of infertility, monitors the safety and efficacy of infertility treatment, and sponsors national prevention programs. A CDC-wide working group found that, despite this effort, considerable gaps and opportunities exist in surveillance, research, communication, and program and policy development. We intend to consult with other federal agencies, professional and consumer organizations, the scientific community, the health care community, industry, and other stakeholders, and participate in the development of a national public health plan for the prevention, detection, and management of infertility. |
Serum concentrations of selected persistent organic pollutants in a sample of pregnant females and changes in their concentrations during gestation
Wang RY , Jain RB , Wolkin AF , Rubin CH , Needham LL . Environ Health Perspect 2009 117 (8) 1244-9 OBJECTIVES: In this study we evaluated the concentrations of selected persistent organic pollutants in a sample of first-time pregnant females residing in the United States and assessed differences in these concentrations in all pregnant females during gestation. METHODS: We reviewed demographic and laboratory data for pregnant females participating in the National Health and Nutrition Examination Survey, including concentrations of 25 polychlorinated biphenyls (PCBs), 6 polychlorinated dibenzo-p-dioxins (PCDDs), 9 polychlorinated dibenzofurans (PCDFs), and 9 organochlorine pesticides. We report serum concentrations for first-time pregnant females (2001-2002; n = 49) and evaluate these concentrations in all pregnant females by trimester (1999-2002; n = 203) using a cross-sectional analysis. RESULTS: The chemicals with >or= 60% detection included PCBs (congeners 126, 138/158, 153, 180), PCDDs/PCDFs [1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin (1234678HpCDD), 1,2,3,6,7,8-hexachlorodibenzo-p-dioxin (123678HxCDD), 1,2,3,4,6,7,8-heptachlorodibenzofuran (1234678HpCDF), 1,1'-(2,2-dichloroethenylidene)-bis(4-chlorobenzene) (p,p'-DDE)], and trans-nonachlor. The geometric mean concentration (95% confidence intervals) for 1234678HpCDD was 15.9 pg/g lipid (5.0-50.6 pg/g); for 123678HxCDD, 9.7 pg/g (5.5-17.1 pg/g); and for 1234678HpCDF, 5.4 pg/g (3.3-8.7 pg/g). The differences in concentrations of these chemicals by trimester were better accounted for with the use of lipid-adjusted units than with whole-weight units; however, the increase in the third-trimester concentration was greater for PCDDs/PCDFs (123678HxCDD, 1234678HpCDF) than for the highest concentration of indicator PCBs (138/158, 153, 180), even after adjusting for potential confounders. CONCLUSION: The concentrations of these persistent organic pollutants in a sample of first-time pregnant females living in the United States suggest a decline in exposures to these chemicals since their ban or restricted use and emission. The redistribution of body burden for these and other persistent organic pollutants during pregnancy needs to be more carefully defined to improve the assessment of fetal exposure to them based on maternal serum concentrations. Additional studies are needed to further the understanding of the potential health consequences to the fetus from persistent organic pollutants. |
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