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Article ; Online: Challenges to Informed, Patient-Centered, and Shared Decision Making for Treatment of Kidney Failure in Older Adults.

Kiernan, Elizabeth / Wong, Susan P Y

American journal of kidney diseases : the official journal of the National Kidney Foundation

2024 Volume 83, Issue 5, Page(s) 561–563

MeSH term(s)	Humans ; Decision Making, Shared ; Patient-Centered Care/methods ; Aged ; Renal Insufficiency/therapy ; Kidney Failure, Chronic/therapy ; Patient Participation
Language	English
Publishing date	2024-01-11
Publishing country	United States
Document type	Editorial
ZDB-ID	604539-x
ISSN	1523-6838 ; 0272-6386
ISSN (online)	1523-6838
ISSN	0272-6386
DOI	10.1053/j.ajkd.2023.12.003
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Zs.A 1669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: MRS in neurodegenerative dementias, prodromal syndromes and at-risk states: A systematic review of the literature.

McKiernan, Elizabeth / Su, Li / O'Brien, John

NMR in biomedicine

2023 Volume 36, Issue 7, Page(s) e4896

Abstract: Background: In recent years, MRS has benefited from increased MRI field strengths, new acquisition protocols and new processing techniques. This review aims to determine how this has altered our understanding of MRS neurometabolic markers in ... ...

Abstract	Background: In recent years, MRS has benefited from increased MRI field strengths, new acquisition protocols and new processing techniques. This review aims to determine how this has altered our understanding of MRS neurometabolic markers in neurodegenerative dementias. Methods: Our systematic review of human in vivo MRS literature since 2002 pertains to Alzheimer's disease (AD), dementia with Lewy bodies (DLB), Parkinson's disease dementia, frontotemporal dementia (FTD), prodromal and 'at-risk' states. Studies using field strengths of 3 T or more were included. Results: Of 85 studies, AD and/or mild cognitive impairment (MCI) were the most common conditions of interest (58 papers, 68%). Only 14 (16%) studies included other dementia syndromes and 13 (15%) investigated 'at-risk' cohorts. Earlier findings of lower N-acetylaspartate and higher myo-inositol were confirmed. Additionally, lower choline and creatine in AD and MCI were reported, though inconsistently. Previously challenging-to-measure metabolites (glutathione, glutamate and gamma-aminobutyric acid) were reportedly lower in AD, FTD and DLB compared with controls. Discussion: Increasing field strength alongside targeted acquisition protocols has revealed additional metabolite changes. Most studies were small and regional metabolite differences between dementia types may not have been captured due to the predominant placement of voxels in the posterior cingulate cortex. The standard of data collection, quality control and analysis is improving due to greater consensus regarding acquisition and processing techniques. Ongoing harmonization of techniques, creation of larger and longitudinal cohorts, and placement of MRS voxels in more diverse regions will strengthen future research.
MeSH term(s)	Humans ; Frontotemporal Dementia ; Prodromal Symptoms ; Parkinson Disease/metabolism ; Alzheimer Disease/metabolism ; Magnetic Resonance Imaging
Language	English
Publishing date	2023-02-06
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1000976-0
ISSN	1099-1492 ; 0952-3480
ISSN (online)	1099-1492
ISSN	0952-3480
DOI	10.1002/nbm.4896
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Article ; Online: Medications that Cause Fetal Anomalies and Possible Prevention Strategies.

Kiernan, Elizabeth / Jones, Kenneth L

Clinics in perinatology

2019 Volume 46, Issue 2, Page(s) 203–213

Abstract: Many conditions that require frequent medication use are common during pregnancy. The purpose of this article is to list some of the most common of these disorders and to discuss the risk to the developing fetus of the medications used most frequently to ...

Abstract	Many conditions that require frequent medication use are common during pregnancy. The purpose of this article is to list some of the most common of these disorders and to discuss the risk to the developing fetus of the medications used most frequently to treat them. Included are drugs used for the treatment of asthma, nausea and vomiting, hyperthyroidism, pain and fever, and depression during pregnancy.
MeSH term(s)	Abnormalities, Drug-Induced/etiology ; Abnormalities, Drug-Induced/prevention & control ; Acetaminophen/adverse effects ; Acetaminophen/therapeutic use ; Adrenal Cortex Hormones/adverse effects ; Adrenal Cortex Hormones/therapeutic use ; Adrenergic beta-Agonists/adverse effects ; Adrenergic beta-Agonists/therapeutic use ; Analgesics, Non-Narcotic/adverse effects ; Analgesics, Non-Narcotic/therapeutic use ; Anti-Asthmatic Agents/adverse effects ; Anti-Asthmatic Agents/therapeutic use ; Antidepressive Agents/adverse effects ; Antidepressive Agents/therapeutic use ; Antiemetics/adverse effects ; Antiemetics/therapeutic use ; Antithyroid Agents/adverse effects ; Antithyroid Agents/therapeutic use ; Asthma/drug therapy ; Congenital Abnormalities/epidemiology ; Depressive Disorder/drug therapy ; Female ; Humans ; Hyperthyroidism/drug therapy ; Leukotriene Antagonists/adverse effects ; Leukotriene Antagonists/therapeutic use ; Maternal-Fetal Exchange ; Methimazole/therapeutic use ; Morning Sickness/drug therapy ; Ondansetron/therapeutic use ; Pregnancy ; Pregnancy Complications/drug therapy ; Propylthiouracil/therapeutic use ; Teratogens
Chemical Substances	Adrenal Cortex Hormones ; Adrenergic beta-Agonists ; Analgesics, Non-Narcotic ; Anti-Asthmatic Agents ; Antidepressive Agents ; Antiemetics ; Antithyroid Agents ; Leukotriene Antagonists ; Teratogens ; Acetaminophen (362O9ITL9D) ; Ondansetron (4AF302ESOS) ; Methimazole (554Z48XN5E) ; Propylthiouracil (721M9407IY)
Language	English
Publishing date	2019-03-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	193116-7
ISSN	1557-9840 ; 0095-5108
ISSN (online)	1557-9840
ISSN	0095-5108
DOI	10.1016/j.clp.2019.02.003
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Article ; Online: Pregnancy outcomes following maternal treatment with rituximab prior to or during pregnancy: a case series.

Perrotta, Kirstie / Kiernan, Elizabeth / Bandoli, Gretchen / Manaster, Rachel / Chambers, Christina

Rheumatology advances in practice

2021 Volume 5, Issue 1, Page(s) rkaa074

Abstract: Objective: Rituximab is a CD20-directed cytolytic antibody used for non-Hodgkin lymphoma, chronic lymphocytic leukaemia and RA, and off label for JIA, multiple sclerosis and lupus. Owing to concerns about infant B cell depletion, the manufacturer ... ...

Abstract	Objective: Rituximab is a CD20-directed cytolytic antibody used for non-Hodgkin lymphoma, chronic lymphocytic leukaemia and RA, and off label for JIA, multiple sclerosis and lupus. Owing to concerns about infant B cell depletion, the manufacturer recommends avoidance of rituximab throughout pregnancy and for 12 months before conception. The aim of this study was to add to the limited data on pregnancy outcomes in women with exposure to rituximab. Methods: Data were obtained from MotherToBaby Pregnancy Studies. Participants were enrolled prospectively into this observational study between 2007 and 2019. Pregnancy exposure and outcome data were collected from medical records, telephone interviews and dysmorphology examinations. The outcomes examined included spontaneous abortion, stillbirth, premature delivery, pregnancy complications, major and minor anomalies, small for gestational age, neonatal complications and serious infections. Results: We classified 19 women with exposure to rituximab into three groups. Group A included three women who received rituximab during pregnancy. Group B included three women who received their last infusion before conception but had assumed pregnancy exposure owing to the long half-life of the drug. Group C included 13 women who used rituximab in the 2 years before pregnancy, with the last infusion given no sooner than five half-lives before conception. Three children had a major structural defect. Preterm delivery occurred in two pregnancies, and two infants were small for gestational age on birth weight. No cases of B cell depletion were reported. Conclusion: No pattern of major structural anomalies or other adverse outcomes was reported in this case series.
Language	English
Publishing date	2021-01-04
Publishing country	England
Document type	Journal Article
ISSN	2514-1775
ISSN (online)	2514-1775
DOI	10.1093/rap/rkaa074
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Article ; Online: Adverse Perinatal Outcomes and Postpartum Suicidal Behavior in California, 2013-2018.

Delker, Erin / Marienfeld, Carla / Baer, Rebecca J / Parry, Barbara / Kiernan, Elizabeth / Jelliffe-Pawlowski, Laura / Chambers, Christina / Bandoli, Gretchen

Journal of women's health (2002)

2023 Volume 32, Issue 5, Page(s) 608–615

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Pregnancy ; Female ; Infant, Newborn ; Humans ; Suicidal Ideation ; Postpartum Period ; California/epidemiology ; Prenatal Care ; Risk Factors
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1139774-3
ISSN	1931-843X ; 1059-7115 ; 1540-9996
ISSN (online)	1931-843X
ISSN	1059-7115 ; 1540-9996
DOI	10.1089/jwh.2022.0255
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Article ; Online: Risk factors for neonatal encephalopathy in late preterm and term singleton births in a large California birth cohort.

Bandoli, Gretchen / Suttner, Denise / Kiernan, Elizabeth / Baer, Rebecca J / Jelliffe-Pawlowski, Laura / Chambers, Christina D

Journal of perinatology : official journal of the California Perinatal Association

2021 Volume 42, Issue 3, Page(s) 341–347

Abstract: Objective: The objective was to investigate maternal and pregnancy characteristics associated with neonatal encephalopathy (NE).: Study design: We queried an administrative birth cohort from California between 2011 and 2017 to determine the ... ...

Abstract	Objective: The objective was to investigate maternal and pregnancy characteristics associated with neonatal encephalopathy (NE). Study design: We queried an administrative birth cohort from California between 2011 and 2017 to determine the association between each factor and NE with and without hypothermia treatment. Results: From 3 million infants born at 35 or more weeks of gestation, 6,857 cases of NE were identified (2.3 per 1000 births), 888 (13%) received therapeutic hypothermia. Risk factors for NE were stronger among cases receiving hypothermia therapy. Substance-related diagnosis, preexisting diabetes, preeclampsia, and any maternal infection were associated with a two-fold increase in risk. Maternal overweight/obesity, nulliparity, advanced maternal age, depression, gestational diabetes or hypertension, and short or long gestations also predicted NE. Young maternal age, Asian race and Hispanic ethnicity, and cannabis-related diagnosis lowered risk of NE. Conclusions: By disseminating these results, we encourage further interrogation of these perinatal factors.
MeSH term(s)	Birth Cohort ; Brain Diseases ; California/epidemiology ; Female ; Gestational Age ; Humans ; Hypothermia ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; Pregnancy ; Premature Birth/epidemiology ; Risk Factors
Language	English
Publishing date	2021-10-26
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	645021-0
ISSN	1476-5543 ; 0743-8346
ISSN (online)	1476-5543
ISSN	0743-8346
DOI	10.1038/s41372-021-01242-z
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Article ; Online: Approach to evaluating pregnancy safety of anti-rheumatic medications in the OTIS MotherToBaby pregnancy studies: what have we learned?

Chambers, Christina / Johnson, Diana L / Kiernan, Elizabeth

Rheumatology (Oxford, England)

2018 Volume 57, Issue suppl_5, Page(s) v34–v39

Abstract: For the last 30 years, pregnancy exposure studies, with varying methodologies, have been the mainstay of post-marketing surveillance for new drugs likely to be used by women of reproductive age. While they provide valuable data to inform use during ... ...

Abstract	For the last 30 years, pregnancy exposure studies, with varying methodologies, have been the mainstay of post-marketing surveillance for new drugs likely to be used by women of reproductive age. While they provide valuable data to inform use during pregnancy, they have limitations that render them necessary but not sufficient in supplying timely information to patients and prescribers. The Organization of Teratology Information Specialists MotherToBaby Pregnancy Studies' collaborative research group operates to help fill this gap. This paper provides an overview of the research that has been and is currently being conducted, as well as best practices determined over the past two decades. The Organization of Teratology Information Specialists MotherToBaby studies can provide earlier signaling with regard to concerns following possible teratogenic exposures, which when examined in conjunction with larger database studies and case-control designs, can move us closer to developing a fuller picture of drug safety for women of reproductive age.
MeSH term(s)	Antirheumatic Agents/adverse effects ; Antirheumatic Agents/analysis ; Case-Control Studies ; Female ; Humans ; Maternal Exposure/adverse effects ; Pregnancy ; Pregnancy Complications/drug therapy ; Prospective Studies ; Rheumatic Diseases/drug therapy ; Teratogens/analysis ; Teratology/methods
Chemical Substances	Antirheumatic Agents ; Teratogens
Language	English
Publishing date	2018-07-01
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/key081
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Article ; Online: Alterations in the Circulating Proteome Associated with Albuminuria.

Kiernan, Elizabeth / Surapaneni, Aditya / Zhou, Linda / Schlosser, Pascal / Walker, Keenan A / Rhee, Eugene P / Ballantyne, Christie M / Deo, Rajat / Dubin, Ruth F / Ganz, Peter / Coresh, Josef / Grams, Morgan E

Journal of the American Society of Nephrology : JASN

2023 Volume 34, Issue 6, Page(s) 1078–1089

Abstract: Significance statement: We describe circulating proteins associated with albuminuria in a population of African American Study of Kidney Disease and Hypertension with CKD (AASK) using the largest proteomic platform to date: nearly 7000 circulating ... ...

Abstract	Significance statement: We describe circulating proteins associated with albuminuria in a population of African American Study of Kidney Disease and Hypertension with CKD (AASK) using the largest proteomic platform to date: nearly 7000 circulating proteins, representing approximately 2000 new targets. Findings were replicated in a subset of a general population cohort with kidney disease (ARIC) and a population with CKD Chronic Renal Insufficiency Cohort (CRIC). In cross-sectional analysis, 104 proteins were significantly associated with albuminuria in the Black group, of which 67 of 77 available proteins were replicated in ARIC and 68 of 71 available proteins in CRIC. LMAN2, TNFSFR1B, and members of the ephrin superfamily had the strongest associations. Pathway analysis also demonstrated enrichment of ephrin family proteins. Background: Proteomic techniques have facilitated understanding of pathways that mediate decline in GFR. Albuminuria is a key component of CKD diagnosis, staging, and prognosis but has been less studied than GFR. We sought to investigate circulating proteins associated with higher albuminuria. Methods: We evaluated the cross-sectional associations of the blood proteome with albuminuria and longitudinally with doubling of albuminuria in the African American Study of Kidney Disease and Hypertension (AASK; 38% female; mean GFR 46; median urine protein-to-creatinine ratio 81 mg/g; n =703) and replicated in two external cohorts: a subset of the Atherosclerosis Risk in Communities (ARIC) study with CKD and the Chronic Renal Insufficiency Cohort (CRIC). Results: In cross-sectional analysis, 104 proteins were significantly associated with albuminuria in AASK, of which 67 of 77 available proteins were replicated in ARIC and 68 of 71 available proteins in CRIC. Proteins with the strongest associations included LMAN2, TNFSFR1B, and members of the ephrin superfamily. Pathway analysis also demonstrated enrichment of ephrin family proteins. Five proteins were significantly associated with worsening albuminuria in AASK, including LMAN2 and EFNA4, which were replicated in ARIC and CRIC. Conclusions: Among individuals with CKD, large-scale proteomic analysis identified known and novel proteins associated with albuminuria and suggested a role for ephrin signaling in albuminuria progression.
MeSH term(s)	Humans ; Female ; Male ; Albuminuria/diagnosis ; Proteome ; Cross-Sectional Studies ; Proteomics ; Glomerular Filtration Rate ; Renal Insufficiency, Chronic ; Hypertension/complications ; Risk Factors
Chemical Substances	Proteome
Language	English
Publishing date	2023-03-09
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Intramural
ZDB-ID	1085942-1
ISSN	1533-3450 ; 1046-6673
ISSN (online)	1533-3450
ISSN	1046-6673
DOI	10.1681/ASN.0000000000000108
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Article ; Online: 7T MRI for neurodegenerative dementias in vivo: a systematic review of the literature.

McKiernan, Elizabeth Frances / O'Brien, John Tiernan

Journal of neurology, neurosurgery, and psychiatry

2017 Volume 88, Issue 7, Page(s) 564–574

Abstract: The spatial resolution of 7T MRI approaches the scale of pathologies of interest in degenerative brain diseases, such as amyloid plaques and changes in cortical layers and subcortical nuclei. It may reveal new information about neurodegenerative ... ...

Abstract	The spatial resolution of 7T MRI approaches the scale of pathologies of interest in degenerative brain diseases, such as amyloid plaques and changes in cortical layers and subcortical nuclei. It may reveal new information about neurodegenerative dementias, although challenges may include increased artefact production and more adverse effects. We performed a systematic review of papers investigating Alzheimer's disease (AD), Lewy body dementia (LBD), frontotemporal dementia (FTD) and Huntington's disease (HD) in vivo using 7T MRI. Of 19 studies identified, 15 investigated AD (the majority of which examined hippocampal subfield changes), and 4 investigated HD. Ultrahigh resolution revealed changes not visible using lower field strengths, such as hippocampal subfield atrophy in mild cognitive impairment. Increased sensitivity to susceptibility-enhanced iron imaging, facilitating amyloid and microbleed examination; for example, higher microbleed prevalence was found in AD than previously recognised. Theoretical difficulties regarding image acquisition and scan tolerance were not reported as problematic. Study limitations included small subject groups, a lack of studies investigating LBD and FTD and an absence of longitudinal data. In vivo 7T MRI may illuminate disease processes and reveal new biomarkers and therapeutic targets. Evidence from AD and HD studies suggest that other neurodegenerative dementias would also benefit from imaging at ultrahigh resolution.
MeSH term(s)	Alzheimer Disease/diagnosis ; Alzheimer Disease/diagnostic imaging ; Alzheimer Disease/pathology ; Hippocampus/pathology ; Humans ; Huntington Disease/diagnosis ; Huntington Disease/diagnostic imaging ; Huntington Disease/pathology ; Magnetic Resonance Imaging/methods ; Neurodegenerative Diseases/diagnostic imaging ; Neurodegenerative Diseases/pathology ; Radionuclide Imaging
Language	English
Publishing date	2017-03-04
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	3087-9
ISSN	1468-330X ; 0022-3050
ISSN (online)	1468-330X
ISSN	0022-3050
DOI	10.1136/jnnp-2016-315022
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Article ; Online: Urinary Biomarkers and Kidney Injury in VA NEPHRON-D: Phenotyping Acute Kidney Injury in Clinical Trials.

Kiernan, Elizabeth A / Hu, David / Philbrook, Heather Thiessen / Ix, Joachim H / Bonventre, Joseph V / Coca, Steven G / Moledina, Dennis G / Fried, Linda F / Shlipak, Michael G / Parikh, Chirag R

American journal of kidney diseases : the official journal of the National Kidney Foundation

2023 Volume 83, Issue 2, Page(s) 151–161

Abstract: Rationale & objective: Urinary biomarkers of injury, inflammation, and repair may help phenotype acute kidney injury (AKI) observed in clinical trials. We evaluated the differences in biomarkers between participants randomized to monotherapy or to ... ...

Abstract	Rationale & objective: Urinary biomarkers of injury, inflammation, and repair may help phenotype acute kidney injury (AKI) observed in clinical trials. We evaluated the differences in biomarkers between participants randomized to monotherapy or to combination renin-angiotensin-aldosterone system (RAAS) blockade in VA NEPHRON-D, where an increased proportion of observed AKI was acknowledged in the combination arm. Study design: Longitudinal analysis. Setting & participants: A substudy of the VA NEPHRON-D trial. Predictor: Primary exposure was the treatment arm (combination [RAAS inhibitor] vs monotherapy). AKI is used as a stratifying variable. Outcome: Urinary biomarkers, including albumin, EGF (epidermal growth factor), MCP-1 (monocyte chemoattractant protein-1), YKL-40 (chitinase 3-like protein 1), and KIM-1 (kidney injury molecule-1). Analytical approach: Biomarkers measured at baseline and at 12 months in trial participants were compared between treatment groups and by AKI. AKI events occurring during hospitalization were predefined safety end points in the original trial. The results were included in a meta-analysis with other large chronic kidney disease trials to assess global trends in biomarker changes. Results: In 707 participants followed for a median of 2.2 years, AKI incidence was higher in the combination (20.7%) versus the monotherapy group (12.7%; relative risk [RR], 1.64 [95% CI, 1.16-2.30]). Compared with the monotherapy arm, in the combination arm the urine biomarkers at 12 months were either unchanged (MCP-1: RR, -3% [95% CI, -13% to 9%], P Limitations: Biomarker measurement was limited to 2 time points independent of AKI events. Conclusions: Despite the increased risk of serum creatinine-defined AKI, combination RAAS inhibitor therapy was associated with unchanged or decreased urinary biomarkers at 12 months. This suggests a possible role for kidney biomarkers to further characterize kidney injury in clinical trials. Plain-language summary: The VA NEPHRON-D trial investigated inhibition of the renin-angiotensin-aldosterone system (RAAS) hormonal axis on kidney outcomes in a large population of diabetic chronic kidney disease patients. The trial was stopped early due to increased events of serum creatinine-defined acute kidney injury in the combination therapy arm. Urine biomarkers can serve as an adjunct to serum creatinine in identifying kidney injury. We found that urinary biomarkers in the combination therapy group were not associated with a pattern of harm and damage to the kidney, despite the increased number of kidney injury events in that group. This suggests that serum creatinine alone may be insufficient for defining kidney injury and supports further exploration of how other biomarkers might improve identification of kidney injury in clinical trials.
MeSH term(s)	Humans ; Acute Kidney Injury/diagnosis ; Albuminuria ; Biomarkers/urine ; Creatinine ; Epidermal Growth Factor ; Nephrons ; Randomized Controlled Trials as Topic ; Renal Insufficiency, Chronic ; Clinical Trials as Topic
Chemical Substances	Biomarkers ; Creatinine (AYI8EX34EU) ; Epidermal Growth Factor (62229-50-9)
Language	English
Publishing date	2023-09-17
Publishing country	United States
Document type	Meta-Analysis ; Journal Article
ZDB-ID	604539-x
ISSN	1523-6838 ; 0272-6386
ISSN (online)	1523-6838
ISSN	0272-6386
DOI	10.1053/j.ajkd.2023.07.012
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