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Birmingham, AL, United States

Hayes R.M.,Vanderbilt University | Wu P.,Vanderbilt University | Shelton R.C.,UAB | Cooper W.O.,Vanderbilt University | And 3 more authors.
American Journal of Obstetrics and Gynecology | Year: 2012

OBJECTIVE: The purpose of this study was to describe antidepressant medication use patterns during pregnancy and pregnancy outcomes. STUDY DESIGN: We evaluated a cohort of 228,876 singleton pregnancies that were covered by Tennessee Medicaid, 1995-2007. RESULTS: Of 23,280 pregnant women with antidepressant prescriptions before pregnancy, 75% of them filled none in the second or third trimesters of pregnancy, and 10.7% of them used antidepressants throughout pregnancy. Filling 1, 2, and ≥3 antidepressant prescriptions during the second trimester was associated with shortened gestational age by 1.7 (95% confidence interval [CI], 1.2-2.3), 3.7 (95% CI, 2.8-4.6), and 4.9 (95% CI, 3.9-5.8) days, when controlled for measured confounders. Third-trimester selective serotonin reuptake inhibitor use was associated with infant convulsions; adjusted odds ratios were 1.4 (95% CI, 0.7-2.8); 2.8 (95% CI, 1.9-5.5); and 4.9 (95% CI, 2.6-9.5) for filling 1, 2, and ≥3 prescriptions, respectively. CONCLUSION: Most women discontinue antidepressant medications before or during the first trimester of pregnancy. Second-trimester antidepressant use is associated with preterm birth, and third-trimester selective serotonin reuptake inhibitor use is associated with infant convulsions. © 2012 Mosby, Inc. All rights reserved. Source

Nakhmani A.,Boston University | Tannenbaum A.,UAB | Tannenbaum A.,Comprehensive Cancer Center
Pattern Recognition Letters | Year: 2013

We propose two novel distance measures, normalized between 0 and 1, and based on Normalized Cross-Correlation for image matching. These distance measures explicitly utilize the fact that for natural images there is a high correlation between spatially close pixels. Image matching is used in various computer vision tasks, and the requirements to the distance measure are application dependent. Image recognition applications require more shift and rotation robust measures. In contrast, registration and tracking applications require better localization and noise tolerance. In this paper, we explore different advantages of our distance measures, and compare them to other popular measures, including Normalized Cross-Correlation (NCC) and Image Euclidean Distance (IMED). We show which of the proposed measures is more appropriate for tracking, and which is appropriate for image recognition tasks. © 2012 Elsevier B.V. All rights reserved. Source

Vaphiades M.S.,UAB | Vaphiades M.S.,University of Alabama at Birmingham | Bhatti M.T.,Duke University | Lesser R.L.,Yale University
Current Opinion in Ophthalmology | Year: 2012

Purpose of Review: To review ocular myasthenia gravis (OMG), a localized form of myasthenia gravis clinically involving only the extraocular, levator palpebrae superioris, and orbicularis oculi muscles. Recent Findings: Ocular manifestations can masquerade as a variety of ocular motility disorders, including central nervous system disorders and peripheral cranial nerve palsies. While sparing the pupils, the diagnosis and management can be challenging. Summary: Because several diagnostic and treatment options are available for OMG, clinicians must decide the sequence and combination based on the level of disease activity and patient disability. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

Hmoud B.,UTMB | Singal A.K.,UAB | Kamath P.S.,Mayo Medical School
Journal of Clinical and Experimental Hepatology | Year: 2014

Mesenteric vein thrombosis is increasingly recognized as a cause of mesenteric ischemia. Acute thrombosis commonly presents with abdominal pain and chronic type with features of portal hypertension. Contrast enhanced CT scan of abdomen is quite accurate for diagnosing and differentiating two types of mesenteric venous thrombosis. Prothrombotic state, hematological malignancy, and local abdominal inflammatory conditions are common predisposing conditions. Over the last decade, JAK-2 (janus kinase 2) mutation has emerged as an accurate biomarker for diagnosis of myeloproliferative neoplasm, an important cause for mesenteric venous thrombosis. Anticoagulation is the treatment of choice for acute mesenteric venous thrombosis. Thrombolysis using systemic or transcatheter route is another option. Patients with peritoneal signs or refractory to initial measures require surgical exploration. Increasing recognition of mesenteric venous thrombosis and use of anticoagulation for treatment has resulted in reduction in the need for surgery with improvement in survival. © 2014 INASL. Source

Singal A.K.,University of Alabama at Birmingham | Parker C.,University of Utah | Bowden C.,UAB | Thapar M.,Drexel University | And 2 more authors.
Hepatology | Year: 2014

Porphyrias are a group of eight metabolic disorders, each resulting from a mutation that affects an enzyme of the heme biosynthetic pathway. Porphyrias are classified as hepatic or erythropoietic, depending upon the site where the gene defect is predominantly expressed. Clinical phenotypes are classified as follows: (1) acute porphyrias with neurovisceral symptoms: acute intermittent porphyria; delta amino-levulinic acid hydratase deficiency porphyria; hereditary coproporphyria; and variegate porphyria and (2) cutaneous porphyrias with skin blistering and photosensitivity: porphyria cutanea tarda; congenital erythropoietic porphyria; hepatoerythropoietic porphyria and both erythropoietic protoporphyrias: autosomal dominant and X-linked. Liver transplantation (LT) may be needed for recurrent and/or life-threatening acute attack in acute intermittent porphyria or acute liver failure or end-stage chronic liver disease in erythropoietic protoporphyria. LT in acute intermittent porphyria is curative. Erythropoietic protoporphyria patients needing LT should be considered for bone marrow transplantation to achieve cure. Conclusion: This article provides an overview of porphyria with diagnostic approaches and management strategies for specific porphyrias and recommendations for LT with indications, pretransplant evaluation, and posttransplant management. © 2014 by the American Association for the Study of Liver Diseases. Source

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