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Pre-pregnancy exposure to arsenic in diet and non-cardiac birth defects
- Jonathan Suhl, Kristin M Conway, Anthony Rhoads, Peter H Langlois, Marcia L Feldkamp, Adrian M Michalski, Jacob J Oleson, Alpa Sidhu, Vijaya Kancherla, John Obrycki, Maitreyi Mazumdar, Paul A Romitti, the National Birth Defects Prevention Study
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- Journal:
- Public Health Nutrition / Volume 26 / Issue 3 / March 2023
- Published online by Cambridge University Press:
- 27 May 2022, pp. 620-632
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- Article
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Objectives:
To explore associations between maternal pre-pregnancy exposure to arsenic in diet and non-cardiac birth defects.
Design:This is a population-based, case–control study using maternal responses to a dietary assessment and published arsenic concentration estimates in food items to calculate average daily total and inorganic arsenic exposure during the year before pregnancy. Assigning tertiles of total and inorganic arsenic exposure, logistic regression analysis was used to estimate OR for middle and high tertiles, compared to the low tertile.
Setting:US National Birth Defects Prevention Study, 1997–2011.
Participants:Mothers of 10 446 children without birth defects and 14 408 children diagnosed with a non-cardiac birth defect.
Results:Maternal exposure to total dietary arsenic in the middle and high tertiles was associated with a threefold increase in cloacal exstrophy, with weak positive associations (1·2–1·5) observed either in both tertiles (intercalary limb deficiency) or the high tertile only (encephalocele, glaucoma/anterior chamber defects and bladder exstrophy). Maternal exposure to inorganic arsenic showed mostly weak, positive associations in both tertiles (colonic atresia/stenosis, oesophageal atresia, bilateral renal agenesis/hypoplasia, hypospadias, cloacal exstrophy and gastroschisis), or the high (glaucoma/anterior chamber defects, choanal atresia and intestinal atresia stenosis) or middle (encephalocele, intercalary limb deficiency and transverse limb deficiency) tertiles only. The remaining associations estimated were near the null or inverse.
Conclusions:This exploration of arsenic in diet and non-cardiac birth defects produced several positive, but mostly weak associations. Limitations in exposure assessment may have resulted in exposure misclassification. Continued research with improved exposure assessment is recommended to identify if these associations are true signals or chance findings.
59 - Wilms' tumor
- from Part VI - Oncology
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- By Michael L. Ritchey, Department of Surgery and Pediatrics, Division of Urology, University of Texas – Houston Medical School, USA, Nadeem N. Dhanani, Department of Urology, University of Texas – Houston Medical School, USA, Patrick G. Duffy, Department of Paediatric Urology, Great Ormond Street Hospital, London, UK, Gill A. Levitt, Department of Paediatric Urology, Great Ormond Street Hospital, London, UK, Anthony J. Michalski, Department of Paediatric Urology, Great Ormond Street Hospital, London, UK
- Edited by Mark D. Stringer, Keith T. Oldham, Pierre D. E. Mouriquand
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- Book:
- Pediatric Surgery and Urology
- Published online:
- 08 January 2010
- Print publication:
- 09 November 2006, pp 759-781
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Summary
Wilms' tumor therapy
Prior to the modern era of cancer treatment, the only opportunity for cure of Wilms' tumor was complete surgical excision. Wilms' tumor was one of the first pediatric malignancies found to be responsive to systemic chemotherapy. Since the initial report by Farber, there has been a dramatic improvement in survival of children with this tumor. Many of these advances have occurred as a result of collaborative efforts of large pediatric cooperative cancer groups, such as the National Wilms Tumor Study Group (NWTSG) and the International Society of Pediatric Oncology (SIOP), which have been able to enroll large numbers of patients treated in a standardized manner since 1969. Now that more than 90% of children with Wilms' tumor can expect cure, these groups are focusing their attention to reducing the intensity of therapy in order to minimize treatment-related toxicity that may adversely affect long-term survival and quality of life. Damage to normal organs and tissues occurs and the effects may not become apparent for many years after treatment.
Tracking the late effects of Wilms' tumor treatment has been an integral part of the NWTSG for many years. Long-term toxicities of treatment are studied in a systematic way among uniform populations of children treated with similar therapies. This has helped to define the long-term adverse effects of treatment in patients alive 5 years or longer after the diagnosis of Wilms' tumor.