ORCID Profile
0000-0002-8995-8711
Current Organisation
The University of Auckland
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Publisher: Wiley
Date: 20-11-2022
DOI: 10.1111/JPC.16270
Abstract: Obesity as a major risk factor for childhood hypertension necessitates careful blood pressure (BP) monitoring of those affected. This study aimed to compare BP classification in a cohort of children affected by obesity using tables versus digital calculations in two sets of guidelines. This study was a secondary analysis of data collected from a randomised clinical trial of a multidisciplinary life‐style assessment and intervention program. Baseline data from 237 children with a body mass index th percentile or st percentile with weight‐related comorbidities and available BP measurements were analysed. We assessed agreement between tables and algorithms in classification of elevated BP re‐hypertension and hypertension based on the American Academy of Paediatrics (AAP) clinical practice guidelines (CPG) and the older Fourth Report using Cohen's weighted kappa. The prevalence of hypertensive diagnoses was also compared between the two guidelines. Agreement between BP tables and algorithmic calculation of percentiles was discordant, though improved in the AAP CPG compared to the Fourth Report (Cohen's kappa = 0.70 vs. 0.57, respectively). None (0%) were missed diagnoses, and 59 (24.9%) were false positives for the Fourth Report, and 0 (0%) were missed diagnoses, and 49 (20.9%) were false positives for the AAP CPG. Under the recent guidelines, there was an increase in prevalence of 6.0% (95% confidence interval (CI) 2.5–9.4% P = 0.0001) for BP ≥90th percentile, and of 3.0% (95% CI 0.4–5.6% p = 0.016) for hypertension (BP ≥ 95th percentile) in the cohort (18.0% and 6.8%, respectively, increased from 12.0% and 3.8%). Digital calculators over tables in clinical practice are recommended where possible to improve the accuracy of paediatric BP classification. Substantial rates of elevated BP/Hypertension were found in this cohort of children and adolescents with overweight and obesity.
Publisher: Hindawi Limited
Date: 2013
DOI: 10.1155/2013/464921
Abstract: Marine omega-3 rich oils are used by more than a third of American adults for a wide range of purported benefits including prevention of cardiovascular disease. These oils are highly prone to oxidation to lipid peroxides and other secondary oxidation products. Oxidized oils may have altered biological activity making them ineffective or harmful, though there is also evidence that some beneficial effects of marine oils could be mediated through lipid peroxides. To date, human clinical trials have not reported the oxidative status of the trial oil. This makes it impossible to understand the importance of oxidation to efficacy or harm. However, animal studies show that oxidized lipid products can cause harm. Oxidation of trial oils may be responsible for the conflicting omega-3 trial literature, including the prevention of cardiovascular disease. The oxidative state of an oil can be simply determined by the peroxide value and anisidine value assays. We recommend that all clinical trials investigating omega-3 harms or benefits report the results of these assays this will enable better understanding of the benefits and harms of omega-3 and the clinical importance of oxidized supplements.
Publisher: Hindawi Limited
Date: 22-02-2022
DOI: 10.1155/2022/4532714
Abstract: Objective. Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy rates in women with idiopathic infertility. However, OSCM has high iodine content and slow clearance resulting in potential iodine excess. If pregnancy occurs, this could impact fetal thyroid gland development and function. We aim to determine the effect of a preconceptional OSCM HSG on the thyroid function of the neonate. Design and Patients. This was a retrospective analysis of newborn TSH data for a cohort of neonates conceived within six months of an OSCM HSG in the Auckland region, New Zealand, from the years 2000 to 2019. Thyroid-stimulating hormone (TSH) levels of these newborns were obtained from newborn screening, which is routinely performed for all children at 48–72 hours of life. The primary outcome was the incidence of permanent or transient congenital hypothyroidism in this cohort. Results. Of 146 babies included, all had normal TSH levels with values ranging from 1 to 7 mIU/L on the whole blood analysis of a capillary heel s le using the Perkin–Elmer AutoDelfia assay. Conception during the first 3 cycles following an OSCM HSG was 76% however, TSH levels in this group were not higher than those conceived in later cycles. Conclusion. Preconceptional OSCM HSG did not increase the risk of congenital hypothyroidism in the New Zealand scenario.
Publisher: Wiley
Date: 20-07-2020
DOI: 10.1111/IJPO.12693
Publisher: Wiley
Date: 09-08-2021
DOI: 10.1002/OBY.23225
Abstract: This study aimed to determine 5‐year outcomes from a 12‐month, family‐based, multidisciplinary lifestyle intervention program for children. This study was the 5‐year follow‐up of a randomized clinical trial comparing a low‐intensity control group (home‐based assessments) with a high‐intensity intervention group (assessments plus weekly sessions) in New Zealand. Participants were aged 5 to 16 years with BMI ≥ 98th centile or 91st centile with weight‐related comorbidities. The primary outcome was BMI standard deviation score (BMISDS). Secondary outcomes included various health markers. Of the 199 children included in the study at baseline (47% who identified as Māori, 53% who identified as female, 28% in the most deprived quintile, mean age = 10.7 years, mean BMISDS = 3.12), 86 completed a 5‐year assessment (43%). BMISDS reduction at 12 months was not retained (control = 0.00 [95% CI: −0.22 to 0.21] and intervention = 0.17 [95% CI: −0.01 to 0.34] p = 0.221) but was greater in participants aged years versus years at baseline (−0.15 [95% CI: −0.33 to 0.03] vs. 0.21 [95% CI: 0.03 to 0.40] p = 0.008). BMISDS trajectory favored participants with high attendance ( p = 0.013). There were persistent improvements in water intake and health‐related quality of life in both groups as well as reduced sweet drink intake in the intervention group. This intervention, with high engagement from those most affected by obesity, did not achieve long‐term efficacy of the primary outcome. Attendance and age remain important considerations for future interventions to achieve long‐term BMISDS reduction.
No related grants have been discovered for Paul Hofman.