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1.
Emerg Infect Dis ; 30(3): 591-594, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38407227

RESUMO

We report 2 autochthonous feline thelaziosis cases caused by the eyeworm Thelazia callipaeda and discuss the spread among dogs in the northeastern United States. Phylogenetic analysis suggests the parasite was introduced from Europe. Adopting a One Health approach is needed to limit further spread of T. callipaeda eyeworms in North America.


Assuntos
Doenças do Gato , Doenças do Cão , Thelazioidea , Gatos , Animais , Cães , Doenças do Gato/epidemiologia , Filogenia , Doenças do Cão/epidemiologia , New England , Loa , Thelazioidea/genética
2.
Pathogens ; 12(11)2023 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-38003748

RESUMO

The American Association of Equine Practitioners strongly advocates evidence-based intestinal strongyle control in horses. It recommends targeted treatment of all heavy egg shedders (>500 eggs per gram (EPG) of feces), while the low shedders (0-200 EPG) are left untreated. As 50-75% of adult horses in a herd are low shedders, preventing them from unnecessary anthelmintic exposure is critical for tackling resistance. There are various fecal egg count (FEC) techniques with many modifications and variations in use, but none is identified as a gold standard. The hypothesis of the study was that the diagnostic performance of 12 commonly used quantitation methodologies (three techniques with four variants) differs. In this regard, method comparison studies were performed using polystyrene beads as proxy for intestinal strongyle eggs. Mini-FLOTAC-based variants had the lowest coefficient of variation (CV%) in bead recovery, whereas McMaster variants had the highest. All four variants of Mini-FLOTAC and the NaNO3 1.33 specific gravity variant of modified Wisconsin followed a linear fit with R2 > 0.95. In contrast, the bead standard replicates for modified McMaster variants dispersed from the regression curve, causing a lower R2. The Mini-FLOTAC method seems less influenced by the choice of floatation solution and has better repeatability parameters and linearity for bead standard recovery. For FEC tests with high R2 (>0.95) but that underestimated the true bead count, a correction factor (CF) was determined to estimate the true count. Finally, the validity of CF was analyzed for 5 tests with R2 > 0.95 to accurately quantify intestinal strongyle eggs from 40 different horses. Overall, this study identified FEC methodologies with the highest diagnostic performance. The limitations in standardizing routine FEC tests are highlighted, and the importance of equalization of FEC results is emphasized for promoting uniformity in the implementation of parasite control guidelines.

3.
Carcinogenesis ; 43(4): 311-320, 2022 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-35166350

RESUMO

Currently, the only definitive method for diagnosing ovarian cancer involves histological examination of tissue obtained at time of surgery or by invasive biopsy. Blood has traditionally been the biofluid of choice in ovarian cancer biomarker discovery; however, there has been a growing interest in exploring urinary biomarkers, particularly as it is non-invasive. In this systematic review, we present the diagnostic accuracy of urinary biomarker candidates for the detection of ovarian cancer. A comprehensive literature search was performed using the MEDLINE/PubMed and EMBASE, up to 1 April 2021. All included studies reported the diagnostic accuracy using sensitivity and/or specificity and/or receiver operating characteristics (ROC) curve. Risk of bias and applicability of included studies were assessed using the QUADAS-2 tool. Twenty-seven studies were included in the narrative synthesis. Protein/peptide biomarkers were most commonly described (n = 18), with seven studies reporting composite scores of multiple protein-based targets. The most frequently described urinary protein biomarker was HE4 (n = 5), with three studies reporting a sensitivity and specificity > 80%. Epigenetic (n = 1) and metabolomic/organic compound biomarkers (n = 8) were less commonly described. Overall, six studies achieved a sensitivity and specificity of >90% and/or an AUC > 0.9. Evaluation of urinary biomarkers for the detection of ovarian cancer is a dynamic and growing field. Currently, the most promising biomarkers are those that interrogate metabolomic pathways and organic compounds, or quantify multiple proteins. Such biomarkers require external validation in large, prospective observational studies before they can be implemented into clinical practice.


Assuntos
Neoplasias Ovarianas , Biomarcadores , Biomarcadores Tumorais , Carcinoma Epitelial do Ovário , Feminino , Humanos , Estudos Observacionais como Assunto , Neoplasias Ovarianas/diagnóstico , Proteínas , Curva ROC , Sensibilidade e Especificidade
4.
Artigo em Inglês | MEDLINE | ID: mdl-37520629

RESUMO

To prepare students to address water-related challenges, undergraduate STEM education must provide them with opportunities to learn and reason about water issues. Water in Society is an introductory-level, innovative, and interdisciplinary undergraduate course offered annually at a large midwestern university. The course focuses on both disciplinary concepts and civic engagement, and is designed around a variety of interactive, research-based practices to support students' learning, engagement with authentic data, scientific models and modeling, and collaboration and learning among peers. This study aims to evaluate, "how have student outcomes and perceptions changed over five years of the course?". The results are based on data from students (n = 326) in five consecutive years of the course, during which time the course transitioned from a face-to-face model to fully asynchronous online model due, in part, to impacts of the COVID-19 pandemic. The particularly rapid and abrupt transition between 2020 and 2021 in response to COVID-19 led to many course changes, including modes of communication between instructors and students and opportunities for collaboration. Here, multiple measures are used to evaluate students' learning about water concepts, model-based reasoning about socio-hydrologic systems, and perceptions of the course across all five years. By the end of each iteration of the course, students improved their knowledge of hydrologic concepts, independent of the course format or other student-level variables. However, results also show that students' performance on complex socio-hydrologic systems modeling tasks, as well as their overall satisfaction with the course, decreased in Year 5 when the course was fully online. Results provide insight into efforts to move undergraduate STEM courses online and specific evidence of the COVID-19 pandemic's impacts on undergraduate STEM teaching and learning about water. Supplementary Information: The online version contains supplementary material available at 10.1186/s43031-022-00049-y.

5.
Pers Individ Dif ; 187: 111393, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34789957

RESUMO

The COVID-19 pandemic has taken a massive toll on mental well-being. The unprecedented level of uncertainty associated with the pandemic may be a contributing factor to stress and anxiety, especially among individuals with high intolerance to uncertainty (Rettie & Daniels, 2021). Individual differences in need for cognitive closure have also been linked to mental distress during unpredictable situations (Berenbaum et al., 2008). The present study tested the hypothesis that individuals with a high need for cognitive closure would experience relatively higher stress and anxiety during the COVID-19 pandemic. College students (N = 400) completed an abbreviated Need for Closure Scale (Roets & Van Hiel, 2011), the Generalized Anxiety Disorder Scale (Spitzer et al., 2006), and the short-version of the Perceived Stress Scale (Cohen & Williamson, 1988). Results supported the hypothesized relationship between high need for cognitive closure and higher levels of stress and anxiety. Findings have relevance to college students who are experiencing heightened psychological stress during the COVID-19 pandemic.

6.
Yale J Biol Med ; 92(1): 115-120, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30923478

RESUMO

With advances in technology and increases in global urbanization, the complexity of our sensory environment has increased dramatically in the last few hundred years. However, our brains have remained essentially unchanged. The cognitive resources that support complex goal-directed behaviors operate differently in urban versus natural environments. In this short perspective, we consider how the attention system, designed for interacting with nature, is taxed by urban environments and discuss how exposure to nature may support its rejuvenation.


Assuntos
Atenção/fisiologia , Meio Ambiente , Natureza , Urbanização , Humanos
8.
Mol Microbiol ; 110(4): 596-615, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30192418

RESUMO

ExoS/ChvI two-component signaling in the nitrogen-fixing α-proteobacterium Sinorhizobium meliloti is required for symbiosis and regulates exopolysaccharide production, motility, cell envelope integrity and nutrient utilization in free-living bacteria. However, identification of many ExoS/ChvI direct transcriptional target genes has remained elusive. Here, we performed chromatin immunoprecipitation followed by microarray analysis (chIP-chip) to globally identify DNA regions bound by ChvI protein in S. meliloti. We then performed qRT-PCR with chvI mutant strains to test ChvI-dependent expression of genes downstream of the ChvI-bound DNA regions. We identified 64 direct target genes of ChvI, including exoY, rem and chvI itself. We also identified ChvI direct target candidates, like exoR, that are likely controlled by additional regulators. Analysis of upstream sequences from the 64 ChvI direct target genes identified a 15 bp-long consensus sequence. Using electrophoretic mobility shift assays and transcriptional fusions with exoY, SMb21440, SMc00084, SMc01580, chvI, and ropB1, we demonstrated this consensus sequence is important for ChvI binding to DNA and transcription of ChvI direct target genes. Thus, we have comprehensively identified ChvI regulon genes and a 'ChvI box' bound by ChvI. Many ChvI direct target genes may influence the cell envelope, consistent with the critical role of ExoS/ChvI in growth and microbe-host interactions.


Assuntos
Proteínas de Bactérias/metabolismo , Regulação Bacteriana da Expressão Gênica/genética , Sinorhizobium meliloti/genética , Sinorhizobium meliloti/metabolismo , Fatores de Transcrição/metabolismo , Proteínas de Bactérias/genética , Sítios de Ligação/genética , Proteínas de Ligação a DNA/genética , Genoma Bacteriano/genética , Glucosiltransferases/genética , Ligação Proteica/genética , Transdução de Sinais , Simbiose/genética , Fatores de Transcrição/genética , Transcrição Gênica/genética
10.
J Vet Diagn Invest ; 24(3): 572-5, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22529128

RESUMO

Serological testing for toxoplasmosis diagnosis remains the method of choice in human medicine due to the accessibility of the requisite sample, the difficulty in predicting the parasite's location in the host for direct detection, and the availability of established commercial methods. In veterinary medicine, although the first 2 conditions are unchanged, there is a need for commercially produced test methods that are validated for Toxoplasma gondii detection across the range of animal species that can serve as intermediate hosts. The development of such a serological method for animals would allow the diagnosis of toxoplasmosis in individual animals and a higher throughput method for population-level toxoplasmosis surveys. The incorporation of a non-species-specific chimeric protein A/G conjugate into an anti-Toxoplasma immunoglobulin G enzyme-linked immunosorbent assay is described. Serum from potential intermediate hosts was reevaluated using this method and compared with earlier testing using an established agglutination procedure. Very good agreement between the 2 tests was noted (κ = 0.81), establishing the method as a useful option for veterinary diagnostic testing.


Assuntos
Proteínas de Bactérias/química , Ensaio de Imunoadsorção Enzimática/veterinária , Imunoglobulina G/sangue , Proteínas Recombinantes de Fusão/química , Proteína Estafilocócica A/química , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/diagnóstico , Animais , Proteínas de Bactérias/genética , Proteínas de Bactérias/imunologia , Curva ROC , Proteínas Recombinantes de Fusão/imunologia , Sensibilidade e Especificidade , Proteína Estafilocócica A/genética , Proteína Estafilocócica A/imunologia , Toxoplasmose Animal/imunologia , Toxoplasmose Animal/parasitologia
11.
J Vet Diagn Invest ; 23(2): 297-301, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21398450

RESUMO

A challenge faced by veterinary diagnosticians in serologic analysis for exposure to pathogens is the need for a protein conjugate capable of antibody attachment in many animal species. The advent of protein conjugates that are less specific in nature allows diagnosis across many species with little or no modification of technique. Toxoplasma gondii is an organism of veterinary interest that has been demonstrated to infect a plethora of warm-blooded animals. However, the serologic tests available for simultaneous diagnosis in this broad range are limited in number. The current study examined the use of an immunoglobulin G enzyme-linked immunosorbent assay (ELISA) modified by the use of non-species-specific protein conjugates in domestic animal species commonly submitted to diagnostic laboratories for evaluation of Toxoplasma exposure status. Comparison with results from an established indirect hemagglutination technique revealed very good agreement between the 2 test methods. This modification of the ELISA provides a useful method for veterinary diagnosticians to perform rapid and accurate evaluation of multiple animal species for Toxoplasma exposure using a single test.


Assuntos
Antígenos de Protozoários/sangue , Ensaio de Imunoadsorção Enzimática/veterinária , Imunoglobulina G/análise , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/parasitologia , Zoonoses/parasitologia , Animais , Ensaio de Imunoadsorção Enzimática/métodos , Testes de Inibição da Hemaglutinação/veterinária , Curva ROC , Sensibilidade e Especificidade , Toxoplasma/imunologia , Toxoplasmose Animal/sangue
13.
Soc Work ; 55(3): 203-12, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20632655

RESUMO

There is a growing practice of adoption services on the Internet with varying degrees of regulation, depending on whether it is domestic infant adoption, public foster care adoption, or international adoption. Regulation is particularly lacking in domestic infant adoptions, with Web sites connecting prospective birth and adoptive parents, sometimes through an adoption brokerage service. International adoptions can also be plagued by unethical practices as the Internet has become available in both developed and developing countries. These activities, although offering the benefits of privacy and convenience, also pose serious problems of potential fraud, exploitation, and, most important, lack of professional consideration of the child's best interest. In this article, the authors review the landscape of current Internet-based adoption activities, examine the benefits and risks of Internet-based adoption activities, and call for social work self-regulation and leadership.


Assuntos
Adoção/legislação & jurisprudência , Regulamentação Governamental , Internet , Fraude/prevenção & controle , Humanos , Estados Unidos
14.
Memory ; 18(3): 265-71, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20209425

RESUMO

Research on retrieval-induced forgetting has shown that the selective retrieval of some information can cause the forgetting of other information. Such forgetting is believed to result from inhibitory processes that function to resolve interference during retrieval. The current study examined whether individuals with ADHD demonstrate normal levels of retrieval-induced forgetting. A total of 40 adults with ADHD and 40 adults without ADHD participated in a standard retrieval-induced forgetting experiment. Critically, half of the items were tested using category cues and the other half of the items were tested using category-plus-one-letter-stem cues. Whereas both ADHD and non-ADHD participants demonstrated retrieval-induced forgetting on the final category-cued recall test, only non-ADHD participants demonstrated retrieval-induced forgetting on the final category-plus-stem-cued recall test. These results suggest that individuals with ADHD do have a deficit in the inhibitory control of memory, but that this deficit may only be apparent when output interference is adequately controlled on the final test.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Sinais (Psicologia) , Memória , Rememoração Mental , Análise de Variância , Feminino , Humanos , Masculino , Modelos Psicológicos , Testes Psicológicos , Adulto Jovem
15.
New Phytol ; 182(4): 891-911, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19383098

RESUMO

This study compared the leaf transcription profiles, physiological characteristics and primary metabolites of two Populus tremuloides genotypes (clones 216 and 271) known to differ in their responses to long-term elevated [CO2] (e[CO2]) at the Aspen free-air CO2 enrichment site near Rhinelander, WI, USA. The physiological responses of these clones were similar in terms of photosynthesis, stomatal conductance and leaf area index under e[CO2], yet very different in terms of growth enhancement (0-10% in clone 216; 40-50% in clone 271). Although few genes responded to long-term exposure to e[CO2], the transcriptional activity of leaf e[CO2]-responsive genes was distinctly different between the clones, differentially impacting multiple pathways during both early and late growing seasons. An analysis of transcript abundance and carbon/nitrogen biochemistry suggested that the CO2-responsive clone (271) partitions carbon into pathways associated with active defense/response to stress, carbohydrate/starch biosynthesis and subsequent growth. The CO2-unresponsive clone (216) partitions carbon into pathways associated with passive defense (e.g. lignin, phenylpropanoid) and cell wall thickening. This study indicates that there is significant variation in expression patterns between different tree genotypes in response to long-term exposure to e[CO2]. Consequently, future efforts to improve productivity or other advantageous traits for carbon sequestration should include an examination of genetic variability in CO2 responsiveness.


Assuntos
Dióxido de Carbono/farmacologia , Carbono/metabolismo , Perfilação da Expressão Gênica , Regulação da Expressão Gênica de Plantas/efeitos dos fármacos , Folhas de Planta/efeitos dos fármacos , Folhas de Planta/genética , Populus/genética , Células Clonais , Regulação da Expressão Gênica de Plantas/efeitos da radiação , Genes de Plantas/genética , Variação Genética/efeitos dos fármacos , Variação Genética/efeitos da radiação , Genótipo , Luz , Nitrogênio/metabolismo , Tamanho do Órgão/efeitos dos fármacos , Tamanho do Órgão/efeitos da radiação , Fotossíntese/efeitos dos fármacos , Fotossíntese/efeitos da radiação , Folhas de Planta/efeitos da radiação , Caules de Planta/anatomia & histologia , Caules de Planta/efeitos dos fármacos , Caules de Planta/efeitos da radiação , Populus/efeitos dos fármacos , Populus/fisiologia , Populus/efeitos da radiação , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estações do Ano , Transcrição Gênica/efeitos dos fármacos , Transcrição Gênica/efeitos da radiação
16.
J Atten Disord ; 11(2): 141-9, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17494831

RESUMO

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is associated with poor inhibition of prepotent responses and deficits in distractor inhibition, but relatively few studies have addressed inhibitory control of proactive interference (PI) in individuals with ADHD. Thus, the goal of the present study was to evaluate resistance to spatial and verbal PI in adults with ADHD. METHOD: Adults with ADHD (n = 32) and adults without ADHD (n = 32) performed a spatial inhibition of return (IOR) task and a semantic IOR task. RESULTS: Adults with and without ADHD showed effective spatial IOR. On the semantic IOR task, adults without ADHD showed semantic inhibition, whereas adults with ADHD showed semantic facilitation (positive priming) instead. CONCLUSION: Adults with ADHD may have domain-specific deficits in resistance to proactive interference. Research has theoretical and clinical implications for adults with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Percepção de Cores , Orientação , Reconhecimento Visual de Modelos , Inibição Proativa , Desempenho Psicomotor , Semântica , Adolescente , Adulto , Atenção , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Feminino , Humanos , Masculino , Tempo de Reação
17.
J Atten Disord ; 10(1): 44-53, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16840592

RESUMO

OBJECTIVE: Children with ADHD show attention-switching impairment. The present study assessed attention-switching ability in adults with ADHD, the extent to which this ability can be improved via targeted training, and the degree to which training extends to novel tasks of attention-switching. METHOD: Adults with ADHD (n = 16) and adults without ADHD (n = 18) were divided into training and non-training groups. Training groups performed six blocks of four different attention-switching tasks, while non-training groups completed non-switching, "filler" tasks. Lastly, the four groups were tested on two novel attention-switching tasks. RESULTS: Adults with ADHD showed impaired attention-switching, relative to non-ADHD adults, but training significantly improved attention-switching in both ADHD and non-ADHD training groups. Finally, training effects transferred to new tasks of attention-switching. CONCLUSION: Adults with ADHD show attention-switching impairments, but deficits may be ameliorated with short-term, targeted training. Research has implications for cognitive training in ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Atenção , Terapia Cognitivo-Comportamental/métodos , Ensino/métodos , Adulto , Feminino , Humanos , Masculino , Resultado do Tratamento
18.
J Nurs Manag ; 12(3): 201-9, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15089958

RESUMO

OBJECTIVES: (1) To determine the acceptability of the Royal College of General Practitioner Guidelines to small samples of nurses, General Practitioners and acute back pain patients, (2) to determine what additional roles for nurses in the management of acute back pain in primary care might be acceptable to these samples, (3) to evaluate the responses of General Practitioners, nurses and patients to a suggested service model based on the RCGP Guidelines, (4) to identify opportunities for and barriers to the further development of such models and to obtain the appraisal of the above by an external group of assessors. METHODOLOGY: Using a qualitative design the pilot study included Primary Care (General Practitioners, Practice Nurses and Patients) with the main outcome measures as: appraisal questionnaires (for RCGP Guideline), qualitative content analysis of focus group narratives, and appraisal of process and outcomes by an external panel. RESULTS: Attitudes towards the RCGP guidelines were positive, but professionals and patients alike did not think their recommendations could be implemented with the current service provision in primary care. There was criticism by professionals of the capacity for a nurse-led service within practices. Access to chiropractors, osteopaths and/or specialist physiotherapists in National Health Service primary care was raised as a need by both groups. All members of the Advisory Panel approved the processes for the recruitment of participants, focus group questions and analysis. DISCUSSION: Barriers to implementation of the RCGP Guideline and to a nurse-led acute back pain service in general practice, were illustrated. These mainly relate to grossly inadequate capacity to deal with multidimensional patient needs, allowing progression to chronic pain states and much higher health care costs. There was a strong desire to include a different group of professionals in primary care. We recommend a local needs assessment and consideration of a national strategy for the implementation of the RCGP Guideline in primary care.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Dor nas Costas , Profissionais de Enfermagem , Médicos de Família , Atenção Primária à Saúde/normas , Doença Aguda , Dor nas Costas/enfermagem , Dor nas Costas/psicologia , Estudos de Viabilidade , Feminino , Grupos Focais , Fidelidade a Diretrizes/normas , Humanos , Masculino , Avaliação das Necessidades , Profissionais de Enfermagem/organização & administração , Profissionais de Enfermagem/psicologia , Papel do Profissional de Enfermagem , Pesquisa Metodológica em Enfermagem , Médicos de Família/organização & administração , Médicos de Família/psicologia , Projetos Piloto , Guias de Prática Clínica como Assunto , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Medicina Estatal , Reino Unido
19.
J Int Neuropsychol Soc ; 10(2): 180-9, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15012838

RESUMO

Children surviving treatment for malignant brain tumors commonly have problems maintaining their premorbid levels of intellectual development and academic achievement. Our group has been especially interested in the effects of treatment on normal appearing white matter (NAWM) on MRI and the influence of NAWM volumes on neurocognitive functioning. The present study assessed NAWM and attentional abilities among 37 long-term survivors of malignant brain tumors, ranging in age from 1.7 to 14.8 (Mdn = 6.5) years at diagnosis, who had been treated with cranial radiation therapy with or without chemotherapy 2.6 to 15.3 (Mdn = 5.7) years earlier. On the Conners' Continuous Performance Test, the Overall Index and 7 of the other 10 indices were significantly deficient compared to age- and gender-corrected normative values. After statistically controlling for the effects of age at diagnosis and time elapsed from treatment, 5 of the 8 indices were significantly associated with cerebral white matter volumes and/or specific regional white matter volumes of the prefrontal/frontal lobe and cingulate gyrus. No gender effects were observed. The results of the present study further support the contention that NAWM is an important substrate for treatment-induced neurocognitive problems among survivors of malignant brain tumors of childhood.


Assuntos
Atenção/fisiologia , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/patologia , Encéfalo/patologia , Encéfalo/fisiopatologia , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/etiologia , Adolescente , Criança , Pré-Escolar , Transtornos Cognitivos/diagnóstico , Intervalo Livre de Doença , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Tempo de Reação
20.
Cancer ; 97(10): 2512-9, 2003 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-12733151

RESUMO

BACKGROUND: The primary objective of this study was to test the hypothesis that, among survivors of pediatric brain tumors, the association between reduced volumes of normal-appearing white matter (NAWM) and intellectual/academic achievement deficits can be explained by patient problems with memory and attention. METHODS: Quantitative tissue volumes from magnetic resonance imaging scans and neurocognitive assessments were obtained for 40 long-term survivors of pediatric brain tumors. They were treated with radiotherapy (RT) with or without chemotherapy 2.6-15.3 years earlier (median, 5.7 years) at an age of 1.7-14.8 years (median, 6.5 years). Neurocognitive assessments included standardized tests of intellect (intelligence quotient [IQ]), attention, memory, and academic achievement. RESULTS: Analyses revealed significant impairments in patients' neurocognitive test performance on all measures. After statistically controlling for age at RT and time from RT, significant associations were found between NAWM volumes and both attentional abilities and IQ, and between attentional abilities and IQ. Subsequent analyses supported the hypothesis that attentional abilities, but not memory, could explain a significant amount of the relationship between NAWM and IQ. The final developmental model predicting academic achievement based on NAWM, attentional abilities, and IQ explained approximately 60% of the variance in reading and spelling and almost 80% of the variance in math. CONCLUSIONS: The authors demonstrated that the primary consequence of reduced NAWM among pediatric patients treated for brain tumors was decreased attentional abilities, leading to declining IQ and academic achievement.


Assuntos
Encéfalo/patologia , Neoplasias Cerebelares/radioterapia , Transtornos Cognitivos/etiologia , Irradiação Craniana/efeitos adversos , Adolescente , Neoplasias Cerebelares/complicações , Neoplasias Cerebelares/patologia , Criança , Pré-Escolar , Transtornos Cognitivos/patologia , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Modelos Biológicos , Testes Neuropsicológicos , Sobreviventes
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