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2.
Acta Oncol ; 52(1): 153-8, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22568405

RESUMEN

BACKGROUND: We report long-term outcomes in adult patients with craniopharyngioma following surgery and radiation therapy (RT). MATERIAL AND METHODS: Fifty-three patients treated with RT (median, 50 Gy in 25 fractions) between 1980 and 2009 with pathologically confirmed craniopharyngioma were reviewed (53% solid and 47% cystic/solid). The median age was 53 years (range, 22-76), 53% were female, 83% were sub-totally resected, 6% were gross totally resected and 11% had a biopsy and/or cyst aspiration alone. RT was delivered adjuvantly in 53% of patients as opposed to salvage intent upon progression. RESULTS: Median follow-up was seven years (86 months, range, 8-259). The 5- and 10-year progression-free survival (PFS) rates were 85% and 69%, overall survival (OS) rates were 76% and 70%, and cause-specific survival (CSS) rates were both 88%, respectively. Both univariable and multivariable analysis identified age (<53 or ≥53) as a prognostic factor for OS (p =0.0003) and CSS (p =0.05). PFS was observed to be worse in patients with >2 surgeries prior to RT (p =0.01). Neither the intent of radiation or tumor type (cystic vs. solid/cystic) were prognostic or predictive. New endocrinopathies and visual dysfunction were observed in 53% and 17% of patients post-surgery, and in 11% and 6% post-RT, respectively. CONCLUSION: We report long-term favorable PFS, CSS and OS for craniopharyngioma post-RT. We observe age as a significant prognostic factor, however, timing of radiation was not.


Asunto(s)
Craneofaringioma/mortalidad , Craneofaringioma/radioterapia , Neoplasias Hipofisarias/mortalidad , Neoplasias Hipofisarias/radioterapia , Adulto , Factores de Edad , Anciano , Craneofaringioma/cirugía , Supervivencia sin Enfermedad , Fraccionamiento de la Dosis de Radiación , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Neoplasias Hipofisarias/cirugía , Pronóstico , Radioterapia Adyuvante/efectos adversos , Adulto Joven
3.
Neurooncol Pract ; 10(2): 186-194, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36970168

RESUMEN

Background: The historic standard of care for adult medulloblastoma has been considered surgery and radiation, while chemotherapy is increasingly being prescribed. This study reviewed 20-year chemotherapy trends at a high-volume center, as well as overall and progression free-survival. Methods: Adults with medulloblastoma treated at an academic center from January 1, 1999 to -December 31, 2020 were reviewed. Patient baseline data were summarized and Kaplan-Meier estimators were used for survival. Results: Forty-nine patients were included; median age was 30 years and male: female ratio was 2:1. Desmoplastic and classical histologies were most common. Of all patients, 23 (47%) were high risk and 7 (14%) metastatic at diagnosis. Only 10 (20%) received initial chemotherapy, of which 70% were high risk and 30% metastatic, with most treated from 2010 to 2020. Forty percent of initial chemotherapy patients received salvage chemotherapy for recurrence or metastases (of all patients, 49% required salvage). Initial chemotherapy regimens were mainly cisplatin/lomustine/vincristine, and at recurrence cisplatin/etoposide. Median overall survival was 8.6 years (95% CI 7.5-∞), with 1-, 5-, and 10-year survival at 95.8%, 72%, and 46.7%. Median overall survival for those who did not receive initial chemotherapy was 12.4 years and 7.4 years for those who did (P-value .2). Conclusions: Twenty years of adult medulloblastoma treatment was reviewed. Initial chemotherapy patients, most of whom were high risk, trended towards worse survival, but this was nonsignificant. The ideal timing and choice of chemotherapy for adult medulloblastoma is unknown-challenges of administering chemotherapy following photon craniospinal irradiation may have prevented it from becoming routine.

4.
Acta Oncol ; 51(5): 629-35, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22537310

RESUMEN

BACKGROUND: We aimed to derive three-dimensional volume-based (V(3D)) response criteria that approximate those based on Response Evaluation Criteria in Solid Tumours (RECIST) in patients with brain metastases (BM) treated with salvage stereotactic radiosurgery (SRS). MATERIAL AND METHODS: Seventy patients with 178 BM were treated with SRS. Each BM was characterised at baseline and at each follow-up MRI according to its widest diameter and V(3D) using ITK-SNAP image segmentation software. RESULTS: The median tumour diameter was 1.2 cm (range, 0.2-4.5 cm) and V(3D) was 0.73 cm(3) (range, 0.01-22.7 cm(3)). The V(3D) percent changes that best matched RECIST response criteria were: an increase of ≥71.5% for progressive disease, a ≥58.5% decrease for partial response and a <58.5% decrease or increase of <71.5% for stable disease (k =0.85). A baseline diameter >3.0 cm (p =0.006) and a V(3D) >6.0 cm(3) (p =0.043) predicted for local failure, and a baseline cumulative V(3D) of >3.0 cm(3) (p =0.02) was adversely prognostic for survival. CONCLUSIONS: We define 3D volume specific criteria to base response upon for brain metastases treated with salvage SRS. Tumours with a V(3D) of greater than 6 cm(3) are at a higher risk of local failure.


Asunto(s)
Neoplasias Encefálicas/secundario , Neoplasias Encefálicas/cirugía , Neoplasias/cirugía , Radiocirugia , Terapia Recuperativa , Adulto , Anciano , Neoplasias Encefálicas/mortalidad , Fraccionamiento de la Dosis de Radiación , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Neoplasias/patología , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , Carga Tumoral
5.
Appl Microbiol Biotechnol ; 94(6): 1543-52, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22101785

RESUMEN

In order to produce a recombinant rhamnogalacturonase from the basidiomycete Irpex lacteus using a molecular approach, PCR primers were designed based on a sequence alignment of four known ascomycete rhamnogalacturonases. Using 5' and 3' rapid amplification of cDNA ends (RACE) experiments, a 1,437-bp full-length cDNA containing an open reading frame of 1,329 bp was isolated. The corresponding putative protein sequence is of 443 amino acids and contains a secretion signal sequence of 22 amino acids. The theoretical mass of this protein is 44.6 kDa with a theoretical isoelectric point of 6.2. The amino acid sequence shared not only significant identities with ascomycete and basidiomycete putative rhamnogalacturonases but also complete similarity with peptides obtained from a recently purified rhamnogalacturonase from I. lacteus. The recombinant protein was successfully expressed in active form in Pichia pastoris. SDS-PAGE assay demonstrated that the recombinant enzyme was secreted in the culture medium and had a molar mass of 56 kDa. This recombinant rhamnogalacturonan hydrolase exhibited a pH optimum between 4.5 and 5 and a temperature optimum between 40°C and 50°C, which correspond to that of the native rhamnogalacturonase from I. lacteus. The study of its specificity through reaction products analysis showed that it was highly tolerant to the presence of acetyl groups on its substrate, even more than the native enzyme.


Asunto(s)
Basidiomycota/enzimología , Clonación Molecular , Proteínas Fúngicas/genética , Expresión Génica , Glicósido Hidrolasas/genética , Pectinas/metabolismo , Pichia/genética , Acetilación , Secuencia de Aminoácidos , Secuencia de Bases , Basidiomycota/química , Basidiomycota/genética , Estabilidad de Enzimas , Proteínas Fúngicas/química , Proteínas Fúngicas/metabolismo , Glicósido Hidrolasas/química , Glicósido Hidrolasas/metabolismo , Concentración de Iones de Hidrógeno , Datos de Secuencia Molecular , Pichia/metabolismo , Alineación de Secuencia , Especificidad por Sustrato
7.
Cancer ; 117(17): 4070-9, 2011 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-21391213

RESUMEN

BACKGROUND: Although pilocytic astrocytoma accounts for up to 40% of all childhood brain tumors, it is a rare disease in adults. Consequently, there are few mature data on the impact of up-front treatment options after surgery that include observation or adjuvant radiotherapy. METHODS: Ten women and 20 men were identified who were diagnosed with pilocytic astrocytoma from 1971 to 2007 and were retrospectively reviewed. The median patient age was 30 years (range, 18-64 years), and the median follow-up was 87 months (range, 16-420 months). Initial surgery included biopsy (10% of patients), subtotal resection (57% of patients), or gross-total resection (33% of patients). Nineteen patients were observed postoperatively, whereas 11 patients received up-front postoperative adjuvant radiotherapy (50 grays in 25 fractions). No patient received adjuvant or concurrent chemotherapy. Progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Differences between survival curves were analyzed with the log-rank test. RESULTS: For the entire cohort, the 5-year and 10-year OS rates were 95% and 85%, respectively, and the 5-year and 10-year PFS rates were 63% and 35%, respectively. The median PFS was 8.4 years. Initial radiation, compared with observation, did not have an impact on OS but significantly improved PFS. The 5-year PFS rate for patients who were observed versus those who received radiation was 42% versus 91%, respectively; and, at 10 years, the PFS rate was 17% versus 60%, respectively (P = .005). Patients who progressed after observation (11 of 19 patients) received various salvage therapies, resulting in a 2-year PFS rate of 68% compared with 33% for patients who progressed after initial radiation (3 of 11 patients) and were salvaged with either chemotherapy or surgery (P = .1). CONCLUSIONS: Adjuvant radiotherapy for pilocytic astrocytoma significantly prolonged PFS at both 5 years and 10 years compared with observation. However, equivalent OS was observed, which reflected the efficacy of salvage therapies.


Asunto(s)
Astrocitoma/radioterapia , Neoplasias Encefálicas/radioterapia , Adolescente , Adulto , Astrocitoma/mortalidad , Astrocitoma/cirugía , Neoplasias Encefálicas/mortalidad , Neoplasias Encefálicas/cirugía , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Radioterapia Adyuvante , Resultado del Tratamiento , Espera Vigilante
8.
J Invertebr Pathol ; 106(2): 179-91, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20833182

RESUMEN

Several Vibrio species are known to be pathogenic to the Pacific oyster Crassostrea gigas. Survival varies according to pathogen exposure and high mortality events usually occur in summer during gametogenesis. In order to study the effects of gametogenetic status and ploidy (a factor known to affect reproduction allocation in oysters) on vibriosis survival, we conducted two successive experiments. Our results demonstrate that a common bath challenge with pathogenic Vibrio splendidus and Vibrio aestuarianus on a mixture of mature, spawning and non-mature oysters can lead to significant mortality. Previous bath challenges, which were done using only non-mature oysters, had not produced mortality. Immunohistochemical analyses showed the affinity of Vibrio for gonadic tissues, highlighting the importance of sexual maturity for vibriosis infection processes in oysters. Mortality rate results showed poor repeatability between tanks, however, in this bath challenge. We then tested a standardized and repeatable injection protocol using two different doses of the same combination of two Vibrio species on related diploid and triploid oysters at four different times over a year. Statistical analyses of mortality kinetics over a 6-day period after injection revealed that active gametogenesis periods correspond to higher susceptibility to vibriosis and that there is a significant interaction of this seasonal effect with ploidy. However, no significant advantage of triploidy was observed. Triploid oysters even showed lower survival than diploid counterparts in winter. Results are discussed in relation to differing energy allocation patterns between diploid and triploid Pacific oysters.


Asunto(s)
Crassostrea/microbiología , Crassostrea/fisiología , Vibrio/aislamiento & purificación , Animales , Susceptibilidad a Enfermedades/fisiopatología , Gametogénesis/fisiología , Reproducción/fisiología , Vibriosis/fisiopatología
9.
Neurooncol Adv ; 3(1): vdab153, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34765975

RESUMEN

BACKGROUND: Lymphopenia may lead to worse outcomes for glioblastoma patients. This study is a secondary analysis of the CCTG CE.6 trial evaluating the impact of chemotherapy and radiation on lymphopenia, and effects of lymphopenia on overall survival (OS). METHODS: CCTG CE.6 randomized elderly glioblastoma patients (≥ 65 years) to short-course radiation alone (RT) or short-course radiation with temozolomide (RT + TMZ). Lymphopenia (mild-moderate: grade 1-2; severe: grade 3-4) was defined per CTCAE v3.0, and measured at baseline, 1 week and 4 weeks post-RT. Preselected key factors for analysis included age, sex, ECOG, resection extent, MGMT methylation, Mini-Mental State Examination, and steroid use. Multinomial logistic regression and multivariable Cox regression models were used to identify lymphopenia-associated factors and association with survival. RESULTS: Five hundred and sixty-two patients were analyzed (281 RT vs 281 RT+TMZ). At baseline, both arms had similar rates of mild-moderate (21.4% vs 21.4%) and severe (3.2% vs 2.9%) lymphopenia. However, at 4 weeks post-RT, RT+TMZ was more likely to develop lymphopenia (mild-moderate: 27.9% vs 18.2%; severe: 9.3% vs 1.8%; p<0.001). Developing any lymphopenia post-RT was associated with baseline lymphopenia (P < .001). Baseline lymphopenia (hazard ratio [HR] 1.3) was associated with worse OS (HR: 1.30, 95% confidence interval [CI] 1.05-1.62; P = .02), regardless of MGMT status. CONCLUSIONS: Development of post-RT lymphopenia is associated with addition of TMZ and baseline lymphopenia and not with RT alone in patients treated with short-course radiation. However, regardless of MGMT status, only baseline lymphopenia is associated with worse OS, which may be considered as a prognostic biomarker for elderly glioblastoma patients.

10.
Animal ; 14(6): 1204-1212, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31941561

RESUMEN

Intramuscular connective tissue (IMCT) is mainly composed of several fibrils (known as total collagen (TCol)) linked between each other by different chemical cross-links (CLs), the whole being embedded in a matrix of proteoglycans (PGs). In the field of beef quality, there is limited information on the role of CLs and PGs. Accordingly, several authors suggest that, to investigate the role of IMCT, it is important to investigate them just like TCol and insoluble collagen (ICol). In muscle, there are two other components, the muscle fibres and intramuscular fat (IMF) content. There are limited data on the relationships between these three components of muscle and then on possibility to independently manipulate these characteristics in order to control the final quality of meat. The present study aimed to investigate whether consistent relationships exist between these different components of muscle. Therefore, the present study compared four muscles of two cattle types (dairy and beef) to determine associations between TCol, ICol, CLs and PGs. Data were analysed across and within muscle (M) and animal type (AT) based on residuals. There was a strong M and AT effect for all muscle characteristics and an interaction M × AT for type I muscle fibres and IMF. Correlations between TCol, ICol and their CLs were M- and AT-independent. Total proteoglycans were positively correlated with TCol and ICol in a muscle-dependent manner irrespective of AT, but no correlation was found with CLs. On the contrary, CLs were negatively correlated with the ratio TPGs : TCol in an M-dependent manner, irrespective of AT. TCol, ICol and CLs were positively and negatively correlated with type IIA and IIB+X muscle fibres only in longissimus thoracis (LT) muscle, regardless the AT. Insoluble collagen was the only parameter of IMCT to be correlated with type I muscle fibres but only in LT muscle, irrespective of AT. There was no correlation between PGs and muscle fibre types, but PGs were the only IMCT component to be related with IMF in an M-dependent manner, irrespective of AT. Finally, there was no correlation between muscle fibre types and IMF content within M and AT. This study revealed that there is a strong relationship between IMCT components irrespective of M, an M-dependent relationship between the IMCT components and muscle fibre types and few (only with PGs) or no relationship between IMF and IMCT and muscle fibres.


Asunto(s)
Composición Corporal/fisiología , Bovinos/fisiología , Tejido Conectivo/fisiología , Fibras Musculares Esqueléticas/clasificación , Fibras Musculares Esqueléticas/fisiología , Animales
11.
J Biomol Screen ; 14(5): 476-84, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19483144

RESUMEN

Preserving the integrity of the compound collection and providing high-quality materials for drug discovery in an efficient and cost-effective manner are 2 major challenges faced by compound management (CM) at Bristol-Myers Squibb (BMS). The demands on CM include delivering hundreds of thousands of compounds a year to a variety of operations. These operations range from single-compound requests to hit identification support and just-in-time assay plate provision for lead optimization. Support needs for these processes consist of the ability to rapidly provide compounds as solids or solutions in a variety of formats, establishing proper long- and short-term storage conditions and creating appropriate methods for handling concentrated, potent compounds for delivery to sensitive biological assays. A series of experiments evaluating the effects of processing compounds with volatile solvents, storage conditions that can induce freeze/thaw cycles, and the delivery of compounds were performed. This article presents the results of these experiments and how they affect compound integrity and the accuracy of compound management processes.


Asunto(s)
Bioensayo , Descubrimiento de Drogas , Estabilidad de Medicamentos , Bioensayo/instrumentación , Bioensayo/métodos , Bioensayo/normas , Descubrimiento de Drogas/instrumentación , Descubrimiento de Drogas/métodos , Preparaciones Farmacéuticas/química , Reproducibilidad de los Resultados
12.
Meat Sci ; 158: 107910, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31419600

RESUMEN

The aim of this study was to compare visible-near-infrared spectroscopy (VIS/NIRS) models developed from fresh or freeze-dried samples for predicting the fatty acid (FA) composition of beef samples. The hypothesis tested is that the removal of water from samples could improve the VIS/NIRS model performance. A total of 454 beef samples obtained from different bovine muscles were used. No significant differences were found in the performance of VIS/NIRS models developed from fresh or freeze-dried samples for predicting both major individual FAs and families of FAs and for some FAs (16:0, 18:0, 18:1 n-9, 18:2 n-6, 20:4 n-6, 22:5 n-3, 22:6 n-3, saturated, mono-unsaturated FA, and total n-3 long chain poly-unsaturated FAs (PUFA)). In contrast, the standard error of predictions for total PUFAs, total n-3 PUFAs, total conjugated linoleic acid, 20:5 n-3, and 18:3 n-3 were improved (by 21% on average; P < .05) in freeze-dried samples compared with fresh samples.


Asunto(s)
Ácidos Grasos/análisis , Carne Roja/análisis , Animales , Bovinos , Liofilización/métodos , Espectroscopía Infrarroja Corta/métodos
13.
Syst Rev ; 8(1): 183, 2019 07 23.
Artículo en Inglés | MEDLINE | ID: mdl-31337424

RESUMEN

BACKGROUND: Infant mental health has emerged as a unique area of practice and research distinguished from child and youth sub-specialties by its advocacy for a relational practice framework with an emphasis on parents/caregivers being integral to assessment, treatment, and prevention initiatives. A diverse array of initiatives offered across a broad spectrum of delivery methods is available to clinicians. However, to date, a large-scale mapping of the research evidence regarding these interventions has yet to be completed to help inform clinician's decisions regarding the best approaches for their clients. To address this knowledge gap, this study aimed to report on the landscape of research pertaining to mental health interventions for infants and preschoolers (0-5 years), and their families at risk for socio-emotional difficulties and negative developmental outcomes. METHOD: A scoping review methodology was used to conduct a large-scale mapping of the intervention research pertaining to infants and preschoolers (0-5) at risk for socio-emotional difficulties. We searched MEDLINE, PsycINFO, EMBASE, Web of Science, The Cochrane Library, CINAHL, LILACS, ProQuest Nursing & Allied Health Source, World Cat, and ClinicalTrials.gov , from inception to December 31, 2012. We extracted information regarding publication date, geographical location, study design, level of risk, population, key intervention mechanism, and outcome measures. RESULTS: We identified 533 potential studies from 1233 title and abstracts after the first round of screening. Full text article review in the second round of screening resulted in a total of 162 included articles for the final analysis. Results indicated that over 50% of interventions evaluated were randomized controlled trials conducted in Westernized countries. Most studies could be subdivided by level of risk within a preventative public health framework including universal, selected, indicated, and direct treatment for children formally diagnosed with a mental disorder. Risk factors experienced by children and their families were heterogeneously defined and numerous outcome measures across included studies. The results of this study are limited to the last search date of 2012. CONCLUSIONS: Key intervention mechanisms spanned a range of approaches including parenting groups, dyadic, in-home, cognitive-behavioral therapy, and day care-based interventions. The findings are discussed in terms of implications for broad trends and gaps in research and policy for this population.


Asunto(s)
Cuidadores/psicología , Terapia Cognitivo-Conductual , Emociones , Trastornos Mentales/prevención & control , Padres/psicología , Problema de Conducta/psicología , Cuidado del Niño/psicología , Desarrollo Infantil , Preescolar , Salud Global , Humanos , Lactante , Recién Nacido , Factores de Riesgo
14.
Int J Radiat Oncol Biol Phys ; 104(3): 640-643, 2019 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-30880270

RESUMEN

PURPOSE: Radiation-induced meningioma is a known late effect of cranial radiation therapy. Cranial magnetic resonance imaging (MRI) can detect small meningiomas, but its potential value as a screening tool is unknown. METHODS AND MATERIALS: MRI was used to screen asymptomatic survivors of childhood acute lymphoblastic leukemia (ALL) treated with cranial radiation therapy ≥10 years previously. The incidence of radiation-induced meningioma and outcomes of this group were compared with a historical cohort of survivors with the same exposure who underwent imaging only to investigate clinical signs or symptoms. RESULTS: One hundred seventy-six childhood leukemia survivors were included in this study: 70 in the screening group and 106 unscreened. Screening MRI was performed a median of 25 years after radiation therapy and detected meningioma in 15 (21.4%). In the unscreened group, 17 patients (16.0%) had neurologic symptoms leading to an MRI a median interval of 24 years after radiation therapy, 9 of whom (8.5%) were diagnosed with meningioma. There was no significant difference between screened versus unscreened patients in the size of meningioma (mean diameter, 1.6 cm vs 2.6 cm; P = .13), meningioma incidence (7.4% vs 4.0% at 25 years; P = .19), or extent of resection. Three patients had persistent neurologic symptoms in the unscreened group versus none among screened patients (P = .28). CONCLUSIONS: Screening MRI was able to detect small meningiomas that were not clinically apparent; however, we could not demonstrate a significant improvement in the chance of total resection or a significant decrease in morbidity. A larger sample could clarify potential reduction in neurologic sequelae associated with screening.


Asunto(s)
Irradiación Craneana/efectos adversos , Imagen por Resonancia Magnética , Neoplasias Meníngeas/diagnóstico por imagen , Meningioma/diagnóstico por imagen , Neoplasias Inducidas por Radiación/diagnóstico por imagen , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Adolescente , Adulto , Adultos Sobrevivientes de Eventos Adversos Infantiles , Enfermedades Asintomáticas , Supervivientes de Cáncer , Niño , Preescolar , Femenino , Humanos , Incidencia , Estimación de Kaplan-Meier , Masculino , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/cirugía , Meningioma/patología , Meningioma/cirugía , Persona de Mediana Edad , Neoplasias Inducidas por Radiación/patología , Neoplasias Inducidas por Radiación/cirugía , Factores de Tiempo , Carga Tumoral
15.
Neuro Oncol ; 21(2): 167-178, 2019 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-30189035

RESUMEN

Glioblastoma (GBM) is the most common primary malignant brain tumor, with a universally poor prognosis. The emergence of molecular biomarkers has had a significant impact on histological typing and diagnosis, as well as predicting patient survival and response to treatment. The methylation status of the O6-methylguanine-DNA methyl-transferase (MGMT) gene promoter is one such molecular biomarker. Despite the strong evidence supporting the role of MGMT methylation status in prognostication, its routine implementation in clinical practice has been challenging. The methods and optimal cutoff definitions for MGMT status determination remain controversial. Variation in detection methods between laboratories presents a major challenge for consensus. Moreover, consideration of other clinical and genetic/epigenetic factors must also be incorporated into treatment decision making. In this review, we distill the available evidence to summarize our position on the optimal use of available assays, and propose strategies for resolving cases with equivocal methylation status and a framework for incorporating this important assay into research and clinical practice.


Asunto(s)
Metilación de ADN , Metilasas de Modificación del ADN/genética , Enzimas Reparadoras del ADN/genética , Regulación Neoplásica de la Expresión Génica , Glioblastoma/diagnóstico , Glioblastoma/terapia , Regiones Promotoras Genéticas , Proteínas Supresoras de Tumor/genética , Glioblastoma/genética , Humanos , Pronóstico
16.
Child Abuse Negl ; 76: 546-560, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28985958

RESUMEN

Parents referred to child welfare services for child maltreatment often struggle against chronic risk factors including violence, substance abuse, mental health concerns, and poverty, which impinge upon their ability to be sensitive caregivers. The first line of intervention within the child welfare context is to modify parenting behavior. This scoping review comprehensively surveyed all available literature to map the extent and range of research activity around the types of interventions available within a child welfare context to parents of infants and toddlers (0-5 years of age), to identify the facilitators and/or barriers to the uptake of interventions, and to check that interventions match the risk factors faced by parents. This scoping review engaged in stringent screening of studies based upon inclusion/exclusion criteria. Sixty-five articles involving forty-two interventions met inclusion criteria. Interventions generally aimed to improve parenting practices, the relationship between parent and child, and/or attachment security, along with reducing child abuse and/or neglect. A notable finding of this scoping review is that at present, interventions for parents of children ages 0-5 involved with the child welfare system are most frequently measured via case study and quasi-experimental designs, with randomized control trials making up 26.2% of included study designs.


Asunto(s)
Maltrato a los Niños/prevención & control , Servicios de Protección Infantil , Protección a la Infancia , Responsabilidad Parental/psicología , Padres/educación , Niño , Maltrato a los Niños/psicología , Crianza del Niño/psicología , Preescolar , Educación no Profesional , Medicina Basada en la Evidencia , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Salud Mental , Padres/psicología , Pobreza , Proyectos de Investigación , Factores de Riesgo , Trastornos Relacionados con Sustancias/psicología , Violencia/psicología
17.
Int J Radiat Oncol Biol Phys ; 69(5): 1521-6, 2007 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-17869023

RESUMEN

PURPOSE: To assess the clinical outcomes and toxicity in patients receiving fractionated external beam radiotherapy (EBRT) for hemangioblastoma of the central nervous system, treated at two Canadian radiation oncology institutions. METHODS AND MATERIALS: Between January 1980 and December 2004, the data of all patients receiving EBRT for central nervous system hemangioblastoma were retrospectively reviewed. The patient, tumor, and treatment characteristics were collected and overall survival, disease-free survival, and EBRT-related toxicities assessed. RESULTS: A total of 18 cases, 5 associated with von Hippel-Lindau disease (VHL) and 13 sporadic (non-VHL), with a total 31 lesions, were documented. These were located in the cerebellum in 20 and spinal cord in 8 patients. EBRT was delivered for recurrence in 12, adjuvantly for residual disease in 4, and definitively in 2. The EBRT schedules ranged from 50.0 to 55.8 Gy in 1.8-2.0-Gy daily fractions (n = 17), typically with parallel-opposed fields to the cerebellar target volumes and direct posterior fields for spinal disease. At a median follow-up of 5.1 years (range, 0.1-14.5), the 5-year OS rate was 69% (95% confidence interval [CI], 50-96%), decreasing to 30% (95% CI, 10-87%) at 10 years. The disease-free survival rate at 5 and 10 years was 57% (95% CI, 37-87%) and 30% (95% CI, 11-83%), respectively. The outcomes differed according to VHL status. The 5-year OS rate was 100% for those with VHL compared with 55% (95% CI, 32-95%) for those with non-VHL disease (log-rank p = 0.003), and the 5-year disease-free survival rate was 80% (95% CI, 52-100%) with VHL compared with 48% (95% CI, 26-89%) without (log-rank p = 0.036). CONCLUSIONS: Fractionated EBRT has a role in the management of extensive intracranial and/or spinal cord disease, the adjuvant treatment of residual postoperative disease, and the treatment of recurrence. More favorable outcomes were reported for VHL-associated lesions than for sporadic cases.


Asunto(s)
Neoplasias Cerebelosas/radioterapia , Hemangioblastoma/radioterapia , Neoplasias de la Médula Espinal/radioterapia , Adolescente , Adulto , Anciano , Colombia Británica , Neoplasias Cerebelosas/mortalidad , Neoplasias Cerebelosas/cirugía , Supervivencia sin Enfermedad , Fraccionamiento de la Dosis de Radiación , Femenino , Hemangioblastoma/mortalidad , Hemangioblastoma/cirugía , Humanos , Masculino , Persona de Mediana Edad , Ontario , Traumatismos por Radiación/complicaciones , Estudios Retrospectivos , Neoplasias de la Médula Espinal/mortalidad , Neoplasias de la Médula Espinal/cirugía , Enfermedad de von Hippel-Lindau/complicaciones
18.
J Child Adolesc Psychopharmacol ; 17(1): 11-7, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17343550

RESUMEN

OBJECTIVE: The glutamatergic prefrontal-striatal pathway has been implicated previously in the neurobiology of attention-deficit/hyperactivity disorder (ADHD). We used short echo proton magnetic resonance spectroscopy (1H-MRS) to examine glutamate in the prefrontal cortex, left striatum, and, as a control area, the occipital lobe. METHOD: Thirteen treatment-naïve ADHD children and 10 healthy comparison subjects participated. All were males between the ages of 6 to 11 years of age. Twelve ADHD subjects were scanned after 8 weeks of treatment. RESULTS: Striatal glutamate, glutamate/glutamine (Glx) and creatine concentrations were greater in the ADHD subjects at baseline as compared to controls. Only striatal creatine, not glutamate or Glx, was reduced after stimulant treatment in the ADHD patients. No significant differences between groups were noted in the remainder of the striatal metabolites or any of the occipital lobe or prefrontal cortex metabolites. CONCLUSIONS: These findings provide initial evidence of a striatal creatine/glutamatergic dysregulation in ADHD.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Cuerpo Estriado/fisiopatología , Creatina/metabolismo , Ácido Glutámico/metabolismo , Glutamina/metabolismo , Espectroscopía de Resonancia Magnética , Corteza Prefrontal/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Estimulantes del Sistema Nervioso Central/uso terapéutico , Niño , Colina/metabolismo , Cuerpo Estriado/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Humanos , Inositol/metabolismo , Imagen por Resonancia Magnética , Masculino , Metilfenidato/uso terapéutico , Vías Nerviosas/efectos de los fármacos , Vías Nerviosas/fisiopatología , Lóbulo Occipital/efectos de los fármacos , Lóbulo Occipital/fisiopatología , Fosfocreatina/metabolismo , Corteza Prefrontal/efectos de los fármacos , Valores de Referencia
19.
Meat Sci ; 77(4): 678-88, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22061958

RESUMEN

The effects of linseed content in concentrates on the fatty acid (FA) composition of adipose tissues and muscles of lambs were studied in a 2×4 design: males (M) vs. females (F) and linseed content (0%, L0, 3%, L3, 6%, L6, 9%, L9). FA proportions were determined both on a DB-wax and on a CP-Sil column in perirenal (PR), dorsal subcutaneous (SC) adipose tissue and in longissusmus dorsi muscle (IM). No effects of linseed contents in the diet on growth performances either in male or female lambs were observed. Linseed supplementation tended to decrease the fatness score. The proportion of linolenic acid increased linearly with the linseed content in the diet, from: 0.6, 0.5, and 0.5% for L0 to 1.9, 1.6, and 1.3% for L9, in PR, SC and IM, respectively. The increase in n-3 PUFA and in total PUFA was similar to that of linolenic acid. The n-6:n-3 ratio decreased from 5.7, 5.3 and 5.8 for L0 to 1.8, 1.7 and 2.7 for L9, in PR, SC and IM, respectively. There was no change in the proportion of docosahexaenoic acid with linseed supplementation. The proportions of C18:1trans-10 and C18:1trans-11 did not vary in PR, SC and IM with linseed supplementation. The total proportion of trans-octadecenoic acid was high in each tissue type and group of lambs. C18:1trans-10 represented about half of the total trans-octadecenoic isomers. With an increase in linolenic acid, most cis- and trans-octadecenoic isomers also increased, but trans-10 and trans-11 isomers did not and cis-9 and cis-11 isomers decreased. With linseed supplementation there was a decrease in the Δ9 desaturase indices in SC.

20.
Nat Commun ; 8(1): 186, 2017 08 04.
Artículo en Inglés | MEDLINE | ID: mdl-28775249

RESUMEN

Cranial radiotherapy improves survival of the most common childhood cancers, including brain tumors and leukemia. Unfortunately, long-term survivors are faced with consequences of secondary neoplasia, including radiation-induced meningiomas (RIMs). We characterized 31 RIMs with exome/NF2 intronic sequencing, RNA sequencing and methylation profiling, and found NF2 gene rearrangements in 12/31 of RIMs, an observation previously unreported in sporadic meningioma (SM). Additionally, known recurrent mutations characteristic of SM, including AKT1, KLF4, TRAF7 and SMO, were not observed in RIMs. Combined losses of chromosomes 1p and 22q were common in RIMs (16/18 cases) and overall, chromosomal aberrations were more complex than that observed in SM. Patterns of DNA methylation profiling supported similar cell of origin between RIMs and SMs. The findings indicate that the mutational landscape of RIMs is distinct from SMs, and have significant therapeutic implications for survivors of childhood cranial radiation and the elucidation of the molecular pathogenesis of meningiomas.Radiation-induced meningiomas are often more aggressive than sporadic ones. In this study, the authors perform an exome, methylation and RNA-seq analysis of 31 cases of radiation-induced meningioma and show NF2 rearrangement, an observation previously unreported in the sporadic tumors.


Asunto(s)
Irradiación Craneana/efectos adversos , Reordenamiento Génico/genética , Genes de la Neurofibromatosis 2 , Neoplasias Meníngeas/genética , Meningioma/genética , Neoplasias Inducidas por Radiación/genética , Adulto , Anciano , Supervivientes de Cáncer , Estudios de Casos y Controles , Neoplasias Cerebelosas/radioterapia , Metilación de ADN , Femenino , Humanos , Factor 4 Similar a Kruppel , Leucemia/radioterapia , Masculino , Meduloblastoma/radioterapia , Neoplasias Meníngeas/etiología , Meningioma/etiología , Persona de Mediana Edad , Mutación , Neoplasias Inducidas por Radiación/etiología , Análisis de Secuencia de ADN , Análisis de Secuencia de ARN , Adulto Joven
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