BACKGROUND: Pancreatic neuroendocrine tumors are rare neoplasms for which few predictive and/or prognostic biomarkers have been validated. Our previous work suggested the potential of the combined expression of N-myc downstream-regulated gen-1 (NDRG-1), O6-methylguanine DNA methyltransferase (MGMT) and Pleckstrin homology-like domain family A member 3 (PHLDA-3) as prognostic factors for relapse and survival. METHODS: In this new multicenter study we evaluated immunohistochemistry expression in 76 patients with advanced PanNET who were treated with capecitabine-temozolomide or everolimus. Based on the immunohistochemistry panel, an immunohistochemistry prognostic score (IPS) was developed. RESULTS: In patients treated with capecitabine and temozolomide, low IPS was an independent prognostic factor for progression-free-survival and overall-survival. Similar findings were observed with highest IPS for overall-survival in patients treated with everolimus. CONCLUSION: From our knowledge, it is the first time that a simple IPS could be useful to predict outcome for patients with metastatic pancreatic neuroendocrine tumors treated with everolimus or capecitabine and temozolomide.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Everolimus/therapeutic use , Immunohistochemistry/methods , Immunosuppressive Agents/therapeutic use , Neuroendocrine Tumors/drug therapy , Neuroendocrine Tumors/pathology , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/analysis , Cell Cycle Proteins/analysis , Cell Line, Tumor , DNA Modification Methylases/analysis , DNA Repair Enzymes/analysis , Female , Humans , Intracellular Signaling Peptides and Proteins/analysis , Male , Middle Aged , Neoplasm Recurrence, Local , Neuroendocrine Tumors/mortality , Nuclear Proteins/analysis , Pancreatic Neoplasms/mortality , Prognosis , Progression-Free Survival , Survival Analysis , Tumor Suppressor Proteins/analysis , Young Adult
OBJECTIVE: The objective was to obtain normalized data from the ADHD Rating Scale-IV-Preschool Version (ADHD-RS-IV-P) in a Spanish sample. METHOD: We translated and adapted the ADHD-RS-IV to our culture to obtain normalized data from a random representative sample of 1,426 Spanish preschool children (3 to <7 years old; 49.7% males). To analyze differences between evaluators, we used MANOVA. Internal consistency was assessed via Cronbach's alpha. RESULTS: The mean age was 4.7 years old. There was a significant sex effect. The questionnaire had an internal consistency between .86 and .96 according to subscale and evaluator. CONCLUSION: To evaluate ADHD in preschool children, it is necessary to use scores standardized by sex. Using a validated scale in schools and primary care centers may be useful for early detection of ADHD.
Attention Deficit Disorder with Hyperactivity/diagnosis , Psychiatric Status Rating Scales/standards , Psychometrics/statistics & numerical data , Surveys and Questionnaires/standards , Attention Deficit Disorder with Hyperactivity/ethnology , Attention Deficit Disorder with Hyperactivity/psychology , Case-Control Studies , Child , Child, Preschool , Female , Humans , Male , Multivariate Analysis , Reproducibility of Results , Schools , Spain , White People
Introducción. La prevalencia del trastorno por déficit de atención/hiperactividad (TDAH) está en constante estudio, y hay pocas publicaciones sobre la prevalencia en niños preescolares. Objetivo. Estudiar la prevalencia de síntomas de TDAH en niños preescolares usando una escala específica (ADHD Rating Scale-IV, versión preescolar, validada para España) desarrollada para esta franja de edad. Sujetos y métodos. Se evalúa la prevalencia de posible TDAH en una muestra representativa de preescolares en Navarra y La Rioja usando diferentes puntos de corte. Resultados. Se encuentra un rango de prevalencia de síntomas de TDAH del 2,5-4,1% según el criterio usado (más o menos estricto). Conclusiones. Existen herramientas específicas que pueden usarse para evaluar el TDAH en preescolares. La prevalencia de posible TDAH en preescolares en España es similar a la encontrada en otros países. La frecuencia de síntomas en esta franja de edad no es más alta que en otras edades, por lo que no es cierto que los síntomas de TDAH sean muy prevalentes en la población general de niños preescolares (AU)
Introduction. There are few studies about preschool attention deficit hyperactivity disorder (ADHD) prevalence. Aim. To study the prevalence of ADHD in preschoolers using an specific scale (ADHD-RS-IV-P-Es) developed for this age range. Subjects and methods. We evaluated the prevalence of possible ADHD in a representative sample of preschoolers in Navarra and La Rioja, Spain. Results. We find a range of prevalence between 2.5-4.1% depending on the criteria that was used (more or less strict). Conclusions. There are specific tools that can be use in preschool ADHD study. The prevalence of preschool ADHD in Spain is similar than in other countries. The frequency of symptoms in this age range is similar to the found in school age children (AU)
Humans , Male , Female , Child, Preschool , Attention Deficit Disorder with Hyperactivity/epidemiology , Impulsive Behavior , Neuropsychological Tests/statistics & numerical data , Neurodevelopmental Disorders/epidemiology , Child Development , Reproducibility of Results , Psychometrics/instrumentation
Nuestro objetivo es realizar un estudio piloto clínico-epidemiológico de trastorno por déficit de atención e hiperactividad (TDAH) en población preescolar. El método utilizado ha sido un estudio poblacional multicéntrico. Evaluamos 1.171 preescolares, el 4,1% de los cuales correspondían a un posible caso de TDAH. Los posibles factores asociados a una presencia de sospecha de TDAH han sido antecedentes familiares de TDAH, consumo de tabaco en el embarazo y antecedentes de dificultades en el desarrollo psicomotor. Es importante realizar una detección precoz del TDAH en la época preescolar para iniciar de forma temprana intervenciones efectivas
Our objective is to conduct a clinical-epidemiological pilot study of Attention deficit hyperactivity disorder (ADHD) in the preschool population. The method used was a multicenter demographic study. We evaluated 1,171 preschool children, 4.1 % of whom could be possible cases of ADHD. The possible factors associated with suspected ADHD were a family history of ADHD, smoking during pregnancy and psychomotor developmental difficulties. An early detection of ADHD at preschool age is important in order to start effective intervention
El nostre objectiu és realitzar un estudi pilot clínic i epidemiològic de trastorn per dèficit datenció i hiperactivitat (TDAH) en la població escolar. El mètode emprat ha estat un estudi poblacional multicèntric. Vam avaluar 1.171 preescolars, el 4,1% dels quals corresponien a un possible cas de TDAH. Els possibles factors associats a una presència de sospita de TDAH han estat antecedents familiars de TDAH, consum de tabac en lembaràs i antecedents de dificultats en el desenvolupament psicomotor. És important realitzar una detecció precoç del TDAH en lèpoca preescolar per iniciar de manera primerenca intervencions efectives
Humans , Male , Female , Child, Preschool , Attention Deficit Disorder with Hyperactivity/prevention & control , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit Disorder with Hyperactivity/pathology , Child, Preschool , Early Diagnosis , Risk Factors , Epidemiologic Studies , Multicenter Studies as Topic/instrumentation , Multicenter Studies as Topic/methods , Multicenter Studies as Topic , Spain
BACKGROUND: As marker genes for bipolar disorder (BP) and attention deficit hyperactivity disorder (ADHD) are not fully identified, we carried out a complete genome analysis to search for genes differentially expressed in ADHD and BP. MATERIALS AND METHODS: We recruited 39 patients (30 ADHD, 9 BP), aged 7 to 23 years. For evaluation of the psychiatric diagnosis, we used a semi-structured interview based on the K-SADS-PL (DSM-IV). RNA was extracted from peripheral blood and analyzed with the GeneChip® Human Genome U133-Plus 2.0 (Affymetrix). For the validation of differentially expressed genes, real-time PCR was used. RESULTS: Hybridization and subsequent statistical analysis found 502 probe-sets with significant differences in expression in ADHD and BP patients. Of these, 82 had highly significant differences. Neuregulin (NRG1), cathepsins B and D (CTSB, CTSD) and prostaglandin-D2-synthase (PTGDS) were chosen for semi-quantitative mRNA determination. The expression of PTGDS was statistically increased in ADHD relative to BP patients (p=0.01). We found no such differential expression with NRG1, CTSB and CTSD genes (p>0.05). CONCLUSIONS: The gene coding for PTGDS was found to be more expressed in patients with ADHD relative to patients with BP, indicating a possible link with the differential etiology of ADHD. The experimental approach we have used is, at least in part, validated by the detection of proteins directly concerned with brain functions, and shows a possible way forward for studies of the connection between brain function genes and psychiatric disorders. LIMITATIONS: Confirmation of our findings requires a larger sample of patients with clearly-defined phenotypes.
Attention Deficit Disorder with Hyperactivity/genetics , Bipolar Disorder/genetics , Intramolecular Oxidoreductases/genetics , Lipocalins/genetics , Adolescent , Child , Female , Gene Expression , Genome-Wide Association Study , Humans , Male , Phenotype , Young Adult
