Case ascertainment uncertainties in prevalence surveys of Parkinson's disease

Using unpublished data from five completed prevalence surveys of Parkinson's disease (PD), we investigated case ascertainment uncertainties that potentially have a direct effect on prevalence. These uncertainties arise from the choice of diagnostic criteria, the choice of screening method, and the amount of information lost because of nonresponse. The surveys were conducted in Argentina, India, China, Italy, and the Netherlands. Our analyses consisted of simple comparisons of prevalence results, positive predictive values (a screening measure), and nonresponse percentages. We found that (a) prevalence comparisons between surveys have diminished value if the surveys used different diagnostic criteria for PD; (b) screening performance may be affected adversely if symptom questions are answered by one family member for the entire family living together rather than by each family member individually; and (c) nonresponse from refusal or unavailability does not necessarily lead to bias, but special caution may be appropriate with prevalence results pertaining to elderly women

Bevacizumab, Irinotecan, or Topotecan Added to Temozolomide for Children With Relapsed and Refractory Neuroblastoma: Results of the ITCC-SIOPEN BEACON-Neuroblastoma Trial

Purpose Outcomes for children with relapsed and refractory high-risk neuroblastoma (RR-HRNB) remain dismal. The BEACON Neuroblastoma trial (EudraCT 2012-000072-42) evaluated three backbone chemotherapy regimens and the addition of the antiangiogenic agent bevacizumab (B). Materials and Methods Patients age 1-21 years with RR-HRNB with adequate organ function and performance status were randomly assigned in a 3 × 2 factorial design to temozolomide (T), irinotecan-temozolomide (IT), or topotecan-temozolomide (TTo) with or without B. The primary end point was best overall response (complete or partial) rate (ORR) during the first six courses, by RECIST or International Neuroblastoma Response Criteria for patients with measurable or evaluable disease, respectively. Safety, progression-free survival (PFS), and overall survival (OS) time were secondary end points. Results One hundred sixty patients with RR-HRNB were included. For B random assignment (n = 160), the ORR was 26% (95% CI, 17 to 37) with B and 18% (95% CI, 10 to 28) without B (risk ratio [RR], 1.52 [95% CI, 0.83 to 2.77]; P = .17). Adjusted hazard ratio for PFS and OS were 0.89 (95% CI, 0.63 to 1.27) and 1.01 (95% CI, 0.70 to 1.45), respectively. For irinotecan ([I]; n = 121) and topotecan (n = 60) random assignments, RRs for ORR were 0.94 and 1.22, respectively. A potential interaction between I and B was identified. For patients in the bevacizumab-irinotecan-temozolomide (BIT) arm, the ORR was 23% (95% CI, 10 to 42), and the 1-year PFS estimate was 0.67 (95% CI, 0.47 to 0.80). Conclusion The addition of B met protocol-defined success criteria for ORR and appeared to improve PFS. Within this phase II trial, BIT showed signals of antitumor activity with acceptable tolerability. Future trials will confirm these results in the chemoimmunotherapy era

Multiple Sclerosis In South America: Month Of Birth In Different Latitudes Does Not Seem To Interfere With The Prevalence Or Progression Of The Disease [esclerose Múltipla Na América Do Sul: Mês De Nascimento Em Diferentes Latitudes Não Parece Interferir Com A Prevalência Ou Progressão Da Doença]

Objective: To assess whether the month of birth in different latitudes of South America might influence the presence or severity of multiple sclerosis (MS) later in life. Methods: Neurologists in four South American countries working at MS units collected data on their patients' month of birth, gender, age, and disease progression. Results: Analysis of data from 1207 MS patients and 1207 control subjects did not show any significant variation in the month of birth regarding the prevalence of MS in four latitude bands (0-10; 11-20; 21-30; and 31-40 degrees). There was no relationship between the month of birth and the severity of disease in each latitude band. Conclusion: The results from this study show that MS patients born to mothers who were pregnant at different Southern latitudes do not follow the seasonal pattern observed at high Northern latitudes.719:00 AM573579Templer, D.I., Trent, N.H., Spencer, D.A., Season of birth in multiple sclerosis (1992) Acta Neurol Scand, 85, pp. 107-109Bharanidharan, P., Monthly distribution of multiple sclerosis patients' births (1997) Int J Biometeorol, 40, pp. 117-118Salemi, G., Ragonese, P., Aridon, P., Is season of birth associated with multiple sclerosis? (2000) Acta Neurol Scand, 101, pp. 381-383Salzer, J., Svenningsson, A., Sundström, P., Season of birth and multiple sclerosis in Sweden (2010) Acta Neurol Scand, 122, pp. 70-73Bayes, H.K., Weir, C.J., O'Leary, C., Timing of birth and risk of multiple sclerosis in the Scottish population (2010) Eur Neur, 63, pp. 36-40Saastamoinen, K.P., Auvinen, M.K., Tienari, P.J., Month of birth is associated with multiple sclerosis but not with HLA-DR15 in Finland (2012) Mult Scler, 18, pp. 563-568Fernandes de Abreu, D.A., Babron, M.C., Rebeix, I., Season of birth and not vitamin D receptor promoter polymorphisms is a risk factor for multiple sclerosis (2009) Mult Scler, 15, pp. 1146-1152Willer, C.J., Dyment, D.A., Sadovnick, A.D., Timing of birth and risk of multiple sclerosis: Population based study (2005) BMJ, 330, p. 120. , Canadian Collaborative Study GroupDeussing, E.C., Jankosky, C.J., Clark, L.L., Estimated incidence of multiple sclerosis among United States Armed Forces personnel using the Defense Medical Surveillance System (2012) Mil Med, 177, pp. 594-600Staples, J., Ponsonby, A.L., Lim, L., Low maternal exposure to ultraviolet radiation in pregnancy, month of birth, and risk of multiple sclerosis in offspring: Longitudinal analysis (2010) BMJ, 340, p. 1640Givon, U., Zeilig, G., Dolev, M., The month of birth and the incidence of multiple sclerosis in the Israeli population (2012) Neuroepidemiology, 38, pp. 64-68Fragoso, Y.D., Shearer, K.D., Adoni, T., Month of birth does not seem to interfere with the development of multiple sclerosis later in life in Brazilian patients (2012) Neuroepidemiology, 39, pp. 70-71Koch, M., de Keyser, J., Tremlett, H., Timing of birth and disease progression in multiple sclerosis (2008) Mult Scler, 14, pp. 793-798Tremlett, H.L., Devonshire, V.A., Does the season or month of birth influence disease progression in multiple sclerosis? 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