Anaplastic Lymphoma Kinase Is Required for Neurogenesis in the Developing Central Nervous System of Zebrafish

10.1371/journal.pone.0063757PLoS ONE85

Prospective single-arm study of 72 Gy hyperfractionated radiation therapy and combination chemotherapy for anaplastic astrocytomas

<p>Abstract</p> <p>Background</p> <p>Despite intensive multimodal treatment, outcome of patients with malignant glioma remains poor, and a standard dose of radiotherapy for anaplastic astrocytoma has not been defined. In the past RTOG study (83-02), the arm of 72 Gy hyperfractionated radiotherapy (HFRT) for malignant gliomas showed better outcome than the arms of higher doses (76.8 – 81.6 Gy) and the arms of lower doses (48 – 54.4 Gy). The purpose of this study is to verify the efficacy of this protocol.</p> <p>Methods</p> <p>From July 1995, 44 consecutive eligible patients with histologically proven anaplastic astrocytoma were enrolled in this study (HFRT group). The standard regimen in this protocol was post-operative radiotherapy of 72 Gy in 60 fractions (1.2 Gy/fraction, 2 fractions/day) with concurrent chemotherapy (weekly ACNU). The primary endpoint was local control rate (LCR), and the secondary endpoints were overall survival (OS), progression-free survival (PFS) and late toxicity.</p> <p>Results</p> <p>Three-year OS of the HFRT group was 64.8% (95% confidence interval; 48.4–81.3%). Three-year PFS rate and LCR were 64.4% (95%CI: 48.4–80.3%) and 81.6% (95%CI: 69.2–94.8%), respectively.</p> <p>The number of failures at 5 years in the HFRT group were 14 (32%). The number of failures inside the irradiation field was only about half (50%) of all failures. One (2%) of the patients clinically diagnosed as brain necrosis due to radiation therapy.</p> <p>Conclusion</p> <p>The results of this study suggested that 72 Gy HFRT seemed to show favorable outcome for patients with anaplastic astrocytoma with tolerable toxicity.</p

Brain Research to Ameliorate Impaired Neurodevelopment - Home-based Intervention Trial (BRAIN-HIT)

<p>Abstract</p> <p>Background</p> <p>This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low- and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low- and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality and morbidity from birth asphyxia disproportionately affect more infants in low- and low-middle-income countries, particularly those from the lowest socioeconomic groups. There is evidence that relatively inexpensive programs of early developmental intervention, delivered during home visit by parent trainers, are capable of improving neurodevelopment in infants following brain insult due to birth asphyxia.</p> <p>Methods/Design</p> <p>This trial is a block-randomized controlled trial that has enrolled 174 children with birth asphyxia and 257 without perinatal complications, comparing early developmental intervention plus health and safety counseling to the control intervention receiving health and safety counseling only, in sites in India, Pakistan, and Zambia. The interventions are delivered in home visits every two weeks by parent trainers from 2 weeks after birth until age 36 months. The primary outcome of the trial is cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and number of home visits completed are evaluated as moderating factors.</p> <p>Discussion</p> <p>The trial is supervised by a trial steering committee, and an independent data monitoring committee monitors the trial. Findings from this trial have the potential to inform about strategies for reducing neurodevelopmental disabilities in at-risk young children in low and middle income countries.</p> <p>Trial Registration</p> <p>Clinicaltrials.gov NCT00639184</p

Fatores associados ao desenvolvimento mental e motor de crianças de quatro creches públicas de Recife, Brasil Factors associated with mental and psychomotor development of infants in four public day care centers in the municipality of Recife, Brazil

OBJETIVO: Identificar os fatores associados aos índices de desenvolvimento mental e motor em lactentes que frequentam creches da rede municipal em Recife. MÉTODOS: Estudo de corte transversal realizado entre fevereiro e abril de 2005 em uma amostra de 108 crianças com idade entre quatro e 24 meses, pertencentes a quatro creches municipais do Recife. O desenvolvimento mental e motor foi avaliado pela Escala de Desenvolvimento Infantil de Bayley II. Por meio de entrevistas às mães, foram obtidas informações sobre as condições socioeconômicas e demográficas das famílias e as características biológicas das crianças ao nascer (peso, sexo e idade gestacional). O estado nutricional foi avaliado através dos índices peso/idade, comprimento/idade, peso/comprimento e da concentração de hemoglobina. RESULTADOS: As médias dos índices de desenvolvimento mental e motor foram 88±11 e 95±12 pontos, respectivamente. A idade gestacional apresentou associação significativa com o desenvolvimento mental e motor e o peso ao nascer e o estado nutricional atual, avaliado pelo índice peso/comprimento, se associaram ao desenvolvimento motor. CONCLUSÕES: As crianças analisadas apresentaram desenvolvimento neuropsicomotor ainda na faixa de normalidade, mas aquém do esperado para a idade, comparado a populações de referência em países desenvolvidos. Os fatores associados ao baixo desempenho do desenvolvimento nessa população estão relacionados aos fatores biológicos, destacando-se os déficits nutricionais, cuja redução deve ser uma prioridade para gestores em saúde e educação.<br>OBJECTIVE: To identify factors associated with mental and psychomotor development of infants enrolled at public day care centers of Recife, Pernambuco, Brazil. METHODS: This is a cross-sectional study conducted with 108 infants aged four to 24 months attending four public day care centers of the Municipality of Recife from February to April 2005. Mental and psychomotor development was assessed by the Bayley Scale of Infant Development II. Family socioeconomic and demographic conditions and infant biological characteristics at birth (weight, sex and gestational age) were obtained by maternal interview. Nutritional status was assessed by the indexes "weight-for-age", "length-for-age" and "weight-for-length" and by hemoglobin level. RESULTS: Mean mental and psychomotor development indexes were 88±11 and 95±12, respectively. Gestational age showed significant association with mental and psychomotor development. Birthweight and current nutritional status assessed by "weight-for-length" were associated with psychomotor development. CONCLUSIONS: Mental and psychomotor development were in the the normal range, but, below the expected for infants of the same age group of reference populations in developed countries. The factors associated with poor developmental indexes in this population are related to biological factors, with emphasis on nutritional deficits. Their reduction should be a priority for health and educational policy managers