Interaction Between Intellectual Disability and Cerebral Palsy on the Co-Occurrence of Autism Spectrum Disorder and Epilepsy

Intellectual disability (ID) is possibly a reason for the higher co-occurrence of Autism Spectrum Disorder (ASD) in children with epilepsy. Cerebral Palsy (CP) has also been found to co-occur with ASD (6.9%-hypotonic, 18.4%-spastic subtype) and with epilepsy (41%), but it is unclear if the co-occurrence of ASD and epilepsy varies by the presence of both, ID and CP. The purpose of this study to evaluate effect modification of CP and ID on ASD-epilepsy co-occurrence

Assessing the impact of misclassification when comparing prevalence data: A novel sensitivity analysis approach

Background: A simple sensitivity analysis technique was developed to assess the impact of misclassification and verify observed prevalence differences between distinct populations. Methods: The prevalence of self-reported comorbid diseases in 4,331 women with surgically-diagnosed endometriosis was compared to published clinical and population-based prevalence estimates. Disease prevalence misclassification was assessed by assuming over-reporting in the study sample and under-reporting in the general (comparison) population. Over- and under-reporting by 10%, 25%, 50%, 75%, and 90% was used to create a 5×5 table for each disease. The new prevalences represented by each table cell were compared by p-values, prevalence odds ratios, and 95% confidence intervals. Results: Three misclassification patterns were observed: 1) differences remained significant except at high degrees (\u3e50%) of misclassification; 2) minimal (10%) misclassification negated any observed difference; and 3) with some (25-50%) misclassification, the difference disappeared, and the direction of significance changed at higher levels (\u3e50%). Conclusions: This sensitivity analysis enabled us to verify observed prevalence differences. This useful, simple approach is for comparing prevalence estimates between distinct populations

Assessing the Impact of Family Status, Family Cohesion, and Acculturation on Youth Violence Among Immigrant Latinos

Background/Objectives: Latino youth violence is an emerging public health concern. The objective is to assess the impact of family status, family cohesion, and acculturation on youth violence among Latino immigrants in Langley Park, MD compared with a control community in Culmore, VA. Methods: Constructs were generated from survey questions to represent family support and cohesion, acculturation, and youth violence. Bivariate and multivariate regression analyses were modeled to evaluate the relationships between family support and cohesion, acculturation, and violence, after adjusting for confounders. Results: After controlling for covariates, family support consistently reduced victimization (PE = ‐0.02, SE = 0.01, t = ‐2.64, p‐value = 0.0085); increased non‐violence attitudes and beliefs (PE = 0.32, SE = 0.05, t = 6.17, p‐value = Conclusions: Family support is associated with reduced violence engagement and risk behaviors among Latino youth. Results will inform the development and implementation of future youth violence prevention programs among ethnic minorities and immigrants

Male Pattern Baldness in Relation to Prostate Cancer–Specific Mortality: A Prospective Analysis in the NHANES I Epidemiologic Follow-up Study

We used male pattern baldness as a proxy for long-term androgen exposure and investigated the association of dermatologist-assessed hair loss with prostate cancer–specific mortality in the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. From the baseline survey (1971–1974), we included 4,316 men who were 25–74 years of age and had no prior cancer diagnosis. We estimated hazard ratios and used Cox proportional hazards regressions with age as the time metric and baseline hazard stratified by baseline age. A hybrid framework was used to account for stratification and clustering of the sample design, with adjustment for the variables used to calculate sample weights. During follow-up (median, 21 years), 3,284 deaths occurred; prostate cancer was the underlying cause of 107. In multivariable models, compared with no balding, any baldness was associated with a 56% higher risk of fatal prostate cancer (hazard ratio = 1.56; 95% confidence interval: 1.02, 2.37), and moderate balding specifically was associated with an 83% higher risk (hazard ratio = 1.83; 95% confidence interval: 1.15, 2.92). Conversely, patterned hair loss was not statistically significantly associated with all-cause mortality. Our analysis suggests that patterned hair loss is associated with a higher risk of fatal prostate cancer and supports the hypothesis of overlapping pathophysiological mechanisms

Liver resection after chemotherapy and tumour downsizing in patients with initially unresectable colorectal cancer liver metastases

AbstractObjectivesAmong patients with initially unresectable colorectal cancer liver metastases (CLM), a subset are rendered resectable following the administration of systemic chemotherapy. This study reports the results achieved in liver resections performed at a single hepatobiliary referral centre after downsizing chemotherapy in patients with initially unresectable CLM.MethodsAll liver resections for CLM performed over a 10-year period at the Toronto General Hospital were considered. Data on initially non-resectable patients who received systemic therapy and later underwent surgery were included for analysis.ResultsBetween January 2002 and July 2012, 754 liver resections for CLM were performed. A total of 24 patients were found to meet the study inclusion criteria. Bilobar CLM were present in 23 of these 24 patients. The median number of tumours was seven (range: 2–15) and median tumour size was 7.0cm (range: 1.0–12.8cm) before systemic therapy. All patients received oxaliplatin- or irinotecan-based chemotherapy. Fourteen patients received combined treatment with bevacizumab. Negative margin (R0) resection was accomplished in 21 of 24 patients. There was no perioperative mortality. Ten patients suffered perioperative morbidity. Eighteen patients suffered recurrence of disease within 9 months. Rates of disease-free survival at 1, 2 and 3 years were 47.6% [95% confidence interval (CI) 30.4–74.6%], 23.8% (95% CI 11.1–51.2%) and 19.0% (95% CI 7.9–46.0%), respectively. Overall survival at 1, 2 and 3 years was 91.5% (95% CI 80.8–100%), 65.3% (95% CI 48.5–88.0%) and 55.2% (95% CI 37.7–80.7%), respectively.ConclusionsLiver resection in initially unresectable CLM can be performed with low rates of morbidity and mortality in patients who respond to systemic chemotherapy, although these patients do experience a high frequency of disease recurrence

Outcomes of Radiofrequency Ablation as First-Line Therapy for Hepatocellular Carcinoma less than 3 cm in Potentially Transplantable Patients

© 2019 European Association for the Study of the Liver Background & Aims: Radiofrequency ablation (RFA) is an effective treatment for single hepatocellular carcinoma (HCC) ≤3 cm. Disease recurrence is common, and in some patients will occur outside transplant criteria. We aimed to assess the incidence and risk factors for recurrence beyond Milan criteria in potentially transplantable patients treated with RFA as first-line therapy. Methods: We performed a retrospective cohort study of potentially transplantable patients with new diagnoses of unifocal HCC ≤3 cm that underwent RFA as first-line therapy between 2000-2015. We defined potentially transplantable patients as those aged 2 cm). Competing risks Cox regression was used to identify predictors of recurrence beyond Milan criteria. Results: We included 301 patients (167 HCC ≤2 cm and 134 HCC >2 cm). Recurrence beyond Milan criteria occurred in 36 (21.6%) and 47 (35.1%) patients in the HCC ≤2 cm and the HCC >2 cm groups, respectively (p = 0.01). The 1-, 3- and 5-year actuarial survival rates after RFA were 98.2%, 86.2% and 79.0% in the HCC ≤2 cm group vs. 93.3%, 77.6% and 70.9% in the HCC >2 cm group (p = 0.01). Tumor size >2 cm (hazard ratio 1.94; 95% CI 1.25–3.02) and alpha-fetoprotein levels at the time of ablation (100–1,000 ng/ml: hazard ratio 2.05; 95% CI 1.10–3.83) were found to be predictors of post-RFA recurrence outside Milan criteria. Conclusion: RFA for single HCC ≤3 cm provides excellent short- to medium-term survival. However, we identified patients at higher risk of recurrence beyond Milan criteria. For these patients, liver transplantation should be considered immediately after the first HCC recurrence following RFA. Lay summary: Radiofrequency ablation and liver transplantation are treatment options for early stages of hepatocellular carcinoma (HCC). After ablation some patients will experience recurrence or metastatic spread of the initial tumor or may develop new tumors within the liver. Despite close follow-up, these recurrences can progress rapidly and exceed transplant criteria, preventing the patient from receiving a transplant. We identified that patients with HCC >2 cm and higher serum alpha-fetoprotein are at greater risk of recurrence beyond the transplant criteria. These data suggest that liver transplantation should be considered immediately after the first HCC recurrence for these patients

X-Rays from Superbubbles in the Large Magellanic Cloud. V. The H II Complex N11

The large H II complex N11 in the Large Magellanic Cloud contains OB associations at several different stages in their life histories. We have obtained ROSAT PSPC and HRI X-ray observations, Curtis Schmidt CCD images, echelle spectra in H-alpha and [N II] lines, and IUE interstellar absorption line observations of this region. The central bubble of N11 has an X-ray luminosity a factor of only 3-7 brighter than predicted for an energy-conserving superbubble, making this the first detection of X-ray emission from a superbubble without a strong X-ray excess. The region N11B contains an extremely young OB association analogous to the central association of the Carina nebula, apparently still embedded in its natal molecular cloud. We find that N11B emits diffuse X-ray emission, probably powered by stellar winds. Finally, we compare the tight cluster HD32228 in N11 to R136 in 30 Dor. The latter is a strong X-ray source, while the former is not detected, showing that strong X-ray emission from compact objects is not a universal property of such tight clusters.Comment: submitted to ApJ 1 April 1997, uses aasms4.sty, 20 pages, 10 figures (figure 3 is color; figures 1a and 4 are gifs; original postscript available from http://www.mpia-hd.mpg.de/MPIA/Projects/THEORY/maclow/papers/n11/n11.htm

Risk of colorectal cancer for carriers of mutations in MUTYH, with and without a family history of cancer

We studied 2332 individuals with monoallelic mutations in MUTYH among 9504 relatives of 264 colorectal cancer (CRC) cases with a MUTYH mutation. We estimated CRC risks through 70 years of age of 7.2% for male carriers of monoallelic mutations (95% confidence interval [CI], 4.6%-11.3%) and 5.6% for female carriers of monoallelic mutations (95% CI, 3.6%-8.8%), irrespective of family history. For monoallelic MUTYH mutation carriers with a first-degree relative with CRC diagnosed by 50 years of age who does not have the MUTYH mutation, risks of CRC were 12.5% for men (95% CI, 8.6%-17.7%) and 10% for women (95% CI, 6.7%-14.4%). Risks of CRC for carriers of monoallelic mutations in MUTYH with a first-degree relative with CRC are sufficiently high to warrant more intensive screening than for the general population

Mutations in the voltage-gated potassium channel gene KCNH1 cause Temple-Baraitser syndrome and epilepsy (vol 47, pg 73, 2015)

"Mutations in the voltage-gated potassium channel gene KCNH1 cause Temple-Baraitser syndrome and epilepsy" published in Nature Genetics (2015), volume 47, pp.73-77