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007). Conclusions EGFR-mutated disease may be associated with a higher risk of metastatic recurrence. Molecular testing may be a promising tool for risk stratification and surveillance following definitive management for early stage disease. Future prospective, multi-center cohort studies are needed to confirm these findings and improve our understanding of how EGFR mutation contributes to prognosis and clinical outcomes.Background BRAFV600E mutation is present in a subset of pediatric brain tumors. Vemurafenib is an oral, selective ATP-competitive inhibitor of BRAFV600E kinase. The goal of this multi-center study conducted through the Pacific Pediatric Neuro-Oncology Consortium (PNOC) was to determine the recommended phase 2 dose (RP2D) and dose limiting toxicities (DLTs) in children less then 18 years with recurrent or progressive BRAFV600E mutant brain tumors. Results Nineteen eligible patients were enrolled. Eleven patients had received three or more prior therapies. Data reported are from the start of treatment for the first patient (April 30 2014) through August 31 2019. The RP2D was defined as 550 mg/m2 twice daily after DLT criteria adjustment for rash. Related grade ≥ 3 adverse events included secondary keratoacanthoma (n = 1); rash (n =16); and fever (n = 5). Subjects received a median of 23 cycles (range 3-63). Four patients remain on treatment. Centrally reviewed best radiographic responses included 1 complete response, 5 partial responses, and 13 stable disease. The steady-state area under the curve (AUC0-∞median) was 604 mg*h/L (range 329-1052). Methods Vemurafenib was given starting at 550 mg/m2, twice daily which corresponds to the adult RP2D. Adverse events were graded using the NIH Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Central imaging review was performed. Pharmacokinetic sampling was performed. Conclusions Vemurafenib has promising anti-tumor activity in recurrent BRAF V600E-positive brain tumors with manageable toxicity. A phase 2 study is ongoing (NCT01748149).Purpose Metformin combined with the mTOR inhibitor rapamycin showed potential synergistic anti-tumor activity in preclinical studies in pancreatic ductal adenocarcinoma (PDA). This phase 1b study (NCT02048384) was conducted to evaluate the feasibility and activity of metformin +/- rapamycin in the maintenance setting for unselected patients with metastatic PDA (mPDA) treated with chemotherapy. Materials and methods Eligible patients with stable or responding mPDA after ≥ 6 months on chemotherapy were randomized 11 to metformin alone (Arm A) or with rapamycin (Arm B), stratified by prior treatment with FOLFIRINOX. Fluorodeoxyglucose (FDG) PET scans and peripheral blood mononuclear cells were obtained for exploratory analyses. Results 22 subjects (11 per arm) received treatment per protocol. Median PFS/OS were 3.5 and 13.2 months respectively, with 2 year OS rate of 37%; there were no differences between arms. No responses were observed by RECIST; however, decreases in FDG avidity and/or CA19-9 were observed in several long-term survivors. Treatment related adverse events of Grade ≥ 3 occurred in 0% vs 27% of patients in Arm A vs B and were asymptomatic hematologic or electrolyte abnormalities that were not clinically significant. Improved survival was associated with low baseline neutrophil lymphocyte ratio, baseline lack of assessable disease by PET, and greater expansion of dendritic cells following treatment. Conclusions Metformin +/- rapamycin maintenance for mPDA was well-tolerated and several patients achieved stable disease associated with exceptionally long survival. Further prospective studies are needed to clarify the role of these agents in the maintenance setting and to enhance patient selection for such approaches.Introduction Parvovirus B19 (PVB19) is one of several viruses transmissible by blood transfusion. Levels of exposure to PVB19 among HIV-infected voluntary blood donors are comparable to those among HIV-negative controls because, in blood donors, the PVB19 infection is transmitted mainly via the respiratory route. check details Thus, we hypothesize that the seroprevalence of PVB19 in HIV-positive blood donors is equal to the seroprevalence of PVB19 in HIV-negative blood donors. The objective of this study was to compare the seroprevalence of PVB19 between asymptomatic HIV-positive and HIV-negative blood donors. Methods A random sample of 360 eligible blood donors were firstly examined for HIV antibodies by using ELISA automaton and so were categorized as HIV-positive donors and HIV-negative donors. Then the two categories of donors were examined for PVB19 IgG and IgM by using ELISA kits. The seroprevalence of PVB19 in HIV-positive donors was compared to that of HIV-negative donors by using chi-square test or Fisher’s exact test. All statistical analyzes were performed with SPSS 21. Results The prevalences of PVB19 IgG and IgM in HIV-positive blood donors were 92.1% (35 of 38) and 44.7% (17 of 38), respectively and those in control group were 89.1% (287 of 322) and 46.3% (149 of 322), respectively. But for both IgG and IgM the difference was not statistically significant (p > 0.05). Conclusion This research confirms our hypothesis the seroprevalence of PVB19 in HIV-positive blood donors is equal to the seroprevalence of PVB19 in HIV-negative blood donors.Introduction this study aimed to evaluate the effectiveness of botulinum toxin A (BoNT-A) injection in hemiparetic patients with chronic spasticity in the upper limb resulting from stroke or traumatic brain injury. Methods we conducted a retrospective study including 45 patients seen, in our department of Physical Medicine and Rehabilitation, between January 2014 and December 2016. All patients received an injection of BoNT-A (Dysport, 100 U/ml). Affected upper-extremity muscles could be injected as per the investigator’s discretion to a maximum total dose of 1000 U. We evaluated muscle tone using Modified Ashworth Scale (MAS). Functional disability was assessed using Modified Frenchay Scale (MFS), Nine Hole Peg Test (NHPT) and Barthel Index (BI). Quality of life (QoL) was assessed using the 36-Item Short Form Health Survey (SF-36). The achievement of treatment goal was assessed by the Goal Attainment Scaling (GAS). Results patients decreased their MAS score over the first and the third months (p less then 0.