GEICO (Spanish Group for Investigation on Ovarian Cancer) treatment guidelines in ovarian cancer 2012

In 2006, under the auspices of The Spanish Research Group for Ovarian Cancer (Spanish initials GEICO), the first “Treatment Guidelines in Ovarian Cancer” were developed and then published in Clinical and Translational Oncology by Poveda Velasco et al. (Clin Transl Oncol 9(5):308–316, 2007). Almost 6 years have elapsed and over this time, we have seen some important developments in the treatment of ovarian cancer. Significant changes were also introduced after the GCIG-sponsored 4th Consensus Conference on Ovarian Cancer by Stuart et al. (Int J Gynecol Cancer 21:750–755, 2011). So we decided to update the treatment guidelines in ovarian cancer and, with this objective, a group of investigators of the GEICO group met in February 2012. This study summarizes the presentations, discussions and evidence that were reviewed during the meeting and during further discussions of the manuscript

Overview of recent TJ-II stellarator results

The main results obtained in the TJ-II stellarator in the last two years are reported. The most important topics investigated have been modelling and validation of impurity transport, validation of gyrokinetic simulations, turbulence characterisation, effect of magnetic configuration on transport, fuelling with pellet injection, fast particles and liquid metal plasma facing components. As regards impurity transport research, a number of working lines exploring several recently discovered effects have been developed: the effect of tangential drifts on stellarator neoclassical transport, the impurity flux driven by electric fields tangent to magnetic surfaces and attempts of experimental validation with Doppler reflectometry of the variation of the radial electric field on the flux surface. Concerning gyrokinetic simulations, two validation activities have been performed, the comparison with measurements of zonal flow relaxation in pellet-induced fast transients and the comparison with experimental poloidal variation of fluctuations amplitude. The impact of radial electric fields on turbulence spreading in the edge and scrape-off layer has been also experimentally characterized using a 2D Langmuir probe array. Another remarkable piece of work has been the investigation of the radial propagation of small temperature perturbations using transfer entropy. Research on the physics and modelling of plasma core fuelling with pellet and tracer-encapsulated solid-pellet injection has produced also relevant results. Neutral beam injection driven Alfvénic activity and its possible control by electron cyclotron current drive has been examined as well in TJ-II. Finally, recent results on alternative plasma facing components based on liquid metals are also presented. ISSN:0029-5515 ISSN:1741-432

Overview of recent TJ-II stellarator results

The main results obtained in the TJ-II stellarator in the last two years are reported. The most important topics investigated have been modelling and validation of impurity transport, validation of gyrokinetic simulations, turbulence characterisation, effect of magnetic configuration on transport, fuelling with pellet injection, fast particles and liquid metal plasma facing components. As regards impurity transport research, a number of working lines exploring several recently discovered effects have been developed: the effect of tangential drifts on stellarator neoclassical transport, the impurity flux driven by electric fields tangent to magnetic surfaces and attempts of experimental validation with Doppler reflectometry of the variation of the radial electric field on the flux surface. Concerning gyrokinetic simulations, two validation activities have been performed, the comparison with measurements of zonal flow relaxation in pellet-induced fast transients and the comparison with experimental poloidal variation of fluctuations amplitude. The impact of radial electric fields on turbulence spreading in the edge and scrape-off layer has been also experimentally characterized using a 2D Langmuir probe array. Another remarkable piece of work has been the investigation of the radial propagation of small temperature perturbations using transfer entropy. Research on the physics and modelling of plasma core fuelling with pellet and tracer-encapsulated solid-pellet injection has produced also relevant results. Neutral beam injection driven Alfvénic activity and its possible control by electron cyclotron current drive has been examined as well in TJ-II. Finally, recent results on alternative plasma facing components based on liquid metals are also presentedThis work has been carried out within the framework of the EUROfusion Consortium and has received funding from the Euratom research and training programme 2014–2018 under Grant Agreement No. 633053. It has been partially funded by the Ministerio de Ciencia, Inovación y Universidades of Spain under projects ENE2013-48109-P, ENE2015-70142-P and FIS2017-88892-P. It has also received funds from the Spanish Government via mobility grant PRX17/00425. The authors thankfully acknowledge the computer resources at MareNostrum and the technical support provided by the Barcelona S.C. It has been supported as well by The Science and Technology Center in Ukraine (STCU), Project P-507F

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Risk assessment of type 2 diabetes mellitus in patients affected by tuberculosis

Introducción: La diabetes mellitus y la tuberculosis son problemas de salud emergentes a nivel mundial, su incidencia anual cada vez es mayor pese a todos los esfuerzos que se hacen por mitigarlas y su asociación podría ser un futuro problema de salud a enfrentar. A través de los años, diferentes investigaciones han demostrado que la Diabetes mellitus incrementa el riesgo de contraer tuberculosis entre 2 y 4 veces, es decir, es un factor predisponente pero no existen investigaciones que definan este riesgo de forma inversa. Objetivo: Determinar el riesgo de desarrollar DM2 en pacientes afectados con tuberculosis. Material y método: Se realizó un estudio cuantitativo, descriptivo y transversal, la población fueron 60 usuarios que asisten a tomar el tratamiento antifímico en 4 unidades operativas del Distrito de Salud 09D04, zona 8 a quienes se les aplico el test de Findrisc. Resultados: El género masculino presenta un mayor riesgo de desarrollar DM2 junto con el grupo etario de <45 años y 45 – 54 años, de forma general el 48% tienen un nivel de riesgo bajo. Conclusión: La población de pacientes afectados con tuberculosis, aunque presentan niveles de riesgo bajo, este se encuentra presente y es necesario tomar medidas para mitigar este riesgo y prevenir comorbilidades.ABSTRACT Introduction: The diabetes mellitus and tuberculosis are emergent health problems around the world its impact has been growing and growing every year even though health professionals do their best effort to eradicate them and these diseases mutations could be a real health problem to fight against in the future. Through the years, different researches have demostrate that Diabetes mellitus increase the risk of getting sick of tuberculosis 2 and 4 times more frequently, it means it is a predisposing factor, but there are not researches that define this risk in a backward effect. Target: Establishrisks of developing Diabetes Mellitus type 2 in patients affected by tuberculosis. Material and Method: A Quantitative, descriptive and transversal study was done, the statistical population was 60 users that take antifimic treatment in 4 Health Centers of District 09D04, zone 8. These users were tested through Findrisc Test. Results: Male patients have more risk of developing Diabetes Mellitus type 2 at the age below 45 years old and between 45 and 54 years old, in general form 48% of patients have a low level risk. Conclusion: The population of patients affected by tuberculosis has a low risk level and it is necessary take actions to mitigate this risk and prevent comorbidity

Agronomic and Metabolomic Side-Effects of a Divergent Selection for Indol-3-Ylmethylglucosinolate Content in Kale (Brassica oleracea var. acephala)

Brassica oleracea var. acephala (kale) is a cruciferous vegetable widely cultivated for its leaves and flower buds in Europe and a food of global interest as a “superfood”. Brassica crops accumulate phytochemicals called glucosinolates (GSLs) which play an important role in plant defense against biotic stresses. Studies carried out to date suggest that GSLs may have a role in the adaptation of plants to different environments, but direct evidence is lacking. We grew two kale populations divergently selected for high and low indol-3-ylmethylGSL (IM) content (H-IM and L-IM, respectively) in different environments and analyzed agronomic parameters, GSL profiles and metabolomic profile. We found a significant increase in fresh and dry foliar weight in H-IM kale populations compared to L-IM in addition to a greater accumulation of total GSLs, indole GSLs and, specifically, IM and 1-methoxyindol-3-ylmethylGSL (1MeOIM). Metabolomic analysis revealed a significant different concentration of 44 metabolites in H-IM kale populations compared to L-IM. According to tentative peak identification from MS interpretation, 80% were phenolics, including flavonoids (kaempferol, quercetin and anthocyanin derivates, including acyl flavonoids), chlorogenic acids (esters of hydroxycinnamic acids and quinic acid), hydroxycinnamic acids (ferulic acid and p-coumaric acid) and coumarins. H-IM kale populations could be more tolerant to diverse environmental conditions, possibly due to GSLs and the associated metabolites with predicted antioxidant potential.publishedVersio

Agronomic and Metabolomic Side-Effects of a Divergent Selection for Indol-3-Ylmethylglucosinolate Content in Kale (Brassica oleracea var. acephala)

Brassica oleracea var. acephala (kale) is a cruciferous vegetable widely cultivated for its leaves and flower buds in Europe and a food of global interest as a “superfood”. Brassica crops accumulate phytochemicals called glucosinolates (GSLs) which play an important role in plant defense against biotic stresses. Studies carried out to date suggest that GSLs may have a role in the adaptation of plants to different environments, but direct evidence is lacking. We grew two kale populations divergently selected for high and low indol-3-ylmethylGSL (IM) content (H-IM and L-IM, respectively) in different environments and analyzed agronomic parameters, GSL profiles and metabolomic profile. We found a significant increase in fresh and dry foliar weight in H-IM kale populations compared to L-IM in addition to a greater accumulation of total GSLs, indole GSLs and, specifically, IM and 1-methoxyindol-3-ylmethylGSL (1MeOIM). Metabolomic analysis revealed a significant different concentration of 44 metabolites in H-IM kale populations compared to L-IM. According to tentative peak identification from MS interpretation, 80% were phenolics, including flavonoids (kaempferol, quercetin and anthocyanin derivates, including acyl flavonoids), chlorogenic acids (esters of hydroxycinnamic acids and quinic acid), hydroxycinnamic acids (ferulic acid and p-coumaric acid) and coumarins. H-IM kale populations could be more tolerant to diverse environmental conditions, possibly due to GSLs and the associated metabolites with predicted antioxidant potential

Fatores predisponentes à infecção do sítio cirúrgico em gastrectomia Factores predisponentes a infección del sitio quirúrgico en gastrectomía Predisposing factors for surgical site infection in case of gastrectomy

A presente investigação teve como objetivo identificar os fatores predisponentes à infecção do sítio cirúrgico relacionados ao procedimento cirúrgico no paciente submetido à cirurgia eletiva de gastrectomia, potencialmente contaminada, na especialidade de Gastrocirurgia, no período compreendido entre 1998 a 2002, em um hospital público do interior paulista. Realizou-se um estudo retrospectivo, por meio do levantamento de informações contidas nos prontuários médicos, utilizando-se para a análise estatística dos dados os testes não paramétricos: Mann-Whitney (variáveis quantitativas) e coeficiente de contingência (variáveis qualitativas). Em 181 casos investigados, detectou-se a ocorrência de infecção do sítio cirúrgico em 17 situações (9,4%); sendo 23,6% classificadas como infecção incisional superficial; 52,9% infecção incisional profunda e 23,6% infecção de órgão/espaço. As variáveis período de internação pós-operatório, período de internação total, duração da cirurgia, tempo de sondagem vesical de demora apresentaram diferença estatisticamente significante entre os grupos com e sem infecção.<br>La finalidad de esta investigación fue la de identificar los factores predisponentes a la infección del sitio quirúrgico relacionados al procedimiento quirúrgico en paciente sometido a la cirugía electiva de gastrectomía, potencialmente contaminada, en la especialidad de Gastrocirugía, en el período entre 1998 y 2002, en un hospital público del interior de São Paulo, Brasil. Para eso, realizamos un estudio retrospectivo, mediante la recopilación de informaciones contenidas nos prontuarios médicos. Para el análisis estadístico de los datos, utilizamos los testes no paramétricos: Mann-Whitney (variables cuantitativas) y coeficiente de contingencia (variables cualitativas). Entre 181 casos investigados, detectamos la ocurrencia de infección del sitio quirúrgico en 17 situaciones (9,4%); sendo 23,6% clasificadas como infección incisional superficial; 52,9% infección incisional profunda y 23,6% de infección de órgano / espacio. Las variables período de internación postoperatorio, período de internación total, tiempo de cirugía, período de permanencia del catéter vesical a permanencia presentaron diferencias estadísticamente significativos entre los grupos con y sin infección.<br>This research aimed to identify the predisposing factors for surgical site infection related to the surgical procedure in patients submitted to a potentially contaminated elective gastrectomy, as a part of Gastric surgery, in the period between 1998 and 2002, at a public hospital in the interior of São Paulo, Brazil. Therefore, a retrospective study was carried out by means of a medical record information survey, using the following non-parametric tests for statistical data analysis: Mann-Whitney (quantitative variables) and contingency coefficient (qualitative variables). Out of the 181 cases that were examined, the occurrence of surgical site infection was detected in 17 situations (9.4%), 23.6% of which were categorized as superficial incisional infection, 52.9% as deep incisional infection and 23.6% as organ/space infection. Statistically significant differences between the groups with and without infection were found for the following variables: post-operative hospitalization period, total hospitalization period, surgery time, time to dwelling vesical catheter removal

Time to Definitive Failure to the First Tyrosine Kinase Inhibitor in Localized GI Stromal Tumors Treated With Imatinib As an Adjuvant: A European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Intergroup Randomized Trial in Collaboration With the Australasian Gastro-Intestinal Trials Group, UNICANCER, French Sarcoma Group, Italian Sarcoma Group, and Spanish Group for Research on Sarcomas

PURPOSE: In 2004, we started an intergroup randomized trial of adjuvant imatinib versus no further therapy after R0-R1 surgery patients with localized, high- or intermediate-risk GI stromal tumor (GIST). PATIENTS AND METHODS: Patients were randomly assigned to 2 years of imatinib 400 mg daily or no further therapy after surgery. The primary end point was overall survival; relapse-free survival (RFS), relapse-free interval, and toxicity were secondary end points. In 2009, given the concurrent improvement in prognosis of patients with advanced GIST, we changed the primary end point to imatinib failure-free survival (IFFS), with agreement of the independent data monitoring committee. We report on a planned interim analysis. RESULTS: A total of 908 patients were randomly assigned between December 2004 and October 2008: 454 to imatinib and 454 to observation. Of these, 835 patients were eligible. With a median follow-up of 4.7 years, 5-year IFFS was 87% in the imatinib arm versus 84% in the control arm (hazard ratio, 0.79; 98.5% CI, 0.50 to 1.25; P = .21); RFS was 84% versus 66% at 3 years and 69% versus 63% at 5 years (log-rank P < .001); and 5-year overall survival was 100% versus 99%, respectively. Among 528 patients with high-risk GIST by local pathologist, 5-year IFFS was 79% versus 73%; among 336 centrally reviewed high-risk patients, it was 77% versus 73%, respectively. CONCLUSION: This study confirms that adjuvant imatinib has an overt impact on RFS. No significant difference in IFFS was observed, although in the high-risk subgroup there was a trend in favor of the adjuvant arm. IFFS was conceived as a potential end point in the adjuvant setting because it is sensitive to secondary resistance, which is the main adverse prognostic factor in patients with advanced GIST

The 1877–1878 El Niño episode: associated impacts in South America

Artículo de publicación ISIAt times when attention on climate issues is strongly focused on the assessment of potential impacts of future climate change due to the intensification of the planetary greenhouse effect, it is perhaps pertinent to look back and explore the consequences of past climate variability. In this article we examine a large disruption in global climate that occurred during 1877–1878, when human influence was negligible. The mechanisms explaining this global disturbance are not well established, but there is considerable evidence that the major El Niño episode that started by the end of 1876 and peaked during the 1877–1878 boreal winter contributed significantly to it. The associated regional climate anomalies were extremely destructive, particularly in the Northern Hemisphere, where starvation due to intense droughts in Asia, South-East Asia and Africa took the lives of more than 20 million people. In South America regional precipitation anomalies were typical of El Niño events, with rainfall deficit and droughts in the northern portion of the continent as well as in northeast Brazil and the highlands of the central Andes (Altiplano). In contrast, anomalously intense rainfall and flooding episodes were reported for the coastal areas of southern Ecuador and Northern Perú, as well as along the extratropicalWest coast of the continent (central Chile, 30◦ S–40◦ S), and in the Paraná basin in the southeast region. By far the most devastating impacts in terms of suffering and loss of life occurred in the semiarid region of northeast Brazil where several hundreds of thousands of people died from starvation and diseases during the drought that started in 1877.This research was sponsored in Chile by Conicyt research grants Fondecyt N◦ 1000445 and N◦ 1040326, and ACT-19