Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

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

Anomalías de circulación atmosférica en 500 y 1000 hpa asociada a la sequía producida en la Argentina durante enero de 2003 a marzo de 2004 Anomalies of the atmospheric circulation at 500 and 1000 hpa associated with the dry period in Argentina from january 2003 to march 2004

<abstract language="por">Neste trabalho se analisa e descreve a situação sinótica associada à precipitação e temperatura do território argentino durante o ano de 2003 e o primeiro trimestre de 2004. A escolha deste período obedece à falta de precipitações em pelo menos dez províncias argentinas, o que ocasionou grandes prejuízos econômicos no setor agropecuário. Com o intuito de determinar as causas deste déficit de precipitações foram analisados os campos médios de altura geopotencial nos níveis de 500 e 1000 hPa e suas anomalias. Em 2003, o déficit de precipitação se associa principalmente às anomalias de geopotencial no nível de 500 hPa, que mostram um fluxo dominante de SO que atravessa o país diagonalmente entre 45&deg;S e 30&deg;S. Em 1000 hPa o anticiclone subtropical do Atlântico se encontra enfraquecido, deslocado para o norte e afastado do continente, enquanto que o anticiclone subrtopical do Pacífico está mais intenso e deslocado para leste respeito da sua posição normal. No primeiro trimestre de 2004 a seca se deve principalmente à presença de uma crista no nível de 500 hPa posicionada no centro do país. As anomalias médias de temperatura do período considerado resultam positivas sobre toda a Argentina. Em 2003, essas anomalias se devem à contribuição do fluxo do N-NE desde o norte do país, à subsidência ocasionada pelo anticiclone do Pacífico mais deslocado para o interior do continente e a orografia. No primeiro trimestre de 2004 as anomalias se originam devido ao fluxo do norte e à freqüente circulação anticiclônica no Atlântico ao sul de 35&deg;S.<br>This paper analyzes and describes the synoptic situation associated with precipitation and temperature in Argentina during 2003 and the first quarter of 2004. The period was selected as during that time drought affected at least ten Argentine provinces, causing great agricultural and ranching losses. In order to find the causes of such rainfall deficit the mean and anomaly geopotential height fields at 500 and 1000 hPa were analyzed. In 2003, rainfall deficit was mainly associated with geopotential anomalies at 500 hPa. They show a prevailing flow from the SW, which crosses the country diagonally from 45&deg;S approximately to 30&deg;S. At 1000 hPa the Atlantic Subtropical Anticyclone is weakened, displaced to the north and away from the continent. The Pacific Subtropical Anticyclone is intensified and located to the east with respect to its normal position. The drought in the first quarter of 2004 is mainly due to a ridge at 500 hPa in the center north of the country. Mean temperature anomalies in the period analyzed are positive throughout the country. High temperatures in 2003 are caused by the input of a N-NE flow from the north of the country, subsidence due to the Pacific Anticyclone shift towards the continent and orography. During the first quarter of 2004 they are generated by a flow from the north and the frequent anticyclonic circulation over the Atlantic to the south of 35&deg;S

Las plantas medicinales en el inventario español sobre los conocimientos Tradicionales relativos al patrimonio natural y a la biodiversidad

En las últimas décadas las organizaciones internacionales han puesto de manifiesto la importancia de los conocimientos ecológicos tradicionales para la conservación y el uso sostenible de la diversidad biológica, como se refleja en el Convenio sobre la Diversidad Biológica (CBD 1992). En España, el marco jurídico que recoge las normas y recomendaciones de esta estrategia es la Ley de Patrimonio Natural y Biodiveresidad 42/2007 que establece la creación del Inventario Español de Conocimientos Tradicionales (IECT) relevantes para la conservación y el uso sostenible de la biodiversidad y geodiversidad. Desde hace más de un año un equipo de más de 60 investigadores, incluyendo botánicos, zoólogos, antropólogos, ecólogos y geólogos de más de 20 centros de investigación y universidades del estado español, están trabajando en el IEDT, con el objetivo de recopilar y difundir la información publicada sobre los conocimientos tradicionales relativos a la flora, fauna, geodiversidad y el manejo de los ecosistemas