The value of metabolic imaging to predict tumour response after chemoradiation in locally advanced rectal cancer

Preliminary data of this work were presented by RCM and awarded at the 2009 Annual Meeting of the Spanish Society of Coloproctology (AECP) held in Barcelona.Background: We aim to investigate the possibility of using 18F-positron emission tomography/computer tomography (PET-CT) to predict the histopathologic response in locally advanced rectal cancer (LARC) treated with preoperative chemoradiation (CRT). Methods: The study included 50 patients with LARC treated with preoperative CRT. All patients were evaluated by PET-CT before and after CRT, and results were compared to histopathologic response quantified by tumour regression grade (patients with TRG 1-2 being defined as responders and patients with grade 3-5 as non-responders). Furthermore, the predictive value of metabolic imaging for pathologic complete response (ypCR) was investigated. Results: Responders and non-responders showed statistically significant differences according to Mandard's criteria for maximum standardized uptake value (SUVmax) before and after CRT with a specificity of 76,6% and a positive predictive value of 66,7%. Furthermore, SUVmax values after CRT were able to differentiate patients with ypCR with a sensitivity of 63% and a specificity of 74,4% (positive predictive value 41,2% and negative predictive value 87,9%); This rather low sensitivity and specificity determined that PET-CT was only able to distinguish 7 cases of ypCR from a total of 11 patients. Conclusions: We conclude that 18-F PET-CT performed five to seven weeks after the end of CRT can visualise functional tumour response in LARC. In contrast, metabolic imaging with 18-F PET-CT is not able to predict patients with ypCR accuratelyFounded by the Fundación Investigación Mutua Madrileña. We are indebted to M. Expósito Ruiz for statistical support. and to J-L Marín Aznar for pathologic analysisYe

The Disability discrimination Act and Developments in Accessible Public Transport in the UK

Objective: To determine the relation between time to surgery (TTS) after neoadjuvant chemoradiotherapy (nCRT) and pathologically complete response (pCR), surgical outcome, and survival in patients with esophageal cancer. Background: Standard treatment for potentially curable esophageal cancer is nCRT plus surgery after 4 to 6 weeks. In rectal cancer patients, evidence suggests that prolonged TTS is associated with a higher pCR rate and possibly with better survival. Methods: We identified patients treated with nCRT plus surgery for esophageal cancer between 2001 and 2011. TTS (last day of radiotherapy to day of surgery) varied mainly for logistical reasons. Minimal follow-up was 24 months. The effect of TTS on pCR rate, postoperative complications, and survival was determined with (ordinal) logistic, linear, and Cox regression, respectively. Results: In total, 325 patients were included. Median TTS was 48 days (p25-p75=40-60). After 45 days, TTSwas associated with an increased probability of pCR [odds ratio (OR) = 1.35 per additional week of TSS, P = 0.0004] and a small increased risk of postoperative complications (OR = 1.20, P <0.001). Prolonged TTS had no effect on disease-free and overall survivals (HR = 1.00 and HR = 1.06 per additional week of TSS, P = 0.976 and P = 0.139, respectively). Conclusions: Prolonged TTS after nCRT increases the probability of pCR and is associated with a slightly increased probability of postoperative complications, without affecting disease-free and overall survivals. We conclude that TTS can be safely prolonged from the usual 4 to 6 weeks up to at least 12 weeks, which facilitates a more conservative wait-and-see strategy after neoadjuvant chemoradiotherapy to be teste

Numerical analysis of different heating systems for warm sheet metal forming

The main goal of this study is to present an analysis of different heating methods frequently used in laboratory scale and in the industrial practice to heat blanks at warm temperatures. In this context, the blank can be heated inside the forming tools (internal method) or using a heating system (external method). In order to perform this analysis, a finite element model is firstly validated with the simulation of the direct resistance system used in a Gleeble testing machine. The predicted temperature was compared with the temperature distribution recorded experimentally and a good agreement was found. Afterwards, a finite element model is used to predict the temperature distribution in the blank during the heating process, when using different heating methods. The analysis also includes the evaluation of a cooling phase associated to the transport phase for the external heating methods. The results of this analysis show that neglecting the heating phase and a transport phase could lead to inaccuracies in the simulation of the forming phase.The authors gratefully acknowledge the financial support of the Portuguese Foundation for Science and Technology (FCT) under project PTDC/EMS-TEC/1805/2012 and by FEDER funds through the program COMPETE—Programa Operacional Factores de Competitividade, under the project CENTRO-07-0224-FEDER-002001 (MT4MOBI). The authors would like to thank Prof. A. Andrade-Campos for helpful contributions on the development of the finite element code presented in this work.info:eu-repo/semantics/publishedVersio

Distribution of populations of broad-snouted caiman (Caiman latirostris, Daudin 1802, Alligatoridae) in the São Francisco River basin, Brazil

We surveyed populations of the broad-snouted caiman, Caiman latirostris, throughout the São Francisco River basin, from Três Marias reservoir, State of Minas Gerais, to the river delta, at the boarder of Sergipe and Alagoas states. We registered the occurrence of crocodilians in 61% of all surveyed localities (n = 64), in which the presence of C. latirostris was confirmed in 44% of the surveyed sites. Caimans occurred in both lentic and lotic habitats, although there was a preference for small dams, oxbow lakes and wetlands. Despite the hunting pressure and human impact on natural habitats, our results indicate that the populations of C. latirostris in the São Francisco basin are not fragmented