Food and Alcohol Disturbance in High School Adolescents: Prevalence, Characteristics and Association with Problem Drinking and Eating Disorders.

Food and alcohol disturbance (FAD) is characterized by the association of alcohol use with compensatory behaviors such as restricting calories, physical activity and purging. Despite not being part of the current nosography, research has grown in the past 10 years, mostly on college students' samples. In this study, we aim to describe the prevalence, characteristics and association of FAD with problem drinking (PD) and eating disorder risk (EDR) in a sample of Italian high school students. Participants were 900 high school students (53.6% males; mean age = 16.22) that were administered standardized questionnaires. Students who screened positive for PD, EDR and both were, respectively, 17.3%, 5.9% and 1.3%. Approximately one out four students reported FAD behaviors, mostly to control weight and by restricting calories, with higher prevalence and severity among those who screened positive for PD. Purging behaviors were rare overall (15.5%), but significantly more frequent in participants who screened positive for both PD and EDR (41.7%). FAD was more strongly associated with alcohol use severity than with ED symptom severity across all subgroups. FAD behaviors appear to be common in the Italian high school population and more strongly associated with PD. Future studies should investigate FAD's impact on adolescents' functioning and possible early interventions.

Genetic diversity and population structure of two Euglossini bee species in a host-parasite relationship.

In the current study, two euglossine species, Exaerete smaragdina and Eulaema nigrita, a cleptoparasite bee and its host, respectively, were used as models to: (i) access the genetic diversity and population structure of both species, sampled along a wide latitudinal range of Atlantic Forest, where the distribution of El. nigrita and Ex. smaragdina co-occurs; (ii) investigate the evolutionary history of these species through the Atlantic Forest, and in a wider scenario, to examine the evolutionary history of these species across others forest domains. Analyses involved males of El. nigrita and Ex. smaragdina sampled through Brazilian territory, including 19 sites in the Atlantic Forest. Bayesian Skyline Plot (BSP) was used to infer possible climate oscillations on population of both species over time. The BSP revealed stability in effective population size for both species in most of the Plio-Pleistocene period. However, BSP results aligned to the starlike configuration in the haplotype network, neutrality test, and population diversity patterns indicated population expansion of the two species during the late Pleistocene. Our findings suggest areas of potential refugia to the climatic oscillations of the Pleistocene in the Atlantic Forest in the Brazilian states of Espírito Santo for El. nigrita and Pernambuco for Ex. smaragdina.

Biomechanical characterization of a fibrinogen-blood hydrogel for human dental pulp regeneration.

In dental practice, Regenerative Endodontic Treatment (RET) is applied as an alternative to classical endodontic treatments of immature necrotic teeth. This procedure, also known as dental pulp revitalization, relies on the formation of a blood clot inside the root canal leading to the formation of a reparative vascularized tissue similar to dental pulp, which would provide vitality to the affected tooth. Despite the benefit of this technique, it lacks reproducibility due to the fast degradation and poor mechanical properties of blood clots. This work presents a method for constructing a fibrinogen-blood hydrogel that mimics the viscoelastic properties of human dental pulp while preserving the biological properties of blood for application in RET. By varying the blood and fibrinogen concentrations, gels with different biomechanical and biological properties were obtained. Rheology and atomic force microscopy (AFM) were combined to study the viscoelastic properties. AFM was used to evaluate the elasticity of human dental pulp. The degradation and swelling rates were assessed by measuring weight changes. The biomimetic properties of the gels were demonstrated by studying the cell survival and proliferation of dental pulp cells (DPCs) for 14 days. The formation of an extracellular matrix (ECM) was assessed by multiphoton microscopy (MPM). The angiogenic potential was evaluated by an ex vivo aortic ring assay, in which the endothelial cells were observed by histological staining after migration. The results show that the Fbg-blood gel prepared with 9 mg ml-1 fibrinogen and 50% blood of the Fbg solution volume has similar elasticity to human dental pulp and adequate degradation and swelling rates. It also allows cell survival and ECM secretion and enhances endothelial cell migration and formation of neovessel-like structures.

Robotic Rectal Resection for Rectal Cancer in Elderly Patients: A Systematic Review and Meta-Analysis.

Rectal cancer is estimated to increase due to an expanding aging population, thus affecting elderly patients more frequently. The optimal surgical treatment for this type of patient remains controversial because they are often excluded from or underrepresented in trials. This meta-analysis aimed to evaluate the feasibility and the safety of robotic surgery in elderly patients (>70 years old) undergoing curative treatment for rectal cancer. Studies comparing elderly (E) and young (Y) patients submitted to robotic rectal resection were searched on PubMed, Embase, and the Cochrane Library. Data regarding surgical oncologic quality, post-operative, and survival outcomes were extracted. Overall, 322 patients underwent robotic resection (81 in the E group and 241 in the Y group) for rectal cancer. No differences between the two groups were found regarding distal margins and the number of nodes yielded (12.70 in the E group vs. 14.02 in the Y group, p = 0.16). No differences were found in conversion rate, postoperative morbidity, mortality, and length of stay. Survival outcomes were only reported in one study. The results of this study suggest that elderly patients can be submitted to robotic resection for rectal cancer with the same oncologic surgical quality offered to young patients, without increasing postoperative mortality and morbidity.

In vitro, ex vivo, and in vivo models for dental pulp regeneration.

Based on the concept of tissue engineering (Cells-Scaffold-Bioactive molecules), regenerative endodontics appeared as a new notion for dental endodontic treatment. Its approaches aim to preserve dental pulp vitality (pulp capping) or to regenerate a vascularized pulp-like tissue inside necrotic root canals by cell homing. To improve the methods of tissue engineering for pulp regeneration, numerous studies using in vitro, ex vivo, and in vivo models have been performed. This review explores the evolution of laboratory models used in such studies and classifies them according to different criteria. It starts from the initial two-dimensional in vitro models that allowed characterization of stem cell behavior, through 3D culture matrices combined with dental tissue and finally arrives at the more challenging ex vivo and in vivo models. The travel which follows the elaboration of such models reveals the difficulty in establishing reproducible laboratory models for dental pulp regeneration. The development of well-established protocols and new laboratory ex vivo and in vivo models in the field of pulp regeneration would lead to consistent results, reduction of animal experimentation, and facilitation of the translation to clinical practice.

Consequences of the COVID-19 pandemic on the diagnosis and treatment of gastric cancer in referral centers in Italy.

BACKGROUND: The coronavirus pandemic had a major impact in Italy. The Italian health system's re-organization to face the emergency may have led to significant consequences especially in the diagnosis and treatment of malignancies. This study aimed to assess the impact of the pandemic in the diagnosis and treatment of gastric cancer in nine Gruppo Italiano RIcerca Cancro Gastrico (GIRCG) centers. METHODS: All patients assessed for gastric adenocarcinoma at nine GIRCG centers between January 2019 and November 2020 were included. Patients were grouped according to the date of "patient 1's" diagnosis in Italy: preCOVID versus COVID. Clinico-pathological and outcome differences between the two groups were analyzed. RESULTS: A total of 632 patients were included in the analysis (205 in the COVID group). The cT4 weighted ratios were higher in 2020 from April to September, with the greatest differences in May, August and September. The cM+ weighted ratio was significantly higher in July 2020. The mean number of gastrectomies had the greatest reduction in March and May 2020 compared with 2019. The median times from diagnosis to chemotherapy, to complete diagnostic work-up or to operation were longer in 2019. The median time from the end of chemotherapy to surgery was 17 days longer in the preCOVID group. CONCLUSIONS: A greater number of advanced or metastatic cases were diagnosed after the spread of SARS-CoV-2 infection, especially after the "full lockdown" periods. During the pandemic, once gastric cancer patients were referred to one of the centers, a shorter time to complete the diagnostic work-up or to address them to the best treatment option was required.

Aegla buenoi n. sp. (Decapoda: Anomura): first record of aeglid crab from Cinzas River basin, Brazil.

A new species of freshwater anomuran crab, Aegla buenoi n. sp., is described. The new taxon was collected from two streams within the Cinzas River basin, Paran state, Brazil. We used morphological and molecular data (COI mtDNA) to distinguish the new species from its congeners. Aegla buenoi n. sp. is differentiated by morphological diagnostic features of the cephalothorax, chelipeds, second abdominal epimeron, and uropods. Molecular results confirm the separation of A. buenoi n. sp. from closely related species (A. castro Schmitt, 1942, A. lata Bond-Buckup Buckup, 1994, and A. jacutinga Marl Teixeira, 2020). Hence, our study increases the known diversity of aeglids and reports the first species of Aegla from the Cinzas River basin.

Is glyphosate toxic to bees? A meta-analytical review.

Glyphosate (GLY) is an herbicide widely used in agriculture. First considered as non-toxic or slightly toxic to bees, GLY and its different formulations have shown, more recently, to affect negatively the survival, development and behavior of these insects, even when used in doses and concentrations recommended by the manufacturer. Thus, the results of research on the toxicity of GLY to bees are often conflicting, which makes a meta-analysis interesting for data integration, generating a statistically reliable result. Therefore, this study aimed to evaluate the GLY effects on mortality of bees through a meta-analysis. For this, a search was carried out in the databases Web of Science, CAPES (Coordination for the Improvement of Higher Education Personnel - Brazil), Scopus, and PubMed. Papers that evaluated the effect of GLY on bee mortality published between 1945 and October 2020, were considered. After obtaining the data, R software was used to perform the meta-analytical tests. Sixteen papers on mortality were selected with 34 data sets. Most of the sets demonstrated differences between the control and experimental groups, showing that the treatments with GLY caused higher mortality of bees. The results considering the methodology used (ingestion or contact), the phase of the biological cycle (adults or larvae), and the dose (ecologically relevant dose and recommended by the manufacturer) were different when compared with their respective control groups. Therefore, GLY can be considered toxic to bees. It is important to emphasize that this meta-analysis identified that papers assessing the toxicity of GLY to bees are still scarce, for both lethal and sublethal effects, mainly for stingless and solitary bee species.

Isolation and characterization of microsatellite markers in two species of the neotropical Epicharis (Hymenoptera, Apidae, Centridini) genus and cross-amplification in related species.

Genetics can provide invaluable tools for management and conservation of bee populations, which are declining worldwide. Among these tools, microsatellite are very useful molecular markers for population analyses. The aim of this study was to isolate and characterize microsatellites for Epicharis (Anepicharis) dejeanii and Epicharis (Epicharis) nigrita, two Neotropical species of solitary bees, both exhibiting the habit of nesting in aggregations. Microsatellite loci were identified from two enriched genomic libraries. The characterization and analysis of loci were carried out using 35 females of E. dejeanii and 34 of E. nigrita. In total, we report the development of 12 microsatellite loci for E. dejeanii and 13 for E. nigrita. For E. dejeanii, all loci were polymorphic, the number of alleles per locus ranged from 2 to 12, averaging 8.7 and, observed and expected heterozygosity were 0.485 (range 0.229-0.857) and 0.633 (range 0.288-0.843), respectively. For E. nigrita, only nine out of 13 loci amplified were polymorphic, the number of alleles per locus ranged from 2 to 12, averaging 5.5. For this species, the observed and expected heterozygosity were 0.440 (range 0.118-0.676) and 0.545 (range 0.167-0.814), respectively. Cross-amplification of primers was successful in other Centridini species. The two sets of loci described for E. dejeanii and E. nigrita species are polymorphic and informative and show promising applicability for both population genetic approaches and relatedness on these and other Centridini species.

Stage IV Gastric Cancer: The Surgical Perspective of the Italian Research Group on Gastric Cancer.

Background/Aim: This work explored the prognostic role of curative versus non-curative surgery, the prognostic value of the various localizations of metastatic disease, and the possibility of identifying patients to be submitted to aggressive therapies. Patients and Methods: Retrospective chart review of stage IV patients operated on in our institutions. Results: Two hundred and eighty-two patients were considered; 73.4% had a single metastatic presentation. In 117 cases, a curative (R0) resection of primary and metastases was possible; 75 received a R1 resection and 90 a palliative R2 gastrectomy. Surgery was integrated with chemotherapy in multiple forms: conversion therapy, HIPEC, neo-adjuvant and adjuvant treatment. Median overall survival (OS) of the entire cohort was 10.9 months, with 14 months for the R0 subgroup. There was no correlation between metastasis site and survival. At multivariate analysis, several variables associated with the lymphatic sphere showed prognostic value, as well as tumor histology and the curativity of the surgical procedure, with a worse prognosis associated with a low number of resected nodes, D1 lymphectomy, pN3, non-intestinal histology, and R+ surgery. Considering the subgroup of R0 patients, the variables pT, pN and D displayed an independent prognostic role with a cumulative effect, showing that patients with no more than 1 risk factor can reach a median survival of 33 months. Conclusions: Our data show that the possibility of effective care also exists for Western patients with stage IV gastric cancer.

Electric eels galore: microsatellite markers for population studies

Fourteen novel microsatellite loci are described and characterized in two species of electric eels, Electrophorus variiand E. voltaifrom floodplains and rivers of the Amazon rainforest. These loci are polymorphic, highly informative, and have the capacity to detect reliable levels of genetic diversity. Likewise, the high combined probability of paternity exclusion value and low combined probability of genetic identity value obtained demonstrate that the new set of loci displays suitability for paternity studies on electric eels. In addition, the cross-amplification of electric eel species implies that it may also be useful in the study of the closely related E. electricus, and to other Neotropical electric fishes (Gymnotiformes) species as tested herein.(AU)

Catorze novos loci microsatélites são descritos e caracterizados em duas espécies de poraquês, Electrophorus varii e E. voltai de planícies alagadas e rios da floresta amazônica. Esses loci são polimórficos, altamente informativos e têm a capacidade de detectar níveis confiáveis de diversidade genética. Da mesma forma, o alto valor de exclusão de paternidade combinado com a baixa probabilidade de identidade genética demonstra que o novo conjunto de loci exibe adequação para estudos de paternidade em poraquês. Além disso, a amplificação cruzada de espécies de peixes elétricos implica que também pode ser útil no estudo da espécie intimamente relacionada E. electricus, e de outras espécies de peixes elétricos neotropicais (Gymnotiformes).(AU)

Inventory of the fish fauna from Laranjinha River, Paranapanema River system, Brazil / Inventário da ictiofauna do rio Laranjinha, sistema do rio Paranapanema, Brasil

Abstract: This work is the most comprehensive survey of the Laranjinha River´s fishes, a tributary of the Cinzas River, Paranapanema River basin. Throughout its course, there is only a low-height dam, including a transposition system located 98 km from its mouth. The sampling was carried out in nine locations, from the source to the mouth, with six field incursions in each location, using different fishing gear. A total of 11,924 fish were collected, distributed in seven orders, 27 families, and 100 species. The most representative order in the number of species was Siluriformes, followed by Characiformes. As for the families, Loricariidae comprised 21% and Characidae 14% of species richness. Phalloceros harpagos was the species with the highest absolute abundance, representing 11.3% of the total, followed by Hypostomus ancistroides with 9.8%. However, considering the average abundance and frequency of occurrence, Hypostomus ancistroides was the most abundant species, followed by Hypostomus cf. paulinus, Psalidodon aff. paranae and Phalloceros harpagos. Among the collected species, the Apteronotus acidops, Brycon orbygnianus, Brycon nattereri, Crenicichla jupiaensis, and Rhinelepis aspera were classified as endangered on the most recent IUCN Red List. Also, from the total sampled fish, 9.8% are considered non-native species. Among the native species recorded, 10 species are large migratory species, which indicates that the Laranjinha River is a route for spawning and maintenance of species diversity in the middle Paranapanema River. Therefore, the Laranjinha River is a heritage of fish diversity and deserves special attention in its preservation.

Resumo: Este é o levantamento mais abrangente de peixes do rio Laranjinha, um afluente do rio das Cinzas, bacia do rio Paranapanema. Ao longo de sua rota, existe apenas uma pequena barragem com um sistema de transposição localizado 98 km de sua nascente. A amostragem foi realizada em nove locais, desde a nascente até a foz, com seis incursões de campo em cada local, com o auxílio de diferentes artes de pesca. Foram coletados 11.924 indivíduos, distribuídos em sete ordens, 27 famílias e 100 espécies. A ordem mais representativa foi Siluriformes, seguida por Characiformes. Quanto às famílias, Loricariidae compôs 21% e Characidae 14% da riqueza de espécies. Phalloceros harpagos foi a espécie com maior abundância absoluta, representando 11,3% do total, seguida por Hypostomus ancistroides, com 9,8%. No entanto, considerando a abundância média e a frequência de ocorrência, Hypostomus ancistroides foi a espécie mais abundante, seguida por Hypostomus cf. paulinus, Psalidodon aff. paranae e Phalloceros harpagos. Entre as espécies coletadas, Apteronotus acidops, Brycon orbygnianus, Brycon nattereri, Crenicichla jupiaensis e Rhinelepis aspera estão listadas em categorias de ameaça na Lista Vermelha da IUCN mais recente. Além disso, do total de indivíduos amostrados, 9,8% são considerados espécies não nativas. Entre as espécies nativas registradas, 10 espécies são migratórias de grande porte, o que indica que o rio Laranjinha é uma rota de desova e manutenção da diversidade de espécies no médio rio Paranapanema. Portanto, o rio Laranjinha é um patrimônio da diversidade de peixes e merece atenção especial em sua preservação.

Transhiatal distal esophagectomy for Siewert type II cardia cancer can be a treatment option in selected patients.

BACKGROUND: While surgical treatment of Siewert I and III (S1,S3) Esophagogastric Junction (EGJ) cancer is codified, the efficay of transhiatal procedure with anastomosis in the lower mediastinum for Siewert II (S2) still remains a dibated topic. METHODS: This is a large multicenter retrospective study. The results of 598 consecutive patients submitted to resection with curative intent from January 2000 to January 2017 were reported. Clinical and oncological outcomes of different procedures performed in S2 tumor were analyzed to investigate the efficacy of transhiatal approach. RESULTS: The 5-year overall survival rate (OS) was poor (32%) for all Siewert types. The most performed operations in S2 cancer were proximal gastrectomy + transthoracic esophagectomy (TTE or Ivor-Lewis procedure, 60%), total gastrectomy + transhiatal distal esophagectomy with anastomosis in the chest (THE, 24%) and total gastrectomy + transthoracic esophagectomy (TGTTE, 15%). Cardiovascular and pulmonary complications were higher after TTE. On the contrary, surgical complications were significantly higher after THE. Postoperative mortality was similar. The distribution of TNM stages was different in the 3 types of procedures: patients submitted to THE had an earlier stage disease. With this bias, OS after THE was higher than after TTE but the difference was not significant (49.85% vs 28.42%, p = 0.0587). CONCLUSIONS: Despite a higher rate of postoperative surgical complications, OS after total gastrectomy and transhiatal distal esophagectomy was at least comparable to that of transthoracic approach in less advanced S2 tumors. Therefore, THE with anastomosis in the chest could be a treatmen option in earlier S2 tumors.

Non-anatomical colonic resections: splenic flexure and transverse colectomy. Central vascular ligation is crucial for survival.

BACKGROUND: Cancers of the transverse colon (TC) and of the splenic flexure (SF) are rather uncommon and their prognosis has been reported significantly poorer as compared to right- and left-sided colon cancers. Several studies tried to investigate which is the optimal surgery for oncological and survival outcomes reporting extended colectomies as more effective than limited resections. METHODS: All consecutive patients with diagnosis of colorectal cancer submitted to surgical resection with anastomosis between January 2005 and December 2016 at the Division of Surgical Oncology and Digestive Surgery, Department of Oncology, at the University of Turin, were included. Based on tumor location, patients were enrolled in arm A (cancer of the ascending colon, right (hepatic) flexure, left and sigmoid colon) or arm B (cancer of the transverse colon and of the left (splenic) flexure). RESULTS: Out of 1433 patients registered, 500 patients fulfilled all inclusion and exclusion criteria and were allocated in arm A (N.=425) or in arm B (N.=75). Central vascular ligation and the achievement of at least 5 cm of healthy margin were always performed in all procedures of both arms. Patients' population of the two arms was homogeneous as concerns demographic characteristics and stage of the disease. In arm A, resections were performed more frequently by mini-invasive approach as compared to arm B. Operative time was statistically longer in arm B. Postoperative complications rate was extremely low and comparable in both arms (13.4 and 8.0 in arms A and B, respectively). No postoperative mortality was observed. Overall 5-year survival rates were similar in arm A and B (82.3% and 73.05%, respectively; P=0.29). Arm B patients were treated either with more limited resections (resection of the TC and of the SF) or with extended colectomies (right- and left-sided, standard or enlarged, hemicolectomies), both associated with central vascular ligation. Despite a shorter length of surgical specimen after limited resections, postoperative complications, lymph node yield, and survival were absolutely comparable in both types of surgical treatments. CONCLUSIONS: Limited resections for TC and SF cancers can be performed with the same clinical, oncological and survival outcomes as compared to more extended colectomies if an adequate size of the specimen for the achievement of at least 5 cm of health margin is associated to Central Vascular Ligation.

Genetic diversity and population structure of Brycon nattereri (Characiformes: Bryconidae): a Neotropical fish under threat of extinction

Brycon nattereri is an endangered Neotropical fish reported along conserved stretches of the upper Paraná, Tocantins and São Francisco rivers. Populations of this species have been very rare in some Paraná River sub basins. This study analyzes the genetic diversity and population structure of B. nattereri in a restricted area of occurrence recently identified in upper Paraná River basin. Seven microsatellite loci and 497 bp of D-Loop mitochondrial region were examined in 92 individuals from four points along the area of occurrence. Both molecular markers indicated a single population distributed along a stretch of the river approximately 80 km long. Although some of the data suggest an ancient bottleneck, current levels of genetic diversity (H E = 0.574 and h = 0.616) were similar to those of other species of the genus Brycon. The results suggest that the population of B. nattereri has been able to maintain satisfactory levels of genetic diversity, in spite of the small area of occurrence. These data have highlighted an important conservation area and action may prove essential to improve the quality of the environment, and especially the water and riparian plant life, if the area is to be managed and conserved efficiently.(AU)

Brycon nattereri é um peixe Neotropical ameaçado de extinção reportado para trechos conservados dos rios Paraná, Tocantins e São Francisco. Populações desta espécie têm sido muito raras em algumas sub-bacias do rio Paraná. Este estudo analisou a diversidade genética e a estrutura populacional de B. nattereri em uma área de ocorrência restrita recentemente identificada na bacia do alto rio Paraná. Sete locos microssatélites e 497 pb da região mitocondrial D-Loop foram examinados para 92 indivíduos de quatro pontos ao longo da área de ocorrência. Ambos os marcadores moleculares indicaram uma única população distribuída em um trecho de aproximadamente 80 km do rio. Embora alguns dados tenham sugerido um antigo gargalo genético, os atuais níveis de diversidade genética (H E = 0,574, h = 0,616) foram similares aos de outras espécies do gênero Brycon. Estes resultados sugerem que a população de B. nattereri tem mantido níveis satisfatórios de diversidade genética, apesar da pequena área de ocorrência. Estes dados destacaram uma importante área de conservação e ações podem melhorar a qualidade do ambiente, especialmente para a vida aquática e mata ciliar, se a área for eficientemente manejada e conservada.(AU)

Elevated platelet count is a negative predictive and prognostic marker in locally advanced rectal cancer undergoing neoadjuvant chemoradiation: a retrospective multi-institutional study on 965 patients.

BACKGROUND: In patients with locally advanced rectal cancer treated by neoadjuvant chemoradiation, pathological complete response in the surgical specimen is associated with favourable long-term oncologic outcome. Based on this observation, nonoperative management is being explored in the subset of patients with clinical complete response. Whereas, patients with poor response have a high risk of local and distant recurrence, and appear to receive no benefit from standard neoadjuvant chemoradiation. Therefore, in order to develop alternative treatment strategies for non responding patients, predictive and prognostic factors are highly needed. Accumulating clinical observations indicate that elevated platelet count is associated with poor outcome in different type of tumors. In this study we investigated the predictive and prognostic impact of elevated platelet count on pathological response and long-term oncologic outcome in patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiation. METHODS: A total of 965 patients were selected from prospectively maintained databases of seven Centers within the SICO Colorectal Cancer Network. Patients were divided into two groups based on a pre-neoadjuvant chemoradiation platelet count cut-off value of 300 × 109/L identified by receiver operating characteristic curve considering complete pathological response as the outcome. RESULTS: Complete pathological response rate was lower in patients with elevated platelet count (12.8% vs. 22.1%, p = 0.001). Mean follow-up was 50.1 months. Comparing patients with elevated platelet count with patients with not elevated platelet count, 5-year overall survival was 69.5% vs.76.5% (p = 0.016), and 5-year disease free survival was 63.0% vs. 68.9% (p = 0.019). Local recurrence rate was higher in patients with elevated platelet count (11.1% vs. 5.3%, p = 0.001), as higher was the occurrence of distant metastasis (23.9% vs. 16.4%, p = 0.007). At multivariate analysis of potential prognostic factors EPC was independently associated with worse overall survival (HR 1.40, 95% CI 1.06-1.86), and disease free survival (HR 1.37, 95% CI 1.07-1.76). CONCLUSIONS: In locally advanced rectal cancer elevated platelet count before neoadjuvant chemoradiation is a negative predictive and prognostic factor which might help to identify subsets of patients with more aggressive tumors to be proposed for alternative therapeutic strategies.

Reappraisal of the systematics of Microglanis cottoides (Siluriformes, Pseudopimelodidae), a catfish from southern Brazil.

The southern region of Brazil is characterized by high species diversity and endemism of freshwater fishes distributed across geographically isolated river basins. Microglanis cottoides has a widespread range across these river basins and occurs in sympatry with other endemic species of the genus (e.g. M. cibelae, M. eurystoma, and M. malabarbai). Herein we tested the monophyly of M. cottoides and presented for the first time information about the molecular phylogeny of species in the genus. The results suggest that M. cottoides currently forms a non-monophyletic group which includes populations endemic to the Uruguay River basin that are more closely related to M. malabarbai, and excludes M. cibelae, found to be nested within M. cottoides. Based on an integrative approach using morphological and molecular data, we propose M. cibelae as a junior synonym of M. cottoides, and the populations of the Uruguay River basin previously assigned to M. cottoides in fact belong to M. malabarbai. Our molecular phylogeny shows that M. cottoides is sister to M. parahybae, which is also a coastal species, and M. malabarbai is sister of M. garavelloi, both endemic to inland river basins. The time-calibrated phylogeny indicates that the separation between inland and the coastal clades occurred in the Tertiary period, and that the species within the coastal basins diverged in the Pliocene, which overlaps with the diversification times estimated for the two inland species as well. This pattern of diversification corroborates some previous studies with other fishes from the same region.

Surgical treatment of hepatic metastases from gastric cancer.

The purpose of the study was to investigate the clinical factors influencing the prognosis of patients submitted to hepatectomy for metastases from gastric cancer and their clinical role. We conducted a retrospective multicentre review. We evaluated how survival from surgery was influenced by patient-related, tumour-related and treatment-related prognostic factors. We analysed data on 144 patients submitted to hepatectomy for metastases from gastric cancer, in the synchronous and metachronous setting. In 117 cases, an R0 resection was achieved, while in 27 an R + hepatic resection was performed. Chemotherapy was administered to 55 patients. Surgical mortality was 2.1% and morbidity 21.5%. One-, 3-, and 5-year OS rates after surgery were 49.9, 19.4 and 11.6%, respectively, with a median OS of 12.0 months. T4 gastric cancer, H3 hepatic involvement, non-curative resection, recurrence after surgery, and abstention from chemotherapy were associated with a worse prognosis. Factor T and H displayed a clear (p < 0.001) cumulative effect. Our data show that R0 resection must be pursued whenever possible. The treatment of T4 gastric cancer with hepatic bilateral and diffuse metastasis (H3) should be considered carefully or it should be probably avoided. Finally, a multimodal treatment associating surgery and chemotherapy offers the best survival results.