Non-stationary analysis for road drainage design under land-use and climate change scenarios.

Frequency analysis has been the most widely used tool worldwide to dimension water-related infrastructures and evaluate flood risks. The concept of stationarity has been a common and practical hypothesis in hydrology for many years. However, in recent decades due to climate change pressure and changes in land use, it has been related to the presence of time-series trends that in hydrology indicate non-stationary effects. In this sense, the need to comprehensively address non-stationary frequency analysis has been identified. This study proposes to incorporate the non-stationary flood frequency analysis into the dimensioning process of road structures with the following objectives: i) evaluate the effect of land use on peak flow in a simulated period of 129 years, ii) evaluate covariates related to land use, and iii) evaluate covariates related to climate change. To this end, road drainage simulation exercises were carried out in three sections of the Ibagué-Cajamarca road located in Colombia. Likewise, the Generalized Additive Models for Location, Scale and Shape was implemented for the non-stationary analysis, and covariates related to climate variability were included, such as El Niño-Southern Oscillation indices (ONI12, ONI3.4, MEI, and SOI), and the Pacific Decadal Oscillation (PDO) index, as well as some related to the evolution of land use such as hydraulic conductivity, soil water storage in the root zone, and infiltration capacity represented in the curve number. The results indicate that the non-stationary analysis improves the prediction of maximum flows, and it is possible to obtain road drainage dimensioning that adjusts to climate and land-use variations.

[Digestive tract malignant neoplasms in patients of No. 11 area IMSS in Nuevo Laredo, Tamaulipas.]. / Neoplasias malignas del aparato digestivoen población derechohabiente del IMSS No. 11,Nuevo Laredo, Tamaulipas.

INTRODUCTION: In the last years, mortality due to malignant neoplasms has shown a reduction in its growing tendencies in developed countries. However,the profile of cancer mortality in developing countries still presents a clear upward pattern, and Mexico is not the exception, for the mortality rate due to malignant tumors has shown an increase recently, which constitutes a great challenge for health institutions. OBJECTIVE: To determine the frequency of malignant neoplasms in the digestive tract in patients treated in the General Hospital Area No. 11 of Mexican Institute of Social Security in Nuevo Laredo, Tamaulipas,Mexico. MATERIALS AND METHODS: From 11,386 histopathologic reports carried out in the Department of Pathology of the General Hospital Area No. 11 IMSS in the year 2000-2006, 165 patients were reported,diagnosed with malignant neoplasms of the digestive tract (NMTD); patients age and gender were analyzed as well as affected areas and histological stock. Benign neoplasms and metastasis were excluded. RESULTS: From the study of 165 cases of patients with malignant neoplasms of digestive tract (NMTD),the most affected age was patients between 60-75 years old, predilection for male (63.78%) and female(36.21%) subjects. According to the Pathology report, 24.4% were diagnosed with hepatic cancer,23.03% were colon and rectum cancer, 20.00%were stomach cancer, 13.33% with pancreatic cancer,and 7.27% were cancer of esophagus. The rest was located in other levels. CONCLUSION: Malignant neoplasms of digestive tract in patients of General Hospital Area No. 11IMSS in Nuevo Laredo are relevant in relation with other Medial Centers may be regional factors contribute to this behavior.

Cisplatin plus gemcitabine versus a cisplatin-based triplet versus nonplatinum sequential doublets in advanced non-small-cell lung cancer: a Spanish Lung Cancer Group phase III randomized trial.

PURPOSE: To compare the survival benefit obtained with cisplatin plus gemcitabine, a cisplatin-based triplet, and nonplatinum sequential doublets in advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Stage IIIB to IV NSCLC patients were randomly assigned to receive cisplatin 100 mg/m2 day 1 plus gemcitabine 1,250 mg/m2 days 1 and 8, every 3 weeks for six cycles (CG); cisplatin 100 mg/m2 day 1 plus gemcitabine 1,000 mg/m2 and vinorelbine 25 mg/m2 days 1 and 8, every 3 weeks for six cycles (CGV); or gemcitabine 1,000 mg/m2 plus vinorelbine 30 mg/m2 days 1 and 8, every 3 weeks for three cycles, followed by vinorelbine 30 mg/m2 days 1 and 8 plus ifosfamide 3 g/m2 day 1, every 3 weeks for three cycles (GV-VI). RESULTS: Five hundred fifty-seven patients were assigned to treatment (182 CG, 188 CGV, 187 GV-VI). Response rates were significantly inferior for the nonplatinum sequential doublet (CG, 42%; CGV, 41%; GV-VI, 27%; CG v GV-VI, P =.003). No differences in median survival or time to progression were observed. Toxicity was higher for the triplet: grade 3 to 4 neutropenia (GC, 32%; CGV, 57%; GV-VI, 27%; P <.05); neutropenic fever (CG, 4%; CGV, 19%; GV-VI, 5%; P <.0001); grade 3 to 4 thrombocytopenia (CG, 19%; CGV, 23%; GV-VI, 3%; P =.0001); and grade 3 to 4 emesis (GC, 22%; GCV, 32%; GV-VI, 6%; P <.0001). CONCLUSION: On the basis of these results, CG remains a standard regimen for first-line treatment of advanced NSCLC.

Prospective assessment of XRCC3, XPD and Aurora kinase A single-nucleotide polymorphisms in advanced lung cancer.

PURPOSE: New therapeutic approaches are being developed based on findings that several genetic abnormalities underlying non-small-cell lung cancer (NSCLC) can influence chemosensitivity. The identification of molecular markers, useful for therapeutic decisions in lung cancer, is thus crucial for disease management. The present study evaluated single-nucleotide polymorphisms (SNPs) in XRCC3, XPD and Aurora kinase A in NSCLC patients in order to assess whether these biomarkers were able to predict the outcomes of the patients. METHODS: The Spanish Lung Cancer Group prospectively assessed this clinical study. Eligible patients had histologically confirmed stage IV or IIIB (with malignant pleural effusion) NSCLC, which had not previously been treated with chemotherapy, and a World Health Organization performance status (PS) of 0-1. Patients received intravenous doses of vinorelbine 25 mg/m(2) on days 1 and 8, and cisplatin 75 mg/m(2) on day 1, every 21 days for a maximum of 6 cycles. Venous blood was collected from each, and genomic DNA was isolated. SNPs in XRCC3 T241M, XPD K751Q, XPD D312N, AURORA 91, AURORA 169 were assessed. RESULTS: The study included 180 patients. Median age was 62 years; 87 % were male; 34 % had PS 0; and 83 % had stage IV disease. The median number of cycles was 4. Time to progression was 5.1 months (95 % CI, 4.2-5.9). Overall median survival was 8.6 months (95 % CI, 7.1-10.1). There was no significant association between SNPs in XRCC3 T241M, XPD K751Q, XPD D312N, AURORA 91, AURORA 169 in outcome or toxicity. CONCLUSIONS: Our findings indicate that SNPs in XRCC3, XPD or Aurora kinase A cannot predict outcomes in advanced NSCLC patients treated with platinum-based chemotherapy.

[Conservative treatment with chemotherapy and radiotherapy in bladder cancer invading the muscle: preliminary results of a prospective study]. / Tratamiento conservador con quimioterapia y radioterapia en el cáncer de vejiga músculo invasivo: resultados preliminares de un estudio prospectivo.

OBJECTIVE: To analyze the possibility and safety of conservative treatment of muscle-invasive bladder cancer and to identify the prognostic factors for survival. METHODS: A total of 33 patients with invasive bladder cancer, clinical stages T2-4NxM0, were treated with aggressive transurethral resection (TUR) followed by three cycles of neoadjuvant methotrexate, cisplatin and vinblastine (MCV) chemotherapy and radiotherapy (60 Gy to the bladder). Cystectomy was recommended to patients without complete response to TUR and MCV chemotherapy. RESULTS: 31 of the 33 patients included in the study completed the protocol and were evaluable. The clinical complete response rate to TUR and MCV chemotherapy was 68% (21/31 Pts.). With a median follow-up of 39 months (range 12-78), 25/31 patients (81%) are alive and 24 (77%) have functioning preserved bladders. Four out of 31 patients (13%) developed distant metastases. The 5-year overall survival and disease free interval was 74.6% and 53.5%, respectively. By multivariate analysis response after TUR and chemotherapy (p = 0.022) was the more important risk factor associated with survival. CONCLUSION: These results indicate that MCV chemotherapy followed by radiotherapy may be effective in preserving bladder function in a high number of patients, with a survival rate comparable to that reported after cystectomy. The true efficacy of neoadjuvant chemotherapy remains to be proven by ongoing randomized trials.

Phase II study of trastuzumab and cisplatin as first-line therapy in patients with HER2-positive advanced gastric or gastroesophageal junction cancer

INTRODUCTION: HER2 over-expression and/or amplification are present in 9-38% of gastric or gastroesophageal junction (GEJ) cancers and are correlated to poor outcome. We conducted a multicentre phase II trial to evaluate trastuzumab in combination with cisplatin in patients with untreated HER2-positive advanced gastric or GEJ cancer. MATERIALS AND METHODS: Chemo-naïve patients with measurable, non-resectable, advanced or metastatic gastric or GEJ adenocarcinoma, with HER2 over-expression and/or amplification (IHC 3+, or IHC 2+ and FISH+), age ≥18 years, ECOG ≤2, left ventricle ejection fraction ≥50% and adequate organ function were eligible. Treatment consisted of trastuzumab (8 mg/kg on cycle 1 day 1 as loading; 6 mg/kg in subsequent cycles) and cisplatin (75 mg/m(2)), both intravenously on day 1, every 21 days. RESULTS: Twenty-two out of 228 patients (10%) were HER2- positive and were included in this phase II trial. The median age was 66 years and ECOG 0/1 was 41%/59%. The median number of cycles was 4 (range 1-41). The confirmed ORR was 32% and disease control was achieved in 64% of patients. Median time to progression was 5.1 months. Grade 3 adverse events included asthenia (27%), neutropenia (18%), anorexia (14%), diarrhoea (9%) and abdominal pain (9%). There were no grade 4 toxicities or treatment-related deaths. Higher baseline HER extracellular domain (ECD) levels were associated with better outcome in terms of response and survival. CONCLUSIONS: Trastuzumab in combination with cisplatin is an active regimen and has a favourable toxicity profile in advanced HER2-positive gastric or gastroesophageal cancers (AU)