Vaira M

Prognostic factors and oncologic outcome in 146 patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: Italian multicenter study S.I.T.I.L.O.

AIMnThe present study was specifically designed to assess the major clinical and pathological variables of patients with colorectal peritoneal carcinomatosis in order to investigate whether currently used criteria appropriately select candidates for peritonectomy procedures (cytoreductive surgery) combined with hyperthermic intraperitoneal chemotherapy (HIPEC).nnnPATIENTS AND METHODSnPreoperative, operative and follow-up data on 146 consecutive patients presenting with peritoneal carcinomatosis of colorectal origin and treated by surgical cytoreduction combined with HIPEC in 5 Italian Hospital and University Centers were prospectively entered in a common database. Univariate and multivariate analyses were used to assess the prognostic value of clinical and pathologic factors.nnnRESULTSnOver a minimum 24-month follow-up, the overall morbidity rate was 27.4% (mortality rate: 2.7%) and was directly related to the extent of surgery. Peritoneal cancer index (PCI), unfavorable peritoneal sites, synchronous or previously resected liver metastasis and the completeness of cytoreduction, all emerged as independent prognostic factors correlated with survival.nnnCONCLUSIONSnUntil research provides more effective criteria for selecting patients based upon the biomolecular features of carcinomatosis, patients should be selected according to the existing independent prognostic variables.

Geographic Variation of the Diet of Melanophryniscus rubriventris (Anura: Bufonidae) in Northwestern Argentina

Abstract Increasing evidence shows that alkaloids in the skins of poisonous frogs are sequestered from a specialized diet of ants. It is considered likely that in the small aposematic bufonid genus Melanophryniscus, skin alkaloids are taken up via a similar system. However, quantitative aspects of the diet in this genus remain poorly studied. As a result, studies that correlate diet and skin alkaloids in these toads are precluded by the lack of extensive information on the diet of most species and populations within the genus. We describe diet composition of Melanophryniscus rubriventris with a particular focus on geographic variation over much of its range distribution in northwestern Argentina and compare the diet of this species with that of other members of the genus. The diet of M. rubriventris was composed of 17 arthropod prey categories. The species consumed primarily small, gregarious prey such as ants, mites, aphids, burrowing bugs, and beetles. Diet composition of the populations studied was similar in the number of prey categories, but we found noticeable interpopulation variation in the proportion of each prey item consumed. Earlier works had reported that ants, collembolans, and mites were prominent in the diet of other Melanophryniscus. Our study indicates that, although ants are common prey, they are not the main prey category in all populations.

Multicystic peritoneal mesothelioma: outcomes and patho-biological features in a multi-institutional series treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

AIMnThis retrospective multi-institutional study addresses the role of surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of multicystic peritoneal mesothelioma (MCPM). MCPM is an uncommon tumour with uncertain malignant potential and no current standard therapy. Additionally, poorly defined pathological and biological features of this disease were investigated.nnnMETHODSnTwelve patients with MCPM underwent 14 procedures of cytoreduction and HIPEC in two Italian referral centres. Nine patients had recurrent disease after previous debulking (one operation in six patients, two in two, four in one). Biological markers related to mesothelioma origin and clinical features were assessed by immunohistochemical studies.nnnRESULTSnMedian follow-up was 64 months (range 5-148). Optimal cytoreduction (residual tumour nodules ≤2.5 mm) was performed in all the procedures. One grade IV postoperative complication (NCI/CTCAE v.3.0) and no operative death occurred. All the patients are presently alive with no evidence of disease, including two patients who underwent the procedure twice, due to locoregional disease recurrence. Five- and ten-year progression-free survival was 90% and 72%, accounting for a. statistically significant difference (P = 0.0001) with progression-free survival following previous debulking surgery (median 11 months; range 2-31). All cases showed low proliferative activity assessed by mitotic rate and Ki-67 expression.nnnCONCLUSIONSnMCPM is a borderline tumour with a high propensity to local-regional recurrence. Definitive tumour eradication by means of cytoreduction and HIPEC seems more effective than debulking surgery in preventing disease relapse. Low mitotic rate and poor Ki-67 expression might be related to the peculiar behaviour of MCMP.

Contamination risk for operators performing semi-closed HIPEC procedure using cisplatin

AIMSnAim of this study was to assess operators safety while performing a semi-closed HIPEC procedure for peritoneal carcinomatosis using cisplatin drugs.nnnMETHODSnEnvironmental air, theater personnel urine, operators gloves and hand skin contamination were assessed during two non-consecutive working days. Six operating surgeons, two anesthesiologists and two theater nurses were included in the study. Glove samples were collected from the inner surface of the external glove and from the external surface of the inner glove from operating surgeons wearing a double pair of gloves. Personnel urine samples were collected before, after and 24xa0h from the procedure.nnnRESULTSnAir and urine samples permanently resulted below detectable levels for cisplatin presence on all the tested sources and sessions. Cisplatin contamination was detected on the inner surface of the external gloves and on the outer surface of the inner gloves, but in a lower concentration for the latter. Skin wipe samples were below detectable levels for platinum presence.nnnCONCLUSIONnThe results suggest that two pairs of gloves are adequate to protect the skin from antiblastic drugs. No sign of direct contact or systemic absorption of drugs was ever detected from the inspected samples. Semi-closed HIPEC technique appears to be a safe procedure for operators.

Geographic and intrapopulational variation in colour and patterns of an aposematic toad, Melanophryniscus rubriventris (Amphibia, Anura, Bufonidae)

The aposematic toad genus Melanophryniscus is a polymorphic group with noticeable variation in colour and pattern. Here, we objectively evaluate variation in spectral reflectance and quantify variation in patterning within and among populations of the species M. rubriventris in NW Argentina. We conducted spectrophotometric analysis on 69 individuals and recorded dorsal and ventral pattern morphs of 727 individuals from six populations. We found high divergence in the reflectance spectra, the extent of brightly coloured areas, and the skin alkaloid profiles with no correlation among coloration varieties, alkaloid profiles, and the geographic distance between populations. Our analyses imply subdivision of sampled populations groupings based mostly on different dorsal colorations. Our results also reveal that populations with very similar patterns may differ markedly in colour and vice versa. It is striking that these aposematic toads show a pronounced variation in colour and patterning among and within populations showing individuals with a conspicuous bright dorsal colouration but also morphs with a rather cryptic black or drab colouration. However, the known presence of several alkaloids classes in all populations suggests that all morphs might be equally unpalatable.

Variation of thermal parameters in two different color morphs of a diurnal poison toad, Melanophryniscus rubriventris (Anura: Bufonidae)

We study the variation in thermal parameters in two contrasting populations Yungas Redbelly Toads (Melanophryniscus rubriventris) with different discrete color phenotypes comparing field body temperatures, critical thermal maximum and heating rates. We found significant differences in field body temperatures of the different morphs. Temperatures were higher in toads with a high extent of dorsal melanization. No variation was registered in operative temperatures between the study locations at the moment of capture and processing. Critical thermal maximum of toads was positively related with the extent of dorsal melanization. Furthermore, we founded significant differences in heating rates between morphs, where individuals with a high extent of dorsal melanization showed greater heating rates than toads with lower dorsal melanization. The color pattern-thermal parameter relationship observed may influence the activity patterns and body size of individuals. Body temperature is a modulator of physiological and behavioral functions in amphibians, influencing daily and seasonal activity, locomotor performance, digestion rate and growth rate. It is possible that some growth constraints may arise due to the relationship of color pattern-metabolism allowing different morphs to attain similar sizes at different locations instead of body-size clines.

Amphibia, Anura, Strabomantidae, Oreobates barituensis : distribution extension, new provincial record and geographic distribution map

Oreobates barituensis Vaira and Ferrari, 2008 (Figure 1) is the most recently described of 16 recognized species of the genus Oreobates Jimenez de la Espada, 1872 (Frost 2009). The genus occurs in western South America from southern Colombia to southwestern Brazil and northwestern Argentina (Hedges et al. 2008). The two Argentinean species of Oreobates (O. discodalis and O. barituensis) inhabit subtropical humid montane forests belonging to the ecoregion of Southern Andean Yungas (Vaira and Ferrari 2008). Oreobates barituensis is currently known only from three close localities (the most distant was separated about 10 km straight-line) in northern Salta province, Argentina, and its possible occurrence in adjacent Bolivia has been discussed (Vaira and Ferrari 2008).

The use of ephemeral reproductive sites by the explosive breeding toad Melanophryniscus rubriventris (Anura: Bufonidae): is it a predator cue mediated behavior?

Amphibians detect quality signals when selecting reproduction sites. We hypothesize that Melanophryniscus rubriventris, an explosive breeding toad that reproduces in small, ephemeral water bodies, is able to select sites without predators. We performed a field experiment simulating oviposition sites, two with predators (tadpoles and bugs) and one control. Contrary to our expectations, we obtained no differences in the number of eggs deposited. We also performed an experiment to test the capability of M. rubriventris tadpoles to detect potential predators. Tadpoles could not detect predators, as other species did. Melanophryniscus rubriventris is selecting spawning sites following other signals, not predation risk. Identifying selection cues is crucial to protect species that depend on threatened habitats.

Patterns of daily and seasonal calling activity of a direct-developing frog of the subtropical Andean forests of Argentina

Climate often regulates different aspects of the life cycle and activity of amphibians. Climatic seasonality may impose severe restrictions on breeding patterns of direct-developing terraranan frogs. We studied the influence of abiotic cues on calling activity of males of the direct-developing frog Oreobates discoidalis in the Yungas forests of north-western Argentina. Vocalization activity and daily emission pattern of the vocal repertoire were registered with a frog-logger, and climatic variables were registered with a data logger. We sampled two reproductive seasons from 2010 to 2011. We used ordinal logistic regression to evaluate the relationship between independent climatic variables and the intensity of calling activity. The calling season of males of O. discoidalis was triggered by the first rainfall of the aestival season. The species could be defined as crepuscular–nocturnal with a calling activity peak at dusk. Sporadic calling activity during day time was associated with conditions of high humidity and rainfall. Both the emission and the intensity of the advertisement call activity were influenced by time of the day, high levels of relative air humidity and presence of rainfall; air temperature was not a determinant factor in the calling activity of this frog species. Territorial calls were strongly associated with full chorus activity that could be associated with a mechanism of inter-male spacing.

Treatment of peritoneal carcinomatosis from ovarian cancer by surgical cytoreduction and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

AIMnOvarian cancer may be considered as an intraperitoneal disease by itself. When surgical removal associated with systemic chemotherapy fails, usually, the history of the patients is characterized by poor prognosis. Some encouraging results have been reported by the treatment of peritoneal carcinomatosis (PC) from ovarian cancer by complete surgical cytoreduction, peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). The purpose of this article was to evaluate the survival benefit and the morbidity of patients with ovarian cancer treated at our institution by cytoreductive surgery associated with hyperthermic intraperitoneal perioperative chemotherapy (HIPEC).nnnMETHODSnBetween October 1995 and December 2012 more than 600 operations for PC were performed; in 308 cases surgical cytoreduction associated with HIPEC was carried out. Eighty-five patients treated by cytoreduction associated with HIPEC were affected by recurrent epithelial ovarian cancer (EOC). Statistical analysis was performed on 70 patients (last 15 patients were too recent for evaluation). Two trials were applied: 1) patients presenting first peritoneal relapse after surgery and systemic chemotherapy (CT), 6 months later from last CT administration; 2) multiple relapse patients.nnnRESULTSnOn 70 patients, morbidity and mortality rates were 35.7% and 7.1%, respectively. Overall median survival was 42.0 months, but in primary EOC was 48.0 months and in recurrent EOC was 28 months (P=0.12). Statistical analysis revealed that the completeness of cytoreduction was the most statistically significant factor related to survival: in completely citoreduced patients, overall survival was 48 months.nnnCONCLUSIONnCitoreductive surgery associated to platinum compounds HIPEC is feasible and relatively safe in recurrent and primary PC from ovarian cancer. Better selection of patients and second-look surgery in high risk-patients have to be investigated to improve those encouraging results.