Rendimiento de la PET/TC con 11C-colina en el seguimiento del cáncer de próstata / Effectiveness of 11C-choline PET/CT in prostate cancer surveillance

Objetivo Analizar el rendimiento diagnóstico de la PET/TC con 11C-colina en el seguimiento del cáncer de próstata (CaP), especialmente en pacientes con antígeno prostático específico (PSA)>1ng/ml. Material y métodos Se evaluaron retrospectivamente 329 exploraciones PET/TC con 11C-colina de 191 pacientes (68,2±7,2 años) con CaP con recaída bioquímica o en seguimiento (PSA en el momento de la PET/TC: 13,0±84,2ng/ml). El tratamiento inicial fue prostatectomía radical en 81 pacientes y otros tratamientos (radioterapia, quimioterapia, hormonoterapia) en 110. La PET/TC se adquirió 20min después de la inyección de 555-740MBq de 11C-colina. El seguimiento mínimo fue superior a 12 meses. Resultados Doscientas diecinueve (66,6%) de las 329 exploraciones PET/TC fueron positivas. El porcentaje de positivos fue significativamente mayor en los pacientes con otro tratamiento inicial diferente a la prostatectomía radical (85,6 frente a 43,6%, respectivamente). Ciento treinta PET/TC (59,4%) mostraron recidiva local, 48 (21,9%) a distancia y 41 (18,7%) local más a distancia. El abordaje terapéutico inicial se modificó en 139 casos (63,5%). De las 81 PET/TC con 11C-colina realizadas con PSA<1ng/ml, 23 (28,4%) fueron positivas. El abordaje terapéutico inicial se modificó en 9 (11,1%). Tres de 63 pacientes (4,8%) fallecieron por CaP. Conclusiones La PET/TC con 11C-colina demostró su eficacia en el seguimiento y la reestadificación del CaP, incluso en pacientes con PSA sérico<1ng/ml. El rendimiento diagnóstico fue diferente según el tratamiento inicial al que fueron sometidos los pacientes, siendo mayor en aquellos tratados inicialmente con otros tratamientos distintos de la PR prostatectomía radical (AU)

Aim Our aim was to analyse the performance of 11C-choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA)<1ng/ml. Material and methods Three hundred and twenty-nine 11C-choline PET/CT examinations from 191 patients (68.2±7.2 years) submitted for PCa surveillance or biochemical recurrence were retrospectively evaluated (PSA at study was 13.0±84.2ng/ml). Main initial treatment was radical prostatectomy in 81 patients, and other treatments (radiotherapy, chemotherapy, hormonotherapy) in 110. PET/CT was acquired 20min after injection of 555-740MBq of 11C-choline. Minimum follow-up was 12 months. Results Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The percentage of positive examinations was significantly higher in patients with other initial treatment than radical prostatectomy compared to patients with radical prostatectomy (85.6 vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 11C-choline PET/CT scans performed with PSA<1ng/ml, 23 (28.4%) showed a positive result. Initial therapeutic approach was changed in 9 (11.1%). Three (4.8%) out of 63 patients died as per PCa. Conclusions 11C-choline PET/CT demonstrated its effectiveness in PCa surveillance and restaging, even in patients with serum PSA<1ng/ml. The diagnostic performance was different depending on the initial treatment, been higher in patients with non-surgical treatment (AU)

Effectiveness of 11C-choline PET/CT in prostate cancer surveillance.

AIM: Our aim was to analyse the performance of [11C]choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA) < 1 ng/mL. MATERIAL AND METHODS: Three hundred and twenty-nine [11C]choline PET/CT examinations from 191 patients (68.2 ±â€¯7.2 years) submitted for PCa surveillance or biochemical recurrence were retrospectively evaluated. PSA at study was 13.0 ±â€¯84.2 ng/mL. Main initial treatment was radical prostatectomy (RP) in 81 patients, and other treatments (radiotherapy, chemotherapy, hormonotherapy) in 110. PET/CT was acquired 20' after injection of 555-740 MBq of [11C]choline. Minimum follow-up was 12 months. RESULTS: Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The percentage of positive examinations was significantly higher in patients with other initial treatment than RP compared to patients with RP (85.6% vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 [11C]choline PET/CT scans performed with PSA < 1 ng/mL, 23 (28.4%) showed a positive result. Initial therapeutic approach was changed in 9 (11.1%). Three (4.8%) out of 63 patients died as per PCa. CONCLUSION: [11C]choline PET/CT demonstrated its effectiveness in PCa surveillance and restaging, even in patients with serum PSA < 1 ng/mL. The diagnostic performance was different depending on the initial treatment, been higher in patients with non-surgical treatment.

Factores predictivos de mortalidad e ingreso en la unidad de cuidados intensivos en pacientes con pielonefritis enfisematosa: experiencia de 5 años en un hospital terciario / Predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis: 5-year experience in a tertiary care hospital

Introduction and objectivesEmphysematous pyelonephritis is a life-threatening infection of the kidney and surrounding tissues associated with a high mortality rate. The aim of this study was to determine predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis, and to propose a therapeutic algorithm based on current literature and our experience.MethodsA retrospective study was done including patients with emphysematous pyelonephritis in a single center in the north of Mexico from 2011-2016. Demographic, clinical, microbiological and biochemical parameters, therapeutic management, and outcomes were assessed. Factors associated with admission to intensive care unit and mortality were determined. Comparison was assessed using χ2 test for categorical variables, and T-test for numerical variables. Univariate and multivariate logistic regression analyses were performed. Statistical significance was set at p<0.05.ResultsA total of 63 patients were included, of which 55(87.3%) were females, with a mean age of 55.5±12.2 years. The most common comorbidities were diabetes and hypertension. Escherichia coli was the most common isolated microorganism (51.7%) and extended-spectrum beta-lactamase-producing agents were reported in 31.7%. Conservative therapy was provided to 38.7%, double J stent 42.9%, open/percutaneous drainage 12.7%, and nephrectomy 25.3%. Overall mortality and intensive care admission were 20.6% and 36.5%, respectively. In the multivariate analysis, hemodynamic instability (p=0.005), qSOFA≥2 (p=0.003), hypoalbuminemia (p=0.02), and early nephrectomy (p=0.002) were associated with intensive care admission. Huang scale 4 (p=0.006) and early nephrectomy (p=0.001) were associated to mortality.ConclusionsEmphysematous pyelonephritis is a life-threatening disease and evidence of management is based in small case series due to the low incidence of this condition.

Introducción y objetivosLa pielonefritis enfisematosa es una infección del riñón y los tejidos circundantes que pone en riesgo la vida del paciente y se asocia a una elevada tasa de mortalidad. El objetivo de este estudio fue determinar los factores predictivos de mortalidad e ingreso en la unidad de cuidados intensivos en pacientes con pielonefritis enfisematosa, y proponer un algoritmo terapéutico basado en la literatura actual y en nuestra experiencia.MétodosSe realizó un estudio retrospectivo incluyendo los pacientes con pielonefritis enfisematosa en un solo centro del norte de México entre 2011 y 2016. Se evaluaron parámetros demográficos, clínicos, microbiológicos y bioquímicos, el manejo terapéutico y los resultados. Se determinaron los factores asociados con el ingreso a la unidad de cuidados intensivos y la mortalidad. La comparación se evaluó mediante la prueba de chi cuadrado para las variables categóricas, y la prueba t de Student para las variables numéricas. Se realizaron análisis de regresión logística univariante y multivariante. La significación estadística se fijó en p<0,05.ResultadosSe incluyeron 63 pacientes, de los cuales 55 (87,3%) eran mujeres, con una edad media de 55,5±12,2 años. Las comorbilidades más frecuentes fueron la diabetes y la hipertensión. Escherichia coli fue el microorganismo más comúnmente aislado (51,7%) y los agentes productores de betalactamasas de espectro extendido se registraron en el 31,7%. Se administró tratamiento conservador al 38,7%, el uso de catéter doble J en el 42,9%, drenaje abierto/percutáneo en el 12,7% y nefrectomía en el 25,3%. La mortalidad global y el ingreso en cuidados intensivos fueron del 20,6% y el 36,5%, respectivamente. En el análisis multivariante, la inestabilidad hemodinámica (p=0,005), la escala qSOFA≥2 (p=0,003), la hipoalbuminemia (p=0,02) y la nefrectomía temprana (p=0,002) se asociaron con el ingreso en cuidados intensivo

Predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis: 5-year experience in a tertiary care hospital.

INTRODUCTION AND OBJECTIVES: Emphysematous pyelonephritis is a life-threatening infection of the kidney and surrounding tissues associated with a high mortality rate. The aim of this study was to determine predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis, and to propose a therapeutic algorithm based on current literature and our experience. METHODS: A retrospective study was done including patients with emphysematous pyelonephritis in a single center in the north of Mexico from 2011 to 2016. Demographic, clinical, microbiological and biochemical parameters, therapeutic management, and outcomes were assessed. Factors associated with admission to intensive care unit and mortality were determined. Comparison was assessed using X2 test for categorical variables, and T-test for numerical variables. Univariate and multivariate logistic regression analyses were performed. Statistical significance was set at P < .05. RESULTS: A total of 63 patients were included, of which 55 (87.3%) were females, with a mean age of 55.5 ±â€¯12.2 years. The most common comorbidities were diabetes and hypertension. Escherichia coli was the most common isolated microorganism (51.7%) and extended-spectrum beta-lactamase-producing agents were reported in 31.7%. Conservative therapy was provided to 38.7%, double J stent 42.9%, open/percutaneous drainage 12.7%, and nephrectomy 25.3%. Overall mortality and intensive care admission were 20.6% and 36.5%, respectively. In the multivariate analysis, hemodynamic instability (P = .005), qSOFA ≥ 2 (P = .003), hypoalbuminemia (P = .02), and early nephrectomy (P = .002) were associated with intensive care admission. Huang scale 4 (P = .006) and early nephrectomy (P = .001) were associated to mortality. CONCLUSIONS: Emphysematous pyelonephritis is a life-threatening disease and evidence of management is based in small case series due to the low incidence of this condition. Hemodynamic instability, hypoalbuminemia, qSOFA ≥ 2, Huang scale ≥3, and early nephrectomy are associated with poor prognosis.

Etiología de la gangrena de Fournier como factor pronóstico de mortalidad: análisis de 121 casos / Etiology of Fournier gangrene as a prognostic factor in mortality: Analysis of 121 cases

Objetivo: Evaluar el origen de la gangrena de Fournier (GF) como factor pronóstico de morbimortalidad. Material y métodos: Los pacientes que acudieron a nuestra clínica con diagnóstico de GF entre 2010 y 2017 se incluyeron de forma retrospectiva. Los pacientes fueron categorizados según el origen de la infección. Se determinaron 3 factores de gravedad en cada grupo: duración de la estancia hospitalaria (días), índice de gravedad de GF y mortalidad. Se realizó un análisis de regresión logística para evaluar los datos. Resultados: De los 130 pacientes evaluados, el origen se estableció en 121 con base en la historia clínica y los hallazgos radiológicos y quirúrgicos. Treinta y cinco pacientes tuvieron un origen intestinal con una mortalidad del 20,68%, en 46 el origen fue testicular y la mortalidad del 2,22%, en 12 pacientes el origen fue urinario, con una mortalidad del 0%, y 28 pacientes tenían enfermedad de origen cutáneo y una mortalidad del 16,6%. El origen testicular fue el más frecuente (38%), además de presentar una estancia hospitalaria y un índice de gravedad de FG más bajo y una mortalidad menor que aquellos con enfermedad de origen intestinal (p = 0,022). Conclusiones: El origen de la infección tiene un valor pronóstico significativo en la mortalidad del paciente

Objective: Evaluate the origin of Fournier gangrene (FG) as a prognostic factor of morbidity and mortality. Material and methods: Patients who came to our clinic with a diagnosis of FG from 2010 to 2017 were included retrospectively. Patients were categorized depending on the origin of the infection. Three severity factors were determined in each group: days of hospital stay, the FG severity index, and mortality. Logistic regression test was performed to analyze the data. Results: Of the 130 patients evaluated, the origin was established in 121 based on the clinical history and radiological and surgical findings. Thirty-five patients had an intestinal origin with a mortality of 20.68%, 46 patients had a testicular origin with a mortality of 2.22%, 12 patients had a urinary origin with a mortality of 0%, and 28 patients with a cutaneous origin with a mortality of 16.6%. The testicular origin was the most frequent (38%) in addition to presenting a lower hospital stay, a lower FG severity index, and a lower mortality than those with an intestinal origin (P = .022). Conclusions: The origin of the infection has a significant prognostic value in the mortality of the patient

Etiology of Fournier gangrene as a prognostic factor in mortality: Analysis of 121 cases. / Etiología de la gangrena de Fournier como factor pronóstico de mortalidad: análisis de 121 casos.

OBJECTIVE: Evaluate the origin of Fournier gangrene (FG) as a prognostic factor of morbidity and mortality. MATERIAL AND METHODS: Patients who came to our clinic with a diagnosis of FG from 2010 to 2017 were included retrospectively. Patients were categorized depending on the origin of the infection. Three severity factors were determined in each group: days of hospital stay, the FG severity index, and mortality. Logistic regression test was performed to analyze the data. RESULTS: Of the 130 patients evaluated, the origin was established in 121 based on the clinical history and radiological and surgical findings. Thirty-five patients had an intestinal origin with a mortality of 20.68%, 46 patients had a testicular origin with a mortality of 2.22%, 12 patients had a urinary origin with a mortality of 0%, and 28 patients with a cutaneous origin with a mortality of 16.6%. The testicular origin was the most frequent (38%) in addition to presenting a lower hospital stay, a lower FG severity index, and a lower mortality than those with an intestinal origin (P=.022). CONCLUSIONS: The origin of the infection has a significant prognostic value in the mortality of the patient.

CHK1 expression in Gastric Cancer is modulated by p53 and RB1/E2F1: implications in chemo/radiotherapy response.

Radiation has a limited but relevant role in the adjuvant therapy of gastric cancer (GC) patients. Since Chk1 plays a critical function in cellular response to genotoxic agents, we aimed to analyze the role of Chk1 in GC as a biomarker for radiotherapy resistance. We analyzed Chk1 expression in AGS and MKN45 human GC cell lines by RT-QPCR and WB and in a small cohort of human patient's samples. We demonstrated that Chk1 overexpression specifically increases resistance to radiation in GC cells. Accordingly, abrogation of Chk1 activity with UCN-01 and its expression with shChk1 increased sensitivity to bleomycin and radiation. Furthermore, when we assessed Chk1 expression in human samples, we found a correlation between nuclear Chk1 accumulation and a decrease in progression free survival. Moreover, using a luciferase assay we found that Chk1's expression is controlled by p53 and RB/E2F1 at the transcriptional level. Additionally, we present preliminary data suggesting a posttranscriptional regulation mechanism, involving miR-195 and miR-503, which are inversely correlated with expression of Chk1 in radioresistant cells. In conclusion, Chk1/microRNA axis is involved in resistance to radiation in GC, and suggests Chk1 as a potential tool for optimal stratification of patients susceptible to receive adjuvant radiotherapy after surgery.

Targeting Chk2 improves gastric cancer chemotherapy by impairing DNA damage repair.

Our results demonstrate that the addition of cisplatin after paclitaxel-induced mitotic arrest was more effective than individual treatment on gastric adenocarcinoma cells (MKN45). However, the treatment did not induce benefits in cells derived from lymph node metastasis (ST2957). Time-lapse microscopy revealed that cell death was caused by mitotic catastrophe and apoptosis induction, as the use of the caspase inhibitor z-VAD-fmk decreased cell death. We propose that the molecular mechanism mediating this cell fate is a slippage suffered by these cells, given that our Western blot (WB) analysis revealed premature cyclin B degradation. This resulted in the cell exiting from mitosis without undergoing DNA damage repair, as demonstrated by the strong phosphorylation of H2AX. A comet assay indicated that DNA repair was impaired, and Western blotting showed that the Chk2 protein was degraded after sequential treatment (paclitaxel-cisplatin). Based on these results, the modulation of cell death during mitosis may be an effective strategy for gastric cancer therapy.

Sospechas de reacciones adversas asociadas a los glucocorticoides inhalados / No disponible

Las notificaciones de sospechas de reacciones adversas enviadas por los profesionales sanitarios y la industria farmacéutica se codifican, evalúan y registran en la base de datos FEDRA. Los corticoides inhalados constituyen el tratamiento inicial de elección para controlar la evolución de la inflamación en el asma bronquial, pero su uso puede no estar exento de efectos adversos. En este trabajo hemos revisado y comparado los sospechas de reacciones adversas para budesonida, fluticasona y beclometasona, registradas en FEDRA hasta abril de 2004, clasificándolas según localización, gravedad y conocimiento previo y analizando la distribución por órgano y sistema para cada principio activo. Se localizaron un total de 307 notificaciones, que incluían 519 sospechas de reacciones adversas. De ellas, 38% eran locales, 93% no graves y sólo un 7% desconocidas. El análisis comparativo de la distribución por principio activo mostró una mayor frecuencia de reacciones cutáneas para budesonida, del sistema nervioso central para fluticasona y digestivas, cardiovasculares y urinarias para beclometasona. Este perfil de reacciones adversas concuerda con la toxicidad conocida para estos principios activos, excepto las reacciones cardiovasculares y urinarias para beclometasona, que podrían estar magnificadas, debido al menor número de notificaciones asociadas a este principio activo (AU)

No disponible

Electrochemical treatment of textile dyes and their analysis by high-performance liquid chromatography with diode array detection.

Several textile dyes were individually exposed to electrochemical treatment. Chromaticity variation and the formation of degradation products were followed using a UV spectrophotometer and HPLC with diode array detection. Dyes studied belong to the azo (color index, C.I. 15,510), methine (C.I. 48,013), indigo (C.I. 73,040), natural (C.I. 75,760) and arylmethane (C.I. 42,000) classes. Aliquots of the solutions treated at constant potential were analyzed and compared with control dye solutions. The final electrolysis solutions obtained by using different electrode materials: Pt, Ti and diamond presented different chromatograms. It was found that the novel (in this application) diamond electrode is efficient in studying the degradation of various dyes. Possible fragmentation and molecule moiety rearrangement are proposed as a result of the electrochemical treatment.