Interim FDG18-PET SUVmax Variation Adds Prognostic Value to Deauville 5-Point Scale in the Identification of Patients with Ultra-High-Risk Diffuse Large B Cell Lymphoma.

INTRODUCTION: Interim response evaluation by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (iPET) in diffuse large B cell lymphoma (DLBCL) could be important to rule out disease progression and has been suggested to be predictive of survival. However, treatment guidance by iPET is not yet recommended for DLBCL in clinical practice. We aimed to compare the predictive value of iPET when utilizing the visual Deauville 5-point scale (DS) and the semiquantitative variation of maximum standardized uptake value (ΔSUVmax). MATERIALS AND METHODS: We included 85 patients diagnosed with DLBCL and uniformly treated with standard protocols. iPET with DS of 1-3 and/or ΔSUVmax ≥66% was defined as negative. Univariable and multivariable Cox regression analyses were performed to determine the independent factors affecting progression free survival (PFS) or overall survival (OS) and to estimate PFS and OS. RESULTS: iPET positivity, measured by DS or ΔSUVmax, showed predictive value of disease refractoriness, improved by combining DS and ΔSUVmax. After a median follow-up of 50.1 months, iPET was an independent predictor for both PFS and OS when interpreted by DS, but only for PFS by ΔSUVmax. Combined visual and semiquantitative analysis (D4-5 & ΔSUVmax<66%) was an independent predictor of PFS and OS, and allowed to identify an ultra-high-risk subgroup of patients with very dismal outcome, increasing the discriminating capacity for iPET. CONCLUSION: Our study suggests that combined DS and ΔSUVmax in iPET assessment predicts refractory disease and distinguishes ultra-high-risk DLBCL patients with a very dismal prognosis, who may benefit from PET-guided therapy adjustment.

Hodgkin's variant of Richter transformation during ibrutinib therapy: A case report and review of the literature.

Hodgkin's variant of Richter transformation is a rare complication of chronic lymphocytic leukemia and is associated with inferior outcomes compared to de novo Hodgkin lymphoma. Further data concerning prognosis and treatment of Hodgkin's variant of Richter transformation occurring in the setting of novel targeted therapies are needed.

Multiband superconductors with degenerate excitation gaps.

There is a tacit assumption that multiband superconductors are essentially the same as multigap superconductors. More precisely, it is usually assumed that the number of excitation gaps in the single-particle energy spectrum of a uniform superconductor (i.e. number of peaks in the density of states of the superconducting electrons) determines the number of contributing bands in the corresponding superconducting model. Here we demonstrate that contrary to this widely accepted viewpoint, the superconducting magnetic properties are sensitive to the number of contributing bands even when the spectral gaps are degenerate and cannot be distinguished. In particular, we find that the crossover between superconductivity types I and II-the intertype regime-is strongly affected by the difference between characteristic lengths of multiple contributing condensates. The reason for this is that condensates with diverse characteristic lengths, when coexisting in one system, interfere constructively or destructively, which results in multi-condensate magnetic phenomena regardless of the presence/absence of the multigap spectrum of a superconducting multiband material.

Technological Nocturne: The Lisbon Industrial Institute and Romantic Engineering (1849-1888).

This article explores technology as romantic culture in the second half of the nineteenth century. It details how new urban nocturnal experiences emerged from the Lisbon Industrial Institute (Instituto Industrial) founded in 1852. It combines the interest in the space of science production, typical of history of science and science studies, with the attention to production and consumption of lighting more commonly found in history of technology and urban history literature. Engineers' practices are put in a cultural continuum with poetry, opera, and modern city life at large. Industrial Institute directors Vitorino Damásio and Fonseca Benevides are described as romantic engineers for whom technology overcame differences between humans through the forging of new social bonds, produced new aesthetic experiences and new ways of feeling, expressed nature's harmony, and led to heroic lives.

[Superiority of 18F-FNa PET/CT for Detecting Bone Metastases in Comparison with Other Diagnostic Imaging Modalities]. / Superioridade da PET/CT com FNa-F18 na Deteção de Metástases Ósseas quando Comparada com Outros Métodos de Diagnóstico por Imagem.

INTRODUCTION: The 18F-NaF positron emission tomography/computed tomography is being considered as an excellent imaging modality for bone metastases detection. This ability was compared with other imaging techniques. MATERIAL AND METHODS: We retrospectively evaluated 114 patients who underwent 18F-NaF positron emission tomography/ computed tomography. Of these, 49 patients also had bone scintigraphy, 61 18F-FDG positron emission tomography/computed tomography and 10 18F-FCH positron emission tomography/computed tomography. We identified the technique that detected the largest number of bone metastases. For the detection of skeletal metastases with the 18F-NaF positron emission tomography/computed tomography study, the contribution of the positron emission tomography component was compared with the contribution of the computed tomography component. Cases in which 18F-NaF positron emission tomography/computed tomography and bone scintigraphy required further additional tests for diagnosis clarification were registered. RESULTS: The 18F-NaF positron emission tomography/computed tomography was superior to bone scintigraphy in 49% of the patients (p < 0.001); it was superior to 18F-FDG positron emission tomography/computed tomography in 59% of the patients (p < 0.001) and it was superior to 18F-FCH positron emission tomography/computed tomography in 40% of the patients (p < 0.001). None of the compared imaging techniques were superior to 18F-NaF positron emission tomography/computed tomography. The positron emission tomography component was superior to computed tomography in 35% of the cases (p < 0.001). Further investigation was suggested in only 3.5% of patients who underwent 18F-NaF positron emission tomography/computed tomography (45% for bone scintigraphy) (p < 0.001). DISCUSSION: As with other authors, our experience also confirms that 18F-NaF positron emission tomography/computed tomography is an excellent imaging modality for the detection of bone metastases, detecting lesions in more patients and more lesions per patient. CONCLUSION: The 18F-NaF positron emission tomography/computed tomography showed a superior ability for the detection of bone metastases when compared with bone scintigraphy, 18F-FDG positron emission tomography/computed tomography and 18F-FCH positron emission tomography/computed tomography.

Introdução: A tomografia por emissão de positrões/tomografia computorizada - FNa-F18 vem sendo considerada como uma modalidade imagiológica com vantagens na pesquisa de metastização óssea. Comparámos a sua capacidade para deteção de metástases ósseas com a de outras técnicas imagiológicas.Material e Métodos: Avaliámos retrospetivamente 114 doentes que realizaram tomografia por emissão de positrões/tomografia computorizada - FNa-F18. Destes, 49 realizaram também cintigrafia óssea, 61 tomografia por emissão de positrões/tomografia computorizada - FDG-F18 e 10 tomografia por emissão de positrões/tomografia computorizada - FCH-F18. Identificámos a técnica que detetou um maior número de metástases ósseas. Comparámos ainda a tomografia por emissão de positrões com a componente tomografia computorizada da tomografia por emissão de positrões/tomografia computorizada - FNa-F18. Registámos as situações  nas quais a tomografia por emissão de positrões/tomografia computorizada FNa-F18 e a cintigrafia óssea necessitaram de exames adicionais para esclarecimento complementar.Resultados: A tomografia por emissão de positrões/tomografia computorizada - FNa-F18 foi superior à cintigrafia óssea em 49% dos doentes (p < 0,001); foi superior à tomografia por emissão de positrões/tomografia computorizada - FDG-F18 em 59% dos doentes (p < 0,001) e foi superior à tomografia por emissão de positrões/tomografia computorizada - FCH-F18 em 40% dos doentes (p < 0,001). Nenhuma das técnicas imagiológicas avaliadas lhe foi superior. Na tomografia por emissão de positrões/tomografia computorizada -FNa-F18 a componente tomografia por emissão de positrões foi superior à tomografia computorizada em 35% dos casos (p < 0,001). Foi sugerida investigação complementar em apenas 3,5% dos doentes que realizaram tomografia por emissão de positrões/ tomografia computorizada - FNa-F18 (45% para a cintigrafia óssea) (p < 0,001).Discussão: Em conformidade com o referido por outros autores, a nossa experiência confirma que a tomografia por emissão de positrões/tomografia computorizada - FNa-F18 tem excelente desempenho na deteção de metástases ósseas, sendo capaz de identificar lesões em mais doentes, e em maior número, quando comparada com outras técnicas imagiológicas.Conclusão: A tomografia por emissão de positrões/tomografia computorizada - FNa-F18 revelou superioridade na deteção de metástases ósseas comparativamente à cintigrafia óssea, à tomografia por emissão de positrões/tomografia computorizada - FDG-F18 e à tomografia por emissão de positrões/tomografia computorizada - FCH- F18.

[PET/CT with 18F-Fluorocholine in Patients with Prostatic Cancer in Biochemical Recurrence]. / PET/CT com Fluorocolina-F18 em Doentes com Carcinoma da Próstata em Recidiva Bioquímica.

INTRODUCTION: In prostate cancer, after therapy with curative intent, biochemical recurrence frequently occurs. The purpose of this study was to evaluate the impact of PET/CT with 18F-fluorocholine in restaging these patients and in their orientation, and to analyze the effect of the risk stratification, the values of PSA and the hormone suppression therapy, in the technique sensitivity. MATERIAL AND METHODS: Retrospective analysis of 107 patients with prostate carcinoma in biochemical recurrence who underwent PET/CT with 18F-fluorocholine in our hospital, between December 2009 and May 2014. RESULTS: The overall sensitivity was 63.2% and 80.0% when PSA > 2 ng/mL. It was possible to identify distant disease in 28% of the patients. The sensitivity increased from 40.0%, in patients with low and intermediate risk, to 55.2% in high-risk patients. Without hormonal suppression therapy, the sensitivity was 61.8%, while in the group under this therapy, was 67.7%. DISCUSSION: PET/CT with 18F-fluorocholine provided important information even in patients with low levels of PSA, however, with significantly increased sensitivity in patients with PSA > 2 ng/mL. Sensitivity was higher in high-risk patients compared with low and intermediate risk patients, however, without a statistically significant difference. The hormone suppression therapy does not appear to influence uptake of 18F-fluorocholine in patients resistant to castration. CONCLUSIONS: In this study, PET/CT with 18F-Fluorocholine showed good results in restaging patients with prostate cancer biochemical recurrence, distinguishing between loco regional and systemic disease, information with important consequences in defining the therapeutic strategy.

Introdução: No carcinoma da próstata, é frequente, após terapêutica com intuito curativo, ocorrer recidiva bioquímica. O objectivo deste trabalho foi avaliar o impacto da PET/CT com fluorocolina-F18 no restadiamento e orientação destes doentes e analisar a influência, da estratificação de risco, dos valores do PSA e da terapêutica de supressão hormonal, na sensibilidade da técnica. Material e Métodos: Análise retrospectiva de 107 doentes com carcinoma da próstata em recidiva bioquímica que realizaram PET/CT com fluorocolina-F18 no nosso hospital, entre dezembro de 2009 e maio de 2014. Resultados: A sensibilidade global foi de 63,2% sendo 80,0% quando PSA > 2 ng/mL. Foi possível identificar doença à distância em 28% dos doentes. A sensibilidade aumentou de 40,0% em doentes de risco baixo e intermédio para 55,2% em doentes de alto risco. Sem terapêutica de supressão hormonal, a sensibilidade foi de 61,8% enquanto no grupo sob essa terapêutica, foi de 67,7%. Discussão: A PET/CT com fluorocolina-F18 forneceu informações relevantes, mesmo em doentes com baixos valores do PSA, contudo, com incremento significativo da sensibilidade nos doentes com PSA >2 ng/mL. A sensibilidade foi superior nos doentes de alto risco comparativamente com os de risco baixo e intermédio, contudo, sem uma diferença estatisticamente significativa. A terapêutica de supressão hormonal parece não influenciar a captação de Fluorocolina-F18 nos doentes resistentes à castração. Conclusões: Neste estudo, a PET/CT com fluorocolina-F18 apresentou bons resultados no restadiamento de doentes com carcinoma da próstata em recidiva bioquímica, distinguindo entre doença loco-regional e sistémica, informação com importantes consequências na definição da estratégia terapêutica.

Fascist labscapes: geneticists, wheat, and the landscapes of Fascism in Italy and Portugal.

This paper explores the role of scientists in the building of fascist regimes in Italy and Portugal by focusing on plant geneticists' participation in the Italian and Portuguese wheat wars for bread self-sufficiency. It looks closely at the work undertaken by Nazareno Strampelli at the National Institute of Genetics for Grain Cultivation (Italy) and by António Sousa da Câmara at the National Agronomic Experiment Station (Portugal), both of whom took wheat as their prime experimental object of genetics research. The main argument is that the production of standardized organisms­the breeder's elite seeds­in laboratory spaces is deeply entangled with their circulation through extended distribution networks that allowed for their massive presence in Italian and Portuguese landscapes such as the Po Valley and the Alentejo. The narrative pays particular attention to the historical development of fascist regimes in the two countries, advancing the argument that breeders' artifacts were key components of the institutionalization of the new political regimes.

[Lung adenocarcinoma: application of the WHO 1999/2004 classification to the caseload of the Pathologic Anatomy Service at the Hospital of the Coimbra University]. / Adenocarcinoma do pulmão: Aplicação da classificação WHO 1999/2004 à casuística do Serviço de Anatomia Patológica do Hospital da Universidade de Coimbra.

A study of 701 primary adenocarcinomas of the lung was made at the Department of Pathology of the Hospital da Universidade de Coimbra for a period of fifteen years, between 1990 and 2004. In the same period 382 metastases were diagnosed, mainly from colon (119) and breast (66). The incidence of primary adenocarcinomas varied from 16 cases in 1990 to 49 cases in men and from 12 to 37 cases in women in that period. From 2001 onwards, the incidence was almost coincident in both genders. In the last four years, since 2001, patients were in the seventies at the time of diagnosis and a considerable number of cases were diagnosed after 80 years of age. The criteria defined by the WHO classification of Tumours of the Lung, Pleura, Thymus and Heart 2004 were applied to the primary adenocarcinomas of the lung and as was expected, bronchioloalveolar carcinomas had its incidence in women while acinar adenocarcinomas were diagnosed mainly in men. These conclusions were obtained via surgical specimens and when surgical biopsies were representative and those were mainly in stage IIB and IIIA. A number of 109 cases had the final diagnosis of adenocarcinoma of the lung based on morphology and immunohistochemistry criteria.