Value Of [f-18]fdg-pet/ct and Ca125, serum levels and kinetic parameters, in early detection of ovarian cancer recurrence. Influence of histological subtypes and tumor stages

To assess the diagnostic accuracy of CA125, its kinetic values and positron emission tomography/computed tomography with 2-deoxy-2-[F-18]fluoro-d-glucose ([F-18]FDG-PET/CT), in relation with tumor characteristics for suspected recurrence of ovarian cancer. To evaluate the performance of CA125-related parameters as a selection criteria to perform a [F-18]FDG-PET/CT.A retrospective analysis of 69 [F-18]FDG-PET/CT for suspected recurrence of ovarian cancer was performed. All patients had 2 measurements of CA125, before PET/CT, to calculate kinetic values, as CA125vel (CA125vel = [CA125a - CA125b]/time) and CA125dt (CA125dt = [log(2) x time]/[logCA125a - CA125b]). Maximum standard uptake value (SUVmax) was calculated. The diagnostic accuracy was calculated for all the variables and the optimal cut-off value of each of them by the receiver-operating characteristics (ROC) analysis. All the tests were compared with tumor characteristics and clinical-radiological evolution during follow-up of at least 6 months.Fifty-five cases were diagnosed of recurrence (11 with CA125<35 U/mL), while 14 showed no disease (11 with CA125< 35 U/mL). All of them were correctly cataloged by PET/CT. CA125, CA125vel, and SUVmax showed higher levels in recurrent patients (mean 129.54U/mL, 24.58U/mL per mo, and 8.69g/mL, respectively) than in nonrecurrent (mean 20.35U/mL, 0.60U/mL per mo, and 0.64g/mL, respectively). No statistical differences in CA125dt were found. Patients with recurrence of high-grade serous carcinoma (HGSC) showed higher CA125 and CA125vel, without differences in the rest of subtypes and International Federation of Gynecology and Obstetrics stages. The ROC analyses for CA125, CA125vel, and CA125dt showed an area under the curve (AUC) of 0.873 (95% confidence interval [CI] 0.77-0.969), 0.903 (95% CI 0.813-0.994), and 0.727 (95% CI 0.542-0.913), respectively, with an optimal cut-off point of 23.95U/mL, 4.49U/mL per mo, and 3.36 months, respectively, while for the SUVmax the AUC was of 0.982 (95% CI 0.948-1.000), and the cut-off point of 2. Multivariate regression analysis identified CA125 and CA125vel as predictors of recurrence.[F-18]FDG-PET/CT is more accurate than the parameters obtained from the CA125 to detect early recurrence. CA125vel is the most suitable parameter, mainly in HGSC. Levels of CA125vel 4.49U/mL per mo facilitate earlier detection by the execution of a [F-18]FDG-PET/CT. The calculation of these parameters is independent of tumor stage at diagnosis

Casos de infección por gripe pandémica (H1N1) 2009 hospitalizados en cuidados intensivos en España: factores asociados a riesgo de muerte, abril 2009 - enero 2010

Fundamento: El análisis de los casos graves de gripe pandémica es necesario para identificar grupos de población vulnerables y adecuar las políticas de prevención y control. Se analizan las características clínicas y epidemiológicas así como los factores asociados a riesgo de muerte en los casos de infección por virus pandémico (H1N1) 2009 hospitalizados en unidades de cuidados intensivos (UCI) en España y notificados entre el 24 de abril de 2009 y el 31 de enero de 2010. Métodos: En el marco de la estrategia nacional de vigilancia de casos hospitalizados por gripe pandémica, se recogió a nivel nacional información clínica y epidemiológica individualizada de todos los casos hospitalizados en UCI por infección por virus pandémico (H1N1) 2009. Resultados: De los 1.231 casos ingresados en una UCI fallecieron 271 (letalidad: 22%). La mediana de edad fue 40 años (rango: 0-90). Un total de 838 (76,3%) pacientes presentaban alguna patología subyacente, siendo la respiratoria la más frecuente (34,1%), seguida en adultos de la obesidad mórbida (18,8%). Un 93,1% recibió tratamiento antiviral y un 25,6% (n=231) lo recibió en 48 horas desde el inicio de síntomas. En el análisis multivariante el cáncer (OR 2,71; IC95% 1,44-5,1), las inmunodeficiencias (OR 2,25; IC95% 1,29-3,92) y la obesidad mórbida (OR 1,79; IC95% 1,13- 2,85) estaban asociados significativamente a muerte en los adultos. Conclusiones: La caracterización de los casos graves de gripe pandémica ha sido clave para identificar como factores de riesgo para sufrir complicaciones y muerte por gripe, la existencia de cáncer e inmunodeficiencias y, por primera vez, la obesidad mórbida en personas adultas

Value Of [f-18]fdg-pet/ct and Ca125, serum levels and kinetic parameters, in early detection of ovarian cancer recurrence. Influence of histological subtypes and tumor stages

To assess the diagnostic accuracy of CA125, its kinetic values and positron emission tomography/computed tomography with 2-deoxy-2-[F-18]fluoro-d-glucose ([F-18]FDG-PET/CT), in relation with tumor characteristics for suspected recurrence of ovarian cancer. To evaluate the performance of CA125-related parameters as a selection criteria to perform a [F-18]FDG-PET/CT.A retrospective analysis of 69 [F-18]FDG-PET/CT for suspected recurrence of ovarian cancer was performed. All patients had 2 measurements of CA125, before PET/CT, to calculate kinetic values, as CA125vel (CA125vel = [CA125a - CA125b]/time) and CA125dt (CA125dt = [log(2) x time]/[logCA125a - CA125b]). Maximum standard uptake value (SUVmax) was calculated. The diagnostic accuracy was calculated for all the variables and the optimal cut-off value of each of them by the receiver-operating characteristics (ROC) analysis. All the tests were compared with tumor characteristics and clinical-radiological evolution during follow-up of at least 6 months.Fifty-five cases were diagnosed of recurrence (11 with CA125<35 U/mL), while 14 showed no disease (11 with CA125< 35 U/mL). All of them were correctly cataloged by PET/CT. CA125, CA125vel, and SUVmax showed higher levels in recurrent patients (mean 129.54U/mL, 24.58U/mL per mo, and 8.69g/mL, respectively) than in nonrecurrent (mean 20.35U/mL, 0.60U/mL per mo, and 0.64g/mL, respectively). No statistical differences in CA125dt were found. Patients with recurrence of high-grade serous carcinoma (HGSC) showed higher CA125 and CA125vel, without differences in the rest of subtypes and International Federation of Gynecology and Obstetrics stages. The ROC analyses for CA125, CA125vel, and CA125dt showed an area under the curve (AUC) of 0.873 (95% confidence interval [CI] 0.77-0.969), 0.903 (95% CI 0.813-0.994), and 0.727 (95% CI 0.542-0.913), respectively, with an optimal cut-off point of 23.95U/mL, 4.49U/mL per mo, and 3.36 months, respectively, while for the SUVmax the AUC was of 0.982 (95% CI 0.948-1.000), and the cut-off point of 2. Multivariate regression analysis identified CA125 and CA125vel as predictors of recurrence.[F-18]FDG-PET/CT is more accurate than the parameters obtained from the CA125 to detect early recurrence. CA125vel is the most suitable parameter, mainly in HGSC. Levels of CA125vel 4.49U/mL per mo facilitate earlier detection by the execution of a [F-18]FDG-PET/CT. The calculation of these parameters is independent of tumor stage at diagnosis

Children living with HIV in Europe: do migrants have worse treatment outcomes?

International audienceTo assess the effect of migrant status on treatment outcomes among children living with HIV in Europe