Urinary CYFRA 21.1 is not a useful marker for the detection of recurrences in the follow-up of superficial bladder cancer

OBJECTIVES: The objective of this prospective study is to establish an appropriate cutoff value of urinary CYFRA 21.1 assay and to assess its utility combined with voided cytology and/or haemoglobin dipstick in the follow-up of patients with superficial bladder cancer. METHODS: From December 2000 to November 2003, 446 patients in follow-up for superficial bladder cancer (Ta-T1) after transurethral resection of the bladder (TURB) were included in a prospective study. Voided urine specimens were collected 7-14 d before cystoscopy and/or TURB for CYFRA 21.1 (one sample), haemoglobin dipstick (one sample), and cytology (three samples). All samples were processed for CYFRA 21.1 and haemoglobin dipstick according to manufacturer instructions. A control group (n=185) was obtained from patients in follow-up after transurethral resection of superficial disease (without recurrences within the following 6 mo). There were 125 recurrent transitional tumours detected by cystoscopy (34 TaG1; 53 TaG2/T1G1-2; 23 Ta-1G3/Tis, and 15 T2-4). Receiver operator characteristic (ROC) curves were constructed and cutoff values were chosen. Sensitivity, specificity, PPV (positive predictive value), NPV (negative predictive value), and their 95% confidence intervals were calculated. RESULTS: ROC curve analysis based on the previously reported cutoff value of 4ng/ml for CYFRA 21.1 demonstrated a sensitivity and specificity of 43% and 68%, respectively. At a cutoff value of 1.5ng/ml, sensitivity was 73.8% with a low specificity (41%). Further lowering of the cutoff point below 1.5ng/ml did not demonstrate a significant increase in sensitivity. Therefore, this value was chosen as the most sensitive CYFRA 21.1 cutoff point during the rest of the study. Specificity increased when all the patients treated with pelvic radiotherapy or with UTI, urethral catheterisation, and intravesical instillations within 3 previous months were not included in our analysis. CYFRA 21.1 plus cytology and the combination of CYFRA 21.1, cytology, and haemoglobin dipstick demonstrated the highest overall sensitivities, and detected 91.3% of Ta-1G3 tumours and 93.3% of T2-4 tumours. However, there were one muscle-invasive tumour, two T1G3/Tis, three T1G2, and nine T1G1 neoplasms with negative combination of cytology and CYFRA 21.1 (1,5ng/ml). All these tumours were smaller than 2cm in size; most were single tumours. Nevertheless, there were 16 tumours larger than 0.5cm (0.5-2cm), and multiple neoplasms were endoscopically detected in 14 patients. Similar results were obtained through the combination of CYFRA 21.1 (cutoff: 1.5ng/ml), cytology, and haemoglobin dipstick. CONCLUSIONS: In our experience the low sensitivity of urinary CYFRA 21.1, even using lower cutoff values and/or a combination with cytology and/or haemoglobin dipstick, makes its application not very useful as a surveillance tool for superficial bladder carcinoma.     

Synthesis and Characterization of PDMS‐, PVP‐, and PS‐Containing ABCBA Pentablock Copolymers

Amphiphilic ABCBA pentablock copolymers based on PVP, PS, and PDMS were synthesized using a combination of ATRP and RAFT polymerizations. The PVP‐block‐PS‐block‐PDMS‐block‐PS‐block‐PVP pentablock copolymer was characterized using a variety of chromatography and spectroscopic methods which showed that a high degree of end group and molecular weight control can be achieved. Preliminary analysis of the aqueous solution behavior of the pentablock copolymer showed that it self‐assembles in water in order to shield the PDMS and PS segments from the water.

     

Estimation of combined effects of carbon and nitrogen sources on the growth and bacteriocin production of Lactobacillus salivarius from human source

Vaginal Lactobacillus salivarius CRL 1328 (Centro de Referencia para Lactobacilos Culture Collection) or the bacteriocin that produces could be included in a urogenital probiotic formula to prevent urogenital infections in women. The objective of this work was to determine the effects of different carbon and nitrogen sources on the growth and bacteriocin production of this microorganism. A fractional factorial design 3^5–1 was applied to evaluate the effects of five nutrients (glucose, lactose, yeast extract, tryptone and meat peptone), at three different concentrations (0, 1 and 2%). Results were statistically analyzed for linear and quadratic effects of nutrients, along with their interactions. All the nutrients tested stimulated the cell growth and bacteriocin production, but lactose had not a significant influence on the last response. The linear effects of higher magnitude on biomass and bacteriocin production were those of yeast extract and tryptone. The results demonstrated that there were significant interactions between the different nutrients, depending on the response evaluated. Maximum bacteriocin production was reached in different growth media with a lower cost than conventional culture media used in the laboratory. These findings will contribute to the design of a pharmaceutical product for the restoration of ecological balance of urogenital tract. (© 2010 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

PREVENTIVE DENTISTRY OR ORAL PUBLIC HEALTH?

What is in a name?– An Argentinian raises the question. She agreed to the publication of her statement while studying for a year in Paris, France.     

Differentiation of strains from a food-borne outbreak ofSalmonella enterica by phenotypic and genetic typing methods

A combination of typing methods was used to identify the strains and the infection source in a food-borne outbreak ofSalmonella enterica occurring in a summer camp and affecting 25 children. All isolates tested were found to be serovar Enteritidis, with an identical biotype API 20E and ribotype. However, they differed in their plasmid profiles and/or antibiograms, and were grouped into three strains. One strain was found in human stools, another in a hen's egg, and the third in both stools and another egg pointing to large Spanish omelettes to be the contaminated food source.