Combined use of established and novel tumour markers in the diagnosis of head and neck squamous cell carcinoma.

Serum SCC, CYFRA 21-1, and CEA are the common tumour markers for head and neck squamous cell carcinoma (HNSCC), although diagnostic sensitivity should be yet improved, especially at early stages. In the present study, we have reported the diagnostic value of two novel serum tumour markers in HNSCC: alpha-L-fucosidase (AFU) activity, and total sialic acid concentration adjusted by total protein concentration (TSA/TP). Using the cut-off 4.0 U/ml, AFU showed a sensitivity of 55% with specificity levels of 91%, 85% and 50% to discriminate HNSCC patients from healthy donors, drinking and smoking subjects, and patients with benign diseases, respectively. Furthermore, AFU showed the best sensitivity (71%) in the detection of patients with premalign lesions. Using the cut-off 12.0 ng/mg, TSA/TP showed the best sensitivity levels (63%) in the diagnosis of HNSCC with specificity levels of 94%, 50% and 90%, regarding healthy donors, drinking and smoking subjects, and patients with benign diseases, respectively. It was of special interest that sensitivity in the diagnosis of HNSCC at non-disseminated stages was improved when using combinations of AFU+CYFRA or TSA/TP+CYFRA, up to 86% or 71% in TNM I, 60% or 80% in TNM II, and 80% or 60% in TNM III, respectively.

Azotemia and mortality among Babesia microti-like infected dogs.

Babesia microti-like piroplasms are a recently recognized cause of illness in dogs in northwest Spain. Our objective was to describe the clinical characteristics and investigate the risk factors for azotemia and death among 58 B microti-like infected dogs. Twenty-one of the 58 (36%) dogs were azotemic at the time that the infection was diagnosed. The case fatality rate during the following week was 22%. Dogs with azotemia at the time of diagnosis were 10 times (95% CI, 3.26-28.8) more likely to die during the following week. Azotemia was the main cause of death for B microti-like infected dogs (attributable fraction = 90%). Severe anemia was present in 45 of the 58 (78%) dogs. Azotemic dogs also presented with hyperphosphatemia, hypoalbuminemia, hypercholesterolemia, proteinuria, and high urine protein: creatinine ratios, suggesting a glomerular component to the disease. Age was the only factor significantly associated with the risk of azotemia (P = .042): on average, a 4-year age increase doubled the risk of an infected dog being azotemic. The only factor significantly associated with mortality was azotemia (P = .001). We concluded that B microti-like infection is associated with a high risk of azotemia and mortality.

[Extramedullary plasmacytoma of the larynx. A case report]. / Plasmocitoma extramedular de laringe. A propósito de un caso.

Extramedullary plasmacytoma of the larynx and localized laryngeal amyloidosis are two entities that are extremely rare in children. We report the case of an 11-year-old child presenting with progressive dysphonia, with a diagnosis of extramedullary plasmacytoma and localized laryngeal amyloidosis. The treatment he received and subsequent follow-up were compared with the few cases found in the literature.

Serum protein response and renal failure in canine Babesia annae infection.

Babesia annae piroplasms have recently been recognised as a cause of infection and disease among dogs in Europe. The pathogenesis and clinical implications of this emerging disease remain poorly understood. We conducted this study to describe the electrophoretic profiles associated with the infection and to determine if B. annae associated azotaemia is caused by renal failure. We examined by microscopy 2,979 canine blood samples submitted to a diagnostic laboratory in NW Spain between September 2001 and April 2002. Small ring-shaped piroplasms were detected in blood smears of 87 samples and the identity of 58 of these presumptive cases were confirmed by PCR. This group of 58 infected dogs and a reference group of 15 healthy non-infected dogs were our study population. For all the dogs, serum protein response to -albumin, alpha-1 globulin, alpha-2 globulin, beta globulin and gamma globulin- was measured by capillary electrophoresis. The response of infected and non-infected dogs was compared and within infected dogs, the response of those with azotaemia (19) was compared with that of non-azotaemic dogs (39). Infected dogs presented a significant elevation of total proteins and all the different globulin fractions, and significantly lower levels of albumin compared to non-infected dogs. Among infected dogs, those presenting azotaemia had significantly lower concentrations of total proteins, albumin, beta and gamma globulins, and significantly higher values of alpha-2 globulin. Specific gravity was below the threshold of 1,025 for all dogs with azotaemia for which a urine sample was available (7) suggesting that azotaemia, in these dogs was of renal origin. Azotaemic dogs had higher concentrations of cholesterol and triglycerides, probably as a result of a liver compensatory response to the loss of proteins. We conclude that serum protein response in B. annae infected dogs corresponds to the pattern of a haemolytic syndrome with intense inflammatory reaction and that the azotaemia associated to the infection is very likely of renal origin.