A search for predictive factors for hypersensitivity reactions to paclitaxel and platinum salts in chemotherapy for gynecologic pelvic neoplasms.

AIMS: To investigate the frequency of and predictive factors for hypersensitivity reactions (HR) to taxanes and platinum salts in a cohort of patients treated for pelvic gynecologic malignancies. METHODS: The medical records of all patients with gynecologic pelvic neoplasms treated with chemotherapy at the Department of Gynecologic Oncology, AO Mauriziano Umberto I of Turin, from September 2007 through August 2008, were retrospectively reviewed. Two multivariate models, regarding carboplatin and taxane chemotherapy, respectively, were performed to evaluate the potential predictive value of various clinical features. RESULTS: The incidence of HR was 14% (22/157). Multivariate models showed that menopausal women had a significantly lower probability of HR (OR 0.12, CI 0.02-1.13, p = 0.06 for the carboplatin model and OR 0.05, CI 0.01-0.63, p = 0.02 for the taxane model) while a history of systemic hypersensitivity was associated with a higher but non-significant risk of HR (OR 2.64, CI 0.78-8.95, p = 0.11, for the carboplatin model and OR 3.42, CI 0.94-12.45, p = 0.06, for the taxane model). CONCLUSION: We confirmed a history of hypersensitivity as a risk factor for HR. Other larger cohorts should be analyzed: we need to find new predictive factors in order to select women who should be submitted to experimental prophylactic strategies.

Fetal echocardiography: a comparison of different techniques.

There is great availability on the market of echocardiographic instruments that have innovative technological systems which use second harmonic imaging. The true usefulness and applicability of these instruments in fetal echocardiography have yet to be verified. The objective of the present study was to verify the impact of this echographic technology in the diagnostic evaluation of the fetal cardiovascular system. Thus, an Acuson Sequoia echograph which uses native tissue harmonic imaging (NTHI) was used to examine 30 pregnant women between the 28th and 32nd week of gestation. The b-mode and m-mode images were acquired and recorded by the conventional method and by the second harmonic imaging method without contrast medium. Two experts in the field analyzed and compared the images recorded by the two methods and made diagnostic and qualitative judgements. The 30 cases examined were unanimously determined to have no visible echo pathologies. The morpho-biometric evaluation obtained by the two methods did not show any significant differences and the quality of the images obtained by the traditional method was found on average to be higher. In conclusion we believe that the use of second harmonic imaging for studies of the fetal heart does not seem to offer any advantages with respect to the conventional method.