[Molecular forms of PSA and differentiating between benign hypertrophy,carcinoma, and disseminated prostatic carcinoma. Correlation between two determination technics]. / Formas moleculares de PSA en la discriminación entre hipertrofia benigna, carcinoma y carcinoma diseminado de próstata. Correlación entre dos diferentes técnicas de determinación.

OBJECTIVE: To determine the correlation between two methods of measurement of total PSA (PSA-T) and free PSA (PSA-F) and the utility of the PSA-F/PSA-T ratio in patients with PSA-T between 4 and 10 ng/ml suspected as having prostate cancer. METHODS: Determinations of both PSA-T and PSA-F were performed using two different techniques in 91 patients suspected as having prostate cancer. Diagnosis was made on the findings of biopsy and the complementary tests. RESULTS: The following correlation was found for the two techniques: R = 0.99 and p < 0.05 for PSA-T, and R = 0.85 and p < 0.05 for PSA-F. For PSA-T values of 4-10 ng/ml and PSA-F greater than 25%, we found two patients with prostate cancer. For a PSA-F/PSA-T ratio less than 9%, all cases had prostate cancer. Three cases with bone metastasis had PSA-T values less than 10 ng/ml. CONCLUSIONS: A PSA-F/PSA-T ratio greater than 25% does not exclude malignancy in patients with a total PSA of 4-10 ng/ml; values less than 9% correspond to prostate cancer. Bone metastasis was found with both methods in patients with total PSA values less than 10 ng/ml.

[Human immunodeficiency virus (HIV) infection. The effectiveness of different diagnostic sequences in suspected pulmonary infection]. / Infección por el virus de la inmunodeficiencia humana (VIH). Rentabilidad de diferentes secuencias diagnósticas ante sospecha de infección pulmonar.

BACKGROUND: Assessment of different diagnostic sequences, in patients VIH(+) with a suspected pulmonary infection. METHODS: A cross-sectional descriptive study of 76 HIV(+) patients with suspected respiratory infection. It has been determined the validity and the pretest and post-test probability of the radiology (Rx) of thorax, 67Ga pulmonary scintigraphy and seric LDH levels, in order to design four different diagnostic algorithms. RESULTS: The diagnostic sequence Rx-LDH-scintigraphy with normal results involved an infection probability of 58.0%. Pathological Rx with successively normal LDH and scintigraphy, implied a likelihood of 97.0%. The LDH elevation in sequence with scintigraphy and Rx rose to 96.1% if both were abnormal and diminished to 8.3% if normal. CONCLUSIONS: The LDH elevation associated with the sequence of normal Rx and scintigraphy suggests a low infection likelihood. On the contrary, associated with pathological Rx and scintigraphy in sequence, practically assures the pulmonary infection.

Infección por el virus de la inmunodeficiencia humana (VlH). Rentabilidad de diferentes secuencias diagnósticas ante sospecha de infección pulmonar / VIH (+) patients: assessment of different diagnostic sequences with a suspected pulmonary infection

Fundamento: Valoración de diferentes secuencias diagnósticas, en pacientes con infección por virus de la inmunodeficiencia humana (VlH), y sospecha de infección pulmonar. Métodos: Estudio descriptivo transversal, de un total de 76 pacientes VIH (+) con sospecha de infección pulmonar. Se determina la validez y razones de probabilidad de infección pulmonar pre y postprueba de la radiografía de tórax (Rx), gammagrafía pulmonar con 67Ga y valores séricos de LDH, con objeto de diseñar cuatro algoritmos diagnósticos diferentes. Resultados: La secuencia diagnóstica Rx-LDH-gammagrafía con resultados normales supuso una probabilidad de infección de 58,0 porciento. Rx alterada con LDH y gammagrafía sucesivamente normales, dio una probabilidad de 97,0 porciento. Una elevación de LDH seguida de gammagrafía y Rx alteradas determinó una probabilidad de infección del 96,1 %. Cuando tras LDH elevada, se obtenía gammagrafía y Rx normales, este porcentaje descendió a 8,3 %. Conclusiones: La elevación de LDH asociada a Rx y gammagrafía secuencialmente normales sugiere una baja probabilidad de infección. Por el contrario, junto a Rx y gammagrafía sucesivamente patológicas, prácticamente aseguran la infección pulmonar (AU)