The HIF1A Functional Genetic Polymorphism at Locus +1772 Associates with Progression to Metastatic Prostate Cancer and Refractoriness to Hormonal Castration

The hypoxia inducible factor 1 alpha (HIF1a) is a key regulator of tumour cell response to hypoxia, orchestrating mechanisms known to be involved in cancer aggressiveness and metastatic behaviour. In this study we sought to evaluate the association of a functional genetic polymorphism in HIF1A with overall and metastatic prostate cancer (PCa) risk and with response to androgen deprivation therapy (ADT). The HIF1A +1772 C>T (rs11549465) polymorphism was genotyped, using DNA isolated from peripheral blood, in 1490 male subjects (754 with prostate cancer and 736 controls cancer-free) through Real-Time PCR. A nested group of cancer patients who were eligible for androgen deprivation therapy was followed up. Univariate and multivariate models were used to analyse the response to hormonal treatment and the risk for developing distant metastasis. Age-adjusted odds ratios were calculated to evaluate prostate cancer risk. Our results showed that patients under ADT carrying the HIF1A +1772 T-allele have increased risk for developing distant metastasis (OR, 2.0; 95%CI, 1.1-3.9) and an independent 6-fold increased risk for resistance to ADT after multivariate analysis (OR, 6.0; 95%CI, 2.2-16.8). This polymorphism was not associated with increased risk for being diagnosed with prostate cancer (OR, 0.9; 95%CI, 0.7-1.2). The HIF1A +1772 genetic polymorphism predicts a more aggressive prostate cancer behaviour, supporting the involvement of HIF1a in prostate cancer biological progression and ADT resistance. Molecular profiles using hypoxia markers may help predict clinically relevant prostate cancer and response to ADT

Advanced circulatory support: artificial heart use in patients with heart failure / Suporte circulatório avançado: uso do coração artificial em pacientes com Insuficiência cardíaca

Objectives: To analyze recent clinical trials about mechanical circulatory support and other adjuvant therapies for the treatment of heart failure. Methods: Articles were selected from the Pubmed and Embase databases published between the years 2015 and 2020, randomized controlled trial or not. The descriptors used were: assisted circulation AND artificial heart AND heart failure, and the descriptor artificial heart was not used for research at EMBASE with 2 articles as results.  And 40 at PubMed with the filters: Controlled Clinical Trial, published in the last 5 years, Humans. Results: Several therapies have been proposed as management alternatives for critically ill patients with heart failure. Among them, we can highlight the HeartMate III implant, which has been shown to have fewer adverse effects compared to HeartMate II; the implantation of an atrial bypass device, which has been shown to decrease the pressure of pulmonary artery occlusion in 1 month compared to the control group, but has shown no long-term effects; and the use of mesenchymal precursor cells, which has not been shown to be significantly effective. Final considerations: It is suggested to carry out further studies to improve the indication criteria, making it possible to allocate resources in hospitalized patients

Self-avoiding fractional Brownian motion - The Edwards model

In this work we extend Varadhan's construction of the Edwards polymer model to the case of fractional Brownian motions in $\R^d$, for any dimension $d\geq 2$, with arbitrary Hurst parameters $H\leq 1/d$.Comment: 14 page

Consumo de bens e serviços por idosos nos arranjos domiciliares unipessoal e residindo com o cônjuge

The objective of this study was to compare the consumption of goods and services by Brazilian elderly who lived by themselves and by those living with an spouse, using the POF data analysis (2008/2009), carried out by IBGE. This study was had a cross-sectional quantitative, descriptive approach. The results allowed finding that most of the elderly were white, living in the urban area of the country, elementary school graduated and the minority was at the AB income range. The living with a spouse family arrangement spent more than the unipersonal in relation to housing, several expenditures, entertainment, transportation, eating at home, smoking, hygiene products and personal care, health assistance and clothes. Therefore, to understand the consumption relationships of this segment is extremely important so that the offered goods and services provide satisfaction and improvement in the elderly quality of life.Este estudo consistiu em comparar o consumo de bens e serviços pelos idosos brasileiros que moravam sozinhos e por aqueles que residiam com o cônjuge, a partir de análises dos dados da Pesquisa de Orçamentos Familiares (POF) (2008/2009), realizada pelo IBGE. A pesquisa teve caráter quantitativo, descritivo, com corte transversal. Os resultados permitiram constatar que a maioria dos idosos eram brancos, residiam na área urbana do país, possuíam o ensino fundamental, e a minoria estava na faixa AB de renda. O arranjo domiciliar residindo com o cônjuge gastava mais do que o unipessoal no que se refere aos itens de despesas com habitação, despesas diversas, lazer, transporte, alimentação dentro do domicílio, fumo, produtos de higiene e cuidados pessoais, assistência à saúde e vestuário. Portanto, entender as relações de consumo deste segmento é extremamente relevante, a fim de que os bens e serviços oferecidos proporcionem satisfação e melhoria na qualidade de vida dos idosos

Gemcitabine as a Therapeutic Alternative during Shortage of BCG: The CHLC (Hospital S. José) Experience

Introdução: Os tumores não músculo invasivos da bexiga devem ser estratificados em grupos de risco de forma a adequar o tratamento após cirurgia a cada doente. Nos tumores de alto risco deve ser realizada terapêutica adjuvante com bacilo de Calmette-Guérin (BCG) intravesical durante 1 a 3 anos. Têm sido reportadas roturas de stock de BCG intravesical, tendo sido o Centro Hospitalar de Lisboa Central (CHLC) afectado nos anos 2014 e 2015, o que obrigou a uma reformulação no tratamento dos doentes que tinham indicação para realização desta terapêutica. A gencitabina poderá ser uma alternativa válida, dado que alguns estudos mostram que poderá ter um papel nos doentes de risco intermédio, como alternativa à mitomicina C, e nos de alto risco, refractários à BCG, com um perfil de toxicidade mais favorável. Material e Métodos: Trata-se de um estudo retrospectivo descritivo que incluiu doentes com tumores da bexiga não musculo-invasivos de alto risco, com início da doença em 2013/2014, afectados pelo período de escassez de BCG no Centro Hospitalar. Resultados: No CHLC, 11 doentes com tumores de alto risco foram submetidos a terapêutica com gencitabina, apenas dois exclusivamente, os restantes sequencialmente com BCG. Apenas dois doentes, tratados com BCG e gencitabina, apresentaram recidiva tumoral. No entanto, um número significativo (6 em 11) sofreram efeitos adversos, dois dos quais que levaram à interrupção da terapêutica. Conclusão: Aparentemente, a gencitabina foi uma boa alternativa de terapêutica adjuvante na ausência do tratamento gold standard (BCG), dada a existência de baixo número de recidivais tumorais, apesar do elevado número de efeitos adversos reportados.info:eu-repo/semantics/publishedVersio

Long-term effects of moderate physical exercise during early childhood on insulin sensitivity in rats during adulthood

It is of great importance to investigate the effects of physical exercise for metabolic health when performed in early life, and what the adulthood response would be. The aim of this study is to analyse the effects of moderate intensity physical exercise protocol during childhood on the adipose tissue and insulin sensitivity of rats during adulthood. Twenty weaned Wistar (28 days old) were divided into control and trained groups. The Control Group was kept sedentary, and the Trained group was submitted to swimming exercise at 80% of the anaerobic threshold (determined by the lactate minimum test) for 1 hour/day, 5 days/week from 28 to 90 days of age. At the end of the experiment, the body weight, adiposity (adipose tissue weight), insulin sensitivity, glycemia, insulinemia, pancreatic insulin, lipogenic activity in mesenteric fat, lipogenic activity and glycogen store in gastrocnemius and glucose uptake by soleus were analyzed. Trained group showed lower body weight gain, fat acumulation, lipid synthesis, glycemia, insulinemia and pancreatic insulin level. Kitt, HOMA-IR, glycogen store in gastrocnemius and glucose uptake by soleus were higher in this group. Therefore, we conclude that the moderate physical exercise performed during childhood can contribute to the reduction of body fat and insulin resistance during adulthood in Wistar rats.É de grande importância a investigação dos efeitos do exercício para a saúde metabólica quando realizado no início da vida, e quais seriam as respostas durante a fase adulta. O objetivo desse estudo é analisar os efeitos do exercício físico de intensidade moderada durante a infância na adiposidade e sensibilidade à insulina de ratos durante a fase adulta. Vinte ratos Wistar desmamados de 28 dias de vida foram divididos em grupos Controle e Treinado. O grupo Controle permaneceu sedentário, enquanto o grupo Treinado realizou exercício de natação a 80% do limiar anaeróbio (determinado pelo teste de lactato mínimo) por 1hora/dia, 5dias/semana do 28º até o 90º dia de vida. No fim do experimento, a massa corporal, adiposidade, sensibilidade à insulina, glicemia, insulinemia, insulina pancreática, atividade lipogênica do tecido adiposo mesentérico, atividade lipogênica e estoques de glicogênio no músculo gastrocnêmio e captação de glicose pelo músculo sóleo foram analizadas. O grupo Treinado apresentou menor ganho de massa corporal, acúmulo de gordura, síntese de lipídios, glicemia, insulinemia e insulina pancreática. Kitt, HOMA-IR, estoques de glicogênio no gastrocnêmio e captação de glicose pelo sóleo foram maiores nesse grupo. Portanto, concluímos que o exercício físico moderado realizado durante a infância pode contribuir para a redução da adiposidade corporal e resistência à insulina durante a fase adulta em ratos Wistar

Influence of serum testosterone on urinary continence and sexual activity in patients undergoing radical prostatectomy for clinically localized prostate cancer

The aim of the present study was to evaluate how serum testosterone level (T) can affect urinary continence and erectile function in patients undergoing radical prostatectomy (RP). We included 257 patients with clinically localized prostate cancer, those who had filled out preoperative quality of life questionnaires (University of California, Los Angeles Prostate Cancer Index, International Index of Erectile Function (IIEF)), and those who had T and total PSA sampled the day before surgery. We calculated correlations between T and age, body mass index (BMI), PSA, urinary function or bother (UF, UB) and sexual function or bother (SF, SB) and IIEF-5 in the whole population and in sub-populations with normal (⩾10.4 nmol l−1) and low (<10.4 ng ml−1) T using Pearson's and Spearman's correlation coefficients. We evaluated differences in these parameters between patients with low and normal T using the unpaired samples t-test and Mann–Whitney test, and finally the correlation between UF and SF, UB and SB, and between PSA and T in the overall population, and separately in patients with low and normal T using the Pearson's correlation coefficient. Mean preoperative T was 13.5 nmol l−1 and 23.7% of patients presented a low T. Mean age, mean BMI and mean preoperative total PSA at RP were 64.3 years, 25.9 kg m−2 and 9.0 ng ml−1, respectively. BMI was negatively correlated with T in the overall population (r=−0.266; P=0.02); moreover, patients with normal T presented lower BMI compared with patients with low T (25.7 vs 27.6: P=0.02). We found a significant correlation between SF scores and T in patients with normal T (r=0.1777: P=0.05). SF was significantly higher in patients with normal T compared with those with low T (74.8 vs 64.8: P=0.05). Furthermore, UF and UB were significantly correlated with SF (r=0.2544: P<0.01) and SB (r=0.2512: P=0.01), respectively, in men with normal T. Serum T was significantly correlated with PSA in men with low T (r=0.3874: P=0.0029), whereas this correlation was missed in the whole population and in men with normal T. The correlation between preoperative PSA and T in men with low T is in agreement with the ‘saturation' model proposed by Morgentaler. The correlation between basal T and preoperative erectile function and urinary continence underlines the importance of assessing T before RP