Higher Prostate Weight Is Inversely Associated With Gleason Score Upgrading In Radical Prostatectomy Specimens.

Background. Protective factors against Gleason upgrading and its impact on outcomes after surgery warrant better definition. Patients and Methods. Consecutive 343 patients were categorized at biopsy (BGS) and prostatectomy (PGS) as Gleason score, ≤6, 7, and ≥8; 94 patients (27.4%) had PSA recurrence, mean followup 80.2 months (median 99). Independent predictors of Gleason upgrading (logistic regression) and disease-free survival (DFS) (Kaplan-Meier, log-rank) were determined. Results. Gleason discordance was 45.7% (37.32% upgrading and 8.45% downgrading). Upgrading risk decreased by 2.4% for each 1 g of prostate weight increment, while it increased by 10.2% for every 1 ng/mL of PSA, 72.0% for every 0.1 unity of PSA density and was 21 times higher for those with BGS 7. Gleason upgrading showed increased clinical stage (P = 0.019), higher tumor extent (P = 0.009), extraprostatic extension (P = 0.04), positive surgical margins (P < 0.001), seminal vesicle invasion (P = 0.003), less insignificant tumors (P < 0.001), and also worse DFS, χ (2) = 4.28, df = 1, P = 0.039. However, when setting the final Gleason score (BGS ≤6 to PGS 7 versus BGS 7 to PGS 7), avoiding allocation bias, DFS impact is not confirmed, χ (2) = 0.40, df = 1, P = 0.530.Conclusions. Gleason upgrading is substantial and confers worse outcomes. Prostate weight is inversely related to upgrading and its protective effect warrants further evaluation.201371042

Higher Prostate Weight Is Inversely Associated with Gleason Score Upgrading in Radical Prostatectomy Specimens

Background. Protective factors against Gleason upgrading and its impact on outcomes after surgery warrant better definition. Patients and Methods. Consecutive 343 patients were categorized at biopsy (BGS) and prostatectomy (PGS) as Gleason score, ≤6, 7, and ≥8; 94 patients (27.4%) had PSA recurrence, mean followup 80.2 months (median 99). Independent predictors of Gleason upgrading (logistic regression) and disease-free survival (DFS) (Kaplan-Meier, log-rank) were determined. Results. Gleason discordance was 45.7% (37.32% upgrading and 8.45% downgrading). Upgrading risk decreased by 2.4% for each 1 g of prostate weight increment, while it increased by 10.2% for every 1 ng/mL of PSA, 72.0% for every 0.1 unity of PSA density and was 21 times higher for those with BGS 7. Gleason upgrading showed increased clinical stage (P=0.019), higher tumor extent (P=0.009), extraprostatic extension (P=0.04), positive surgical margins (P<0.001), seminal vesicle invasion (P=0.003), less “insignificant” tumors (P<0.001), and also worse DFS, χ2=4.28, df=1, P=0.039. However, when setting the final Gleason score (BGS ≤6 to PGS 7 versus BGS 7 to PGS 7), avoiding allocation bias, DFS impact is not confirmed, χ2=0.40, df=1, P=0.530.Conclusions. Gleason upgrading is substantial and confers worse outcomes. Prostate weight is inversely related to upgrading and its protective effect warrants further evaluation

Substrates, emergence and initial development of passion fruit seedlings

The propagation of any crop is understood as a crucial step for the success of the crop, being the main form of propagation of passion fruit to sexual, where almost all cases of commercial plantations, orchards are formed from seedlings generated from seeds produced in substrates. The objective was then to evaluate the effect of different substrates on the emergence and initial development of passion fruit (Passiflora edulis) seedlings. The experimental design was a randomized block with 6 treatments and 4 repetitions with 25 seeds per experimental unit. The seeds were submitted to the treatments, sown in different substrates, being: T1 = Pure soil (100%); T2 = Soil (75%) + humus (25%); T3 = Soil (75%) + bovine manure (25%); T4 = Soil (75%) + chicken manure (25%); T5 = Soil (75%) + Natufert® organomineral fertilizer (25%); T6 = Soil (75%) + coffee straw (25%). Thirty days after sowing the variables were evaluated, percentage of germination. Sixty days after sowing were evaluated: number of leaves; plant height; collection diameter; root length; leaf green mass; leaf dry mass; green root mass; dry root mass. The treatment Terra (75%) + coffee straw (25%) proved to be the most recommended with regard to variables of the aerial part, while Terra (75%) + humus (25%) and Terra (75%) + bovine manure (25%) were the most suitable for the root development of seedlings.A propagação de qualquer cultivo é compreendida como uma etapa crucial para o sucesso da cultura, sendo a principal forma de propagação do maracujazeiro a sexuada, onde quase totalidade dos casos de plantios comerciais, os pomares são formados a partir de mudas geradas de sementes. A produção de mudas de qualidade passa pela escolha do substrato mais indicado para cada cultura. Objetivou-se avaliar a influência de diferentes substratos na emergência e desenvolvimento inicial de plântulas de maracujazeiro amarelo (Passiflora edulis). O delineamento experimental foi em blocos casualizados com 6 tratamentos e 4 repetições com 25 sementes por unidade experimental, semeadas em tubetes de 280 mL. Os tratamentos foram compostos por diferentes tipos de substratos na proporção de 3:1, sendo eles: solo puro; solo + esterco de galinha; solo+esterco de boi; solo + Natufert®; solo + húmus; solo + palha de café. Foram avaliados a altura das plantas (cm); o número de folhas; o diâmetro do coleto (mm); o comprimento da raiz (cm); a massa verde das folhas; a massa verde das raízes; a massa seca das folhas e a massa seca das raízes. Os substratos resultantes da mistura de solo + palha de café se mostrou o mais indicado na emergência e desenvolvimento inicial de plântulas de maracujazeiro amarelo

As práticas colaborativas como um recurso para as situações de divórcio

Este artigo propõe a utilização das Práticas Colaborativas como um procedimento apropriado para as situações de divórcio e seus desdobramentos. Nesse método extrajudicial de resolução de controvérsias, não adversarial e interdisciplinar, o processo decisório é construído de forma conjunta, articulando interesses por meio do diálogo. Dessa forma, a prática se pauta no protagonismo e na corresponsabilização das partes.As Práticas Colaborativas se apresentam como uma alternativa à litigiosidade e surgem em consonância com a política nacional de tratamento adequado de conflitos, na medida em que, além de buscarem acordos satisfatórios e duradouros, que otimizem recursos, cuidam das questões emocionais inerentes ao divórcio. Com isso, pais e filhos tendem a sofrer menos, pois constroem conjuntamente um relacionamento funcional para após a ruptura

Elderly widows' experience of sexuality and their perceptions regarding the family's opinion

O objetivo deste trabalho foi descrever a vivência da sexualidade por mulheres idosas viúvas, frequentadoras de um Centro de Convivência do Idoso, e verificar a percepção quanto à opinião dos seus familiares. Tratou-se de uma pesquisa qualitativa e exploratório-descritiva. Os dados foram coletados por meio de entrevistas semiestruturadas e submetidos à análise de conteúdo temática. Emergiram desta as categorias: 1) a vivência da sexualidade sofreu algumas modificações após o estado de viuvez garantindo submissão às normas e regras sociais para o comportamento feminino; 2) as idosas assumem ter optado pela vida sem um novo companheiro; 3) a família apoia o convívio social, mas não existe declaração de apoio para novos relacionamentos amorosos; e 4) houve ressignificação das questões de gênero no tocante às mudanças relativas ao papel social da mulher, depois da viuvez. Concluímos, portanto, que essas mulheres não vivem, de forma plena e livre, sua sexualidade, pois se submetem às normas sociais.The aim of this study was to describe the experience of sexuality of elderly widows attending an Elderly Community Centre and to verify their perceptions regarding their relatives' opinion. This was a qualitative and descriptive-exploratory research. Data were collected through semi-structured interviews and submitted to a thematic content analysis. The following categories emerged: 1) the experience of sexuality was modified after the women became widows, so that the female behavior complies with social norms and rules; 2) the elderly widows assume they have opted for life without a new partner; 3) the family supports social interaction, but there is no statement of support for new loving relationships; and 4) gender issues were redefined in relation to changes in the social role of women after widowhood. We conclude, therefore, that these women do not experience, neither fully nor freely, their sexuality, because they submit to the social norms