Cardioprotective role of IGF-1 in the hypertrophied myocardium of the spontaneously hypertensive rats: A key effect on NHE-1 activity

Aim: Myocardial Na+/H+ exchanger-1 (NHE-1) hyperactivity and oxidative stress are interrelated phenomena playing pivotal roles in the development of pathological cardiac hypertrophy and heart failure. Exercise training is effective to convert pathological into physiological hypertrophy in the spontaneously hypertensive rats (SHR), and IGF-1—key humoral mediator of exercise training—inhibits myocardial NHE-1, at least in normotensive rats. Therefore, we hypothesize that IGF-1 by hampering NHE-1 hyperactivity and oxidative stress should exert a cardioprotective effect in the SHR. Methods: NHE-1 activity [proton efflux (JH+) mmol L−1 min−1], expression and phosphorylation; H2O2 production; superoxide dismutase (SOD) activity; contractility and calcium transients were measured in SHR hearts in the presence/absence of IGF-1. Results: IGF-1 significantly decreased NHE-1 activity (JH+ at pHi 6.95: 1.39 ± 0.32, n = 9 vs C 3.27 ± 0.3, n = 20, P <.05); effect prevented by AG1024, an antagonist of IGF-1 receptor (2.7 ± 0.4, n = 7); by the PI3K inhibitor wortmannin (3.14 ± 0.41, n = 7); and the AKT inhibitor MK2206 (3.37 ± 0.43, n = 14). Moreover, IGF-1 exerted an antioxidant effect revealed by a significant reduction in H2O2 production accompanied by an increase in SOD activity. In addition, IGF-1 improved cardiomyocyte contractility as evidenced by an increase in sarcomere shortening and a decrease in the relaxation constant, underlined by an increase in the amplitude and rate of decay of the calcium transients. Conclusion: IGF-1 exerts a cardioprotective role on the hypertrophied hearts of the SHR, in which the inhibition of NHE-1 hyperactivity, as well as the positive inotropic and antioxidant effects, emerges as key players.Fil: Yeves, Alejandra del Milagro. Centro de Investigaciones Cardiovasculares (conicet- Universidad Nacional de la Plata); ArgentinaFil: Burgos, Juan Ignacio. Centro de Investigaciones Cardiovasculares (conicet- Universidad Nacional de la Plata); ArgentinaFil: Caicedo Medina, Julian Alberto. Centro de Investigaciones Cardiovasculares (conicet- Universidad Nacional de la Plata); ArgentinaFil: Villa-Abrille, María Celeste. Centro de Investigaciones Cardiovasculares (conicet- Universidad Nacional de la Plata); ArgentinaFil: Ennis, Irene Lucia. Centro de Investigaciones Cardiovasculares (conicet- Universidad Nacional de la Plata); Argentin

Potential associations of adult nocturia. Results from a national prevalence study

Aim To determine the prevalence of nocturia and associated risk factors in the Colombian population aged ≥18 years old. Methods This is a cross-sectional population-based study conducted in 1060 participants in Colombia. Nocturia was assessed with the Spanish version of the ICIQ-OAB, using the ICS terminology. Descriptive statistics were used to evaluate nocturia prevalence. Logistic regression analysis was carried out to determine the association of nocturia with predefined variables. Results The prevalence of nocturia was 55.9% and it was more common in women than men (53.96% vs. 46.04%; p = .004). At least three episodes of nocturia were observed in 20.37% of the participants who had a severe alteration in their quality of life (p < .01). The bivariate model showed an association between nocturia and obesity (odds ratio [OR], 1.69; 90% confidence interval [CI]: 1.22–2.34), diabetes mellitus (OR, 2.99; 90% CI: 1.86–4.83), high blood pressure (OR, 2.04; 90% CI: 1.52–2.72), cardiovascular disease (OR, 1.75; 90% CI: 1.08 – 2.83), depression (OR, 1.89; 90% CI: 1.23–2.89), obstructive sleep apnea (OR, 1.70; 90% CI: 1.17 - 2.46), and childhood enuresis (OR, 1.45; 90% CI: 1.04–2.02). The multivariate model showed an association with obesity (OR, 2.0; 95% CI: 1.14 - 3.51) in women, as well as age ≥ 65 years (OR, 3.18; 95% CI: 1.26 – 8.02) and erectile dysfunction (OR, 3.44; 95% CI: 1.21 – 9.72) in men. Childhood enuresis was significantly associated with nocturia in both genders (OR, 1.61; 95% CI: 1.09 - 2.40 in women and OR, 1.66; 95% CI: 1.09–2.52 in men). Conclusion There is a significant prevalence of nocturia in our population and a clear association with impaired quality of life. We consider important to inquire about history of childhood enuresis to define the risk of presenting nocturia in adulthood. Nocturia was associated with multiple comorbidities. Obesity and erectile dysfunction play an important role as modifiable risk factor.Apuntar Determinar la prevalencia de nocturia y factores de riesgo asociados en la población colombiana ≥18 años. Métodos Este es un estudio transversal de base poblacional realizado en 1060 participantes en Colombia. La nocturia se evaluó con la versión española del ICIQ-OAB, utilizando la terminología de la ICS. Se utilizaron estadísticas descriptivas para evaluar la prevalencia de la nocturia. Se realizó un análisis de regresión logística para determinar la asociación de la nicturia con variables predefinidas. Resultados La prevalencia de nocturia fue del 55,9% y fue más frecuente en mujeres que en hombres (53,96% vs. 46,04%; p  = 0,004). Se observaron al menos tres episodios de nocturia en el 20,37% de los participantes que presentaron una alteración severa en su calidad de vida ( p < .01). El modelo bivariado mostró una asociación entre nocturia y obesidad (odds ratio [OR], 1,69; intervalo de confianza [IC] del 90 %: 1,22–2,34), diabetes mellitus (OR, 2,99; IC del 90 %: 1,86–4,83), hipertensión arterial (OR, 2,04; IC 90 %: 1,52–2,72), enfermedad cardiovascular (OR, 1,75; IC 90 %: 1,08 – 2,83), depresión (OR, 1,89; IC 90 %: 1,23–2,89), apnea obstructiva del sueño ( OR, 1,70; IC 90%: 1,17 - 2,46), y enuresis infantil (OR, 1,45; IC 90%: 1,04-2,02). El modelo multivariado mostró asociación con la obesidad (OR, 2,0; IC 95%: 1,14 - 3,51) en mujeres, así como con edad ≥ 65 años (OR, 3,18; IC 95%: 1,26 - 8,02) y disfunción eréctil (OR, 3,44; IC 95%: 1,21 – 9,72) en hombres. La enuresis infantil se asoció significativamente con la nocturia en ambos sexos (OR, 1,61; IC 95%: 1,09 - 2,40 en mujeres y OR, 1,66; IC 95%: 1,09-2,52 en hombres). Conclusión Existe una importante prevalencia de nocturia en nuestra población y una clara asociación con deterioro de la calidad de vida. Consideramos importante indagar sobre antecedentes de enuresis infantil para definir el riesgo de presentar nocturia en la edad adulta. La nicturia se asoció con múltiples comorbilidades. La obesidad y la disfunción eréctil juegan un papel importante como factor de riesgo modificable.Revista Internacional - Indexad

Pixel-Wise Recognition for Holistic Surgical Scene Understanding

This paper presents the Holistic and Multi-Granular Surgical Scene Understanding of Prostatectomies (GraSP) dataset, a curated benchmark that models surgical scene understanding as a hierarchy of complementary tasks with varying levels of granularity. Our approach enables a multi-level comprehension of surgical activities, encompassing long-term tasks such as surgical phases and steps recognition and short-term tasks including surgical instrument segmentation and atomic visual actions detection. To exploit our proposed benchmark, we introduce the Transformers for Actions, Phases, Steps, and Instrument Segmentation (TAPIS) model, a general architecture that combines a global video feature extractor with localized region proposals from an instrument segmentation model to tackle the multi-granularity of our benchmark. Through extensive experimentation, we demonstrate the impact of including segmentation annotations in short-term recognition tasks, highlight the varying granularity requirements of each task, and establish TAPIS's superiority over previously proposed baselines and conventional CNN-based models. Additionally, we validate the robustness of our method across multiple public benchmarks, confirming the reliability and applicability of our dataset. This work represents a significant step forward in Endoscopic Vision, offering a novel and comprehensive framework for future research towards a holistic understanding of surgical procedures.Comment: Preprint submitted to Medical Image Analysis. Official extension of previous MICCAI 2022 (https://link.springer.com/chapter/10.1007/978-3-031-16449-1_42) and ISBI 2023 (https://ieeexplore.ieee.org/document/10230819) orals. Data and codes are available at https://github.com/BCV-Uniandes/GraS

Anxiety and depression in association with lower urinary tract symptoms: results from the COBaLT study

La depresión y la ansiedad se han asociado con síntomas del tracto urinario inferior (STUI) en varios estudios. En nuestra población la prevalencia de STUI es alta, por lo que es fundamental y objetivo de este estudio determinar la asociación entre ansiedad, depresión y STUI en una gran población hispana. Métodos Se realizó un subanálisis de un estudio poblacional transversal para estimar la prevalencia de STUI en la población colombiana (estudio COBaLT) (Plata et al. en Neurourol Urodyn 38:200–207, 2018). Para evaluar la salud mental se utilizó la Escala Hospitalaria de Ansiedad y Depresión (HADS). Se llevó a cabo una regresión logística para estimar la asociación de la depresión y la ansiedad con diferentes STUI. Las variables que resultaron estadísticamente significativas ( p  < 0,05) se incluyeron en un modelo multivariado. Resultados Se evaluaron un total de 1060 personas. La prevalencia de ansiedad en mujeres y hombres fue del 17,1% y 6,7%, respectivamente. La depresión en mujeres y hombres fue del 20,1% y 9,4%, respectivamente. Se encontró asociación entre ansiedad y vejiga hiperactiva (VH) sin incontinencia urinaria (OR = 3,7) y STUI moderados o graves en hombres (OR = 3,8). En las mujeres, la ansiedad se asoció con nicturia (OR = 4,2) e incontinencia urinaria de esfuerzo (OR = 2,4). Para la depresión, se encontró una asociación entre disfunción sexual (OR = 4,3) y STUI moderados o graves (OR = 4,0) en hombres; mientras que en las mujeres se asoció con la incontinencia urinaria de esfuerzo (OR = 2,3), la sensación de vaciado incompleto (OR = 1,7) y la disminución de la frecuencia de la actividad sexual (OR = 1,8). Conclusiones Las asociaciones encontradas son consistentes con otros informes. Es fundamental indagar sobre posibles síntomas relacionados con la esfera mental en la consulta de urología para realizar las derivaciones adecuadas y el manejo posterior.Q1Q1Depression and anxiety have been associated with lower urinary tract symptoms (LUTS) in several studies. In our population, the prevalence of LUTS is high, consequently, it is essential and an objective of this study, to determine the association between anxiety, depression, and LUTS in a large Hispanic population. Methods A sub-analysis of a cross‐sectional population‐based study to estimate LUTS prevalence in the Colombian population was performed (COBaLT study) (Plata et al. in Neurourol Urodyn 38:200–207, 2018). The Hospital Anxiety and Depression Scale (HADS) was used to evaluate mental health. Logistic regression was carried out to estimate the association of depression and anxiety with different LUTS. Variables that proved statistically significant (p < 0.05) were included in a multivariate model. Results A total of 1060 individuals were assessed. The prevalence of anxiety in women and men was 17.1% and 6.7%, respectively. Depression in women and men was 20.1% and 9.4%, respectively. An association was found between anxiety and overactive bladder (OAB) without urinary incontinence (OR = 3.7) and moderate or severe LUTS in men (OR = 3.8). In women, anxiety was associated with nocturia (OR = 4.2) and stress urinary incontinence (OR = 2.4). For depression, an association was found between sexual dysfunction (OR = 4.3) and moderate or severe LUTS (OR = 4.0) in men; while in women it was associated with stress urinary incontinence (OR = 2.3), the sensation of incomplete emptying (OR = 1.7) and decreased frequency of sexual activity (OR = 1.8). Conclusions The associations found are consistent with other reports. It is essential to inquire about possible symptoms related to the mental sphere in the urology consultation to make appropriate referrals and subsequent management.Revista Internacional - IndexadaS

Hallazgos histopatológicos en pacientes con cáncer de próstata con criterios de muy bajo riesgo llevados a prostatectomía radical

Objetivo: Describir los hallazgos de la patología definitiva de los pacientes inicialmente clasificados con tumores de muy bajo riesgo que fueron llevados a prostatectomía radical (PR). Materiales y métodos: Estudio observacional retrospectivo. Se revisaron las historias clínicas de pacientes llevados a PR entre enero de 2007 y diciembre de 2015. Se describieron y analizaron los hallazgos histopatológicos posquirúrgicos, con el objetivo de determinar si cumplir con dichos criterios eran predictores de enfermedad órgano-confinada y de bajo riesgo. Resultados: Se revisaron 609 historias clínicas de pacientes llevados a PR, de las cuales 83 (13,6 %) casos cumplían con criterios de muy bajo riesgo. La media de edad de estos pacientes fue de 59 (DE ± 7) años y la mediana de PSA al diagnóstico fue de 5,4 (RIQ 4,3-6,8) ng/dl. En la patología definitiva, la mediana del volumen tumoral fue del 4 % (RIQ: 1-10 %). El puntaje de Gleason fue de 3 + 3 en 55 (66,3 %) pacientes, mientras que 28 (33,7 %) fueron reclasificados a uno mayor. Solo 2 (2,4 %) pacientes se reclasificaron como pT3a, 80 (96,4 %) pacientes fueron clasificados como pT2 y un (1,2 %) paciente fue reclasificado como pT0. No se evidenció compromiso ganglionar en ninguno de los pacientes llevados a linfadenectomía. Conclusión: Los hallazgos demuestran que hasta una tercera parte de los pacientes con tumores inicialmente clasificados como de muy bajo riesgo tienen puntajes de Gleason mayor en la patología definitiva; sin embargo, solo el 3 % tienen tumores localmente avanzados, lo cual es consistente con lo reportado en la literatura mundial. Los criterios de Epstein son adecuados para predecir la presencia de tumores órgano-confinados.1-6Objectives: To describe the histological findings in patients with prostate cancer (PCa) clinically classified as very low risk who underwent treatment with radical prostatectomy (RP). Material and methods: A retrospective observational study was conducted. Clinical records of patients who underwent RP between 2007-2015 who met Epstein criteria for very low risk disease were reviewed. Histological diagnosis was described and analyzed to determine if such criteria predicted very low risk. Results: A total of 609 records were reviewed; 83 (13.6%) met Epstein’s criteria. Mean age was 59 (SD±7) years and median PSA at diagnosis was 5.4 ng/dl (IQR 4.3 – 6.8). Pathology showed a median tumor volume of 4% (IQR 1 – 10%). Gleason score was 3+3 in 55 (66.3%) cases, but 28 (33.7%) were reclassified to a greater score. Two (2.4%) patients were reclassified as pT3a, 80 (96.4%) as pT2 and 1 (1.2%) was found to be pT0. In those subjected to pelvic lymphadenectomy (42.2%) no positive lymph nodes were found. Conclusions: Up to one-third of the patients clinically classified with very low risk PCa had a greater Gleason score. Only 3% had locally advanced tumors, which is comparable to previous studies. Epstein’s criteria seem to be adequate in predicting organ-confined disease

Eficacia del consumo de licopenos en la prevención primaria de cáncer de próstata : una revisión sistemática de la literatura y meta-análisis

OBJETIVO: Evaluar la eficacia del consumo de licopenos en la prevención primaria de CaP. MÉTODOS: Se realizó una búsqueda sistemática de la literatura en marzo de 2015 y se revisaron artículos publicados entre 1990-2015. Se utilizaron los términos de búsqueda: prostate cancer, prostatic neoplasm, lycopene, prevention, efficacy and effectiveness (MeSH). Se revisaron artículos de investigación en humanos, en inglés y cuyo texto completo fuera accesible. Los tipos de estudio fueron: ensayos clínicos, cohortes y casos y controles. Se encontraron 343 artículos, de los cuales se incluyeron 27 en la revisión sistemática. Después de que estos últimos fueron analizados en profundidad, se incluyeron 23 en el meta-análisis agrupando las razones de probabilidad (OR) y riesgos relativos (RR) de estudios de casos y controles y cohortes, respectivamente, y sus intervalos de confianza (IC 95%), utilizando modelos de efectos aleatorios con Review Manager 5.2. RESULTADOS: De los 27 artículos incluidos en la revisión sistemática, 22 fueron de casos y controles y 5 de cohortes. Para los estudios de casos y controles, el total de pacientes con CaP involucrados fue de 13.999; el total de controles fue 22.028. Los estudios de cohortes contaron con un total de 187.417 participantes y se diagnosticó CaP en 8.619 de estos. El meta-análisis determinó una razón de probabilidad (OR) de CaP de 0,94 (IC 95% 0,89-1,00) y riesgo relativo (RR) de 0,90 (0,85-0,95) en relación al consumo de licopenos y/o tomates crudos o cocidos. CONCLUSIONES: Aunque nuestro estudio encontró que existe una asociación inversa estadísticamente significativa entre la ingesta de licopenos y CaP, la magnitud de esta asociación es débil y proviene de estudios observacionales únicamente, lo cual no permite recomendar su uso como estándar de práctica clínica. Se requieren ensayos clínicos aleatorizados de alta calidad que permitan esclarecer la evidencia actual.Q4Q3Artículo de revisión187-197OBJECTIVE: To evaluate the efficacy of lycopene intake in primary prevention of prostate cancer (PCa). METHODS: A systematic search of the literature was conducted in March 2015 and the articles published between the years 1990-2015 were reviewed. The following search terms were used: prostate cancer, prostatic neoplasm, lycopene, prevention, effectiveness and efficacy (MeSH). Publications including research in humans, written in English and whose texts were accessible were reviewed. The types of studies included were: clinical trials, cohort and case-control studies. We found 343 articles; of these, 27 were included in the systematic review. After the latter were rigorously analyzed, 23 were included in the meta-analysis using the pooled odds ratios (OR) and risk ratios (RR) of case-control and cohort studies, respectively, and their confidence intervals (95% CI), using random-effects models with Review Manager 5.2. RESULTS: Out of the 27 articles included in the systematic review, 22 were case-control and 5 were cohort studies. For the case-control studies, the total number of patients with PCa was 13,999 and the total number of controls 22,028. Cohort studies included 187,417 patients and PCa was diagnosed in 8,619 of these. The metaanalysis determined an OR = 0.94 (IC 95% 0.89-1.00) and RR = 0.9 (IC 95% 0.85-0.95) of PCa related with lycopene and/or raw or cooked tomatoes intake. CONCLUSIONS: Although our study found that there is a statistically significant inverse association between lycopene intake and PCa, the magnitude of this association is weak and comes solely from observational studies, which do not allow recommending its use as a standard of practice. High-quality randomized clinical trials are required to clarify current evidence

Diagnostic accuracy of multiparametric magnetic resonance imaging in detecting extracapsular extension in intermediate and high - risk prostate cancer

Q4Q3Artículo original688-696Objectives: To evaluate the diagnostic performance of preoperative multiparametric magnetic resonance imaging (mp-MRI) as a predictor of extracapsular extension (ECE) and unfavorable Gleason score (GS) in patients with intermediate and high-risk prostate cancer (PCa). Materials and methods: Patients with clinically localized PCa who underwent radical prostatectomy (RP) and had preoperative mp-MRI between May-2011 and December-2013. Mp-MRI was evaluated according to the European Society of Urogenital Radiology MRI prostate guidelines by two different readers. Histopathological RP results were the standard reference. Results: 79 patients were included; mean age was 61 and median preoperative prostate-specific antigen (PSA) 7.0. On MRI, 28% patients had ECE evidenced in the mp-MRI, 5% seminal vesicle invasion (SVI) and 4% lymph node involvement (LNI). At RP, 39.2% had ECE, 26.6% SVI and 12.8% LNI. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of mp-MRI for ECE were 54.9%, 90.9%, 76%, 81% and 74.1% respectively; for SVI values were 19.1%, 100%, 77.3%, 100% and 76.1% respectively and for LNI 20%, 98.4%, 86.7%, 66.7% and 88.7%. Conclusions: Major surgical decisions are made with digital rectal exam (DRE) and ultrasound studies before the use of Mp-MRI. This imaging study contributes to rule out gross extraprostatic extension (ECE, SVI, LNI) without competing with pathological studies. The specificity and NPV are reasonable to decide surgical approach. A highly experienced radiology team is needed to provide accurate estimations of tumor extension and aggressiveness