Impact of benign prostatic hyperplasia pharmacological treatment on transrectal prostate biopsy adverse effects

Background. Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Among 242 consecutive unselected patients who underwent prostate biopsy, after excluding those with history of prostate biopsy/surgery or using medications not for BPH, we studied 190 patients. On the 15th day after procedure patients were questioned about symptoms lasting over a week and classified according to pharmacological BPH treatment. Results. Thirty-three patients (17%) were using alpha-blocker exclusively, five (3%) 5-alpha-reductase inhibitor exclusively, twelve (6%) patients used both medications, and 140 (74%) patients used none. There was no difference in regard to age among groups (P = 0.5). Postbiopsy adverse effects occurred as follows: hematuria 96 (50%), hematospermia 53 (28%), hematochezia 22 (12%), urethrorrhagia 19 (10%), fever 5 (3%), and pain 20 (10%). There was a significant negative correlation between postbiopsy hematuria and BPH pharmacological treatment with stronger correlation for combined use of 5-alpha-reductase inhibitor and alpha-blocker over 6 months (P = 0.0027). Conclusion. BPH pharmacological treatment, mainly combined for at least 6 months seems to protect against prostate biopsy adverse effects. Future studies are necessary to confirm our novel results. © 2014 Marina Zamuner et al.Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Amongsem informaçãosem informação(2013) Overview: Prostate Cancer. 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(2012) Ultrasound in Medicine and Biology, 38 (10), pp. 1689-1694. , 10.1016/j.ultrasmedbio.2012.06.006Reis, L.O., Reinato, J.A.S., Silva, D.C., Matheus, W.E., Denardi, F., Ferreira, U., The impact of core biopsy fragmentation in prostate cancer (2010) International Urology and Nephrology, 42 (4), pp. 965-969. , 2-s2.0-78751646334 10.1007/s11255-010-9720-0Anastasiadis, A., Zapała, L., Cordeiro, E., Antoniewicz, A., Dimitriadis, G., De Reijke, T., Complications of prostate biopsy (2013) Expert Review of Anticancer Therapy, 13 (7), pp. 829-837. , 10.1586/14737140.2013.811056Campeggi, A., Ouzaid, I., Xylinas, E., Lesprit, P., Hoznek, A., Vordos, D., Abbou, C.C., De La Taille, A., Acute bacterial prostatitis after transrectal ultrasound-guided prostate biopsy: Epidemiological, bacteria and treatment patterns from a 4-year prospective study (2013) International Journal of Urology, 21 (2), pp. 152-155. , 10.1111/iju.12207Pinkhasov, G.I., Lin, Y.-K., Palmerola, R., Smith, P., Mahon, F., Kaag, M.G., Dagen, J.E., Raman, J.D., Complications following prostate needle biopsy requiring hospital admission or emergency department visits - Experience from 1000 consecutive cases (2012) BJU International, 110, pp. 369-374. , 2-s2.0-84856569661 10.1111/j.1464-410X.2011.10926.xPeyromaure, M., Ravery, V., Messas, A., Toublanc, M., Boccon-Gibod, L., Boccon-Gibod, L., Pain and morbidity of an extensive prostate 10-biopsy protocol: A prospective study in 289 patients (2002) Journal of Urology, 167 (1), pp. 218-221Ozdal, O.L., Ozden, C., Benli, K., Gokkaya, S., Bulut, S., Memis, A., Effect of short-term finasteride therapy on peroperative bleeding in patients who were candidates for transurethral resection of the prostate (TUR-P): A randomized controlled study (2005) Prostate Cancer and Prostatic Diseases, 8 (3), pp. 215-218. , DOI 10.1038/sj.pcan.4500818, PII 4500818Pastore, A.L., Mariani, S., Barrese, F., Palleschi, G., Valentini, A.M., Pacini, L., Petrozza, V., Cappa, M., Transurethral resection of prostate and the role of pharmacological treatment with dutasteride in decreasing surgical blood loss (2013) Journal of Endourology, 27 (1), pp. 68-70. , 10.1089/end.2012.0231Hahn, R.G., Fagerström, T., Tammela, T.L.J., Van Vierssen Trip, O., Beisland, H.O., Duggan, A., Morrill, B., Blood loss and postoperative complications associated with transurethral resection of the prostate after pretreatment with dutasteride (2007) BJU International, 99 (3), pp. 587-594. , 2-s2.0-33846934500 10.1111/j.1464-410X.2006.06619.xArratia-Maqueo, J.A., Garza-Cortés, R., Gómez-Guerra, L.S., Cortés-Gonzlez, J.R., Effect of one month treatment with dutasteride on transurethral resection of the prostate (2010) Actas Urologicas Espanolas, 34 (10), pp. 866-869. , 2-s2.0-78049478337 10.1016/j.acuro.2010.06.00

Propiedades psicométricas del Inventario de Situaciones y Respuestas de Ansiedad Breve (ISRA-B)

Introducción y objetivos La ansiedad es la reacción emocional más estudiada, que nos pone en alerta ante la posibilidad de obtener un resultado negativo, por lo que resulta adaptativa en la gran mayoría de las ocasiones, aunque también está en la base de los trastornos emocionales más prevalentes. Por ello, su evaluación ha generado mucha investigación y transferencia. El Inventario de Situaciones y Respuestas de Ansiedad (ISRA) fue desarrollado en España, incluye 22 situaciones (S) y 24 respuestas (R) de ansiedad, que al cruzarlas se forman 224 reactivos (del tipo «en tal S, experimento esta R»). Desde hace más de tres décadas ha sido ampliamente utilizado en la investigación, así como en la práctica, y se han publicado estudios sobre sus propiedades psicométricas en diferentes países. Una versión más breve (ISRA-B) de 46 ítems, sin contenidos cruzados S × R, sino una escala de 22 S y otra de 24 R, con las que evalúan las mismas ocho facetas de la ansiedad, ha mostrado buenas propiedades psicométricas también; sin embargo, existen menos publicaciones psicométricas en población española. El objetivo de este estudio fue analizar las propiedades psicométricas del ISRA-B en España. Método Para ello se contó con 3, 346 voluntarios (36.4% hombres), con edades de 15 a 94 años (media: 30.3; DE: 14.6). Resultados Los resultados confirmaron excelente consistencia interna para Total (.94) y subescala R (.91), buena para S (.89) y sistemas de respuesta Fisiológico (.86) y Cognitivo (.84), y aceptable para Motor (.70). También se encontró buena estabilidad test-retest al cabo de un mes (.78) y buena validez externa al correlacionar .87 con el ISRA original. La estructura factorial del ISRA-B obtenida se adecuó al modelo de Lang de tres sistemas de R y al modelo de Endler de interacción S × R, en los que se basa. Asimismo, se presentan los datos normativos, por sexo y grupo. Conclusión Se concluye que el ISRA-B es válido y confiable, mejora su aplicabilidad respecto al ISRA original, conservando sus propiedades psicométricas. Introduction and objectives: Anxiety is the most studied emotional reaction, which alerts us of the possibility of obtaining a negative result, making it adaptive in the vast majority of cases, although it is also one of the underlying factors of the most prevalent emotional disorders. Therefore, its assessment has generated a lot of research and transfer. The Inventory of Situations and Responses of Anxiety (ISRA) was developed in Spain and it includes 22 situations (S) and 24 responses (R) of anxiety, by which 224 items are formed by crossing them (i.e., «in such Situation, I experience this Reaction»). For more than three decades, it has been widely used in research and practice, and its psychometric properties have been published in different countries. A shorter, 46-item version (ISRA-B), with a 22 S scale plus another of 24 R was developed. The same eight facets of anxiety were assessed, showing good psychometric properties as well. However, there are few publications on the psychometric data using Spanish population. The objective of this study was to analyze the psychometric properties of ISRA-B in Spain. Methods: Three thousand three hundred and forty six volunteers (36.4% men), aged 15 to 94 years (mean: 30.3; SD: 14.6) were included. Results: The results confirmed excellent internal consistency for the Total (.94) and the Responses subscale (0.91), good for the Situations (0.89), as well as the Physiological (, 86) and Cognitive (0.84) response systems, and acceptable for the Motor (0.70). Good test-retest stability was also found after two months (0.78) and good external validity when correlated with the original ISRA (0.87). The results confirm the factor structure of the ISRA-B, adjusted to Lang''s triple response system model and to Endler''s S × R interaction model, on which it is based. Likewise, the normative data are presented, differentiated by sex and group. Conclusions: It is concluded that the ISRA-B is a valid and reliable instrument, which improves its applicability compared to the original ISRA by simplifying its format and number of items, while preserving its psychometric properties

United classification of cosmic gamma-ray bursts and their counterparts

United classification of gamma-ray bursts and their counterparts is established on the basis of measured characteristics: photon energy E and emission duration T. The founded interrelation between the mentioned characteristics of events consists in that, as the energy increases, the duration decreases (and vice versa). The given interrelation reflects the nature of the phenomenon and forms the E-T diagram, which represents a natural classification of all observed events in the energy range from 10E9 to 10E-6 eV and in the corresponding interval of durations from about 10E-2 up to 10E8 s. The proposed classification results in the consequences, which are principal for the theory and practical study of the phenomenon.Comment: Keywords Gamma rays: burst

Aplicación del enfoque fisiográfico para el relevamiento de suelos semidetallado en el departamento Guaraní, Misiones

Se estudia la relación paisaje-suelo en el departamento Guaraní, Misiones, aplicando el enfoque fisiográfico. Para la clasificación de las unidades de paisaje se utilizó el Modelo Digital de Elevaciones y parámetros del terreno derivados. En cada unidad se realizan descripciones del sitio (relieve, vegetación, uso del suelo) y el reconocimiento de perfiles de suelo. Los resultados permitieron diferenciar cinco unidades a nivel de Gran Paisaje: La Meseta central constituye el relieve más antiguo, con lomas muy amplias y pendientes suaves, donde dominan suelos rojos profundos (Ultisoles y Oxisoles), y se desarrolla el cultivo de té y yerba mate; las Estribaciones de la Meseta central es un sector más erosionado, con pendientes mayores y dominancia de Alfisoles rojos y Ultisoles, siendo un área de reserva ecológica; El Lomerío comprende lomadas de menor extensión y mayores pendientes que las anteriores, donde dominan Alfisoles rojos y afloramientos rocosos. Entre las lomadas se desarrollan valles en “U”, donde se reconocen Alfisoles pardos y Molisoles. El uso de los suelos es para la producción de té, yerba mate, ganadería y forestación en las lomas y cultivos anuales en los valles; La Serranía se caracteriza por cerros fuertemente disectados con laderas de pendientes pronun ciadas, donde los valles son estrechos y en forma de “V”. Dominan los Entisoles y afloramientos rocosos en sectores cuspidales o de mayor pendiente, mientras que en áreas planas, se desarrollan Molisoles. El uso de los suelos es para producción de yerba mate, tabaco, citronela y forestación, siendo la unidad que presenta mayor cobertura de vegetación natural; El valle del Río Uruguay presenta Entisoles en sectores de pendiente y Molisoles en terrazas, donde se producen cultivos anuales. El análisis fisiográfico realizado será de utilidad para el relevamiento de suelos y la confección de la Carta a escala semidetallada del departamento.Fil: Moretti, Lucas M. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Cerro Azul; ArgentinaFil: Tenti Vuegen, Leonardo M. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Suelos. ArgentinaFil: Barbaro, S.E. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Cerro Azul; ArgentinaFil: Hopechek, L.A. Provincia de Misiones. Ministerio del Agro y la Producción; ArgentinaFil: Lanfranco, M. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Manfredi; ArgentinaFil: Alvarenga, F.A. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Cerro Azul; ArgentinaFil: Florentín, J. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Cerro Azul; ArgentinaFil: Pahr, Norberto Manuel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Montecarlo; ArgentinaFil: Von Wallis, Alejandra. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Montecarlo; ArgentinaFil: Rodriguez, Darío M. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Suelos; ArgentinaFil: Schulz, Guillermo A. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Suelos; ArgentinaFil: Escobar, Dardo. Ministerio de Agricultura, Ganadería y Pesca; ArgentinaFil: Ybarra, Diego Daniel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Corrientes; ArgentinaFil: Perucca, S. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Marcos Juárez. Agencia de Extensión Rural Río Cuarto; ArgentinaFil: Iwasita, Bárbara Eloisa. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Cerro Azul; Argentin

Observation of inverse Compton emission from a long γ-ray burst.

Long-duration γ-ray bursts (GRBs) originate from ultra-relativistic jets launched from the collapsing cores of dying massive stars. They are characterized by an initial phase of bright and highly variable radiation in the kiloelectronvolt-to-megaelectronvolt band, which is probably produced within the jet and lasts from milliseconds to minutes, known as the prompt emission1,2. Subsequently, the interaction of the jet with the surrounding medium generates shock waves that are responsible for the afterglow emission, which lasts from days to months and occurs over a broad energy range from the radio to the gigaelectronvolt bands1-6. The afterglow emission is generally well explained as synchrotron radiation emitted by electrons accelerated by the external shock7-9. Recently, intense long-lasting emission between 0.2 and 1 teraelectronvolts was observed from GRB 190114C10,11. Here we report multi-frequency observations of GRB 190114C, and study the evolution in time of the GRB emission across 17 orders of magnitude in energy, from 5 × 10-6 to 1012 electronvolts. We find that the broadband spectral energy distribution is double-peaked, with the teraelectronvolt emission constituting a distinct spectral component with power comparable to the synchrotron component. This component is associated with the afterglow and is satisfactorily explained by inverse Compton up-scattering of synchrotron photons by high-energy electrons. We find that the conditions required to account for the observed teraelectronvolt component are typical for GRBs, supporting the possibility that inverse Compton emission is commonly produced in GRBs

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

MAGIC very large zenith angle observations of the Crab Nebula up to 100 TeV

Aims. We measure the Crab Nebula gamma-ray spectral energy distribution in the 100 TeV energy domain and test the validity of existing leptonic emission models at these high energies.Methods. We used the novel very large zenith angle observations with the MAGIC telescope system to increase the collection area above 10 TeV. We also developed an auxiliary procedure of monitoring atmospheric transmission in order to assure proper calibration of the accumulated data. This employs recording optical images of the stellar field next to the source position, which provides a better than 10% accuracy for the transmission measurements.Results. We demonstrate that MAGIC very large zenith angle observations yield a collection area larger than a square kilometer. In only 56 h of observations, we detect the gamma-ray emission from the Crab Nebula up to 100 TeV, thus providing the highest energy measurement of this source to date with Imaging Atmospheric Cherenkov Telescopes. Comparing accumulated and archival MAGIC and Fermi/LAT data with some of the existing emission models, we find that none of them provides an accurate description of the 1 GeV to 100 TeV gamma-ray signal