Prostate cancer treatment in Portugal: a nationwide analysis

Different treatment options exist for localized prostate cancer. Treatments performed in high-volume hospitals are associated with better results. Our objective was to describe time trends in prostate cancer treatments in Portugal and case volume per hospital. We used the national database of diagnosis-related group of the Portuguese Central Administration of the Health System to describe the number of radical prostatectomy (RP), brachytherapy (BT) and external radiotherapy (eRT) treatments performed in all National Health System hospitals. There was a rapid increase in the annual number of RP until 2006 and then a deceleration; BT treatments augmented significantly until 2011. The utilization of eRT also increased, surpassing RP after 2010. From the 46 hospitals performing RP, only eight had a case-volume > 50 treatments/year, and from the nine hospitals performing BT, only four accomplished > 15 treatments/year. In the 11 hospitals with eRT, nine performed > 50/year. Regarding RP, there was negative correlation between the hospital volume and length of stay (r = − 0.303; p = 0.041). In the Portuguese National Health Service there was a steep increase in the number of prostate cancer treatments, and there is an ample margin for concentration of RP and BT treatments, for improvement of the hospitals case volume. © 2023, The Author(s).We are grateful to the Administração Central do Sistema de Saúde (ACSS) as the source of the data and Drª. Lucybell Moreira of Centro Hospitalar de S. João for extracting the data used in the manuscript. This work has been funded by National funds, through the Foundation for Science and Technology (FCT)—project UIDB/50026/2020 and UIDP/50026/2020

Tapeworm eggs in a 270 million-year-old shark coprolite

Remains of parasites in vertebrates are rare from the Mesozoic and Paleozoic. Once most parasites that live in – or pass through – the gastrointestinal tract of vertebrates, fossil feces (coprolites) or even intestinal contents (enterolites) can eventually preserve their remains. Here we announce the discovery of a spiral shark coprolite from the Paleozoic bearing a cluster of 93 small oval-elliptical smooth-shelled structures, interpreted as eggs of a tapeworm.The eggs were found in a thin section of an elasmobranch coprolite. Most of the eggs are filled by pyrite and some have a special polar swelling (operculum), suggesting they are non-erupted eggs. One of the eggs contains a probable developing larva. The eggs are approximately 145–155 mm in length and 88–100 mm in width and vary little in size within the cluster. The depositional and morphological features of the eggs closely resemble those of cestodes. Not only do the individual eggs have features of extant tapeworms, but their deposition all together in an elongate segment is typical to modern tapeworm eggs deposited in mature segments (proglottids). This is the earliest fossil record of tapeworm parasitism of vertebrates and establishes a timeline for the evolution of cestodes. This discovery shows that the fossil record of vertebrate intestinal parasites is much older than was hitherto known and that the interaction between tapeworms and vertebrates occurred at least since the Middle-Late Permian

Androgen-deprivation therapy and cognitive decline in the NEON-PC prospective study during the COVID-19 pandemic

Background: Androgen-deprivation therapy (ADT) has been associated with cognitive decline, but results are conflicting. This study describes changes in cognitive performance in patients with prostate cancer, according to ADT, during the first year after prostate cancer diagnosis. Patients and methods: Patients with prostate cancer treated at the Portuguese Institute of Oncology of Porto (n = 366) were evaluated with the Montreal Cognitive Assessment (MoCA), before treatment and after 1 year. All baseline evaluations were performed before the coronavirus disease 2019 (COVID-19) pandemic and 69.7% of the 1-year assessments were completed after the first lockdown. Cognitive decline was defined as the decrease in MoCA from baseline to the 1-year evaluation below 1.5 standard deviations of the distribution of changes in the whole cohort. Participants scoring below age- and education-specific normative reference values in the MoCA were considered to have cognitive impairment. Age- and education-adjusted odds ratios (aORs) were computed for the association between ADT and cognitive outcomes. Results: Mean MoCA scores increased from baseline to the 1-year evaluation (22.3 versus 22.8, P < 0.001). Cognitive decline was more frequent in the ADT group, and even more after the onset of the COVID-19 pandemic (aOR 6.81 versus 1.93, P for interaction = 0.233). The 1-year cumulative incidence of cognitive impairment was 6.9% (9.1% before and 3.7% after the pandemic onset), which was higher among patients receiving ADT, but only after the pandemic (aOR 5.53 versus 0.49, P for interaction = 0.044). Conclusions: ADT was associated with worse cognitive performance of patients with prostate cancer, mostly among those evaluated after the first COVID-19 lockdown. © 2022 The AuthorsFunding text 1: This study was funded by the European Regional Development Fund through the Operational Programme Competitiveness and Internationalisation, and national funding from the Fundação para a Ciência e a Tecnologia - FCT (Portuguese Ministry of Science, Technology and Higher Education) under the project ‘NEON-PC - Neuro-oncological complications of prostate cancer: longitudinal study of cognitive decline’ (POCI-01-0145-FEDER-032358; Ref. PTDC/SAU-EPI/32358/2017), and the Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit; UIDB/04750/2020) and Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (LA/P/0064/2020), financed by national funds from FCT . AC and SM were funded under the scope of the project ‘NEON-PC - Neuro-oncological complications of prostate cancer: longitudinal study of cognitive decline’ (POCI-01-0145-FEDER-032358; Ref. PTDC/SAU-EPI/32358/2017). An individual PhD grant attributed to NA (SFRH/BD/119390/2016) was funded by FCT and the ‘ Programa Operacional Capital Humano ’ (POCH/FSE). ; Funding text 2: This study was funded by the European Regional Development Fund through the Operational Programme Competitiveness and Internationalisation, and national funding from the Fundação para a Ciência e a Tecnologia - FCT (Portuguese Ministry of Science, Technology and Higher Education) under the project ‘NEON-PC - Neuro-oncological complications of prostate cancer: longitudinal study of cognitive decline’ (POCI-01-0145-FEDER-032358; Ref. PTDC/SAU-EPI/32358/2017), and the Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit; UIDB/04750/2020) and Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (LA/P/0064/2020), financed by national funds from FCT. AC and SM were funded under the scope of the project ‘NEON-PC - Neuro-oncological complications of prostate cancer: longitudinal study of cognitive decline’ (POCI-01-0145-FEDER-032358; Ref. PTDC/SAU-EPI/32358/2017). An individual PhD grant attributed to NA (SFRH/BD/119390/2016) was funded by FCT and the ‘Programa Operacional Capital Humano’ (POCH/FSE). The authors have no relevant financial or nonfinancial interests to disclose. The datasets generated and analysed in this study will not be publicly available given that the included patients do not specifically provide their consent for public sharing of their data and that anonymization is unlikely to be feasible, because the identification of patients treated in only one institution within a relatively short period may be possible when taking sociodemographic and clinical characteristics into account. Ethics approval was obtained from the Ethics Committee of the Portuguese Institute of Oncology of Porto (Ref. CES 89/017) and by the Portuguese Data Protection Authority (Authorisation 3478/2017). The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent was obtained from all participants after the project's aims and procedures had been fully explained by a member of the research team. Not applicable

Mixed carbon nanomaterial/epoxy resin for electrically conductive adhesives

The increasing complexity of printed circuit boards (PCBs) due to miniaturization, increased the density of electronic components, and demanding thermal management during the assembly triggered the research of innovative solder pastes and electrically conductive adhesives (ECAs). Current commercial ECAs are typically based on epoxy matrices with a high load (>60%) of silver particles, generally in the form of microflakes. The present work reports the production of ECAs based on epoxy/carbon nanomaterials using carbon nanotubes (single and multi-walled) and exfoliated graphite, as well as hybrid compositions, within a range of concentrations. The composites were tested for morphology (dispersion of the conductive nanomaterials), electrical and thermal conductivity, rheological characteristics and deposition on a test PCB. Finally, the ECA’s shelf life was assessed by mixing all the components and conductive nanomaterials, and evaluating the cure of the resin before and after freezing for a time range up to nine months. The ECAs produced could be stored at −18 °C without affecting the cure reaction.This research was funded by the Portugal Incentive System for Research and Technological Development,Project in Co-Promotion n◦039479/2019 (Factory of the Future: Smart Manufacturing 2019–202

Elderly persons in a situation of dependence: informal caregiver stress and coping

Objective: Study the relationship between psychological (stress) and psychological (coping) of the informal caregiver of the elderly in a situation of dependence. Methods: Cross-sectional study involving a sample selected by convenience, of 110 informal caregivers of "Conselho de Faro", Portugal. Data was collected in the homes by application of four instruments to these caregivers (sociodemographic data, assessment of stress intensity; abbreviated scale of coping and Barthel's dependence assessment. Results: The coping strategies centered on the problem (Chi-square = 10.243, p <= 0.037) and on the medium (Chi-square = 9.574, p <= 0.048) were used by the informal caregivers of the more dependent elderly. However, strategies centered on the caregiver were those that generated less stress (beta = -0.378, p <= 0.000). Conclusion: The "coping strategies centered on the caregiver" are those that generate less perception of stress in the informal caregivers

Tapeworm Eggs in a 270 Million-Year-Old Shark Coprolite

Remains of parasites in vertebrates are rare from the Mesozoic and Paleozoic. Once most parasites that live in - or pass through - the gastrointestinal tract of vertebrates, fossil feces (coprolites) or even intestinal contents (enterolites) can eventually preserve their remains. Here we announce the discovery of a spiral shark coprolite from the Paleozoic bearing a cluster of 93 small oval-elliptical smooth-shelled structures, interpreted as eggs of a tapeworm. The eggs were found in a thin section of an elasmobranch coprolite. Most of the eggs are filled by pyrite and some have a special polar swelling (operculum), suggesting they are non-erupted eggs. One of the eggs contains a probable developing larva. The eggs are approximately 145-155 mu m in length and 88-100 mu m in width and vary little in size within the cluster. The depositional and morphological features of the eggs closely resemble those of cestodes. Not only do the individual eggs have features of extant tapeworms, but their deposition all together in an elongate segment is typical to modern tapeworm eggs deposited in mature segments (proglottids). This is the earliest fossil record of tapeworm parasitism of vertebrates and establishes a timeline for the evolution of cestodes. This discovery shows that the fossil record of vertebrate intestinal parasites is much older than was hitherto known and that the interaction between tapeworms and vertebrates occurred at least since the Middle-Late Permian

DORMANCY OF SEEDS AND PLANTS PRODUCTION OF Dimorphandra mollis Benth.

Dimorphandra mollis Benth. \ue9 uma esp\ue9cie florestal nativa, encontrada nos biomas Cerrado e Caatinga, de grande import\ue2ncia em fun\ue7\ue3o de sua utilidade econ\uf4mica e ecol\uf3gica, o que justifica a exist\ueancia de programas de produ\ue7\ue3o de mudas. Este trabalho teve por objetivo estudar metodologias eficientes para supera\ue7\ue3o da dorm\ueancia das sementes e avaliar, em viveiro florestal, os efeitos de diferentes substratos e da fertiliza\ue7\ue3o sobre o crescimento inicial das mudas. Foram realizados os seguintes tratamentos para supera\ue7\ue3o de dorm\ueancia: T1 - testemunha (sementes sem escarifica\ue7\ue3o); T2 - escarifica\ue7\ue3o manual com lixa no50; T3 - imers\ue3o em \ue1gua a 80\ub0C e (T4) a 100\ubaC at\ue9 atingir a temperatura ambiente; T5 - fervura em \ue1gua a 100\ubaC durante 10, (T6) 30 e (T7) 60 segundos; T8 - escarifica\ue7\ue3o qu\uedmica com \ue1cido sulf\ufarico durante 20, (T9) 30 e (T10) 40 minutos. Para a produ\ue7\ue3o de mudas, o delineamento experimental adotado foi o inteiramente casualizado, em arranjo fatorial 4 x 2 (quatro substratos: Tropstrato\uae puro, e os demais: Tropstrato\uae, p\uf3 de coco e vermiculita com composto org\ue2nico; sem e com fertiliza\ue7\ue3o). Os melhores resultados para a supera\ue7\ue3o da dorm\ueancia s\ue3o obtidos com a escarifica\ue7\ue3o manual com lixa para metal n\uba50 ou fervura em \ue1gua durante 10 segundos. O p\uf3 de coco e a vermiculita, combinados com composto org\ue2nico, s\ue3o bons substratos para produ\ue7\ue3o de mudas de Dimorphandra mollis.Dimorphandra mollis Benth. is an important native forest species coming from Cerrado and Caatinga due to its economical and ecological use, what justifies the existence of programs of seedling production. This paper aimed to study the efficient methodology to overcome dormancy in seeds and to evaluate, in natural nursery, the effects of distinct substrates and the fertilization on the initial growth of plants. The following treatments applied: T1 - control (seeds whithout scarification); T2 \u2013 manual scarification with sandpaper number 50; T3 - immersion in water at 80 and (T4) at 100\ubaC; T5 - boil in water at 100\ubaC for 10, (T6) 30 and (T7) 60 seconds; T8 - chemical scarification with sulfuric acid for 20, (T9) 30 and (T10) 40 minutes. For the seedling production, the experiment was arranged in 4 x 2 factorial, complete randomized design (4 substrates: Tropstrato\uae pure, and the others: Tropstrato\uae, coconut fiber and vermiculite with organic compost; without and with fertilization). The best results for overcoming dormancy are obtained with the manual scarification with sandpaper n\uba50 or boil in water at 100\ubaC for 10 seconds. The coconut fiber and the vermiculite with organic compost are good substrates for the seedling production of Dimorphandra mollis

Contaminações difusas em água freática e nos ecossistemas nas microbacias pareadas dos Igarapés Cumaru e São João.

As contaminações subterrâneas podem ter origens diversas, dentre elas, as de origem agrícola e pecuária classificadas em inorgânicas (fertilizantes), orgânicas (pesticidas) e biológicas (bactérias e vírus). Foram monitorados o íon nitrato (NO3-) e os coliformes totais em poços de 8 m a 17 m em seis classes de uso da terra - vegetação ripária, sistemas agroflorestais (SAFs), capoeira (regeneração de até 20 anos), agricultura com derruba e queima, agricultura sem queima e pastagem - presentes nas Bacias dos Igarapés Cumaru (1.850 ha) e São João (1.330 ha) em 2014, nos meses de fevereiro a julho para nitrato, e de abril a dezembro para coliformes totais. As amostras de água para análise de nitrato foram preservadas com 10 mg de timol em frascos de 250 ml de polietileno, após filtração através de membranas de policarbonato, até realização de análise em cromatógrafo de íons DX 120 Dionex (limite de detecção de 0,90 mg.L-1). As amostras para análise de coliformes totais foram coletadas, refrigeradas a 4 °C e analisadas no mesmo dia utilizando o método do número (NMP/100ml) de microrganismos no substrato cromogênico Collilert/Quanti-Tray® da Idexx Laboratories, Inc. No agroecossistema de agricultura com derruba e queima, na Bacia do Cumaru, durante o período chuvoso, foram encontradas as maiores concentrações de NO3- (49,63 15,88 mg L-1 e 15,88 mg L-1, respectivamente) em março (423 mm de chuva) e abril (553 mm de chuva). A queima recente na área nesses meses pode ter propiciado uma maior lixiviação deste íon, adicionando-se a prováveis infiltrações originadas de fossas a céu aberto. Os valores encontrados neste caso, estão acima dos valores permitidos para águas subterrâneas segundo a Resolução CONAMA n°396, no valor de 10 mg.L-1, para qualquer uso preponderante da água. Entretanto, na Microbacia do Igarapé São João os valores de nitrato foram de menor grandeza, porém mais altos na agricultura com derruba e queima, em especial nos mesmos meses de março e abril, correspondendo a 3,51 mg.L-1 e 3,82 mg.L-1, respectivamente. A presença de coliformes totais, por sua vez, se evidenciaram nos meses de abril, maio, agosto e setembro, nas classes de agricultura com derruba e queima, agricultura sem queima e pastagem na Bacia do Cumaru, e de agricultura com derruba e queima, agricultura sem queima e capoeira na Bacia do Igarapé São João, ultrapassando 8000 micro-organismos por 100 mL, valor este acima do estipulado pela mesma Resolução citada acima. A existência de fossas a céu aberto ao redor das áreas monitoradas e depósitos de lixo próximos aos poços provavelmente explicam a contaminação difusa da água freática nos sistemas de agricultura com derruba e queima, agricultura sem queima e capoeira. Com relação a pastagem na Bacia do Cumaru, apesar de menor relação de número de cabeças de gado por área, comparada a pastagem em São João, o nível de água médio anual do poço é mais baixo (5,6 m), fato que deve ter ocasionado maior contaminação por coliformes do que na pastagem em São João. A forma de como está sendo manejado o gado e as características da paisagem na região também influenciam na contaminação de coliformes fecais, inclusive E. coli. Ressalta-se que os poços foram instalados em terrenos com pequenos declives, esperando-se portanto maior contaminação nas áreas mais baixas onde se localizam os igarapés amplamente utilizado pelos agricultores familiares residentes nas duas bacias estudadas

Carbono orgânico dissolvido na precipitação, solução de solo, água freática, e água fluvial nas microbacias dos igarapés São João e Cumaru sob diferentes usos da terra.

Editores técnicos: Balbina Maria Araújo Soriano, Carlos Roberto Padovani, Lineu Neiva Rodrigues, Marcia Divina de Oliveira, Suzana Maria Salis

Control of prostate cancer associated with withdrawal of a supplement containing folic acid, L-methyltetrahydrofolate and vitamin B12: a case report

<p>Abstract</p> <p>Introduction</p> <p>This is the first report of possible direct stimulation of hormone-resistant prostate cancer or interference of docetaxel cytotoxicity of prostate cancer in a patient with biochemical relapse of prostatic-specific antigen. This observation is of clinical and metabolic importance, especially at a time when more than 80 countries have fortified food supplies with folic acid and some contemplate further fortification with vitamin B₁₂.</p> <p>Case presentation</p> <p>Our patient is a 71-year-old Caucasian man who had been diagnosed in 1997 with prostate cancer, stage T1c, and Gleason score 3+4 = 7. His primary treatment included intermittent androgen deprivation therapy including leuprolide + bicalutamide + deutasteride, ketoconazole + hydrocortisone, nilandrone and flutamide to resistance defined as biochemical relapse of PSA. While undergoing docetaxel therapy to treat a continually increasing prostate-specific antigen level, withdrawal of 10 daily doses of a supplement containing 500 μg of vitamin B₁₂as cyanocobalamin, as well as 400 μg of folic acid as pteroylglutamic acid and 400 μg of L-5-methyltetrahydrofolate for a combined total of 800 μg of mixed folates, was associated with a return to a normal serum prostatic-specific antigen level.</p> <p>Conclusion</p> <p>This case report illustrates the importance of the effects of supplements containing large amounts of folic acid, L-5-methyltetrahydrofolate, and cyanocobalamin on the metabolism of prostate cancer cells directly and/or B vitamin interference with docetaxel efficacy. Physicians caring for patients with prostate cancer undergoing watchful waiting, hormone therapy, and/or chemotherapy should consider the possible acceleration of tumor growth and/or metastasis and the development of drug resistance associated with supplement ingestion. We describe several pathways of metabolic and epigenetic interactions that could affect the observed changes in serum levels of prostate-specific antigen.</p