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. © 2013 Leonardo Oliveira Reis et al.Pinthus, J.H., Witkos, M., Fleshner, N.E., Sweet, J., Evans, A., Jewett, M.A., Krahn, M., Trachtenberg, J., Prostate Cancers Scored as Gleason 6 on Prostate Biopsy are Frequently Gleason 7 Tumors at Radical Prostatectomy: Implication on Outcome (2006) Journal of Urology, 176 (3), pp. 979-984. , DOI 10.1016/j.juro.2006.04.102, PII S0022534706011645King, C.R., McNeal, J.E., Gill, H., Presti Jr., J.C., Extended prostate biopsy scheme improves reliability of Gleason grading: Implications for radiotherapy patients (2004) International Journal of Radiation Oncology Biology Physics, 59 (2), pp. 386-391. , DOI 10.1016/j.ijrobp.2003.10.014, PII S0360301603021187Chun, F.K., Steuber, T., Erbersdobler, A., Currlin, E., Walz, J., Schlomm, T., Haese, A., Karakiewicz, P.I., Development and internal validation of a nomogram predicting the probability of prostate cancer Gleason sum upgrading between biopsy and radical prostatectomy pathology (2006) European Urology, 49 (5), pp. 820-826. , 2-s2.0-33645760008 10.1016/j.eururo.2005.11.007Gonzalgo, M.L., Bastian, P.J., Mangold, L.A., Trock, B.J., Epstein, J.I., Walsh, P.C., Partin, A.W., Relationship between primary Gleason pattern on needle biopsy and clinicopathologic outcomes among men with Gleason score 7 adenocarcinoma of the prostate (2006) Urology, 67 (1), pp. 115-119. , DOI 10.1016/j.urology.2005.07.037, PII S0090429505011337Kvåle, R., Møller, B., Wahlqvist, R., Fosså, S.D., Berner, A., Busch, C., Kyrdalen, A.E., Halvorsen, O.J., Concordance between Gleason scores of needle biopsies and radical prostatectomy specimens: A population-based study (2009) BJU International, 103 (12), pp. 1647-1654. , 2-s2.0-67149126604 10.1111/j.1464-410X.2008.08255.xBillis, A., Magna, L.A., Ferreira, U., Correlation between tumor extent in radical prostatectomies and preoperative PSA, histological grade, surgical margins, and extraprostatic extension: Application of a new practical method for tumor extent evaluation (2003) International Braz J Urol, 29 (2), pp. 113-120Epstein, J.I., Allsbrook Jr., W.C., Amin, M.B., Egevad, L.L., Bastacky, S., Lopez Beltran, A., Berner, A., Young, R.H., The 2005 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma (2005) American Journal of Surgical Pathology, 29 (9), pp. 1228-1242. , DOI 10.1097/01.pas.0000173646.99337.b1Cookson, M.S., Aus, G., Burnett, A.L., Canby-Hagino, E.D., D'Amico, A.V., Dmochowski, R.R., Eton, D.T., Thompson, I., Variation in the Definition of Biochemical Recurrence in Patients Treated for Localized Prostate Cancer: The American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel Report and Recommendations for a Standard in the Reporting of Surgical Outcomes (2007) Journal of Urology, 177 (2), pp. 540-545. , DOI 10.1016/j.juro.2006.10.097, PII S0022534706028576Colleselli, D., Pelzer, A.E., Steiner, E., Ongarello, S., Schaefer, G., Bartsch, G., Schwentner, C., Upgrading of Gleason score 6 prostate cancers on biopsy after prostatectomy in the low and intermediate tPSA range (2010) Prostate Cancer and Prostatic Diseases, 13 (2), pp. 182-185. , 2-s2.0-77952543434 10.1038/pcan.2009.54Montironi, R., Mazzucchelli, R., Scarpelli, M., Lopez-Beltran, A., Mikuz, G., Algaba, F., Boccon-Gibod, L., Prostate carcinoma II: Prognostic factors in prostate needle biopsies (2006) BJU International, 97 (3), pp. 492-497. , 2-s2.0-33645000123 10.1111/j.1464-410X.2006.05973.xFitzsimons, N.J., Presti Jr., J.C., Kane, C.J., Terris, M.K., Aronson, W.J., Amling, C.L., Freedland, S.J., Is Biopsy Gleason Score Independently Associated With Biochemical Progression Following Radical Prostatectomy After Adjusting for Pathological Gleason Score? (2006) Journal of Urology, 176 (6), pp. 2453-2458. , DOI 10.1016/j.juro.2006.08.014, PII S0022534706019665Müntener, M., Epstein, J.I., Hernandez, D.J., Gonzalgo, M.L., Mangold, L., Humphreys, E., Walsh, P.C., Nielsen, M.E., Prognostic significance of Gleason score discrepancies between needle biopsy and radical prostatectomy (2008) European Urology, 53 (4), pp. 767-776. , 2-s2.0-39549100371 10.1016/j.eururo.2007.11.016Serkin, F.B., Soderdahl, D.W., Cullen, J., Chen, Y., Hernandez, J., Patient risk stratification using Gleason score concordance and upgrading among men with prostate biopsy Gleason score 6 or 7 (2010) Urologic Oncology, 28 (3), pp. 302-307. , 2-s2.0-77951607370 10.1016/j.urolonc.2008.09.030Freedland, S.J., Kane, C.J., Amling, C.L., Aronson, W.J., Terris, M.K., Presti Jr., J.C., Upgrading and Downgrading of Prostate Needle Biopsy Specimens: Risk Factors and Clinical Implications (2007) Urology, 69 (3), pp. 495-499. , DOI 10.1016/j.urology.2006.10.036, PII S0090429506024502Sved, P.D., Gomez, P., Manoharan, M., Kim, S.S., Soloway, M.S., Limitations of biopsy Gleason grade: Implications for counseling patients with biopsy Gleason score 6 prostate cancer (2004) Journal of Urology, 172 (1), pp. 98-102. , DOI 10.1097/01.ju.0000132135.18093.d6Ozden, C., Oztekin, C.V., Ugurlu, O., Gokkaya, S., Yaris, M., Memis, A., Correlation between upgrading of prostate biopsy and biochemical failure and unfavorable pathology after radical prostatectomy (2009) Urologia Internationalis, 83 (2), pp. 146-150. , 2-s2.0-70349276002 10.1159/000230014Hong, S.K., Han, B.K., Lee, S.T., Kim, S.S., Min, K.E., Jeong, S.J., Jeong, H., Lee, S.E., Prediction of Gleason score upgrading in low-risk prostate cancers diagnosed via multi (≥12)-core prostate biopsy (2009) World Journal of Urology, 27 (2), pp. 271-276. , 2-s2.0-63649106008 10.1007/s00345-008-0343-3Dong, F., Jones, J.S., Stephenson, A.J., Magi-Galluzzi, C., Reuther, A.M., Klein, E.A., Prostate cancer volume at biopsy predicts clinically significant upgrading (2008) Journal of Urology, 179 (3), pp. 896-900. , 2-s2.0-39149109597 10.1016/j.juro.2007.10.060Liu, J.J., Brooks, J.D., Ferrari, M., Nolley, R., Presti Jr., J.C., Small prostate size and high grade disease-biology or artifact? (2011) Journal of Urology, 185 (6), pp. 2108-2111. , 2-s2.0-79955796559 10.1016/j.juro.2011.02.053Ngo, T.C., Conti, S.L., Shinghal, R., Presti Jr., J.C., Prostate size does not predict high grade cancer (2012) Journal of Urology, 187 (2), pp. 477-480. , 2-s2.0-84855603087 10.1016/j.juro.2011.10.042Rahmouni, A., Yang, A., Tempany, C.M., Frenkel, T., Epstein, J., Walsh, P., Leichner, P.K., Zerhouni, E., Accuracy of in-vivo assessment of prostatic volume by MRI and transrectal ultrasonography (1992) Journal of Computer Assisted Tomography, 16 (6), pp. 935-940. , 2-s2.0-0026481087Varma, M., Morgan, J.M., The weight of the prostate gland is an excellent surrogate for gland volume (2010) Histopathology, 57 (1), pp. 55-58. , 2-s2.0-77954546284 10.1111/j.1365-2559.2010.03591.

Mechanisms Predisposing Penile Fracture And Long-term Outcomes On Erectile And Voiding Functions

Purpose. To determine the mechanisms predisposing penile fracture as well as the rate of long-term penile deformity and erectile and voiding functions. Methods. All fractures were repaired on an emergency basis via subcoronal incision and absorbable suture with simultaneous repair of eventual urethral lesion. Patients' status before fracture and voiding and erectile functions at long term were assessed by periodic follow-up and phone call. Detailed history included cause, symptoms, and single-question self-report of erectile and voiding functions. Results. Among the 44 suspicious cases, 42 (95.4%) were confirmed, mean age was 34.5 years (range: 18-60), mean follow-up 59.3 months (range 9-155). Half presented the classical triad of audible crack, detumescence, and pain. Heterosexual intercourse was the most common cause (28 patients, 66.7%), followed by penile manipulation (6 patients, 14.3%), and homosexual intercourse (4 patients, 9.5%). "Woman on top" was the most common heterosexual position (n = 14, 50%), followed by "doggy style" (n = 8, 28.6%). Four patients (9.5%) maintained the cause unclear. Six (14.3%) patients had urethral injury and two (4.8%) had erectile dysfunction, treated by penile prosthesis and PDE-5i. No patient showed urethral fistula, voiding deterioration, penile nodule/curve or pain. Conclusions. "Woman on top" was the potentially riskiest sexual position (50%). Immediate surgical treatment warrants long-term very low morbidity. © 2014 Leonardo O. Reis et al.Kamdar, C., Mooppan, U.M.M., Kim, H., Gulmi, F.A., Penile fracture: Preoperative evaluation and surgical technique for optimal patient outcome (2008) BJU International, 102 (11), pp. 1640-1644. , 2-s2.0-56649083856 10.1111/j.1464-410X.2008.07902.xKramer, A.C., Penile fracture seems more likely during sex under stressful situations (2011) Journal of Sexual Medicine, 8 (12), pp. 3414-3417. , 2-s2.0-82955237445 10.1111/j.1743-6109.2011.02461.xSawh, S.L., O'Leary, M.P., Ferreira, M.D., Berry, A.M., Maharaj, D., Fractured penis: A review (2008) International Journal of Impotence Research, 20 (4), pp. 366-369. , 2-s2.0-48249147767 10.1038/ijir.2008.12Amit, A., Arun, K., Bharat, B., Navin, R., Sameer, T., Shankar, D.U., Penile fracture and associated urethral injury: Experience at a tertiary care hospital (2013) Canadian Urological Association Journal, 7, pp. E168-E170Moslemi, M.K., Evaluation of epidemiology, concomitant urethral disruption and seasonal variation of penile fracture: A report of 86 cases (2013) Canadian Urological Association Journal, 7, pp. E572-E575Hatzichristodoulou, G., Dorstewitz, A., Gschwend, J.E., Herkommer, K., Zantl, N., Surgical management of penile fracture and long-term outcome on erectile function and voiding (2013) The Journal of Sexual Medicine, 10, pp. 1424-1430Nomura, J.T., Sierzenski, P.R., Ultrasound diagnosis of penile fracture (2010) Journal of Emergency Medicine, 38 (3), pp. 362-365. , 2-s2.0-77949914168 10.1016/j.jemermed.2008.03.010Ash, A., Miller, J., Preston, D., Point-of-care ultrasound used to exclude penile fracture (2012) Critical Ultrasound Journal, 417Beysel, M., Tekin, A., Gürdal, M., Yücebaş, E., Dengör, F., Evaluation and treatment of penile fractures: Accuracy of clinical diagnosis and the value of corpus cavernosography (2002) Urology, 60 (3), pp. 492-496. , 2-s2.0-0036753673 10.1016/S0090-4295(02)01813-7Gamal, W.M., Osman, M.M., Hammady, A., Aldahshoury, M.Z., Hussein, M.M., Saleem, M., Penile fracture:;ong-term results of surgical and conservative management (2011) Journal of Trauma, 71 (2), pp. 491-493. , 2-s2.0-80051783736 10.1097/TA.0b013e318209311

Anatomical Features Of The Urethra And Urinary Bladder Catheterization In Female Mice And Rats. An Essential Translational Tool [características Anatômicas Da Cateterização Da Uretra E Bexiga De Camundongos E Ratos Fêmeas. Instrumento Essencial Na Pesquisa Pré Clínica]

PURPOSE: To present fundamental anatomical aspects and technical skills necessary to urethra and urinary bladder catheterization in female mice and rats. METHODS: Urethral and bladder catheterization has been widely utilized for carcinogenesis and cancer research and still remains very useful in several applications: from toxicological purposes as well as inflammatory and infectious conditions to functional aspects as bladder dynamics and vesicoureteral reflux, among many others. RESULTS: Animal models are in the center of translational research and those involving rodents are the most important nowadays due to several advantages including human reproducibility, easy handling and low cost. CONCLUSIONS: Although technical and anatomical pearls for rodent urethral and bladder access are presented as tackles to the advancement of lower urinary tract preclinical investigation in a broaden sight, restriction to female animals hampers the male microenvironment, demanding future advances.26SUPPL. 2106110Reis, L.O., Fávaro, W.J., Ferreira, U., Billis, A., Fazuoli, M.G., Cagnon, V.H., Evolution on experimental animal model for upper urothelium carcinogenesis (2010) World J Urol, 28, pp. 499-505Mulder, G.J., Scholtens, E., Meijer, D.K., Collection of metabolites in bile and urine from the rat (1981) Methods Enzymol, 77, pp. 21-30Krinke, G.J., (2000) The Laboratory Rat, , San Diego, CA: Academic PressPhillips, J.I., Davies, I., The comparative morphology of the bladder and urethra in young and old female C57BL/Icrfat mice (1980) Exp Geront, 15, pp. 551-562Andersson, K.E., Arner, A., Urinary bladder contraction and relaxation: Physiology and pathophysiology (2004) Physiol Rev, 84, pp. 935-986Reis, L.O., Pereira, T.C., Favaro, W.J., Cagnon, V.H., Lopes-Cendes, I., Ferreira, U., Experimental animal model and RNA interference: A promising association for bladder cancer research (2009) World J Urol, 27, pp. 353-361Marini, R.P., Esteves, M.I., Fox, J.G., A technique for catheterization of the urinary bladder in the ferret (1994) Lab Anim, 28, pp. 155-15

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. How Many Men Get Prostate Cancer?, , http://www.cancer.org/acs/groups/cid/documents/webcontent/003072-pdf.pdfRabbani, F., Stroumbakis, N., Kava, B.R., Cookson, M.S., Fair, W.R., Incidence and clinical significance of false-negative sextant prostate biopsies (1998) Urologe - Ausgabe A, 37 (6), p. 660Thompson, I.M., Pauler, D.K., Goodman, P.J., Tangen, C.M., Lucia, M.S., Parnes, H.L., Minasian, L.M., Coltman Jr., C.A., Prevalence of prostate cancer among men with a prostate-specific antigen level ≤4.0 ng per milliliter (2004) New England Journal of Medicine, 350 (22), pp. 2239-2246+2321. , DOI 10.1056/NEJMoa031918Ahrens, M.J., Bertin, P.A., Vonesh, E.F., Meade, T.J., Catalona, W.J., Georganopoulou, D., PSA enzymatic activity: A new biomarker for assessing prostate cancer aggressiveness (2013) Prostate, 73 (16), pp. 1731-1737. , 10.1002/pros.22714Rifkin, M.D., Alexander, A.A., Pisarchick, J., Matteucci, T., Palpable masses in the prostate: Superior accuracy of US-guided biopsy compared with accuracy of digitally guided biopsy (1991) Radiology, 179 (1), pp. 41-42. , 2-s2.0-0025969342Loeb, S., Vellekoop, A., Ahmed, H.U., Catto, J., Emberton, M., Nam, R., Rosario, D.J., Lotan, Y., Systematic review of complications of prostate biopsy (2013) European Urology, 64 (6), pp. 876-892. , 10.1016/j.eururo.2013.05.049Shen, P.-F., Zhu, Y.-C., Wei, W.-R., Li, Y.-Z., Yang, J., Li, Y.-T., Li, D.-M., Zeng, H., The results of transperineal versus transrectal prostate biopsy: A systematic review and meta-analysis (2012) Asian Journal of Andrology, 14 (2), pp. 310-315. , 2-s2.0-84858059084 10.1038/aja.2011.130Kravchick, S., Cytron, S., Mamonov, A., Peled, R., Linov, L., Effect of short-term dutasteride therapy on prostate vascularity in patients with benign prostatic hyperplasia: A pilot study (2009) Urology, 73 (6), pp. 1274-1278. , 2-s2.0-67349198057 10.1016/j.urology.2008.08.461Liao, C.-H., Guh, J.-H., Chueh, S.-C., Yu, H.-J., Anti-angiogenic effects and mechanism of prazosin (2011) Prostate, 71 (9), pp. 976-984. , 2-s2.0-79955575350 10.1002/pros.21313Keledjian, K., Borkowski, A., Kim, G., Isaacs, J.T., Jacobs, S.C., Kyprianou, N., Reduction of human prostate tumor vascularity by the α1- adrenoceptor antagonist terazosin (2001) Prostate, 48 (2), pp. 71-78. , DOI 10.1002/pros.1083Angulo, J., Cuevas, P., Fernández, A., La Fuente, J.M., Allona, A., Moncada, I., De Tejada, I.S., Tadalafil enhances the inhibitory effects of tamsulosin on neurogenic contractions of human prostate and bladder neck (2012) The Journal of Sexual Medicine, 9 (9), pp. 2293-2306. , 10.1111/j.1743-6109.2012.02821.xReis, L.O., Zani, E.L., Alonso, J.C., Simões, F.A., Rejowski, R.F., Ferreira, U., Does the criterion for prostate biopsy indication impact its accuracy? A prospective population-based outpatient clinical setting study (2011) Actas Urologicas Espanolas, 35 (1), pp. 10-14. , 2-s2.0-79151485525 10.1016/j.acuro.2010.06.011Junqueira, V.C.N., Zogbi, O., Cologna, A., Dos Reis, R.B., Tucci, Jr.S., Reis, L.O., Westphalen, A.C., Muglia, V.F., Is a visible (hypoechoic) lesion at biopsy an independent predictor of prostate cancer outcome? (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

Humeral chondrosarcoma associated with lung metastases in a young dog - case report

ABSTRACT Chondrosarcoma, an unusual malignant neoplasm, develops in cartilaginous tissue and presents low rate of metastasis, mainly affecting the axial skeleton from the adult to senile dogs. In the face of unusual occurrence of chondrosarcoma in the long bones of young dogs, the present report aimed to describe it in the right humerus of a two-and-a-half-year-old Siberian Husky, attended at the Veterinary Hospital of the University of Franca, with limping of the right thoracic limb, for 20 days. The radiographic examination of the humerus showed bone lysis and periosteal proliferation. In the incisional biopsy, proliferation of atypical chondrocytes with diffuse distribution, interspersed with compact bone matrix, was observed. The amputation of the limb was performed, and the fragment histopathological analysis showed grade I chondrosarcoma. Periodic returns were made for neoplastic staging, and at 240 days after surgery lung metastases were detected, however, the tutor did not authorize chemotherapy and radiotherapy for financial reasons and due to the absence of respiratory symptoms so far (410 days after surgery). Although uncommon, chondrosarcoma can affect the long bones of young dogs, with clinical signs similar to other bone neoplasms, and, even with the radical limb amputation, can demonstrate systemic metastasis

Expanding indication of padeliporfin (WST11) vascular-targeted photodynamic therapy: results of prostate cancer Latin-American multicenter study

OBJECTIVES: To explore the proportion of patients with higher risk localized prostate cancer (PCa) that would become safely biopsy negative 12 months after non-thermal focal therapy with padeliporfin vascular-targeted photodynamic therapy (VTP). METHODS: Multicenter study in a scenario of prostate-specific antigen (PSA) ≤20ng/ml and variable PCa target volumes Gleason pattern 3 or low-volume secondary Gleason pattern 4, all patients received VTP, consisting of intravenous 4mg/kg padeliporfin activated by light-diffusing fibers in the prostate. The prostate was biopsied at baseline, months 6 and 12, PSA, patient-reported functional outcomes and quality of life (QoL) questionnaires were recorded at baseline, months 3, 6, and 12 and adverse events (AE) throughout the study. RESULTS: In the intention-to-treat population (n=81), the proportion of patients with negative biopsies at month 12 was 74% (60/81 patients; 95% CI: 63.1%,83.2%). In the per-protocol population, the proportion was 79% (58/73 patients; 95% CI: 68.4%,88.0%). Questionnaire results indicated a slight improvement in urinary function and limited deterioration in sexual function. No difference in QoL was observed over time. A total of 42/81 (52%) patients reported mild or moderate and 4 of 81 (4.9%) experienced serious AE, all resolved without sequelae. No phototoxicity, cardiovascular event, fistula or prolonged urinary incontinence, secondary cancer or death was reported. CONCLUSIONS: Results support the efficacy, safety, and QoL associated with padeliporfin focal treatment for low/intermediate risk localized PCa

Differentially expressed plasmatic microRNAs in Brazilian patients with Coronavirus disease 2019 (COVID-19): preliminary results

Background: Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is known that host microRNAs (miRNAs) can be modulated to favor viral infection or to protect the host. Herein, we report preliminary results of a study aiming at identifying differentially expressed plasmatic miRNAs in Brazilian patients with COVID-19. Methods and results: miRNAs were extracted from the plasma of eight patients with COVID-19 (four patients with mild COVID-19 and four patients with severe/critical COVID-19) and four healthy controls. Patients and controls were matched for sex and age. miRNA expression levels were detected using high-throughput sequencing. Differential miRNA expression and enrichment analyses were further evaluated. A total of 18 miRNAs were differentially expressed between patients with COVID-19 and controls. miR-4433b-5p, miR-6780b-3p, miR-6883-3p, miR-320b, miR-7111-3p, miR-4755-3p, miR-320c, and miR-6511a-3p were the most important miRNAs significantly involved in the PI3K/AKT, Wnt/β-catenin, and STAT3 signaling pathways. Moreover, 42 miRNAs were differentially expressed between severe/critical and mild patients with COVID-19. miR-451a, miR-101-3p, miR-185-5p, miR-30d-5p, miR-25-3p, miR-342-3p, miR-30e-5p, miR-150-5p, miR-15b-5p, and miR-29c-3p were the most important miRNAs significantly involved in the Wnt/β-catenin, NF-κβ, and STAT3 signaling pathways. Conclusions: If validated by quantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in a larger number of participants, the miRNAs identified in this study might be used as possible biomarkers for the diagnosis and severity of COVID-19