Prostate cancer screening: guidelines review and laboratory issues.

Background Prostate-specific antigen (PSA) remains as the most used biomarker in the detection of early prostate cancer (PCa). Clinical practice guidelines (CPGs) are produced to facilitate incorporation of evidence into clinical practice. This is particularly useful when PCa screening remains controversial and guidelines diverge among different medical institutions, although opportunistic screening is not recommended. Methods We performed a systematic review of guidelines about PCa screening using PSA. Guidelines published since 2008 were included in this study. The most updated version of these CPGs was used for the evaluation. Results Twenty-two guidelines were selected for review. In 59% of these guidelines, recommendations were graded according to level of evidence (n = 13), but only 18% of the guidelines provided clear algorithms (n = 4). Each CPG was assessed using a checklist of laboratory issues, including pre-analytical, analytical, and post-analytical factors. We found that laboratory medicine specialists participate in 9% of the guidelines reviewed (n = 2) and laboratory issues were frequently omitted. We remarked that information concerning the consequences of World Health Organization (WHO) standard in PSA testing was considered by only two of 22 CPGs evaluated in this study. Conclusions We concluded that the quality of PCa early detection guidelines could be improved properly considering the laboratory issues in their development.

Long-term follow-up of the corneal endothelium after pediatric cataract surgery.

PURPOSE: To evaluate the long-term effects on corneal endothelium after pediatric cataract surgery. METHODS: We conducted a cross-sectional study of 58 eyes operated for unilateral pediatric cataract with a mean age at the time of cataract surgery of 38.2 ± 41.6 months (range, 1-171 months) and a mean follow-up between cataract surgery and assessments of 149.6 ± 69.8 months (range, 30-319 months). Parameters that were studied were endothelial cell density, hexagonal cell percentage, and coefficient of variation of cell area. Parameters in the operated eyes were compared with the normal unoperated eyes. RESULTS: Regarding the endothelial cell density (Student t test, P = 0.000), there are statistically significant differences between groups (operated and unoperated eyes), with an average loss of 9.2% in the operated eyes. With the hexagonal cell percentage (Student t test, P = 0.508) and the coefficient of variation of cell area (Wilcoxon test, P = 0.595), there was an absence of statistically significant differences between the operated and unoperated eyes. CONCLUSIONS: Endothelial cell loss was 9.2%, and no difference was found in hexagonal cell percentage and coefficient of variation of cell area between the operated and unoperated eyes 12.5 years after unilateral pediatric cataract surgery.