Psychometric validation of the Spanish version of the Expanded Prostate Cancer Index Composite-26.

PURPOSE: To assess the validity, reliability, and responsiveness of the Spanish version of the Expanded Prostate cancer Index Composite (EPIC) with 26 items. METHODS: Multicentric longitudinal study of patients diagnosed with localized or locally advanced prostate cancer (any T, any N, M0) treated with active surveillance, surgery, external radiotherapy, or brachytherapy. The EPIC-50 was administered initially to the cohort (n = 324 patients), until it was replaced in November 2019 by the EPIC-26 (n = 543), in both groups before treatment and 12 months after. We assessed confirmatory factor analysis (CFA), reliability with Cronbach's alpha coefficient, criterion validity with the intraclass correlation coefficient (ICC), and responsiveness by testing a priori hypotheses on deterioration effect size (ES). RESULTS: The CFA confirmed the five-domain structure of the EPIC-26 proposed by the original instrument (comparative fit index = 0.95). The agreement between EPIC-50 (gold standard) and EPIC-26 domains was excellent (ICC > 0.90). Cronbach's alpha was > 0.7 in almost all domains, and the floor effect was near zero, although ceiling effect was higher than 50% in urinary incontinence and bowel domains. Hypothesized changes between before and 12 months after treatment were confirmed: ES > 0.8 in both urinary incontinence and sexual domains among patients who underwent surgery; and ES ranging 0.44-0.48 for bowel and sexual domains in patients treated with external radiotherapy. CONCLUSION: The Spanish version of the EPIC-26 has demonstrated adequate metric properties, similar to those of the original version, with acceptable goodness-of-fit indices, good criterion validity, reliability, and responsiveness to detect changes after radical prostatectomy or external radiotherapy.

Bone health and therapeutic agents in advanced prostate cancer.

Prostate cancer is the most frequent genitourinary tumor worldwide. Maintaining an optimum bone health throughout the natural course of prostate cancer is an important aspect in the management of this disease, particularly in this at risk population of older and frail patients who experience bone loss related to androgen-deprivation therapy (ADT) and/or patients who develop bone metastases. The number of treatment options for advanced prostate cancer that combine ADT with docetaxel, new hormonal agents and/or radiotherapy has increased substantially in recent years. Bisphosphonates and other bone targeted agents such as denosumab have shown an improvement in bone mineral density and are suited for patients with treatment-related osteoporosis and/or bone metastases with an increased risk of skeletal-related events (SREs). In this context, the aim of this review is to analyse key aspects of bone health and therapies that can prevent the occurrence of SREs throughout the clinical course of prostate cancer, and how to combine them with new available treatments in this setting.

Tritordeum: a novel cereal for food processing with good acceptability and significant reduction in gluten immunogenic peptides in comparison with wheat.

BACKGROUND: Tritordeum is a novel cereal obtained from the hybridization between durum wheat and a wild barley. This study evaluates acceptance, digestibility and immunotoxic properties of tritordeum, a novel cereal for food processing. Nineteen healthy volunteers participated in a study with different diets to compare tritordeum bread with wheat and gluten-free breads. RESULTS: Tritordeum breads had a similar acceptance to the wheat bread usually consumed, and the acceptance was significantly higher than the gluten-free bread and standardized wheat bread supplied in the study. There was no evidence for gastrointestinal symptoms among volunteers during the study. The reductions in the numbers of immunogenic epitopes in tritordeum in comparison with wheat were 78% for α-gliadins, 57% for γ-gliadins and 93% for ω-gliadins. The analysis of gluten immunogenic peptides (GIP) in stool samples showed a significantly lower excretion in the tritordeum ingestion phase than in the wheat ingestion phase. CONCLUSIONS: These results suggest that tritordeum may be an option of interest for general food processing, and especially for those who want to reduce their intake of gluten. However, it is not suitable for celiac disease sufferers as it contains gluten. © 2017 Society of Chemical Industry.

Profilaxis antimicrobiana en rotura prematura de membranas en los hospitales Manuel Nuñez Butrón de Puno y Carlos Monge Medrano de Juliaca, 1997

Se realizó un ensayo clínico controlado, prospectivo, longitudinal del 1 de febrero al 22 de julio de 1997 en el hospital Manuel Núñez Butrón y Carlos Monge Medrano de Juliaca con la hipótesis de que el uso de profilaxis antimicrobiana en RPM no modifica la incidencia de infección materno-neonatal. Se dieron los siguientes criterios de inclusión: Paciente diagnosticada. Paciente que permanezca hospitalizada desde el momento del diagnóstico hasta por lo menos 3 días después del parto. Paciente con diagnóstico de RPM que no esté recibiendo tratamiento antibiótico de RPM que no esté recibiendo tratamiento antibiótico en el momento de la hospitalización y los siguientes criterios de exclusión: pacientes que ingresan con diagnóstico de corioamnionitis, que estén tomando medicamentos inmunosupresores, con antecedentes de cardiopatía reumática, con diabetes insulinodependientes, con prótesis valvular cardiaca, sometidas a varias exploraciones pélvicas desde que se produjo la RPM, que por la RPM u otro motivo esté recibiendo antibióticos. En dicho periódo de tiempo se produjeron 1.283 partos de los cuales 130 presentaron RPM, representando una frecuencia de 10.13 por ciento. En forma aleatoria se les dividió en un grupo de estudio (64) y un grupo control (66), los del primer grupo recibieron amoxicilina a razón de 500 mg. cada 8 hrs. vía oral desde su ingreso. Ambos grupos fueron seguidos tras la pesquisa de infección materno-neonatal en base al cuadro clínico y en caso necesario con exámenes auxiliares respectivos. Se encontraron 28 casos de infección en el grupo de estudio vs 17 en el grupo control. En cuanto a la infección materna: 12 en el grupo de estudio y 8 en el grupo control. Finalmente 7 infecciones neonatales en el grupo de estudio vs 3 en el grupo control. La conclusión fue: la profilaxis antimicrobiana no fue efectiva, debido a que su aplicación no modificó el desarrollo de infección en relación al grupo control. Se dieron las siguientes recomendaciones: 1. Que se realicen estudios similares en cada centro hospitalario para ver la conveniencia o no de la profilaxis antimicrobiana en los protocolosde manejo. 2. Realizar estudios similares en gestaciones de 32 o menos semanas, en cuyo caso podría estar indicada la profilaxis antimicrobiana para alargar el período de latencia. 3. De ser posible realizar cultivos para ver que tipo de gérmenes patógenos prevalecen y de ser necesario dar un tratamiento antibiótico más específico.