Cryotherapy versus radical prostatectomy as a salvage treatment for radio-recurrent prostate cancer.

INTRODUCTION: The aim of this study is to compare outcomes of SRP (salvage radical prostatectomy) with SCAP (salvage cryoablation of the prostate) in local radio-recurrent PCa (prostate cancer) patients. MATERIALS AND METHODS: A retrospective analysis of a multicentric European Society of Uro-technology (ESUT) database was performed. Data on patients with local recurrent PCa after radiotherapy who underwent salvage treatment were collected. Patients and their respective disease characteristics, perioperative complications as well as oncological outcomes were then described. The treatment success rate was defined as PSA nadir < 0,4 ng/ml. Any complications were graded according to the modified Clavien system. A descriptive and comparative analysis was performed using SPSS software. RESULTS: 25 patients underwent SRP and 71 patients received SCAP. The mean follow-up was 24 months. The median PSA level before initial treatment was 8.3 (range 7-127) ng/ml. The success rates of SRP and SCAP were largely comparable (88% (22 patients) vs. 67.7% (48 patients), respectively, p = 0.216). The mean serum PSA levels at 12 months after salvage treatment were 1.2 ± 0.2 ng/mL vs. 0.25 ± 0.5 ng/mL, p > 0.05). During the follow-up period, only 3 (12%) patients in the SRP group had PSA recurrence compared with 21 patients (29.6%) in the SCAP group. The 5-year BRFS was similar (51,6% and 48,2%, p = 0,08) for SRP and SCAP respectively. The 5-year overall survival rate was 91.7%, and 89,7% (p = 0.669) and the 5-year cancer-specific survival was 91.7%, and 97,1% (p = 0.077), after SRP and SCAP respectively. No difference was found regarding the complications. CONCLUSIONS: Both SRP and SCAP should be considered as valid treatment options for patients with local recurrence of PCa after radiotherapy. SCAP has a potentially lower risk of morbidity and acceptable intermediate-term oncological efficacy, but a longer follow up and a higher number of patients is ideally needed to draw any long-term conclusions regarding the oncological data.

The Influence of the Soil Profile on the Formation of the Elemental Image of Grapes and Wine of the Cabernet Sauvignon Variety.

The features for assessing the authenticity of wines by region of origin are studied, based on the relationship between the mineral composition of the wine, the grapes, and the soil profile (0 to 160 cm) from the place of growth of Cabernet Sauvignon grapes. Soil, grape, and wine samples were taken from the territories of six vineyards in the Anapa district of Krasnodar Territory, Russia. Using the methods of ICP-OES, thermal, and X-ray phase analysis, the soils were differentiated into three groups, differing in mineralogical and mineral compositions. The soil samples of the first group contained up to 31% quartz, the second group up to 25% quartz and 19% mixed calcite, and the third group up to 32% calcite and 15% quartz. The formation of the elemental image of the grapes was studied, taking into account the total content and mobile forms of metals in the soil. The territorial proximity of the vineyards did not affect the extraction of elements from the soil into the grape berry, and the migration of metals for each territory was selective. According to the values of the biological absorption coefficient, the degree of transition of metals from the soil to a berry was estimated. For K, Ti, Zn, Rb, Cu, and Fe in all berries, the coefficient was higher than 1.00, which means that the berry extracts contained not only mobile-form, but also difficult-to-dissolve metal compounds. The migration of macro-components from the soil to the berry was low, and amounted to 6-7% for Ca, 0.8-3.0% for Na, and 25-70% for Mg of the concentration of their mobile forms. For all territories, the maximum correlation between metal concentrations in grapes and soil was observed for samples from a depth of 0-40 cm. The discriminant model based on concentrations of Rb, Al, K, Sr, Co, Na, Pb, Ca, and Ni showed the formation of clusters in the territories of vineyard cultivation. The developed model allow the problems of identifying wines by region to be solved with high accuracy, using their elemental image.

Plain language summary of the HIMALAYA study: tremelimumab and durvalumab for unresectable hepatocellular carcinoma (liver cancer).

WHAT IS THIS SUMMARY ABOUT?: This is a summary of results from a phase 3 clinical study called HIMALAYA. HIMALAYA looked at treatment with one dose of a medication called tremelimumab combined with multiple doses of a medication called durvalumab (the STRIDE regimen) or multiple doses of durvalumab alone. These treatments were compared with a medication called sorafenib in participants with unresectable hepatocellular carcinoma (HCC). HCC is a type of liver cancer that is difficult to treat because it is often diagnosed when it is unresectable, meaning it can no longer be removed with surgery. Sorafenib has been the main treatment for unresectable HCC since 2007. However, people who take sorafenib may experience side effects that can reduce their quality of life, so alternative medicines are being trialed. Tremelimumab and durvalumab are types of drugs called immunotherapies, and they both work in different ways to help the body's immune system fight cancer. WHAT WERE THE RESULTS OF THE STUDY?: Participants who took STRIDE lived longer than participants who took sorafenib, whilst participants who took durvalumab alone lived a similar length of time as participants who took sorafenib. Participants who took STRIDE or durvalumab had a lower relative risk of experiencing worsening in their quality of life than participants who took sorafenib. The side effects that participants who received STRIDE or durvalumab experienced were expected for these types of treatments and could mostly be managed. WHAT DO THE RESULTS OF THE STUDY MEAN?: Overall, STRIDE is more effective than sorafenib for people with unresectable HCC.

Study of the Magnesium Comenate Structure, Its Neuroprotective and Stress-Protective Activity.

The crystal structure and the biological activity of a new coordination compound of magnesium ions with comenic acid, magnesium comenate, was characterized and studied. Quantitative and qualitative analysis of the compound was investigated in detail using elemental X-ray fluorescent analysis, thermal analysis, IR-Fourier spectrometry, UV spectroscopy, NMR spectroscopy, and X-ray diffraction analysis. Based on experimental analytical data, the empirical formula of magnesium comenate [Mg(HCom)2(H2O)6]·2H2O was established. This complex compound crystallizes with eight water molecules, six of which are the hydration shell of the Mg2+ cation, and two more molecules bind the [Mg(H2O)6]2+ aquacation with ionized ligand molecules by intermolecular hydrogen bonds. The packing of molecules in the crystal lattice is stabilized by a branched system of hydrogen bonds with the participation of solvate water molecules and oxygen atoms of various functional groups of ionized ligand molecules. With regard to the biological activity of magnesium comenate, a neuroprotective, stress-protective, and antioxidant effect was established in in vitro and in vivo models. In in vitro experiments, magnesium comenate protected cerebellar neurons from the toxic effects of glutamate and contributed to the preservation of neurite growth parameters under oxidative stress caused by hydrogen peroxide. In animal studies, magnesium comenate had a stress-protective and antioxidant effect in models of immobilization-cold stress. Oral administration of magnesium comenate at a dose of 2 mg/kg of animal body weight for 3 days before stress exposure and for 3 days during the stress period led to a decrease in oxidative damage and normalization of the antioxidant system of brain tissues against the background of induced stress. The obtained results indicate the advisability of further studies of magnesium comenate as a compound potentially applicable in medicine for the pharmacological correction of conditions associated with oxidative and excitotoxic damage to nerve cells.

Can Rare Earth Elements Be Considered as Markers of the Varietal and Geographical Origin of Wines?

The possibility of establishing the varietal and territorial affiliation of wines by the content of rare earth elements (REE) in them was studied. ICP-OES and ICP-MS with subsequent chemometric processing of the results were applied to determine the elemental image of soils containing negligible REE amounts, grapes grown on these soils, and wine materials of Cabernet Sauvignon, Merlot, and Moldova varieties produced from these grapes. To stabilize and clarify wine materials, the traditional processing of wine materials with various types of bentonite clays (BT) was used, which turned out to be a source of REE in the wine material. Discriminant analysis revealed that the processed wine materials were homogeneous within one denomination and that those of different denominations were heterogeneous with respect to the content of REE. It was found that REE in wine materials were transferred from BT during the processing, and thus they can poorly characterize the geographical origin and varietal affiliation of wines. Analysis of these wine materials according to the intrinsic concentrations of macro- and microelements showed that they formed clusters according to their varietal affiliation. In terms of their influence on the varietal image of wine materials, REE are significantly inferior to macro- and microelements, but they enhance their influence to a certain extent when used together.

Cryo-EM reveals an asymmetry in a novel single-ring viral chaperonin.

Chaperonins are ubiquitously present protein complexes, which assist the proper folding of newly synthesized proteins and prevent aggregation of denatured proteins in an ATP-dependent manner. They are classified into group I (bacterial, mitochondrial, chloroplast chaperonins) and group II (archaeal and eukaryotic cytosolic variants). However, both of these groups do not include recently discovered viral chaperonins. Here, we solved the symmetry-free cryo-EM structures of a single-ring chaperonin encoded by the gene 246 of bacteriophage OBP Pseudomonas fluorescens, in the nucleotide-free, ATPγS-, and ADP-bound states, with resolutions of 4.3 Å, 5.0 Å, and 6 Å, respectively. The structure of OBP chaperonin reveals a unique subunit arrangement, with three pairs of subunits and one unpaired subunit. Each pair combines subunits in two possible conformations, differing in nucleotide-binding affinity. The binding of nucleotides results in the increase of subunits' conformational variability. Due to its unique structural and functional features, OBP chaperonin can represent a new group.

Data on the influence of clarification and stabilization with bentonite clays on the elemental composition of red wines determining their varietal affiliation.

The research data on the effect of bentonite clays (BT) in the process of clarification and stabilization on the elemental composition determining the varietal affiliation of wines are analyzed in the article. The initial objects were three untreated wine samples produced from Cabernet Sauvignon, Merlot and Moldova grape varieties in the Krasnodar Territory. Clarification and stabilization of untreated wine samples was carried out with 32 samples of BT of various degrees of dispersion and trademarks. The concentrations of metals, i.e., macro- and microelements, in bentonite clays, untreated and treated wine samples were determined by ICP-OES and ICP-MS methods. The results of the influence of stabilization and clarification of various wines with 32 BT on their elemental composition based on the concentrations of 16 micro- and macroelements isolated chemometrically from 39 elements are shown in the article. The elemental composition of the initial wine varieties as well as wine samples obtained after their clarification and stabilization (32 samples per each variety) was established based on the results of three parallel measurements. The aim of the study was to assess the contribution of macro- and microelements to the formation of the elemental image of wines determining their varietal affiliation. Using discriminant analysis and principal component analysis, the presence of cluster structures in treated and untreated wine samples was established in accordance with their varieties with respect to the concentrations of isolated macro- and microelements. The role of microelements was shown to be higher than that of macroelements in the formation of varietal image of wines. The combination of the most informative macro- and microelements in determining the cluster structure of wine samples increases the possibilities of assessing the intravarietal similarity and intervarietal differences of wines.

Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma.

BACKGROUND: A single, high priming dose of tremelimumab (anti-cytotoxic T lymphocyte­associated antigen 4) plus durvalumab (anti­programmed cell death ligand-1), an infusion regimen termed STRIDE (Single Tremelimumab Regular Interval Durvalumab), showed encouraging clinical activity and safety in a phase 2 trial of unresectable hepatocellular carcinoma. METHODS: In this global, open-label, phase 3 trial, the majority of the patients we enrolled with unresectable hepatocellular carcinoma and no previous systemic treatment were randomly assigned to receive one of three regimens: tremelimumab (300 mg, one dose) plus durvalumab (1500 mg every 4 weeks; STRIDE), durvalumab (1500 mg every 4 weeks), or sorafenib (400 mg twice daily). The primary objective was overall survival for STRIDE versus sorafenib. Noninferiority for overall survival for durvalumab versus sorafenib was a secondary objective. RESULTS: In total, 1171 patients were randomly assigned to STRIDE (n=393), durvalumab (n=389), or sorafenib (n=389). The median overall survival was 16.43 months (95% confidence interval [CI], 14.16 to 19.58) with STRIDE, 16.56 months (95% CI, 14.06 to 19.12) with durvalumab, and 13.77 months (95% CI, 12.25 to 16.13) with sorafenib. Overall survival at 36 months was 30.7%, 24.7%, and 20.2%, respectively. The overall survival hazard ratio for STRIDE versus sorafenib was 0.78 (96.02% CI, 0.65 to 0.93; P=0.0035). Overall survival with durvalumab monotherapy was noninferior to sorafenib (hazard ratio, 0.86; 95.67% CI, 0.73 to 1.03; noninferiority margin, 1.08). Median progression-free survival was not significantly different among all three groups. Grade 3/4 treatment-emergent adverse events occurred for 50.5% of patients with STRIDE, 37.1% with durvalumab, and 52.4% with sorafenib. CONCLUSIONS: STRIDE significantly improved overall survival versus sorafenib. Durvalumab monotherapy was noninferior to sorafenib for patients with unresectable hepatocellular carcinoma. (Funded by AstraZeneca; ClinicalTrials.gov number, NCT03298451.)

Identification of Clinically Significant Prostate Cancer by Combined PCA3 and AMACR mRNA Detection in Urine Samples.

PURPOSE: Preclinical evaluation of PCA3 and AMACR transcript simultaneous detection in urine to diagnose clinical significant prostate cancer (prostate cancer with Gleason score ≥7) in a Russian cohort. PATIENTS AND METHODS: We analyzed urine samples of patients with a total serum PSA ≥2 ng/mL: 31 men with prostate cancer scheduled for radical prostatectomy, 128 men scheduled for first diagnostic biopsy (prebiopsy cohort). PCA3, AMACR, PSA and GPI transcripts were detected by multiplex reverse transcription quantitative polymerase chain reaction, and the results were used for scores for calculation and statistical analysis. RESULTS: There was no significant difference between clinically significant and nonsignificant prostate cancer PCA3 scores. However, there was a significant difference in the AMACR score (patients scheduled for radical prostatectomy p=0.0088, prebiopsy cohort p=0.029). We estimated AUCs, optimal cutoffs, sensitivities and specificities for PCa and csPCa detection in the prebiopsy cohort by tPSA, PCA3 score, PCPT Risk Calculator and classification models based on tPSA, PCA3 score and AMACR score. In the clinically significant prostate cancer ROC analysis, the PCA3 score AUC was 0.632 (95%CI: 0.511-0.752), the AMACR score AUC was 0.711 (95%CI: 0.617-0.806) and AUC of classification model based on the PCA3 score, the AMACR score and total PSA was 0.72 (95%CI: 0.58-0.83). In addition, the correlation of the AMACR score with the ratio of total RNA and RNA of prostate cells in urine was shown (tau=0.347, p=6.542e-09). Significant amounts of nonprostate RNA in urine may be a limitation for the AMACR score use. CONCLUSION: The AMACR score is a good predictor of clinically significant prostate cancer. Significant amounts of nonprostate RNA in urine may be a limitation for the AMACR score use. Evaluation of the AMACR score and classification models based on it for clinically significant prostate cancer detection with larger samples and a follow-up analysis is promising.

HIV Type 1 Subtype A1 Dominates in Armenia.

OBJECTIVE: There is scarce information about the molecular epidemiology of HIV-infection in Armenia (former USSR). The objective of this work was to estimate the distribution of HIV-1 subtypes in this country and get any information about HIV drug resistance in naÏve patients. DESIGN: A joint study involving 78 patients was carried out in Yerevan, Armenia and Moscow, Russia in 2009-2013. The cohort studies included mostly IDUs (28.2%) and heterosexuals (69.2%). RESULTS: The phylogenetic analyses based on population sequencing of partial pol gene found subtype A1 being the most prevalent (92.3%), followed by subtype B (3.9%). The HIV-1 tropism inferred from env V3-loop sequences was determined in 27 samples, among them R5-tropic viruses were found in 13 (48.1%) patients and X4- variants--in 14 (51.9%) patients. The prevalence of drug resistance in naïve patients was low (1.5%) with the only one mutation K219Q found. CONCLUSION: The composition and distribution of HIV-1 genetic variants in Armenia are evidently influenced by the Russian and other FSU countries epidemic, due to the significant volume of Armenian migrant/re-emigrant flows. Continued surveillance of HIV-1 circulating subtypes and drug resistance in Armenia is important for the proper management of HIV infection in this country.

HIV-1 genetic variants in the Russian Far East.

A molecular analysis of HIV-1 subtypes and recombinants circulating in cities in the Russian Far East was performed. The study included samples from 201 outpatients from Vladivostok, Khabarovsk, and Blagoveshchensk. In most parts of Russia, patients are infected with HIV-1 subtype A, known as the IDU-A variant. Subtype B, including the IDU-B variant, is rare in Russia but widespread in the Ukraine, and the CRF02_AG is prevalent in Central Asian countries and Siberia, Russia. One of the challenges of this study in the Far East was to determine whether the molecular landscape of HIV infection in this region is influenced by the bordering countries, including China and Japan, where a distinct set of HIV subtypes is circulating, such as B', C, and CRF01_AE. The distribution of HIV-1 genetic variants in the cities studied was as follows: subtype A (IDU-A), 55.7%; subtype B, 25.3% (IDU-B variant-24.3%); subtype C, 10.0%; CRF02_AG, 1.5%; and CRF63_02A1, 7.5%. A phylogenetic analysis confirmed the relationship of subtype A viruses with the IDU-A variant predominating in Ukraine, Russia and other former Soviet Union (FSU) countries, of subtype B viruses with IDU-B in the Ukraine and of CRF02_AG variants with variants in Uzbekistan, Russia, and other former USSR countries. Subtype C sequences were not uniform, and most clustered between each other and HIV-1 sequences originating from Africa; there was only one sample possibly related to Chinese variants. Thus, despite close cultural and commercial relationships among Russia, China, and Japan, the distribution of HIV-1 subtypes in the Russian Far East is still primarily influenced by contacts with the countries of the former USSR.

Short communication: molecular epidemiology of HIV type 1 infection in Kazakhstan: CRF02_AG prevalence is increasing in the southeastern provinces.

To analyze HIV-1 genetic variants in Kazakhstan, HIV-1 sequences were obtained from 205 antiretroviral-treated (ART) and naive patients in 2009-2013. Samples were collected in the most populous cities and provinces of Kazakhstan. On the basis of phylogenetic analyses of partial pol sequences, subtype A variant intravenous drug user (IDU)-A (which is dominant in the former Soviet Union) was found in 60.0% of the individuals, followed by CRF02_AG (34.6%); the rest of the samples were subtype B, CRF03_AB, CRF63_02A1, and CRF07_BC. The proportion of CRF02_AG has increased significantly since 2001-2003, when it was less than 5%. The majority of the CRF02_AG cases were found in Almaty, the former capital and the most populous city in Kazakhstan. The IDU-A variant dominated in the industrial regions of northern and central Kazakhstan and some other regions. Both dominant HIV-1 genetic variants were almost equally represented in the two main transmission groups: IDUs and heterosexuals. The analysis of drug-resistant mutations found a low prevalence of drug resistance in 165 therapy-naive individuals (3.0%). Thus, in the beginning of the second decade of the 2000s, the HIV epidemic in Kazakhstan is driven by two main genetic variants: IDU-A and CRF02_AG.

Measurement of the nuclear polarization of hydrogen and deuterium molecules using a Lamb-shift polarimeter.

Lamb-shift polarimeters are used to measure the nuclear polarization of protons and deuterons at energies of a few keV. In combination with an ionizer, the polarization of hydrogen and deuterium atoms was determined after taking into account the loss of polarization during the ionization process. The present work shows that the nuclear polarization of hydrogen or deuterium molecules can be measured as well, by ionizing the molecules and injecting the H2(+) (or D2(+)) ions into the Lamb-shift polarimeter.