Prostatitis, other genitourinary infections and prostate cancer risk: Influence of non-steroidal anti-inflammatory drugs? Results from the EPICAP study.

Epidemiological studies have suggested that prostatitis may increase the risk of prostate cancer due to chronic inflammation. We studied the association between several genitourinary infections and the risk of prostate cancer based on data from the EPICAP study. EPICAP is a population-based case-control study conducted in the département of Hérault, France, between 2012 and 2014. A total of 819 incident cases and 879 controls have been face to face interviewed using a standardized questionnaire gathering information on known or suspected risk factors of prostate cancer, and personal history of genitourinary infections: prostatitis, urethritis, orchi-epididymitis, and acute pyelonephritis. Odds Ratios (OR) and their 95% confidence interval were estimated using multivariate unconditional logistic regression. Overall, 139 (18%) cases and 98 (12%) controls reported having at least one personal history of genitourinary infections (OR = 1.64 [1.23-2.20]). The risk increased with the number of infections (p-trend < 0.05). The association was specifically observed with personal history of chronic prostatitis and acute pyelonephritis (OR = 2.95 [1.26-6.92] and OR = 2.66 [1.29-5.51], respectively) and in men who did not use any non-steroidal anti-inflammatory drugs (OR = 2.00 [1.37-2.91]). Our results reinforce the hypothesis that chronic inflammation, generated by a personal history of genitourinary infections, may play a role in prostate carcinogenesis.

[Management of refractory ascites by the automated low flow pump system (Alfapump)]. / Prise en charge de l'ascite réfractaire par la pompe péritonéovésicale (Alfapump).

Refractory ascites affects 10% of patients with advanced cirrhosis. Recurrent ascites is commonly managed by repeat large volume paracentesis with volume expansion, and in selected patients, by the implantation of a transjugular intrahepatic portosystemic shunt (TIPS). Both approaches are associated with potential complications, including vascular traumatic injuries in the setting of paracentesis. A new automatic pump has been developed to mechanically remove ascites from the peritoneal cavity to the bladder. The benefit of this pump in terms of reduced frequency of paracentesis should be balanced by the risk of adverse events that include infection, catheter dysfunction, and renal insufficiency. The place of this new device in the management of ascites due either to portal hypertension or to cancer remains to be determined.

[Renal and hepatic metastasis from meningeal hemangiopericytoma]. / Métastases rénale et hépatique d'un hémangiopéricytome méningé.

The authors report the case of a 57-year-old woman operated in 1992 for meningeal haemangiopericytoma. Nine years later, this patient was operated for a liver tumour and then a renal tumour, which were both diagnosed as haemangiopericytoma and therefore corresponded to metastases of the primary tumour. The presence of a renal tumour in a patient previously operated for meningeal haemangiopericytoma should raise the suspicion of renal metastasis. Localized metastases can be treated by surgical resection. The possibility of late recurrence justifies annual thoraco-abdominal CT scan and bone scan for more than ten years.

Significant hematocrit decrease in healthy horses during clinical anesthesia / Redução significante dos valores de hematócrito em equinos saudáveis durante anestesia

Xylazine (XYL) and acepromazine (ACP) are known to decrease the hematocrit (HT) of horses when administered alone. However in routine anesthesia these drugs are administered by associations which ultimate effect in the HT is unknown but may cause false impressions about the hydration status, blood loss and red blood cell indices. The objective of this study was to characterize the values of HT in horses anesthetized with XYL, ACP, ketamine, midazolam, guaiphenesin, isoflurane and ephedrine. Twenty healthy horses were premedicated with either XYL 0.8 mg/kg (XYL group, n=10) or XYL 0.5 mg/kg plus ACP 0.05 mg/kg (XYL+ACP group, n=10). Anesthesia was induced with ketamine, midazolam and guaiphenesin and maintained with isoflurane. Ephedrine was infused for cardiovascular support. HT, vital parameters and blood gas values were evaluated at baseline, between each drug administration, after standing and 24 hours after baseline (24hBL). The HT started to decrease 17 and 40 minutes after premedication in XYL group and XYL+ACP group, respectively (p<0.05). The maximum decrease of 19% in XYL group and 17% in XYL+ACP group was observed after 1 hour of premedication (p<0.05). In both groups HT remained low for longer than 180 minutes and returned to baseline at 24hBL. A significant HT decrease should be considered in anesthetized healthy horses receiving XYL, ACP, ketamine, midazolam, guaiphenesin, isoflurane and ephedrine.

A administração isolada de xilazina (XIL) e acepromazina (ACP) pode diminuir o hematócrito (HT) de equinos. Na rotina anestésica, estes fármacos são administrados em associações, cujo efeito final no HT não é conhecido, mas pode causar falsas impressões sobre o grau de hidratação, perda sanguínea e índices hematimétricos. O objetivo deste estudo foi caracterizar os valores de HT de equinos anestesiados com XYL, ACP, cetamina, midazolam, EGG, isofluorano e efedrina. Vinte equinos hígidos foram pré-tratados com XIL 0,8 mg/kg (grupo XIL, n=10) ou XIL 0,5 mg/kg associada à ACP 0,05 mg/kg (grupo XIL+ACP, n=10). A anestesia foi induzida com cetamina, midazolam e EGG e mantida com isofluorano. A efedrina foi utilizada para suporte cardiovascular. O HT, parâmetros vitais e hemogasometria foram avaliados no momento basal, entre administração de cada fármaco, após retorno à posição quadrupedal e 24 horas após momento basal (24hBL). A diminuição do HT iniciou-se 17 e 40 minutos após administração da medicação préanestésica no grupo XIL e grupo XIL+ACP, respectivamente (p<0,05). A queda máxima de 19% no grupo XIL e 17% no grupo XIL+ACP foi observada após 1 hora da administração da medicação pré-anestésica (p<0,05). Em ambos os grupos, o HT permaneceu baixo por mais de 180 minutos e retornou aos valores basais em 24hBL. Deve-se considerar a ocorrência de uma redução significativa do HT em equinos hígidos anestesiados com XYL, ACP, cetamina, midazolam, EGG, isofluorano e efedrina.