Usefulness of Tissue Biomarkers versus Prostate-Specific Membrane Antigen-Positron Emission Tomography for Prostate Cancer Biochemical Recurrence after Radical Prostatectomy.

Despite curative-intent local therapy, approximately 27% to 53% of prostate cancer (PCa) patients experience prostate-specific antigen (PSA) recurrence, known as biochemical recurrence (BCR). BCR significantly raises the risk of PCa-related morbidity and mortality, yet there is no consensus on optimal management. Prostate-specific membrane antigen-positron emission tomography (PSMA PET) has emerged as highly sensitive imaging, distinguishing local recurrences from distant metastases, crucially influencing treatment decisions. Genomic biomarkers such as Decipher, Prolaris, and Oncotype DX contribute to refining recurrence risk profiles, guiding decisions on intensifying adjuvant therapies, like radiotherapy and androgen deprivation therapy (ADT). This review assesses PSMA PET and biomarker utility in post-radical prostatectomy BCR scenarios, highlighting their impact on clinical decision-making. Despite their promising roles, the routine integration of biomarkers is limited by availability and cost, requiring further evidence. PSMA PET remains indispensable for restaging and treatment evaluation in these patients. Integrating biomarkers and PSMA PET promises to optimize personalized management strategies for BCR, though more comprehensive consensus-building studies are needed to define their standardized utility in clinical practice.

In-depth exploration of catalytic sites on amorphous solid water: I. The astrosynthesis of aminomethanol.

Chemical processes taking place on ice-grain mantles are pivotal to the complex chemistry of interstellar environments. In this study, we conducted a comprehensive analysis of the catalytic effects of an amorphous solid water (ASW) surface on the reaction between ammonia (NH3) and formaldehyde (H2CO) to form aminomethanol (NH2CH2OH) using density functional theory. We identified potential catalytic sites based on the binding energy distribution of NH3 and H2CO reactants, on a set-of-clusters surface model composed of 22 water molecules and found a total of 14 reaction paths. Our results indicate that the catalytic sites can be categorized into four groups, depending on the interactions of the carbonyl oxygen and the amino group with the ice surface in the reactant complex. A detailed analysis of the reaction mechanism using Intrinsic Reaction Coordinate and reaction force analysis, revealed three distinct chemical events for this reaction: formation of the C-N bond, breaking of the N-H bond, and formation of the O-H hydroxyl bond. Depending on the type of catalytic site, these events can occur within a single, concerted, albeit asynchronous, step, or can be isolated in a step-wise mechanism, with the lowest overall transition state energy observed at 1.3 kcal mol-1. A key requirement for the low-energy mechanism is the presence of a pair of dangling OH bonds on the surface, found at 5% of the potential catalytic sites on an ASW porous surface.

Chemical stimulation or glutamate injections in the nucleus of solitary tract enhance conditioned taste aversion.

Taste memory depends on motivational and post-ingestional consequences after a single taste-illness pairing. During conditioned taste aversion (CTA), the taste and visceral pathways reach the nucleus of the solitary tract (NTS), which is the first relay in the CNS and has a vital function in receiving vagal chemical stimuli and humoral signals from the area postrema that receives peripheral inputs also via vagal afferent fibers. The specific aim of the present set of experiments was to determine if the NTS is involved in the noradrenergic and glutamatergic activation of the basolateral amygdala (BLA) during CTA. Using in vivo microdialysis, we examined whether chemical NTS stimulation induces norepinephrine (NE) and/or glutamate changes in the BLA during visceral stimulation with intraperitoneal (i.p.) injections of low (0.08 M) and high (0.3 M) concentrations of lithium chloride (LiCl) during CTA training. The results showed that strength of CTA can be elicited by chemical NTS stimulation (Ringer's high potassium solution; 110 mM KCl) and by intra-NTS microinjections of glutamate, immediately after, but not before, low LiCl i.p. injections that only induce a week aversive memory. However visceral stimulation (with low or high i.p. LiCl) did not induce significantly more NE release in the amygdala compared with the NE increment induced by NTS potassium depolarization. In contrast, high i.p. concentrations of LiCl and chemical NTS stimulation induced a modest glutamate sustained release, that it is not observed with low LiCl i.p. injections. These results indicate that the NTS mainly mediates the visceral stimulus processing by sustained releasing glutamate in the BLA, but not by directly modulating NE release in the BLA during CTA acquisition, providing new evidence that the NTS has an important function in the transmission of signals from the periphery to brain systems that process aversive memory formation.

Resección endoscópica de adenoma gigante de la ampolla de Vater con crecimiento intraductal: a propósito de un caso / Endoscopic resection of a giant adenoma of the ampulla of vater with intraductal growth: report of a case

Los tumores ampulares representan un grupo diverso aunque infrecuente de lesiones ubicadas en la confluencia de los conductos pancreático y biliar. Representan el 1-2% de los tumores del tracto digestivo, estos pueden ser benignos y malignos. Entre los tumores benignos, el adenoma es el más frecuente y su incidencia oscila entre 0,04 y 0,12%. Pueden ser sésiles o pediculados e histológicamente diferenciarse en tubulares, túbulo-vellosos y vellosos. Debido a su potencial maligno, el tratamiento recomendado es la resección bien sea quirúrgica o endoscópica; esta última indicada en tumores menores de 4,5cm. Se reporta el caso de paciente masculino de 78 años quien consultó por ictericia, dolor abdominal y pérdida de peso de 2 meses de evolución. Se realizó ultrasonido y tomografía abdominal que reportan imagen sólida en confluente biliopancreático. Se realizó duodenoscopia encontrando tumoración ampular de 6 centímetros de diámetro de aspecto velloso. Dada la edad y comorbilidades del paciente se decidió ampulectomía endoscópica parcelar. En la colangiografía retrograda endoscópica se observó imagen de defecto en tercio distal de colédoco por lo que se procedió a extraer con balón de Fogarty, obteniéndose masa tumoral de aspecto velloso pediculada la cual es resecada sin complicaciones. El hallazgo histopatológico reportó adenoma túbulo-velloso con displasia de bajo grado y en controles endoscópicos e histológicos de seguimiento a los 10 meses del procedimiento no se ha evidenciado recidiva tumoral y clínicamente el paciente se encuentra asintomático y en buenas condiciones generales

Ampullary tumors represent a various group but uncommon lesions located at the confluence of the pancreatic and bile ducts. They account for 1 to 2% of the digestive tract tumors, they may be benign and malignant. Among benign tumors, the adenoma is the most common and its incidence ranges from 0.04 a 0.12%. They can be sessile or pedunculated and histologically differentiated tubular, tubulo villous and villous. Because of its malignant potential, the recommended treatment is surgical resection or endoscopic either, the latter indicated in tumors less 4.5 cm. A case of 78 years old male patient who consulted with jaundice, abdominal pain and two months weight loss. It performed abdominal ultrasound and CT reporting in confluent biliopancreatic solid image. Duodenoscopy was performed finding ampullary tumor six inches diameter appearance fluffy. Considering patient age and comorbidities, it decided parcel endoscopic ampullectomy. In endoscopic retrograde cholangiography, defect image was observed in distal choledochal, so we proceeded to extract with Fogarty Balloon, giving pedunculated villous tumor, which is removed without complications. The histopathological finding was tubule villous adenoma, with low grade dysplasia. In endoscopic and histologycal controls up to procedure ten months, is not clinically evidence tumor recurrence and the patient is asymptomatic in good general conditions

Ectasia vascular antral: tratamiento quirúrgico / Watermelon stomach: surgical treatment

La ectasia vascular gástrica antral es una entidad reconocida clínica e histopatológicamente, de etiología no precisada, siendo a su vez una causa infrecuente de sangrado digestivo crónico o agudo. Existen muy pocos casos clínicos documentados en la literatura. Existen variadas formas de enfrentar esta patología, existiendo consenso que las más exitosas son la cirugía invasiva y/o terapia endoscópica ND:YAG láser. Se presenta un caso clínico de una mujer de 70 años atendida en nuestro hospital en el cual no contamos con terapia endoscópica, siendo sometida a tratamiento quirúrgico convencional (Antrectomía) con buen resultado.

Acatisia inducida por tietilperazina en paciente embarazada / Akathisia induced by thiethylperazine in a pregnant patient

La acatisia es un efecto lateral neurológico agudo común a diversos fármacos que actúan a nivel dopaminérgico, su manifestación fundamental es la inquietud psicomotora, es importante diagnosticar y tratar precozmente este síndrome. Tietilperazina es una fenotiazina cuyo efecto antiemético es usado en diversas circunstancias clínicas, presentamos el caso de una paciente hospitalizada por hiperemesis gravídica que es derivada a psiquiatría por la presencia de síntomas aparentemente ansiosos. El examen clínico permite sospechar acatisia por Tietilperazina Torecan®, el cuadro cede completamente con la suspensión del fármaco. Nos parece interesante comunicar este caso por la implicancia para los especialistas.

Akatisia is an common neurological complication of treatment with dopaminergic drugs, subjetive feeling of restlessness is their main symptom, it's important to recognize this syndrome early and to treat immediately. Thietylperazine is an phenothiazine drug with antiemetic effect used for medical practice, we present a case of 35 years old pregnancy inpatient referred to psychiatrist for anxiety, the diagnosis was akatisia induced by thietylperazide.