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1.
Int J Mol Sci ; 22(4)2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33671469

RESUMO

Bone metastasis remains the most frequent and the deadliest complication of prostate cancer (PCa). Mechanisms leading to the homing of tumor cells to bone remain poorly characterized. Role of chemokines in providing navigational cues to migrating cancer cells bearing specific receptors is well established. Bone is an adipocyte-rich organ since 50 to 70% of the adult bone marrow (BM) volume comprise bone marrow adipocytes (BM-Ads), which are likely to produce chemokines within the bone microenvironment. Using in vitro migration assays, we demonstrated that soluble factors released by human primary BM-Ads are able to support the directed migration of PCa cells in a CCR3-dependent manner. In addition, we showed that CCL7, a chemokine previously involved in the CCR3-dependent migration of PCa cells outside of the prostate gland, is released by human BM-Ads. These effects are amplified by obesity and ageing, two clinical conditions known to promote aggressive and metastatic PCa. In human tumors, we found an enrichment of CCR3 in bone metastasis vs. primary tumors at mRNA levels using Oncomine microarray database. In addition, immunohistochemistry experiments demonstrated overexpression of CCR3 in bone versus visceral metastases. These results underline the potential importance of BM-Ads in the bone metastatic process and imply a CCR3/CCL7 axis whose pharmacological interest needs to be evaluated.


Assuntos
Adipócitos/metabolismo , Adipócitos/patologia , Medula Óssea/patologia , Osso e Ossos/patologia , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Receptores CCR3/metabolismo , Envelhecimento/patologia , Medula Óssea/efeitos dos fármacos , Osso e Ossos/efeitos dos fármacos , Linhagem Celular Tumoral , Quimiocina CCL7/metabolismo , Quimiotaxia/efeitos dos fármacos , Meios de Cultivo Condicionados/farmacologia , Humanos , Masculino , Metástase Neoplásica , Obesidade/complicações , Neoplasias da Próstata/complicações
2.
J Sex Med ; 18(3): 515-525, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33642238

RESUMO

BACKGROUND: Men with prostate cancer (PCa) often experience sexual dysfunction following diagnosis and treatment, yet little is known about the support they receive to deal with this. AIM: To explore men's experiences of support for sexual dysfunction following PCa diagnosis. METHODS: This study included a U.K.-wide survey of men 18-42 months post-diagnosis of PCa, identified through cancer registries. The survey measured sexual function and the extent to which men perceived sexual dysfunction to be a problem (Expanded Prostate Cancer Index Composite-26), access to and experience of medications, devices, and specialist services for sexual dysfunction, and included a free-text question for further comments. Analysis focussed on men who reported poor sexual function, which they considered a moderate or big problem. Descriptive statistics explored the characteristics of men offered intervention and those that found this helpful. Free-text responses were analyzed using thematic analysis. OUTCOME: The main outcome of this study was to assess access to and experience of medications, devices, and specialist services for sexual dysfunction. RESULTS: 39.0% of all survey respondents (13,978/35,823) reported poor sexual function, which they considered a moderate or big problem. 51.7% of these men were not offered any intervention to aid sexual functioning. 71.9% of those offered an intervention reported trying it, of whom 48.7% found the intervention helpful. Men treated with surgery or brachytherapy were most likely to be offered an intervention. Medication was the most commonly offered intervention and 39.3% of those who tried medication found this helpful. Although offered less often, approximately half of the men who tried devices or attended specialist services found the intervention helpful. Free-text responses indicated that barriers to accessing support included inadequate information and support from healthcare professionals, embarrassment, negative views about treatment options, concerns about side effects and safety, and inconsistencies between secondary and primary care. Barriers to continuing use included limited effectiveness of treatments, inadequate ongoing support, and funding constraints. Drivers of sexual recovery included patient proactivity and persistence with trying different treatment options and ongoing support from health professionals. CLINICAL IMPLICATIONS: There is an urgent need to ensure that all men are offered, and have equal access to, sexual care support, with referral to specialist services when required. STRENGTHS & LIMITATIONS: This study presents data from a large, U.K.-wide, population-based study of men with PCa and includes quantitative and qualitative findings. The possibility of non-response bias should, however, be considered. CONCLUSION: There are significant shortcomings in the support offered to U.K. men with sexual dysfunction following diagnosis and treatment for PCa which need to be addressed. Watson E, Wilding S, Matheson L, et al. Experiences of Support for Sexual Dysfunction in Men With Prostate Cancer: Findings From a U.K.-Wide Mixed Methods Study. J Sex Med 2021;18:515-525.


Assuntos
Braquiterapia , Neoplasias da Próstata , Disfunções Sexuais Fisiológicas , Humanos , Masculino , Neoplasias da Próstata/complicações , Neoplasias da Próstata/terapia , Comportamento Sexual , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/terapia , Inquéritos e Questionários
3.
Brain Nerve ; 73(2): 179-182, 2021 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-33561832

RESUMO

An 80-year-old man was diagnosed with prostate cancer in April 2014 and underwent anticancer treatment. His serum prostate-specific antigen (PSA) level was abruptly increased on December 26, 2014. He was admitted to the neurological department of our hospital on January 14, 2015, because of the appearance of staggering gait and diplopia. Neurological examination revealed marked opsoclonus, limb ataxia and ataxic gait. The patient was diagnosed with paraneoplastic opsoclonus and ataxia caused by prostate cancer relapse. Steroid pulse therapy was initiated and his symptoms, including opsoclonus and ataxia, markedly improved. Although most cases of paraneoplastic opsoclonus precede the discovery of cancer, our case developed symptoms simultaneously with relapse and acute progression of prostate cancer. Paraneoplastic opsoclonus with prostate cancer is rare. Additionally, our case showed excellent response of opsoclonus to steroid therapy without treatment of the underlying disease. (Received June 1, 2020; Accepted September 18, 2020; Published February 1, 2021).


Assuntos
Ataxia Cerebelar , Transtornos da Motilidade Ocular , Neoplasias da Próstata , Idoso de 80 Anos ou mais , Ataxia/tratamento farmacológico , Ataxia/etiologia , Humanos , Masculino , Recidiva Local de Neoplasia , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico
4.
Nihon Shokakibyo Gakkai Zasshi ; 118(2): 154-160, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33563855

RESUMO

A man in his 70s presented to Kyojinkai Komatsu Hospital with lower left abdominal pain and hematochezia after repeated use of laxatives. Computed tomography (CT) revealed continuous bowel wall thickening from the descending colon to the rectum. The symptoms and CT findings were consistent with ischemic colitis. The patient's condition improved with conservative treatment. However, the patient was reexamined 3 months later because complaints of constipation and voiding difficulty continued. Colonoscopic findings revealed rectal stenosis and reddish edematous mucosa with nodular alterations. Although CT showed that the abnormality in the descending and sigmoid colon had resolved, the wall thickening and annular stricture of the rectum persisted. The prostate was irregularly enlarged, encircling and compressing the rectum. Rectal biopsy results did not reveal malignancy. However, moderately to poorly differentiated adenocarcinoma was detected by prostate biopsy. Consequently, the patient was diagnosed with prostate cancer with rectal involvement. The rectal wall thickening and the symptoms improved following hormone therapy. Thus, concomitant prostate cancer invasion should be considered when CT reveals continuous colon wall thickening up to the rectum in a patient suspected of ischemic colitis.


Assuntos
Adenocarcinoma , Colite Isquêmica , Neoplasias da Próstata , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico por imagem , Colite Isquêmica/diagnóstico por imagem , Colite Isquêmica/etiologia , Humanos , Masculino , Neoplasias da Próstata/complicações , Neoplasias da Próstata/diagnóstico por imagem , Reto/diagnóstico por imagem
5.
Cell Transplant ; 30: 963689721991477, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33522308

RESUMO

TRANSLATIONAL RELEVANCE: No prophylactic treatments for COVID-19 have been clearly proven and found. In this pandemic context, cancer patients constitute a particularly fragile population that would benefit the best from such treatments, a present unmet need. TMPRSS2 is essential for COVID-19 replication cycle and it is under androgen control. Estrogen and androgen receptor dependent cues converge on TMPRSS2 regulation through different mechanisms of action that can be blocked by the use of hormonal therapies. We believe that there is enough body of evidence to foresee a prophylactic use of hormonal therapies against COVID-19 and this hypothesis can be easily tested on cohorts of breast and prostate cancer patients who follow those regimens. In case of pandemic, if the protective effect of hormonal therapies will be proven on cancer patients, the use of specific hormonal therapies could be extended to other oncological groups and to healthy individuals to decrease the overall risk of infection by SARS-CoV-2.Given the COVID-19 coronavirus emergency, a special focus is needed on the impact of this rapidly spreading viral infection on cancer patients. Androgen receptor (AR) signaling in the transmembrane protease serine 2 (TMPRSS2) regulation is emerging as an important determinant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) susceptibility. In our study, we analyzed AR and TMPRSS2 expression in 17,352 normal and 9,556 cancer tissues from public repositories and stratified data according to sex and age. The emerging picture is that some patient groups may be particularly susceptible to SARS-CoV-2 infection and may benefit from antiandrogen- or tamoxifen-based therapies. These findings are relevant to choose proper treatments in order to protect cancer patients from concomitant SARS-CoV-2 contagion and related symptoms and put forward the idea that hormonal therapies could be used as prophylactic agents against COVID-19.


Assuntos
Antagonistas de Receptores de Andrógenos/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/complicações , Antagonistas de Estrogênios/uso terapêutico , Neoplasias da Próstata/complicações , Tamoxifeno/uso terapêutico , Antagonistas de Receptores de Andrógenos/farmacologia , Antineoplásicos Hormonais/farmacologia , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/metabolismo , /metabolismo , Descoberta de Drogas , Antagonistas de Estrogênios/farmacologia , Feminino , Humanos , Masculino , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/metabolismo , Receptores Androgênicos/análise , Receptores Androgênicos/metabolismo , Serina Endopeptidases/análise , Serina Endopeptidases/metabolismo , Transdução de Sinais/efeitos dos fármacos , Tamoxifeno/farmacologia
6.
Value Health ; 24(2): 216-226, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33518028

RESUMO

OBJECTIVES: The Depression Care for People with Cancer program (DCPC) is a cost-effective depression care model for UK patients with cancer. However, DCPC's cost-effectiveness in the United States is unknown, particularly for patients with prostate cancer in the United States. This study evaluates the health and economic impact of providing DCPC to patients with prostate cancer. METHODS: DCPC was compared with usual care in a mathematical model that simulates depression and its outcomes in a hypothetical cohort of US patients with prostate cancer. DCPC was modeled as a sequential combination of universal depression screening, post-screening evaluations, and first-line combination therapy. Primary outcomes were lifetime direct costs of depression care, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Secondary outcomes included life expectancy, number of depression-free months and lifetime depressive episodes, duration of depressive episodes, cumulative incidence of depression, lifetime depression diagnoses/misdiagnoses, and the cumulative incidence of maintenance therapy for depression. Sensitivity analyses were used to examine uncertainty. RESULTS: In the base case, DCPC dominated usual care by offering 0.11 more QALYs for $2500 less per patient (from averted misdiagnoses). DCPC also offered 5 extra depression-free months, shorter depressive episodes, and a lower chance of maintenance therapy. DCPC's trade-offs were a higher cumulative incidence of depression and more lifetime depressive episodes. Life expectancy was identical under usual care and DCPC. Sensitivity analyses indicate that DCPC was almost always preferable to usual care. CONCLUSION: Compared with usual care, DCPC may offer more value to US patients with prostate cancer. DCPC should be considered for inclusion in prostate cancer survivorship care guidelines.


Assuntos
Depressão/etiologia , Depressão/terapia , Neoplasias da Próstata/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Antidepressivos/economia , Antidepressivos/uso terapêutico , Análise Custo-Benefício , Depressão/economia , Gastos em Saúde , Humanos , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Psicoterapia/economia , Psicoterapia/métodos , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , Estados Unidos
7.
Hinyokika Kiyo ; 67(1): 47-51, 2021 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-33535298

RESUMO

A 53-year-old man was diagnosed with prostate cancer with multiple bone metastasis. Therefore androgen deprivation therapy was initiated. After treatment with denosumab injection for bone metastasis, hypocalcemia and hypophosphatemia occurred. Despite treatment for hypocalcemia with vitamin D and calcium lactate,his serum calcium and phosphate levels were refractory to treatment. The etiology of hypophosphatemia was investigated,and the level of serum fibroblast growth factor 23 (FGF23) was abnormally elevated. Three months after the first measurement of FGF23,the patient died of prostate cancer. Severe hypophosphatemia is a typical manifestation of tumor-induced hypophosphatemic osteomalacia (TIO),which is a paraneoplastic condition, mediated by FGF23 overexpression in most cases. His osteoblastic metastasis,however,did not meet the disease criteria of osteomalacia. Several reports have suggested that excessive FGF23 may mediate both severe hypophosphatemia and aggressive castrationresistant prostate cancer characteristics. Management of serum FGF23 may be a novel therapeutic strategy for castration-resistant prostate cancer with hypophosphatemia.


Assuntos
Hipocalcemia , Hipofosfatemia , Neoplasias da Próstata , Antagonistas de Androgênios , Fatores de Crescimento de Fibroblastos , Humanos , Hipocalcemia/tratamento farmacológico , Hipocalcemia/etiologia , Hipofosfatemia/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico
9.
Clin Nucl Med ; 46(5): e286-e289, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315669

RESUMO

ABSTRACT: Prostate cancer osteoblastic metastases may have different morphologies, and some of these may overlap with certain benign bone lesions. In this series of 5 prostate cancer patients, we describe bone lesions with central lucency and surrounding peripheral sclerosis and their varying appearances on different imaging modalities. Although prostate cancer metastases are commonly associated with sclerotic lesions, they can also present as osteolytic or lucent lesions, and these lesions should be carefully evaluated. The findings emphasize the importance of correlation with prior imaging, comparing findings on different imaging techniques and follow-up to differentiate benign disease from metastatic disease in these situations.


Assuntos
Neoplasias da Próstata/complicações , Esclerose/complicações , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias da Próstata/patologia , Esclerose/diagnóstico por imagem
11.
Cancer Nurs ; 44(1): 71-78, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-31895173

RESUMO

BACKGROUND: Cancer-related fatigue (CRF) is a complex multidimensional symptom. Identifying the fatigue dimension that may be most bothersome can guide in the development of individualized management strategies. OBJECTIVE: The purpose of this article is to describe the multidimensional fatigue experience of men with prostate cancer. METHODS: Data for this study were obtained from an ongoing descriptive longitudinal study at the National Institutes of Health, involving men diagnosed with nonmetastatic prostate cancer scheduled to receive external beam radiation therapy. Data were analyzed at 7 time points: baseline, before treatment initiation (T1), treatment midpoint (T2), treatment completion (T3), and 1 month (T4), 3 months (T5), 6 months (T6), and 12 months (T7) after treatment completion. Study data were obtained from medical records and self-report (fatigue, depressive symptoms, and sleep disturbance) questionnaires. RESULTS: Scores for total fatigue peaked at T2 and remained significantly different from baseline at T3. After T3, total fatigue scores were not significantly different from baseline. Affective fatigue had the highest scores (worst fatigue) reported during treatment, sensory fatigue scores were highest from T4 to T6, and cognitive fatigue scores were highest at T7. Affective and sensory fatigue scores peaked at T2, whereas behavioral and cognitive fatigue scores peaked at T3. CONCLUSION: Independent changes in specific dimensions of CRF were observed during and post treatment. IMPLICATIONS FOR PRACTICE: Understanding the specific dimensions of CRF and how they change during and post treatment can help guide clinicians to recommend targeted and personalized management strategies.


Assuntos
Fadiga/etiologia , Fadiga/psicologia , Neoplasias da Próstata/complicações , Neoplasias da Próstata/radioterapia , Idoso , Humanos , Estudos Longitudinais , Masculino , Registros Médicos , Pessoa de Meia-Idade , Autorrelato
13.
Clin Nucl Med ; 46(5): e273-e275, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323739

RESUMO

ABSTRACT: A 68-year-old man underwent 18F-prostate-specific membrane antigen (PSMA) PET/CT for staging of a newly diagnosed prostate adenocarcinoma. Unexpectedly, PET/CT revealed high focal 18F-PSMA brain uptake, which initially was suspected for a brain metastasis. Corresponding CT and MRI scans revealed characteristic imaging features of an intracranial dermoid cyst at this site. This is an exceptional location for a dermoid cyst, which had been followed up conservatively with no substantial changes. This case shows that dermoid cyst should be added to the reported list of benign neoplasms that shows "false-positive" PSMA uptake during evaluation of patients with prostate carcinoma, representing a potential interpretative pitfall.


Assuntos
Antígenos de Superfície/metabolismo , Cisto Dermoide/diagnóstico por imagem , Radioisótopos de Flúor , Glutamato Carboxipeptidase II/metabolismo , Achados Incidentais , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/complicações , Idoso , Transporte Biológico , Cisto Dermoide/complicações , Cisto Dermoide/metabolismo , Humanos , Masculino , Estadiamento de Neoplasias , Neoplasias da Próstata/patologia
14.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370963

RESUMO

Malignant lymphomas of the prostate are very rare tumours and are generally not considered in the clinical or pathological diagnosis of prostatic enlargement. We report a case of a 56-year-old man who presented with long-standing history of low back pain and a 2-month history of voiding lower urinary tract symptoms. He denied any history of urinary retention, trauma, catheterisation or any constitutional symptoms. Examination revealed no lymphadenopathy and hepatosplenomegaly. Digital rectal examination showed an irregular, moderately enlarged nodular prostate. His prostate-specific antigen was 1.54 ng/mL. MRI of the pelvis did not show any focal lesion apart from abnormal signal intensity in the central zone. Bone scan was negative. Transrectal ultrasound-guided prostate biopsy revealed diffuse large B cell lymphoma. Bone marrow biopsy and whole body positron emission tomography/CT were unremarkable. The patient achieved complete remission after receiving six cycles of R-CHOP chemotherapy.


Assuntos
Sintomas do Trato Urinário Inferior/etiologia , Linfoma Difuso de Grandes Células B/diagnóstico , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Biópsia com Agulha de Grande Calibre , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Humanos , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Próstata/diagnóstico por imagem , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/patologia , Rituximab/uso terapêutico , Tomografia Computadorizada por Raios X , Agentes Urológicos/uso terapêutico , Vincristina/uso terapêutico
15.
In Vivo ; 34(6): 3723-3730, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33144490

RESUMO

BACKGROUND/AIM: Influenza viruses, corona viruses and related pneumotropic viruses cause sickness and death partly by inducing cytokine storm, a hyper-proinflammatory host response by immune cells and cytokines in the host airway. Based on our in vivo experience with digitoxin as an inhibitor of TNFα-driven NFĸB signaling for cytokine expression in prostate cancer in rats and in cystic fibrosis in humans, we hypothesize that this drug will also block a virally-activated cytokine storm. Materials Methods: Digitoxin was administered intraperitoneally to cotton rats, followed by intranasal infection with 107TCID50/100 g of cotton rat with influenza strain A/Wuhan/H3N2/359/95. Daily digitoxin treatment continued until harvest on day 4 of the experiment. RESULTS: The cardiac glycoside digitoxin significantly and differentially suppressed levels of the cytokines TNFα, GRO/KC, MIP2, MCP1, and IFNγ, in the cotton rat lung in the presence of influenza virus. CONCLUSION: Since cytokine storm is a host response, we suggest that digitoxin may have a therapeutic potential not only for influenza and but also for coronavirus infections.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Digitoxina/farmacologia , Pulmão/virologia , Pneumonia Viral/tratamento farmacológico , Neoplasias da Próstata/tratamento farmacológico , Animais , Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Citocinas/biossíntese , Citocinas/genética , Modelos Animais de Doenças , Humanos , Influenza Humana/tratamento farmacológico , Influenza Humana/metabolismo , Influenza Humana/virologia , Pulmão/patologia , Masculino , NF-kappa B/genética , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Neoplasias da Próstata/complicações , Neoplasias da Próstata/patologia , Neoplasias da Próstata/virologia , Ratos , Fator de Necrose Tumoral alfa/genética
16.
Biomed Pharmacother ; 131: 110748, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33152916

RESUMO

The severe form of COVID-19 has significant sex disparities, with high fatalities commonly reported among males than females. The incidence of COVID-19 has also been higher in males compared with their female counterparts. This trend could be attributed to a better responsive and robust immune system in females. Cytokine storm is one of the pathophysiological features of severe COVID-19, and it occurs as a result of over-activation of immune cells leading to severe inflammation and tissue damage. Nevertheless, it is well modulated in females compared to their male counterparts. Severe inflammation in males is reported to facilitate progression of mild to severe COVID-19. The sex hormones, estrogens and androgens which exist in varying functional levels respectively in females and males are cited as the underlying cause for the differential immune response to COVID-19. Evidence abounds that estrogen modulate the immune system to protect females from severe inflammation and for that matter severe COVID-19. On the contrary, androgen has been implicated in over-activation of immune cells, cytokine storm and the attendant severe inflammation, which perhaps predispose males to severe COVID-19. In this review efforts are made to expand understanding and explain the possible roles of the immune system, the sex hormones and the angiotensin-converting enzyme (ACE) systems in male bias to severe COVID-19. Also, this review explores possible therapeutic avenues including androgen deprivation therapy (ADT), estrogen-based therapy, and ACE inhibitors for consideration in the fight against COVID-19.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antagonistas de Androgênios/farmacologia , Antagonistas de Androgênios/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Animais , Criança , Pré-Escolar , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Suscetibilidade a Doenças , Feminino , Hormônios Esteroides Gonadais/fisiologia , Humanos , Imunidade Inata , Lactente , Recém-Nascido , Inflamação , Masculino , Camundongos , Pessoa de Meia-Idade , Peptidil Dipeptidase A/fisiologia , Pneumonia Viral/complicações , Pneumonia Viral/imunologia , Pneumonia Viral/terapia , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico , Isomerases de Dissulfetos de Proteínas/fisiologia , Receptores de Superfície Celular/fisiologia , Receptores Virais/fisiologia , Distribuição por Sexo , Fumar/efeitos adversos , Adulto Jovem
17.
Actas urol. esp ; 44(9): 630-636, nov. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198087

RESUMO

INTRODUCCIÓN: El cáncer de próstata (CP) es el segundo cáncer más frecuente del mundo y en los varones. Se estima que la incidencia crezca a 1,7 millones de casos nuevos y 499.000 nuevas muertes en 2030. El tratamiento del cáncer de próstata organoconfinado (CPOC) puede afectar a un individuo tanto física como mentalmente, así como sus relaciones cercanas y su trabajo o vocación, lo cual condiciona la calidad de vida (CV) relacionada con la salud. OBJETIVO: Conocer el impacto en la CV atribuible al tratamiento del CPOC. MATERIALES Y MÉTODOS: Es un estudio observacional multicéntrico de carácter prospectivo de 406 pacientes con CPOC tratados desde enero del año 2015 hasta junio del 2018. La muestra se dividió en cuatro grupos de estudio (GA, GB, GC y GD), correspondientes a los distintos métodos de abordaje quirúrgico: prostatectomía radical (PR), radioterapia externa (RTE), braquiterapia (BT) y diferente a monoterapia con alguno de los otros, respectivamente. RESULTADOS: La edad en el GC fue inferior, la media del antígeno prostático específico (PSA, prostatic specific antigen) de todos los pacientes fue 8,13 ng/ml, el grupo de mayor media de PSA fue el GB con 10,43 ng/dL, la media del estadio tumoral (TNM,) fue 3,82, la CV postratamiento en GD fue inferior respecto a los demás grupos. CONCLUSIÓN: El tratamiento del CPOC afecta la CV La monoterapia curativa, concretamente la PR y la BT, afectan menos a la CV que la radioterapia externa u otras alternativas terapéuticas. La incontinencia urinaria y las fístulas secundarias al tratamiento del CPOC son las que producen más deterioro en la CV. El cuestionario SF 36 validado internacionalmente es una medida transversal de la CV, útil para comparar el impacto de los tratamientos del CPOC


INTRODUCTION: Prostate cancer (PCa) is the second most common male cancer in the world. Its incidence is estimated to grow to 1.7 million new cases and 499,000 new deaths by 2030. Treatment of OCPC can affect patients physically and mentally, as well as their close relationships and their job or career, which conditions health-related quality of life (QoL). OBJECTIVE: Evaluate the impact on QoL attributable to the treatment for Organ Confined Prostate Cancer (OCPC). MATERIALS AND METHODS: Prospective multicenter observational study of 406 patients with OCPC treated from January 2015 to June 2018. The sample was divided into four study groups, according to the type of treatment: radical prostatectomy (RP) (GA), external radiotherapy (ERT) (GB), brachytherapy (BT) (GC) and other treatments different from monotherapy with RP, ERT or BT (GD). RESULTS: The age in GC was lower, the mean Prostate Specific Antigen (PSA) of all patients was 8.13 ng/ml, the group with the highest mean PSA was GB with a mean of 10.43 ng/dL, the mean Tumor Stage (TNM) was 3.82, and GD had the lowest post treatment quality of life. CONCLUSION: OCPC treatment affects QoL. Curative monotherapies, specifically RP and BT, have less effect on QoL than external radiotherapy or other therapeutic alternatives. Urinary incontinence and fistulas secondary to OCPC have the highest impact on QOL impairment. The internationally validated SF 36 questionnaire is a useful cross-sectional measure of QOL to compare the impact of OCPC treatment modalities


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Qualidade de Vida , Neoplasias da Próstata/fisiopatologia , Neoplasias da Próstata/terapia , Neoplasias da Próstata/complicações , Inquéritos e Questionários , Análise de Variância , Estatísticas não Paramétricas , Resultado do Tratamento , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/fisiopatologia , Fístula da Bexiga Urinária/etiologia , Fístula da Bexiga Urinária/fisiopatologia , Fístula Retal/etiologia , Fístula Retal/fisiopatologia , Fístula Urinária/etiologia , Fístula Urinária/fisiopatologia , Fatores de Risco , Prostatectomia/efeitos adversos
18.
Clin Nucl Med ; 45(12): 1032-1033, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33065616

RESUMO

A 70-year-old man with prostate adenocarcinoma was diagnosed by transrectal biopsy, with Gleason of 4 + 5 and initial PSA of 225 ng/mL since March 2020. Ga-PSMA PET/CT was performed as part of initial staging. The images showed an enlarged prostate with focal PSMA uptake in both lobes. Retroperitoneal and pelvic lymph nodes with moderate uptake of PSMA were shown. Another finding was a moderate PSMA uptake in the both lung parenchymas associated with opacities in CT. The patient denied any symptoms of coronavirus disease and was referred to the emergency department for RT-PCR COVID-19, and the result was positive.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Adenocarcinoma/complicações , Idoso , Infecções por Coronavirus/complicações , Humanos , Achados Incidentais , Linfonodos/patologia , Masculino , Glicoproteínas de Membrana , Compostos Organometálicos , Pandemias , Pneumonia Viral/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/complicações , Neoplasias da Próstata/patologia
19.
Medicine (Baltimore) ; 99(43): e22591, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120746

RESUMO

INTRODUCTION: COVID-19 is now a global pandemic. Although there are very few studies describing the characteristics of SARS-CoV-2 infections in patients with prostate cancer, these patients are likely to be more susceptible to COVID-19 than healthy people because of their immunosuppressed state. However, there is no evidence that prostate cancer is a risk factor for COVID-19. METHODS: We searched the Wanfang database, the China Science Journal Citation Report (VIP database), the China National Knowledge Infrastructure (CNKI), Web of Science, EMBASE, PubMed, and the Cochrane Library for studies related to the topic. We designed a standardized data extraction sheet and used Epidata software 3.1 for data extraction. In accordance with the Cochrane 5.1.0 standard, both a quality assessment and a risk assessment were carried out for the research meeting the inclusion criteria. The data were analyzed using Revman 5.3 and Stata 13.0 software. RESULTS: The study integrated existing research findings and a meta-analysis of the data to investigate the prevalence of prostate cancer in males infected with SARS-CoV-2 and the adverse clinical outcomes in male patients with or without COVID-19. CONCLUSION: The results of this research may provide a basis for judging if prostate cancer is a risk factor for males infected with SARS-CoV-2, and the findings can effectively help to prevent COVID-19 in patients with prostate cancer. ETHICS AND DISSEMINATION: Ethics approval is not required for this systematic review as it will involve the collection and analysis of secondary data. The results of the review will be reported in international peer-reviewed journals PRORPERO REGISTRATION NUMBER:: CRD42020194071.


Assuntos
Betacoronavirus , Infecções por Coronavirus/etiologia , Pneumonia Viral/etiologia , Neoplasias da Próstata/complicações , Protocolos Clínicos , Infecções por Coronavirus/diagnóstico , Saúde Global , Humanos , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Prevalência , Prognóstico , Neoplasias da Próstata/epidemiologia , Medição de Risco , Fatores de Risco
20.
Actas urol. esp ; 44(8): 535-541, oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197144

RESUMO

INTRODUCCIÓN: Pocos son los estudios que comparan la prostatectomía radical abierta (PRA) con la prostatectomía radical laparoscópica (PRL) y sus resultados funcionales, como la continencia urinaria (CU), que es uno de los objetivos prioritarios tras el control oncológico. OBJETIVOS: Comparar la CU postoperatoria en los pacientes con adenocarcinoma de próstata localizado intervenidos mediante PRA frente a PRL. MATERIAL Y MÉTODOS: Comparación de dos cohortes (312 con PRA y 206 con PRL) entre los años 2007 y 2015. El estado de CU se recogió a los 3, 6, 12, 18 y 24meses. Para el manejo estadístico hemos agrupado la continencia en: a)CU, pacientes que no precisaron absorbentes, y b)incontinencia urinaria (IU), pacientes que precisaron absorbentes. Para el contraste de variables cualitativas se ha utilizado el test de la chi cuadrado para las variables cualitativas y ANOVA para las cuantitativas. Análisis multivariable mediante regresión logística para la variable dependiente IU. La significación estadística se consideró cuando existió una p < 0,05. RESULTADOS: En el 51,7% se realizó conservación neurovascular. A los 24meses de la cirugía, el 72,4% presentaban CU, de los cuales el 87,8% con PRA frente al 78,1% con PRL (p = 0,004). El 22,7% presentaron recidiva bioquímica (RB), siendo el 83% tratados con radioterapia de rescate (RTR). Los pacientes con RTR presentaron mayor porcentaje de IU frente a los que no la recibieron (p = 0,036). Se objetivó mayor porcentaje de estenosis de la anastomosis en PRA (p = 0,03). CONCLUSIONES: La PRL, la no preservación de los fascículos neurovasculares y la RTR se relacionaron directamente con la CU postoperatoria


INTRODUCTION: There are very few articles comparing open radical prostatectomy (ORP) vs. laparoscopic radical prostatectomy (LRP) and their functional results or urinary continence (UC), which is one of the most important objectives to pursue after oncological results. OBJECTIVES: To compare postoperative UC in patients with localized prostatic adenocarcinoma treated with OPR or LRP. MATERIAL AND METHODS: Comparison between two patient cohorts (312 for ORP and 206 for LRP) between 2007-2015. The UC was evaluated at 3, 6, 12, 18 and 24months. Continence was defined and classified as follows: a)UC, no need of pads, and b)urinary incontinence (UI), use of pads. To compare the qualitative variables, we employed the chi-squared test and ANOVA for quantitative variables. We performed a multivariate analysis using logistic regression with dependent qualitative variable UI. Statistical significance when P<.05. RESULTS: Nerve-sparing was performed in 51.7% cases. At 24months after surgery, 72.4% patients had UC, of which 87.7% were from the ORP group and 78.1% in the LRP group (P=.004). 22,7% of patients experienced biochemical recurrence (BR), with 83% treated with salvage radiotherapy (SRT), presenting greater UI percentage (P=.036). ORP patients showed a higher percentage of anastomosis stricture (P=.03). CONCLUSIONS: LRP, non-nerve sparing, and SRT were directly related to postoperative UI


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Adenocarcinoma/cirurgia , Neoplasias da Próstata/cirurgia , Incontinência Urinária/etiologia , Prostatectomia/métodos , Laparoscopia/métodos , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Adenocarcinoma/complicações , Neoplasias da Próstata/complicações , Prostatectomia/efeitos adversos , Laparoscopia/efeitos adversos , Resultado do Tratamento , Fatores de Tempo , Absorventes Higiênicos , Fatores de Risco , Análise Multivariada
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