Vínculos entre psicooncología y enfermería en el cuidado continuo de personas con cáncer de próstata / Links between Psycho-Oncology and Nursing in the Ongoing Care of Individuals with Prostate Cancer

Introducción: La enfermería en oncología ocupa un lugar preponderante dentro del equipo multidisciplinar, y el concepto de cuidado va más allá de actividades técnicas, donde toda relación terapéutica implica, de modo necesario, un proceso de relación interpersonal, para lo cual se deben desarrollar habilidades y destrezas comunicativas. Objetivo: Analizar los vínculos entre la psicooncología y la enfermería en el cuidado continuo de personas con cáncer de próstata. Métodos: Revisión bibliográfica sistemática de artículos publicados desde 2011 hasta 2020 en las bases de datos SciELO, Google académico y Dialnet. Se elaboró la pregunta guía a través del acrónimo PICo. La estrategia de búsqueda se realizó mediante los descriptores en Ciencias de la Salud (DeCS) "Psicooncología", "Enfermería", "Cuidados continuos", "Neoplasia de la próstata" y "Enfermedades crónicas" con los operadores booleanos AND y OR. Se utilizó el diagrama de flujo (PRISMA). Se accedió a interpretar los referentes teóricos y organización del conocimiento en las 16 bibliografías seleccionadas. Conclusiones: La revisión realizada permitió enfatizar la importancia de integrar técnicas y habilidades de la psicooncología, sus beneficios y aplicación desde las perspectivas de enfermería, con el propósito de favorecer el bienestar biopsicosocial de la persona con cáncer de próstata(AU)

Introduction: Nursing in oncology occupies a preponderant place within the multidisciplinary team, and the concept of care goes beyond technical activities, any therapeutic relationship necessarily implies an interpersonal relationship process, for which skills and communication skills must be developed. Objective: To analyze the links between psycho-oncology and nursing in the continuous care of individuals with prostate cancer. Methods: We develop a systematic bibliographic review of articles published from 2011 to 2020 in the SciELO, Google academic and Dialnet databases. The guiding question was developed through the acronym PICo. The search strategy was carried out using the Health Sciences (DeCS) descriptors "Psychooncology", "Nursing", "Continuous care", "Prostate neoplasia" and "Chronic diseases" with the Boolean operators AND and OR. PRISMA flow chart was used. It was agreed to interpret the theoretical references and organization of knowledge in the 16 selected bibliographies. Conclusions: The review carried out made it possible to emphasize the importance of integrating techniques and skills of psycho-oncology, their benefits and application from the nursing perspectives, with the purpose of favoring the bio psychosocial well-being of the person with prostate cancer(AU)

Puntos de encuentro entre Teorías de Swanson y Roy en el cuidado continuo del adulto mayor con cáncer prostático / Meeting Points between Swanson's and Roy´s Theories in Continuous Care for the Elderly with Prostate Cancer

Introducción: La gestión del cuidado de enfermería, en las personas mayores es un desafío actual para la profesión. Lo que implica planificar y coordinar cuidados seguros y de calidad. Donde se atribuye la necesidad de integrar el enfoque de las teorías y su práctica en el cuidado sistémico y dinámico a la persona en su realidad total. Objetivo: Analizar los puntos de encuentro entre las teorías de Swanson y Roy en el cuidado continuo del adulto mayor con cáncer de próstata. Métodos: Revisión bibliográfica sistemática, durante 2019, de artículos publicados desde 2009 hasta 2019 en las bases de datos SciELO y Google académico. La pregunta guía se elaboró a través del acrónimo PICo. La estrategia de búsqueda se realizó mediante aceptación de los descriptores en Ciencias de la Salud (DeCS) "Teorías de enfermería", "Modelo de adaptación de Callista Roy", "Teoría de Kristen Swanson", "Cuidados continuos", "Adulto mayor", "Neoplasia de la próstata" y "Enfermedades crónicas" con el operador booleano AND, se utilizó el diagrama de flujo (PRISMA). El análisis de contenido permitió interpretar los referentes teóricos y la organización del conocimiento de las 13 bibliografías seleccionadas. Conclusiones: Resulta limitada la producción científica encontrada en relación al alcance de las teorías de Swanson y Roy en la atención al paciente con cáncer. Ambas teorías tienen implícitas, en la fundamentación de sus componentes, un acercamiento biopsicosocial al modo de cuidar en la práctica clínica y la cultura del cuidado continuo en el adulto mayor con cáncer de próstata, desde la perspectiva de enfermería(AU)

Introduction: Nursing care management in the elderly is a current challenge for the profession. This implies planning and coordinating safe and quality care, processes requiring to integrate theoretical approach and their praxis into systemic and dynamic care to the person in a total reality. Objective: To analyze the meeting points between the theories of Swanson and Roy in the continuous care of the elderly with prostate cancer. Methods: Systematic bibliographic review, carried out during 2019, of articles published from 2009 to 2019 in the SciELO and Google Scholar databases. The guiding question was developed through the acronym PICO. The search strategy was carried out by accepting the following descriptors in Health Sciences (DeCS): teorías de enfermería [nursing theories], modelo de adaptación de Callista Roy [Callista Roy's adaptation model], teoría de Kristen Swanson [Kristen Swanson's theory], cuidados continuos [continuous cares], adulto mayor [elderly], neoplasia de la próstata [prostate neoplasm] and enfermedades crónicas [chronic diseases] with the Boolean operator AND. The flow diagram (PRISMA) was used. Content analysis allowed to interpret the theoretical references and to organize knowledge of the thirteen selected bibliographies. Conclusions: There is limited scientific production found about the scope of Swanson's and Roy´s theories regarding the care of patients with cancer. Both theories include implicitly, in the foundation of their components, a biopsychosocial approach to the way of caring, in clinical praxis, as well as the culture of continuous care for the elderly with prostate cancer, from the nursing perspective(AU)

Comportamiento de las infecciones del sistema genitourinario en el Hospital Universitario "Comandante Faustino Pérez Hernández". Matanzas. 2014-2019 / Behavior of the genitourinary system infections in the University Hospital "Comandante Faustino Perez Hernandez". 2014-2019

RESUMEN Introducción: durante mucho tiempo los términos infección y sepsis han sido utilizados en forma alternativa, la tendencia actual es referirse al término infección como proceso bacteriano dependiente del germen. Objetivo: caracterizar el comportamiento de las infecciones urológicas en el servicio de urología del Hospital Universitario Comandante "Faustino Pérez Hernández", Matanzas. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal, a los pacientes atendidos en el servicio de urología del hospital Faustino Pérez, mediante el método de pesquisaje activo en el periodo comprendido desde enero de 2014 hasta diciembre de 2019. Resultados: se comprobó que la mayor parte de la población sometida a estudio es adulta mayor, predominando el sexo masculino. Entre las patologías crónicas asociadas a infecciones se encuentran la diabetes mellitus, la insuficiencia renal crónica, las inmunodeficiencias. El uso de catéteres se presentó en más de un 64% de los pacientes con infecciones. La echerichia coli fue el germen de mayor incidencia seguido de la klepsiella, pseudomonas. Conclusiones: la hiperplasia benigna de próstata, las litiasis, estenosis uretrales y los tumores uroteliales y prostático, son las principales causas obstructivas asociadas a infecciones. Un grupo importante de los pacientes operados presentaron infección del sitio quirúrgico. La sensibilidad bacteriana ante los antibióticos mostró mayor sensibilidad a meropenem, aztreonam y amikacina (AU).

Summary Introduction: the terms infection and sepsis have being alternatively used during many years; the current tendency is referring to the term infection as a germ- dependent bacterial process. Objective: to characterize the behavior of urologic infections in urological service of the University Hospital "Comandante Faustino Perez Hernandez". Materials and methods: an observational, descriptive, cross-sectional research has been made to the patients who have attended the urology service of the University Hospital "Comandante Faustino Perez Hernandez", using the method of active screening in the period from January 2014 until December 2019. Results: it was proved that the biggest part of the studied population is elder adult people, predominating the male sex. Diabetes mellitus, chronic renal failure, immunodeficiency were found among the chronic diseases associated to infections. The use of catheters was present in more than 64% of patients. Echerichia coli was the germ with highest incidence, followed by Klepsiella, andPseudomonas. Conclusions: benign prostatic hyperplasia, lithiasis, urethral stenosis, prostatic and urothelial tumors are the main obstructive causes associated to infections. An important group of patients who underwent surgery presented infections at the surgical site. Bacteria showed higher sensitivity to antibiotics like meropenem, aztreonam and amikacin (AU).

Role of Adiponectin in prostate cancer

ABSTRACT Obesity is defined as a chronic and excessive growth of adipose tissue. It has been associated with a high risk for development and progression of obesity-associated malignancies, while adipokines may mediate this association. Adiponectin is an adipose tissue-derived adipokines, with significant anti-diabetic, anti-inflammatory, anti-atherosclerotic and anti-proliferative properties. Plasma adiponectin levels are decreased in obese individuals, and this feature is closely correlated with development of several metabolic, immunological and neoplastic diseases. Recent studies have shown that prostate cancer patients have lower serum adiponectin levels and decreased expression of adiponectin receptors in tumor tissues, which suggests plasma adiponectin level is a risk factor for prostate cancer. Furthermore, exogenous adiponectin has exhibited therapeutic potential in animal models. In this review, we focus on the potential role of adiponectin and the underlying mechanism of adiponectin in the development and progression of prostate cancer. Exploring the signaling pathways linking adiponectin with tumorigenesis might provide a potential target for therapy.

Cáncer de próstata: actualización / Câncer de próstata: atualização / Prostate cancer: update

Introducción: en Cuba el cáncer de próstata es la primera causa de muerte por cáncer en hombres. Objetivo: sistematizar las bases teóricas esenciales que sustenten la autopreparación del estudiante de medicina y al médico general para su participación en la prevención, diagnóstico precoz y manejo del paciente con cáncer de próstata. Método: en la Facultad de Medicina de Guantánamo, entre septiembre y diciembre de 2018; se hizo una búsqueda en las bases de datos electrónicas a través del metabuscador Google Scholar. Resultados: se elaboró una monografía sobre las consideraciones actuales sobre el cáncer d próstata al nivel de los estudiantes de medicina y del médico general que contuvo los siguientes núcleos de conocimientos: definición, fisiopatología, etiología, diagnóstico y tratamiento. Conclusiones: la expresión clínica de este cáncer es diversa y aún no se cuenta con biomarcadores precisos para su diagnóstico, lo que hace ineludible la habilitación de los médicos generales para contribuir con eficiencia en su prevención y diagnóstico clínico precoz en función de asegurar al paciente una mayor posibilidad de cura y supervivencia(AU)

Introduction: in Cuba, prostate cancer is the leading cause of cancer death in men. Objective: systematize the essential theoretical bases that sustain the self-preparation of the medical student and the general practitioner for their participation in the prevention, early diagnosis and management of the patient with prostate cancer. Method: in the Faculty of Medicine of Guantánamo, between September and December 2018; a search was made in the electronic databases through the Google Scholar metasearch engine. Results: a monograph was prepared on the current considerations on prostate cancer at the level of medical students and general practitioner that contained the following nuclei of knowledge: definition, pathophysiology, etiology, diagnosis and treatment. Conclusions: the clinical expression of this cancer is diverse and precise biomarkers are not yet available for its diagnosis, which makes it essential for general practitioners to be able to contribute efficiently to its prevention and early clinical diagnosis in order to ensure the patient a greater chance of cure and survival(AU)

Introdução: em Cuba, o câncer de próstata é a principal causa de morte por câncer em homens. Objetivo: sistematizar as bases teóricas essenciais que sustentam a autopreparação do estudante de medicina e do clínico geral para sua participação na prevenção, diagnóstico precoce e manejo do paciente com câncer de próstata. Método: na Faculdade de Medicina de Guantánamo, entre setembro e dezembro de 2018; foi realizada uma busca nas bases de dados eletrônicas por meio do mecanismo de metabusca do Google Acadêmico. Resultados: elaborouse uma monografia sobre as atuais considerações sobre o câncer de próstata em nível de estudantes de medicina e clínico geral que continha os seguintes núcleos de conhecimento: definição, fisiopatologia, etiologia, diagnóstico e tratamento. Conclusões: A expressão clínica desse tipo de câncer é diversa e ainda não tem biomarcadores precisos para o diagnóstico, o que torna inevitável permitindo que clínicos gerais para contribuir de forma eficaz na prevenção e no diagnóstico clínico precoce em termos de assegurar ao paciente um maior chance de cura e sobrevivência(AU)

Polygamy, sexual behavior in a population under risk for prostate cancer diagnostic: an observational study from the Black Sea Region in Turkey

ABSTRACT Aim: Although prostate cancer (PCa) is the most common cancer type in men, a replaceable risk factor has not yet been established. In our study, we assessed the relationship between the number of sexual partners, age of first sexual experience and age of first masturbation and prostate cancer incidence. Materials and Methods: In Ordu University Department of Urology between January 2013 and September 2016, in PSA elevation and rectal examination, patients with prostate biopsy were evaluated due to nodule palpation in the prostate. At younger ages and at present, their first masturbation ages, first sexual debut ages, and total sexual partner numbers were recorded. The correlation between the obtained data and PCa frequency was evaluated. Results: The study included 146 patients with PCa identified on biopsy and 171 patients with benign biopsy results who answered the questions. 66.7% of the ones whose biopsy results were benign and 40.6% of cancer suspects had only one sexual partner. The median number of sexual partners was 1±4 (1-100) in the benign group and 2±6 (1-500) in the malignant group (p=0.039). There was a negative correlation between age of first sexual debut and number of partners (r: −0,479; p <0.001). Conclusion: In our study, it appears that there may be an association between the number of sexual partners and prostate cancer in the patient group with PSA level above 4ng/mL. Avoidance of sexual promiscuity or participation in protected sex may be beneficial to protect against prostate cancer.

Prostate cancer in renal transplant recipients

ABSTRACT As patients with end-stage renal disease are receiving renal allografts at older ages, the number of male renal transplant recipients (RTRs) being diagnosed with prostate cancer (CaP) is increasing. Historically, the literature regarding the management of CaP in RTR's is limited to case reports and small case series. To date, there are no standardized guidelines for screening or management of CaP in these complex patients. To better understand the unique characteristics of CaP in the renal transplant population, we performed a literature review of PubMed, without date limitations, using a combination of search terms including prostate cancer, end stage renal disease, renal transplantation, prostate cancer screening, prostate specific antigen kinetics, immuno-suppression, prostatectomy, and radiation therapy. Of special note, teams facilitating the care of these complex patients must carefully and meticulously consider the altered anatomy for surgical and radiotherapeutic planning. Active surveillance, though gaining popularity in the general low risk prostate cancer population, needs further study in this group, as does the management of advance disease. This review provides a comprehensive and contemporary understanding of the incidence, screening measures, risk stratification, and treatment options for CaP in RTRs.

Disparities in cancer epidemiology and care delivery among Brazilian indigenous populations / Disparidades na epidemiologia e no tratamento de câncer nas populações indígenas brasileiras

ABSTRACT Objective: To assess aspects related to cancer in indigenous population. Methods: This is a retrospective study developed in a public university hospital. We included patients with 18 or more years of age, diagnosed with solid tumors, and followed between 2005 and 2015. Clinical features were assessed by descriptive statistics, and survival was evaluated by Kaplan-Meier curves and multivariate Cox regression. Results: Fifty patients were included. The cancer incidence was 15.73 per 100,000. The mean age at diagnosis was 54 years and most patients were female (58%). Cancer of the cervix (28%) and prostate (16%) were the most common. The mean time between the onset of symptoms and the diagnosis was 9 months and from diagnosis to the treatment was 3.4 months. Disease diagnosed at stage IV (17%) had worse overall survival (HR: 11.4; p<0.05). The 5-year survival rate ranged from 88% for prostate cancer to 0% for lung cancer. All 5-year survival rates were lower as compared to other populations. Conclusion: The most prevalent cancer sites were cervix and prostate. Disease stage and primary site were prognostic factors.

RESUMO Objetivo: Avaliar os aspectos relacionados a câncer em populações indígenas. Métodos: Estudo retrospectivo conduzido em um hospital universitário público. Foram incluídos pacientes com 18 anos ou mais, diagnosticados com tumores sólidos e acompanhados entre 2005 e 2015. Os aspectos clínicos foram avaliados por meio de estatística descritiva, e a sobrevida foi avaliada por meio de curvas de Kaplan-Meier e regressão multivariada de Cox. Resultados: Foram incluídos 50 pacientes. A incidência de câncer foi 15,73 por 100 mil. A média de idade ao diagnóstico foi 54 anos, e a maioria era do sexo feminino (58%). O câncer de colo uterino (28%) e o de próstata (16%) foram os mais frequentes. O tempo médio entre o início dos sintomas e o diagnóstico foi 9 meses, e entre o diagnóstico e o tratamento, de 3,4 meses. Doença diagnosticada no estágio IV (17%) resultou em pior sobrevida global (HR: 11,4; p<0,05). A sobrevida em 5 anos variou de 88% para o câncer de próstata a 0% para pulmão. Todas as taxas de sobrevida em 5 anos foram menores em comparação a outras populações. Conclusão: Os locais mais frequentes de neoplasia foram colo de útero e próstata. O estágio da doença e o sítio primário foram fatores prognósticos.

Decreased expression of Toll-like receptor 4 and 5 during progression of prostate transformation in transgenic adenocarcinoma of mouse prostate mice

Chronic inflammation has been considered an important risk factor for development of prostate cancer. Toll-like receptors (TLRs) recognize microbial moieties or endogenous molecules and play an important role in the triggering and promotion of inflammation. In this study, we examined whether expression of TLR4 and TLR5 was associated with progression of prostate transformation in the transgenic adenocarcinoma of mouse prostate (TRAMP) model. The expression of TLR4 and TLR5 was evaluated by immunohistochemisty in formalin-fixed paraffin-embedded prostate tissue from wild-type (WT) and TRAMP mice. Normal prostate tissue from WT mice showed strong expression of TLR4 and TLR5. However, TLR4 expression in the prostate tissue from TRAMP mice gradually decreased as pathologic grade became more aggressive. TLR5 expression in the prostate tissue from TRAMP mice also decreased in low-grade prostate intraepithelial neoplasia (PIN), high-grade PIN and poorly differentiated adenocarcinoma. Overall, our results suggest that decreased expression of TLR4 and TLR5 may contribute to prostate tumorigenesis.

Inflamación y cáncer de próstata: implicaciones biológicas y posible utilidad clínica / Inflammation and prostate cancer: Biological implications and clinical usefulness

El cáncer de próstata es la neoplasia no cutánea que afecta con mayor frecuencia a los hombres en todo el mundo. Existe evidencia que señala un papel de la inflamación crónica en el desarrollo de distintas neoplasias en humanos, entre ellas el cáncer de próstata. Esta asociación fue sugerida hace mucho tiempo por la observación de infiltrados en muestras de tejido prostático de pacientes con cáncer y, más recientemente, por los altos niveles de citocinas proinflamatorias en el suero de pacientes con esta enfermedad. Muchos estudios han determinado la asociación de ciertos polimorfismos de base única en genes asociados a inflamación con el riesgo de desarrollar cáncer de próstata. En los últimos años se han descrito los efectos de moléculas inflamatorias sobre el comportamiento biológico de esta neoplasia; se destacan entre ellos el potencial de inducir la proliferación de células cancerígenas y la des-diferenciación de células del estroma. La influencia de la inflamación en el desarrollo y avance del cáncer de próstata se ha convertido en un asunto de interés debido al potencial diagnóstico y terapéutico de su uso. Se espera que en el futuro una mejor comprensión biológica de esta asociación lleve a una explotación práctica de su utilidad clínica.

Worldwide, prostate cancer is the non-cutaneous neoplasm that most frequently affects men. Recent evidence demonstrates a role for chronic inflammation in the development of different cancer types in humans, including prostate cancer. This association was suggested long ago by the observation of inflammatory infiltrates in tissue samples from patients with prostate cancer. More recently it has been supported by high levels of circulating pro-inflammatory cytokines in serum of patients with this disease. Multiple studies have found association between certain single nucleotide polymorphisms in genes associated with inflammation, and the risk of developing prostate cancer. In the last few years, the effects of inflammatory molecules on the behavior of this disease have been described; among them, the potential to induce cancer cell proliferation and dedifferentiation of stromal cells. The influence of inflammation in the development and progression of prostatic cancer has become a topic of interest because of the potential use in diagnosis and therapy. It is expected that a better biological understanding of the mechanisms underlying this association may lead to a practical exploitation of its clinical usefulness.

Chemical Castration for Sexual Offenders: Physicians' Views

No abstract available.

Elevated Insulin and Insulin Resistance Are Associated with the Advanced Pathological Stage of Prostate Cancer in Korean Population

The study was designed to investigate the effect of serum glucose, insulin and insulin resistance on the risk of prostate cancer (CaP) and on the clinicopathological characteristics in Korean men. Subjects were retrospectively recruited from 166 CaP patients underwent radical prostatectomy and 166 age-matched benign prostatic hyperplasia (BPH) patients. The serum was taken on the morning of the day of operation and insulin resistance was assessed by homeostasis model assessment insulin resistance index (HOMA-IR). Men in highest tertile of insulin was associated with 55% reduced odds of CaP than those with the lowest tertile (OR = 0.45, 95% CI = 0.23-0.89, P = 0.022). The patients in highest tertile of insulin had a more than 5.6 fold risk of locally advanced stage than those in the lowest tertile (OR = 5.62, 95% CI = 1.88-16.83, P = 0.002). Moreover, the patients in the highest tertile HOMA-IR group was associated with an increased risk of locally advanced stage than the lowest tertile group (OR = 3.10, 95% CI = 1.07-8.99, P = 0.037). These results suggest that elevated insulin and insulin resistance are associated with the advanced pathological stage of prostate cancer in Korean patients.

Relación de los cánceres de próstata y de mama con el consumo de alcohol / Prostate and breast cancer: their relationship with alcohol intake

Además del hábito de fumar y de la alimentación, el consumo de alcohol es uno de los factores de riesgo más importante para los cánceres humanos. Las localizaciones del organismo asociadas con este riesgo incluyen el tracto aerodigestivo superior, hígado, mama, colon, recto y, con algún grado de incertidumbre, estómago, próstata y pulmón. Aquí analizamos el mecanismo por el cual el consumo de alcohol promueve la inducción de cáncer en las etapas del proceso de iniciación y promoción de los cánceres de mama y de próstata. Se hace énfasis especialmente en la necesidad de una biotransformación del etanol al mutágeno/carcinógeno acetaldehído y de la estimulación de un proceso de generación de radicales libres del propio alcohol y de especies reactivas de oxígeno. En recientes estudios en nuestro laboratorio encontramos nuevas vías metabólicas para la generación in situ de metabolitos reactivos de etanol, en mama y próstata de rata y la aparición de un daño celular asociado. Visualizamos el efecto estimulador del consumo de alcohol sobre la activación de otros carcinógenos ambientales, su capacidad para inhibir procesos de reparación de daños en el ADN, sobre el sistema inmunitario y en la progresión del proceso carcinogénico. Señalamos posibilidades preventivas que surgen más allá de evitar el consumo de bebidas alcohólicas, que involucran sustancias protectoras componentes de la dieta.

diet a risk factor for benign prostatic hyperplasia and carcinoma prostate?

To find an association between diet and benign prostatic hyperplasia [BPH] and carcinoma prostate [CaP]. Ninety three out of 250 subjects were selected representing the normals, BPH and CaP cases; food frequency questionnaire was duly filled. Food intake was calculated by using food guide pyramid and was categorized as low, moderate and high. In addition to common diets, we studied consumption of reused oil/ghee in our study. No association of protein, milk and milk products, cereals, fats [saturated/ unsaturated/both fats, oil/ghee branded or unbranded], vegetables, fruits and smoked food/barbecue was found with BPH and CaP cases. But there was a significant association between oil/ghee reuse and BPH and CaP. This study did not find an association between the common diet components and BPH and CaP cases. However a significant association was observed in case of oil/ghee reuse. So it is concluded that commonly used diet components in our setup could not be incriminated as etiological/risk factors for BPH and CaP in our community except reused oil/ghee and hence forth its consumption must be stopped

Cáncer de próstata en el momento actual de la vida argentina / Present status of prostate cancer in Argentina

Prostate cancer (PCa) is the most common malignancy in men, and represents the third leading cause of cancer mortatlity in men older than 60 years. It is a solid tumor with the particularity to occur in two different forms: the histologic or indolent, accounting for up to 10 percent during the 5 decade of life, 30 percent during the 7 and 80 percent after the 8, and the clinical form, affecting 1 for each six men...

Prostate cancer and acromegaly: [review] / Câncer de próstata e acromegalia: [revisão]

Acromegalic patients have an increased prevalence of prostatic disorders compared to age-matched healthy subjects. Increased size of the whole prostate or the transitional zone, together with an elevated incidence of other structural changes, such as nodules, cysts, and calcifications, have been reported. Prostate enlargement in young acromegalic patients with low testosterone levels due to central hypogonadism supports the hypothesis that chronic GH and IGF-I excess cause prostate hyperplasia. The relationship between prostatic carcinoma and acromegaly is, until now, only circumstantial. Long-term follow-up of these patients is necessary since epidemiologic studies showed association between serum IGF-I levels in the upper normal limit and prostate cancer in the general population. This review approaches prostate diseases in patients with acromegaly.

Pacientes com acromegalia têm uma prevalência aumentada de desordens prostáticas em comparação a controles saudáveis da mesma idade. Aumento do tamanho de toda a próstata ou da zona de transição, juntamente com uma incidência elevada de outras alterações estruturais, como nódulos, cistos e calcificações, foi descrito. O aumento da próstata em acromegálicos jovens e com níveis baixos de testosterona devido ao hipogonadismo central sugere que o excesso crônico do GH e do IGF-I cause hiperplasia prostática. A relação entre câncer de próstata e acromegalia é, até o momento, apenas circunstancial. Entretanto, um seguimento prolongado desses pacientes é necessário uma vez que estudos epidemiológicos reportaram uma associação entre níveis séricos de IGF-I no limite superior da normalidade e câncer de próstata na população geral. Esta revisão aborda as patologias prostáticas em pacientes com acromegalia.

IGF-I, insulin and prostate cancer: [review] / IGF-I, insulina e câncer de próstata: [revisão]

Prostate cancer is the second most frequent malignancy diagnosed in adult men. Androgens are considered the primary growth factors for prostate normal and cancer cells. However, other non-androgenic growth factors are involved in the growth regulation of prostate cancer cells. The association between IGF-I and prostate cancer risk is well established. However, there is no evidence that the measurement of IGF-I enhances the specificity of prostate cancer detection beyond that achievable by serum prostate-specific antigen (PSA) levels. Until now, there is no consensus on the possible association between IGFBP-3 and prostate cancer risk. Although not well established, it seems that high insulin levels are particularly associated with risk of aggressive prostatic tumours. This review describes the physiopathological basis, epidemiological evidence, and animal models that support the association of the IGFs family and insulin with prostate cancer. It also describes the potential therapies targeting these growth factors that, in the future, can be used to treat patients with prostate cancer.

O câncer de próstata é a segunda neoplasia mais frequentemente diagnosticada em homens adultos. Os androgênios são considerados fatores de crescimento primários para células prostáticas normais e malignas. Entretanto, outros fatores de crescimento não androgênicos estão envolvidos na regulação do crescimento das células prostáticas malignas. Associação entre IGF-I e risco de câncer de próstata é bem estabelecida. No entanto, não há evidência de que a dosagem do IGF-I melhore a especificidade na detecção do câncer de próstata, além daquela alcançada pelos níveis de antígeno prostático específico (PSA). Até hoje, não há consenso sobre a possível associação entre IGFBP-3 e risco de câncer de próstata. Apesar de não estar estabelecido, altos níveis de insulina parecem particularmente associados ao risco de tumores prostáticos agressivos. Esta revisão descreveu base fisiopatológica, evidências epidemiológicas e modelos animais que apoiam a associação da família das IGFs e insulina com câncer de próstata. Também foram descritas terapias potenciais que têm como alvo esses fatores de crescimento, os quais, no futuro, poderão ser usados para tratar pacientes com câncer de próstata.

Polimorfismo G1385A del gen RNASEL y su asociación con el desarrollo de cáncer de próstota: estudio preliminar / G138A polymorphism of the RANASEL gene and its association with the development of prostate cancer: preliminary study

El cáncer de Próstata (CAP), es una enfermedad compleja de origen multifactorial. Se caracteriza por patrones heterogéneos de crecimiento de tejido neoplásico, que varían ampliamente en su progresión, edad de aparición y respuesta al tratamiento. Se considera la segunda causa más común de muerte por malignidad en hombres y se estima que uno de cada cinco padece de CAP en el curso de su vida. La etiología genética de la transformación neoplásica de las células prostáticas normales aún es desconocida, sin embargo, investigaciones epidemiológicas han demostrado un fuerte componente genético en su desarrollo, y sugieren tanto un patrón de herencia mendeliana como la presencia de loci de susceptibilidad a lo largo del genoma humano. Se ha descrito una región cromosómica relacionada con el CAP denominada como HPC1, en el locus 1q24-25, donde se ubica el gen RNASEL, y las mutaciones en el mismo, se han asociado con la presencia del CAP en múltiples grupos familiares. EL gen RNASEL codifica para una ribonucleasa que degrada ARN viral y celular y que interviene en la apoptosis. Se ha reportado disminución de la actividad enzimática de hasta tres veces en portadores del polimorfismo G1385A de este gen, y la misma se ha asociado frecuentemente con el desarrollo del CAP. Mediante la utilización de una variante de la Reacción en Cadena de la Polimerasa (RCP), una amplificación alelo específica, se estudiaron 103 individuos masculinos con y sin CAP pertenecientes a la población de Maracaibo, Venezuela, evidenciándose ausencia de asociación.

Prostate Cancer (CAP), is a complex disease with a multifactorial origin. It is characterized by heterogenous patterns of growth of neoplasic tissue, varying widely in its progression, age of beginning and therapy response. It is considered as the second most common cause of death by cancer in men and, it has been estimated, that one of five, suffers of CAP through the course of his life. The genetic etiology of neoplasic transformation of normal prostate cells is still not known; nevertheless, investigations in epidemiology have demonstrated a strong genetic component in its development, suggesting so much a pattern of mendelian inheritance as the presence of loci of susceptibility throughout the human genome. It has been described a cromosomic location related to the CAP in locus 1q24-25, denominated HPC1, where the gene RNASEL is located, and the seggregation of its alleles has been associated with the development of CAP in numerous familiar groups. The RNASEL gene codifies for a ribonuclease protein that degrades viral and cellular ARN and takes part in the apoptosis. A decrease of the enzymatic activity up to three times in carriers of the G1385A polymorphism of this gene has been reported, and the same has been associated frequently with the development of CAP. Using a variant of the Polymerase Chain Reaction, Allele specific amplification, this investigation had as objective to determine the association between variant G1385A and CAP, in a sample of 103 masculine individuals with and without CAP, pertaining to the population of Maracaibo, Venezuela, An association between these variants and CAP could not be demonstrated.