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Piper is a large plant genus containing essential oils rich in mono and sesquiterpenes and other secondary metabolites showing different biological activities. Piper aequale, cordoncillo, is used in México for urinary and prostate ailments, suggesting a potential therapeutic effect against prostate cancer. Due to the lack of chemical and pharmacological information on this species, in this work antimicrobial and antiproliferative activities were evaluated. Leaves ethanol and methanol extracts were used to assess antioxidant activity (DPPH, FRAP), antimicrobial activity (Kirby-Bauer) against clinically relevant strains and antiproliferative activity on prostate cancer cell line PC-3 (MTT assay). Methanolic extract exhibited the highest antioxidant activity, with 69.08% (DPPH) and inhibitory effects on pathogenic bacterial strains associated with urinary tract infections. Ethanolic extract displayed moderate antiproliferative activity (IC5081.28 µg/mL), showing cytotoxicity from 100 µg/mL. This study demonstrates P. aequale exhibits inhibitory effects against bacteria associated with urinary problems and antiproliferative properties in prostate cancer cells.

Piper es un género numeroso de plantas con aceites esenciales ricos en mono y sesquiterpenos y otros metabolitos bioactivos. Piper aequale, cordoncillo, se usa en México para afecciones urinarias y prostáticas, sugiriendo un posible efecto terapéutico contra el cáncer de próstata. Con poca información química y farmacológica, en este trabajo se evaluaron las actividades antimicrobiana y antiproliferativa. En los extractos etanólico EE y metanólico EM de hojas se determinaron la actividad antioxidante (DPPH, FRAP), antimicrobiana (Kirby-Bauer) frente a cepas clínicamente relevantes y antiproliferativa en la línea celular PC-3 de cáncer de próstata (ensayo MTT). EM exhibió la mayor actividad antioxidante, 69,08% (DPPH) y efecto inhibidor de bacterias asociadas a infecciones urinarias. EE mostró actividad antiproliferativa moderada (IC5081,28 µg/mL) y citotoxicidad a partir de 100 µg/mL. Este estudio demostró que P. aequale ejerció actividad antimicrobiana contra bacterias presentes en afecciones urinarias y actividad antiproliferativa en células de cáncer de próstata.

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Introduction@#Prostate cancer is a significant health problem worldwide. Transrectal ultrasound guided biopsy has limitations in the detection of clinically significant disease, hence, new imaging including multiparametric MRI and MRI targeted biopsy is developed. In most centers, reading and contouring of the prostate and identification of significant lesions on MRI are performed by radiologists. In this institution, these steps are performed by a urologist.@*Objective@#To determine the clinically significant cancer detection rate in patients undergoing MRI fusion-targeted and random systematic prostate biopsy where MRI PIRADS scoring, identification of lesions and contouring are performed by a trained urologist in a Philippine tertiary hospital.@*Methods@#This is a cross-sectional study of patients who underwent MRI fusion prostate biopsy in the Philippine General Hospital (PGH) from June 2021 to June 2023. Clinically significant cancer (csCancer) detection rates were calculated for MRI fusion prostate biopsy, random systematic prostate biopsy, and PIRADS scoring. Concordance was also determined between PIRADS scores and histopathological results.@*Results@#Forty six (46) patients who underwent MRI fusion biopsy in PGH were included in the study, representing a total of 90 lesions identified by urologists using mpMRA with PIRADS scores of at least 3. Of the patients, 13 (14.4%) were diagnosed with csCancer, while a large proportion was diagnosed with benign prostatic tissue. The csCancer detection rate of MRI fusion biopsy was 28.3% (13/46) and 8.7% (4/46) for random biopsy. The csCancer detection rate was 11.1%, 14.6%, and 36.4% for PIRADS 3, 4, and 5, respectively.@*Conclusion@#The detection rate of clinically significant prostate cancer using MRI fusion-targeted prostate biopsy based on urologist-performed MRI reading and contouring was superior to random systematic approach. The positive predictive value of PIRADS scores when interpreted by urologists was lower compared to reported values in the literature and did not show concordance. This may reflect lowered thresholds for labeling prostate lesions as suspicious in urologists.

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INTRODUCTION@#68Ga-PSMA PET is an effective imaging modality in the evaluation of prostate cancer. However, there is limited data on its use in the evaluation of therapeutic response, particularly in radioligand therapy.@*OBJECTIVE@#Our aim is to investigate the diagnostic accuracy of 68Ga-PSMA PET hybrid imaging in evaluating response to 177Lu-PSMA therapy in patients with mCRPC compared with the standard use of serum PSA.@*METHODOLOGY@#A systematic review was done according to the Cochrane diagnostic accuracy reviews guidelines and the PRISMA checklist of literature from January 2015 to August 2020. Literature search, study selection, and data extraction were conducted by 2 reviewers. Statistical analysis of data was done using Meta-DiSc v1.4@*RESULTS@#A total of 5 studies were included following screening. A total of 128 patients were included in the review. Using PSA response as the reference standard, the pooled sensitivity and specificity of 68Ga-PSMA PET hybrid imaging to evaluate treatment response to 177Lu-PSMA therapy was 85% (Cl: 74 to 92%) and 74% (Cl: 62 to 84%), respectively. The computed diagnostic accuracy was 79.7%.@*CONCLUSION@#68Ga-PSMA PET hybrid imaging is an effective diagnostic procedure in evaluating treatment response to 177Lu-PSMA therapy ligand therapy with good sensitivity, specificity, and diagnostic accuracy.

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De acordo com a literatura, não há consenso sobre um tempo de atraso razoável desde o diagnóstico até a operação da prostatectomia radical (PR) sem piora do prognóstico. Objetivo: Avaliar a influência desse tempo no risco de recorrência da doença em pacientes com adenocarcinoma acinar da próstata tratados com PR. Método: Quatrocentos e doze pacientes submetidos à PR foram avaliados retrospectivamente. Destes, 172 foram excluídos por dados incompletos e outros 28, por estadiamento pré- -operatório como câncer de próstata de alto risco (PSA > 10 ng/mL ou escore de Gleason na biópsia > 7). Os estadiamentos pré e pós-operatórios foram comparados, e a análise de sobrevida feita pelo método de Kaplan-Meier para examinar a influência do tempo na discordância entre os estadiamentos pré e pós-operatórios. Resultados: Para os 212 pacientes da amostra, o tempo médio desde o diagnóstico até a PR foi de 176,1 ± 120,2 dias (mediana de 145,5 dias), variando de 29 a um máximo de 798 dias. A curva de Kaplan-Meier indicou que o câncer piorava quanto maior o atraso entre o diagnóstico e a operação. Pacientes submetidos à cirurgia dentro de 60 dias tiveram cerca de 95% de probabilidade de não aumentarem o risco inicial de recorrência. Esse número caiu para 80%, 70% e 50% nos pacientes operados em até 100, 120 e 180 dias, respectivamente. Conclusão: O atraso na realização da PR representa risco contínuo de recorrência da neoplasia. O tempo ideal para PR é de até 60 dias a partir da biópsia da próstata, uma vez que a probabilidade de upstaging é inferior a 5% nesse período.

There is no consensus in the literature on a reasonable delay time from diagnosis to radical prostatectomy (RP) surgery, without worsening the prognosis. Objective: To evaluate the influence of the delay on the risk of disease recurrence in patients with acinar adenocarcinoma of the prostate treated with RP. Method: Four hundred and twelve patients undergoing RP were retrospectively evaluated. Of these, 172 were excluded due to incomplete data and another 28 due to preoperative staging as high-risk prostate cancer (PSA > 10 ng/mL or Gleason score on biopsy > 7). Pre-and postoperative stagings were compared and survival analysis was performed using the Kaplan-Meier method to investigate the influence of time on discordance between pre- and postoperative stagings. Results:For the 212 patients of the sample, the average time from diagnosis to RP was 176.1 ± 120.2 days (median 145.5 days), ranging from 29 to a maximum of 798 days. The Kaplan-Meier curve indicated that the cancer worsened the longer the delay between diagnosis and surgery. Patients undergoing surgery within 60 days had an approximately 95% probability of not increasing the initial risk of recurrence. This number fell to 80%, 70% and 50% in patients operated on up to 100, 120 and 180 days, respectively. Conclusion:Delay in performing RP represents a continuous risk of relapse. The ideal time for RP is up to 60 days from prostate biopsy, as the probability of upstaging is less than 5% in this period

Según la literatura, no existe consenso sobre un tiempo razonable de retraso desde el diagnóstico hasta la cirugía de prostatectomía radical (PR), sin empeorar el pronóstico. Objetivo: Evaluar la influencia de este tiempo sobre el riesgo de recurrencia de la enfermedad en pacientes con adenocarcinoma acinar de próstata tratados con PR. Método: Se evaluaron retrospectivamente 412 pacientes sometidos a PR. De ellos, 172 fueron excluidos por datos incompletos y otros 28 por estadificación preoperatoria como cáncer de próstata de alto riesgo (PSA > 10 ng/mL o puntuación de Gleason en la biopsia > 7). Se compararon las estadificaciones pre y posoperatorias y se realizó un análisis de supervivencia utilizando el método de Kaplan-Meier para examinar la influencia del tiempo en la discordancia entre las estadificaciones pre y posoperatorias. Resultados: Para los 212 pacientes de la muestra, el tiempo promedio desde el diagnóstico hasta la PR fue de 176,1 ± 120,2 días (mediana 145,5 días), oscilando entre 29 y 798 días. La curva de Kaplan-Meier indicó que el cáncer empeoraba cuanto mayor era el retraso entre el diagnóstico y la cirugía. Los pacientes sometidos a cirugía dentro de los 60 días tenían aproximadamente un 95% de probabilidad de no aumentar el riesgo inicial de recurrencia. Esta cifra cayó al 80%, 70% y 50% en los pacientes operados hasta 100, 120 y 180 días, respectivamente. Conclusión: El retraso en la realización de la PR representa un riesgo continuo de restablecimiento de la neoplasia. El momento ideal para la PR es hasta los 60 días desde la biopsia de próstata, ya que la probabilidad de upstaging es inferior al 5% en este periodo.

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Introducción: El cáncer de próstata es el cáncer de mayor prevalencia en hombres. La enfermedad y el tratamiento generan síntomas urinarios, intestinales, sexuales, hormonales y emocionales que repercuten en el rendimiento funcional de los hombres quienes las padecen, el automanejo de los síntomas ha sido considerada desde la Organización Mundial de la Salud (OMS) como una estrategia para permitir que los hombres puedan conocer mejor su enfermedad y generar habilidades para manejarla desde un ámbito domiciliario. Objetivo: Determinar la efectividad de la Intervención Prostactive para el automanejo de síntomas y su repercusión en el rendimiento funcional, en personas con cáncer de próstata en tratamiento que asisten a la Unidad Oncológica de la Clínica Nogales entre 2022 y 2023. Materiales y métodos: Es un diseño experimental paralelo determinado por la conformación aleatoria de dos grupos con un tamaño de muestra de 100 participantes, 50 para el control (GC) que recibirá el cuidado habitual y 50 para el experimental (GI) al cual se implementó la intervención Prostactive que consta de 4 sesiones presenciales en las cuales se le explicará cómo manejar los síntomas que presenta debido al cáncer de próstata y el tratamiento. Posteriormente se realizó el seguimiento telefónico para conocer el estado de salud a la semana 8 después de las sesiones presenciales. Resultados: la Intervención Prostactive mejoró los niveles de autoeficacia en los participantes del GI, el rendimiento funcional (0,0001) además del automanejo de síntomas urinarios con diferencias estadísticamente significativas frente al GC. No se identificaron cambios en los síntomas obstructivos (valor P= 0.6), síntomas sexuales y síntomas hormonales. Conclusión: La Intervención Prostactive mejora el automanejo de síntomas en hombres con CP en tratamiento, además de la autoeficacia y el Rendimiento Funcional. (AU)

Introduction: Prostate cancer is more prevalent in men. The disease and treatment generate urinary, intestinal, sexual, hormonal and emotional symptoms that impact the functional performance of men who suffer from them. Self-management of symptoms has been considered since the World Health Organization (WHO) as a strategy to allow men to better understand their disease and generate skills to manage it from a home environment. Objective: Determine the effectiveness of the Prostactive Intervention for the selfmanagement of symptoms and its impact on functional performance, in people with prostate cancer undergoing treatment who attend the Oncology Unit of the Nogales Clinic between 2022 and 2023. Materials and methods: It is a parallel experimental design determined by the random formation of two groups with a sample size of 100 participants, 50 for the control (CG) who will receive the usual care and 50 for the experimental (GI) to which the Prostactive intervention was implemented, which It consists of 4 face-to-face sessions in which you will be explained how to manage the symptoms you present due to prostate cancer and the treatment. Subsequently, telephone follow-up was carried out to determine the health status at week 8 after the face-to-face sessions. Results: the Prostactive Intervention improved the levels of self-efficacy in the IG participants, functional performance (0.0001) in addition to the self-management of urinary symptoms with statistically significant differences compared to the CG. No changes were identified in obstructive symptoms (P value= 0.6), sexual symptoms, and hormonal symptoms. Conclusion: The Prostactive Intervention improves symptom self-management in men with CP undergoing treatment, in addition to self-efficacy and Functional Performance. (AU)

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Objetivo: Describir las características clínicas, complicaciones intraquirúrgicas y posquirúrgicas y los desenlaces oncológicos de los pacientes sometidos a prostatectomía radical por laparoscopia en un centro de alta complejidad en la ciudad de Cali, Colombia. Método: Estudio observacional de cohorte retrospectiva entre el 2011 y el 2021. Se incluyeron pacientes llevados a prostatectomía laparoscópica por diagnóstico de cáncer de próstata. Se clasificaron en bajo, mediano y alto riesgo según antígeno específico de próstata (PSA) y estadios clínicos TNM. Se agruparon según la escala de la International Society of Urological Pathology (ISUP). La clasificación D'Amico determinó el riesgo de recurrencia bioquímica. Se realizó un análisis de supervivencia a 60 meses según el método de Kaplan-Meier. Se estimaron los factores relacionados con la recaída y la probabilidad de tiempo libre de enfermedad con la regresión de Cox univariante y multivariante. Resultados: Se incluyeron 379 pacientes. La mediana de PSA inicial fue de 8,3. El 25,34% fue clasificado como patología localmente avanzada. La supervivencia global a cinco años fue del 97%. Los pacientes con persistencia bioquímica con enfermedad localmente avanzada tuvieron un 44% de probabilidad de recaer. La probabilidad de recaída a cinco años en pacientes con riesgo alto era de del 35%. Conclusiones: El factor de riesgo con mayor impacto en la recaída oncológica a los 60 meses es la persistencia bioquímica a los seis meses del procedimiento. Los pacientes con alto riesgo según la clasificación D'Amico presentaron una mayor recaída.

Objective: To describe the clinical characteristics, intra- and post-surgical complications, and oncological outcomes of patients undergoing laparoscopic radical prostatectomy in a high-complexity center in the city of Cali, Colombia. Method: Observational retrospective cohort study between 2011 and 2021. Patients undergoing laparoscopic prostatectomy with diagnosis of prostate cancer were included. They were classified as low, medium and high risk according to prostate specific antigen (PSA) and clinical TNM. They were grouped according to the International Society of Urological Pathology (ISUP) scale. The D'Amico classification determined the risk of biochemical recurrence. A 60-month survival analysis was performed according to the Kaplan-Meier method. Factors related to relapse and the probability of disease-free time were estimated with univariate and multivariate Cox regression. Results: Three hundred and seventy-nine patients were included. The median initial PSA was 8.3. Twenty-five-point thirty-four percent were classified as locally advanced pathology. The 5-year overall survival was 97%. Patients with biochemical persistence with locally advanced disease had a 44% probability of relapse. The 5-year probability of relapse in high-risk patients was 35%. Conclusions: The risk factor with the greatest impact on oncological relapse at 60 months is biochemical persistence 6 months after the procedure. Patients with high risk according to the D'Amico classification had a greater relapse

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Introduction: Prostate cancer is the second most common cancer worldwide among men. Among the various therapeutic modalities, radical prostatectomy is the primary treatment option, which can be performed using the following techniques: retropubic (RRP), perineal (RPP), video laparoscopic (VLP), and robot-assisted (RALP). RALP has gained widespread use in urology, primarily due to its technical advantages and superior functional outcomes, such as the maintenance of urinary continence and the preservation of erectile function. However, the oncological outcomes of RALP are comparable to those of RRP and VLP.Objectives: To analyze the perioperative, functional, and oncological outcomes of prostatectomies performed via RRP, VLP, and RALP at a tertiary hospital in Curitiba, Paraná, Brazil.Methodology: The study included 367 patients diagnosed with prostate cancer who underwent radical prostatectomy between 2016 and 2021, with 221 patients undergoing RRP, 118 undergoing VLP, and 37 undergoing RALP. Preoperative clinical data and outcomes of interest were assessed through a retrospective analysis of medical records.Results: A lower frequency of sexual dysfunction was observed among patients who underwent RALP (p=0.039) and VLP (p<0.0001) compared to those who underwent RRP. However, the mean surgery time was longer for RALP compared to both RRP (p=0.001) and VLP (p=0.001). Regarding oncological outcomes, RALP demonstrated a higher frequency of free urethral margins (p=0.033). The other oncological, functional, and perioperative factors were statistically similar across the three types of surgery.Conclusion: RALP is associated with a shorter hospital stay and a lower rate of sexual dysfunction up to one year after prostatectomy, compared to RRP. The oncological outcomes were generally equivalent across the techniques, with the exception of urethral margin status (AU)

Introdução: O câncer de próstata é um dos mais incidentes no mundo, ficando atrás apenas do câncer de pele na população masculina. Entre as opções terapêuticas, a prostatectomia radical se destaca, com as principais técnicas sendo: retropúbica (RRP), perineal (RPP), videolaparos-cópica (VLP) e laparoscópica assistida por robôs (RALP). A técnica robótica tem sido amplamente utilizada na urologia devido às suas vantagens técnicas e melhores desfechos funcionais, como a manutenção da continência urinária e a preservação da função erétil. No entanto, os desfechos oncológicos da técnica robótica ainda carecem de dados consistentes que comprovem sua superioridade em relação às outras técnicas.Objetivos: Comparar os desfechos perioperatórios, funcionais e oncológicos de prostatectomias realizadas por RRP, VLP e RALP em pacientes de um hospital terciário em Curitiba-PR (Brasil).Metodologia: Foram incluídos no estudo 367 pacientes diagnosticados com câncer de próstata e submetidos a prostatectomia radical entre 2016 e 2021, sendo 211 via RRP, 118 via VLP e 37 via RALP. Os dados clínicos pré-operatórios e os desfechos de interesse foram coletados por meio de análise retrospectiva dos prontuários.Resultados: Observou-se menor frequência de disfunção sexual e menor tempo de internamento entre os pacientes submetidos à cirurgia via RALP (p=0,039 e p=0,0007) e VLP (p=0,029 e p<0,0001) em comparação com RRP. No entanto, o tempo médio de cirurgia foi maior para RALP quando comparado a RRP (p=0,001) e VLP (p=0,001). Em relação aos desfechos oncológicos, a frequência de margem cirúrgica uretral livre de neoplasia foi maior no grupo RRP comparado ao RALP (p=0,033). Os demais fatores oncológicos, funcionais e perioperatórios foram semelhantes entre os tipos de cirurgia.Conclusão: A RALP está associada a menor tempo de internamento e menor taxa de disfunção sexual até um ano após a prostatectomia, em comparação com a RRP. Os benefícios oncológicos foram equivalentes entre as técnicas, exceto para a margem cirúrgica uretral (AU)

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Abstract Prostate cancer (PCa) is a highly prevalent condition among men worldwide, resulting in reduced quality of life and increased costs to health systems due to hospitalization and death. This study aimed to explore and understand the evolution of PCa in Brazil from 2008 to 2018. Data were obtained from the National Health System Department of Informatics (DATASUS) using code C61 for malignant prostatic neoplasms. We presented the hospitalization and mortality rates in a temporal-, regional- and age-dependent manner. From 2008 to 2018, a year-dependent increase in hospital admissions due to PCa was reported in Brazil, in which the Southeast region showed the highest prevalence. Men aged ≥80 and those 70-79 years old had similar hospitalization rates, followed by men aged 60-69, 50-59, 40-49 and 30-39 years old. Similarly, an increase in deaths due to PCa was reported during this period, with the highest rates seen in the Southeast. Men aged ≥80 years had higher mortality rates, followed by those aged 70-79, 60-69, 50-59, 40-49 and 30-39 years old. The results obtained indicate an age- and region-dependent increase in PCa morbidity and mortality in Brazil overtime and may contribute to the ongoing discussion on the role and future perspective of the health care system in Brazil

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Objetivo: La prostatectomía radical se asocia con complicaciones como incontinencia urinaria y disfunción eréctil. Múltiples estudios reportan discrepancia entre el tiempo de recuperación de la incontinencia urinaria y disfunción eréctil percibida por el paciente comparado con lo informado en la historia clínica. El objetivo de nuestro estudio es comparar la concordancia que existe entre la recuperación de la continencia urinaria y función eréctil reportados por el paciente y la historia clínica. Métodos: Se recolectó una muestra de hombres con cáncer de próstata llevados a prostatectomía radical. Se interrogó el tiempo de recuperación de continencia urinaria y función eréctil posterior a cirugía. El seguimiento mínimo fue un año. Resultados: Entre 2000-2018 se escogieron 158 pacientes. La recuperación de continencia urinaria reportada por la paciente a los 6 meses fue del 82,3 vs. 86,6% reportada en historia clínica, a los 12 meses de la cirugía el reporte de recuperación de la continencia por la paciente fue del 92,5 vs. 95,4 % en la historia clínica, con una diferencia del 2,9%. La recuperación de función eréctil reportada por el paciente a los 6 meses fue de del 69 vs. 77,8% por historia clínica, a los 12 meses la tasa de recuperación reportada por el paciente fue del 77,8 vs. 65,9% por historia clínica. Conclusiones: Se demostró una baja tasa de discrepancia de continencia urinaria y recuperación de la función eréctil entre lo informado por el paciente y la historia clínica. El tiempo entre la cirugía y la solicitud de recuperación no afecta los resultados.

Objective: Radical prostatectomy is associated with complications like urinary incontinence and erectile dysfunction. Multiple studies report a discrepancy between recovery time of urinary continence and erectile function perceived by the patient compared to report on clinical history. The objective of our study is to compare the concordancy of recovery of urinary continence and erectile function between the patient's report and clinical history. Methods: A sample of men with prostate cancer who underwent radical prostatectomy was collected. Recovery time of urinary continence and erectile function after surgery by the patient and clinical history was reported. The time of follow-up was at least one year. Results: Between 2000-2018, 158 patients were collected. The recovery time of urinary continence reported by the patient at 6 months was 82.3 vs. 86.6% reported on clinical history. At 12 months after surgery, the recovery of urinary continence reported by the patient was 92.5 vs. 95.4% on clinical history, with a difference of 2.9%. The recovery of erectile function reported by the patient at 6 months was 69 vs. 77.8% on clinical history, and 12 months after surgery the recovery rate reported by the patient was 77.8 vs. 65.9% on clinical history. Conclusion: A low discrepancy of recovery of urinary continence and erectile function between the report by the patient and clinical history was observed. The time between surgery and the recovery request does not change the results

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Objective: The objective of the study is to determine through a historical cohort, the characteristics, treatment patterns, and outcomes of a population with hormone-sensitive metastatic cancer at a referral center in Bogota. Method: This was a historical cohort observational study. All patients with metastatic hormone-sensitive prostate cancer from 2018 to May 2022 who received androgen deprivation therapy with or without treatment intensification were included through convenience sampling. The distribution of the epidemiological variables of interest, treatment of choice, and survival analysis was performed, as well as the distribution by years of the therapies of choice. Statistical significance was set at p < 0.05. Results: We included 125 hormone-sensitive metastatic prostate cancer (mHSPC) patients with a median age of 73.5 years (confidence interval: 71.48-75.31), a median PSA of 209 ng/mL, and 90% of patients with synchronous mHSPC. The distribution of high-volume mHSPC was 92% and M1b was 91%. The distribution of castration methods over time revealed that 21% of the patients underwent surgical castration and 79% received pharmacological castration. Since 2018, 40% of patients received androgen deprivation therapies (ADT) exclusively, 30% received treatment with taxanes, and 30% received androgen receptor axis-directed therapies. Trends in treatment distribution from 2018 to 2022 indicated a decline in exclusive ADT use from 41% in 2019 to 16% in 2022. 9% of the patients abandoned treatment. Conclusion: A description of the population of a national reference center for the treatment of hormone-sensitive prostate cancer with demographic characteristics according to global trends was provided

Objetivo: Caracterizar a la población y el tratamiento recibido de pacientes con cáncer metastásico hormonosensible (mHSPC) en un centro de referencia en Bogotá. Método: Cohorte histórica, observacional. Se incluyeron todos los pacientes con mHSPC que recibieron terapia de supresión androgénica, con o sin intensificación, desde el 2018 hasta mayo del 2022. Muestreo por conveniencia. Se describe la distribución de las variables epidemiológicas de interés, el tratamiento de elección, se realiza un análisis de supervivencia, así como de distribución por años de las terapias de elección. Se consideró significación estadística con un grado de significación (p) < 0,05. Resultados: Se incluyeron 125 pacientes con mHSPC, con una mediana de edad de 73,5 años (IC: 71,48-75,31), con una mediana de antigeno porstático específico (PSA) de 209 ng/mL, el 90% de los pacientes con mHSPC sincrónicos. La distribución de mHSPC de alto volumen fue del 92%, M1b 91%. La distribución global en el tiempo de castración quirúrgica fue del 21% y farmacológica del 79%. El 40% de los pacientes recibieron desde el 2018 terapia de deprivación de andrógenos (ADT) exclusiva, tratamiento con taxanos el 30% y terapias dirigidas al eje del receptor de andrógenos el 30% de los pacientes. Se describen las tendencias de distribución por años desde 2018 hasta 2022, pasando de ADT exclusiva en un 41% para el 2019 a un 16% para el 2022. El 9% de los pacientes abandonaron el tratamiento. Conclusión: Se realiza una descripción de la población de un centro de referencia nacional en el tratamiento de cáncer de próstata hormonosensible con características demográficas acorde a las tendencias globales

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RESUMO Introdução: este artigo procurou aprofundar o conhecimento acerca da técnica de drenagem linfática subcutânea, como forma de tratamento paliativo do linfedema secundário em doentes com câncer da próstata. Desenvolvimento: revisão da literatura realizada entre os dias 13 e 17 do mês de novembro de 2023, nas bases de dados Medline e CINHAL. A literatura que suporta esta análise revela-se escassa, quer para o estudo da técnica no local, quer para a padronização do procedimento. Estas considerações explanam os benefícios que a técnica oferece na melhoria da qualidade de vida do homem, no contexto sexual, psicológico, social e nas repercussões econômicas. Conclusão: a drenagem linfática subcutânea é uma técnica pouco conhecida e pouco utilizada na prática clínica, porém é uma opção a considerar no tratamento de linfedema secundário em contexto paliativo, uma vez que pode melhorar a qualidade de vida do doente.

ABSTRACT Introduction: this article sought to deepen knowledge about the subcutaneous lymphatic drainage technique as a form of palliative treatment for secondary lymphedema in prostate cancer patients. Development: literature review carried out between November 13 and 17, 2023, in the Medline and CINHAL databases. The literature supporting this analysis is scarce, both in terms of studying the technique on site and standardizing the procedure. These considerations explain the benefits that the technique offers in improving men's quality of life, in the sexual, psychological and social contexts, and in the economic repercussions. Conclusion: subcutaneous lymphatic drainage is a technique that is little known, and little used in clinical practice, but it is an option to consider in the treatment of secondary lymphedema in a palliative context, as it can improve the patient's quality of life.

RESUMEN Introducción: este artículo buscó profundizar el conocimiento sobre la técnica de drenaje linfático subcutáneo como forma de tratamiento paliativo del linfedema secundario en pacientes con cáncer de próstata. Desarrollo: revisión de la literatura realizada entre el 13 y 17 de noviembre de 2023, en las bases de datos Medline y CINHAL. La literatura sobre el tema es escasa, tanto sobre el estudio de la técnica en el sitio como sobre la estandarización del procedimiento. Estas consideraciones explican los beneficios que tiene la técnica para mejorar la calidad de vida de los hombres, a nivel sexual, psicológico, social y las repercusiones económicas. Conclusión: el drenaje linfático subcutáneo es una técnica poco conocida y poco utilizada en la práctica clínica, pero es una opción que se debe considerar en el tratamiento del linfedema secundario en el contexto paliativo, ya que puede mejorar la calidad de vida del paciente.

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A periodontite tem sido reconhecida como um estímulo inflamatório sistêmico crônico com potencial risco para o desenvolvimento ou agravamento de várias condições de saúde sistêmica, incluindo doenças da próstata. Assim, este estudo apresenta duas propostas de investigação distintas com objetivos específicos: 1) um estudo caso-controle para avaliar a associação entre periodontite e câncer de próstata (CAP); 2) uma revisão sistemática e meta análise para avaliar a associação entre periodontite e os níveis de PSA (Antígeno Prostático Específico) O estudo caso-controle incluiu 372 indivíduos, sendo 152 homens com CAP (idade 63.028.67 anos) e 220 controles (idade 62.718.79 anos), selecionados no Ambulatório de Urologia do Hospital Luxemburgo, Belo Horizonte ­ Minas Gerais. Os participantes foram submetidos a exame periodontal completo e a condição periodontal classificada de acordo com os critérios da Academia Americana de Periodontia e da Federação Européia de Periodontologia de 2018. O estadiamento do CAP foi realizado de acordo com os escores do sistema de Gleason. A associação entre CAP e variáveis de interesse foi avaliada por regressão logística multivariada. Os casos apresentaram maior ocorrência (p=0,019) e gravidade (p=0,005) de periodontite. A ocorrência de CAP foi associada a escolaridade <9 anos (OR ajustado=1,95), ao consumo de álcool (OR ajustado=3,46), ao tabagismo (OR ajustado=2,53) e a periodontite (OR ajustado=1,76). Em relação à gravidade do CAP, os escores de Gleason 1-2 foram associados à periodontite (OR ajustado=1,90), mas os escores de Gleason 3-5 não. Além disso, foi observado no grupo caso um aumento dos níveis de PSA com o aumento da gravidade da periodontite (estágios). A revisão sistemática se baseou nas diretrizes do PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) e teve a seguinte pergunta PECO: homens com periodontite apresentam níveis aumentados de PSA no sangue? Foi realizada uma busca nas bases de dados PubMed, Embase, Scielo, Web of Sciences, Cochrane Library e literatura cinzenta até janeiro/2024. Foram incluídos 6 estudos, sendo 4 estudos observacionais e 2 ensaios clínicos. A qualidade metodológica foi avaliada usando as ferramentas Joana Briggs e ROBINS-I e o nível de evidência usando o sistema GRADE. Os estudos observacionais apontaram níveis de APE significativamente mais baixos em indivíduos sem periodontite (p=0,04). Os ensaios clínicos não randomizados não verificaram mudança nos níveis de PSA após o tratamento periodontal não-cirúrgico (p=0,13). Na metanálise, indivíduos com PSA>4,0 ng/ml apresentaram periodontite mais grave (OR=1,19 IC95% 0,68­2,09; I2=0%), entretanto não significativo. Houve correlação positiva entre PSA e nível de inserção clínica (r=0,55 IC95% 0,41­0,66; I2=0,0%). Não houve diferença nos níveis de PSA antes e após o tratamento periodontal (diferença média -0,18 IC95% -0,94­0,57; I2=0%). No geral, concluiu-se que a periodontite foi associada à ocorrência de câncer de próstata e não houve evidências de uma associação direta entre níveis de PSA e periodontite, apesar de observações sugerirem possível relação entre a gravidade da periodontite, parâmetros clínicos periodontais e PSA.

Periodontitis has been recognized as a chronic systemic inflammatory stimulus with potential risk for the development or worsening of several systemic health conditions, including prostate diseases. Thus, this study presents two specific research proposals with specific objectives: 1) a case-control study to evaluate the association between periodontitis and prostate cancer (PCA); 2) a systematic review and meta-analysis to evaluate the association between periodontitis and PSA (prostate-specific antigen) levels. The case-control study included 372 individuals, being 152 men with CAP (age 63.02 ± 8.67 years) and 220 controls (age 62.71 ± 8.79 years), selected at the Urology Outpatient Clinic of Hospital Luxemburgo, Belo Horizonte ­ Minas Gerais. Participants underwent a complete periodontal examination and periodontal status was classified according to the 2018 American Academy of Periodontology and European Federation of Periodontology criteria. CAP staging was performed according to Gleason system scores. The association between CAP and variables of interest was assessed by multivariate logistic regression. Cases had a higher occurrence (p=0.019) and severity (p=0.005) of periodontitis. The occurrence of CAP was associated with educational level <9 years (adjusted OR=1.95), alcohol consumption (adjusted OR=3.46), smoking (adjusted OR=2.53), and periodontitis (adjusted OR=1.76). Regarding CAP severity, Gleason scores 1­2 were associated with periodontitis (adjusted OR=1.90), but Gleason scores 3­5 were not. Furthermore, an increase in PSA levels was observed in the case group with increasing severity of periodontitis (stages). The systematic review was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and had the following PECO question: Do men with periodontitis have increased blood levels of PSA? A search was carried out in the PubMed, Embase, Scielo, Web of Sciences, Cochrane Library databases and gray literature until January/2024. Six studies were included, being 4 observational studies and 2 clinical trials. The methodological quality was assessed using the Joana Briggs and ROBINS-I tools and the level of evidence using the GRADE system. Observational studies showed significantly lower PSA levels in individuals without periodontitis (p=0.04). Non-randomized clinical trials did not find changes in PSA levels after non surgical periodontal treatment (p=0.13). In the meta-analysis, individuals with PSA>4.0 ng/ml had more severe periodontitis (OR=1.19 95%CI 0.68­2.09; I2=0%), although not significant. There was a positive correlation between PSA and clinical attachment level (r=0.55 95%CI 0.41­0.66; I2=0.0%). There was no difference in PSA levels before and after periodontal treatment (mean difference -0.18 95%CI -0.94­0.57; I2=0%). Overall, it was concluded that periodontitis was associated with the occurrence of prostate cancer and there was no evidence of a direct association between PSA levels and periodontitis, although observations suggest a possible relationship between the severity of periodontitis, clinical periodontal parameters and PSA.

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Introdução: O câncer de próstata é o segundo mais comum entre os homens no Brasil, atrás apenas do câncer de pele não melanoma. Atualmente, há interesse em analisar dados referentes ao câncer com métodos do tipo machine learning. Objetivo: Investigar as características físicas, socioeconômicas e de hábitos de vida que podem estar associadas ao diagnóstico de câncer de próstata no Brasil. Método: Uma base de microdados referente à Pesquisa Nacional de Saúde 2019 foi utilizada, com a seleção de 42.799 indivíduos do sexo masculino; esse grupo foi analisado por meio de métodos estatísticos e modelagem por machine learning (regressão logística e árvore de decisão). Resultados: Os modelos aplicados permitiram identificar com bom nível de acurácia (próximo ou acima de 80%) os indivíduos que receberam o diagnóstico de câncer de próstata (DCP), além de grupos com características específicas mais fortemente associadas a essa doença. Entre as variáveis mais significativamente ligadas à taxa de DCP, destacam-se: idade, diagnóstico de alto nível de colesterol, se possui plano de saúde e nível de instrução. Conclusão: Os modelos indicam um nível de associação significativo de fatores socioeconômicos, físicos e alimentares com a frequência de DCP no grupo analisado. O alto nível de acurácia e a sensibilidade dos modelos demonstram o potencial dos métodos de machine learning para a previsão de DCP.

Introduction: Prostate cancer is the second most common cancer among men in Brazil, behind only non-melanoma skin cancer. Currently, there is interest in analyzing data related to cancer with machine learning type methods. Objective: The investigation of physical, lifestyle and socioeconomic features that may be associated with prostate cancer diagnosis in Brazil. Method: A microdata base referring to the 2019 National Health Survey in Brazil was utilized, and 42,799 male individuals were selected; this group was analyzed through statistical methods and machine learning modeling (logistic regression and decision tree). Results: The models applied allowed to identify with a good level of accuracy (near or above 80%) individuals with diagnosis of prostate cancer (DPC), in addition to groups with specific features more strongly associated with this disease. Among the variables more significantly associated with DPC rate, the following stand out: age, diagnosis of high level of cholesterol, health insurance, and level of education. Conclusion: The models indicate a significant level of association of socioeconomic, physical, and dietary factors with the frequency of DPC in the group analyzed. The high level of accuracy and sensitivity of the models demonstrates the potential of machine learning methods for predicting DPC.

Introducción: El cáncer de próstata es el segundo cáncer más común entre los hombres en el Brasil, sólo detrás del cáncer de piel no melanoma. Actualmente existe interés en analizar datos relacionados con el cáncer con métodos de tipo machine learning. Objetivo: Investigar características físicas, de estilo de vida y socioeconómicas que pueden estar asociadas con el diagnóstico de cáncer de próstata en el Brasil. Método: Se utilizó una base de microdatos referente a la Encuesta Nacional de Salud de 2019, con la selección de 42 799 individuos de sexo masculino; este grupo fue analizado mediante métodos estadísticos y modelado de machine learning(regresión logística y árbol de decisión). Resultados: Los modelos aplicados permitieron identificar con buen nivel de exactitud (cerca o por encima del 80%) a los individuos con diagnóstico de cáncer de próstata (DCP), además de grupos con características específicas más fuertemente asociadas a esta enfermedad. Entre las variables más significativamente asociadas a la tasa de DCP destacan las siguientes: la edad, el diagnóstico de nivel alto de colesterol, si se tiene seguro médico y el nivel de educación. Conclusión:Los modelos indican un nivel significativo de asociación de factores socioeconómicos, físicos y dietéticos con la frecuencia de DCP en el grupo analizado. El alto nivel de exactitud y sensibilidad de los modelos demuestra el potencial de los métodos de machine learning para predecir la DCP.

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Introducción: En Uruguay el cáncer de próstata ocupa el primer lugar en incidencia y el tercer lugar en mortalidad en el hombre. La mayoría de estos cánceres se diagnostican en estadios precoces. Hoy en día, para pacientes con adenocarcinoma de muy bajo riesgo, bajo riesgo o riesgo intermedio favorable, la vigilancia activa es una opción adecuada. Objetivos: Describir una población de pacientes con cáncer de próstata de muy bajo riesgo, bajo riesgo o riesgo intermedio favorable, en vigilancia activa en COMERI. Material y métodos: Estudio descriptivo, observacional, retrospectivo. Se incluyeron pacientes con cáncer de próstata de muy bajo riesgo, bajo riesgo o riesgo intermedio favorable, tratados entre 2010 y 2018 en COMERI. Se recopilaron datos en el sistema de registro clínico electrónico. Resultados: Se incluyeron 33 pacientes, la mediana de edad al diagnóstico fue de 74 años. Todos los pacientes fueron sometidos a controles clínicos y determinación de PSA cada 3 meses. El tacto rectal se realizó en forma anual. El tiempo mediano de vigilancia activa fue de 33 meses. Durante el seguimiento, se observaron pocas variaciones en los valores de PSA. El 21% de los pacientes fue sometido a una nueva biopsia durante el seguimiento activo, y en todos los casos, el Gleason se mantuvo incambiado. Ningún paciente abandonó la modalidad de vigilancia activa. Conclusión: En nuestro entorno, la vigilancia activa se considera una opción terapéutica válida para pacientes altamente seleccionados con cáncer de próstata de muy bajo riesgo, bajo riesgo o riesgo intermedio favorable, y es bien aceptada por ellos.

Introduction: In Uruguay, prostate cancer ranks first in incidence and third in mortality among men. The majority of these cancers are diagnosed at early stages. Nowadays, active surveillance is an appropriate option for patients with adenocarcinoma of very low risk, low risk, or favorable intermediate risk. Objectives: To describe a population of patients with prostate cancer of very low risk, low risk, or favorable intermediate risk under active surveillance at COMERI. Materials and Methods: Descriptive, observational, retrospective study. Patients with prostate cancer of very low risk, low risk, or favorable intermediate risk treated between 2010 and 2018 at COMERI were included. Data were collected from the electronic clinical registry system. Results: Thirty-three patients were included, with a median age at diagnosis of 74 years. All patients underwent clinical monitoring and PSA determination every 3 months. Digital rectal examination was performed annually. The median time of active surveillance was 33 months. During follow-up, there were few variations in PSA values. 21% of patients underwent a repeat biopsy during active surveillance, and in all cases, the Gleason score remained unchanged. No patient discontinued active surveillance. Conclusion: In our setting, active surveillance is considered a valid therapeutic option for highly selected patients with prostate cancer of very low risk, low risk, or favorable intermediate risk, and it is well accepted by them.

Introdução: No Uruguai, o câncer de próstata ocupa o primeiro lugar em incidência e o terceiro lugar em mortalidade entre os homens. A maioria desses cânceres é diagnosticada em estágios precoces. Atualmente, para pacientes com adenocarcinoma de risco muito baixo, baixo risco ou risco intermediário favorável, a vigilância ativa é uma opção adequada. Objetivos: Descrever uma população de pacientes com câncer de próstata de risco muito baixo, baixo risco ou risco intermediário favorável sob vigilância ativa em COMERI. Material e métodos: Estudo descritivo, observacional, retrospectivo. Foram incluídos pacientes com câncer de próstata de risco muito baixo, baixo risco ou risco intermediário favorável, tratados entre 2010 e 2018 em COMERI. Os dados foram coletados no sistema de registro clínico eletrônico. Resultados: Foram incluídos 33 pacientes, com mediana de idade no diagnóstico de 74 anos. Todos os pacientes foram submetidos a controles clínicos e determinação de PSA a cada 3 meses. O toque retal foi realizado anualmente. O tempo médio de vigilância ativa foi de 33 meses. Durante o acompanhamento, houve poucas variações nos valores de PSA. 21% dos pacientes foram submetidos a uma nova biópsia durante a vigilância ativa, e em todos os casos, o Gleason permaneceu inalterado. Nenhum paciente abandonou a modalidade de vigilância ativa. Conclusão: Em nosso ambiente, a vigilância ativa é considerada uma opção terapêutica válida para pacientes altamente selecionados com câncer de próstata de risco muito baixo, baixo risco ou risco intermediário favorável, e é bem aceita por eles.

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Introducción: El examen físico mediante el tacto rectal es una manera de encontrar temprano el cáncer de próstata. Aunque este resulta de suma importancia en las pesquisas, tiene poca aceptación debido a los tabúes arraigados en la sociedad. Por tanto, es necesario educar a la población masculina. Objetivo: Elevar el nivel de conocimientos sobre el examen y autoexamen de próstata en pacientes mayores de 45 años. Métodos: Se realizó un estudio cuasiexperimental de intervención educativa en un universo constituido por 62 pacientes mayores de 45 años pertenecientes al Policlínico Docente Área Este, de la ciudad de Camagüey. La muestra quedó conformada por 55 pacientes que cumplieron con los criterios de selección del estudio. Se analizaron las variables grupo de edades, nivel educacional; así como los conocimientos sobre las características generales del cáncer de próstata, prevención y control de los factores de riesgo, examen y autoexamen de próstata, antes y después de aplicada la intervención educativa. Resultados: En la muestra analizada predominaron los pacientes de entre 45-49 años (30,9 por ciento) y el nivel educacional técnico medio (43,6 por ciento), mientras se logró elevar el conocimiento en relación a las características generales del cáncer de próstata (40,0/94,6 por ciento), prevención y control de los factores de riesgo (20,0/92,7 por ciento), y de 7,3/87,3 por ciento en lo concerniente al examen y autoexamen de próstata. Conclusiones: Se alcanzaron valores estadísticamente significativos, de manera que se logró elevar el nivel de conocimientos en la muestra estudiada(AU)

Introduction: Examination by digital rectal examination is a way to early find prostate cancer. Although this examination is utmost important in the investigations, it has little acceptance due to the taboos rooted in society. In this sense, it is necessary to educate the male population. Objective: To raise the level of knowledge about prostate examination and self-examination in patients older than 45 years of age. Methods: A quasi-experimental study of educational intervention was carried out in a universe consisting of 62 patients older than 45 years of age from Área Este Teaching Polyclinic, in the city of Camagüey. The sample was made up of 55 patients who met the study selection criteria. The variables were analyzed age group, educational level; as well as knowledge about the general characteristics of prostate cancer, prevention and control of risk factors, prostate examination and self-examination before and after the educational intervention is applied. Results: In the studied sample, patients between 45-49 years of age (30.9percent) and the average technical educational level (43.6percent) predominated, while knowledge was raised in relation to the general characteristics of prostate cancer (40.0/94.6percent), prevention and control of risk factors (20.0/92.7percent), and 7.3/87.3percent regarding prostate examination and self-examination. Conclusions: Statistically significant values were reached, so that the level of knowledge was raised in the sample studied(AU)

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Introducción: Los cánceres de cuello uterino y próstata tienen una importante carga de morbilidad en países en desarrollo. La autoeficacia para solicitar el tamizaje es un elemento clave en la prevención. Objetivo: Comparar la percepción de hombres y mujeres sobre autoeficacia para el tamizaje de cáncer cervical y de próstata. Métodos: Estudio mixto con 50 mujeres y 50 hombres. Se indagaron datos sociodemográficos. Se aplicó la escala de autoeficacia de detección del cáncer cervical, con una modificación de esta para medición de cáncer de próstata en hombres. La autoeficacia se clasificó por niveles y las variables asociadas a esta se identificaron con regresión robusta. Se realizaron entrevistas semiestructuradas a 27 individuos (18 hombres y 9 mujeres) con baja y alta autoeficacia, así como a individuos de "otra" religión, para conocer las diferencias en la intención del tamizaje. Se crearon tres categorías de análisis basadas en el modelo de creencias en salud. Resultados: Mujeres y hombres fueron similares, excepto en religión, ocupación y antecedentes de Papanicolaou o examen rectal. La autoeficacia fue mayor entre las mujeres (ß aj.:-15,29 IC del 95 %: -18,36 a -12,21) y los no creyentes (ß aj.: -5,38 IC del 95 %: -10,33 a -0,44). Ellas buscan más el tamizaje que los hombres, quienes necesitan tener síntomas para hacerlo, necesitan tener síntomas. La vergüenza e incomodidad son barreras expresadas por ambos sexos. En los hombres, el machismo es una fuerte barrera para solicitar el tamizaje. La religión asocia el sexo con impureza, siendo una barrera entre las mujeres. Los servicios de atención de la salud solo se centran en el cribado femenino. Conclusiones: Los roles de género y elementos de religión son expresiones culturales que determinan la intención de detección del cáncer en hombres y mujeres. Las intervenciones de los servicios de salud deben considerar estos elementos para mejorar la cobertura de detección temprana y reducir la morbimortalidad de estos dos tipos de cáncer.

Introduction: Cervical and prostate cancers have a significant burden of disease in developing countries. Self-efficacy to request screening is a key element in prevention. Objective: To compare the perception of men and women on self-efficacy for cervical and prostate cancer screening. Methods: Mixed study with 50 women and 50 men. Sociodemographic data was investigated. The cervical cancer detection self-efficacy scale was applied, with a modification for measuring prostate cancer in men. Self-efficacy was classified by levels and the variables associated with it were identified with robust regression. Semi-structured interviews were conducted with 27 individuals (18 men and 9 women) with low and high self-efficacy and of "other religion" to know the differences in the intention of the screening. Three categories of analysis were created based on the health belief model. Results: Women and men were similar except for religion, occupation, and history of Pap smear or rectal exam. Self-efficacy was higher among women (Adj. ß: -15.29, 95% CI: -18.36 to -12.21) and non-believers (Adj. ß: -5.38, 95% CI: -10.33 to -0.44). They seek screening more than men because they need to have symptoms. Shame and discomfort are barriers expressed by both genders. In men, machismo is a strong barrier to request screening. Religion associates sex with impurity, thus, acts as a barrier among women. Health care services only focus on female screening. Conclusions: gender roles and elements of religion are cultural expressions, which determine the intention of cancer detection in men and women. Health services interventions should consider these elements to improve the coverage of early detection and reduce the morbidity and mortality of these two types of cancer.

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SUMMARY: In solid and malignant tumors, innate and adaptive immunity are combined in antitumor responses. This study aimed to analyze the activation of plasma cells and the correlation between the infiltration of B and T lymphocytes with the degree of malignancy or Gleason grade in human prostate biopsies diagnosed with cancer. Prostate cancer biopsies were obtained from the Clinical Hospital of Universidad de Chile (n=70), according to the bioethical norms of the institution. Histological sections of 5µm thickness were processed for immunohistochemistry with primary antibodies against BL and total TL (HRP/DAB). Recognition and quantification were performed under a Leica DM750 optical microscope. Microsoft Excel and GraphPad software were used for the statistical study. Correlation coefficient (Pearson) and mean comparison tests (Kruskal-Wallis and Dunn) and p≤ 0.05 were developed. B and T lymphocyte populations were inversely interregulated in prostate cancer (Gleason) (r= -0.46). Their relationship with Gleason grade is variable according to lymphocyte type (LB vs. Gleason r= -0.0.47 and LT vs. Gleason r= -0.21). Histological diagnosis of prostate cancer correlates with a predominance of LT. The malignancy of the pathology correlates with a predominance of LTs, according to the Gleason grade. The increased knowledge of B and T lymphocyte infiltration and plasma cell activation could be used to better target clinical trials on treatments based on immune system responses. Immunotherapy could be a new paradigm to apply better antitumor therapy strategies.

En tumores sólidos y malignos, la inmunidad innata y adaptativa se combinan en respuestas antitumorales. Este estudio tuvo como objetivo analizar la activación de células plasmáticas y la correlación entre la infiltración de linfocitos B y T con el grado de malignidad o grado de Gleason en biopsias de próstata humana diagnosticadas con cáncer. Las biopsias de cáncer de próstata se obtuvieron del Hospital Clínico de la Universidad de Chile (n=70), de acuerdo con las normas bioéticas de la institución. Secciones histológicas de 5 µm de espesor fueron procesadas para inmunohistoquímica con anticuerpos primarios contra LB y LT total (HRP/DAB). El reconocimiento y las cuantificaciones se realizaron bajo un microscopio óptico Leica DM750. Para el estudio estadístico se utilizaron los programas Microsoft Excel y GraphPad. Se desarrollaron pruebas de coeficiente de correlación (Pearson) y comparación de medias (Kruskal-Wallis y Dunn) y p≤ 0.05. Los resultados muestran que las poblaciones de linfocitos B y T están inversamente interreguladas en el cáncer de próstata (r= -0,4578). Su relación con el grado de Gleason es variable según el tipo de linfocito (LB vs Gleason r= -0,47* y LT vs Gleason r= -0,21). Se concluye que la malignidad del cáncer de próstata se correlaciona con un predominio de LT, versus el grado de Gleason. El mayor conocimiento de la infiltración de linfocitos B y T y la activación de células plasmáticas podría aprovecharse para una mejor orientación de ensayos clínicos en tratamientos basados en las respuestas del sistema inmunitario. La inmunoterapia podría ser un nuevo paradigma para aplicar mejores estrategias de terapias antitumorales.

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Introdução: o câncer é um grave problema de saúde pública, considerado a segunda causa de óbitos no Brasil. Devido à sua relevância, é indispensável um controle eficiente dos casos através do acompanhamento da taxa de mortalidade. Dessa forma, o trabalho analisou a evolução da mortalidade por câncer para as localizações primárias mais frequentes, segundo sexo, durante o período de 2010 a 2020. Metodologia: trata-se de um estudo observacional descritivo, no qual os dados foram obtidos através do Atlas On-line de Mortalidade por Câncer. Os dados colhidos correspondem ao número de óbitos estratificados por tipo de câncer mais frequente, por ano estudado e por sexo, além das taxas de mortalidade específica bruta e a taxa de mortalidade ajustada por idade para o sexo masculino e feminino, para cada tipo de câncer em estudo, considerando a população padrão mundial, sendo avaliado por regressão linear a significância da tendência temporal. Resultados: no Brasil, no período de 2010 a 2020, as neoplasias mais frequentes em mulheres foram câncer de mama, câncer nos brônquios e pulmões, câncer no colo do útero, câncer no cólon e no pâncreas e em homens foram brônquios e pulmões, câncer de próstata, câncer de estômago, de esôfago e no fígado e vias biliares, sendo observado uma tendência crescente na taxa de mortalidade em mulheres e decrescente na taxa de mortalidade em homens. Conclusão: os resultados demonstram um possível comprometimento com a notificação durante o período de pandemia por Covid-19 e um possível rastreamento ainda deficiente de câncer na população masculina.

Introduction: cancer is a severe public health problem, considered the second cause of death in Brazil. Due to its relevance, efficient control of cases by monitoring the mortality rate is essential. Thus, the work analysed the evolution of cancer mortality for the most frequent primary locations, according to sex, from 2010 to 2020. Methodology: this is a descriptive observational study in which data were obtained through the Atlas Online Cancer Mortality Report. The data collected correspond to the number of deaths stratified by the most frequent type of cancer, by year studied and by sex, in addition to the crude specific mortality rates and the age-adjusted mortality rate for males and females, for each type of cancer. Understudy, considering the standard world population, the significance of the temporal trend is evaluated by linear regression. Results: in Brazil, from 2010 to 2020, the most frequent neoplasms in women were breast cancer, bronchial and lung cancer, cervical cancer, colon and pancreas cancer and in men, they were bronchial and lung cancer, cancer prostate, stomach, oesophagal and liver and biliary tract cancer, with an increasing trend in the mortality rate in women and a decreasing trend in the mortality rate in men. Conclusion: the results demonstrate a possible compromise with notification during the Covid-19 pandemic and a possible still poor screening of cancer in the male population.

ABSTRACT

Transgênero (trans) é um termo que alberga toda a diversidade de gênero. A incongruência de gênero faz parte desse espectro e refere-se à pessoa cuja identidade de gênero é oposta ao sexo que lhe foi atribuído no nascimento. A terapia hormonal de afirmação de gênero, bem como a cirurgia de afirmação de gênero, é necessária para adequar o corpo ao gênero ao qual a pessoa se identifica. Os homens trans necessitam da terapia com testosterona, que visa reduzir as concentrações de estradiol e incrementar a testosterona circulante para níveis fisiológicos masculinos, resultando em masculinização. A mulher trans receberá o estradiol, associado ou não a um antiandrogênico, visando reduzir a testosterona e incrementar o estrogênio para níveis femininos, resultando em feminização. A cirurgia de afirmação de gênero é, frequentemente, requerida para completar as modificações fenotípicas para o homem e a mulher trans. O ginecologista e obstetra tem um papel crucial no provimento de cuidados a essa população. O presente artigo visa sistematizar algumas ações que o ginecologista e obstetra pode oferecer e que têm potencial para melhorar a qualidade de vida dos homens e mulheres trans. (AU)

Transgenero (trans) is an umbrella term that encompasses all gender diversity. Gender Incongruity is part of this spectrum and refers to the person whose gender identity is opposed to the sex assigned to them at birth. Gender-affirming hormone therapy as well as gender-affirming surgery are necessary to adapt the body to the gender to which the person identifies. Trans men require testosterone therapy to reduce estradiol concentrations and increase circulating testosterone to male physiological levels resulting in masculinization. Trans women will receive estradiol associated or not with an antiandrogenic to reduce testosterone and increase estrogen to female levels resulting in feminization. gender-affirming surgery is often required to complete phenotypic modifications for trans men and women. The gynecologist and obstetrician plays a crucial role in to provide care to this population. This article aims to systematize some actions that the gynecologist and obstetrician can offer to improve the quality of life of trans men and women. (AU)

ABSTRACT

INTRODUCCIÓN: El cáncer prostático (CaP) es una patología de alta prevalencia e incidencia mundial. El tamizaje ha perseguido el diagnóstico precoz de esta enfermedad para otorgar tratamientos oportunos. Nosotros buscamos caracterizar los pacientes de un hospital local respecto al diagnóstico y etapificación, y comparar estos resultados con datos previamente reportados. MATERIAL Y MÉTODO: Análisis retrospectivo de pacientes diagnosticados con CaP en un hospital institucional. Se recolectaron variables clínicas al momento del diagnóstico, los métodos de etapificación, el estadío según TNM y grado histológico. RESULTADOS: Se incluyeron 129 pacientes en el análisis. La mediana de APE (ng/mL) al diagnóstico fue de 7,29. El grado histológico fue clasificado como ISUP 1 en 37,5%. Se realizó una resonancia magnética multiparamétrica de próstata (RMmp) en el 42,19% de los pacientes, siendo clasificados como PIRADS 4 en mayor proporción (21,09%). La etapificación con PET-CT PSMA se utilizó principalmente en el grupo de alto riesgo y ante dudas frente a etapificación con medios convencionales. Se prefirió la Tomografía computada (TC) contrastada y la cintigrafía ósea en los otros grupos. 6,25% fue catalogado N1 y 9,37% M1. CONCLUSIÓN: La etapa al diagnóstico de nuestra serie es algo mayor a lo reportado por países desarrollados, pero considerablemente menor a lo publicado por otros países de Latinoamérica e inclusive de otros hospitales de nuestro país. Pareciera ser de gran relevancia nacional contar con protocolos claros de tamizaje y acceso a APE con el fin de disminuir los casos diagnosticados en etapas avanzadas.

INTRODUCTION: Prostate cancer (PCa) is a disease with a high prevalence and incidence worldwide. Screening has pursued the early diagnosis of this disease to provide early treatment. We sought to characterize patients from a local hospital with respect to diagnosis and staging and to compare these results with previously reported data. METHODS: We conducted a retrospective analysis of patients diagnosed with PCa at an institutional hospital. Clinical variables were collected at the time of diagnosis, staging methods, TNM stage, and histological grade. RESULTS: 129 patients were included in the analysis. The median PSA (ng/mL) at diagnosis was 7.29. The histological grade was classified as ISUP 1 in 37.5%. An MRI was performed in 42.19% of the patients, being classified mostly as PIRADS 4 (21.09%). PET-CT PSMA staging was used mainly in the high-risk group, preferring contrast-enhanced CT and bone scintigraphy in the other groups. 6.25% were classified as N1 and 9.37% as M1. CONCLUSION: The stage at diagnosis in our series is somewhat higher than that reported by developed countries but considerably lower than that published by other Latin American countries and even from other hospitals in our country. It is of great national relevance to have clear protocols for screening and access to PSA to reduce the cases diagnosed in advanced stages.