Neuroendocrine Cancer of the Prostate.

Neuroendocrine cancer of the prostate is considered to be a rare entity with bad prognosis and limited therapeutic options. We performed a prospective analysis of the patients treated in our hospital for prostate cancer between 1st January 2015 and 31rd December 2018. Neuroendocrine phenomena were tested by immunohistochemistry and laboratory chemistry on the request of the clinicians in the cases when a positive diagnosis was suspected. Clinical tableaux of high suspicion of neuroendocrine cancer included radiological progression of a metastatic disease without PSA rise, relatively extended metastatic disease associated to a low PSA, disease with non-pulmonary visceral metastases. 10 patients were diagnosed with neuroendocrine tumour out of 521 prostate cancers. Half of the patients had a survival over a year. 3 patients received 3 lines of efficacious palliative chemotherapy. 1 patient underwent prostatectomy after neoadjuvant chemotherapy for a localised disease. The incidence of neuroendocrine tumours among prostate cancer patients was higher than expected. Some of the patients had a relatively good outcome.

Challenges in Selecting an Appropriate Heat Stress Index to Protect Workers in Hot and Humid Underground Mines.

BACKGROUND: A detailed evaluation of the underground mine climate requires extensive measurements to be performed coupled to climatic modeling work. This can be labor-intensive and time-consuming, and consequently impractical for daily work comfort assessments. Therefore, a simple indicator like a heat stress index is needed to enable a quick, valid, and acceptable evaluation of underground climatic conditions on a regular basis. This can be explained by the unending quest to develop a "universal index," which has led to the proliferation of many proposed heat stress indices. METHODS: The aim of this research study is to discuss the challenges in identifying and selecting an appropriate heat stress index for thermal planning and management purposes in underground mines. A method is proposed coupled to a defined strategy for selecting and recommending heat stress indices to be used in underground metal mines in the United States and worldwide based on a thermal comfort model. RESULTS: The performance of current heat stress indices used in underground mines varies based on the climatic conditions and the level of activities. Therefore, carefully selecting or establishing an appropriate heat stress index is of paramount importance to ensure the safety, health, and increasing productivity of the underground workers. CONCLUSION: This method presents an important tool to assess and select the most appropriate index for certain climatic conditions to protect the underground workers from heat-related illnesses. Although complex, the method presents results that are easy to interpret and understand than any of the currently available evaluation methods.

A Method to Protect Mine Workers in Hot and Humid Environments.

BACKGROUND: Work comfort studies have been extensively conducted, especially in the underground and meteorological fields resulting in an avalanche of recommendations for their evaluation. Nevertheless, no known or universally accepted model for comprehensively assessing the thermal work condition of the underground mine environment is currently available. Current literature presents several methods and techniques, but none of these can expansively assess the underground mine environment since most methods consider only one or a few defined factors and neglect others. Some are specifically formulated for the built and meteorological climates, thus making them unsuitable to accurately assess the climatic conditions in underground development and production workings. METHODS: This paper presents a series of sensitivity analyses to assess the impact of environmental parameters and metabolic rate on the thermal comfort for underground mining applications. An approach was developed in the form of a "comfort model" which applied comfort parameters to extensively assess the climatic conditions in the deep, hot, and humid underground mines. RESULTS: Simulation analysis predicted comfort limits in the form of required sweat rate and maximum skin wettedness. Tolerable worker exposure times to minimize thermal strain due to dehydration are predicted. CONCLUSION: The analysis determined the optimal air velocity for thermal comfort to be 1.5 m/s. The results also identified humidity to contribute more to deviations from thermal comfort than other comfort parameters. It is expected that this new approach will significantly help in managing heat stress issues in underground mines and thus improve productivity, safety, and health.