Limited improvement of incorporating primary circulating prostate cells with the CAPRA score to predict biochemical failure-free outcome of radical prostatectomy for prostate cancer.

OBJECTIVE: To establish a prediction model for early biochemical failure based on the Cancer of the Prostate Risk Assessment (CAPRA) score, the presence or absence of primary circulating prostate cells (CPC) and the number of primary CPC (nCPC)/8ml blood sample is detected before surgery. PATIENTS AND METHODS: A prospective single-center study of men who underwent radical prostatectomy as monotherapy for prostate cancer. Clinical-pathological findings were used to calculate the CAPRA score. Before surgery blood was taken for CPC detection, mononuclear cells were obtained using differential gel centrifugation, and CPCs identified using immunocytochemistry. A CPC was defined as a cell expressing prostate-specific antigen and P504S, and the presence or absence of CPCs and the number of cells detected/8ml blood sample was registered. Patients were followed up for up to 5 years; biochemical failure was defined as a prostate-specific antigen>0.2ng/ml. The validity of the CAPRA score was calibrated using partial validation, and the fractional polynomial Cox proportional hazard regression was used to build 3 models, which underwent a decision analysis curve to determine the predictive value of the 3 models with respect to biochemical failure. RESULTS: A total of 267 men participated, mean age 65.80 years, and after 5 years of follow-up the biochemical-free survival was 67.42%. The model using CAPRA score showed a hazards ratio (HR) of 5.76 between low and high-risk groups, that of CPC with a HR of 26.84 between positive and negative groups, and the combined model showed a HR of 4.16 for CAPRA score and 19.93 for CPC. Using the continuous variable nCPC, there was no improvement in the predictive value of the model compared with the model using a positive-negative result of CPC detection. The combined CAPRA-nCPC model showed an improvement of the predictive performance for biochemical failure using the Harrell׳s C concordance test and a net benefit on DCA in comparison with either model used separately. The use of primary CPC as a predictive factor based on their presence or absence did not predict aggressive disease or biochemical failure. CONCLUSION: Although the use of a combined CAPRA-nCPC model improves the prediction of biochemical failure in patients undergoing radical prostatectomy for prostate cancer, this is minimal. The use of the presence or absence of primary CPCs alone did not predict aggressive disease or biochemical failure.

[Prostate cancer screening is associated with educational level and knowledge about the disease]. / Nivel educacional como determinante en tamizaje de cáncer de próstata.

BACKGROUND: The screening of prostate cancer allows an earlier diagnosis, allowing more therapeutic options. This screening depends in part on spontaneous patients'’ consultation, which is largely related to their educational level. AIM: To evaluate the association between educational level, knowledge of the disease, and prostatic screening. MATERIAL AND METHODS: A questionnaire was applied to 377 men aged between 50 and 90 years to determine their educational level, knowledge of the disease, if they had any prostate screening and age at first screening. Data was analyzed with R Commander. RESULTS: Eighty one percent of respondents had some knowledge of the disease and of these, 68% had prostate screenings compared with 34% of those without knowledge of the disease. Information about prostate cancer was reported by 71% and 96% of respondents with primary and university education, respectively. Fifty nine and 90% of respondents with primary and university education had prostate screenings performed, respectively. CONCLUSIONS: Those respondents with a prostate cancer screening had a better knowledge of the disease and a higher educational level.

Nivel educacional como determinante en tamizaje de cáncer de próstata / Prostate cancer screening is associated with educational level and knowledge about the disease

Background: The screening of prostate cancer allows an earlier diagnosis, allowing more therapeutic options. This screening depends in part on spontaneous patients’ consultation, which is largely related to their educational level. Aim: To evaluate the association between educational level, knowledge of the disease, and prostatic screening. Material and methods: A questionnaire was applied to 377 men aged between 50 and 90 years to determine their educational level, knowledge of the disease, if they had any prostate screening and age at first screening. Data was analyzed with R Commander. Results: Eighty one percent of respondents had some knowledge of the disease and of these, 68% had prostate screenings compared with 34% of those without knowledge of the disease. Information about prostate cancer was reported by 71% and 96% of respondents with primary and university education, respectively. Fifty nine and 90% of respondents with primary and university education had prostate screenings performed, respectively. Conclusions: Those respondents with a prostate cancer screening had a better knowledge of the disease and a higher educational level.

Association between periodontal disease and plasma levels of cholesterol and triglycerides / Asociación entre enfermedad periodontal y niveles plasmáticos de colesterol y triglicéridos

Objective: Untreated Periodontal Disease Seems To Cause Low Grade Systemic Inflammation And Blood Lipid Alteration Leading To Increased Cardiovascular Disease Risk. To Start Testing This Hypothesis In Colombian Patients, A Multicentre Study Was Conducted Including The Three Main State Capitals: Bogota, Medellin And Cali. Methods: In This Study 192 (28.4%) Advanced And 256 (37.8%) Moderate Periodontitis Patients Were Investigated For Socio-Demographic Variables, City Of Precedence, Periodontal Parameters, Smoking, Red Complex Periodontopathic Bacteria, Serum Antibodies Against Porphyromonas Gingivalis And Aggregatibacter Actinomycetemcomitans And Blood Lipids Including Total Cholesterol, HDL, LDL And Triglycerides (TG). Those Parameters Were Compared To 229 (33.8%) Controls Having Periodontal Health Or Gingivitis. Results: Advanced Periodontitis Had Worst Periodontal Indexes, Than Moderate Periodontitis And Controls. Interestingly, Higher HDL And TG Levels Were Present In Periodontitis. BMI <30 And Smoking Were Associated With Increased HDL, HDL-35, LDL And TG, While Glycemia >100 Mg/Dl Associated With HDL, HDL-35 And TG. Tannerella Forsythia Showed A Significant Association With HDL-35 In Bivariate Analysis And Serum Igg1 Against P. Gingivalis Associated With HDL-35 And Serum Igg1 Against T. Forsythia Associated With TG And Serum Igg2 Against A. Actinomycetemcomitans Correlated With Levels Of HDL Y HDL-35. In Logistic Regression The Periodontitis Patients From Cali Presented Reduced HDL Levels As Compared To Bogota And Medellin Patients. Presence Of Igg1 Antibodies Against P. Gingivalis And A. Actinomycetemcomitans Correlated With Reduced HDL Levels. Conclusion: This Study Confirmed That Untreated Periodontitis Generates Alteration In Serum Lipid Levels And Systemic Bacterial Exposure Against Important Periodontopathic Bacteria Could Be The Biological Link.

Objetivo: La periodontitis no tratada parece causar inflamación sistémica, así como alteración de los niveles sanguíneos de lípidos, lo que conduce a un mayor <<<<<<<<

Association between periodontal disease and plasma levels of cholesterol and triglycerides.

OBJECTIVE: untreated periodontal disease seems to cause low grade systemic inflammation and blood lipid alteration leading to increased cardiovascular disease risk. To start testing this hypothesis in colombian patients, a multicentre study was conducted including the three main state capitals: bogota, medellin and cali. METHODS: in this study 192 (28.4%) advanced and 256 (37.8%) moderate periodontitis patients were investigated for socio-demographic variables, city of precedence, periodontal parameters, smoking, red complex periodontopathic bacteria, serum antibodies against porphyromonas gingivalis and aggregatibacter actinomycetemcomitans and blood lipids including total cholesterol, hdl, ldl and triglycerides (tg). Those parameters were compared to 229 (33.8%) controls having periodontal health or gingivitis. RESULTS: advanced periodontitis had worst periodontal indexes, than moderate periodontitis and controls. Interestingly, higher hdl and tg levels were present in periodontitis. Bmi <30 and smoking were associated with increased hdl, hdl-35, ldl and tg, while glycemia >100 mg/dl associated with hdl, hdl-35 and tg. Tannerella forsythia showed a significant association with hdl-35 in bivariate analysis and serum igg1 against p. Gingivalis associated with hdl-35 and serum igg1 against t. Forsythia associated with tg and serum igg2 against a. Actinomycetemcomitans correlated with levels of hdl y hdl-35. In logistic regression the periodontitis patients from cali presented reduced hdl levels as compared to bogota and medellin patients. Presence of igg1 antibodies against p. Gingivalis and a. Actinomycetemcomitans correlated with reduced hdl levels. CONCLUSION: this study confirmed that untreated periodontitis generates alteration in serum lipid levels and systemic bacterial exposure against important periodontopathic bacteria could be the biological link.

OBJETIVO: La periodontitis no tratada parece causar inflamación sistémica, así como alteración de los niveles sanguíneos de lípidos, lo que conduce a un mayor riesgo de enfermedades cardiovasculares. Para empezar a probar esta hipótesis en pacientes Colombianos, se realizó un estudio multicéntrico que incluyó las tres ciudades principales: Bogotá, Medellín y Cali. MÉTODOS: Se estudiaron 192 pacientes con periodontitis avanzada (2.,4%) y 256 (37.8%) con periodontitis moderada, para medir variables sociodemográficas, ciudad de procedencia, parámetros periodontales, fumar, presencia de bacterias periodontopáticas, anticuerpos séricos contra Porphyromonas gingivalis y Aggregatibacter actinomycetemcomitans, así como niveles de lípidos en sangre incluyendo colesterol total, HDL, LDL y triglicéridos (TG). Estos parámetros se compararon con 229 (33.8%) pacientes controles sanos/gingivitis. RESULTADOS: Los pacientes con periodontitis avanzada tuvieron peores índices periodontales que los de periodontitis moderada y los controles. Mayores niveles de HDL y TG estuvieron presentes en pacientes con periodontitis. El índice de masa corporal >30 y el hábito de fumar se asociaron con aumento de HDL, HDL-35, LDL y TG, mientras la glicemia >100 mg/dL se asoció con HDL, HDL-35 y TG. En el análisis bivariado Tannerella forsythia mostró asociación significativa con HDL-35 e IgG1 sérica contra P. gingivalis estuvo asociada a HDL-35 así como IgG1 contra T. forsythia con TG y la IgG2 contra A. actinomycetemcomitans se correlacionó con los niveles de HDL y HDL-35. En la regresión logística se observó que la región de Cali tuvo niveles menores de HDL en comparación con los pacientes de Bogotá y Medellín. La presencia de anticuerpos IgG1 contra P. gingivalis y A. actinomycetemcomitans se asoció con niveles reducidos de HDL. CONCLUSIÓN: Este estudio confirmó que la periodontitis no tratada genera alteración en los niveles de lípidos séricos y la exposición bacteriana sistémica a las bacterias periodontopáticas podría ser el vínculo biológico.