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Bacteriophages have been proposed as biological controllers to protect plants against different bacterial pathogens. In this scenario, one of the main challenges is the low viability of phages in plants and under adverse environmental conditions. This work explores the use of 12 compounds and 14 different formulations to increase the viability of a phage mixture that demonstrated biocontrol capacity against Pseudomonas syringae pv. actinidiae (Psa) in kiwi plants. The results showed that the viability of the phage mixture decreases at 44 °C, at a pH lower than 4, and under UV radiation. However, using excipients such as skim milk, casein, and glutamic acid can prevent the viability loss of the phages under these conditions. Likewise, it was demonstrated that the use of these compounds prolongs the presence of phages in kiwi plants from 48 h to at least 96 h. In addition, it was observed that phages remained stable for seven weeks when stored in powder with skim milk, casein, or sucrose after lyophilization and at 4 °C. Finally, the phages with glutamic acid, sucrose, or skim milk maintained their antimicrobial activity against Psa on kiwi leaves and persisted within kiwi plants when added through roots. This study contributes to overcoming the challenges associated with the use of phages as biological controllers in agriculture.

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Prostate cancer (PCa) is the second most prevalent cancer in men. In 2020, approximately 1,414,259 new cases were reported that accounted for 3,75,324 deaths (Sung et al. in CA 71:209-249, 2021). PCa is often asymptomatic at early stages; hence, routine screening and monitoring based on reliable biomarkers is crucial for early detection and assessment of cancer progression. Early diagnosis of disease is key step in reducing PCa-induced mortality. Biomarkers such as PSA have played vital role in reducing recent PCa deaths. Recent research has identified many other biomarkers and also refined PSA-based tests for non-invasive diagnosis of PCa in patients. Despite progress in screening methods, an important issue that influences treatment is heterogeneity of the cancer in different individuals, necessitating personalized treatment. Currently, focus is to identify biomarkers that can accurately diagnose PCa at early stage, indicate the stage of the disease, metastatic nature and chances of survival based on individual patient profile (Fig. 1). Fig. 1 Graphical abstract.

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Payment for ecosystem services (PES) is a mechanism where a consumer is able and ready to pay for the protection of the precise ecosystem service and there must be a provider such as local societies receiving an economic resource, who in return, must have the ability to maintain that ecosystem service. Economic valuation provides basis for payment for ecosystem services. Therefore, objective of this study was to evaluate tourism and carbon stock services of the Islamabad Capital Territory (ICT), Pakistan. Two forest zones (Chirpine and Scrub) of Islamabad capital territory (ICT) were selected for estimation of carbon stock and their carbon credits and carbon worth, a questionnaire-based survey was conducted for tourism as a payment for ecosystem services. The method for carbon stock assessment was systematic sampling for Chirpine forest whereas random sampling was done for scrub forest. The size of sampling plot was 17.84 m radius, and a total of 93 plots (49 Scrub zone and 44 Chirpine zone) was taken in the study area. The carbon stock of both zones (Chirpine and Scrub zone) is 22556.75 ton/ha (Chirpine 20105.79, Scrub 2450.96) and total carbon dioxide sequestered by both zone is 82557.72 ton/ha (Chirpine 73587.2, Scrub 8970.52), total carbon credits of both zone is 302160.87 (Chirpine 269328.97, Scrub 32831.9) and the carbon worth of both Chirpine and scrub zone is 4532418.92 $ (Chirpine 4039937.09$, Scrub 492481.83$). Similarly, from tourism point of view, in Shakar Parian, 94% tourists were agreed for PES whereas 6% were disagreed for the PES (the 6% tourist were disagreed to contribute for PES, 40% were agreed for Rs.5 contribution and 54% for Rs.10.). moreover, in Lake view Park, 97% tourists were agreed and 3% are disagreed (In Lake View Park 5% tourists were disagreed for the PES contribution whereas 32% were agreed for Rs.5 and 63% were for Rs.10). In Damen e Koh, around 87% tourist were agreed and 13% were disagreed, (24% were agreed for the contribution of Rs.5 and 63% tourists were agreed for the contribution of Rs.10). In Marghazar Zoo, 93% tourists were agreed (22% were agreed for contribution of Rs.5 and 71% tourist were agreed for contribution of Rs.10) and 7% are disagreed for PES whereas 7% tourists were not agreed for contribution. PES may implement to compensate forest and parks manager to ensure better management of the forests and parks. Due to prime location and scenic beauty of the ICT, it has huge potential for implementation of PES mechanism for sustainable forest management and conservation. Therefore, it is recommended that Capital Development Authority (CDA) Islamabad should devise a plan for implementation of PES in forests and parks of ICT for its sustainable management of recreational and forest resources.

O pagamento por serviços ecossistêmicos (PES) é um mecanismo no qual um consumidor é capaz e está pronto para pagar pela proteção do serviço ecossistêmico preciso e deve haver um provedor, como sociedades locais, que recebe um recurso econômico, que, em troca, deve ter capacidade para manter esse serviço ecossistêmico. A avaliação econômica fornece a base para o pagamento de serviços ecossistêmicos. Portanto, o objetivo deste estudo foi avaliar os serviços de turismo e estoque de carbono do território da capital de Islamabad (ICT), Paquistão. Duas zonas florestais (Chirpine e Scrub) do território da capital de Islamabad (ICT) foram selecionadas para estimativa do estoque de carbono e seus créditos de carbono e valor de carbono. Uma pesquisa baseada em questionário foi realizada para turismo como pagamento por serviços ecossistêmicos. O método para avaliação do estoque de carbono foi a amostragem sistemática para a floresta de Chirpine, enquanto a amostragem aleatória foi feita para a floresta de cerrado. O tamanho da parcela de amostragem foi de 17,84 m de raio, e um total de 93 parcelas (49 zona Scrub e 44 zona Chirpine) foi considerado na área de estudo. O estoque de carbono de ambas as zonas (zona Chirpine e Scrub) é de 22.556,75 ton/ha (Chirpine 20.105,79, Scrub 2.450,96), e o dióxido de carbono total sequestrado por ambas as zonas é de 82.557,72 ton/ha (Chirpine 73.587,2, Scrub 8.970,52); créditos totais de carbono de ambas as zonas são 302.160,87 (Chirpine 269.328,97, Scrub 32.831,9), e o valor de carbono tanto do Chirpine quanto da zona de scrub é 4.532.418,92 $ (Chirpine 4.039.937,09 $, Scrub 492481,83 $). Da mesma forma, do ponto de vista do turismo, em Shakar Parian 94% dos turistas concordaram com o PES, enquanto 6% discordaram do PES (6% dos turistas não concordaram em contribuir para o PES, 40% concordaram com a contribuição de R$ 5 e 54% para R$ 10). além disso, no Lake View Park, 97% dos turistas concordaram e 3% discordaram (no Lake View Park, 5% dos turistas discordaram da contribuição do PES, enquanto 32% concordaram em R$ 5 e 63% foram em R$ 10). Em Damen e Koh, cerca de 87% dos turistas concordaram e 13% discordaram (24% concordaram com a contribuição de R$ 5 e 63% dos turistas concordaram com a contribuição de R$ 10). No Jardim Zoológico de Marghazar, 93% dos turistas concordaram (22% aceitaram a contribuição de R$ 5 e 71% dos turistas aceitaram contribuir com R$ 10) e 7% discordaram para PES. enquanto 7% turistas não foram acordados para contribuição. O PSA pode ser implementado para compensar o gestor florestal e de parques para garantir uma melhor gestão de florestas e parques. Devido à localização privilegiada e beleza cênica do ICT, possui enorme potencial para implementação de mecanismo de PSA para manejo e conservação florestal sustentável. Portanto, recomenda-se que a autoridade de desenvolvimento da capital (CDA) de Islamabad elabore um plano para implementação de PES em florestas e parques de ICT para sua gestão sustentável de recursos recreativos e florestais.

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Benign prostatic hyperplasia (BPH) is the most common adenoma in old men. Tomatoes are a rich source of bioactive compounds that, as well as selenium (Se), possess antioxidant and antiproliferative activity. The aim was to evaluate the therapeutic effect of Se in combination with a tomato extract in aged rats with BPH. Aged male Wistar rats were divided in the following groups (n = 10 rats/group): Control (C), BPH, BPH + Finasteride (BPH + F), BPH + Tomato Lipidic Extract (BPH + E), BPH + Selenium (BPH + S) and BPH plus E plus S (BPH + E + S). After 4 weeks of treatment, prostate weight, diuresis, antioxidants enzymes, prooxidants and inflammatory markers, growth factors and androgens were determined. BPH + E + S reduced prostate weight by 59.29% and inhibited growth by 99.35% compared to BPH + F which only decreased weight and inhibited growth by 15.31% and 57.54%, respectively. Prooxidant markers were higher with BPH + F (49.4% higher vs. BPH), but BPH + E + S decreased these markers (94.27% vs. BPH) and increased antioxidant activity. Finally, diuresis was higher with the BPH + E + S combination and markers of inflammation and growth factors were significantly lower with respect to BPH + F. Our findings provide a beneficial and protective therapeutic option of E + S directed against androgens, oxidative stress and inflammation that regulates cell proliferation in the prostate gland.

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BACKGROUND/AIM: Prostate cancer (PCa) is one of the most frequent neoplasms in men around the world. In recent years, the search for new biomarkers with greater prognostic potential for PCa has intensified. This study aimed to evaluate single nucleotide polymorphisms (SNPs) and a combined panel of these polymorphisms in relation to biochemical recurrence in patients who were through prostatectomy, with an average of 7 years of follow-up. MATERIALS AND METHODS: Patients diagnosed with PCa (n=197) participated in this cohort study. Thirteen SNPs were analyzed: rs2279115 (BCL-2), rs26677604 (CASP3), rs1052571 (CASP9), rs11781886 (NKX3-1), rs2735343 (PTEN), rs2494750 (AKT1), rs2699887 (PI3KCA), rs3195676 (AMACR), rs17302090 (AR), rs2536 (mTOR), rs1695 (GSTP1), rs2308321 (MGMT) and rs1544410 (VDR). Variants were combined and four main panels were defined: cell death, cell survival, growth receptors, and metabolism. Genotyping was performed by real-time PCR. RESULTS: We did not observe any significant relation between the panels of variants analyzed, apart from the rare allele (G) of rs2308321 (MGMT) that was associated with a higher risk of recurrence (p=0.036) when compared to the prevalent (A) in the allelic model. CONCLUSION: This MGMT variant occurs in an exon, and it could potentially affect DNA repair and, therefore, the biochemical relapse of PCa patients.

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This study considers the role that public service announcements (PSAs) play in addressing violence against women (VAW) in Latin America. Using content analysis, the study examines 407 PSAs about VAW from 20 Latin American countries. The results show that 62.3% of the PSAs encourage bystanders to denounce violence while portraying women as victims in 48.8% of the PSAs. However, 71.7% of PSAs did not include a helpline or how to report the crime, only 11.8% of the PSAs have non-narrative, or factual information, about VAW, and just 6.4% engage in compelling narrative messaging or storytelling.

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Abstract Background Secukinumab has shown high efficacy in randomized controlled trials in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Here, we investigated its real-life effectiveness and tolerability in a cohort of AS and PsA patients. Methods We retrospectively analyzed medical records of outpatients with AS or PsA treated with secukinumab between December 2017 and December 2019. ASDAS-CRP and DAS28-CRP scores were used to measure axial and peripheral disease activity in AS and PsA, respectively. Data were collected at baseline and after 8, 24, and 52 weeks of treatment. Results Eighty-five adult patients with active disease (29 with AS and 56 with PsA; 23 males and 62 females) were treated. Overall, mean disease duration was 6.7 years and biologic-naïve patients were 85%. Significant reductions in ASDAS-CRP and DAS28-CRP were observed at all time-points. Body weight (in AS) and disease activity status at baseline (particularly in PsA) significantly affected disease activity changes. ASDAS-defined inactive disease and DAS28-defined remission were achieved in comparable proportions between AS and PsA patients, at both 24 weeks (45% and 46%) and 52 weeks (65.5% and 68%, respectively); male sex was found an independent predictor of positive response (OR 5.16, P = 0.027). After 52 weeks, achievement of at least low disease activity and drug retention were observed in 75% of patients. Secukinumab was well-tolerated and only mild injection-site reactions were recorded in 4 patients. Conclusion In a real-world setting, secukinumab confirmed great effectiveness and safety in both AS and PsA patients. The influence of gender on treatment response deserves further attention.

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INTRODUCTION: Prostate MRI detecting PI-RADs = 3 lesions has low diagnostic utility for prostate malignancy. Use of PSA density has been suggested to further risk-stratify these men, to potentially avoid biopsies in favor of monitoring. We evaluate the ability of PSA density (PSAd) to risk-stratify PIRADs 3 lesions across patients who underwent a prostate biopsy in a large multi-institutional collaborative. MATERIALS AND METHODS: Pennsylvania Urology Regional Collaborative (PURC) is a voluntary quality improvement collaborative of 11 academic and community urology practices in Pennsylvania and New Jersey. A retrospective analysis was performed on all patients in the PURC database that had a prostate MRI with PI-RADs 3 lesions only. PSA just before the MRI and prostate size reported on MRI were used to calculate the PSA. Clinicopathologic data were evaluated. Univariable analysis using Chi-Square and Kruskal Wallis tests and multivariable logistic regression were used to identify predictors of any PCa, and clinically significant prostate cancer (csPCa) was defined as ≥ Grade Group 2 (GG2.) RESULTS: Between May 2015 and March 2021, 349 patients with PIRADs 3 lesions only were identified and comprised the cohort of interest. Median PSA was 5.0 with a prostate volume of 58cc and a median PSA density of 0.11, 10.6% of the cohort was African American with 81.4% being Caucasian. Significant prostate cancer was detected in 70/349 (20.0%) men. Smaller prostate volume, abnormal DRE, and higher PSAd were significantly associated with clinically significant prostate cancer on univariable analysis. In men with PSAd <0.15, 31/228 (13.6%) harbored csPCa. Multivariable analysis confirmed that men with PSAd >0.15 were more likely to harbor clinically significant prostate cancer (P < 0.001). CONCLUSION: Across a large regional collaborative, patients with PIRADs 3 lesions on mpMRI were noted to have clinically significant cancer in 20% of biopsies. Using a PSA density cut-off of 0.15 may result in missing clinically significant prostate cancer in 13.6%. This information is useful for prebiopsy risk stratification and counseling.

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Despite of the capacity that several drugs have for specific inhibition of the androgen receptor (AR), in most cases, PCa progresses to an androgen-independent stage. In this context, the development of new targeted therapies for prostate cancer (PCa) has remained as a challenge. To overcome this issue, new tools, based on nucleic acids technology, have been developed. Aptamers are small oligonucleotides with a three-dimensional structure capable of interacting with practically any desired target, even large targets such as mammalian cells or viruses. Recently, aptamers have been studied for treatment and detection of many diseases including cancer. In PCa, numerous works have reported their use in the development of new approaches in diagnostics and treatment strategies. Aptamers have been joined with drugs or other specific molecules such as silencing RNAs (aptamer-siRNA chimeras) to specifically reduce the expression of oncogenes in PCa cells. Even though these studies have shown good results in the early stages, more research is still needed to demonstrate the clinical value of aptamers in PCa. The aim of this review was to compile the existing scientific literature regarding the use of aptamers in PCa in both diagnosis and treatment studies. Since Prostate-Specific Membrane Antigen (PSMA) aptamers are the most studied type of aptamers in this field, special emphasis was given to these aptamers.

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OBJECTIVE: To evaluate the impact of the digital rectal exam (DRE) on PSA measurements and clinical decision-making. METHODS: Healthy male volunteers between 50 and 70 years old were recruited during a 30-day public screening program. PSA levels were measured using two different methods (standard enhanced chemiluminescence immunoassay-ECLIA, and novel immunochromatography assay-ICA/rapid PSA) in the same blood sample. Two blood samples were drawn; first before DRE and the second 30-40 min after DRE. The effect of DRE on PSA levels and its impact on clinical decision-making for individual patients were evaluated based on different biopsy trigger cutoffs. RESULTS: ECLIA-PSA was measured in 74 participants both pre- and 37 ± 5 min post-DRE, mean age 57.2 ± 8.3 years, and mean prostate volume 33.6 (20-80) cm3. Both total and free ECLIA-PSA increased significantly after DRE (mean increase of 0.47 and 0.26 ng/ml, respectively, both p < 0.001). Different internationally accepted biopsy triggers were reached after DRE only: 5 total PSA > 3 ng/ml, 13 increase > 0.75 ng/ml, 3 PSA density > 0.15, and 1 free/total PSA < 0.18. On two occasions, patients were pushed away from biopsy trigger after DRE due to free/total PSA > 0.18. ICA-PSA was detectable (> 2.0 ng/ml) in 5 of 45 measured samples (11%) before DRE and 13/45 (29%) after DRE, p = 0.0316. Four among five detectable ICA-PSA tests increased after DRE. CONCLUSION: Performing DRE immediately before PSA measurement might change the clinical decision-making on a significant number of occasions (roughly 1 in 3); even though the mean increase (0.47 ng/ml) looks deceivingly small. Further studies are required that include gold standard tests (biopsy, or imaging).

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BACKGROUND: There is an ongoing search for molecular markers that are specific, sensitive, and able to predict the stage of prostate cancer (PCa), which is the second most prevalent type of cancer in men worldwide. This study examined whether different single nucleotide polymorphisms (SNPs) were reliable markers of susceptibility to and prognosis of PCa in a sample of Brazilian patients. METHODS AND RESULTS: DNA samples were extracted from peripheral blood cells of 283 PCa patients and matched with samples from healthy controls. Single nucleotide polymorphisms (SNPs in four genes (BCL-2-rs2279115, CASP3-rs4647603, CASP9-rs1052571, and NKX3-1-rs11781886) were genotyped by real-time PCR using the TaqMan® probe. Odds Ratios with 95% confidence intervals were calculated for allelic and genotypic frequencies. The association between polymorphic variants, risk of developing PCa, and clinicopathological characteristics was analyzed by univariate and multivariate logistic regression analysis. SNPs in CASP3, CASP9, and NKX3-1 genes, either alone or in combination (BCL-2+NKX3-1 and CASP3+NKX3-1) were associated with the risk of developing PCa. Genotypes and tumor histopathological data indicated that the BCL-2, NKX3-1, and CASP3 allelic variants, either alone or combined in pairs, were associated with a poor prognosis of PCa. CONCLUSIONS: Genetic polymorphisms in CASP3, NKX3-1, and BCL-2 genes were associated with susceptibility to PCa. The SNPs in the three genes alone and the SNP in the BCL-2 gene combined with the other two genes were strongly associated with adverse outcomes in PCa patients and are promising candidates for molecular markers for PCa prognosis.

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INTRODUCTION: Prostate cancer (PCa) is the second most prevalent neoplasm among men in the world. Its treatment has a wide spectrum of alternatives and variables, ranging from active surveillance through radio and/or brachytherapy, to surgery. OBJECTIVE: The present work aimed to identify the predictive factors for biochemical recurrence and to evaluate the toxicity of the treatment using the association of external beam radiation therapy (EBRT) with high dose rate brachytherapy (HDR-BT) applied in the treatment of patients with prostate cancer. METHODS: Longitudinal retrospective study, using a prospectively collected database between 2005 and 2014 of 186 consecutive patients records with a diagnosis of low, intermediate, or high-risk prostate cancer treated with EBRT combined with HDR-BT, in a single medical institution located in the city of Campinas, SP, Brazil (Radium Institute). PSA increase over 2 ng/ml above the nadir PSA was considered as biochemical recurrence, following the definition of the Phoenix Consensus. Continuous and clinically relevant categorical variables (age, initial PSA, delivered dose in EBRT, number of implants, number of positive cores in transrectal biopsy, use of hormone blockade, Gleason score, TNM staging, post treatment PSA and PSA Nadir) were evaluated with absolute (n) and percentage (%) values using multiple logistic regression and validated our previously described optimal PSA nadir as predictor of biochemical recurrence. RESULTS: Post treatment PSA was the only independent predictor of biochemical recurrence, P<0.0001. The lower the PSA nadir the lower the biochemical recurrence risk (P=0.0009). PSA nadir >1 was the best cutoff (P=0.018) determinant of biochemical recurrence. The incidence of grade 3 late toxicity to the genitourinary tract was 0.6%, and there were no cases of severe complications to the gastrointestinal tract. CONCLUSION: External Beam Radiation Therapy conjugated to Brachytherapy in the treatment of Prostate Cancer has demonstrated low biochemical recurrence rates, mainly when PSA nadir <1, with low toxicity into both GU and GI tracts.

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The Chilean workforce has over 200,000 people that are intermittently exposed to altitudes over 4000 m. In 2012, the Ministry of Health provided a technical guide for high altitude workers that included a series of actions to mitigate the effects of hypoxia. Previous studies have shown the positive effect of oxygen enrichment at high altitudes. The Atacama Large Millimeter / submillimeter Arrays (ALMA) radiotelescope operate at 5,050 m (Array Operation Site, AOS) and is the only place in the world where Pressure Swing Adsorption (PSA) and Liquid Oxygen technologies have been installed at a large scale. Here we discuss our experience using oxygen supplementation at ALMA, to prevent the malaise and/or risks associated with exposure at 5,050 m. Antenna operators experienced chronic intermittent hypobaric hypoxia (CIHH, shiftwork 8 days HA*6 days rest SL) over 4 years. Studies to define normal O2 saturation values were performed in OSF and AOS by continuous recording during the shift. The outcomes showed no differences between production procedures (PSA or Liquid oxygen) in regulating oxygen availability at AOS facilities. As a result, big-scale installations have difficulties reaching the appropriate oxygen concentration due to leaks in high mobility areas. In addition, the PSA plant requires adequation and maintenance to operate at a very high altitude.

La fuerza laboral chilena cuenta con más de 200.000 personas que están expuestas intermitentemente a altitudes superiores a los 4000 m. En 2012, el Ministerio de Salud entregó una guía técnica para trabajadores de altura que incluía una serie de acciones para mitigar los efectos de la hipoxia. Estudios anteriores han demostrado el efecto positivo del enriquecimiento de oxígeno en altitudes elevadas. El radiotelescopio Atacama Large Millimeter/submillimeter Arrays (ALMA) opera a 5.050 m (Array Operation Site, AOS) y es el único lugar en el mundo donde se han instalado tecnologías de adsorción por cambio de presión (PSA) y oxígeno líquido a gran escala. Aquí discutimos nuestra experiencia usando suplementos de oxígeno en ALMA, para prevenir el malestar y/o los riesgos asociados con la exposición a 5.050 m. Los operadores de antena experimentaron hipoxia hipobárica intermitente crónica (CIHH, trabajo por turnos 8 días HA*6 días descanso SL) durante 4 años. Se realizaron estudios para definir valores normales de saturación de O2 en OSF y AOS mediante registro continuo durante el turno. Los resultados no mostraron diferencias entre los procedimientos de producción (PSA u oxígeno líquido) en la regulación de la disponibilidad de oxígeno en las instalaciones de AOS. Como resultado, las instalaciones a gran escala tienen dificultades para alcanzar la concentración de oxígeno adecuada debido a fugas en áreas de alta movilidad. Además, la planta de PSA requiere de adecuación y mantenimiento para operar a gran altura.

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OBJECTIVE: To evaluate the effects of pre- and intraprocedural opioids on adverse events in children undergoing procedural sedation with ketamine in the emergency department (ED). STUDY DESIGN: We conducted a retrospective cohort study of all children aged 0-18 years who underwent procedural sedation with intravenous ketamine alone, or in combination with an opioid, at a tertiary-care pediatric ED between June 1, 2018, and August 31, 2020. We explored predictors of serious adverse events (SAEs), desaturation or respiratory intervention, and vomiting. RESULTS: Of 1164 included children (694 male, 59.6%; median age 5.0 years [IQR 2.0-8.0]), 80 (6.8%) vomited, 63 (5.4%) had a desaturation or required respiratory interventions, and 6 (0.5%) had SAEs. Pre- and intraprocedural opioids were not independent predictors of sedation-related adverse events. A concurrent respiratory illness (aOR 3.73; 95% CI 1.31-10.60, P = .01), dental procedure (aOR 3.05; 95% CI 1.25-7.21, P = .01), and a greater total ketamine dose (aOR 1.75; 95% CI 1.21-2.54, P = .003) were independent predictors of desaturation or respiratory interventions. A greater total ketamine dose (aOR 1.86; 95% CI 1.16-2.98, P = .01) and older age (aOR 1.15; 95% CI 1.07-1.24, P < .001), were independent predictors of vomiting. CONCLUSIONS: Pre- and intraprocedural opioids do not increase the likelihood of sedation-related adverse events. SAEs are rare during pediatric procedural sedation with ketamine in the ED.

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BACKGROUND: Patients with prostate-specific antigen (PSA) persistence are at the increased risk of disease progression. The aim of our study was to evaluate the impact of early salvage therapy on oncological outcomes in patients with persistent PSA after radical prostatectomy (RP). METHODS: Within a single tertiary centre database, we identified men with persistent (≥ 0.1 ng/ml) versus undetectable (< 0.1 ng/ml) PSA 4-8 weeks after RP for high-risk prostate cancer (HRPCa). The cumulative incidence function was used to estimate cancer-specific survival (CSS) and clinical progression-free survival (CPFS). The Kaplan-Meier method was used to estimate overall survival (OS). The effects on oncological outcomes of salvage radiotherapy (SRT) ± androgen deprivation therapy (ADT) vs. ADT monotherapy were tested in the subgroup of patients with persistent PSA. RESULTS: Of 414 consecutive patients who underwent RP for HRPC, 125 (30.2%) had persistent PSA. Estimated 10-year CPFS, CSS and OS for men with persistent vs. undetectable PSA were 63.8% vs. 93.5%, 78.5% vs. 98.3% and 54% vs. 83.2% (all p < 0.0001), respectively. In men with persistent PSA, ADT alone was associated with higher risk (hazard ratio (HR) for worse CSS (HR 3.9, p = 0.005) and OS (HR 4.7, p < 0.0001) but not for CP (HR 1.6, p = 0.2) when compared with SRT ± ADT. CONCLUSION: In patients who underwent RP for HRPCa, persistent PSA was associated with poor oncological outcomes. Early SRT ± ADT resulted in significantly improved CSS and OS in men with persistent PSA comparing with early androgen deprivation monotherapy.

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El antígeno específico de próstata (PSA, del inglés, Prostate Specific Antigen) es una glicoproteína producida por la próstata, y es el marcador tumoral de mayor uso. Sin embargo, su baja especificidad para diferenciar entre cáncer de próstata y otras alteraciones no malignas, como la hipertrofia benigna de la próstata (HBP) y la prostatitis aguda, limitan su utilidad diagnóstica

Prostate Specific Antigen (PSA) is a glycoprotein produced by the prostate and is the most widely used tumor marker. However, its low specificity to differentiate between prostate cancer and other non-malignant conditions, such as benign prostate hypertrophy (BPH) and acute prostatitis, limits its diagnostic utility

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The Chilean workforce has over 200,000 people that are intermittently exposed to altitudes over 4,000 m. In 2012, the Ministry of Health provided a technical guide for high-altitude workers that included a series of actions to mitigate the effects of hypoxia. Previous studies have shown the positive effect of oxygen enrichment at high altitudes. The Atacama Large Millimeter/submillimeter Array (ALMA) radiotelescope operates at 5,050 m [Array Operations Site (AOS)] and is the only place in the world where pressure swing adsorption (PSA) and liquid oxygen technologies have been installed at a large scale. These technologies reduce the equivalent altitude by increasing oxygen availability. This study aims to perform a retrospective comparison between the use of both technologies during operation in ALMA at 5,050 m. In each condition, variables such as oxygen (O2), temperature, and humidity were continuously recorded in each AOS rooms, and cardiorespiratory variables were registered. In addition, we compared portable O2 by using continuous or demand flow during outdoor activities at very high altitudes. The outcomes showed no differences between production procedures (PSA or liquid oxygen) in regulating oxygen availability at AOS facilities. As a result, big-scale installations have difficulties reaching the appropriate O2 concentration due to leaks in high mobility areas. In addition, the PSA plant requires adequacy and maintenance to operate at a very high altitude. A continuous flow of 2-3 l/min of portable O2 is recommended at 5,050 m.

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Objetivo: Determinar la asociación del nivel de antígeno prostático específico (PSA) plasmático y PSA masa según riesgo de padecer enfermedades prostáticas con el perfil antropométrico. Materiales y métodos: Estudio correlacional, de enfoque cuantitativo de dimensión transversal y retrospectiva. La muestra estuvo constituida por 156 historias clínicas de pacientes varones, con pruebas de PSA y datos antropométricos. Para el análisis de la relación de las variables se utilizó la prueba Rho de Spearman, con un nivel de confianza de 95 %. Resultados: La edad promedio de los pacientes fue 67,85±10,83 años y presentaron un valor medio de PSA de 3,57±7,30 ng/mL. El 9,60 % (15 pacientes) tuvo un riesgo bajo de padecer enfermedades prostáticas (PSA = 4,1-9,90 ng/mL); el 5,10 % (8 individuos) mostró riesgo intermedio (PSA= 10-19,90 ng/mL); y el 3, 80 %(6 pacientes) tuvo un riesgo alto (PSA ≥20 ng/mL). El promedio del índice de masa corporal (IMC) fue 26,37±3,81 kg/m2 : 85 pacientes (54,50 %) tenían sobrepeso; y 18 (11,50 %), obesidad. La media de PSA masa fue14,89±30,50 μg; la superficie corporal (SC) se calculó en 3,93± 2,72 m2; y el volumen plasmático fue 4,18± 0,21 L. Se evidenció una correlación positiva muy baja entre el PSA plasmático y la edad (rho = 0,184; p = 0,022), así como con entre la PSA masa y la edad (rho = 0,176; p = 0,028). Se obtuvo una asociación positiva moderada entre el PSA plasmático y la superficie corporal (SC) (rho = 0,456; p = 0,000); y entre el PSA masa y SC (rho = 0,463; p = 0,000). No se encontró relación entre el IMC y el PSA. Conclusiones: Se evidenció la asociación entre el valor de PSA plasmático y PSA masa con el perfil antropométrico, según el riesgo de padecer enfermedades prostáticas, que fue mayor con la superficie corporal y la edad.

Objective: To determine the association between plasma and mass prostate-specific antigen (PSA) levels and the anthropometric profile, taking into account the risk of prostate pathologies. Materials and methods: A correlational, quantitative, cross-sectional and retrospective study conducted with a sample of 156 medical records of male patients with PSA tests and anthropometric data. Spearman's Rho with a 95 % confidence level was used to analyze the relationship between the variables. Results: The average age of the patients was 67.85 ± 10.83 years and their mean PSA value was 3.57 ± 7.30 ng/mL. Fifteen (15) patients (9.60 %) had a low risk (PSA = 4.1 - 9.90 ng/mL), eight (5.10 %) a medium risk (PSA = 10 - 19.90 ng/mL) and six (3.80 %) a high risk (PSA ≥ 20 ng/mL) of developing prostate pathologies. The mean body mass index (BMI) was 26.37 ± 3.81 kg/m2: 85 patients (54.50 %) were overweight and 18 (11.50 %) were obese. The mean mass PSA was 14.89 ± 30.50 μg, the body surface area (BSA) was 3.93 ± 2.72 m2 and the plasma volume was 4.18 ± 0.21 L. A very low positive correlation was evidenced between plasma PSA and age (rho = 0.184; p = 0.022) and between mass PSA and age (rho = 0.176; p = 0.028). There was a moderate positive association between plasma PSA and BSA (rho = 0.456; p = 0.000) and between mass PSA and BSA (rho = 0.463; p = 0.000). No relationship was found between BMI and PSA. Conclusions: The association between plasma and mass PSA levels and the anthropometric profile was demonstrated, taking into account the risk of prostate pathologies, which increased with BSA and age.

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INTRODUCTION: Congenital adrenal hyperplasia (CAH), a genetic disease characterized by defective cortisol synthesis and excessive levels of sex hormones, can cause precocious puberty in both sexes in untreated individuals and virilization in female patients with a 46, XX karyotype. The female paraurethral (Skene's) gland has been reported as prostate analogous. Growth of prostate tissue is associated with androgen production; therefore, prostate-specific antigen (PSA) levels may represent a marker of virilization in 46, XX patients with CAH. OBJECTIVES: To describe PSA levels in 46, XX patients and evaluate whether higher PSA levels are associated with androgenization and the severity of the disease. STUDY DESIGN: Sixty-six patients with CAH and a 46, XX karyotype were included, irrespective of age. Serum PSA, testosterone, 17-hydroxyprogesterone (17-OHP) and androstenedione levels were measured. Patients' age, age at diagnosis, forms of the disease, Prader classification, bone age assessment, sex of rearing, surgery, and the presence of clinical complications were obtained from their medical records. RESULTS: The mean age of patients was 11.45 ± 10.74 years. Forty-three patients (65%) were diagnosed neonatally at a median of 0.08 years (mean 1.47 ± 2.34 years), with registers of 17-OHP measurements (Guthrie test) being available in 51%. Testosterone, 17-OHP and androstenedione were significantly high. PSA was detectable in 25% of cases (levels >0.01 ng/ml), with a mean of 0.03 ± 0.09 ng/ml, and only in patients over five years of age. A correlation was found between PSA and age (p < 0.001), age at diagnosis (p = 0.002), testosterone (p = 0.001) and androstenedione (p = 0.023). There was no correlation between PSA and the forms of CAH or Prader classification. A sub-analysis of the patients over five years of age in whom PSA was detectable also showed that there was a correlation between PSA (p < 0.05) and age at analysis, age at diagnosis, testosterone and androstenedione levels. DISCUSSION: Limitations of this study include the small sample size due to the rareness of the disease, its retrospective nature, the absence of a control group, the fact that the sample was selected at two referral centers, which could have resulted in a selection bias, and the use of different reference values in the different laboratories conducting the PSA tests. CONCLUSIONS: PSA is detectable in 25% of 46, XX patients with CAH, only after five years of age. PSA level increases significantly with age, age at diagnosis, and testosterone and androstenedione levels, confirming a correlation between PSA levels and elevated androgen levels.

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RESUMEN El cáncer de próstata suele diagnosticarse tardíamente en obesos debido a que el exceso de tejido adiposo dificulta la detección del tumor al interferir en la exploración física (dificultad para realizar el tacto rectal) y en la confiabilidad de exámenes de diagnóstico complementarios como el Antígeno Prostático Específico (PSA, por sus siglas en inglés), retardando de esta forma la realización de la biopsia prostática. Con el objetivo de identificar la relación entre la obesidad y la agresividad del cáncer de próstata al momento de su diagnóstico, se realizó un estudio transversal, analítico en 136 pacientes diagnosticados con cáncer de próstata mediante biopsia transrectal, en el Hospital Provincial "Carlos Manuel de Céspedes", de Bayamo, Granma, Cuba, desde el 1ro de enero de 2018 hasta el 31 de diciembre de 2020. El análisis de asociación entre las variables (Índice de Masa Corporal [IMC], PSA, Suma de Gleason y Estadio Clínico) se realizó a través de la prueba de Tukey y la U de Mann-Whitney. La edad promedio de los pacientes fue de 66,1 años. No se encontró asociación significativa entre el PSA y el IMC (p > 0,05), sin embargo, el valor del PSA mostró una tendencia a disminuir en la medida que aumentó el IMC. La suma de Gleason y el Estadio Clínico mostraron una asociación directa con el IMC, (p<0,003) y (p=0.000) respectivamente. Los pacientes con sobrepeso y obesidad fueron más propensos a presentar valores de PSA más bajos y mayor Gleason, manifestándose en estos un mayor riesgo de cáncer de próstata agresivo al momento del diagnóstico.

ABSTRACT Prostate cancer is often diagnosed late in obese because excess adipose tissue makes it difficult to detect the tumor by interfering with physical examination (difficulty performing rectal touch) and the reliability of complementary diagnostic tests such as Psa, the delaying prostate biopsy. In order to identify the relationship between obesity and the aggressiveness of prostate cancer at the time of diagnosis, a cross-sectional, analytical study was conducted in 136 patients diagnosed with prostate cancer by transrectal biopsy, at the Provincial Hospital "Carlos Manuel de Céspedes", Bayamo, Granma, Cuba, from January 1, 2018 to December 31, 2020. The association analysis between the variables (Body Mass Index [BMI], PSA, Gleason Sum and Clinical Stage) was performed through the Mann-Whitney Tukey and U test. The average age of patients was 66.1 years. No significant association was found between PSA and BMI (p > 0.05), however, the psa value showed a tendency to decrease as BMI increased. The sum of Gleason and the Clinical Stadium showed a direct association with BMI, (p<0.003) and (p-0.000) respectively. Overweight and obese patients were more likely to develop lower PSA and higher Gleason values, with an increased risk of aggressive prostate cancer at the time of diagnosis.

RESUMO O câncer de próstata é frequentemente diagnosticado tardiamente em obesidade porque o excesso de tecido adiposo dificulta a detecção do tumor interferindo no exame físico (dificuldade em realizar o toque retal) e a confiabilidade de exames diagnósticos complementares como psa, a biópsia da próstata retardando. Como objetivo de identificar a relação entre obesidade e agressividade do câncer de próstata no momento do diagnóstico, foi realizado umestudo transversal e analítico em 136 pacientes diagnosticados comcâncer de próstata por biópsiatransretal, no Hospital Provincial "Carlos Manuel de Céspedes", bayamo, Granma, Cuba, de 1º de janeiro de 2018 a 31 de dezembro de 2020. A análise de associação entre as variáveis (Índice de Massa Corporal [IMC], PSA, Gleason Sum e Estágio Clínico) foi realizada através do teste Mann-WhitneyTukey e U. A idademédia dos pacientes foi de 66,1 anos. Nãofoi encontrada associação significativa entre PSA e IMC (p > 0,05), porém, o valor do PSA apresentou tendência a diminuir à medida que o IMC aumentou. A soma de Gleason e do Estádio Clínico mostrou associação direta com o IMC, (p<0.003) e (p-0,000), respectivamente. Pacientes com sobrepeso e obesidade foram mais propensos a desenvolver menores valores de PSA e Gleason mais elevados, commaior risco de câncer agressivo de próstata no momento do diagnóstico.