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OBJETIVO: Determinar la tasa de recurrencia del cáncer de próstata localizado después de la prostatectomía radical según la clasificación D'Amico. MÉTODOS: Estudio de cohorte retrospectivo comparativo de 5 años. Se obtuvieron datos de registros clínicos de pacientes con cáncer de próstata localizado, que se sometieron a prostatectomía radical y se evaluó la tasa de recurrencia de la enfermedad. Se analizó con pruebas estadísticas descriptivas y comparativas. Una p < 0.05 se consideró significativo. RESULTADOS: Se analizó 108 pacientes, la edad promedio 65.3 años. Acerca de la clasificación de riesgo de D'Amico, 33.33% de bajo riesgo, 55.56% riesgo intermedio y 11.11% alto riesgo. La tasa de recurrencia de APE fue 14,81%. Los pacientes de bajo riesgo tuvieron recurrencia del 13.89%, riesgo intermedio 18.33% y alto riesgo no tuvieron recurrencia. Sobre piezas quirúrgicas, el 25.93% presentaron características adversas. La escala de Gleason postoperatoria muestra un aumento de 44.44% en bajo riesgo, 26.67% en riesgo intermedio y 41.67% en alto riesgo. CONCLUSIONES: La prostatectomía radical ofrece un control adecuado del cáncer de próstata localizado. La tasa de recurrencia del APE fue menor que otros informes internacionales. Asimismo, la recurrencia bioquímica del riesgo bajo, intermedio y alto fue similar a la tendencia global. OBJECTIVE: The objective of the study was to determine the recurrence rate of localized prostate cancer after radical prostatectomy according to the D'Amico classification. METHODS: This was a observational and 5-year comparative retrospective cohort study. Data were obtained from clinical records of patients with localized prostate cancer who underwent radical prostatectomy and the recurrence rate of the disease was evaluated. It was analyzed with descriptive and comparative statistical tests, p<0.05 was considered significant. RESULTS: One hundred and eight patients were analyzed, and the average age was 65.3 years. About D'Amico's risk classification, 33.33% low risk, 55.56% intermediate risk, and 11.11% high risk. The prostate-specific antigen (PSA) recurrence rate was 14.81%. Low-risk patients had recurrence of 13.89%, intermediate risk 18.33%, and high risk had no recurrence. Regarding surgical pieces, 25.93% presented adverse characteristics. The post-operative Gleason scale shows an increase of 44.44% in low risk, 26.67% in intermediate risk, and 41.67% in high risk. CONCLUSIONS: Radical prostatectomy offers adequate control of localized prostate cancer. The PSA recurrence rate was lower than other international reports. Likewise, the biochemical recurrence of low, intermediate, and high risk was similar to the global trend.

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AIM: This study aims to assess primary care physicians (PCPs) knowledge and skills regarding prostate cancer early detection (PCa-ED). MATERIALS AND METHODS: A survey about knowledge and skills of PCa-ED was delivered to PCP. Logistic regression analysis was conducted for the propensity of PCP to test prostatic specific antigen (PSA) on asymptomatic men. RESULTS: The survey was completed by 170 PCP. Score on risk factors knowledge was 51.5 ± 15.7% a better score was not associated with conducting PCa-ED (p = 0.674). The 40.6% answered having an institutional program on PCa-ED and 86% having access to PSA testing. Testing PSA on asymptomatic men was found in 40%. Moreover, 61.2% do not performed any digital rectal examination for PCa-ED, and this was not associated with preventing factors such as lack of space, time, and assistance (p > 0.05). Fewer years in practice and being a family medicine resident were associated with a less likelihood of testing PSA in asymptomatic men. The only associated factor in the multivariable model was having access to PSA testing (odds ratio: 3.36 confidence interval 95% 1.54-7.30) p = 0.002). CONCLUSIONS: A low rate of PCP performs PCa-ED and using concepts outside evidence-based recommendations. A national program on PCa-ED and continuing medical education for PCP are a promising strategy to improve PCa-ED.

OBJETIVO: Evaluar el conocimiento y las habilidades de los médicos de primer contacto en la detección oportuna del cáncer de próstata (DO-CaP). MÉTODO: Se aplicó una encuesta a médicos de primer contacto. Se realizó un análisis de regresión logística evaluando la propensión de los médicos a medir el antígeno prostático específico (APE) en sujetos asintomáticos. RESULTADOS: Contestaron 170 médicos y la calificación del conocimiento sobre factores de riesgo fue de 51.5 ± 15.7%, pero una mejor calificación no se asoció con realizar DO-CaP (p = 0.674). El 40.6% respondió contar con un programa institucional en DO-CaP y un 86% con acceso a la prueba de APE. El 40% medían el APE en sujetos asintomáticos. El 61.2% no ­realizaba ningún examen digital rectal para DO-CaP, y esto no se asoció con factores limitantes como falta de tiempo, espacio o asistencia (p > 0.05). Menos años en práctica y ser residente de medicina familiar disminuyeron la probabilidad de determinar el APE en asintomáticos. El único factor asociado en el análisis multivariado fue el acceso a la prueba de APE (odds ratio: 3.36; intervalo de confianza del 95%: 1.54-7.30; p = 0.002). CONCLUSIÓN: Una baja proporción de médicos de primer contacto realizan DO-CaP y utilizan conceptos alejados de la evidencia científica. Un programa nacional en DO-CaP y de educación continua para médicos de primer contacto es una estrategia prometedora para mejorar la DO-CaP.

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INTRODUCCIÓN: El cáncer de próstata es el segundo cáncer más diagnosticado en hombres en Chile y el mundo. El tamizaje modificó la etapa de diagnóstico, siendo actualmente en EE.UU. un 80 por cinto localizada, 12 por cinto compromiso regional y 4 por ciento metastásico. Tamizaje con APE no está considerado dentro de un programa nacional en Chile. El objetivo de este estudio es caracterizar a la población diagnosticada de cáncer de próstata en un Hospital público en Chile. MATERIALES Y MÉTODO: Estudio descriptivo, retrospectivo. Se revisaron todas las fichas de los pacientes ingresados al GES por Cáncer de Próstata en el Hospital Carlos Van Buren de Valparaíso desde el año 2014 a 2016. RESULTADOS: Se revisaron 259 fichas y se analizaron 226. Edad promedio fue 70,5 años. 46 por ciento presentó APE sobre 20 ng/dL. 31 por ciento presentó metástasis. 42 por ciento recibió tratamiento paliativo. 57 por ciento se realizó tratamiento curativo, con edad promedio 67,4 años. De estos, 31,8 por ciento a cirugía, 68 por ciento índice Gleason <6 y 90 por ciento APE <20. 68 por ciento a RDT con o sin HT, 44 por ciento índice Gleason <6, 75 por ciento APE <20. DISCUSIÓN: El tamizaje del cáncer de próstata es un tema en discusión. En Chile no hay un programa nacional para realizar APE. Centros de atención primaria con acceso a APE tienen mayor tasa de tamizaje. La etapa al diagnóstico en nuestro centro difiere a las series de países desarrollados, siendo considerablemente superior la etapa metastásica. Esto podría deberse a la poca cobertura para detección temprana. Parece ser necesario implementar un programa nacional con cobertura de tamizaje para cáncer de próstata.(AU)

INTRODUCTION: Prostate cancer is the second most diagnosed cáncer in Chile and the world. Screening modified the stage at diagnosis, beeing now in the US 80 pertcent localized, 12 pertcent with regional compromised and 4 pertcent metastatic. Screening with PSA isn't considerd within a national program in Chile. The objetive of this study is to caracterize men diagnosed with prostate cancer at a public hospital in Chile. MATERIALS AND METHODS: Retrospective and descriptive study. Every patient who entered GES because of prostate cancer at the Carlos Van Buren Hospital from Valparaiso between 2014 and 2016 was review. RESULTS: 259 clinical records were review and 226 analized. Mean age was 70,5 years. 46 pertcent had PSA above 20 ng/dL. 31 % had metástasis. 42 % received paliative treatment. 57 % had curative treatment with a mean age of 67,4 years.From this group 31,8 pertcent surgery with a Gleason index <6 and 90 pertcent PSA <20. 68 pertcent had EBRT with or without HT, 44 pertcent of this group had Gleason index <6 and 75 pertcent PSA <20. DISCUSSION: Prostate cancer screening it's a debated topic. In Chile there's no national program to do a PSA. Primary care centers with acces to PSA have more rate of screening. Stage at diagnosis in our center difers from developed countries series, beeing metastatic stage considerably superior. This could be because of the low screening rate for early diagnosis. It seems necesary to implement a national program for prostate cancer screening.(AU)

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Because of the limitations of standard culture techniques, the development of new recombinant protein expression systems with biotechnological potential is a key challenge. Ideally, such systems should be able to effectively and accurately synthesize a protein of interest with intrinsic metabolic capacity. Here, we describe such a system that was designed based on a plasmid vector containing promoter elements derived from the metallothionein MTIIa promoter, as well as processing and purification elements. This promoter can be induced by heavy metals in a culture medium to induce the synthesis of human prostate-specific antigen (hPSA), which has been modified to insert elements for purification, proteolysis, and secretion. We optimized hPSA production in this system by comparing the effects and contributions of ZnCl2, CdCl2, and CuSO4 in HEK293FT, HeLa, BHK-21, and CHO-K1 cells. We also compared the effectiveness of three different transfection agents: multi-walled carbon nanotubes, Lipofectamine 2000, and X-tremeGENE HP Reagent. hPSA production was confirmed via the detection of enhanced green fluorescent protein fluorescence, and cell viability was determined. The expression of hPSA was compared with that of the native protein produced by LNCaP cells, using enzyme-linked immunosorbent assay and sodium dodecyl sulfate polyacrylamide gel electrophoresis. X-tremeGENE reagent, the BHK-21 cell line, and CuSO4 showed the highest hPSA production rates. Furthermore, BHK-21 cells were more resistant to the oxidative stress caused by 100 µM CuSO4. These results suggest that the proposed optimized inducible expression system can effectively produce recombinant proteins with desired characteristics for a wide range of applications in molecular biology.

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Prostate cancer is very frequent, but secondary ureteral metastasis are extremely rare. We present a 55 year old man with a 2 month history of right flank pain and lower urinary tract symptoms. Prostatic specific antigen of 11.3 ng/mL. Computed tomography showed right hydroureteronephrosis, a developing urinoma and right iliac adenopathies. He underwent right ureteronephrectomy, iliac lymphadenectomy and prostate biopsy. Pathology revealed prostatic carcinoma infiltrating the ureteral muscularis propria, without mucosal involvement. There are 46 reported cases of prostate cancer with ureteral metastases. Ureteral metastasis are a rare cause of renal colic and need of a high index of suspicion.

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Purpose We investigated the effect of antibiotics on PSA in asymptomatic patients with mild PSA elevation. Materials and Methods We prospectively evaluated, in a non-randomized design, 106 asymptomatic patients with PSA of 4-10ng/mL, with a negative digital rectal examination and with no urinary tract infection evidence for 2 years. Patients were divided into two groups: those treated with antibiotics for 3 weeks (G1) and those who were not treated (G2). PSA was taken six weeks after and prostate biopsy was performed in all patients. Results PCa was diagnosed in 25 of 106 patients (23.6%): 16 (25.0%) in G1 and 9 (21.4%) in G2 (p>0.05). PSA normalization was experienced in 24.5%. In G1, PSA returned to <4ng/mL in 15 (23.4%) patients compared to 11 (26%) patients in G2. In the patients with a positive biopsy, no significant variation was noted in PSA, fPSA, %fPSA and DPSA after antibiotic treatment. A significantly lower cancer detection rate was noted with decreased PSA, fPSA, and DPSA after antibiotic use. A PSA reduction rate of ≥10% occurred in 58.5%, and this was similar in both G1 and G2 groups. The sensibility, specificity and accuracy of PSA reduction of ≥10% were 31%, 23% and 25%, respectively. Conclusion Empirical antibiotic therapy in asymptomatic male patients is not related to PSA reduction. The greater than 10% PSA reduction after antibiotic in this population cannot postpone prostate biopsy. .

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To assess total testosterone and prostatic-specific antigen (PSA) kinetics among diverse chemical castrations, advanced-stage prostate cancer patients were randomized into three groups of 20: Group 1, Leuprolide 3.75 mg; Group 2, Leuprolide 7.5 mg; and Group 3, Goserelin 3.6 mg. All groups were treated with monthly application of the respective drugs. The patients' levels of serum total testosterone and PSA were evaluated at two time periods: before the treatment and 3 months after the treatment. Spearman's rank correlation coefficient was utilized to verify the hypothesis of linear correlation between total testosterone and PSA levels. At the beginning the patients' age, stage, grade, PSA, and total testosterone were similar within the three groups, with median age 72, 70, and 70 years in Groups 1, 2, and 3, respectively. Three months after the treatment, patients who received Leuprolide 7.5 mg presented significantly lower median total testosterone levels compared with Goserelin 3.6 mg and Leuprolide 3.75 mg (9.5 ng/dL vs. 20.0 ng/dL vs. 30.0 ng/dL, respectively; p = .0072), while those who received Goserelin 3.6 mg presented significantly lower PSA levels compared with Leuprolide 7.5 mg and Leuprolide 3.75 mg (0.67 vs. 1.86 vs. 2.57, respectively; p = .0067). There was no linear correlation between total testosterone and PSA levels. Overall, regarding castration levels of total testosterone, 28.77% of patients did not obtain levels ≤50 ng/dL and 47.80% did not obtain levels ≤20 ng/dL. There was no correlation between total testosterone and PSA kinetics and no equivalence among different pharmacological castrations.

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La violencia sexual es un problema de salud y de justicia social, la inmediata actuación médico legal, la buena colecta de indicios fueron fundamentales para el diagnóstico certero por el laboratorio forense. Se evaluaron y validaron tres ensayos forenses para la investigación de fluido seminal en indicios de víctimas de violencia sexual. Se analizó 251 indicios colectados a 215 víctimas por Medicina Forense en el Laboratorio de Biología Forense del Instituto de Investigaciones Forenses de La Paz. Se aplicó tres métodos para la pesquisa de componentes del semen: Fosfatasa ácida, espermatozoides y Antígeno Prostático Específico (PSA). El 55% de las víctimas comprendían edades entre 4 a 17 años. El 86% de los casos correspondieron a delitos de violación. Se detectó la presencia de semen en 130 víctimas (60%). Componentes seminales individuales como la Fosfatasa Acida en 120 víctimas (56%); espermatozoides en 55 víctimas (26%) y PSA en 130 víctimas (60%). Se detectó la presencia de fluido seminal mediante 3 ensayos forenses en el 60% de las víctimas, siendo la mayoría casos de Violación. Indicios impregnados con sangre no interfirieron en la pesquisa de semen.

Sexual assault is a problem of public health and social justice, the immediate procedure, the successful collection of the physical evidence at the time from Legal Medical, were essentials to accurate investigation by Forensic laboratory. Were applied three assays to Forensic investigation of semen in evidences from sexual assault victims. 251 evidences were analyzed from 215 victims by Medical Forensic and Biology Forensic Laboratory, IDIF - La Paz to victims by Medical Forensic and Biology Forensic Laboratory, IDIF - La Paz to investigate semen components were applied 3 methods: Phosphatase acid, spermatozoa, and Prostatic Specific Antigen (PSA). 55% victims had between 4 to 17 years. 86% were rape assault cases. Seminal fluid was identified on 130 victimas (60%); Phosphatase acid about 120 victims (56%); sperms in 55 victims (26%) and PSA in 130 victims (60%). Seminal fluid component was detected about 60% victimas from rape assault. Blood stains don't produce interference.

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OBJECTIVE: We compared the safety and efficacy of the 12-core biopsy with those of the conventional systematic 6-core biopsy with PSA levels between 4.1 and 20.0 ng/mL. MATERIALS AND METHODS: This study included 428 patients who underwent a 6-core biopsy and 128 patients who underwent a 12-core biopsy. Biopsies were performed transrectally under ultrasound guidance. The 12-core biopsy scheme involved obtaining 6 far lateral cores. RESULTS: For patients with PSA level between 4.1 and 10.1 ng/mL, 47 of the 265 patients who underwent 6-core biopsy and 32 of the 91 patients who underwent a12-core biopsy were diagnosed with prostate cancer (p = 0.0006). Among the patients with a PSA level between 10.1 and 20.0 ng/mL, 48 of 163 patients who underwent the 6-core biopsy and 16 of 37 patients who underwent the 12-core biopsy were diagnosed with prostate cancer (p = 0.0606). Three of the 95 patients who were diagnosed with prostate cancer through the 6-core biopsy and 12 of the 48 patients who were diagnosed through the 12-core biopsy had cancer located in the anterior apex. The 12-core biopsy increased the diagnostic rate in the apex (p = 0.001). No statistically significant differences were found in incidence of complications. CONCLUSION: We concluded that the 12-core biopsy is a safe and more effective procedure for increasing the diagnostic rate of prostate cancer than the 6-core biopsy in patients with PSA level between 4.1 and 10.0 ng/mL, and the most useful anatomical area to be added was found to be cores from the anterior apex.

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Serum and urinary prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA) from 20 dogs were measured. PAP and PSA tests were carried out in authomatized equipment with commercial kits used for humans. Mean PAP serum value was 0.7U/l and urinary 0.1U/l. Mean serum and urinary PSA were 0.005ng/dl and 0.004ng/dl, respectively. In vivo determination of these two biomarkers in dogs is a new form of diagnosis in veterinary medicine and these values should be correlated with the morphological lesion of the prostate gland.

Realizaram-se mensurações sérica e urinária de fosfatase ácida prostática (PAP) e antígeno prostático específico (PSA) de 20 cães. Os testes de PAP e PSA foram feitos em um equipamento automatizado, com o uso de kits comerciais para humanos. A média de PAP sérico foi de 0,7U/l e urinário 0,U/l. As médias do PSA sérico e urinário foram 0,005ng/dL e 0,004ng/dl, respectivamente. A determinação do dois biomarcadores in vivo é uma nova opção de diagnóstico na medicina veterinária e os valores obtidos devem ser correlacionados com a lesão morfológica da próstata.

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Serum and urinary prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA) from 20 dogs were measured. PAP and PSA tests were carried out in authomatized equipment with commercial kits used for humans. Mean PAP serum value was 0.7U/l and urinary 0.1U/l. Mean serum and urinary PSA were 0.005ng/dl and 0.004ng/dl, respectively. In vivo determination of these two biomarkers in dogs is a new form of diagnosis in veterinary medicine and these values should be correlated with the morphological lesion of the prostate gland.(AU)

Realizaram-se mensurações sérica e urinária de fosfatase ácida prostática (PAP) e antígeno prostático específico (PSA) de 20 cães. Os testes de PAP e PSA foram feitos em um equipamento automatizado, com o uso de kits comerciais para humanos. A média de PAP sérico foi de 0,7U/l e urinário 0,U/l. As médias do PSA sérico e urinário foram 0,005ng/dL e 0,004ng/dl, respectivamente. A determinação do dois biomarcadores in vivo é uma nova opção de diagnóstico na medicina veterinária e os valores obtidos devem ser correlacionados com a lesão morfológica da próstata.(AU)

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