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Id: biblio-1285649
Autor: Batista, A A S; Franco, B M; Perez, M M; Pereira, E G; Rodrigues, T; Wroclawski, M L; Fonseca, F L A; Suarez, E R.
Título: Decreased levels of cathepsin Z mRNA expressed by immune blood cells: diagnostic and prognostic implications in prostate cancer
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;54(10):e11439, 2021. tab, graf.
Idioma: en.
Projeto: FAPESP.
Resumo: Cathepsin Z (CTSZ) is a cysteine protease responsible for the adhesion and migration of both immune and tumor cells. Due to its dual role, we hypothesized that the site of CTSZ expression could be determinant of the pro- or anti-tumorigenic effects of this enzyme. To test this hypothesis, we analyzed CTSZ expression data in healthy and tumor tissues by bioinformatics and evaluated the expression levels of CTSZ mRNA in the blood cells of prostate cancer (PCa) patients by qRT-PCR compared with healthy subjects, evaluating its diagnostic and prognostic implications for this type of cancer. Immune cells present in the blood of healthy patients overexpress CTSZ. In PCa, we found decreased CTSZ mRNA levels in blood cells, 75% lower than in healthy subjects, that diminished even more during biochemical relapse. CTSZ mRNA in the blood cells had an area under the curve for PCa diagnosis of 0.832, with a 93.3% specificity, and a positive likelihood ratio of 9.4. The site of CTSZ mRNA expression is fundamental to determine its final role as a protective determinant in PCa, such as CTSZ mRNA in the blood cells, or a malignant determinant, such as found for CTSZ expressed in high levels by different types of primary and metastatic tumors. Low CTSZ mRNA expression in the total blood is a possible PCa marker complementary to prostate-specific antigen (PSA) for biopsy decisions, with the potential to eliminate unnecessary biopsies.
Descritores: Neoplasias da Próstata/diagnóstico
Catepsina Z
-Prognóstico
Células Sanguíneas
RNA Mensageiro
Antígeno Prostático Específico
Limites: Humanos
Masculino
Responsável: BR1.1 - BIREME


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Id: lil-672863
Autor: Aiken, WD.
Título: Prostate cancer screening still a contentious issue
Fonte: West Indian med. j;61(1):114-114, Jan. 2012.
Idioma: en.
Descritores: Neoplasias da Próstata/diagnóstico
Programas de Rastreamento/métodos
-Antígeno Prostático Específico
Grupo com Ancestrais do Continente Africano/etnologia
Limites: Humanos
Masculino
Tipo de Publ: Carta
Responsável: BR1.1 - BIREME


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Id: biblio-1145135
Autor: Meneghini, Kevin Francisco Durigon; Department of SurgeryTing, Hsu Yuan; Dumith, Samuel Carvalho.
Título: Prostate examination among adult and elderly subjects in southern Brazil: a cross-sectional population-based study
Fonte: Säo Paulo med. j;138(6):483-489, Nov.-Dec. 2020. tab.
Idioma: en.
Projeto: Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS).
Resumo: ABSTRACT BACKGROUND: Population-wide screening for prostate cancer remains a controversial topic, given the need for an individualized approach to patients regarding the risks and benefits of prostate-specific antigen testing and digital rectal examination. OBJECTIVE: The aim of this study was to investigate the prevalence of, and factors associated with, prostate examination among men aged 45 or older. DESIGN AND SETTING: Cross-sectional population-based study developed in the city of Rio Grande (RS), Brazil. METHODS: The outcome of interest was a history of prostate examination (prostate-specific antigen testing or digital rectal examination). The following independent variables were analyzed: age group, skin color, marital status, schooling, economic level, leisure-time physical activity, smoking habits, excessive alcohol consumption, overweight, health insurance, visits to the doctor during the preceding year, hypertension and diabetes. After a two-stage sampling process, the final sample consisted of 281 male individuals. RESULTS: The prevalence of a history of prostate-specific antigen testing or digital rectal examination was 68.3% (95% confidence interval (CI): 62.2 to 74.5). The highest prevalence rates were observed among men aged 70 years or older (88%) and the lowest among smokers (36%). The following characteristics were found to be associated with the outcome: advanced age; marital status other than single; more schooling and higher economic status; practicing physical activity; non-smoking habits; overweight; having health insurance; and having visited a doctor during the preceding year. CONCLUSION: Approximately two thirds of the study population had been screened for prostate examination, mostly older individuals, with higher socioeconomic status and a healthier lifestyle.
Descritores: Antígeno Prostático Específico/sangue
Exame Retal Digital/estatística & dados numéricos
Detecção Precoce de Câncer/estatística & dados numéricos
-Neoplasias da Próstata/diagnóstico
Fatores Socioeconômicos
Brasil
Estudos Transversais
Cidades
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-1282621
Autor: Fernandes, Ana Carolina; Ramos, Ana Raquel; Candelária, André; Rocha, Liliane; Barrancos, Patrícia.
Título: Consulta do Registo de Saúde Eletrónico ­ Análise ética de um caso clínico / Electronic Health Registry Query - Ethical Case Study / Consulta electrónica de registros de salud - Estudio de caso ético
Fonte: Rev. bras. med. fam. comunidade;15(42):2272, 20200210.
Idioma: pt.
Resumo: Introducción: La bioética surgió de la necesidad de regular un código de conducta ética que evitara las prácticas médicas abusivas llevadas a cabo durante varios siglos. El Procedimiento Deliberativo (PD), aplicado a la medicina, ayuda a tomar decisiones éticas de forma objetiva (equilibrada, podenrada) y justa. Con la presentación de este caso clínico se pretende, como ejemplo, demostrar la importancia de aplicar el PD en la práctica clínica en medicina general y familiar (MGF). Caso clínico: Un hombre de 58 años que, después de un antígeno prostático específico alterado, fue derivado a una consulta de urología. Un mes después de la biopsia de próstata, asiste a la consulta de MGF con la confianza de que el resultado sería negativo. Sin su autorización, el médico de familia (MF) accedió al registro electrónico de salud y descubrió que el paciente tenía un adenocarcinoma de próstata, aunque no habia sido re-evaluado por Urologia. Se eligió el problema ético más importante y se definió el curso de acción óptimo que cumplía los criterios de legalidad, publicidad y temporalidad. Conclusión: La decisión del médico siempre debe beneficiar el paciente. El PD permite tomar decisiones estructuradas, por lo cual debe aplicarse en el contexto de la MGF frente a problemas éticos

Introduction: Bioethics emerged from the need to implement an ethical code of conduct that would avoid abusive clinical practice carried for centuries. The Deliberative Procedure (DP) applied to medicine helps in making ethical decisions in a well-reasoned and fair manner. This clinical case report is intended to exemplify the importance of applying the deliberative process in clinical practice in general practice/family medicine (GP/FM). Clinical case: Male, 58 years old referenced to urology office visit after positive Prostate-Specific Antigen (PSA) test. A month after prostatic biopsy he went to the medical consultation with his Family Doctor, believing the result was negative. His family doctor assessed his health electronic record without his authorization, and verified the result of the biopsy was a prostatic adenocarcinoma, without new urology appointment. It was elected the most important ethic problem and defined the action curse that accomplish the legality, publicity and temporary criteria. Conclusions: Whatever the physician decides, it should always be for the benefit of the wearer. DP allows structured decision making so it should be applied in the context of GP/FM in the face of ethical problems.

Introdução: A bioética surgiu da necessidade de regulamentar um código de conduta ética que evitasse as práticas médicas abusivas realizadas durante vários séculos. O Procedimento Deliberativo (PD) aplicado à medicina, ajuda na tomada de decisões éticas de forma ponderada e justa. Com a apresentação deste caso clínico pretende-se exemplificar a importância da aplicação do PD na prática clínica em Medicina Geral e Familiar (MGF). Apresentação do caso: Homem de 58 anos que no seguimento de um antígeno específico da próstata (PSA) alterado foi referenciado à consulta de urologia. Um mês após biópsia prostática recorre à consulta de MGF confiante de que o resultado seria negativo. Sem a sua autorização, o Médico de Família (MF) acedeu ao Registo de Saúde Eletrónico e verificou que o doente apresentava um adenocarcinoma da próstata, embora não tivesse ainda consulta de reavaliação de urologia. Foi eleito o problema ético mais importante e definido o curso de ação ótimo que cumpria os critérios de legalidade, publicidade e temporalidade. Conclusões: Qualquer que seja a decisão do médico, deve ser sempre em benefício da pessoa. O PD permite uma tomada de decisão estruturada pelo que deve ser aplicado no contexto de MGF perante a ocorrência de problemas éticos.
Descritores: Bioética
Antígeno Prostático Específico
Confidencialidade
Comitês de Ética em Pesquisa
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: BR408.1 - Biblioteca da Faculdade de Medicina - BFM


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Id: biblio-891392
Autor: Wroclawski, Marcelo Langer.
Título: New US Preventive Service Task Force recommendations for prostate cancer screening: a needed update, but not enough / Nova recomendação do US Preventive Service Task Force para rastreamento do câncer de próstata: uma mudança necessária, mas ainda insuficiente
Fonte: Einstein (Säo Paulo);15(3):7-10, July-Sept. 2017.
Idioma: en.
Descritores: Neoplasias da Próstata/diagnóstico
Programas de Rastreamento/normas
Antígeno Prostático Específico/sangue
Detecção Precoce de Câncer
-Neoplasias da Próstata/prevenção & controle
Estados Unidos
Comitês Consultivos
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Editorial
Responsável: BR1.1 - BIREME


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Id: lil-742865
Autor: Silva, Rodrigo Donalisio da; Kim, Fernando J.
Título: Focal cryotherapy in low-risk prostate cancer: are we treating the cancer or the mind? - the cancer
Fonte: Int. braz. j. urol;41(1):5-9, jan-feb/2015.
Idioma: en.
Descritores: Neoplasias da Próstata/terapia
Crioterapia/métodos
-Neoplasias da Próstata/diagnóstico
Fatores de Risco
Resultado do Tratamento
Terapia de Salvação/métodos
Antígeno Prostático Específico/sangue
Crioterapia/normas
Medição de Risco
Conduta Expectante
Limites: Humanos
Masculino
Responsável: BR1.1 - BIREME


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Id: lil-742868
Autor: Reis, Leonardo de Oliveira; Carter, H. Ballentine.
Título: The Mind: Focal Cryotherapy in Low-Risk Prostate Cancer: Are We Treating the Cancer or the Mind?
Fonte: Int. braz. j. urol;41(1):10-14, jan-feb/2015.
Idioma: en.
Descritores: Neoplasias da Próstata/psicologia
Neoplasias da Próstata/terapia
Crioterapia/métodos
-Neoplasias da Próstata/diagnóstico
Vigilância da População/métodos
Fatores de Risco
Resultado do Tratamento
Antígeno Prostático Específico/sangue
Medição de Risco
Criocirurgia/métodos
Conduta Expectante
Limites: Humanos
Masculino
Responsável: BR1.1 - BIREME


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Id: lil-796878
Autor: Mussi, Thais Caldara; Garcia, Rodrigo Gobbo; Queiroz, Marcos Roberto Gomes de; Lemos, Gustavo Caserta; Baroni, Ronaldo Hueb.
Título: Prostate cancer detection using multiparametric 3 – tesla MRI and fusion biopsy: preliminary results
Fonte: Int. braz. j. urol;42(5):897-905, Sept.-Oct. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective: To evaluate the diagnostic efficacy of transrectal ultrasonography (US) biopsy with imaging fusion using multiparametric (mp) magnetic resonance imaging (MRI) in patients with suspicion of prostate cancer (PCa), with an emphasis on clinically significant tumors according to histological criteria. Materials and Methods: A total of 189 consecutive US/MRI fusion biopsies were performed obtaining systematic and guided samples of suspicious areas on mpMRI using a 3 Tesla magnet without endorectal coil. Clinical significance for prostate cancer was established based on Epstein criteria. Results: In our casuistic, the average Gleason score was 7 and the average PSA was 5.0ng/mL. Of the 189 patients that received US/MRI biopsies, 110 (58.2%) were positive for PCa. Of those cases, 88 (80%) were clinically significant, accounting for 46.6% of all patients. We divided the MRI findings into 5 Likert scales of probability of having clinically significant PCa. The positivity of US/MRI biopsy for clinically significant PCa was 0%, 17.6% 23.5%, 53.4% and 84.4% for Likert scores 1, 2, 3, 4 and 5, respectively. There was a statistically significant difference in terms of biopsy results between different levels of suspicion on mpMRI and also when biopsy results were divided into groups of clinically non-significant versus clinically significant between different levels of suspicion on mpMRI (p-value <0.05 in both analyzes). Conclusion: We found that there is a significant difference in cancer detection using US/MRI fusion biopsy between low-probability and intermediate/high probability Likert scores using mpMRI.
Descritores: Neoplasias da Próstata/patologia
Neoplasias da Próstata/diagnóstico por imagem
Imageamento por Ressonância Magnética/métodos
Biópsia Guiada por Imagem/métodos
-Próstata/patologia
Próstata/diagnóstico por imagem
Imageamento por Ressonância Magnética/instrumentação
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
Estudos Retrospectivos
Antígeno Prostático Específico/sangue
Ultrassonografia de Intervenção/métodos
Estatísticas não Paramétricas
Gradação de Tumores
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


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Id: lil-796894
Autor: Logghe, Pieter; Verlinde, Rolf; Bouttens, Frank; Van den Broecke, Caroline; Deman, Nathalie; Verboven, Koen; Maes, Dirk; Merckx, Luc.
Título: Long term outcome and side effects in patients receiving low-dose I125 brachytherapy: a retrospective analysis
Fonte: Int. braz. j. urol;42(5):906-917, Sept.-Oct. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objectives: To retrospectively evaluate the disease free survival (DFS), disease specific survival (DSS),overall survival (OS) and side effects in patients who received low-dose rate (LDR) brachytherapy with I125 stranded seeds. Materials and methods: Between july 2003 and august 2012, 274 patients with organ confined prostate cancer were treated with permanent I125 brachytherapy. The median follow-up, age and pretreatment prostate specific antigen (iPSA) was 84 months (12-120), 67 years (50-83) and 7.8 ng/mL (1.14-38), respectively. Median Gleason score was 6 (3-9). 219 patients (80%) had stage cT1c, 42 patients (15.3%) had stage cT2a, 3 (1.1%) had stage cT2b and 3 (1.1%) had stage cT2c. The median D90 was 154.3 Gy (102.7-190.2). Results: DSS was 98.5%.OS was 93.5%. 13 patients (4.7%) developed systemic disease, 7 patients (2.55%) had local progression. In 139 low risk patients, the 5 year biochemical freedom from failure rate (BFFF) was 85% and 9 patients (6.4%) developed clinical progression. In the intermediate risk group, the 5 year BFFF rate was 70% and 5 patients (7.1%) developed clinical progression. Median nPSA in patients with biochemical relapse was 1.58 ng/mL (0.21 – 10.46), median nPSA in patients in remission was 0.51 ng/mL (0.01 – 8.5). Patients attaining a low PSA nadir had a significant higher BFFF (p<0.05). Median D90 in patients with biochemical relapse was 87.2 Gy (51 – 143,1). Patients receiving a high D90 had a significant higher BFFF (p<0.05). Conclusion: In a well selected patient population, LDR brachytherapy offers excellent outcomes. Reaching a low PSA nadir and attaining high D90 values are significant predictors for a higher DFS.
Descritores: Neoplasias da Próstata/radioterapia
Braquiterapia/efeitos adversos
Radioisótopos do Iodo/administração & dosagem
Radioisótopos do Iodo/efeitos adversos
-Prognóstico
Neoplasias da Próstata/patologia
Reto/efeitos da radiação
Fatores de Tempo
Uretra/efeitos da radiação
Bexiga Urinária/efeitos da radiação
Modelos Logísticos
Estudos Retrospectivos
Fatores de Risco
Antígeno Prostático Específico/sangue
Medição de Risco
Relação Dose-Resposta à Radiação
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Idoso
Idoso de 80 Anos ou mais
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


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Id: lil-796893
Autor: Fiamegos, Alexandros; Varkarakis, John; Kontraros, Michael; Karagiannis, Andreas; Chrisofos, Michael; Barbalias, Dimitrios; Deliveliotis, Charalampos.
Título: Serum testosterone as a biomarker for second prostatic biopsy in men with negative first biopsy for prostatic cancer and PSA>4ng/mL, or with PIN biopsy result
Fonte: Int. braz. j. urol;42(5):925-931, Sept.-Oct. 2016. tab.
Idioma: en.
Resumo: Abstract Introduction: Data from animal, clinical and prevention studies support the role of androgens in prostate cancer growth, proliferation and progression. Results of serum based epidemiologic studies in humans, however, have been inconclusive. The present study aims to define whether serum testosterone can be used as a predictor of a positive second biopsy in males considered for re-biopsy. Material and Methods: The study included 320 men who underwent a prostatic biopsy in our department from October 2011 until June 2012. Total testosterone, free testosterone, bioavailable testosterone and prostate pathology were evaluated in all cases. Patients undergoing a second biopsy were identified and biopsy results were statistically analyzed. Results: Forty men (12.5%) were assessed with a second biopsy. The diagnosis of the second biopsy was High Grade Intraepithelial Neoplasia in 14 patients (35%) and Prostate Cancer in 12 patients (30%). The comparison of prostatic volume, total testosterone, sex hormone binding globulin, free testosterone, bioavailable testosterone and albumin showed that patients with cancer of the prostate had significantly greater levels of free testosterone (p=0.043) and bioavailable T (p=0.049). Conclusion: In our study, higher free testosterone and bioavailable testosterone levels were associated with a cancer diagnosis at re-biopsy. Our results indicate a possible role for free and bioavailable testosterone in predicting the presence of prostate cancer in patients considered for re-biopsy.
Descritores: Neoplasias da Próstata/patologia
Neoplasias da Próstata/sangue
Testosterona/sangue
Biópsia/métodos
Antígeno Prostático Específico/sangue
Neoplasia Prostática Intraepitelial/patologia
Neoplasia Prostática Intraepitelial/sangue
-Próstata/patologia
Padrões de Referência
Valores de Referência
Biomarcadores Tumorais/sangue
Valor Preditivo dos Testes
Fatores de Risco
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME



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