Cancer-specific anxiety is the most frequently reported psychological response after radical prostatectomy (RP). We evaluated the prevalence of pretreatment psychiatric pathology in patients with ...prostate cancer undergoing RP and identified the effects of psychiatric diagnoses on their survival and prognosis.
Retrospective multicenter observational study including 1078 men treated with RP for organ-confined prostate cancer. Groups: GP: patients with psychiatric pathology prior to RP; GNP: patients without psychiatric pathology prior to RP. Urological, oncological and psychiatric variables, descriptive statistics and multivariate analysis were included.
37.94% of patients presented a psychiatric diagnosis. Adjuvant radiotherapy was required in 27.83% and hormone therapy in 23.38%; being more frequent in GP. Cancer-specific survival was higher in GNP. Anxiety, depression, insomnia, smoking, psychosis and alcoholism were the most frequent. Low TNM and low presence of LUTS and SUI increased the probability of absence of psychiatric pathology. Fatigue, erectile dysfunction and cognitive impairment after RP with RT and/or HT were higher in GP. Older age and higher PSA at diagnosis increased the relative risk of psychiatric pathology and worse outcome. The most frequently related factors were RP, PSA, age and survival time.
Psychiatric pathology is present in patients undergoing radical prostatectomy for prostate cancer, with a high impact on survival and prognostic outcomes.
La ansiedad específica del cáncer es la reacción psicológica más frecuentemente tras la prostatectomía radical (PR). Evaluamos la prevalencia de la patología psiquiátrica pretratamiento de cáncer de próstata mediante PR e identificamos la influencia de los diagnósticos psiquiátricos en la supervivencia y pronóstico en los pacientes.
Estudio retrospectivo multicéntrico observacional, 1.078 varones intervenidos mediante PR por cáncer de próstata órgano-confinado. Grupos: GP: pacientes con patología psiquiátrica previa a la PR; GNP: pacientes sin patología psiquiátrica previa a la PR, variables urológicas, oncológicas y psiquiátricas, estadística descriptiva y análisis multivariante.
El 37,94% presentó algún diagnóstico psiquiátrico. Fue necesario tratamiento adyuvante de radioterapia en 27,83% y hormonoterapia en 23,38%; más frecuentes en GP. La supervivencia cáncer-específica fue superior en GNP. La ansiedad, depresión, insomnio, tabaquismo, psicosis y alcoholismo fueron los más frecuentes. El bajo TNM y baja presencia de STUI e IUE aumentó la probabilidad de ausencia de patología psiquiátrica. En GP aumentó la fatiga, disfunción eréctil y deterioro cognitivo tras la PR junto con RT y/o HT. A mayor edad y mayor PSA al diagnóstico, aumentó el riesgo relativo de patología psiquiátrica y peor evolución. Los factores más relacionados fueron la PR, PSA, la edad y el tiempo de supervivencia.
La patología psiquiátrica está presente en pacientes tratados mediante prostatectomía radical debido a cáncer de próstata, teniendo alto impacto en los resultados de supervivencia y pronóstico.
•In vitro estrogenic activity was quantified in male bile extracts of feral red mullet.•Major PAH metabolites and alkylphenols were quantified in the same fish bile extracts.•Contribution of these ...compounds to the estrogenicity measured was found negligible.•PAH and alkylphenol fish exposure was low in most of the studied Mediterranean sites.•High estrogenicity in male fish from Mar Menor lagoon warrants further studies.
A biological screening was performed to establish the total exposure to estrogenic compounds of red mullet (Mullus barbatus) collected at several sites along the Spanish Mediterranean coast by testing male fish bile extracts using the in vitro ER-LUC reporter gene assay. In addition, major metabolites were identified and measurements of OH-PAHs (1-naphthol, 9-phenantrol, 9-fluorenol, 1-pyrenol, 1OH-BaP and 3OH-BaP) and alkylphenols (4-n-nonylphenol (4-n-NP) and 4-tertoctylphenol (4-tert-OP)) in the same fish bile extracts were taken by gas chromatography–mass spectrometry in electron ionization mode (GC–EI-MS). Relative in vitro estrogenic potencies of the chemically quantified compounds were also tested. The highest biliary concentrations of 1-pyrenol, 9-fluorenol and 4-n-NP were found in fish from Barcelona and from the Mar Menor coastal lagoon. However, these concentrations can be considered relatively low compared to values reported in red mullet from other polluted waters in the Mediterranean Sea. The contribution of 1-pyrenol, 4-n-NP and 4-tert-OP to the total estrogenic potency measured in male fish bile was found to be negligible, indicating the presence of other estrogenic compounds in red mullet bile. Estrogenic potency in bile from male fish was markedly elevated in Mar Menor lagoon (234.8±5.7pgE2EQ/μl), and further research will be necessary to explain whether the presence of natural and synthetic-hormones in the lagoon contributed to this finding. Values of approximately 15–16E2EQpg/mg bile can be regarded as preliminary baseline levels of bile estrogenicity in male red mullet from the western Mediterranean Sea.
BackgroundDimethyl fumarate (DMF) is prescribed for the treatment of adult patients with relapsing remitting multiple sclerosis (RRMS). Although mild to moderate adverse reactions such as flushing ...and gastrointestinal events are common, haematologic abnormalities may also occur. Haematologic abnormalities are usually of limited clinical relevance. Particularly, transient eosinophilia has been reported within 2 months of DMF treatment, which could lead to significant damage to tissues, skin, airway, gastrointestinal tract, and the cardiac and nervous system.PurposeThis research aimed to clarify the relationship between DMF treatment and the development of severe eosinophilia in RMSS patients.Material and methodsA 25-year-old male RRMS patient, diagnosed in 2007, was treated with interferon beta-1b, natalizumab and glatiramer acetate. In October 2015, the patient switched to DMF treatment due to lesions on MRI. DMF was administered 120 mg once a day for 7 days, followed by 120 mg twice a day for 7 days, 120 mg in the morning and 240 mg in the afternoon for 14 days, and finally the recommended dose of 240 mg twice a day. The patient suffered flushing and gastrointestinal events, commonly associated with DMF treatment, and omeprazole 20 mg twice a day was administered. After 1 month under the recommended dose, laboratory tests showed severe leukocytosis (19420/μL) and eosinophilia (5950/μL). DMF and omeprazole were removed, prednisone 1 mg/kg was administered for 13 days in decreasing doses and laboratory tests were repeated. The relationship between DMF treatment and the appearance of eosinophilia was evaluated using a modified Karch–Lasagna algorithm.ResultsThe second laboratory tests showed normal levels of eosinophils and the patient did not suffer any tissue damage. According to the modified Karch–Lasagna algorithm, the present case corresponds to a possible adverse reaction (score 4). This reaction was reported to the Regional Pharmacovigilance Centre.ConclusionIn this case, severe eosinophilia could have been caused by DMF, omeprazole or both drugs as omeprazole may also be associated with eosinophilia. Patients treated with DMF and omeprazole could require pharmacovigilance in order to prevent the development of severe eosinophilia.References and/or acknowledgementsXu Z, et al. Dimethyl fumarate for multiple sclerosis. Cochrane Database Syst Rev2015.Pérez-Arellano JL, et al. Manejo práctico de una eosinofilia. An Med Interna (Madrid) 2004;21:244–52.No conflict of interest
Background
The diagnostic strategy for pulmonary embolism (PE) includes a D‐dimer test when PE probability is low or intermediate, but false‐positive D‐dimer results are frequent and can result in an ...unnecessary computed tomography pulmonary angiogram. The PE rule‐out criteria (PERC) rule excludes PE without D‐dimer testing when pretest probability is <15%. The aim of this study was to assess the safety of the PERC rule strategy in patients included in the Registro Informatizado de la Enfermedad TromboEmbolica venosa (RIETE) registry.
Methods
This retrospective cohort study used data from the RIETE registry, an ongoing, international prospective registry of patients with objectively confirmed venous thromboembolism. The primary outcome was the failure rate of the PERC strategy, represented by the proportion of PERC‐negative (PERC‐N) patients with a PE included in the registry. Secondary outcomes were a comparison of the clinical characteristics, treatment strategy, and outcome of PERC‐N versus PERC‐positive (PERC‐P) patients at 3 months.
Results
From 2001 to 2021, a total of 49,793 patients with acute PE were enrolled in the RIETE registry. We included 48,903 in the final analysis after exclusion of 890 patients with an undetermined PERC status. Only 346 patients were PERC‐N with a failure rate of 0.7% (95% confidence interval 0.6%–0.8%). PERC‐N patients presented more frequently with chest pain but less often with dyspnea, syncope, or hypotension. They also had subsegmental or segmental PE more frequently, were more often treated with direct oral anticoagulants, and received mechanical or pharmacological thrombolysis less often. In addition, PERC‐N patients had a lower incidence of recurrent deep vein thrombosis, major bleeding, and death attributed to PE during the 3‐month follow‐up.
Conclusions
A low failure rate of the PERC rule was observed in the RIETE registry, thus supporting its use to safely identify patients with an unlikely probability of PE.
This work aimed to validate the removal of total petroleum hydrocarbons (TPH) in a pilot system (on-site). Six piles of oil-contaminated soil were treated with 1) bioremediation (BIO) by three ...simultaneous technologies (bioaugmentation (bacterial consortium), phyto- (Panicum maximum) and vermiremediation (Pontoscolex corethrurus)), and compared with 2) natural attenuation (NA). Removal of alkanes, polycyclic aromatics (PAH), total petroleum hydrocarbons (TPH), and bacterial diversity were evaluated at 0, 35, 70, and 112 days. Biomass and number of shoots of P. maximum, the secondary vegetation, and the abundance of meso and macrofauna were measured initially and at the end. After 112 days, BIO significantly removed more alkanes (76%), PAH (68%), and TPH (76%) than NA treatment (23%, 19%, 24%). P. maximum biomass increased significantly (300%), with 97.3 ± 11.8 shoots m−2. After 112 days, the secondary plants Lippia dulcis, Taraxacum officinale, Bidens pilosa and bacterial phylum Actinobacteria (18%) were the most abundant. The abundance of the earthworm Protozapotecia australis was reduced, while the most abundant group of mesofauna was Acari (56%–71%). This combination of technologies improved the development of grass and secondary plants, which generated a more favorable microhabitat for soil organisms to remove TPH more efficiently.
•Bacterial/vermi/phyto-bioremediation removes >70% of TPH in a pilot system.•The biomass and number of grass shoots increased significantly after 112 days.•Twenty-one herbaceous were identified after bioremediation after 112 days.•Mixed bioremediation ameliorates soil health.
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