The Asian Prostate Cancer (A-CaP) Study is an Asia-wide initiative that has been developed over the course of 2 years. The study was launched in December 2015 in Tokyo, Japan, and the participating ...countries and regions engaged in preparations for the study during the course of 2016, including patient registration and creation of databases for the purpose of the study. The Second A-CaP Meeting was held on September 8, 2016 in Seoul, Korea, with the participation of members and collaborators from 12 countries and regions. Under the study, each participating country or region will begin registration of newly diagnosed prostate cancer patients and conduct prognostic investigations. From the data gathered, common research themes will be identified, such as comparisons among Asian countries of background factors in newly diagnosed prostate cancer patients. This is the first Asia-wide study of prostate cancer and has developed from single country research efforts in this field, including in Japan and Korea. At the Second Meeting, participating countries and regions discussed the status of preparations and discussed various issues that are being faced. These issues include technical challenges in creating databases, promoting participation in each country or region, clarifying issues relating to data input, addressing institutional issues such as institutional review board requirements, and the need for dedicated data managers. The meeting was positioned as an opportunity to share information and address outstanding issues prior to the initiation of the study. In addition to A-CaP-specific discussions, a series of special lectures was also delivered as a means of providing international perspectives on the latest developments in prostate cancer and the use of databases and registration studies around the world.
Treatment options for castration-resistant prostate cancer (CRPC) are available, but clear instructions for the selection of appropriate treatment are lacking. A meeting of urology experts based in ...Thailand was convened with the following objectives: (1) to reach a consensus and share real-life experiences about how to identify CRPC; (2) to choose the appropriate treatment for CRPC patients; (3) to evaluate disease progression using novel inhibitors of the androgen receptor pathway; (4) to identify the frequency of monitoring disease; and (5) to promote rational use of corticosteroids in CRPC patients. This consensus document can provide guidance to other urologists in Thailand to provide appropriate treatment to metastatic CRPC patients in a timely manner.
Stones in the urinary tract are a common medical problem in the general population. At present, the great expansion in minimally invasive techniques has led to the decrease in open surgery. ...Extracorporeal shock wave lithotripsy (ESWL) has been introduced as an alternative approach which disintegrates stones in the kidney and upper urinary tract through the use of shock waves. Nevertheless, as there are limitations with the success rate in ESWL, other minimally invasive modalities for kidney stones such as percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) are also widely applied.
To evaluate the effectiveness and complications of ESWL compared with PCNL or RIRS for managing kidney stones.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library), MEDLINE, EMBASE and reference lists of articles without language restriction.
Randomised controlled trials (RCTs) assessing the use of ESWL compared to PCNL or RIRS for kidney stone management.
Two authors independently assessed all the studies for inclusion. Statistical analyses were performed using the random effects model and the results expressed as risk ratio (RR) for dichotomous outcomes or mean difference (MD) for continuous data with 95% confidence intervals (CI).
Three studies (214 patients) were included, however results could not be pooled. Two RCTs compared ESWL to PCNL. The success rate at three months for lower pole kidney stones was statistically higher for PCNL (RR 0.39, 95% CI 0.27 to 0.56). Re-treatment (RR 1.81, 95% CI 0.66 to 4.99) and using auxiliary procedures (RR 9.06, 95% CI 1.20 to 68.64) after PCNL were less compared to ESWL. The efficiency quotient (EQ) in PCNL was higher than ESWL. Hospital stay (MD -3.30 days, 95% CI -5.45 to -1.15), duration of treatment (MD -36.00 minutes, 95% CI -54.10 to -17.90) and complications were less for ESWL. One RCT compared ESWL versus RIRS for lower pole kidney stones. The success rate was not significantly different at the end of the third month (RR 0.91, 95% CI 0.64 to 1.30).
Results from three small studies, with low methodological quality, indicated ESWL is less effective for lower pole kidney stones than PCNL but not significantly different from RIRS. Hospital stay and duration of treatment was less with ESWL. More RCTs are required to investigate the effectiveness and complications of ESWL for kidney stones compared to PCNL or RIRS.
Background
The most common geriatric psychiatric disorders are anxiety and depression. The 5‐alpha reductase inhibitor (5‐ARIs), finasteride (Fin), is a standard medication used to treat benign ...prostatic hyperplasia (BPH), that often occurs in the elderly. However, the effects of Fin on mental health in aged population are still unclear. D‐galactose (D‐gal)‐induced aging has been recognized worldwide, as a model to mimic natural aging in rodents. Therefore, we investigated the effect of Fin on anxiety and depression‐like behaviors in D‐gal‐induced aging male rats.
Method
Twenty‐male Wistar rats (8‐week‐old) were randomly divided into two groups (n = 10/group) to receive either vehicle as control or D‐gal (150 mg/kg/day via subcutaneous injection) for 18 weeks. At week 13, rats in each group were divided into two subgroups (n = 5/subgroup) in order to receive either vehicle (drinking water) or Fin (5 mg/kg/day) via oral gavage. At the end of the treatment, elevated‐plus maze (EPM), and splash test (ST) were performed for quantifying anxiety and depression‐like behaviors, while open‐field test (OFT) to determine locomotor activity. In addition, blood in each rat was collected for determining the metabolic profiles.
Result
D‐gal‐treated rat showed no effect on metabolic disturbance, but increased systemic oxidative stress (Figure 1A‐C). Anxiety and depression‐like behavior were observed in D‐gal‐treated rats, as indicated by a decrease % preference index in the open arm of EPM and grooming time in ST (Figure 1D‐E). Fin‐treated control rats demonstrated hypercholesterolemia (Figure 1A‐B), and depression‐like behavior was observed (Figure 1E). Anxiety and depression‐like behaviors were attenuated in Fin‐treated D‐gal rats (Figure 1D‐E). Regarding the locomotor activity, no significant difference was found among all groups. (Figure 1F).
Conclusion
FIN exposure induced metabolic disturbance, and depression‐like behaviors in male rats. In contrast, Fin ameliorated anxiety and depression‐like behaviors in D‐gal‐induced aging rat, which may due to a reducing systemic oxidative stress. The findings in this study provide information for future clinical applications such as the use of Fin for therapeutic approach for anxiety/depression‐like behaviors in the elderly. However, caution is advised when using Fin in young men since it may induce depressive‐like behaviors.
Background
Finasteride (FIN), a 5‐alpha reductase inhibitor (5‐ARIs), is one of the drugs approved for the treatment of androgenetic alopecia (AGA) and benign prostatic hyperplasia (BPH). AGA has ...been found to be associated with obesity. Obesity and AGA themselves often co‐occurs with anxiety and depression. Nevertheless, several studies reported adverse effects of FIN on anxiety and depression, especially in young men. A previous study also reported that FIN caused anxiety and depression in male rats; however, the effects of chronic FIN exposure in young obese condition has not been investigated.
Method
Twenty male Wistar rats (8‐week‐old) were divided into two groups (N = 10/group) to feed with either normal diet (ND) or high‐fat diet (HFD) for 18 weeks. At week 13, rats in each dietary group were subdivided into two subgroups to treat with either vehicle as control or FIN (5 mg/kg/day) via oral gavage. At the end of the experimental protocol, the anxiety/depression‐like behaviors were measured using the Elevated‐Plus Maze (EPM) and the Splash Test (ST), while the Open‐Field Test (OFT) was examined for locomotor activity. In addition, blood in each rat was collected for determining the metabolic profiles.
Result
HFD‐fed rats developed obesity and hypercholesterolemia, with an increase in systemic oxidative stress (Figure 1A‐C). Anxiety and depressive‐like behaviors were observed in vehicle‐treated HFD‐fed rats, as indicated by decreasing % preference index in the open arm of EPM and grooming time in ST (Figure 1D‐E). FIN treated ND‐fed rats also showed depression‐like behaviors, similar to those in vehicle‐treated HFD‐fed rats (Figure 1E). Although FIN increased plasma cholesterol levels in HFD‐fed rats, it did not aggravate anxiety and depression‐like behaviors in HFD‐fed rats. Regarding the locomotor activity, no significant difference was found among all groups. (Figure 1F).
Conclusion
All of these findings suggest that FIN exposure induced metabolic disturbance, and depression‐like behaviors as similar to obesity without the aggravating effects of FIN and obesity on depressive‐like behaviors.
The Asian Prostate Cancer (A-CaP) Study is an Asia-wide initiative that has been developed over the course of 2 years. The A-CaP Study is scheduled to begin in 2016, when each participating country ...or region will begin registration of newly diagnosed prostate cancer patients and conduct prognosis investigations. From the data gathered, common research themes will be identified, such as comparisons among Asian countries of background factors in newly diagnosed prostate cancer patients. This is the first Asia-wide study of prostate cancer and has developed from single country research efforts in this field, including in Japan and Korea. The inaugural Board Meeting of A-CaP was held on December 11, 2015 at the Research Center for Advanced Science and Technology, The University of Tokyo, attended by representatives of all participating countries and regions, who signed a memorandum of understanding concerning registration for A-CaP. Following the Board Meeting an A-CaP Launch Symposium was held. The symposium was attended by representatives of countries and regions participating in A-CaP, who gave presentations. Presentations and a keynote address were also delivered by representatives of the University of California San Francisco, USA, and the Peter MacCallum Cancer Centre, Australia, who provided insight and experience on similar databases compiled in their respective countries.
Several studies have reported side effects of finasteride (FIN), such as anxiety/depression in young men. Obesity is also positively associated with anxiety/depression symptoms; however, the impacts ...of long-term FIN treatment and FIN withdrawal in young obese individuals are still elusive. The present study aimed to investigate the effect of long-term treatment and its withdrawal on anxiety/depression and brain pathologies in lean and obese adult male rats. Forty-eight male Wistar rats were equally divided into two groups and fed either a normal or high-fat diet. At age 13 weeks, rats in each dietary group were divided into three subgroups: 1) the control group receiving drinking water, 2) the long-term treatment group receiving FIN orally at 5 mg/kg/day for 6 weeks, and 3) the withdrawal group receiving FIN orally at 5 mg/kg/day for 2 weeks followed by a 4-week withdrawal period. Anxiety/depression-like behaviors, biochemical analysis, brain inflammation, oxidative stress, neuroactive steroids, brain metabolites, and microglial complexity were tested. The result showed that lean rats treated with long-term FIN and its withdrawal exhibited metabolic disturbances, depressive-like behavior, and both groups showed increased neurotoxic metabolites and reduced microglial complexity. Obesity itself led to metabolic disturbances and brain pathologies, including increased inflammation, oxidative stress, and quinolinic acid, as well as reduced microglial complexity, resulting in increased anxiety- and depression-like behaviors. Interestingly, the long-term FIN treatment group in obese rats showed attenuation of depressive-like behaviors, brain inflammation, and oxidative stress, along with increased brain antioxidants, suggesting the possible benefits of FIN in obese conditions.
Prostate cancer is the second most common cancer among men worldwide, and it is ranked first in the United States and Europe. Since prostate cancer is slow-growing, active surveillance for low-risk ...cancer has been increasingly supported by various guidelines. Most prostate cancers reactivate telomerase to circumvent the replicative senescence caused by the end replication problem; therefore, telomerase inhibition is potentially useful for the suppression of prostate cancer progression during this active surveillance or for the prevention of cancer recurrence after conventional therapies. In this study, we demonstrated that the perylene derivatives, PM2 and PIPER, could suppress hTERT expression and telomerase activity in the short-term treatment of LNCaP and PC3 prostate cancer cells. Long-term treatment with subcytotoxic doses of these compounds in both prostate cancer cells showed telomere shortening and a significant increase in senescent cells. Although the acute cytotoxicity of PM2 was about 30 times higher than that of PIPER in both prostate cancer cells, the cellular uptake of both compounds was comparable as determined by flow cytometry and fluorescent microscopy.
•Progressive muscle relaxation is a complementary therapy with a recognised positive effect on cancer symptoms relief.•Progressive muscle relaxation can be effective on a cluster of drowsiness and ...fatigue symptoms.
Diabetic erectile dysfunction (DED) is one of the most frequently occurring complications of diabetes mellitus (DM) in men, and past studies have usually overlooked the effect DED has on quality of ...life (QoL). The objectives of this study are to determine the prevalence of DED and to investigate QoL, and the factors that influence QoL, in Thai men who are living with DED. Five hundred and eighty-two Thai men living with diabetes who enrolled in the diabetic and general medical outpatient clinic at a tertiary hospital in the northern part of Thailand were surveyed to determine the prevalence of DED, as well as QoL and its influencing factors, for men living with DED. The average age of the men was 58.2 years old (±SD = 10.1, range = 34.3 - 80 years old). DED was found in 417 out of the 582 men (71.5 %). The International Index of Erectile Function (IIEF-5) mean score was 17.03 (±SD = 3.47). The QoL was found to be at a moderate level (= 95.42 ±SD = 11.39). The QoL domains found to be at a good level were the psychological (= 23.84 ±SD = 3.42) and environmental domains (= 31.4 ±SD = 3.98), while domains found to be at a moderate level were the social relationships (= 10.77 ±SD = 1.93) and physical domains (= 24.9 ±SD = 3.13). The mean score of the QoL of men living with DED was lower than that of men without DED. The most important factor associated with poor QoL was severity of DED, while men who have a good QoL tend to have a higher education level and more frequent sexual intercourse (p < 0.05). The study showed that the prevalence of erectile dysfunction in Thai men living with DED was high. DED has a moderate impact on QoL, especially on the social relationship domain. The results suggest the importance of screening for DED in clinical settings for early detection of, and creating supportive strategies for treating men with, diabetes mellitus.
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