Interval to biochemical recurrence following radical prostatectomy does not affect survival in men with low-risk prostate cancer

Objectives

To evaluate the temporal relationship between interval to biochemical recurrence (BCR) following radical prostatectomy (RP) and prostate cancer-specific mortality (PCSM).

Patients and methods

The study comprised of 2,116 men from the Victorian Radical Prostatectomy Register, a whole-of-population database of all RPs performed between 1995 and 2000 in Victoria, Australia. Follow-up prostate-specific antigen and death data were obtained via record linkage to pathology laboratories and the Victorian Registry of Births, Deaths and Marriages. Poisson regression models with PCSM as the outcome were fit to the data. Models included age at surgery, Gleason score and tumour stage as covariates.

Results

Median post-surgery and post-BCR follow-up was 10.3 and 7.5 years, respectively. 695 men (33 %) experienced BCR during follow-up, of which 82 % occurred within 5 years of RP; 66 men died from prostate cancer. Men with combined high Gleason sum (≥4 + 3) and extra-prostatic (≥pT3a) disease had substantially increased mortality rate with early BCR, while those experiencing BCR after a longer interval had significantly lower mortality. Men with combined low Gleason sum (≤3 + 4) and organ-confined disease (≤pT2c) risk disease were not at any substantial risk of death in this time frame regardless of timing of BCR following RP.

Conclusions

This study evaluates the temporal relationship between BCR and PCSM using a whole-of-population cohort of men treated with RP. Men with low-risk features of prostate cancer at time of RP have low mortality even if they experience early BCR. This subgroup may be counselled regarding their favourable long-term prognosis.     

Segmental ureterectomy does not compromise the oncologic outcome compared with nephroureterectomy for pure ureter cancer

Purpose

Pure ureter cancers are rare and account for only 1–3 % of urothelial carcinomas with limited data. Nowadays, nephron-sparing methods are reserved mainly for imperative cases. This study intends to assess the oncologic outcome between segmental ureterectomy (SU) and radical nephroureterectomy (RNU) for pure ureteral urothelial carcinoma.

Methods

From July 2004 to August 2010, 112 patients at a single tertiary referral center were included. Perioperative data were obtained from our institutional database. Postoperative CT scan, cystoscopy, and contralateral renal echo were performed regularly for survey of disease recurrence.

Results

The mean length of follow-up was 43.8 and 48.3 months for the RNU and SU group, respectively. The bladder recurrences, local recurrences, distant metastasis, and cancer-specific survival rates showed no significant differences between RNU and SU (36.4 vs. 34.2 %, p = 0.83; 23.4 vs. 14.3 %, p = 0.27; and 16.9 vs. 8.6 %, p = 0.244, and 13.0 vs. 5.7 %, p = 0.249, respectively).

Conclusion

The study suggested that SU is not inferior to RNU for ureter cancer in oncologic outcomes and is less invasive and better nephron preservation.     

Disparities in Intimate Partner Violence Prenatal Counseling: Setting a Baseline for the Implementation of the Guidelines for Women's Preventive Services

Prenatal health care counseling is associated with positive health outcomes for mothers and infants. Moreover, pregnant women are considered a vulnerable population at risk of being victims of intimate partner violence. Pregnancy provides a unique opportunity to identify and refer women experiencing intimate partner violence to community resources; however, in prior research, most women reported that their prenatal care providers did not talk to them about intimate partner violence. Given the importance for providers to offer prenatal health care counseling on intimate partner violence, it is concerning that there is scant knowledge on Asian, Native Hawaiian, and other Pacific Islander mothers'' experiences in this area. The study''s objectives were (a) to determine the proportion of mothers who received prenatal health care counseling on intimate partner violence; and, (b) to examine racial differences of those who received prenatal health care counseling on intimate partner violence. Hawai‘i''s Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2004–08 were analyzed for 8,120 mothers with information on receipt of intimate partner violence prenatal health care counseling. Overall, 47.7% of mothers were counseled on intimate partner violence. Compared to Whites, Native Hawaiians, Japanese, Chinese, and Koreans were significantly less likely to report receiving prenatal health care counseling in intimate partner violence, but the opposite association was observed for Samoans. Intimate partner violence continues to be a significant problem for women, thus, this study''s findings may be used as important baseline data to measure the progress made given the implementation of the new Guidelines for Women''s Preventive Services in intimate partner violence screening and counseling.     

生物样品中氯胺酮的提取与检测方法技术新进展

目的综述各种生物检材中提取检测氯胺酮及其代谢物的方法。方法参考国内外相关文献,介绍了各生物检材特点,并列举了多种预处理和分析方法的优势与不足。结果由于氯胺酮的特殊药理作用,其娱乐性滥用现象较为严重和普遍,因此被列入新型毒品范畴。本文综述了几种快速、准确地检测出人体内氯胺酮及其代谢物的方法,并对各方法特点进行了总结概括。结论氯胺酮生物检材的提取检测方法正沿着更加方便、快速、准确的方向发展。     

急性心肌梗死并发恶性心律失常的急救与护理

目的探讨急性心肌梗死（Acute myocardial infarction,AMI）并发恶性心律失常患者的急救方法、护理措施。方法选取我院2012年7月至2013年7月收治抢救的10例心肌梗死病发恶性心律失常患者,回顾性分析其急救方法、护理措施,主要包含严密监测病情,观察生命体征变化,给予科学化护理措施。结果经过急救与护理,抢救成功9例,成功率90．0％。护理及时发现心率异常者8例,发现率为88．9％。急救前后的心功能参数变化均有统计学意义,P〈0．05。结论针对急性心肌梗死并发恶性心律失常患者,必须给予及早、积极的急救措施,采取合理、科学的护理方法,提高抢救成功率,降低死亡率。     

Simulation of the θ′ Precipitation Process with Interfacial Anisotropy Effects in Al-Cu Alloys

The effects of anisotropic interfacial properties and heterogeneous elasticity on the growth and ripening of plate-like θ′-phase (Al₂Cu) in Al-1.69 at.% Cu alloy are studied. Multi-phase-field simulations are conducted and discussed in comparison with aging experiments. The precipitate/matrix interface is considered to be anisotropic in terms of its energy and mobility. We find that the additional incorporation of an anisotropic interfacial mobility in conjunction with the elastic anisotropy result in substantially larger aspect ratios of the precipitates closer to the experimental observations. The anisotropy of the interfacial energy shows comparably small effect on the precipitate’s aspect ratio but changes the interface’s shape at the rim. The effect of the chemo-mechanical coupling, i.e., the composition dependence of the elastic constants, is studied as well. We show that the inverse ripening phenomenon, recently evidenced for δ’ precipitates in Al-Li alloys (Park et al. Sci. Rep. 2019, 9, 3981), does not establish for the θ′ precipitates. This is because of the anisotropic stress fields built around the θ′ precipitates, stemming from the precipitate’s shape and the interaction among different variants of the θ′ precipitate, that disturb the chemo-mechanical effects. These results show that the chemo-mechanical effects on the precipitation ripening strongly depend on the degree of sphericity and elastic isotropy of the precipitate and matrix phases.     

Two discrete masses of leiomyomatosis in a patient, one extending to the right atrium

Leiomyomatosis extending to the right side of the heart through the inferior vena cava (IVC) is an extremely rare neoplasm. Although it is pathologically classified as a benign neoplastic formation, its growth and recurrence rate makes its extirpation mandatory. In this case report, we describe a 57-year-old woman who presented with leiomyotosis extending from the IVC to the right atrium (RA). This patient had presented with uterine leiomyoma three years previously. The patient died in the operating theatre from hemostatic problems after surgical complications arising from the unexpected presence of a second tumor.