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PURPOSETo generate and present survey results on important issues relevant to treatment and follow-up of localized and locally advanced, high-risk prostate cancer (PCa) focusing on developing countries.METHODSA panel of 99 PCa experts developed more than 300 survey questions of which 67 questions concern the main areas of interest of this article: treatment and follow-up of localized and locally advanced, high-risk PCa in developing countries. A larger panel of 99 international multidisciplinary cancer experts voted on these questions to create the recommendations for treatment and follow-up of localized and locally advanced, high-risk PCa in areas of limited resources discussed in this article.RESULTSThe panel voted publicly but anonymously on the predefined questions. Each question was deemed consensus if 75% or more of the full panel had selected a particular answer. These answers are based on panelist opinion and not on a literature review or meta-analysis. For questions that refer to an area of limited resources, the recommendations considered cost-effectiveness as well as the possible therapies with easier and greater access. Each question had five to seven relevant answers including two nonanswers. Results were tabulated in real time.CONCLUSIONThe voting results and recommendations presented in this article can guide physicians managing localized and locally advanced, high-risk PCa in areas of limited resources. Individual clinical decision making should be supported by available data; however, as guidelines for treatment of localized and locally advanced, high-risk PCa in developing countries have not been defined, this article will serve as a point of reference when confronted with this disease.

PURPOSETo present a summary of the treatment and follow-up recommendations for the biochemical recurrence in castration-sensitive prostate cancer (PCa) acquired through a questionnaire administered to 99 PCa experts from developing countries during the Prostate Cancer Consensus Conference for Developing Countries.METHODSA total of 27 questions were identified as related to this topic from more than 300 questions. The clinician's responses were tallied and presented in a percentage format. Topics included the use of imaging for staging biochemical recurrence, treatment recommendations for three different clinical scenarios, the field of radiation recommended, and follow-up. Each question had 5-7 relevant response options, including “abstain” and/or “unqualified to answer,” and investigated not only recommendations but also if a limitation in resources would change the recommendation.RESULTSFor most questions, a clear majority (> 50%) of clinicians agreed on a recommended treatment for imaging, treatment scenarios, and follow-up, although only a few topics reached a consensus > 75%. Limited resources did affect several areas of treatment, although in many cases, they reinforced more stringent criteria for treatment such as prostate-specific antigen values > 0.2 ng/mL and STAMPEDE inclusion criteria as a basis for recommending treatment.CONCLUSIONA majority of clinicians working in developing countries with limited resources use similar cutoff points and selection criteria to manage patients treated for biochemically recurrent castration-sensitive PCa.

This paper compares a traditional Colombian structural design to the same structure with viscous-type energy dampers, considering both structural behavior and construction costs. To this effect, a building was designed: first, in accordance with the Colombian Seismic-Resistant Construction Regulations (NSR-10); and then according to the recommendations of American Society of Civil Engineers with regard to damping systems. Finally, the quantities and construction costs were calculated. As a result, an unconventional structure was obtained which was more expensive than a traditionally designed building. Still, said structure had less cross-sections, stresses, and displacements. The above demonstrates that, while the initial cost of this method may be higher, the extra cost can be offset when an earthquake occurs, as the building has better earthquake resistance.

ABSTRACT Objective To describe and compare the number of surgeries, mortality rate, length of hospital stay, and costs of transurethral resection of the prostate and open prostatectomy for the treatment of benign prostatic hyperplasia, between 2008 and 2018, in the Public Health System in São Paulo, Brazil. Methods Ecological and retrospective study using data from the informatics department of the Brazilian Public Health System database. Procedure codes were “open prostatectomy” and “transurethral resection of the prostate.” The outcomes analyzed were compared between transurethral resection of the prostate and open prostatectomy according to the hospital surgical volume and presence or absence of a residency program. Results A total of 18,874 surgeries were analyzed (77% transurethral resection of the prostate) and overall mortality was not statistically different between procedures. Intermediate and high-volume centers had shorter length of hospital stay than low-volume centers for transurethral resection of the prostate (3.28, 3.02, and 6.58 days, respectively, p=0.01 and p=0.004). Length of hospital stay was also shorter for open prostatectomy in high-volume compared to low-volume centers (4.86 versus 10.76 days, p=0.036). Intrahospital mortality was inversely associated with surgical volume for transurethral resection of the prostate. Centers with residency program had shorter length of hospital stay considering open prostatectomy and less mortality regarding transurethral resection of the prostate. Open prostatectomy was 64% more expensive than transurethral resection of the prostate. Conclusion The findings suggest the importance of investing in specialized centers, which could be potential referral centers for surgical cases.

Covid-19 menjadi masalah kesehatan dunia. Pada tanggal 11 Maret 2020, WHO menetapkan Covid-19 sebagai pandemi. Pada tanggal 7 Mei 2020, Indonesia melaporkan 12.776 kasus konfirmasi Covid-19 dan 252 kasus positif berasal dari Provinsi Sumatera Barat. Berdasarkan bukti ilmiah, Covid-19 dapat menular dari manusia ke manusia melalui percikan batuk/bersin (droplet). Rekomendasi standar untuk mencegah penyebaran infeksi adalah menggunakan masker, menjaga jarak, mencuci tangan secara teratur menggunakan sabun dan air bersih dan lainnya. Tujuan kegiatan ini adalah untuk meningkatkan pengetahuan masyarakat melalui baliho yang memaparkan informasi terkait Covid-19 yang dapat dilihat dan di akses oleh orang banyak, meningkatkan ketahanan pangan kelompok rentan melalui pendistribusian sembako, dan pembagian masker non-medis sebagai upaya pencegahan penularan Covid-19. Kegiatan ini dilaksanakan di Jorong Balai Gadang, Nagari Koto Laweh, Kecamatan X Koto, Kabupaten Tanah Datar. Pelaksanaan kegiatan terdiri atas tiga kegiatan yaitu: kegiatan pertama yaitu pemasangan baliho tentang pencegahan penularan Covid-19 dan new normal COVID-19. Kegiatan kedua adalah membagikan 40 paket sembako (berisi beras, telur, minyak goreng, gula) kepada masyarakat yang terkena dampak ekonomi dari pandemi Covid-19 dan kegiatan ketiga adalah pembagian masker. Hasil kegiatan yang diperoleh adalah semua kegiatan dapat terlaksana dengan baik. Pemasangan baliho dapat digunakan masyarakat sebagai sumber informasi yang dapat di akses dengan mudah. Pemberian sembako dapat membantu masyarakat rentan pangan dalam memenuhi kebutuhan asupan gizi di masa pandemi. Pembagian masker dapat digunakan oleh masyarakat sebagai upaya memutus mata rantai penularan Covid-19. Sebaiknya masyarakat benar-benar mengikuti protokol kesehatan dalam kehidupan sehari-hari sesuai dengan informasi yang terdapat pada baliho.

Abstract Background The Expanded Prostate Index Composite for Clinical Practice (EPIC-CP) is a short version of the original EPIC, developed to facilitate the instrument’s use in routine care. This study aimed to validate the EPIC-CP Portuguese version, and evaluate its role in presenting early functional outcomes of surgically treated prostate cancer patients at a Latin American referral center. Methods The EPIC-CP was self-administered prospectively and individually by all localized prostate cancer patients, before and after robotic-assisted radical prostatectomy, from March 2017 to June 2018 at a single institution. For validation, we used the Cronbach’s alpha coefficient to evaluate internal consistency. The EPIC-CP domains were compared before surgery, and 6 months and 12 months after surgery. Statistical analyses were performed using the student’s t test, and Wilcoxon and Friedman tests, with p values

Background Exercise is recommended for all patients with COPD. Evidence for its benefit is considerably weaker in the more severe stages of the disease. The aim of this study was to investigate whether high-intensity interval training could improve exercise capacity, pulmonary hemodynamics and cardiac function in patients with severe COPD and hypoxemia. Methods Stable patients with COPD GOLD stage III or IV and hypoxemia were included. They underwent extensive cardiopulmonary testing including right heart catheterization, lung function tests, echocardiography and 6-minute walk test before and after completion of 10 weeks of high-intensity interval training performed with supplemental oxygen. Primary endpoint was change in pulmonary artery pressure measured by right heart catheterization. Results Ten patients with very severe airflow obstruction, mean FEV1 28.7% predicted and mean FEV1/VC 0.39 completed the exercise programme. Pulmonary artery pressure remained unchanged following the intervention (26,3 mmHg vs. 25,8 mmHg at baseline, p 0.673). Six-minute walk distance improved by a mean of44.8 m (p 0.010), which is also clinically significant. We found marginally improved left ventricular ejection fraction on echocardiography (54.6% vs 59.5%, p 0.046). Conclusion High-intensity interval training significantly improved exercise capacity while pulmonary hemodynamics remained unchanged. The improvement may therefore be due to mechanisms other than altered pulmonary artery pressure. The increase in ejection fraction is of uncertain clinical significance. The low number of patients precludes firm conclusions.

Se presenta una investigación documental en la que se elaboró una definición de formación cultural y se rastreó en los Estándares Básicos de Competencia en Lengua Extranjera (MEN, 2006) desde cuatro núcleos temáticos que estructuraron esta definición. Los hallazgos muestran una propuesta de formación cultural que se queda en los niveles básicos de ésta – núcleos temáticos 1 y 2–; no trasciende a niveles superiores –núcleos temáticos 3 y 4–; enfatiza en la apariencia de la cultura; no presenta continuidad en el proceso de formación; es prescriptiva y limitada en la redacción de los Estándares; tiende hacia una aplicación generalizada.