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Objective. Monotherapy with nonsteroid antiandrogens may be used in a number of patients with advanced prostate cancer (PC). We present the results of analysis of survival and safety of treatment in patients with nonmetastatic (M0) locally advanced PC treated with bicalutamide, 150 mg, or castrated in two studies. Materials and methods: These were pooled data of two open-labeled multicenter studies of the identical design. The patients with PC (T3— 4) were randomized to treatment with bicalutamide, 150 mg/day or castration (bilateral orchiectomy or goserelin acetate, 3.6 mg, once every 28 days) in a ratio of 2:1. Results: 480 patients with locally advanced PC were randomized. During a median follow-up of 6.3 years, mortality was 56%. There were significant differences in overall survival (relative risk 1.05; the upper 95% CI 1.31; p=0.70) and in interval before progression (1.20; 1.45; p=0.11) between both groups. Bicalutamide therapy was ascertained to have an advantage in two life quality indices: sexual function (p=0.029) and physical capacities (p=0.046). The most common adverse reactions were hot flushes in the castration group and breast pain and gynecomastia in the bicalutamide group. The frequency of other side effects of the therapy was low. Bicalutamide was well tolerated. The drug used during the study had to be discontinued due to adverse reactions only in several cases. There were no new problems associated with the safety of bicalutamide therapy during a long-term follow-up. Conclusion: Monotherapy with bicalutamide in a dose of 150 mg is an attractive alternative to castration in patients with locally advanced PC in whom hormonal treatment is indicated.

AimsTo identify whether clinical information routinely collected and recorded on clinical files is available for the identification of metabolic syndrome and to assess the prevalence of risk factors for the syndrome in a sample of people with intellectual disabilities (ID) and mental illness treated with antipsychotic medication.MethodsA retrospective analysis was performed for 76 adults with ID and comorbid mental illness, for whom treatment with antipsychotic medication was established. Statistical analysis was performed using SPSS 16.0. The Student t-test for parametric data and χ2-test for non-parametrical data were used.ResultsFive of the six criteria for metabolic syndrome were available in all or a high proportion of the files, however no measurement for waist circumference was recorded in any of the files. Aripiprazole appears to be the least risky antipsychotic for metabolic syndrome.ConclusionIt is important to develop a systematic protocol to record diagnostic variables for metabolic syndrome in at risk populations such as those with ID and mental illness treated with regular antipsychotics.

The importance of enterococci as a nosocomial etiologic agent is well documented; however, enterococci are also capable of causing a variety of community-acquired infections. Vancomycin resistance in a clinical Enterococcus isolate was first reported in 1986, and since then vancomycin-resistant enterococci (VRE) have been reported world-wide. This report describes a case of E. faecium with the VanA phenotype, isolated from meningitis in Sao Paulo, Brazil. Two E. faecium strains were isolated. One strain showed VanA phenotype, and the molecular characterization of the VanA gene was confirmed by polymerase chain reaction. The other strain was susceptible to vancomycin and teicoplanin. The authors would like to call the attention of the scientific community to this first identification of a VRE case in Sao Paulo, Brazil.

This was a somewhat unusual discussion meeting in that it was preoccupied with very common medical conditions and with technologies which in many cases are so simple that many would think they should scarcely be regarded as technologies at all. Three quarters of the world’s inhabitants live in rural areas and survive on near subsistence agriculture - they are clearly affected with a great variety of severe diseases, especially in childhood, but diseases of a type which cause little trouble now in the rest of the world. The resources available to help these vast rural populations are very limited, and certainly too small to enable us to deal with the diseases in exactly the same way as this has been done elsewhere. Yet it is urgent to do something, as the population is rising at least as fast as food and other resources. The meeting therefore set out to review a number of the aspects of the rural situation which are particularly important for health. These included the improvement of agriculture and food production, and water supply. We considered the most recent results of aetiological research and asked whether enough facts are available. Some of the results were surprising - for example it appeared that infections of the gut are important causes of malnutrition in West Africa. It is important to have a particularly deep and accurate understanding of what contributes most to ill health, because in these rural areas it is only possible to intervene in a few ways, and if the little money available is spent on unimportant interventions there will be little benefit to the population and no money left to ‘try again’. This is thus a challenge to scientific investigation which in some cases might be simple - watching where people draw water, subtle - finding out what makes them want to have or not have children, or complicated - studying food samples in depth and analysing data with the aid of a computer.