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João P Lima,1 João Carvalho,1 Vasco Quaresma,1 Edgar Tavares-da-Silva,1 Rodolfo Silva,2 Paulo Azinhais,2 Gracinda Costa,2 Arnaldo Figueiredo1 1Urology and Renal Transplantation Department, Coimbra University Hospital Center, Coimbra, Portugal; 2Nuclear Medicine Department, Coimbra University Hospital Centre, Coimbra, PortugalCorrespondence: João P LimaUrology and Renal Transplantation Department, Coimbra University Hospital Center, Praceta R. Prof. Mota Pinto, Coimbra, 3004-561, PortugalEmail joaopedrosolima@gmail.comBackground: Recommended imaging modalities for prostate cancer staging have disappointing sensitivities, whereas [68Ga]-PSMA PET/CT (PET-PSMA) shows promising sensitivities and specificities in the initial management of prostate cancer. Recent studies have revealed that a significant change of management when PET-PSMA was used, with favorable negative predictive values.Methods: In this retrospective study, we analyzed every PET-PSMA performed in our center for initial staging of intermediate and high-risk prostate cancer. Patients were divided into two groups based on whether imaging modalities other than PET-PSMA were performed. In patients submitted to radical prostatectomy, PET-PSMA findings were compared to histological analysis of the specimen.Results: PET-PSMA results of 57 patients were gathered, with 77.2% (n=44) having performed CT scan or bone scan (BS) prior to PET-PSMA. Prostate cancer management strategy was changed in 61.4% (n=27), when PET-PSMA was performed following CT and BS. BS and CT results were consistent with PET-PSMA in 43.2% and 44.8%, respectively. In 30 cases, a curative strategy was used based on PET-PSMA findings. PET-PSMA revealed a negative predictive value of 95.2% in 23 patients submitted to radical prostatectomy with bilateral pelvic lymphadenectomy. Prostate SUV values on preoperative PET-PSMA correlated with initial PSA, ISUP grade, PC risk staging and presence of extraprostatic lesions.Conclusions: PET-PSMA is a key element for prostate cancer staging and management, with high diagnostic accuracy. More prospective studies need to be implemented to determine its role as a first-line staging tool.Keywords: PET-CT, prostate cancer, specificity and sensitivity, metastasis, lymphatic metastases, bone metastases

Roberto Jarimba,1 João Pedroso Lima,1 Miguel Eliseu,1 João Carvalho,1 Hugo Antunes,1,2 Edgar Tavares da Silva,1,2 Pedro Moreira,1 Arnaldo Figueiredo1,2 1Urology and Renal Transplantation Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; 2Faculty of Medicine, University of Coimbra, Coimbra, PortugalCorrespondence: Roberto JarimbaUrology and Renal Transplantation Department, Centro Hospitalar e Universitário de Coimbra, Rua Professor Mota Pinto, Coimbra 3004-561, PortugalTel +351968209250Email robertojarimba@chuc.min-saude.ptIntroduction: Prostate cancer is the most commonly diagnosed cancer in men. Radical prostatectomy is a potentially curative alternative for localized disease, although a significant percentage of these patients will suffer a biochemical recurrence with associated mortality. A wide spectrum of anticancer properties of statins has been demonstrated and the role of these drugs in prevention and treatment of other types of cancer is being increasingly studied.Objective: The aim of this study was to investigate whether the use of statins is associated with reduced risk of biochemical recurrence among patients submitted to radical prostatectomy.Patients and Methods: We retrospectively reviewed 875 patients submitted to radical prostatectomy between January 2009 and December 2018. Approximately 45.7% of the patients were on medication with statins at the time of surgery. We evaluated a possible association between statin use and biochemical recurrence and which patients would benefit the most with statin treatment.Results: Overall, statins were associated with an approximately 40% reduction in risk of biochemical recurrence at a median follow-up time of 51.2 months (HR 0.599, p< 0.05). Patients with pT2c staging (HR 0.486, p=0.017) and ISUP ≥ 3 (HR 0.61, p=0.011) seem to have benefited more from statin use.Conclusion: In this cohort, use of statins proved beneficial in reducing the risk of biochemical recurrence among patients submitted to radical prostatectomy. Prospective studies are required to confirm this result and to evaluate its safety profile in those patients.Keywords: prevention, prostate cancer, radical prostatectomy, recurrence, statins

This article discusses the complexity of the barbarism of social relations in Brazil. Through the federal intervention in Rio de Janeiro in 2018, we indicate the centrality of the public safety policy, the media approach and the reorganization of the morality made by the evangelical movements in the consensus building needed for the consolidation of neoconservative hegemony – process that culminates in the results obtained in the elections of 2018. The consensus on the necessity for coercion appears as a nexus in the distinct speeches that permeated the intensification of the militarization of public security, expressed in the federal intervention in Rio de Janeiro, and of politics itself, establishing once and for all the social regression characteristic of late-capitalism.