Search Results (3)

Background: Prostate cancer (PCa) is one of the most prevalent cancers in the world. Standard methods of screening and diagnosis for prostate cancer have been effective but can result in overtreatment of indolent prostate cancer, leading to increased morbidity. Multiparametric magnetic resonance imaging (MRI) and fusion biopsy are effective tools to achieve better diagnostic accuracy. A combination of multiparametric MRI and photodynamic therapy can be used as an alternative to active surveillance in low-risk prostate cancer to better detect disease progression while avoiding overtreatment. Methods: We conducted a retrospective multicenter study on 13 patients with low-risk prostate cancer who underwent vascular-targeted photodynamic therapy. The patients were evaluated for up to 15 months after the procedure using biochemical parameters like serum Prostate Specific Antigen (PSA), digital rectal examination, multiparametric MRI, and functional parameters like the International Prostate Symptom Score (IPSS), the 15-question International Index of Erectile Function questionnaire (IIEF-5), quality of life score (QoL), the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and a uroflowmetry examination. Results: The patients did not experience any significant complications during or after the treatment. A decrease in serum PSA and prostate volume was observed from 7.38 ng/mL to 3.8 ng/ml with functional improvement evidenced by a decrease in the IPSS (from 15.4 to 11), QoL (from 3.15 to 2), and the IIEF-5 (from 17.23 to 16) score, and an improvement in uroflowmetry. Conclusion: Vascular-targeted photodynamic therapy is a safe and effective alternative to active surveillance in patients with low-risk prostate cancer. Full article

Vascular cell adhesion molecule-1 (VCAM-1) and E-selectin are involved in different inflammatory diseases and may be potential cardiovascular risk biomarkers in psoriasis. They play an important role in regulating the recruitment and adhesion to endothelial cells during inflammation, affecting various conditions like vasculitis, atherosclerosis, and cardiovascular diseases. Positive outcomes have been observed when using Tumor Necrosis Factor Alpha (TNF-α) inhibitors and biological therapies that target selectins to control the functioning of endothelial cells and reduce inflammation in psoriasis and related conditions. Moreover, the effects of systemic treatments and ultraviolet B (UVB) phototherapy on VCAM-1 and E-selectin levels in psoriasis patients highlights the potential to impact the severity of psoriasis and activation of endothelial cells. In addition, various factors such as age, sex, metabolic syndrome, hyperglycemia, migraines, and tobacco smoking have been found to affect levels of VCAM-1 and E-selectin. This sheds light on understanding the complex relationship between endothelial activation and the development of diseases. Studies show the potential of using the levels of VCAM-1 and E-selectin as indicators of systemic treatment effectiveness and the progression of the disease. In summary, this review highlights the importance of VCAM-1 and E-selectin as potential biomarkers for assessing inflammation, disease severity and cardiovascular risk in individuals with psoriasis. The shared mechanisms of psoriasis and atherosclerosis, along with the effect of treatments on endothelial activation markers, provide significant insights for further research and approaches to manage inflammatory diseases in the future. Full article

Upper tract urothelial carcinoma (UTUC) accounts for 5–10% of urothelial cancers and is associated with high morbidity and mortality. Increasing incidence of UTUC has been observed since the 1970’s, alongside the evolution of advance imaging techniques, precision biopsy equipment, and risk stratification models. The high morbidity of radical nephroureterectomy (RNU) which is still the gold-standard treatment for high-risk UTUC, has driven the development of kidney-sparing surgery alternatives for low-risk UTUC. Now, several treatment approaches have outcomes comparable to RNU for low-risk UTUC and guidelines are recommending kidney-sparing surgery for favorable low-risk disease. The main categories of kidney-sparing surgery include segmental ureterectomy, endoscopic ablation, chemoablation, and vascular-targeted phototherapy. These treatments are highly nuanced making them difficult to compare, but for most cases of favorable low-grade disease, we recommend endoscopic laser ablation with optional adjuvant intracavitary therapy. Adverse events associated with kidney-sparing surgery include ureteral stricture, bleeding requiring transfusion, and bladder recurrence of UTUC. Limitations of kidney-sparing surgery include appropriate tissue sampling (contributing to under-grading and under-staging), higher rates of ipsilateral recurrence, and potential for grade and stage progression. Collectively, these may subsequently necessitate RNU. Here, we review the technical variations and evidence behind kidney-sparing therapies as well as their practicality in the real world. Full article