Aims: To identify the definition for urinary continence (UC) after radical prostatectomy (RP) which reflects best patients' perception of quality of life (QoL). Methods: Continence was prospectively assessed in 634 patients, 12 months after RP using the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) and the number of pads employed in a 24-hour period (pad usage). We used the one-way ANOVA technique with posthoc pairwise comparisons according to Scheffé's method (homogeneous subsets) for assessing the degree of QoL deficit related to urinary incontinence (UI). Results: The continence prevalence is 64.4%, 74.1%, 88.3%, and 35.8% using "0 pads," "1 safety pad," "1 pad," and "ICIQ score 0" definitions, respectively. Pad usage is moderately strongly associated with ICIQ 1, 2, and 3 (ρ = 0.744, 0.677, and 0.711, respectively; p < 0.001). Concordance between classical UC definitions is acceptable between "0 pads-ICIQ score 0" (K = 0.466), but poor for "1 safety pad" and "1 pad" (K = 0.326 and 0.137, respectively). Patients with "0 pad usage" have better QoL related to urine leakage than patients with "1 safety pad" or "1 pad" (1.41 vs. 2.44 and 3.11, respectively; p < 0.05). There were no significant differences found regarding QoL between patients with ICIQ score 0 and ICIQ score 2 (1.01 vs. 1.63; p = 0.63). Conclusions: Pad usage and the ICIQ-SF's answers provide useful information. We propose a combined definition (0 pads and ICIQ score ≤2) as it is the definition with the least impact on daily QoL.

We herein report a rare case of a 25-year-old immunocompetent male patient with disseminated tuberculosis of central nervous system (CNS), first presenting as multiple cerebral lesions with no meningeal involvement. Subsequent diagnostic workup disclosed extensive peritoneal involvement. A broad differential diagnosis was considered, including neoplastic and infectious diseases. The diagnosis was confirmed with positive PCR result for Mycobacterium tuberculosis in the biopsied mesenteric tissue. The patient was started on tuberculostatic regimen with favorable outcome. No acquired or hereditary immunodeficiency was documented. Disseminated tuberculosis in immunocompetent individuals is extremely rare. Genetic susceptibility factors have been reported in individuals with extensive forms of the disease and a high index of suspicion is required, as observed in our case.

Background Vortioxetine is a new antidepressant with a distinctive pharmacological profile. It combines inhibition of serotinine transporter with modulation of various serotonine receptors. Its cognitive benefit in adults depressed patients has been previously demonstrated. There is evidence of its antidepressant effect in the elderly but not specifically of its utiliity in demented population. Effects in a group of different types of dementia patients are showed and hypothesis of its efficacy based on its properties are proposed. Method A retrospective study was conducted. Eligible patients were those observed in our memory outpatient clinics during 2019. All patients had behavioural symptoms (BPSD), Main symptoms were anxiety, apathy, irritability and restlessness. Thirty‐two patients were reviewed. Result 32 patients were included, of which 60,6% were women. Median age was 74 years (SD 12,070). Alzheimer´s disease was the most common type of dementia (51.5%), as expected. Median dose of vortioxetine used was 10 mg/day. Symptoms that led to vortioxetine initiation were anxiety (57,6%), apathy (48,5%) and irritability (42,4%). Depreesion was present in 33,3% of cases, but anxiety and apathy were the symptoms that improved the most after vortioxetine introduction. 60,6% of patients were concomitantly treated with antidementia drugs, mostly Rivastigmine (30,3%). Coexistent benzodiazepines or antipsychotics use in patients treated with vortioxetine was not significant (24,2% and 21,2% each one). No side effects were reported. Conclusion Vortioxetine may be an useful option for BPSD in dementia population. Available evidence indicates that target receptors for vortioxetine play an important role in brain networks, and this could explain its efficacy regardless the antidepressive effect. No safety concerns were found in this group of patients with doses from 10 to 20 mg/day according with tolerability profile already described. Further studies with a more extensive number of eligible patients and prospective design are needed.

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