What's known on the subject? and What does the study add?• Metabolic syndrome can identify patients at high risk of cardiovascular disease. The prevalence of metabolic syndrome is increasing worldwide and is associated with increased age, obesity and hypogonadism. The association between metabolic syndrome and prostate cancer development has not been studied comprehensively, and published studies report divergent results.• This study indicates that tumours detected in men with metabolic syndrome are more aggressive than those detected in men without this condition. Objective• To further examine the association between metabolic syndrome (MS), prostate cancer (PC) detection risk and tumour aggressiveness. Patients and Methods• From 2006 to 2010, 2408 men not receiving 5a-reductase inhibitors were scheduled for prostatic biopsy due to PSA above 4 ng/mL and/or abnormal digital rectal examination. Results• The rates of PC detection were 34.5% and 36.4% respectively in men with and without MS, P = 0.185.High grade PC rates (Gleason score 8-10) were 35.9% and 23.9% respectively, P < 0.001. The advanced disease rates (cT3-4 N0-1 M0-1) were 17% and 12.7% respectively, P = 0.841. • The high risk PC rates (cT2c-4 or Gleason score [8][9][10] or PSA > 20) were 38.5% and 33.0% respectively, P = 0.581. • Multivariate analysis confirmed that MS was not associated with the risk of PC detection but it was associated with an increased risk of high grade tumours (odds ratio 1.75, 95% CI 1.26-2.41), P < 0.001. Conclusion• MS seems not be associated with an increased risk of PC detection but it is associated with an increased risk of more aggressive tumours.

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differentially methylated in LG and HG BC using two different genomewide methylation-profiling platforms. Multivariable logistic regression prediction models were created. RESULTS: There were 211 bladder cancer patients (180 nonmuscle invasive) and 102 controls. In univariate analyses, all methylation biomarkers were statistically significant predictors of cancer vs. no cancer (all p-values <0.01), and HG vs. LG-BC (all p-values<0.01). In multivariable analysis, NID2, TWIST1 and age were independent predictors of BC (all p<0.05). Multivariable models predicting BC overall and discriminating between high-grade and lowgrade bladder cancer reached AUCs of 0.89 and 0.78, respectively. CONCLUSIONS: Our multi-centric study supports the promise of epigenetic urinary markers in non-invasively detecting bladder cancer and discriminating between grades. Validation in different clinical settings including patients with hematuria, bladder cancer surveillance or screening in high-risk populations is warranted to support its utility.

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Introduction: The initial palliative care includes pharmacological palliative treatment of pain, depression, anxiety , delirium, nausea and dyspnea. Objective: To study the drugs administered to oncologic patients in initial palliative care and its possible side effects. Methods: This retrospective study included 40 oncologic patients with mean age of 69+14.12 under initial palliative care. Results: Opioids, benzodiazepines, neuroleptics, non-steroidal anti-inflammatory drugs (NSAID), corticosteroids had been prescribed in initial palliative care. Opioids such as fentanyl 0.007 mg/kg/day (3.3%), meperidine 0.64 mg/kg/day (3.3%), tramadol 7.4 mg/kg/day (3.3%), methadone 0.2 mg/kg/day (6.70%) and morphine 0.05 mg/kg/day (70.0%) were given for pain control. For anxiolytic and sedative effects, benzodiazepines such as bromazepam 0.092 mg/kg/day (3.3%), diazepam 0.31 mg/kg/day (3.3%), lorazepam 0.012 mg/kg/day (6.7%), alprazolam 0.006 mg/kg/day (6.7%), midazolam 0.014mg/kg/day (13.0%), clonazepam 0.67 mg/kg/day (20.0%), were administered. Levomepromazine 0,65 mg/kg/day (6,70%), quetiapine 0,25mg/kg/day (6,7%), haloperidol 0,06 mg/kg/day (26,7%), chlorpromazine 0,13 mg/kg/day were the neuroleptics prescribed for delirium/hallucination. In pain adjuvant therapy, NSAID such as dipyrone 3.7 mg/kg/day (90.00%), ketoprofen 2.7 mg/kg/day (6.70%) and tenoxicam 0.79mg/kg/day (3.3%) were administered. To treat nausea/vomiting dexamethasone 0.11 mg/kg/day was given to 53.40% patients. Constipation (66,60%), urinary retention (33,30%), nausea/vomiting (33,30% and hypotension (16,60%), motor agitation (33,30%) were described in this study as pharmacological side effects. Conclusions: Drug-related agranulocytosis and hypotension should be observed with the administration of dypirone. Respiratory depression with the association of opiods and benzodiazepines; extrapyramidal side effect (akathisia) due to administration of neuroleptics and dexamethasone immunosuppression should be considered in these patients' drug prescription.