Review Article

Role of Adiponectin in prostate cancer

Vol. 45 (2): 220-228, March – April, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0261


Xiaobo Hu 1,2, Cong Hu 2, Caiping Zhang 2, Min Zhang 2, Shiyin Long 2, Zhaohui Cao 1,2
1 Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China; 2 Department of Biotechnology, School of Pharmacy and Biosciences, University of South China, Hengyang, China


Obesity is defined as a chronic and excessive growth of adipose tissue. It has been associated with a high risk for development and progression of obesity-associated malignancies, while adipokines may mediate this association. Adiponectin is an adipose tissue-derived adipokines, with significant anti-diabetic, anti-inflammatory, anti-atherosclerotic and anti-proliferative properties. Plasma adiponectin levels are decreased in obese individuals, and this feature is closely correlated with development of several metabolic, immunological and neoplastic diseases. Recent studies have shown that prostate cancer patients have lower serum adiponectin levels and decreased expression of adiponectin receptors in tumor tissues, which suggests plasma adiponectin level is a risk factor for prostate cancer. Furthermore, exogenous adiponectin has exhibited therapeutic potential in animal models. In this review, we focus on the potential role of adiponectin and the underlying mechanism of adiponectin in the development and progression of prostate cancer. Exploring the signaling pathways linking adiponectin with tumorigenesis might provide a potential target for therapy.

Keywords: Prostatic Neoplasms; Obesity; Stress, Physiological

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A review of the possibility of adopting financially driven live donor kidney transplantation

Vol. 44 (6): 1071-1080, November – December, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0693


Aline Adour Yacoubian 1, 2, Rana Abu Dargham 1, 2, Raja B. Khauli 1, 2
1 Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon; 2 Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Beirut, Lebanon


Kidney transplantation for end-stage renal disease remains the preferred solution due to its survival advantage, enhanced quality of life and cost-effectiveness. The main obstacle worldwide with this modality of treatment is the scarcity of organs. The de­mand has always exceeded the supply resulting in different types of donations. Kidney donation includes pure living related donors, deceased donors, living unrelated do­nors (altruistic), paired kidney donation and more recently compensated kidney dona­tion. Ethical considerations in live donor kidney transplantation have always created a debate especially when rewarding unrelated donors. In this paper, we examine the problems of financially driven kidney transplantation, the ethical legitimacy of this practice, and propose some innovative methods and policies that could be adopted to ensure a better practice with accepted ethical guidelines.

Keywords:  Kidney Transplantation; Kidney Diseases; Review [Publication Type]

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5-alpha Reductase Inhibitors and risk of male breast cancer: a systematic review and meta-analysis

Vol. 44 (5): 865-873, September – October, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0531


Jiamin Wang 1, Shankun Zhao 1, Lianmin Luo 1, Ermao Li 1, Xiaohang Li 1, ZhiGang Zhao 1
1 Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China


 Objective: To assess the relationship between 5α-reductase inhibitors (5ARIs) and the risk of male breast cancer (MBC).

Material and Methods: We systematically searched Medline via PubMed, Embase and the Cochrane Library Central Register up to May 2017 to identify published articles related to 5ARIs and the risk of MBC.

Results: Summary effect estimates were calculated by a random-effect model, and tests for multivariable-unadjusted pooled risk ratios (RR) and heterogeneity, as well as the sensitivity analyses were conducted to assess publication bias. All four studies were conducted in a quality assessment according to the Newcastle Ottawa Scale system. The strength of association between 5ARIs and the prevalence of MBC was evaluated by using summarized unadjusted pooled RR with a 95% confidence interval [CI]. Four studies involving 595.776 participants, mean age range from 60 to 73.2 years old, were included in a meta-analysis, which produced a summary unadjusted RR of the risk of MBC for the treatment of 5ARIs of 1.16 (95% CI 0.85-1.58, P=0.36) and the multivariable-adjusted RR is 1.03, (95% CI 0.75-1.41, p=0.86). There was no heterogeneity among included studies (I2=0%, P=0.49). Estimates of total effects were generally consistent with the sensitivity.

Conclusion: We did not observe a positive association between the use of 5ARIs and MBC. The small number of...

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Review of post bariatric surgery effects on common genitourinary physiology

Vol. 44 (4): 680-687, July – August, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0416


Aline A. Yacoubian 1, Rami Nasr 1
1 Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon


Background: Obesity is a worldwide challenging health problem. Weight loss through medical management of obesity has not always been successful, thus, giving rise to the need for surgical intervention. Bariatric surgery has been shown to be helpful for morbidly obese patients. However, studies have also shown the effect of surgery on stone formation, fertility and erectile function. This review summarizes the main find­ings of several studies that analyze stone formation and fertility in men as well as erectile function post bariatric surgery. The underlying pathophysiologic alterations post bariatric surgery include increased absorption of oxalate leading to hyperoxaluria, hypocitraturia and increased urinary calcium oxalate supersaturation. Contradicting data exist on the effect of bariatric surgery on fertility and erectile function. Further studies are needed to analyze the mechanisms.

Keywords: Obesity; Bariatric Surgery; Nephrolithiasis; Fertility

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Clinical features of carriers of reciprocal chromosomal translocations involving chromosome 2: report of nine cases and review of the literature

Vol. 44 (4): 785-793, July – August, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0233


Xinyue Zhang 1, Hongguo Zhang 1, Cong Hu 1, Ruixue Wang 1, Qi Xi 1, Ruizhi Liu 1
1 Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China


Objective: To explore the clinical features of carriers of chromosome 2 translocations, enabling informed genetic counseling of these patients.

Materials and Methods: Eighty-two male carriers of a translocation who were infertile or receiving fertility counseling were recruited. Cytogenetic analyses were performed using G-banding. A search of PubMed was performed to determine whether the identi­fied translocations on chromosome 2 are involved in male infertility. The relationships of translocation breakpoints with male infertility and recurrent pregnancy loss were analyzed.

Results: Of the 82 translocation carriers, 9 (11%) were carriers of a chromosome 2 translocation. Four cases had oligozoospermia or infertility, while five had normal se­men. In an analysis of the literature, 55 patients who were carriers of chromosome 2 translocations were also reviewed. Breakpoints at 2p13 and 2q31 were observed in six patients each, and were the most common. Breakpoints at 2p23, 2p13, 2p11.2, 2q31, and 2q37 were associated to both pre-gestational and gestational infertility, while other breakpoints were associated with gestational infertility.

Conclusions: All breakpoints at chromosome 2 were correlated with gestational infer­tility. Carriers of chromosome 2 translocations should therefore receive counseling to continue with natural conception and use of different technologies available via...

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Clinical and pathologic factors predicting reclassification in active surveillance cohorts

Vol. 44 (3): 440-451, May – June, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0320


Pablo S. Sierra 1, Shivashankar Damodaran 2, David Jarrard 2, 3
1 Fundacion Valle del Lili -Universidad Icesi, Cali, Colombia; 2 Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; 3 University of Wisconsin Carbone Cancer Center, Madison, WI, USA


The incidence of small, lower risk well-differentiated prostate cancer is increasing and almost half of the patients with this diagnosis are candidates for initial conservative management in an attempt to avoid overtreatment and morbidity associated with sur¬gery or radiation. A proportion of patients labeled as low risk, candidates for Active Surveillance (AS), harbor aggressive disease and would benefit from definitive treat¬ment. The focus of this review is to identify clinicopathologic features that may help identify these less optimal AS candidates.
A systematic Medline/PubMed Review was performed in January 2017 according to PRISMA guidelines; 83 articles were selected for full text review according to their relevance and after applying limits described.
For patients meeting AS criteria including Gleason Score 6, several factors can assist in predicting those patients that are at higher risk for reclassification including higher PSA density, bilateral cancer, African American race, small prostate volume and low testosterone. Nomograms combining these features improve risk stratification.
Clinical and pathologic features provide a significant amount of information for risk stratification (>70%) for patients considering active surveillance. Higher risk patient subgroups can benefit from further evaluation or consideration of treatment. Recom¬mendations will continue to evolve as data from longer term AS cohorts...

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