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ABSTRACTIntroductionAndrogen deprivation therapy consists of the cornerstone of prostate cancer medical treatment. Until recently, castration of hypothalamus-hypophysis-gonadal axial was based on injectable medical agents. A few years ago, a novel per os administered GnRH antagonist was approved leading testosterone to castration level. Relugolix was approved by FDA in 2020, and it is the first per os administered GnRH antagonist. The present study is a literature review of the efficacy, safety and clinical perspectives of relugolix.Areas coveredA literature narrative review was conducted using PubMed/MEDLINE, Scopus, and the Cochrane library. Studies written in English language, considering efficacy, safety and cost-effectiveness of relugolix compared with other androgen deprivation therapies were included in the review.Expert opinionRecent studies have examined efficacy of relugolix revealing a testosterone suppression percentage of 78.4% after 48 weeks from treatment initiation. Moreover, relugolix has been associated with less major cardiovascular events as well as better rate of testosterone recovery after treatment completion compared with the GnRH agonists. However, there is no head-to-head trial comparing relugolix with injectable GnRH antagonists, so far. As a result, a trial comparing the methods of antagonists’ administration should be performed in the future.

ABSTRACTIntroductionThe prostate cancer (PCa) consists the most frequently diagnosed malignancy of urogenital system in males. Traditionally, treatment of localized PCa was based on surgery or radiotherapy while hormonotherapy was used in more advanced stages. However, the implementation of radiolabels has revolutionized the landscape of prostate cancer. Specifically, prostate-specific membrane antigen (PSMA) has been investigated in different aspects of PCa therapeutic era.Areas coveredA literature review is presented about the implications of PSMA radiolabels on prostate cancer treatment. PSMA tracers were initially used as an imaging technique. Afterwards, PSMA labeled with isotopes presenting cytotoxic abilities, such as lutetium-117 and actinium-225, while reports exist about the use of radioligand immunotherapy. Meanwhile, ongoing trials examine the development of novel radionuclides as well as the evolution of the PSMA-targeted ligands.Expert opinionCurrently, PSMA radioligand treatment of prostate cancer is approved in the metastatic stage of the disease. Meanwhile, a variety of trials exist about its possible role in less advanced stages. However, plenty of parameters should be addressed before these implementations, such as PSMA dosage, dosimetry issues, and its safety profile. A future well-designed study with proper patient selection is mandatory to further explore PSMA radioligand theranostics perspectives.

The lubricated interface at the piston-ring and liner and its interaction with different lubricants and testing conditions is examined in terms of experimental measurements that show the minimum oil film thickness developed at the lubricated or depending on conditions partly lubricated conjunction and the surface interaction intensity, as measured from the friction sensor. An analysis is carried out with the use of different parameters for the experiments as well as different lubricants in a simplified piston-ring simulation test rig. This analysis is further enhanced with the squeeze film effect investigations close to the stroke reversals and together with cavitation initiation and load-carrying effect results from previous experimental data, light is shed on the interacting surface’s behaviour at the different lubrication regimes. Another parameter, the viscosity index of the lubricant is used as an indication of the effects of squeeze film shift and friction force measurements and how the load and temperature effect are influencing the squeeze film.

ABSTRACTIntroductionPremature ejaculation (PE) is a sexual dysfunction of unknown etiology affecting a substantial number of males and deteriorating sexual health and quality of life of the patient and his partner. Treatment still remains challenging; however, pharmacotherapy is considered the mainstay of therapy with behavioral and psychosexual interventions being particularly important as adjudicate procedures, within the context of a holistic approach.Areas coveredThe authors review the literature on the available medications for PE, both officially registered and non-registered. Currently, only dapoxetine and an anesthetic spray containing lidocaine and prilocaine (Fortacin™) are officially approved, with the rest being used off-label. Herein, updated data regarding the efficacy and safety of the pharmaceutical agents are presented.Expert opinionOn-demand dapoxetine is reportedly efficacious and safe in treating lifelong PE and is the first medication to be approved for this purpose. Fortacin has also shown considerable efficacy and may be reliably used on-demand. Phosphodiesterase type 5 inhibitors (PDE5Is) have been found to be effective in the treatment of PE and are therefore recommended either as monotherapy or combined with other therapies (i.e. dapoxetine). Adverse events of any therapy should be taken under consideration. Physicians should encourage patients to discuss their needs and expectations and grade any improvement of their condition with treatment.

Purpose: This study aims to compare cavitation shapes between the simulating test rig and the engines to strengthen the findings that were first observed in the simplified experiments. Different forms of cavitation were identified, and their shape and size (length and width) were dictated from reciprocating speed and viscosity of the lubricant. Cavitation degrades performance in engineering applications and its effect is that it alters the oil film pressure. Design/methodology/approach: Lubricant formulations were used for parametric study as well as different operating testing parameters in a simulating test rig and single cylinder engines with visualisation windows. An algorithm was used for extracting cavitation data from imaging, and comparison was made. Findings: Similar phenomena at the simulating test rig and the engine were investigated and compared. The effect of different operating conditions was assessed along with the variations produced from the parametric lubricant study. Research limitations/implications: Engine results are limited due to manufacturing difficulties of visualisation windows and oil starvation. Firing tests are another difficult challenge as the modified section pressure is under more pressure and the window view is affected by combustion process. Limited pictures can be captured before cleaning is required. A lubricant manufacturer has to provide data regarding the chemistry of the lubricants. Originality/value: The effect of cavitation in piston ring lubrication along with variable operating and lubricant parameters is further studied with quantification of cavitation results through image processing. These forms of cavities are affected by lubricant properties and operating conditions. A link between viscosity, cavitation, shear thinning properties, oil film thickness (OFT) and friction is given.

ABSTRACTIntroductionMedical treatment for prostate cancer (PC) targets hormonal pathways used by malignant cells. Research advances aided in gaining knowledge about implicated molecular pathways and opened the way for establishment of new types of therapies by modifying immunological mechanisms. The aim of this review is to present completed and ongoing research projects regarding PC immunotherapy.Areas coveredA literature search was conducted in PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and https://www.clinicaltrials.gov/from inception until 07/2021, to identify completed or ongoing Phase III trials regarding several immunotherapies against PC. Studies on vaccine therapies, CTLA-4 inhibitors, PD-1/PD-L1 inhibitors, PARP inhibitors, PSMA-targeted therapies, and tyrosine kinase inhibitors were considered eligible.Expert opinionAlthough many molecules are being tested against PC cells, only sipuleucel-T has gain approval in the USA. The main reason for this delay in establishing immunotherapy as a standard option for managing PC is the heterogeneity and tumor immune microenvironment complexities. Ipilimumab and olaparib were proved to prolong overall survival significantly against placebo, but a lot of research is going on to identify which patients and at what stage of disease will benefit the most before incorporating them in clinical practice. More recent options such as PSMA-targeted treatments are currently evaluated.Article HighlightsIntense research performed on immunotherapy for prostate cancer.Vaccine therapy with sipuleucel-T, the only approved immunotherapy for prostate cancer.Ipilimumab shows survival benefits.Olaparib shows survival benefits.Findings should be confirmed on further trials to identify target population characteristics and proper disease stage.Immunotherapy is not yet a standard due to tumor environment complex interaction between immune system and malignant cells.

Atypical small acinar proliferation is a histopathological diagnosis of unspecified importance in prostate needle-biopsy reports, suggestive but not definitive for cancer. The terminology corresponds to some uncertainty in the biopsy report, as the finding might represent an underlying non-cancerous pathology mimicking cancer or an under-sampled prostate cancer site. Therefore, traditional practice favors an immediate repeat biopsy. However, in modern urological times, the need of urgent repeat biopsy is being challenged by some authors as in the majority of cases, the grade of cancer found in subsequent biopsy is reported to be low or the disease to be non-significant. On the other hand, high risk disease cannot be excluded, whereas no clinical or pathological factors can predict the final outcome. In this review, we discuss the significance of the diagnosis of atypical small acinar proliferation in the biopsy report, commenting on its importance in modern urological practice.