Failure to Achieve PSA Level ≤I ng/ml Following Neo-Adjuvant LHRHa Therapy Predicts for a Lower Biochemical Control Rate and Overall Survival in Localized Prostate Cancer Treated with Radiotherapy

PURPOSE: To investigate whether failure to suppress the prostate-specific antigen (PSA) level to /=2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy in patients scheduled to undergo external beam radiotherapy for localized prostate carcinoma is associated with reduced biochemical failure-free survival. METHODS AND MATERIALS: A retrospective case note review of consecutive patients with intermediate- or high-risk localized prostate cancer treated between January 2001 and December 2002 with neoadjuvant hormonal deprivation therapy, followed by concurrent hormonal therapy and radiotherapy was performed. Patient data were divided for analysis according to whether the PSA level in Week 1 of radiotherapy was 1 ng/mL in 52. At a median follow-up of 49 months, the 4-year actuarial biochemical failure-free survival rate was 84% vs. 60% (p = 0.0016) in favor of the patients with a PSA level after neoadjuvant hormonal deprivation therapy of 1 ng/mL at the beginning of external beam radiotherapy after >/=2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of

Homocysteine is lower in the Third Trimester of Pregnancy in Women with Enhanced Folate status from continued Folic Acid Supplementation.

Background: In many countries current recommendations are that women take a daily 400ug folic acid supplement, from before conception until the end of the 12th week of gestation, for the prevention of neural tube defects. Low folate status is associated with an elevated concentration of plasma total homocysteine (tHcy), a risk factor that is associated with pregnancy complications such as pre-eclampsia. Methods: In a longitudinal study, tHcy and corresponding folate status were determined in 101 pregnant women at 12, 20 and 35 weeks of gestation, in 35 non-pregnant control subjects sampled conconcurrently, and in a subgroup (n=21 pregnant, 19 non-pregnant women) at 3 days post-partum. Results: Plasma tHcy concentrations were significantly lower throughout pregnancy compared with control subjects, with values lowest in the 2nd trimester before increasing toward non-pregnant values in the 3rd trimester. Importantly, tHcy concentrations were lower in pregnant women taking folic acid supplements compared to those not, an effect which reached significance in the 3rd trimester (5.25 umol/l v 6.89 umol/l, P <0.05). Furthermore, during the 3rd trimester, tHcy concentrations were significantly higher in pregnant women with a history of miscarriage compared to those with no previous history (7.32 umol/l v 5.62 u­mol/l, P <0.01). Conclusion: This is the first longitudinal study to show that homocysteine levels rise in late pregnancy towards non-pregnant levels; a rise which can be limited by enhancing folate status through continued folic acid supplementation. These results indicate a potential role for continued folic acid supplementation in reducing pregnancy complications associated with hyperhomocysteinaemia.

Isotope Hydrology of the Oldman River basin, southern Alberta, Canada

The partially semi-arid Oldman River basin (OMRB), located in southern Alberta (Canada), has an area of 28 200 km2, is forested in its western headwater part, and is used for agriculture in its eastern part. Hydrometric measurements indicate that flow in the Oldman River has decreased by ~34% between 1913 and 2003, and it is predicted that water withdrawals will increase in the next 20 years. The objective of this study was to determine whether isotope ratio measurements can provide further insight into the water dynamics of the Oldman River and its tributaries. Surface water samples were collected monthly between December 2000 and March 2003. Groundwater samples were taken from 58 wells during one-time sampling trips. Runoff within the OMRB is currently about 70 mm year-1, with a corresponding runoff ratio of 0Ð18. Seasonal flow characteristics are markedly different upstream and downstream of the Oldman River reservoir. Upstream, sharp increases in flow in late spring and early summer are followed by a rapid decrease to base flow levels. Downstream, a prolonged high flow peak is observed due to the storage effect of the Oldman River reservoir. The seasonal variation in the isotopic composition of surface water from upstream sites is small. This suggests that peak runoff is not predominantly generated by melting snow accumulated during the preceding winter, but mainly by relatively well-mixed young groundwater. A significant increase in the d18O and d2H values in the downstream part of the basin was observed. The increase in the isotopic values is partly due to surface water and groundwater influx with progressively higher d18O and d2H values in the eastern part, and partly due to evaporation. Hence, the combination of hydrometric data with isotope measurements yields valuable insights into the water dynamics in the OMRB that may be further refined with more intensive measurement programmes in the future.

Nitrogen budget for the Oldman River Basin, southern Alberta, Canada

The Oldman River Basin (OMRB), located in southern Alberta (Canada), with an area of 28,200 km2, is mainly forested in its western part and is used for intensive agriculture in its eastern part. The objective of this paper is to estimate the nitrogen (N) budget for the Oldman River Basin as a whole and its sub-basins, and to discuss differences in the N budget between various sub-basins. Better knowledge of the N budget in this watershed may be also utilized for understanding N dynamics in similar watersheds within semi-arid climatic regions. The model used is a mass balance spreadsheet model that takes into account N inputs and N export through surface water. During the last 120 years, anthropogenic N inputs to the OMRB have increased circa 40 fold. By the end of the 20th century, the OMRB received an annualN input of about 5174 kg N km-2 yr-1, whereas only about 25 kg N km-2 yr-1 were exported via riverine flow. For the sub-basins, annual N inputs ranged from 2516 to 19011 kg N km-2 yr-1, and annual N export via riverine flows varied between 6 and 277 kg N km-2 yr-1. Over 85% of total N inputs to the OMRB are due to anthropogenic activities, including manure (55%), synthetic fertilizer (27%), and N fixation on agricultural lands (4%). Sewage accounted for less than 1%, and N inputs from atmospheric deposition and fixation in forests represented 6 and 8% respectively. Despite increasing anthropogenic N inputs, N export with riverine flow currently accounts for only 1% of the inputs, indicating thatmost of theNinputs are currently retained in the OMRB or are re-emitted into the atmosphere.

Isotopic Assessment of Sources of Surface Water Nitrate within the Oldman River Basin, Southern Alberta, Canada

Concentrations and isotopic compositions of NO-3 from the Oldman River (OMR) and some of its tributaries (Alberta, Canada) have been determined on a monthly basis since December 2000 to assess temporal and spatial variations of riverine NO-3 sources within the OMR basin. For the OMR sites, NO-3 -N concentrations reached up to 0.34 mg L-1, d15N-NO-3 values varied between –0.3 and +13.8‰, and d18O-NO-3 values ranged from –10.0 to +5.7‰. For the tributary sites, NO-3 -N concentrations were as high as 8.81 mg L-1, d15N-NO-3 values varied between –2.5 and +23.4‰, and d18O-NO-3 values ranged from –15.2 to +3.4‰. Tributaries in the western, relatively pristine forested part of the watershed add predominantly NO-3 to the OMR with d15N-NO-3 indicative of soil nitrification. In contrast, tributaries in the eastern agriculturally-urban-industrially-used part of the basin contribute NO-3 with d15N-NO-3 values of about +16‰ indicative of manure and/or sewage derived NO-3. This difference in d15N-NO-3 values of tributaries was found to be independent of the season, but rather indicates a spatial change in the NO-3 source, which correlates with land use changes within the OMR basin. As a consequence of tributary influx, d15N-NO-3 values in the Oldman River increased from +6‰ in the downstream direction (W to E), although [NO-3 -N] increased only moderately (generally