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To answer this question and establish the strategy to follow in the management of these patients, we have reviewed the INFAC Bulletin published in 2012, the clinical practice guidelines of NICE 2010 and the European Society of Urology 2014 and the consensus on the management of Benign Prostatic Hyperplasia (BPH) developed by various scientific societies, including Semfyc.

The clinical practice guidelines and the documents reviewed recommend different management depending on the severity of the symptoms, assessed with the IPSS scale, International Prostatic Symptom Score. If symptoms are mild (IPSS <8), expectant surveillance is indicated, with lifestyle modification and annual review if there are no changes. On the other hand, if symptoms are moderate-severe (IPSS ≥8), pharmacological treatment is recommended; for this purpose there are several therapeutic alternatives that we will review below.

In relation to the adverse effects of this therapeutic group, it should be noted that in 2011 the FDA issued a safety note recommending that the patient be evaluated to rule out the existence of prostate cancer before initiating treatment with 5-alpha-reductase inhibitors. This recommendation is based on the results of the PCPT and REDUCE studies, which had shown a net decrease in the risk of prostate cancer at the expense of low-grade malignant cancer, while an increase in high-grade malignant prostate cancers was observed. It is believed that this may be due to the fact that these drugs cause a decrease in PSA of up to 50% from baseline, which makes early diagnosis of high-grade cancer more difficult.

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Few people know, but the açaí is one of the healthiest foods that exist. Currently produced in larger numbers in Pará and Amazonas, it is considered an exotic delicacy, an aphrodisiac, and consumed in many places around the world.

To begin with, we will talk about how the fruit is effective in the treatment of some diseases. There are studies that prove that the consumption of açaí fights cancerous diseases, since it is very rich in a specific fat, the oleic acid, blocking genes that cause the disease. Because it leaves the brain always active, it protects against some possible damage that can even develop into Alzheimer’s disease.

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