Application of 16 G Biopsy Needle in Transperineal Template-Guided Prostate Biopsy

2021 ◽  
pp. 1-5
Author(s):  
Xue-fei Ding ◽  
Yang Luan ◽  
An-le Xia ◽  
Liang-yong Zhu ◽  
Qin Xiao ◽  
...  
Keyword(s):  
Pain Score ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Control Group ◽  
Observation Group ◽  
Clinical Value ◽  
Biopsy Needle ◽  
Significant Difference ◽  
Positive Rate ◽  
Biopsy Gleason Score

<b><i>Background:</i></b> The aim of this study was to evaluate the clinical value of 16 G biopsy needle in transperineal template-guided prostate biopsy (TTPB), compared with 18 G biopsy needle. <b><i>Methods:</i></b> The patients who underwent TTPB from August 2020 to February 2021 were randomized into 2 groups using a random number table. The control group (<i>n</i> = 65) and the observation group (<i>n</i> = 58) performed biopsy with 18 G (Bard MC l820) and 16 G (Bard MC l616) biopsy needles, respectively. Positive rate of biopsy, Gleason score, complications, and pain score were statistically analyzed. <b><i>Results:</i></b> The age, prostate volume, PSA, and the number of cores were comparable between the 2 groups. The positive rate of biopsy in the observation group was 68.9% (40/58), meanwhile the control group was 46.2% (30/65). There was statistical difference between the 2 groups (<i>p</i> = 0.011). Gleason score of the observation group (8 [7–9]) was higher than that of the control group (8 [6–9]) (<i>p</i> = 0.038). There was no significant difference in pain score and complications including hematuria, hematospermia, perineal hematoma, infection, and urinary retention between the 2 groups (<i>p</i> &#x3e; 0.05). <b><i>Conclusions:</i></b> 16 G biopsy needle significantly improved the positive rates and accurately evaluate the nature of lesions, meanwhile did not increase the incidence of complications compared with 18 G biopsy needle.

scholarly journals Needle biopsy size and pathological Gleason Score diagnosis: No evidence for a link

2013 ◽  
Vol 7 (9-10) ◽  
pp. 567 ◽  
Author(s):  
Antonio Cicione ◽  
Francesco Cantiello ◽  
Cosimo De Nunzio ◽  
Andrea Tubaro ◽  
Rocco Damiano
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Kappa Statistic ◽  
Study Groups ◽  
Localized Prostate Cancer ◽  
Needle Size ◽  
Biopsy Needle ◽  
Biopsy Gleason Score

Background: Biopsy Gleason score (GS), in combination with other clinical parameters, is important to take a therapeutic decision for patients with diagnosis of localized prostate cancer. However, preoperative GS is often upgraded after a radical prostatectomy. Increasing the amount of tissue in prostate biopsy may be a way to avoid this issue. We evaluate the influence of a larger biopsy needle size on the concordance between biopsy and pathological GS.Methods: We analyzed paired biopsies and prostatectomy specimens from 104 cases of men with clinically localized prostate cancer. At the time of prostate biopsy, the patients were prospectively randomized into two needle groups (16-Gauge [G] and 18G) using a 1:1 ratio. GS concordance was estimated performing kappa statistic testing, overall concordance rate and risk to under grade biopsy GS=6. A logistic regression analysis was performed to evaluate the patients’ characteristics as possible risk factors.Results: The overall concordance between prostate biopsy and pathological GS was 76.9% and 75.6% (p = 0.875) and the k values were 0.821 and 0.811 (p = 0.424), respectively, for 16G and 18G needle study groups. The risk to undergrade a biopsy GS=6 was 21.1% and 15.4% (p = 0.709) using a 16G and 18G needle, respectively. Age, prostate-specific antigen, prostate volume and needle calibre were not independently associated with a higher risk of GS discordance.Conclusions: Needle size does not affect the concordance between biopsy and pathological GS. Although GS is not the only way to determine treatment, it is still an unresolved urological issue.

Analysis on Nursing Effect of Octreotide on Acute Pancreatitis

2021 ◽  
Vol 7 (4) ◽  
pp. 300-307
Author(s):  
Chenxia Wu ◽  
Li He
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Symptoms ◽  
Nursing Intervention ◽  
Effective Rate ◽  
Occurrence Rate ◽  
Control Group ◽  
Observation Group ◽  
Clinical Value ◽  
Nursing Satisfaction ◽  
Satisfaction Scale

To explore the clinical value of octreotide therapy and nursing intervention in patients with acute pancreatitis. 120 patients with acute pancreatitis admitted to the Department of Digestive Medicine from June 2018 to August 2019 were selected. Two groups of patients were treated with octreotide. They were randomly divided into observation group (intensive nursing intervention) and control group (routine nursing) with 60 patients in each group. Compared with the control group (81.67%), the total effective rate (93.33%) was higher in the observation group (P<0.05%); After treatment, C reactive protein, lactate dehydrogenase, WBC and hemodiastase of patients in the observation group were better than those in the control group (P<0.05); compared with the control group (18.33%), the occurrence rate of hypoglycemia in the observation group (6.67%) was lower (P<0.05%); At the same time, the Nursing Satisfaction Scale of the observation group (95.00%) was higher than that of the control group (78.33%), (P<0.05%). Patients with acute pancreatitis treated with octreotide and strengthened nursing intervention can obtain more obvious therapeutic effect, so that the clinical symptoms and related laboratory indicators of patients have been significantly improved. At the same time, the clinical value was significant with a lower occurrence rate of hypoglycemia and higher nursing satisfaction scale.

scholarly journals Predictors of Gleason score upgrading in patients with prostate biopsy Gleason score ≤6

2014 ◽  
Vol 8 (5-6) ◽  
pp. 342 ◽  
Author(s):  
Hasmet Sarici ◽  
Onur Telli ◽  
Orhan Yigitbasi ◽  
Musa Ekici ◽  
Berat Cem Ozgur ◽  
...  
Keyword(s):  
Gleason Score ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Radical Retropubic Prostatectomy ◽  
Small Sample ◽  
Ultrasound Guided ◽  
Increased Risk ◽  
Biopsy Gleason Score

Introduction: The discrepancy between prostate biopsy and prostatectomy Gleason scores is common. We investigate the predictive value of prostate biopsy features for predicting Gleason score (GS) upgrading in patients with biopsy Gleason scores ≤6 who underwent radical retropubic prostatectomy (RRP). Our aim was to determine predictors of GS upgrading and to offer guidance to clinicians in determining the therapeutic option.Methods: We performed a retrospective study of patients who underwent RRP for clinically localized prostate cancer at 2 major centres between January 2007 and March 2013. All patients with either abnormal digital examination or elevated prostate-specific antigen at screening underwent transrectal ultrasound-guided prostate biopsy. Variables were evaluated among the patients with and without GS upgrading. Our study limitations include its retrospective design, the fact that all subjects were Turkish and the fact that we had a small sample size.Results: In total, 321 men had GS ≤6 on prostate biopsy. Of these, 190 (59.2%) had GS ≤6 concordance and 131 (40.8%) had GS upgrading from ≤6 on biopsy to 7 or higher at the time of the prostatectomy. Independent predictors of pathological upgrading were prostate volume <40 cc (p < 0.001), maximum percent of cancer in any core (p = 0.011), and >1 core positive for cancer (p < 0.001).Conclusions: When obtaining an extended-core biopsy scheme, patients with small prostates (≤40 cc), greater than 1 core positive for cancer, and an increased burden of cancer are associated with increased risk of GS upgrading. Patients with GS ≤6 on biopsy with these pathological parameters should be carefully counselled on treatment decisions.

scholarly journals Sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of acute cerebral infarction

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Xuewen Wo ◽  
Jinyan Han ◽  
Jiajia Wang ◽  
Xinmin Wang ◽  
Xiaoying Liu ◽  
...  
Keyword(s):  
Plasma Level ◽  
Cerebral Infarction ◽  
Antiplatelet Therapy ◽  
Adverse Reactions ◽  
Dual Antiplatelet Therapy ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference ◽  
Better Than

Objective: To observe the clinical efficacy of sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of elderly patients with acute cerebral infarction (ACI). Methods: One hundred and twenty-two elderly patients with ACI who were admitted to the department of neurology of our hospital at May 2016-August 2018 were selected grouped into a control group and an observation group by random number table method, 61 in each group. On the basis of conventional treatment, the patients in the control group were given dual antiplatelet therapy (aspirin enteric-coated tablets + clopidogrel bisulfate tablets), while the patients in the observation group were given sequential butylphthalide therapy on the basis of the control group. The clinical effects of the two groups were compared after four weeks of treatment, and the changes of National Institutes of Health Stroke Scale (NIHSS), ADL score, plasma 3-mercaptopyruvate sulphurtransferase (3-MST) and Amyloid β42 (Aβ42) levels and the occurrence of adverse reactions during treatment were recorded. Results: The clinical efficacy of the observation group was better than that of the control group (P<0.05). There was no significant difference in NIHSS and ADL scores between the two groups before treatment (P>0.05). After treatment, the NIHSS and ADL scores of the observation group were better than those of the control group (P<0.05). There was no significant difference in plasma levels of 3-MST and AB42 between the two groups before treatment (P>0.05). The level of plasma 3-MST in the observation group was higher than that in the control group, and the level of plasma Aβ42 was lower than that in the control group (P<0.05). No serious adverse reactions occurred during the treatment period in both groups. Conclusion: Butylphthalide sequential therapy combined with dual antiplatelet therapy is effective in the treatment of elderly ACI. It can effectively improve the plasma level of 3-MST and decrease the plasma level of Aβ42, which is conducive to improving the living ability and neurological function of patients and has high safety. doi: https://doi.org/10.12669/pjms.36.4.1831 How to cite this:Wo X, Han J, Wang J, Wang X, Liu X, Wang Z. Sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of acute cerebral infarction. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1831 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Observations on the Application of Nursing Risk Management in the Care of Critically Ill Patients in the Respiratory Unit

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Yannan Sun
Keyword(s):  
Risk Management ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Treatment Satisfaction ◽  
Clinical Symptoms ◽  
Statistical Significance ◽  
Management Model ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference

 Objective: Investigate the effectiveness of nursing risk management in the care of critically ill patients in the respiratory unit. Methods: Among the critically ill respiratory patients admitted to our hospital between May 2019 and April 2020, 78 patients were randomly selected and divided into an observation group and a control group, each consisting of 39 patients. In the observation group, a nursing risk management model was implemented, i.e., patients' clinical symptoms were observed at any time to monitor their treatment satisfaction and the effectiveness of their care and routine care was implemented for the control group. Results: The heart rate, respiratory rate, and pH of patients in the observation group were more stable than those in the control group, and their respiratory status was better, with differences in data. There was also significant statistical significance (P<0.05). The incidence of patient-provider disputes, unplanned extubation, and unplanned events were lower in the observation group compared to the control group, and their data difference was statistically significant (P<0.05). The treatment satisfaction as well as the total effective rate of patients in the observation group was also much higher than that of the control group, and there was also a statistically significant difference in the data (P<0.05). Conclusion: The nursing risk management model has a significant therapeutic effect in the care of critically ill respiratory patients. Therefore, it is worth popularizing to use in the clinical nursing of respiratory critical patients.

scholarly journals Study on the Effect of Pain Nursing Intervention in ENT Wards

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Baoyi Huang ◽  
Fengmei Xu ◽  
Hongmei Kuang
Keyword(s):  
Quality Of Life ◽  
Severe Pain ◽  
Nursing Intervention ◽  
Control Group ◽  
Nursing Interventions ◽  
Observation Group ◽  
Clinical Value ◽  
Clinical Nursing ◽  
And Control

Objective: To explore the effectiveness of pain nursing interventions for patients in ENT. Methods: The 200 ENT patients admitted from March 2018 to March 2020 were divided into observation group (n=100) and control group (n=100). The control group was used conventional clinical nursing methods, and the observation group received pain nursing intervention as a comparison with the control group. Results: The observation group had 83 cases, 14 cases and 3 cases of mild, moderate and severe pain, respectively, while the control group are of 43 cases, 43cases and 14 cases. Nursing intervention can significantly reduce the pain of patients after otolaryngology surgery, improve the quality of life of patients, and has high clinical value for application.

scholarly journals Analysis of the clinical value of Baogan Lishui decoction and convetional western medicine in treating Hepatitis B cirrhosis refractory ascites

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Huaide Lin
Keyword(s):  
Chinese Medicine ◽  
Hepatitis B ◽  
Combination Treatment ◽  
Western Medicine ◽  
Clinical Effect ◽  
Refractory Ascites ◽  
Control Group ◽  
Observation Group ◽  
Quality And Safety ◽  
Clinical Value

Objective: To investigate the clinical effect of combination treatment of Chinese medicine Baogan Lishui decoction and western medicine on hepatitis B cirrhosis related refactory ascites.Method: Control group was given conventional western medicine therapy while the observation group was given same conventional western medicine therapy with additional of Chinese medicine Baogan Lishui decoction.Result: The total effective of clinical treatment on hepatitis B cirrhosis related refractory ascites in observation group was higher than that of the control group which was 88.89% compared to 71.11%, respectively and it was significant different (p<0.05).Conclusion: The combination treatment of Chinese medicine Baogao Lishui decoction and conventional western medicine can significantly increased the treatment effect on hepatitis B cirrhosis refractory ascites, and thus increases the quality and safety of life.

scholarly journals Efficacy of carprostol tromethamine combined with mifepristone in the treatment of uterine fibroids

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Jun Wang ◽  
Xian Zhang
Keyword(s):  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Treatment Effect ◽  
Uterine Fibroids ◽  
Operation Time ◽  
Clinical Treatment ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference ◽  
Better Than

【Abstract】Objective: To investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids. METHODS: A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as subjects. According to the two different treatment methods, patients were divided equally. The observation group and the control group, each group of 33 people. The oxytocin drug treatment was medicated to the control group, and the prostaglandin tromethamine combined with mifepristone was medicated to the observation group. The treatment effect, adverse reaction, operation, and uterine muscle before and after surgery were observed in these two groups. Tumor tissue progesterone receptor and estrogen receptor levels. Results: The clinical treatment effect of the observation group was 93.94%, and the clinical treatment effect of the control group was 60.61%. The clinical treatment effect of the observation group was significantly higher than that of the control group; also the incidence of adverse reactions in the observation group in terms of rash, fatigue, nausea and vomiting was much lower than the control group, and could observe a significant difference. Finally in observation group, the amount of intraoperative blood loss, operation time and hospitalization time were better than those of the control group. The progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group, it is worth to make further comparison. Conclusion: Carprostol tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.

Effect of alpha-blocker use on morbidity and lower urinary tract symptoms in patients undergoing transrectal ultrasound-guided prostate biopsy

2021 ◽  
pp. 039156032110383
Author(s):  
Remzi Salar ◽  
Güven Erbay
Keyword(s):  
Prostate Biopsy ◽  
Voiding Dysfunction ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Urine Volume ◽  
Maximum Flow ◽  
Control Group ◽  
Alpha Blocker ◽  
Urinary Tract Symptoms ◽  
Significant Difference

Objective: To evaluate voiding dysfunction and morbidity after transrectal ultrasound (TRUS)-guided prostate biopsy and to investigate whether pre-intervention alpha-blocker treatment had any effect on morbidity and voiding dysfunction. Material and methods: The study included 197 consecutive patients who underwent TRUS-guided prostate biopsy between January 2014 and January 2018. The patients were divided into two groups, those receiving alpha-blocker (silodosin) and those not receiving alpha-blocker treatment before the procedure (controls). All patients were evaluated before and one week after the procedure with the International Prostate Symptom Score (IPSS), measurements of maximum flow rate ( Qmax), post-void residual urine volume (PVR) and prostate volume, and procedure-related complications were also recorded. All analyzed parameters were compared by within-group and between-group evaluations. Results: There was no significant difference between the two groups in terms of IPSS, Qmax and prostate volume values before biopsy. In the follow-up evaluation performed on the seventh day after biopsy, IPSS, PVR and prostate volume were found to be increased, whereas Qmax was decreased in the control group ( p < 0.05). In the silodosin group, an increase in prostate volume was observed, but there were no significant changes in IPSS, Qmax and PVR values. Acute urinary retention (AUR) after the biopsy procedure developed in two patients (2%) in the silodosin group, and in nine patients (9.1%) in the control group ( p = 0.02). No significant difference was found between the two groups in terms of biopsy-related complications, except for AUR. Conclusion: We believe that alpha-blocker treatment initiated before biopsy may be advantageous in preventing voiding dysfunction that may develop after the procedure.

scholarly journals Effectiveness of Transversus Abdominis Plane Block for Postoperative Analgesia in Obstetric Cases Undergoing Caesarean Section

2019 ◽  
Vol 4 (2) ◽  
pp. 755-758
Author(s):  
Roshan Pradhan ◽  
Seema Kumari Mishra ◽  
Lalit Kumar Rajbanshi ◽  
Kanak Khanal ◽  
Batsalya Arjyal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Rescue Analgesia ◽  
Visual Analogue Pain ◽  
Significant Difference

Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption. Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section. Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively. Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points.  Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

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