scholarly journals Study on individualized prostate biopsy guided by prostate specific antigen at different ranges

2021 ◽  
Vol 5 (1) ◽  
pp. 8-12
Author(s):  
Jin-Qi Song ◽  
Ya-Nan Zhou ◽  
Gang-Liang Tu ◽  
Hui Xu ◽  
Meng Ding

Background: Prostate specific antigen (PSA) is the most commonly used indicator for screening of prostate cancer(PCa), and the studies on PSA in PCa are very extensive at present. How to effectively use this indicator is worth for further study which this article wish to address.  Objective: The aim of this study is to explore how PSA in different ranges can better guide the individualized prostate biopsy.  Methods: A total of 117 patients with suspected PCa admitted to the Affiliated Hospital of Chengde Medical College from October 2018 to July 2020 were selected as the research subjects. PSA level and ratio of free and total PSA (F/TPSA) value of each patient were measured, and ultrasound-guided transrectal prostate biopsy was conducted for each patient, and then the PSA measurement results were compared with the prostate biopsy results.  Results: The result of biopsy was PCa in 40 cases, BPH in 77 cases. The positive expression rates of Group I in BPH and PCa patients were 25.97% and 87.50%, respectively, and the difference was statistically significant (P < 0.05).The positive expression rates of Group II in BPH and PCa patients were 10.39% and 75.00%, respectively, and the difference was statistically significant (P < 0.05). The sensitivity, specificity, positive predictive value and diagnostic coincidence rates of Group I and Group II were 87.50%, 74.03%, 63.63%, 78.63% and 75.00%, 89.61%, 78.94% and 84.62%, respectively.  Conclusion: Under different TPSA intervals, F/T < 0.16 has different diagnostic efficacy for PCa. Group I is more sensitive and suitable for early screening. Group II has stronger specificity in the diagnosis of PCa, Higher diagnostic coincidence rate, and has more diagnostic advantages before biopsy. Selecting Group II can help clinicians make more patient-friendly decisions and reduce the incidence of complications related to biopsy. According to patients’ aspiration for biopsy, auxiliary examinations such as magnetic resonance scan of prostate and bone scan should be performed actively for patients who meet the criteria I if they refuse to undergo biopsy. On the premise of not affecting PCa secondary prevention as much as possible, a more individualized biopsy plan was developed for patients. 

2020 ◽  
Vol 17 (2) ◽  
pp. 82-86
Author(s):  
Am Anamur Rashid Choudhury ◽  
Md Waliul Islam ◽  
Md Golam Mowla Chowdhury ◽  
Tasmina Parveen ◽  
Parveen Sultana

Objectives : To evaluate complications in Intra-prostatic local Anaesthesia and Periprostatic local Anaesthesia for TRUS Guided Prostate Biopsy. Methods: This study was carried out in the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College (DMCH) and Comfort Nursing Home, Dhaka during the period of January 2009 to October 2009, evaluate complications between periprostatic with intraprostatic local anaesthesia for transrectal prostate biopsy. For this purpose, a total number of 60 consecutive patients having increased prostate specific antigen (PSA >4.0ng/ml), abnormal DRE/transrectal ultrasound were admitted in the above mentioned hospitals were enrolled in this study for surgical management. Result : The age ranged from 50 to 90 years and the maximum number was found in the age group of 61-70 years in both groups. The mean(±SD) age was 68.5±7.5 years and 70.3±8.2 years in group I and group II respectively. No systemic lidocaine toxicity was observed in group II. But only dizziness were found in 2 cases (6.7%) and visual disturbance were found in 1 (3.3%) case respectively in group I. Urinary tract infection was found 2(6.7%) in group I and 1(3.3%) in group II patients. Hematuria was found 23(76.7%) in group I and 19(63.3%) in group II. Rectal bleeding was found 14(46.7%) in group I and 11(36.7%) in group II. The statistically not significant (p>0.05) between two groups in chi square and fisher exact test respectively. Conclusion : It is a simple and safe method that is less painful and it should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy. Complications wer4e less in intra-prostatic local anaesthesia than periprostatic local anaesthesia for TRUS guided prostate Biopsy. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.82-86


2020 ◽  
Vol 15 (2) ◽  
pp. 33-39
Author(s):  
AM Anamur Rashid Choudhury ◽  
Md waliul Islam ◽  
Sharif Shahjamal ◽  
Kazi Rafiqul Abedin ◽  
Abu Bakar Siddique ◽  
...  

Objectives: To compare pain, systemic lidocaine toxicity and complications between periprostatic with intraprostatic local anaesthesia for transrectal prostate biopsy. Methods: This study was carried out in the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College (DMCH) and Comfort Nursing Home, Dhaka during the period of January 2009 to October 2009, For this purpose, a total number of 60 consecutive patients having increased prostate specific antigen (PSA >4.0ng/ml), abnormal DRE/transrectal ultrasound were admitted in the above mentioned hospitals were enrolled in this study for surgical management. Results: The age ranged from 50 to 90 years and the maximum number was found in the age group of 61-70 years in both groups. The mean(±SD) age was 68.5±7.5 years and 70.3±8.2 years in group I and group II respectively. The mean(±SD) PSA was 17.0±12.8ng/ ml with their PSA ranged from 5.9- 62.8ng/ml in group I and in group II was 17.2±17.3ng/ml with their PSA ranged from 4.6 – 55.1ng/ml, which was not significant (p>0.05) between two groups. Normal digital rectal was found 14(46.7%) and 16(53.3%) in group I and group II respectively. Carcinoma was found 13(43.3%) and 14(46.7%) in group I and group II respectively and rest of them were benign in group I and group II respectively. The mean(±SD) pain degree during biopsy was 2.6±1.1 and 2.0±1.2 in group I and group II respectively according to allocated pain score. Pain degree after 30 minutes of biopsy, most of the patients had no pain in both groups. Pain during anesthesia it was found that 4(13.3%) and 13(43.3%) of the patients had no pain in group I and group II respectively. The mean(±SD) pain degree during anesthesia was 2.7±1.2 and 2.1±1.2 in group I and group II respectively. Conclusion: It is a simple and safe method that is less painful and it should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy. The decreased discomfort of this procedure may enable more core biopsies to be taken in patients at high risk for prostate cancer or in those with an enlarged prostate Bangladesh Journal of Urology, Vol. 15, No. 2, July 2012 p.33-39


2005 ◽  
Vol 43 (1) ◽  
Author(s):  
Yılmaz Aksoy ◽  
Hülya Aksoy ◽  
Münacettin Ceviz ◽  
Ahmet Yavuz Balcı ◽  
Güray Okyar ◽  
...  

AbstractThe aim of this study was to investigate whether or not there is an increase in serum total and free prostate specific antigen levels (t-PSA, f-PSA) in patients with and without benign prostatic hyperplasia (BPH) undergoing extracorporeal circulation during cardiovascular bypass. The study included a total of 50 men. Of these, 35 patients underwent elective coronary artery bypass grafting with extracorporeal circulation [with (n=20, group I) and without (n=15, group II) BPH]. Another 15 patients underwent renal or ureteral surgery (group III) and served as a control group. Serum t-PSA and f-PSA levels were measured before surgery and 3h and 3days after surgery. All patients underwent urethral catheterization 24h before surgery. In groups I and II, patients had an increase in t-PSA 3h after surgery compared to baseline values (p=0.0001 and p=0.011, respectively). Also, 3days after surgery, mean t-PSA levels were higher than baseline levels (p=0.004) in group I. Serum t-PSA levels were higher at 3h than at day 3 in groups I and II (p=0.003 and p=0.02, respectively). Mean serum f-PSA levels obtained 3h after surgery were increased in both groups I and II when compared to baseline values (p=0.0001 and p=0.001, respectively). There was no significant difference between f-PSA values before and 3days after surgery in all groups. In the control group, there was no significant increase in either serum t-PSA or f-PSA levels obtained at different times. There was a modest increase in the percentage of free prostate specific antigen (% f-PSA) 3h after the operation in group II (p=0.025); the values returned to baseline within 3days. It was suggested that t-PSA and f-PSA serum levels increase due to extracorporeal cardiopulmonary circulation as a consequence of ischemic damage to the prostate. In patients with BPH, this rise may be higher than in those without BPH, because BPH patients generally have larger prostate volumes that may be more vulnerable to ischemic damage. Because f-PSA has a shorter half-life, postsurgical levels of f-PSA may not show this ischemic damage to the prostate during the late postoperative period and f-PSA appears to be cleared more rapidly than t-PSA.


2012 ◽  
Vol 19 (1) ◽  
Author(s):  
Zulfian Hasibuan ◽  
Soetojo Wirjopranoto ◽  
Wahjoe Djatisoesanto ◽  
Widodo J Pujiraharjo

Objective: Determine change in serum prostate-specific antigen (PSA) and International Index of Erectile Function (IIEF-5) following transurethral resection of the prostate (TURP). Material & Method: Eighteen men with age range of 50 – 69 years, were divided in two groups, group I 50-59 years (mean 56,5) and group II 60-69 years (mean 67,2). Both groups underwent measurement of serum PSA and IIEF-5 pre-operative, and repeated at 30, 60, and 90 days after TURP. Results: Level of serum PSA after TURP is decreased in most patients after 30, 60, and 90 days (72%, 72% and 78%). Mean value of PSA pre-operatively is 5,3 ± 3,3 ng/ml. After TURP, serum PSA level was 3,5 ± 3,0 ng/ml (30 days); 2,9 ± 2,9 ng/ml (60 days) and 1,8 ± 1,3ng/ml (90 days). Pre-operative PSA level was significantly decreased in Group I during the 60 and 90 days post TURP, while in Group II pre-operative PSA level was significantly decreased only in 90 days of observation. Overall there is no significant difference in PSA levels in both groups (p > 0,05). The decrease of PSA per gram resected in 30, 60, and 90 days were 0,10 ng/ml; 0,16 ng/ml and 0,24 ng/ml consecutively. There is no change in normal IIEF-5 score. Decrease of the IIEF-5 score in group I was measured at 30 days, but the score increased after 60 and 90 days. Meanwhile Group II showed decrease of IIEF-5 score. Pre-operative IIEF-5 score compared to the 30 days post TURP was significantly different but not significantly different compared with to score at 60 and 90 days. In Group I IIEF-5 score was significantly higher compared to Group II (p < 0,05). Prostatitis was found in 8 patients, but there is no difference in serum PSA level decrease between patients with or without prostatitis. Conclusion: There was significant decrease in serum PSA after TURP in BPH patients with LUTS at every measurement at 30, 60, and 90 days. PSA level after TURP depends on various factors, including pre-operative PSA, pre-operative prostate volume and prostate volume resected. Incidence of erectile dysfunction post TURP was low. Keywords: Prostate-specific antigen, benign prostatic hyperplasia, transurethral resection of the prostate, erectile dysfunction.


2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Budi Utomo ◽  
Yulianto Wahyono

Abstract : Nerve Mobilization, Myofacial Release, Carpal Tunnel Syndrome. Carpal tunnel syndrome (CTS) is defined with signs and symptoms resulting from compression of the median nerve at the wrist. CTS lead to discomfort and pain, limited daily activities, sleep deprivation and the inability to work. Nerve mobilization is manipulative technique in which the nerve tissue is moved and stretched out both motions relative to the surrounding (interface mechanical) or with the development of tension. Myofascial Release (MFR) refers to massage techniques, instructions for stretching the fascia and releasing bonds between fascia and integument, muscles, bone, with the aim to relieve pain, increase range of motion and balance the body. Some research concluded the difference in the length of time the treatment is with a shorter time can produce significant pain reduction. The aim of this study was to determine the effect of the difference between the provision of nerve mobilization and myofacial release to the reduction of pain in patients with carpal tunnel syndrome. This research is a quasi experimental study with two group pre test and post test control design. The subjects were all patients diagnosed with carpal tunnel syndrome who came to the clinic physiotherapy Dr. Moewardi Surakarta hospital who met the inclusion criteria, exclusion and drop out. Number of research subjects in group I, amounting to 8 people and group II amounted to 7 people. Group I was treated nerve mobilization and group II were treated Myofacial release. Treatment was given 2 times per week for 3 weeks. Results: (1) mobilization of the nerve may reduce pain in patients with CTS (p = 0.012), (2) MFR can reduce a patient's pain CTS (p = 0.018), (3) there is no difference between mobilization nerves and MFR to reduce pain CTS patients (p= 0.189).


2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Michael Maddox ◽  
Joseph Renzulli ◽  
Dragan Golijanin ◽  
Sammy Elsamra ◽  
Matthew Somerville ◽  
...  

1960 ◽  
Vol 11 (1) ◽  
pp. 75 ◽  
Author(s):  
M Wodzicka

The monthly wool growth of three groups of rams was studied at Beltsville, Maryland. Group I received natural daylight (at 38° 53' N.) and was shorn monthly. Group II had a 7:17 hours of daylight to hours of darkness rhythm and was shorn every 6 months, once in winter and once in summer. Group III received natural daylight and was likewise shorn every 6 months. The rams of all groups produced more wool in summer than in winter. This difference was significant (P<0.001). The mean body weight and food intake were both greater in the winter months, which indicated that the seasonal rhythm of wool growth was not a consequence of poorer feeding in winter. The rams which were shorn monthly (group I) grew considerably more wool than the other two groups, but the difference was not statistically significant. The short-day treatment of group II did not increase the annual wool production nor decrease the seasonal rhythm of wool growth. The balance of evidence from this and other experiments indicates that temperature rather than light controls the seasonal rhythm of wool growth.


2010 ◽  
Vol 138 (1-2) ◽  
pp. 50-55 ◽  
Author(s):  
Biljana Pejovic ◽  
Milica Rankovic-Janevski ◽  
Niveska Bozinovic-Prekajski

Introduction. Drug safety depends on trough levels. Objective. Objective of the study was to measure gentamicin and amikacin trough levels in neonates and to identify risk groups by gestational and postnatal age. Methods. Gentamicin and amikacin were applied according to the clinical practice guidelines. Trough levels (mg/l) were deter- mined using fluorescence polarization immunoassay methodology. Target trough levels were <2 mg/l for gentamicin, and <10 mg/l for amikacin. Patients were divided in 3 groups by gestational age: I ?32, II 33-36, and III ?37 gestational weeks and, by postnatal age, in 2 groups: ?7 and >7 days. Results. Out of 163 neonates, 111 were receiving gentamicin and 52 amikacin. Mean amikacin trough level was 7.8?4.8 mg/l and, in group I 10.5?4.9 mg/l, which was above the target range and significantly higher than in group II (LSD, p<0.05). In the amikacin group, 26 patients were 7 and less, and 26 more than 7 days old, without significant differences in trough levels between the groups. In the gentamicin group, 52.3% of neonates had trough values within the target range. Gentamicin trough level in group I was above the trough range, 3.7?1.8, 2.3?1.5 in group II and, 1.8?1.4 mg/l in group III. The difference in trough levels among the groups was highly significant (F=9.015, p<0.001, ?2=17. 576, p<0.001). Further analysis revealed that differences between groups I and II (LSD, p=0.002) and between I and III (LSD, p=0.000) were highly significant. Conclusion. Obtained gentamicin and amikacin trough levels are high. Inverse correlation has been confirmed between trough level and gestational age, with highly significant difference, and the risk group has been identified. There is obviously a need to change the dosing regimen in terms of those with extended intervals, particularly for neonates of the lowest gestational age, along with pharmacokinetic measurements.


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