scholarly journals Role of flexible cystoscopy and ultrasound in the detection of recurrent Bladder Tumour

KYAMC Journal ◽  
2013 ◽  
Vol 3 (1) ◽  
pp. 214-219
Author(s):  
Md Mohsin Uddin ◽  
A K M Anwarul Islam ◽  
Md Saiful Islam
Keyword(s):  
Effective Means ◽  
Bladder Tumour ◽  
Transitional Cell ◽  
False Negative ◽  
Abdominal Ultrasound ◽  
Flexible Cystoscopy ◽  
Prospective Comparative Study ◽  
The Cost

Background: Rigid cystoscopy under anaesthesia for the surveillance of recurrent bladder tumour creates a large urological workload. Recently, flexible cystoscopy became a popular alternative and an easy, safe and effective means of check cystoscopy in following-up patients of superficial transitional cell carcinoma (TCC) of the urinary bladder. Because of the frequency of tumor recurrences and the necessity of finding, whether a less invasive, easily repeatable investigation is capable of providing precise information about the bladder cavity, and, could decrease the frequency of repeated rigid cystoscopy under anaesthesia and inpatient admission; we have decided to perform this study. Methods: This is a prospective comparative study that involved 85 patients (70 male and 15 female) with a mean age of 61 years (41-80 years), who had undergone one or more transurethral resections for TCC of bladder (stage pTa and pT1; grade I and II.) in the department of Urology, BSMMU between July 2005 -Feb 2007. Ultrasonography(USG) of the bladder was performed one week before check cystoscopy. We have calculated sensitivity and accuracy of USG and flexible in comparison to rigid cystoscopy.Results: Eighty five (85) sessions of follow-up investigations- Ultrasound and flexible cystoscopy showed 31 recurrences confirmed by rigid cystoscopy and biopsy. In over 85 rigid cystoscopies, 54 were negative and 31 were positive for tumour. Sensitivity, the most important parameter, was 97% for the two examinations together. Each method separately had the following sensitivity: ultrasound 77%; flexible cystoscopy 90%.Conclusion: Considering that there was only one false-negative result of combined abdominal ultrasound and flexible cystoscopy; with this follow-up scheme we could have saved our patient from rigid cystoscopies, reducing the cost of in-patient admission and anaesthesia.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13655 KYAMC Journal Vol. 3, No.-1, June 2012 pp.214-219

scholarly journals Audit of safety, efficacy, and cost-effectiveness of local anaesthetic cystodiathermy

2010 ◽  
Vol 92 (8) ◽  
pp. 706-709 ◽  
Author(s):  
Kim Davenport ◽  
Francis X Keeley ◽  
Anthony G Timoney
Keyword(s):  
Cost Effectiveness ◽  
Local Anaesthetic ◽  
Past History ◽  
Transitional Cell ◽  
General Anaesthetic ◽  
Patient Anxiety ◽  
Bladder Transitional Cell Carcinoma ◽  
Flexible Cystoscopy ◽  
History Of

INTRODUCTION The aim of this study was to audit our experience of cystodiathermy under local anaesthetic (LA) at the time of flexible cystoscopy for recurrent superficial bladder transitional cell carcinoma (TCC). PATIENTS AND METHODS A total of 264 flexible cystoscopies were performed on patients with a past history of TCC. The number and site of recurrences were recorded and selected patients were offered cystodiathermy. Patient tolerability was noted. At follow-up, any recurrence was recorded. RESULTS Eighty patients (30%) had 91 procedures showing one or more recurrences. Fifty-one of the 80 patients (64%) were treated with cystodiathermy under LA. All completed treatment. Forty-five (88%) tolerated the procedure well. Forty-seven (92%) treatments were completed within 5 min. At a median follow-up of 15 weeks, 30 (59%) treated patients had no recurrence and three (6%) had recurrence at the site of treatment. CONCLUSIONS LA cystodiathermy is an effective and well-tolerated alternative to general anaesthetic cystodiathermy that enables treatment at the time of detection and may, thereby, reduce patient anxiety.

Transforming Music Teaching via Technology: The Role of Professional Development

2003 ◽  
Vol 51 (4) ◽  
pp. 289-301 ◽  
Author(s):  
William I. Bauer ◽  
Sam Reese ◽  
Peter A. McAllister
Keyword(s):  
Professional Development ◽  
Music Teachers ◽  
Effective Means ◽  
Music Technology ◽  
Music Teaching ◽  
Demographic Information ◽  
Teaching Music ◽  
K 12

The purpose of this study was to determine if 1-week technology workshops can be an effective means for the professional development of music teachers in using technology for instruction. The results indicate that three indicators of effectiveness—teacher knowledge, teacher comfort, and frequency of teacher use—can he significantly improved in these settings. Participants ( N = 63) were music teachers enrolled in summer music technology workshops. At the beginning of the workshops, participants completed a questionnaire designed to provide demographic information and assess their knowledge of music technology, degree of comfort with music technology, and the frequency with which they used music technology in their teaching. Following an intensive weeklong workshop dealing with strategies for teaching music to K—12 students using music technology, participants completed a second questionnaire that was parallel to the first. Participants completed another similar questionnaire 9 to 10 months after the workshop. Significant differences were found between the pre-and. postworkshop questionnaires, between the preworkshop and follow-up questionnaires, and, between the postworkshop and follow-up questionnaires in all three areas. There was also a moderate correlation ( r = .43, p = .00) between participants' frequency of technological use and the degree to which they reported their access to technological resources.

FDG-PET in the Serial Assessment of Patients with Lymphoma in Complete Remission.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 216-216 ◽  
Author(s):  
Pier Luigi Zinzani ◽  
Vittorio Stefoni ◽  
Valentina Ambrosini ◽  
Enrico Derenzini ◽  
Gerardo Musuraca ◽  
...  
Keyword(s):  
Complete Remission ◽  
Fdg Pet ◽  
False Negative ◽  
Great Majority ◽  
True Negative ◽  
Non Hodgkin Lymphoma ◽  
Pet Scans ◽  
Negative Scan

Abstract FDG-PET role in the assessment of lymphoma patients is well established but only few papers evaluated the usefulness of FDG-PET during follow up. Aim: to prospectively investigate the value of serial FDG-PET scans in the follow up of lymphoma patients in complete remission. All lymphoma patients who achieved a complete remission were prospectively enrolled in the study and scheduled for serial FDG-PET scans at 6, 12, 18 and 24 months; further scans were then carried out on annual basis (overall 421 pts, 160 pts with Hodgkin’s Disease (HD) and 261 pts with non-Hodgkin Lymphoma (NHL) were studied). All patients had a final assessment using other imaging procedures and/or biopsy and/or clinical evolution. FDG-PET findings were reported as positive, indeterminate or negative for relapse; after comparison with all available data, PET results were categorized as true positive (TP), true negative (TN), false positive (FP), indeterminate turned out to be relapse (I+) and indeterminate turned out to be complete remission (I-). Results: PET documented relapse in 42 cases at 6 mo (14 HD (8.8%) and 28 NHL (10.7%); in 31 cases at 12 mo (14 HD (9.5%) and 17 NHL (7.3%); in 27 cases at 18 mo (6 HD (4.5%) and 21 NHL (3.2%); in 9 cases at 24 mo (3 HD (2.4%) and 6 NHL (3.2%); and in 5 cases at > 36 mo (2 HD (2.8%) and 3 NHL (6.5%). Out of 125 scans reported as positive for relapse, 109 turned out to be TP (PPV of 87%); no false negative scan was recorded, and in the great majority of cases PET detected the presence of relapse before clinical evidence. Our results confirm that FDG-PET is a valid tool for lymphoma patients follow-up. The higher incidence of relapse occurred in both HD and NHL quite early after complete remission (at 6 and 12 months for HD and at 6, 12 and 18 months for NHD), thus confirming the usefulness of performing FDG-PET scans at these times in order to identify recurrence. The role of serial PET at later times (after 18 months for HD and 24 months for NHL) was found less relevant.

scholarly journals Role of topical cyclosporine in prevention of pterygium recurrence, after primary excision.

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Munawar Ahmed
Keyword(s):  
Healing Time ◽  
Complete Healing ◽  
P Value ◽  
Eye Drops ◽  
Fellow Eye ◽  
Department Of Ophthalmology ◽  
Prospective Comparative Study ◽  
Recurrent Pterygium

Role of topical cyclosporine in prevention of pterygium recurrence, after primary excision. Purpose: To evaluate the effect of cyclosporine on pterygium recurrence after primary excision Study Design: Non randomized prospective comparative study. Place and Duration of Study: The study was conducted in the department of Ophthalmology Liaquat University of Medical and Health Sciences Jamshoro from 2015 to 2017 Material and Methods: One hundred and thirty eyes of 65 patients having bilateral pterygium, at least 2mm encroaching on the cornea, were randomly selected for study. After informed consent patient was seen on slit lamp, the dimensions of pterygium was measured. The eye with more pterygium was selected for post-operative cyclosporine and was named as cyclo- eye and fellow eye was selected for simple excision and was named as non-cyclo eye. Immediate post-operative treatment was tobramycin dexamethasone eye ointment twice and moxifloxacine eye drops three times daily until corneal epithelium was restored, followed by moxifloxacine and Cyclosporine eye drops twice daily until complete healing of ocular surface occurred and then cyclosporine 0.05% alone once daily in the evening up to three months. In the fellow eye tobramycin dexamethasone eye ointment and moxifloxacine eye drops were used for complete healing time followed by tears alone three times for three months. Recurrence was defined as 1mm encroachment of pterygium on the cornea. Follow up was done for six months. Results: Fifty-three patients who completed 6 months follow were only included in the results. In cyclo-eyes recurrent pterygium was observed only in 04(07.55%) and in non-cyclo eyes recurrence was observed in 23(43.40%). Therefore, cyclosporine was able to reduce pterygium recurrence further in 19(35.85%) eyes, but healing time increased. Mean healing time in cyclo-eyes 21.1354 days and in non-cyclo-eyes 15.0213 days. Standard deviation in cyclo-eyes 1.3412 and in non-cyclo-eyes 1.0413. P-value was 0.002 and 0.004 respectively. Conclusion: Cyclosporine is effective in reducing the recurrence rate of pterygium. Key words: Pterygium, cyclosporine, recurrence  

scholarly journals What is the role of bronchial thermoplasty in the management of severe asthma?

2018 ◽  
Vol 12 ◽  
pp. 175346661879241
Author(s):  
Aoife O’Reilly ◽  
Stephen Lane
Keyword(s):  
Efficacy And Safety ◽  
Inhaled Corticosteroid ◽  
Comorbid Conditions ◽  
Persistent Effect ◽  
Bronchial Thermoplasty ◽  
Chronic Inflammatory Condition ◽  
The Cost ◽  
The Ideal

Asthma is a common chronic inflammatory condition of the airways. Conventional therapy comprises inhaled corticosteroid and bronchodilators as well as trigger avoidance and management of comorbid conditions. A small group remain symptomatic despite these strategies and novel therapies have been developed. Bronchial thermoplasty is a nonpharmacological therapy which targets airway smooth muscle to improve asthma control. Clinical trials to date have shown the efficacy and safety of bronchial thermoplasty with a persistent effect on extended follow up. Questions remain regarding the exact mechanism of action of bronchial thermoplasty, the cost effectiveness of the procedure and the ideal criteria for patient selection.

Transitional cell carcinoma of the upper urinary tract: Follow-up and prognostic factors

1996 ◽  
Vol 63 (1) ◽  
pp. 50-54
Author(s):  
F. Pagano ◽  
A. Tasca ◽  
C.A. Levorato
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Survival Rate ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Univariate Analysis ◽  
Bladder Tumour ◽  
Transitional Cell ◽  
Overall Survival Rate

— Of the 176 patients treated in our Institute over the last 16 years for upper tract transitional cell carcinoma (UTTCC), 155 were included in this study, 97 of whom had undergone nephroureterectomy, 28 conservative surgery and 30 endourologic treatment. The overall survival rate at 5 and 10 years was 73% and 58%, respectively. Univariate analysis of overall survival rate (O.S.) and disease-free survival rate (D.F.S.) showed no difference between patients with superficial and with invasive tumours, while multivariate analysis highlighted a difference. No difference was evident upon univariate and multivariate analysis of the patients with superficial tumours who underwent conservative (19) vs. radical (45) surgery. The same can be said for the so-called good prognosis tumours (pTa-T1-G2) and poor prognosis tumours (pT1-G3, pT2-4, G2-3) submitted to radical surgery. Overall survival was better in patients with no recurrent tumours compared to those with recurrences; furthermore prognosis was worse for patients with more than 2 recurrences. Tumour site, mono or multifocality and associated bladder tumour did not influence prognosis. Our experience confirms the basic importance of grade as a prognostic factor for UTTCC and the favourable prognosis for patients with superficial tumours, regardless of surgical technique. A rigid follow-up is mandatory for patients with more than 2 recurrences.

The Nurse Cystoscopist Extending the Role

2005 ◽  
Vol 15 (8) ◽  
pp. 342-345
Author(s):  
Isobel Forsyth ◽  
Shafaque Shaikh ◽  
Iain Gunn
Keyword(s):  
Waiting Times ◽  
Bladder Tumour ◽  
Direct Access ◽  
Patients Experience

Nurse-led cystoscopy has become an established service for bladder tumour surveillance patients. The role of the nurse cystoscopist has been developed to include diagnostic cystoscopy with telephone follow-up and counselling. Direct access to the service has reduced waiting times from presentation to diagnosis. The telephone follow-up has improved patients' experience of a diagnostic urology service.

The Cost of Bladder Tumour Treatment and Follow-up

2002 ◽  
Vol 36 (5) ◽  
pp. 344-347 ◽  
Author(s):  
Hans Hedelin ◽  
Sten Holmäng ◽  
Lena Wiman
Keyword(s):  
Bladder Tumour ◽  
The Cost

scholarly journals Thyroid Nodules in the Follow-Up of Irradiated Individuals: Comparison of Thyroid Ultrasound with Scanning and Palpation1

1997 ◽  
Vol 82 (12) ◽  
pp. 4020-4027 ◽  
Author(s):  
Arthur B. Schneider ◽  
Carlos Bekerman ◽  
Joel Leland ◽  
Jeffrey Rosengarten ◽  
Hyewon Hyun ◽  
...  
Keyword(s):  
Physical Examination ◽  
Thyroid Nodules ◽  
False Negative ◽  
Thyroid Ultrasound ◽  
Thyroid Ultrasonography ◽  
Serum Thyroglobulin ◽  
Neck Irradiation ◽  
A Prospective Study

In 1974 we began a prospective study of a cohort of 4296 individuals exposed to therapeutic head and neck irradiation during childhood for benign conditions. To define the role of thyroid ultrasonography in following irradiated individuals, we studied a subgroup of 54 individuals. They all had been screened between 1974–1976 and had normal thyroid scans and no palpable nodules at that time. Thyroid ultrasonography, thyroid scanning, physical examination, and serum thyroglobulin measurements were performed. One or more discrete ultrasound-detected nodules were present in 47 of 54 (87%) subjects. There were a total of 157 nodules, 40 of which were 1.0 cm or larger in largest dimension. These 40 nodules occurred in 28 (52%) of the subjects. Thirty (75%) of these 1.0-cm or larger nodules matched discrete areas of diminished uptake on corresponding thyroid scans. The 10 that did not match (false negative scans for ≥1.0-cm nodules) were the only nodules of this size in 7 subjects. Of 11 nodules 1.5 cm or larger, only 5 were palpable. Serum thyroglobulin correlated to the number (P = 0.04; r2 = 0.10), but not the volume of the thyroid nodules (P = 0.07; r2 = 0.08). We conclude that thyroid nodules are continuing to occur and are exceedingly common in this irradiated cohort of individuals. The results confirm that thyroid ultrasonography is more sensitive than physical examination and scanning. However, thyroid ultrasound is so sensitive and nodules so prevalent that great caution is needed in interpreting the results.

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