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Head to Head Comparison of the Chun Nomogram, Percentage Free PSA and Primary Circulating Prostate Cells to Predict the Presence of Prostate Cancer at Repeat Biopsy

  • Murray, Nigel P;Reyes, Eduardo;Orellana, Nelson;Fuentealba, Cynthia;Jacob, Omar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2941-2946
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    • 2016
  • Background: The limitations of total serum PSA values remain problematic, especially after an initial negative prostate biopsy. In this prospective study of Chilean men with a continued suspicion of prostate cancer due to a persistently elevated total serum PSA, abnormal digital rectal examination and initial negative prostate biopsy were compared with the use of the on-line Chun nomagram, detection of primary malignant circulating prostate cells (CPCs) and free percent PSA to predict a positive second prostate biopsy. We hypothesized that men negative for circulating prostate cells have a small risk of clinically significant prostate cancer and thus may be conservatively observed. Men positive for circulating prostate cells should undergo biopsy to confirm prostate cancer. Materials and Methods: Consecutive men with a continued suspicion of prostate cancer underwent 12 core TRUS prostate biopsy; age, total serum PSA and percentage free PSA and Chun nomagram scores were registered. Immediately before biopsy an 8ml blood simple was taken to detect primary mCPCs. Mononuclear cells were obtained by differential gel centrifugation and identified using double immunostaining with anti-PSA and anti-P504S. Biopsies were classifed as cancer/no-cancer, mCPC detecton test as negative/positive and the total number of cells/8ml registered. Areas under the curve (AUC) for percentage free PSA, Chun score and CPCs were calculated and compared. Diagnostic yields were calculated with reference to the number of possible biopsies that could be avoided and the number of clinically significant cancers that would be missed. Results: A total of 164 men underwent a second biopsy; 41 (25%) had cancer; the AUCs were 0.65 for free PSA, 0.76 for the Chun score and 0.87 for CPC detection, the last having a significantly superior prediction value (p=0.01). Using cut off values of free PSA <10%, Chun score >50% and ${\geq}1$ CPC detected, CPC detection had a higher diagnostic yield. Some 4/41 cancers complied with the criteria for active surveillance, free PSA and the Chun score missed a higher number of significant cancers when compared with CPC detection. Conclusions: Primary CPC detection outperformed the use of free PSA and the Chun nomagram in predicting clinically significant prostate cancer at repeat prostate biopsy.

Awareness Of Predisposing Factor To Smoking Among Adult In Sokoto

  • John, Ikpeama Osita;Mariam, Onuzulike Nonye;Adimabua, Okafor Patrick;Anthonia, Ikpeama Chizoba;Joy, Ikpeama Chinwe;Osazuwa, Igbineweka Osa;Andrew, Ikpeama Emeka;Jacob, Ofuenyi;Paulastella, Nwosu Nchedochukwu;Nnanna, Ibeh Isaiah;Mokwe, Gerald Chukwudi;Uchechi, Ogwuegbu Juliet;Otugeme, Franklin;Muazu, Mary
    • The Korean Journal of Food & Health Convergence
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    • v.5 no.1
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    • pp.1-11
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    • 2019
  • Smoking has become one of the public health harzard affecting the world. In the UK, smoking is responsible for around one in five deaths. The illnesses caused by smoking extend beyond the well-reported links with cancer, heart disease and respiratory illnesses. Hence the research to determine the awareness of the predisposing factor to smoking among adults in sokoto metropolis. A cross-sectional form of descriptive survey research design was used for this study. This is because descriptive studies are used when the characteristics of a population are either unknown or partially known (Hennekens & Buring, 2007), and it was used by Ganley and Rosario (2013) in a related research this justified the use of similar design in a study of similar nature.Two hundred and seventy returned questionnaire was collected, analyzed using descriptive statistic of frequency count, normative percentage and grand mean; as well as inferential statistics of chi-square (${\chi}^2$). The level of significant was fixed at 0.05. Appropriate degrees of freedom were worked out. There was statistical significant influence or relationship with marital status on the predisposing factors of smoking chi-square of 19716.516 greater than the critical value 43.77297at df 30 p<0.05. There were statistical significance chi-square =27468.348 which is greater than the critical value 43.77297 at df= 30. These show that there is a relationship on gender awareness of predisposing factors to smoking rejecting the null hypotheses. The respondents across different lever/year higher institution shows that the awareness of predisposing factors of smoking there were a statistical significance difference chi-square =7168.429 (df=88) greater than critical value 102.342 rejecting the null hypotheses. There is consistent evidence that links exposure to depictions of smoking in movies and initiation of smoking in young people. Over the years television shows and films have effectively built up associations between smoking and glamour, sex and risk-taking. Social learning theory describes how we learn by example from others. We are strongly influenced by our parents, and other people we look up to, such as peers, actors and pop stars. This can lead us to emulate their behaviour and try smoking.

Use of Non-carbapenem Antibiotics in Patients with Urinary Tract Infection Caused by Extended-spectrum Beta-lactamase-producing Enterobacteriaceae (Extended-spectrum β-lactamase 를 생산하는 Enterobacteriaceae 요로감염에서 카바페넴 이외의 항생제 사용 가능성에 대한 고찰)

  • Seo, Yu Bin;Kim, Young Keun;Lee, Jacob;Song, Wonkeun
    • Korean Journal of Healthcare-Associated Infection Control and Prevention
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    • v.21 no.2
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    • pp.50-56
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    • 2016
  • Background: Alternatives to carbapenem are increasingly needed to decrease the usage of carbapenem. We evaluated the possibility of using non-carbapenem antibiotics against urinary tract infections (UTI) caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Methods: This retrospective study was performed at 2 university hospitals between October 2010 and December 2012. All diagnosed adult cases of ESBL-PE UTI were identified from the microbiological database. The subjects were divided into 3 groups based on the empirical antibiotic classes and susceptibility: carbapenem (C) group, susceptible non-carbapenem (SNC) group, and non-susceptible non-carbapenem (NSNC) group. Results: A total of 84 patients were eligible for analysis. For empirical therapy, 41, 23, and 20 patients were included in the NSNC, SNC, and C empirical groups, respectively. During the empirical therapy, 7 patients (17.1%) in the NSNC group, 18 patients (78.3%) in the SNC group, and 19 patients (78.3%) in the C group experienced clinical improvement. No significant difference was observed between the SNC and C empirical groups (P=0.192). Severe sepsis or shock was the predictor of empirical SNC treatment failure (P=0.048). There was a tendency to use carbapenem as a definite therapy in cases of NSNC. In contrast, empirical SNC was maintained as a definite therapy. Conclusion: SNC could be considered as an alternative to carbapenems for treating ESBL-PE UTI. This strategy might decrease the usage of carbapenem without clinical deterioration. However, it should be noted that SNC therapy may fail in the case of severe sepsis or shock.

Smooth versus Textured Tissue Expanders: Comparison of Outcomes and Complications in 536 Implants

  • Omar Allam;Jacob Dinis;Mariana N. Almeida;Alexandra Junn;Mohammad Ali Mozaffari;Rema Shah;Lauren Chong;Olamide Olawoyin;Sumarth Mehta;Kitae Eric Park;Tomer Avraham;Michael Alperovich
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.42-51
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    • 2024
  • Background Increasing concerns regarding the safety of textured surface implants have resulted in surgeons transitioning from textured tissue expanders (TEs) to smooth TEs. Given this change has only recently occurred, this study evaluated outcomes between smooth and textured TEs. Methods Women who underwent two-stage breast reconstruction using TEs from 2013 to 2022 were included. TE-specific variables, perioperative information, pain scores, and complications were collected. Chi-squared, t-test, and linear regression analyses were performed. Results A total of 320 patients received a total of 384 textured and 152 smooth TEs. Note that 216 patients received bilateral reconstruction. TEs were removed in 9 cases. No significant differences existed between groups regarding comorbidities. Smooth TEs had a higher proportion of prepectoral placement (p < 0.001). Smooth TEs had less fills (3±1 vs. 4±2, p < 0.001), shorter expansion periods (60±44 vs. 90±77 days, p < 0.001), smaller expander fill volumes (390±168 vs. 478±177 mL, p < 0.001), and shorter time to exchange (80±43 vs. 104±39 days, p < 0.001). Complication rates between textured and smooth TEs were comparable. Smooth TE had a greater proportion of TE replacements (p = 0.030). On regression analysis, pain scores were more closely associated with age (p = 0.018) and TE texture (p = 0.046). Additional procedures at time of TE exchange (p < 0.001) and textured TE (p = 0.017) led to longer operative times. Conclusion As many surgeons have transitioned away from textured implants, our study shows that smooth TEs have similar outcomes to the textured alternatives.