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Digital rectal examination

Olivier Rager, Marlise Picarra, Emmanouil Astrinakis, Valentina Garibotto, Gaël Amzalag
A 23-year-old African native male patient presented with fever, lumbalgia and dysuria after returning from a trip to Togo. His physical examination revealed pain over the pubic symphysis and rectal tenderness on digital exam. The C-reactive protein (CRP) level was elevated along with positive blood and urinary cultures for methicillin-resistant Staphylococcus aureus . An magnetic resonance imaging that has been performed to rule out arthritis/osteomyelitis in the pubis revealed edema of the symphysis. An 18 F-FDG positron emission tomography/computed tomography supported the diagnosis of prostate infection and showed a focal uptake of the pubic symphysis, with diffuse hyper-metabolism of the insertions of the rectus abdominis and longus adductor muscles, corresponding to athletic pubalgia...
October 9, 2018: Molecular Imaging and Radionuclide Therapy
Adarsh Pratap Singh, Amit Kumar, Anita Dhar, Shipra Agarwal, Sudhir Bhimaniya
BACKGROUND: Colorectal carcinoma in the pediatric age group is rare and tends to be very aggressive and present late, due to which it has a very poor prognosis. It may present with distant metastasis; however, metastasis to the testes is very rare and signifies an advanced stage of the disease. Surgery is the only effective modality to cure patients with localized colorectal carcinomas. However, statistics show a higher incidence of unresectable disease and a higher metastasis rate in childhood colorectal carcinomas...
October 11, 2018: Journal of Medical Case Reports
Amarnath Jena, Rajesh Taneja, Sangeeta Taneja, Aru Singh, Venkatesh Kumar, Anshuman Agarwal, Narasimhan Subramanian
OBJECTIVE: The current study was designed to test the diagnostic performance of 68 Ga-prostate-specific membrane antigen (PSMA) PET and multiparametric MRI along with clinical parameters in the characterization of prostatic lesions. MATERIALS AND METHODS: Eighty-two men with 63 malignant and 21 benign histologically proven prostate lesions who underwent complete clinical workup were included in this retrospective study. All patients underwent simultaneous whole-body 68 Ga-PSMA PET/MRI with dedicated multiparametric MRI...
October 9, 2018: AJR. American Journal of Roentgenology
I Ezgi Eryilmaz, Berna Aytac Vuruskan, Onur Kaygısız, Unal Egeli, Berrin Tunca, Yakup Kordan, Gulsah Cecener
BACKGROUND: Atypical small acinar proliferation (ASAP) is a precursor lesion of prostate cancer (PC), and PC develops from this suspicious focus or an unsampled malignant gland nearby. However, PC-related molecular alterations that could guide the timing of repeat biopsies and help monitor PC risk in ASAP-diagnosed patients have not been investigated. The purpose of this study was to first investigate the expression of seven different PC-related RNAs that included serine 2 (TMPRSS2): erythroblastosis virus E26 oncogene homolog (ERG) gene (TMPRSS2-ERG, T2E) fusion, alpha-methylacyl-CoA racemase (AMACR), kallikrein related peptidase 3 (KLK3), androgen receptor (AR), prostate cancer specific antigen 3 (PCA3), and matrix metalloproteinases (MMP)-2 and 9...
October 7, 2018: Prostate
P F Pinsky, E Miller, P Prorok, R Grubb, E D Crawford, G Andriole
OBJECTIVE: To examine prostate cancer incidence and mortality by arm in the randomized Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial. SUBJECTS AND METHODS: Subjects aged 55-74 at 10 screening centers were randomized between 1993 and 2001 to an intervention or usual care arm. Intervention arm men received 6 annual prostate-specific antigen (PSA) tests and 4 annual digital rectal exams. Subjects were followed for prostate cancer (PCa) incidence and for mortality by active follow-up processes and by linkage to state cancer registries and the National Death Index...
October 5, 2018: BJU International
Navin Shah, Vladimir Ioffe, Thomas Huebner, Ivelina Hristova
To compare prostate cancer (PCa) characteristics diagnosed by prostate biopsy (Pbx) in the 3 years before and after the 2012 United States Preventive Services Task Force (USPSTF) recommendations for PCa screening, we completed a retrospective comparative analysis of 402 sequential PCa patients diagnosed from 2010 to 2012 (3 years) with 552 PCa patients diagnosed from 2015 to 2017 (3 years). Data was collected on patient age, race, total number of biopsies performed, prostate specific antigen (PSA), Gleason sum score (GSS), and digital rectal examination (DRE)...
2018: Reviews in Urology
Kazuhiko Morikawa, Shinsuke Takenaga, Koichi Masuda, Asami Kano, Takao Igarashi, Hiroya Ojiri, Kaoru Ueda, Mamoru Ishiyama, Nei Fukasawa
BACKGROUND: A solitary fibrous tumor (SFT) is a rare mesenchymal tumor that occurs mostly in pleural sites, and an SFT occurring in the ischiorectal fossa is extremely rare. Because of the rarity, there are few reports detailing an SFT in the ischiorectal fossa. CASE PRESENTATION: A pararectal tumor was incidentally found in a 42-year-old man during a routine medical examination. The patient had no symptoms and no previous medical history. In the physical examination, a smooth-margined and hard elastic mass was felt, and in a digital rectal examination, the rectal mucosa appeared normal...
October 3, 2018: Surgical Case Reports
Cong Huang, Gang Song, He Wang, Guangjie Ji, Jie Li, Yuke Chen, Yu Fan, Dong Fang, Gengyan Xiong, Zhongcheng Xin, Liqun Zhou
Objective: To develop and internally validate nomograms based on multiparametric magnetic resonance imaging (mpMRI) to predict prostate cancer (PCa) and clinically significant prostate cancer (csPCa) in patients with a previous negative prostate biopsy. Materials and Methods: The clinicopathological parameters of 231 patients who underwent a repeat systematic prostate biopsy and mpMRI were reviewed. Based on Prostate Imaging and Reporting Data System, the mpMRI results were assigned into three groups: Groups "negative," "suspicious," and "positive...
2018: BioMed Research International
Marcin Cichocki, Tomasz Konecki, Zbigniew Jabłonowski
OBJECTIVE: Introduction: Prostate cancer is currently one of the most important health issues especially for developed countries. It is the most common solid organ malignancy amongst men in Europe with 214 new cases per 100.000 men per year and the second most common cause of cancer death. The choice of therapy depends upon the clinical stage (cTNM), PSA level and Gleason histological score. Gleason score of radical prostatectomy specimens is the strongest predictor of disease progression...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Shotaro Yasuoka, Go Kimura, Yuka Toyama, Keichi Moriya, Keigo Takahashi, Ryo Matsuoka, Keita Shibayama, Kotaro Obayashi, Yasushi Inoue, Takao Shindo, Shigeki Iigaya, Yuki Endo, Jun Akatsuka, Tatsuro Hayashi, Satoko Nakayama, Tsutomu Hamasaki, Koiti Inokuchi, Yukihiro Kondo
A 73-year-old man presented with right lower back pain and dysuria. Right hydronephrosis and a large pelvic large mass were seen on computed tomography (CT). Although his prostate-specific antigen (PSA) was 0.5 ng/mL, an irregularly enlarged, stony, hard prostate was palpable on digital rectal examination. A prostate tumor was suspected, and a transrectal prostate biopsy and right transurethral ureteral stent placement were performed. Histological and immunohistochemical studies revealed diffuse large B-cell lymphoma...
2018: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Marko Simunovic, Vanja Grubac, Kevin Zbuk, Raimond Wong, Angela Coates
Background: Patients with rectal cancer in whom the mesorectal fascia is threatened by tumour are more likely than all patients with stage II/III disease to benefit from preoperative radiotherapy (RT). The objective of this study was to assess whether the status of the mesorectal fascia versus a stage II/III designation can best inform the use of preoperative RT in patients undergoing major rectal cancer resection. Methods: We reviewed the charts of consecutive patients with primary rectal cancer treated by a single surgeon at McMaster University, Hamilton, Ontario, between March 2006 and December 2012...
October 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Marc J Gollub, Ivana Blazic, Seth Felder, Andrea Knezevic, Mithat Gonen, Julio Garcia-Aguilar, P Phillip Paty, J Joshua Smith
PURPOSE: To determine if DCE-MRI adds diagnostic value to the combined use of T2WI and DWI-MRI in the determination of clinical complete response (cCR) after neoadjuvant treatment (NAT) in patients with locally advanced rectal cancer. METHODS AND MATERIALS: In this IRB-approved, HIPAA-compliant retrospective study, response was assessed using a 5-point confidence score by T2WI and DWI-MRI only ('standard MRI'), then with addition of DCE-MRI. Review of digital rectal exams and endoscopy notes produced a clinical overall response score...
September 21, 2018: European Radiology
Ben Van Calster, Laure Wynants, Jan F M Verbeek, Jan Y Verbakel, Evangelia Christodoulou, Andrew J Vickers, Monique J Roobol, Ewout W Steyerberg
CONTEXT: Urologists regularly develop clinical risk prediction models to support clinical decisions. In contrast to traditional performance measures, decision curve analysis (DCA) can assess the utility of models for decision making. DCA plots net benefit (NB) at a range of clinically reasonable risk thresholds. OBJECTIVE: To provide recommendations on interpreting and reporting DCA when evaluating prediction models. EVIDENCE ACQUISITION: We informally reviewed the urological literature to determine investigators' understanding of DCA...
September 19, 2018: European Urology
Oluwarotimi S Nettey, Austin J Walker, Mary Kate Keeter, Ashima Singal, Aishwarya Nugooru, Iman K Martin, Maria Ruden, Pooja Gogana, Michael A Dixon, Tijani Osuma, Courtney M P Hollowell, Roohollah Sharifi, Marin Sekosan, Ximing Yang, William J Catalona, Andre Kajdacsy-Balla, Virgilia Macias, Rick A Kittles, Adam B Murphy
INTRODUCTION AND OBJECTIVE: Studies have linked Black race to prostate cancer (CaP) risk but most fail to account for established risk factors such as 5-ARI use, prostate volume, socioeconomic status, and hospital setting. We assess whether Black race remains associated with CaP and Gleason ≥3 + 4 CaP, after adjusting for clinical setting and socioeconomic and clinical factors at prostate biopsy, with a focus on men aged 40-54years, who may be excluded from current screening guidelines...
September 17, 2018: Urologic Oncology
Yi Zhou, Zhien Zhou, Qianyue Li, Yinyan Xu, Hao Sun, Yu Xiao, Zhiyong Liang, Weigang Yan, Zhigang Ji, Hanzhong Li
To compare the accuracy of magnetic resonance-guided prostate biopsy (MR-GPB) and template-guided transperineal prostate saturation biopsy (TTPSB).A total of 219 patients with elevated prostate-specific antigen, abnormal digital rectal examination or ultrasound findings were enrolled. All patients underwent multiparametric magnetic resonance image (mpMRI). Patients with a Prostate Imaging Reporting and Data System (PI-RADS) score of 3 to 5 underwent MR-GPB using 2 to 5 biopsy cores and then immediately underwent an 11-region TTPSB...
September 2018: Medicine (Baltimore)
Phillipa J Malpas, Warwick Bagg, Jill Yielder, Alan F Merry
AIM: We set out to explore the question, what ethical challenges do medical students identify when asked to perform or observe a sensitive examination, given a historical background relevant to this context. METHOD: Thematic analysis of 21 Ethics Reports from 9 female and 12 male students. RESULTS: Overall 14 students undertook a sensitive examination without the patient's consent; three did not carry out a sensitive examination because of a lack of consent; and two students (or their senior colleagues) gained the patient's written consent for the student to undertake the examination...
September 21, 2018: New Zealand Medical Journal
Cosimo De Nunzio, Giorgia Tema, Riccardo Lombardo, Alberto Trucchi, Mariangela Bellangino, Francesco Esperto, Marianna Deroma, Flavia Proietti, Andrea Vecchione, Andrea Tubaro
BACKGROUND: The aim of our study is to explore the association between cigarette smoking and the risk of prostate cancer (PCa) diagnosis as well as high grade disease in men undergoing prostate biopsies. METHODS: From 2008 to 2016, we prospectively enrolled a consecutive series of men with no history of PCa undergoing prostate biopsies. Variables assessed the day of the biopsy included: Family history of PCa, age, body mass index (BMI), comorbidities, digital rectal examination (DRE), prostate volume, PSA, free PSA, smoking status, number of cigarette/day, smoking time, smoking starting age and smoking cessation...
September 19, 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
C Huang, G Song, H Wang, G J Ji, Y K Chen, Q He, L Q Zhou
Objective: To develop a nomogram based on prostate imaging reporting and data system version 2 (PI-RADS v2) to predict clinically significant prostate cancer in patients with a prior negative prostate biopsy. Methods: The clinical and pathological data of 231 patients who underwent repeat prostate biopsy and multiparametric MRI (mpMRI) were reviewed. Based on PI-RADS v2, the mpMRI results were assigned as PI-RADS grade from 0 to 2. A Logistic regression nomogram for predicting the probabilities of clinically significant prostate cancer were constructed...
August 28, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Thomas Steuber, Pierre Tennstedt, Annalisa Macagno, Alcibiade Athanasiou, Anja Wittig, Ramy Huber, Bruno Golding, Ralph Schiess, Silke Gillessen
OBJECTIVES: To investigate and further validate if two novel cancer-related glycoproteins, discovered by a genetic-guided proteomics approach, can distinguish benign disease from prostate cancer (PCa) in men with enlarged prostates. PATIENTS AND METHODS: A retrospective study was performed that included men with a total prostate-specific antigen (PSA) concentration of 2.0-10 ng/mL, negative digital rectal examination and enlarged prostate (volume ≥35 mL). Serum samples were collected between 2011 and 2016 at a single centre from 474 men before they underwent prostate biopsy...
September 14, 2018: BJU International
Stephen Brawley, Ravinder Mohan, Christopher D Nein
In the United States, prostate cancer will be diagnosed in one out of seven men in his lifetime. Most cases are localized, and only one in 39 men will die from the disease. Prostate cancer is most often detected using serum prostate-specific antigen testing. The National Comprehensive Cancer Network guidelines use four main factors to stratify risk of disease progression or recurrence and to determine the recommended treatment: clinical stage, pathologic grade, prostate-specific antigen level, and comorbidity-adjusted life expectancy...
June 15, 2018: American Family Physician
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