BackgroundInfection after transrectal ultrasound (TRUS) guided biopsy of the prostate is a major and potentially life-threatening problem. Using antibiotic premedication can not completely eliminate infection after biopsy.ObjectivesWe performed this study to determine the value of using povidone-iodine in prevention of post biopsy infection.Patients and MethodsTotally, 280 patients who were referred for TRUS guided biopsy of the prostate were divided randomly into two equal groups. The case group received an intrarectal mixture of povidone-iodine and lidocaine gel before performing biopsy, while the control group received only lidocaine gel. Patients were followed up for 30 days for possible signs of infection including fever, chills and dysuria.ResultsThe mean age in the case group was 68.7 ± 7 years and 68.1 ± 7 years in the control group (P = 0.78). Overall, there were signs and symptoms of infection in 78 patients (27.9%), of which 27 (19.3%) were in the case group, while 51 (36.4%) were in the control group (P = 0.001, OR = 2.4, 95% CI = 1.4-4.1).ConclusionSimple use of widely available povidone-iodine for cleaning the rectum before TRUS guided prostate biopsy can reduce the infection rate.
Computed tomography (CT)-guided percutaneous transthoracic biopsy of the lung is a well-established diagnostic technique, but it can pose complications to the patients. Air embolism is one of the rarest but potentially fatal complications of this procedure. The authors report a fatal case of systemic and massive air embolism to the coronary and cerebral arteries after the performance of lung biopsy. Careful reviewing of the obtained CT images during the procedure may avoid a missing systemic air embolism and can immediately provide an adequate therapy also in asymptomatic patients. This extremely rare complication is an inevitable event and may happen in spite of appropriate experience and meticulous care.
Background:Transrectal ultrasound guided biopsy of the prostate is the most common modality used to diagnose prostate cancer.Objectives:The aim of this study was to evaluate the optimal number of cores at prostate biopsy, which have the most diagnostic value with least adverse effects.Patients and Materials:Transrectal ultrasonography (TRUS) guided biopsy was performed in 180 patients suspicious for prostate cancer due to either abnormal rectal examination or elevated PSA. The patients were divided randomly into three groups of six-core, twelve-core and eighteen-core biopsies. The detection rate of prostate cancer in each group with the rate of post biopsy urinary infection and prostatitis were compared.Results:Prostate cancer was diagnosed in 8 (13.3%), 21 (35%) and 24 (40%) patients in six, twelve and eighteen core biopsy groups, respectively. Urinary tract infection and prostatitis occurred in 17 (28.3%), 23 (38.3%) and 35 (58.3%) patients in six, twelve and eighteen core biopsy groups, respectively. Considering the detection rate of prostate cancer, there was a significant difference between 6 and 12 core biopsy groups (P = 0.006) and 12-core biopsies detected more cases of prostate cancer, but there was no significant difference between 12 and 18 core biopsy groups (P = 0.572). Considering the infection rate, there was no significant difference between 6 and 12 core biopsy groups (P = 0.254), but there was a significant difference between 12 and 18 core biopsy groups (P = 0.028) and infectious complications occurred more frequently in 18-core biopsy group.Conclusions:The best balance between detection rate of prostate cancer and infectious complications of biopsies achieved in twelve-core biopsy protocol. Twelve-core biopsy enhances the rate of prostate cancer detection with minimum adverse effects.
Using mathematical functions and enhancing tools such as wavelet transform and other mathematical functions can improve the performance of CNN in any image processing task such as segmentation and classification.
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