Patient tolerance and complication rates of transperineal prostate biopsy with coaxial technique under local anesthesia: initial experience of a single institution.

OBJECTIVE: Due to infectious complications of transrectal prostate biopsy (TRBx), the transperineal prostate biopsy (TPBx) technique is gaining popularity and is the first-line method in many institutions. We share our experience of the first 100 patients with TPBx, performed using the coaxial needle technique under local anesthesia. PATIENTS AND METHODS: We retrospectively reviewed the records of the first 100 patients who had undergone TPBx between December 2022 and September 2023. Complication rates, cancer detection rates, patient tolerance, and pain response to the TPBx under local anesthesia at different steps of the procedure were collected. RESULTS: The mean age, total prostate-specific antigen (PSA), prostate volume, and PSA density were 64.5±7.5 years, 8.82±12 ng/mL, 58.4±26.4 mL, and 0.17±0.18 ng/mL2. Prostate cancer (PCa) was detected at histopathological evaluation in 51 patients. The mean positive core number and percentage of cancer involvement per core in patients who have PCa were 5.4±3.2 and 68.5±29.1, respectively. The mean pain score during the entire procedure was 2.85±1.48. When the steps are evaluated separately, the mean pain score during the probe placement step, local anesthetic, and sampling steps were 3.35±1.65, 2.54±1.45, and 0.9±0.82, respectively. CONCLUSIONS: Transperineal prostate biopsy with coaxial needle technique under local anesthesia is a well-tolerated procedure with feasible complication rates and patient discomfort.

Diffusion restriction associated with bevacizumab treatment in recurrent glial tumors, evaluation of survival with ADC measurement analysis.

OBJECTIVE: Recurrent glial tumors treated with bevacizumab often develop diffusion restriction. In this study, we investigated the diffusion restriction pattern after bevacizumab treatment along with the relationship between apparent diffusion coefficient (ADC) values of regions with diffusion restriction and survival period as there are conflicting results on this relationship. PATIENTS AND METHODS: We retrospectively identified 24 patients treated with bevacizumab for recurrent glial tumor who had low ADC values after the onset of the treatment. Magnetic resonance imaging (MRI) findings were analyzed for the presence of restricted diffusion, time to onset, location, duration of restriction, and persistence of restriction after cessation of bevacizumab treatment. A retrospective study was performed to investigate the relationship between ADC values obtained at first post-bevacizumab scan and survival periods. RESULTS: Diffusion restriction appeared 2 to 6 months after the onset of bevacizumab therapy and persisted up to 24 months while on bevacizumab. The restricted diffusion persisted up to 6 months after cessation of bevacizumab. Our results showed that there is a negative correlation between ADC values and progression free survival as well as overall survival. Patients having diffusion restriction areas with lower ADC values after the initiation of bevacizumab treatment, are found to have increased overall and progression free survival (p<0.05). CONCLUSIONS: In patients with recurrent glial tumor treated with bevacizumab, diffusion restriction can be observed and the ADC values obtained from these areas at first post-bevacizumab MRI scan correlate with progression free and overall survival with the worst survival seen in patients with higher ADC values which therefore can be considered as an imaging marker that can predict the prognosis.

Advanced oxidation protein product levels as a marker of oxidative stress in paediatric patients with chronic tonsillitis.

We aimed to determine whether advanced oxidation protein product (AOPP) levels can serve as a marker of oxidative stress in paediatric patients with chronic tonsillitis. Thirty children with chronic tonsillitis and 30 healthy children (control group) were recruited from the Otorhinolaryngology (ORL) and Paediatric Surgery departments, respectively, of Dumlupinar University Hospital. In the patient group, blood samples were collected before tonsillectomy, and tonsil tissue was sampled during the operation. Blood samples were also obtained from the control subjects. AOPP levels in the serum and tonsil tissue were measured by the spectrophotometric method. Serum AOPP levels were significantly higher in the patient group (13.1 ± 3.3 ng/ml) than in the control group (11.6 ± 2.3 ng/ml; P < 0.05). In addition, the mean AOPP level (41.9 ± 13.5 ng/mg protein) in the tonsil tissue in the patient group was significantly higher than the mean serum AOPP levels in the control and patient groups (P < 0.05). AOPP levels are elevated in the tonsil tissue and serum of patients with chronic tonsillitis compared to the serum AOPP levels in healthy controls. AOPPs may represent a novel class of pro-inflammatory molecules that are involved in oxidative stress in chronic tonsillitis. AOPPs may be used as a marker of oxidative stress in paediatric patients with chronic tonsillitis.