Can expressed prostatic secretions effect prostate biopsy decision of urologist?

OBJECTIVES: To evaluate the frequency of NIH category IV prostatitis, and the use of expressed prostatic secretions tests in an effort to improve the reliability of prostate specific antigen as an indicator, to avoid unnecessary prostate biopsy. MATERIALS AND METHODS: 178 expressed prostatic secretion positive patients with serum prostate specific antigen levels of ≥ 2.5 ng / mL were included in present prospective study. The diagnostic evaluation included detailed history and physical examination, digital rectal examination, urine analysis, urine culture, and expressed prostatic secretions tests. Transrectal ultrasonography was used both to measure prostate volume and conduct 12 core prostate biopsy. RESULTS: The prevalence of NIH category IV prostatitis was 36.9% (178 / 482) in our population of men. In our study patients (n: 178) prostate biopsy results were classified as; 66 prostatitis, 81 BPH, and 31 Pca. In asymptomatic prostatitis group, expressed prostatic secretion mean leucocyte ratio was higher compared to other two groups (p < 0.0001). The relation between number of expressed prostatic secretion leucocytes and prostatitis, benign prostate hyperplasia, and prostate cancer is analyzed. If 16 is taken as the cut of number for leucocyte presence, its sensitivity is 0.92 (AUC = 0.78 p = 0.01). CONCLUSIONS: The number of leucocytes in expressed prostatic secretion is higher in the chronic prostatitis group. If the leukocyte presence of 16 and above is taken as the cut off point, the sensitivity becomes 0.92 (AUC = 0.78). We firmly believe that our new cut off value may be used as to aid prostate specific antigen and derivates while giving biopsy decision.

Comparison of a New and Rapid Method: Brucella Coombs Gel Test With Other Diagnostic Tests.

BACKGROUND: The aim of this study was to detect reliability of Brucella Coombs gel test (BCGT) by comparing with with ELISA (IgG + IgM), Standard agglutination test, and Brucella immunocapture agglutination methods in serological diagnosis of brucellosis. METHODS: Brucella Coombs gel test (BCGT), Brucella ELISA (IgG + IgM), Standard agglutination test, and Brucella immunocapture agglutination tests of 78 patients with presumptive diagnosis of brucellosis which were sent to Microbiology Laboratory of Konya Numune Hospital from various regions of Konya were studied. RESULTS: Of 78 patients with ELISA IgG and IgM, STA, BICA and BCGT; 26, 21, 10, 12 and 12 were positive. When compared with BICA, the sensitivity and specifity of BCGT were 100% and 100%, respectively. CONCLUSION: According to results BCGT can be used as a diagnostic test in routine laboratories after more comprehensive studies in control groups and patients.

Is a Cholestrol-Enriched Diet a Risk Factor for Alveolar Bone Loss?

BACKGROUND: This study aims to investigate the effects of a 2% cholesterol-enriched diet on alveolar bone loss (ABL) and serum levels of pro-oxidants and antioxidant enzymes in rats with experimental periodontitis. METHODS: Rats were randomized into the four groups: 1) group C (standard diet/periodontally healthy); 2) group Hc (high-cholesterol diet); 3) group HcP (high-cholesterol diet/periodontitis); and 4) group P (standard diet/periodontitis). All rats were fed for 8 weeks. At 6 weeks, experimental periodontitis was induced. At the end of week 8, the rats were sacrificed. Histomorphometric and histopathologic analyses were performed. Malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase, and glutathione peroxidase (GPX) levels in serum were measured with enzyme-linked immunosorbent assay. RESULTS: Experimental groups exhibited increases in: 1) total cholesterol, 2) low-density lipoprotein, and 3) high-density lipoprotein compared to group C. The cholesterol-enriched diet induced ABL in group Hc; groups HcP and P had more extensive ABL. The most polymorphonuclear leukocyte infiltration in periodontal tissues was found in group HcP. MDA levels were higher in all experimental groups than in group C, but significant in the HcP group. A high-cholesterol diet, with or without periodontitis, resulted in more decreases in GPX and more increases in NO compared to group P. CONCLUSION: Although any additive effect of cholesterol-enriched diet to ABL was not found in rats with ligature-induced experimental periodontitis, these findings revealed that a cholesterol-enriched diet could lead to ABL and an increase in periodontal inflammation and serum pro-oxidants.

A prospective, randomized trial to evaluate the efficacy of clean intermittent catheterization versus triamcinolone ointment and contractubex ointment of catheter following internal urethrotomy: long-term results.

PURPOSE: Our aim was to evaluate clean intermittent catheterization (CIC) results in combination with triamcinolone ointment and contractubex ointment for lubrication of the catheter after optical internal urethrotomy (OIU). METHODS: Ninety patients who underwent OIU were randomized into three groups. Two weeks after operation, patients were treated with CIC (group A), triamcinolone ointment CIC (group B), and contractubex ointment CIC (group C). Follow-up continued for 24 months after the OIU. Postoperative results were compared between the three groups. RESULTS: There were no significant differences in the baseline characteristics of the patients or the etiology of the urethral stricture between the three groups. The mean preoperative Q max was 4.31 ml/s. The average score of preoperative international prostate symptom score (IPSS) was 23.1 points. In both groups, after treatment, significant improvements in Q max and IPSS were noted at all follow-up period (p < 0.05). But for Q max and IPSS, there were not any significant differences between groups at all follow-up period (p > 0.05). Overall recurrence rate was 28.9 % (26 out of 90 patients) at the end of the study. Recurrence rates were, however, not found to be statistically significant between these three groups (p > 0.05). CONCLUSION: Our results indicate that the urethral dilation protocol with CIC after first OIU is a safe, simple, well-tolerated, office-based procedure. Triamcinolone or contractubex ointments of the CIC do not provide an additional benefit. Currently, urethral dilation with CIC after first OIU seems to be the only proven procedure that decreased the recurrence rate.