Inverted papilloma of the urinary bladder: Rigorous surveillance needed: An Indian experience.

Aims: Inverted papilloma (IP) is an uncommon benign neoplasm of the urinary tract. Its multiplicity, recurrence, and association with transitional cell carcinoma (TCC) leads to conflicting clinical conclusions regarding its biological behavior, and hence, the need for rigorous follow-up protocols. In this study, we review all cases of urinary bladder IP in our institution and determine the need for strict follow-up. Materials and Methods :0 We included consecutive patients from August 2004 to August 2008 with IP of the urinary bladder in this study who did not have prior or concurrent urothelial carcinoma. A single pathologist performed the histologic review. The patients had undergone strict a follow-up schedule every 6 months. Results: In our study of the 24 patients, the mean age at presentation was 53.5 (range 22-81) years. The mean follow-up period was 25.8 months (range 6-58 months). Of the 24 patients, 21 were men and 3 were women. No patient had a synchronous or previous bladder tumor. The most common presenting symptoms were macroscopic hematuria and dysuria. All were solitary tumors except one, most commonly found at the bladder neck and trigone. The average follow-up period was 2.5 years without any evidence of recurrence. Conclusions: We conclude that when diagnosed by strictly defined criteria, IP as benign urothelial neoplasm was with extremely low incidence of recurrence and good prognosis. It does not seem to be a risk factor for TCC, especially if located in the bladder. Therefore, a good transurethral resection is adequate therapy and follow-up protocol as rigorous as those for TCC may not be necessary.

Effective Way in Reducing Missing Report Rate of Nosocomial Infection / 中华医院感染学杂志

OBJECTIVE To reduce the missing report rate of nosocomial infection(NI) by establishing relevant surveillance protocol,improve the early warming system of NI,and therefore prevent the outbreak and prevalence of NI.METHODS Based on Nosocomial Infection Diagnosis Standard published by Chinese Ministry of Health in 2001,116 213 patient data from Jan 2000 to Dec 2006 had been reviewed;factors associated with NI missing report rate had been reevaluated;measures to reduce the rate had been made;and the feedback information of NI control had been collected.Meanwhile,according to high risk factors provided by the hospital information system,the prospective investigations had been made.Surveillance protocol had been established as above.RESULTS By the implementation of the protocol,the missing report rate of NI had been under control,lower than the standard rate of 20% for tertiary hospitals.In 2005,the protocol was reinforced and the NI missing report rate had been reduced to 7.4% by 2006.CONCLUSIONS The real-time monitoring of NI cases is an effective way in reducing missing report rate of NI.