ABSTRACT
OBJECTIVE: To analyze the performance of two mobile phone apps-the Rotterdam prostate cancer risk app and the Coral app-in a cohort of patients undergoing prostate biopsies. METHODS: A consecutive series of men undergoing prostate biopsies were enrolled in two centers. Indications for prostate biopsy included abnormal prostate-specific antigen levels (PSA >4â¯ng/mL) and/or an abnormal digital rectal examination (DRE). Prostate cancer risk and high-grade prostate cancer risk were assessed using the Rotterdam prostate cancer risk app (iOS) and the Coral app (iOS). The usability of the apps was also assessed and compared using the Post-Study System Usability Questionnaire (PSSUQ) developed by IBM. RESULTS: Overall, 1682 patients with a median age of 68 (62-73) years were enrolled. The Rotterdam app outperformed the Coral app in the prediction of prostate cancer (AUC: 0.70 versus 0.631, pâ¯=â¯0.001) and of high-grade prostate cancer (0.75 versus 0.69, pâ¯=â¯0.001) (Fig. 1). PSSUQ data revealed that both Rotterdam and Coral applications were comparable in terms of usefulness (87% versus 83%, pâ¯=â¯0.708), information quality (74% versus 72%, pâ¯=â¯0.349), interface quality (79% versus 74%, pâ¯=â¯0.216) and satisfaction (76% versus 76%, pâ¯=â¯0.935), respectively. In terms of preferences, 26/50 (54%) preferred the Rotterdam app, while 24/50 (46%) preferred the Coral app. CONCLUSION: In our experience the Rotterdam App outperformed the Coral App for the prediction of prostate cancer or high-grade cancer diagnosis. In particular we confirmed, using the Rotterdam app, that only one out of ten patients with a low Rotterdam score will harbor high-grade prostate cancer on biopsy.
Subject(s)
Cell Phone , Mobile Applications , Prostate/pathology , Prostatic Neoplasms/diagnosis , Risk Assessment/methods , Aged , Biopsy , Humans , Male , Middle Aged , Reproducibility of ResultsABSTRACT
OBJECTIVE: To evaluate the clinical and biochemical effects of long-acting testosterone undecanoate injections in men with prostate cancer treated with brachytherapy, as the use of testosterone therapy (TTh) in men with prostate cancer is highly controversial, with limited published safety data, particularly after brachytherapy treatment. PATIENTS AND METHODS: In all, 20 men treated with brachytherapy for prostate cancer received TTh for symptoms of testosterone deficiency from February 2005 to August 2013. Symptoms of testosterone deficiency included low libido, erectile dysfunction, and fatigue. The mode of TTh was long-acting testosterone undecanoate injections in all cases. Sexual function was assessed by Sexual Health Inventory for Men (SHIM) questionnaire. Serum PSA and testosterone concentrations were recorded monthly for 3 months, then every 3 months for the first year, every 6 months for the second year, and annually then after. RESULTS: The mean (range) age was 62 (49-74) years and the mean (range) serum PSA level at the time of prostate cancer diagnosis was 6.2 (2-11.5) ng/mL. The Gleason score was 2 + 3 in one patient, 3 + 3 in 15 patients, 3 + 4 in three patients and 4 + 4 in one patient. In all, 15 men were stage T1c and five were T2a. The mean (range) baseline total testosterone concentration was 343 (200-592) ng/dL, and 6.9 (2.1-9.7) ng/dL for free testosterone. The mean SHIM scores improved with treatment from 16.1 at baseline to 22.1 with TTh (P = 0.002). There was a decrease in mean PSA level from baseline of 0.7 ng/mL before initiation of TTh to 0.1 ng/mL at last follow-up (P < 0.001), with a median (range) follow-up of 31 (12-48) months. There were no cases of prostate cancer progression or recurrence. CONCLUSIONS: With a median of 31-months follow-up, long-acting testosterone injections in men with prostate cancer treated with brachytherapy produced significant clinical benefits. There were no cases of rising serum PSA, prostate cancer progression or recurrence.
Subject(s)
Androgens/therapeutic use , Brachytherapy/adverse effects , Prostatic Neoplasms/radiotherapy , Testosterone/analogs & derivatives , Testosterone/deficiency , Aged , Humans , Male , Middle Aged , Prospective Studies , Prostate-Specific Antigen/blood , Surveys and Questionnaires , Testosterone/blood , Testosterone/therapeutic use , Treatment OutcomeABSTRACT
El hemangioma uretral es una causa muy infrecuente de uretrorragia. Es un tumor benigno que tiende a recurrir si el tratamiento no es el adecuado. El método diagnóstico de elección es la uretrocistoscopía orientada por una adecuada y exhaustiva anamnesis. Existen diferentes modalidades de tratamiento las que deben ser individualizadas según las características del hemangioma. Presentamos el caso de un paciente joven con uretrorragia intermitente secundario a hemangioma único en uretra anterior tratado mediante fotocoagulación con láser Holmium.
Urethral hemangioma is a rare cause of urethral bleeding. It is a benign tumor that tends to recur if treatment is not adequate. The diagnostic method of choice is urethrocystoscopy guided by adequate and thorough history. There are different treatment modalities, which should be individualized according to the characteristics of the hemangioma. We report the case of a young patient with intermittent urethral bleeding due to a single hemangioma in anterior urethra treated by holmium laser photocoagulation.
Subject(s)
Humans , Hemangioma/surgery , Holmium , Urethral Neoplasms/surgery , Laser Therapy/methods , Cystoscopy , Laser Coagulation , Hemangioma/diagnosis , Lasers, Solid-State , Urethral Neoplasms/diagnosisABSTRACT
Because information about travel medicine in Chile is lacking, a knowledge, attitudes, and practices evaluation in international travelers and medical students was done. The travelers and medical students did not know the travel medicine and sanitary conditions of their destinations, although they perceived travel-associated health risks, but <10% had any vaccination and 5% got sick during international trips.
Subject(s)
Communicable Disease Control , Communicable Diseases , Health Knowledge, Attitudes, Practice , Students, Medical/statistics & numerical data , Travel , Adult , Chile , Communicable Diseases/etiology , Humans , Middle Aged , Risk Factors , Students, Medical/psychology , Surveys and Questionnaires , Young AdultABSTRACT
La insuficiencia Renal Crónica Terminal (IRCT) es un problema mundial con tasas de incidencia en aumento, especialmente en mayores de 75 años. Las opciones de tratamiento más utilizadas en Chile son la hemodiálisis crónica (HDC) y el tratamiento conservador (TC). El objetivo principal del estudio es determinar y comparar la sobrevida a 1 año en pacientes mayores de 75 años con IRCT, sometidos a HDC versus TC; el objetivo secundario es comparar entre ambos grupos las variables: edad, sexo, etiología de la IRCT, comorbilidades, referencia al especialista, apoyo social, laboratorio y causa de muerte. Se diseñó un estudio descriptivo retrospectivo; entre Enero 2004 y Marzo 2006, 34 pacientes cumplieron los criterios de inclusión. El análisis estadístico se realizó Econ la curva de sobrevida de Kaplan-Meier, T-student y Chi cuadrado. La sobrevida general a 1 año fue de 50 por ciento;70 por ciento en los pacientes en HDC y de 21,4 por ciento en TC (p<0,005). La excepción, fueron los pacientes que ingresaron a HDC presentando más de 4 comorbilidades, donde la mortalidad a 1 año fue similar a la encontrada en pacientes con TC. De los que no ingresaron a HDC el 57,14 por ciento se debió a rechazo del paciente o familiares y el 42,8 a falta de apoyo social. En ningún caso fue por tener más de 75 años. La primera causa de muerte de los pacientes en HDC fue sepsis (66,7 por ciento); en TC fue IRC descompensada (63,6 por ciento). Consideramos necesario profundizar sobre las características de esta población para ofrecerles la mejor opción terapéutica disponible.
End stage renal disease (ESRD) is a worldwide problem with an increasing rate of incidence, especially in elders than 75 years old. The most used treatment options in Chile are the chronic hemodialysis (CHD) and the conservative treatment (CT). The main objective of the study is to determine and compare the 1 year survival rates in patients older than 75 years with ESRD, under CHD versus CT; the secondary objective is to compare between the same 2 groups the variables age, gender, etiology of the ESRD, comorbidities, specialist derivation, social support, labs and causes of death. A retrospective descriptive study was designed between January of 2004 and March of 2006, 34 patients complied the inclusion criteria. The statistical analysis was made with Kaplan-meier survival curve, T-student and Chi-square. The general survival rate after 1 year was 50 percent. 70 percent in the patients under CHD and 21,4 percent with CT (p<0,005). The exception were the patients which went under CHD having more than 4 comorbid conditions, where the mortally after 1 year was similar than those with CT. Between the patients who didn`t get into CHD, the 57,14 percent was due to a rejection from the patient himself or of their relatives and 42,8 percent due to absence of a social support. In none of the cases was due to being older than 75. The first cause of death between the patients under CHD was sepsis (66,7 percent) and under CT was an acute decompensation of the CRF (63,6 percent). It is considered necessary to research about the characteristics of this population in order to offer them the best therapeutic options available.
