Introduction: Current diagnosis of prostate cancer is based on transrectal ultrasound guided random biopsies. These procedures alongside with the discovery of PSA lead to a tremendous improvement of prostate cancer diagnosis rate in the last decades. Random ultrasound guided biopsy has its minuses and several attempts were made to improve the detection rate of the disease. MRI-US fusion targeted biopsies is one of them. Aim: This paper is a literature review of several important European studies and tries to draw a conclusion for the usefulness of MRI-US image fusion prostate biopsy in improving prostate cancer detection Material and methods: We have analyzed 5 papers published since 2013 which compare random ultrasound biopsies with MRI-US fusion. The analyzed parameters were clinical significant cancer detected as described by the study and any cancer detected Results: All 5 papers show superiority in cancer detection rates for both clinically significant and any cancer. Conclusions: MRI-US is a useful tool for improving detection rate of clinically significant prostate cancer. INTRODUCTION in general Prostate cancer is a serious public health matter, being the first cancer in men in terms of incidence and the second cause of cancer death in the U.S. in the Cancer, following year cardiovascular diseases as the leading cause of mortality. Prostate cancer, in particular is becoming more and more important due population aging. [1] is taught to surpass While throughout the history prostate cancer was poorly understood, with few cases recorded due to the low life expectancy, during the XXth century groundbreaking understanding, diagnosing and treating the disease. discoveries were made in Early diagnosis methods included open transperineal biopsies, blind transperineal needle biopsy and finger guided transrectal biopsy. First attempts to use transrectal ultrasound for prostate imaging were made by Takahasi and Ouchi in 1963 but they in 1968 obtained poor performed first clinical useful TRUS. In 1989 Hodge and al. started the modern era of standard sextant [2]. Watanabe images 1 Carol Davila Central University Emergency Military Hospital, Bucharest 2 Saarbrucken, Germania 3 Carol Davila University of Medicine and Pharmacy, Bucharest 5
This study analyzes the satisfaction of the patients with radical prostatectomy according to the signs and symptoms included in the EORTC QLQ – C30 and EORTC QLQ – PR25 questionnaires, including their relation with the health state that influences the pre and postoperative life quality. Fifty patients with prostate cancer in a localized stage were studied and analyzed in a prospective manner and for a period of 12 months, before and 6 months after the radical prostatectomy. In choosing the patients, the common denominator was the use of the same postoperative plan and the lack of postoperative complications, as well as the lack of chronic diseases. Erectile dysfunction, urine incontinence were quite frequent after radical prostatectomy, while the urinary obstruction and the weak urinary stream were less frequent. In this regard, people noticed a significant decrease of life quality. Although the study addressed a small group of patients, the results are similar to those belonging to other clinical studies. Even if the aspect of life quality is more rarely taken into account, the questionnaires regarding the life quality are specific, useful and quite cheap in evaluating different therapies.
Introduction: Venous thromboembolism (VTE), in its clinical spectrum, includes both deep venous thrombosis (DVT) and pulmonary embolism (PE). It is a disease with high incidence and morbidity in hospital and community settings. Venous thromboembolism has various risk factors and there are studies proving that the risk of increasing the incidence of the disease is proportional to the risk factors. Diagnosis, treatment and complications of lower limb deep vein thrombosis (DVT) depend on the anatomical location and extent of the process. The post-thrombotic syndrome (PTS) is the most common complication of deep vein thrombosis (DVT) and clinically it is characterized by chronic pain, edema, enlarged veins, skin induration and other signs of the affected limb, while, in severe cases, it can develop venous ulcers. The incidence of peripheral trophic disorders by age and the prevalence of risk factors for deep vein thrombosis of the lower limbs were examined in this regard. Materials and method: A retrospective study (January 2013 - December 2015) was conducted by collecting data from medical documents available in "Floreasca" Emergency Hospital Bucharest, Romania. The patients diagnosed with deep vein thrombosis, on the basis of Doppler ultrasound, were divided into two groups, according to age: group A (59 patients aged ≤50 years) and group B (130 patients aged> 50 years). A number of data from the medical anamnesis, along with clinical and paraclinical data were collected by us and we were interested in the incidence of peripheral trophic disorders caused by deep vein thrombosis of the lower limbs correlated with the risk factors. The study showed the incidence of deep venous thrombosis in a certain age and a certain environment of origin. The incidence of patients who have had a VTE history is half the patients with deep vein thrombosis who have had prophylactic anticoagulant therapy before hospitalization. The incidence of patients who have had prophylactic anticoagulant therapy before hospitalization is 61.1% of the patients with deep vein thrombosis and a VTE history. The incidence of trophic disorders caused by deep vein thrombosis of the lower limbs in patients who have had prophylactic anticoagulant therapy before hospitalization and in patients who also had a history of VTE is higher in those over 50 years old. The study showed the association of some risk factors for venous thrombosis with an age-related factor. Conclusions: Improving preventive strategies and an optimally efficient utilization of these strategies for patients at risk of venous thrombosis can lead to improved clinical outcomes in practice and also to the post-thrombotic syndrome prevention. Taking into consideration the risk factors by age group and a better understanding of epidemiology and the risk factors for the first or recurrent venous thrombosis can lead to optimal use of prophylactic strategies and improved quality of life. DVT affects all age groups and the incidence associated with PTS is high, therefore the prevalence of PTS in general population is considerable. 1 Sanitary Post High School “Fundeni”-Bucharest 2 Carol Davila University of Medicine and Pharmacy, Bucharest 3 Toxicology Clinic, “Floreasca” Emergency Hospital, Bucharest 4 Surgery Clinic, “Sf. Pantelimon” Emergency Hospital, Bucharest 5 Carol Davila University Emergency Military Hospital, Bucharest 37
