Life-threatening meningitis resulting from transrectal prostate biopsy.
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After antibiotic prophylaxis with metronidazole and levofloxacin, a transrectal sextant biopsy was performed under the guide of transrectal ultrasonography (TRUS) for a 75-year-old suspicious patient with prostate adenocarcinoma. Although antibiotics were also given after this procedure, the patient still developed fever, anxious, agrypnia and headache. Blood cultures remained negative. Lumbar puncture was performed and was consistent with Escherichia coli bacterial meningitis. (+info)
Foetal age determination and development in elephants.
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Elephants have the longest pregnancy of all mammals, with an average gestation of around 660 days, so their embryonic and foetal development have always been of special interest. Hitherto, it has only been possible to estimate foetal ages from theoretical calculations based on foetal mass. The recent development of sophisticated ultrasound procedures for elephants has now made it possible to monitor the growth and development of foetuses of known gestational age conceived in captivity from natural matings or artificial insemination. We have studied the early stages of pregnancy in 10 captive Asian and 9 African elephants by transrectal ultrasound. Measurements of foetal crown-rump lengths have provided the first accurate growth curves, which differ significantly from the previous theoretical estimates based on the cube root of foetal mass. We have used these to age 22 African elephant foetuses collected during culling operations. Pregnancy can be first recognized ultrasonographically by day 50, the presumptive yolk sac by about day 75 and the zonary placenta by about day 85. The trunk is first recognizable by days 85-90 and is distinct by day 104, while the first heartbeats are evident from around day 80. By combining ultrasonography and morphology, we have been able to produce the first reliable criteria for estimating gestational age and ontological development of Asian and African elephant foetuses during the first third of gestation. (+info)
The current role of imaging for prostate brachytherapy.
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Prostate brachytherapy is a radiotherapy technique for early stage prostate cancer that uses imaging guidance to place radioactive sources directly into the prostate gland. Transrectal ultrasound is used to facilitate a template-guided transperineal approach to the prostate and permits a highly conformal method of prostate radiotherapy with doses far higher than can be achieved with other radiation techniques. Maturing data has validated this technique as an acceptable treatment option with favourable and durable biochemical outcomes. The radiologist has a major role to play in the process: patient selection, guiding source delivery and follow-up after treatment all require close collaboration with colleagues in Radiation Oncology and Medical Physics. This review emphasises the specific contribution of imaging in the context of currently reported outcomes data. (+info)
High Intensity Focused Ultrasound (HIFU): a useful alternative choice in prostate cancer treatment. Preliminary results.
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INTRODUCTION AND AIMS: High-Intensity Focused Ultrasound (HIFU) represents an alternative choice in mini-invasive treatment of prostate cancer. The technology of the device used to perform the treatment allows to exactly destroy a pre-selected area and to save all the tissues around it. We report our experience on the effectiveness and complications of this tecnique. MATERIALS AND METHODS: From May 2006 to April 2007, 25 patients with prostate cancer were treated through Ablatherm (EDAP France) in spinal anesthesia. In the first six patients HIFU and TUR-P (Trans-Urethral Resection of Prostate) were performed in the same session and a suprapubic catheter was placed. In the other 14 patients HIFU was afterwards performed. In these patients a trans-urethral catheter was placed. All patients were divided into three groups: low risk (17 patients), intermediate risk (6 patients) and high risk (2 patients). The follow-up consisted in PSA evaluation after 1, 3, 6, 9, 12 months and in transrectal biopsy after six months. Complications related to the treatment, and symptomatological and sexual life tests were evaluated before and after the treatment. RESULTS: HIFU overall success rate was 84% (biochemical relapses in only 4 patients out of 25). Success rate was represented as follows: 94.2% in the low risk group, 83.4% in the intermediate risk group and 0% in the high risk group. No complications occurred during the treatment nor in the immediately post-operative time. CONCLUSIONS: We demonstrated that HIFU represents a useful alternative choice in mini-invasive therapy of prostate cancer. Particularly, results are remarkable in localized (low-intermediate risk) and low morbility prostate cancer. The role of this procedure in high risk patients needs to be further evaluated. Transrectal HIFU represents a mini-invasive therapeutic option that makes the treatment of prostate cancer possible in 84% of cases. Our results agree with the literature data and demonstrate that the success of the procedure depends on the correct indication of treatment and is strictly related to progression risk parameters. (+info)
Imaging techniques for prostate cancer: implications for focal therapy.
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