Hypoechoic versus hypervascular lesion in the diagnosis of prostatic carcinoma

Objective: The goal of this study was to get a better understanding the role of Power Doppler (PDUS) and conventional Gray Scale transrectal ultrasound (TRUS) in targeting prostatic biopsy in men with high prostate-specific antigen (PSA).Patients and methods: A prospective comparative study of 100 men, categorized according to PSA level into two groups: Group (A) with a PSA level (4.0–10.0) ng/ml (Gray zone) and Group (B) with PSA >10.0 ng/ml, above Gray zone. Gray Scale scanning was done, followed by Color Doppler and Power Doppler to test the blood flow all over the prostate and suspicious foci. Twelve systematic TRUS-guided core needle biopsies were performed, and additional biopsies of abnormal lesions on Gray Scale TRUS and PD-TRUS. The demographic data, clinical data, imaging results, laboratory investigations, histopathological report and its correlation with pathological results and any complications during or post the procedure estimated.Results: The age of the Group (A) ranged between 50 and 75 years with a mean± S.D. of 65.7 ± 6.8 years, while in the Group (B), it ranged between 54 and 84 years with a mean ± S.D. of 69.5 ± 6.3 years. TRUS biopsy revealed prostate cancer in 11 (35.5%) out of 31 cases of the Group (A) and 35 (50.7%) out of 69 cases of the Group (B) (p < 0.003). Thirty out of 39 (76.9%) from Group (B) were hypervascular in PDUS (p < 0.04). PDUS sensitivity, specificity, positive predictive value (PPV) and negative predictive values were 74.5%, 85.7%, 84.4% and 76.4%

Genitourinary brucellosis: results of a multicentric study

This study reviewed the clinical, laboratory, therapeutic and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multicentre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 male, 90.2%) were pooled. In male patients, the most frequent involved site was the scrotal area (n=327, 83.8%), as epididymo-orchitis (n=204, 58%), orchitis (n=112, 31.8%) and epididymitis (n=11, 3.1%). In female patients, pyelonephritis (n=33/38, 86.8%) was significantly higher than in male patients (n=11/352, 3.1%; p<0.0001). The mean blood leukocyte count was 7530 +/- 3115/mm(3). Routine laboratory analysis revealed mild to moderate increases for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The mean treatment duration and length of hospital stay were significantly higher when there were additional brucellar foci (p<0.05). Surgical operations including orchiectomy and abscess drainage were performed in nine (2.3%) patients. Therapeutic failure was detected in six (1.5%), relapse occurred in four (1%), and persistent infertility related to brucellosis occurred in one patient. A localized scrotal infection in men or pyelonephritis in women in the absence of leucocytosis and with mild to moderate increases in inflammatory markers should signal the possibility of brucellar genitourinary disease