RESUMEN
INTRODUCTION: An elevated PSA and a negative prostate biopsy (PB) can be a false negative PB that ignores a prostate cancer (PCa) or a false positive PSA not related to PCa. The objective of this study was to analyze a group of patients who had a negative first BP for a PSA superior to 4 ng/mL and at least one additional PB and to compare these cases with controls who had the diagnosis PCa from the first PB. METHODS: Retrospective single-center study comparing patients with an elevated PSA and repeat biopsy following a first negative PB and patients with PCa diagnosed from the first PB. RESULTS: The 63 cases were younger than the 75 controls and had more often a normal digital rectal examination. Their prostate volume was larger and their number of PSA before the first PB lower: this corresponded to a lower PSA in the second (7/64), third (6/31), fourth (3/9) and sixth (1/1) PB. Among these cases with PCa, the length of core invaded by cancer and the total length of cancer of the entire PB were smaller than controls. In 76% of cases, the Gleason score among cases was 6 or less. CONCLUSION: PCa discovered on repeat biopsy had features of better prognosis than those of controls. We propose an algorithm for management of patients with elevated PSA and negative first PB.
Asunto(s)
Antígeno Prostático Específico/sangre , Próstata/patología , Adenocarcinoma/diagnóstico , Anciano , Biopsia , Estudios de Casos y Controles , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/diagnóstico , Estudios RetrospectivosRESUMEN
INTRODUCTION: Renal transplantation is an attractive alternative to haemodialysis for patients with renal failure. Preserving renal function after renal transplantation depends on rejection episodes and infections of the graft. PURPOSE: To clarify the characteristics of acute pyelonephritis encountered in a population of kidney transplant patients and to discern risk factors occurring during the first year after transplantation. METHOD: Data for all renal transplantations between January 1, 2006, and December 31, 2007 came from a database. Patients were at least 18 years old. A retrospective analysis was done. RESULTS: One hundred and eighty-four patients were included in the study. The incidence of acute pyelonephritis was 10.9%. In our sample, there were significantly more women who experienced pyelonephritis (P=0.012). Patients who had grafts with at least one episode of acute pyelonephritis were significantly younger (P=0.013) than transplanted patients without a history of acute pyelonephritis (44.4±10.5 and 52.2±13.4 years, respectively). CONCLUSION: Our study shows a lower incidence of pyelonephritis compared with the literature. Moreover, we found that young age and female gender were risk factors for developing this infection.