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Biomedical subjects

J M Carey

Publications and source records attributed to J M Carey.

10 recordsLinked to original sources
PubMed2001

Transrectal ultrasound guided biopsy of the prostate. Do enemas decrease clinically significant complications?

PURPOSE: Transrectal ultrasound guided biopsy of the prostate is the most common modality used to diagnose prostate cancer. Although many biopsy protocols have been described, in our opinion the role of enema before biopsy has not been definitively assessed in the literature. MATERIALS AND METHODS: A retrospective review of 448 transrectal ultrasound guided biopsies was performed. All biopsies were done with the same equipment, and all patients received identical antibiotic prophylaxis with ciprofloxacin. There were 38 patients excluded from the study secondary to alternate antibiotic prophylaxis. A total of 225 patients received enemas before biopsy, while 185 did not. Clinically significant complications necessitating office visit, secondary therapy and hospitalization were evaluated. RESULTS: Overall, clinically significant complications developed in 4.4% (10 of 225) of patients who had versus 3.2% (6 of 185) of those who did not have an enema (p = 0.614). There were 2 patients in each group who underwent transurethral prostatic resection or suprapubic prostatectomy for gross hematuria and/or urinary retention after biopsy. Of the patients who received enemas 2 were hospitalized for urinary retention and complicated urinary tract infection. One patient in the group without enema was hospitalized for gross hematuria and clot urinary retention. No patients who did not receive enema preparation were hospitalized for infectious complications. CONCLUSIONS: Transrectal ultrasound guided prostate biopsy accompanied by quinolone antibiotic prophylaxis remains a relatively safe procedure. Enema before biopsy provides no clinically significant outcome advantage, and potentially increases patient cost and discomfort.

Adenocarcinoma↗
PubMed2000

Paediatric urinary tract infection and the necessity of complete urological imaging.

OBJECTIVE: To evaluate voiding cysto-urethrography (VCUG) in assessing children with urinary tract infection (UTI) when renal/bladder ultrasonography and renal scintigraphy show no abnormality. PATIENTS AND METHODS: A total of 468 renal scintigrams taken in children for an indication of UTI between January 1996 and December 1998 were reviewed. The renal and bladder ultrasonograms of those children with a normal renal scan were then reviewed. Children with both normal renal scans and normal ultrasonography were then evaluated for the frequency and grade of vesico-ureteric reflux (VUR) on VCUG. RESULTS: Of the 468 patients, 453 (97%) had complete imaging studies; 152 of the children evaluated had normal renal scans, of whom 101 had a normal renal ultrasonogram. Twenty-three (23%) children with both a normal renal scan and renal/bladder ultrasonogram showed VUR on VCUG, of whom 14 had bilateral VUR and 13 grade III or higher VUR. CONCLUSION: This study indicates that about 23% of patients may have significant VUR despite both a normal renal scan and ultrasonogram. Therefore, VCUG remains important in evaluating and managing children with UTI.

Clinical Protocols↗
PubMed1994

Chromium determination by supercritical fluid chromatography with inductively coupled plasma mass spectrometric and flame ionization detection.

Supercritical fluid chromatography (SFC) has been investigated for the separation of a pair of beta-ketonate chromium compounds and a thermally labile organochromium dimer. A limited comparison between flame ionization detection (FID) and inductively coupled plasma mass spectrometric (ICP-MS) detection of these compounds is presented. The beta-ketonate complexes were observed with both detectors, while the thermally labile dimer was not observed with ICP-MS detection. Detection limits for these compounds with ICP-MS were in the range of 0.9 to 3 pg with FID giving values between 10 and 250 pg. Reproducibility of the method is between 1 and 4% relative standard deviation (R.S.D.). The technique provided a linear response over approximately three orders of magnitude. The effect of two mobile phases (nitrous oxide and carbon dioxide) on the detection by each of the detectors are presented in a qualitative manner. Finally, the SFC-ICP interface heating method and the manner in which the restrictor is heated in the FID system are compared and there effect on the chromatography discussed.

Chromatography, High Pressure Liquid↗
PubMed1993

Alternate methods of sample introduction for plasma mass spectrometry.

The most common method of sample introduction for plasma mass spectrometry is solution nebulization, which suffers from a number of short-comings; therefore, a great deal of effort has been placed on the investigation of other sample introduction methods. The common solution nebulization method and its disadvantages are discussed and, in some detail, several alternative methods of sample introduction are reviewed. The methods include electrothermal vaporization, hydride generation, liquid chromatography, gas chromatography, and supercritical fluid chromatography. Advantages and disadvantages of each of these methods will be discussed along with examples from work performed in our laboratory.

Mass Spectrometry↗