Biomedical subjects

T Tarcan

Publications and source records attributed to T Tarcan.

24 records · Page 2Linked to original sources

PubMed1995

Antimicrobial prophylaxis in management of urinary tract stones by extracorporeal shock-wave lithotripsy: is it necessary?

OBJECTIVES: In a prospective randomized study, we evaluated the incidence of urinary tract infections following extracorporeal shock-wave lithotripsy (ESWL) and the necessity of prophylactic antibiotic administration in patients treated with this modality. METHODS: A total of 360 consecutive patients with renal and ureteric stones who had sterile urine before ESWL treatment and did not have any increased risk of infection received either a single dose of 400 mg of ofloxacin or no prophylaxis. Patients were followed by simple urine analysis and urine cultures together, with clinical evaluations. RESULTS: Only 3 patients (0.8%) had positive urine cultures at 1 week after ESWL. Two of these patients were in the antibiotic prophylaxis group. CONCLUSIONS: The incidence of urinary tract infections after ESWL is extremely low, provided that patients have sterile urine before ESWL, and prophylactic antibiotics are not required.

Adult↗

PubMed1995

When should one perform shockwave lithotripsy for lower caliceal stones?

Extracorporal shockwave lithotripsy of lower caliceal stones is often unrewarding because of the difficulty of passing stone fragments. We report our results in SWL of lower pole stones in 219 patients and compare them with the results of SWL of middle (82 patients) and upper pole (85 patients) stones. The stone-free rate of SWL monotherapy was found to be 59%, 77%, and 64% in lower, middle, and upper caliceal stones, respectively. In lower pole stones, SWL was unsuccessful in 41% of the patients, of whom 9% had minimal residual asymptomatic stones (less than 4 mm in greatest diameter). In comparison with the results of percutaneous nephrolithotomy (PCN) of lower pole urolithiasis in the literature, SWL was unsuccessful in large stones, with stone-free rates of 13% and 0 when the stone size was 3 to 4.9 cm2 and > 5 cm2, respectively. A stone-free rate of 82% when the stone burden was < 1 cm2 is similar to the PCN results of other centers, suggesting that SWL may be the first choice of treatment in lower pole stones of this size. We achieved a stone-free rate of 59% when the stone size was between 1 and 3 cm2, which is lower than the stone-free rates of PCN in the literature. In spite of its lower stone-free rates, SWL, with its lower morbidity, may still be considered an acceptable treatment modality in this range of moderate stone burden, especially when there is a patient desire for conservative treatment.

Adolescent↗

PubMed1995

Transrectal ultrasonography versus digitally guided prostate biopsies in patients with palpable lesions on digital rectal examination.

OBJECTIVE: To compare the efficacy of digital and ultrasonographic guidance of biopsies when there is a palpable lesion on the prostate. PATIENTS AND METHODS: Forty patients with a palpable nodule confined to a single lobe of the prostate underwent digitally guided biopsies of this lesion or biopsies directed by transrectal ultrasonography (TRUS) and/or systematic biopsies. RESULTS: According to the histopathological examination, 21 patients were found to have prostate carcinoma (PCa) using TRUS-guided biopsies, whereas digitally guided biopsies revealed PCa in 18 patients but did not detect three cases. In the study group, the prostate of 10 patients had a normal ultrasonographic appearance and two patients had PCa revealed by systematic biopsies. CONCLUSION: We suggest that in the presence of a palpable lesion in the prostate, regardless of TRUS findings, systematic biopsies are mandatory. Present data indicates that digitally guided biopsies are unnecessary as they do not provide additional information over systematic or TRUS-guided biopsies.

Aged↗

PubMed1995

The diagnostic accuracy of digital rectal examination, transrectal ultrasonography, prostate-specific antigen (PSA) and PSA density in prostate carcinoma.

OBJECTIVE: To evaluate the efficacy of digital rectal examination (DRE), transrectal ultrasonography (TRUS), prostate-specific antigen (PSA) and PSA density (PSAD) in the diagnosis of prostate cancer (CaP). PATIENTS AND METHODS: Retrospective data were analysed from a selected population of 159 patients (mean age 66.7 years, range 50-83), 56 with histologically diagnosed CaP and 103 with benign prostatic hyperplasia (BPH). RESULTS: Among the four methods, DRE was found to have accuracy, sensitivity and specificity rates of 79.9, 91 and 73.8% respectively. The most common clinical practice, the combination of PSA (> 4 ng/mL), DRE and TRUS, showed a higher accuracy, a similar specificity rate, but a lower sensitivity (84.2, 91.2 and 71.4%, respectively). Rates from the combination of PSAD (> 0.15 ng/mL/cm3) with DRE and TRUS were not significantly different from those obtained using the combination of PSA, DRE and TRUS. CONCLUSION: PSAD alone or in combination did not improve the diagnostic value of PSA. We cannot claim DRE was the best method for the diagnosis of CaP, because this study group did not represent a true screening population. However, this study revealed that DRE should not be omitted from the physical examination of patients and, despite technological developments, it remains a major tool in the diagnosis of CaP.

Aged↗

PubMed1995

Social and medical aspects of undescended testes in Turkey.

In this study, 6,381 primary school boys were examined in Turkey in the years 1990 and 1991 and families and medical personnel were questioned about the information they had on undescended testes and their behavior regarding this matter was noted. Undescended testes were found in 91/6,381 pupils (1.43%) Forty-six families (58.7%) were aware of the abnormality. In 36 of these 46 cases (78%), the mother was the first who noticed the problem. Only 3 cases were first diagnosed by medical staff (nurses or doctors). Eighteen cases were diagnosed under 2 years of age, but apparently they had not been managed correctly because of ignorance regarding possible complications. Of the 46 families, who were aware of the problem, only 29 (63%) had seen a physician. In other words, only 31% (29/91) of the boys with undescended testes received medical help. This study has shown that no genital organ examination of the newborn is performed after most deliveries and there is a considerable unawareness of undescended testes both by the families and by medical personnel.

Adolescent↗

PubMed1994

The role of ureteroscopy as a diagnostic and therapeutic tool in various indications.

Ureteroscopy is now in routine use for the diagnosis and treatment of various pathologies in the upper urinary tract. We report here on our experience in diagnostic and therapeutic applications of the 11.5 F rigid ureteroscope in 85 patients and 88 ureters. An overall success rate of 68.18% (60/88) was achieved when therapeutic and diagnostic interventions were evaluated together. Success rate was 66.65% in the treatment of ureteral stones (all locations), 100% in the removal of retained catheters, and 81.82% in diagnostic interventions. Frequencies of complications like postoperative fever, stone migration, and various degrees of ureteral perforation were 5.68%, 5.68%, and 7.95%, respectively, consistent with current literature. We conclude that rigid ureteroscopy can be safely applied for appropriate indications in the hands of competent urologists.

Adult↗