Urology
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Randomized Controlled Trial Comparative Study
Optimal approach for prostate cancer detection as initial biopsy: prospective randomized study comparing transperineal versus transrectal systematic 12-core biopsy.
Transperineal and transrectal prostate biopsy are both used for prostate cancer detection. However, which approach is superior remains unknown. In this study, we performed a prospective randomized study to compare the efficacy of transperineal versus transrectal 12-core initial prostate biopsy. ⋯ No significant differences were found in the cancer detection rate, cancer core rate, or complications between the two approaches. We believe that the preferred approach as an initial prostate biopsy is the transrectal approach, which does not require spinal anesthesia or another burdensome process.
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Multicenter Study
Impact of previous bacille Calmette-Guérin failure pattern on subsequent response to bacille Calmette-Guérin plus interferon intravesical therapy.
To evaluate the effect of the bacille Calmette-Guérin (BCG) failure pattern in patients with non-muscle-invasive bladder cancer on the subsequent response to intravesical immunotherapy. ⋯ Patients with non-muscle-invasive bladder cancer with disease recurrence more than 1 year after BCG treatment and who were treated with low-dose BCG plus interferon-alpha had response rates similar to those of BCG-N patients treated with regular-dose BCG plus interferon. Although cystectomy should still be strongly considered, these patients might benefit from another trial with intravesical immunotherapy. In contrast, recurrence within 1 year of BCG treatment should lead to consideration of either cystectomy or alternative intravesical therapies.
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Comparative Study
Productivity and cost implications of implementing electronic medical records into an ambulatory surgical subspecialty clinic.
Electronic medical records (EMRs) have been proposed as technology through which the quality of healthcare could be improved. We present an analysis of the cost and productivity implications associated with the transition from transcription to an EMR system in an ambulatory setting. ⋯ The results of our study have shown that the implementation of an EMR system when an economy of scale exists coincides with an increase in the revenue per encounter and per provider compared with transcription. The advantage of the fixed costs of an EMR system compared with the variable costs of a transcription-based system is the allowance of cash savings in an ambulatory surgical subspecialty practice.