1.Can we omit systematic biopsies in patients undergoing MRI fusion-targeted prostate biopsies?
Jeffrey J LEOW ; Soon Hock KOH ; Marcus Wl CHOW ; Wayren LOKE ; Rolando SALADA ; Seok Kwan HONG ; Yuyi YEOW ; Chau Hung LEE ; Cher Heng TAN ; Teck Wei TAN
Asian Journal of Andrology 2023;25(1):43-49
Magnetic resonance imaging (MRI)-targeted prostate biopsy is the recommended investigation in men with suspicious lesion(s) on MRI. The role of concurrent systematic in addition to targeted biopsies is currently unclear. Using our prospectively maintained database, we identified men with at least one Prostate Imaging-Reporting and Data System (PI-RADS) ≥3 lesion who underwent targeted and/or systematic biopsies from May 2016 to May 2020. Clinically significant prostate cancer (csPCa) was defined as any Gleason grade group ≥2 cancer. Of 545 patients who underwent MRI fusion-targeted biopsy, 222 (40.7%) were biopsy naïve, 247 (45.3%) had previous prostate biopsy(s), and 76 (13.9%) had known prostate cancer undergoing active surveillance. Prostate cancer was more commonly found in biopsy-naïve men (63.5%) and those on active surveillance (68.4%) compared to those who had previous biopsies (35.2%; both P < 0.001). Systematic biopsies provided an incremental 10.4% detection of csPCa among biopsy-naïve patients, versus an incremental 2.4% among those who had prior negative biopsies. Multivariable regression found age (odds ratio [OR] = 1.03, P = 0.03), prostate-specific antigen (PSA) density ≥0.15 ng ml-2 (OR = 3.24, P < 0.001), prostate health index (PHI) ≥35 (OR = 2.43, P = 0.006), higher PI-RADS score (vs PI-RADS 3; OR = 4.59 for PI-RADS 4, and OR = 9.91 for PI-RADS 5; both P < 0.001) and target lesion volume-to-prostate volume ratio ≥0.10 (OR = 5.26, P = 0.013) were significantly associated with csPCa detection on targeted biopsy. In conclusion, for men undergoing MRI fusion-targeted prostate biopsies, systematic biopsies should not be omitted given its incremental value to targeted biopsies alone. The factors such as PSA density ≥0.15 ng ml-2, PHI ≥35, higher PI-RADS score, and target lesion volume-to-prostate volume ratio ≥0.10 can help identify men at higher risk of csPCa.
Male
;
Humans
;
Prostate/pathology*
;
Prostatic Neoplasms/pathology*
;
Prostate-Specific Antigen
;
Magnetic Resonance Imaging/methods*
;
Image-Guided Biopsy/methods*
;
Retrospective Studies
2.Socio-economic Status, Food Security Status and its Coping Strategies among ‘The Lost Food Project’ (TLFP) Recipients in Klang Valley during COVID-19 Pandemic
Nur Arina Bakeri ; Norhasmah Sulaiman ; Nur Syaqiera Mansor ; Wan Ying Gan ; Seok Kwan Tan
Malaysian Journal of Medicine and Health Sciences 2023;19(No.1):80-88
Introduction: The Lost Food Project (TLFP) is a non-profit organization who continuously working on their strategic
plan in combating the food insecurity problem by distributing food surplus to low income households within Klang
Valley. This cross-sectional study aims to determine the socioeconomic status, food security status and its coping
strategies among TLFP recipients in Klang Valley during COVID-19 pandemic. Methods: This study was conducted
from April to June 2021. There were 88 respondents recruited through convenience sampling. A set of questionnaires regarding food assistance, nutrition knowledge, food security and its coping strategies was prepared, and the
respondents were interviewed either by phone, face-to-face or self-administered questionnaire. Results: The prevalence of food insecurity among households in this study was 59.1%. Most of them have moderate (37.5%) to good
(27.5%) nutrition knowledge. The coping strategy that most of the respondents applied was ‘using less expensive
food’ (58.3%) with at least once per week within the past one month. Food insecure households tend to adopt more
coping strategies compared to those food secure households (p<0.001). Moreover, households who rent their house
(p<0.01), low household income (p<0.05) and high monthly food and drinks expenditure (p<0.01) were associated
with the food insecurity among TLFP recipients. Conclusion: The study concluded that lower household income,
higher food and drinks expenditure and those who rent the house have negative impacts on household’s food security status. Thus, the situation forced them to apply more food-related coping strategies in their daily life. Further research should be conducted on the effectiveness of TLFP in helping them to improve Malaysian’s food security status.