This review discusses the efficiency and sensitivity of 68 Ga-labelled prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) imaging in comparison to other radiotracers and imaging techniques. It also conveys its impact on the treatment or management of prostate cancer patients. PSMA, observed in almost all prostate cancer cells, is used for staging and treatment, due to its high multiplication in this cancer when compared to normal tissues. PSMA PET/magnetic resonance imaging (MRI) has applications in the management of prostate cancer. Though PSMA PET/MRI has yielded preliminary results, it is still studied as an imaging biomarker for tumor responses. PSMA-PET/CT is known for its highly sensitive resolution, as it lights up only the parts harboring prostate cancer or tumor cells and not any other kind of lesion. Therefore, 68 Ga-PSMA-PET imaging is chosen over other variants of 68 Ga-PSMA-11, such as 177 Lu-PSMA or 225 Ac-PSMA, and it is used for its greater ability to detect metastatic sites in patients with biochemical recurrence and low serum prostate-specific antigens values. The efficacy of 68 Ga-PSMA PET/CT also allows for estimation of oligometastases, as it supports the design of therapeutic trials in measuring long-term effects in patients. Finally, 68 Ga-PSMA PET/ CT is effective in identifying recurrence localization and, hence, permits the ability to choose the best therapeutic strategy as early as possible.

Background and objectives: The most common Gram-negative bacteria, such as enteric bacilli, Escherichia coli and Klebsiella pneumoniae, and Gram-positive bacteria, such as Streptococcus spp., are seen in patients suffering from cirrhosis and/or chronic liver diseases. The objective of this prospective observational study was to compare the efficacy and pattern of antibiotic use in patients with bacterial translocation. Methods: This 10-month study was conducted at the Gastroenterology Department of the KIMS hospital, Telangana, India. The patients were more than 18 years of age (n = 60) and diagnosed with liver cirrhosis and/ or chronic liver diseases. All data was analyzed statistically, at a significance threshold of p < 0.05. Results: Among the 60 patients, the Child-Pugh-Turcotte scores were A in 30%, B in 35% and C in 14%. White blood cell count was reduced from 12,620 ± 1,266 (before treatment) to 8,385 ± 944 (after treatment with antibiotics; p < 0.05). Serum glutamic pyruvic transaminase values were reduced from 360.1 ± 87.3 (before treatment) to 141.9 ± 37.9 (after treatment with antibiotics therapy (p < 0.001), whereas serum bilirubin values were reduced from 6.064 ± 0.91 (Before treatment) to 3.514 ± 0.44 (after treatment with antibiotics therapy; p < 0.0001). The mortality rate was 6.6 %, i.e. only 4 patients died post-treatment. It was also observed that meropenem was prescribed in the majority of cases and norfloxacin was the least prescribed of all antibiotics. Conclusions: Our study suggests that antibiotic treatment might be effective for patients suffering with cirrhosis or chronic liver diseases with improved life expectancy.

understanding of the risks associated with pulmonary misplacement and how to improve delivery of service is required. It is well known that feeding through a pulmonary placed NGT can lead to serious harm or mortality. The National Patient Safety Agency (NPSA) issued guidelines in 2011 to try to reduce reported cases of feeding into the lungs. However,it is unknown whether the introduction of an NG tube into the lungs,in itself can introduce infection. Methods We conducted two snapshot audits at a tertiary centre between 2012-2013. Between these audits, organised training of nursing and core medical trainees was conducted. Audits involved spot-checks on 34 wards, assessing notes of all patients with NGTs in situ that day. These were then compared to NPSA guidelines. We also did a retrospective study on the outcome of cases with pulmonary misplaced tubes, between 2012-2013. To identify these, chest X-ray reports were searched. Patient mortality and cases that later developed sepsis or chest infection were calculated. They were then compared to a group of controls that did have correctly placed NGTs. Results The number of patients with NG tubes in situ were 38 and 46 in 2012 and 2013 respectively. None of these had cases of pulmonary misplacement. After the training that staff received there was a remarkable improvement in guideline adherence in 2013. Documentation of insertion increased by 46% (p < 0.001), and length of NGT recording increased by 53.9% (p < 0.001). pH checks being the first line confirmation of position, rather than X-ray, increased by 33.8% (p = 0.002). In the 18 patients that had pH checks in 2013, 7 patients did not require a second line Xray to check position. From the radiology search there were 27 patients that did have pulmonary misplacement out of a total of 1332 (2.03%). For mortality RR = 1.33 (95% CI: 0.8424-2.1077, P = 0.2199). For development of infection the RR = 1.94 which was statistically significant (95% CI: 1.1362-3.3207, P = 0.0152). Direct logistic regression was performed on patient age to assess the impact on the likelihood of developing disease. However, this was not found to be statistically significant. Conclusion It appears that training of both nursing and medical staff can have a huge benefit in increasing adherence to guidance. This study suggests that patients are nearly twice as likely to develop chest infection or sepsis after pulmonary misplacement of their NGT. Although other factors such as age have been shown to have little affect on this outcome, factors such as patient morbidity before misplacement could not be assessed. Disclosure of Interest None Declared.