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.
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