The authors acknowledge the Carefusion Foundation for support via a clinical excellence grant of this work titled &#8220;Prospective evaluation of procedural povidone iodine rectal preparation to reduce infectious complications following ultrasound guided prostate needle biopsy.&#8221;

这名患者的相关研究经机构审查委员会（IRB）对人类的研究。 1.患者准备和定位<ol><li>把病人的程序套件，并将其放置在他们的右侧或左侧膝盖弯曲至胸前。 </li><li>执行手术超时即病人，手术过程，并指示进行审查和确认。 </li><li>当指出，通过麻醉服务管理静脉镇静。 </li></ol> 2.进行直肠指诊（DRE） <ol><li>将大小合适的手套到双手。 </li><li>将戴手套的手指润滑进入直肠后穹窿并检查前列腺感觉需要注意力集中在经直肠超声检查的潜在可疑的地方。10 </li></ol> 3.创建聚维酮碘直肠制备（PIRP） <ol><li>倾将15ml 10％的市售的聚维酮碘溶液到无菌盆地。 </li><li>添加5毫升市售1％利多卡因凝胶此盆。 </li><li>混合内容物15秒以创建碘伏浆料。 </li></ol> PIRP 4初级管理<ol><li>使用无菌肛拭培养直肠保管库。 </li><li>开辟一个4厘米×4厘米的无菌纱布上，浸泡在聚烯吡酮碘的浆液，然后插入到直肠保管库。只有一个小尾巴纱布留从肛门所产生的。 </li><li>留在原地的纱布为其后它被取出并丢弃2分钟。 </li></ol> PIRP 5.二级管理<ol><li>使用一次性棉签妇科画肛周区域与PIRP解决方案。 </li><li>插入此妇科拭子插入直肠跳马到3厘米从肛门的距离。 </li><li>为了进一步延长直肠黏膜PIRP的曝光，拭直肠VAU其中在一个类似的方式中至少三次。 </li><li>使聚维酮碘溶液干燥2 -在进行标准经直肠超声检查和随后的活组织检查之前3分钟11这是重要的，因为PIRP的杀菌作用所需要的溶液以干燥在暴露粘膜。 </li><li>使用无菌肛拭培养直肠保管库。 </li></ol> 6.直肠超声和活检<ol><li>通过直肠插入超声波探头。 </li><li>请在所有泌尿惯例相一致的标准的方式对前列腺和随后的活检测量。11,12 </li></ol>

<ol>
	<li>Nam, R. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increasing+hospital+admission+rates+for+complications+after+transrectal+ultrasound+guided+prostate+biopsy.">Increasing hospital admission rates for complications after transrectal ultrasound guided prostate biopsy.</a> J Urol. 189, S12-S17 (2013).</li><li>Feliciano, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+incidence+of+fluoroquinolone+resistant+infections+after+prostate+biopsy+are+fluoroquinolones+still+effective+prophylaxis.">The incidence of fluoroquinolone resistant infections after prostate biopsy are fluoroquinolones still effective prophylaxis.</a> J Urol. 179 (3), 952-955 (2008).</li><li>Kehinde, O., Al-Maghrebi, M., Sheikh, M., Anim, J. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Combined+ciprofloxacin+and+amikacin+prophylaxis+in+the+prevention+of+septicemia+after+transrectal+ultrasound+guided+biopsy+of+the+prostate.">Combined ciprofloxacin and amikacin prophylaxis in the prevention of septicemia after transrectal ultrasound guided biopsy of the prostate.</a> J Urol. 189 (3), 911-915 (2013).</li><li>Taylor, A. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeted+antimicrobial+prophylaxis+using+rectal+swab+cultures+in+men+undergoing+transrectal+ultrasound+guided+prostate+biopsy+is+associated+with+reduced+incidence+of+postoperative+infectious+complications+and+cost+of+care.">Targeted antimicrobial prophylaxis using rectal swab cultures in men undergoing transrectal ultrasound guided prostate biopsy is associated with reduced incidence of postoperative infectious complications and cost of care.</a> J Urol. 187 (4), 1275-1279 (2012).</li><li>Gyorfi, J. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peri+procedural+povidone+iodine+rectal+preparation+reduces+microorganism+counts+and+infectious+complications+following+ultrasound-guided+needle+biopsy+of+the+prostate.">Peri procedural povidone iodine rectal preparation reduces microorganism counts and infectious complications following ultrasound-guided needle biopsy of the prostate.</a> World J Urol. 32 (4), 905-909 (2014).</li><li>Park, D. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Control+of+infective+complications+of+transrectal+prostate+biopsy.">Control of infective complications of transrectal prostate biopsy.</a> Surg Infect Larchmt. 15 (4), 431-436 (2014).</li><li>Park, D. S., Oh, J. J., Lee, J. H., Jang, W. K., Hong, Y. K., Hong, S. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Simple+use+of+the+suppository+type+povidone+iodine+can+prevent+infectious+complications+in+transrectal+ultrasound+guided+prostate+biopsy.">Simple use of the suppository type povidone iodine can prevent infectious complications in transrectal ultrasound guided prostate biopsy.</a> Adv Urol. , (2009).</li><li>AbuGhosh, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+prospective+randomized+trial+of+povidone+iodine+prophylactic+cleansing+of+the+rectum+before+transrectal+ultrasound+guided+prostate+biopsy.">A prospective randomized trial of povidone iodine prophylactic cleansing of the rectum before transrectal ultrasound guided prostate biopsy.</a> J Urol. 189 (4), 1326-1331 (2013).</li><li>Gerber, G. S., Brendler, C. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+the+Urological+Patient:+History,+Physical+Exam,+and+Urinalysis.">Evaluation of the Urological Patient: History, Physical Exam, and Urinalysis.</a> Campbell Walsh Urology. , (2015).</li><li>Hodge, K. K., McNeal, J. E., Terris, M. K., Stamey, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Random+systematic+versus+directed+ultrasound+guided+transrectal+core+biopsies+of+the+prostate.">Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate.</a> J Urol. 142 (1), 71-74 (1989).</li><li>Donoghue, P. M., McSweeney, S. E., Jhaveri, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genitourinary+imaging:+current+and+emerging+applications.">Genitourinary imaging: current and emerging applications.</a> J Postgrad Med. 56 (2), 131-139 (2010).</li></ol>

The authors have nothing to disclose.

下面TRUS PNB感染继发于直肠跳马细菌易位进入富含血管的前列腺。基于该原理，我们已经探索使用主题防腐剂如聚烯吡酮碘，以减少前，前列腺活检微生物菌落计数的简单方法。我们的经验突出了从4.3％下降至0.6％（P = 0.02），在使用这个PIRP方案的活检的时间。此外，我们假设在直肠保管库的微生物的减少97％是本降低全身性感染的基本原理的因素。 我们与外用聚维酮的结果?...

前列腺癌是最常见的癌症的男性和癌症相关死亡的第二大原因。在2014年，大约233000箱子将被诊断在美国有近3万人屈服于这种恶性肿瘤。1在前列腺特异性抗原（PSA）验血和直肠指诊（DRE）发挥前列腺癌筛查的重要作用，经直肠超声引导下前列腺穿刺活检（TRUS PNB）更是获得了病理组织学诊断最常用的手段。 TRUS PNB过程​​包括将超声探头插入病人的直肠，然后通常获得12-14活检正好位于前方前列腺的周边区。每个穿刺活检需要一个18G的针头通过直肠前壁通道进入富含血管的前列腺。因此，出血和感染引起的细菌易位的理论风险存在以下的步骤。无theless，精算并发症发生率后处理过程在历史上仍然很低。 预防性抗生素前TRUS PNB是常规处方与喹诺酮类抗生素是最常用的药物。尽管有足够的预防，当代研究牵连增加感染并发症后活检。2。此外，有研究认为这上升的感染并发症TRUS PNB以喹诺酮类耐药微生物尤其是大肠杆菌的出现大肠杆菌 。3 喹诺酮类药物耐药性的这种上涨的幅度意味着需要替代预防方案的TRUS PNB程序。为此，几个不同的途径正在调查中。一种方法涉及一个静脉内或肌内抗生素的给药在活检时间结合的口服喹诺酮4虽然这种策略可以减少以下TRUS PNB败血症事件这种方法的一个主要限制是进一步发展抗性微生物此抗生素家族的潜力。另一最近研究方法融合使用预活检直肠拭子筛选患者定植喹诺酮耐药直肠菌群5如果检测到这样的生物体，一个"针对性"抗生素治疗方案可以基于所识别的耐药性细菌的灵敏度分布可以采用株。虽然该方法是优雅的，取得这样的棉签，有选择地对喹诺酮类药物的选择性培养基中培养，和剪裁抗生素的实际过程之后要求可能缺乏的许多临床实践的临床和实验室的基础设施。 政府防腐剂，以减少可能出现其他的方法来限制​​TRUS PNB感染活检前直肠金库微生物菌落计数的一个话题。聚维酮iodone是一种廉价的，容易得到的试剂是当应用到手术部位记录，以减少细菌的数量。在两种结直肠癌和妇科手术应用是公知的。因此，使用povidine碘作为直肠制剂会提出一个可生产，简单，经济有效的方法，以减少TRUS PNB感染，而无需进行前活组织检查额外的准备。相对于泌尿文献，先前的工作已经指出，在下面的TRUS PNB临床感染的降低。6-9本视频演示PIRP的技术中，突出的容易和简单地集成到临床实践。 所有接受TRUS PNB患者最初出现在一个专业泌尿外科就诊转诊或初步评估前列腺癌筛查。该评估entailed患者的血清前列腺特异性抗原（PSA）及直肠指诊（DRE）的表现进行了审查。无论是PSA或DRE异常提示的建议一个TRUS PNB。 该TRUS PNB过程​​，所有的病人和包括感染，出血相关风险的讨论，和尿潴留进行了澄清。所有患者接受口服抗生素预防三天无论是喹诺酮类药物（如环丙沙星）或磺胺（复方新诺明）前活检。

<table><tbody><tr><td>Povidone Iodine Solution, 10% Topical Microbicide Antiseptic, 8 fl oz.</td><td>Equate</td><td>4067979</td><td></td></tr><tr><td>4 x 4 sterile gauze pads, white</td><td>Dukal Corporation</td><td>DKL1412</td><td></td></tr><tr><td>disposable gynecologic swab&amp;nbsp;</td><td>numerous vendors</td><td></td><td></td></tr><tr><td>1% lidocaine gel&amp;nbsp;</td><td>numerous vendors</td><td></td><td></td></tr></tbody></table>

povidone iodine rectal preparation at time of prostate needle biopsy is a simple and reproducible means to reduce risk of procedural infection

单一的机构和人群为基础的研究强调，感染并发症经直肠超声引导前列腺穿刺活检（直肠PNB）正在增加。这种感染主要由于喹诺酮类其中殖民直肠跳马和被转运到活检手术过程中血液性微生物。聚维酮碘直肠制剂（PIRP）活检的时间是一个简单的，可重复的方法，以减少下TRUS PNB直肠微生物菌落计数，因此产生的感染。 所有患者施用的口服抗生素治疗前三天活检。该PIRP技术包括最初的定位病人的标准方式的TRUS PNB。以下直肠指检，15毫升市售聚维酮碘的10％溶液中，用5毫升1％利多卡因果冻混合以创建浆料。 4cm的×4厘米的无菌纱布是SOA的KED在该浆料，然后插入之后将其除去直肠保管库2分钟。此后，一次性妇科棉拭子用于绘制两肛门周围区域和直肠拱顶至3厘米从肛门的距离。聚维酮碘溶液然后使其干燥2 - 继续进行标准经直肠超声检查和随后的活组织检查之前3分钟。 此PIRP技术已在我们的机构自2012年三月在实践与相关联的减少后的活检感染的从4.3％至0.6％（P = 0.02）。这种预防治疗方案的主要优点是它的简单性和可重复性，以采用容易获得，便宜的试剂，以减少感染。此外，该技术避免了暴露患者额外全身性抗生素具有多重耐药生物的潜在进一步传播。 PIRP在TRUS PNB的使用，但是，是不适用的患者碘或贝类一个llergies。

自2012年一月份（截止目前）有165例患者已纳入本质量改进措施，这PIRP技术已经在实践中。在这个时候，只有一个病人（0.6％）经历了全身性败血症的形式的感染性并发症。这名患者定植一个多重抗药性E.大肠杆菌菌株 。该患者下面PIRP给予直肠拭子指出，直肠跳马仍然定植2.1×10 5 CFU / ml的细菌，从而质疑PIRP是否适当治疗直肠保管库。 一个当代人口进行TRUS PNB 20...

Watch this Scientific Journal Video about Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection at JoVE.com

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection

Here, we present a protocol for use at the time of transrectal ultrasound guided prostate needle biopsy (TRUS PNB) that is a simple and cost-effective means to reduce infections following the procedure.

聚维酮碘直肠准备在前列腺穿刺活检的时间是一个简单的和可重复的手段，以减少程序感染的风险

Single institution and population-based studies highlight that infectious complications following transrectal ultrasound guided prostate needle biopsy ...

povidone-iodine-rectal-preparation-at-time-prostate-needle-biopsy-is

Research

JoVE Journal

Medicine

31.9K 次观看.  Penn State Milton S. Hershey Medical Center. Here, we present a protocol for use at the time of transrectal ultrasound guided prostate needle biopsy (TRUS PNB) that is a simple and cost-effective means to reduce infections following the procedure.

视频: Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection

PRP as a New Approach to Prevent Infection: Preparation and In vitro Antimicrobial Properties of PRP

Implant-associated infection is becoming more and more challenging to the healthcare industry worldwide due to increasing antibiotic resistance, transmission of antibiotic resistant bacteria between animals and humans, and the high cost of treating infections.
In this study, we disclose a new strategy that may be effective in preventing implant-associated infection based on the potential antimicrobial properties of platelet-rich plasma (PRP). Due to its well-studied properties for promoting healing, PRP (a biological product) has been increasingly used for clinical applications including orthopaedic surgeries, periodontal and oral surgeries, maxillofacial surgeries, plastic surgeries, sports medicine, etc.
PRP could be an advanced alternative to conventional antibiotic treatments in preventing implant-associated infections. The use of PRP may be advantageous compared to conventional antibiotic treatments since PRP is less likely to induce antibiotic resistance and PRP's antimicrobial and healing-promoting properties may have a synergistic effect on infection prevention. It is well known that pathogens and human cells are racing for implant surfaces, and PRP's properties of promoting healing could improve human cell attachment thereby reducing the odds for infection. In addition, PRP is inherently biocompatible, and safe and free from the risk of transmissible diseases.
For our study, we have selected several clinical bacterial strains that are commonly found in orthopaedic infections and examined whether PRP has in vitro antimicrobial properties against these bacteria. We have prepared PRP using a twice centrifugation approach which allows the same platelet concentration to be obtained for all samples. We have achieved consistent antimicrobial findings and found that PRP has strong in vitro antimicrobial properties against bacteria like methicillin-sensitive and methicillin-resistant Staphylococcus aureus, Group A Streptococcus, and Neisseria gonorrhoeae. Therefore, the use of PRP may have the potential to prevent infection and to reduce the need for costly post-operative treatment of implant-associated infections.

PRP as a New Approach to Prevent Infection: Preparation and In vitro Antimicrobial Properties of PRP

Implant-associated infection is a significant clinical complication. This study describes an approach using platelet-rich plasma (PRP) to prevent implant-associated infections, presents the protocol for preparing PRP with constant platelet concentration, and reports the newly identified antimicrobial properties of PRP and related protocols for examining such antimicrobial properties in vitro.

PRP作为一种新的方法，以防止感染的制备及<em在体外</em&gt;抗菌性能的PRP

Implant-associated infection is becoming more and more challenging to the healthcare industry worldwide due to increasing antibiotic resistance, ...

科研

免疫与感染

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses

Optical coherence tomography (OCT) is the optical equivalent of ultrasound imaging, based on the backscattering of near infrared light. OCT provides real time images with a 15 &#181;m axial resolution at an effective tissue penetration of 2-3 mm. Within the OCT images the loss of signal intensity per millimeter of tissue penetration, the attenuation coefficient, is calculated. The attenuation coefficient is a tissue specific property, providing a quantitative parameter for tissue differentiation. 
Until now, renal mass treatment decisions have been made primarily on the basis of MRI and CT imaging characteristics, age and comorbidity. However these parameters and diagnostic methods lack the finesse to truly detect the malignant potential of a renal mass. A successful core biopsy or fine needle aspiration provides objective tumor differentiation with both sensitivity and specificity in the range of 95-100%. However, a non-diagnostic rate of 10-20% overall, and even up to 30% in SRMs, is to be expected, delaying the diagnostic process due to the frequent necessity for additional biopsy procedures. 
We aim to develop OCT into an optical biopsy, providing real-time imaging combined with on-the-spot tumor differentiation. This publication provides a detailed step-by-step approach for percutaneous, needle based, OCT of renal masses.

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses

Optical coherence tomography (OCT) is a high resolution imaging technique that allows analysis of tissue specific optical properties providing the means for tissue differentiation. We developed needle based OCT, providing real-time imaging combined with on-the-spot tumor differentiation. This publication describes a method for percutaneous, needle based OCT of renal masses.

在体内 ，经皮，基于针，肾群众的光学相干断层扫描

Optical coherence tomography (OCT) is the optical equivalent of ultrasound imaging, based on the backscattering of near infrared light. OCT provides real ...

医学

Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser

The occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem with a high incidence in the aging male population. Although it is not a life-threatening disease, BPH causes problems that seriously impact the quality of life. Here, we introduce a new technique called photoselective vaporesection of the prostate (PVRP) in treating BPH, which can be seen as a variation of photoselective vaporization of the prostate (PVP). This procedure presents several advantages compared to the PVP technique including less laser energy loss, less intraoperative complications as well as more tissue resection rate.

Here we present a protocol to perform Photoselective Vaporesection of the Prostate (PVRP) for benign prostatic hyperplasia (BPH) treatment.

选择性绿激光锂三硼酸晶体激光 Vaporesection 前列腺的研究

The occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem with a high incidence in the aging ...

Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy

Here, we present a protocol to perform targeted prostate biopsy using a magnetic resonance imaging-ultrasound (MRI/US) fusion system. Prostate cancer has traditionally been diagnosed via transrectal ultrasound (TRUS) biopsy. Though considered the gold standard, TRUS is unable to visualize most prostate cancer lesions and therefore requires sampling of the entire prostate. This biopsy method often undergrades prostate cancer and fails to detect up to 35% of cancers on initial biopsy. Prostate MRI has been shown to have excellent sensitivity in the detection of cancerous lesions, and advancements in MRI technology during the last decade have led to the development of targeted biopsy. In targeted biopsy, a software platform overlays MRI data onto live TRUS images to create a fused MRI/US three-dimensional model of the prostate. Regions suspicious for malignancy on MRI are contoured by a radiologist, uploaded into the fusion system, and then displayed within the live MRI/US fused model. The urologist is then able to directly biopsy these targets. When compared to conventional TRUS biopsy, MRI/US fusion technology has been demonstrated to improve the detection of clinically significant cancer while reducing insignificant cancer detection. This technology, therefore, has the potential to diagnose prostate cancer primarily in men who would benefit from treatment.

Presented herein is a protocol to perform targeted biopsy of the prostate using an MRI-ultrasound fusion system.

Mri-超声融合技术在靶向前列腺活检中的应用

Here, we present a protocol to perform targeted prostate biopsy using a magnetic resonance imaging-ultrasound (MRI/US) fusion system. Prostate cancer has ...

Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking

Previous methods for biobanking prostate tissue, following radical prostatectomy, generally involved random sampling. In order to increase efficiency, and enable a greater range of downstream applications, a more targeted method of sampling prostate tissue was developed. Here we use both magnetic resonance imaging (MRI) and biopsy data to target specific areas of the organ for sampling. The method involves use of a previously published prostate slicing device which removes a 5 mm transverse slice from a predetermined region of the prostate, followed by the removal of 6 mm punch biopsies from predetermined areas of this slice. These samples can be stored frozen or fixed for biobanking purposes, or used fresh immediately with 70% confidence of tumor content, as compared with 10% confidence from the random sampling approach. This enables the use of all standard downstream techniques such as genomics, proteomics or histological work, but also work that requires fresh tissue such as live tissue imaging or ex vivo culture.

This method involves utilization of clinical diagnostic data for prostate cancer patients in order to guide sampling procedures, when biobanking tissue following radical prostatectomy. This overcomes issues with previously published methods around efficiency and availability of fresh tissue for a wider range of downstream applications.

使用磁共振成像和活检数据指导前列腺癌生物库的取样程序

Previous methods for biobanking prostate tissue, following radical prostatectomy, generally involved random sampling. In order to increase efficiency, and ...

Focal Laser Ablation of Prostate Cancer: An Office Procedure

In this article, we describe and illustrate an outpatient procedure for focal laser ablation (FLA) of prostate cancer (PCa). The procedure is conceptually similar to a fusion biopsy and is performed under local anesthesia in a clinic setting; treatment time is usually less than one hour. Laser insertion is guided by ultrasound; lesion targeting is via magnetic resonance imaging-ultrasound (MRI/US) fusion, as in targeted prostate biopsy. Real-time ablation monitoring is achieved utilizing a thermal probe adjacent to the laser fiber. The video demonstrates procedure planning, patient preparation, various steps during the procedure, and treatment monitoring. Safety, feasibility, and efficacy of this approach have been established during a previous trial. Outpatient FLA under local anesthesia is an option for management of intermediate risk prostate cancer.

This article presents and describes an outpatient treatment for prostate cancer using focal laser ablation. Laser catheter placement is guided by MRI-ultrasound fusion imaging in a fashion similar to prostate needle biopsy. Treatment is monitored in real-time with a thermal probe, placed adjacent to the laser fiber.

前列腺癌聚焦激光消融:办公室程序

In this article, we describe and illustrate an outpatient procedure for focal laser ablation (FLA) of prostate cancer (PCa). The procedure is conceptually ...

Micro-Ultrasound Guided Transperineal Prostate Biopsy: A Clinic-Based Procedure

Prostate cancer is the most common solid malignancy in men and requires a biopsy for diagnosis. This manuscript describes a freehand micro-ultrasound guided transperineal technique performed under local anesthesia, which maintains accuracy, keeps patients comfortable, has low adverse events, and minimizes the need for disposables. Prior micro-ultrasound-guided transperineal techniques required general or spinal anesthesia. The key steps described in the protocol include (1) the placement of the local anesthesia, (2) micro-ultrasound imaging, (3) and the visualization of the anesthetic/biopsy needle while uncoupled from the insonation plane. A retrospective review of 100 patients undergoing this technique demonstrated a 68% clinically significant cancer detection rate. Pain scores were prospectively collected in a subset of patients (N = 20) and showed a median procedural pain score of 2 out of 10. The 30 day Grade III adverse event rate was 3%; one of these events was probably related to the prostate biopsy. Overall, we present a simple, accurate, and safe technique for performing a micro-ultrasound-guided transperineal prostate biopsy.

This manuscript outlines the steps for performing a micro-ultrasound-guided transperineal prostate biopsy under local anesthesia.

Prostate cancer is the most common solid malignancy in men and requires a biopsy for diagnosis. This manuscript describes a freehand micro-ultrasound ...

A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound

Traditional transrectal ultrasound (TRUS)-guided prostate biopsy has limited sensitivity and specificity, particularly for detecting early-stage prostate cancer, due to a lack of precise lesion targeting. An improved cognitive fusion-guided prostate biopsy method has been developed to enhance lesion targeting by integrating three parameters of prostate multiparametric MR (mpMRI) images into TRUS images. Prostate mpMRI measurement is initially performed to obtain three key parameters: the rotation angle (&#945;), the distance from the rectal wall (X), and the distance from the prostate apex (Y). These parameters are then cognitively applied in real-time, TRUS-guided prostate needle biopsy to detect target lesions. This improved transperineal cognitive fusion biopsy method enhances diagnostic accuracy, improves reproducibility, and reduces reliance on operator experience. Clinical application in 423 patients demonstrated a prostate cancer detection rate of 73.5%, with 62.9% classified as clinically significant cancers. Compared with equipment-intensive methods such as MRI-ultrasound fusion biopsy, this approach is cost-effective, practical, and well-suited for broader clinical adoption. Additionally, the method&#39;s flexibility supports integration with other imaging techniques, such as 68Ga-PSMA PET/CT, further improving detection rates for patients with high-risk prostate cancer.

Prostate biopsy is the gold standard diagnostic method for prostate cancer. Cognitive fusion-guided prostate biopsy, which combines transrectal ultrasound with pre-measured MRI parameters, improves biopsy accuracy and enhances the detection rate of clinically significant prostate cancer.

使用多参数磁共振成像和经直肠超声的认知融合引导前列腺活检

Traditional transrectal ultrasound (TRUS)-guided prostate biopsy has limited sensitivity and specificity, particularly for detecting early-stage prostate ...

Peripheral Intravenous Catheter Insertion

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT
The purpose of peripheral intravenous catheter (PIV) insertion is to infuse medications, perform intravenous (IV) fluid therapy, or inject radioactive tracers for special examination procedures. Placing a PIV is an invasive procedure and requires the use of an aseptic, no-touch technique. 
Common IV venipuncture sites are the arms and hands in adults and the feet in children. According to the Intravenous Nurses Society (INS), the feet should be avoided in the adult population because of the risk of thrombophlebitis. Venipuncture sites should be carefully assessed for contraindications, such as pain, wounds, decreased circulation, a previous cerebral vascular accident (CVA), dialysis fistulas, or a mastectomy on the same side. The median cubital vein and the cephalic vein in the wrist area should be avoided when possible. The cephalic vein has been associated with nerve damage when used for IV placements. The most distal site available on the hand or arm is preferred so that future venipuncture sites may be used if infiltration or extravasation occurs.
This video will demonstrate the insertion of a PIV, including the preparation and attachment of an IV extension set. Although a PIV securement device is used here to stabilize the IV catheter, according to INS recommendations, some facilities may not elect to purchase these devices, and the alternate chevron or U-shaped taping method may also be used.

Peripheral Intravenous Catheter Insertion: No Touch Technique

外周静脉导管插入

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT
The purpose of peripheral intravenous catheter ...

教育

JoVE Science Education

临床技能

护理技巧

Hand hygiene

Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing consists of a fast, vigorous rubbing motion across all parts of the hands, with lathered surfaces, followed by 15 seconds of washing under water. Handwashing works by mechanically removing microorganisms from the hands and rinsing them with water. Microorganisms are not killed by handwashing. There are three techniques of hand washing.
Hand washing 
By performing hand hygiene at the right moments and using appropriate techniques, hands become clean and safe as infectious organisms are not transmitted to yourself or others. Using handwashing products that contain an antimicrobial or antibacterial ingredient is recommended in any setting where the risk for infection is high, such as:
<ul>
	<li>&#8226; When hands are visibly soiled with blood and body fluids</li>
	<li>&#8226;&#160;Before eating and after toileting</li>
	<li>&#8226;&#160;When exposed to spore-forming microorganisms.</li>
</ul>
Antiseptic hand wash
An antiseptic hand rub is used to decrease the number of microorganisms present on hand surfaces by applying an antiseptic hand rub. Ethanol-based hand antiseptics containing 70% to 90% alcohol appear to be the most effective against common pathogens found on the hands.
All healthcare workers must practice proper hand hygiene at all times, including:
<ul>
	<li>&#8226;&#160;Just before touching a patient</li>
	<li>&#8226;&#160;Before performing an aseptic task or working with invasive devices</li>
	<li>&#8226;&#160;Before switching from a soiled to a clean body site on a patient</li>
	<li>&#8226;&#160;After contacting a patient or their immediate surroundings</li>
	<li>&#8226;&#160;Following exposure to blood, bodily fluids, or contaminated surfaces (with or without glove use)</li>
	<li>&#8226;&#160;Immediately following glove removal</li>
</ul>
Antiseptic hand rub or surgical hand antisepsis 
Surgical hand antisepsis is an antiseptic hand wash or hand-rub technique that is an integral part of the preparation for surgery by surgical personnel. Its purpose is to eliminate transient microorganisms and reduce resident hand flora. The most currently used antiseptics are chlorhexidine (CHG) and povidone-iodine (PVI). These agents are applied with a sponge and brush. This technique involves coating the elbow to the fingers and can take up to three minutes, depending on hospital protocol.

手部卫生

Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and ...

聚维酮碘直肠准备在前列腺穿刺活检的时间是一个简单的和可重复的手段，以减少程序感染的风险

摘要

探索更多视频

此视频中的章节

PRP作为一种新的方法，以防止感染的制备及

在体内，经皮，基于针，肾群众的光学相干断层扫描

选择性绿激光锂三硼酸晶体激光 Vaporesection 前列腺的研究

Mri-超声融合技术在靶向前列腺活检中的应用

使用磁共振成像和活检数据指导前列腺癌生物库的取样程序

前列腺癌聚焦激光消融:办公室程序

Micro-Ultrasound Guided Transperineal Prostate Biopsy: A Clinic-Based Procedure

使用多参数磁共振成像和经直肠超声的认知融合引导前列腺活检

外周静脉导管插入

手部卫生

聚维酮碘直肠准备在前列腺穿刺活检的时间是一个简单的和可重复的手段，以减少程序感染的风险

摘要

探索更多视频

此视频中的章节

PRP作为一种新的方法，以防止感染的制备及

在体内 ，经皮，基于针，肾群众的光学相干断层扫描

选择性绿激光锂三硼酸晶体激光 Vaporesection 前列腺的研究

Mri-超声融合技术在靶向前列腺活检中的应用

使用磁共振成像和活检数据指导前列腺癌生物库的取样程序

前列腺癌聚焦激光消融:办公室程序

Micro-Ultrasound Guided Transperineal Prostate Biopsy: A Clinic-Based Procedure

使用多参数磁共振成像和经直肠超声的认知融合引导前列腺活检

外周静脉导管插入

手部卫生

在体内，经皮，基于针，肾群众的光学相干断层扫描