Science science

Engineers create specially grown, 'superhemophobic' titanium surface that's extremely repellent to blood, which could form the basis for surgical implants with lower risk of rejection by the body.

Engineers create specially grown, 'superhemophobic' titanium surface that's extremely repellent to blood, which could form the basis for surgical implants with lower risk of rejection by the body.
Engineers create specially grown, 'superhemophobic' titanium surface that's extremely repellent t...

Just a quick comment for clarification: There are many types of titanium implants that use blood to their advantage, like bony plates and implants to help heal bony fractures and dental implants.

The types of implants that would benefit from a hemophobic or even omni-phobic surface (many surfaces can't connect) would be blood vessel stents, catheters and types of tubing. These run a risk of clotting and infection, and a surface that doesn't allow platelets to group up (clot) or bacteria to bind (infection) would be beneficial.

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Every man with suspected prostate cancer should have an MRI scan, which is twice as likely to identify the presence of dangerous tumours as the invasive biopsy used currently, say doctors.

Every man with suspected prostate cancer should have an MRI scan, which is twice as likely to identify the presence of dangerous tumours as the invasive biopsy used currently, say doctors.
Every man with suspected prostate cancer should have an MRI scan, which is twice as likely to ide...

This is purely informational. This is NOT medical advice. This is NOT a substitution for medical care. Do NOT take advice from a random redditor. There's a 1% chance I'm just a moth jumping from key to key

The MRI is more sensitive but it is not specific. The biopsy is specific. Every test for prostate cancer is a way of determining the risk of prostate cancer. The two most common tools are 1) PSA and 2) the digital rectal exam.

A PSA above 4 is a risk factor for prostate cancer. A PSA above 4 means you have an elevated risk of prostate cancer. There are cases where the PSA is low and you have prostate cancer. And there are cases where the PSA is markedly elevated and you don't have prostate cancer. Usually urologists will look as PSA trends to gauge whether someone needs a biopsy or not. Things like an infection or urinary retention can cause the PSA to skyrocket so urologists will treat the infection and measure the PSA 4 months later to see that it went down. The DRE looks for the presence of nodules, firmness, or asymmetry to the prostate. Having a nodule again increases the risk of having prostate cancer. edit: A DRE also checks for anal tumors. A colonoscopy does not look for anal tumors.

Both of these tests help determine when a biopsy is required. Sometimes people do not want a biopsy so there are other options.

Parametric MRI - Its sensitive for high grade prostate cancer, especially if there is seminal vesicle involvement or extra capsular extension. However this will not do anything for low grade prostate cancer and it will also not specify the gleason score of the cancer. edit of note, many people are now getting these MRIs, before or after a biopsy. This test provides a lot of useful information FISH test - this is a DNA probe that will look for abnormalities. This will tell you if your risk is greater or lower. PCA3 test - another test that will only tell if your risk is higher or lower

However, none of these tests are absolute. They only determine the risk of having prostate cancer. Also, these tests are often not covered by insurance

So what does the prostate biopsy involve.

An ultrasound probe will be placed in your bottom and will initially be used to calculate the size of your prostate. A normal prostate starts around 15 cc and becomes bigger as you age. This is normal and called BPH. A needle biopsy gun will then be used. The gun is guided by the same ultrasound probe. The gun shoots through your rectal wall and into your prostate, grabbing a core of tissue. This process is repeated 12 times to obtain 12 cores representing your prostate A DNA swab will be taken from your mouth. If the biopsies are positive for cancer, they will DNA match the cores to your DNA swab to ensure it is indeed your tissue. This procedure can be done in office with local anesthesia or in the OR with general anesthesia. In both cases, the above process is the same. It's a 50:50 split with men who do it in office vs OR. Total biopsy time is 5-10 minutes.

Risks of Biopsy

Sepsis - because the rectal wall is being punctured, there is a risk of sepsis. You are put on antibiotics before the procedure and after. Further an IM dose of a potent antibiotic is given 1 hour before the procedure. The risk is about 1 in 200-300. If you become septic, you must go to the ER and get IV antibiotics Bleeding in urine and sperm - this is normal and will only last a few days. Not painful

Benefits of Biopsy

Number of cores with cancer - The 12 samples that were taken will act as a map to highlight where the cancer is. The number of positive cores helps determine the extent of cancer Gleason score - Ranges from 1-5 however almost all cancers are at least a 3. Each core gets scores. The first number is the grade for the majority of the core and the second core is the remainder of the core. So a low grade cancer is a 3+3=6. A high grade cancer is like a 4+5=9. Note the order of the numbers matters. A 4+3=7 is worse than a 3+4=7. Percent core involvement - This number shows how much of the core has cancer. 10% is low involvement. 100% is very high involvement.

What happens afterwards

The prostate biopsy allows the urologist to place you in a risk category. This ranges from very low risk to very high risk. This process is called risk stratification. A baseline CT abdomen and pelvis along with a bone scan is obtained to rule out metastatic disease (prostate cancer metastasizes to the bone) He/she discusses treatment options

Treatment options

Radiation (IMRT) - Usually very effective. You go to the radiation center daily for a few months and have your prostate zapped. Risks include bladder and bowel dysfunction during the treatment which usually resolves after treatment is over edit: There is brachytherapy where radioactive pellets are placed in the prostate which deliver a radiation dose over a period of years. This fell out of favor due to a devastating complication of a rectal-anal fistula. Further, all radiation treatments have the side effect of radiation cystitis which can lead to urinary frequency, urgency, and nocturia androgen deprivation therapy (ADT) - Uses a drug like Lupron to stop the production of testosterone. Most prostate cancers need testosterone to grow. Usually this is done prior and during IMRT. Side effects include hot flashes, fatigue, and low libido edit: The effects wear off when the drug course is over. However some people may have the cancer grow back. These people get placed on intermittent hormone ablation. (robotic) radical prostatectomy - surgically remove your prostate. This is the gold standard as your are physically taking all the cancer out. Risks include urinary incontinence and erectile dysfunction. edit Risk of positive margins meaning not all of the cancer was removed. active surveillance - Prostate cancer is a slow growing cancer. If you have <3 positive cores with Gleason score 3+3=6 and a PSA <10, it is perfectly acceptable to do nothing. You will have your PSA drawn every 6 months and a repeat prostate biopsy every 2-3 years.

There are many other options but these three are the most common. It is up to you to determine the amount of risk you are willing to accept.

The most important thing in all of this is the yearly PSA and DRE. It is crucial that you have these checked. The PSA is sensitive but not specific. This does not mean it is not important. An elevated PSA raises your risk of prostate cancer to 20%. A nodule on your prostate increases the risk to 40%. Of that 20-40% risk, there is a 10% risk of having high grade prostate cancer. Only the prostate biopsy is absolute. Everything else only changes your risk. Edit: Typically screening starts at 50 for most men and 40 for men with a family history of prostate cancer

GET YOUR YEARLY PSA AND DRE (if you want it and you understand the risks of screening)

edit: minor typos

edit2: It seems that there is some controversy with the PSA test. One thing I've tried to be clear in my post is risk. We have tools in our arsenal. Not all of them are perfect. There are risks and benefits to every tool. It is your job to make a decision on how much risk you want to undertake. The USPSTF recommendation is a 2012 recommendation. The industry has taken note and made changes. Specifically the cutoff for PSA is now at 4 and not every diagnosed cancer is treated.

edit3: The point of this post isn't to give medical advice and I apologize if at times it may have seen so. I'm just trying to illustrate the process that is often a black box for many people. It's difficult to explain this process without trying to give medical advice. I understand that recommending the PSA/DRE falls under medical advice so I've tweaked that sentence to be more lawyer friendly.

Sea level in the Northeast and in some other US regions will rise significantly faster than the global average, according to a new report. In a worst-case scenario, global sea level could rise by about 8 feet by 2100. The report lays out 6 scenarios intended to inform national and regional planning.

Sea level in the Northeast and in some other US regions will rise significantly faster than the g...

According to NOAA, sea levels are rising about 1/8 inch per year. I don't think people are going to react strongly until or unless it accelerates to the point they NOTICE it. When will that be, I often wonder. It's as if the general public has heard this so much and for so long that they have become numb to it. Scary.

New computational model, built on an artificial intelligence (AI) platform, performs in the 75th percentile for American adults on standard intelligence test, making it better than average, finds Northwestern University researchers.

New computational model, built on an artificial intelligence (AI) platform, performs in the 75th ...

I have two critiques of this:

Those kinds of problems are profoundly artificial problems, they're hard exactly because they're the kind of unusual logic that's rarely seen naturally, but is easily expressed via simple rules. Of all the different kinds of IQ tests available, it seems like this one would be the easiest for a computer to do well on. It seems like an important part of any IQ test is understanding the problem, to take instructions and see how they apply to the information provided. In this case the machine had the instructions understood for it, and programmed in to it in a way that would be useful.

Basically, this seems like an interesting result, but something that really only applies to a tiny niche.

Try one of these subthreads