Disease relevance of Digital Rectal Examination

• Evaluation of the digital rectal examination as a screening test for prostate cancer. Rotterdam section of the European Randomized Study of Screening for Prostate Cancer [1].
• MATERIALS AND METHODS: A total of 31 men underwent followup interval biopsy 3 years after high grade prostatic intraepithelial neoplasia diagnosis in 1996 to 1997, regardless of change in serum prostate specific antigen (PSA) or digital rectal examination findings [2].
• Toxicity was scored according to the Radiation Therapy Oncology Group (RTOG) grading system; local control was evaluated by serial digital rectal examination (DRE) and prostate specific antigen (PSA) measurements [3].
• METHODS: Ten men aged 19 to 45 years with a history of bladder exstrophy underwent digital rectal examination and free and total serum PSA determinations [4].
• METHODS: Since 1995, patients who had undergone a sphincter-saving operation for rectal cancer (n = 312) were followed-up by a standard program including rectal palpation, carcinoembryonic antigen monitoring, computed tomography, and EUS [5].

High impact information on Digital Rectal Examination

• The marginal cost, or cost per cancer, of digital rectal examination (DRE) markedly increased by the third year relative to several proposed prostate-specific antigen (PSA) scenarios [6].
• Data from a total of 752 consecutive men who were either white or African-American and whose indication for biopsy included a serum PSA of greater than 4.0 ng/mL and/or an abnormal digital rectal examination were analyzed [7].
• We discuss the selective use of digital rectal examination, transrectal sonography, directed prostate biopsy, and prostate-specific antigen determinations before therapy and in subsequent follow-up in this age group of men during androgen replacement [8].
• A significant difference was observed between VCP level 1 and 2 patients in the positive rate for the digital rectal examination (P < 0.01), serum prostate-specific antigen level (P < 0.0001), cancer volume (P < 0.0001), Gleason score (P < 0.0001), stage (P < 0.0001), and progression-free and overall survival (P < 0.0001 for both) [9].
• Patient age, digital rectal examination status, prostate specific antigen, free prostate specific antigen, number of cores and biopsy interval were not independent predictors of cancer in men with ASAP [10].

Chemical compound and disease context of Digital Rectal Examination

• Among the opportunities not previously addressed, the GIM service most frequently addressed digital rectal examination for prostate cancer and cholesterol measurement [11].
• As determined by milk progesterone, rectal palpation was more accurate for diagnosis of luteal cysts than for diagnosis of follicular cysts [12].
• The results indicate that management programmes based on the strategic use of PGF2alpha are an effective alternative to traditional programmes based on rectal palpations and intrauterine infusions to control endometritis at a herd level [13].
• For these reasons, testosterone treatment should be performed only when the presence of prostate cancer is unlikely; i.e. when PSA levels are within normal limits and digital rectal examination does not reveal any suspicious findings [14].
• Current evidence especially from the USA strongly suggests that combing the improving prostate-specific antigen test (Hybritech Tandem assay) with the digital rectal examination increases the early detection rate for prostate cancer [15].

Biological context of Digital Rectal Examination

• American Cancer Society and American Urology Association recommend screening with both digital rectal examination (DRE) and prostate-specific antigen (PSA) testing [16].
• Survival analysis indicated that cows receiving PGF2 alpha for reproductive therapy and synchronization of estrus had an 11% higher rate of first AI and 10% higher rate of pregnancy than did cows receiving the rectal palpation [17].
• The diets contained adequate amount of vitamins A, D, and E. From 10 d postpartum until pregnancy was confirmed by rectal palpation, half the cows on each diet received a supplement of 400 mg beta-carotene per head daily [18].
• Treatment with fenprostalene (groups 2 and 3) decreased the number of cows with a palpable uterine lumen detectable during per rectal palpation at 28 to 42 days after parturition [19].
• Several techniques, including progesterone assay at days 21, 28 and 35, heat detection twice daily, rectal palpation at day 60 or planned slaughter, were combined to determine the importance of gestation losses after a single cervical transfer of 128, 10 to 12-day-old bovine embryos [20].

Anatomical context of Digital Rectal Examination

• The prostates of 36 patients who were treated with intravesical bacillus Calmette-Guerin were evaluated by digital rectal examination and transrectal ultrasonography [21].
• CONCLUSIONS: As in healthy men, PSA and digital rectal examination can be performed in spinal cord injured men to screen for prostate cancer [22].
• METHODS: Ninety patients with a history of lower urinary tract infections, non-suspicious digital rectal examination and PSA between 4 and 20 ng/mL were analyzed [23].
• Several studies have shown the clinical utility of PSA levels for staging patients with PCa, especially when associated with other parameters, such as tumour grade, digital rectal examination and transrectal ultrasound findings, to establish the likelihood of disease extension outside the gland and of positive lymph nodes [24].
• Serum total testosterone, prolactin, thyroid stimulating hormone, lipid profile and prostate-specific antigen (PSA) were determined by standard methods and prostate volume by digital rectal examination [25].

Associations of Digital Rectal Examination with chemical compounds

• PATIENTS: Seventy-seven men with low total testosterone or free testosterone levels, with normal results of digital rectal examination and prostate-specific antigen (PSA) levels of 4.0 ng/mL or less [26].
• (Hybritech Tandem assay) or digital rectal examination was suspicious for cancer [27].
• MATERIALS AND METHODS: A total of 44 patients with increased prostate specific antigen (PSA) and/or abnormal digital rectal examination on initial evaluation were randomized to receive 400 IU vitamin E (22) vs placebo (22) [28].
• CONCLUSIONS: Parenteral testosterone replacement in hypogonadal men with normal pretreatment digital rectal examination and serum PSA levels does not alter PSA or PSA velocity beyond established nontreatment norms [29].
• However, pregnancy was not maintained by Day 60 in the 3 females detected as pregnant by rectal palpation and increased progesterone concentrations at Day 50 [30].

Gene context of Digital Rectal Examination

• CONCLUSIONS: Our data indicate that serum IGF-1 or IGF binding protein-3 does not predict the results of prostate biopsy in men with elevated PSA or abnormal digital rectal examination [31].
• Serum from 604 of 611 biopsied men (18% with positive digital rectal examinations, tPSA range 3.0 to 220 ng/mL, 144 men with PCa) was analyzed for hK2 (research assay) and tPSA and fPSA (Prostatus) [32].
• Prostate cancer can be detected at an early, potentially curable stage by screening based on digital rectal examination and serum prostate specific antigen (PSA) [33].
• METHODS: In the Prostate Cancer Prevention Trial, we randomly assigned 18,882 men 55 years of age or older with a normal digital rectal examination and a prostate-specific antigen (PSA) level of 3.0 ng per milliliter or lower to treatment with finasteride (5 mg per day) or placebo for seven years [34].
• Results were sent to the Prostate Cancer Project. MAIN RESEARCH VARIABLES: Prostate cancer knowledge and participation in free prostate screening with a digital rectal examination and prostate specific antigen [35].

Analytical, diagnostic and therapeutic context of Digital Rectal Examination

• In our study, 1,233 randomly selected men living in Stockholm in 1988 were invited to participate in an early detection (ED) program, in which suspicious findings provided by digital rectal examination (DRE), transrectal ultrasonography (TRUS) and/or a PSA value >/=10.0 ng/mL were followed up by biopsy [36].
• If only pre-operative parameters were studied, serum PSA and RT-PCR PSA status were 2 independent pre-operative predictors of PSA recurrence compared with Gleason score on biopsy and digital rectal examination [37].
• Based on these observations, we recommend no further evaluation, that is digital rectal examination or imaging studies, in men with an undetectable PSA following radical prostatectomy [38].
• We examined the effects of prostatic manipulations, including digital rectal examination, prostate massage, transrectal ultrasonography and transrectal needle biopsy, on serum PSA levels in 199 men [39].
• Although there is appreciable variation in the frequency of use of these methods, respondents generally recommended office visit with digital rectal examination, serum PSA and urinalysis every 3 months in year 1, every 6 months in years 2 to 5 and annually thereafter [40].

References