Medicine and Health Sciences Commons^™

Delayed Diagnosis Of Mycobacterium Bovis Bacillus Calmette-Guérin Periprosthetic Joint Infection Following Total Knee Arthroplasty, Christopher E. Pelt, Salika Shakir, Michael J. Cahill, Jakrapun Pupaibool, Barbara C. Cahill

SKMC Student Presentations and Publications

Periprosthetic joint infection (PJI) can present challenges in diagnosis and treatment, particularly in the setting of atypical causative organisms such as fungi and mycobacteria. Herein, we present a case and provide a review of the diagnosis and treatment of an unusual PJI caused by bacillus Calmette-Guérin, administered during the treatment of bladder cancer 3 years prior to total knee arthroplasty and subsequent PJI. Although the patient's history of bladder cancer was known, neither his Bacillus Calmette-Guérin treatment nor its potential for distant site spread that could lead to PJI were appreciated, leading to a prolonged diagnostic evaluation and treatment course.

Small Cell Carcinoma Of The Bladder: A Rare Case, Simita Gaglani, James Sander

Research Symposium

In this case report, we explore a case of small cell bladder carcinoma in a 75-year-old man with a history of smoking. This is a unique, aggressive subtype of bladder cancer which, in this patient, presented with gross hematuria. Workup included cystoscopy and transurethral resection of the bladder tumor, and pathological confirmation of the diagnosis elicited a referral to oncology for staging CT and potential chemotherapeutic measures. While the small cell carcinoma was successfully identified, it had already invaded the detrusor muscle on presentation, prompting the question of how to go about diagnosing and treating this subtype of bladder cancer …

Prolonged Length Of Stay In Illeal Conduit Compared To Neobladder Diversion In Radical Cystectomy Patients For Bladder Cancer, Ryan J. Moriarty, Young Son, Brian Thomas, Ronald Clearie, Lance Earnshaw, Dayna Devincentz, Thomas Mueller

Research Day

Background:

Radical cystectomy and urinary diversion has become the standard treatment for invasive and complicated malignancies of the bladder, urethra, and ureters. [1] Robotic-assisted radical cystectomy (RARC), introduced in the last decade, has been associated with favorable perioperative outcomes when compared to open radical cystectomy. Yet little is known about how different urinary diversion types compare in regards to length of hospital stay, readmission rates, and perioperative course. This data analysis seeks to identify the statistically significant differences in postoperative course of ileal conduit versus neobladder among patients with staged bladder cancer.

Methods:

The American College of Surgeons National Surgical …

Neoadjuvant Chemotherapy With Radical Cystectomy Versus Radical Cystectomy Alone For Muscle-Invasive Bladder Cancer, Ahmed M. El-Zeiny, Atef A. Badawy, Baher M. Salman, Mohamed A. Elsayed, Sultan M. Sultan

Menoufia Medical Journal

Background Radical cystectomy (RC) is the gold standard in the treatment of muscle-invasive bladder cancer. Objectives To compare the pathologic response and perioperative morbidity of neoadjuvant chemotherapy (NAC) with cystectomy against RC alone as a treatment for muscle-invasive bladder cancer. Patients and methods This randomized controlled clinical trial took place between December 2020 and December 2021. The study enrolled 40 patients with muscle-invasive transitional cell carcinoma of the urinary bladder. Patients were randomized into two treatment groups: group I (20 patients) was treated with RC alone, and group II (20 patients) received three cycles of NAC with cystectomy. Results Of …

Klrf1, A Novel Marker Of Cd56bright Nk Cells, Predicts Improved Survival For Patients With Locally Advanced Bladder Cancer, Neelam Mukherjee, Niannian Ji, Xi Tan, Chun-Liang Chen, Onika D. V. Noel, Maria Rodriguez-Padron, Chun-Lin Lin, David G. Alonzo, Tim H. Huang, Robert S. Svatek

School of Medicine Publications and Presentations

Background

Bladder tumor-infiltrating CD56bright NK cells are more tumor cytotoxic than their CD56dim counterparts. Identification of NK cell subsets is labor-intensive and has limited utility in the clinical setting. Here, we sought to identify a surrogate marker of bladder CD56bright NK cells and to test its prognostic significance.

Methods

CD56bright and CD56dim NK cells were characterized with the multiparametric flow (n = 20) and mass cytometry (n = 21) in human bladder tumors. Transcriptome data from bladder tumors (n = 351) profiled by The Cancer Genome Atlas (TCGA) were analyzed. The expression levels of individual markers in intratumoral …

Rapid Detection Of Recurrent Non-Muscle Invasive Bladder Cancer In Urine Using Atr-Ftir Technology, Abdullah I. El-Falouji, Dalia M. Sabri, Naira M. Lofti, Doaa M. Medany, Samar A. Mohamed, Mai Alaa-Eldin, Amr Mounir Selim, Asmaa A. El Leithy, Haitham F. Kalil, Ahmed El-Tobgy, Ahmed Mohamed

Chemistry Faculty Publications

Non-muscle Invasive Bladder Cancer (NMIBC) accounts for 80% of all bladder cancers. Although it is mostly low-grade tumors, its high recurrence rate necessitates three-times-monthly follow-ups and cystoscopy examinations to detect and prevent its progression. A rapid liquid biopsy-based assay is needed to improve detection and reduce complications from invasive cystoscopy. Here, we present a rapid spectroscopic method to detect the recurrence of NMIBC in urine. Urine samples from previously-diagnosed NMIBC patients (n = 62) were collected during their follow-up visits before cystoscopy examination. Cystoscopy results were recorded (41 cancer-free and 21 recurrence) and attenuated total refraction Fourier transform infrared (ATR-FTIR) …

Value Of Diffusion-Weighted Mri In The Diagnosis And Staging Of Urinary Bladder Cancer, Magda S.A Elsattar Mohamed, Mohamed A. E. Maaly, Waleed A. E. Mousa

Menoufia Medical Journal

Background Bladder cancer is one of the most common cancers in Egypt. Currently, diffusion-weighted imaging (DWI) is the only imaging technique that is able to assess molecular diffusion in vivo and provide information about the biophysical properties of tissue such as cell organization, density, and microstructure. Objectives This study is designed to detect the value of diffusion-weighted MRI in the diagnosis and staging of urinary bladder cancer. Patients and methods This study is a prospective study of descriptive and analytical design. The study included 30 adult patients with suspected bladder mass, who attended Menoufia University Hospitals. Results This study included …

What After Bcg Fails In Non-Muscle Invasive Bladder Cancer?, M Hammad Ather

Section of Urology

No abstract provided.

The Investigation Between Voiding Function Medication And The Risk Of Bladder Cancer In Patients With Spinal Cord Injury, Kai-Hua Chen, Ting-Yao Wang, Chien-Min Chen, Chuan-Pin Lee, Yao-Hsu Yang, Chu-Hsu Lin, Kuan-Yu Kung, Vincent Chin-Hung Chen

Rehabilitation Practice and Science

Bladder cancer (BC) is a chronic complication of spinal cord injury (SCI). Limited studies have focused on the risks of BC in SCI patients using voiding function medication for bladder dysfunction. In this retrospective, national-wide, population-based cohort study, SCI patients with registration in the National Health Insurance Research Database (NHIRD) from 1998 to 2013 were included. We investigated the risk of BC in SCI patients administered voiding function medications and other comorbidities by 2-year landmark analysis. SCI patients were divided into medication user (bethanechol, oxybutynin, or tolterodine) and non-medication user groups at landmark period. They were followed until the development …

Molecular Drivers Of Bladder Cancer Motility, Bryan Wehrenberg

Dissertations & Theses (Open Access)

Bladder cancer (BC) progression is measured by the degree of tumor cell invasion into the bladder wall and dissemination to distant sites. The study of BC cell motility will both enable development of anti-invasion therapeutics to limit progression of early-stage disease and improve our understanding of the metastatic process which drives patient mortality in BC. BCs display a great deal of intertumoral heterogeneity, and can be divided into basal and luminal subtypes, which are biologically and clinically distinct entities. Here, I examine the invasion phenotypes of BC as a function of both subtype and epithelial to mesenchymal transition (EMT) status. …

Towards The Point Of Care And Noninvasive Classification Of Bladder Cancer From Urine Sediment Infrared Spectroscopy. Spectral Differentiation Of Normal, Abnormal And Cancer Patients, Monika Kujdowicz, David Perezguaita, Piotr Chłosta, Krzysztof Okon, Kamilla Malek

Articles

Bladder cancer (BC) is the 9th cancer cause of death and one of most cost-intensive in the world. The diagnostic tools are still not at all satisfactory. Herein we evaluated the potential of infrared spectroscopy to detect molecular changes that precede and accompany the carcinogenesis in voided urine sediment. We collected 165 samples from patients being diagnosed for BC and measured them with attenuated total reflectance Fourier transformed infrared spectroscopy (ATR FTIR). Samples were primarily divided into three groups according to cytology that indicated the presence of normal, abnormal and cancer cells. ATR FTIR spectra of sediments were analyzed with …

Supporting Patient Education On Bladder Cancer And Risk Factors Specific To Vermont, Evan Gaston

Family Medicine Clerkship Student Projects

Physician and patient education materials regarding the incidence of bladder cancer in Vermont, the absence of recommended screening, and discussion of risks of bladder cancer with emphasis on private well water testing through the Vermont Department of Health.

Characteristics Of Nontuberculous Mycobacterial Infections At A Midwestern Tertiary Hospital: A Retrospective Study Of 365 Patients., Claire E Hannah, Bradley A Ford, Jina Chung, Dilek Ince, Karolyn A Wanat

Department of Dermatology and Cutaneous Biology Faculty Papers

Background: The prevalence of infections due to nontuberculous mycobacteria (NTM) is increasing worldwide, yet little is known about the epidemiology and pathophysiology of these ubiquitous environmental organisms. Pulmonary disease due to Mycobacterium avium complex is most prevalent, but many other NTM species can cause disease in virtually any organ system. As NTM becomes an increasingly common cause of morbidity and mortality, more information is needed about the epidemiology of NTM disease.

Methods: We conducted a retrospective chart review of all patients with cultures that grew NTM at a Midwestern tertiary hospital from 1996 to 2017. Information on demographics, medical history, …

Discoidin Domain Receptor 1 Functionally Interacts With The Igf-I System In Bladder Cancer, Simone Buraschi, Alaide Morcavallo, Thomas Neill, Manuela Stefanello, Chiara Palladino, Shi-Qiong Xu, Antonino Belfiore, Renato V. Iozzo, Andrea Morrione

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

Association Between Metabolic Syndrome And Second Primary Cancer Among Colorectal Cancer Patients, Olukayode Ayodeji Agbeyomi

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third most common diagnosed cancer in both women and men in the United States. The gradual increase of incidence of second primary cancer (SPC) among CRC individuals has been a concern in recent times. Many CRC survivals have been forced back to be hospitalized for life-threatening cancers that are nonmetastatic cancers of CRC. Literature has suggested that there may be a relationship between metabolic syndrome (MetS) and CRC cases. The importance of early surveillance, detection, and treatment of SPC in CRC patients is significant to achieve better survival rates. The aim of this retrospective quantitative …

Long-Term Survival Of Bladder Cancer Metastatic To Femoral Neck Treated With Chemotherapy, Radiation, And Arthroplasty: A Case Report, John Defant, Scott Huff, Joseph D. Henningsen, Anil Krishnamurthy

Scholarship in Medicine - All Papers

Case: A 64-year-old male suffered a pathologic left femoral neck fracture. Biopsy demonstrated metastatic urothelial cancer with a non-muscle invasive bladder cancer primary confirmed by cystoscopy. Patient underwent hemiarthroplasty, chemotherapy, radiation, and eventually, a conversion to total hip arthroplasty. Today, over a decade from initial surgery, the patient remains alive and highly functional. To our knowledge, this is the only report of bone metastatic bladder cancer with over 10-year survival. Conclusion: Bladder cancer metastatic to bone has a 5-year survival rate of 3%. Surgical resection of metastasis with reconstruction may confer a survival benefit in bony oligometastatic bladder cancer.

Genitourinary Effects Of Smoking In Men: An Alternative Approach To Smoking Cessation Through Patient Education, Michael J. Lawrence

Family Medicine Clerkship Student Projects

Smoking remains a prominent problem in Vermont, especially outside Chittenden County. The genitourinary effects of smoking tend to be poorly appreciated among patients. This presents an opportunity for further patient education and incentivization to quit. This project focused on the genitourinary effects of smoking in men, specifically highlighting how smoking increases risk of bladder cancer, poorer outcomes in prostate cancer, and a higher risk of erectile dysfunction. The project culminated in creation of an educational poster intended for display in patient bathrooms in a medical setting.

Lsd1 Promotes Bladder Cancer Progression By Upregulating Lef1 And Enhancing Emt., Qiubo Xie, Tang Tang, Jian Pang, Jing Xu, Xingxia Yang, Linang Wang, Yiqiang Huang, Zhuowei Huang, Gaolei Liu, Dali Tong, Yao Zhang, Luofu Wang, Dianzheng Zhang, Weihua Lan, Qiuli Liu, Jun Jiang

PCOM Scholarly Papers

Epithelial-to-mesenchymal transition (EMT) is one of the important underlying molecular mechanisms for most types of cancers including bladder cancer. The precise underlying molecular mechanism in EMT-mediated bladder cancer progression is far from completed. LSD1, a histone lysine-specific demethylase, is known to promote cancer cell proliferation, metastasis, and chemoresistance. We found in this study that LSD1 is highly upregulated in bladder cancer specimens, especially those underwent chemotherapy, and the elevated levels of LSD1 are highly associated with bladder cancer grades, metastasis status, and prognosis. Inhibiting or knockdown LSD1 repressed not only EMT process but also cancer progression. Mechanistically, LSD1 complexes with …

Molecular Subtyping Bladder Cancer: Is It Ready For Clinical Practice?, Funda Vakar Lopez

Turkish Journal of Medical Sciences

Bladder cancer, one of the more common cancers, is a heterogeneous disease, both morphologically and clinically. Although histological classification and extent of the disease (staging) guide treatment options, the heterogeneity in responses to therapy highlights the need for better stratification of patients for the appropriate therapy in order to achieve better outcomes. Several molecular classifications of muscle-invasive bladder cancer have been proposed but currently their use in clinical practice is limited by the complexity of the methods used and diversity of the subtypes.

Prognostic Nomogram For Bladder Cancer With Brain Metastases: A National Cancer Database Analysis., Zhixian Yao, Zhong Zheng, Wu Ke, Renjie Wang, Xingyu Mu, Feng Sun, Xiang Wang, Shivank Garg, Wenyin Shi, Yinyan He, Zhihong Liu

Department of Radiation Oncology Faculty Papers

BACKGROUND: This study aimed to establish and validate a nomogram for predicting brain metastasis in patients with bladder cancer (BCa) and assess various treatment modalities using a primary cohort comprising 234 patients with clinicopathologically-confirmed BCa from 2004 to 2015 in the National Cancer Database.

METHODS: Machine learning method and Cox model were used for nomogram construction. For BCa patients with brain metastasis, surgery of the primary site, chemotherapy, radiation therapy, palliative care, brain confinement of metastatic sites, and the Charlson/Deyo Score were predictive features identified for building the nomogram.

RESULTS: For the original 169 patients considered in the model, the …

Hyperthermia And Immunotherapy: Clinical Opportunities., Mark D Hurwitz

Department of Radiation Oncology Faculty Papers

Hyperthermia holds great promise to advance immunotherapy in the treatment of cancer. Multiple trials have demonstrated benefit with the addition of hyperthermia to radiation or chemotherapy in the treatment of wide-ranging malignancies. Similarly, pre-clinical studies have demonstrated the ability of hyperthermia to enhance each of the 8 steps in the cancer-immunotherapy cycle including stimulation of tumor-specific immunity. While there has been an extensive recent focus on augmenting immunotherapy with radiation, surprisingly to date, there have been no clinical trials assessing the combination of hyperthermia with immunotherapy. The study of hyperthermia with immunotherapy is particularly compelling when considered in the context …

Inhibition Of Urothelial Carcinoma By Type I Interferon Activation Of The Innate And Adaptive Immune Response, Devin Plote

Dissertations & Theses (Open Access)

Bacillus Calmette-Guerin (BCG) is the first line therapy for bladder cancer patients with non-invasive disease. However, roughly 40% of patients exhibit no response, tumor recurrence or tumor progression following BCG treatment. Type I interferon (IFN-I) has potent anti-tumor effects against urothelial carcinoma (UC) and may be an alternative treatment option for patients who do not respond to BCG standard of care. However, the mechanisms that mediate the IFN-I-stimulated immune responses against UC are not fully elucidated. Herein, we evaluated the anti-tumor mechanisms of IFN-I in UC by use of adenoviral interferon-α (Ad-IFNα/Syn3) in human patients, and poly(I:C) or lentiviral IFNa …

Reprogrammed Lipid Metabolism In Bladder Cancer With Cisplatin Resistance., Min Young Lee, Austin Yeon, Muhammad Shahid, Eunho Cho, Vikram Sairam, Robert Figlin, Khae-Hwan Kim, Jayoung Kim

Articles, Abstracts, and Reports

Due to its tendency to recur and acquire chemoresistance quickly, bladder cancer (BC) remains to be an elusive and difficult disease. Patients with recurrent and chemoresistant BC have an extremely poor prognosis. One possible approach that may provide insightful and valuable information regarding resistance mechanisms is looking into the lipid metabolism of BC cells. Metabolism of lipids is essential for cancer cells and is associated with the regulation of a variety of key cellular processes and functions. This study conducted a comparative lipidomic profiling of two isogenic human T24 bladder cancer cell lines, one of which is clinically characterized as …

Assembling And Validating Data From Multiple Sources To Study Care For Veterans With Bladder Cancer, Florian R. Schroek, Brenda E. Sirovich, John D. Seigne, Douglas J. Robertson, Philip P. Goodney

Dartmouth Scholarship

Despite the high prevalence of bladder cancer, research on optimal bladder cancer care is limited. One way to advance observational research on care is to use linked data from multiple sources. Such big data research can provide real-world details of care and outcomes across a large number of patients. We assembled and validated such data including (1) administrative data from the Department of Veterans Affairs (VA), (2) Medicare claims, (3) data abstracted by tumor registrars, (4) data abstracted via chart review from the national electronic health record, and (5) full text pathology reports.

Computational Drug Design: A Multitargeted Approach In Bladder Cancer, Travis C. Lantz, Joydeb Majumder, Gaurav Chopra

The Summer Undergraduate Research Fellowship (SURF) Symposium

Cancer is a complex, robust disease with multiple redundant disease pathways which lead to tumor development, growth, and eventually even death. Despite known redundancies, cancer therapeutics continue to be developed against a single protein target. Initial disease regression occurs followed by relapse in a drug resistant disease state. In response, combinational drug clinical trial targeting multiple pathways began, and have failed due to increased toxicity caused by adverse drug interactions. Development of a single drug that differentially targets multiple disease pathways will result in a more potent therapeutic while inducing minimal toxicity. This was done computationally through in-lab software packages, …

Evaluation Of Second-Look Transurethral Resection In The Management Of Superficial Bladder Tumors, Mahmoud Mahdy, Mohamed Badreldin, Shady M. Salem, Tarek M. A. Baky

Menoufia Medical Journal

Objectives The aim of the present study was to evaluate the role of second-look transurethral resection of bladder tumors (TURBT) in the management of non-muscle-invasive bladder cancer (NMIBC). Background Bladder cancer is the ninth most common cancer diagnosis worldwide. Second-look TURBT ensures adequate evaluation of the muscularis propria while detecting and treating residual tumors. Patients and methods Thirty-one NMIBC patients underwent a second-look TURBT 2 weeks after the initial TURBT. The procedures carried out included reassessment of the bladder for the detection of residual lesions after initial resection, and the resection of the base of the previous resection site for …

Tgfβƒ1 Promotes Gemcitabine Resistance Through Regulating The Lncrna-Let/Nf90/Mir-145 Signaling Axis In Bladder Cancer, Junlong Zhuang, Lan Shen, Lin Yang, Xiaojing Huang, Qun Lu, Yangyan Cui, Xi Zheng, Xiaozhi Zhao, Dianzheng Zhang, Ruimin Huang, Hongqian Guo, Jun Yan

PCOM Scholarly Papers

High tumor recurrence is frequently observed in patients with urinary bladder cancers (UBCs), with the need for biomarkers of prognosis and drug response. Chemoresistance and subsequent recurrence of cancers are driven by a subpopulation of tumor initiating cells, namely cancer stem-like cells (CSCs). However, the underlying molecular mechanism in chemotherapy-induced CSCs enrichment remains largely unclear. In this study, we found that during gemcitabine treatment lncRNA-Low Expression in Tumor (lncRNA-LET) was downregulated in chemoresistant UBC, accompanied with the enrichment of CSC population. Knockdown of lncRNA-LET increased UBC cell stemness, whereas forced expression of lncRNA-LET delayed gemcitabine-induced tumor recurrence. Furthermore, lncRNA-LET was …

Neutrophil-To-Lymphocyte Ratio Is Elevated In Recurringnonmuscle Invasive Bladder Cancer, Emrah Yürük, Theodore Robert Saitz, Serkan Gönültaş, Ege Can Şerefoğlu, Ahmet Yaser Müslümanoğlu

Turkish Journal of Medical Sciences

Background/aim: Although it has been shown that the neutrophil-to-lymphocyte ratio (NLR) may predict the progression of nonmuscle invasive bladder cancer (NMIBC), its association with the recurrence of NMIBC has been poorly studied. The aim of this study is to evaluate the association between NLR and disease recurrence in patients with NMIBC. Materials and methods: The medical records of 428 consecutive initially diagnosed NMIBC patients who underwent transurethral resection between January 2010 and July 2014 were retrospectively reviewed. Patients without a preoperative NLR (n = 6), without a minimum of 6 months of follow-up (n = 56), who were lost to …

Association Of B7-H4 Gene Polymorphisms In Urothelial Bladder Cancer, Asuman Özgöz, Murat Şamli, Deni̇z Di̇nçel, Ahmet Şahi̇n, Ümi̇t İnce, Yeşi̇m Sağlican, Faruk Balci, Hale Şamli

Turkish Journal of Medical Sciences

Background/aim: We aimed to study polymorphisms of the B7-H4 gene in order to evaluate a possible association in urothelial carcinoma, as it is highly expressed in cancer tissues. Materials and methods: In this study B7-H4 gene rs10754339, rs10801935, and rs3738414 SNPs were studied by PCR-RFLP method in paraffin-embedded tumor specimens from 62 urothelial carcinoma patients and in a control group including 30 patients without bladder cancer. Results: We detected that the rs10754339 polymorphism was more frequent in the cancer patients when compared with the control group (P < 0.05). Only the rs3738414 polymorphism showed a statistically significant difference in frequency between pathologic diagnostic groups. Conclusion: The rs10754339 AA genotype distribution was found to have a higher frequency whereas the rs3738414 AG genotype distribution was lower in the bladder cancer group (P < 0.05). None of the genotype distributions showed a significant difference from the control group for the rs10801935 polymorphism. We conclude that B7-H4 has the potential to be a useful prognostic marker in urothelial carcinoma.

Grading Complication Following Radical Cystectomy And Ileal Conduit For Bladder Cancer Using Clavien Grading System., Syed Johar Raza, M Hammad Ather, Faisal Aziz Khan, Zaheer Alam

Hammad Ather

Objective: To determine the 30-day complication rate of radical cystectomy and urinary diversion using a validated system.

Study Design: An analytical descriptive study. Place and

Duration of Study: The Aga Khan University Hospital, Karachi, from 1990 to 2010.

Methodology: Patients who had undergone ileal conduit (IC) formation, following radical cystectomy (RC) for muscle invasive transitional cell carcinoma, were studied, using a prospectively maintained data base. Basic details were determined, complications were noted and graded according to the modified Clavien grading system (CG). Results were presented using descriptive statistics.

Results: Of all the RC performed at this hospital 89 patients received …