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A busy haematuria clinic
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Histologically bladder carcinoma can be either transitional cell-, squamous cell-or adeno-carcinoma; although, in the West, the latter two are rare. TCC may occur between the renal pelvis and the urethra, i.e., they arise from the urothelium. However, the bladder is the commonest site. The typical presentation is one of painless haematuria. Other urinary symptoms the patient may experience are: increased urinary frequencyurgencydysuriarecurrent UTIs.
Bladder Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Bladder carcinoma in situ (CIS) is highly malignant sub-category of NMIBC with a high propensity for progression. It can be diffuse or focal, symptomatic or asymptomatic, and may or may not be associated with other non-muscle or muscle invasive tumors. Macroscopically, lesions may appear as raised red “velvety” patches or be indistinguishable from adjacent urothelium.
Complications Related to Neurogenic Bladder Dysfunction I
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
The most important risk factor for the development of bladder carcinoma is irritation of the bladder mucosa. This includes chronic bladder infection, prolonged indwelling catheterization, and bladder stone disease. Other risk factors include smoking and altered immunologic function.
Human epidermal growth factor receptor 2 (HER2) gene amplification in non-muscle invasive urothelial bladder cancers: Identification of patients for targeted therapy
Published in Arab Journal of Urology, 2020
Vinita Agrawal, Niharika Bharti, Rakesh Pandey
Most of the studies of HER2 expression in bladder carcinoma have been performed on MIBC and show varying expression ranging between 9% and 81% [12]. In a study on metastatic urothelial bladder carcinoma treated with platinum-based chemotherapy, Bellmunt et al. [5] reported that HER2 status varies in different populations. HER2 3+ staining and FISH amplification was seen in 22% of Spanish and 4% of Greek cohorts with no association with overall survival in univariate or multivariate analysis in any of the cohorts. In a study of 1005 invasive bladder cancers, Lae et al. [13] found lower HER2 2/3+ expression (9%) and gene amplification (5%). Other studies have reported HER2 gene amplification in 10–12% of muscle-invasive and metastatic tumours [14,15]. In the present study from the Indian subcontinent, we found higher HER 2/3+ expression (44%), HER2 3+ expression (36%) and amplification (16%) in MIBCs. This variability could be due to the different populations studied, methods and cut-offs used, antibodies, as well as tumour heterogeneity and advanced stage at diagnosis.
Immunosuppression in relapsing remitting multiple sclerosis: moving towards personalized treatment
Published in Expert Review of Neurotherapeutics, 2020
Aurora Zanghì, Emanuele D’Amico, Francesco Patti
Cyclophosphamide is an alkylating agent related to nitrogen mustard that binds to DNA and disrupts cell replication. It has been studied as a treatment for MS for the past 40 years and many reports suggest that it is efficacious in cases of worsening RRMS. The most widely used regimen is monthly pulsed therapy with 800 mg/m2 administered monthly for 1 year, followed by bimonthly treatments in those who are responders, although numerous other regimens have been proposed [29]. The safety profile for cyclophosphamide is well established. Aside from the anticipated side effects of nausea, vomiting, alopecia, transient immunosuppression, and amenorrhea that are commonly observed in this therapeutic class, the most common general causes for concern are hemorrhagic cystitis, gonadal toxicity (in both men and women), bladder cancer. The risk of bladder carcinoma appears to be associated with cumulative exposures of >100 g and possibly related to duration of exposure (2.7 years) [40].
Current and emerging bladder cancer biomarkers with an emphasis on urine biomarkers
Published in Expert Review of Molecular Diagnostics, 2020
Antonio Lopez-Beltran, Liang Cheng, Thomas Gevaert, Ana Blanca, Alessia Cimadamore, Matteo Santoni, Francesco Massari, Marina Scarpelli, Maria R. Raspollini, Rodolfo Montironi
Urothelial bladder carcinoma represents the 9th and 4th most common cancer worldwide and in men in the USA, respectively [1]. About 80% of urothelial bladder carcinomas are diagnosed as non-muscle invasive and the remaining 20% as muscle-invasive bladder carcinoma. Most non-muscle bladder carcinoma will experience tumor recurrences [2]. Of them, 10–30% will progress to aggressive disease [3]; therefore, early diagnosis and detection of tumor recurrences are of great relevance in patient management [4–7]. Currently, the diagnosis of bladder carcinoma requires cystoscopy, a procedure which is unpleasant and costly [8], and cytological analysis of neoplastic cells shed in urine by the tumor [9–11]. A major criticism of urine cytology is that of being pathologist experienced-dependent [12–14].