Rutgers Cancer Institute of New Jersey advances understanding of surgical treatment options for genitourinary cancers

UrologyHelping to advance scientific and clinical knowledge to combat cancers that affect the bladder, kidneys, urinary tract and male reproductive organs, physician scientists at Rutgers Cancer Institute of New Jersey are presenting their latest research in this area at the 2015 Genitourinary Cancers Symposium (co-sponsored by the American Society of Clinical Oncology, American Society for Radiation Oncology and the Society of Urologic Oncology) in Orlando later this week.Through a population-based study, investigators examined complication rates in patients with uncontrolled diabeteswho underwent surgery to remove the entire bladder and nearby lymph nodes. Typically this procedure – known as a radical cystectomy – is performed in the elderly population where diabetes rates can be high, and it is associated with a high incidence of postoperative disease and death.

Read the rest of the article http://www.medicalnewstoday.com/releases/289960.php.

 

Recent gut and urinary tract infections may curb risk of rheumatoid arthritis

Urology_Infectious DiseaseRecent gut and urinary tract infections may curb the risk of developing rheumatoid arthritis, suggests research published online in the Annals of the Rheumatic Diseases.One possible explanation could lie in the way in which these infections alter the types of bacteria resident in the gut (microbiome), say the researchers.They set out to look at the impact of different types of infection on the risk of developing rheumatoid arthritis in almost 6500 people living in south and central Sweden.Some 2831 of the entire sample had been newly diagnosed with rheumatoid arthritis between 1996 and 2009. The remaining 3570, who were randomly selected from the population, were healthy, but matched for age, sex, and area of residence with the patients.All participants were asked whether they had had any gut, urinary tract, or genital infections in the preceding two years. They were also asked if they had had prostatitis (inflamed prostate), or antibiotic treatment for sinusitis, tonsillitis/other throat infection, or pneumonia during this time.

Read the rest of the article at http://www.medicalnewstoday.com/articles/288755.php.

New data provide evidence that Hexvix can improve the overall survival in bladder cancer patients

UrologyPhotocure ASA, a specialty pharmaceutical company focused on photodynamic technologies in dermatology andcancer, is pleased to note that a study on the impact of Hexvix on survival in bladder cancer patients has been published in the World Journal of Urology.

The study investigated the impact on survival in bladder cancer patients of photodynamic diagnosis (PDD)-guided bladder tumor resection (TUR-BT), including that guided by Hexvix (hexaminolevulinate (HAL)).The findings from this retrospective study of 224 patients demonstrate for the first time that Hexvix guided TUR-BT in bladder cancer patients, who later progressed to requiring radical cystectomy (RC), significantly increased the three year overall survival (p=0.037) and the median three year recurrence free survival (p=0.002) compared to patients in the comparator group. For more information read here http://www.medicalnewstoday.com/releases/288726.php

 

 

 

Laparoscopic surgery for bladder cancer leads to good long-term cancer control

Urology

Long-term survival rates following laparoscopic surgery for bladder cancer are comparable to those of open surgery, according to a study published in BJU International. The findings, which come from the largest study to date with long-term follow-up after this type of minimally invasive surgery, indicate that prospective randomized trials comparing these two bladder cancer surgeries are warranted.

Open radical cystectomy, or removal of the bladder though open surgery, is the treatment of choice for muscle invasive and high-risk non-muscle invasive bladder cancer; however, the surgery can lead to serious complications. Some hospitals are using minimally invasive procedures such as laparoscopic radical cystectomy, but there is little information on the effectiveness of these procedures for preventing cancer recurrence over the long term.

To address this, the European Association of Urology (EAU)-section of Uro-technology has been building a large database of laparoscopic radical cystectomy procedures performed across Europe. When exploring this database, an international team led by Simone Albisinni, MD and Roland van Velthoven, MD, PhD, of the Université Libre de Bruxelles in Belgium, found that laparoscopic radical cystectomy can lead to reliable cancer control even many years after surgery. After 5 years, 66 percent of patients had no signs of bladder cancer recurrence, and among those followed for 10 years, 62 percent had no signs of recurrence.

“Analyzing over 500 patients and with a median follow-up of 5 years, these results are vital to globally evaluate the efficacy of this procedure. They suggest that a laparoscopic approach to bladder cancer, when performed correctly, can be as safe as open surgery with regards to cancer control, though maintaining the benefits of a minimally invasive approach,” said Dr. Albisinni.

The authors noted that there is growing interest for robotic-assisted radical cystectomy, another minimally invasive procedure, in the international community as well; however, many hospitals in Europe do not own a robot. Laparoscopic equipment, on the other hand, is more widely available. “As such, this data represents crucial information for urologists who are performing laparoscopic surgery, or who wish to implement laparoscopic cystectomy in their departments. In spite of the technical difficulty and the need for a learning curve, these findings support the use of a laparoscopic approach for the management of bladder cancer,” said Dr. Albisinni.

Adapted by MNT from original media release

Researchers identify method to assess urinary tract infection risk in women after pelvic-floor surgery

Urology

Researchers at Loyola University Chicago Stritch School of Medicine may have identified a way to assess who is at risk for developing a urinary tract infection (UTI) following pelvic-floor surgery. These findings were reported in the latest issue of PLOS ONE.

Urinary tract infections (UTIs) are the most common type of bacterial infection and have estimated treatment costs exceeding $1 billion a year in the United States. Women who undergo surgery for pelvic-organ prolapse or urinary incontinence are more likely to develop a UTI following the procedure. Clinicians have lacked effective methods to identify, and ultimately treat, specific patients with an increased UTI risk in the past.

This study found that certain urinary bacteria and antimicrobial peptides, which normally help the bladder immune system function, may identify women at increased risk for a UTI following pelvic-floor surgery.

“This information may help us improve UTI prevention and treatment strategies for women down the road,” said Katherine Radek, PhD, senior author, assistant professor, Department of Surgery and a member of Loyola’s Burn & Shock Trauma Research Institute.

The study explored the relationship between urinary bacteria, antimicrobial peptides and UTI symptom severity in 54 women undergoing pelvic-floor surgery. Study participants completed a questionnaire and provided a catheterized urine specimen obtained under anesthesia on the day of surgery. The urine was analyzed using advanced DNA-based detection methods.

Thirteen participants (24 percent) had positive urine cultures before surgery. The rest (n = 41, 76 percent) had negative urine cultures before surgery. Of these 54 women, 10 (18.5 percent) developed UTI symptoms after surgery, while four (7 percent) had positive urine cultures after surgery.

Researchers found that the diversity and abundance of specific urinary bacteria and the amount of a specific antimicrobial peptide were different in women who developed a UTI following surgery compared with those who did not: lower risk of postoperatvie UTI correlated with greater bacterial diversity, greater abundance of the Lactobacillus species and higher levels of the antimicrobial peptide β-defensin-1.

Further insight into the mechanisms by which bladder bacteria and antimicrobial peptides communicate during normal and disease states will facilitate the development of better prevention and/or treatment strategies for UTI-susceptible populations.

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/286897.php

 

 

 

Genes expressed during urinary tract infections suggest next-generation treatment

Nephrolgy_Urology

Urinary tract infections can occur with no apparent cause, and as effectiveness of antibiotics fades, treating them is also becoming less predictable.

University of Michigan Medical School researchers have identified bacterial genes that help the infections spread, providing a potential new target for treating UTIs, a global public health concern mostly affecting women. UTIs lead to lost work time, emergency room visits and health care spending of $3.5 billion in the United States.

The research findings, published in Proceedings of the National Academy of Sciences, reveal the specific genes expressed by Escherichia coli, the bacteria that most often causes UTIs in otherwise healthy people.

“The bacterium is becoming resistant to currently available antibiotics, making it imperative to develop new treatment and prevention strategies,” says senior study author Harry T. Mobley, Ph.D., the Frederick G. Novy professor and chair of the Department of Microbiology and Immunology at the University of Michigan Health System. “The next logical step is to identify and develop therapies that selectively block these UTI-specific genes.”

In the study of 42 women, 7.7 percent had infections that were resistant to ciprofloxacin and 15.3 percent did not respond to trimethoprim/ sulfamethoxazole, two antibiotics commonly used for treatment.

The U-M team used genomic screening tools to take a deeper look at the mechanisms for infection. Rather than the expected virulence factor, the newly discovered E. coli-specific genes helped protect the bacterial species from the toxic effect of metal ions the body uses to fight infection.

Attacking this function, and other mechanisms that promote survival of the bacteria in the urinary tract, may be a strategy for new microbial agents, authors say.

The U-M has a remarkable record in research of molecular mechanisms leading to bacterial infections. The Mobley research team is among scientists identifying a potential approach for a vaccine to prevent urinary tract infections.

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/286876.php

 

 

 

Kidney function likely affected by perceived racial discrimination

Nephrology_Urology

Perceived racial discrimination may contribute to disparities related to kidney disease, according to a study presented at ASN Kidney Week 2014 at the Pennsylvania Convention Center in Philadelphia, PA.

Psychosocial factors such as perceived racial discrimination have been associated with chronic diseases, but little is known about the relationship between perceived racial discrimination and kidney function decline. Researchers led by Angedith Poggi-Burke, MPH and Deidra Crews, MD, FASN (National Institute on Aging and Johns Hopkins University School of Medicine, respectively) studied 1,574 adults with preserved kidney function in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (Baltimore City, Maryland). The team found that 20% of individuals perceived themselves to have been discriminated against ‘a lot’ because of their race. Such individuals were more likely to be African American and have a higher educational background, but they were more likely to be living in poverty than those who reported little-to-no perceived discrimination. Additionally, those who perceived ‘a lot’ of discrimination had higher systolic blood pressure but a lower prevalence of diabetes than those perceiving little-to-no discrimination.

Overall, perceived racial discrimination was linked with greater kidney function decline over 5 years of follow-up that was independent of socio-demographic, lifestyle, and health factors. When analyzed by race and sex, the link between perceived racial discrimination and kidney function decline remained only among African American women. Systolic blood pressure was responsible for 15% of this association.

“Perceived racial discrimination may contribute to disparities in kidney disease and might exert its effect on risk of kidney function decline through stress-related pathways,” said Dr. Crews. “This study can serve as a basis for future studies focusing on psychosocial stressors and their potential contributions to the initiation and progression of kidney disease.”

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/285537.php

Picture courtesy of www.medindia.net