A possible protective role for Bacillus Calmette-Guérin therapy in urinary bladder cancer in the era of COVID-19: a brief report

Given the systemic immunogenic effects of Bacillus Calmette-Guérin (BCG) therapy in patients with bladder cancer and its non-specific immunogenic effects in viral respiratory diseases, we aimed to study severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in bladder cancer patients with a history of BCG therapy. In the present study, all bladder cancer survivors with a history of BCG therapy were identified and included in the study according to the data recovered from the UORC (Uro-Oncology Research Center) registry database. These patients were followed up in terms of acquiring coronavirus disease 2019 (COVID-19). Among the studied patients, 102 eligible bladder cancer patients with a history of BCG therapy entered the study. The males constituted the majority of the patients (86.3%), and more than half of the study population (55.9%) were above 65 years old. Among the understudy patients, 12.7% were confirmed for COVID-19. The study results did not show a statistically significant association between the time and number of BCG therapy courses and SARS-CoV-2 infection. Although no statistically significant association was observed between receiving BCG therapy and developing COVID-19, the infection rate in patients who had recently received BCG therapy was lower than those who had received therapy more than a year ago.

Human microbiome and prostate cancer development: current insights into the prevention and treatment / 医学前沿

The huge communities of microorganisms that symbiotically colonize humans are recognized as significant players in health and disease. The human microbiome may influence prostate cancer development. To date, several studies have focused on the effect of prostate infections as well as the composition of the human microbiome in relation to prostate cancer risk. Current studies suggest that the microbiota of men with prostate cancer significantly differs from that of healthy men, demonstrating that certain bacteria could be associated with cancer development as well as altered responses to treatment. In healthy individuals, the microbiome plays a crucial role in the maintenance of homeostasis of body metabolism. Dysbiosis may contribute to the emergence of health problems, including malignancy through affecting systemic immune responses and creating systemic inflammation, and changing serum hormone levels. In this review, we discuss recent data about how the microbes colonizing different parts of the human body including urinary tract, gastrointestinal tract, oral cavity, and skin might affect the risk of developing prostate cancer. Furthermore, we discuss strategies to target the microbiome for risk assessment, prevention, and treatment of prostate cancer.

Oxford-MEST classification in IgA nephropathy patients: a report from Iran

There is a limited knowledge about the morphological features of IgA nephropathy [IgAN]in the middle east region. The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory. At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system. In this survey, of 102 patients 71.6% were male. The mean age of the patients was 37.7 +/- 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2%, E: 32%, S: 67% also, T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis [P=0.003] and interstitial fibrosis/tubular atrophy frequency distribution [P=0.045], between males and females. Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents [P<0.001]. There was also significant correlation of serum creatinine with segmental glomerulosclerosis [P<0.001]. Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease. In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system

Effect of allopurinol in decreasing proteinuria in type 2 diabetic patients

Diabetic nephropathy is the most prevalent cause of end-stage renal disease. Besides factors such as angiotensin II, cytokines, and vascular endothelial growth factor, uric acid may play a role as the underlying cause of diabetic nephropathy. We evaluated allopurinol effects on proteinuria in diabetic patients with nephropathy. In a double-blinded randomized controlled trial on 40 patients with type 2 diabetes mellitus and diabetic nephropathy [proteinuria, at least 500 mg/24 h and a serum creatinine level less than 3 mg/dL], allopurinol [100 mg/d] was compared with placebo. Administration of antihypertensive and renoprotective drugs [angiotensin-converting enzyme inhibitors and angiotensin receptor blockers continued for both groups, without changes in dosage. Proteinuria was compared at baseline and 2 and 4 months between the two groups. Each group consisted of 9 men and 11 women. There were no difference between two groups regarding age, body mass index, duration of diabetes mellitus, systolic and diastolic blood pressure, fasting blood glucose, blood urea nitrogen, serum creatinine, serum potassium, and urine volume. Serum levels of uric acid [P=.02] and 24-hour urine protein [P=.049] were significantly lower in the patients on allopurinol, after 4 months of receiving allopurinol, compared with the control group. Low-dose allopurinol can reduce severity of proteinuria after 4 months of drug administration, which is probably due to decreasing the serum level of uric acid. Thus, allopurinol can be administered as an adjuvant cost-effective therapy for patients with diabetic nephropathy

Comparison of ultrasonography and intravenous urography in the screening and diagnosis of hematuria causes

Our aim was to compare transabdominal ultrasonography [US] and intravenous urography [IVU] in the evaluation of patients with hematuria. Two hundred patients with hematuria were assessed by US and IVU, and if needed, by cystoscopy, ureteroscopy, and CT scan, to determine the definite cause of hematuria. The results of US and IVU were compared according to the definite diagnoses. Of 97 patients with microscopic hematuria, 44 [45%] had a documented cause for hematuria, and of 103 patients with gross hematuria, 76 [74%] had a definite disorder [P <.001]. Urinary calculi were found in 105 patients, 93 [88.5%] and 73 [69.5%] of which were detected by US and IVU, respectively [P <.001]. There were 3 and 6 cases of kidney and bladder neoplasms, respectively, all of which were revealed by US, but only 2 renal tumors were detectable on IVU. Ultrasonography had a higher sensitivity than IVU for diagnoses of kidney calculi, lower ureteral calculi, and urologic neoplasms [95.3% versus 65.1% for kidney calculi, P =.039; 89.7% versus 69.2% for lower ureteral calculi, P <.001; and 100% versus 22.3% for urologic neoplasms, P <.001], but in calculi of the middle and upper ureter and of the whole ureter, there were no differences between US and IVU.Our results are in favor of using US in the initial evaluation of hematuria. However, we must choose our diagnostic tool according to the patient's condition and suspected disorders causing hematuria