Bladder preservation in muscle-invasive bladder cancer: a comprehensive review

ABSTRACT Background Standard management of muscle-invasive bladder cancer involves radical cystectomy with pelvic lymph node dissection. However, patients may be ineligible for surgery or may wish to avoid the morbidity of cystectomy due to quality of life concerns. Bladder preservation therapies have emerged as alternatives treatment options that can provide comparable oncologic outcomes while maintaining patients' quality of life. Objective To review bladder preservation therapies, patient selection criteria, and functional and oncologic outcomes for BPT in muscle-invasive bladder cancer. Materials and Methods We conducted a comprehensive literature review of bladder preservation therapies in Pubmed and Embase. Discussion The ideal patient for BPT has low-volume T2 disease, absence of CIS, absence of hydronephrosis, and a maximal TURBT with regular surveillance. Technological advancements involving cancer staging, TURBT technique, and chemotherapy and radiation therapy regimens have improved BPT outcomes, with oncologic outcomes now comparable to those of radical cystectomy. Advancements in BPT also includes a heightened focus on improving quality of life for patients undergoing bladder preservation. Preservation strategies with most evidence for use include trimodality therapy and partial cystectomy with pelvic lymph node dissection. Conclusions This review highlights the breadth of strategies that aim to preserve a patient's bladder while still optimizing local tumor control and overall survival. Future areas for innovation include the use of predictive biomarkers and implementation of immunotherapy, moving the field towards patient-tailored care.

A comparative evaluation of the pharmaceutical quality of different brands of metformin hydrochloride tablets available in Abuja, Nigeria

Background: Metformin hydrochloride tablets are the most commonly prescribed drug for the management of Type II Diabetes Mellitus. This has resulted in increased importation and manufacturing of various brands of the tablets in Nigeria. Objective: To evaluate the pharmaceutical quality of different brands of metformin hydrochloride tablets available in Abuja, Nigeria. Method: Ten brands of metformin hydrochloride tablets were purchased and subjected to pharmaceutical quality evaluations such as friability, hardness, disintegration and dissolution tests. Content of active pharmaceutical ingredient (API) was determined using spectrophotometric analysis as well as reverse phasehigh performance liquid chromatography (RP-HPLC).Results: All the brands were elegantly labelled, packaged and within their shelf lives. With exception of one brand, they all had NAFDAC registration number. The weight uniformity, friability, hardness and disintegration time values for all the brands were within acceptable limits. Three brands of the products released less than 70 % of their API after 45 min and therefore failed the dissolution test. There was disparity between content assay results using UV spectrophotometry and HPLC. HPLC results showed that only brand failed the test by having 86 % of the API while with UV spectrophotometry; four brands failed the test.Conclusion: This investigation suggest that four brands of metformin hydrochloride tablets available in Abuja, did not met official specifications even though only one brand was implicated by HPLC analysis. Consequently, this research would recommend continuous sentinel surveillance of metformin tablets and the use of HPLC for product analysis for its high sensitivity and accuracy

A phylum level analysis reveals lipoprotein biosynthesis to be a fundamental property of bacteria

Bacterial lipoproteins are proteins that are post-translationally modified with a diacylglyceride at an N-terminal cysteine, which serves to tether these proteins to the outer face of the plasma membrane or to the outer membrane. This paper reviews recent insights into the enzymology of bacterial lipoprotein biosynthesis and localization. Moreover, we use bioinformatic analyses of bacterial lipoprotein signal peptide features and of the key biosynthetic enzymes to consider the distribution of lipoprotein biosynthesis at the phylum level. These analyses support the important conclusion that lipoprotein biosynthesis is a fundamental pathway utilized across the domain bacteria. Moreover, with the exception of a small number of sequences likely to derive from endosymbiont genomes, the enzymes of bacterial lipoprotein biosynthesis appear unique to bacteria, making this pathway an attractive target for the development of novel antimicrobials. Whilst lipoproteins with comparable signal peptide features are encoded in the genomes of Archaea, it is clear that these lipoproteins have a distinctive biosynthetic pathway that has yet to be characterized.

Effect of processing methods on some nutrients, antinutrients and toxic substances in amaranthus cruentus.

The presence of antinutrients and toxic substances severely limits the nutritional benefits of vegetables. The objective of this study was to assess the effects of processing methods on some of these substances. Effects of boiling and sun drying on oxalate, cyanide and nitrate, vitamin C, β-carotene, and the mineral elements Fe, Cu, Mg, Na and K in Amaranthus cruentus were investigated. Both methods significantly (p < 0.05) reduced oxalate, cyanide and nitrate levels. Vitamin C content was significantly (p < 0.05) decreased. β-carotene level increased on boiling but was reduced in sundried vegetable. Boiling exceeding 5 minutes significantly (p < 0.05) reduced β-carotene level. The mineral elements decreased upon boiling but sun drying had no significant effect on their levels. We conclude that both methods are effective means of reducing the levels of antinutrients and toxic substances in Amaranthus cruentus to tolerable levels with boiling being a better method.