Effect of bladder cancer variant histology on survival outcome in patients treated with radical cystectomy: A single-centre experience.

CONTEXT: Bladder cancer (BC) is the sixth most common malignant neoplasm in men. Recently, great effort has been devoted to the study of BC variant histology (VH). Yet, the results from these studies have shown conflicting data and remain unclear whether their presence alters recurrence and survival rates after radical cystectomy (RC). AIMS: We undertook this study aiming to test the effect on VH on recurrence-free survival (RFS) and overall survival (OS) in single-center RC patients. SETTINGS AND DESIGN: We have retrospectively analyzed medical records and pathology reports from 331 patients who underwent RC with or without pelvic lymphadenectomy at University Urology Clinic-Skopje, North Macedonia, in the period between 2010 and 2018. SUBJECTS AND METHODS: Microscopic analysis of the specimens involved the evaluation of histological tumor type, tumor grade, pathological tumor node metastasis stage, presence of lymphovascular invasion, and resection margin status. STATISTICAL ANALYSIS USED: Univariable and multivariable Cox regression models were applied to test the effect of VH on RFS and OS. RESULTS: We found 185 patients who matched our inclusion criteria. At multivariable analyses, lymphovascular invasion and positive resection margins were associated with shorter RFS. Similarly, patients diagnosed with lymphovascular invasion, positive resection margins, and a pelvic lymph node metastasis had poorer OS. VH was not found to be an independent predictor of both RFS and OS (P > 0.05). CONCLUSIONS: The present study did not reveal prognostic effect of VH on RFS and OS. In our series, histomorphologic parameters including lymphovascular invasion, resection margins, and pelvic lymph node metastasis were the most relevant predictors on survival outcome after RC.

Adenoid Vegetations - Reservoir of Bacteria for Chronic Otitis Media with Effusion and Chronic Rhinosinusitis.

INTRODUCTION: Otitis media and rhinosinusitis are commonly encountered illnesses in pediatric population. Literature reports have documented the association between the occurrence of these two conditions and even their almost identical microbiological findings. Until recently, the key factor in the association of these two conditions was considered to be the hypertrophic adenoid tissue, but within the past few years there have been evidences in the literature about the presence of bacterial biofilms on the adenoids suggesting biofilms to be also responsible for both conditions, chronic otitis media with effusion and chronic rhinosinusitis. AIM: The aim of this study was to make a microbiological analysis of the adenoid tissue specimens taken from patients with chronic otitis media with effusion and chronic or recurrent rhinosinusitis and to determine their potential for biofilms formation. METHODS: After the surgical intervention, adenoidectomy, microbiological evaluation and analysis of the adenoid tissue specimens taken from 20 patients were made. Having in mind the disease history, chronic otitis media with effusion was diagnosed in all 20 patients and chronic rhinosinusitis in 9 patients. RESULTS: The results obtained from the microbiological analyses showed many potentially pathogenic bacteria in the adenoids that were almost identical with the most common organisms incorporated in the etiopathogenesis of both conditions, in chronic otitis media with effusion and in chronic rhinosinusitis. In 7 (35%) patients Haemophylus influenzae was isolated, in 6 (30%) Streptococcus pneumoniae, in 4 (20%) Moraxella catаrrhalis, in 2 (10%) patients Staphylococcus aureus and in 1 (5%) patient Streptococcus pyogenes - group A was isolated. One bacterium was isolated from all adenoid vegetations, except in one case when two bacteria (Haemophylus influenzae and Staphylococcus aureus) were concurrently isolated. CONCLUSION: Our results have shown that the key role in adenoid vegetations in chronic otitis media with effusion and chronic rhinosinusitis is not only the mechanism of rhinopharyngeal obstruction, but also the presence of bacterial strains with a large potential for formation of biofilms adhered to their surface, especially in cases with symptoms of chronic otitis media with effusion and chronic rhinosinusitis that were resistant to antibiotic therapy.

Speech Perception Outcomes after Cochlear Implantation in Children with GJB2/DFNB1 associated Deafness.

BACKGROUND: Cochlear implants (CI) for the rehabilitation of patients with profound or total bilateral sensorineural hypoacusis represent the initial use of electrical fields to provide audibility in cases where the use of sound amplifiers does not provide satisfactory results. AIMS: To compare speech perception performance after cochlear implantation in children with connexin 26-associated deafness with that of a control group of children with deafness of unknown etiology. STUDY DESIGN: Retrospective comparative study. METHODS: During the period from 2006 to, cochlear implantation was performed on 26 children. Eighteen of these children had undergone genetic tests for mutation of the Gap Junction Protein Beta 2 (GJB2) gene. Bi-allelic GJB2 mutations were confirmed in 7 out of 18 examined children. In order to confirm whether genetic factors have influence on speech perception after cochlear implantation, we compared the post-implantation speech performance of seven children with mutations of the GBJ2 (connexin 26) gene with seven other children who had the wild type version of this particular gene. The latter were carefully matched according to the age at cochlear implantation. Speech perception performance was measured before cochlear implantation, and one and two years after implantation. All the patients were arranged in line with the appropriate speech perception category (SPC). Non-parametric tests, Friedman ANOVA and Mann-Whitney's U test were used for statistical analysis. RESULTS: Both groups showed similar improvements in speech perception scores after cochlear implantation. Statistical analysis did not confirm significant differences between the groups 12 and 24 months after cochlear implantation. CONCLUSION: The results obtained in this study showed an absence of apparent distinctions in the scores of speech perception between the two examined groups and therefore might have significant implications in selecting prognostic indicators of speech perception following cochlear implantation.