Relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer.

Introduction: Bladder cancer is one of the most important diseases that threatens oral and dental health due to its nature and side effects of chemotherapy. Therefore, the present study was conducted to investigate the relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer. Methods: This cross-sectional study was conducted on patients with bladder cancer in Ahvaz, 2023. Subjects were selected randomly from the patients those were registered in Cancer Registry Center in Ahvaz Jundishapur University of Medical sciences and invited to Golestan Hospital for data collection through clinical evaluation, the Oral Health Literacy Adult Questionnaire (OHL-AQ), and the Oral Health Impact Profile-14 (OHIP-14PER) questionnaire. The data were analyzed using Pearson correlation coefficient, independent t-test, and analysis of variance. Results: The number of participants was 194. The mean oral health literacy in patients with bladder cancer was 9.74 ± 2.39, indicating insufficient oral health literacy. A significant association was observed between OHL-AQ and DMFT index, but no significant association was found between OHIP-14PER and DMFT index. Furthermore, a significant correlation was found between OHL-AQ and OHIP-14PER (r = -0.68) in patients with bladder cancer. Conclusion: Based on the findings of the present study, all dimensions of oral health literacy have correlation with the oral health-related quality of life in patients with bladder cancer. Therefore, adopting oral health behaviors and increasing oral health literacy can be the best way to improve the oral health-related quality of life to among patients with bladder cancer.

Machine Learning Models for Predicting the Type and Outcome of Ureteral Stones Treatments.

Background: Kidney and ureter stones are the third pathologies in urological diseases. Less invasive treatments such as transureteral lithotripsy and extracorporeal shock wave lithotripsy are used to treat ureteral stones. Data mining has provided the possibility of improving decision-making in choosing the optimal treatment. In this paper predictive models for the detection of ureter stone treatment (first model) and its outcome (second model) is developed based on the patient's demographic, clinical, and laboratory factors. Methods and Material: In this cross-sectional study a questionnaire was used to identify the most effective features in the predictive models, and Information on 440 patients was collected. The models were constructed using machine learning techniques (Multilayer perceptron, Classification, and regression tree, k-nearest neighbors, Support vector machine, Naïve Bayes classifier, Random Forest, and AdaBoost) in the Bigpro1 analytical system. Results: Among the Holdout and K-fold cross-validation methods used, the Holdout method showed better performance. From the data-based balancing methods used in the second model, the Synthetic Minority oversampling technique showed better performance. Also, the AdaBoost algorithm had the best performance. In this algorithm, accuracy, sensitivity, specificity, precision, F- measure, and Area under the carve in the first model were 89%, 87%, 91%, 90%, 89%, and 94% respectively, and in the second model were 81%, 81%, 82%, 84%, 82%, and 85% respectively. Conclusions: The results were promising and showed that the data mining techniques could be a powerful assistant for urologists to predict a surgical outcome and also to choose an appropriate surgical treatment for removing ureter stones.

Can bladder shear wave elastography be an alternative method for detection of neurogenic bladder instead of urodynamic study?

BACKGROUND: In the normal physiology of the bladder wall, it has sufficient elasticity so that it can maintain normal pressure during filling phase of bladder. Bladder functional pathology can cause many problems for patients. METHOD: This evaluation is a cross-sectional study conducted on patients suspected of neurogenic bladder. In this study, patient refered for urodynamic testing at first, urodynamic test performed by urologist and then Shear wave elastography was performed by radiologist. Data such as age, sex, height, and weight, and other demographic data were also evaluated. Patients were informed before and after the urodynamic and Shear wave sonography tests. Finally, the data were entered into SPSS software and were statistically analyzed. RESULTS: We observed that the mean and standard deviation of the age was 15.7 ± 6.2 years. Also found that in gender 19 (63.3%) patients were males and 11 (36.7%) were female. On the other hand, in terms of BMI, most patients were normal in this regard (50%), as well as in other cases, including weight loss in 3 (10%) patients, overweight in 8 (26.6%) patients, and obese were in 4 patients (13.3%). in our assessment about the efficacy of the ultrasound elastography approach to the anterior wall, which showed that the specificity of the test in the diagnosis of neurogenic bladder was 83% and this is statistically significant in patients (P < 0.05). We also observed in the posterior wall posture that the specificity of this test was 85% in the diagnosis of neurogenic bladder, which indicates a high diagnostic capability of this test, and this is statistically significant in patients (P < 0.05). CONCLUSION: Based on the results observed in this evaluation, ultrasound elastography has a high specificity for neurogenic bladder detection in comparison with urodynamic study. Accordingly, due to the less invasive nature of this method than urodynamic study, this method can be used to identify patients with neurogenic bladder.

Accuracy of Magnetic Resonance Spectroscopy Techniques in Prostate Cancer and Prostatitis.

BACKGROUND: Considering the non-invasive nature of magnetic resonance spectroscopy (MRS) and its ability to detect prostate lesions, the present study aimed to investigate the accuracy of MRS techniques in distinguishing between prostate cancer (PCa) and prostatitis. METHODS: Thirty-three patients (18 patients with PCa and 15 patients with prostatitis) were recruited for this study. Magnetic resonance imaging (MRI) and MRS were performed using 1.5-T system GE- modle Optima 450 Discovery (GE Medical Systems, US). The (Cho+Cr)/Cit ratio of hypointense T2 areas were calculated. The diagnostic accuracy including sensitivity and specificity indices, with 0.95 confidence interval as well as PPV and NPV were calculated for each variable. The receiver operating characteristic (ROC) area under the curve (AUC) was outlined and investigated. The mean quantitative values between the two groups (PCa and Prostatitis) were compared using independent t test. RESULTS: The mean ratios of Cho+Cr/Cit in PCa was 1.54 ± 0.63 and 0.83 ± 0.48 for PCa and prostatitis, respectively, indicating a significant statistical difference (P = 0.00). A reduction in citrate was seen in both PCa and prostatitis tissue. Significant elevation in choline peak was shown for PCa. Moreover, creatinine level was low in both normal tissue and PCa without significant difference. Sensitivity, specificity, accuracy, PPV and NPV of MRS were 94.4% (95% CI, 74.2-99), 80% (95% CI, 54.8-93), 96%, 85% and 92.4%, respectively. CONCLUSION: The results of this study indicate an acceptable level of sensitivity, specificity and accuracy of MRS in the differential diagnosis of PCa and prostatitis.

An investigation into the sensitivity of shear wave ultrasound elastography to measure the anterior bladder wall pressure in patients with neurogenic bladder.

INTRODUCTION AND OBJECTIVE: Urodynamic testing (urodynamics) is widely used for evaluating bladder function as a result of high detrusor compliance. This aggressive and uncomfortable test is especially difficult for children. This study aimed to determine the sensitivity of shear wave ultrasound elastography (SWE) as a new method for evaluating the biomechanical characteristics of bladder to measure the anterior bladder wall pressure in children with neurogenic bladder (NB). MATERIALS AND METHODS: The present prospective clinical study was carried out on 30 children with allegedly NB and 20 healthy children as control group. These children referred to Ahwaz Golestan Hospital in 2018. After clinical evaluations, urodynamics was performed for children with NB and detrusor compliance was measured in cm/H2O. The ultrasonography of the SWE was performed on the anterior wall of the bladder (Estimated bladder capacity (EBC) 50%) for the two groups. The relationship between shear wave speed (SWS) and detrusor compliance was estimated using Pearson's correlation coefficient. Independent t-test was used to compare SWS between two groups. RESULTS: In patients with NB, there was a significant relationship between the mean SWS of the anterior bladder wall and detrusor compliance (R = 0.89, P = 0.0001). The comparison between normal and NB groups showed that the mean SWS of the anterior bladder wall in the patients was significantly higher than the healthy group (1.88 ± 0.88 m/s vs. 0.94 ± 0.15; P = 0.0001). There was also no significant relationship between SWS, gender, age, weight, and body mass index of patients (P > 0.05). CONCLUSION: The results showed that SWE can be used as a useful alternative for urorodynamic testing in the evaluation of NB (bladder dysfunction) in children.

Effect of Local Fibrinogen Administration on Postoperative Bleeding in Open Prostatectomy Surgery.

BACKGROUND: Open prostatectomy is still accompanied by some postoperative bleeding. Prescribing fibrinogen to promote clot formation in patients with bleeding is of critical importance. This research studied the effects of local injection of fibrinogen on level of postoperative bleeding in open prostatectomy. METHODS: Overall, 44 patients were randomly entered in a study on open prostatectomy. Patients in the intervention group received local injections of 500 mg fibrinogen (20 mL) dissolved in distilled water, and the control group patients only received 20 mL of normal saline, where the injections were given by the surgeon at the prostatectomy operation site. All patients were tested for hemoglobin, hematocrit, PT, PTT, INR, and fibrinogen level. Also, the amount of blood loss and requirement for blood products were recorded. RESULTS: The study groups showed no difference regarding baseline variables. One patient in the fibrinogen group (1.66%) and four patients in the control group (6.66%) received blood products (P < 0.05), and the blood drainage tube at 24 hours after operation was 36.50) 18.70 (mL in the fibrinogen group and 151.36) 120.58 (mL in the control group (P = 0.005). There were no differences in hemoglobin, hematocrit, PT, PTT, INR, and serum fibrinogen level between the groups at any time. CONCLUSIONS: The current study demonstrated that using fibrinogen in patients with high bleeding risk may effectively reduce the amount of bleeding and its subsequent blood transfusion requirement, after open prostatectomy surgery.

CD8+ T Lymphocyte Subsets in Bladder Tumor Draining Lymph Nodes.

BACKGROUND: Cytotoxic CD8+ T cells, as essential parts of the adaptive immune system, play pivotal roles in anti-tumor immune responses. It is well documented that cytokine expression profiles and activation status of these cells during anti-tumor immune responses affect the outcome of host-tumor interaction. OBJECTIVE: To investigate the percentages of CD8+ lymphocytes and their subsets in tumor draining lymph nodes of patients with bladder cancer. METHODS: Forty-five patients with bladder cancer, candidate for radical cystectomy, were recruited. Mononuclear cells were isolated from draining lymph nodes using Ficoll-Hypaque gradient centrifugation, and were activated by PMA/Ionomycin in the presence of Golgi inhibitors. The cells were then permeabilized and stained with appropriate flourochrome conjugated antibodies against CD3, CD8, IFN-γ, IL-17 and IL-4 molecules. Data were collected on a four-color flow cytometer and analyzed by CellQuestPro software. RESULTS: Despite no difference in the frequency of IL-17 producing CD8+ (Tc17) lymphocytes, the mean expression of IL-17 in this subset was significantly elevated in high-grade patients (p=0.011). The percentage of double positive IFN-γ/IL-17 CD8+ lymphocytes was also significantly increased in node positive patients compared to node negative ones (p=0.046). Our results also demonstrated that the percentage of IFN-γ producing CD8+ (Tc1) lymphocytes was significantly increased in the patients with higher histological grade compared to those with lower ones (p=0.038). CONCLUSION: IFN-γ and IL-17 producing CD8+ T cells may increase in advanced stages of bladder cancer, but their correlation with tumor prognosis remains to be investigated.

Abortifacient effect of Prangos ferulacia on pregnant rats.

PURPOSE: Prangos ferulacea grows in southern Iran and used in Iranian herbal medicine for gastrointestinal disorders, but it seems it has an abortifacient effect on pregnant women. To verify its potential as an abortifacient agent, we administered the leaves of this plant to pregnant rats. MATERIAL AND METHODS: Hydroalcoholic and aqueous extract of the leaves was administered orally at different doses to 60 rats on the first 18 days of pregnancy. Group 1 (G1) was considered as control group and was given only water. Groups 2-5 (G2-G5) received 25, 50, 100 mg/g per day and Groups 6-8 (G6-G8) received 300, 500 and 1000 mg/g per day, respectively. On Day 18 of pregnancy, they were killed and laparotomized. The uterine horns of each group were opened to see whether they contained any live and degenerated/dead fetuses. We used Student's t-test to analyze the data (p < or = .05 was considered significant). RESULTS: Of the total 504 fetuses in the studied groups, 13 fetuses (2.57%) were aborted. The abortion rate in the control group was 2 (1.94%) of 103 fetuses; the abortion rate was higher in the treated groups but not statistically significant. There was no relationship between the dose and type of extract and abortion rate in all studied groups. CONCLUSION: This study shows that the aqueous or hydroalcoholic extract of P. ferulacea is ineffective on the rate of abortion of pregnant rats. Future studies should be performed with higher doses to test the efficacy of this agent on other animals.