The increasing indications of FDG-PET/CT in the staging and management of Invasive Bladder Cancer.

The management of locally advanced muscle invasive bladder cancer (MIBC) often necessitates neo-adjuvant chemotherapy (NAC) to eliminate any micro-metastatic disease prior to definitive radical cystectomy (RC) and pelvic lymph node dissection (PLND). The most common imaging techniques traditionally used during this process are computerised tomography (CT) and magnetic resonance imaging (MRI), both of which lack a high sensitivity for nodal staging. In this paper, we attempt to review the evolving indications of F-fluoro-2-deoxy-D-glucose positron emission tomography/computerised tomography (FDG-PET/CT) imaging, in the pre-clinical and post-treatment staging of bladder cancer, with a focus on its ability to evaluate response to NAC. We concluded that use of FDG-PET/CT allows for improved nodal staging and metastatic disease detection, compared to traditional imaging modalities. This enabled earlier detection of tumour response to NAC and/or residual disease, impacting factors such as duration of chemotherapy, with its associated adverse effects, and timing of surgical intervention. However, further studies are required to reliably assess its impact on both overall and disease-free survival.

A silent giant staghorn renal calculus managed successfully with open pyelolithotomy: a case report.

Staghorn calculi (SC) are associated with high morbidity and mortality; therefore, meticulous planning is required to minimize complications. In this case report, we will discuss the management of a giant right-sided SC (~ 8 cm in diameter), which was incidentally found in a 40-year-old male, who presented with left-sided renal colic symptoms with no associated renal impairment. This case was further complicated by multiple smaller calculi surrounding the giant SC. Hence, open surgery was preferred to minimally invasive techniques. The patient underwent an uncomplicated right-sided open pyelolithotomy for his staghorn calculus and was calculi free at 1-month follow-up. His renal function returned to normal levels, highlighting effective management of the stones.

Understanding angiogenesis and the role of angiogenic growth factors in the vascularisation of engineered tissues.

Tissue engineering is a rapidly developing field with many potential clinical applications in tissue and organ regeneration. The development of a mature and stable vasculature within these engineered tissues (ET) remains a significant obstacle. Currently, several growth factors (GFs) have been identified to play key roles within in vivo angiogenesis, including vascular endothelial growth factor (VEGF), platelet derived growth factor (PDGF), FGF and angiopoietins. In this article we attempt to build on in vivo principles to review the single, dual and multiple GF release systems and their effects on promoting angiogenesis. We conclude that multiple GF release systems offer superior results compared to single and dual systems with more stable, mature and larger vessels produced. However, with more complex release systems this raises other problems such as increased cost and significant GF-GF interactions. Upstream regulators and pericyte-coated scaffolds could provide viable alternative to circumnavigate these issues.

Guideline of guidelines: Muscle-invasive bladder cancer.

Muscle-invasive bladder cancer accounts for 25% of bladder cancer cases and represents a spectrum of disease, which can result in significant morbidity and mortality for anyone affected. Current management has evolved through years of research and clinical practice. It is based on a risk-benefit approach, which is often tailored to the individual requirements of patients and involves cystectomy, neoadjuvant and adjuvant therapies, and multimodal surveillance paradigms to achieve high survival rates. Multiple guidelines exist to assist the clinicians in this decision-making process, but their adherence is often variable. In this article, we aimed to review the 4 most commonly used guidelines from the European Association of Urology, the National Institute for Health and Care Excellence, the National Comprehensive Cancer Network, and the American Urological Association.

A retrospective analysis of smoking cessation measures: A single-center approach.

Smoking is a detrimental addiction contributing to many pathologies including cardiovascular disease and cancer. This retrospective study's aim was to assess the impact that conservative measures, like nicotine replacement therapy (NRT) and cessation clinic referral, have on smoking cessation on a respiratory ward. The baseline data obtained on admission to the hospital revealed that only 50% of patients were asked about their smoking status. Using a checklist, the health care professionals were encouraged to take a more proactive approach in promoting smoking cessation, resulting in 100% of the patients being asked about their smoking status. Of these, 81.8% agreed to try nicotine replacement therapy and 36.3% agreed to a Hertfordshire Stop Smoking Service referral. In the future, further studies are planned to assess the long-term effectiveness of this intervention in getting patients to stop smoking by following them up at a 3-month interval.