Urinary bladder cancer (UBC) is a prevalent malignancy worldwide, exhibiting high recurrence rates and significant morbidity and mortality. Traditional diagnostic and prognostic methods often fall short in providing the precision required for effective patient stratification and personalized treatment. Genomic and transcriptomic studies have revolutionized our understanding of UBC by unveiling molecular alterations that drive tumor initiation, progression, and therapeutic response. This systematic review explores the role and application of genomic and transcriptomic analyses in the diagnostics and survival prediction of non-invasive and invasive UBC. We conducted a comprehensive literature search in MEDLINE, Web of Science, and Scopus up to October 2023, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our search yielded 1,256 records (412 in MEDLINE, 378 in Web of Science, and 466 in Scopus), and 356 duplicates were removed. Our findings highlight key mechanisms of action, including mutations in FGFR3, TP53, and RB1 genes, and alterations in pathways such as PI3K/AKT/mTOR and MAPK/ERK, which are pivotal in UBC pathogenesis. Recent research advances, including liquid biopsies and single-cell sequencing, offer promising non-invasive diagnostic tools and deeper insights into tumor heterogeneity. This review underscores the critical importance of integrating genomic and transcriptomic data into clinical practice to improve diagnostics, prognostic assessments, and personalized treatment strategies for UBC patients. Future research should focus on integrating multi- omics data and validating molecular biomarkers in large clinical trials to further enhance patient outcomes.
Testicular cancer is the most common malignancy in young men, with early and accurate diagnosis being critical for effective management and prognosis. Traditionally, the diagnostic approach relies on scrotal ultrasound and serum tumor markers, which, while effective, have limitations in characterizing complex lesions and detecting small, non- palpable tumors or metastatic disease. Recent advancements in imaging technology have introduced multiparametric MRI (mpMRI) as a promising tool in the diagnostic armamentarium for testicular cancer. MpMRI combines multiple imaging sequences, including T2-weighted imaging, diffusion-weighted imaging (DWI), and dynamic contrast- enhanced MRI (DCE-MRI), providing detailed anatomical and functional information about testicular lesions. This systematic review consolidates and evaluates current evidence regarding the role of mpMRI in the diagnosis, staging, and follow-up of testicular cancer.
Key findings from the literature suggest that mpMRI offers superior sensitivity and specificity compared to conventional imaging techniques, particularly in distinguishing between benign and malignant lesions. It is also highly effective in the precise localization and staging of tumors, including the detection of small lymph node metastases, which are often missed by ultrasound or CT. This review highlights the potential of mpMRI to enhance diagnostic precision and influence treatment strategies in testicular cancer, while also identifying areas for further research, such as the optimization of imaging protocols and the assessment of mpMRI's impact on long-term clinical outcomes. The review underscores the importance of mpMRI as a non-invasive, highly informative imaging modality that could lead to more personalized and effective management of testicular cancer.
Abstract
Androgen deprivation therapy (ADT) remains a cornerstone in the treatment of prostate cancer, but patient responses vary significantly.
This systematic review evaluates the role and application of genomic and transcriptomic markers in assessing ADT efficacy and resistance.
We analyzed 40 studies focusing on key markers such as AR-V7, TMPRSS2-ERG, RNA expression profiles, and the 23-gene signature.
Our findings highlight the potential of these markers to personalize ADT, improve patient stratification, and guide treatment decisions.
Despite promising results, challenges remain in standardization, cost, and clinical integration.
Corresponding author. Mytsyk Yulian, Regional Specialist Hospital, Wroclaw, Poland, mytsyk.yulian@gmail.com
UDC 577.151.042:616.72-002.772:616.72-007.274
Summary
Introduction. Identification of microorganisms that colonize combat wounds and cause wound infection is of primary importance for the subsequent successful treatment of the patient. The resistance of microorganisms to antimicrobial drugs makes the efforts of modern medicine in the fight against infectious agents ineffective. The problem of infertility is closely related to combat injuries, their infection, stress, and neurotic disorders.
Aim. Obtaining and summarizing data on microbial colonization of mine-blast wounds of pelvic organs and the microbiome of the genitourinary system of combatants.
Materials and methods. 84 smears were taken from 56 wounds of 36 patients with injuries of the pelvic organs who were being treated. 73 patients with injuries were examined for the presence of mycoflora in the urogenital tract. Isolation of pure bacterial cultures was carried out by inoculating the studied material using meat-peptone agar, blood agar, chromogenic agars. For the diagnosis of urogenital or other infections by the PCR method, a scraping from the back wall of the urethra was taken from the patients.
Results. Predominant microorganisms in positive cultures of smears were non-fermenting gram- negative rods, which in 28 % of cultures belonged to the genus Acinetobacter, in 26 % to the genus Pseudomonas. As for associated infections, 20 % of them consisted of the genus Acinetobacter, 32 % – Enterobacter, 4 % – Klebsiella and 29 % – Pseudomonas. Gram-positive cocci were isolated in 37 % of positive smear cultures. The frequency of isolation of the genus Streptococcus in monoinfection was 2.5 %, followed by the genus Clostridium – 2 %, Bacillus – 3 %, Enterococcus – 4 % and Actynomycceas – 4 %. In associated infections, the frequency of isolation of the genus Streptococcus was 4 %, followed by the genus Clostridium – 2 %, Bacillus – 4 %, Enterococcus – 3 % and Actynomycceas – 5 %. When analyzing the microflora of the genitourinary system, it was found that the priority role belongs to the combined infection, when there are associations of specific pathogens such as Ureaplasma spp., Mycoplasma spp., Chlamidia spp., Neisseria gonorrhoeae, Trichomonas vaginalis, Streptococcus spp., Enterococcus faecalis, which is 80 % of the entire microbiome.
Conclusions. Acinetobacter baumanii and Klebsiella pneumoniae are the dominant microflora complicating the course of combat wounds during almost two years of Russia’s full-scale war against Ukraine. Probably, the duration of hostilities, the large number of wounded, and the forced mass unsystematic use of various antibiotics lead to rapid changes in the spectrum of pathogens of combat wounds. Combat wounds and their infection, stress, and nervous disorders lead to an imbalance of microflora, in particular microflora of the genitourinary system, which can be one of the causes of infertility. Chlamydia and Ureaplasma are the most common microorganisms that colonize the urogenital tract of men injured as a result of hostilities.
Keywords: sombat wound, microbial flora, genitourinary system, infertility
Abstract
Background. Liver involvement secondary to multiple myeloma is a rare and uncommon radiologic finding.
Such extraosseous secondary lesions as well as tongue involvement require pathohistological confirmation to prevent misdiagnosis. Clinical and laboratory diagnostics are challenging in patients with COVID-19 and underlying multiple myeloma and its secondary lesions, leading to difficulties in treatment and outcomes.
Case Report. A 64-year-old male patient, not vaccinated against COVID-19, with a history of multiple myeloma presented with symptoms of headache, fatigue, dyspnea, cough, and fever. The patient’s medical history was intricate, involving cholecystectomy and a diagnosis of multiple myeloma, which was subsequently treated with chemotherapy and radiation therapy. Additionally, uncommon liver and tongue involvement secondary to multiple myeloma was found. Upon admission, the patient’s peripheral oxygen saturation was 90%, accompanied by increasing shortness of breath and a respiratory rate of 26 breaths per minute. A positive COVID-19 test was recorded. A lung computed tomography revealed bilateral multifocal areas of ground-glass opacity and consolidation, encompassing the entire pulmonary regions, corresponding to CO-RADS 6. The patient was admitted to the intensive care unit. Despite initiating oxygen support and symptomatic therapy, the patient’s death occurred. Autopsy confirmed the development of severe acute respiratory distress syndrome and bilateral hemorrhagic pneumonia, with multiple myeloma as a contributing factor.
Conclusions. This case report highlighted the rare occurrence of secondary liver involvement in multiple myeloma, characterized by nodules with distinct imaging features. It underscored the importance of identify- ing coexisting lesions, such as tongue involvement, and the diagnostic challenges they pose. Additionally, the case emphasized the need for comprehensive clinical assessment in patients with concurrent COVID-19 and underlying multiple myeloma, as it may lead to the development of acute respiratory distress syndrome.
Keywords
2019 Novel Coronavirus Disease; Multiple Myeloma; Liver Involvement; Acute Respiratory Distress Syn- drome; Computed Tomography; Diffuse Alveolar Damage