Publications by authors named "Ahmed Mansour"

153 Publications

A randomized controlled trial of two-doses of vaginal progesterone 400 vs. 200 mg for prevention of preterm labor in twin gestations.

J Perinat Med 2021 Sep 14. Epub 2021 Sep 14.

Department of Obstetrics and Gynecology, Ain-Shams University, Cairo, Egypt.

Objectives: To compare between the effectiveness and safety of two different daily doses of vaginal progesterone (400 vs. 200 mg) in the prevention of preterm labor in twin pregnancy.

Methods: This is a prospective single-blinded randomized controlled trial conducted on 100 primi-gravida who had twin pregnancy and attended the antenatal clinic of a University hospital. They were equally and randomly allocated into two arms each containing 50 patients. Arm 1 received 400 mg and arm 2 received 200 mg vaginal progesterone daily at bed time starting from 14 weeks of pregnancy to 36 weeks. Transvaginal ultrasound was performed for assessment of the length of cervix at 14 and 22 weeks.

Results: Both arms of the current study were comparable regarding the cervical length at 14 and 22 weeks, mean gestational age at delivery, incidence of pre-term delivery, birth weight of the first twin. Second twin in addition to the average weight of both twins. No statistical significance differences between two arms regarding incidence of early neonatal death. NICU, mechanical ventilation, length of admission in NICU for the first twin. Second twin as well as both twins.

Conclusions: Vaginal progesterone treatment with different doses was tolerable, but wasn't effective in the prevention of preterm labor in twin pregnancy.
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http://dx.doi.org/10.1515/jpm-2021-0131DOI Listing
September 2021

Sulfonate improves water solubility and cell selective toxicity and alters the lysozyme binding activity of half sandwich Rh(iii) complexes.

Dalton Trans 2021 Aug 2;50(31):10701-10706. Epub 2021 Aug 2.

Department of Chemistry, Faculty of Science, Cairo University, Gamma Street, Giza, Cairo 12613, Egypt.

Introduction of the propyl-sulfonic acid group at N1 of the coordinated 2-(2-pyridyl)benzimidazole ligand (L) in [RhCl(η-CMe)L](CFSO) gives rise to a water-soluble complex, which can bind to the model protein lysozyme via non-covalent interactions. The complex shows selective moderate toxicity against Cryptococcus neoformans (MIC = 21.6-43.3 μM) and exhibits no cytotoxicity to healthy HEK293 cells.
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http://dx.doi.org/10.1039/d1dt00979fDOI Listing
August 2021

Coupled Organic-Inorganic Nanostructures with Mixed Organic Linker Molecules.

ACS Appl Mater Interfaces 2021 Aug 30;13(31):37483-37493. Epub 2021 Jul 30.

Institut für Physik, Universität Augsburg, 86135 Augsburg, Germany.

The electronic properties of semiconducting inorganic lead sulfide (PbS) nanocrystals (NCs) and organic linker molecules are dependent on the size of NCs as well as the used ligands. Here, we demonstrate that a weakly binding ligand can be successfully attached to PbS NCs to form a coupled organic-inorganic nanostructure (COIN) by mixing with a strong binding partner. We use the weakly binding zinc β-tetraaminophthalocyanine (Zn4APc) in combination with the strongly binding 1,2-ethanedithiol (EDT) as a mixed ligand system and compare its structural, electronic, and (photo-)electrical properties with both single-ligand COINs. It is found that binding of Zn4APc is assisted by the presence of EDT leading to improved film homogeneity, lower trap density, and enhanced photocurrent of the derived devices. Thus, the mixing of ligands is a versatile tool to achieve COINs with improved performance.
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http://dx.doi.org/10.1021/acsami.1c08614DOI Listing
August 2021

The association between sarcopenia and bladder cancer-specific mortality and all-cause mortality after radical cystectomy: A systematic review and meta-analysis.

Arab J Urol 2021 Jan 16;19(1):98-103. Epub 2021 Jan 16.

Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

: To compare cancer-specific mortality (CSM) and all-cause mortality (ACM) between patients with and without sarcopenia who underwent radical cystectomy for bladder cancer. : We performed a systematic review and meta-analysis of original articles published from October 2010 to March 2019 evaluating the effect of sarcopenia on CSM and ACM. We extracted hazard ratios (HRs) and 95% confidence intervals (CIs) for CSM and ACM from the included studies. Heterogeneity amongst studies was measured using the -statistic and the index. Meta-analysis was performed using a random-effects model if heterogeneity was high and fixed-effects models if heterogeneity was low. : We identified 145 publications, of which five were included in the meta-analysis. These five studies represented 1447 patients of which 453 were classified as sarcopenic and 534 were non-sarcopenic. CSM and ACM were increased in sarcopenic vs non-sarcopenic patients (HR 1.64, 95% CI 1.30-2.08, < 0.01 and HR 1.41, 95% CI 1.22-1.62, < 0.01, respectively). : Sarcopenia is significantly associated with increased CSM and ACM in bladder cancer. Identifying patients with sarcopenia will augment preoperative counselling and planning. Further studies are required to evaluate targeted interventions in patients with sarcopenia to improve clinical outcomes. ACM: all-cause mortality; ASA: American Association of Anesthesiologists; BMI: body mass index; CCI: Charlson Comorbidity Index; CSM: cancer-specific mortality; CSS: cancer-specific survival; ECOG: Eastern Cooperative Oncology Group; HR: hazard ratio; NAC: neoadjuvant chemotherapy; NIH: National Institutes of Health; OS: overall survival; RC: radical cystectomy; RCT: randomised controlled trial; SMI: Skeletal Muscle Index.
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http://dx.doi.org/10.1080/2090598X.2021.1876289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954502PMC
January 2021

The chemopreventive effect of thymol against dimethylhydrazine and/or high fat diet-induced colon cancer in rats: Relevance to NF-κB.

Life Sci 2021 Jun 11;274:119335. Epub 2021 Mar 11.

Pharmacology and Toxicology Department, Faculty of Pharmacy, Al-Azhar University, Cairo (Boys), Egypt. Electronic address:

Aim: Evaluating the possible protective effect of thymol as an approach against 1,2 N,N-dimethylhydrazine and/or high-fat diet (HFD)-induced colon cancer.

Main Methods: Adult male Wistar rats were divided into 7 groups, namely a normal control group, colon cancer groups received DMH (40 mg/kg i.p., twice weekly), 20% HFD and DMH/HFD, thymol (20 mg/kg/day, p.o.), thymol/DMH and thymol/DMH/HFD (treatment of all groups continued for 16 weeks).

Key Findings: Thymol significantly reduced the elevated serum levels of colon related tumor markers carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) as well as the apoptotic marker, caspase-3 compared with the colon cancer group. In addition, it mitigated colonic tissue oxidative stress markers and inflammatory mediators. Moreover, the histopathological study revealed reduction of mucous secretion with elongated nuclei, frequent mitotic figures, focal nuclear stratification, mild interstitial edema, and markedly dilated congested blood vessels, aberrant crypt foci (ACF); adenoma with moderate to severe dysplasia of colon corrected by thymol treatment.

Significance: The administration of thymol had a promising preclinical protective efficacy and could be considered as a new strategy for the prophylaxis from colon cancer in clinical practices.
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http://dx.doi.org/10.1016/j.lfs.2021.119335DOI Listing
June 2021

Phototriggered cytotoxic properties of tricarbonyl manganese(I) complexes bearing α-diimine ligands towards HepG2.

J Biol Inorg Chem 2021 02 27;26(1):135-147. Epub 2021 Feb 27.

Department of Chemistry, Faculty of Science, Cairo University, Gamma Street, Giza, 12613, Cairo, Egypt.

Reaction between bromo tricarbonyl manganese(I) and N,N'-bis(phenyl)-1,4-diaza-1,3-butadiene ligands, bearing different electron-donating and electron-withdrawing groups R = OCH, Cl, and NO in the ortho- and para-positions on the phenyl substituent, afforded [MnBr(CO)(N-N)] complexes. The influence of the character and position of the substituent on the dark stability and carbon monoxide releasing kinetics was systematically investigated and correlated with the data of the time-dependent density functional theory calculations. The combined UV/Vis and IR data clearly revealed that the aerated solutions of [MnBr(CO)(N-N)] in either coordinating or noncoordinating solvents are dark stable and the fluctuations observed during the incubation period especially in the case of the nitro derivatives may be attributed to the exchange of the axial bromo ligand with the coordinating solvent molecules. The free ligands and nitro complexes were non-cytotoxic to HepG2 cells under both the dark and illumination conditions. In the dark, Mn(I) compounds, incorporating o-OCH and o-Cl, exhibited excellent cytotoxicity with IC values of 18.1 and 11.8 μM, while their para-substituted analogues were inactive in the dark and active upon the irradiation at 365 nm with IC values of 5.7 and 6.7 μM, respectively.
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http://dx.doi.org/10.1007/s00775-020-01843-7DOI Listing
February 2021

Effect of Direct-Acting Antiviral Drugs on Erectile Functions among Hepatitis C Patients: A Prospective Interventional Study.

Endocr Metab Immune Disord Drug Targets 2021 Feb 12. Epub 2021 Feb 12.

Urology Department; Faculty of Medicine; Tanta University; Tanta. Egypt.

Background & Objective: Erectile dysfunction (ED) is one of the extrahepatic manifestations of hepatitis C virus infection that greatly affects patients' quality of life. Unfortunately, some of the drugs used for HCV treatment may have a negative impact on the patient's erectile function such as the pegylated interferon. Currently, with the introduction of directacting antiviral drugs, there are scarce data in the literature about its potential impact on erectile function. In these settings, we aimed to assess the impact of sofosbuvir-based therapy on male erectile function.

Methods: This prospective interventional study was carried out in Benha University hospitals between January 2019 and May 2020. The study included all consecutive HCV patients with simultaneous ED coming to the hepatology outpatient clinic. Patients were divided into a study group who received sofosbuvir-based therapy (group A) or a control group who received silymarin therapy (group B). The International Index of Erectile Function-5 (IIEF-5) was used for assessment of erectile function at different time points (pretreatment, 6 months, and 12 months after treatment). Different variables in both groups have been statistically analyzed.

Results: Overall, 75 patients who received sofosbuvir-based therapy and a control group (n = 35) matched for age and pretreatment variables (Child-Turcotte-Pugh score and Fibrosis- 4 score). There was no significant difference between both groups in the pretreatment data. On the other hand, the posttreatment IIEF-5 was significantly higher in the sofosbuvir arm compared to the silymarin arm both at six months (p<0.001) and at 12 months (p<0.001). Furthermore, the age and the stage of liver fibrosis were negatively correlated with IIEF-5 at all-time points.

Conclusion: The age and the stage of liver fibrosis are significantly correlated with the degree of ED. Furthermore, sofosbuvir-based therapy may be associated with significant improvement in the patients' erectile function.
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http://dx.doi.org/10.2174/1871530321666210212143932DOI Listing
February 2021

Anti-PLA2R and anti-THSD7A as Diagnostic Serological Markers of Idiopathic Membranous Nephropathy: A Single Centre Study.

Egypt J Immunol 2020 Jun;27(2):1-9

Department of Medical Microbiology & Immunology , Faculty of Medicine, Benha University, Benha, Egypt.

Idiopathic Membranous Nephropathy (IMN) is a renal-limited autoimmune disease and accounts for approximately 80% of MNs. This study aimed to evaluate the role of circulating Anti-PLA2R and anti-THSD7A autoantibodies in the diagnosis and differentiation between primary and secondary MN. This study was conducted on 58 adult patients with biopsy-proven membranous glomerulopathy (MGN). All were subjected to measurement of Anti-PLA2R1 by an Enzyme-Linked Immunosorbent Assay and anti-THSD7A was detected by an indirect immunofluorescence assay. Among the 58 patients, 79.3% were diagnosed as IMN, and 20.7% as secondary membranous glomerulopathy (SMN). Among IMN patients, 32 patients (69.6%) showed positive anti-PLA2R1 antibodies, 2 patients (4.3%) were positive for anti-THSD7A antibodies and the remaining 12 patients (26.1%) were negative for both types of antibodies. Patients with SMN were negative for the two antibodies. The IMN patients had lower serum creatinine compared to the SMN patients (P=0.017). In conclusion, the study demonstrates that approximately 70% of patients with idiopathic membranous nephropathy have antibodies against PLA2R indicating that Anti-PLA2R may be fast, easy, relatively sensitive, and non-invasive test for diagnosis of IMN..
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June 2020

Role of the ancillary ligand in controlling the lysozyme affinity and electronic properties of terpyridine -Re(CO) complexes.

Dalton Trans 2021 Feb;50(4):1197-1201

Department of Chemistry, Faculty of Science, Cairo University, Gamma Street, Giza, Cairo 12613, Egypt.

The lysozyme binding affinity and the electronic properties of [ReX(CO)3(terpy-κ2N1,N2)] (X = Br- and triazolateCOOCH2CH3,CF3) were reported. The triazolate complex was prepared in a [3 + 2] cycloaddition click reaction. The bromo compound reacted with lysozyme affording adducts with Re(CO)3+ fragments, while the triazolate compound persisted. A red shift of the MLCT band of the triazolate compound in progressively less polar solvents may be due to the negative solvatochromism.
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http://dx.doi.org/10.1039/d0dt04140hDOI Listing
February 2021

Intracranial hemorrhage in primary immune thrombocytopenia (ITP): 20 years' experience in pediatrics.

Eur J Pediatr 2021 May 15;180(5):1545-1552. Epub 2021 Jan 15.

Department of Pediatric Hematology/Oncology, Alexandria University, Alexandria, Egypt.

Incidence of intracranial hemorrhage (ICH) among children with primary immune thrombocytopenia (ITP) varies among different studies. We published data during the period of 1997-2007 of ICH in children with primary ITP, addressing risk factors and outcome. The aim of this study is to assess changes in incidence, risk factors, and outcome of ICH in children with ITP from last decade and to report the overall 20 years' experience. We compared 2008-2018 with the decade before it. Data of children with ITP and ICH during study period and ITP control cases were analyzed. Neurosurgical intervention and outcome were also reported. A total of 4340 children with primary ITP were evaluated. Twenty-five (0.63%) ICH events were reported over 2 decades. Head trauma, hematuria, and platelet counts < 10 × 109/L were the risk factors mostly associated with ICH. Overall mortality was 24%, and a further 28% had neurologic sequelae. Neurosurgical intervention was done in 12% of cases with good outcome.Conclusion: Persistent platelet counts < 10 × 109/L were a significant risk factor for ICH in both time periods, while head trauma and hematuria were more reported in the period of 2008-2018 as significant risk factors for ICH. Outcome was comparable in both periods. What is Known: • ICH is a rare complication of ITP; however, early recognition of risk factors and aggressive treatment might lead to complete recovery without sequalae. Platelet counts less than < 10 × 109/L are the main risk factor for ICH. Few studies reported other significant risk factors. What is New: • Hematuria and head trauma are significant risk factors for ICH in ITP, in addition to having a persistently low platelet count < 10 × 109/L. (more than 90 days in chronic ITP, 45 days in persistent and 21 days in acute ITP) • Combined treatment with IVIG and HDMP followed by platelet transfusion was associated with complete recovery without sequelae in almost 50% of patients.
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http://dx.doi.org/10.1007/s00431-020-03923-xDOI Listing
May 2021

Correlates of refusal of radical cystectomy in patients with muscle-invasive bladder cancer.

Urol Oncol 2021 04 8;39(4):236.e9-236.e20. Epub 2021 Jan 8.

Department of Urology, UT Health San Antonio, San Antonio, TX; UT Health San Antonio/MD Anderson Mays Cancer Center, San Antonio, TX; Urology and Nephrology Center, Mansoura University, Egypt. Electronic address:

Purpose: To evaluate factors associated with radical cystectomy (RC) refusal, subsequent treatment decisions, and their influence on overall survival (OS).

Materials And Methods: We queried the National Cancer Database for patients with non-metastatic muscle-invasive bladder cancer (MIBC), cT2-T4M0. Patients who refused recommended RC were further stratified by treatment into chemotherapy, radiation therapy, chemoradiotherapy, and no treatment groups. Patients were excluded from the analysis if surgery was not planned, not recommended; or if survival data were unknown. Multivariate logistic regression modeling was utilized to identify independent predictors of refusing RC. Cox proportional hazards model with propensity score overlap weighting was utilized to identify survival predictors. Kaplan-Meier analysis was utilized to evaluate survival according to treatment.

Results: A total of 74,159 MIBC patients were identified. Among patients with documented reasons for no surgery, 5.4% refused RC despite physician recommendation. Predictors of refusal on multivariate analysis included female gender (P = 0.016), advancing age ≥80 (vs. <60, P < 0.001), African American race (vs. white, P < 0.001) Medicaid (vs. private insurance, P < 0.001) and advancing T stage (T4 vs. T2, P < 0.001). Patients treated at academic centers were less likely to decline RC (vs. community centers, P < 0.001). Median survival after RC was 40.44 months vs. 12.52 months in refusal group. Undergoing chemoradiation had significantly improved survival in those patients compared to monotherapy or no treatment (hazard ratio 0.25, P < 0.001). Overlap weighted model Identified RC refusal as an independent predictor of poor OS (P < 0.001).

Conclusions: Several sociodemographic and clinical factors are associated with refusing radical cystectomy. Such refusal is associated with poor survival outcomes.
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http://dx.doi.org/10.1016/j.urolonc.2020.11.023DOI Listing
April 2021

Ruptured Heterotopic Pregnancy: A Rare Encounter in Acute Surgical Care Settings.

Cureus 2020 Nov 30;12(11):e11782. Epub 2020 Nov 30.

Surgery, Buriadah Central Hospital, Buriadah, SAU.

Heterotopic pregnancy is a rare, life-threatening clinical entity with an overall incidence of about 1:30,000 in spontaneous natural conception cases, especially in cases of delayed diagnosis or conflicting clinical features. Here, we present an unusual case of heterotopic pregnancy in a 22-year-old multigravida presented to the emergency department (ED) with a clinical picture of the acute abdomen following recent abdominal trauma. Abdominal ultrasound revealed hemoperitoneum and a single viable intrauterine pregnancy at seven weeks' gestation. Following surgical exploration, the patient underwent removal of the ectopic pregnancy tissue with right salpingectomy. Since the presence of a conflicting history or equivocal physical signs and symptoms makes it difficult to diagnose heterotopic pregnancy, ED physicians and surgeons must consider the diagnosis even when dealing with viable intrauterine pregnancies. Besides, acute abdominal pain associated with shock should be regarded as suggestive of heterotopic pregnancy. Thus, prompt evaluation and a high index of suspicion are of paramount importance to prevent unwanted sequelae.
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http://dx.doi.org/10.7759/cureus.11782DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779178PMC
November 2020

Development and implementation of competency-based assessment for urological ultrasound training using SonoSim: A preliminary evaluation.

Indian J Urol 2020 Oct-Dec;36(4):270-275. Epub 2020 Oct 1.

Department of Urology, University of Texas Health San Antonio, San Antonio, TX, USA.

Introduction: Urology residents are encouraged to learn ultrasound (U/S) imaging, yet there are few tools available for teaching and assessing a resident`s competence. The aim of this study was to test the new SonoSim LiveScan and to propose a competency-based assessment model for the urology graduate medical education.

Materials And Methods: Urology residents attended an interactive training session covering the urological U/S techniques guided by the assessment model developed by the authors. Faculty members evaluated the residents using defined objectives, and the residents were surveyed on their comfort level for performing each of the model tasks. A subset of the residents then underwent a structured testing using the SonoSim LiveScan device 6 months following the training. The model developed assessed: general U/S setup, structure identification, and pathologic clinical scenarios.

Results: The residents felt most comfortable in identifying the bladder (4.73/5) and the kidneys (4.53/5) during the training sessions. They felt least comfortable while testing for total ureteric obstruction (3.13/5). All the residents were confident that additional U/S training sessions would improve their comfort level in performing the assessed objectives. Resident`s assessment performed at 6 months had a median test score of 15.5/20 and the assessment scores increased with resident seniority. Self-reported comfort, however, did not seem to correlate with seniority. In general, the residents felt that the SonoSim device was highly functional (4.4/5) and the pathologic assessments in particular were very helpful (4.4/5).

Conclusions: Through pilot testing, we propose that a competency-based assessment used with the SonoSim LiveScan could guide the resident`s education through the acquisition of U/S skills and warrants testing in a larger cohort.
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http://dx.doi.org/10.4103/iju.IJU_22_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759178PMC
October 2020

Pyoderma Gangrenosum after Fat Grafting in Alloplastic Breast Reconstruction: An Unusual Outcome.

Plast Reconstr Surg Glob Open 2020 Nov 20;8(11):e3223. Epub 2020 Nov 20.

Department of Surgery - Division of Plastic and Reconstructive Surgery, Lehigh Valley Health Network, Allentown, Pa.

Pyoderma gangrenosum (PG) is a rare and painful inflammatory skin disorder that has been recently associated with breast surgery. It is commonly mistaken for postoperative ischemia or wound infection and does not show response to antibiotics or debridement. We describe the first case of post-surgical PG (PSPG) after alloplastic breast reconstruction involving fat grafting. A 47-year-old woman underwent bilateral mastectomy and 2-stage alloplastic breast reconstruction, with fat grafting from the abdomen. Two days post-surgery, she developed bilateral erythema with tender grouped pustules that progressed rapidly into necrotic ulcerations. She did not respond to antibiotics and serial debridement. Subsequent biopsy confirmed a diagnosis of PG. She was started on steroid therapy and responded well. She was discharged on a steroid regimen, local wound care, and eventually a T-cell inhibitor. Over the next 12 months, her wounds healed without surgical intervention. PSPG has been observed in a variety of reconstructive breast surgeries, but never reported in the setting of fat grafting. As PG involves subcutaneous fat, fat grafting may accelerate and exacerbate the course of disease. Treatment for PSPG includes systemic steroid therapy or other immunomodulatory agents (or both). Surgical management remains controversial, as serial debridement and reconstruction have shown to exacerbate and stimulate disease progression. A long-term follow-up is recommended to monitor for wound healing. Delayed diagnosis of PG in breast reconstruction patients can lead to severe morbidity and disfigurement. This is first case of PSPG following fat grafting in the literature.
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http://dx.doi.org/10.1097/GOX.0000000000003223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722579PMC
November 2020

An Organic Borate Salt with Superior -Doping Capability for Organic Semiconductors.

Adv Sci (Weinh) 2020 Sep 6;7(17):2001322. Epub 2020 Jul 6.

Institut für Physik and IRIS Adlershof Humboldt-Universität zu Berlin Berlin D-12489 Germany.

Molecular doping allows enhancement and precise control of electrical properties of organic semiconductors, and is thus of central technological relevance for organic (opto-) electronics. Beyond single-component molecular electron acceptors and donors, organic salts have recently emerged as a promising class of dopants. However, the pertinent fundamental understanding of doping mechanisms and doping capabilities is limited. Here, the unique capabilities of the salt consisting of a borinium cation (MesB; Mes: mesitylene) and the tetrakis(penta-fluorophenyl)borate anion [B(CF)] is demonstrated as p-type dopant for polymer semiconductors. With a range of experimental methods, the doping mechanism is identified to comprise electron transfer from the polymer to MesB, and the positive charge on the polymer is stabilized by [B(CF)]. Notably, the former salt cation leaves during processing and is not present in films. The anion [B(CF)] even enables the stabilization of polarons and bipolarons in poly(3-hexylthiophene), not yet achieved with other molecular dopants. From doping studies with high ionization energy polymer semiconductors, the effective electron affinity of MesB[B(CF)] is estimated to be an impressive 5.9 eV. This significantly extends the parameter space for doping of polymer semiconductors.
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http://dx.doi.org/10.1002/advs.202001322DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507313PMC
September 2020

Modulation of Amyloidogenic Peptide Aggregation by Photoactivatable CO-Releasing Ruthenium(II) Complexes.

Pharmaceuticals (Basel) 2020 Jul 29;13(8). Epub 2020 Jul 29.

Department of Pharmacy, University of Naples Federico II, 80134 Napoli, Italy.

Three Ru(II)-based CO-releasing molecules featuring bidentate benzimidazole and terpyridine derivatives as ligands were investigated for their ability to modulate the aggregation process of the second helix of the C-terminal domain of nucleophosmin 1, namely nucleophosmin 1 (NPM1), a model amyloidogenic system, before and after irradiation at 365 nm. Thioflavin T (ThT) binding assays and UV/Vis absorption spectra indicate that binding of the compounds to the peptide inhibits its aggregation and that the inhibitory effect increases upon irradiation (half maximal effective concentration (EC) values in the high micromolar range). Electrospray ionization mass spectrometry data of the peptide in the presence of one of these compounds confirm that the modulation of amyloid aggregation relies on the formation of adducts obtained when the Ru compounds react with the peptide upon releasing of labile ligands, like chloride and carbon monoxide. This mechanism of action explains the subtle different behavior of the three compounds observed in ThT experiments. Overall, data support the hypothesis that metal-based CO releasing molecules can be used to develop metal-based drugs with potential application as anti-amyloidogenic agents.
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http://dx.doi.org/10.3390/ph13080171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464691PMC
July 2020

National Trends and Impact of Regionalization of Radical Cystectomy on Survival Outcomes in Patients with Muscle Invasive Bladder Cancer.

Clin Genitourin Cancer 2020 12 22;18(6):e762-e770. Epub 2020 May 22.

Department of Urology, University of Texas Health, San Antonio, TX; Mays Cancer Center at UT Health San Antonio/MD Anderson, San Antonio, TX; Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. Electronic address:

Objective: To evaluate national trends and the effect of surgical volume on perioperative mortality and overall survival (OS)in patients undergoing radical cystectomy (RC) for muscle invasive bladder cancer (MIBC).

Methods: We investigated the National Cancer Database to identify patients with localized MIBC (cT2a-T4, M0) who underwent RC from 2004 to 2014. Demographics, 30- and 90-day mortality rates, as well as OS were analyzed. Hospitals were stratified into low-, medium-, and high-volume centers according to median number of RCs performed per year. Multivariate logistic regression models were fitted to identify independent predictors of perioperative mortality. Kaplan-Meier survival curves were generated to evaluate OS. Cox proportional hazard modeling was performed to identify independent predictors of OS.

Results: A total of 24,763 patients with localized MIBC who underwent RC from 2004 to 2014 were included in the study. Overall, most (70.85%) RCs occurred at low-volume hospitals, whereas only 15.83% were performed at high-volume hospitals. Thirty-day mortality rates were 2.87%, 2.19%, and 1.83% (P < .01); and 90-day mortality rates were 8.25%, 6.9%, and 5.9% (P < .01) at low-, medium-, and high-volume hospitals, respectively. Multivariate analyses identified RC volume as an independent predictor of 30- and 90-day mortality. RC in high-volume hospitals was associated with a 35% risk reduction in 30-day mortality (odds ratio 0.65, 95% confidence interval [CI] 0.49-0.85; P < .01), and a 26% risk reduction in 90-day mortality (0.74, 95% CI, 0.63-0.87; P < .01).

Conclusions: Treatment at high-volume centers offers improved outcomes and OS benefit. However, in the United States, only 16% of RCs are performed in high-volume hospitals.
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http://dx.doi.org/10.1016/j.clgc.2020.05.012DOI Listing
December 2020

Cytotoxicity of photoactivatable bromo tricarbonyl manganese(i) compounds against human liver carcinoma cells.

Dalton Trans 2020 Jul;49(27):9294-9305

Department of Chemistry, Faculty of Science, Cairo University, Gamma Street, Giza, Cairo 12613, Egypt.

Two series of photoinduced tricarbonyl manganese(i) compounds were prepared from the reaction of [MnBr(CO)3(2-C(H)[double bond, length as m-dash]O)] (2-C(H)[double bond, length as m-dash]O: quinoline-2-carboxaldehyde and pyridine-2-carboxaldehyde) and para-substituted aniline derivatives (X = OH, OCH3, Cl and NO2). Different electron-donating and electron-withdrawing substituents were introduced in the para-position of the phenyl ring to investigate their influence on the stability of the compounds in the dark and the photophysical properties upon illumination at 525 nm. When kept in the dark, the aerated solutions of the complexes in dimethyl sulfoxide (DMSO) and CH2Cl2 were stable. In the solution, the complexes bearing electron-withdrawing substituents, exchange their bromo ligands with DMSO solvent molecules, as evidenced from infrared and UV/Vis studies as well as time-dependent density functional theory (TDDFT) calculations. The complexes were assessed for their cytotoxicity, both in the dark and upon exposure to a 525 nm LED, against the human hepatocarcinoma cell line (HepG2). A marked reduction in the viability of HepG2 cells treated with the complex functionalized with quinoline and methoxy substituent was observed after illumination in a dose-dependent manner, with an IC50 value of 7.1 μM, making it the most phototoxic compound in our study.
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http://dx.doi.org/10.1039/d0dt01539cDOI Listing
July 2020

Quantitative Analysis of Doping-Induced Polarons and Charge-Transfer Complexes of Poly(3-hexylthiophene) in Solution.

J Phys Chem B 2020 Sep 19;124(35):7694-7708. Epub 2020 Jul 19.

Institut für Physik und Astronomie, Universität Potsdam, 14476 Potsdam, Germany.

The mechanism and the nature of the species formed by molecular doping of the model polymer poly(3-hexylthiophene) (P3HT) in its regioregular (rre-) and regiorandom (rra-) forms in solution are investigated for three different dopants: the prototypical π-electron acceptor 2,3,5,6-tetrafluoro-7,7,8,8-tetracyanoquinodimethane (FTCNQ), the strong Lewis acid tris(pentafluorophenyl)borane (BCF), and the strongly oxidizing complex molybdenum tris[1-(methoxycarbonyl)-2-(trifluoromethyl)ethane-1,2-dithiolene] (Mo(tfd-COMe)). In a combined optical and electron paramagnetic resonance study, we show that the doping of rreP3HT in solution occurs by integer charge transfer, resulting in formation of P3HT radical cations (polarons) for all of the dopants considered here. Remarkably, despite the different chemical nature of the dopants and dopant-polymer interaction, the formed polarons exhibit essentially identical optical absorption spectra. The situation is very different for the doping of rraP3HT, where we observe formation of a charge-transfer complex with FTCNQ and of a "localized" P3HT polaron on nonaggregated chains upon doping with BCF, while there is no indication of dopant-induced species in the case of Mo(tfd-COMe). We estimate the ionization efficiency of the respective dopants for the two polymers in solution and report the molar extinction coefficient spectra of the three different species. Finally, we observe increased spin delocalization in regioregular compared to regiorandom P3HT by electron nuclear double resonance, suggesting that the ability of the charge to delocalize on aggregates of planarized polymer backbones plays a significant role in determining the doping mechanism.
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http://dx.doi.org/10.1021/acs.jpcb.0c03517DOI Listing
September 2020

Nuclear NADPH oxidase-4 associated with disease progression in renal cell carcinoma.

Transl Res 2020 09 31;223:1-14. Epub 2020 May 31.

Department of Urology, University of Texas Health, San Antonio, Texas.

Nuclear NADPH oxidase-4 (Nox4) is a key component of metabolic reprogramming and is often overexpressed in renal cell carcinoma (RCC). However, its prognostic role in RCC remains unclear. Here we examined the significance of nuclear Nox4 on disease progression and development of drug resistance in advanced RCC. We analyzed human RCC tissue from multiple regions in the primary index tumor, cancer-associated normal adjacent parenchyma, intravascular tumor in locally advanced cancer patients. We found that the higher nuclear Nox4 expression was significantly associated with progression and death. These findings were consistent after controlling for other competing clinical variables. In contrast, patients with lower nuclear Nox4, even in higher stage RCC had better prognosis. We identified a subset of patients with high nuclear Nox4 who had rapid disease progression or died within 6 months of surgery. In addition, higher nuclear Nox4 level correlated with resistance to targeted therapy and immunotherapy. Western blotting performed on fresh human RCC tissue as well as cell-lines revealed increased nuclear Nox4 expression. Our data support an important prognostic role of Nox4 mediated regulation of RCC independent of other competing variables. Nox4 localizes to the nucleus in high-grade, high-stage RCC. Higher nuclear Nox4 has prognostic significance for disease progression, poor survival, and development of drug resistance in RCC.
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http://dx.doi.org/10.1016/j.trsl.2020.05.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111697PMC
September 2020

Analyzing National Incidences and Predictors of Open Conversion During Minimally Invasive Partial Nephrectomy for cT1 Renal Masses.

J Endourol 2021 01 22;35(1):30-38. Epub 2020 Jun 22.

Department of Urology and UT Health San Antonio, San Antonio, Texas, USA.

To analyze predictors of open conversion during minimally invasive partial nephrectomy (MIPN) for cT1 renal masses. The National Cancer Database (NCDB) was investigated for kidney cancer patients who underwent partial nephrectomy (PN) between 2010 and 2015. Patients who underwent MIPN were stratified into converted and nonconverted groups. Sociodemographics, facility characteristics, and surgical outcomes were compared between the two groups, and multivariate logistic regression model was fitted to identify independent predictors of open conversion. In total, 54,246 patients underwent PN for kidney cancer during the 6-year period. Of those, 18,994 (35%) were open partial nephrectomies (OPNs) and 35,252 (64%) were MIPN. Overall, 1010 (2.87%) of MIPNs were converted to OPN. There was an increasing utilization of MIPN from 50.35% in 2010 to 74.73% in 2015. Patients who had open conversion had more 30-day readmissions (5.95% 3.31%,  < 0.01). On multivariate analysis; high-volume facility (>30 MIPNs/year), year of surgery (2015 2010), and robotic approach predicted a lower likelihood of conversion (odds ratio [OR] 0.52, confidence interval [CI] 0.44-0.62; OR 0.59, CI 0.47-0.73; and OR 0.31, CI 0.27-0.35; respectively,  < 0.001 for all). Conversely, Medicaid ( private insurance; OR 1.75, CI 1.39-2.19,  < 0.001) and male sex (OR 1.26, CI 1.11-1.44,  < 0.001) were independent predictors of conversion. Open conversion in MIPN occurred in 2.87% of cases. There was an increasing utilization of MIPN associated with decreased conversion rates. Higher volume hospitals and progressing year of surgery were associated with less likelihood of conversion.
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http://dx.doi.org/10.1089/end.2020.0161DOI Listing
January 2021

Ameliorative effect of 2-methoxyestradiol on radiation-induced lung injury.

Life Sci 2020 Aug 1;255:117743. Epub 2020 May 1.

Department of Pharmacology and Toxicology, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, Egypt. Electronic address:

Aims: Radiation-induced lung injury (RILI) is a serious complication of radiation therapy. Development of an effective drug that selectively protects normal lung tissues and sensitizes tumor cells to radiotherapy is an unmet need. 2-Methoxyestradiol (2ME2) possesses polypharmacological properties, which qualifies it as an effective radioprotector. Our aim is to explore the potential protective effects of 2ME2 against early and late stages of RILI and the underlying mechanisms.

Main Methods: BALB/c mice were either treated with 2ME2 (50 mg/kg/day i.p., for 4 weeks); or received a single dose of 10 Gy ionizing radiation (IR) delivered to the lungs; or 10 Gy IR and 2ME2. Animal survival and pulmonary functions were evaluated. Immune-phenotyping of alveolar macrophages (AM) in the broncho-alveolar lavage fluids (BALF) was determined by flow cytometry. ELISA was used to evaluate the expression levels of TNF-α, TGF-β; and IL-10 in BALF. Lung tissues were used for histopathological examination or immunofluorescence staining for CD68 (pan-macrophage marker), Arginase-1 (Arg1, M2-specific marker), inducible nitric oxide synthase (iNOS, M1-specific marker) and HIF-1α. VEGF and γH2AX expression in lung tissues were detected by western blot.

Key Findings: The results demonstrated that 2ME2 improved the survival, lung functions and histopathological parameters of irradiated mice. Additionally, it attenuated the radiation-induced AM polarization and reduced the pneumonitis and fibrosis markers in lung tissues. Significant reduction of TNF-α and TGF-β with concomitant increase in IL-10 concentrations were observed. Moreover, the expression of HIF-1α, VEGF and γH2AX declined.

Significance: 2ME2 is a promising radioprotectant with fewer anticipated side effects.
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http://dx.doi.org/10.1016/j.lfs.2020.117743DOI Listing
August 2020

The potential chemotherapeutic effect of β-ionone and/or sorafenib against hepatocellular carcinoma via its antioxidant effect, PPAR-γ, FOXO-1, Ki-67, Bax, and Bcl-2 signaling pathways.

Naunyn Schmiedebergs Arch Pharmacol 2020 09 8;393(9):1611-1624. Epub 2020 Apr 8.

Pharmacology and Toxicology Department, Faculty of Pharmacy, Beni-Suef University, P.O. Box 62514, Beni-Suef, Egypt.

Proliferation and apoptosis are two primary driving forces behind the pathogenesis of hepatocellular carcinoma (HCC). HCC is associated with Ki-67 and Bcl-2 overexpression, reduced Bax expression inducing disturbance of equilibrium between cellular proliferation and apoptosis, and exacerbated by reduced expression of PPAR-γ and FOXO-1. Our objective was to examine the mechanism by which the cyclic isoprenoid, β-ionone (βI), attenuated hepatocarcinogenesis and compare its possible anticancer activity with sorafenib (SF) as standard HCC treatment. HCC induction was achieved by supplying Wistar rats with 0.01% diethylnitrosamine (DENA) for 8 consecutive weeks by free access of drinking water. The effects of βI (160 mg/kg/day) administered orally were evaluated by biochemical, oxidative stress, macroscopical, and histopathological analysis. In addition, immunohistochemical assay for localization and expression of Bax and Bcl-2 and RT-PCR for expression levels of PPAR-γ, FOXO-1, and Ki-67 mRNA were performed. βI treatment significantly reduced the incidence, total number, and multiplicity of visible hepatocyte nodules, attenuated LPO, near-normal restoration of all cancer biomarkers, and antioxidant activities, indicating the chemotherapeutic impact of βI. Histopathological analysis of the liver confirmed that further. βI also induced pro-apoptotic protein Bax expression and reduced anti-apoptotic expression of Bcl-2 protein. Moreover, βI induced mRNA expression of tumor suppressor genes (PPAR-γ and FOXO-1) and decreased proliferative marker Ki-67 mRNA expression. For the first time, the present study provides evidence that βI exerts a major anticancer effect on DENA-induced HCC, at least in part, through inhibition of cell proliferation, oxidative stress, and apoptogenic signal induction mediated by downregulation of Bcl-2 and upregulation of Bax, PPAR-γ, and FOXO-1 expressions.
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http://dx.doi.org/10.1007/s00210-020-01863-9DOI Listing
September 2020

Metal complexes as a promising source for new antibiotics.

Chem Sci 2020 Mar 12;11(10):2627-2639. Epub 2020 Feb 12.

Centre for Superbug Solutions , Institute for Molecular Bioscience , The University of Queensland , St. Lucia , Queensland 4072 , Australia . Email: ; Email:

There is a dire need for new antimicrobial compounds to combat the growing threat of widespread antibiotic resistance. With a currently very scarce drug pipeline, consisting mostly of derivatives of known antibiotics, new classes of antibiotics are urgently required. Metal complexes are currently in clinical development for the treatment of cancer, malaria and neurodegenerative diseases. However, only little attention has been paid to their application as potential antimicrobial compounds. We report the evaluation of 906 metal-containing compounds that have been screened by the Community for Open Antimicrobial Drug Discovery (CO-ADD) for antimicrobial activity. Metal-bearing compounds display a significantly higher hit-rate (9.9%) when compared to the purely organic molecules (0.87%) in the CO-ADD database. Out of 906 compounds, 88 show activity against at least one of the tested strains, including fungi, while not displaying any cytotoxicity against mammalian cell lines or haemolytic properties. Herein, we highlight the structures of the 30 compounds with activity against Gram-positive and/or Gram-negative bacteria containing Mn, Co, Zn, Ru, Ag, Eu, Ir and Pt, with activities down to the nanomolar range against methicillin resistant (MRSA). 23 of these complexes have not been reported for their antimicrobial properties before. This work reveals the vast diversity that metal-containing compounds can bring to antimicrobial research. It is important to raise awareness of these types of compounds for the design of truly novel antibiotics with potential for combatting antimicrobial resistance.
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http://dx.doi.org/10.1039/c9sc06460eDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069370PMC
March 2020

Antimicrobial properties of half-sandwich Ir(iii) cyclopentadienyl complexes with pyridylbenzimidazole ligands.

Dalton Trans 2020 Apr;49(14):4491-4501

Institut für Anorganische Chemie, Julius-Maximilians-Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany.

Reaction between 2-(2'-pyridyl)benzimidazole derivatives and [{IrCl(η5-C5Me5)}2(μ-Cl)2] afforded mono- and binuclear "piano-stool" Ir(iii) compounds of type [IrnCln(η5-C5Me5)n(L)]Cln (n = 1, L = LET (1) and LSO3H (2); n = 2, L = LBN (3)), which were fully characterized, including the X-ray crystallographic analysis of 1. While the free ligands and compound 3 exhibited no toxicity to the tested microbes, compound 1 was highly potent against bacteria (MIC = 12.9-25.8 nM) and fungi (MIC < 0.40 nM). However, complex 1 induced damage to non-malignant cell lines (human embryonic kidney (HEK293), CC50 = 0.995 μg mL-1) and human RBCs (HC10 = 10.9 μg mL-1 and HC50 > 32 μg mL-1). Interestingly, complex 2, bearing the benzimidazole ligand with an alkylated sulfonate side chain (LSO3H), was selectively potent against C. neoformans with MIC value of 11.2 nM and was non-toxic to HEK293. According to DNA binding studies, compounds 1-3 could be considered as moderate metallo intercalators with a binding constant of 5.0 × 104-1.0 × 105 M-1. Alternatively, evidence was obtained, from ESI-MS measurements, for the non-covalent mode of binding of 2 to hen egg white lysozyme, while compounds 1 and 3 decomposed during the interaction with that protein. This may be attributed to the electrostatic and H-bonding interactions between the polar sulfonate group and charged protein side-chains.
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http://dx.doi.org/10.1039/d0dt00451kDOI Listing
April 2020

Facile and noninvasive passivation, doping and chemical tuning of macroscopic hybrid perovskite crystals.

PLoS One 2020 17;15(3):e0230540. Epub 2020 Mar 17.

Physical Sciences and Engineering Division (PSE), King Abdullah University of Science and Technology (KAUST), KAUST Solar Center (KSC), Thuwal, Kingdom of Saudi Arabia.

Halide vacancies and associated metallic lead (Pb°) observed at the surface and deep inside macroscopic organolead trihalide perovskite crystals is removed through a facile and noninvasive treatment. Indeed, Br2 vapor is shown to passivate Br-vacancies and associated Pb° in the bulk of macroscopic crystals. Controlling the exposure time can markedly improve the overall stoichiometry for moderate exposures or introduce excessive bromide for long exposures, resulting in p-doping of the crystals. In the low dose passivation regime, Hall effect measurements reveal a ca. 3-fold increase in carrier mobility to ca. 15 cm2V-1s-1, while the p-doping increases the electrical conductivity ca. 10000-fold, including a 50-fold increase in carrier mobility to ca. 150 cm2V-1s-1. The ease of diffusion of Br2 vapor into macroscopic crystals is ascribed to the porosity allowed in rapidly grown crystals through aggregative processes of the colloidal sol during growth of films and macroscopic crystals. This process is believed to form significant growth defects, including open voids, which may be remnants of the escaping solvent at the solidification front. These results suggest that due to the sol-gel-like nature of the growth process, macroscopic perovskite crystals reported in this study are far from perfect and point to possible pathways to improving the optoelectronic properties of these materials. Nevertheless, the ability of the vapor-phase approach to access and tune the bulk chemistry and properties of nominally macroscopic perovskite crystals provides interesting new opportunities to precisely manipulate and functionalize the bulk properties of hybrid perovskite crystals in a noninvasive manner.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230540PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077828PMC
June 2020

Microbiome within Primary Tumor Tissue from Renal Cell Carcinoma May Be Associated with PD-L1 Expression of the Venous Tumor Thrombus.

Adv Urol 2020 18;2020:9068068. Epub 2020 Feb 18.

Department of Urology, University of Texas Health San Antonio, San Antonio, TX, USA.

Objective: To perform a proof of concept microbiome evaluation and PD-L1 expression profiling in clear-cell renal cell carcinoma (cc-RCC) with associated tumor thrombus (TT).

Methods: After IRB approval, six patients underwent radical nephrectomy (RN) with venous tumor thrombectomy (VTT). We collected fresh tissue specimens from normal adjacent, tumor, and thrombus tissues. We utilized RNA sequencing to obtain PD-L1 expression profiles and perform microbiome analysis. Statistical assessment was performed using Student's -test, chi-square, and spearman rank correlations using SPSS v25.

Results: We noted the tumor thrombus to be mostly devoid of diverse microbiota. A large proportion of was detected and unknown if this is a surgical or postsurgical contaminant; however, it was noted more in the thrombus than other tissues. Microbiome diversity profiles were most abundant in the primary tumor compared to the thrombus or normal adjacent tissue. Differential expression of PD-L1 was examined in the tumor thrombus to the normal background tissue and noted three of the six subjects had a threshold above 2-fold. These three similar subjects had foreign microbiota that are typical residents of the oral microbiome.

Conclusion: Renal tumors have more diverse microbiomes than normal adjacent tissue. Identification of resident oral microbiome profiles in clear-cell renal cancer with tumor thrombus provides a potential biomarker for thrombus response to PD-L1 inhibition.
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http://dx.doi.org/10.1155/2020/9068068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049446PMC
February 2020

Pathological downstaging following radical cystectomy for muscle-invasive bladder cancer: Survival outcomes in the setting of neoadjuvant chemotherapy versus transurethral resection only.

Urol Oncol 2020 04 16;38(4):231-239. Epub 2020 Jan 16.

Department of Urology, UT Health San Antonio, San Antonio, TX; Mays Cancer Center at UT Health San Antonio/MD Anderson, San Antonio, TX; Department of Urology, Urology and Nephrology Center, Mansoura University, Egypt. Electronic address:

Introduction: Neoadjuvant chemotherapy (NAC) improves survival for patients undergoing radical cystectomy for muscle-invasive bladder cancer (MIBC). The overall survival (OS) advantage with NAC is primarily seen in patients who achieve pathological downstaging. However, a substantial number of patients achieve pathological downstaging following transurethral resection (TUR) without NAC.

Objectives: To analyze the OS outcomes in patients who achieve pathological downstaging in the setting of NAC vs. TUR only.

Materials And Methods: We reviewed the National Cancer Database (NCDB) for patients diagnosed with MIBC who underwent radical cystectomy between 2004 and 2014. Patients who achieved complete downstaging (CD) (pT0N0) or noninvasive downstaging (NID) (pT0/Tis/TaN0) were further analyzed. OS was evaluated by comparing those who underwent NAC to those who underwent TUR only.

Results: A total of 24,763 patients with MIBC were identified. 1,781 (7.2%) patients had NID and 1,015 (4.1%) had CD. Of all patients, 3,838 (15.5%) underwent NAC. In patients with NID, 757 (42.5%) underwent NAC and 1024 (57.5%) had cystectomy after TUR only. In patients with CD, 465 (45.8%) had NAC, while 550 (54.2%) had TUR only. In both NID and CD, cT2 patients were more likely to have TUR only (P = 0.019, P < 0.001), cT3 patients were more likely to receive NAC (P = 0.008, P < 0.001). Compared to the TUR only group, NAC was associated with improved 5-year OS in those with NID, 77% compared to 68% (HR 0.68, 95% CI [0.52-0.90]), as well as those with CD, 80% vs. 70% (HR 0.59, 95% CI [0.39-0.89]).

Conclusions: NAC was associated with significant overall survival benefit in the subset of patients who achieved CD and NID at radical cystectomy. Overall, NAC was underutilized in patients with MIBC.
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http://dx.doi.org/10.1016/j.urolonc.2019.12.019DOI Listing
April 2020

Urinary Diversion Disparity Following Radical Cystectomy for Bladder Cancer in the Hispanic Population.

Urology 2020 Mar 27;137:66-71. Epub 2019 Dec 27.

Department of Urology, University of Texas Health San Antonio (UTHSA), San Antonio, TX; Experimental Development Therapeutics Program/Urology, MD Anderson Cancer Center/UT Health Science Center, Houston, TX. Electronic address:

Objective: To determine if disparities in quality of surgical care exist between Hispanics and non-Hispanics undergoing radical cystectomy for bladder cancer.

Materials And Methods: An observational cohort study was conducted retrospectively on patients who underwent radical cystectomy for urothelial carcinoma of the bladder at our institution between January 2005 and July 2018. Data was collected on demographic, clinical, and pathological characteristics of patients, including self-reported ethnicity. Univariable and multivariable logistic or linear regression analyses were used to evaluate the association of ethnicity with receipt of neoadjuvant chemotherapy, utilization of laparoscopic surgery, number of lymph nodes removed, and continent urinary diversion.

Results: We identified 507 patients in our database out of which, 136 (27%) were Hispanic and 371 (73%) were non-Hispanic. Compared to non-Hispanics, Hispanics had a higher body mass index (26.9 kg/m vs 28.2 kg/m, P = .006) and lived further away from site of surgery (34 vs 96 miles, P = .02). No significant differences were observed in receipt of neoadjuvant chemotherapy, laparoscopic surgery, or number of lymph nodes removed during cystectomy between ethnicity groups. However, Hispanics were less likely than non-Hispanics to receive a continent urinary diversion on multivariable analysis (odds ratio 0.30, 95% confidence interval 0.10 - 0.92, P = .03).

Conclusion: Disparity exists in the delivery of continent urinary diversions for Hispanic patients undergoing radical cystectomy for bladder cancer. Further investigation is needed to determine the potential causes for this disparity in care delivered.
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http://dx.doi.org/10.1016/j.urology.2019.12.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063861PMC
March 2020
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