Medical-rehabilitation endeavors, care interventions and connotations of a medical-social type, in a complex polypathological case: paraplegia, spondylodiscitis, kidney failure in the haemodialysis stage, and bilateral nephrostomies post operated bladder neoplasm

Introduction Paraplegia or paralysis of lower extremities is caused mainly by disorders of the spinal cord and cauda equina. They are classified as traumatic and non traumatic. Non traumatic paraplegia has multiple causes such as cancer, infection, intervertebral disc disease, vertebral injury and spinal cord vascular disease. The current case report presents the case of a male patients with paraplegia related to the thoracic spondylodiscitis in a patient on haemodialysis. Material and method. Having the patient’s consent and The Teaching Emergency Hospital “Bagdasar-Arseni” Ethics Committee’s approval, N.O. 17464/14.06.2019, a 72 years old patient, which known with operated bladder neoplasm (2015-neobladder), Chronic kidney failure in haemodialysis program and spondylodiscitis T10-T11 operated in 29.12.2018. Results and discussions. The patient improved on most of the assessment scales/scores implemented in our clinic’s Division Motor FIM ( Functional İndependence Measure) from 43/91 to 54/91,AIS (American Spinal Injury Association Impairment Scale) from 85/100 motor to 92/100. Conclusions. İnfectious diseases are important causes of non-traumatic paraplegia. The risk of infection on haemodialysis patient is further increased because of frequent routine skin penetration for venipuncture and operative procedures such as placement of venous catheters and vascular grafts. Key words: paraplegia, haemodialysis, spondylodiscitis, neoplasm, nephrostomy,

Evaluation of platelet distribution width as a diagnostic and prognostic biomarker in bladder neoplasm

Aim: To evaluate the role of preoperative platelet distribution width (PDW) as a potential biomarker for distinguishing malignancy and tumor advantage of bladder neoplasm. Methods: The study included 210 subjects with bladder cancer, 76 subjects with urothelial papilloma and 132 healthy control subjects. Preoperative PDW along with other blood indices was evaluated. Results: PDW was higher in urothelial papilloma patients than that in bladder cancer patients (p < 0.001). Bladder cancer patients with advanced-stage disease exhibited lower PDW levels compared with patients with early stage disease. Conclusion: Reduced preoperative PDW level is an indicator of malignancy and advanced bladder cancer stages, suggesting it as a potential biomarker in bladder cancer diagnosis and prognosis.

Exploring the Pathological Mechanism of Bladder Cancer Based on Tumor Mutational Burden Analysis

Although immunotherapy has progressed in the treatment of bladder cancer, some patients still have poor prognosis. New therapeutic targets are eager to be discovered to improve the outcomes of bladder cancer. With the development of high-throughput sequencing and tumor profiling, potential tumor biomarkers were identified. Through the interpretation of related data from the Cancer Genome Atlas database (TCGA), some key genes have been discovered to drive the development and prognosis of urinary bladder neoplasm. On account of the success of immunotherapy in many cancer types, we established the relationship between tumor mutation burden and immune microenvironment of bladder cancer and found the changes of several immune cells in this disease. Based on the understanding of the bladder tumor genome and immune environment, this study is supposed to provide new therapies for the treatment of bladder neoplasm.