Bowel and bladder care
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Item Bladder Preservation for Muscle-Invasive Bladder Cancer With Variant Histology(Elsevier, 2023-01-01) Brocklehurst, A.; Varughese, M.; Birtle, A.A growing body of evidence has shown bladder-preservation with chemo-radiotherapy achieves comparable survival to Radical Cystectomy (5-year OS 50%-70%) and superior quality of life outcomes for patients with muscle-invasive urothelial carcinoma of the bladder (UC). However, up to 55% of patients harbor variant histology and in this review we aim to clarify the role of bladder-preservation for this group. We first draw the distinction between urothelial carcinoma with divergent differentiation (UCDD) and non-urothelial carcinoma (NUC). UCDD is common, increasing in prevalence, and whilst each subtype may have its own characteristics current evidence suggests comparable outcomes with radical cystectomy and bladder-preservation. Non-urothelial carcinoma is a collection of distinct pathologies each deserving of its own management strategy. However, these tumors are rare, and evidence is generated from retrospective studies with significant inherent bias. Small cell carcinoma of the bladder has good evidence for bladder-preservation; however, other pathologies such as Squamous Cell Carcinoma and Adenocarcinoma are not well supported. We recommend careful multidisciplinary appraisal of the evidence for each subtype and honest patient discussion about the limited evidence before reaching management decisions. As we look to the future molecular-profiling may help better characterize these tumors and aid in treatment selection.Item Considerations for peripheral blood transport and storage during large-scale multicentre metabolome research(BMJ, 2023-02-08) Alexander, J. L.; Wyatt, N. J.; Camuzeaux, S.; Chekmeneva, E.; Jimenez, B.; Sands, C. J.; Fuller, H.; Takis, P.; Ahmad, T.; Doyle, J. A.; Hart, A.; Irving, P. M.; Kennedy, N. A.; Lees, C. W.; Lindsay, J. O.; McIntyre, R. E.; Parkes, M.; Prescott, N. J.; Raine, T.; Satsangi, J.; Speight, R. A.; Jostins-Dean, L.; Powell, N.; Marchesi, J. R.; Stewart, C. J.; Lamb, C. A.Item Fundamentals of Bowel Cancer for Biomedical Engineers(Springer, 2023-04-01) Tian, J.; Afebu, K. O.; Bickerdike, A.; Liu, Y.; Prasad, S.; Nelson, B. J.Bowel cancer is a multifactorial disease arising from a combination of genetic predisposition and environmental factors. Detection of bowel cancer and its precursor lesions is predominantly performed by either visual inspection of the colonic mucosa during endoscopy or cross-sectional imaging. Most cases are diagnosed when the cancer is already at an advanced stage. These modalities are less reliable for detecting lesions at the earliest stages, when they are typically small or flat. Removal of lesions at the earliest possible stage reduces the risk of cancer death, which is largely due to a reduced risk of subsequent metastasis. In this review, we summarised the origin of bowel cancer and the mechanism of its metastasis. In particular, we reviewed a broad spectrum of literatures covering the biomechanics of bowel cancer and its measurement techniques that are pertinent to the successful development of a bowel cancer diagnostic device. We also reviewed existing bowel cancer diagnostic techniques that are available for clinical use. Finally, we outlined current clinical needs and highlighted the potential roles of medical robotics on early bowel cancer diagnosis.Item Better documentation is better care for patients with Inflammatory Bowel Disease(Wiley, 2023-02-01) Sayers, A.