Genitourinary Diseases Research Articles

Association between number of hospitalizations of older adults and heatwaves in Slovenia 1999-2018

Abstract Background Heatwaves frequency, intensity, and duration increase with global climate change. The association between heat and mortality in older adults is well documented, but less is known about associations with hospitalizations. Knowing which diseases contribute to a higher number of hospitalizations during heatwaves is important for planning appropriate public health preventive measures. Methods We assessed short-term association between the number of hospitalizations for older adults (75+ years) and heatwaves in the years 1999 to 2018 in Slovenia. We estimated the relative risks (RR) with 95 % confidence interval for the number of hospitalizations for the observed diagnosis (all causes, circulatory, respiratory, endocrine and genitourinary diseases) and gender associated with heatwaves in Slovenia for each year, comparing the number of hospitalizations during heatwaves with reference days. Results We could not find an association between heatwaves and hospitalizations for all cause hospitalizations in all observed years. In some years the association was even negative. In cause specific analyses heatwaves were associated with increased hospitalizations for endocrine diseases in 2012 (32%; 95% CI: 1%, 73%), 2013 (23%; 95% CI: 5%, 33%), 2014 (48%; 95% CI: 4%, 110%) and 2015 (42%; 95% CI: 7%, 89%), but not for cardiovascular, respiratory and genitourinary diseases. Conclusions Older adults are most susceptible to the effects of extreme heat due to physiological changes that occur with aging, chronic diseases, certain medications, a sedentary lifestyle and social isolation. The results of our study will help in planning appropriate preventive public health measures to better protect older adults during the next heatwaves in Slovenia. Key messages • Heatwaves will become longer, more frequent and more intense in the near future. • Endocrine diseases are the most important cause for hospitalization during heatwaves. Public health measures shoud adress these most vulnerable groups.

An international environmental scan of the scope and characteristics of patient decision aids which are freely available online

ObjectiveTo analyse the scope and characteristics of freely available online patient decision aids. MethodsAn international environmental scan of online decision aids, with no language restriction, was conducted by searching aids in the recent Cochrane review and 35 online sources. Aid characteristics were extracted and analysed. ResultsOf 1555 decision aids identified, there were 1222 unique aids after removing duplicates. Of these, 785 met eligibility criteria. The aids were from 17 countries (30 % from the Netherlands, 20 % from the US) and 44 % in English. Nearly all had a downloadable PDF or were printable and 32 % were interactive web-based. Many aids (72 %) were about a treatment decision. Most common diseases addressed were cancer (23 %), especially breast cancer, musculoskeletal diseases (11 %), and genitourinary system diseases (10 %). ConclusionsThere are many freely available decision aids, with most addressing treatment decisions and particular health conditions. Many (21 %) of the aids identified were duplicates, some topics are covered by multiple versions of decision aids, and other topics have few decision aids. Practice implicationsWhile many decision aids exist online, initiatives are needed to minimise aid duplication, achieve better distribution of aids across health decisions/topics, encourage greater collaboration between developers, and adaption of existing aids.

Longitudinal assessment of the impact of prevalent diabetes on hospital admissions and mortality in the general population: a prospective population-based study with 19 years of follow-up

BackgroundHospitalization indicates the presence of severe disease and constitutes a leading cost in health care. We aimed to prospectively assess if prevalent diabetes mellitus contributes to excess all-cause and cause-specific hospital admissions and mortality at the population level.MethodsWe used a Swedish prospective population-based cohort, including 25,642 individuals of whom 4.2% had prevalent diabetes at baseline (mean age 61.2 ± 6.8 years, age range 44.8–73.4 years). We compared the number of hospitalizations and mortality classified according to the main chapters of the 10th revision of the International Classification of Diseases (ICD-10) during follow-up using nationwide inpatient registries, comparing individuals with and without prevalent diabetes, using multivariate adjusted negative binomial regression (incidence rate ratio, IRR) and Cox regression, respectively.ResultsDuring a median follow-up of 19 years, 18,904 subjects were hospitalized at least once [median 3 (IQR 2–6)] and 6767 (26.4%) individuals died. Overall, subjects with diabetes were hospitalized (IRR 1.83, p < 0.001) more often, and had a higher incidence rate of hospital admissions due to endocrine diseases (IRR 14.6, p < 0.001), dermatological diseases (IRR 3.7, p < 0.001), injuries and poisoning (IRR 2.7, p < 0.001), infectious diseases (IRR 2.5, p < 0.001), psychiatric diseases (IRR 2.0, p < 0.001), but also cardiovascular, hematological, genitourinary, neurologic and respiratory diseases compared with non-diabetic individuals. No difference was observed for hospital admissions due to cancer or musculoskeletal disorders. All-cause mortality was higher (HR 1.77, p < 0.001) in individuals with diabetes, with disease-specific mortality being significant only for cardiovascular and endocrine disease-related death.ConclusionsAt the population level, prevalent diabetes increased the hospitalization burden longitudinally due to diseases of most of the ICD-10 main chapters, except for cancer and musculoskeletal disorders. These novel findings challenge the current view on the spectrum of prevalent diabetes-related conditions and may have implications for screening and treatment strategies in diabetes.Permission of graphical illustrationsSource: Pixabay.com. No permission or acknowledgement is required.

Diagnosis and evaluating the urgent CT KUB at king Fahad specialist hospital, Buraydah, Saudi Arabia 2022.

PURPOSE: The aim of this research was to evaluate the diagnostic yield of urgent CT KUBs and assess the appropriateness of their use in the investigation of acute renal colic at King Fahad specialist hospital , Buraydah, Saudi Arabia 2022. METHODS: All data were collected retrospectively from patient’s records including all patients who presented to the emergency and inpatients undergo unenhanced CT KUB to rule out urinary tract stones . Follow-up requests of known urolithiasis and any scan done for other clinical indications were excluded ,representing 3.7% . RESULTS: This study reviewed 1671 patients, 24.9% were aged between 31 and 40 years old, with nearly 60% being males. Most patients were admitted to ER (98%) and referred by non-urology physicians (99%). The prevalence of patients who were diagnosed with renal stones was 38.7%. Among patients who were presented with acute renal colic and CT scan revealed no urolithiasis, there was 11% with incidental and other alternative diagnosis. The most common finding was genitourinary diseases (48.9%), followed by gastrointestinal diseases (27.2%). CONCLUSION: The significant percentage of negative CT KUB of the examined patients reflects the physicians misapplication with this technique with a subsequent reduction in the rate of renal calculi detection with unnecessary radiation exposure as well as increased the alternative/incidental of extraordinary findings, which may indicate further emergency abdominal CT studies. Therefore, urology opinion before CT-KUB requested for patients with atypical presentation is highly advised. Additionally , departmental ultrasound is suggested mainly for the young females prior to CT scan to rule out any gynecological conditions that can mimic renal stones.

Deconvolution of Human Urine across the Transcriptome and Metabolome.

Early detection of the cell type changes underlying several genitourinary tract diseases largely remains an unmet clinical need, where existing assays, if available, lack the cellular resolution afforded by an invasive biopsy. While messenger RNA in urine could reflect the dynamic signal that facilitates early detection, current measurements primarily detect single genes and thus do not reflect the entire transcriptome and the underlying contributions of cell type-specific RNA. We isolated and sequenced the cell-free RNA (cfRNA) and sediment RNA from human urine samples (n = 6 healthy controls and n = 12 kidney stone patients) and measured the urine metabolome. We analyzed the resulting urine transcriptomes by deconvolving the noninvasively measurable cell type contributions and comparing to plasma cfRNA and the measured urine metabolome. Urine transcriptome cell type deconvolution primarily yielded relative fractional contributions from genitourinary tract cell types in addition to cell types from high-turnover solid tissues beyond the genitourinary tract. Comparison to plasma cfRNA yielded enrichment of metabolic pathways and a distinct cell type spectrum. Integration of urine transcriptomic and metabolomic measurements yielded enrichment for metabolic pathways involved in amino acid metabolism and overlapped with metabolic subsystems associated with proximal tubule function. Noninvasive whole transcriptome measurements of human urine cfRNA and sediment RNA reflects signal from hard-to-biopsy tissues exhibiting low representation in blood plasma cfRNA liquid biopsy at cell type resolution and are enriched in signal from metabolic pathways measurable in the urine metabolome.

Analysis of Risk Factors for Death from Melanoma and Genitourinary Diseases in Male Patients with Cutaneous Melanoma: A Cohort Propensity Score Matching Study.

To analyze the influencing factors of male cutaneous melanoma (CM) patients dying from genitourinary diseases (GUD). We searched the surveillance, epidemiology, and end results (SEER) database and extracted data on male CM patients according to the inclusion and exclusion criteria, including male patients whose cause of death was CM (cohort A) or GUD (cohort B). Comparisons between the two cohorts were performed before and after propensity score matching (PSM). An interaction analysis between age and year of diagnosis was also conducted. Cox regression analysis were performed to find the risk factors for death from GUD. Seven thousand seventy-eight CM patients were included, including 6415 (90.6%) in cohort A and 663 (9.4%) in cohort B. Compared with cohort A, cohort B patients were older (median age 74 ys. vs 65 ys.) and were more under the localized stage and had longer survival time no matter before or after PSM (all p<0.001). The stage was an inhibitory factor for cohort B (p <0.001). After PSM, only age and year of diagnosis were found to be cohort B's promoting factors (p<0.001). The interaction analysis showed that older patients diagnosed in later years (2009-2020) had a higher risk of dying from GUD compared to those diagnosed earlier (p<0.05). Patients with a later year of diagnosis (2009-2020) had a lower median survival time than patients with an earlier year of diagnosis (2000-2008) (p<0.001). When the patient's year of diagnosis was earlier (2000-2008), older patients (>75 ys.) had a higher risk of dying from GUD than younger patients (≤75 ys.) (p<0.001). We first reported a significant interaction between age and year of diagnosis in male CM patients dying from GUD, highlighting the increased risk in older patients diagnosed more recently. We may pay attention to the possibility of dying from genitourinary diseases for CM patients.

Povezanost med vročinskimi valovi in obiski na Internistični prvi pomoči Univerzitetnega kliničnega centra Ljubljana v obdobju 2013–2017

Background: Heatwaves have a severe impact on the number of deaths and emergency department visits, making them the most hazardous natural disaster due to climate change in many regions of the world. Our aim was to assess the short-term association between emergency department visits and heat waves from 2013 to 2017 to see whether any difference in the number of visits occurred at the Emergency Department in Ljubljana University Medical Centre during that period. Methods: The design of our study is a retrospective cross-sectional epidemiologic study. We estimated relative risks (RR) for a number of ED visits during heatwave days and reference period days for the observed diagnoses (all causes, diseases of the circulatory system, respiratory system, endocrine diseases, diseases of the digestive system and genitourinary diseases) sex, and age (from 19 to 74 years old, 75 years old and older), as well as 99.6% confidence intervals (CI) and excess ED visits in percent (%) associated with heatwaves occurring in the years from 2014 to 2017. Data were analyzed for the patients arriving at the Emergency Department of the Ljubljana University Medical Centre during summer time, from May to September. The region covers around 550,000 people and is considered an urban and rural area. Results: The results of our study showed that there was no statistically significant increase in number of ED visits during heatwaves for all causes in all observed years. We noticed even statistically significant protective phenomena between heatwaves and the number of ED visits. These happened in the years 2015 and 2017 for both sexes and circulatory system diseases, in 2016 for men, circulatory system diseases, and in 2015 for respiratory system diseases. We showed a statistically significant association between heatwaves and the number of visits in the ED for endocrine diseases in 2013. Conclusion: Despite the increased heat load in the last observed years, the number of ED visits in Ljubljana has remained stable or even decreased. Further studies on how each intervention affects the behavior of the observed population are needed to clarify whether public health measures and inter-sectoral cooperation impact the number of ED visits.

Health And Menstrual Hygiene Of Adolescent Girls In Vijayapura District.

One-fifth of the world's population is in their adolescent years, and in India, 20.9% of people are in this age range. Adolescent girls were unable to obtain the proper knowledge due to social prohibitions and cultural beliefs, which resulted in poor hygiene habits. Due to these behavior's, microorganisms are harbored, which raises the risk of Genito-urinary diseases. To better understand the menstrual hygiene practices of teenage girls in the Vijayapura district, a study on the subject was undertaken. The study's goal was to investigate the menstrual hygiene habits of teenage females in Vijayapura. The study's secondary data-based paper's methodology. As a result of this study, teenage girls' health instruction must focus on menstrual hygiene and health for them to continue practicing good hygiene. With increased understanding and safe menstrual practices, reproductive system infections and their consequences can be prevented.

Healthcare utilisation and associated costs for methadone versus buprenorphine recipients: Examination of interlinked primary and secondary care electronic health records in England.

More evidence for patterns of healthcare utilisation and associated costs among people receiving opioid agonist therapy (OAT) is needed. We investigated primary and secondary healthcare usage and costs among methadone and buprenorphine recipients in England. We conducted a cohort study using the Clinical Practice Research Datalink GOLD and Aurum databases of patients who were prescribed OAT between 1 January 2007 and 31 July 2019. The cohort was linked to Hospital Episode Statistics admitted patient care, outpatient and emergency department data, neighbourhood- and practice-level Index of Multiple Deprivation quintiles and mortality records. Negative binomial regression models were applied to estimate weighted rate ratios (wRR) of healthcare utilisation. Total and mean costs were calculated using Unit Costs of Health and Social Care and the National Healthcare Service Payment by Results National Tariffs. Among 12,639 patients observed over 39,016 person-years, we found higher rate of hospital admissions (wRR 1.18; 1.08-1.28) among methadone compared with buprenorphine recipients. The commonest hospital discharge diagnoses among methadone patients were infectious diseases (19.2%), mental and behavioural disorders (17.0%) and drug-related poisoning (16.5%); the three commonest among buprenorphine patients were mental and behavioural diseases (21.5%), endocrine (13.8%) and genitourinary system diseases (13.1%). Methadone patients had similar mean costs compared with buprenorphine patients (cost difference: £539.01; 432.11-1006.69). Differences in healthcare utilisation frequency for methadone versus buprenorphine recipients were observed. The differences in associated costs were mainly driven by hospital admissions. These findings offer valuable insights for optimising care strategies and resource allocation for OAT recipients.

Effect of Inter-Hospital Transfer on Mortality in Patients Admitted through the Emergency Department.

Background: Despite advancements in emergency medical systems, inter-hospital transfer (IHT) remains a critical component. Several studies have analyzed the impact of IHT on patient outcomes. Some studies have reported positive effects, indicating that transfers can improve patient prognosis. However, other studies have suggested that transfers may worsen outcomes. We investigated whether IHT is associated with in-hospital mortality. Methods: This retrospective observational study utilized data on patient outcomes from the National Emergency Department Information System (NEDIS) from 2016 to 2018, focusing on patients admitted to hospitals after visiting the emergency department (ED). The primary outcome was the in-hospital mortality rate. Results: This study included 2,955,476 adult patients admitted to emergency medical centers, with 832,598 (28.2%) undergoing IHT. The in-hospital mortality rate was significantly higher in the transfer group (6.9%) than in the non-transfer group (4.8%). Multiple logistic regression analysis revealed that IHT was an independent predictor of in-hospital mortality (adjusted odds ratio [aOR] 1.114, 95% confidence interval [CI] 1.101-1.128) after adjusting for variables. Sub-analysis indicated that higher severity scores, shorter symptom onset-to-arrival duration, and diagnoses of infectious or respiratory diseases were significantly associated with increased in-hospital mortality among transferred patients. Conclusions: This study identifies IHT as a significant factor associated with increased in-hospital mortality. Additionally, it suggested the need for policies to mitigate the risks associated with IHT, particularly in critically ill patients, those with the acute phase response, and those with infectious, genitourinary, and respiratory diseases.

Multisystem health comorbidity networks of metabolic dysfunction-associated steatotic liver disease

The global burden of metabolic dysfunction-associated steatotic liver disease (MASLD) is growing, but its subsequent health consequences have not been thoroughly examined. A phenome-wide association study was conducted to map the associations of MASLD with 948 unique clinical outcomes among 361,021 Europeans in the UK Biobank. Disease trajectory and comorbidity analyses were applied to visualize the sequential patterns of multiple comorbidities related to the occurrence of MASLD. The associations jointly verified by observational and polygenic phenome-wide analyses were further replicated by two-sample Mendelian randomization analysis using data from the FinnGen study and international consortia. The observational and polygenic phenome-wide association study revealed the associations of MASLD with 96 intrahepatic and extrahepatic diseases, including circulatory, metabolic, genitourinary, neurological, gastrointestinal, and hematologic diseases. Sequential patterns of MASLD-related extrahepatic comorbidities were primarily found in circulatory, metabolic, and inflammatory diseases. Mendelian randomization analyses supported the causal associations between MASLD and the risk of several intrahepatic disorders, metabolic diseases, cardio-cerebrovascular disease, and ascites but found no associations with neurological diseases. This study elucidated multisystem comorbidities and health consequences of MASLD, contributing to the development of combination interventions targeting distinct pathways for health promotion among patients with MASLD. X.L. was funded by the Natural Science Fund for Distinguished Young Scholars of Zhejiang Province (LR22H260001) and the National Nature Science Foundation of China (82204019) and Y.D. was funded by the Key Project of Traditional Chinese Medicine Science and Technology Plan of Zhejiang Province (GZY-ZJ-KJ-24077) and the National Natural Science Foundation of China (82001673 and 82272860).

Complete Spectrum of Physical Comorbidities with Autism Spectrum Disorder in a Nationwide Cohort.

The associations between autism spectrum disorder (ASD) and physical diseases (PD) based on ICD-8 and ICD-10 diagnoses were studied, comparing with the risks of the general population. All individuals diagnosed before 30th April 2018 with ASD (n = 12,063) and a 5% random sample of the general population (n = 41,251) were drawn from Danish registers of the birth cohorts 1984-1995. For each of the entire spectrum of 13 PD categories, participants were followed from birth to first diagnosis, death, emigration, or 31st December 2017, whichever came first. Time from inclusion at birth to time of first physical diagnosis, accounting for censoring, was studied by use of time-stratified Cox models. When compared to the control sample, the individuals with ASD had a substantial added immediate risk in infancy and in childhood for 12 of the 13 categories. Particularly prominent were estimated associations for nervous system diseases at ages 0-9, and diseases of the eye and adnexa at ages 0-11. The associations were observed for both sexes, but were stronger among females than males, especially for genitourinary system diseases. On the cumulative scale, individuals with ASD were at pronounced greater risk through follow-up for 8 categories, with the greatest cumulative risk of respiratory system diseases, which at ages 5 and 30 was 24.9% and 41.5% for the ASD cohort while for the control sample it was 16.3% and 34.5% at the same ages. Especially in infancy and childhood, the present study found increased risks for a multitude of physical diseases.

Use of humic acids in the treatment of genitourinary diseases

Currently, diseases of the urogenital system has acquired medical and social importance. This is primarily due to the significant prevalence of this group of diseases in the structure of general morbidity, disability, and mortality and their frequent recurrence and effect on the somatic and emotional state of the patient. In addition to socio-demographic problems, urogenital disorders have significant economic consequences. The total annual costs of treating uronephrological diseases, including accompanying therapy, are estimated at 40 billion US dollars. However, according to expert forecasts, by 2030, the prevalence of this group of diseases is expected to increase by 25%, as well as direct costs of disease treatment and indirect costs associated with partial or total disability due to disease development and premature death. Thus, searching for and developing new drugs for the treatment of diseases of the urogenital organs are crucial. Chemical compounds, potentially significant in this aspect, can be obtained by organic synthesis and isolated from natural sources. Thus, exploring the potential of natural compounds that have high biological activity and favorable safety profile is a significant reason to realize and address this issue. An interesting but understudied groups of natural compounds of plant origin are humic substances. Recent preclinical studies have shown that they are able to exert antitumor, nephroprotective, and diuretic effects and exhibit antibacterial and antifungal properties. This review aimed to summarize and systematize currently available information on the known pharmacological effects and possible mechanisms of action of humic acids and the prospects for their use in the treatment and prevention of genitourinary diseases.

What can go wrong when doing right? A pictorial review of iatrogenic genitourinary complications.

A growing number of treatments for genitourinary diseases can result in various iatrogenic complications. Multimodality imaging in the post-procedural setting is essential for early and accurate diagnosis to limit morbidity and mortality. We review common and uncommon treatment-induced pathologies affecting the genitourinary system via a case-based approach. We illustrate notable complications affecting the kidneys, ureters, bladder, and urethra induced by percutaneous procedures, external beam radiation, immunotherapy, laparoscopic/robotic pelvic surgery, and intravesicular BCG. Finally, we provide guidance on optimal imaging techniques for diagnosis and highlight the role of image-guided interventions for mitigation of complications.

Knowledge-guided generative artificial intelligence for automated taxonomy learning from drug labels.

To automatically construct a drug indication taxonomy from drug labels using generative Artificial Intelligence (AI) represented by the Large Language Model (LLM) GPT-4 and real-world evidence (RWE). We extracted indication terms from 46421 free-text drug labels using GPT-4, iteratively and recursively generated indication concepts and inferred indication concept-to-concept and concept-to-term subsumption relations by integrating GPT-4 with RWE, and created a drug indication taxonomy. Quantitative and qualitative evaluations involving domain experts were performed for cardiovascular (CVD), Endocrine, and Genitourinary system diseases. 2909 drug indication terms were extracted and assigned into 24 high-level indication categories (ie, initially generated concepts), each of which was expanded into a sub-taxonomy. For example, the CVD sub-taxonomy contains 242 concepts, spanning a depth of 11, with 170 being leaf nodes. It collectively covers a total of 234 indication terms associated with 189 distinct drugs. The accuracies of GPT-4 on determining the drug indication hierarchy exceeded 0.7 with "good to very good" inter-rater reliability. However, the accuracies of the concept-to-term subsumption relation checking varied greatly, with "fair to moderate" reliability. We successfully used generative AI and RWE to create a taxonomy, with drug indications adequately consistent with domain expert expectations. We show that LLMs are good at deriving their own concept hierarchies but still fall short in determining the subsumption relations between concepts and terms in unregulated language from free-text drug labels, which is the same hard task for human experts.

Polycystic ovary syndrome presents as a multimorbid condition by age 50: birth cohort linkage to national register data.

This population-based follow-up study investigated register-based disease diagnoses and medication use up till age of 50 years among women with polycystic ovary syndrome (PCOS) that were identified from a population-based birth cohort. Population-based longitudinal cohort study. Women reporting oligo/amenorrhea and hirsutism at age 31 and/or who were diagnosed with PCOS by a physician by age 46 (n = 244) and women without PCOS symptoms or diagnosis (n = 1556) in the Northern Finland Birth Cohort 1966. National register data on diagnosed diseases (International Statistical Classification of Diseases [ICD]-8-10) and medication use (Anatomical Therapeutic Chemical) until the age of 50. Women with PCOS had a 26% higher risk for any registered diagnosis (risk ratio [RR]: 1.26 [1.09-1.46]) and a 24% higher risk for medication use (RR: 1.24 [1.05-1.46]) compared with non-PCOS women, even after adjusting for several confounders. Several main ICD categories were more prevalent among women with PCOS versus non-PCOS controls, eg, endocrine, metabolic, nervous system, musculoskeletal, and genitourinary diseases in addition with different symptoms and injuries. Surprisingly, even though the overall morbidity was only increased in women with PCOS with a body mass index (BMI) ≥ 25 kg/m2, there were several ICD main categories that showed higher comorbidity risk especially in women with PCOS with a BMI < 25 kg/m2. Several medications were prescribed more often to women with PCOS versus non-PCOS controls, eg, medications related to the alimentary tract and metabolism, the cardiovascular system, genitourinary system drugs and sex hormones, dermatologic and hormonal preparations, and medications to treat the musculoskeletal, nervous, and respiratory systems. Women with PCOS are burdened with multimorbidity and higher medication use, independent of BMI and other confounders. Accordingly, preventive strategies are needed to alleviate the disease burden and improve the health outcomes of women with PCOS.

Application of PLK1 and HOXA13 Gene Expression Levels in Urine in the Diagnosis of Non-muscle Invasive Bladder Cancer.

Bladder cancer is the most common urinary tract neoplasm, affecting many people annually. Current diagnostic and surveillance methods for bladder cancer are frequently invasive and lack sensitivity and specificity. This study aimed to develop an accurate and non-invasive urine-based gene expression assay, including fibroblast growth factor receptor 3 (FGFR3), homeobox A13 (HOXA13), and polo-like kinase 1 (PLK1), to diagnose non-muscle-invasive bladder cancer (NMIBC) at stages Ta and T1. The samples were acquired from 62 patients with NMIBC, 31 control individuals, and 31 patients with non-cancerous genitourinary tract diseases. The expression levels of three relevant genes were determined using quantitative RT-PCR. In addition, the sensitivity and specificity of the data for these genes were computed. Our results showed that PLK1, HOXA13, and FGFR3 expressions of genes were significantly elevated in patients compared to the control groups (p = 0.0001; p = 0.039). The sensitivity and specificity for the FGFR3 gene were 55% and 76%, respectively (p = 0.39). These parameters for HOXA13 were 100% and 93% (p = 0.0001) and for PLK1 were 100% and 86% (p = 0.0001) for diagnosing and monitoring NMIBC. HOXA13 and PLK 1 exhibited adequate specificity and sensitivity for diagnosis. The results of this research showed that despite the higher expression of these genes in urine, only HOXA13 and PLK1 had sufficient and proper specificity and sensitivity, so the urinary expression of these two genes can be used in future studies for diagnosis and monitoring in cancer bladder.

Single-port robotic-assisted laparoscopic synchronous surgery in pediatric patent processus vaginalis

PurposePatent processus vaginalis (PPV) is usually observed in pediatric abdominal surgery; however, robotic single-port surgery in repairing processus vaginalis has not been reported in children. Herein, we present our clinical experiences in single-port robotic surgeries for PPV repair to evaluate both efficacy and safety.MethodsRetrospective analysis of patients underwent single-port robotic-assisted laparoscopic surgery for genitourinary diseases from May 2020 and May 2023 in our center. Among these patients, 21 children had PPV repaired at the same time. The case characteristics and follow-up data were recorded.ResultsTwenty-one of the 53 children were found to have PPV during genitourinary surgery. The simultaneous treatment of the primary disease and PPV with a single-port robotic-assisted platform was both convenient and safe. There was no significant increase in total operation time, and no excessive intraoperative hemorrhage was observed in any of the operations. There were no complications observed on follow-up.ConclusionWith a high incidence of PPV in children, a single-port robotic-assisted procedure is feasible and effective if simultaneously performed when addressing a primary abdominal disease.

Abstract 4968: Discovery of cancer-associated factors in 293.5 million diagnosis records using statistical machine learning analysis

Abstract Cancer, a leading global public health issue, ranks as the second leading cause of death in the United States, with projections indicating 1,958,310 new cases and 609,820 deaths in 2023. Accurately quantifying specific pre-disease diagnosis factors associated with cancer, as well as predicting cancer through disease trajectories and imaging modalities, presents a complex and formidable challenge. A comprehensive temporal trajectory analysis of cancer diseases, using disease trajectories as an insight within large cohorts in the USA, has not yet been developed. Our analysis used a comprehensive EHR dataset stretching back to 1999, encompassing 293,501,891 records and involving 3,019,978 patients within Ochsner Health, a large integrated health system across the State of Louisiana. According to our investigation, those diagnosed at the ICD chapter level with diseases of the genitourinary system (genitourinary diseases, ICD-10 Chapter 14, relative risk (RR=1.65)) or endocrine nutritional and metabolic diseases (obesity, ICD-10 Chapter 4, RR=1.35) have an elevated risk of being diagnosed with cancer in the subsequent five years. The top four individual diagnosis ICD-10 codes associated with increased risk are N60 (Benign Mammary dysplasia, RR=7.80), M34 (Systemic sclerosis, RR=7.72), R43 (Disturbances of smell and taste, RR=6.93), and R92 (Abnormal and inconclusive findings on diagnostic imaging of the breast, RR=6.59). Furthermore, in our investigation of specific types of cancer risk across 17 cancer types (Breast, Skin, Prostate, Lung, Pancreatic, etc.), we observed that the most common diseases associated with breast and skin cancer involved immune mechanisms (RR=8.35 and 8.68), genitourinary issues (RR=4.13 and 2.48), obesity (RR=3.42 , 3.35), and cardiovascular conditions (ICD-10 Chapter 9, RR=1.73 and 2.19). For prostate cancer, associations were found with obesity (RR=3.50), human immunodeficiency virus (HIV, ICD-10 Chapter 1, RR=2.39). Across lung cancer, involvement with chronic viral hepatitis (ICD-10 Chapter 1, RR=4.00), cardiovascular issues (RR=3.52), genitourinary problems (RR=4.13), and obesity (RR=3.42) were indicated. Our comprehensive analysis has the potential to contribute to the early detection, diagnosis trajectories, and improved understanding of the pathological processes underlying cancer in patients worldwide. Citation Format: Md Ashad Alam, Nick Duesbery, Daniel Daniel Fort. Discovery of cancer-associated factors in 293.5 million diagnosis records using statistical machine learning analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4968.

The Finnish Adoptive Family Study of Schizophrenia: differences in somatic diseases and conditions between adoptees with high or low genetic risk for schizophrenia spectrum disorders

Background and aims There is some evidence that offspring of patients with schizophrenia have higher somatic morbidity, which is thought to be partially due to genetic links between somatic disorders and schizophrenia. This study explored differences in somatic diseases and conditions of adoptees with high genetic risk (HR) or low genetic risk (LR) for schizophrenia spectrum disorders. Material and methods The study is part of the Finnish Adoptive Family Study of Schizophrenia. The adoptive research design used made it possible to examine how the somatic health of adoptees raised in similar adoptive families, is affected by their genetic susceptibility to schizophrenia. The study sample consisted of 373 adoptees, of whom 190 had HR and 183 had LR for schizophrenia spectrum disorders. Data on somatic morbidity were gathered from the hospital records and from the national registers of the Care Register of Health Care and the Social Insurance Institution. Results The only statistically significant difference found was in genitourinary diseases, the likelihood being twofold higher in HR adoptees compared to LR adoptees (16.8% vs. 8.2%; adj. OR = 2.13, 95% CI 1.06–4.25, p = .033). Adoptees who were female and aged over 40 had a higher prevalence of genitourinary illnesses than non-adoptees. Conclusion The significant prevalence of genitourinary diseases in adoptees at risk for schizophrenia spectrum disorders suggests that some specific somatic diseases and schizophrenia may have a shared hereditary etiology. More research is required for specific somatic diseases in study populations that can differentiate between the effects of genetic and environmental factors.