BACKGROUND: Although gene expression profiling provided a comprehensive molecular characterization of different subtypes of bladder urothelial carcinoma (UC), which are distinct in their biological features and prognosis, such a system is not yet applicable for routine clinical practice. This study aimed to examine the expression of these molecular classes of UC using simple panel of immunohistochemical markers. MATERIALS AND METHODS: Tissue sections from 192 specimens of UC were stained with FGFR3, CK5, CCNB1, HER-2, and P53. The molecular classes identified were correlated with clinicopathologic characteristics and patient survival. RESULTS: The most frequent class in our cohort was urobasal B (UroB) (44.1%), followed by squamous cell carcinoma-like (SCCL) (22%), genomically unstable (GU) (20.3%), and urobasal A (UroA) (13.6%). Patients with SCCL were significantly younger (P .0001). Both the SCCL and GU types were of significantly higher histopathologic grade (P .0001). UroA tumors were mainly of the T1 stage (75%), whereas 61.5% of the SCCL and 58.3% of the GU types were of stage T2 (P .001). Prognosis was significantly different among groups. The SCCL class showed the lowest overall survival (38.5%; P = .030) and metastasis-free survival (69.2%; P = .017). The best prognosis was for UroA, with an overall survival of 75% and no metastatic events. CONCLUSION: The distribution of UC subtypes in our study was uniquely different from other studies. This simple immunohistochemical panel could be suggested as a clinically applicable tool that has the potential to be used routinely in guiding individualized treatment of UC.

Background and aims: Clinicopathological features of Basal-like Breast Cancer (BLBC) in African American women have been extensively studied. Comparatively, less is known about these tumors in patients from countries in the North African region. The aim of this study was to assess the frequency and clinicopathological characteristics of BLBC in Egyptian patients with comparison to British patients. Material and methods: Tissue microarray blocks were constructed from primary invasive breast cancer from 321 Egyptian and 527 British BC patients. Sections were stained immunohistochemically with oestrogen receptor (ER), progesterone receptor (PR), HER2, CK19, CK14, EGFR, CK5/6, P53 and Ki67. BLBC phenotype was identified by lacking of staining of ER, PR, HER2 and positive staining for any of the CK14, CK5/6 and/or EGFR. Results: The rate of BLBC phenotype was higher in Egyptian cohort (21%) than the British cohort (13%). BLBC tumors from both Egyptian and British patients were significantly associated with tumors of higher histopathological grade (P0.001& P0.001), higher proliferation rate (P0.001& P=0.001), and higher rate of P53 expression (P0.001& P0.001) respectively. Compared with the British tumors, BLBC in Egyptian women were significantly of larger tumor size (P0.001) and were associated with more advanced lymph node (LN) stage (P0.001). Conclusion: BLBC occurred more frequently in Egyptian patients compared with British women and are characterized by unfavorable biological features akin to BLBC in African American women. These warrant further studies to unravel the genetic background of BLBC and whether their aggressive features are related to ethnic origin or other multi-factorial and environmental variables.

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Aging is a complex process and many factors in the elderly, especially multiple diseases and related unnecessary drug use, support a deprescription approach to this age group to save money and health cost. In this review, we have searched for studies related to the pharmacoeconomic aspect of this deprescription approach in the elderly. Few studies are available, but they are promising and effective in paving the way for prospective longitudinal studies to assess the role of deprescription in optimizing the drugs prescribed to aged patients in a way that reduces the costs of both drug adverse effects and/or hospitalization. Awareness of deprescription is important not only to society, but also to hospital stuff and individual patients.

Squamous cell carcinoma of the conjunctiva (SCC) is considered as one of the ocular surface squamous neoplasia (OSSN). It is the most common conjunctival malignancy. In this report, we describe the short term success of surgical excision, followed by topical chemotherapy, with 5-fluorouracil (5-FU) and mitomycin C (MMC) eye drops, in a 43-year old Egyptian woman.

Squamous cell carcinoma of the conjunctiva (SCC) is considered as one of the ocular surface squamous neoplasia (OSSN). It is the most common conjunctival malignancy. In this report, we describe the short term success of surgical excision, followed by topical chemotherapy, with 5-fluorouracil (5-FU) and mitomycin C (MMC) eye drops, in a 43-year old Egyptian woman.

Squamous cell carcinoma of the conjunctiva (SCC) is considered as one of the ocular surface squamous neoplasia (OSSN). It is the most common conjunctival malignancy. In this report, we describe the short term success of surgical excision, followed by topical chemotherapy, with 5-fluorouracil (5-FU) and mitomycin C (MMC) eye drops, in a 43-year old Egyptian woman.

Purpose: This study determined the clinical impact and causes of loss to follow-up (LTFU) from the patients’ perspective in individuals with proliferative diabetic retinopathy (PDR) who received panretinal photocoagulation (PRP) and/or intravitreal injections (IVIs) of anti-vascular endothelial growth factor (VEGF). Methods: This prospective cohort study included 467 patients with PDR who received PRP and/or IVIs of anti-VEGF between May 2013 and June 2018. LTFU was defined as missing any follow-up visit for any interval exceeding 6 months, provided that patients eventually resumed care. Main outcome measures include rates and causes of LTFU. Results: A total of 391 patients (83.7%) were followed, and 76 patients (16.3%) were LTFU over the study period. Rates of LTFU decreased with age (P = 0.005). Questionnaire analysis conducted for patients LTFU showed a significant positive correlation between best corrected visual activity (BCVA) loss and patient’s lack of trust and satisfaction with treatment [rs = 0.458, P 0.001]. There was also a significant positive correlation between treatment unaffordability and number of IVIs of anti-VEGF [rs = 0.55, P 0.001] and lack of social support and age [rs = 0.39, P 0.001]. Conclusions: LTFU threatens vision in PDR patients receiving PRP and/or IVIs of anti-VEGF. Possibly, patient-specific LTFU causes should be addressed before treatment in order to minimize the risk of LTFU.