Muscle invasive bladder cancer in Upper Egypt: the shift in risk factors and tumor characteristics

<p>Abstract</p> <p>Background</p> <p>In Egypt, where bilharziasis is endemic, bladder cancer is the commonest cancer in males and the 2^ndin females; squamous cell carcinoma (SCC) is the commonest type found, with a peculiar mode of presentation. The aim of this study is to identify and rank the risk factors of muscle invasive bladder cancer (MIBC) in Upper Egypt and describe its specific criteria of presentation and histopathology.</p> <p>Methods</p> <p>This is an analytical, hospital based, case controlled study conducted in south Egypt cancer institute through comparing MIBC cases (n = 130) with age, sex and residence matched controls (n = 260) for the presence of risk factors of MIBC. Data was collected by personal interview using a well designed questionnaire. Patients' records were reviewed for histopathology and Radiologic findings.</p> <p>Results</p> <p>The risk factors of MIBC were positive family history [Adjusted odds ratio (AOR) = 7.7], exposure to pesticides [AOR = 6.2], bladder stones [AOR = 5], consanguinity [AOR = 3.9], recurrent cystitis [AOR = 3.1], bilharziasis [odds ratio (OR) = 5.8] and smoking [OR = 5.3]. SCC represented 67.6% of cases with burning micturition being the presenting symptom in 73.8%.</p> <p>Conclusion</p> <p>MIBC in Upper Egypt is usually of the SCC type (although its percentage is decreasing), occurs at a younger age and presents with burning micturition rather than hematuria. Unlike the common belief, positive family history, parents' consanguinity, exposure to pesticides and chronic cystitis seem to play now more important roles than bilharziasis and smoking in the development of this disease in this area.</p

Plant-water relationships in the Great Basin Desert of North America derived from Pinus monophylla hourly dendrometer records

Water is the main limiting resource for natural and human systems, but the effect of hydroclimatic variability on woody species in water-limited environments at sub-monthly time scales is not fully understood. Plant-water relationships of single-leaf pinyon pine (Pinus monophylla) were investigated using hourly dendrometer and environmental data from May 2006 to October 2011 in the Great Basin Desert, one of the driest regions of North America. Average radial stem increments showed an annual range of variation below 1.0 mm, with a monotonic steep increase from May to July that yielded a stem enlargement of about 0.5 mm. Stem shrinkage up to 0.2 mm occurred in late summer, followed by an abrupt expansion of up to 0.5 mm in the fall, at the arrival of the new water year precipitation. Subsequent winter shrinkage and enlargement were less than 0.3 mm each. Based on 4 years with continuous data, diel cycles varied in both timing and amplitude between months and years. Phase shifts in circadian stem changes were observed between the growing season and the dormant one, with stem size being linked to precipitation more than to other water-related indices, such as relative humidity or soil moisture. During May–October, the amplitude of the phases of stem contraction, expansion, and increment was positively related to their duration in a nonlinear fashion. Changes in precipitation regime, which affected the diel phases especially when lasting more than 5–6 h, could substantially influence the dynamics of water depletion and replenishment in single-leaf pinyon pine