Introduction: There is a challenge on the medical efficacy of intravesical Bacillus Calmette-Guérin (BCG) therapy and the power of the immune system boosting, which can be influenced by the age of the non-muscle-invasive bladder cancer (NMIBC) patients. This meta-analysis evaluates the efficacy of BCG therapy among aged (>70) and younger patients with non-muscle-invasive bladder cancer (NMIBC). Methods: The central database of PubMed, Scopus, and Web of Science were queried until August 4, 2021, by using "BCG," "Bladder Cancer," "AGE," and "efficacy" keywords. After excluding duplicated results, titles and abstracts were evaluated by two independent reviewers. The exclusion criteria included non-English studies, conference abstracts, reviews, editorials, letters, and comments. Three main outcomes, disease-free survival (DFS), progression-free survival (PFS), and cancer-specific survival (CSS), were considered. The statistical analysis was performed using STATA (version 14; Stata Corp, College Station, Texas, USA). Results: From 1115 found documents, the 24 research articles were recruited in the systematic review, and 10 were the candidate for meta-analysis. The overall estimate of H.R. revealed that BCG therapy in those over age 70 is significantly associated with an improved risk of progression and cancer-specific death in studied patients. However, this association was not statistically significant for DFS (1.04 (95% CI: 0.85,1.26)). Conclusion: The BCG maintenance therapy improved CSS and PFS oncological outcomes in elderly patients with NMIBC. BCG therapy did not significantly change the DSF.

Shamshirgaran A, et al. Clin Exp Vaccine Res. 2025 Jan;14(1):44-50. https://doi.org/10.7774/cevr.2025.14.e2

Objective: This study aimed to evaluate the impact of the skin-to-stone distance in the supine and prone positions on the outcome of shockwave lithotripsy of kidney stones.Methods: In a prospective randomized clinical trial study, 81 patients that candidates for shockwave lithotripsy (SWL) of kidney stones were randomly divided into two groups to perform SWL in the prone position (40 patients) or conventional supine position (41 patients). Demographic data, stone characteristics, skin-to-stone distances (SSD) in CT, SSD during SWL with an ultrasound probe in prone and supine positions, total shock wave rate, total energy (kilovolt), visual analog scale (VAS), complications (Clavien-Dindo scale system), and SWL success rate evaluated in two intervention and control groups. All statistical analysis was performed by independent T-test, Chi-Square test, Fisher exact test, paired T-test, and SPSS 22.0 software for windows.Results: There were no significant differences between demographic characteristics, SWL sessions, the median number of SWLs, the median SWL time, median total energy, VAS, and complications in the two groups. The SFR was numerically higher in the prone SWL group than in the supine SWL group (80% vs. 73.2%) but was not significantly different (P = 0.468). Also, the inline ultrasound (US) measuring of the SSD in the prone position was significantly different from US SSD measures in the supine position in the two groups (Ps = 0.001 and 0.024). The mean SSD was lower in the US measurement during the SWL process that measured in supine and prone position than the CT measurement (73.5 vs. 101.1), which means the routine SSD measured by CT scan is higher than SSD in the US probe measurement during SWL.Conclusion: The prone position SWL modification could be effective in obese patients with a BMI of more than 30 and increase the stone-free rate (P=0.039) with a similar safety profile and comparable VAS score. It seems the SSD measured by the ultrasound is a more accurate dynamic measurement during the SWL and needs to define the SSD according to the SSD calculation by the US probe of the therapy head. SFR was numerically higher in the prone compared with the supine treatment groups

This case report presents a rare instance of synchronous adrenal ganglioneuroma and an ipsilateral retroperitoneal mass in a 51‐year‐old woman with episodic hypertensive crises and increased symptom frequency. Imaging revealed a hypodense mass near the right kidney and an additional adrenal mass, which led to surgical intervention. Laboratory findings indicated hypercortisolism, and both masses were surgically removed by the laparoscopy approach. Postoperative pathology identified both masses as maturing‐type ganglioneuroma, with no signs of malignancy or complications. This case highlights the diagnostic and therapeutic challenges of such rare presentations and emphasizes the importance of detailed imaging, surgical excision, and histopathological analysis. The potential link between elevated cortisol levels and ganglioneuroma, as observed here, underscores the need for further research into these benign tumors.