We recommend cystoscopy and urine cytology for faecal material as the first-line investigations in all patients with a suspected enterovesical fistulae. CT scanning and barium enema should not be first line investigations but may be performed subsequently to help determine the aetiology and planning of surgery.

Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to Coronavirus disease 2019 (COVID-19) due to age, disease, and treatment-related immunosuppression. We aimed to assess risk factors of outcome and elucidate the impact of CLL-directed treatments on the course of COVID-19. We conducted a retrospective, international study, collectively including 941 patients with CLL and confirmed COVID-19. Data from the beginning of the pandemic until March 16, 2021, were collected from 91 centers. The risk factors of case fatality rate (CFR), disease severity, and overall survival (OS) were investigated. OS analysis was restricted to patients with severe COVID-19 (definition: hospitalization with need of oxygen or admission into an intensive care unit). CFR in patients with severe COVID-19 was 38.4%. OS was inferior for patients in all treatment categories compared to untreated (p < 0.001). Untreated patients had a lower risk of death (HR = 0.54, 95% CI:0.41–0.72). The risk of death was higher for older patients and those suffering from cardiac failure (HR = 1.03, 95% CI:1.02–1.04; HR = 1.79, 95% CI:1.04–3.07, respectively). Age, CLL-directed treatment, and cardiac failure were significant risk factors of OS. Untreated patients had a better chance of survival than those on treatment or recently treated.

IRC3 is a recurrently mutated gene in chronic lymphocytic leukemia (CLL) but the functional implications of BIRC3 mutations are largely unexplored. Furthermore, little is known about the prognostic impact of BIRC3 mutations in CLL cohorts homogeneously treated with first-line fludarabine, cyclophosphamide, and rituximab (FCR). By immunoblotting analysis, we showed that the non-canonical nuclear factor-κB pathway is active in BIRC3-mutated cell lines and in primary CLL samples, as documented by the stabilization of MAP3K14 and by the nuclear localization of p52. In addition, BIRC3-mutated primary CLL cells are less sensitive to fludarabine. In order to confirm in patients that BIRC3 mutations confer resistance to fludarabine-based chemoimmunotherapy, a retrospective multicenter cohort of 287 untreated patients receiving first-line FCR was analyzed

The clinical and physiological results in 13 patients having a colonic J reservoir-anal anastomosis (CR) and 15 consecutive patients having a straight colo-anal reconstruction (SC) have been compared. The groups were matched for age, sex, level of tumour and proximal and distal resection margins. The incidence of postoperative complications was similar in each group. The mean follow-up in CR patients was 7 +/- 4 months and 47 +/- 23 months in SC patients. Stool frequency per 24 h was less than or equal to 2 in all CR patients while it was greater than 2 in 40 per cent of the SC patients (P less than 0.05). Three CR patients and six SC patients had minor incontinence, all but one of the rest were fully continent. One patient had a major leak. There was no significant difference in mean resting anal voluntary contraction pressure in the two groups, with mean values within the normal range. The mean rectal sensitivity threshold volume in CR patients (83 +/- 30 ml) and SC patients (52 +/- 22 ml) was significantly different (P less than 0.05) as was the mean maximum tolerable volume (317 +/- 122 ml and 174 +/- 83 ml respectively, P less than 0.01). There was no significant difference in balloon expulsion testing, defaecating proctography or methyl cellulose evacuation in the two groups. The addition of a colonic reservoir appears to avoid the high stool frequency occurring in some patients after straight colo-anal anastomosis.