Urology Commons^™

Evaluating The Baseline Hemoglobin, Albumin, Lymphocyte, And Platelet (Halp) Score In The United States Adult Population And Comorbidities: An Analysis Of The Nhanes, Ryan Antar, Christian Farag, Vincent Xu, Arthur Drouaud, Olivia Gordon, Michael J. Whalen

Urology Faculty Publications

Introduction: As a composite immunonutritional biomarker, the Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score has shown promise in assessing a patient's overall health status by integrating several routinely collected laboratory indicators. This biomarker has been examined in many different populations of patients and disease states (i.e., cancer), but an integrated, universal rubric using standardized thresholds has not thus far been developed. Pre-existing large population-based databases represent an ideal source to examine the distribution of HALP and the influence of diverse health statuses on this score.

Methods: We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey …

Post Traumatic Internal Iliac Arteriovenous Fistula Presenting With Persistent Gross Hematuria., Amanda Smart, Michael Wynne, Daniel Stein

Urology Faculty Publications

No abstract provided.

Atypical Presentation Of Obstructed Hemivagina And Ipsilateral Renal Anomaly, Christopher Grant, Christopher E. Bayne, N. Kern, Craig A. Peters

Urology Faculty Publications

Herlyn-Werner-Wunderlich Syndrome, otherwise known as obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), is a rare Müllerian anomalyconsisting of uterine didelphys, hemivaginal septum, and ipsilateral renal agenesis. Patients often present at the onset of menarche with abdominal pain and a pelvic mass from an obstructed hemivagina. We report a child who presented with a febrile urinary tract infection and upon further workup was found to have OHVIRA.

Urinary Tract Infection In Children With Spina Bifida And Spinal Cord Injury., Obumneke Amadi, Harolyn Belcher

GW Research Days 2016 - 2020

Introduction: Urinary tract infections (UTI) are one of the most common bacterial infections (Schappert & Rechtsteiner, 2008; Litwin et al., 2005). Data from the National Ambulatory Medical Care Survey estimated that UTI caused 8.1 million physicians visits (Schappert & Rechtsteiner, 2008). Children with spina bifida (SB) and spinal cord injury (SCI) are at high risk for UTI (Ouyang et al., 2010; Nair et al., 2005). The purpose of this study was to examine the organisms associated with UTI in the population of children with SB and SCI who were treated in out-patient and in-patient settings at the Kennedy Krieger …

An Enduring Legacy Of Discovery: Margaret Stirewalt., Lucie Henein, James J Cody, Michael H Hsieh

Urology Faculty Publications

No abstract provided.

Dysuria: An Uncommon Presentation In Emergency Department Following Bladder Neck Disruption., Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell

Emergency Medicine Faculty Publications

Prostate cancer is the most common life-threatening cancer diagnosed in men. Complications of prostatectomies vary and often include urinary incontinence, erectile dysfunction and pain, while other complications go unreported. While emergency physicians are already familiar with the more common post-operative complications presenting to their departments, including urinary retention, ileus, surgical site infections, venous thromboembolisms and urinary tract infections, they must have a high index of suspicion for rarer complications. We report a case of posterior bladder neck disruption as a complication of a robotic assisted laparoscopic prostatectomy that presented to the emergency department as dysuria and abdominal pain following urination.

Metastatic Melanoma To The Bladder: Case Report And Review Of The Literature., Rohit V. Patil, Solomon L Woldu, Elena Lucas, Andrew M Quinn, Franto Francis, Vitaly Margulis

Urology Faculty Publications

A 49-year-old Caucasian woman presented to the dermatology clinic for follow-up of malignant melanoma with a complaint of painless gross hematuria. Two years prior she was diagnosed with malignant melanoma from a skin lesion on her left flank treated with wide excision, negative axillary sentinel lymph node biopsy, and adjuvant radiotherapy. Subsequently, she had no evidence of disease until urologic evaluation of her hematuria revealed two lesions in her bladder and cytopathology demonstrated findings consistent with malignant melanoma. We review literature on melanoma metastatic to the bladder and discuss the potential role of metastasectomy and other treatment strategies in such …

H-Ipse Is A Pathogen-Secreted Host Nucleus Infiltrating Protein (Infiltrin) 3 Expressed Exclusively By The Schistosoma Haematobium Egg Stage, Luke Pennington, Abdulaziz Alouffi, Evaristus Mbanefo, Debalina Ray, David Heery, Theodore Jardetzky, Michael Hsieh, Franco Falcone

Urology Faculty Publications

Urogenital schistosomiasis, caused by the parasitic trematode Schistosoma haematobium, affects over 112 million people worldwide. As with S. mansoniinfections, the pathology in urogenital schistosomiasis is mainly related to the egg stage, which induces granulomatous inflammation of affected tissues. Schistosoma eggs and their secretions have been studied extensively for the related S. mansoniorganism which is more amenable to laboratory studies. Indeed, we have shown that IPSE/alpha-1 (M-IPSE herein), a major protein secreted from S .mansoni eggs, can infiltrate host cells. Although M-IPSE function is unknown, its ability to translocate to their nucleus and bind DNA suggests a possible …

Press-Pulse: A Novel Therapeutic Strategy For The Metabolic Management Of Cancer, Thomas Seyfried, George Yu, Joseph Maroon, Dominic D'Agostino

Urology Faculty Publications

Background

A shift from respiration to fermentation is a common metabolic hallmark of cancer cells. As a result, glucose and glutamine become the prime fuels for driving the dysregulated growth of tumors. The simultaneous occurrence of “Press-Pulse” disturbances was considered the mechanism responsible for reduction of organic populations during prior evolutionary epochs. Press disturbances produce chronic stress, while pulse disturbances produce acute stress on populations. It was only when both disturbances coincide that population reduction occurred.

Methods

This general concept can be applied to the management of cancer by creating chronic metabolic stresses on tumor cell energy metabolism (press disturbance) …

The Nih-Niaid Schistosomiasis Resource Center At The Biomedical Research Institute: Molecular Redux., James J Cody, Wannaporn Ittiprasert, André N Miller, Lucie Henein, Margaret M Mentink-Kane, Michael H. Hsieh

Urology Faculty Publications

Schistosomiasis remains a health burden in many parts of the world. The complex life cycle of Schistosoma parasites and the economic and societal conditions present in endemic areas make the prospect of eradication unlikely in the foreseeable future. Continued and vigorous research efforts must therefore be directed at this disease, particularly since only a single World Health Organization (WHO)-approved drug is available for treatment. The National Institutes of Health (NIH)-National Institute of Allergy and Infectious Diseases (NIAID) Schistosomiasis Resource Center (SRC) at the Biomedical Research Institute provides investigators with the critical raw materials needed to carry out this important research. …

Global Assessment Of Schistosomiasis Control Over The Past Century Shows Targeting The Snail Intermediate Host Works Best., Susanne H Sokolow, Chelsea L Wood, Isabel J Jones, Scott J Swartz, Melina Lopez, Michael H. Hsieh, Kevin D Lafferty, Armand M Kuris, Chloe Rickards, Giulio A De Leo

Urology Faculty Publications

BACKGROUND: Despite control efforts, human schistosomiasis remains prevalent throughout Africa, Asia, and South America. The global schistosomiasis burden has changed little since the new anthelmintic drug, praziquantel, promised widespread control.

METHODOLOGY: We evaluated large-scale schistosomiasis control attempts over the past century and across the globe by identifying factors that predict control program success: snail control (e.g., molluscicides or biological control), mass drug administrations (MDA) with praziquantel, or a combined strategy using both. For data, we compiled historical information on control tactics and their quantitative outcomes for all 83 countries and territories in which: (i) schistosomiasis was allegedly endemic during the …

Anuria Secondary To Bilateral Obstructing Ureteral Stones In The Absence Of Renal Colic., Carolyn A Salter, Christopher Lang, Hernan O Altamar

Emergency Medicine Faculty Publications

BACKGROUND: Obstructing ureteral stones are a rare cause of anuria, which is typically from prerenal or renal etiologies. Classically, obstructive stones cause moderate to severe renal colic. Urolithiasis is rarely considered during evaluation of painless anuria.

CASE PRESENTATION: We present an unusual case of a 73-year-old Caucasian female who presented with anuria and was found to have large bilateral obstructing ureteral stones in the absence of renal colic.

CONCLUSION: Given that patients with obstructive anuria can be asymptomatic, urolithiasis should be considered in all patients presenting with anuria.

Smallpox And Dracunculiasis: The Scientific Value Of Infectious Diseases That Have Been Eradicated Or Targeted For Eradication. Is Schistosomiasis Next?, Michael H. Hsieh, Margaret M. Mentink-Kane

Urology Faculty Publications

No abstract provided.

Development Of A Biosensor-Based Rapid Urine Test For Detection Of Urogenital Schistosomiasis., Kathleen E Mach, Ruchika Mohan, Shailja Patel, Pak Kin Wong, Michael Hsieh, Joseph C Liao

Urology Faculty Publications

No abstract provided.

Alterations In Dna Methylation May Be The Key To Early Detection And Treatment Of Schistosomal Bladder Cancer, Simon L. Conti, Jared Honeycutt, Justin I. Odegaard, Mark L. Gonzalgo, Michael H. Hsieh

Urology Faculty Publications

No abstract provided.

Hepatitis B Vaccines And Hpv Vaccines Have Been Hailed As Major Public Health Achievements In Preventing Cancer--Could A Schistosomiasis Vaccine Be The Third?, Michael H. Hsieh, Julia M L Brotherton, Afzal A Siddiqui

Urology Faculty Publications

No abstract provided.

Antibiotic Prophylaxis And Reflux: Critical Review And Assessment, Bernarda Viteri Baquerizo, Craig A. Peters

Urology Faculty Publications

The use of continuous antibiotic prophylaxis (CAP) was critical in the evolution of vesicoureteral reflux (VUR) from a condition in which surgery was the standard of treatment to its becoming a medically managed condition. The efficacy of antibiotic prophylaxis in the management of VUR has been challenged in recent years, and significant confusion exists as to its clinical value. This review summarizes the critical factors in the history, use, and investigation of antibiotic prophylaxis in VUR. This review provides suggestions for assessing the potential clinical utility of prophylaxis.

Double Trouble: A Rare Case Of Bilateral Upper Pole Ureteropelvic Junction Obstruction, Craig A. Peters, Nirmal Pathak

Urology Faculty Publications

A 16-year-old girl presented with bilateral back pain caused by bilateral upper pole ureteropelvic junction obstructions; an extremely rare phenomenon. Bilateral robotically assisted upper pole pyeloplasties were preformed at the same setting with an excellent clinical response. Although rare, upper pole ureteropelvic junction obstruction is a defined entity that urologists should be aware of.

Do Not Judge A Kidney By Its Pelvis: A Rare Case Of An Unobstructed Dilated Renal Pelvis, Aaron D. Martin, Craig A. Peters

Urology Faculty Publications

We present a rare case of an unobstructed dilated renal pelvis in a newborn female. Prenatal imaging documented a large abdominal cyst in a stable fetus. Postnatal imaging confirmed persistence of this large cyst but with an unclear etiology. The child was taken to surgery by the pediatric surgeons with concern for a possible harmful nonurologic diagnosis. Intraoperative findings were that of a severely dilated renal pelvis; however, in the absence of an expected ureteropelvic junction obstruction. Reduction pyeloplasty without interference of the ureteropelvic junction proved successful.

Unclamped Hand-Assisted Laparoscopic Partial Nephrectomy For Predominantly Endophytic Renal Tumors, Jason D. Engel, Stephen B. Williams

Urology Faculty Publications

PURPOSE: To describe our initial experience with unclamped laparoscopic hand-assisted partial nephrectomy for predominantly endophytic renal masses in the setting of relative contraindication to warm ischemia.

MATERIALS AND METHODS: Unclamped laparoscopic hand-assisted partial nephrectomy was performed on eight consecutive patients from June 2009 to March 2010. All patients had predominantly endophytic renal masses with a preferential enhancing rim noted on the pre-operative computed tomography. The unclamped hand-assisted approach was utilized for no warm ischemia, minimal blood loss, and enhanced visualization of the tumor bed with improved operative exposure.

RESULTS: Mean age of the participants was 55.8 years. All patients underwent …

Androgen Receptor-Target Genes In Afircan American Prostate Cancer Disparities, Bi-Dar Wang, Qi Yang, Fernando Bianco, Ramez Andrawis, Thomas W. Jarrett, Harold A. Frazier, Steven R. Patierno, Norman H. Lee

Urology Faculty Publications

The incidence and mortality rates of prostate cancer (PCa) are higher in African American (AA) compared to Caucasian American (CA) men. To elucidate the molecular mechanisms underlying PCa disparities, we employed an integrative approach combining gene expression profiling and pathway and promoter analyses to investigate differential transcriptomes and deregulated signaling pathways in AA versus CA cancers. A comparison of AA and CA PCa specimens identified 1,188 differentially expressed genes. Interestingly, these transcriptional differences were overrepresented in signaling pathways that converged on the androgen receptor (AR), suggesting that the AR may be a unifying oncogenic theme in AA PCa. Gene promoter …

Integrated Next-Generation Sequencing Of 16s Rdna And Metaproteomics Differentiate The Healthy Urine Microbiome From Asymptomatic Bacteriuria In Neuropathic Bladder Associated With Spinal Cord Injury, Derrick E. Foutts, Rembert Pieper, Sebastian Szpakowski, Hans G. Pohl, Susan M. Knoblach, Moo-Jin Suh, Shih-Ting Huang, Inger Ljungberg, Bruce M. Sprague, Sarah K. Lucas, Manolito Torralba, Karen E. Nelson, Suzanne L. Groah

Urology Faculty Publications

Background

Clinical dogma is that healthy urine is sterile and the presence of bacteria with an inflammatory response is indicative of urinary tract infection (UTI). Asymptomatic bacteriuria (ABU) represents the state in which bacteria are present but the inflammatory response is negligible. Differentiating ABU from UTI is diagnostically challenging, but critical because overtreatment of ABU can perpetuate antimicrobial resistance while undertreatment of UTI can result in increased morbidity and mortality. In this study, we describe key characteristics of the healthy and ABU urine microbiomes utilizing 16S rRNA gene (16S rDNA) sequencing and metaproteomics, with the future goal of utilizing this …

Surgical Complications After Robot-Assisted Laparoscopic Radical Prostatectomy: The Initial 1000 Cases Stratified By The Clavien Classification System, Faisal Ahmed, Jonathan Rhee, Douglas Sutherland, Compton Benjamin, Jason D. Engel, Harold Frazier

Urology Faculty Publications

No abstract provided.