Urology Commons^™

Racial/Ethnic Disparities In Survival Among Men Diagnosed With Prostate Cancer In Texas, Arica L. White, Ann L. Coker, Xianglin L. Du, Katherine S. Eggleston, Melanie Williams

CRVAW Faculty Journal Articles

BACKGROUND:

To the authors' knowledge, few studies to date have examined racial differences in prostate cancer survival while controlling for socioeconomic status (SES). No such studies have examined this association in Texas, a large state with significant ethnic and racial diversity. The objective of this analysis was to determine whether racial disparities in survival for men diagnosed with prostate cancer in Texas from 1995 through 2002 remained after adjusting for SES, rural residence, and stage of disease.

METHODS:

A cohort of 87,449 men who were diagnosed with prostate cancer was identified from the Texas Cancer Registry. The SES measure was …

Understanding The Context Of Balanced Scorecard Implementation: A Hospital-Based Case Study In Pakistan., F Rabbani, Sabrina Nh Lalji, Farhat Abbas, Sm Wasim Jafri, Junaid A. Razzak, Naheed Nabi, Firdous Jahan, Agha Ajmal, Max Petzold, Mats Brommels, Goran Tomson

Section of Urology

Background: As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods: Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs …

Triggers Of Blood Transfusion In Percutaneous Nephrolithotomy, Ali Akbar Zehri, Syed Raziuddin Biyabani, Khurram Muthair Siddiqui, Amanullah Memon

Section of Urology

Objective: To determine the triggers of blood transfusion in patients undergoing percutaneous nephrolithotomy (PCNL).
Study Design: Observational study.
Place and Duration of Study: The Aga Khan University Hospital, Karachi, from 1988 to 2007.
Methodology: The percutaneous surgery database was retrospectively reviewed to identify patients with postoperative haemorrhage and need for blood transfusion. Blood loss was estimated by the postoperative drop in haemoglobin factored by the quantity of any blood transfusion. Various patients and procedure-related factors were assessed for association with total blood loss or blood transfusion requirement using stepwise univariate, forward multivariate regression analysis.
Results: A total of 326 procedures …

Urological Involvement In Renal Transplantation., Daniel D Sackett, Pooja Singh, Costas D Lallas

Department of Urology Faculty Papers

Historically, urologists were the primary surgeons in renal transplantation. Specialization and increased complexity of the field of transplantation, coupled with a de-emphasis of vascular surgical training in urology, has created a situation where many renal transplants are carried out by surgeons with a general surgery background. Because of its genitourinary nature, however, urological input in renal transplantation is still vital. For living donors, a urologist should be involved to help evaluate and prepare certain patients for eventual donation. This could involve both medical and surgical intervention. Additionally, urologists who carry out living donor nephrectomy maintain a sense of ownership in …

The Minimally Invasive Management Of Ureteropelvic Junction Obstruction In Horseshoe Kidneys, Costas D. Lallas, M.D., Facs, Raymond W. Pak, M.D., Christopher Pagnani, M.D., Scott G. Hubosky, M.D., Brent V. Yanke, M.D., Frank X. Keeley, M.D, Demetrius H. Bagley, M.D., Facs

Department of Urology Faculty Papers

Purpose: Data regarding the treatment of ureteropelvic junction obstruction (UPJO) in horseshoe kidneys are limited. We performed a retrospective analysis of our experience with minimally invasive treatment of UPJO in patients with this anomaly. Methods: Between March of 1996 and March 2008, 9 patients with horseshoe kidneys were treated for UPJO at our institution. Of these patients, 6 were managed with retrograde endopyelotomy, 2 with laparoscopic pyeloplasty, and one by robotic pyeloplasty. Outcomes of these procedures were retrospectively reviewed. Results: A total of nine patients were available for analysis. Four of six patients who underwent endopyelotomy had available follow-up, with …

The Mechanosensory Role Of Primary Cilia In Vascular Hypertension, Surya M. Nauli, Xingjian Jin, Beerend P. Hierck

Pharmacy Faculty Articles and Research

Local regulation of vascular tone plays an important role in cardiovascular control of blood pressure. Aside from chemical or hormonal regulations, this local homeostasis is highly regulated by fluid-shear stress. It was previously unclear how vascular endothelial cells were able to sense fluid-shear stress. The cellular functions of mechanosensory cilia within vascular system have emerged recently. In particular, hypertension is insidious and remains a continuous problem that evolves during the course of polycystic kidney disease (PKD). The basic and clinical perspectives on primary cilia are discussed with regard to the pathogenesis of hypertension in PKD.

Laparo-Endoscopic Single Site Retroperitoneal Partial Nephrectomy: A Novel Concept, Alejandro R. Rodriguez, Tariq Hakky, Philippe E. Spiess

Urology Faculty Publications

Purpose: Various treatment options are available for small incidentally detected kidney masses, including surveillance, partial nephrectomy and probe ablative therapies. When partial nephrectomy is considered, the procedure can be safely approached laparoscopically, either pure or robot assisted, in experienced hands. Laparo-endoscopic single site (LESS) surgery is a novel approach for partial nephrectomies in well selected cases. In this video, we present our experience with the LESS retroperitoneal partial nephrectomy using the Gelpoint device.

Material and Methods: A 63 year old male patient with a BMI of 31, and a history of a T1c prostate cancer, had a 1.5 cm right …

Validation Of Updated Partin’S Table In Pakistani Patients Undergoing Radical Prostatectomy For Prostate Cancer, Nazim Muhammad, Farhat Abbas, Nuzhat Faruqui, Muhammad Islam, Zubair Ahmad

Section of Urology

Objectives: To establish the usefulness and validity of 2007 Partin’s table in our population with prostate cancer.
Materials and methods: Between January 1998 to June 2009, all patients with clinically localized carcinoma prostate who were treated with intent of radical retro-pubic prostatectomy (RRP) were included. Clinical, operative and pathological data was gathered. All biopsy and final histopathology Gleason scores were re-assigned in a double blind manner. Pre-operative serum PSA, TNM clinical stage and biopsy Gleason scores were plotted on Partin’s table and its predictive value and pathological findings of specimen were compared and analyzed by using Receiver operating characteristic …

The History Of Urological Care And Training At Thomas Jefferson University, Max Koppel, Md, Patrick J. Shenot, Md, Dolores Bryne, Phd, Leonard G. Gomella, Md

Department of Urology Faculty Papers

The Department of Urology at Thomas Jefferson University and Thomas Jefferson University Hospital is generally acknowledged as the oldest formal Department of Urology in the US, formally designated as the Department of Genitourinary Surgery in 1904. The Department has been under the direction of 8 chairmen and has trained over 144 residents and 25 fellows with over 200 Jefferson Medical College graduates specializing in urology. Thomas Jefferson University was originally founded as Jefferson Medical College in 1824. Dr. George McClelland petitioned Jefferson College at Cannonsburg (now Washington and Jefferson College) to add a medical school to their institution. While technically …

Is There An Optimal Management For Localized Prostate Cancer?, Jaspreet Singh, Edouard J. Trabulsi, Leonard G. Gomella

Department of Urology Faculty Papers

Widespread screening with prostate-specific antigen (PSA) has led to a significant increase in the detection of early stage, clinically localized prostate cancer (CaP). Various treatment options for localized CaP are discussed in this review article including active surveillance, radical prostatectomy, radiation therapy, and cryotherapy. The paucity of high-level evidence adds a considerable amount of controversy when choosing the "optimal" intervention, for both the treating physician and the patient. The long time course of CaP intervention outcomes, combined with continuing modifications in treatments, further complicate the matter. Lacking randomized trials that compare treatment options, this review article attempts to summarize the …

Editorial Comment From Dr Lallas To Robotic-Assisted Laparoscopic Radical Prostatectomy: Learning Curve Of First 100 Cases., Costas Lallas

Department of Urology Faculty Papers

Editorial comment.

Is There An Optimal Management For Localized Prostate Cancer?, Jaspreet Singh, Edouard J. Trabulsi, Leonard G. Gomella

Department of Urology Faculty Papers

Widespread screening with prostate-specific antigen (PSA) has led to a significant increase in the detection of early stage, clinically localized prostate cancer (CaP). Various ­treatment options for localized CaP are discussed in this review article including active ­surveillance, radical prostatectomy, radiation therapy, and cyrotherapy. The paucity of high-level evidence adds a considerable amount of controversy when choosing the “optimal” ­intervention, for both the treating physician and the patient. The long time course of CaP intervention outcomes, combined with continuing modifications in treatments, further complicate the ­matter. Lacking randomized trials that compare treatment options, this review article attempts to summarize the …

Modification And Implementation Of Nccn Guidelines On Prostate Cancer In The Middle East And North Africa Region., Waleed A. Hassen, Farrok A. Karsan, Farhat Abbas

Department of Surgery Docs

Abstract

A prostate cancer committee was established to modify the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) on Prostate Cancer for adaptation and implementation in the Middle East and North Africa (MENA) region. The objective was to enhance the multidisciplinary approach to the treatment of prostate cancer. The committee, comprising regional experts in the fields of urologic, medical, and radiation oncology, reviewed the 2009 version of the NCCN Guidelines on Prostate Cancer and suggested modifications based on the unique needs of the regions determined through published evidence and local expertise. The committee identified several areas in the NCCN Guidelines …

The Quality-Of-Life Impact Of Prostate Cancer Treatments., Jaspreet Singh, Edouard J. Trabulsi, Leonard G. Gomella

Department of Urology Faculty Papers

Many options exist for the treatment of localized prostate cancer. In the decision to choose a therapeutic option for localized disease, many variables need to be considered such as tumor characteristics, clinical stage, the patient's overall health and life expectancy, and preferences of both the physician and patient. Another important consideration is the health-related quality of life (HRQOL) implications of a given treatment option. The importance of HRQOL relative to the potential side effects of prostate cancer treatments has grown over the past few years. Although our collective awareness has increased, objective data on HRQOL for prostate cancer treatment are …

The Effect Of Culture On Urinary Incontinence: Do We Really Understand?, Karen A. Karlowicz

Ellmer School of Nursing Faculty Publications

No abstract provided.

Radical Nephrectomy With Ivc Thrombectomy (Level-Iii) Conducted On Veno-Veno Bypass, Tariq S. Hakky, Lucas R. Wiegand, Devannand Mangar, Angel Alsina, Philippe E. Spiess

Urology Faculty Publications

Introduction: We report a 43 year old man who was diagnosed with a level-I thrombus and was managed on oral sunitinib for two months by a community Urologist. The thrombus progressed to a level-III and he subsequently developed a pulmonary embolus, which required oral anticoagulation. He was then referred to our facility for definitive surgical care. A computed tomography scan demonstrated a 12 by 15 centimeter right renal mass and on magnetic resonance venography of the abdomen a tumor-thrombus extending into the infradiaphragmatic inferior vena cava was noted. Pre-operatively consults with hepatobiliary, vascular, and chest surgeons were obtained.

Methods: The …

Prostate Cancer Region Prediction Using Maldi Mass Spectra, Ayyappa Vadlamudi, Shao-Hui Chuang, Xiaoyan Sun, Lisa Cazares, Julius Nyalwidhe, Dean Troyer, O. John Semmes, Jiang Li, Frederic D. Mckenzie

Electrical & Computer Engineering Faculty Publications

For the early detection of prostate cancer, the analysis of the Prostate-specific antigen (PSA) in serum is currently the most popular approach. However, previous studies show that 15% of men have prostate cancer even their PSA concentrations are low. MALDI Mass Spectrometry (MS) proves to be a better technology to discover molecular tools for early cancer detection. The molecular tools or peptides are termed as biomarkers. Using MALDI MS data from prostate tissue samples, prostate cancer biomarkers can be identified by searching for molecular or molecular combination that can differentiate cancer tissue regions from normal ones. Cancer tissue regions are …