Bortezomib-releasing silica-collagen xerogels for local treatment of osteolytic bone- and minimal residual disease in multiple myeloma.

Background: Accumulation of malignant plasma cells in the bone marrow causes lytic bone lesions in 80% of multiple myeloma patients. Frequently fracturing, they are challenging to treat surgically. Myeloma cells surviving treatment in the presumably protective environment of bone lesions impede their healing by continued impact on bone turnover and can explain regular progression of patients without detectable minimal residual disease (MRD).

Comprehensive analysis of factors associated with significant blood loss during percutaneous nephrolithotomy.

Introduction: The objective of this study is to conduct a thorough investigation of the risk factors associated with blood loss during PCNL, within the setting of a US urban tertiary care center.

Materials And Methods: We conducted a retrospective analysis of our endourology database to identify adult patients who underwent PCNL for stone extraction at our tertiary stone center between October 2014 and December 2022. Patients were categorized into two groups based on the extent of blood loss: significant blood loss (SBL) and no significant blood loss (NSBL).

Reverse Trendelenburg Positioning Minimizes Stone Retropulsion During Ureteroscopic Laser Lithotripsy: A Prospective Randomized Study.

Retropulsion of stone fragments during ureteroscopic laser lithotripsy (URSLL) remains a challenge for urologists and is associated with increased operative time and reduced stone-free rate (SFR). In this study, we compared the rate of retropulsion of ureteral stones during URSLL between the standard dorsal lithotomy (SDL) position and dorsal lithotomy position with reverse Trendelenburg (RT). Patients with ureteral stones requiring surgical intervention between May 2019 and January 2022 were randomized to undergo URSLL in either SDL or RT positions.

The effects of continuing aspirin on blood loss and postoperative outcomes in percutaneous nephrolithotomy.

Background: Percutaneous nephrolithotomy (PCNL) is an effective surgery for complex kidney stones yet with inherent bleeding risks. It remains unclear whether aspirin should be discontinued prior to PCNL. We aimed to further substantiate the safety of continuing aspirin during PCNL surgery and to determine whether aspirin status affects postoperative outcomes following PCNL.

Mini-Incision Direct Festoon Access, Cauterization, and Excision (MIDFACE): A 12-Year Analysis of a Novel Festoon Surgery.

Background: Surgical festoon management often entails aggressive dissection, flaps, unsightly scars, prolonged recovery, and high recurrence rates. The authors present outcomes with subjective and objective evaluation of an office-based, novel, minimally invasive (1-cm incision) festoon repair: mini-incision direct festoon access, cauterization, and excision (MIDFACE).

Methods: Charts of 75 consecutive patients from 2007 to 2019 were evaluated.

Displacement of Lower Pole Stones During Retrograde Intrarenal Surgery Improves Stone-free Status: A Prospective Randomized Controlled Trial.

Purpose: Lower pole renal stones are associated with the lowest stone-free status of any location in the urinary tract during retrograde intrarenal surgery. Prior work has suggested displacing lower pole stones to a more accessible part of the kidney to improve stone-free status. We sought to prospectively compare the efficacy of laser lithotripsy in situ vs after displacement during retrograde intrarenal surgery for lower pole stones.

Care and Complexity in Emergency Housing: an Examination of the COVID-19 Shelter-in-Place (SIP) Hotel Program to House People Experiencing Homelessness in San Francisco.

In this study, we consider the patient, provider, and public health repercussions of San Francisco's (SF) COVID-related response to homelessness using tourist hotels to house people experiencing homelessness (PEH). We describe the demographics, medical comorbidities, and healthcare utilization patterns of a subset of PEH who accessed the shelter-in-place (SIP) hotel sites during the 2020-2021 pandemic. We focus on how SIP hotels impacted connection to outpatient care and higher-cost emergency utilization.

Quality of Information for Post-Prostatectomy Incontinence Treatments on YouTube.

Objective: To assess the quality of information on YouTube regarding post-prostatectomy incontinence treatments. The 2019 American Urological Association(AUA)/(SUFU) Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction guidelines recommend the placement of a male sling or artificial urinary sphincter. Patient education is essential for appropriate expectations and patient satisfaction.

Evaluation of entropy driven jet symmetry transitions.

Here we determine whether entropy drives planar turbulent jets into round turbulent jets. Determining when a jet flow transitions from one symmetry to the next is an important but incompletely resolved problem. The constructal view argues that the transition between symmetries of jet flows is governed by the minimization or maximization of entropy.

A prospective randomized study evaluating the necessity of narcotics following ureteroscopy for urinary stone disease.

Purpose: To evaluate the efficacy of non-narcotic analgesics and preoperative counseling in managing postoperative pain and narcotic use following ureteroscopic laser lithotripsy (URS).

Methods: Adult patients at a single academic center undergoing URS for nephrourolithiasis were recruited. After informed consent, subjects were randomized into three groups: NARC-15 tablets oxycodone-acetaminophen 5/325 mg (A-OXY), 2.

"Nobody Wants to Talk About It, Especially in This Building": A Qualitative Study of How People Living in Permanent Supportive Housing Approach End-Of-Life Care.

Permanent supportive housing (PSH) is long-term affordable housing with onsite social services. End-of-life care (EOLC) involves a discussion about the type of medical care an individual hopes to receive at the end of their life. This qualitative study examines the goals, desires, and expectations for EOLC for people living in PSH.

Long-Term Complications of Open and Robot-Assisted Laparoscopic Radical Prostatectomy in an Afro-Caribbean Population.

Background With the Afro-Caribbean population increasing in the United States, their complication profiles following open (ORP) and robot-assisted laparoscopic (RALP) radical prostatectomy warrants investigation. The purpose of this pilot study was to evaluate differences in long-term complications between ORP and RALP in Afro-Caribbeans. Methods A retrospective review of patients undergoing ORP or RALP between April 2010 and August 2019 at an academic medical center and county hospital was conducted.

Do Infection-Associated Stone Subtypes Behave the Same Clinically? A Retrospective Bicenter Study.

Infection-associated renal stones are commonly composed of magnesium-ammonium-phosphate (MAP) and carbonate apatite (CA). The clinical implications of these two different, but closely related stone types, are unknown. We sought to compare the clinical, microbiologic, and metabolic characteristics of patients with MAP and CA stone types.

Is metformin use associated with changes in urinary parameters in stone formers?

Introduction: Diabetes mellitus (DM) is associated with an increased risk of nephrolithiasis and is often treated with metformin. The relationship between metformin and nephrolithiasis formation remains unclear, as studies have demonstrated conflicting results.

Methods: We conducted a cross-sectional analysis of stone-forming patients at our stone clinic prior to the initiation of stone-directed medical management.

The impact of metabolic syndrome components on urinary parameters and risk of stone formation.

Purpose: To investigate the relationship between metabolic syndrome (MS) and urinary abnormalities in stone-forming patients. Additionally, to delineate whether severity of urinary derangements is impacted by the number of co-occurring MS components.

Methods: Stone-forming patients who underwent initial metabolic workup prior to medical intervention at a comprehensive stone clinic were retrospectively reviewed and included in the study.

Prospective Randomized Evaluation of Idiopathic Hyperoxaluria Treatments.

Calcium oxalate (CaOx) stone formation is influenced by urinary oxalate excretion. Stone formers with elevated urinary oxalate are commonly prescribed a low-oxalate diet or oral supplementation with vitamin B6 and magnesium to reduce urinary oxalate excretion. This study aims to compare the effects of dietary modification supplementation a combination of both on urinary oxalate.

The T-Tilt Position: A Novel Modified Patient Position to Improve Stone-Free Rates in Retrograde Intrarenal Surgery.

Purpose: Residual fragments following retrograde intrarenal surgery can lead to future stone episodes. The lower pole of the kidney presents a unique challenge as it is the most difficult location for retrograde intrarenal surgery. We investigated a modified patient position to increase stone-free rate by analyzing presence of residual fragments.

A Modular In Vitro Platform for the Production of Terpenes and Polyketides from CO.

A long-term goal in realizing a sustainable biocatalysis and organic synthesis is the direct use of the greenhouse gas CO as feedstock for the production of bulk and fine chemicals, such as pharmaceuticals, fragrances and food additives. Here we developed a modular in vitro platform for the continuous conversion of CO into complex multi-carbon compounds, such as monoterpenes (C ), sesquiterpenes (C ) and polyketides. Combining natural and synthetic metabolic pathway modules, we established a route from CO into the key intermediates acetyl- and malonyl-CoA, which can be subsequently diversified through the action of different terpene and polyketide synthases.

Factors Affecting Patient Radiation Exposure During Prone and Supine Percutaneous Nephrolithotomy.

Radiation exposure from fluoroscopy poses risks to patients and surgeons. Percutaneous nephrolithotomy (PCNL) has traditionally required fluoroscopy, however, the use of ultrasound (US) has decreased radiation exposure. US guidance in supine PCNL (S-PCNL) may further reduce radiation exposure.

Ultrasound-Guided Access in a Malrotated Kidney: Optimally Safe and Effective.

Management of renal calculi in a patient with kidney malrotation can be difficult because of complexity and alteration of collecting system anatomy. Pyelolithotomy, whether open, laparoscopic, or robotic, has been shown to be an effective method of stone removal in this patient population; however, it is not always ideal because of its invasiveness and increased morbidity. Ideally, a percutaneous approach may be less invasive, and if feasible, it can optimize patient safety and stone-free status.

Endoscopic Creation of a Neochimneycystotomy: A Case Report of a Ureteroileal Chimney Stricture.

There are many nonmalignant complications after urinary reconstruction. Anastomotic strictures and redundancy of an ileal chimney are such. A patient with both issues might necessitate an open surgical approach; yet endoscopic techniques are more attractive for these older frail patients.