Recommendations to Improve Neonatal Circumcision Training.

Background: Although multiple specialties perform neonatal circumcision (NC), overall NC proceduralist availability is limited. The approach to training new practitioners varies. This study aims to describe NC training experiences, current practices, and make suggestions for future improvements.

Growth in Newborn Circumcisions Performed by Pediatric Urologists and Advanced Practice Providers Between 2010 and 2021 in the United States.

Objective: To characterize changes in the proportion of newborn circumcisions performed by pediatric urologists and advanced practiced providers (APPs) in the United States over the last decade.

Methods: The Merative MarketScan Commercial Database was queried for newborn circumcision private health insurance claims (Common Procedural Terminology 54150) between 2010 and 2021. Setting (inpatient/outpatient), US Census Bureau region, clinician specialty, and patient age (days) were determined for the full study time period, and by study year.

Physician Perspectives on Performing Newborn Circumcisions: Barriers and Opportunities.

Objective: Over half of infant boys born in the United States undergo newborn circumcision. However, available data indicate that boys who are publicly insured, or Black/African American, have less access to desired newborn circumcision, thus concentrating riskier, more costly operative circumcision among these populations. This study ascertains perinatal physician perspectives about barriers and facilitators to providing newborn circumcisions, with a goal of informing future strategies to ensure more equitable access.

Streamlining surgical trays for common pediatric urology Procedures: A quality improvement initiative.

Introduction: Procedures involving the external genitalia are the most common pediatric urologic operations. Our group identified excess instrumentation for these cases to be a potential cause of operating room (OR) inefficiency at our large, freestanding pediatric hospital. This quality improvement (QI) initiative aimed to streamline surgical instrumentation for the most-performed pediatric urologic procedures at our hospital.

COVID-19 Pandemic Adversely Affects the Provision of Desired Newborn Circumcision: Perinatal Physician Perspectives.

Over half of boys in the United States undergo circumcision, which has its greatest health benefits and lowest risks when performed during the newborn period under local anesthesia. The COVID-19 pandemic has affected delivery of patient care in many ways and likely also influenced the provision of newborn circumcisions. Prior to the pandemic, we planned to conduct a qualitative study to ascertain physician perspectives on providing newborn circumcision care.

Prospective pediatric study comparing glomerular filtration rate estimates based on motion-robust dynamic contrast-enhanced magnetic resonance imaging and serum creatinine (eGFR) to Tc DTPA.

Background: Current methods to estimate glomerular filtration rate (GFR) have shortcomings. Estimates based on serum creatinine are known to be inaccurate in the chronically ill and during acute changes in renal function. Gold standard methods such as inulin and Tc diethylenetriamine pentaacetic acid (DTPA) require blood or urine sampling and thus can be difficult to perform in children.

Feed and wrap magnetic resonance urography provides anatomic and functional imaging in infants without anesthesia.

Objective: To describe a technique for performing magnetic resonance urogram (MRU) in infants without sedation or anesthesia.

Methods: Eighteen infants underwent MRU in the absence of sedating medications using a 'feed and wrap' technique (FW-MRU). Dynamic contrast enhanced images were obtained.

Development of nephrolithiasis in a renal transplant patient during treatment with Cinacalcet.

Background: Secondary hyperparathyroidism often accompanies chronic kidney disease, which can result in severe bone abnormalities and nephrolithiasis. Renal transplantation can correct the mineral abnormalities associated with chronic kidney disease, but one year after transplantation many recipients continue to exhibit persistent hyperparathyroidism.

Case Report: Cinacalcet, a second-generation calcimimetic, has been shown to be effective in decreasing serum calcium levels in post kidney transplant patients with hyperparathyroidism.

Lack of predictive correlation between peripheral arterial tone and colour flow Doppler parameters in men with erectile dysfunction.

Objective: To evaluate whether peripheral arterial tone (PAT) can predict the results of penile colour flow Doppler in the evaluation of erectile dysfunction (ED).

Patients And Methods: Fifty men presenting to an ED clinic were tested with an Endo-PAT2000 machine (Itamar Medical, Caesarea, Israel), which assessed augmentation index (AI), a measure of arterial stiffness, and reactive hyperaemia index (RHI), a measure of endothelial vasodilatation. Penile haemodynamics were measured and used to identify both arterial insufficiency (abnormal peak systolic velocity [PSV]) and veno-occlusive disease (abnormal end diastolic velocity [EDV]) after pharmacological erection with prostaglandin E1 using colour flow Doppler.

Effect of delaying surgery on radical prostatectomy outcomes: a contemporary analysis.

Unlabelled: Study Type - Therapy (case series). Level of Evidence 4. What's known on the subject? and What does the study add? For patients electing surgical treatment, the question of the effect of surgical delay on clinical outcomes in prostate cancer is controversial.

Novel intravesical therapies for non-muscle-invasive bladder cancer refractory to BCG.

The definitive treatment for patients with non-muscle-invasive bladder cancer (NMIBC) who fail to respond to intravesical BCG is cystectomy. When a patient is deemed BCG-refractory and cannot or will not undergo cystectomy, alternative intravesical therapy may be the most effective way to minimize recurrence and progression. A number of immunotherapeutic and chemotherapeutic agents have been given intravesically over the years, and several recently and currently investigated novel agents appear to be particularly promising for the management of BCG-refractory NMIBC.

Intravesical delivery of rapamycin suppresses tumorigenesis in a mouse model of progressive bladder cancer.

Early-stage bladder cancer occurs as two distinct forms: namely, low-grade superficial disease and high-grade carcinoma in situ (CIS), which is the major precursor of muscle-invasive bladder cancer. Although the low-grade form is readily treatable, few, if any, effective treatments are currently available for preventing progression of nonmuscle-invasive CIS to invasive bladder cancer. Based on our previous findings that the mammalian target of Rapamycin (mTOR) signaling pathway is activated in muscle-invasive bladder cancer, but not superficial disease, we reasoned that suppression of this pathway might block cancer progression.