Squamous cell carcinoma of the upper urinary tract: clinical characteristics, treatment patterns, and survival outcomes in the National Cancer Database.

Purpose: We sought to investigate the disease characteristics, treatment patterns, and survival outcomes of upper urinary tract squamous cell carcinoma (UT-SCC) using the National Cancer Database (NCDB).

Methods: The NCDB was queried for UT-SCC patients from 2004 to 2020. Patients with upper tract urothelial carcinoma (UTUC) were also identified for comparison with UT-SCC.

Comparative Analysis of Safety and Efficacy Between Anterior and Posterior Calyceal Entry in Supine Percutaneous Nephrolithotomy.

One advantage of supine percutaneous nephrolithotomy (sPCNL) is the ability to access anterior as well as posterior calyces, but the safety and efficacy of anterior calyceal entry has never been investigated to our knowledge. We prospectively evaluated patients scheduled for sPCNL comparing anterior and posterior calyceal access. After Institutional Review Board approval, we prospectively enrolled 100 consecutive patients undergoing sPCNL from February to September 2023.

Artificial Intelligence in Urology: Application of a Machine Learning Model to Predict the Risk of Urolithiasis in a General Population.

This research presents our application of artificial intelligence (AI) in predicting urolithiasis risk. Previous applications, including AI for stone disease, have focused on stone composition and aiding diagnostic imaging. AI applications centered around patient-specific characteristics, lifestyle considerations, and diet have been limited.

Prognostic factors and treatment impact on overall survival in patients with renal neuroendocrine tumour.

Background: Renal neuroendocrine neoplasms (R-NEN) are exceptionally rare tumours characterized by high mortality rates.

Objective: The objective of this study is to analyse prognostic factors and treatment impact on overall survival in patients with R-NEN.

Design Setting And Participants: We identified all patients with R-NEN in the National Cancer Database (NCDB) from 2004 to 2019 and identified prognostic factors for improved survival.

Transurethral Resection of Bladder Tumor Outcomes Are Predicted by a 5-Item Frailty Index.

Objective: To evaluate the mFI-5 as a predictor of postoperative outcomes following transurethral resection of bladder tumor (TURBT).

Methods: The National Surgical Quality Improvement Program database was queried for TURBT cases from 2015-2019. mFI-5 scores were calculated by assigning a point to chronic obstructive pulmonary disease, congestive heart failure, dependent functional status, hypertension, and diabetes.

Comparison of metabolic parameters between pure-uric acid and mixed-uric acid kidney stone formers.

Purpose: We seek to compare clinical and 24-h urine parameters between pure-uric acid (UA) and UA-CaOx stone formers in our practice and explore how any differences in metabolic profiles could suggest different prevention strategies between the two groups.

Methods: We retrospectively reviewed patients with either pure- or mixed-UA nephrolithiasis from 2020 to 2023 at a tertiary care center. We included patients with a 24-h urine collection and a stone analysis detecting any amount of UA.

Evaluation of the Current Status of Artificial Intelligence for Endourology Patient Education: A Blind Comparison of ChatGPT and Google Bard Against Traditional Information Resources.

Artificial intelligence (AI) platforms such as ChatGPT and Bard are increasingly utilized to answer patient health care questions. We present the first study to blindly evaluate AI-generated responses to common endourology patient questions against official patient education materials. Thirty-two questions and answers spanning kidney stones, ureteral stents, benign prostatic hyperplasia (BPH), and upper tract urothelial carcinoma were extracted from official Urology Care Foundation (UCF) patient education documents.

Differences in cancer presentation, treatment, and mortality between rural and urban patients diagnosed with kidney cancer in the United States.

Introduction: Rural-urban discrepancies in care and outcomes for kidney cancer (KCa) in the United States remains poorly understood. Our study aims to improve our understanding of the influence of rurality on KCa outcomes in the United States by analyzing differences in presentation, treatment, and mortality between urban areas (UAs) and rural areas (RAs) in the Surveillance, Epidemiology, and End Results (SEERs) database.

Methods: SEERs data was queried from 2000 to 2019 for KCa patients.

Open retropubic prostatectomy in a patient with bladder exstrophy for management of hematuria and urethral discharge - A case report.

Bladder exstrophy (BE) is a rare congenital disorder causing bladder and urethral malformation due to an abdominal wall embryological defect. Traditionally, BE had a poor life expectancy, but advances now offer a normal lifespan. A 57-year-old male with BE history and ureterosigmoidostomy repair presented with intractable hematuria, urethral discharge, and recurrent prostatic infections.

Drivers of calcium oxalate stone formation in the octogenarian population.

Introduction: American Urological Association (AUA) guidelines suggest metabolic testing via 24-h urine studies in high-risk, interested first-time stone formers, and recurrent stone formers. If metabolic testing is not available or otherwise not feasible, clinicians may need to utilize empiric therapy. Debility and social barriers, particularly in the elderly population, may limit the practicality of metabolic testing, and therefore, empiric therapy is of particular importance.

Adjuvant intraluminal therapies for upper tract urothelial carcinoma.

Upper urinary tract urothelial carcinomas (UTUCs) are often identified and first treated endoscopically. After proper risk stratification, adjuvant treatment may be recommended. Consequently, as adjuvant therapy becomes more common place in the oncological armamentarium, we seek to better characterize its existing and future therapeutic landscape.

Opioid-free percutaneous nephrolithotomy: an initial experience.

Introduction: The opioid epidemic in the United States is an ongoing public health crisis that is in part fueled by excessive prescribing by physicians. Percutaneous nephrolithotomy (PCNL) is a procedure that conventionally involves opioid prescriptions for adequate post-operative pain control. We aimed to evaluate the feasibility of a non-opioid pain regimen by evaluating post-operative outcomes in PCNL patients discharged without opioids.

Selecting an Endourology Society Fellowship Program: The Candidates' Perspectives.

Understanding the factors that influence the decision of urology residents to pursue an Endourology Society (ES) fellowship and the criteria used by applicants to rank programs may help residents and program directors (PDs) optimize the match process. In the present study, we surveyed current ES fellows to gain better insight surrounding their decision-making process. A survey was emailed to all ES fellows, comprising Endourology and Stone Disease (ESD), Laparoscopic and Robotic Surgery (MIS), and combination of ESD/MIS (COM) programs.

The Role of Experience: How Case Volume and Endourology-Fellowship Training Impact Surgical Outcomes for Ureteroscopy.

Surgical experience is associated with superior outcomes in complex urologic cases, such as prostatectomy, nephrectomy, and cystectomy. The question remains whether experience is predictive of outcomes for less complex procedures, such as ureteroscopy (URS). Our study examined how case volume and endourology-fellowship training impacts URS outcomes.

Protonation of P-Stereogenic Phosphiranes: Phospholane Formation via Ring Opening and C-H Activation.

Protonation of cyclopropanes and aziridines is well-studied, but reactions of phosphiranes with acids are rare and have not been reported to result in ring opening. Treatment of -Mes*PCHCHR (Mes* = 2,4,6-(-Bu)CH, R = Me or Ph, --) or -Mes*PCHCHPh (-) with triflic acid resulted in regiospecific -Markovnikov C-protonation with ring opening and cyclophosphination of a Mes* --Bu group to yield the phospholanium cations [PH(CHCHR)(4,6-(-Bu)-2-CMeCHCH)][OTf] (R = Me or Ph, -), which were deprotonated with NEt to give phospholanes -. Enantioenriched or racemic - both gave racemic .

Pharmacokinetics of Cefazolin in Patients With Obesity Undergoing Surgery Requiring Cardiopulmonary Bypass.

Objective: The authors' objective was to determine the adequacy of an institutional standard dosing practice for infection prophylaxis in open cardiac surgery in patients heavier than 120 kg undergoing cardiopulmonary bypass.

Design: A prospective, single-center, open-label study was used to determine if cefazolin serum concentrations were maintained above the minimum inhibitory concentration (MIC) throughout surgery. A pharmacokinetic model describing cefazolin disposition was developed for perioperative patients with morbid obesity, based on these values.

Conformational Rigidity and Protein Dynamics at Distinct Timescales Regulate PTP1B Activity and Allostery.

Protein function originates from a cooperation of structural rigidity, dynamics at different timescales, and allostery. However, how these three pillars of protein function are integrated is still only poorly understood. Here we show how these pillars are connected in Protein Tyrosine Phosphatase 1B (PTP1B), a drug target for diabetes and cancer that catalyzes the dephosphorylation of numerous substrates in essential signaling pathways.

Management of a Patient Requiring Intrathecal Drain Insertion and Removal in the Setting of Concomitant Dual Antiplatelet Therapy With Clopidogrel and Aspirin: A Case Report.

We report a case of deliberate intrathecal catheter insertion and removal in the setting of continuous dual-antiplatelet therapy with clopidogrel and aspirin. A patient with recently sited bare metal intracerebral stents developed severe symptomatic hydrocephalus and required temporary cerebrospinal fluid diversion. The risks of intracerebral in-stent thrombosis or delayed intervention precluded following guidelines for the management of clopidogrel in neuraxial procedures.

Custom Titanium Ridge Augmentation Matrix (CTRAM): A Case Report.

This is a case report of a custom titanium ridge augmentation matrix (CTRAM). Using cone beam computed tomography (CBCT), a custom titanium space-maintaining device was developed. Alveolar ridges were virtually augmented, a matrix was virtually designed, and the CTRAM was additively manufactured with titanium (Ti6Al4V).

Paravertebral analgesia in transapical transcatheter aortic valve replacement.

Introduction: Transapical transcatheter aortic valve replacement is an option for patients who are not candidates for traditional aortic valve surgery but have severe aortic stenosis and unfavorable ileo-femoral anatomy. Epidural analgesia in these cases has been associated with improved morbidity and mortality. The following manuscript presents the findings of an initial clinical experience employing paravertebral analgesia for patients undergoing transapical transcatheter aortic valve replacement.

PTP1B inhibition suggests a therapeutic strategy for Rett syndrome.

The X-linked neurological disorder Rett syndrome (RTT) presents with autistic features and is caused primarily by mutations in a transcriptional regulator, methyl CpG-binding protein 2 (MECP2). Current treatment options for RTT are limited to alleviating some neurological symptoms; hence, more effective therapeutic strategies are needed. We identified the protein tyrosine phosphatase PTP1B as a therapeutic candidate for treatment of RTT.