Publications by authors named "Ghani K"
Understanding renal pelvis pressure (P) during ureteroscopy (URS) has become increasingly important. High irrigation rates, desirable to maintain visualization and limit thermal dose, can increase P. Use of a multi-channel ureteroscope (m-ureteroscope) with a dedicated drainage channel is one strategy that may facilitate simultaneous low P and high flowrate.
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- - Ureteral stents are commonly used after ureteroscopy to prevent complications from kidney stones, yet they can cause significant pain and urinary issues, which has led to calls for their omission in many cases.
- - Guidelines support not using stents in uncomplicated surgeries, but over 80% of procedures still involve them, partly due to insufficient evidence about their impact on pain and patient outcomes.
- - A new study is being conducted where patients randomly choose whether to have a stent or not, while those who refuse randomization will be observed based on the doctor's decision, aiming to gather real-world data on the effectiveness of stent omission.
Article Synopsis
- - Over the last 30 years, miniaturized percutaneous nephrolithotomy (mPCNL) has gained popularity due to its potential to reduce complications compared to standard procedures, but there's still debate over best practices and management strategies that hinders wider use.
- - An international panel of urology experts developed a consensus document on mPCNL to provide a comprehensive framework for practice, which included reviewing literature, identifying research gaps, and conducting surveys to gather expert opinions.
- - The study revealed 58 key questions on mPCNL practices, and consensus was achieved on 30 questions, affirming mPCNL as an effective technique for treating upper urinary tract stones in both adults and children.
Article Synopsis
- - Clinical trials for cancer often face low enrollment due to unnecessary kidney function eligibility criteria, which limit the number of eligible patients and complicate the screening process while creating inequity in access to trials.
- - An analysis of phase 3 urologic oncology trials from 2007 to 2021 revealed that 35% of trials listed kidney function restrictions, but 41% of those trials tested interventions that had no possible impact on renal function.
- - The findings indicate a disconnect between trial exclusions based on kidney function and the actual effects of interventions, suggesting that revising eligibility criteria could improve trial access and effectiveness.
Background And Objective: Decipher is a tissue-based genomic classifier (GC) developed and validated in the post-radical prostatectomy (RP) setting as a predictor of metastasis. We conducted a prospective randomized controlled cluster-crossover trial assessing the use of Decipher to determine its impact on adjuvant treatment after RP.
Methods: Eligible patients had undergone RP within 9 mo of enrollment, had pT3-4 disease and/or positive surgical margins, and prostate-specific antigen <0.
Introduction: How renal mass biopsy (RMB) impacts patient management with T1 renal masses (T1RMs) is unclear. We explore the association between RMB and utilization of active surveillance (AS), nephron-sparing interventions, and radical nephrectomy (RN).
Methods: Data were analyzed retrospectively using the MUSIC-KIDNEY (Michigan Urological Surgery Improvement Collaborative Kidney Mass: Identifying and Defining Necessary Evaluation and Therapy) registry.
Objective: To determine the association between kidney stone history and predicted 10-year risk of atherosclerotic cardiovascular disease (CVD) events in a nationally representative US adult sample without existing CVD.
Methods: This was a cross-sectional study of the 2017-2020 National Health and Nutrition Examination Survey that included a nationally representative sample of 3842 adults aged 40-79 free from CVD. Kidney stone history was assessed through self-reporting.
Article Synopsis
- A global survey of endourologists revealed that while single use flexible ureteroscopes (su-fURS) are a potential alternative to reusable ones, their adoption remains limited, with most surgeons using them for less than half of their procedures.
- Main barriers to greater usage include cost concerns (59.1%) and environmental impact (12.5%), with a notable percentage of respondents (26.0%) having never used su-fURS at all.
- Additionally, desired improvements for future models focus on features like a smaller outer shaft, enhanced optics, and the ability to suction fragments, while the inclusion of temperature sensors was deemed unnecessary by many participants.
Article Synopsis
- This study evaluates how effective and safe preoperative alpha-blocker therapy is for patients undergoing ureteroscopy (URS) for kidney stones.
- It includes a systematic review of 15 randomized trials with over 1600 patients, showing that adding alpha-blockers significantly reduces complications, procedure time, and stone retention rates.
- However, while beneficial, alpha-blockers increase the risk of ejaculatory dysfunction and are less effective for stones in the renal/proximal ureter area.
Purpose: To experimentally measure renal pelvis pressure (P) in an ureteroscopic model when applying a simple hydrodynamic principle, the siphoning effect.
Methods: A 9.5Fr disposable ureteroscope was inserted into a silicone kidney-ureter model with its tip positioned at the renal pelvis.
Importance: Technical skill in complex surgical procedures may affect clinical outcomes, and there is growing interest in understanding the clinical implications of surgeon proficiency levels.
Objectives: To determine whether surgeon scores representing technical skills of robot-assisted kidney surgery are associated with patient outcomes.
Design, Setting, And Participants: This quality improvement study included 10 urological surgeons participating in a surgical collaborative in Michigan from July 2021 to September 2022.
Hydatidosis, is a zoonotic disease prevalent in sheep-raising regions globally. Musculoskeletal hydatidosis is uncommon and usually remains asymptomatic over a long period. The detection of musculoskeletal hydatidosis often signifies extensive cyst spread within the bone marrow cavity, making treatment difficult with a high recurrence rate.
View Article and Find Full Text PDFObjective: Life expectancy models are useful tools to support clinical decision-making. Prior models have not been used widely in clinical practice for patients with renal masses. We sought to develop and validate a model to predict life expectancy following the detection of a localized renal mass suspicious for renal cell carcinoma.
View Article and Find Full Text PDFBackground: The extent of illicit drug use among university students necessitates effective preventive programs. To identify and assess the effectiveness of university-based interventions in preventing or reducing illicit drug use.
Methods: The MEDLINE (PubMed), SCOPUS, ISI (Web of Science), and other sources were searched according to the Cochrane Collaboration method.
Ureteral stents can cause significant patient discomfort, yet the temporal dynamics and impact on activities remain poorly characterized. We employed an automated tool to collect daily ecological momentary assessments (EMAs) regarding pain and the ability to work following ureteroscopy with stenting. Our aims were to assess feasibility and better characterize the postoperative patient experience.
View Article and Find Full Text PDFIntroduction: High fluid temperatures have been seen in both in vitro and in vivo studies with laser lithotripsy, yet the thermal distribution within the renal parenchyma has not been well characterized. Additionally, the heat-sink effect of vascular perfusion remains uncertain. Our objectives were twofold: first, to measure renal tissue temperatures in response to laser activation in a calyx, and second, to assess the effect of vascular perfusion on renal tissue temperatures.
View Article and Find Full Text PDFSmall renal masses (SRMs) are a heterogeneous group of tumours with varying metastatic potential. The increasing use and improving quality of abdominal imaging have led to increasingly early diagnosis of incidental SRMs that are asymptomatic and organ confined. Despite improvements in imaging and the growing use of renal mass biopsy, diagnosis of malignancy before treatment remains challenging.
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- The study aims to gather laser lithotripsy settings from experts for different clinical situations and to identify ways to minimize complications.
- A survey was conducted among laser specialists, revealing that the majority use Holmium-YAG lasers, with variations in settings for specific scenarios like middle-ureteral, pelvic, and lower pole stones.
- Experts reported a general consensus on preferred techniques, with preventive measures like power limits and intermittent activation commonly employed to reduce thermal injury risks during procedures.
Artificial phantoms used in photothermal near-infrared laser lithotripsy research generally fail to mimic both the chemical and the physical properties of human stones. Though high-energy, 1 J pulses are capable of fracturing hard human stones into several large fragments along natural boundaries, similar behavior has not been observed in commonly used gypsum plasters like BegoStone. We developed a new brushite-based plaster formulation composed of ≈90% brushite that undergoes rapid fracture in the manner of human stones under fragmentation pulse regimes.
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