Publications by authors named "Gyan Pareek"

Prostate cancer (PCa) is highly prevalent among aging men and a significant contributor to global mortality. Balancing early detection and treatment of "clinically significant" disease with avoiding over-detection and overtreatment of slow-growing tumors is challenging, especially for elderly patients with competing health risks and potentially aggressive disease phenotypes. This review emphasizes the importance of individualized approaches for diagnosing and treating PCa in geriatric patients.

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Objective: To study the impact of a student-specific urology conference for students considering a career in urology. The first symposium specifically for medical students interested in urology was designed to provide an opportunity to present their research, explore urological subspecialties, and network with faculty members, residents, and other students.

Methods: Medical students and faculty at a US medical school organized the inaugural New England Student Urology Symposium (NESUS).

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  • The study investigates the relationship between isolated PIRADS 3 lesions found in the transitional zone (TZ) and peripheral zone (PZ) of the prostate, and the occurrence of clinically significant prostate cancer (csPCa) in patients undergoing biopsies.
  • Researchers analyzed data from a group of patients who had mpMRI-fusion biopsies from 2016 to 2021 and excluded those with prior cancer diagnoses or higher PIRADS scores.
  • Results showed that csPCa was significantly more prevalent in PZ lesions compared to TZ lesions, suggesting that PIRADS 3 lesions in the TZ are less likely to indicate clinically significant cancer, which is crucial for making biopsy decisions.
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  • Higher risk of kidney stones in primary hyperparathyroidism is known, but the risk in normocalcemic primary hyperparathyroidism (NPHPT) is still unclear.
  • A case study highlighted a patient with recurrent calcium kidney stones and severe idiopathic hypercalciuria despite having NPHPT.
  • Surgical removal of the parathyroid adenoma did not decrease the patient's kidney stone risk or burden, prompting an examination of the relationship between the adenoma and stone formation in NPHPT.*
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Purpose: Both lower urinary tract symptoms (LUTS) and prostate cancer (PCa) are common in elderly men. While LUTS are generally due to a benign etiology, they may provoke an evaluation with prostate-specific antigen (PSA), which can lead to a cascade of further testing and possible overdiagnosis in patients with competing risks. There is limited patient and provider understanding of the relationship between LUTS and PCa risk, and a lack of clarity in how to evaluate these men to balance appropriate diagnosis of aggressive PCa with avoidance of overdiagnosis.

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  • The study aimed to examine how postgraduate medical education type (US vs international) and gender affect matching rates for urologic training applicants.
  • Between 2010 and 2024, data from 5 different urologic societies showed that US/Canadian graduates had a much higher match rate (83.8%) compared to international medical graduates (23.3%).
  • Female applicants also experienced better matching outcomes (81.2%) than their male counterparts (57%), indicating a need for more investigation into diversity in urological subspecialties.
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Background: Prebiopsy prostate-specific antigen density (PSAD) is a well-known predictor of clinically significant prostate cancer (csPCa). Since prostate-specific antigen (PSA) and prostate volume (PV) increase normally with aging, PSAD thresholds may vary. The purpose of the study was to determine if PSAD was predictive of csPCa in different age strata.

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Introduction: This study aims to assess the feasibility and safety of same-day discharge after transurethral resection of the prostate.

Materials And Methods: Five years of records were retrospectively analysed. Length of stay categorised patients into Groups 1 (same-day discharge) and 2 (standard-length discharge).

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Prostate cancer (PCa) is a common malignancy in males. The pathology review of PCa is crucial for clinical decision-making, but traditional pathology review is labor intensive and subjective to some extent. Digital pathology and whole-slide imaging enable the application of artificial intelligence (AI) in pathology.

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Prostatic acinar adenocarcinoma accounts for approximately 95% of prostate cancer (CaP) cases. The remaining 5% of histologic subtypes of CaP are known to be more aggressive and have recently garnered substantial attention. These histologic subtypes - namely, prostatic ductal adenocarcinoma (PDA), intraductal carcinoma of the prostate (IDC-P), and cribriform carcinoma of the prostate (CC-P) - typically exhibit distinct growth characteristics, genomic features, and unique oncologic outcomes.

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  • Robotically assisted laparoscopic radical prostatectomy (RALP) is recognized as the best surgical method for treating clinically significant prostate cancer, and ongoing quality assurance efforts are necessary to reduce complications, especially with the trend towards same-day patient discharge.
  • A study using data from the National Surgical Quality Improvement Program (NSQIP) analyzed various preoperative and perioperative factors that could lead to complications post-RALP, assessing data from 11,811 patients between 2019 and 2021.
  • Key findings revealed that factors like older age, higher body mass index, prior pelvic surgeries, and certain surgical practices were linked to increased risks of complications, with specific issues like urinary leaks and lymphocele more likely among patients with a
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Background: Multiparametric magnetic resonance imaging (mpMRI) is increasingly used for risk stratification and preoperative staging of prostate cancer. It remains unclear how Grade Group (GG) interacts with the ability of mpMRI to determine the presence of extraprostatic extension (EPE) on surgical pathology.

Methods: A retrospective review of a robotic assisted laparoscopic radical prostatectomy (RALP) database from 2016-2020 was performed.

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Background: "Shared decision-making" (SDM) is a cornerstone of prostate cancer (PCa) screening guidelines due to tradeoffs between clinical benefits and concerns for over-diagnosis and over-treatment. SDM requires effort by primary-care-providers (PCP) in an often busy clinical setting to understand patient preferences with the backdrop of patient risk factors. We hypothesized that SDM for PCa screening, given its prominence in guidelines and practical challenges, may be associated with quality preventative healthcare in terms of other appropriate cancer screening and encouragement of other preventative health behaviors.

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The incidence of stone disease has increased significantly in the past 30 years, with a reported prevalence of 11% of the U.S. population in 2022, up from 9% in 2012 and 5.

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Numerous imaging modalities are available to the provider when diagnosing or surveilling kidney stones. The decision to order one over the other can be nuanced and especially confusing to non-urologic practitioners. This manuscript reviews the main modalities used to image stones in the modern era - renal bladder ultrasound, Kidney Ureter Bladder plain film radiography (KUB), magnetic resonance imaging (MRI), and non-contrast computerized tomography (NCCT).

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The SARS-CoV-2 virus has caused a pandemic, infecting nearly 80 million people worldwide, with mortality exceeding six million. The average survival span is just 14 days from the time the symptoms become aggressive. The present study delineates the deep-driven vascular damage in the pulmonary, renal, coronary, and carotid vessels due to SARS-CoV-2.

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  • Morbidity and mortality rates from prostate cancer (PCa) differ based on socioeconomic and demographic factors, prompting a study on prescreening PSA counseling (PPC) rates in male-to-female transgender (MtF-TG) patients compared to non-transgender patients.
  • The analysis used data from the Behavioral Risk Factor Surveillance System (BRFSS) spanning 2014 to 2018, including 175,383 respondents aged 40-79, revealing that 0.3% identified as MtF-TG, with overall PPC rates being 62.4%.
  • Ultimately, while PPC rates were initially lower among MtF-TG individuals, this difference was not significant when accounting for education and income levels,
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Background: The previous COVID-19 lung diagnosis system lacks both scientific validation and the role of explainable artificial intelligence (AI) for understanding lesion localization. This study presents a cloud-based explainable AI, the “COVLIAS 2.0-cXAI” system using four kinds of class activation maps (CAM) models.

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Radiogenomics, a combination of "Radiomics" and "Genomics," using Artificial Intelligence (AI) has recently emerged as the state-of-the-art science in precision medicine, especially in oncology care. Radiogenomics syndicates large-scale quantifiable data extracted from radiological medical images enveloped with personalized genomic phenotypes. It fabricates a prediction model through various AI methods to stratify the risk of patients, monitor therapeutic approaches, and assess clinical outcomes.

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Background: COVID-19 is a disease with multiple variants, and is quickly spreading throughout the world. It is crucial to identify patients who are suspected of having COVID-19 early, because the vaccine is not readily available in certain parts of the world. Methodology: Lung computed tomography (CT) imaging can be used to diagnose COVID-19 as an alternative to the RT-PCR test in some cases.

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Purpose: The role of erectile dysfunction (ED) has recently shown an association with the risk of stroke and coronary heart disease (CHD) via the atherosclerotic pathway. Cardiovascular disease (CVD)/stroke risk has been widely understood with the help of carotid artery disease (CTAD), a surrogate biomarker for CHD. The proposed study emphasizes artificial intelligence-based frameworks such as machine learning (ML) and deep learning (DL) that can accurately predict the severity of CVD/stroke risk using carotid wall arterial imaging in ED patients.

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  • * Timely detection of CVD complications in DR patients is essential, and since traditional CAD risk assessments can be costly, low-cost imaging methods like carotid B-mode ultrasound can be utilized for better risk stratification.
  • * The use of artificial intelligence (AI) in analyzing large data sets helps identify risk factors for atherosclerosis in DR patients, thus aiding in CVD risk assessment and highlighting the interconnection between DR, CAD, and their implications during the COVID-19 pandemic.
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(1) Background: COVID-19 computed tomography (CT) lung segmentation is critical for COVID lung severity diagnosis. Earlier proposed approaches during 2020-2021 were semiautomated or automated but not accurate, user-friendly, and industry-standard benchmarked. The proposed study compared the COVID Lung Image Analysis System, COVLIAS 1.

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Synopsis of recent research by authors named "Gyan Pareek"

  • - Gyan Pareek's recent research primarily focuses on prostate cancer, exploring factors influencing its diagnosis, treatment outcomes, and the role of emerging technologies like artificial intelligence in enhancing management practices.
  • - His studies include comparisons of prostate cancer incidence between different lesion types, evaluations of preoperative and postoperative care strategies, and the impact of lower urinary tract symptoms on prostate cancer screening practices in elderly men.
  • - Additionally, Pareek investigates disparities in urologic fellowship match rates by gender and medical education backgrounds, contributing to a better understanding of training equity in urology.