Hospital volume and short-term outcomes after cytoreductive nephrectomy.

Purpose: To investigate the impact of hospital volume on short-term outcomes after cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma (mRCC).

Methods: We identified mRCC patients who underwent CN from 2006 to 2013 in the National Cancer Database. Annual hospital CN volume was categorized as high (top 20th percentile) and low.

Hospital volume and outcomes of robot-assisted partial nephrectomy.

Objective: To evaluate the impact of hospital volume on outcomes of robot-assisted partial nephrectomy (RAPN).

Materials And Methods: Patients with renal cell carcinoma who underwent RAPN between 2010 and 2013 were identified in the National Cancer Database. Hospital yearly RAPN volume was categorized into groups by sorting patients as closely as possible into five groups of equal size (quintiles): very low; low; medium; high; and very high volume.

Early discharge and post-discharge outcomes in patients undergoing radical cystectomy for bladder cancer.

Objective: To assess whether discharging patients early after radical cystectomy (RC) is associated with an increased risk of readmission and post-discharge complications.

Materials And Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent an elective RC from 2012 to 2015. Patients were stratified into two groups: those with a length of hospital stay (LOS) of 4-5 days (early-discharge group) and those with an LOS of 6-9 days (routine-discharge group).

Impact of surgical waiting time on survival in patients with upper tract urothelial carcinoma: A national cancer database study.

Purpose: To evaluate the impact of surgical waiting time (SWT) on the survival outcome in patients with upper tract urothelial carcinoma (UTUC).

Materials And Methods: We identified patients with nonmetastatic UTUC who underwent radical nephroureterectomy (RNU) between 2004 and 2013 in the National Cancer Database. The association between SWT and overall survival (OS) was evaluated using Cox proportional hazards regression.

Predischarge Predictors of Readmissions and Postdischarge Complications in Robot-Assisted Radical Prostatectomy.

Background And Objective: Robot-assisted radical prostatectomy (RARP) has become the preferred surgical treatment for localized prostate cancer in the United States. Little is reported about the association between predischarge outcomes and postdischarge outcomes following RARP. The objective of this study was to explore the predischarge predictors of readmissions and postdischarge complications in RARP.

Segmentation of renal parenchymal area from ultrasound images using level set evolution.

This paper presents a framework for segmentation of renal parenchymal area from ultrasound images based on a 2-step level set method. We used distance regularized level set evolution method to partition the kidney boundary, followed by region-scalable fitting energy minimization method to segment the kidney collecting system, and determined renal parenchymal area by subtracting the area of the collecting system from the gross kidney area. The proposed method demonstrated excellent validity and low inter-observer variability.

Use of and regional variation in initial CT imaging for kidney stones.

Objective: We sought to determine the prevalence of initial computed tomography (CT) utilization and to identify regions in the United States where CT is highly used as the first imaging study for children with nephrolithiasis.

Methods: We performed a cross-sectional study in 9228 commercially insured children aged 1 to 17 years with nephrolithiasis who underwent diagnostic imaging in the United States between 2003 and 2011. Data were obtained from MarketScan, a commercial insurance claims database of 17,827,229 children in all 50 states.

Daily mean temperature and clinical kidney stone presentation in five U.S. metropolitan areas: a time-series analysis.

Background: High ambient temperatures are a risk factor for nephrolithiasis, but the precise relationship between temperature and kidney stone presentation is unknown.

Objectives: Our objective was to estimate associations between mean daily temperature and kidney stone presentation according to lag time and temperatures.

Methods: Using a time-series design and distributed lag nonlinear models, we estimated the relative risk (RR) of kidney stone presentation associated with mean daily temperatures, including cumulative RR for a 20-day period, and RR for individual daily lags through 20 days.

Tamsulosin and spontaneous passage of ureteral stones in children: a multi-institutional cohort study.

Purpose: Tamsulosin is associated with increased passage of ureteral stones in adults but its effectiveness in children is uncertain. We determined the association between tamsulosin and the spontaneous passage of ureteral stones in children.

Materials And Methods: We performed a multi-institutional retrospective cohort study of patients 18 years or younger who presented between 2007 and 2012 with ureteral stones up to 10 mm and who were treated with tamsulosin or oral analgesics alone.

Renal parenchymal area and risk of ESRD in boys with posterior urethral valves.

Background And Objectives: Approximately 20% of boys with posterior urethral valves develop ESRD; however, few factors associated with the risk of ESRD have been identified. The objective of this study was to determine if renal parenchymal area, defined as the area of the kidney minus the area of the pelvicaliceal system on first postnatal ultrasound, is associated with the risk of ESRD in infants with posterior urethral valves.

Design, Setting, Participants, & Measurements: A retrospective cohort of boys who were diagnosed with posterior urethral valves at less than 6 months of age between 1988 and 2011 and followed for at least 1 year at a free-standing children's hospital was assembled.

Correlation of fundus autofluorescence with fluorescein and indocyanine green angiography in choroidal melanocytic lesions.

Purpose: To correlate fundus autofluorescence (FAF) patterns with fluorescein/indocyanine green angiographic (FA/ICGA) features in choroidal melanocytic lesions.

Methods: Retrospective chart review of 30 consecutive patients with choroidal nevi and melanoma who underwent FAF photography and FA/ICGA. The FAF pattern was classified as patchy or diffuse.

Detection of elevated signaling amino acids in human diabetic vitreous by rapid capillary electrophoresis.

Elevated glutamate is implicated in the pathology of PDR. The ability to rapidly assess the glutamate and amino acid content of vitreous provides a more complete picture of the chemical changes occurring at the diabetic retina and may lead to a better understanding of the pathology of PDR. Vitreous humor was collected following vitrectomies of patients with PDR and control conditions of macular hole or epiretinal membrane.

A role for excitatory amino acids in diabetic eye disease.

Diabetic retinopathy is a leading cause of vision loss. The primary clinical hallmarks are vascular changes that appear to contribute to the loss of sight. In a number of neurodegenerative disorders there is an appreciation that increased levels of excitatory amino acids are excitotoxic.