Publications by authors named "William Nahas"

Context: The role of plasma metanephrine in adrenal venous sampling (AVS) for assessing lateralization in primary aldosteronism (PA) requires further clarification.

Objective: To evaluate the performance of plasma metanephrine in AVS for determining aldosterone lateralization in PA, with or without mild autonomous cortisol secretion (MACS).

Methods: Sequential AVS under cosyntropin stimulation was conducted in 58 consecutive patients with PA and indication for AVS.

View Article and Find Full Text PDF

Background: Our study aimed to correlate ERG and PTEN expressions in prostate biopsy with multiparametric magnetic resonance imaging PI-RADS score, clinical reclassification, and prognosis of very low-risk prostate cancer (PCa) patients under active surveillance (AS).

Methods: We evaluated 101 very low-risk PCa patients under AS between 2013 and 2018. They were followed with DRE, PSA, MRI, and re-biopsies every 1-2 years.

View Article and Find Full Text PDF

Background: Infections by carbapenem-resistant Pseudomonas aeruginosa (CRPA) have been associated with high morbidity and mortality among solid organ recipients.

Objectives: To delineate the epidemiological and molecular characteristics of a recurrent outbreak of imipenem (IMP)-producing P. aeruginosa (CRPA) among kidney transplant (KT) recipient METHODS: We described a recurring CRPA outbreak in a KT ward, divided into two periods: before unit closure (Feb 2019-2020) and after reopening (Aug 2020-Dec 2023).

View Article and Find Full Text PDF

Purpose: This prospective study aimed to identify risk factors associated with progression to stage 3 chronic kidney disease (CKD) and the occurrence of kidney stone formation or growth following nephrectomy for urolithiasis.

Materials And Methods: From January 2006 to May 2013, patients undergoing nephrectomy for urolithiasis were enrolled. Renal function was assessed using estimated glomerular filtration rate (eGFR) via the Chronic Kidney Disease Epidemiology Collaboration equation, while kidney stone events were detected using computed tomography.

View Article and Find Full Text PDF

Purpose: High-risk localized prostate cancer (HRLPC) commonly progresses to metastatic disease after local treatment. Neoadjuvant androgen deprivation therapy (nADT) before radical prostatectomy (RP) has recently been suggested to improve early oncological outcomes in HRLPC. We aimed to perform an exploratory analysis of the pathological outcomes from a prospective trial testing nADT before RP.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to compare two classification systems, the Comprehensive Complication Index (CCI) and the Clavien-Dindo classification (CDC), in elderly patients undergoing percutaneous nephrolithotomy (PCNL) and to find out what factors predict complications post-surgery.
  • In a retrospective analysis of 244 patients aged 60 and older, 15.6% experienced complications within 30 days of surgery, with length of hospital stay and emergency room admissions showing a significant correlation with both classification systems.
  • Although CDC and CCI were equally effective in predicting hospital stay and ER visits, CDC underestimated hospitalization costs compared to CCI, and certain factors like higher ASA physical status, comorbidity index, and
View Article and Find Full Text PDF
Article Synopsis
  • - The study investigates the role of PIEZO2, a mechanotransducer, in bladder function and its possible link to lower urinary tract dysfunction in men with bladder outlet obstruction caused by benign prostatic hyperplasia (BPH).
  • - Researchers analyzed bladder wall samples from men undergoing prostate surgery and found that PIEZO2 expression was lower in those with BPH, especially in patients experiencing urinary retention.
  • - The results suggest that reduced PIEZO2 expression may contribute to bladder dysfunction in BPH patients, indicating a need for further research into its therapeutic potential.
View Article and Find Full Text PDF
Article Synopsis
  • A meta-analysis was conducted to evaluate the effectiveness of Reverse Trendelenburg (RevTren) and Trendelenburg (Tren) surgical positions versus standard dorsal lithotomy in reducing ureteral stone migration during ureteroscopic laser lithotripsy.
  • The study reviewed 137 articles, ultimately including 8 that involved 1,374 patients, highlighting that RevTren significantly reduced stone migration and improved success rates, while Tren increased stone success despite promoting migration to upper calyces.
  • Both alternative positions offer notable benefits over the standard method without increasing complications, suggesting they can be safely integrated into clinical practice for better patient outcomes.
View Article and Find Full Text PDF

Introduction: Endoscopic Combined Intrarenal Surgery (ECIRS) has emerged as a promising technique for the management of large and complex kidney stones, potentially offering advantages over traditional Percutaneous Nephrolithotomy (PCNL). This study aims to evaluate best practices, outcomes, and future perspectives associated with ECIRS.

Materials And Methods: A comprehensive PubMed search was conducted from 2008 to 2024, using MESH terms and the following key words: "ECIRS" and "Endoscopic Combined Intrarenal Surgery" The search yielded 157 articles, including retrospective cohort studies, two randomized controlled trials (RCTs), and four meta-analyses comparing ECIRS with PCNL.

View Article and Find Full Text PDF

Introduction: Neoadjuvant cisplatin-based combination chemotherapy (NAC) followed by radical cystectomy is the standard of care for cisplatin-fit patients harboring muscle-invasive bladder cancer (MIBC). Prediction of response to NAC is essential for clinical decision-making regarding alternatives in case of non-response, and bladder-sparing in case of complete response. This research aimed to assess the performance of machine learning in predicting therapeutic response following NAC treatment in patients with MIBC.

View Article and Find Full Text PDF
Article Synopsis
  • * Urinary septic shock occurred in 0.56% of patients, with significant risk factors being the presence of comorbidities (higher Charlson Comorbidity Index), larger kidney stones, and a positive preoperative urine culture.
  • * Patients with a Charlson Comorbidity Index greater than 2, stones 35 mm or larger, and a positive urine culture faced an even higher risk for septic shock, highlighting the importance of careful perioperative management to
View Article and Find Full Text PDF

Objective: To compare the outcomes of retrograde flexible ureteroscopy (fURS) with retroperitoneal laparoscopic ureterolithotomy (RLU) for large proximal ureteric stones.

Patients And Methods: A prospective randomised trial was conducted from January 2018 through December 2022 including patients with impacted proximal ureteric stones of 15-25 mm. Patients underwent fURS or RLU.

View Article and Find Full Text PDF

Purpose: To evaluate the impact of the COVID-19 pandemic on the care of patients with bladder cancer in a tertiary oncology center.

Materials And Method: We performed a retrospective analysis of patients admitted to a tertiary cancer center for the treatment of bladder cancer between 2019 and 2022. Surgical volumes, patient demographics, clinical characteristics, and postoperative outcomes were compared across these years.

View Article and Find Full Text PDF

Background: Peyronie's disease is characterized by the formation of fibrotic plaques in the penile tunica albuginea. Effective treatments are limited, warranting the investigation of new promising therapies, such as the application of microRNAs that regulate fibrosis-related genes.

Objective: We aimed to investigate the therapeutic potential of mimicking microRNA-29b in a fibrin-induced rat model of Peyronie's disease.

View Article and Find Full Text PDF

Lower urinary tract abnormalities are directly implicated in the etiology of renal dysfunction in 6 to 24% of dialytic patients. These patients require bladder capacity and compliance readjustment before being considered viable candidates for renal transplantation. Vesical augmentation surgeries often involve the use of intestinal segments.

View Article and Find Full Text PDF

Introduction: Urinary tract infection involves mortality rate when combined with ureteral obstruction. Lithotripsy has been contraindicated; however, it has been shown to be safe in selected situations. No specific criteria have been widely accepted to indicate which patients are suitable for definitive treatment.

View Article and Find Full Text PDF

Introduction: Ureteral stricture is often a consequence of urolithiasis or previous endourological procedures (1-3). Precisely delineating the stricture zone intraoperatively is crucial to minimize ureter shortening and target only the affected tissue (4, 5). Flexible ureteroscopy offers a significant advantage in this regard.

View Article and Find Full Text PDF

Purpose: Limited high-quality studies have compared robot-assisted laparoscopic prostatectomy (RALP) vs open retropubic radical prostatectomy. We sought to compare their postoperative outcomes in a randomized setting.

Materials And Methods: In a single center, 354 men with newly diagnosed prostate cancer were assessed for eligibility; 342 were randomized (1:1).

View Article and Find Full Text PDF

Several phase II trials have investigated neoadjuvant novel androgen receptor signaling inhibitors (ARSIs) in combination with androgen deprivation therapy (ADT) followed by radical prostatectomy (RP) in prostate cancer (PC) patients. However, data regarding complications of intense hormone therapy and surgical complications are scarce. Our objective was to evaluate the occurrence of cardiovascular (CV) and thromboembolic (TE) adverse events (AE) in patients with localized PC who have received intense neoadjuvant ADT followed by prostatectomy.

View Article and Find Full Text PDF

Objective: To provide an updated view on the role of cell-free DNA as a predictor of pathological response to neoadjuvant therapy in patients with muscle-invasive bladder cancer.

Methods: A systematic review was conducted from September 2023 to October 2023. Selected studies from the MEDLINE and clinical trial databases were critically analyzed regarding the clinical efficacy of cell-free DNA as a predictive instrument after neoadjuvant therapy in bladder cancer.

View Article and Find Full Text PDF

Here, in a multi-ancestry genome-wide association study meta-analysis of kidney cancer (29,020 cases and 835,670 controls), we identified 63 susceptibility regions (50 novel) containing 108 independent risk loci. In analyses stratified by subtype, 52 regions (78 loci) were associated with clear cell renal cell carcinoma (RCC) and 6 regions (7 loci) with papillary RCC. Notably, we report a variant common in African ancestry individuals ( rs7629500 ) in the 3' untranslated region of VHL, nearly tripling clear cell RCC risk (odds ratio 2.

View Article and Find Full Text PDF

Background: Success rates in endourological procedures, notably percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS), have demonstrated suboptimal outcomes, leading to more reinterventions and radiation exposure. Recently, the use of intraoperative computed tomography (ICT) scans has been hypothesized as a promising solution for improving outcomes in endourology procedures. With this considered, we conducted a comprehensive systematic review and meta-analysis encompassing all available studies that evaluate the impact of the use of intraoperative CT scans on surgical outcomes compared to conventional fluoroscopic-guided procedures.

View Article and Find Full Text PDF