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Habous M, Tal R, Nassar M, Mahmoud S, Tealab A, Elkhouly M, Kamil U, Kamr H, Mekawi Z, Remeah A, Abdelwahab O, Mulhall J. 163 Defining Predictors of Penile Implant Infection. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Honan M, Serina E, Tal R, Rempel D. Wrist Postures While Typing on a Standard and Split Keyboard. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/154193129503900515] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fifty experienced typists participated in a laboratory based repeated measures study with two factors: keyboard height (three) and keyboard configuration (three). The work surface heights tested were 63, 67 and 71 cm. The three keyboard configurations tested were: standard (Apple Extended™), alternative keyboard A (Microsoft Natural Keyboard) and alternative keyboard B (equivalent to Natural Keyboard with Leveler™ extended). Wrist and forearm posture data was acquired using electronic goniometers during 10 minutes of typing at each keyboard/height level. Across all heights tested, wrist extension, wrist ulnar deviation, and forearm pronation were statistically significantly closer to neutral when using alternative keyboard B than when using the standard keyboard.
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Honan M, Jacobson M, Tal R, Rempel D. Changes in wrist postures during a prolonged typing task. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/154193129604001310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Twenty experienced typists participated in a laboratory based study to determine whether wrist and forearm postures changed over a 4 hour period of intensive keyboard use. Subjects were randomly assigned to use a conventional keyboard or a fixed split keyboard. Posture data was acquired using electrogoniometers after a 10 warm-up period and at the end of each hour. Wrist and forearm postures did not change significantly over the four hour period among subjects using the split geometry keyboard. On the conventional keyboard, all joint postures were stable except right wrist extension and left forearm pronation. The right wrist extension increased by 5° over the four hour period (p=.002) and left pronation decreased by approximately 9° (p=.001). Wrist postures among typists exposed for the first time to a split keyboard remained constant throughout a four hour period of intensive typing. On the conventional keyboard, some postures drifted over the four hour period.
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Terrier J, Tal R, Mulhall J. Troubles sensitifs post-« incision+patch » pour maladie de Lapeyronie. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Irani M, Seifer D, Grazi R, Irani S, Tal R. Vitamin D decreases serum VEGF levels correlating with clinical improvement in vitamin D-deficient women with PCOS: a randomized placebo-controlled trial. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yoder N, Tal R, Martin J. Abdominal ectopic pregnancy cases after in vitro fertilization: a systematic review of a rare complication. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tal R, Liu Y, Pluchino N, Shaikh S, Mamillapalli R, Taylor H. A mouse 5-fluorouracil based submyeloablation model for the study of bone marrow-derived cell trafficking in reproduction. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Habous M, Farag M, Williamson B, Laban O, Mahmoud S, Abdelwahab O, Elkhouly M, Kamil U, Binsaleh S, Tal R, Ralph D, Mulhall JP. Conservative Therapy is an Effective Option in Patients With Localized Infection After Penile Implant Surgery. J Sex Med 2016; 13:972-6. [PMID: 27162191 DOI: 10.1016/j.jsxm.2016.04.064] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/05/2016] [Accepted: 04/10/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Traditionally, penile implant (PI) infections have been managed by removal with immediate or delayed replacement. Recently, interest has been focused on conservative therapy (CT) using antibiotic therapy. AIM To investigate the success rate and predictive factors affecting the outcome of CT in PI infection patients. METHODS Patients diagnosed with early, localized PI infection were considered candidates for CT. Exclusion criteria included temperature >37.5°C, WBC >13,000/μL, and appearance of any sign of sepsis. In patients with purulent drainage, culture swabs were taken and an antibiotic was chosen based on sensitivity results. Oral antibiotics were used until the local infection was completely resolved. Patients were evaluated weekly during this process. RESULTS Thirty-seven patients were retrospectively reviewed and constituted the study population. Mean age was 58.1 (range 37-85; SD 9.9) years. All were diabetic. Mean BMI was 31.8 (range 24-47; SD 5.0). PI was malleable in 33 cases and inflatable in 4 cases. Culture results (n = 19) included Staphylococcus epidermidis (42 %), pseudomonas (21%), Escherichia coli (21%), and S aureus (16%). Four of 37 patients needed the PI removed due to CT failure and onset of systemic symptoms, at a mean time-point of 75 ± 1.8 days after CT commencement. In men who were cured, mean time to complete healing was 49 (range 29-97; SD 15.8) days. Two of 37 patients (5%) had PI removal because of persistent penile pain despite complete wound healing, at a mean time point of 128 ± 2.5 days after CT commencement. All men managed conservatively resumed sexual intercourse. CONCLUSION CT of localized PI infection appears to be a viable option for such patients, with the majority of patients retaining their implant and resuming sexual activity.
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Tal R, Deveci S, Kennison T, Guhring P, Parker M, Narus J, Mulhall J. 099 The Prevalence And Predictors Of Vasovagal Reactions In Men Being Trained In Penile Injection Therapy. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zu'bi F, Ofer Y, Amnipor D, Gruenwald I, Kol S, Amiel G, Tal R. P-01-069 Sperm cryopreservation and utilization in men with testicular cancer. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.03.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Miranda E, Tal R, Guhring P, Parker M, Mulhall J. 033 An Assessment Of The Impact Of Testosterone Supplementation Therapy On Hemoglobin A1C (HbA1C) Levels In Diabetic And Non-Diabetic Men. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tal R, Berookhim B, Stember DS, Jenkins L, Narus J, Garcia D, Wolchasty N, Mulhall JP. MP76-12 REGULAR LOW DOSE SILDENAFIL REDUCES VENOUS LEAK RATES AFTER RADICAL PROSTATECTOMY. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mazzola C, Müller A, Tal R, Mulhall J. Les injections intracaverneuses peuvent-elles sauver les échecs des traitements oraux par inhibiteurs de la phosphodiestérase de type 5 ? Prog Urol 2015; 25:814. [DOI: 10.1016/j.purol.2015.08.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Irani M, Seifer D, Grazi R, Bhatt D, Julka N, Kalgi B, Irani S, Tal O, Tal R. Vitamin D supplementation decreases TGF beta-1 bioavailability correlating with clinical improvement in Vitamin D deficient women with PCOS: a randomized placebo-controlled trial. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mor A, Tal R, Irani M, Garg D, Haberman S, McCalla S, Perlman J, Grazi R, Minkoff H. A simple and fast approach to confirm the presence of an intrauterine pregnancy. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.1090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sullivan J, Tal R, Heck M, Bernstein M, Nelson C, Mulhall J. PD48-01 PEYRONIE'S DISEASE FOLLOWING RADICAL PROSTATECTOMY: INCIDENCE IN A POPULATION WITH FORMAL PRE OPERATIVE ASSESSMENT. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tal R, Matsushita K, Bennett N, Mulhall JP. PD26-11 DEFINING THE UTILITY OF SALVAGE SURGERY FOR INFECTED PENILE IMPLANTS. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tal R, Tal O, Seifer B, Seifer D. Anti-mullerian hormone (AMH) as a predictor of implantation and clinical pregnancy following art: a meta-analysis. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.1142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tal R, Stember DS, Logmanieh N, Narus J, Mulhall JP. Erectile dysfunction in men treated for testicular cancer. BJU Int 2014; 113:907-10. [DOI: 10.1111/bju.12331] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tal R, Deveci S, Choi JM, Mulhall JP. PD20-07 THE CHRONOLOGY AND SEVERITY OF PENILE SENSORY CHANGES AFTER PLAQUE INCISION AND GRAFTING SURGERY FOR PEYRONIE’S DISEASE. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.1697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yossepowitch O, Ehrlich Y, Lubin M, Tal R, Konichezsky M, Baniel J. Lymphovascular invasion in testicular germ cell tumors: clinicopathological correlates. Cent European J Urol 2013; 66:266-70. [PMID: 24707361 PMCID: PMC3974483 DOI: 10.5173/ceju.2013.03.art5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 06/27/2013] [Accepted: 08/20/2013] [Indexed: 11/22/2022] Open
Abstract
Introduction We assessed clinical–pathological correlates of lymphovascular invasion in testicular germ–cell tumors. Material and methods Archived pathology specimens from 145 patients treated by radical orchiectomy for testicular germ cell tumors at our institution in 1995–2006 were reanalyzed by a dedicated urologic pathologist, and the corresponding medical records were reviewed. The association of lymphovascular invasion with clinical and pathological parameters was tested using stepwise logistic regression analysis. Results Lymphovascular invasion was identified in 38 (26%) patients and was associated with younger age, testicular pain at presentation, elevated serum tumor markers, nonseminoma histology, and advanced clinical stage. Orchalgia was indicated as the impetus for referral in 67 (46%) patients and characterized as a dull aching sensation, persistent or intermittent in nature. Among the 98 men diagnosed with clinical stage I, those presenting with testicular pain had a 1.8X–higher likelihood of lymphovascular invasion than those without pain (95% CI 1.13–14.9, p = 0.02), and patients with elevated serum tumor markers had an 8.5–fold increased probability of lymphovascular invasion than those presenting with normal tumor markers (CI 1.1–54.2, p = 0.05). Among men with nonseminoma histology, elevated tumor markers was the strongest predictor of lymphovascular invasion in both univariate and multivariate analyses (OR 5.05, 95% CI 1.16–21.8, p = 0.03). Conclusion Providing pathologists with information on pre–orchiectomy tumor marker levels and, possibly, testicular pain at presentation may increase their vigilance in searching for lymphovascular invasion, potentially improving their diagnostic accuracy. Whether it may also translate into improved oncological outcomes needs further evaluation.
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Tal R, Seifer D, Khanimov M, Grazi R, Leader B. Characterization of women with ultra high serum anti-mullerian hormone (AMH) levels and its association with polycystic ovarian syndrome (PCOS) phenotype. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tal R, Seifer D, Shohat-Tal A, Malter H, Grazi R. Angiopoietin-2 is increased in follicular fluid of polycystic ovarian syndrome (PCOS) women during controlled ovarian stimulation and correlates with number of oocytes retrieved. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nelson CJ, Hsiao W, Balk E, Narus J, Tal R, Bennett NE, Mulhall JP. Injection anxiety and pain in men using intracavernosal injection therapy after radical pelvic surgery. J Sex Med 2013; 10:2559-65. [PMID: 23898886 DOI: 10.1111/jsm.12271] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Intracavernosal injection (ICI) therapy is a well-recognized treatment strategy with high success rates for men with erectile dysfunction. Despite this, injection anxiety and pain related to injection are significant barriers to its use. AIMS This study aims to examine injection anxiety and injection pain in patients using ICI. METHODS Men starting ICI therapy post radical pelvic surgery completed questionnaires at initial visit, at each of the two ICI training sessions and at a 4-month follow-up visit. MAIN OUTCOME MEASURES Injection Anxiety Scale, Injection Pain Scale, Injection Reaction Inventory, and the Erectile Function Domain of the International Index of Erectile Function. RESULTS Average age of the 68 men was 60±8 years. At 4 months, the self-reported frequency of ICI use was: 29%<1/week, 26% 1/week, 40% 2/week, and 5% 3/week. Mean injection anxiety score at first injection was 5.7±2.8 (range 0-10) and significantly decreased to a 4.1±3 at 4 months (P<0.001). At first injection, 65% reported high injection anxiety (≥5) and this significantly decreased to 42% (P=0.003) at 4 months. Anxiety at first injection was negatively related to ICI frequency at 4 months (r=-0.23, P=0.08). Mean injection pain score at first injection was low (2.2±1.8, range 0-10) and 59% rated injection pain≤2. Injection pain remained consistent across time periods. At first injection, injection anxiety (assessed prior to injection) was related to injection pain (r=0.21, P=0.04) and subjects (n=21) who reported high injection anxiety (≥5) across time points, reported an increase in injection pain scores from first injection to 4 months (2.7 vs. 3.7, P=0.05). CONCLUSIONS Although injection anxiety decreased with ICI use, mean injection anxiety remained at a moderate level (4.4) and 42% of men continued to report "high" injection anxiety at 4 months. While injection pain was low, injection anxiety and pain were related. These data suggest the need for a psychological intervention to help lower injection anxiety related to ICI.
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Mulhall JP, Verma N, Deveci S, Tal R, Kobylarz K, Müller A. Sildenafil citrate improves erectile function after castration in a rat model. BJU Int 2013; 113:656-61. [PMID: 23773301 DOI: 10.1111/bju.12175] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
TAKE HOME MESSAGE The administration of phosphodiesterase 5 inhibitor commencing at the time of castration might preserve erectile function. OBJECTIVE To determine if sildenafil citrate treatment could improve erectile function after castration. To determine if sildenafil citrate treatment reduces collagenisation and apoptosis in erectile tissue after castration. MATERIALS AND METHODS In all, 60 Sprague-Dawley rats were studied; the rats were divided into the following groups: sham - no orchidectomy (S), control - orchidectomy only (O) and treatment - orchidectomy plus sildenafil treatment (V), with 10 rats per group. Erectile haemodynamics assessment was done at 7 days (S7, O7, V7) and at 28 days (S28, O28, V28) yielding a total of six groupings. Functional assessment measured the mean maximum intracavernosal pressure-mean arterial pressure (ICP/MAP) ratio. TUNEL assay was used to define apoptotic indices (AIs) and Masson's trichrome staining was used to evaluate smooth muscle-collagen (SM-C) ratios. RESULTS The S28 group had the highest and the O7 group the lowest ICP/MAP ratio, at a mean (sd) of 70 (6)% and 36 (6)%, respectively. Both treatment groups, V7 [42 (12)%] and V28 [49 (13)%] showed statistically significant improvements over their corresponding control groups: O7 [36 (6)%] and O28 [37 (9)%] (P < 0.05). However, ICP/MAP values for V7 and V28 remained significantly below the S28 group (P < 0.001). There were no significant differences in ICP/MAP values between the 28-day and 7-day ICP/MAP ratios within each group (S, O, V). There were no significant differences in SM-C ratio between the O and V groups (O7 vs V7, P = 0.45; O28 vs V28, P = 0.16). There were no significant differences in AIs between the O and V groups (O7 vs V7, P = 0.54; O28 vs V28, P = 0.8). CONCLUSIONS Daily treatment with sildenafil improved erectile function in rats after castration. ICP/MAP ratios increased significantly in the treatment groups compared with the control groups with the greatest erectile function occurring 28 days from administration. In this series of experiments the improved erectile function recovery with sildenafil after surgical castration cannot be explained by smooth muscle protection and decreased collagenisation. The improved erectile function with sildenafil after surgical castration cannot be explained by reduced apoptosis in erectile tissue.
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