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Nelson BJ, Fazili A, Erturk E. Risk Factors for Readmission after Shock Wave Lithotripsy for Urinary Stones. Urol Pract 2017; 4:106-110. [PMID: 37592667 DOI: 10.1016/j.urpr.2016.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cost saving measures have put an increased emphasis on reducing complications and rehospitalization. We analyzed the rate of readmission and presentation to emergency departments within 90 days of shock wave lithotripsy to identify prognostic risk factors for this outcome. METHODS We retrospectively reviewed patients who underwent shock wave lithotripsy at our institution from January 2011 to May 2013 using the Modulith® SLX-F2 lithotripter for solitary ureteral or renal stones 2.0 cm or smaller. The primary outcome was readmission or presentation to the emergency department within 90 days. Secondary end points included stone-free rates at 30 and 90 days. Univariate and multivariate logistic regression analyses were performed to identify risk factors for primary and secondary outcomes. RESULTS The study population consisted of 307 patients with renal and 270 with ureteral stones. Mean stone size was 9.2 mm. The 90-day readmission rate was 11.6%. Of analyzed metrics only urgency of procedure predicted readmission. Among patients who were readmitted renal colic was the most common chief complaint (67%), followed by infection (10%) and postoperative hematoma or hematuria (7.5%). Stone-free rates were 57% and 78% at 30 and 90 days, respectively. Stone size and nonurgent shock wave lithotripsy status predicted stone-free status. CONCLUSIONS The 90-day readmission rate following shock wave lithotripsy was 11.6%. Urgency of shock wave lithotripsy was predictive of this outcome. Stone centers should monitor their readmission rates following shock wave lithotripsy to establish national standards and guide decision making when considering other endourological methods if these outcomes are considered unacceptable.
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Affiliation(s)
- Benjamin J Nelson
- Department of Urology, University of Rochester Medical Center, Rochester, New York
| | - Anees Fazili
- Department of Urology, University of Rochester Medical Center, Rochester, New York
| | - Erdal Erturk
- Department of Urology, University of Rochester Medical Center, Rochester, New York
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Rojas KD, Montero ML, Yao J, Messing E, Fazili A, Joseph J, Ou Y, Rubens DJ, Parker KJ, Davatzikos C, Castaneda B. Methodology to study the three-dimensional spatial distribution of prostate cancer and their dependence on clinical parameters. J Med Imaging (Bellingham) 2015; 2:037502. [PMID: 26236756 PMCID: PMC4518233 DOI: 10.1117/1.jmi.2.3.037502] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 06/29/2015] [Indexed: 11/14/2022] Open
Abstract
A methodology to study the relationship between clinical variables [e.g., prostate specific antigen (PSA) or Gleason score] and cancer spatial distribution is described. Three-dimensional (3-D) models of 216 glands are reconstructed from digital images of whole mount histopathological slices. The models are deformed into one prostate model selected as an atlas using a combination of rigid, affine, and B-spline deformable registration techniques. Spatial cancer distribution is assessed by counting the number of tumor occurrences among all glands in a given position of the 3-D registered atlas. Finally, a difference between proportions is used to compare different spatial distributions. As a proof of concept, we compare spatial distributions from patients with PSA greater and less than [Formula: see text] and from patients older and younger than 60 years. Results suggest that prostate cancer has a significant difference in the right zone of the prostate between populations with PSA greater and less than [Formula: see text]. Age does not have any impact in the spatial distribution of the disease. The proposed methodology can help to comprehend prostate cancer by understanding its spatial distribution and how it changes according to clinical parameters. Finally, this methodology can be easily adapted to other organs and pathologies.
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Affiliation(s)
- Kristians Diaz Rojas
- Pontificia Universidad Católica del Perú, Department of Engineering, Section in Electrical and Electronic, Laboratory Medical Images, Av. Universitaria 1801, San Miguel Lima 32, Perú
| | - Maria L. Montero
- Pontificia Universidad Católica del Perú, Department of Science, Section of Mathematics, Laboratory Statistics, Av. Universitaria 1801, San Miguel Lima 32, Perú
| | - Jorge Yao
- University of Rochester Medical Center, Department of Pathology and Laboratory Medicine, 601 Elmwood Avenue, Box 648, Rochester, New York 14642, United States
| | - Edward Messing
- University of Rochester Medical Center, Department of Urology, 601 Elmwood Avenue, Box 648, Rochester, New York 14642, United States
| | - Anees Fazili
- University of Rochester Medical Center, Department of Urology, 601 Elmwood Avenue, Box 648, Rochester, New York 14642, United States
| | - Jean Joseph
- University of Rochester Medical Center, Department of Urology, 601 Elmwood Avenue, Box 648, Rochester, New York 14642, United States
| | - Yangming Ou
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02129, United States
| | - Deborah J. Rubens
- University of Rochester Medical Center, Department of Imaging Sciences, 601 Elmwood Avenue, Box 648, Rochester, New York 14642, United States
| | - Kevin J. Parker
- University of Rochester, Department of Electrical and Computer Engineering, Hopeman Engineering Building 203, Box 270126, Rochester, New York 14627, United States
| | - Christos Davatzikos
- University of Pennsylvania, Departments of Radiology and Electrical and Computer Engineering, 3600 Market Street, Suite 380, Philadelphia, Pennsylvania 19104, United States
| | - Benjamin Castaneda
- Pontificia Universidad Católica del Perú, Department of Engineering, Section in Electrical and Electronic, Laboratory Medical Images, Av. Universitaria 1801, San Miguel Lima 32, Perú
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Ghazi A, Siebert A, Fazili A, Agrawal V, feng C, Peyre S. MP23-13 MEDICAL STUDENT DELIBERATE PRACTICE ON A VIRTUAL-REALITY CURRICULUM CAN ACHIEVE EQUIVALENCY TO SENIOR UROLOGY RESIDENT REAL-TIME TRAINING. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Stone J, Candela B, Alleluia V, Fazili A, Richards M, Feng C, Peyre S, Joseph J, Ghazi A. MP23-09 A NOVEL TECHNIQUE FOR SIMULATED SURGICAL PROCEDURES USING 3D PRINTING TECHNOLOGY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Chowriappa A, Raza SJ, Fazili A, Field E, Malito C, Samarasekera D, Shi Y, Ahmed K, Wilding G, Kaouk J, Eun DD, Ghazi A, Peabody JO, Kesavadas T, Mohler JL, Guru KA. Augmented-reality-based skills training for robot-assisted urethrovesical anastomosis: a multi-institutional randomised controlled trial. BJU Int 2014; 115:336-45. [DOI: 10.1111/bju.12704] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ashirwad Chowriappa
- Roswell Park Cancer Institute; Buffalo NY USA
- State University of New York; Buffalo NY USA
| | | | - Anees Fazili
- University of Rochester Medical Center; Rochester NY USA
| | - Erinn Field
- Roswell Park Cancer Institute; Buffalo NY USA
| | | | | | - Yi Shi
- Roswell Park Cancer Institute; Buffalo NY USA
| | | | | | - Jihad Kaouk
- Cleveland Clinic Foundation; Cleveland OH USA
| | | | - Ahmed Ghazi
- University of Rochester Medical Center; Rochester NY USA
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Yeh CR, Da J, Song W, Fazili A, Yeh S. Estrogen receptors in prostate development and cancer. Am J Clin Exp Urol 2014; 2:161-168. [PMID: 25374919 PMCID: PMC4219301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 06/25/2014] [Indexed: 06/04/2023]
Abstract
Prostate cancer (PCa) is an androgen-sensitive disease, which can be pharmacologically controlled by androgen blockade. To date, a growing body of evidence showed that estrogen and estrogen receptors (ERs) could regulate prostate development, as well as cancer initiation and progression. This review will address the expression levels and function of ERs in different stages of PCa progression. The functions of ERs in different types of prostate cells, the ligand effect, and the potential applications of selective estrogen modulators (SERMs) will also be discussed. To further dissect ERs' roles in prostate development, cell type specific ER knockout mouse models were generated. Results collected from the prostate cell type-specific ERαKO mouse models provided new insights about the cell type specific ERα roles in prostate development prenatally and postnatally. The results of ERs' roles in mouse PCa mode and the correlation of ERs expression and biomedical outcome will also be discussed.
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Affiliation(s)
- Chiuan-Ren Yeh
- Department of Urology, University of Rochester Medical Center Rochester, NY 14642
| | - Jun Da
- Department of Urology, University of Rochester Medical Center Rochester, NY 14642
| | - Wenbin Song
- Department of Urology, University of Rochester Medical Center Rochester, NY 14642
| | - Anees Fazili
- Department of Urology, University of Rochester Medical Center Rochester, NY 14642
| | - Shuyuan Yeh
- Department of Urology, University of Rochester Medical Center Rochester, NY 14642
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Fazili A, Levey H, Houman J, Wu G. MP37-12 COMPARISON OF INTRACORPOREAL AND EXTRACORPOREAL ILEAL CONDUITS IN 164 CONSECUTIVE ROBOT-ASSISTED RADICAL CYSTECTOMIES. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Fazili A, Agarawal V, Ghazi A. MP14-09 SIMULATOR OLYMPICS: AN EFFECTIVE INCENTIVE IN PROMOTING VOLUNTARY SIMULATOR TRAINING BY SURGICAL RESIDENTS. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Butt ZM, Fazili A, Tan W, Wilding GE, Filadora V, Kim HL, Mohler JL, O'Leary KA, Guru KA. Does the presence of significant risk factors affect perioperative outcomes after robot-assisted radical cystectomy? BJU Int 2009; 104:986-90. [PMID: 19549262 DOI: 10.1111/j.1464-410x.2009.08539.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the effect of preoperative risk factors on perioperative outcomes up to 3 months after robot-assisted radical cystectomy (RARC), as RC continues to be associated with a high rate of morbidity and mortality. PATIENTS AND METHODS From 2005 to 2007, 66 consecutive patients had RARC at Roswell Park Cancer Institute. Patient demographics, preoperative risk factors and complications up to 3 months after RARC were reviewed from a prospective quality-assurance database. Patients were stratified into high- and low risk groups based on age, previous abdominal surgery, chronic obstructive pulmonary disease (COPD), body mass index (BMI), Revised Cardiac Risk Index (RCRI) and American Society of Anesthesiologists (ASA) score. RESULTS Age, previous abdominal surgery, COPD, BMI, RCRI score and ASA score did not significantly influence complications during or up to 3 months following RARC (P > 0.05). Advanced age was associated with a higher RCRI score (P = 0.014) and an increased likelihood of admission to the Intensive Care Unit (P = 0.007). A higher ASA score was associated with an increased overall hospital stay (P = 0.039). Previous abdominal surgery was associated with more frequent unscheduled postoperative clinic visits (P = 0.014). Operative duration did not significantly influence complication rates (P > 0.05). Fifteen of 62 patients (24%) had a major complication, while 15 (24%) had minor complications within 3 months of surgery. The reoperation rate was 11% and the overall mortality rate was 1.6%. CONCLUSIONS RARC appears to be well tolerated, independent of comorbid risk factors such as age, BMI, RCRI and ASA score.
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Affiliation(s)
- Zubair M Butt
- Urologic Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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Fazili A, Kohler TS, Brannigan RE. FERTILITY PRESERVATION: MICRODISSECTION TESTICULAR SPERM EXTRACTION (MICRO-TESE) IN MEN WITH CANCER PRIOR TO ONCOLOGIC THERAPY. J Urol 2009. [DOI: 10.1016/s0022-5347(09)62043-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yuh B, Butt Z, Fazili A, Piacente P, Tan W, Wilding G, Mohler J, Guru K. Short-term quality-of-life assessed after robot-assisted radical cystectomy: a prospective analysis. BJU Int 2009; 103:800-4. [DOI: 10.1111/j.1464-410x.2008.08070.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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