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To describe a rare case of gummatous syphilis of the penis with urethrocutaneous fistula mimicking penile carcinoma causing a diagnostic dilemma.
A 54 year old man presented with an ulcerative lesion on glans penis. Patient was managed with partial penectomy in view of erosive growth giving rise to urethrocutaneous fistula.
Histopathology showed granulation tissue, necrotizing vasculitis and epithelioid cell granuloma. Immunohistochemistry stained positive for Treponema and patient was treated accordingly.
Syphilis is rarely encountered in daily clinical practice in the penicillin era. Despite a negative serology and the clinical picture highly suggestive of malignancy, the histopathology helped in clinching the rare diagnosis.
Syphilis is rarely encountered in daily clinical practice in the penicillin era. Despite a negative serology and the clinical picture highly suggestive of malignancy, the histopathology helped in clinching the rare diagnosis.
Crizotinib is a first-generation tyrosine kinase inhibitor used for anaplastic lymphoma kinase (ALK) positive cancers. Simple and complex renal cyst formation is a rare complication of crizotinib use that has been reported previously in the adult population.
We report a case of a right renal mass in a 17-year-old with ALK-positive epithelioid inflammatory myofibroblastic sarcoma treated with Crizotinib. After cessation of Crizotinib and initiating Alectenib, a second generation ALK inhibitor, the mass decreased in size and the patient remained asymptomatic without evidence of recurrence at three months of follow-up.
We report a case of a right renal mass in a 17-year-old with ALK-positive epithelioid inflammatory myofibroblastic sarcoma treated with Crizotinib. After cessation of Crizotinib and initiating Alectenib, a second generation ALK inhibitor, the mass decreased in size and the patient remained asymptomatic without evidence of recurrence at three months of follow-up.
To determine predictive factors for antimicrobial resistance patterns and to develop an antimicrobial treatment algorithm for afebrile outpatients presenting with complicated cystitis.
We performed a retrospective, single-center, cross-sectional study of 2,891 outpatients with a diagnosed afebrile complicated cystitis from 2012 to 2018. For patients with confirmed urinary tract infection and antimicrobial sensitivities, univariate analyses and multivariable regression models were used to determine odds ratios for predicting resistance to trimethoprim-sulfamethoxazole, ciprofloxacin, nitrofurantoin, first-generation cephalosporin, and third-generation cephalosporin for the 2012-2016 data. Antimicrobial choice algorithms were created using 2012-2016 results and tested on 2017-2018 data.
For afebrile outpatients presenting with complicated cystitis, overall prevalence of resistance for trimethoprim-sulfamethoxazole, ciprofloxacin, nitrofurantoin, first-generation cephalosporin, and third-generation cephalo are dependent on patient place of residence (ZIP code), status of the host urinary tract (complicated or uncomplicated), and prior urine culture resistance data. When using our complicated cystitis treatment algorithm regardless of uropathogen, our results outperformed real-life scenario provider choice and our prior published algorithm for uncomplicated cystitis, which can help guide empiric antimicrobial choice.
To assessed rates of positive publications within the urologic literature, comparing the years 2012 and 2017.
All studies published in Journal of Urology, Neurourology and Urodynamics, Urologic Oncology, Journal of Endourology, and Urology in 2012 and 2017 were reviewed. The primary study outcome was proportion of positive studies. Additional article characteristics, including associated citations and subspecialty focus, were recorded and statistical analyses used to assess for differences in negative publication rates based on these variables.
A total of 1,796 articles meeting inclusion criteria were analyzed (2012, 959; 2017, 837). The overall proportion of positive studies decreased in comparison of 2012 and 2017. (90%-86%, P =.01). A statistically significant decrease was seen in 2 of 5 journals Neurourology and Urodynamics (97%-87%, P = .01) and Journal of Endourology (93%-83%, P <.01). DFMO inhibitor There were no significant differences in associated citations for positive vs negative studies in either year. Logistic regression focused on year and journal revealed that studies published in 2017 and Urology were more likely to be negative.
The vast majority of studies within the urologic literature are positive, with only a small increase in negative study publication comparing 2012 vs 2017. Continued efforts are needed to identify publication bias and promote dissemination of negative research findings.
The vast majority of studies within the urologic literature are positive, with only a small increase in negative study publication comparing 2012 vs 2017. Continued efforts are needed to identify publication bias and promote dissemination of negative research findings.
To capture the perspectives of urology program directors (PDs) regarding the change in United States Medical Licensing Examination (USMLE) Step 1 scoring to pass/fail (binary) and the impact of this change on the urology residency application process.
A validated survey was developed and distributed via email to urology PDs at all Accreditation Council for Graduate Medical Education-accredited programs.
A total of 65 PDs completed the survey, for a response rate of 49.0%. Most PDs (58.7%) did not agree that binary USMLE Step 1 scoring is a good idea. The majority (84.6%) felt that this change would make it more difficult to compare applicants objectively and that the change would increase emphasis on Step 2 clinical knowledge (CK) scores. Likewise, 73.8% of PDs reported that they would start requiring applicants to submit Step 2 CK scores and 78.5% of PDs felt that Step 2 CK should remain numerically scored. Free text responses highlighted concerns for students at medical schools with pass/fail grading n of applicants with respect to the early match timeline.
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