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Effect with the COVID-19 lockdown on hard working liver transplant recipients. Just one centre observational review.
The rate of pT0 in the surgery only group was 2.7% compared to 15.0% (p < 0.001) for patients treated with NAC. On multivariate analysis, patients of AA race that received NAC were less likely to achieve pT0 (OR = 0.55, 95% CI 0.31-0.98, p = 0.04) when controlling for age, sex, co-morbidities income, education and timing of cystectomy after starting NAC.

Our results suggest that African American patients are less likely to achieve pathologic complete response to NAC prior to cystectomy.
Our results suggest that African American patients are less likely to achieve pathologic complete response to NAC prior to cystectomy.INTRODUCTION The opioid epidemic is a growing problem in the United States. There is a high rate of opioid oversupply for treatment of symptomatic nephrolithiasis, partly due to patients being seen by multiple providers. In Pennsylvania, there are efforts to integrate a prescription drug monitoring program (PDMP) within the electronic medical record (EMR). The objectives of this study were to evaluate prescribing practices for opioids for symptomatic nephrolithiasis and the incidence of prescriptions not documented within the EMR.
Adults who presented for treatment of symptomatic nephrolithiasis were sequentially evaluated from May - October 2017 at Penn State Milton S. Hershey Medical Center. With IRB approval, we evaluated opioids prescribed in the EMR, which was compared to the PDMP for each stone episode. We calculated daily morphine milligram equivalents (MME) and total MME available to patients.

A total of 301 patients were identified (52% male) with a mean age of 50.0 +/- 16.7 years and 249 (83%) ofinimize opioid use and reduce oversupplying patients.INTRODUCTION Distal ureteral stones (DUS) are common in patients presenting to the emergency department (ED) with renal colic. The majority of DUS will pass spontaneously and therefore conservative care is common. Follow up is imperative as some of these stones might not pass and potentially lead to complications. The aim of our study was to evaluate the rate of compliance with follow up and to find predictive variables for it.
We retrospectively surveyed the medical records of all patients who had a non-contrast computed tomography (NCCT) at our ED between 01/03/16 and 31/5/17. We included patients with a DUS smaller than 10 mm that were treated conservatively. We obtained demographic, clinical, laboratory and imaging data. Compliance to follow up was evaluated by surveying the medical records and by calling the patients. We then compared the characteristics of patients who returned for follow up to those who did not.

A total of 230 consecutive patients were included in our cohort 194 (84%) patients were male and the average age was 46 y (21-82); 138 patients (60%) returned for a follow up visit while 92 patients (40%) did not. Univariate analysis revealed stone size and admission to hospital to be predictive of compliance to follow up while multivariate analysis revealed only hospital admission to be predictive of compliance.

Only 60% of the patients with DUS treated conservatively return for a follow up visit. Hospital admission, which likely reflects appropriate patients counseling by a urologist and adequate follow up scheduling, was found to be associated with increased compliance with follow up.
Only 60% of the patients with DUS treated conservatively return for a follow up visit. Hospital admission, which likely reflects appropriate patients counseling by a urologist and adequate follow up scheduling, was found to be associated with increased compliance with follow up.INTRODUCTION Inter-institutional re-review of prostate needle biopsy (PNBx) material is required at many institutions before definitive treatment, but adds time and cost and may not significantly alter urologic management. We aim to determine the utility of universal PNBx re-review on influencing the decision to recommend definitive local therapy for patients with prostate cancer.
From 2017-2020, 590 prostate biopsy specimens from outside institutions were re-reviewed at our center for patients considering prostatectomy. Clinical and pathologic characteristics from initial and secondary review were analyzed. check details Potential for change in treatment candidacy (CTC) was determined by re-diagnosis to non-malignant tissue or change in candidacy for active surveillance (AS) versus definitive treatment (i.e. prostatectomy or radiation therapy). Thus, the following scenarios were considered CTC downgrading to non-malignant tissue, downgrading ISUP Grade Group (GG) ≥ 2 to GG1, and upgrading GG1 to GG ≥ 2. Any changes betwet in patients with GG1 and GG2 prostate cancer, i.e. those considering AS. This process appears unnecessary in GG3+ patients, as management for patients considering surgery would not change. This may allow for judicious redirection of hospital resources.INTRODUCTION We sought to describe clinical characteristics and identify prognostic factors among patients with primary malignancies of the epididymis (PMEs).
The Surveillance, Epidemiology, and End Results (SEER) database (1975-2015) was queried to identify patients with PME. Descriptive statistics and multivariable Cox proportional hazards models were used.

Eighty-nine patients with PME were identified. Median age was 57 years (5-85), and median overall survival (OS) was 16.8 years. The most commonly represented histologies were rhabdomyosarcoma (19.1%), B-cell lymphoma (16.9%), leiomyosarcoma (16.9%), and liposarcoma (12.4%). In multivariable analysis, tumor size ≥ 4 cm was associated with worse OS (HR = 4.46, p = 0.01) compared to tumors < 4 cm. Patients with nonsarcomatoid histology had OS similar to patients with sarcomatoid histology (HR = 0.95, p = 0.92). Disease with regional invasion (HR = 5.19, p = 0.007) and distant metastasis (HR = 29.80, p = 0.0002) had worse OS compared to localized disease. Receipt of radiotherapy was associated with enhanced OS (HR = 0.10, p = 0.006), whereas receipt of chemotherapy was not associated with OS.

We describe the largest cohort of PMEs to date. Larger lesions and tumor stage were independently associated with poor overall survival, while receipt of radiotherapy was associated with enhanced overall survival.
We describe the largest cohort of PMEs to date. Larger lesions and tumor stage were independently associated with poor overall survival, while receipt of radiotherapy was associated with enhanced overall survival.INTRODUCTION To assess the relationship between pain after ureteral stent removal and patient and procedural factors.
A validated survey designed to assess the relationship between quality of life and treatment decisions in kidney stone disease was randomly distributed to patients with a history of a ureteral stent in seven medical centers across North America participating in an endourology research collaborative between July 2016 and June 2018. The primary outcome was increased pain after ureteral stent removal. Statistical analyses were performed using Chi-square and multiple logistic regression.

A total of 327 surveys were analyzed. Twenty seven percent of patients reported increased pain in the hours after ureteral stent removal. Patients with a stent ≤ 7 days were significantly more likely to experience pain after stent removal compared to those with a stent > 7 days (33.3% versus 22.8%, p = 0.04). Female gender (OR 2.41, 95% CI 1.42-4.10) was associated with increased pain after stent removal, while increasing age was inversely associated (OR 0.52, 95% CI 0.36-0.74). After adjustment, patients with a stent > 7 days were significantly less likely to report pain in the hours after removal (OR 0.59, 95% CI 0.35-0.99).

Approximately one in four patients will experience increased pain after ureteral stent removal. Female patients, younger patients, and patients with a stent ≤ 7 days were more likely to experience an increase in pain immediately following stent removal. Understanding factors associated with post-stent removal pain may be helpful in counseling patients at high risk stent removal morbidity.
Approximately one in four patients will experience increased pain after ureteral stent removal. Female patients, younger patients, and patients with a stent ≤ 7 days were more likely to experience an increase in pain immediately following stent removal. Understanding factors associated with post-stent removal pain may be helpful in counseling patients at high risk stent removal morbidity.INTRODUCTION The advent of ureteroscopy has revolutionized the treatment many urologic diseases, including benign essential hematuria. This systematic review examines the treatment of benign essential hematuria (BEH) with ureteroscopic interventions.
We performed a systematic review of the literature from 1977 to May 2020. We included studies that evaluated the use of ureteroscopy to diagnose or treat BEH. Demographics, follow up, findings, treatment method and success rate were extracted from each identified paper. Quality analysis was performed independently by both authors.

Our search resulted in 587 articles. Fifteen of these studies met inclusion criteria and were included in the final analysis. No randomized controlled trials were found. All 15 studies were case series. Nine studies were graded as good, five as fair, and one as poor. Follow up ranged from 2 to 108 months. A total of 307 patients underwent ureteroscopy for suspected BEH; 223 (73%) were diagnosed with a discrete lesion, 33 (11%) with a diffuse lesion, and 44 (14%) had no lesions seen on ureteroscopy. Of those diagnosed with discrete lesions, the most common was minute venous ruptures (35%), followed by hemangiomas (26%). Ureteroscopic treatment successfully relieved the hematuria and symptoms in most patients, and was more successful in those treated for discrete lesion (115/120, 96%) than diffuse (10/19, 53%).

Ureteroscopic treatment of BEH yields excellent outcomes. In this systematic review, 96% of patients with discrete lesions and 53% of patients with diffuse lesions had resolution of their hematuria after ureteroscopic interventions.
Ureteroscopic treatment of BEH yields excellent outcomes. In this systematic review, 96% of patients with discrete lesions and 53% of patients with diffuse lesions had resolution of their hematuria after ureteroscopic interventions.The University of Central Florida Health Sciences Library is a digital library with 98% of resources being electronic and available online. Though almost all aspects of the library's operations were impacted by the closing of the physical space during the coronavirus pandemic, being a digital library helped the library team transition quickly to remote reference, programming and instruction services.COVID-19, a novel respiratory disease caused by the SARS-CoV-2 coronavirus, was first recognized in Wuhan, China in December 2019 and declared a pandemic by the World Health Organization in March 2020. Health science librarians continue to navigate the global health crisis while providing critical information services to their institutions. An informal survey was conducted to obtain some general information on the types of responses by health science librarians to this event. Among the findings is an opportunity for librarians to strengthen interdepartmental relationships and disaster response plans in preparation for future pandemics and disaster events.
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