Soham Dasgupta¹, Megan Stark², Sonal Bhatt³, Peter Fischbach¹, Shriprasad Deshpande¹

Congenital Heart Disease, Vol.13, No.6, pp. 1058-1063, 2018, DOI:10.1111/chd.12681

Abstract Introduction: A cardiac cause is an extremely rare etiology of pediatric chest pain. Despite its low sensitivity/specificity, exercise stress testing (EST) is widely used to determine the prognosis in patients with suspected/established coronary disease. We aimed to look at the utility of a combined cardiopulmonary EST in the evaluation of pediatric patients with chest pain.
Methods: After institutional review board approval, a retrospective chart review was performed of all pediatric patients who were referred for an EST for chest pain from January 2014 to 2017. Patients with incomplete records, severe congenital heart disease, and a prior EST… More >

Susan F. Saleeb¹, Sarah R. McLaughlin², Dionne A. Graham², Kevin G. Friedman¹, David R. Fulton¹

Congenital Heart Disease, Vol.13, No.1, pp. 46-51, 2018, DOI:10.1111/chd.12539

Abstract Objective: Using a Standardized Clinical Assessment and Management Plan (SCAMP) for pediatric patients presenting to clinic with chest pain, we evaluated the cost impact associated with implementation of the care algorithm. Prior to introduction of the SCAMP, we analyzed charges for 406 patients with chest pain, seen in 2009, and predicted 21% reduction of overall charges had the SCAMP methodology been used. The SCAMP recommended an echocardiogram for history, examination, or ECG findings suggestive of a cardiac etiology for chest pain.
Design: Resource utilization was reviewed for 1517 patients (7-21 years) enrolled in the SCAMP from July… More >

Adam J. Rensing¹, Anand Mohapatra¹, Aaron M. Potretzke¹, Jennifer K. Sehn², Robert S. Figenshau¹

Canadian Journal of Urology, Vol.24, No.1, pp. 8673-8675, 2017

Abstract Lymphoepithelioma-like carcinoma (LELC) is a rare finding in the upper urinary tract. The presenting clinical findings mimic those of other more common upper-tract tumors, such as urothelial carcinoma. Preoperative imaging has not been shown to reliably predict the diagnosis of LELC. This tumor can be misdiagnosed as a reactive inflammatory lesion or lymphoma if the proper immunohistochemical stains for cytokeratin are not used. More >

Nazih Khater, Mohamed Keheila, Michelle Lightfoot, Jim Shen, Samuel Abourbih, Muhannad Alsyouf, Roger Li, D. Duane Baldwin

Canadian Journal of Urology, Vol.24, No.1, pp. 8634-8640, 2017

Abstract Introduction: Percutaneous nephrolithotomy (PCNL) is associated with significant variability in postoperative pain and subsequent narcotic use. The purpose of this study was to determine the factors associated with high narcotic use following PCNL.
Materials and methods: A single-center retrospective review of patients undergoing initial PCNL between 2004 and 2014 was performed. Preoperative, intraoperative and postoperative factors associated with postoperative narcotic usage were analyzed. The primary outcome variable was mean narcotic usage, standardized to intravenous morphine-equivalents. Patients in the lowest 75th percentile were compared to those in the highest 25th percentile. Univariate and multivariate statistical analyses were performed, with… More >

James Furr¹, Ryan Baker¹, Quy Pham¹, Puneet Sindhwani²

Canadian Journal of Urology, Vol.24, No.2, pp. 8744-8748, 2017

Abstract Introduction: Advances in vasectomy technique have minimized patient discomfort; however fear of pain remains a primary concern. The objective is to determine how the anticipation of pain associated with vasectomy compares with patient's actual intraoperative experienced pain levels.
Materials and methods: A cohort of patients undergoing clinic vasectomy was analyzed. Using visual analog pain scale patients were asked to rate their anticipated pain score (APS) pre-procedure and then an experienced pain score (EPS) post-procedure. Patients were also stratified by APS scores (high versus low). Changes in pain score were compared across these groups. Pain scores stratified by… More >

Ram A. Pathak¹, David D. Thiel¹, Alexander Parker², Michael G. Heckman³, Julia E. Crook³, Nancy N. Diehl³, Andrea Tavlarides², Scott W. Alford¹, Todd C. Igel¹

Canadian Journal of Urology, Vol.24, No.3, pp. 8795-8801, 2017

Abstract Introduction: To compare visual analog scale (VAS) pain scores between patients with a 2-minute versus 10-minute delay of peri-prostatic lidocaine injection prior to transrectal ultrasound-guided prostate biopsies (TRUS-bx).
Materials and methods: Eighty patients who underwent standard 12-core TRUS-bx by a single surgeon were prospectively randomized into four different treatment arms: bibasilar injection with a 2-minute delay, bibasilar injection plus a single apical injection with a 2-minute delay, bibasilar injection with a 10-minute delay, and bibasilar injection plus a single apical injection with a 10-minute delay. Patients were asked to report their level of pain on the VAS… More >

Masaaki Yanishi, Hidefumi Kinoshita, Takashi Yoshida, Hisanori Taniguchi, Kenji Yoshida, Takao Mishima, Yoshihiro Komai, Kaneki Yasuda, Motohiko Sugi, Tadashi Matsuda

Canadian Journal of Urology, Vol.24, No.6, pp. 9098-9102, 2017

Abstract Introduction: To evaluate safety and excellent cosmetic outcome with laparoendoscopic single-site surgery (LESS). In this study, we compared the usefulness and efficacy of LESS versus conventional laparoscopic surgery for the treatment of urachal remnants.
Materials and methods: We retrospectively reviewed the medical records of 20 consecutive patients who underwent either conventional laparoscopic surgery or LESS from January 2007 to February 2015 at Kansai Medical University Hospital. Ten patients underwent surgery using the standard laparoscopic 3-port technique, and 10 patients underwent LESS. The patients included 12 males and 8 females (mean age, 24.5 years; range, 10-68 years). The… More >

Jimmy C. Lu¹, Manish Bansal², Sarina K. Behera³, Jeffrey R. Boris⁴, Brian Cardis⁵, John S. Hokanson⁶, Bahram Kakavand⁷, Roy Jedeikin⁸

Congenital Heart Disease, Vol.12, No.6, pp. 751-755, 2017, DOI:10.1111/chd.12509

Abstract Objective: As part of the American College of Cardiology Adult Congenital and Pediatric Cardiology Section effort to develop quality metrics (QMs) for ambulatory pediatric practice, the chest pain subcommittee aimed to develop QMs for evaluation of chest pain.
Design: A group of 8 pediatric cardiologists formulated candidate QMs in the areas of history, physical examination, and testing. Consensus candidate QMs were submitted to an expert panel for scoring by the RAND-UCLA modified Delphi process. Recommended QMs were then available for open comments from all members.
Patients: These QMs are intended for use in patients 5–18 years old, referred… More >

Baogang Tian¹, Yang Shao¹, Zhijiong Wang¹, Jian Li^2,*

Molecular & Cellular Biomechanics, Vol.14, No.3, pp. 187-194, 2017, DOI:10.3970/mcb.2017.014.187

Abstract The purpose of this study was to explore the clinical efficacy and safety of posterior pedicle screw fixation in the treatment of thoracolumbar burst fracture. A total of 120 patients with thoracolumbar burst fractures were selected from January 2014 to December 2016. 60 patients were divided into the study group, and 60 patients were as the control group. The patients in the study group were treated with posterior pedicle screw fixation. The control group was treated with posterior non-traumatic pedicle screw fixation. After treatment, there were six months follow up. The clinical indexes, complications, and… More >

Iryna Makovey, Robert Dolinga, Daniel A. Shoskes

Canadian Journal of Urology, Vol.23, No.1, pp. 8176-8178, 2016

Abstract Psychological factors may play a role in the pathophysiology of chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS). This case series describes a cohort of 10 men presenting with CP/CPPS whose symptoms began after an extramarital sexual encounter, who strongly believed they had a sexually transmitted infection (STI) despite negative testing, and who have had no improvement with empiric antibiotic treatment. Patients’ clinical presentation and physical exam findings are reviewed. All men were clinically phenotyped with the UPOINT system. Pelvic floor spasm and not infection was prominent in these men. Treatment recommendations are proposed and compliance More >