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Objective: To assess the impact of a planned research gap year (RGY) on match outcomes and research productivity among urology residency applicants in the context of the highly competitive urology specialty and the new pass/fail format for the United States Medical Licensing Exam (USMLE) Step 1 exam., Methods: We conducted an Institutional Review Board-approved analysis of applicants to our program during the 2022-2023 and 2023-2024 application cycles. Data on demographics, medical school rank, having a home urology program, USMLE Step 1 scores, and Electronic Residency Application Service (ERAS) research entries were collected. Match outcomes were verified via the Society of Academic Urologists listing. Statistical analyses were performed to compare characteristics and outcomes between the two cohorts., Results: Out of 560 total applicants, 61 (10.9%) pursued a RGY. RGY applicants were older (28.2 vs 26.9 years, P <.001), attended higher-ranked medical schools (medical school rank 28 vs 56, P = .028), with lower USMLE Step 1 scores (237 vs 244, P = .004). RGY applicants demonstrated higher research productivity, with a median of 26 ERAS research entries compared to 12 in non-RGY applicants (P <.001). Match rates were comparable (88.5% vs 85.3%, P = .496). RGY utilization was similar between allopathic and osteopathic applicants., Conclusion: A planned RGY produced more research but did not culminate in higher match rates. The opportunity to take an RGY was equally accessible to both MD and DO applicants. While an RGY may enhance research output, we did not observe an increased match rate among those who utilized it., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare.

Objective: To evaluate the contribution of the standardized letter of recommendation (SLOR) to the likelihood of matching in urology residency by applying a novel scoring system and characterize utilization in the 2022 application cycle., Methods: We conducted an investigation of all applicants to our urology residency program during the 2022 cycle. We developed a scoring system to assess SLOR strength across all templates. Match outcomes were verified with the Society of Academic Urologists listing. Statistical analysis was performed to assess for factors predictive of a successful match., Results: Out of 386 total applicants, 239 (61.9%) had at least 1 SLOR in their application. SLOR utilization was more prevalent in MD applicants, in those with higher Step 2 scores, and in those who matched (P <.01). The majority of SLOR scores (66.5%) were above a 3.5/5 in our cohort. Step 1 score, number of research entries, and presence of an SLOR were predictive of successful match. However, a SLOR score of <3 was strongly associated with not matching (OR 0.021, P <.01)., Conclusion: The presence of a SLOR in our cohort overall was associated with a successful match. A poor SLOR score was highly deleterious to an applicant's chance of matching in urology. Our SLOR scoring system can be used across all letter templates and demonstrates that strength of SLOR can significantly impact an applicant's chance of matching., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To assess prescribing and refilling trends of narcotics in postoperative urology patients at our institution. Although the opioid epidemic remains a public health threat, no series has assessed prescribing patterns across urologic surgery disciplines following discharge., Methods: All urologic surgeries were retrospectively reviewed from May 2017-April 2018. Demographics, comorbidities, and postoperative pain management strategies were analyzed. Narcotics usage following surgery were reported in total morphine equivalents (TME). Opioid refill rate was characterized by medical specialty and stratified by urologic discipline., Results: 817 cases were reviewed. Mean age and TME at discharge was 57±15.6 years and 35.43±19.5 mg, respectively. 13.6% (mean age 55±15.9) received a narcotic refill following discharge (mean TME/refill 37.7±28.9 mg). A higher proportion of patients with a pre-operative opioid prescription received a refill compared to opioid naïve patients (38.2% vs 21.6%, P < .01). Refill rate did not differ between urologic subspecialties (P = .3). Urologists were only responsible for 20.4% of all refills filled, despite all patients continuing follow-up with their surgeon. Procedures with the highest rates of post-operative refills were in oncology, male reconstruction/trauma and endourology. Patients with a history of chronic pain (OR 1.9, CI 1.1-3.3) preoperative narcotic prescription (OR 1.6, CI 1.0-2.6), and higher ASA score (OR 1.8, CI 1.6-2.8) were more likely to obtain a postoperative opioid prescription refill., Conclusion: Approximately 1 in 7 postoperative urology patients receive a postoperative narcotics refill; however, nearly two-thirds receive refills exclusively from non-urologic providers. Attempts to avoid overprescribing of postoperative narcotics need to account for both surgeon and nonsurgeon sources of opioid refills., (Copyright © 2021 Elsevier Inc. All rights reserved.)

A series of glycolamide naproxen prodrugs containing a nitrate group as a nitric oxide (NO) donor moiety has been synthesized. These compounds were evaluated for their anti-inflammatory activity, naproxen release, and gastric tolerance. Compounds 4a, 4b, 5a, 5b, 7b, and 7c exhibited anti-inflammatory activity equivalent to that of the parent NSAID, naproxen-Na, in the rat carrageenan paw edema model. At equimolar doses relative to naproxen-Na, the NO-donor glycolamide derivatives 4a, 4b, 5a, 5b, 7b, and 7c were gastro-sparing in the rat. Naproxen formation from these NO-donor glycolamides varied among the structures examined, with the N-substituent on the amide group having a particular influence, and demonstrated their prodrug nature. Compound 7b was selected for exemplary demonstration that the glycolamide nitrates can be bioactivated to release NO. These data open the possibility that naproxen glycolamide nitrates may represent a safer alternative to naproxen as anti-inflammatory medicines.

Cyclooxygenase (COX, EC 1.14.99.1) inhibitor-nitric oxide (NO) donor (CINOD) hybrid compounds represent an attractive alternative to NSAID and coxib therapy. This report compares two CINODs, NMI-1182 (naproxen-glyceryl dinitrate) and AZD3582 (naproxen-n-butyl nitrate), for their ability to inhibit COX-1 and -2, deliver bioavailable nitric oxide, and release naproxen, using in vitro biochemical and pharmacological methods. In human whole blood, both CINODs showed inhibition, comparable to naproxen, of both COX isozymes and slowly released naproxen. Both CINODs donated bioavailable NO, as detected by cGMP induction in the pig kidney transformed cell line, LLC-PK1, but NMI-1182 was more potent by 30-100 times than AZD3582, GTN, GDN, and ISDN and considerably faster in inducing cGMP synthesis than AZD3582. The nitrate groups of GTN, NMI-1182, and AZD3582 appeared to be bioactivated via a common pathway, since each compound desensitized LLC-PK1 cells to subsequent challenge with the other compounds. Similar cGMP induction also occurred in normal, untransformed cells (human renal proximal tubule epithelial cells and hepatocytes from man, rat, and monkey); again, NMI-1182 was superior to AZD3582. NMI-1182 was also the more metabolically labile compound, releasing more absolute nitrate and nitrite (total NO(x)) in human stomach (in which NO is salutary) and liver S9 homogenates. Naproxen was also more rapidly freed from NMI-1182 than AZD3582 in human stomach, although liver S9 hydrolyzed both CINODs with similar rates. These in vitro tests revealed that NMI-1182 may be a better CINOD than AZD3582 because of its superior NO donating and naproxen liberating properties.

The aim of the present study was to examine the ability of the nonpungent vanilloid VR1 receptor agonist, olvanil, to activate the afferent and efferent function of capsaicin-sensitive C-fibers in guinea pig airways. We found that while capsaicin (10 nM-10 microM) and resiniferatoxin (0.1 nM-1.0 microM) evoked a robust contraction of the guinea pig trachea in vitro, olvanil (10 nM-10 microM) was a weak spasmogen. In addition, pretreatment with olvanil caused only a minor reduction of subsequent responses to capsaicin or resiniferatoxin. Using single fiber recording from guinea pig airway C-fibers, we found that olvanil (10 microM) did not evoke action potential discharge although these fibers responded vigorously to capsaicin after prolonged treatment with olvanil (10 microM). These findings are indicative of significant differences in the relative sensitivity of vanilloid VR1 receptor-transfected cells and the peripheral terminals of airway C-fibers to pungent and nonpungent vanilloid VR1 receptor agonists.

Cardiovascular disease (CVD) has become the leading cause of death for Native Americans and Alaska Natives. CVD risk factors (diabetes, hypertension, obesity, hypercholesterolemia, smoking, and sedentary lifestyle) have been studied in a number of Native American tribes, and such studies are increasing as the CVD mortality rate rises. This article reviews the literature between 1980 and 1991 concerning the prevalence of CVD risk factors in this population. In addition to summarizing the data, we describe limitations inherent in comparison and address the need for standardization of methodology in future studies.

1. Several alpha 1- and alpha 2-adrenoceptor agonists and antagonists were examined for effects on spontaneous and stimulus-evoked release of [3H]noradrenaline from sympathetic nerves in guinea-pig vas deferens. 2. Prazosin (0.1 and 1 microM), phentolamine (30 microM) and yohimbine (10 microM) each enhanced the stimulus-evoked release of [3H]noradrenaline. 3. Prazosin and phentolamine increased the spontaneous outflow of [3H]noradrenaline, whereas yohimbine was without effect. 4. Methoxamine (10 microM) and clonidine (0.1 microM) inhibited the stimulus-evoked release of [3H]noradrenaline, whereas only methoxamine (1 microM) decreased the spontaneous outflow of [3H]noradrenaline. 5. The identity of prejunctional alpha-adrenoceptors in the guinea-pig vas deferens is discussed.