22 results on '"Lydia Glick"'
Search Results
2. Preventing Prostate Biopsy Complications: to Augment or to Swab?
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Mark Mann, Kanata Syed, Jay D. Raman, Timothy M. Han, Robert G. Uzzo, Thomas J. Guzzo, John Danella, Lydia Glick, Sage Vincent, Eric A. Singer, Jeffrey J. Tomaszweski, Marc Smaldone, Bruce L. Jacobs, Adam C. Reese, Edouard J. Trabulsi, Leonard G. Gomella, Serge Ginzburg, Thomas Lanchoney, and Danielle Squadron more...
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Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Prostate biopsy ,medicine.drug_class ,Urology ,Antibiotics ,030232 urology & nephrology ,Risk Assessment ,Sepsis ,03 medical and health sciences ,Prostate cancer ,Postoperative Complications ,0302 clinical medicine ,Prostate ,Internal medicine ,Biopsy ,medicine ,Humans ,Antibiotic prophylaxis ,Ultrasonography, Interventional ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Rectum ,Bacterial Infections ,Odds ratio ,Antibiotic Prophylaxis ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,business - Abstract
To use data from a large, prospectively- acquired regional collaborative database to compare the risk of infectious complications associated with three American Urologic Association- recommended antibiotic prophylaxis pathways, including culture-directed or augmented antibiotics, following prostate biopsy.Data on prostate biopsies and outcomes were collected from the Pennsylvania Urologic Regional Collaborative, a regional quality collaborative working to improve the diagnosis and treatment of prostate cancer. Patients were categorized as receiving one of three prophylaxis pathways: culture-directed, augmented, or provider-discretion. Infectious complications included fever, urinary tract infections or sepsis within one month of biopsy. Odds ratios of infectious complication by pathway were determined, and univariate and multivariate analyses of patient and biopsy characteristics were performed.11,940 biopsies were included, 120 of which resulted in infectious outcomes. Of the total biopsies, 3246 used "culture-directed", 1446 used "augmented" and 7207 used "provider-discretion" prophylaxis. Compared to provider-discretion, the culture-directed pathway had 84% less chance of any infectious outcome (OR= 0.159, 95% CI = [0.074, 0.344], P0.001). There was no difference in infectious complications between augmented and provider-discretion pathways.The culture-directed pathway for transrectal prostate biopsy resulted in significantly fewer infectious complications compared to other prophylaxis strategies. Tailoring antibiotics addresses antibiotic-resistant bacteria and reduces future risk of resistance. These findings make a strong case for incorporating culture-directed antibiotic prophylaxis into clinical practice guidelines to reduce infection following prostate biopsies. more...
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- 2021
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Catalog
3. MP33-04 CONTRAST-ENHANCED ULTRASONOGRAPHY FOR THE EVALUATION OF COMPLEX RENAL CYSTS
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Cassra Clark, Corinne Wessner, Shuo Wang, Andrew Denisenko, Andrew Shumaker, Joonyau Leong, Andrea Quinn, Erica Mann, Lydia Glick, Timothy Han, Kibo Nam, Katherine Smentkowski, John Eisenbrey, Leonard Gomella, Edouard Trabulsi, Costas Lallas, Mark Mann, James Mark, Flemming Forsberg, Andrej Lyshchik, Ethan Halpern, and Thenappan Chandrasekar more...
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Urology - Published
- 2022
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4. The Evidence For and Against Prostate-Reducing Procedures for Men with Neurogenic Bladder
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Timothy M. Han, Lydia Glick, Patrick J. Shenot, Akhil K Das, and Alex Uhr
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medicine.medical_specialty ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Population ,030232 urology & nephrology ,Urology ,Hyperplasia ,urologic and male genital diseases ,medicine.disease ,Biochemistry ,03 medical and health sciences ,Bladder outlet obstruction ,0302 clinical medicine ,medicine.anatomical_structure ,Quality of life ,Lower urinary tract symptoms ,Prostate ,Concomitant ,medicine ,business ,education ,Molecular Biology ,Neurogenic bladder dysfunction - Abstract
The evaluation of anatomic bladder outlet obstruction due to benign prostatic hyperplasia in patients with neurogenic bladder dysfunction can be a challenging and complex process for urologists. Lower urinary tract symptoms are non-specific, and the attribution of symptoms to underlying neurologic disease may result in withholding potentially beneficial therapies and procedures from patients with benign prostatic hyperplasia. Conversely, the underlying neurologic disorder may have profound effects on lower urinary tract symptoms and quality of life and must be considered in patient management decisions. Thorough evaluation is necessary to evaluate male patients with concomitant benign prostatic hyperplasia and neurogenic bladder with careful attention to the underlying neurologic disease. While surgical management of anatomic bladder outlet obstruction has a clear role in carefully selected and thoroughly evaluated patients with neurogenic bladder, treatment strategies must be individualized for each patient. This review seeks to explore the role of prostate-reducing surgeries in management of patients with neurogenic bladder and to compile evidence for and against these procedures in this population. Only a few studies have been published exploring prostate-reducing surgery in the management of patients with neurogenic bladder, with no recent trials. These existing studies are poorly controlled and are characterized by small, heterogeneous study populations, retrospective design, and high risk of bias. While some studies suggest positive outcomes from prostate-reducing surgery for management of patients with neurogenic bladder, more high-quality trials are needed. more...
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- 2020
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5. Castleman Disease: An Uncommon Mass in the Retroperitoneum
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Timothy M. Han, Ashley N. Vogel, Kim HooKim, Helen Y. Xu, Lydia Glick, and Costas D. Lallas
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Adult ,medicine.medical_specialty ,business.industry ,Castleman Disease ,Urology ,Castleman disease ,MEDLINE ,medicine.disease ,medicine.anatomical_structure ,Humans ,Medicine ,Retroperitoneal space ,Female ,Retroperitoneal Space ,Radiology ,business - Published
- 2020
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6. How I Do It: PureWick female external catheter: a non-invasive urine management system for incontinent women
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Alex, Uhr, Lydia, Glick, Suzanne, Barron, Jillian, Zavodnick, James R, Mark, Patrick, Shenot, and Alana, Murphy
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Cross Infection ,Catheter-Related Infections ,Urinary Tract Infections ,Humans ,Female ,Urinary Catheters ,Urinary Catheterization - Abstract
Catheter associated urinary tract infections (CAUTIs) are common hospital-acquired infections and remain a significant medical and financial challenge to the healthcare system. Despite this risk, incontinent women may require prolonged catheterization to accurately monitor urine output and prevent skin breakdown. The PureWick Female External Urinary Catheter is a promising non-invasive urine collection system for use in incontinent women that may help reduce CAUTI rates, maintain skin integrity, accurately quantify urine output, and avoid extra healthcare costs. more...
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- 2021
7. Saȉd Sheikh Samatar and Lydia Glick Samatar—love, poetry, and history in the Horn of Africa
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Peter B. Golden, David D. Laitin, Jonathan Lurie, and Lydia Glick Samatar
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History ,Poetry ,French horn ,media_common.quotation_subject ,Moirai ,Ancient history ,Geopolitics ,Romance ,Somali ,language.human_language ,language ,Fiqh ,Diplomacy ,media_common - Abstract
The Horn of Africa’s arduous environment and distinctive culture have long challenged scholars, geopolitical diplomats, and the Somali people who make a living in the deserts of the Ethiopian Ogaden, the Somali coastal cities, and on the trade routes of the region. Going well beyond the received academic theories that elevated clanship to explain everything in pastoral life, Saȉd Samatar’s deep experience in his community led him to see the importance of poetry, diplomacy, and Islamic jurisprudence in Somali affairs. The fates of fortune that brought Samatar to Rutgers University and prominence as an Africanist historian are almost stranger than fiction. This chapter details both the romance of English teacher Lydia with camel herder Saȉd, their marriage, and their respective careers. The backdrop to this remarkable story were the Mennonite programs in education, development, and health care in newly independent Somalia’s cities of Mogadishu, Chismaio, and Jamama that brought the two together. more...
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- 2021
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8. How I Do It: Anticoagulation management for common urologic procedures
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Lydia, Glick, Thenappan, Chandrasekar, Scott G, Hubosky, Seth, Teplitsky, Mihir, Shah, Joon Yau, Leong, Geoffrey, Ouma, and James R, Mark
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Risk Factors ,Decision Trees ,Practice Guidelines as Topic ,Preoperative Period ,Anticoagulants ,Humans ,Urologic Surgical Procedures ,Postoperative Hemorrhage - Abstract
Appropriate perioperative management of antithrombotic medications is critical; for every patient, the risk of bleeding must be balanced against individual risk of thrombosis. There has been a rapid influx of new antithrombotic therapies in the past 5 years, yet there is a lack of clear and concise guidelines on the management of anticoagulant and antiplatelet therapy during urologic surgery. Here we describe our approach to perioperative antithrombotic counseling, including the timing of stopping and restarting these medications. These practice guidelines have been developed in consultation with the Vascular Medicine service at our institution as well as after a review of current literature, and apply to common urologic procedures. Many cases are complex and require medical consultation or a multidisciplinary approach to management. We believe that by presenting our systematic method of antithrombotic management, including when to involve other discplines, we can increase knowledge and comfort amongst urologists in managing these medications in the perioperative period. more...
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- 2020
9. EDITORIAL COMMENT
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Lydia Glick, Sage A Vincent, Danielle Squadron, Timothy M Han, Kanata Syed, John F Danella, Serge Ginzburg, Thomas J Guzzo, Thomas Lanchoney, Jay D Raman, Marc Smaldone, Robert G Uzzo, Jeffrey J Tomaszweski, Adam Reese, Eric A Singer, Bruce Jacobs, Edouard J Trabulsi, Leonard G Gomella, and Mark J Mann more...
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Urology - Published
- 2020
10. Male urinary incontinence after prostate disease treatment
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Akhil K, Das, Victor, Kucherov, Lydia, Glick, and Paul, Chung
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Male ,Prostatic Diseases ,Urinary Incontinence ,Humans ,Self Report - Abstract
Incontinence after prostate treatment (IPT) is an important and common problem for men and can lead to decreased quality of life. The proper evaluation and management of IPT requires both knowledge of the mechanisms for its development and of multiple evolving therapy types.An update is provided on the evaluation and management for IPT. The underlying pathophysiology of the contributing conditions is explored along with the appropriate assessment prior to therapy. Surgical techniques including the artificial urinary sphincter (AUS) and male urethral sling are detailed specifically and compared.IPT can result from radical prostatectomy (RP), prostate radiation, and surgery for benign prostatic hyperplasia. All of these may increase the risk for stress urinary incontinence (SUI), urge urinary incontinence (UUI), or mixed incontinence. SUI after RP remains the largest component of IPT. Perioperative pelvic floor muscle therapy and advances in surgical technique have helped to prevent and treat post-RP SUI. The AUS and male urethral sling are both excellent surgical options for SUI with the AUS being currently indicated for a broader set of patients. Predominant UUI should be treated in a stepwise manner based upon guidelines for overactive bladder.Evaluation of men with IPT should include determining components of SUI and UUI as these will direct medical and surgical therapy. While advances in surgical technique and technology have reduced prevalence of SUI after RP, many men still require treatment. Surgical treatments with AUS and male urethral sling provide excellent outcomes in well selected patients. more...
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- 2020
11. An overview of biomarkers in the diagnosis and management of prostate cancer
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Alex, Uhr, Lydia, Glick, and Leonard G, Gomella
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Male ,Biomarkers, Tumor ,Humans ,Prostatic Neoplasms - Abstract
Prostate cancer is a common malignancy with highly variable clinical presentation and outcomes. Diagnosis and management remain a challenge and at times become highly controversial. Novel biomarker assays have shown promise as an adjunctive tool to aid in patient shared decision-making, risk stratification, and disease management. This presentation at the 2020 Jefferson Urology Symposium provided a review of current commonly used biomarkers for prostate cancer.We reviewed the current literature on the use of biomarkers in the diagnosis and treatment decisions in localized prostate cancer.Biomarker assays were reviewed and presented according to clinical application of each test. In the consideration of initial prostate biopsy the blood tests for PHI, and 4K Score, and urine tests PCA3, Select MDx and ExoDx are available. In the consideration of treatment versus active surveillance in the biopsy positive setting OncotypeDx, Prolaris and Decipher are available. In patients with an initial negative biopsy, 4K score, PCA3, ExoDx and the tissue biopsy based Confirm MDx assay can help guide the decision to perform repeat biopsy. In the consideration for adjuvant radiation following radical prostatectomy the most extensive literature available supports the use of Prolaris or Decipher tissue assays.With the significant burden of men being diagnosed with prostate cancer, it is desirable to appropriately risk stratify patients to avoid unnecessary biopsies and over-treatment in low risk patients and guide appropriate treatment strategies in high risk patients. Selected biomarkers presented are useful adjunctive precision medicine tools to aid in shared decision making and to direct treatment decisions. more...
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- 2020
12. Simple frameshifts in minimally invasive surgery postoperative pain management significantly reduce opiate prescriptions
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Thenappan, Chandrasekar, Lydia, Glick, Daniella, Wong, Timothy M, Han, Joon Yau, Leong, Misung, Yi, James R, Mark, Mark J, Mann, Edouard J, Trabulsi, and Costas D, Lallas
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Analgesics, Opioid ,Male ,Pain, Postoperative ,Urologic Neoplasms ,Humans ,Minimally Invasive Surgical Procedures ,Urologic Surgical Procedures ,Female ,Prospective Studies ,Middle Aged ,Drug Prescriptions ,Aged - Abstract
To evaluate the impact of an 'opt-in' non-narcotic postoperative pain regimen on narcotic utilization and patient-reported pain scores.A prospective, non-blinded pre- and post-interventional trial was conducted, including a lead-in period for baseline evaluation. The intervention group received a new pain protocol prioritizing non-narcotic medications, an 'opt-in' requirement for opiates, and standardized patient education. Study outcomes included opiate prescription and utilization (measured in Morphine Equivalent Doses) and reported pain scores on postoperative day (POD) 1, discharge and follow up.At discharge, 70% fewer patients were prescribed any opioids (ARR: -0.7; p0.001); the amount prescribed was reduced by 95% (pre-intervention 69.3 mg versus post-intervention 3.5 mg, p0.001). Mean opioids used following discharge decreased by 76% (14.7 mg versus 3.5 mg, p = 0.011). In a subgroup analysis of robotic prostatectomies, there was a 95% reduction in mean opioids prescribed at discharge (64.6 mg versus 3.2 mg, p0.001) and 82% reduction in utilization over entire postoperative course (87.6 mg versus 15.7 mg, p = 0.001). There was no significant difference in pain scores between intervention groups at POD 1, discharge and follow up for patients (entire cohort and post-prostatectomy).A standardized pain protocol with 'opt-in' requirements for opiate prescription, emphasis on non-narcotic medications, and patient education, resulted in significant reductions in opioid use. Simple frameshifts in pain management can yield significant gains in the opioid epidemic. more...
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- 2020
13. PD61-08 HOLMIUM LASER ENUCLEATION OF THE PROSTATE AS A SIZE-INDEPENDENT TREATMENT IN LARGE PROSTATES <u>></u> 150 GRAMS
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Thomas Hardacker, Tomy Perez, Patrick J. Shenot, Lydia Glick, Akhil K Das, and Timothy M. Han
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medicine.anatomical_structure ,business.industry ,Prostate ,Urology ,Enucleation ,Holmium laser ,Medicine ,Gold standard (test) ,business ,Nuclear medicine - Abstract
INTRODUCTION AND OBJECTIVE:Current guidelines list holmium laser enucleation of the prostate (HoLEP) as the gold standard size-independent surgical procedure for management of benign prostatic hype... more...
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- 2020
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14. MP66-11 HOW TO PREVENT PROSTATE BIOPSY COMPLICATIONS: TO AUGMENT OR TO SWAB?
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Jay D. Raman, Edouard J. Trabulsi, Claudette Fonshell, Serge Ginzburg, Joon Yau Leong, John Danella, Mark Mann, Kaynaat Syed, Timothy M. Han, Jeffrey J. Tomaszewski, Thomas J. Guzzo, Lydia Glick, Christopher Caputo, Marc C. Smaldone, Leonard G. Gomella, Adam C. Reese, Thomas Lachoney, Robert G. Uzzo, and Danielle Squadrito more...
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medicine.medical_specialty ,Prostate biopsy ,medicine.diagnostic_test ,business.industry ,Urology ,medicine ,Radiology ,Augment ,business - Published
- 2020
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15. PD61-11 INITIAL EXPERIENCE OF HOLMIUM LASER ENUCLEATION OF THE PROSTATE FOLLOWING PREVIOUS PROSTATIC URETHRAL LIFT FOR MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA
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Timothy M. Han, Thomas Hardacker, Patrick J. Shenot, Tomy Perez, Lydia Glick, and Akhil K Das
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medicine.medical_specialty ,business.industry ,Urology ,Enucleation ,Holmium laser ,Hyperplasia ,urologic and male genital diseases ,medicine.disease ,medicine.anatomical_structure ,Prostate ,Medicine ,business ,Prostatic urethral lift - Abstract
INTRODUCTION AND OBJECTIVE:Prostatic urethral lift (PUL) has become a commonly performed procedure for symptomatic benign prostatic hyperplasia (BPH). The current recommendation for PUL is for a pa... more...
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- 2020
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16. PD32-10 SETTING THE STANDARDS
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Edouard J. Trabulsi, Rodrigo Noorani, Leonard G. Gomella, Christopher J.D. Wallis, Thenappan Chandrasekar, Hanan Goldberg, Lydia Glick, James Ryan Mark, Mark Mann, Costas D. Lallas, Timothy M. Han, Seth Teplitsky, Zachary Klaassen, and Joon Yau Leong more...
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Economic growth ,business.industry ,Urology ,Field (Bourdieu) ,Medicine ,business ,Productivity - Abstract
INTRODUCTION AND OBJECTIVE:Research productivity amongst academic urologists is strongly encouraged, but little data is available on productivity metrics within the field of urology. We provide the... more...
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- 2020
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17. Setting the Standards: Examining Research Productivity Among Academic Urologists in the USA and Canada in 2019
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Thenappan Chandrasekar, Hanan Goldberg, Edouard J. Trabulsi, Seth Teplitsky, Lydia Glick, James Ryan Mark, Zachary Klaassen, Rodrigo Noorani, Christopher J.D. Wallis, Costas D. Lallas, Timothy M. Han, Joon Yau Leong, and Leonard G. Gomella more...
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Male ,medicine.medical_specialty ,Canada ,Urology ,Urologists ,education ,030232 urology & nephrology ,Graduate medical education ,Scopus ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Productivity ,Accreditation ,Descriptive statistics ,business.industry ,Research ,Teaching ,Test (assessment) ,030220 oncology & carcinogenesis ,Family medicine ,Cohort ,Female ,business ,Associate professor - Abstract
Background Research productivity among academic urologists is strongly encouraged, but little data are available on productivity metrics within the field. Objective To provide the first comprehensive survey of research productivity among academic urologists in the USA and Canada. Design, setting, and participants Using the Accreditation Council for Graduate Medical Education, the Canadian Resident Matching Service, and individual program websites, all active accredited urology faculties were identified. For each individual, we collected data on American Urological Association section, title, gender, fellowship training, Scopus H-index, and citations. Comprehensive searches were completed during March–May 2019. Outcome measurements and statistical analysis Descriptive statistics for demographic comparisons were performed using analysis of variance for continuous variables and chi‐square test for categorical variables. Multivariable logistic regressions were used to identify the predictors of H-index greater than the median. Results and limitations A total of 2214 academic urology faculties (2015 in USA and 199 in Canada) were identified. The median and mean H-indices for the entire cohort of physicians were 11 and 16.1, respectively. On multivariable analysis, physicians in the North Central and Western Sections (vs mid-Atlantic), who were fellowship trained (vs no fellowship training), and of higher academic rank (professor and associate professor vs clinical instructor) were more likely to have H-index values greater than the median. Additionally, female physicians (vs male) were more likely to have H-index values less than the median. Conclusions This study represents the first comprehensive assessment of research productivity metrics among academic urologists. These represent key benchmarks for trainees considering careers in academics and for practicing physicians gauging their own productivity in relation to their peers. Patient summary In this study, we provide the first comprehensive assessment of research productivity among academic urologists in the USA and Canada. Our results help provide key benchmarks for trainees considering careers in academics and for practicing physicians gauging their own productivity in relation to peers. more...
- Published
- 2019
18. Understanding the Public’s Intentions to Purchase and to Persuade Others to Purchase Antibiotic-Free Meat
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Kaitlin Shartle, Rachel A. Smith, Nkuchia M. M'ikanatha, Xun Zhu, and Lydia Glick
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Adult ,Male ,Persuasion ,Meat ,Health (social science) ,media_common.quotation_subject ,Persuasive Communication ,050801 communication & media studies ,050109 social psychology ,Intention ,Interpersonal communication ,Article ,Homophily ,Food Preferences ,0508 media and communications ,Surveys and Questionnaires ,medicine ,Humans ,0501 psychology and cognitive sciences ,Consumer behaviour ,media_common ,Communication ,05 social sciences ,Cognition ,Consumer Behavior ,Purchasing ,Anti-Bacterial Agents ,Anxiety ,Female ,medicine.symptom ,Psychology ,Social psychology ,Psychosocial - Abstract
Extending the effectiveness of media-based campaigns into interpersonal networks has been a long concern for studies on persuasive messages, yet there is much to understand about why people attempt to persuade others to engage in health-related behaviors. This study investigated two alternative predictors of interpersonal persuasion: psychosocial determinants of behavior and homophily. We used the integrated model of behavior (IMB) to predict consumers’ intentions to purchase antibiotic-free meat, and extended the model to predict consumers’ intentions to encourage important others to do so. IMB variables predicted 44% of future purchasing intentions and 40% of future persuasion intentions. The findings support a homophily explanation for persuasion: people intend to persuade important others to do what they do. In addition, a person-centered analysis identified three audience segments based on antibiotic-resistance-related behaviors, cognitions, and experiences: Purchasers, Resisters, and New Adopters. The covariate analysis revealed that people who had more topic awareness of antibiotic use in animal husbandry, knowledge of someone with an antibiotic-resistant infection, and health mavenism were more likely to be Purchasers than Resisters or New Adopters. Anxiety, however, was highest among New Adopters and lowest among Resisters. Implications for theory and practice are discussed. more...
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- 2016
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19. Setting the standards: Examining research productivity amongst academic urologists in the United States and Canada in 2019
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C.J.D. Wallis, L.G. Gomella, E.J. Trabulsi, Thenappan Chandrasekar, Z. Klaassen, Lydia Glick, Hanan Goldberg, R. Noorani, J.R. Mark, S. Teplitsky, J. Y. Leong, T. M. Han, and Costas D. Lallas
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Economic growth ,Urology ,Business ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,lcsh:RC254-282 ,Productivity - Published
- 2020
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20. Examining the real-world utility of immune checkpoint inhibitors in genitourinary oncology: A single-institution retrospective
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Thenappan Chandrasekar, Nathan Handley, William Kevin Kelly, Edouard J. Trabulsi, James Ryan Mark, Lydia Glick, Leonard G. Gomella, Costas D. Lallas, Cassra B Clark, and Timothy M. Han
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Oncology ,Cancer Research ,medicine.medical_specialty ,Genitourinary system ,business.industry ,Internal medicine ,Immune checkpoint inhibitors ,medicine ,Single institution ,business - Abstract
e17112 Background: Immune Checkpoint Inhibitors (ICI) are increasingly utilized for genitourinary (GU) malignancies. However, data is lacking on the efficacy of these drugs in “real-world” populations - patients who do not fit the strict clinical trial criteria, but may still benefit from therapy. We performed a retrospective analysis of patients receiving ICI at a single tertiary-care institution, with special attention to clinical trial enrollment, adverse events, progression and survival. Methods: Patients receiving ICI for GU malignancies at Thomas Jefferson University Hospital from January 2017 to January 2019 were identified. Descriptive statistics of treatment and pathologies were performed. Progression-free survival (PFS) was calculated from start of ICI to documentation of progression or last follow-up. PFS and overall survival were assessed using Kaplan Meier log-rank test, stratified by trial enrollment. Results: 111 patients were included: 37 on ICI clinical trial, 70 received ICI “off-trial” and 4 received ICI in both settings. 11 patients (10%) underwent multiple courses of ICI throughout treatment. The number of patients initiating ICI increased annually; by 2018, the number of patients initiated on ICI “off-trial” exceeded those initiating ICI “on-trial” (79% vs 21%). Treated pathology included Urothelial Carcinoma (UC; 42%), Renal Cell Carcinoma (RCC; 28%), and Prostate Adenocarcinoma (PCa; 20%). “Off-trial” ICI was more often administered later in the disease course, compared to a more even distribution of “on-trial” ICI administration. Mean PFS and OS for both cohorts can be seen in Table. Conclusions: As seen in our single-institution referral center, the use of immune checkpoint inhibitors has significantly increased – and is now more commonly used off-trial than on-trial. As their use becomes more common, their efficacy in “off-trial” populations must be further investigated. [Table: see text] more...
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- 2020
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21. The multidisciplinary clinic approach for bladder cancer treatment in the neoadjuvant therapy era
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Edouard J. Trabulsi, William Kevin Kelly, Anne Calvaresi, James Ryan Mark, William Tester, Thenappan Chandrasekar, Mark D. Hurwitz, Timothy M. Han, Adam P. Dicker, Robert B. Den, Leonard G. Gomella, Mark Mann, Katherine E. Smentkowski, Nathan Handley, Lydia Glick, and Costas D. Lallas more...
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Cancer Research ,medicine.medical_specialty ,Bladder cancer ,Oncology ,Multidisciplinary approach ,business.industry ,medicine.medical_treatment ,General surgery ,medicine ,Urologic Oncology ,business ,medicine.disease ,Neoadjuvant therapy - Abstract
475 Background: As urologic oncology becomes increasingly complex, the coordination of optimal and efficient care to patients can be challenging. Within our institution, we initiated a multidisciplinary center (MDC) comprised of urology, oncology and radiation oncology in 1996 to help meet these needs. The positive benefits of this approach have been demonstrated in other settings, but outcomes related to bladder cancer remain unclear, especially in the era of neoadjuvant (NA) therapy. Methods: Patients with localized or node positive muscle invasive bladder cancer (MIBC) without prior treatment were obtained from available multidisciplinary appointment records, dating from 7/5/17 to 9/25/19. Charts were then retrospectively reviewed to gather demographic data, treatment data, and pathological outcomes. Results: 66 patients fitting study criteria were identified. Average age was 71.3 years. 45 (68%) patients from this cohort were deemed to be radical cystectomy (RC) candidates, with 37 RC operations completed at time of record review. Of RC-eligible patients, 35/45 (77%) had received NA therapy, either in the form of neoadjuvant chemotherapy (NAC) and/or immunotherapy (NAI). 3 patients declined RC after receiving NAC. 15 patients underwent chemoradiation treatment (23%), while 7 (11%) underwent supportive care without definitive treatment. Downstaging at RC from MIBC ( more...
- Published
- 2020
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22. Preparing for Antibiotic Resistance Campaigns: A Person-Centered Approach to Audience Segmentation
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Nicole M. Hackman, Madisen Quesnell, Rachel A. Smith, Nkuchia M. M'ikanatha, and Lydia Glick
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Adult ,Male ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Health (social science) ,Adolescent ,Health Promotion ,Intention ,Library and Information Sciences ,Audience segmentation ,Article ,Person-centered therapy ,Odds ,Young Adult ,Antibiotic resistance ,medicine ,Humans ,Marketing ,Medical prescription ,Aged ,business.industry ,Communication ,Public health ,Public Health, Environmental and Occupational Health ,Drug Resistance, Microbial ,Middle Aged ,Public relations ,United States ,Latent class model ,Anti-Bacterial Agents ,Female ,Public Health ,Stewardship ,business ,Goals - Abstract
Antibiotic resistance is growing threat to public health threat that calls for urgent attention. However, creating campaigns to slow the emergence and spread of drug-resistant pathogens is challenging because the goal—antibiotic stewardship—encompasses multiple behaviors. This study provided a novel approach to audience segmentation for a multifaceted goal, by using a person-centered approach to identify profiles of US adults based on shared stewardship intentions. The latent class analysis identified three groups: Stewards, Stockers, and Demanders. The findings suggest campaigns with goals aimed at encouraging Stewards to follow through on their intentions, encouraging Stockers to dispose of their leftover antibiotics, and convincing Demanders to accept provider’s evidence-based judgment when a prescription for antibiotics is not indicated. Covariate analysis showed that people who held more inaccurate beliefs about what antibiotics can treat had higher odds of being Demanders and Stockers instead of Stewards. People with stronger health mavenism also had higher odds of being Stockers instead of Stewards. The covariate analysis provided theoretical insight into the strategies to pursue in campaigns targeting these three groups. more...
- Published
- 2015
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