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  1. Article ; Online: Diagnostic and cost-effectiveness of axial skeleton MRI in staging high-risk prostate cancer.

    El-Taji, Omar / Evans, Hannah / Arora, Vandan / Amin, Suzanne / Kumar, Manal / Rajan, Thiagarajan Nambi

    BJUI compass

    2023  Volume 4, Issue 3, Page(s) 346–351

    Abstract: Introduction: Current literature suggests that axial skeleton magnetic resonance imaging (AS-MRI) is more sensitive than Tc 99m bone scintigraphy (BS) for detecting bone metastases (BM) in high-risk prostate cancer (PCa). However, BS is still widely ... ...

    Abstract Introduction: Current literature suggests that axial skeleton magnetic resonance imaging (AS-MRI) is more sensitive than Tc 99m bone scintigraphy (BS) for detecting bone metastases (BM) in high-risk prostate cancer (PCa). However, BS is still widely performed. Its diagnostic accuracy has been studied; however, its feasibility and cost implications are yet to be examined.
    Methods: We reviewed all patients with high risk PCa undergoing AS-MRI over a 5-year period. AS-MRI was performed on patients with histologically confirmed PCa and either PSA > 20 ng/ml, Gleason ≥8, or TNM Stage ≥T3 or N1 disease. All AS-MRI studies were obtained using a 1.5-T AchievaPhilips™MRI scanner. We compared the AS-MRI positivity and equivocal rate with that of BS. Data were analysed according to Gleason score, T-stage and PSA. Multivariate logistic regression analyses were used to quantify the strength of association between positive scans and clinical variables. Feasibility and burden of expenditure was also evaluated.
    Results: Five hundred three patients with a median age of 72 and a mean PSA of 34.8 ng/ml were analysed. Eighty-eight patients (17.5%) were positive for BM on AS-MRI (mean PSA 99 [95% CI 69.1-129.9]). Comparatively 409 patients (81.3%) were negative for BM on AS-MRI (mean PSA 24.7 (95% CI [21.7-27.7]) (
    Conclusion: The use of AS-MRI to stage BM in high-risk PCa is both feasible and results in a reduced burden of expenditure.
    Language English
    Publishing date 2023-01-31
    Publishing country United States
    Document type Journal Article
    ISSN 2688-4526
    ISSN (online) 2688-4526
    DOI 10.1002/bco2.210
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Bladder Sparing Approaches for Muscle-Invasive Bladder Cancers.

    El-Taji, Omar M S / Alam, Sameer / Hussain, Syed A

    Current treatment options in oncology

    2016  Volume 17, Issue 3, Page(s) 15

    Abstract: Opinion statement: Organ preservation has been increasingly utilised in the management of muscle-invasive bladder cancer. Multiple bladder preservation options exist, although the approach of maximal TURBT performed along with chemoradiation is the most ...

    Abstract Opinion statement: Organ preservation has been increasingly utilised in the management of muscle-invasive bladder cancer. Multiple bladder preservation options exist, although the approach of maximal TURBT performed along with chemoradiation is the most favoured. Phase III trials have shown superiority of chemoradiotherapy compared to radiotherapy alone. Concurrent chemoradiotherapy gives local control outcomes comparable to those of radical surgery, but seemingly more superior when considering quality of life. Bladder-preserving techniques represent an alternative for patients who are unfit for cystectomy or decline major surgical intervention; however, these patients will need lifelong rigorous surveillance. It is important to emphasise to the patients opting for organ preservation the need for lifelong bladder surveillance as risk of recurrence remains even years after radical chemoradiotherapy treatment. No randomised control trials have yet directly compared radical cystectomy with bladder-preserving chemoradiation, leaving the age-old question of superiority of one modality over another unanswered. Radical cystectomy and chemoradiation, however, must be seen as complimentary treatments rather than competing treatments. Meticulous patient selection is vital in treatment modality selection with the success of recent trials within the field of bladder preservation only being possible through this application of meticulous selection criteria compared to previous decades. A multidisciplinary approach with radiation oncologists, medical oncologists, and urologists is needed to closely monitor patients who undergo bladder preservation in order to optimise outcomes.
    MeSH term(s) Chemoradiotherapy/methods ; Combined Modality Therapy ; Cystectomy ; Humans ; Neoplasm Invasiveness/pathology ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/radiotherapy ; Neoplasm Recurrence, Local/surgery ; Patient Selection ; Urinary Bladder/pathology ; Urinary Bladder/surgery ; Urinary Bladder Neoplasms/drug therapy ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/radiotherapy ; Urinary Bladder Neoplasms/surgery
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057351-0
    ISSN 1534-6277 ; 1527-2729
    ISSN (online) 1534-6277
    ISSN 1527-2729
    DOI 10.1007/s11864-016-0390-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Selective transperineal prostate biopsy for fluoroquinolone-resistance patients reduces sepsis and cost.

    Al-Mitwalli, Abdullah / Kyriazis, Grigorios / El-Taji, Omar / Chandra, Elizabeth / Deborah, Wearmouth / Burns, Phillipa / Fady, Youssef / Simms, Matthew / Nicholas, Smith

    Current urology

    2021  Volume 15, Issue 2, Page(s) 115–118

    Abstract: Background: Urosepsis is a recognized complication of transrectal ultrasound-guided prostate biopsy (TRUS-Bx). Pre-biopsy rectal swabs have been used to identify patients with microorganisms in the rectal flora resistant to the conventionally used ... ...

    Abstract Background: Urosepsis is a recognized complication of transrectal ultrasound-guided prostate biopsy (TRUS-Bx). Pre-biopsy rectal swabs have been used to identify patients with microorganisms in the rectal flora resistant to the conventionally used empirical prophylaxis. The transperineal route of biopsy (TP-Bx) has a lower complication risk but comes at an increased cost.
    Materials and methods: Retrospective cohort study including patients undergoing prostate biopsies between October/2015 and April/2018. The intervention cohort, a rectal swab was performed, the result of which dictated the biopsy route; TRUS-Bx against TP-Bx. TP-Bx for patients with fluoroquinolone resistance or extended-spectrum β-lactamase. The control cohort underwent TRUS without a rectal swab receiving empirical antibiotics-oral ciprofloxacin and intravenous gentamicin.
    Results: Total 1000 patients were included in which 500 underwent a swab, 14 (2.8%) developed post-TRUS biopsy infective complications with 3 having positive bacteremia (0.6%); 500 had no swab, 47 (9.4%) developed post-TRUS biopsy infective complications with 22 (4.4%,
    Conclusions: We have demonstrated a protocol that reserves template biopsies for higher risk patients and can significantly reduce sepsis and other infectious complication rates whilst also proving to be a cost-efficient strategy. We recommend that units not utilizing rectal swabs to uncover the fluoroquinolone resistance rate by introducing them. We advocate units that already utilize rectal swabs, to introduce transperineal biopsy for their higher risk patients.
    Language English
    Publishing date 2021-04-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2253664-4
    ISSN 1661-7657 ; 1661-7649
    ISSN (online) 1661-7657
    ISSN 1661-7649
    DOI 10.1097/CU9.0000000000000013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Bladder reconstruction: The past, present and future.

    El-Taji, Omar M S / Khattak, Altaf Q / Hussain, Syed A

    Oncology letters

    2015  Volume 10, Issue 1, Page(s) 3–10

    Abstract: Ileal conduit urinary diversion is the gold standard treatment for urinary tract reconstruction following cystectomy. This procedure uses gastrointestinal segments for bladder augmentation, a technique that is often associated with significant ... ...

    Abstract Ileal conduit urinary diversion is the gold standard treatment for urinary tract reconstruction following cystectomy. This procedure uses gastrointestinal segments for bladder augmentation, a technique that is often associated with significant complications. The substantial progression in the fields of tissue engineering and regenerative medicine over the previous two decades has resulted in the development of techniques that may lead to the construction of functional
    Language English
    Publishing date 2015-04-28
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2573196-8
    ISSN 1792-1082 ; 1792-1074
    ISSN (online) 1792-1082
    ISSN 1792-1074
    DOI 10.3892/ol.2015.3161
    Database MEDical Literature Analysis and Retrieval System OnLINE

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