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Article ; Online: Editorial Comment.

Farkouh, Ala'a / Baldwin, D Duane

2024 Volume 211, Issue 6, Page(s) 742

MeSH term(s)	Humans ; Male
Language	English
Publishing date	2024-05-09
Publishing country	United States
Document type	Editorial ; Comment ; Journal Article
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1097/JU.0000000000003932
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Zs.MO 331: Show issues

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Article: Sperm DNA fragmentation in male infertility: From bench to bedside.

Farkouh, Ala'a / Saleh, Ramadan / Shah, Rupin / Agarwal, Ashok

Arab journal of urology

2023 Volume 21, Issue 4, Page(s) 199–203

Abstract: Objectives: Sperm DNA fragmentation (SDF) is a molecular marker of sperm chromatin health. Elevated SDF is associated with male infertility, recurrent pregnancy loss, and failure of assisted reproductive technologies (ART). In 2021, the sixth edition of ...

Abstract	Objectives: Sperm DNA fragmentation (SDF) is a molecular marker of sperm chromatin health. Elevated SDF is associated with male infertility, recurrent pregnancy loss, and failure of assisted reproductive technologies (ART). In 2021, the sixth edition of the World Health Organization (WHO) Manual for the Laboratory Examination and Processing of Human Semen has listed SDF as an extended test of semen that can be ordered under certain circumstances. However, the manual neither explained the indications for testing nor provided clear guidance on diagnostic thresholds. Methods: This article summarizes the current body of knowledge regarding clinical applications of SDF, including the appropriate population to test, methods of testing, and management strategies. Results: Several etiologic factors and pathophysiologic mechanisms for SDF have been described including poor lifestyle habits, noxious exposures, and varicocele. Four SDF assays are included in the WHO manual and may be utilized based on resources and expertise. Strategies to lower SDF levels in infertile men include addressing underlying causes, supplementation with antioxidants, shorter abstinence periods, and use of testicular sperm for intracytoplasmic sperm injection. Conclusion: SDF testing can be implemented in the evaluation of infertile men and couples experiencing ART failure and appropriate management strategies can be offered to improve reproductive outcomes. There is vast potential for future research regarding the clinical utility of SDF in the evaluation and treatment of infertile couples.
Language	English
Publishing date	2023-11-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2631788-6
ISSN	2090-598X
ISSN	2090-598X
DOI	10.1080/20905998.2023.2278200
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Article ; Online: Outcome of Mini-PCNL Under Loco-Regional Anesthesia: Outcomes of a Systematic Review.

Shahait, Mohammed / Farkouh, Ala'a / Mucksavage, Philip / Somani, Bhaskar

Current urology reports

2023 Volume 24, Issue 9, Page(s) 417–426

Abstract: Purpose of review: Miniaturized PCNL (mi-PCNL) for stone disease is performed under a general anesthesia. However, the role of loco-regional anesthesia in mi-PCNL and its outcomes are not well defined yet. Here, we review the outcomes and complications ... ...

Abstract	Purpose of review: Miniaturized PCNL (mi-PCNL) for stone disease is performed under a general anesthesia. However, the role of loco-regional anesthesia in mi-PCNL and its outcomes are not well defined yet. Here, we review the outcomes and complications of loco-regional anesthesia for mi-PCNL. A Cochrane-style review was performed in accordance with the preferred reporting items for systematic reviews to evaluate the outcomes of loco-reginal anesthesia for URS in stone disease, including all English language articles from January 1980 and October 2021. Recent findings: Ten studies with a total of 1663 patients underwent mi-PCNL under loco-regional anesthesia. The stone-free rate (SFR) for mi-PCNL under neuro-axial anesthesia ranged between 88.3 and 93.6%, while it ranged between 85.7 and 93.3% for mi-PCNL under local anesthesia (LA). The conversion rate to another anesthesia modality was 0.5%. The complications ranged widely between 3.3 and 85.7%. The majority were Grade I-II complications and none of the patients had grade V complications. Our review shows that mi-PCNL under loco-regional anesthesia is feasible with good SFR and a low risk of major complications. The conversion to general anesthesia is needed in a small minority, with the procedure itself being well tolerated and a big step towards establishing an ambulatory pathway for these patients.
MeSH term(s)	Humans ; Kidney Calculi ; Treatment Outcome ; Anesthesia, Conduction ; Anesthesia, General ; Minority Groups ; Nephrostomy, Percutaneous
Language	English
Publishing date	2023-07-07
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2057354-6
ISSN	1534-6285 ; 1527-2737
ISSN (online)	1534-6285
ISSN	1527-2737
DOI	10.1007/s11934-023-01169-2
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Zs.A 5528: Show issues

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Article ; Online: Beyond conventional sperm parameters: the role of sperm DNA fragmentation in male infertility.

Farkouh, Ala'a / Finelli, Renata / Agarwal, Ashok

Minerva endocrinology

2021 Volume 47, Issue 1, Page(s) 23–37

Abstract: Infertility is a condition that widely affects couples all over the world. In this regard, sperm DNA fragmentation can lead to harmful reproductive consequences, including male infertility and poor outcomes after assisted reproductive techniques. The ... ...

Abstract	Infertility is a condition that widely affects couples all over the world. In this regard, sperm DNA fragmentation can lead to harmful reproductive consequences, including male infertility and poor outcomes after assisted reproductive techniques. The investigation of sperm DNA fragmentation in male infertility diagnostics has constantly increased over time, becoming more common in clinical practice with the recent publication of several guidelines regarding its testing. This narrative review aims to provide a comprehensive overview of the pathogenesis and causes of sperm DNA fragmentation, as well as the assays which are commonly performed for testing. Moreover, we discuss the most recently published evidence regarding the use of sperm DNA fragmentation testing in clinical practice, highlighting the implications of high sperm DNA fragmentation rate on human reproduction, and the therapeutic approaches for the clinical management of infertile patients. Our review confirms a significant harmful impact of sperm DNA fragmentation on reproduction and points out several interventions which can be applied in clinics to reduce sperm DNA fragmentation and improve reproductive outcomes. Sperm DNA fragmentation has been shown to adversely impact male fertility potential. As high sperm DNA fragmentation levels have been associated with poor reproductive outcomes, its testing may significantly help clinicians in defining the best therapeutic strategy for infertile patients.
MeSH term(s)	DNA Fragmentation ; Humans ; Infertility, Male/diagnosis ; Male ; Reproduction ; Reproductive Techniques, Assisted ; Spermatozoa/pathology
Language	English
Publishing date	2021-12-09
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	3062786-2
ISSN	2724-6116
ISSN (online)	2724-6116
DOI	10.23736/S2724-6507.21.03623-X
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Article ; Online: Do Flat Panel Detector C-Arms Decrease Radiation Exposure Compared to Conventional Image Intensifiers?

Gentry, Vance / Farkouh, Ala'a / Chen, Natalie / Amasyali, Akin S / Lee, Jenna / Srikureja, Nathaniel / Keheila, Mohamed / Okhunov, Zhamshid / Baldwin, D Duane

Urology

2024 Volume 185, Page(s) 150–156

Abstract: Objective: To compare the radiation dose and image quality between flat panel detector (FPD) and traditional image intensifier (II) C-arms at their lowest radiation settings.: Methods: In a ureteroscopy simulation using a cadaver model, the radiation ...

Abstract	Objective: To compare the radiation dose and image quality between flat panel detector (FPD) and traditional image intensifier (II) C-arms at their lowest radiation settings. Methods: In a ureteroscopy simulation using a cadaver model, the radiation exposure was compared between FPD and II at 4 pulses-per-second (pps) using both low dose and automatic exposure control (AEC) settings. Additionally, the lowest dose settings for each machine were compared (4 pps with low dose in the FPD and 1 pps with low dose in the II). Five trials of 5 minutes were conducted for each setting. Four new optically stimulated luminescent dosimeters were used in each trial to record radiation exposure. Ten blinded urologists completed a survey rating image quality for each setting. Results: When comparing the FPD and II at their lowest possible settings, the FPD produced significantly more radiation (P <.05). Using both machines at 4 pps in low dose mode resulted in no significant difference between C-arms (P >.05). Conversely, operating the C-arms at 4 pps and AEC resulted in significantly higher radiation exposure from the FPD compared to the II (P <.05). There was no significant difference in image quality at each setting. Conclusion: FPDs produce significantly more radiation at the lowest settings compared to IIs. Surgeons should employ IIs when reducing radiation exposure as low as possible is imperative, such as when operating on pediatric and pregnant patients.
MeSH term(s)	Humans ; Child ; Radiation Dosage ; Radiographic Image Enhancement ; Radiation Exposure ; Phantoms, Imaging ; Computer Simulation
Language	English
Publishing date	2024-02-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2024.01.015
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Zs.A 1142: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 275: Show issues

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Article ; Online: Outcomes of Percutaneous Nephrolithotomy Under Local Anesthesia: Outcomes of a Systematic Review of Literature.

Shahait, Mohammed / Farkouh, Ala'a / Mucksavage, Philip / Proietti, Silvia / Somani, Bhaskar

Journal of endourology

2023 Volume 37, Issue 8, Page(s) 855–862

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Nephrolithotomy, Percutaneous/adverse effects ; Nephrolithotomy, Percutaneous/methods ; Kidney Calculi/surgery ; Kidney Calculi/etiology ; Anesthesia, Local ; Postoperative Complications/etiology ; Anesthesia, General ; Treatment Outcome
Language	English
Publishing date	2023-07-05
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	356931-7
ISSN	1557-900X ; 0892-7790
ISSN (online)	1557-900X
ISSN	0892-7790
DOI	10.1089/end.2023.0184
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Zs.A 2628: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: A systematic review of pN0 testicular seminoma: a new clinical entity and future directions.

Farkouh, Ala'a / Shete, Kanha / Cheng, Kai Wen / Buell, Matthew I / Hu, Brian

Urologic oncology

2023 Volume 41, Issue 12, Page(s) 476–482

Abstract: Retroperitoneal lymph node dissection (RPLND) for testicular seminoma with enlarged retroperitoneal lymph nodes has received increased consideration and exposed a new clinical entity: pN0 disease. Enlarged, nonmetastatic retroperitoneal lymph nodes ... ...

Abstract	Retroperitoneal lymph node dissection (RPLND) for testicular seminoma with enlarged retroperitoneal lymph nodes has received increased consideration and exposed a new clinical entity: pN0 disease. Enlarged, nonmetastatic retroperitoneal lymph nodes provide insight into the natural history of seminoma while offering a benchmark for improving the accuracy of staging. The purpose of this systematic review was to report the pN0 rates, describe risk factors associated with it, and discuss emerging research that may reduce its incidence. We performed a systemic review of published literature on PubMed, Embase, Web of Science, as well as oncology meeting abstracts evaluating histology of lymph nodes in patients with testicular seminoma treated primarily with retroperitoneal lymph node dissection. Studies were excluded if histology was not reported. A total of 15 publications and abstracts were included. Although study designs were heterogeneous, there was a minimal risk of bias. Overall, the reported pN0 rates were 0% to 22%. In prospective clinical trials it was 9% to 16%. The presence of pN0 was associated with preoperative smaller lymph nodes, a solitary enlarged lymph node, or negative serum miRNA-371. The incidence of pN0 seminoma is concerning as it points to a potential historical overtreatment; however, it also represents an important inflection for testicular cancer research as quantifiable improvements in clinical staging will translate to clear benefits to patients.
MeSH term(s)	Male ; Humans ; Testicular Neoplasms/pathology ; Seminoma/pathology ; Prospective Studies ; Lymph Nodes/pathology ; Lymph Node Excision ; Retroperitoneal Space/pathology ; Neoplasms, Germ Cell and Embryonal/pathology ; Neoplasm Staging ; Retrospective Studies
Language	English
Publishing date	2023-11-14
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2023.10.008
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Zs.A 4817: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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ab Jg. 2022: Lesesaal (EG)

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Article: Sperm DNA integrity and male infertility: a narrative review and guide for the reproductive physicians.

Farkouh, Ala'a / Salvio, Gianmaria / Kuroda, Shinnosuke / Saleh, Ramadan / Vogiatzi, Paraskevi / Agarwal, Ashok

Translational andrology and urology

2022 Volume 11, Issue 7, Page(s) 1023–1044

Abstract: Background and objective: Conventional semen analysis (SA) remains an essential tool in the initial male fertility evaluation and subsequent follow-up. However, it neither provides information about the functional status of spermatozoa nor addresses ... ...

Abstract	Background and objective: Conventional semen analysis (SA) remains an essential tool in the initial male fertility evaluation and subsequent follow-up. However, it neither provides information about the functional status of spermatozoa nor addresses disorders such as idiopathic or unexplained infertility (UI). Recently, assessment of sperm DNA fragmentation (SDF) has been proposed as an extended sperm test that may help overcome these inherent limitations of basic SA. In this review, we aim to: (I) discuss the pathophysiological aspects of SDF, including natural repair mechanisms, causes, and impact on reproductive outcomes; (II) explain different assessment tools of SDF, and describe potential therapeutic options to manage infertile men with high SDF; and (III) analyse the strengths, weaknesses, opportunities and threats (SWOT) of current research on the topic. Methods: This review was constructed from original studies, systematic reviews and meta-analyses that were published over the years up until August 2021, related to the various aspects of SDF. Key content and findings: Different mechanisms lead to high SDF, including defective chromatin packaging, apoptosis, and seminal oxidative stress. The relevance of sperm DNA integrity to male fertility/infertility has been supported by the frequent observation of high levels of SDF in infertile men, and in association with risk factors for infertility. Additionally, high SDF levels have been inversely correlated with the outcomes of natural pregnancy and assisted reproduction. Terminal deoxynucleotidyl transferase dUTP nick end labelling, sperm chromatin structure assay, sperm chromatin dispersion, and Comet assay are four commonly used assays for measurement of SDF. Addressing lifestyle risks and underlying conditions, antioxidants, hormonal therapy, and advanced sperm selection techniques have all been proposed as potential therapeutic options to lower SDF. Conclusions: The sum of literature provides evidence of detrimental effects of high SDF on both natural and assisted fertility outcomes. Standardization of the techniques used for assessment of SDF and their incorporation into the work up of infertile couples may have significant implications on the future management of a selected category of infertile men with high SDF.
Language	English
Publishing date	2022-07-26
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2851630-8
ISSN	2223-4691 ; 2223-4691 ; 2223-4683
ISSN (online)	2223-4691
ISSN	2223-4691 ; 2223-4683
DOI	10.21037/tau-22-149
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Article ; Online: Prevalence of Depression in Patients with Type 1 Diabetes between 10 and 17 Years of Age in Jordan.

Alassaf, Abeer / Gharaibeh, Lobna / Zurikat, Rajai O / Farkouh, Ala'a / Ibrahim, Sarah / Zayed, Ayman A / Odeh, Rasha

Journal of diabetes research

2023 Volume 2023, Page(s) 3542780

Abstract: Methods: The study was conducted by distributing the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to adolescents with T1D seen at Jordan University Hospital between February 2019 and February 2020. Demographic, clinical, and ...

Abstract	Methods: The study was conducted by distributing the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to adolescents with T1D seen at Jordan University Hospital between February 2019 and February 2020. Demographic, clinical, and socioeconomic data were collected using electronic clinical charts. Possible predictors of depression were assessed using logistic regression analysis. Results: A total of 108 children were enrolled in the study with mean age of 13.7 ± 2.3 years. Fifty-eight children (53.7%) had a CES depression score less than 15, and 50 children (46.3%) had a depression score of 15 or more. The number of diabetes-related hospital admissions and the frequency of self-monitoring of blood glucose (SMBG) were significantly different between the two groups. In the multivariable analysis, both gender and SMBG frequency were statistically significant. Girls were more likely to have a depression score ≥ 15 (OR = 3.41, Conclusion: The prevalence of depressive symptoms is relatively high in adolescents with T1D, especially in those living in developing countries. Longer diabetes duration, higher glycated hemoglobin level, and less frequent blood glucose monitoring are associated with higher depression scores.
MeSH term(s)	Adolescent ; Male ; Child ; Female ; Humans ; Diabetes Mellitus, Type 1 ; Prevalence ; Blood Glucose ; Blood Glucose Self-Monitoring ; Depression ; Jordan
Chemical Substances	Blood Glucose
Language	English
Publishing date	2023-02-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2711897-6
ISSN	2314-6753 ; 2314-6753
ISSN (online)	2314-6753
ISSN	2314-6753
DOI	10.1155/2023/3542780
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Article: Quality and reliability of YouTube videos in Arabic as a source of patient information on prostate cancer.

Baqain, Laith / Mukherji, Deborah / Al-Shamsi, Humaid O / Abu-Gheida, Ibrahim / Ibraheem, Akram Al / Rabii, Kamal Al / Farkouh, Ala'a / Shahait, Mohammed

Ecancermedicalscience

2023 Volume 17, Page(s) 1573

Abstract: Background: Prostate cancer remains a major public health challenge in the Arab world with few population-based screening programmes, a high incidence of advanced disease at diagnosis, and limited patient access to sub-specialist care. A large number of ...

Abstract	Background: Prostate cancer remains a major public health challenge in the Arab world with few population-based screening programmes, a high incidence of advanced disease at diagnosis, and limited patient access to sub-specialist care. A large number of patients diagnosed with prostate cancer use the (World Wide Web) internet to learn more about the disease and treatment options; however, material in the Arabic language is scarce. This study aims to objectively assess the quality and reliability of the information on YouTube™, which is the most globally used video platform, pertaining to prostate cancer videos published in Arabic. Methods: A total of 100 videos were identified by searching specific keywords in Arabic (Prostate cancer, prostate cancer treatment and prostate). Retrieved videos were analysed and categorised into four groups according to content as useful, misleading, personal experience, or irrelevant. Useful videos were assessed using the global quality scale (GQS) as a validated measure of quality, which is graded on a 5-point Likert scale, with 1 representing poor quality and 5 representing excellent quality. The modified DISCERN tool was used as a measure of reliability. The tool has a potential total score of 5 points, with higher scores indicating higher reliability. Results: Most of the speakers in these videos identified themselves as health workers (77%). Only 8% of the videos sources were hospital or medical organisations. Of the 100 retrieved videos, 86% were found to have useful content, while 14% were found to be misleading or irrelevant. The median GQS score of the useful videos was 4 (IQR: 4-5), while the median modified DISCERN tool was 4 (IQR: 3-4). Conclusion: To our knowledge, this is the first in-depth study to objectively assess the quality and reliability of information pertaining to prostate cancer in the Arabic language on YouTube™. More efforts are needed to improve the quality of prostate cancer educational materials and videos in the Arabic language on YouTube™. Patient focus groups are planned as the next step to address the information gap for patients with prostate cancer in the Arabic language.
Language	English
Publishing date	2023-07-13
Publishing country	England
Document type	Journal Article
ISSN	1754-6605
ISSN	1754-6605
DOI	10.3332/ecancer.2023.1573
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