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Article ; Online: Positive Impact of Implementing a Comprehensive Genetic Testing Protocol for Prostate Cancer Patients in a Multi-disciplinary Uro-oncology Practice. Letter.

Ramanathan, Siddharth / Korman, Andrew / Korman, Howard / Balaraman, Savitha

Urology practice

2022 Volume 10, Issue 2, Page(s) 111

MeSH term(s)	Male ; Humans ; Prostatic Neoplasms/diagnosis ; Genetic Testing ; Medical Oncology
Language	English
Publishing date	2022-12-22
Publishing country	United States
Document type	Letter
ISSN	2352-0787
ISSN (online)	2352-0787
DOI	10.1097/UPJ.0000000000000383
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Article: Improving Patient Outcomes While Reducing Empirical Treatment with Multiplex-Polymerase-Chain-Reaction/Pooled-Antibiotic-Susceptibility-Testing Assay for Complicated and Recurrent Urinary Tract Infections.

Haley, Emery / Luke, Natalie / Korman, Howard / Baunoch, David / Wang, Dakun / Zhao, Xinhua / Mathur, Mohit

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 19

Abstract: This study compared rates of empirical-therapy use and negative patient outcomes between complicated and recurrent urinary tract infection (r/cUTI) cases diagnosed with a multiplex polymerase chain reaction or pooled antibiotic susceptibility testing (M- ... ...

Abstract	This study compared rates of empirical-therapy use and negative patient outcomes between complicated and recurrent urinary tract infection (r/cUTI) cases diagnosed with a multiplex polymerase chain reaction or pooled antibiotic susceptibility testing (M-PCR/P-AST) vs. standard urine culture (SUC). Subjects were 577 symptomatic adults (
Language	English
Publishing date	2023-09-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13193060
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Article: Multiplex Polymerase Chain Reaction/Pooled Antibiotic Susceptibility Testing Was Not Associated with Increased Antibiotic Resistance in Management of Complicated Urinary Tract Infections.

Korman, Howard J / Mathur, Mohit / Luke, Natalie / Wang, Dakun / Zhao, Xihua / Levin, Michael / Wenzler, David L / Baunoch, David

Infection and drug resistance

2023 Volume 16, Page(s) 2841–2848

Abstract: Objective: To compare antibiotic resistance results at different time points in patients with urinary tract infections (UTIs), who were either treated based upon a combined multiplex polymerase chain reaction (M-PCR) and pooled antibiotic susceptibility ...

Abstract	Objective: To compare antibiotic resistance results at different time points in patients with urinary tract infections (UTIs), who were either treated based upon a combined multiplex polymerase chain reaction (M-PCR) and pooled antibiotic susceptibility test (P-AST) or were not treated. Methods: The M-PCR/P-AST test utilized here detects 30 UTI pathogens or group of pathogens, 32 antibiotic resistance (ABR) genes, and phenotypic susceptibility to 19 antibiotics. We compared the presence or absence of ABR genes and the number of resistant antibiotics, at baseline (Day 0) and 5-28 days (Day 5-28) after clinical management in the antibiotic-treated (n = 52) and untreated groups (n = 12). Results: Our results demonstrated that higher percentage of patients had a reduction in ABR gene detection in the treated compared to the untreated group (38.5% reduction vs 0%, Conclusion: Our results with both resistance gene and phenotypic antibiotic susceptibility results demonstrated that treatment based upon rapid and sensitive M-PCR/P-AST resulted in reduction rather than induction of antibiotic resistance in symptomatic patients with suspected complicated UTI (cUTI) in an urology setting, indicating this type of test is valuable in the management of these types of patients. Further studies of the causes of gene reduction, including elimination of ABR gene-carrying bacteria and loss of ABR gene(s), are warranted.
Language	English
Publishing date	2023-05-09
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494856-1
ISSN	1178-6973
ISSN	1178-6973
DOI	10.2147/IDR.S406745
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Article: A Diagnostic Test Combining Molecular Testing with Phenotypic Pooled Antibiotic Susceptibility Improved the Clinical Outcomes of Patients with Non-

Korman, Howard J / Baunoch, David / Luke, Natalie / Wang, Dakun / Zhao, Xihua / Levin, Michael / Wenzler, David L / Mathur, Mohit

Research and reports in urology

2023 Volume 15, Page(s) 141–147

Abstract: Purpose: Complicated UTIs (cUTIs) cause significant morbidity and healthcare resource utilization and cost. Standard urine culture has limitations in detecting polymicrobial and non-: Methods: Patients who had symptoms typical of cUTI and positive M- ... ...

Abstract	Purpose: Complicated UTIs (cUTIs) cause significant morbidity and healthcare resource utilization and cost. Standard urine culture has limitations in detecting polymicrobial and non- Methods: Patients who had symptoms typical of cUTI and positive M-PCR/P-AST test results were recruited from urology clinics. Symptom reduction and clinical cure rates were measured from day 0 through day 14 using the American English Acute Cystitis Symptom Score (ACSS) Questionnaire. Clinical cure was defined based on the sum of the scores of four US Food and Drug Administration (FDA) symptoms and the absence of visible blood in the urine. Results: Of 264 patients with suspected cUTI, 146 (55.4%) had exclusively non- Conclusion: Patients with cUTIs treated based on the M-PCR/P-AST diagnostic test had significantly improved symptom reduction and clinical cure rates compared to untreated patients among those with non-
Language	English
Publishing date	2023-05-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2649530-2
ISSN	2253-2447
ISSN	2253-2447
DOI	10.2147/RRU.S404260
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Article ; Online: Positive Impact of Implementing a Comprehensive Genetic Testing Protocol for Prostate Cancer Patients in a Multi-disciplinary Uro-oncology Practice.

Ramanathan, Siddharth / Korman, Andrew / Ramanathan, Sadhna / Korman, Howard / Ghilezan, Michael I / Levin, Michael / Wojno, Kirk / Martinez, Alvaro / Balaraman, Savitha

Urology practice

2022 Volume 10, Issue 1, Page(s) 34–39

Abstract: Introduction: Prior to the 2017 Philadelphia Consensus Conference guidelines, genetic testing for prostate cancer was conducted based on personal and family history of malignancy pursuant to National Comprehensive Cancer Network recommendations. The ... ...

Abstract	Introduction: Prior to the 2017 Philadelphia Consensus Conference guidelines, genetic testing for prostate cancer was conducted based on personal and family history of malignancy pursuant to National Comprehensive Cancer Network recommendations. The updated 2019 guidelines addressed the subject of genetic testing by endorsing point-of-care genetic testing and referral to genetic counseling. However, limited literature is available regarding successful implementation of a streamlined method for genetic testing. This paper explores the benefits of implementing an on-site guideline-based genetic testing process for prostate cancer patients. Methods: Data were retrospectively reviewed for 552 prostate cancer patients seen in a uro-oncology clinic since January 2017. Prior to September 2018 genetic testing was recommended based on National Comprehensive Cancer Network guidelines, and swabs for testing were procured off-site 1 mile from the clinic (n = 78). After September 2018 genetic testing was recommended based on the Philadelphia Consensus Conference guidelines, and swabs for testing were procured at the clinic itself (n = 474). Results: A statistically significant increase in testing compliance was observed after the implementation of on-site, guideline-based testing. Genetic testing compliance increased from 33.3% to 98.7%. The time to receive the genetic test results was also reduced from 38 days to 21 days. Conclusions: The implementation of an on-site, guideline-based genetic testing model for prostate cancer patients significantly improved compliance with genetic testing to 98.7% and decreased the time to receive genetic test results by 17 days. Adopting a guideline-based model with on-site genetic testing can significantly improve the detection rate for pathogenic and actionable mutations and increase the utilization of targeted therapies.
MeSH term(s)	Male ; Humans ; Retrospective Studies ; Genetic Testing/methods ; Prostatic Neoplasms/diagnosis ; Genetic Counseling ; Mutation
Language	English
Publishing date	2022-12-12
Publishing country	United States
Document type	Journal Article
ISSN	2352-0787
ISSN (online)	2352-0787
DOI	10.1097/UPJ.0000000000000350
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Article ; Online: Variation and Correlation in Postoperative Imaging After Shockwave Lithotripsy and Ureteroscopy by Treatment Modality: Results of a Statewide Clinical Registry.

DiBianco, John Michael / Daignault-Newton, Stephanie / Conrado, Bronson / Jafri, S Mohammad / Korman, Howard / Johnson, Jeremy / Ghani, Khurshid R / Dauw, Casey A

Urology

2022 Volume 168, Page(s) 79–85

Abstract: Objective: To understand how patient, practice/urologist-level factors impact imaging after ureteroscopy (URS) and shockwave lithotripsy (SWL).: Methods: Using the Reducing Operative Complications from Kidney Stones (ROCKS) clinical registry from the ...

Abstract	Objective: To understand how patient, practice/urologist-level factors impact imaging after ureteroscopy (URS) and shockwave lithotripsy (SWL). Methods: Using the Reducing Operative Complications from Kidney Stones (ROCKS) clinical registry from the Michigan Urological Surgery Improvement Collaborative (MUSIC), we identified patients undergoing URS and SWL between 2016-2019. Frequency and modality of 60-day postoperative imaging was assessed. We made bivariate comparisons across demographic/clinical data and assessed provider/practice-level imaging rate variation. We assessed correlation between imaging use within practices by treatment modality. Multivariable logistic regression controlling for practice/urologist variation was used to adjust for group differences. Results: 14,894 cases were identified (9621 URS, 5273 SWL) from 33 practices and 205 urologists. Overall postoperative imaging rate was 49.1% and was significantly different following URS and SWL (36.3% vs 72.4%, P<0.01). Substantial practice variation was seen in rates following URS (range 0-93.1%) and SWL (range 36-95.2%). Odds of postoperative imaging by practice varied significantly (range 0.02-1.96). Moderate postoperative imaging correlation for URS and SWL (0.7, P<0.001) was seen. No practice had significantly higher odds of post-URS imaging. There was increased odds of postoperative imaging for SWL modality, larger stones and renal stones. Conclusion: Imaging rates after URS are almost half the rate for SWL with wide variation, underscoring uncertainty with how postoperative imaging is approached. However, practices who have higher post-URS imaging rates also image highly after SWL. Increased patient complexity and renal stone location drive imaging following URS.
MeSH term(s)	Humans ; Ureteroscopy/methods ; Lithotripsy/adverse effects ; Lithotripsy/methods ; Kidney Calculi/surgery ; Postoperative Period ; Registries ; Treatment Outcome ; Ureteral Calculi/therapy
Language	English
Publishing date	2022-07-06
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.2022.06.029
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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)
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Article ; Online: The Diagnosis of Urinary Tract Infections Using a Novel At-home Testing Protocol to Enhance Telemedicine: A Retrospective Analysis.

Korman, Andrew / Ramanathan, Siddharth / Shen, Nathan / Gerndt, Zachary A / Luke, Natalie / Wang, Dakun / Zhao, Hannah / Huang, Shuguang / Dewar, Rajan / Wojno, Kirk / Sirls, Larry / Balaraman, Savitha / Korman, Howard

Urology

2023 Volume 173, Page(s) 26–31

Abstract: Objective: To retrospectively analyze a novel courier-based home urine collection strategy for patients with symptoms of urinary tract infections (UTIs). This model was developed to provide patient care using telehealth during the coronavirus 2019 ... ...

Abstract	Objective: To retrospectively analyze a novel courier-based home urine collection strategy for patients with symptoms of urinary tract infections (UTIs). This model was developed to provide patient care using telehealth during the coronavirus 2019 pandemic. Methods: We analyzed data from 2206 patients with symptomatic UTIs to investigate the efficacy of a home urine collection protocol. The primary outcome was the impact of home versus office collection. Results: We analyzed the results of 1112 patient samples collected in-office and 1084 patient samples collected at home. There was no difference in the rate of bacterial identification between females in the office and home collection groups. However, males in the office collection group had a higher rate of bacterial identification (p = .002). The turnaround time was significantly faster in the home collection group than the office collection group (4.08 hours shorter, p < 0.0014). Antibiotic use prior to sample collection was significantly higher in the home collection group for both males (p = .0004) and females (p = .004). Changes in antibiotics were significantly higher in the home collection group than in the office collection group for both males (p = .0009) and females (p = .0006). Conclusion: Our home collection protocol is a viable method to provide prompt and reliable outpatient care to urology patients suffering from UTIs. Furthermore, this approach resulted in adequate management and quicker turnaround times. Our findings demonstrate the clinical viability of a decentralized healthcare model to treat UTIs.
MeSH term(s)	Male ; Female ; Humans ; Retrospective Studies ; Urinary Tract Infections/microbiology ; Anti-Bacterial Agents/therapeutic use ; Urology ; Telemedicine
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-01-10
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.2022.12.023
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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: Development and Optimization of a Subtraction-Normalized Immunocyte Profiling Signature for Prostate Cancer Active Surveillance Risk Stratification.

Van Neste, Leander / Henao, Ricardo / Wojno, Kirk J / Signes, Jorge / DeHart, Jessica / Busta, Angela / Marriott, Elyse / Willing, Marian / Argentini, Andrea / Hurley, Patrick M / Korman, Howard / Hafron, Jason / Putzi, Mathew / Pieczonka, Chris M / Karsh, Lawrence I / Morris, David S / Kassis, Amin I / Kantoff, Philip W

The Journal of urology

2023 Volume 211, Issue 3, Page(s) 415–425

Abstract: Purpose: Less invasive decision support tools are desperately needed to identify occult high-risk disease in men with prostate cancer (PCa) on active surveillance (AS). For a variety of reasons, many men on AS with low- or intermediate-risk disease ... ...

Abstract	Purpose: Less invasive decision support tools are desperately needed to identify occult high-risk disease in men with prostate cancer (PCa) on active surveillance (AS). For a variety of reasons, many men on AS with low- or intermediate-risk disease forgo the necessary repeat surveillance biopsies needed to identify potentially higher-risk PCa. Here, we describe the development of a blood-based immunocyte transcriptomic signature to identify men harboring occult aggressive PCa. We then validate it on a biopsy-positive population with the goal of identifying men who should not be on AS and confirm those men with indolent disease who can safely remain on AS. This model uses subtraction-normalized immunocyte transcriptomic profiles to risk-stratify men with PCa who could be candidates for AS. Materials and methods: Men were eligible for enrollment in the study if they were determined by their physician to have a risk profile that warranted prostate biopsy. Both training (n = 1017) and validation cohort (n = 1198) populations had blood samples drawn coincident to their prostate biopsy. Purified CD2 Results: The best final model for the AS setting was obtained by combining an immunocyte transcriptomic profile based on 2 cell types with PSA density and age, reaching an AUC of 0.73 (95% CI: 0.69-0.77). The model significantly outperforms ( Conclusions: While further validation in an intended-use cohort is needed, the immunocyte transcriptomic model offers a promising tool for risk stratification of individual patients who are being considered for AS.
MeSH term(s)	Male ; Humans ; Prostate-Specific Antigen ; Leukocytes, Mononuclear/pathology ; Watchful Waiting ; Prostatic Neoplasms/pathology ; Biopsy ; Risk Assessment
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2023-12-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1097/JU.0000000000003824
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Ui VI Zs.91: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 331: Show issues

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Article ; Online: Evaluation of an RNAseq-Based Immunogenomic Liquid Biopsy Approach in Early-Stage Prostate Cancer.

Van Neste, Leander / Wojno, Kirk J / Henao, Ricardo / Mane, Shrikant / Korman, Howard / Hafron, Jason / Kernen, Kenneth / Tinawi-Aljundi, Rima / Putzi, Mathew / Kassis, Amin I / Kantoff, Philip W

Cells

2021 Volume 10, Issue 10

Abstract: The primary objective of this study is to detect biomarkers and develop models that enable the identification of clinically significant prostate cancer and to understand the biologic implications of the genes involved. Peripheral blood samples (1018 ... ...

Abstract	The primary objective of this study is to detect biomarkers and develop models that enable the identification of clinically significant prostate cancer and to understand the biologic implications of the genes involved. Peripheral blood samples (1018 patients) were split chronologically into independent training (
MeSH term(s)	Humans ; Liquid Biopsy/methods ; Male ; Middle Aged ; Neoplasm Staging ; Prostatic Neoplasms/surgery ; Sequence Analysis, RNA/methods
Language	English
Publishing date	2021-09-28
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells10102567
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Article ; Online: Endovascular management of ureteroarterial fistula: a rare potentially life threatening cause of hematuria.

Copelan, Alexander / Chehab, Monzer / Cash, Charles / Korman, Howard / Dixit, Purushottam

Journal of radiology case reports

2014 Volume 8, Issue 7, Page(s) 37–45

Abstract: Ureteroarterial fistula is a rare, potentially life-threatening cause of hematuria characterized by an abnormal channel between a ureter and artery. The rarity of this condition, complexity of predisposing risk factors and intermittence of symptoms may ... ...

Abstract	Ureteroarterial fistula is a rare, potentially life-threatening cause of hematuria characterized by an abnormal channel between a ureter and artery. The rarity of this condition, complexity of predisposing risk factors and intermittence of symptoms may delay or obscure its diagnosis. With a high index of suspicion and careful angiographic evaluation, embarking on this condition is not only possible but sets the stage for curative intervention. We report a case of a ureteroarterial fistula presenting with intermittent hematuria, successfully diagnosed at angiography and managed with endovascular stent graft placement.
MeSH term(s)	Aged ; Diagnosis, Differential ; Female ; Hematuria/etiology ; Humans ; Radiography ; Stents ; Ureteral Diseases/complications ; Ureteral Diseases/diagnostic imaging ; Ureteral Diseases/etiology ; Ureteral Diseases/therapy ; Urinary Fistula/complications ; Urinary Fistula/diagnostic imaging ; Urinary Fistula/etiology ; Urinary Fistula/therapy
Language	English
Publishing date	2014-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2586384-8
ISSN	1943-0922 ; 1943-0922
ISSN (online)	1943-0922
ISSN	1943-0922
DOI	10.3941/jrcr.v8i7.1879
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