Using Unsupervised Clustering to Characterize Phenotypes Among Older Kidney Transplant Recipients: A Cohort Study.

Background: Older kidney transplant recipients have inferior outcomes compared to younger recipients, and this risk may be compounded by donor characteristics.

Objective: We applied an unsupervised machine learning clustering approach to group older recipients into similar phenotypes. We evaluated the association between each cluster and graft failure, and the impact of donor quality on outcomes.

A Novel Cooling Device for Kidney Transplant Surgery.

Prolonged warm ischemia time (WIT) in kidney transplantation is associated with numerous adverse outcomes including delayed graft function and decreased patient and graft survival. Circumventing WIT lies in maintaining renal hypothermia and efficiently performing the vascular anastomosis during this portion of the procedure. Although numerous methods of intra-operative renal cooling have been proposed, most suffer from practical limitations, and none have been widely adopted.

The Impact of Combined Warm and Cold Ischemia Time on Post-transplant Outcomes.

Background: Prolonged warm ischemia time (WIT) and cold ischemia time (CIT) are independently associated with post-transplant graft failure; their combined impact has not been previously studied. We explored the effect of combined WIT/CIT on all-cause graft failure following kidney transplantation.

Methods: The Scientific Registry of Transplant Recipients was used to identify kidney transplant recipients from January 2000 to March 2015 (after which WIT was no longer separately reported), and patients were followed until September 2017.

Laparoscopic pyeloplasty practice patterns in Canada.

Introduction: Ureteropelvic junction obstruction (UPJO) is a condition characterized by partial or complete obstruction of urine transport from the renal pelvis to the ureter and can present with intermittent flank pain, recurrent urinary tract infections, renal stones, or renal dysfunction. While historically, open pyeloplasty was the gold standard for surgical management, laparoscopic methods to repair UPJO have largely taken over as the preferred approach for adolescent and adult patients. Despite near universal adoption of laparoscopic pyeloplasty among Canadian urologists, it remains a technically complex procedure and considerable variability exists in the procedural steps performed.

CanMEDS scholars: A national survey on urology residents' attitudes towards research during training.

Introduction: Participation in scholarly activity is an important tenet of residency training and is firmly entrenched in Canada since the introduction of CanMEDS roles by the Royal College of Physicians and Surgeons. As Canadian residency programs transition to competency-based training, it will remain important to understand how to best implement and encourage scholarly pursuits among resident trainees. The objective of this study was to understand the experiences, attitudes, and barriers that surgical residents face when pursuing research during their training.

Randomized, controlled trial of laser vs. bipolar plasma vaporization treatment of benign prostatic hyperplasia.

Introduction: Prostate vaporization technology is becoming a standard of care for treatment of moderate, symptomatic benign prostatic hyperplasia (BPH). We compared two transurethral prostate vaporization technologies with respect to cost, efficiency, efficacy, safety, and surgical team satisfaction.

Methods: Fifty-five patients meeting standardized symptom criteria for BPH were randomized to either Olympus Plasma Button or Biolitec EVOLVE diode laser vaporization.

Study habits of Canadian urology residents: Implications for development of a competence by design curriculum.

Introduction: The purpose of this study was to evaluate the study habits of Canadian urology residents throughout their residency training.

Methods: A survey was administered to all final-year Canadian urology residents over a two-year period. Sixty-seven respondents answered a survey consisting of 54 questions scored on a 10-point Likert score.

Serum follicle-stimulating hormone levels predict time to development of castration-resistant prostate cancer.

Introduction: Treatment of advancing prostate cancer focuses on blocking the activation of the androgen receptor with resultant prolonged perturbation of the hypothalamic-pituitary-gonadal axis. Androgen deprivation therapy (ADT) is marked, however, by eventual progression to castration- resistant prostate cancer (CRPC). Emerging evidence has postulated that follicle-stimulating hormone (FSH) may lead to proliferative and mutagenic responses of prostate cancer.

Impact of body mass index on clinical outcomes associated with percutaneous nephrolithotomy.

Introduction: Percutaneous nephrolithotomy (PCNL) is the preferred treatment for patients with large renal calculi or stones that have not responded to extracorporeal shock wave lithotripsy (ESWL). The objective of this study was to compare outcomes and complications of PCNL in patients of various body mass indices (BMI) to determine the safety of this procedure in patients with elevated BMI.

Methods: A retrospective chart review of 114 patients who underwent PCNL between 2006 and 2009 was performed.

Variables influencing the likelihood of cardiac dysrhythmias during extracorporeal shock wave lithotripsy.

Introduction: Extracorporeal shock wave lithotripsy (ESWL) is a safe and effective treatment of upper urinary tract calculi. While serious side effects are rare, transient cardiac dysrhythmias (CD) may be associated with ESWL. The exact etiology of these events, which are often unpredictable, is poorly understood.

Urolithiasis in the elderly.

Objectives: Urolithiasis is an increasing problem in patients ≥ 80 years. Our objective was to compare patients ≥ 80 years with urolithiasis to a younger cohort in terms of presentation and management.

Methods: Patients referred to a tertiary care stone clinic for management of urolithiasis over a 5 year period were reviewed.

Fenretinide promotes functional recovery and tissue protection after spinal cord contusion injury in mice.

The inflammatory response is thought to contribute to secondary damage after spinal cord injury (SCI). Polyunsaturated fatty acids (PUFAs) play an important role in the onset and resolution of inflammation. Arachidonic acid (AA), an omega-6 PUFA, contributes to the initiation of inflammatory responses, whereas docosahexaenoic acid (DHA), an omega-3 PUFA, has antiinflammatory effects.

Fenretinide corrects newly found ceramide deficiency in cystic fibrosis.

Chronic and persistent lung infections cause the majority of morbidity and mortality in patients with cystic fibrosis (CF). Galactosyl ceramide has been previously shown to be involved in Pseudomonas internalization. Therefore, we assessed ceramide levels in the plasma of patients with CF and compared them to healthy volunteers using high-performance liquid chromatography followed by mass spectrometry.