Urology

Breaking News: The Downfall of the PSA

May 23, 2012
Breaking News: The Downfall of the PSA

The United States Preventive Services Task Force stands their ground in this week’s Annals of Internal Medicine and recommends against the routine use of the PSA as a screening tool for prostate cancer. This Class D recommendation is grounded in data that suggests a “very small” mortality benefit at the risk of significant over-diagnosis and unnecessary treatment. The PSA should still be used to follow response to treatment in those already diagnosed with prostate cancer. This recommendation has already set off a media frenzy and…

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Does Cranberry Juice Prevent Urinary Tract Infections?

November 9, 2011
Does Cranberry Juice Prevent Urinary Tract Infections?

By Jessie Yu

Faculty Peer Reviewed

A healthy 21-year-old female college student presents to clinic after one day of dysuria and increased frequency. You diagnose her with a recurrent urinary tract infection (UTI), and as you hand her a prescription for empiric antibiotic treatment, she asks you if drinking cranberry juice will prevent these in the future…

Drinking cranberry juice to prevent urinary tract infections (UTIs) has been a traditional folk remedy for hundreds of years. Stroll into any New York City pharmacy and…

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Medicine By Numbers

January 21, 2011
Medicine By Numbers

How to Counsel a Patient on Prostate Cancer Screening in 5 Minutes

By Caprice Cadacio, MD

Faculty Peer Reviewed

A good screening test is relatively inexpensive and noninvasive.  In addition, effective treatment should be available if the disease  being screened for is confirmed.  Lastly, detecting the disease before a patient becomes symptomatic must be more beneficial than detection after the patient experiences signs or symptoms.

The latter point is often debated in prostate cancer screening,…

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Circumcision as Primary Protection?

October 8, 2010
Circumcision as Primary Protection?

Emily Taylor, MD

Faculty Peer Reviewed

The earliest documented evidence of circumcision is in artwork from the Sixth Dynasty in Egypt (2345-2181 BC) found in a wall relief from Saqqara in Lower Egypt. Circumcised North Americans were described by Columbus upon arrival to the continent; circumcision was practiced by Australian aboriginals, native South Americans, and Pacific Islanders. It is unknown if circumcision was common amongst some earlier ancestor of all these peoples, or if it evolved independently in…

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Prostate Cancer Screening: Where Do We Stand Now?

December 9, 2009
Prostate Cancer Screening: Where Do We Stand Now?

Annery Garcia

Prostate cancer is the second most common cancer in western men and the second leading cause of cancer-related deaths in men in the U.S.1 In 2007 approximately 218,890 men were diagnosed with prostate cancer, and it is expected that one out of six men will receive the diagnosis in their lifetime.2 Although considered to be a slow-growing tumor, the American Cancer Society estimated that in 2008 186,330 new cases of prostate cancer would be diagnosed, and 26,000 men will…

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Prostate Cancer and Antioxidants

February 25, 2009

Commentary by Christopher Tully MD, PGY-1

Faculty Peer Reviewed

An apple a day. . . keeps the prostate cancer away? While it is an overstatement to say that an apple can prevent cancer, the notion of taking “something” to prevent cancer initiation and growth is nothing new. Primary prevention has long been a goal of researchers and physicians with the aim of preventing the morbidity and mortality associated with malignant disease. Prostate cancer is an appropriate choice in studying this topic since we…

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Breaking News: USPSTF Issues New Prostate Cancer Screening Guidelines

August 5, 2008

Commentary by Cara Litvin MD, Executive Editor, Clinical Correlations

The US Preventive Services Task Force issued new guidelines for prostate cancer screening on Monday.  For the first time, the task force recommends AGAINST routine screening in patients over 75 years of age, citing the “moderate to substantial” harms over small to no benefits from screening. The task force reports that there continues to be inadequate evidence that the PSA improves healthcare outcomes at any age.  However, even if there is eventual evidence that screening is beneficial in younger patients, because men over…

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A Brief Glance at the Relationship between Varicocele and Infertility

March 19, 2008
A Brief Glance at the Relationship between Varicocele and Infertility

Commentary by Melissa Freeman MD, PGY-2

A 30 year-old male resident presents to his primary care physician for a routine physical examination. A small, nontender left-sided scrotal mass is felt. The patient states that this asymptomatic mass has been present for one year and was evaluated by a prior physician who felt that further work-up was unnecessary. He is sent for a testicular ultrasound which reveals a grade II varicocele. His testosterone level was low and he later had a semen analysis which was abnormal.…

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FDA Approves Label Revision for Erectile Dysfunction Drugs

October 24, 2007
FDA Approves Label Revision for Erectile Dysfunction Drugs

Commentary by Kathy Lee, Pharm.D. Pharmacy Practice Resident

On October 18 2007, the FDA announced the approval of labeling changes to erectile dysfunction (ED) drugs in the class known as phosphodiesterase type 5 (PDE-5) inhibitors. This includes drugs Cialis®, Levitra®, Viagra®, as well as Revatio®, a PDE-5 inhibitor indicated for pulmonary arterial hypertension (PAH). The label revisions draw attention to the potential risk of sudden hearing loss, sometimes associated with vestibular symptoms such as tinnitus, vertigo, and dizziness. Based on 29 postmarketing reports of this incidence,…

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Does Circumcision Decrease the Transmission of HIV?

December 18, 2006
Does  Circumcision Decrease the Transmission of HIV?

Recently, two large clinical trials in Kenya and Uganda that examined the role of circumcision in men to prevent the spread of HIV were halted on the grounds that not offering circumcision to men taking part in the trial would be unethical.  The trials involved nearly 3,000 heterosexual men in Kenya and nearly 5,000 men in Uganda, none of whom were infected with HIV prior to starting the trial.  In the Kenayn trial, men who were circumcised had a 53% relative risk reduction (2%…

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