Michael W. McDonald

Leiomyosarcoma of the penis

We report a case of an aggressive leiomyosarcoma of the penis treated with radical surgery, radiotherapy and chemotherapy. The patient died 7 months after diagnosis.

Testicular tumor in blacks

Although testicular tumors are less common in blacks than in whites, they do occur and must be considered in making a differential diagnosis of scrotal masses. At The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston, 19 black men were treated for testicular tumor between 1944 and 1980, representing 1.4 per cent of the total of 1,380 patients treated for testicular tumor. Since blacks made up 7.9 per cent of all patients treated at UT M. D. Anderson Hospital, blacks with testicular tumor were seen about one-fifth as often as would be expected if there were no racial variation in the incidence of the disease. Twelve patients had a diagnosis of seminoma, five embryonal carcinoma, one teratocarcinoma, and one interstitial cell tumor. The majority of patients had metastatic disease at the time of diagnosis. Five of 12 patients with seminoma and 5 of 6 with nonseminomatous cancer died of disease. Prognosis today, however, is no worse for blacks than for whites.

PNFLBA-02 A HEAD TO HEAD COMPARATIVE PHASE II TRIAL OF STANDARD URINE CULTURE AND SENSITIVITY VERSUS DNA NEXT GENERATION SEQUENCING TESTING FOR URINARY TRACT INFECTIONS

Many studies have discussed clinical practice guidelines for the treatment of cystitis and pyelonephritis. Treatment of uncomplicated urinary tract infections (UTIs) can be based on empiric antibiotic therapy. For complicated or recurrent UTIs, therapy can be based on laboratory-controlled culture and sensitivity (C&S) reports. The diagnosis of UTI by clinical criteria alone has an error rate of up to 33%. In addition, positive laboratory culture results do not always indicate a diagnosis of UTI. Comparison of urine in a conventional culture model versus DNA next-generation sequencing (NGS) to accurately identify and provide information on resistance factors (mobile genetic elements) is warranted. Our study was a head-to-head comparative phase II study of standard urine C&S versus DNA NGS testing for the diagnosis and treatment efficacy in patients with symptoms of acute cystitis based on short-term outcomes.

MP90-15 NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) MAY IMPROVE 30-DAY READMISSION RATES TO THE ED FOR ACUTE EPISODES OF RENAL COLIC

on stone activity is not well studied. Our goal was to determine if SI CaOx correlates with stone activity in calcium oxalate (CaOx) stone formers. METHODS: We reviewed the charts of 604 patients from our stone clinic between 2005 and 2016 and identified CaOx stone formers who had a baseline 24-hour urine collection and at last one follow-up urine collection after the initiation of drug and/or dietary therapy. Patient demographics, imaging studies, serum chemistries, and 24-hour urine studies were recorded in a timeline for each patient. SI was calculated using JESS for each 24-hour urine study. Stone recurrence (SR) was defined as stone growth or new stone formation and no recurrence (NR) indicated no new stone formation. Absolute SI values were compared between times of SR and times of NR, and change in SI from baseline to time of SR were correlated with SI. Statistical analysis was performed with SAS, and significance was set at p<0.05. RESULTS: In total, 255 patients with 358 events were included in the analysis. Mean patient age was 51 13 SD years, with a male:female ratio of 1.3. Comparing NR (98 patients with 97 events) to SR (157 patients with 113) demonstrated no significant difference in mean SI CaOx values (5.6 2.8 versus 5.6 2.9, p1⁄40.6). In addition, in patients who experienced SR (n1⁄4157) no significant difference was seen comparing mean SI CaOx values during NR (n1⁄4148) or SR (n1⁄4113) events (5.9 2.8 versus 5.6 2.9, respectively, p1⁄40.08). For all patients with SR, 65 were identified who experienced both changes from SR to NR (median DSI CaOx 0.20, IQR -1.46-1.21) and NR to SR (median DSI CaOx 0.52, IQR -1.55-1.47). No significant difference was seen (p1⁄40.84). CONCLUSIONS: At first evaluation, neither absolute nor change in SI correlates with stone recurrence and may not be a reliable way to follow effectiveness of medical therapy.