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Griffiths L, Aro T, Samson P, Derisavifard S, Gaines J, Alaiev D, Mullen G, Rai A, Williams T, Patel V, Guanay G, Leavitt D, Hartman C, Smith A, Hoenig D, Okeke Z. Prospective Randomized Trial of Antibiotic Prophylaxis Duration for Percutaneous Nephrolithotomy in Low-Risk Patients. J Endourol 2023; 37:1075-1080. [PMID: 37578113 DOI: 10.1089/end.2022.0678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
Introduction and Objective: Postoperative infection and sepsis account for the most common complications following percutaneous nephrolithotomy (PCNL), as high as 14% in low-risk patients. Although the American Urological Association (AUA) recommends perioperative antibiotics for 24 hours or less for PCNL, practice patterns vary regarding duration of antibiotic therapy. We aimed to compare the efficacy of 24-hour antibiotic coverage vs short-course protocol of antibiotic prophylaxis for PCNL. Materials and Methods: Low-risk patients with a sterile preoperative urine culture undergoing PCNL were prospectively randomized to antibiotics for up to 24 hours after procedure (24Hr) or continued until external urinary catheters were removed (CR) study groups. Patients were given a first generation cephalosporin, or ciprofloxacin in patients with penicillin allergy. Exclusion criteria included age <18 years, receiving antibiotics immediately before the procedure, history of urosepsis, presence of indwelling catheter >1 week, multistage procedure, immunosuppression, pregnancy, multiple antibiotic allergies, and patients who are breastfeeding. Results: Ninety-eight patients were randomized to either 24Hr (n = 49) or CR (n = 49). Mean duration of antibiotic administration was 20.6 and 34.0 hours in the 24Hr and CR groups (p = 0.04), respectively. Age, comorbidities, stone size, operative time, number of punctures, dilations, and proportion of "tubeless" procedures were similar between groups. There were no differences in febrile episodes, rates of systemic inflammatory response syndrome, bacteremia, or culture-proven postoperative urinary tract infection between the 24Hr and CR groups. Overall complication rates were similar between groups. In a subgroup analysis which excluded "tubeless" patients (24 and 29 patients in 24Hr and CR groups, respectively), no differences were seen in postoperative outcomes. Conclusions: In a randomized, prospective study, we found that a 24-hour protocol for antibiotic prophylaxis is not associated with increased risk of infection-related events compared to giving antibiotics until external catheters are removed in patients with low infectious risk undergoing PCNL. Clinicaltrials.gov: NCT02579161.
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Affiliation(s)
- Luke Griffiths
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Tareq Aro
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Patrick Samson
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
- Department of Urology, Weill Cornell Medicine, New York, New York, USA
| | - Samir Derisavifard
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Jacob Gaines
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Daniel Alaiev
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Gregory Mullen
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Arun Rai
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Thomas Williams
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Vinay Patel
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Geoffrey Guanay
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - David Leavitt
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | | | - Arthur Smith
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - David Hoenig
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
| | - Zeph Okeke
- Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA
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Frainey BT, Majerus SJA, Derisavifard S, Lewis KC, Williams AR, Balog BM, Butler RS, Goldman HB, Damaser MS. First in Human Subjects Testing of the UroMonitor: A Catheter-free Wireless Ambulatory Bladder Pressure Monitor. J Urol 2023; 210:186-195. [PMID: 37293725 DOI: 10.1097/ju.0000000000003451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/28/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Urodynamics is the standard method of diagnosing bladder dysfunction, but involves catheters and retrograde bladder filling. With these artificial conditions, urodynamics cannot always reproduce patient complaints. We have developed a wireless, catheter-free intravesical pressure sensor, the UroMonitor, which enables catheter-free telemetric ambulatory bladder monitoring. The purpose of this study was twofold: to evaluate accuracy of UroMonitor pressure data, and assess safety and feasibility of use in humans. MATERIALS AND METHODS Eleven adult female patients undergoing urodynamics for overactive bladder symptoms were enrolled. After baseline urodynamics, the UroMonitor was transurethrally inserted into the bladder and position was confirmed cystoscopically. A second urodynamics was then performed with the UroMonitor simultaneously transmitting bladder pressure. Following removal of urodynamics catheters, the UroMonitor transmitted bladder pressure during ambulation and voiding in private. Visual analogue pain scales (0-5) were used to assess patient discomfort. RESULTS The UroMonitor did not significantly alter capacity, sensation, or flow during urodynamics. The UroMonitor was also easily inserted and removed in all subjects. The UroMonitor reproduced bladder pressure, capturing 98% (85/87) of voiding and nonvoiding urodynamic events. All subjects voided with only the UroMonitor in place with low post-void residual volume. Median ambulatory pain score with the UroMonitor was rated 0 (0-2). There were no post-procedural infections or changes to voiding behavior. CONCLUSIONS The UroMonitor is the first device to enable catheter-free telemetric ambulatory bladder pressure monitoring in humans. The UroMonitor appears safe and well tolerated, does not impede lower urinary tract function, and can reliably identify bladder events compared to urodynamics.
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Affiliation(s)
- Brendan T Frainey
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Steve J A Majerus
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samir Derisavifard
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kevin C Lewis
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Anna R Williams
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Brian M Balog
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Robert S Butler
- Quantitative Health Sciences Department, Cleveland Clinic, Cleveland, Ohio
| | - Howard B Goldman
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Margot S Damaser
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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Frainey BT, Majerus SJA, Derisavifard S, Lewis KC, Williams AR, Balog BM, Butler RS, Goldman HB, Damaser MS. Reply by Authors. J Urol 2023; 210:195. [PMID: 37293724 DOI: 10.1097/ju.0000000000003451.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Brendan T Frainey
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Steve J A Majerus
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samir Derisavifard
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kevin C Lewis
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Anna R Williams
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Brian M Balog
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Robert S Butler
- Quantitative Health Sciences Department, Cleveland Clinic, Cleveland, Ohio
| | - Howard B Goldman
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Margot S Damaser
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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Giusto LL, Derisavifard S, Zahner PM, Rueb JJ, Deyi L, Jiayi L, Weilin F, de Jesus Moreira R, Gomelsky A, Balzarro M, Goldman HB. Telemedicine follow-up is safe and efficacious for synthetic midurethral slings: a randomized, multi-institutional control trial. Int Urogynecol J 2021; 33:1007-1015. [PMID: 33877376 PMCID: PMC8056194 DOI: 10.1007/s00192-021-04767-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 03/10/2021] [Indexed: 02/08/2023]
Abstract
Introduction and hypothesis The objective was to assess whether telemedicine-based follow-up is equivalent to office-based follow-up in the early postoperative period after routine synthetic midurethral sling placement. Methods This is a prospective, international, multi-institutional, randomized controlled trial. Patients undergoing synthetic midurethral sling placement were randomized to 3-week postoperative telemedicine versus office-based follow-up. The primary outcome was the rate of unplanned events. Secondary outcomes included patient satisfaction, crossover from telemedicine to office-based follow-up, and compliance with 3- to 5-month office follow-up. Results We included 238 patients (telemedicine: 121 vs office: 117). No differences in demographics or medical comorbidities were noted between the study groups (p = 0.09–1.0). No differences were noted in unplanned events: hospital admission, emergency department visit, or unplanned office visit or call (14% vs 12.9%, p = 0.85) or complications (9.9% vs 8.6%, p = 0.82). Both groups were equally “very satisfied” with their surgical outcomes (71.1% vs 69%, p = 0.2). Telemedicine patients were more compliant with 3- to 5-month office follow-up (90.1% vs 79.3%, p = 0.04). Conclusions After synthetic midurethral sling placement, telemedicine follow-up is a safe patient communication option in the early postoperative period. Telemedicine patients reported no difference in satisfaction compared with office-based follow-up but had greater compliance with 3- to 5-month follow-up.
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Affiliation(s)
- Laura L Giusto
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Samir Derisavifard
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Patricia M Zahner
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Jessica J Rueb
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Luo Deyi
- West China Hospital of Sichuan University, Chengdu, China
| | - Li Jiayi
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Fang Weilin
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | | | | | - Matteo Balzarro
- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Howard B Goldman
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
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Kocher NJ, Derisavifard S, Rueb J, Goldman HB. Predictive factors of PNE success in a contemporary series: A single institution experience. Neurourol Urodyn 2020; 40:376-383. [PMID: 33205855 DOI: 10.1002/nau.24571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/05/2020] [Accepted: 10/29/2020] [Indexed: 11/06/2022]
Abstract
PURPOSE Peripheral nerve evaluation (PNE) permits a trial of sacral neuromodulation to determine candidates for single stage implant. Before routine fluoroscopy, PNE success rates were 40%-50% compared to approximately 77% with staged procedures. There are limited data on PNE success rates with the use of fluoroscopy and improved techniques. We evaluated a contemporary series of PNE patients to determine predictors of PNE success and persistent functional response following permanent implantation. METHODS A retrospective review of PNE patients at a large academic center from 2015 to 2019 was performed. Patients with urgency-frequency, urge incontinence, and/or fecal incontinence (FI) were included. Rates of permanent implant after successful PNE trial and continued improvement at ≥1 month were reviewed. Multivariable logistic regression determined predictors of PNE success and continued response at follow-up. RESULTS A total of 102 PNE patients were included. A total of 78 patients (76.5%) were PNE responders. Predictors of PNE success included younger age (p = .014), urgency incontinence (p = .021), FI (p = .017), absence of a neurologic diagnosis (p = .04), presence of bellows and toe responses (p = .038), and perineal sensation (p = .027). A total of 68 of 78 PNE responders (87.2%) maintained optimal responses at ≥1 month. Absence of a neurologic diagnosis was predictive of persistent success at follow-up (p = .013). CONCLUSIONS This contemporary PNE series revealed screening success equivalent to a two-staged approach. A small proportion of patients demonstrate suboptimal responses following permanent implant. Conversion from testing to permanent implant may not be the ideal outcome as it may overestimate success, and evaluation for persistent improvement should be investigated further as a more reliable indicator of successful screening.
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Affiliation(s)
- Neil J Kocher
- Department of Urology, Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, USA
| | - Samir Derisavifard
- Department of Urology, Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, USA
| | - Jessica Rueb
- Department of Urology, Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, USA
| | - Howard B Goldman
- Department of Urology, Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, USA
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Derisavifard S, Giusto LL, Zahner P, Rueb JJ, Goldman HB. Safety of Intradetrusor OnabotulinumtoxinA (BTX-A) Injection in the Asymptomatic Patient With a Positive Urine Dip. Urology 2019; 135:38-43. [PMID: 31600558 DOI: 10.1016/j.urology.2019.09.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate differences in adverse events (AE) in asymptomatic patients with a positive urine dip (UD) at time of intradetrusor onabotulinumtoxinA (BTX-A) injection vsthose with a defined negative UD. MATERIALS AND METHODS All intradetrusor BTX-A injections were retrospectively reviewed at a single institution between 2016 and 2018. Exclusion criteria included an indwelling catheter, recent positive urine culture, recent antibiotic course, or absence of UD on the day of injection. A positive UD was defined using 7 different definitions with varying combinations of any level of positive blood, leukocyte esterase, or nitrite. Negative UDs were defined those excluded from the positive UD group. We compared multiple positive UD-defined groups to their respective negative UD cohorts with regards to outcomes and demographics. RESULTS A total of 212 patients underwent 335 cycles of BTX-A injections over a 2-year period. The average age was 65 years (range: 21-90). The majority received 100 units (73%) of BTX-A for a non-neurogenic diagnosis (73%). The overall rate of AEs, urinary tract infection, and urinary retention was 14.6%, 9%, and 3%, respectively. In all groups, the most common AE was urinary tract infection followed by urinary retention. There were no major Clavien-Dindo-defined complications. There was no statistically significant difference in the total or categorical AE rates between positive and negative UD groups using all 7 definitions of a positive UD (P = .05-1.0). CONCLUSION These data do not support the practice of obtaining a preprocedure UD in asymptomatic patients undergoing intradetrusor BTX-A injection for any indication; test results are unable to predict outcomes or AEs.
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Affiliation(s)
- Samir Derisavifard
- The Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.
| | - Laura L Giusto
- The Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Patricia Zahner
- The Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Jessica J Rueb
- The Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Howard B Goldman
- The Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
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Abstract
Neuromodulation encompassing sacral and peripheral modalities is an established, effective, and safe higher-order treatment option approved in the USA for managing refractory overactive bladder, non-obstructive urinary retention, and fecal incontinence. This review highlights the most recent literature, indications, treatment durability, and the latest innovations in this field. Regarding sacral neuromodulation (SNM), recent work suggests improved parameters for optimal lead placement, increased data to support the lasting effects of treatment, and novel applications of this technology to other pelvic disorders. In addition, there are emerging technologies with smaller MRI compatible devices. Newer data on percutaneous tibial nerve stimulation (PTNS) suggests it may be more beneficial for certain patients. With new technology, implantable tibial nerve stimulators are ushering in a new frontier of nerve stimulation in the comfort of the patient's home.
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Affiliation(s)
- Courtenay K Moore
- Glickman Urologic and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Q-10, Cleveland, OH, 44195, USA.
| | - Jessica J Rueb
- Glickman Urologic and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Q-10, Cleveland, OH, 44195, USA
| | - Samir Derisavifard
- Glickman Urologic and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Q-10, Cleveland, OH, 44195, USA
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Samson PC, Gupta NK, Derisavifard S, Kavoussi LR, Vira MA. MP80-13 THE USE OF VIDEOCONFERENCING FOR MONITORING INPATIENT POST-OPERATIVE UROLOGIC PATIENTS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morganstern B, Derisavifard S, Elmasri M, Murphy M, Rapkin B, Palmer LS, Ghorayeb SR. MP66-13 NOVEL SONOGRAPHIC EVALUATION OF ADOLESCENT VARICOCELES. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Samson P, Derisavifard S, Morganstern B, Patel V, Leavitt D, Gaunay G, Motamedinia P, Elsamra S, Toor J, Smith A, Hoenig D, Okeke Z. PD35-04 PROSPECTIVE RANDOMIZED TRIAL OF ANTIBIOTIC PROPHYLAXIS DURATION FOR PERCUTANEOUS NEPHROLITHOTOMY: PRELIMINARY RESULTS. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Given the low incidence and delayed diagnosis, ureterocele management in the adult population is poorly described in the literature. Moreover, there is only one case report characterizing the condition with prolapse in an adult male. Approaches to therapy include transurethral incision or puncture with or without a combined percutaneous approach, and excision with or without partial nephrectomy for a duplicated system with a nonfunctioning upper pole moiety. We present a case of prolapsed, single intravesical ureterocele in a man presenting with hematuria and lower urinary-tract symptoms. A 54-year-old man with no significant medical history presents with increasing nocturia and urinary hesitancy. The development of gross hematuria prompted urologic evaluation. On imaging, the patient was found to have 4.3 × 3.3 cm bladder mass consistent with a prolapsed ureterocele that was managed by transurethral excision with a cutting loop. Postoperatively, the patient's symptoms resolved completely without complication. We suggest that complete transurethral ureterocele excision is an effective, definitive treatment option.
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Affiliation(s)
- Samir Derisavifard
- The Smith Institute for Urology, North Shore-Long Island Jewish Health System, New Hyde Park, New York
| | - Piruz Motamedinia
- The Smith Institute for Urology, North Shore-Long Island Jewish Health System, New Hyde Park, New York
| | - Zeph Okeke
- The Smith Institute for Urology, North Shore-Long Island Jewish Health System, New Hyde Park, New York
| | - Arthur Smith
- The Smith Institute for Urology, North Shore-Long Island Jewish Health System, New Hyde Park, New York
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Abstract
A new type of Cu2+ fluorescent sensor, coucage, has been prepared with a photosensitive nitrophenyl group incorporated into the backbone of a coumarin-tagged tetradentate ligand. Coucage provides a selective fluorescence response for Cu2+ over other biologically relevant metal ions. Coordination of Cu2+ dims the fluorescence output until irradiation with UV light cleaves the ligand backbone, which relieves the copper-induced quenching to provide a turn-on response. Experiments in live MCF-7 cells show that coucage can be used for detecting changes in intracellular Cu2+ upon the addition of excess exogenous copper. If improvements can be made to increase its affinity for copper, this new type of turn-on sensor could be used as a tool for visualizing the cellular distribution of labile copper to gain insight into the mechanisms of copper trafficking.
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Affiliation(s)
- Katie L. Ciesienski
- Department of Chemistry, Duke University, P.O. Box 90346, Durham, North Carolina 27708
| | - Lynne M. Hyman
- Department of Chemistry, Duke University, P.O. Box 90346, Durham, North Carolina 27708
| | - Samir Derisavifard
- Department of Chemistry, Duke University, P.O. Box 90346, Durham, North Carolina 27708
| | - Katherine J. Franz
- Department of Chemistry, Duke University, P.O. Box 90346, Durham, North Carolina 27708
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