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  • Bloom, Jonathan  (11)
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  • 1
    Language: English
    In: Communications of the ACM, 01 January 2004, Vol.47(1), pp.47-49
    Description: SpeechWorks and Ford designed and realized a prototype targeted at relaxing the limitations of the current speech recognition systems by adopting a conversational speech interface coupled with a touch-screen display. The multimodality of the system allows users to adapt to their environment, for example,...
    Keywords: Engineering ; Computer Science ; Mathematics
    ISSN: 00010782
    E-ISSN: 1557-7317
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  • 2
    Language: English
    In: The Journal of Urology, May 2016, Vol.195(5), pp.1487-1491
    Description: Ureteroscopy is increasingly used to manage nephrolithiasis, upper urinary tract urothelial carcinoma and other urological conditions. In this study we determine the rate of readmission and emergency department visits after ureteroscopy in an underserved population, as well as factors associated with these unplanned visits. A retrospective chart review from 2010 to 2014 of all elective ureteroscopies was conducted at a single tertiary hospital serving an underserved population in a major metropolis. Demographic, operative and discharge characteristics were collected and analyzed. A total of 276 ureteroscopies were performed with 15.6% presenting to the emergency department within 30 days. Overall 5.8% were readmitted. Readmitted patients were more likely to have hypertension (OR 3.64, p=0.02), asthma or chronic obstructive pulmonary disease (OR 5.54, p=0.001), 2 or more comorbidities (OR 3.65, p=0.12), or a complication associated with ureteroscopy (OR 7.27, p=0.007). The patients who sought care in the emergency department after ureteroscopy were less likely to have had a ureteral stent in place before ureteroscopy (OR 0.35, p=0.017) or an endoscopic urological procedure within the last 30 days (OR 0.35, p=0.045). About two-thirds of patients who presented to the emergency department complained of pain alone, while the most common complaints for readmitted patients were fever and pain (43.8%). The majority of emergency department visits after ureteroscopy were due to pain. These patients were less likely to have a preoperative ureteral stent placed or a history of recent urological procedures. Readmission rates were associated with overall comorbidities and complications.
    Keywords: Ureteroscopy ; Patient Readmission ; Comorbidity ; Emergency Service, Hospital ; Stents ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 3
    Language: English
    In: The Journal of Urology, April 2017, Vol.197(4), pp.e108-e108
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2017.02.329 Byline: Michael Goltzman, Jonathan Bloom, John Phillips Author Affiliation: Valhalla, NY Article Note: (footnote) Source of Funding: None
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 4
    Language: English
    In: The Journal of Urology, April 2016, Vol.195(4), pp.e528-e528
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2016.02.093 Byline: Lorenzo Marconi Author Affiliation: Coimbra, Portugal Article Note: (footnote) Source of Funding: none
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 5
    Language: English
    In: The Journal of Urology, April 2016, Vol.195(4), pp.e1130-e1131
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2016.02.2424 Byline: Vladimir Valera, Derek Prabharasuth, Jonathan Bloom, John Phillips, Muhammad Choudhury, Sensuke Konno Author Affiliation: Valhalla, NY Article Note: (footnote) Source of Funding: Seize the Ribbon
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 6
  • 7
    Language: English
    In: The Canadian journal of urology, October 2017, Vol.24(5), pp.9017-9023
    Description: We sought to determine our rate of postoperative sepsis after ureteroscopy as well as identifying associative factors, common antibiotic practices along with culture data. Records of all patients who underwent elective ureteroscopy from 2010 to 2015 at an urban tertiary care facility were retrospectively reviewed. Factors thought to be associated with infection were collected, along with comorbidities depicted as Charlson Age-Adjusted Comorbidity Index (CAACI) and American Society of Anesthesia (ASA) score. Each patient's course was reviewed to determine if they were treated for postoperative sepsis as defined by standardized criteria. A total of 345 patients underwent elective ureteroscopy with 15 (4.3%) being treated for sepsis postoperatively. This resulted in an additional 5.33 ± 3.84 days of hospitalization per patient. The sepsis group grew three gram positive organisms and five multi-drug resistant (MDR) gram negatives while 7/15 (46.7%) had negative cultures. The most common preoperative antibiotics used in the sepsis group were cefazolin (60.0%), gentamicin (48.5%) and ciprofloxacin (20.0%). Univariate analysis showed prior endoscopic procedures, recent treatment for urinary tract infections (UTI), multiple comorbidities and longer operative times associated with sepsis. However, significant variables after multivariate analysis were treatment for UTI within the last month, (OR) 7.19 (2.25-22.99), p = 0.001. Patients with multiple comorbidities, prior endoscopic procedures, longer operative times and especially those recently treated for a urinary infection should be carefully monitored after ureteroscopy for signs of sepsis. Perioperative antibiotics in these patients should be selected to cover both MDR organisms and gram positives.
    Keywords: Postoperative Complications -- Epidemiology ; Sepsis -- Epidemiology ; Ureteroscopy -- Adverse Effects
    ISSN: 1195-9479
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 8
    In: Case Reports in Surgery, 2018, Vol.2018, 4 pages
    Description: Penile and scrotal entrapment from a metal ring placed at the base of the penis is a rare, but important clinical dilemma encountered in urology. Emergent presentation to the urologist, after ring placement far longer than safely practiced, risks ischemic and permanent injury to penile, scrotal, and intrascrotal structures. Treating urologists should be aware of the prevalence of metal ring use, their potential complications, and the surgical approach to their safe removal. We present two patients who were identified at our institution with strangulating injuries of retained penile rings. The first patient was a healthy, 43-year-old male with a metal ring retained for 24 hours that was safely removed with industrial bolt cutters. The second patient, a 74-year-old male, died as a result of sepsis from injuries secondary to penoscrotal ischemia after 〉48 hour ring retention despite prompt removal at emergent presentation. Although rare, sexual practices may include the use of penoscrotal rings. When retained, ischemic injury and edema may lead to strangulation. Emergent removal may require industrial equipment that is not within the confines of normal operating room tools. Tissue injury may be severe and sepsis life-threatening, even after ring removal.
    Keywords: Penis;
    ISSN: 2090-6900
    E-ISSN: 2090-6919
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  • 9
    Language: English
    In: Health Equity, 01 May 2018, Vol.2(1), pp.55-61
    Description: Purpose: Prostate cancer screening is a controversial topic. We examined trends in Prostate Specific Antigen (PSA) testing in an underserved population before and after the United States Preventative Services Task Force (USPSTF) recommendation against screening. Methods: Data were collected...
    Keywords: Prostate Biopsy ; Prostate Cancer ; Prostate Specific Antigen ; Urban Health ; Uspstf
    E-ISSN: 2473-1242
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  • 10
    Language: English
    In: Journal of endourology, 10 June 2019
    Description: Percutaneous Nephrolithomy (PCNL) is a complex, multi-step surgery that has shown a steady increase in use over the last decade in the US. We sought to evaluate the trends and factors associated with PCNL usage across New York State (NYS). Our goal was to characterize patient demographics and socioeconomic factors across high, medium, and low volume institutions. We searched the New York State, Statewide Planning and Research Cooperative System (SPARCS) database from 2006-2014 using ICD-9 Procedure Codes 55.04 (Percutaneous Nephrostomy with fragmentation) for all hospital discharges. Patient demographics including age, gender, race, insurance status, and length of hospital stay were obtained. We characterized each hospital as a low, medium, or high volume center by year. Patient and hospital demographics were compared and reported using chi-square analysis and student's t-test for categorical and continuous variables respectively, with statistical significance as a p-value of 〈0.05. We identified a total of 4,576 procedures performed from 2006 to 2014 at a total of 77 hospitals in New York State (Table 1). Total PCNL volume performed across all NYS hospitals increased in the last decade, with the greatest amount of procedures performed in 2012-2013. Low Volume institutions were more likely to provide care to minority populations (21.4% vs. 17.3%, p〈0.001) and those with Medicaid (25.5% vs. 21.5%, p〈0.001). High volume institutions provided care to patients with private insurance (42.1% vs. 34.0%, p〈0.001) and had a shorter length of stay (3.3 days vs. 4.1 days, p〈0.001). Our data provides insight into the patient demographics of those treated at high-, medium-, and low-volume hospitals for PCNL across NYS. Significant differences in race, insurance status, and length of stay were noted between Low and High Volume institutions, indicating that racial and socioeconomic factors play a role in access to care at high volume centers.
    Keywords: Ureteroscopy and Percutaneous Procedures ; Endourology ; Stone Disease ; Pcnl ; Health Care Disparities ; Medicine;
    ISSN: 08927790
    E-ISSN: 1557-900X
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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