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Radical Prostatectomy by Laparotomy: Retrospective Study Comparing Separate and Continuous Stitches in the Performance of Vesicourethral Anastomosis at a Single Center in the Public Health Network

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Open Journal of Urology 2024年第6期14卷 368-379页

作者： Guilherme Canabrava rodrigues Silva Tarcizo Afonso Nunes Rafael Calvão Barbuto Thiffany Quartarollo lopes Beatriz Melo De Almeida Departamento de Cirurgia da FMUFMG e da PUC-MG Belo Horizonte Brazil Departamento de Cirurgia da FMUFMG Belo Horizonte Brazil Acadmica de Medicina da Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Brasil Acadmica de Medicina da Pontifcia Universidade Catlica de Minas Gerais (PUC-MG) Betim Brasil

Background: Prostate cancer ranks as the second most prevalent malignancy in men, with treatment strategies ranging from observation to various interventions. Radical prostatectomy is a common approach, aiming for a cure, and the technique for vesico-urethral anastomosis varies, employing separate or continuous stitches. However, a consensus on the optimal technique is lacking. This study aims to compare vesico-urethral anastomosis techniques (separate vs. continuous stitches) in laparotomy-based radical prostatectomies, evaluating peri and postoperative outcomes. Materials and Method: A retrospective analysis of 140 patients’ medical records yielded 86 eligible cases, divided into two groups based on anastomosis technique. Both groups underwent surgery at the same urology center between 2016 and 2019, with a follow-up period exceeding 12 months. Pre-operative characteristics were statistically similar between groups. Results: Perioperative complication rates did not significantly differ between the two techniques (p > 0.99). However, the continuous stitch group experienced a 20-minute longer procedure time (p 0.05), patients with continuous stitches had 2.5 times higher diaper usage at twelve months (p Conclusion: This research suggests that vesico-urethral anastomosis with separate stitches yields superior results in laparotomy-based radical prostatectomies compared to continuous stitches, demonstrating benefits in surgical time, hospital stay, sentinel drain duration, stenosis rates, and long-term urinary incontinence outcomes.

关键词： Prostate Cancer Urinary Incontinence Urethrovesical Anastomosis

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Transarterial embolization is an acceptable bridging therapy to hepatocellular carcinoma prior to liver transplantation

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World Journal of Transplantation 2024年第2期14卷 126-134页

作者： Gabriel Lazzarotto-da-Silva leandro A Scaffaro Mauricio Farenzena Lucas Prediger Rafaela K Silva Flávia Heinz Feier Tomaz J M Grezzana-Filho Pablo D rodrigues Alexandre de Araujo Mario Reis Alvares-da-Silva Roberta C Marchiori Cleber Rosito Pinto Kruel Marcio Fernandes Chedid Department of Liver Transplant and Hepatobiliary Surgery Unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Department of Interventional Radiology Unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Department of Gastroenterology and Hepatology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil

BACKGROUND Hepatocellular carcinoma(HCC)is an aggressive malignant neoplasm that requires liver transplantation(LT).Despite patients with HCC being prioritized by most organ allocation systems worldwide,they still have to wait for long *** therapies(LRTs)are employed as bridging therapies in patients with HCC awaiting *** largely used in the past,transarterial embolization(TAE)has been replaced by transarterial chemoembolization(TACE).However,the superiority of TACE over TAE has not been consistently shown in the *** To compare the outcomes of TACE and TAE in patients with HCC awaiting *** All consecutive patients with HCC awaiting LT between 2011 and 2020 at a single center were *** patients underwent LRT with either TACE or *** patients also underwent percutaneous ethanol injection(PEI),concom-itantly or in different treatment *** choice of LRT for each HCC nodule was determined by a multidisciplinary *** primary outcome was waitlist dropout due to tumor progression,and the secondary outcome was the occurrence of adverse *** the subset of patients who underwent LT,complete pathological response and post-transplant recurrence-free survival were also *** Twelve(18.5%)patients in the TACE group(only TACE and TACE+PEI;n=65)and 3(7.9%)patients in the TAE group(only TAE and TAE+PEI;n=38)dropped out of the waitlist due to tumor progression(P log-rank test=0.29).Adverse events occurred in 8(12.3%)and 2(5.3%)patients in the TACE and TAE groups,respectively(P=0.316).Forty-eight(73.8%)of the 65 patients in the TACE group and 29(76.3%)of the 38 patients in the TAE group underwent LT(P=0.818).Among these patients,complete pathological response was detected in 7(14.6%)and 9(31%)patients in the TACE and TAE groups,respectively(P=0.145).Post-LT,HCC recurred in 9(18.8%)and 4(13.8%)patients in the TACE and TAE groups,respectively(P=0.756).Posttransplant recurrence-free survival was simila

关键词： Hepatocellular carcinoma Transarterial embolization Transarterial chemoembolization Liver transplantation Locoregional therapy Bridging

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Sarcopenia and Anemia Are Predictors of Poor Prognostic in Cervical Cancer Patients

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 693-704页

作者： leandro Santos de Araujo Resende Francine Vilela de Amorim Miguel Soares Conceição Rodrigo Menezes Jales Patrick Nunes Pereira Luis Otávio Sarian Glauco Baiocchi Sophie Derchain Agnaldo lopes da Silva Filho Department of Gynecology and Obstetrics Botucatu Medical School S&#227o Paulo State University UNESP S&#227o Paulo Brazil Department of Health Sciences University of Sao Francisco S&#227o Paulo Brazil Department of Obstetrics and Gynecology School of Medical Science State University of Campinas (UNICAMP) Campinas Brazil Department of Gynecologic Oncology AC Camargo Cancer Center Sao Paulo Brazil Department of Gynecology and Obstetrics School of Medicine of the Federal University of Minas Gerais Belo Horizonte Brazil

Objective: Evaluate pretreatment sarcopenia and anemia as prognostic factors in women undergoing treatment for cervical cancer (CC) with concurrent chemoradiotherapy (CCRT). Methods: 151 women with CC were analysed in this cohort study. Pretreatment computed tomography (CT) images were analysed to assess skeletal muscle index (SMI). Hazard ratios (HR) and multivariate Cox proportional HR were used to analyse association between low SMI, age, body mass index (BMI), haemoglobin levels, histological type, and International Federation of Gynaecology and Obstetrics (FIGO) stage with PFS and OS. Results: A total of 151 patients were included, 53 (35.1%) presented pretreatment sarcopenia;51 (34%) stage I/II and 100 (66%) stage III/IV. Among those patients in advanced stage (III/IV) 37 (70%) (p = 0.28) were sarcopenic at the beginning of treatment. Sarcopenia was associated with worse progression-free survival (PFS) and overall survival (OS) in our cohort [HR 0.97 (p = 0.01)] [HR 0.73 (p = 0.001)], as well as anemia [HR 0.73 (p = 0.001)] [HR 0.78 (p = 0.001)]. Linear regression models indicated that despite showing no association with age, neutrophil or platelet counts, sarcopenia was associated with pretreatment anemia levels (p = 0.01). After a multivariate analysis, only haemoglobin (anemia) and complete CCRT remained associated with PFS and OS. Sarcopenia and anemia were associated with worse PFS and OS in FIGO stage I/II. Conclusion: Pretreatment sarcopenia was significantly associated with low haemoglobin levels. Anemia and incomplete CCRT were independently associated with poor prognosis in women with CC. Pretreatment sarcopenia, as low SMI, was a predictor of poor prognostic in early stages of CC.

关键词： Cervical Cancer Sarcopenia Anemia Chemoradiotherapy

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Flight performance and wing morphology in the bat Carollia perspicillata:biophysical models and energetics

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Integrative Zoology 2023年第5期18卷 876-890页

作者： Lucas de Oliveira CARNEIRO Breno MELLADO Marcelo rodrigues NOGUEIRA Ariovaldo Pereira da CRUZ-NETO leandro Rabello MONTEIRO Laboratório de Ciências Ambientais Centro de Biociências e BiotecnologiaUniversidade Estadual do Norte FluminenseCampos dos GoytacazesRio de JaneiroBrasil Departamento de Biodiversidade Universidade Estadual PaulistaRio ClaroSão PauloBrasil

Studies on functional performance are important to understand the processes responsible for the evolution of *** trait variation within species influences the energetic cost of locomotion and impacts life history traits,with ecological and evolutionary *** study examined wing morphology correlates of flight performance measured by energetic expenditure in the Seba’s short-tailed bat,Carollia *** the flight experiments,nature caught bats(59 females,57 males)were allowed to fly for 3 min in a *** each flight,thermographic images were taken to measure body temperature,and biophysical models were used to calculate sensible heat loss as a measure of energetic *** morphological traits were measured for each individual and associated with heat loss and power required to fly on performance *** morphological traits explained 7-10%of flight energetic cost,and morphologies with the best performance would save the energy equivalent to 9-30%of total daily *** optimal performance areas within the *** morphospace were consistent with predicted selection trends from the literature.A trade-off between demands for flight speed and maneuverability was *** loading and camber presented sexual *** morphological differences are likely associated with more economical but less maneuverable flight in females,leading them to fly more often in open areas along the forest *** findings demonstrate how small scale changes in wing morphology can affect life history strategies and fitness.

关键词： aerodynamics Chiroptera infrared thermography performance surfaces Phyllostomidae wing morphometrics

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Can the Ucides cordatus Fishing and the Crassostrea gasar Creation on the Amazon Coast Make up the Curriculum of Rural Schools

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Journal of Fisheries Science 2021年第1期3卷 37-46页

作者： Ivaney dos Santos Cardoso Elaine Vasconcelos Bezerra Alves leandro lopes rodrigues Ana Célia Barbosa Guedes LuãCaldas de Oliveira Manoel Luciano Aviz de Quadros Débora Tatyane Oliveira Xavier Altevir Signor Fabricio Nilo Lima da Silva Instituto Federal de Educação Ciência e Tecnologia do Pará(IFPA)Campus Avançado VigiaRodovia PA-140Km 55próximo ao trevo de São CaetanoVigiaPará68.780-000Brasil Universidade da Amazônia(UNAMA) Campus Alcindo Cacela.Avenida Alcindo Cacela287-UmarizalBelémPará66060-000Brasil Instituto Federal de Educação Ciência e Tecnologia do Pará(IFPA)Campus Breves.Rua Antônio Fulgêncio da Silvas/n-Bairro:Parque UniversitárioBrevesPará68.800-000Brasil Faculdade Católica Paulista.Avenida Cristo Rei n 305 17515-200MaríliaSão PauloBrasil Universidade Estadual do Oeste do Paraná(UNIOESTE) Campus Toledo.Rua da Faculdade645-Jardim La Salle85903-000ToledoParanáBrasil

The fishing and ostreiculture activities practiced in the coast of the Eastern Amazon in the state of Pará,Brazil,became important to be inserted in rural ***,this literature review aimed to realize a brief theoretical discussion about the important aspects of rural education in promoting the development of fishing and *** the accomplishment of the literary research it was sought to explain the definition in education;rural education and valorization of the rural environment;environmental education as a transversal theme;fishing and aquaculture as a teaching strategy;considerations of fishing and ostreiculture;challenges and perspectives of the teaching of fishing and aquaculture in education;and booklet as a pedagogical tool in *** conclusion,the use of fishing and ostreiculture as a strategy for rural schools through environmental education is important to foster fishing activity in communities,as well as the sustainable use of natural resources.

关键词： Fishing resources Ostreiculture Environmental education Brazil

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Influence of fire on woody vegetation of savanna and forest formations in the Cerrado biome

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林业研究:英文版 2023年第5期34卷 1207-1216页

作者： Aline das Gracas Costa Fillipe Tamiozzo Pereira Torres Gumercindo Souza Lima Fabiano rodrigues de Melo Carlos Moreira Miquelino Eleto Torres Bruno Leao Said Schettini Vicente Paulo Santana Neto AndréLuiz lopes de Faria Department of Forest Engineering Federal University of VicosaUFVVicosaMG 36570-900Brazil Department of Geography Federal University of VicosaUFVVicosaMG 36570-900Brazil

Wildfires have environmental,economic,and social impacts,and can shape the landscape and benefit ecosystems such as the *** study evaluated the diversity,similarity,and floristic and structural differences of woody savanna and forest formations of the Cerrado,when affected and not affected by ***-eight 25-400m2 plots were randomly allocated and divided into Burnt Cerrado and Unburnt Cerrado,Burnt Forest,and Unburnt Forest,and divided into three levels of inclusion according to diameter class(smaller than 2 cm,2-5 cm and larger than5 cm).Species were identified,DBH and height measured,and phyto sociological parameters such as volume,diversity,and floristic similarity *** Cerrado had lower diversity,density,and dominance at all inclusion levels compared to the Unburnt Cerrado,and showed similarities between treatments at the inclusion *** Forest had smaller differences in diversity,density,and dominance than Unburnt *** formation was similar at level 1 of inclusion and in the total ***,it was dissimilar at lower *** lower density and diversity of species at the lowest levels of inclusion was associated with mortality from fire.

关键词： Biodiversity Brazil Burning Floristic Phytosociology

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Assessment of periportal fibrosis in Schistosomiasis mansoni patients by proton nuclear magnetic resonance-based metabonomics models

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World Journal of Hepatology 2022年第4期14卷 719-728页

作者： Milena Lima rodrigues Tatiane Priscila Santos rodrigues da Luz Caroline Louise Diniz Pereira Andrea Dória Batista Ana Lúcia Coutinho Domingues Ricardo Oliveira Silva Edmundo Pessoa lopes Programa de Pós-Graduação em Medicina Tropical Centro de Ciências MédicasUniversidade Federal de PernambucoRecife 50670-901PernambucoBrazil Programa de Pós-Graduação em Química Centro de Ciências Exatas e da NaturezaUniversidade Federal de PernambucoRecife 50670-740PernambucoBrazil Hospital das Clínicas Departamento de Medicina ClínicaUniversidade Federal de PernambucoRecife 50670-901PernambucoBrazil

BACKGROUND The evaluation of periportal fibrosis(PPF)is essential for a prognostic assessment of patients with Schistosomiasis *** WHO Niamey Protocol defines patterns of fibrosis from abdominal ultrasonography,^(1)H-nuclear magnetic resonance(NMR)-based metabonomics has been employed to assess liver fibrosis in some *** To build 1H-NMR-based metabonomics models(MM)to discriminate mild from significant periportal PPF and identify differences in the metabolite *** A prospective cross-sectional study was performed on schistosomiasis patients at a University Hospital in Northeastern *** evaluated 41 serum samples from 10 patients with mild PPF(C Niamey pattern)and 31 patients with significant PPF(D/E/F Niamey patterns).MM were built using partial least squares-discriminant analysis(PLS-DA)and orthogonal projections to latent structures discriminant analysis(OPLS-DA)*** PLS-DA and OPLS-DA resulted in discrimination between mild and significant PPF groups with R2 and Q2 values of 0.80 and 0.38 and 0.72 and 0.42 for each model,*** OPLS-DA model presented accuracy,sensitivity,and specificity values of 92.7%,90.3%,and 100%to discriminate significant *** metabolites identified as responsible by discrimination were:Nacetylglucosamines,alanine,glycolaldehyde,carbohydrates,and *** MMs discriminated mild from significant PPF patterns in patients with Schistosomiasis mansoni through identification of differences in serum metabolites profiles.

关键词： Metabolomics Portal hypertension Schistosoma mansoni Biomarkers Neglected disease Nuclear magnetic resonance

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Ophthalmic manifestations in patients with inflammatory bowel disease: a review

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World Journal of Gastroenterology 2017年第32期23卷 5836-5848页

作者： leandro lopes Troncoso Ana Luiza Biancardi Haroldo Vieira de Moraes Jr Cyrla Zaltman Department of Ophthalmology Universidade Federal do Rio de Janeiro Department of Internal Medicine Gastroenterology DivisionUniversidade Federal do Rio de Janeiro

Clinical manifestations of inflammatory bowel disease(IBD) are not locally restricted to the gastrointestinal tract, and a significant portion of patients have involvement of other organs and systems. The visual system is one of the most frequently affected, mainly by inflammatory disorders such as episcleritis, uveitis and scleritis. A critical review of available literature concerning ocular involvement in IBD, as it appears in Pub Med, was performed. Episcleritis, the most common ocular extraintestinal manifestation(EIM), seems to be more associated with IBD activity when compared with other ocular EIMs. In IBD patients, anterior uveitis has an insidious onset, it is longstanding and bilateral, and not related to the intestinal disease activity. Systemic steroids or immunosuppressants may be necessary in severe ocular inflammation cases, and control of the underlying bowel disease is important to prevent recurrence. Our review revealed that ocular involvement is more prevalent in Crohn's disease than ulcerative colitis, in active IBD, mainly in the presence of other EIMs. The ophthalmic symptoms in IBD are mainly nonspecific and their relevance may not be recognized by the clinician; most ophthalmic manifestations are treatable, and resolve without sequel upon prompt treatment. A collaborative clinical care team for management of IBD that includes ophthalmologists is central for improvement of quality care for these patients, and it is also cost-effective.

关键词：煽动性的肠疾病 Crohns 疾病 Ulcerative 大肠炎眼睛的复杂并发症看表明

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Fecal marker levels as predictors of need for endoscopic balloon dilation in Crohn's disease patients with anastomotic strictures

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World Journal of Gastroenterology 2017年第35期23卷 6482-6490页

作者： Susana lopes Patrícia Andrade Eduardo rodrigues-Pinto Joana Afonso Guilherme Macedo Fernando Magro Gastroenterology Department Faculty of MedicineHospital de Sao Joao Department of Pharmacology and Therapeutics University of Porto

AIM To evaluate the accuracy and best cut-off value of fecal calprotectin(FC) and fecal lactoferrin(FL) to predict disease recurrence in asymptomatic patients presenting with anastomotic strictures. METHODS This was a longitudinal single tertiary center study based on prospectively collected data(recorded in a clinical database created for this purpose) performed between March 2010 and November 2014. Crohn's disease(CD) patients with anastomotic stricture who submitted to postoperative endoscopic evaluation were included. Stools were collected on the day before bowel cleaning for FC and FL. Endoscopic balloon dilation(EBD) was performed if the patient presented an anastomotic stricture not traversed by the colonoscope, regardless of patients' symptoms. Successful dilation was defined as passage of the colonoscope through the dilated stricture into the neotermimal *** recurrence was defined as a modified Rutgeerts score of ≥ i2 b. RESULTS In a total of 178 patients who underwent colonoscopy, 58 presented an anastomotic stricture, 86% were asymptomatic, and 48(54% male; median age of 46.5 years) were successfully dilated. Immediate success rate was 92% and no complications were recorded. FC and FL levels correlated significantly with endoscopic recurrence(P < 0.001) with an optimal cut-off value of 90.85 μg/g(sensitivity of 95.5%, specificity of 69.2%, positive predictive value(PPV) of 72.4%, negative predictive value(NPV) of 94.7% and accuracy of 81%] for FC and of 5.6 μg/g(sensitivity of 77.3%, specificity of 69.2%, PPV of 68%, NPV of 78.4% and accuracy of 72.9%) for *** Fecal markers are good predictors of CD endoscopic recurrence in patients with asymptomatic anastomotic stricture. FC and FL may guide the need for EBD in this context.

关键词： Crohn's disease Anastomotic strictures Endoscopic balloon dilation Fecal markers Po stoperative recurrence

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Evaluation of the Usability of a Telehealth System for COVID-19 According to the Perception of the User Professional

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E-Health Telecommunication Systems and Networks 2022年第3期11卷 101-108页

作者： Lídia Maria Lourençön rodrigues Agia Cristina Broilo Rui Pedro Charters lopes Rijo Domingos Alves Department of Social Medicine Ribeir&#227 o Preto Medical School University of S&#227 o Paulo Ribeir&#227 o Preto Brazil TopMed Healthcare and Telemedicine LTDA Florianópolis Brazil School of Technology and Management Polytechnic Institute of Leiria Leiria Portugal

With the advent of the pandemic, the Brazilian Ministry of Health structured in record time the Telehealth Service of the Unified Health System called TeleSUS, an ecosystem based on the intensive use of information technology involving automated mechanisms and a personalized health care center at distance. In addition to constant evaluations carried out in the service as a public health strategy, at clinical and epidemiological levels, the team involved in the project was also concerned with evaluating the system developed to enable the operation of remote care, from the conception of the organization of health actions to the technological development of the digital health tool. The objective of this study was to carry out an evaluation of a telehealth system, measuring the degree of satisfaction of users of health professionals regarding its usability and identifying factors that positively and/or negatively influence the evaluation.

关键词： System Evaluation Health Information Systems Telehealth

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