Abstract Objective Lower urinary tract symptoms (LUTS) affect approximately 10% of children worldwide and are related to psychosocial manifestations and compromised quality of life, both for children and their families. The assessment of emotional conditions of LUTS in children is recommended by International Children's Continence Society; however, there is no specific instrument in the Brazilian Portuguese language. Therefore, the aim of this study was to translate, culturally adapt and assess the internal consistency of the Brazilian Portuguese version of the Pediatric Incontinence Questionnaire (PINQ). Material and methods This cross-sectional study was performed at two referral centers for childhood voiding dysfunction. The 20-item PINQ was translated into Brazilian Portuguese and culturally adapted according to Beaton, 2000. His-standard methodology consists of 6 phases: translation, synthesis, back-translation, expert committee, and pre-test. The internal consistency was assessed using Cronbach's alpha. Results The PINQ-br version was developed, validated by a committee of experts, and pre-tested on 44 children diagnosed with lower urinary tract symptoms, 23 boys and 21 girls (mean age: 9.7 and 9.6 years old respectively), as well as on their parents. The internal consistency was considered satisfactory, reaching Cronbach's alpha coefficient of 0.74 when applied to children and 0.82 when applied to parents. Conclusions The PINQ was translated and culturally adapted to Brazilian Portuguese to assess the impact of LUTS on the health-related quality of life in Brazilian children and adolescents.

ABSTRACT Introduction: Bladder and urinary sphincter malfunctioning that results from some change in the central and/or peripheral nervous system is defined as neurogenic bladder. The urinary tract symptoms that can be related to its filling, emptying, or both have a significant impact on the quality of life of individuals. The present review was based on the document prepared for the public health system in Brazil as a treatment guidelines proposal. Material and Methods: Survey questions were structured as per PICO (Population, Intervention, Control, and Outcome). Search strategies were defined and performed in the MEDLINE/Pubmed, Embase, Epistemonikos and Google Scholar databases. The selection of articles followed the evidence hierarchy concept; evidence body was identified, and the quantitative study data were extracted. The quality of evidence and grade of recommendation were qualitatively assessed according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations). Results: A total of 2.707 articles were identified, with 49 of them being selected to compose the basis for this review. Neurogenic bladder treatments were classified according to their focus on filling or emptying symptoms and sub- classified in pharmacological and surgical treatments. Conclusion: Treatment guidelines are important tools for the public health system to promote the best practice when treating neurogenic bladder patients.

Resumo A vigilância popular ambiental (VPA) promove o protagonismo dos sujeitos em situação de vulnerabilidade ambiental na produção e avaliação de dados sobre a poluição a que estão submetidos. O objetivo deste trabalho foi analisar as experiências de VPA desenvolvidas em duas localidades impactadas por siderúrgicas: Santa Cruz/RJ e Piquiá de Baixo/MA. Nesses locais foram realizadas atividades de monitoramento ambiental comunitário (MAC) dos níveis de material particulado de 2,5 micrômetros (MP2,5) na atmosfera, entre novembro de 2016 e julho de 2017, utilizando equipamento monitor de qualidade do ar de baixo custo e fácil operação. As médias mensais dos níveis de MP2,5 em Piquiá e Santa Cruz foram elevadas, a depender da época avaliada, pois ultrapassaram a média anual recomendada pela Organização Mundial de Saúde (OMS), de 10 µg/m3, e por várias vezes a média diária recomendada, de 25 µg/m3. A ideia principal desta proposta de monitoramento consistiu em estabelecer, com o engajamento das comunidades atingidas, um processo capaz de apresentar um contraponto às informações oficiais sobre cenários locais de poluição atmosférica. Os dados de poluição produzidos possibilitam que essas comunidades tenham uma atuação mais qualificada nos espaços públicos de debate e tomada de decisão.

Abstract Environmental surveillance by the people fosters the protagonism of individuals in a situation of environmental vulnerability to generate and evaluate data regarding the pollution to which they are exposed. The scope of this work was to analyze such experiences in two areas impacted by the steel industry: Santa Cruz/RJ and Piquiá de Baixo/MA. At these sites, community environmental monitoring (CEM) activities were conducted to measure 2.5 micrometer particulate matter (PM2.5) levels in the atmosphere, between November/2016 and July/2017. Such activities were conducted using a low-cost and easy-to-operate air quality monitor. Monthly averages of PM2.5 levels in Piquiá and Santa Cruz were high, depending on the period assessed, since they surpassed the annual average recommended by the World Health Organization (WHO) of 10 µg/m3, and, on several occasions, the recommended daily average of 25 µg/m3. The main idea of this monitoring proposal was to establish a process capable of presenting a counterpoint to official information on local atmospheric pollution scenarios, with the involvement of affected communities. The pollution data produced enable these communities to participate in public debates and decision-making processes in a more informed way.

Resumo A vigilância popular ambiental (VPA) promove o protagonismo dos sujeitos em situação de vulnerabilidade ambiental na produção e avaliação de dados sobre a poluição a que estão submetidos. O objetivo deste trabalho foi analisar as experiências de VPA desenvolvidas em duas localidades impactadas por siderúrgicas: Santa Cruz/RJ e Piquiá de Baixo/MA. Nesses locais foram realizadas atividades de monitoramento ambiental comunitário (MAC) dos níveis de material particulado de 2,5 micrômetros (MP2,5) na atmosfera, entre novembro de 2016 e julho de 2017, utilizando equipamento monitor de qualidade do ar de baixo custo e fácil operação. As médias mensais dos níveis de MP2,5 em Piquiá e Santa Cruz foram elevadas, a depender da época avaliada, pois ultrapassaram a média anual recomendada pela Organização Mundial de Saúde (OMS), de 10 µg/m3, e por várias vezes a média diária recomendada, de 25 µg/m3. A ideia principal desta proposta de monitoramento consistiu em estabelecer, com o engajamento das comunidades atingidas, um processo capaz de apresentar um contraponto às informações oficiais sobre cenários locais de poluição atmosférica. Os dados de poluição produzidos possibilitam que essas comunidades tenham uma atuação mais qualificada nos espaços públicos de debate e tomada de decisão.

Abstract Environmental surveillance by the people fosters the protagonism of individuals in a situation of environmental vulnerability to generate and evaluate data regarding the pollution to which they are exposed. The scope of this work was to analyze such experiences in two areas impacted by the steel industry: Santa Cruz/RJ and Piquiá de Baixo/MA. At these sites, community environmental monitoring (CEM) activities were conducted to measure 2.5 micrometer particulate matter (PM2.5) levels in the atmosphere, between November/2016 and July/2017. Such activities were conducted using a low-cost and easy-to-operate air quality monitor. Monthly averages of PM2.5 levels in Piquiá and Santa Cruz were high, depending on the period assessed, since they surpassed the annual average recommended by the World Health Organization (WHO) of 10 µg/m3, and, on several occasions, the recommended daily average of 25 µg/m3. The main idea of this monitoring proposal was to establish a process capable of presenting a counterpoint to official information on local atmospheric pollution scenarios, with the involvement of affected communities. The pollution data produced enable these communities to participate in public debates and decision-making processes in a more informed way.

ABSTRACT Introduction Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was first introduced in Brazil in 2008, with a fast growing number of surgeries performed each year. Objective Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features. As secondary endpoint, describe functional outcomes (urinary continence and sexual potency) from RARP performed in the Sírio-Libanês Hospital (SLH), a private institution, in São Paulo, from April 2008 to December 2015. Materials and Method Data from 104 consecutive patients operated by two surgeons from the SLH (MA and SA) between 2008 and 2015, with a minimum 12 months follow-up, were collected. Patient features (age, body mass index - BMI, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and follow-up data (time to reach urinary continence and sexual potency) were the variables collected at 1, 3, 6 and 12 month and every 6 months thereafter. Continence was defined as the use of no pad on medical interview and sexual potency defined as the capability for vaginal penetration with or without fosphodiesterase type 5 inhibitors. Results Mean age was 60 years old and mean BMI was 28.45 kg/m2. BMI >30kg/m2 (p<0.001) and age (p=0.011) were significant predictors for worse sexual potency after surgery. After 1, 3, 6 and 12 months, 20.7%, 45.7%, 60.9% and 71.8% from patients were potent, respectively. The urinary continence was reached in 36.5%, 80.3%, 88.6% and 92.8% after 1, 3, 6 and 12 months, respectively. Until the end of the study, only one patient was incontinent and 20.7% were impotent. Conclusion Age was a predictor of urinary and erectile function recovery in 12 months. BMI was significant factor for potency recovery. We obtained in a private hospital good functional results after 12 months of follow-up.

Trinta e nove touros provenientes de propriedades de pecuária leiteira (n=9) e de pecuária de corte (n=30), situadas na região do Médio Paraíba, Rio de Janeiro (RJ), foram investigados para a presença de Campylobacter fetus e Tritrichomonas foetus. Para a pesquisa de Campylobacter, amostras de esmegma foram coletadas e submetidas à técnica de cultivo e isolamento e amostras de lavado prepucial ao teste de Imunofluorescência Direta (IFD). Para a pesquisa de Tritrichomonas, foi utilizada a técnica de exame direto a partir de lavado prepucial. Foi observada a presença de C. fetus em 14 amostras (35,9 %), por meio da IFD, e o isolamento de C. fetus, subespécie venerealis, foi obtido a partir de quatro amostras (10,3%). T. foetus não foi identificado nas amostras investigadas. A alta freqüência de C. fetus observada nos animais investigados sugere a presença da campilobacteriose na região do Médio Paraíba, em rebanhos com problemas reprodutivos.

Thirty nine breeding bulls from dairy farms (n=9) and beef farms (n=30) located in Médio Paraíba region at Rio de Janeiro - Brazil state were investigated for the presence of Campylobacter fetus and Tritrichomonas foetus. For Campylobacter investigation, smegma samples were examined by culture and prepucial washings were examined by direct immunofluorescence technique (DIF). The prepucial washings were also examined for Tritrichomonas foetus presence by direct examination. C. fetus was identified in 14 samples (35.9 %) by DIF technique and C. fetus subspecies venerealis was isolated from four samples (10.3%). T. foetus was not detected in bull samples. The high frequency of C. fetus observed in bull samples suggests the occurrence of Campylobacteriosis among herds which have reproductive problems at the Médio Paraíba region.

The authors report an unusual case of fungal keratitis caused by Histoplasma capsulatum in a male immunocompetent patient. PCR confirmed the presence of the fungus DNA in the material studied. To our knowledge this is the first reported case in humans described all over the world.

Disfunções do trato urinário inferior são uma causa importante de morbidade e diminuição da qualidade de vida em homens e mulheres idosos. Com o envelhecimento progressivo da população, é importante compreender os distúrbios miccionais mais comuns nesta população. A maioria dos problemas miccionais em homens idosos tem origem multifatorial, requerendo uma avaliação ampla dos órgãos do trato urinário inferior, da capacidade funcional e neurológica dos pacientes e dos problemas clínicos coexistentes. A avaliação urodinâmica é uma ferramenta importante na investigação de pacientes idosos com sintomas do trato urinário inferior. Ela não é necessária em todos os casos e só deve ser indicada após a exclusão de problemas não urológicos e potencialmente reversíveis que poderiam causar ou contribuir para os sintomas miccionais. Embora os exames urodinâmicos possam revelar diagnósticos comuns como obstrução vesical ou incontinência urinária de esforço, na população idosa é freqüente a ocorrência de achados como hiperatividade detrusora e falência da contratilidade vesical, com implicações prognósticas e terapêuticas importantes. O objetivo deste artigo é descrever os problemas urológicos mais comuns nos idosos e discutir as indicações e características dos exames urodinâmicos nestas condições.

Lower urinary tract dysfunction is a major cause of morbidity and decreased quality of life in elderly men and women. With the progressive aging of the population, it is important to understand common micturitional disorders that may occur in this population. Most urinary problems in the elderly are multifactorial in origin, demanding a comprehensive assessment of the lower urinary tract organs, functional impairments, and concurrent medical diseases. Urodynamics is a highly valuable tool in the investigation of elderly patients with lower urinary tract symptoms. Urodynamic tests are not always necessary, being indicated after excluding potentially reversible conditions outside the urinary tract that may be causing or contributing to the symptoms. Although urodynamic tests may reveal common diagnoses such as bladder outlet obstruction and stress urinary incontinence in the elderly population, findings such as detrusor overactivity and impaired detrusor contractility are common and have important prognostic and therapeutic implications. The purpose of this article is to describe common urologic problems in the elderly and review the indications for and clinical aspects of urodynamic studies in these conditions.

Bilateral endogenous endophthalmitis is a rare condition initiated by infection by microbes in the bloodstream, such as those arising from a foci of infective endocarditis. We report a case and discuss the diagnostic aspects and the clinical outcome of a patient with characteristic findings of the disease. The patient was a 49 year old white male who had a metallic aortic valve implanted 7 months previously, and who presented to the hospital with 10 days of fever, cough and dyspnea, then diarrhea and mental confusion. On the second day of hospitalization, he experienced sudden loss of vision in both eyes. A Gram-positive coccobacillus was isolated from the bloodstream, he was treated with fluoroquinolone with disappearance of fever, decreased ocular inflammation, and improvement in his vision to light perception. He later underwent valve replacement surgery but died during the procedure. We review the occurrence of ocular signs and symptoms and their importance in patients with endocarditis.

RESUMO Foram avaliados os prontuários de 249 pacientes portadores de retinoblastoma vistos no Hospital A. C. Camargo da Fundação Antônio Prudente no período de janeiro de 1975 a dezembro de 1989; desses, 164 (65,9%) eram unilaterais e 85 (34,1%) eram bilaterais. A idade de aparecimento dos primeiros sinais variou de presente ao nascimento aos 113 meses; a idade de encaminhamento ao Serviço variou de 0 a 115 meses, podendo-se constatar uma demora no encaminhamento principalmente nas faixas de menor idade. O tumor era intra-ocular ao diagnóstico em 156 (63,9%) e extra-oculares em 88 (36,1%). Verificamos uma tendência à diminuição de encaminhamentos nos estádios extra-oculares nos últimos anos. A freqüência total de óbitos foi de 26,6%; observou-se diminuição dessa taxa a partir de 1982, tanto nos tumores intra como nos extra-oculares. Acreditamos que o diagnóstico e o encaminhamento precoces a centros especializados de tratamento são fatores essenciais para o progresso na cura desta doença.

SUMMARY Charts of 249 on line retinoblastoma patients from A. C. Camargo Hospital/Antonio Prudente Fundation/São Paulo were reviewed. We founded 65,9% of unilateral cases and 34,1% of bilateral. The age at which signs were noticed ranged from birth to 113 months, and the referral age ranged from less than 1 month to 115 months. The tumors were intraocular (IO) in 63,9% and had extraocular (EO) extension in 36,1%. The death rate was 26,6% of the total cases; among the IO it was 5,1% and among the EO it was 64,8%. We believe that an early diagnosis and referral to specialized centers are the main factors related to progress in treatment and cure of this disease.

RESUMO Este estudo analisa os resultados das culturas obtidas de material de úlceras de córnea em 263 pacientes no período de setembro de 1986 a fevereiro de 1989. Confirma estudos anteriores de que o isolamento de bactérias (41,8%) é mais freqüente que o de fungos (3,8%). Neste período, pela primeira vez foram isoladas 2 cepas de Acanthamoeba sp. como agente etiológico de úlcera de córnea. Entre as bactérias Gram positivas, Staphylococcus aureus foi a mais freqüentemente isolada (22,1%), e entre as bactérias Gram negativas, Pseudomonas sp. foi a mais encontrada (7,6%). Entre as ceratites micóticas, os fungos mais freqüentemente Isolados foram Aspergillus sp. e Fusarium sp. Foram demonstradas alterações nos perfis de sensibilidade das bactérias aos antibióticos testados em relação a estudo realizado neste mesmo Laboratório de Microbiologia Ocular da Escola Paulista de Medicina. Houve aumento de resistência bacteriana à cefalotina, tobramicina e amicacina, enquanto a gentamicina apresentou níveis de sensibilidade semelhantes em relação ao estudo anterior.

SUMMARY Some ethiological aspects of corneal ulcers in 263 patients that were submitted to corneal culture in the Laboratório de Microbiologia Ocular da Escola Paulista de Medicina were analysed. Positive cultures were obtained in 132 of the samples, where bacterias were isolated in 41,8% and fungy in 3,8%. Acanthamoeba sp. was isolated in 2 samples. Staphylococcus aureus was the most frequent bacteria isolated (22,1%) and among Gram negative bacteria, Pseudomonas sp. was isolated in 7,6%. Comparing the results of this study with those performed before at the same laboratory, we demonstrate an increase of bacterial resistency to antibiotics like cefalotin, tobramicin and amicacin, while gentamicin keeps the some level of sensibility.