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Mesentery-Sparing Technique: a New Intracorporeal Approach for Urinary Diversion in Robot-Assisted Radical Cystectomy MesenterySparing Mesentery Sparing Technique RobotAssisted Robot Assisted
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Faria, Eliney Ferreira

; Maciel, Carlos Vaz de Melo

; Melo, Pablo Almeida

; Tobias-Machado, Marcos

; Machado, Roberto Dias

; Reis, Rodolfo Borges dos

; Costa-Gualberto, Rodrigo José

International braz j urol

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aug 2024, Volume 50 N. 4 Pages 489 - 499

Abstract: En | Text: En | PDF: En

ABSTRACT Background Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is associated with significant morbidity and mortality. We present an alternative technique that preserves the complete mesenteric vascularization during the isolation of the intestinal segment used in ICUD, including distal vessels. This approach aims to minimize the risk of ischemia in both the ileal anastomosis and the isolated loop at the diversion site. Methods This cohort study included 31 patients, both male and female, who underwent RARC with ICUD from February 2018 to November 2023, performed by a single surgeon. Intraoperative and postoperative complications data were retrieved for analysis, employing our proposed mesentery-sparing technique in all cases. The primary endpoint was the incidence of intraoperative and postoperative complications directly attributable to the mesentery-sparing approach in ICUD. Secondary endpoints included other postoperative variables not directly related to mesentery preservation, such as the incidence of postoperative ileus requiring parenteral nutrition and the duration of hospitalization. Results None of the patients experienced intraoperative or postoperative complications directly related to mesentery-sparing, such as intestinal fistulae or internal hernias. The median duration of hospitalization was 6 days, and postoperative ileus necessitating total parenteral nutrition occurred in 19% of the patients. Minor complications (Clavien–Dindo grades I-II) accounted for 27.6% of the cases and major complications (grades III-V) accounted for 20.6%. Conclusion The mesentery-sparing technique outlined herein offers an alternative method for preserving the vascularization of intestinal segments and reducing the risk of intestinal complications in ICUD during RARC. Roboticassisted Robotic assisted (RARC (ICUD mortality vessels site 3 female 201 2023 surgeon analysis mesenterysparing sparing preservation mesenterysparing, sparing, hernias days 19 Clavien–Dindo ClavienDindo Clavien Dindo III I II I-II 276 27 27.6 IIIV V III-V 206 20 20.6% 202 1 2 27. 20.6 20.

https://doi.org/10.1590/s1677-5538.ibju.2024.0153

PHASE ANGLE AS A PREDICTOR OF MUSCLE MASS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
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BONGIOLO, Angela Martinha

; MACHADO, Marcos José

; LAZAROTTO, Bruno Ayala

; RUPP, Maria Luiza Cimardi

; DAL-PIZZOL, Felipe

; PIRES, Maria Marlene de Souza

Arquivos de Gastroenterologia

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2024, Volume 61 elocation e23095

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Malnutrition/sarcopenia is frequent in patients with inflammatory bowel diseases (IBD), and results in muscle catabolism, impacting treatment response, postoperative complications, and quality of life. Objective: This study aims to assess whether the phase angle (PhA) is a parameter for predicting reduced muscle mass in patients with IBD. Methods: Adult patients with IBD were included in this cross-sectional study. For the estimation of muscle mass and the calculation of the PhA, we used bioelectrical impedance analysis (BIA). Crohn’s disease (CD) and ulcerative colitis (UC) activity scores were defined using the Harvey-Bradshaw index and partial Mayo score, respectively. The area under the ROC curve was calculated to identify the PhA cut-off point for reduced muscle mass. Results: The sample consisted of 145 patients, with 39 (26.9%) with IBD in the active phase. There was a correlation of the PhA with skeletal muscle mass (SMM) (rs 0.35, P<0.001) and with the skeletal muscle mass index (SMI) (rs 0.427, P<0.001), and the associations remained in the most active form (moderate or severe) of IBD. The ROC curve analysis indicated that the cut-offs points of the PhA ≤5.042 for female and PhA ≤6.079 for male can be used to predict muscle mass reduction. Conclusion: The PhA can be considered a predictor of muscle mass reduction in IBD patients, and we can use it for screening and monitoring the evolution of malnutrition. Malnutritionsarcopenia Malnutrition sarcopenia IBD, , (IBD) catabolism response complications life Objective (PhA Methods crosssectional cross sectional BIA. BIA . (BIA) Crohns Crohn s CD (CD UC (UC HarveyBradshaw Harvey Bradshaw score respectively cutoff cut off Results 14 3 26.9% 269 26 9 (26.9% SMM (SMM rs 035 0 35 0.35 P<0.001 P0001 P 001 SMI (SMI 0427 427 0.427 P<0.001, moderate severe cutoffs offs 5042 5 042 ≤5.04 6079 6 079 ≤6.07 Conclusion malnutrition (IBD (BIA 1 26.9 2 (26.9 03 0.3 P<0.00 P000 00 42 0.42 504 04 ≤5.0 607 07 ≤6.0 26. (26. 0. P<0.0 P00 4 0.4 50 ≤5. 60 ≤6. (26 P<0. P0 ≤5 ≤6 (2 P<0 ≤ ( P<

RESUMO A desnutrição/sarcopenia é frequente em pacientes com doenças inflamatórias intestinais (DII), resultando em catabolismo muscular, com impacto nas respostas aos tratamentos, complicações cirúrgicas e na qualidade de vida. Objetivo: Este estudo tem como objetivo, avaliar se o ângulo de fase (AF) é um parâmetro para a predição de redução de massa muscular em pacientes com DII. Métodos: Pacientes adultos com DII foram incluídos neste estudo transversal. A estimativa da massa muscular e o cálculo do AF foram realizados a partir do exame de bioimpedância elétrica (BIA). As atividades da doença de Crohn e retocolite ulcerativa foram definidas pelo índice Harvey-Bradshaw e escore parcial de Mayo, respectivamente. A área de curva ROC foi calculada para identificar o ponto de corte do AF para a massa muscular reduzida. Resultados: A amostra foi composta por 145 pacientes, sendo 39 (26.9%) com DII em fase ativa. Houve correlação do AF com massa muscular esquelética (MME) (rs 0.35, P<0.001) e com o índice de massa muscular esquelética (IMME) (rs 0.427, P<0.001), mantendo-se as associações na forma mais ativa (moderada ou grave) da DII. A análise da curva ROC indicou que os pontos de corte de AF ≤5.042 para mulheres e ≤6.079 para homens podem ser usados para prever a redução da massa muscular. Conclusão: O AF pode ser considerado um preditor de redução de massa muscular nos pacientes com DII e ser utilizado para triagem e acompanhamento da evolução da desnutrição. desnutriçãosarcopenia desnutrição sarcopenia DII, , (DII) tratamentos vida Objetivo objetivo (AF Métodos transversal BIA. BIA . (BIA) HarveyBradshaw Harvey Bradshaw Mayo respectivamente reduzida Resultados 14 3 26.9% 269 26 9 (26.9% MME (MME rs 035 0 35 0.35 P<0.001 P0001 P 001 IMME (IMME 0427 427 0.427 P<0.001, mantendose mantendo moderada grave 5042 5 042 ≤5.04 6079 6 079 ≤6.07 Conclusão (DII (BIA 1 26.9 2 (26.9 03 0.3 P<0.00 P000 00 42 0.42 504 04 ≤5.0 607 07 ≤6.0 26. (26. 0. P<0.0 P00 4 0.4 50 ≤5. 60 ≤6. (26 P<0. P0 ≤5 ≤6 (2 P<0 ≤ ( P<

https://doi.org/10.1590/s0004-2803.246102023-95

1H NMR Chemical Profile and Antioxidant Activity of Eugenia punicifolia Extracts Over Seasons: A Metabolomic Pilot Study H Seasons
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Neves, Kidney O. G.

; Santos, Maria F. C.

; Mar, Josiana M.

; Pontes, Flávia L. D.

; Tormena, Claudio F.

; Chaves, Francisco C. M.

; Campos, Francinete R.

; Sanches, Edgar Aparecido

; Bezerra, Jaqueline A.

; Machado, Marcos B.

; Santos, Alan D. C.

Journal of the Brazilian Chemical Society

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2024, Volume 35 N. 7 elocation e-20240010

Abstract: En | Text: En | PDF: En

Eugenia punicifolia (Kunth) DC. is a medicinal plant used to treat diseases related to oxidative processes. In this work, 1H nuclear magnetic resonance (NMR) spectroscopy and multivariate analysis have been employed to track the chemical changes and antioxidant activity of dimethyl sulfoxide (DMSO) extracts from E. punicifolia leaves over seasons. Principal component analysis (PCA) applied to 1H NMR allowed discriminating DMSO extracts from leaves collected in the dry and rainy seasons and pointed out sucrose, catechin, and epicatechin as responsible for separating dry season samples and quercetin, acid gallic, glucose, and fatty acids contributed for rainy samples grouping. Notably, antioxidant assays revealed that dry season extracts exhibited a higher radical scavenging capacity. When those compounds were submitted to partial least squares-discriminant analysis (PLS-DA) only sucrose and fatty acids presented variable importance projection (VIP) score > 1, both metabolites are related somehow to the defense mechanisms of the plant. This pilot study may suggest new experimental approaches for more effectively monitoring the spectrum-effect relationship of E. punicifolia leaf extracts. Kunth (Kunth DC processes work H (NMR (DMSO E PCA (PCA catechin quercetin gallic glucose grouping Notably capacity squaresdiscriminant squares discriminant PLSDA PLS DA (PLS-DA VIP (VIP 1 spectrumeffect spectrum effect

https://doi.org/10.21577/0103-5053.20240010

VALIDAÇÃO DE MÉTODO ANALÍTICO PARA QUANTIFICAÇÃO DOS ESTRÓGENOS NATURAIS (E1, E2 E E3) E SINTÉTICO (EE2) EM ÁGUA SUPERFICIAL E MATERIAL PARTICULADO EM SUSPENSÃO DE UM ESTUÁRIO SUBTROPICAL DO ATLÂNTICO SUL, BRASIL E1, E1 (E1 E3 EE2 EE (EE2 SUL (E (EE
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Toledo Netto, Pedro

; Machado, Marcos Canto

; Mafra Júnior, Luiz Laureno

; Martins, César C.

Química Nova

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2024, Volume 47 N. 9 elocation e-20240057

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Marine pollution has become relevant for coastal conservation units and ecosystems of great ecological importance. This study validated analytical methods to investigate the occurrence of the emerging contaminants 17β-estradiol (E2), estrone (E1), estriol (E3), and 17α-ethinylestradiol (EE2) in surface waters and suspended particulate matter (SPM) from Guaratuba Bay, South Atlantic, Brazil. The analysis was performed by liquid chromatography coupled to a fluorescence detector (LC-FLD) after pre-concentration of surface water samples by solid phase extraction (SPE) or solid-liquid extraction for SPM samples. The recovery percentages were between 48 and 87%, and the coefficient of variation (CV) between 3 and 24% for SPM and from 64 to 107% (CV of 4 to 42%) for surface water. The method thus proved to be accurate and precise at the concentrations studied (ng g−1 and µg L−1). The concentration ranged from 10 to 177 ng L−1 in surface waters and from 392 to 4108 ng g−1 in SPM. E2, EE2, and E3 were found in SPM under different climatic conditions and population occupation. EE2 was determined in all sampling campaigns, especially in summer, when the number of tourists increases considerably. The presence of EE2 in the SPM of Guaratuba Bay warns for possible implications for the health of coastal environments. importance 17βestradiol βestradiol 17β estradiol β E2 E , (E2) E1, E1 (E1) E3, (E3) 17αethinylestradiol αethinylestradiol 17α ethinylestradiol α EE (EE2 (SPM Atlantic Brazil LCFLD LC FLD (LC-FLD preconcentration pre SPE (SPE solidliquid 87 87% CV 24 6 107 42% 42 g1 g 1 g− L−1. L1 L . L−1) 17 L− 39 410 occupation campaigns summer considerably environments (E2 (E1 (E3 (EE 8 2 41 (E

https://doi.org/10.21577/0100-4042.20240057

Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer Longterm Long term VEIL (VEIL
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Tobias-Machado, Marcos

; Ornellas, Antonio A.

; Hidaka, Alexandre K.

; Medina, Luis G.

; Mattos, Pablo A. L.

; Besio, Ruben S.

; Abreu, Diego

; Castro, Pedro R.

; Nishimoto, Ricardo H.

; Astigueta, Juan

; Dourado, Aurus

; Machado, Roberto D.

; Magnabosco, Wesley J.

; Corona-Montes, Victor

; Villoldo, Gustavo M.

; Zampolli, Hamilton C.

; Taha, Anis

; Auad, Pericles R.

; Faria, Eliney F.

; Arantes, Paulo B. O.

; Tavares, Alessandro

; Nascimento, Francisco S. M. S.

; Brazão Jr., Eder S.

; Rocha, Maurício M.

; Costa, Walter H.

; Panico, Vinicius

; Reis, Leonardo O.

; Almeida-Carrera, Roberto J.

; Silva, Rafael C.

; Zequi, Stênio C.

; Calixto, José R. R.

; Sotelo, Rene

International braz j urol

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oct 2023, Volume 49 N. 5 Pages 580 - 589

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer. Objective VEIL. . (VEIL) Methods 2 CoalitionLatin Coalition Latin PeCLA PeC LA (PeC-LA technique intermediate/highrisk intermediatehighrisk intermediate/high risk intermediate high nonfixed non fixed diameter range Results 200 2020 5 4568 45 68 (45-68 old 9 60120. 60120 60 120 (60-120) 1 616. 616 6 16 (6-16) 157 15 7 15.7% 19 1.9 86 8 8. 48 4.8 respectively 267 26 26.7 nonpalpable 28 2.8 10y y 742 74 74.2 848 84 84.8% pN0 pN pN1 100 100% 824 82 82.4% 727 72 72.7 91 9.1% Conclusion morbidity noninvasive invasive biopsy nonbulky bulky (VEIL highrisk intermediatehigh 20 202 456 (45-6 6012 12 (60-120 61 (6-16 15.7 1. 4. 26. 2. 74. 84.8 82.4 72. 9.1 (45- 601 (60-12 (6-1 15. 84. 82. 9. (45 (60-1 (6- (4 (60- (6 ( (60

https://doi.org/10.1590/s1677-5538.ibju.2023.0065

Pediatric incontinence questionnaire (PINQ): translation and transcultural adaptation to Brazilian Portuguese PINQ (PINQ) (PINQ
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Pereira, Rita Pavione Rodrigues

; Leitão, Angélica Quintino

; Fotakos, Gabriella Silva

; Reis, Joceara Neves dos

; Rocha, Flávio Eduardo Trigo

; Machado, Marcos Giannetti

; Bower, Wendy F.

; Tanaka, Clarice

Jornal de Pediatria

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2023, Volume 99 N. 4 Pages 379 - 384

Abstract: En | Text: En | PDF: En

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. (LUTS 10 families Childrens Children s Society however language Therefore translate PINQ. . (PINQ) crosssectional cross sectional dysfunction 20item item 20 Beaton 2000 Hisstandard His standard phases translation synthesis backtranslation, backtranslation back back-translation pretest. pretest pre test. test pre-test Cronbachs Cronbach PINQbr br developed experts pretested tested 4 2 mean age 97 9 7 9. 96 respectively, respectively , respectively) parents satisfactory 074 0 74 0.7 082 82 0.8 healthrelated health adolescents 1 (PINQ 200 07 0. 08 8

https://doi.org/10.1016/j.jped.2023.01.002

CORRELATION OF SOIL PHYSICAL ATTRIBUTES WITH FURROWING SHANK STRENGTH AND DEPTH IN A NO-TILL SEEDER
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Lenz, Anderson M.

; Maggi, Marcio F.

; Gurgacz, Flavio

; Bassegio, Doglas

; Machado, Marcos V. M.

Engenharia Agrícola

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feb 2022, Volume 42 N. 1 elocation e20210139

Abstract: En | Text: En | PDF: En

ABSTRACT Furrowing shank horizontal strength and working depth can be correlated with soil compaction in a no-till sowing. This study aimed to evaluate the correlation of furrowing shank strength and working depth with soil physical properties at two working speeds (1.58 and 1.87 m s-1) and four compaction levels induced by an agricultural tractor (0P, 1P, 3P, and 5P+Ballast), with four repetitions in an RBD. Thereby, we aimed to verify a potential increase in sampling density of soil compaction data. Horizontal strength at 1.58 m s-1 had Pearson correlations ranging from 0.74 to 0.73 with soil penetration resistance (SPR), and from 0.57 to 0.72 with some soil properties collected by volumetric ring. Working depth also correlated with several parameters ranging from 0.49 to 0.81. The highest correlations were verified for the speed of 1.58 m s-1, at which shanks maintained greater depth. This increased soil contact with the shank, hence sensitivity to compaction. Our findings show that furrowing shank horizontal strength and working depth can be used to monitor soil compaction.

https://doi.org/10.1590/1809-4430-eng.agric.v42n1e20210139/2022

Lifestyle Intervention in Reducing Cardiometabolic Risk Factors in Students with Dyslipidemia and Abdominal Obesity: A Randomized Study
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Pamplona-Cunha, Heloisa

; Rosini, Nilton

; Caetano, Roberta

; Machado, Marcos José

; Silva, Edson Luiz da

International Journal of Cardiovascular Sciences

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feb 2022, Volume 35 N. 1 Pages 68 - 79

Abstract: En | Text: En | PDF: En

Abstract Background The long incubation periods of cardiovascular diseases offer opportunities for controlling risk factors. In addition, preventive interventions in childhood are more likely to succeed because lifestyle habits become ingrained as they are repeated. Objective To investigate the effects of recreational physical activities, in combination or not with a qualitative nutritional counseling, in cardiometabolic risk factors of students with dyslipidemia and abdominal obesity. Methods Students (8-14 years old) were randomly divided into three groups (n=23 each): i ) Control; ii ) PANC, students undergoing Physical Activity and Nutritional Counseling, and iii ) PA, students submitted to Physical Activity, only. Blood samples (12-h fasting) were collected for biochemical analysis and anthropometric markers were also assessed. Two-Way RM-ANOVA and Holm-Sidak’s test, and Friedman ANOVA on Ranks and Dunn’s test were applied. P ≤ 0.05 was considered significant. Effect sizes were evaluated by Hedges’ g and Cliff’s δ for normal and non-Gaussian data, respectively. Results Compared to the control group and to baseline values, both interventions caused significant average reductions in total cholesterol (11%; p <0.001), LDL-c (19%; p=0.002), and non-HDL-c (19%; p=0.003). Furthermore, students in the PANC group also experienced a significant decrease in body fat compared to baseline (p=0.005) and to control (5.2%; g=0.541). Conclusions The proposed strategies were effective to reduce cardiometabolic risk factors in children and adolescents. The low cost of these interventions allows the implementation of health care programs in schools to improve the students’ quality of life.

https://doi.org/10.36660/ijcs.20200286

Salvage Retzius sparing robotic assisted radical prostatectomy: the first brazilian experience
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Nunes-Silva, Igor

; Hidaka, Alexandre Kyoshi

; Monti, Carlos Roberto

; Tobias-Machado, Marcos

; Zampolli, Hamilton de Campos

International braz j urol

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dec 2021, Volume 47 N. 6 Pages 1279 - 1280

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Salvage Radical Prostatectomy after radiation therapy is challenging and associated with high rates of serious complications (1, 2). The novel Retzius-Sparing RARP (RS-RARP) approach has shown excellent continence outcomes (3, 4). Purpose: To describe step-by-step our Salvage Retzius-Sparing RARP (sRS-RARP) operative technique and report feasibility, safety and the preliminary oncological and continence outcomes in the post-radiation scenario. Materials and Methods: Twelve males presenting local prostate cancer recurrence after radiotherapy that underwent sRS-RARP were included. All patients performed preoperative multiparametric MRI and PSMA-PET. Surgical technique: 7cm peritoneum opening at Douglas pouch, Recto-prostatic space development, Seminal vesicles and vas deferens isolation and section, Extra-fascial dissection through peri-prostatic fat, Neurovascular bundle control, Bladder neck total preservation and opening, Anterior dissection at Santorini plexus plane, Apex dissection with urethra preservation and section, Prostate release, Vesicouretral modified Van Velthoveen anastomosis, Rocco Stitch, Oncological and continence outcomes reported with minimum 1-year follow-up. Results: Ten patients had previously received external beam radiation (EBR) whereas two received previous brachytherapy plus EBR. At 1, 3 and 12 months after surgery, 25%, 75% and 91.6% of the men used one safety pad or less, respectively. No major complications or blood transfusions were reported. Final pathology reported pT2b 41.6%, pT2c 33.3% and pT3a 25%, positive surgical margins 25%, positive lymph nodes were not found, biochemical recurrence 16.6%. Conclusion: Salvage Retzius-Sparing Robotic Assisted Radical Prostatectomy approach appears to be technically feasible and oncologically safe with potential to provide better continence outcomes.

https://doi.org/10.1590/s1677-5538.ibju.2021.0260 86 downloads

10.

REPLY BY THE AUTHORS: RE: Impact of COVID-19 on a urology residency program
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Danilovic, Alexandre

; Torricelli, Fabio Cesar Miranda

; Anjos, Gabriel dos

; Cordeiro, Mauricio Dener

; Machado, Marcos Giannetti

; Srougi, Miguel

; Nahas, William C.

International braz j urol

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aug 2021, Volume 47 N. 4 Pages 911 - 912

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2021.0060.1 86 downloads

11.

Impact of COVID-19 on education, health and lifestyle behaviour of Brazilian urology residents
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Prezotti, José Antonio

; Henriques, João Victor T.

; Favorito, Luciano A.

; Canalini, Alfredo F.

; Machado, Marcos G.

; Brandão, Thulio B. V.

; Barbosa, Akemi M. V.

; Moromizato, Julyana K. M.

; Anzolch, Karin M. J.

; Fernandes, Roni de C.

; Rodrigues, Fransber R. A.

; Bellucci, Carlos H. S.

; Silva, Caroline S.

; Pompeo, Antonio Carlos L.

; Bessa Jr., Jose de

; Gomes, Cristiano M.

International braz j urol

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aug 2021, Volume 47 N. 4 Pages 753 - 776

Abstract: En | Text: En | PDF: En

ABSTRACT Objectives: To evaluate the impact of COVID-19 on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents. Materials and Methods: A web-based survey was sent to 468 Brazilian urology residents from postgraduate years (PGY) 3 to 5 to collect data on clinical practice and training after 4 months of COVID-19. We also assessed health-related and behavior changes, rate of infection by SARS-CoV-2, deployment to the front line of COVID-19, residents’ concerns, and access to personal protective equipment (PPE). Results: Massive reductions in elective and emergency patient consultations, diagnostic procedures and surgeries were reported across the country, affecting PGY 3 to 5 alike. Most in-person educational activities were abolished. The median damage to the urological training expected for 2020 was 6.0 [3.4 – 7.7], on a scale from 0 to 10, with senior residents estimating a greater damage (P< 0.001). Educational interventions developed included online case-based discussions, subspeciality conferences and lectures, and grand rounds. Most senior residents favored extending residency to compensate for training loss and most younger residents favored no additional training (p< 0.001). Modifications in health and lifestyle included weight gain (43.8%), reduced physical activity (68.6%), increased alcoholic intake (44.9%) and cigarette consumption (53.6%), worsening of sexual life (25.2%) and feelings of sadness or depression (48,2%). Almost half were summoned to work on the COVID-19 front-line and 24.4% had COVID-19. Most residents had inadequate training to deal with COVID-19 patients and most reported a shortage of PPE. Residents’ concerns included the risk of contaminating family members, being away from residency program, developing severe COVID-19 and overloading colleagues. Conclusions: COVID-19 had a massive impact in Brazilian urology residents´ training, health and lifestyle behavior, which may reflect what happened in other medical specialties. Studies should confirm these findings to help developing strategies to mitigate residents’ losses.

https://doi.org/10.1590/s1677-5538.ibju.2021.99.09 170 downloads

12.

Development of a TD-NMR Method to Monitor Brazil Nuts Oil Content: A Green and Low-Cost Based Approach
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Ribeiro, Úrsula A.

; Queiroz, Leonardo C.

; Marassi, Agide G.

; Carvalho, André S.

; Barros, Gabriel A.

; Consalter, Daniel M.

; Bezerra, Jaqueline A.

; Santos, Alan D. C.

; Colnago, Luiz Alberto

; Machado, Marcos B.

Journal of the Brazilian Chemical Society

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jul 2021, Volume 32 N. 7 Pages 1405 - 1412

Abstract: En | Text: En | PDF: En

Growth in the international popularity of Brazil nuts oil (Bertholletia excelsa, Bonpl.) has demanded a closer look at quality aspects of the nuts. In this context, time-domain 1H nuclear magnetic resonance spectroscopy (TD-NMR) can be a useful tool for assessing the lipid portion of such matrices. In this work, a TD-NMR method was developed and validated to assess the oil content directly from Brazil nuts following the ISO 10565:1998 and DOQ-CGCRE-008. Full validation was addressed covering the working range from 0.67 to 25.00 g (coefficient of determination, R2= 0.9993). Limits of detection (LOD) and quantification (LOQ) were 0.20 and 0.67 g, respectively. The repeatability and intermediate precision assays met the guide requirements. Oil contents obtained in two laboratories (different equipment) were statistically similar (66.93 ± 4.69 and 70.13 ± 4.15%), highlighting the method’s robustness. The developed approach has the potential to be adopted as an industrial reference method for in situ monitoring of Brazil nuts oil contents.

https://doi.org/10.21577/0103-5053.20210039 105 downloads

13.

Role of salvage lymph node dissection in patients previously treated for prostate cancer: systematic review
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Fantin, João Paulo Pretti

; Furst, Maria Claudia Bicudo

; Tobias-Machado, Marcos

; Muller, Roberto Lodeiro

; Machado, Roberto Dias

; Santos, Alexandre Cesar

; Magnabosco, Wesley Justino

; Alcantara-Quispe, Cinthia

; Faria, Eliney Ferreira

International braz j urol

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jun 2021, Volume 47 N. 3 Pages 484 - 494

Abstract: En | Text: En | PDF: En

ABSTRACT Prostate cancer is the most common invasive cancer in men. Radical prostatectomy (RP) is a definitive treatment option, but biochemical recurrence can reach 40%. Salvage lymphadenectomy is a relatively recent approach to oligometasis and has been rapidly diffused primarily due to improvement in imaging diagnosis and results showing possibly promising therapy. A systematic literature review was performed in March 2020, according to the PRISMA statement. We excluded studies with patients with suspicion or confirmation of visceral and / or bone metastases. A total of 27 articles were included in the study. All studies evaluated were single arm, and there were no randomized studies in the literature. A total of 1,714 patients received salvage lymphadenectomy after previous treatment for localized prostate cancer. RP was the most used initial therapeutic approach, and relapses were based on PET / CT diagnosis, with Coline-11C being the most widely used radiopharmaceutical. Biochemical response rates ranged from 0% to 80%. The 5 years - Free Survival Biochemical recurrence was analyzed in 16 studies with rates of 0% up to 56.1%. The articles do not present high levels of evidence to draw strong conclusions. However, even if significant rates of biochemical recurrence are not evident in all studies, therapy directed to lymph node metastases may present good oncological results and postpone the onset of systemic therapy. The long-term impact in overall survival and quality of life, as well as the best strategies for case selection remains to be determined.

https://doi.org/10.1590/s1677-5538.ibju.2020.0051 450 downloads

14.

Impact of COVID-19 on a urology residency program
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Danilovic, Alexandre

; Torricelli, Fabio Cesar Miranda

; Anjos, Gabriel dos

; Cordeiro, Mauricio Dener

; Machado, Marcos Giannetti

; Srougi, Miguel

; Nahas, William C.

International braz j urol

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mar 2021, Volume 47 N. 2 Pages 448 - 453

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2020.0707 579 downloads

15.

Robotic parastomal hernia repair
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Tobias-Machado, Marcos

; Gomes, Daniel Coser

; Faria, Eliney Ferreira

; Zampolli, Hamilton de Campos

International braz j urol

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mar 2021, Volume 47 N. 2 Pages 857 - 858

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction and Objective: Annually, more than one hundred thousand new stomas are created in the United States and near 30-50% of those will develop parastomal hernia (1). Occasionally parastomal hernias may result in life threatening complications such as bowel obstruction or strangulation requiring urgent surgical intervention (2). The minimally invasive surgery for these hernias are preferred, specially when the primary case was either laparoscopic or robot-assisted. Our objective is to demonstrate a step-by-step robotic approach with and without mesh placement and their outcomes in two different scenarios: elective and emergency. Materials and Methods: We present two cases, a 56-year-old male with three years prior robot-assisted radical cystectomy with ileal conduit and a 82-year-old male with five year post operation of laparoscopic radical cystectomy with bilateral ureterostomies. Both of them had parastomal hernia, the first case was an urgency due to bowel obstruction while the second case was an elective procedure. Using three portals, we choose the primary repair for the first case and placement of a biological mesh within the keyhole technique (3) for the second one. Results: In the first case we had an operative time of 110min, total blood loss of 40cc and for the second case an operative time of 140min with total blood loss of 20cc. Both patients were discharged within 24h and had a follow-up of 2 years with no recurrence. Conclusions: The capability for complex sutures and dissection of intracorporeal structures makes the robotic platform a powerful ally (4) and we believe in its superiority over conventional laparoscopy. Although further studies are required, our initial series suggests that the robotic parastomal hernia repair is feasible and reproducible, with or without mesh placement and could be demonstrated its use for either elective or emergency situations.

https://doi.org/10.1590/s1677-5538.ibju.2020.0347 397 downloads

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