ABSTRACT Objectives: To evaluate the impact of COVID-19 pandemics on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents after 1 year of socio-economic restrictions. Materials and Methods: An electronic survey was e-mailed to all postgraduate (PG) students registered by the Brazilian Society of Urology. The survey included an assessment of socio-demographic, clinical practice, educational, health-related and behavior parameters. We also evaluated which subareas of urology were predominantly affected. A similar survey was adapted and sent to the directors of all urology residency programs. Results: COVID-19 pandemic has severely impacted the clinical, surgical, and educational activities of urology residents in Brazil. Urology residents reported >50% decrease in multiple surgical modalities. We highlight kidney transplantation surgeries (66.2%), minor surgeries (62.3%), endoscopic surgeries (42.6%) and reconstructive surgeries (38.8%). This could represent a critical skills gap that residents may face beyond the COVID-19 pandemic. Furthermore, PG students faced stressful situations that caused worsening of mental and physical health, such as getting redirected to assistance of COVID-19 patients (66.9%), and high rate of infection by SARS-CoV-2 (58.2%). Conclusions: The COVID-19 pandemic has severely impacted the clinical, surgical, and educational activities of urology residents in Brazil. This could represent a critical skills gap that residents may face beyond the COVID-19 pandemic. PG students faced stressful situations that caused worsening of mental and physical health such as redirection to assistance of COVID-19 patients, concern about their own contamination and of family members. Objectives COVID19 COVID 19 COVID-1 practice socioeconomic socio economic restrictions Methods emailed e mailed (PG sociodemographic, sociodemographic demographic, demographic socio-demographic healthrelated related parameters affected programs Results Brazil 50 >50 modalities 66.2%, 662 66.2% , 66 2 (66.2%) 62.3%, 623 62.3% 62 3 (62.3%) 42.6% 426 42 6 (42.6% 38.8%. 388 38.8% . 38 8 (38.8%) Furthermore 66.9%, 669 66.9% 9 (66.9%) SARSCoV2 SARSCoV SARS CoV SARS-CoV- 58.2%. 582 58.2% 58 (58.2%) Conclusions members COVID1 COVID- 5 >5 66.2 (66.2% 62.3 (62.3% 42.6 4 (42.6 38.8 (38.8% 66.9 (66.9% SARS-CoV 58.2 (58.2% > 66. (66.2 62. (62.3 42. (42. 38. (38.8 (66.9 58. (58.2 (66. (62. (42 (38. (58. (66 (62 (4 (38 (58 (6 ( (3 (5

ABSTRACT Objectives To evaluate the familiarity of Brazilian urology residents with laparoscopy, methods of training and perspectives. Material and methods a questionnaire with 23 questions was sent by e-mail to all urological residents of 86 Urology Residence Programs certified by the Brazilian Society of Urology (BSU). Results 225 valid answers (85% of all residents) responded. Most residences belong to academic hospitals mainly in the Southeast region of Brazil. Women account for 5% of residents and 82% of programs perform less than 100 procedures per year. Residents have access to LESS, RAL and 98% to surgical laparoscopy and 87% of these participate actively at the surgery, but 84.9% do not have access to RAL. The most common laparoscopic procedure is radical nephrectomy (73.2%), but only 28.8% of residents acted as surgeons, and third year residents (R3) are those that mainly performed this procedure (statistical significance, p <0.05). 61% of residents do not participate in hands-on courses or fellowship in laparoscopy, among those who attended these fellowships, 23.47% were sponsored by BSU in equal regions of the country. Although there are several opportunities of training in laparoscopy, 42% of residents do not have access to any kind of preparation and 52% have no structured specific program. R3 perception of laparoscopy experience is significantly higher than R2 and R1 residents. Almost 30% of them affirms that they are prepared for professional life regarding urologic laparoscopy. Conclusion Brazilian urologic residents have access to laparoscopy and actively participate in the learning process. Robotic surgery is expanding in the country, although still very far from residents. Brazilian resident, at the end of medical residency, is motivated to perform laparoscopic procedures.

ABSTRACT The use of PSA in the screening, detection and prognosis of prostate cancer (PCa) has revolutionized the diagnosis and treatment of this disorder with an increase in detection rates and PCa organ-confined. Despite these benefits and ease of implementation, tracking PCa remains a matter of great controversy. We conducted a literature review and demographic and epidemiological data in Brazil feeling to assess the current state of screening and whether there is justification for population programs. the differences are valued between developed and underdeveloped countries as the incidence, mortality, screening and access to health. an analysis of the advantages and disadvantages of screening is made as well as a critical analysis of existing studies on screening and some recommendations on a rational screening.

ABSTRACT Validate the EORTC risk tables in Brazilian patients with NMIBC. Methods: 205 patients were analyzed. The 6 parameters analyzed were: histologic grading, pathologic stage, size and number of tumors, previous recurrence rate and concomitant CIS. The time for first recurrence (TFR), risk score and probability of recurrence were calculated and compared to the probabilities obtained from EORTC risk tables. C-index was calculated and accuracy of EORTC tables was analyzed. Results: pTa was presented in 91 (44.4%) patients and pT1 in 114 (55.6%). Ninety-seven (47.3%) patients had solitary tumor, and 108 (52.7%) multiple tumors. One hundred and three (50.2%) patients had tumors smaller than 3 cm and 102 (40.8%) had bigger than 3 cm. Concomitant CIS was observed in 21 (10.2%) patients. Low grade was presented in 95 (46.3%) patients, and high grade in 110 (53.7%). Intravesical therapy was utilized in 105 (56.1%) patients. Recurrence was observed in 117 (57.1%) patients and the mean TFR was 14,2 ± 7,3 months. C-index was 0,72 for 1 year and 0,7 for 5 years. The recurrence risk was 28,8% in 1 year and 57,1% in 5 years, independently of the scoring risk. In our population, the EORTC risk tables overestimated the risk of recurrence in 1 year and underestimated in 5 years. Conclusion: The validation of the EORTC risk tables in Brazilian patients with NMIBC was satisfactory and should be stimulated to predict recurrence, although these may overestimated the risk of recurrence in 1 year and underestimated in 5 years.

INTRODUCTION: Substantial controversy exists regarding the association between testosterone serum levels and prostate cancer. OBJECTIVE: To evaluate the levels of hypothalamic-pituitary-testicular axis hormones in the sera of men with prostate cancer and atypical small acinar proliferation as well as those with normal biopsies. METHODS: A study cohort of 186 men with suspected prostate cancer who had undergone transrectal prostate biopsies was used in this study. The patients were divided into the following three groups based on the histology of the biopsy samples: no neoplasia, atypical small acinar proliferation or prostate cancer. Demographic data were also collected. Levels of total testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, and serum prostate-specific antigen were measured in blood samples. RESULTS: Initially, 123 men were found to be without neoplasia, 26 with atypical small acinar proliferation and 37 with prostate cancer. After a second biopsy was taken from the men diagnosed with atypical small acinar proliferation, the diagnoses were revised: 18 were diagnosed with atypical small acinar proliferation and 45 with prostate cancer. No significant differences between the groups were identified regarding age, smoking history, chronic diseases, body mass index or PSA levels (P >.0.05). The mean serum levels of testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin and estradiol were similar in all of the groups (P >.0.05). Furthermore, in individuals with prostate cancer, the Gleason scores and prevalence of hypogonadism were not significantly different (P.> 0.05). CONCLUSION: The present study revealed no difference in the serum levels of testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin or estradiol in men without neoplasia compared with those with atypical small acinar proliferation or prostate cancer.

Introduction and objectives: To investigate two ureterolithotomy approaches for treatment of large and impacted upper ureteral stones, we prospectively evaluated the perioperative features of consecutive patients submitted to ureterolithotomy following failure of endourological treatment. Methods: Of the 110 patients included in the study, 34 underwent laparoscopic ureterolithotomy. Patients were divided into three ureterolithotomy subgroups (group A, 76 open procedures; group B, 16 transperitoneoscopies and group C, 19 retroperitoneoscopies). All procedures were performed into a urology residency program. Results: The patients’ age, sex, ASA classification and stones characteristics showed no significant difference between the groups. Overall, complication rates and the operation times recorded were similar. One patient had bilateral stones and both sides were managed in a single transperitoneoscopy procedure. Three retroperitoneoscopies were converted to an open surgery due technical difficulties. A prolonged urinary leakage occurred in 3/35 cases (8.5%) where 2 patients were treated by placing a ureteral catheter. Both laparoscopic groups have significantly less analgesia requirements and shorter hospitalization (p < 0.001 and p = 0.003, respectively). All patients were stone-free in the follow-up 1-month visit. Conclusions: To our knowledge, my in a laparoscopic training scenario. Even though these procedures were performed by limited laparoscopic experience urologists, laparoscopy offered significant advantages over traditional open ureterolithotomy, resulting in improved analgesia, shorter hospital stays and similar complication rates.

Introducción y objetivos: Con objeto de investigar dos enfoques en la práctica de ureterolitotomías para el tratamiento de cálculos impactados de grandes dimensiones, hemos llevado a cabo la evaluación y el seguimiento de las características perioperatorias de pacientes consecutivos sometidos a una ureterolitotomía tras obtener resultados desfavorables al aplicar un tratamiento endourológico. Métodos: De los 110 pacientes incluidos en el estudio, 34 se sometieron a una ureterolitotomía laparoscópica. Se dividió a los pacientes en tres subgrupos de ureterolitotomías: grupo A, 76 intervenciones abiertas; grupo B, 16 transperitoneoscopias, y grupo C, 19 retroperitoneoscopias. Todos los procedimientos se llevaron a cabo durante un programa de especialización en urología para médicos residentes. Resultados: La edad y el sexo de los pacientes, la clasificación ASA y las características de los cálculos no mostraron diferencias significativas entre los grupos. En general, la tasa de complicaciones y la duración de las intervenciones registradas fueron similares. Uno de los pacientes presentaba cálculos bilaterales y ambos lados se trataron en un único procedimiento de transperitoneoscopia. Tres retroperitoneoscopias finalizaron en cirugía abierta debido a dificultades técnicas. En 3 de los 35 casos (8,5%) se produjo fuga urinaria prolongada y 2 de estos pacientes recibieron tratamiento mediante la inserción de un catéter ureteral. Ambos grupos laparoscópicos tuvieron necesidades analgésicas significativamente menores y una hospitalización de menor duración (p < 0,001 y p = 0,003, respectivamente). Ningún paciente presentaba cálculos en la visita de seguimiento realizada al mes siguiente. Conclusiones: Según la información de que disponemos, ésta es la primera comparación prospectiva entre laparoscopia y ureterolitotomía abierta que se realiza en un entorno de formación en laparoscopia. A pesar de que estas intervenciones las realizaron residentes con limitada experiencia laparoscópica, la laparoscopia aportó ventajas significativas sobre la ureterolitotomía abierta tradicional, que dio como resultado una mejor analgesia y una estancia en el hospital menos prolongada, con similares tasas de complicaciones.

OBJETIVO: Determinar eficácia e achados pós-operatórios após 354 rizotomias por radiofreqüência e 21 descompressões neurovasculares como tratamento de 367 pacientes com dor facial (290 neuralgia idiopática do trigêmeo, 52 neuralgia sintomática do trigêmeo, 16 dor facial atípica, 9 neuralgia pós-herpética). MÉTODO: Achados clínicos e taxa de sucesso das cirurgias foram considerados para a avaliação. Uma escala avaliando alívio da dor e complicações sensoriais e funcionais foi utilizada para classificar os pacientes. RESULTADOS: A rizotomia por radiofreqüência foi realizada em 273 pacientes com neuralgia idiopática do trigêmeo e em todos os outros pacientes, exceto neuropatia trigeminal; descompressão neurovascular foi realizada em 18 pacientes com neuralgia idiopática do trigêmeo; 100% dos pacientes com neuralgia idiopática do trigêmeo, 96.2% dos pacientes com neuralgia sintomática, 37.5% dos pacientes com dor facial atípica e 88.9% dos doentes com neuralgia pós-herpética tiveram alívio da dor. CONCLUSÃO: Ambas as técnicas são úteis para a neuralgia idiopática do trigêmeo. A rizotomia por radiofreqüência foi também eficiente para tratar neuralgia sintomática do trigêmeo e pós-herpética, mas não foi uma boa técnica como tratamento da dor facial atípica.

OBJECTIVE: To determine the outcomes of 354 radiofrequency rhizotomies and 21 neurovascular decompressions performed as treatment for 367 facial pain patients (290 idiopathic trigeminal neuralgia, 52 symptomatic trigeminal neuralgia, 16 atypical facial pain, 9 post-herpetic neuralgia). METHOD: Clinical findings and surgery success rate were considered for evaluation. A scale of success rate was determined to classify patients, which considered pain relief and functional/sensorial deficits. RESULTS: Radiofrequency rhizotomy was performed in 273 patients with idiopathic trigeminal neuralgia and in all other patients, except for trigeminal neuropathy; neurovascular decompression was performed in 18 idiopathic trigeminal neuralgia patients; 100% idiopathic trigeminal neuralgia, 96.2% symptomatic trigeminal neuralgia, 37.5% atypical facial pain and 88.9% post-herpetic neuralgia had pain relief. CONCLUSION: Both techniques for idiopathic trigeminal neuralgia are usefull. Radiofrequency rhizotomy was also efficient to treat symptomatic facial pain, and post-herpetic facial pain, but is not a good technique for atypical facial pain.

Uso de Novas Tecnologias de Informação por Profissionais da Área da Saúde na Bahia é um estudo descritivo sobre o grau de utilização da tecnologia da informação na área de saúde na cidade do Salvador, Bahia. O objetivo deste artigo é verificar a familiaridade que os médicos têm com a Tecnologia da Informação com vistas a se inferir procedimentos de relacionamento com os médicos e entre os principais atores da área da saúde. O estudo foi desenvolvido a partir de revisão de literatura e de múltiplas pesquisas de campo, realizadas entre médicos e usuários do segmento de laboratórios de análises clínicas. O levantamento realizado descreve o que é típico da relação que o médico tem com a tecnologia da informação e com os laboratórios de análises clínicas, bem como investiga as peculiaridades das relações existentes entre profissionais e pacientes, em que se revê o entendimento da prestação de serviços no setor. São utilizados percentuais, indicações de moda, medidas de posição e associação, por se tratar de estudo exploratório, com escalas nominais predominantemente. Os resultados demonstram que o uso intenso da tecnologia é uma tendência da população pesquisada e revela o grande impacto organizacional que pode ser proporcionado pela adoção de novas tecnologias no setor de saúde nos próximos anos.

New Technologies of Information Use by Health Professionals in Bahia is a descriptive study of how much of the information technology is in usage amongst the health area in the city of Salvador, Bahia, Brazil. It was developed from the revision of literature and multiple field researches carried through medicine doctors and users of the segment of clinical analyses laboratories. The research describes what is typical in the relation that the doctor has with the information technology and with clinical analyses laboratories, as well as it investigates the peculiarities of the relationship of professionals with patients, reviewing the meaning of to provide assistance in the sector. Since it was an exploratory study with nominal scales, predominantly, it was used percentile indicators, mode, measures of position and association. The results demonstrate that the use of technology is a trend of the studied population and reveal that relevant impact is to be proportionated by the adoption of new technologies in the health sector in the following years.

O objetivo do artigo, escrito em forma de ensaio, é defender o argumento de que a persistência de Antonio Carlos Magalhães na cena política baiana deveu-se ao fato do uso, com prodigalidade, do complexo midiático de propriedade deste político e, assim, influenciar o processo de competição política, levando a nascente democracia baiana pós-ditadura à oligarquização. Paradoxalmente, a popularização da mídia não produziu uma desordem oligárquica na Bahia; pelo contrário, ela se tornou um novo instrumento oligarquizador do regime político. A inserção política das forças conservadoras na Bahia encontra-se, hoje, imbricada com a mídia, resultando numa demonstração prática da complementaridade que se verifica no exercício da política através da mídia. O caso da gestão municipal em Salvador, no período Lídice da Mata, de 1992 a 1996, é apresentado como exemplo de influência da mídia na percepção dos eleitores. São usados dados secundários e entrevistas com antigos assessores da então prefeita. Os autores concluem que há uma nova forma de se fazer política profissional na Bahia, sendo a mídia o vetor desta nova forma de sociabilidade política.

This essay poses the argument that the persistent overwhelming presence of Antonio Carlos Magalhães on the political scene in Bahia is due to his free use of his own media enterprises to his own strategic benefit. This fact brought about an unbalance on the local political process. It has contributed to build a situation best described as a political oligarchy which held since the end of the military regime till the present. It is a paradox to observe that although there happened a decompression on the media censorship, this fact did not result on a free competition among politicians through the media. Rather, the media became an instrument to support the increase in political power of a group that structured itself in the local scene best defined as an oligarchy. Political forces in Bahia are very much imbricated with media companies. Indeed, politics is carried out through the media. The essay analyses the case of Lidice da Matta's period as Mayor of the city of Salvador , Bahia , from 1992 to 1996. During her mayorship there was several situations on which a political group used the midia to influence public opinion against her, and against those other politicians without ditrect acces, or control, to midia companies. The authors conducted interviews with late public officials close to the then Mayor da Mata, data as well as secondary data. The author concluded that there is a new way through which politics is performed, beeing the nidia its vector.

A vegetação fluminense, em particular aquela proveniente da Restinga de Jurubatiba, foi investigada por um grupo multidisciplinar de botânicos, químico, radiobiólogo, fisiologistas de insetos e geneticista. Amostras de 564 espécimes foram coletadas, identificadas, organizadas em herbário e um banco de dados está sendo elaborado contendo, além das clássicas informações botânicas, dados químicos e indicações quanto ao uso econômico potencial destas plantas, em paisagismo, como alimentos alternativos ou como plantas medicinais. Estudos fitoquímicos da Guttiferae, Clusia hilariana, forneceram ácido oleanólico e nemorosona. Estes metabólitos foram ensaiados no barbeiro Rhodnius prolixus, vetor da doença de Chagas. Por fim, observou-se que plantas aquáticas apresentaram teores muito altos do radionuclídeo natural, polônio-210, fato este que parece estar relacionado mais com as condições de solo do que com um aporte atmosférico.

The fluminense vegetation, more specifically the flora from the Jurubatiba restinga has been investigated by a multidisciplinary team of botanists, chemist, radiobiologist, insect physiologists and geneticist. Vouchers of 564 specimens have been collected, identified, organized in an herbarium, and a database is being build up containing, in addition to classical botanical data, chemical data and information on the potential economic use either for landscape gardening, alternative foods or as medicinal plants. Phytochemical studies of the Guttiferae, Clusia hilariana, yielded oleanolic acid and nemorosone. Their biological activities against the haematophagous insect Rhodnius prolixus vector of Chagas disease have been investigated. Finally, it has been observed that aquatic plants possessed high levels of the natural radionuclide polonium-210, which seems to be originated mainly from soil rather than from atmospheric supply.

A larva-minadora-da-folha-dos-citros, Phyllocnistis citrella (Gracillariidae), é atualmente uma praga de importância econômica na citricultura nacional. O objetivo deste trabalho foi identificar o complexo de parasitóides desta praga em Jaguariúna, SP, Brasil, antes e depois da introdução de Ageniaspis citricola (Encyrtidae). Coletas de brotações infestadas pela praga foram realizadas semanalmente, no período de Julho/96 a Abril/99. Durante o período do levantamento, A. citricola foi introduzido nesta área. Antes dessa introdução, Galeopsomyia fausta (Eulophidae) era a principal espécie a atacar P. citrella (91,83% dos parasitóides encontrados), mas A. citricola tornou-se predominante após seu estabelecimento na área de liberação (60,10% contra 38,30% de G. fausta). Também outros parasitóides foram encontrados: Cirrospilus sp. C (Eulophidae), Horismenus sp. (Eulophidae), Elasmus sp. (Elasmidae), Eupelmus sp. (Eupelmidae) and Conura (Ceratosmicra) sp. (Chalcididae).

The citrus leafminer, Phyllocnistis citrella (Gracillariidae), is among the main pests of citrus in Brazil. The objective of this work was to conduct a survey of parasitoids attacking CLM in Jaguariúna, State of São Paulo, Brazil, before and after the introduction of Ageniaspis citricola (Encyrtidae). Collections of new leaves were made weekly at citrus groves from July-1997 to April-1999. During the survey period, A. citricola was introduced in the area. Before this introduction, Galeopsomyia fausta (Eulophidae) was the predominant species (about 91.83% of the species composition), but A. citricola became predominant after its establishment (60.10% against 38.30% G. fausta). Other parasitoids found were Cirrospilus sp. C (Eulophidae), Horismenus sp. (Eulophidae), Elasmus sp. (Elasmidae), Eupelmus sp. (Eupelmidae) and Conura (Ceratosmicra) sp. (Chalcididae).

O presente ensaio é um diálogo com as teorias que imputam aos meios de comunicação uma quase exclusiva importância, no que concerne à questão da construção da identidade de uma sociedade. Focaliza o papel do Estado na sua capacidade de exercer influência sobre a construção de auto identidade que uma sociedade faz de si. O período analisado aborda escolhas deliberadas de política cultural feitas por governos diferentes na Bahia. De modo concomitante, verifica-se a força de uma narrativa televisiva, capaz de influir nas escolhas de governo, em decorrência da capacidade que tem a televisão de construir identidades coletivas. A abordagem do texto é histórica descritiva. Este ensaio é uma versão modificada do texto apresentado pelo autor no GT de Televisão, no congresso da INTERCOM, em Manaus, 2000.

This text aims to bring about a dialog with authors for whom the means of communications represent the proeminent variable, maybe the very one which explains the process by which a community constructs its self identity. It focus on the role of the state, with its capacity to influence on the process of identity building of any given society. The text covers a historical period depicting deliberate choices of public policy made by different governors in the state of Bahia. In parallel, the text also focus on how televisive narratives impact on how a society interprets itself. The text is based on a historical descriptive approach. This is a slightly modified version of a text previously presented by the author at INTERCOM, Manaus, 2000.

Os autores descrevem dois pacientes com associação de polipose intestinal e tumor do sistema nervoso central (síndrome de Turcot), discutindo aspectos clínicos, genéticos e terapêuticos.

The authors describe two patients with the association of polyposis-coli and central nervous system tumor (Turcot's syndrome). Clinical, genetic and therapeutic aspects are discussed.

Relatamos 5 casos de doentes portadores de aneurismas da região da artéria coroidéia anterior. Aspectos clínicos, anatômicos e cirúrgicos são discutidos.

Five cases of anterior choroidal artery aneurysms are reported. Clinical, anatomical and surgical aspects are discussed.

É relatado o caso de doente de 5 anos de idade, com siringomielia no qual a administração de contraste, destinado a exame perimielográfico, foi realizado incidentalmente, no interior da cavidade siringomiélica. São considerados alguns aspectos relativos aos métodos diagnósticos dessa entidade.

The radiological findings of syringomyelography are described in a five years old patient who underwent a percutaneous injection of opaque contrast mediun (Lipiodol) into the intraspinal syringomyelic cavity. The clinical picture, the usual diagnostic methods and the place of syringomyelography for the diagnosis of syringomielia are discussed.