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ABSTRACT Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths. In Brazil, it is likewise the second most common cancer among men, second only to non-melanoma skin cancers. The aim of this consensus is to align different opinions and interpretations of the medical literature in a practical and patient-oriented approach. The first Brazilian Consensus on the Treatment of Advanced Prostate Cancer was published in 2017, with the goal of reducing the heterogeneity of therapeutic conduct in Brazilian patients with metastatic prostate cancer. We acknowledge that in Brazil the incorporation of different technologies is a big challenge, especially in the Sistema Único de Saúde (SUS), which allows for the disparity in the options available to patients treated in different institutions. In order to update the recommendations and to make them objective and easily accessible, once more a panel of specialists was formed in order to discuss and elaborate a new Brazilian Consensus on Advanced Prostate Cancer. This Consensus was written through a joint initiative of the Brazilian Society of Clinical Oncology (SBOC) and the Brazilian Society of Urology (SBU) to support the clinical decisions of physicians and other health professionals involved in the care of patients with prostate cancer.

https://doi.org/10.1590/s1677-5538.ibju.2018.0798 885 downloads

Impact of 68GA-PSMA PET / CT on treatment of patients with recurrent / metastatic high risk prostate cancer - a multicenter study
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Mattiolli, Aline B.

; Santos, Allan

; Vicente, Andreia

; Queiroz, Marcelo

; Bastos, Diogo

; Herchenhorn, Daniel

; Srougi, Miguel

; Peixoto, Fabio A.

; Morikawa, Lisa

; Silva, João Luiz Fernandes da

; Etchebehere, Elba

International braz j urol

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Out 2018, Volume 44 Nº 5 Páginas 892 - 899

Resumo: En | Texto: En | PDF: En

ABSTRACT Purpose: The purpose of our study was to evaluate the clinical impact of 68Ga-PSMA PET / CT in the setting of biochemical recurrence of prostate cancer. Materials and Methods: We retrospectively evaluated 125 prostate cancer patients submitted to the 68Ga-PSMA PET / CT due to biochemical recurrence. The parameters age, Gleason score, PSA levels, and the highest SUVmax were correlated to potential treatment changes. The highest SUVmax values were correlated with age and Gleason score. The median follow-up time was 24 months. Results: 68Ga-PSMA PET / CT led to a treatment change in 66 / 104 (63.4%) patients (twenty-one patients were lost to follow-up). There was a significant change of treatment plan in patients with a higher Gleason score (P = 0.0233), higher SUVmax (p = 0.0306) and higher PSA levels (P < 0.0001; median PSA = 2.55 ng / mL). Conclusion: 68Ga-PSMA PET / CT in prostate cancer patients with biochemical recurrence has a high impact in patient management.

https://doi.org/10.1590/s1677-5538.ibju.2017.0632 1112 downloads

First brazilian consensus of advanced prostate cancer: recommendations for clinical practice
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Sasse, Andre Deeke

; Wiermann, Evanius Garcia

; Herchenhorn, Daniel

; Bastos, Diogo Assed

; Schutz, Fabio A.

; Maluf, Fernando Cotait

; Coura Filho, George

; Morbeck, Igor Alexandre Protzner

; Cerci, Juliano J.

; Smaletz, Oren

; Lima, Volney Soares

; Adamy Jr., Ari

; Campos, Franz Santos de

; Carvalhal, Gustavo Franco

; Cezar, Leandro Casemiro

; Dall´Oglio, Marcos Francisco

; Sadi, Marcus Vinicius

; Reis, Rodolfo Borges dos

; Nogueira, Lucas

International braz j urol

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Jun 2017, Volume 43 Nº 3 Páginas 407 - 415

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction Prostate cancer still represents a major cause of morbidity, and still about 20% of men with the disease are diagnosed or will progress to the advanced stage without the possibility of curative treatment. Despite the recent advances in scientific and technological knowledge and the availability of new therapies, there is still considerable heterogeneity in the therapeutic approaches for metastatic prostate cancer. Objectives This article presents a summary of the I Brazilian Consensus on Advanced Prostate Cancer, conducted by the Brazilian Society of Urology and Brazilian Society of Clinical Oncology. Materials and Methods Experts were selected by the medical societies involved. Forty issues regarding controversial issues in advanced disease were previously elaborated. The panel met for consensus, with a threshold established for 2/3 of the participants. Results and Conclusions The treatment of advanced prostate cancer is complex, due to the existence of a large number of therapies, with different response profiles and toxicities. The panel addressed recommendations on preferred choice of therapies, indicators that would justify their change, and indicated some strategies for better sequencing of treatment in order to maximize the potential for disease control with the available therapeutic arsenal. The lack of consensus on some topics clearly indicates the absence of strong evidence for some decisions.

https://doi.org/10.1590/s1677-5538.ibju.2016.0490 1303 downloads

Hemorrhagic encephalopathy in dengue shock syndrome: a case report
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Souza, Luiz José de

; Martins, André Luiz de Oliveira

; Paravidini, Paulo César Leitão

; Nogueira, Rita Maria Ribeiro

; Gicovate Neto, Carlos

; Bastos, Diogo Assed

; Siqueira, Edno Wallace da Silva

; Carneiro, Rodrigo da Costa

Brazilian Journal of Infectious Diseases

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Jun 2005, Volume 9 Nº 3 Páginas 257 - 261

Resumo: En | Texto: En | PDF: En

Dengue fever is the most important arboviral infection in the world, with an estimated 100 million cases per year and 2.5 billion people at risk. Encephalopathy is a rare complication of dengue virus infection and may occur as a consequence of intracranial hemorrhage, cerebral edema, hyponatremia, cerebral anoxia, fulminant hepatic failure with portosystemic encephalopathy, microcapillary hemorrhage or release of toxic products. We report a rare case of hemorrhagic encephalopathy in dengue shock syndrome caused by type 3 dengue virus.

4572 downloads Citado 2 vezes em SciELO

Aminotransferase changes and acute hepatitis in patients with dengue fever: analysis of 1,585 cases
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Souza, Luiz José de

; Alves, José Galvão

; Nogueira, Rita Maria Ribeiro

; Gicovate Neto, Carlos

; Bastos, Diogo Assed

; Siqueira, Edno Wallace da Silva

; Souto Filho, João Tadeu Damian

; Cezário, Thiago de Abreu

; Soares, Carlos Eduardo

; Carneiro, Rodrigo da Costa

Brazilian Journal of Infectious Diseases

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Abr 2004, Volume 8 Nº 2 Páginas 156 - 163

Resumo: En | Texto: En | PDF: En

INTRODUCTION: Type 3 dengue virus caused an extensive epidemic in the state of Rio de Janeiro in summer 2002. In some of the patients, it was found in an atypical form with increased aminotransferase levels and acute hepatitis. MATERIAL AND METHODS: An analysis was made of 1,585 serologically confirmed dengue cases at the Dengue Reference Center in Campos dos Goytacazes, Rio de Janeiro state. The grade of hepatic aggression was established according to the alterations in the aminotransferase levels: grade A - normal levels of aminotransferase; grade B - elevated aminotransferase, with increased levels of at least one of the enzymes; grade C - elevated aminotransferase, with the levels of at least one of the enzymes increased to more than three times the reference values; grade D - acute hepatitis, with aminotransferase levels increased to at least 10 times their normal values. RESULTS: Among the 1,585 serologically confirmed dengue cases, 44.5% presented alterations in the aminotransferase levels (grade B), 16.9% presented grade C liver involvement and 3.8% of the patients had progressed to acute hepatitis (grade D). The average values for the rise in aspartate aminotransferase and alanine aminotransferase were 93.3 U/L and 86.0 U/L. The greatest alterations were observed among females (p<0.001), cases of dengue hemorrhagic fever (p<0.001), and cases with sequential infections (p=0.001). CONCLUSIONS: Liver damage with elevation of aminotransferases and reactive hepatitis was a common complication of dengue virus infection in these patients.

8407 downloads Citado 15 vezes em SciELO

Prevalência de obesidade e fatores de risco cardiovascular em Campos, Rio de Janeiro
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Souza, Luiz J. de

; Gicovate Neto, Carlos

; Chalita, Félix E.B.

; Reis, Aldo F.F.

; Bastos, Diogo A.

; Souto Filho, João T.D.

; Souza, Thiago F. de

; Côrtes, Vitor A.

Arquivos Brasileiros de Endocrinologia & Metabologia

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Dez 2003, Volume 47 Nº 6 Páginas 669 - 676

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVOS: Determinar a prevalência de obesidade e sua associação com hipertensão arterial sistêmica (HAS), dislipidemias (DL), diabetes mellitus (DM) e outros fatores de risco cardiovascular. CASUÍSTICA E MÉTODOS: Estudo de delineamento transversal de 1039 adultos >18anos da região urbana, amostragem aleatória em estágios múltiplos e conglomerados. Os dados foram obtidos no domicílio, através de questionário, avaliação clínica e coleta de sangue para análise laboratorial. RESULTADOS: A prevalência de obesidade (IMC >30kg/m2) foi de 17,8% (IC95%15,5-20,1), enquanto que a obesidade abdominal (CA >102cm e >88cm para homens e mulheres, respectivamente) esteve presente em 35,1% (IC95%32,2-38) dos entrevistados. A obesidade foi mais freqüente entre as mulheres - 20,2% do que entre os homens - 15,2% (p= 0,01) e apresentou associação positiva com a idade (p= 0,05), sedentarismo (p= 0,02), HAS (p< 0,001) e DL (p= 0,005). Nos pacientes com e sem excesso de gordura abdominal as freqüências de HAS, DM e DL foram respectivamente de: 57,7% / 32,0% (p< 0,001), 11,8% / 6,4% (p= 0,03) e 32,2% / 24,1% (p= 0,005). CONCLUSÕES: A obesidade foi mais freqüente entre as mulheres e aumentou com o avançar da idade. Os indivíduos com obesidade e/ou excesso de gordura abdominal apresentaram maior prevalência de HAS, DM e DL em relação aos pacientes eutróficos.

OBJECTIVES: To determine the prevalence of obesity and its association with systemic arterial hypertension (SAH), dyslipidemia (DL), diabetes mellitus (DM) and other cardiovascular risk factors. SAMPLE AND METHODS: Cross-sectional study of 1039 adults >18 years from an urban region, randomly selected in conglomerates and in a multiple stage process. Data were obtained in the household through a questionnaire, clinical evaluation and blood sampling for laboratory analysis. RESULTS: The overall prevalence of obesity (BMI >30kg/m2) was 17.8% (CI95%15.5-20.1), while abdominal obesity (AC >102cm and >88cm for men and women, respectively) was present in 35.1% (CI95%32.2-38) of the interviewees. Overall obesity was more common among women (20.2%) than men (15.2%) (p= 0.01), with a positive association with age (p= 0.05), sedentarism (p= 0.02), SAH (p< 0.001) and DL (p= 0.005). Among the patients with and without excess abdominal fat, the SAH, DM and DL rates were respectively of: 57.7% / 32.0% (p< 0.001), 11.8% / 6.4% (p= 0.03) and 32.2% / 24.1% (p= 0.005). CONCLUSIONS: Overall obesity was more common among women and it increased with age. Individuals with obesity and/or excess abdominal fat presented a greater prevalence of SAH, DM and DL, as compared to healthy individuals.

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Prevalence of dyslipidemia and risk factors in Campos dos Goytacazes, in the Brazilian State of Rio de Janeiro
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Souza, Luiz José de

; Souto Filho, João Tadeu Damian

; Souza, Thiago Ferreira de

; Reis, Aldo Franklin Ferreira

; Gicovate Neto, Carlos

; Bastos, Diogo Assed

; Côrtes, Vitor Azevedo

; Chalita, Félix Elias Barros

; Teixeira, Cláudio Luiz

Arquivos Brasileiros de Cardiologia

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Set 2003, Volume 81 Nº 3 Páginas 257 - 264

Resumo: En | Texto: En | PDF: En

OBJECTIVE: To determine the prevalence of dyslipidemias in adults in the city of Campos dos Goytacazes, in the Brazilian state of Rio de Janeiro, and to identify its relation to risk factors. METHODS: Cross-sectional, population-based, observational study with sampling through conglomerates and stratified according to socioeconomic levels, sex, and age, with 1,039 individuals. Risk factors, familial history, blood pressure, anthropometric measurements, glucose, triglycerides and cholesterol were determined. RESULTS: The following prevalences were observed: of dyslipidemias 24.2%; of hypercholesterolemia, 4.2%; of elevated LDL-C, 3.5%; of low HDL-C, 18.3%; and of hypertriglyceridemia, 17.1%. The following mean levels were observed: cholesterol, 187.6± 33.7 mg/dL; LDL-C, 108.7±26.8 mg/dL; HDL-C, 48.5±7.7 mg/dL; and triglycerides, 150.1±109.8 mg/dL. The following variables showed a positive correlation with dyslipidemia: increased age (P<0.001), male sex (P<0.001), low familial income (P<0.001), familial history (P<0.01), overweight/obesity (P<0.001), waist measure (P<0.001), high blood pressure (P<0.001), and diabetes mellitus (P<0.001). The following variables had no influence on dyslipidemias: ethnicity, educational level, smoking habits, and sedentary lifestyle. CONCLUSION: The frequency of lipid changes in the population studied was high, suggesting that measures for the early diagnosis should be taken, in association with implementation of programs for primary and secondary prevention of atherosclerosis.

4538 downloads Citado 7 vezes em SciELO

Prevalência de diabetes mellitus e fatores de risco em Campos dos Goytacazes, RJ
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Souza, Luiz José de

; Chalita, Félix Elias Barros

; Reis, Aldo Franklin F.

; Teixeira, Cláudio Luiz

; Gicovate Neto, Carlos

; Bastos, Diogo Assed

; Filho, João Tadeu D. S.

; Souza, Thiago Ferreira de

; Côrtes, Vitor Azevedo

Arquivos Brasileiros de Endocrinologia & Metabologia

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Fev 2003, Volume 47 Nº 1 Páginas 69 - 74

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO: Determinar a prevalência de diabetes mellitus (DM) e fatores de risco em adultos, em Campos dos Goytacazes. MÉTODOS: Estudo transversal, de base populacional, com amostragem por conglomerados, estratificada pelo nível sócio-econômico. Foram realizadas duas visitas a 1039 indivíduos, com aplicação de questionário, avaliação da pressão arterial, medidas antropométricas e coleta de amostra de sangue em jejum para análise da glicose, triglicerídeos, colesterol, HDL-c e LDL-c. RESULTADOS: A prevalência ajustada pela idade foi de 6,0%. Homens (6,3%) e mulheres (5,7%) tiveram resultados semelhantes, assim como brancos (5,9%) e não brancos (6,3%). A prevalência de DM foi maior em pessoas com história familiar da doença (p<0,001). A prevalência de DM aumentou de 2,1% na faixa de 18-29 anos para 18,3% nos pacientes acima de 70 anos de idade (p<0,001). O DM foi mais prevalente entre os pacientes portadores de hipertensão arterial, dislipidemia e excesso de peso (p<0,001). CONCLUSÕES: Os resultados se encontram próximo dos números de prevalência em outras regiões do Brasil. Assim, percebemos a grande importância do DM no contexto de saúde pública como doença crônica não transmissível.

OBJECTIVE: To determine the prevalence of diabetes mellitus (DM) and risk factors in adults of Campos dos Goytacazes, RJ. METHODS: A cross-sectional study of a populational basis was performed, with sample conglomerates stratified by social and economical levels. Two visits were performed to 1039 individuals, with application of a questionnaire, evaluation of the arterial blood pressure, anthropometric measurements and collection of fasting blood for glucose, triglycerides, cholesterol, HDL-c and LDL-c. RESULTS: The age-adjusted prevalence was 6.0%. Men (6.3%) and women (5.7%) had similar results, as well white (5.9%) and non-white (6.3%). The prevalence of DM was higher in people with family history of the disease (p<0.001). The prevalence of DM increased from 2.1% in people with 18-29 years to 18.3% in those with more than 70 years of age (p<0.001). DM was more prevalent among patients with arterial hypertension, dyslipidemia and weight excess (p<0.001). CONCLUSIONS: The results are similar to prevalence numbers in other regions of Brazil. Thus, we realize the great importance of DM on public health context as a chronic and non-transmissible disease.

23043 downloads Citado 12 vezes em SciELO

Hepatitis in Dengue Shock Syndrome
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Souza, Luiz José de

; Carneiro, Helder Gonçalves

; Souto Filho, João Tadeu Damian

; Souza, Thiago Ferreira de

; Côrtes, Vitor Azevedo

; Gicovate Neto, Carlos

; Bastos, Diogo Assed

; Siqueira, Edno Wallace da Silva

Brazilian Journal of Infectious Diseases

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Dez 2002, Volume 6 Nº 6 Páginas 322 - 327

Resumo: En | Texto: En | PDF: En

Dengue fever is the most frequent arbovirus disease in the world and the most important one in terms of morbidity and mortality. Atypical manifestations of dengue have become commonplace during the last few years, including hepatic damage, which manifests mainly by pain in the right hypochondrium and an increase in the levels of aminotransferases. We describe a case of acute hepatitis in a patient with Dengue Shock Syndrome Grade III. We analyzed the clinical and laboratory aspects of this atypical complication of dengue as well as the differential diagnoses.

9359 downloads Citado 5 vezes em SciELO

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