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au:Guimarães, Gustavo Cardoso

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Transformação do trabalho no contexto da covid-19: experiências de trabalhadores da Estratégia Saúde da Família covid19 covid 19 covid-19 covid1 1 covid-1 covid-
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Rosário, Celita Almeida

; Souto, Ester Paiva

; Morosini, Márcia Valéria Guimarães Cardoso

; Petra, Priscila Cardia

; Matta, Gustavo Corrêa

Trabalho, Educação e Saúde

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2024, Volume 22 elocation e02904268

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

Resumo O artigo teve por objetivo apresentar as percepções sobre a resposta à pandemia de covid-19 tendo em vista o trabalho em saúde de profissionais da Estratégia Saúde da Família no município do Rio de Janeiro. Analisaram-se as repercussões da covid-19 nas condições e relações de trabalho, assim como a percepção sobre o correspondente processo de vacinação no município. Dezesseis entrevistas semiestruturadas foram conduzidas com profissionais que compõem a equipe mínima da Estratégia em duas unidades de clínica da família de duas áreas programáticas de saúde. O estudo visa colaborar com a produção de conhecimento para o enfrentamento de emergências em saúde pública na Atenção Primária à Saúde, com a proposição de ações e políticas do município nesse nível de atenção, além de contribuir para maior compreensão do processo de vacinação no Sistema Único de Saúde. covid19 covid 19 covid-1 Janeiro Analisaramse Analisaram se atenção covid1 1 covid-

Abstract This article aimed to present the perceptions of the response to the COVID-19 pandemic in terms of the health work of Family Health Strategy professionals in the municipality of Rio de Janeiro, Brazil. The repercussions of COVID-19 on working conditions and relationships and the perception of the corresponding vaccination process in the municipality were analyzed. Sixteen semi-structured interviews were conducted with professionals who comprise the minimum strategy team in two family clinic units in two health program areas. The study aims to collaborate with the production of knowledge for dealing with public health emergencies in Primary Health Care, proposing actions and policies for the municipality at this level of care, and contributing to a greater understanding of the vaccination process in the Unified Health System. COVID19 COVID 19 COVID-1 Janeiro Brazil analyzed semistructured semi structured areas Care care System COVID1 1 COVID-

Resumen El objetivo de este artículo fue presentar las percepciones de la respuesta a la pandemia de Covid-19 en lo que se refiere al trabajo sanitario de los profesionales de la Estrategia de Salud de la Familia en el municipio de Río de Janeiro, estado de Rio de Janeiro, Brasil. Se analizaron las repercusiones de la Covid -19 en las condiciones y relaciones de trabajo, así como la percepción del correspondiente proceso de vacunación en el municipio. Se realizaron dieciséis entrevistas semiestructuradas a los profesionales que componen el equipo mínimo de la Estrategia en dos unidades de clínica familiar de dos áreas del programa de salud. El estudio tiene como objetivo colaborar con la producción de conocimiento para el enfrentamiento de emergencias en salud pública en la Atención Primaria de Salud, proponiendo acciones y políticas para el municipio en este nivel de atención, además de contribuir para una mayor comprensión del proceso de vacunación en el Sistema Único de Salud. Covid19 19 Covid-1 Janeiro Brasil -1 atención Covid1 1 Covid- -

https://doi.org/10.1590/1981-7746-ojs2904

COVID-19-associated coagulopathy and acute kidney injury in critically ill patients COVID19associated COVIDassociated COVID 19 associated 1
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Silva, Bruno Caldin da

; Cordioli, Ricardo Luiz

; Santos, Bento Fortunato Cardoso dos

; Guerra, João Carlos de Campos

; Rodrigues, Roseny dos Reis

; Souza, Guilherme Martins de

; Ashihara, Carolina

; Midega, Thais Dias

; Campos, Niklas Söderberg

; Carneiro, Bárbara Vieira

; Campos, Flávia Nunes Dias

; Guimarães, Hélio Penna

; Matos, Gustavo Faissol Janot de

; Aranda, Valdir Fernandes de

; Ferraz, Leonardo José Rolim

; Corrêa, Thiago Domingos

einstein (São Paulo)

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2023, Volume 21 elocation eAO0119

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay. Methods Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission. Results Out of 30 patients included, 13 (43.4%) met the criteria for acute kidney injury. Comparing both groups, patients with acute kidney injury were older: 73 (60-84) versus 54 (47-64) years, p=0.027, and had a lower baseline glomerular filtration rate: 70 (51-81) versus 93 (83-106) mL/min/1.73m2, p=0.004. On day 1, D-dimer and fibrinogen levels were elevated but similar between groups: 1780 (1319-5517) versus 1794 (726-2324) ng/mL, p=0.145 and 608 (550-700) versus 642 (469-722) g/dL, p=0.95, respectively. Rotational thromboelastometry data were also similar between groups. However, antithrombin activity and protein C levels were lower in patients who developed acute kidney injury: 82 (75-92) versus 98 (90-116), p=0.028 and 70 (52-82) versus 88 (78-101) µ/mL, p=0.038, respectively. Mean protein C levels were lower in the group with acute kidney injury across multiple time points during their stay in the intensive care unit. Conclusion Critically ill patients experiencing acute kidney injury exhibited lower endogenous anticoagulant levels. Further studies are needed to understand the role of natural anticoagulants in the pathophysiology of acute kidney injury within this population. COVID19. COVID19 COVID 19. 19 COVID-1 not tests fibrinolysis 0 1 3 7 admission included 43.4% 434 43 4 (43.4% groups older 6084 60 84 (60-84 5 4764 47 64 (47-64 years p0027 p 027 p=0.027 rate 5181 51 81 (51-81 9 83106 83 106 (83-106 mLmin173m2 mLminm mL min 73m2 m mL/min/1.73m2 p0004 004 p=0.004 Ddimer D dimer 178 13195517 1319 5517 (1319-5517 179 7262324 726 2324 (726-2324 ngmL ng ng/mL p0145 145 p=0.14 550700 550 700 (550-700 469722 469 722 (469-722 gdL g dL g/dL p095 95 p=0.95 respectively However 8 7592 75 92 (75-92 90116, 90116 90 116 , (90-116) p0028 028 p=0.02 5282 52 (52-82 78101 78 101 (78-101 µmL µ µ/mL p0038 038 p=0.038 population COVID1 COVID- 43.4 (43.4 6 (60-8 476 (47-6 p002 02 518 (51-8 8310 10 (83-10 mLmin mLmin173m 73m mL/min/1.73m p000 00 p=0.00 17 1319551 131 551 (1319-551 726232 72 232 (726-232 p014 p=0.1 55070 55 (550-70 46972 46 (469-72 p09 p=0.9 759 (75-9 9011 11 (90-116 p=0.0 528 (52-8 7810 (78-10 p003 03 p=0.03 43. (43. (60- (47- p00 (51- 831 (83-1 131955 (1319-55 72623 23 (726-23 p01 p=0. 5507 (550-7 4697 (469-7 p0 (75- 901 (90-11 (52- 781 (78-1 (43 (60 (47 (51 (83- 13195 (1319-5 7262 2 (726-2 p=0 (550- (469- (75 (90-1 (52 (78- (4 (6 (5 (83 (1319- (726- p= (550 (469 (7 (90- (78 ( (8 (1319 (726 (55 (46 (90 (131 (72 (9 (13 (1

https://doi.org/10.31744/einstein_journal/2023ao0119

Should obesity be associated with worse urinary continence outcomes after robotic-assisted radical prostatectomy? a propensity score matching analysis
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Mourão, Thiago Camelo

; Oliveira, Renato Almeida Rosa de

; Favaretto, Ricardo de Lima

; Santana, Thiago Borges Marques

; Sacomani, Carlos Alberto Ricetto

; Bachega Jr., Wilson

; Guimarães, Gustavo Cardoso

; Zequi, Stênio de Cássio

International braz j urol

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Jan 2022, Volume 48 Nº 1 Páginas 122 - 130

Resumo: En | Texto: En | PDF: En

ABSTRACT Purpose: To analyze the association between obesity and urinary incontinence rate in men submitted to robot-assisted radical prostatectomy (RARP) in a high-volume cancer center. Materials and Methods: We reported 1.077 men who underwent RARP as the primary treatment for localized prostate cancer from 2013 to 2017. Patients were classified as non-obese (normal BMI or overweight) or obese men (BMI ≥30kg/m2). They were grouped according to the age, PSA level, D’Amico risk group, Gleason score, ASA classification, pathological stage, prostate volume, salvage/adjuvant radiotherapy, perioperative complications, and follow-up time. Urinary continence was defined as the use of no pads. For the analysis of long-term urinary continence recovery, we conducted a 1:1 propensity-score matching to control confounders. Results: Among the obese patients, mean BMI was 32.8kg/m2, ranging 30 - 45.7kg/m2. Only 2% was morbidly obese. Obese presented more comorbidities and larger prostates. Median follow-up time was 15 months for the obese. Complications classified as Clavien ≥3 were reported in 5.6% of the obese and in 4.4% of the non-obese men (p=0.423). Median time for continence recovery was 4 months in both groups. In this analysis, HR was 0.989 for urinary continence recovery in obese (95%CI=0.789 - 1.240; p=0.927). Conclusions: Obese can safely undergo RARP with similar continence outcomes comparing to the non-obese men when performed by surgeons with a standardized operative technique. Future studies should perform a subgroup analysis regarding the association of obesity with other comorbidities, intending to optimize patient counseling.

https://doi.org/10.1590/s1677-5538.ibju.2021.0457

Prostate Cancer Screening in Brazil: a single center experience in the public health system
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Oliveira, Renato Almeida Rosa de

; Guimarães, Gustavo Cardoso

; Mourão, Thiago Camelo

; Favaretto, Ricardo de Lima

; Santana, Thiago Borges Marques

; Lopes, Ademar

; Zequi, Stenio de Cassio

International braz j urol

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Jun 2021, Volume 47 Nº 3 Páginas 558 - 565

Resumo: En | Texto: En | PDF: En

ABSTRACT Purpose: Incidence and mortality of prostate cancer (PCa) are still increasing in developing countries. Limited access to the health system or more aggressive disease are potential reasons for this. Ethnic and social differences in developed countries seem to make inappropriate to extrapolate data from other centers. We aim to report the epidemiological profile of a PSA-screened population from a cancer center in Brazil. Materials and Methods: We retrospectively selected 9.692 men enrolled in a PCa prevention program, comprising total PSA level and digital rectal examination at the first appointment, associated with complementary tests when necessary. Men aged over 40 years-old were included after shared decision-making process. Prostate biopsy (TRUS) was performed when clinically suspected for PCa. After the diagnosis, patients underwent appropriate treatment. Results: TRUS was performed in 5.5% of men and PCa incidence was 2.6%. Overall ratio between number of patients who needed to be screened in order to diagnose one cancer was 38.9 patients, with 2.1 biopsies performed to diagnose a cancer. Positive predictive value (PPV) of TRUS biopsy in this strategy was 47.2%, varying from 38.5% (<50 years-old) to 60% (>80 years-old). We evidenced 70 patients (27.9%) classified as low risk tumors, 74 (29.5%) as intermediate risk, and 107 (42.6%) as high-risk disease. Conclusions: PSA-screening remains controversial in literature. In front of a huge miscegenated people and considering the big proportion of high-risk PCa, even in young men diagnosed with the disease, it is imperative to inform patients and health providers about these data particularities in Brazil.

https://doi.org/10.1590/s1677-5538.ibju.2020.0392 655 downloads

COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Cruz, Isabella D'Andrea Garcia da

; Echegaray, Mariana V.F.

; Humes, Eduardo de Castro

; Silveira, Júlia Belizário

; Santi, Talita Di

; Miguel, Euripedes Constantino

; Corchs, Felipe

; Fatori, Daniel

; Campello, Guilherme

; Oliveira, Gabriel M. de

; Argolo, Felipe C.

; Ferreira, Felipe de M.

; Machado, Gustavo

; Argeu, Adriana

; Oliveira, Graça Maria Ramos de

; Serafim, Antônio de Pádua

; Siqueira, Luciana de Lima

; Rossi, Luciane de

; Rios, Izabel Cristina

; Oliveira, Talita Rodrigues de

; Antoniazzi, Leilane C. K.

; Gagliotti, Daniel Augusto Mori

; Abelama Neto, Emílio

; Oliveira Junior, Paulo Novais de

; Correia, Aline Villalobo

; Gonçalves, Luca Schilling

; Tortato, Liana Silva

; Busato, Wagner Machado Moraes

; Guimarães-Fernandes, Flávio

; Alves, Marcos

; Leite Netto, Oswaldo Ferreira

; Schoueri, Patrícia de Campos Lindenberg

; Roque, Márcio de Assis

; Merlin, Silvia Stahl

; Boer, Giovana Cardoso Machado

; Sallet, Paulo Clemente

; Malbergier, André

; Spedo, Mariana Abrahão

; Kamitsuji, Carla Satie

; Faria, Elizabeth de

; Moreira, Moacyr Vergara de Godoy

; Kaufman, Arthur

; Abdo, Carmita

; Scanavino, Marco de Tubino

; Lancman, Selma

; Tavares, Hermano

; Polanczyk, Guilherme

; Brunoni, André R.

; Forlenza, Orestes V.

; Barros-Filho, Tarcísio Eloy Pessoa de

Clinics

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2021, Volume 76 elocation e2631

Resumo: En | Texto: En | PDF: En

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

Editorial Comment: Role of Diffusion-Weighted Magnetic Resonance Imaging (DWMRI) in Assessment of Primary Penile Tumor Characteristics and Its Correlations With Inguinal Lymph Node Metastasis: A Prospective Study
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Guimarães, Gustavo Cardoso

International braz j urol

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Dez 2020, Volume 46 Nº 6 Páginas 1092 - 1093

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2020.06.05 287 downloads

Editorial Comment: Penile cancer information on the internet: a needle in a haystack
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Guimarães, Gustavo Cardoso

International braz j urol

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Dez 2020, Volume 46 Nº 6 Páginas 1090 - 1091

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2020.06.04 340 downloads

Editorial Comment: A modified clinicopathological tumor staging system for survival prediction of patients with penile cancer
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Guimarães, Gustavo Cardoso

International braz j urol

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Mar 2020, Volume 46 Nº 2 Páginas 275 - 276

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2020.02.06 256 downloads

External validation of nomogram to predict inguinal lymph node metastasis in patients with penile cancer and clinically negative lymph nodes
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Maciel, Carlos Vaz de Melo

; Machado, Roberto Dias

; Morini, Mariana Andozia

; Mattos, Pablo Aloisio Lima

; Reis, Ricardo dos

; Reis, Rodolfo Borges dos

; Guimarães, Gustavo Cardoso

; Cunha, Isabela Werneck da

; Faria, Eliney Ferreira

International braz j urol

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Ago 2019, Volume 45 Nº 4 Páginas 671 - 678

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction Penile cancer (PC) occurs less frequently in Europe and in the United States than in South America and parts of Africa. Lymph node (LN) involvement is the most important prognostic factor, and inguinal LN (ILN) dissection can be curative; however, ILN dissection has high morbidity. A nomogram was previously developed based on clinicopathological features of PC to predict ILN metastases. Our objective was to conduct an external validation of the previously developed nomogram based on our population. Materials and methods We included men with cN0 ILNs who underwent ILN dissection for penile carcinoma between 2000 and 2014. We performed external validation of the nomogram considering three different external validation methods: k-fold, leave-one-out, and bootstrap. We also analyzed prognostic variables. Performance was quantified in terms of calibration and discrimination (receiver operator characteristic curve). A logistic regression model for positive ILNs was developed based on clinicopathological features of PC. Results We analyzed 65 men who underwent ILN dissection (cN0). The mean age was 56.8 years. Of 65 men, 24 (36.9%) presented with positive LNs. A median 21 ILNs were removed. Considering the three different methods used, we concluded that the previously developed nomogram was not suitable for our sample. Conclusions In our study, the previously developed nomogram that was applied to our population had low accuracy and low precision for correctly identifying patients with PC who have positive ILNs.

https://doi.org/10.1590/s1677-5538.ibju.2018.0756 534 downloads

10.

Completely endophytic renal tumor: A laparoscopic approach
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Santos, Victor Espinheira

; Meduna, Rafael Ribeiro

; Bachega Jr., Wilson

; Guimarães, Gustavo Cardoso

International braz j urol

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Out 2018, Volume 44 Nº 5 Páginas 1050 - 1050

Resumo: En | Texto: En | PDF: En

ABSTRACT Kidney cancer is the third most common urologic malignancy and a 2% annual increase in the incidence has occurred over the past two decades, largely because of the increased utilization of imaging. The majority of these tumors are small, so the indications for nephron-sparing surgery and for minimally invasive surgery are continually expanding. Complex kidney lesions, such as those completely endophytic, are still a challenge even for experienced surgeons. Our objective is to demonstrate the operative technique for laparoscopic partial nephrectomy with the aid of intra-operative ultrasound in a man with a totally endophytic renal lesion. Case: A 52 years old man, asymptomatic, with incidental renal mass of 2.9 cm, completely endophytic (R.E.N.A.L score 9p) submitted to partial laparoscopic nephrectomy. Surgical time was 2 hours, with 20 minutes of ischemia. Pathological anatomy confirmed tumor of clear cells T1a, free margins.

https://doi.org/10.1590/s1677-5538.ibju.2017.0534 485 downloads

11.

Prostate Cancer – Local Treatment after Radiorecurrence: HIFU – High-Intensity Focused Ultrasound
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Zequi, Stênio de Cássio

; Mourão, Thiago Camelo

; Guimarães, Gustavo Cardoso

International braz j urol

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Jun 2018, Volume 44 Nº 3 Páginas 429 - 432

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/s1677-5538.ibju.2018.03.03 1322 downloads

12.

Vivenciando a Rede: Caminhos para a Formação do Médico no Contexto do SUS
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Couto, Vanessa Brito Miguel

; Santos, Candice Messias Barbosa

; Sampaio, Bernardo Pires

; Almeida, Igor Santos de

; Medeiros, Scarlet Cardoso

; Santos, Nicolle Guimarães Souza

; Menezes, Tallita Anny Matos

; Santos, Daniel Cezar

; Coelho, Fátima Luisa Penha

; Correia, Gustavo Soares

; Guzman, Julio Lenin Diaz

Revista Brasileira de Educação Médica

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Jun 2018, Volume 42 Nº 2 Páginas 5 - 14

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

RESUMO Os cursos de educação médica têm implementado disciplinas e módulos que aproximem os discentes da realidade da saúde nacional, a fim de se adequarem às crescentes necessidades de reorganização da formação médica. O presente artigo relata uma experiência de acadêmicos de Medicina da Universidade Estadual de Santa Cruz (UESC) com as atividades e ações incluídas no módulo de Gestão e Rede de Atenção à Saúde, parte da Prática de Integração Ensino-Serviço-Comunidade (PIESC), como proposta de reorientação do currículo na aquisição de habilidades de liderança e gerenciamento de recursos físicos e humanos em saúde. A proposta foi inserir os discentes em diferentes níveis de complexidade tecnológica do SUS a fim de contextualizar o estudo da Rede de Atenção à Saúde (RAS) por meio de vivências e pesquisa-ação em serviços de saúde situados nos diferentes níveis de atenção. Para isso, foram realizadas entrevistas semiestruturadas com profissionais e usuários em cada ambiente visitado. Tais vivências ampliaram a visão dos acadêmicos sobre os serviços de saúde, possibilitando um melhor entendimento da estruturação da RAS, bem como um dimensionamento dos entraves encontrados nos diferentes cenários e proporcionando uma experiência in loco das críticas e dificuldades apresentadas e vividas por usuários e profissionais. Percebeu-se que não há resolutividade dos problemas de saúde dos usuários nos serviços, bem como existe uma falta de entendimento destes acerca de seus direitos e da continuidade da atenção à saúde nos diferentes níveis de atenção. Explicitou-se que as instâncias primárias de atenção não funcionam como porta de entrada adequada, o que culmina com a desestruturação da RAS observada. A experiência relatada neste artigo demonstrou um modo dinâmico de abordar a temática da Gestão e Rede de Atenção à Saúde, além de contribuir para a formação do estudante de Medicina, já que possibilitou um melhor entendimento da rede quanto às práticas em saúde e às dimensões do processo saúde-doença implicados na gestão do SUS.

ABSTRACT Medical courses in Brazil have implemented subjects and modules that aim to bring students closer to actual national health concerns, as one way of adapting to the growing needs for medical training reorganization. Thus, this article reports on the experience of medical students at the Universidade Estadual de Santa Cruz (UESC) [State University of Santa Cruz] with activities and actions included in the Health Care Network and Management module, part of the Teaching-Service-Community Intergration Practice (PIESC), as a proposal for the reorientation of the curriculum and acquisition of leadership skills and management of physical and human resources in health. The proposal was to insert the students at different levels of technological complexity of the Unified Health System (SUS) in order to contextualize the study of the Health Care Network (RAS) through experiences and action research in health services located at different care levels. Semi-structured interviews with professionals and users were therefore performed in each visited environment. These experiences served to broaden the students’ vision of health care networks, enabling a better understanding of how the services are structured, as well as of the magnitude of the obstacles found in different scenarios, providing an in loco experience of the criticisms and difficulties faced by users and professionals. It was noticed that user health problems are often not resolved within the health care services, and the users lack understanding of their health rights. A lack of continuity of the health care was also observed through the various health care levels. Thus, it is concluded that the instances of primary care fail to offer adequate gateway services, culminating in the breakdown of the observed network. The experiment reported in this article demonstrated a dynamic way to approach the issue of Health Care Network Management, contributing to medical student training, as it enabled a better understanding of the network in terms of the health practices and the dimensions of the health-disease process involved in the management of the SUS.

https://doi.org/10.1590/1981-52712015v42n2rb2016107 1937 downloads

13.

Long-term results of the implantation of the AMS 800 artificial sphincter for post-prostatectomy incontinence: a single-center experience
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Sacomani, Carlos Alberto Ricetto

; Zequi, Stênio de Cássio

; Costa, Walter Henriques da

; Benigno, Bruno Santos

; Campos, Rodrigo Sousa Madeira

; Bachega Jr., Wilson

; Guimarães, Gustavo Cardoso

International braz j urol

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Fev 2018, Volume 44 Nº 1 Páginas 114 - 120

Resumo: En | Texto: En | PDF: En

ABSTRACT Objectives Report the long-term outcomes of the AMS 800 artificial sphincer (AS) for the treatment post-prostatectomy incontinence (PPI) in a single center in Brazil. Materials and Methods Clinical data from patients who underwent the procedure were retrieved from the medical records of individuals with more than 1 year of follow-up from May 2001 to January 2016. Continence status (number of pads that was used), complications (erosion or extrusion, urethral atrophy, and infection), malfunctions, and need for secondary implantation were evaluated. The relationship between complications and prior or subsequent radiation therapy (RT) was also examined. Results From May 2001 to January 2016, 121 consecutive patients underwent AS implantation for PPI at an oncological referral center in Brazil. At the last visit, the AS remained implanted in 106 patients (87.6%), who reported adequate continence status (maximum of 1 pad/day). Eight-two subjects (67.8%) claimed not to be using pads on a regular basis at the final visit (completely dry). Revision occurred in 24 patients (19.8%). Radiation therapy (RT) for prostate cancer following radical prostatectomy was used in 47 patients before or after AS placement. Twelve patients with a history of RT had urethral erosion compared with 3 men without RT (p=0.004). Conclusion Considering our outcomes, we conclude that AS implantation yields satisfactory results for the treatment of PPI and should remain the standard procedure for these patients. Radiation therapy is a risk factor for complication.

https://doi.org/10.1590/s1677-5538.ibju.2017.0165 678 downloads

14.

“Além da Mama”: o Cenário do Outubro Rosa no Aprendizado da Formação Médica
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Couto, Vanessa Brito Miguel

; Sampaio, Bernardo Pires

; Santos, Candice Messias Barbosa

; Almeida, Igor Santos de

; Santos, Nicolle Guimarães Souza

; Santos, Daniel Cézar

; Coelho, Fátima Luísa Penha

; Menezes, Tallita Anny Matos de

; Correia, Gustavo Soares

; Medeiros, Scarlet Cardoso

; Guzman, Julio Lenin Diaz

Revista Brasileira de Educação Médica

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Jan 2017, Volume 41 Nº 1 Páginas 30 - 37

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

RESUMO O câncer de mama pode ser considerado, atualmente, um problema de saúde pública devido a sua crescente incidência e índices de letalidade. Diante disso, o movimento Outubro Rosa visa chamar a atenção da população a respeito dessas neoplasia em mulheres de todo o mundo, de modo que suas ações têm por objetivo comum realizar o diagnóstico precoce no intuito de diminuir a mortalidade em decorrência dessa neoplasia. Dessa forma, o presente artigo objetiva relatar a experiência de acadêmicos do curso de Medicina da Universidade Estadual de Santa Cruz, no Módulo de Práticas de Integração Ensino, Serviço e Comunidade III (Piesc III), numa ação conjunta com a Equipe de Saúde da Família (ESF) de Iguape, em Ilhéus (BA), no contexto do movimento Outubro Rosa, objetivando também compartilhar considerações sobre a formação médica levantadas pelo grupo acerca da vivência descrita. No período, realizou-se abordagem inicial na sala de espera, anamnese dirigida e foi feito o exame físico das mamas das pacientes que compareceram à Unidade de Saúde da Família. A experiência não consistiu apenas em identificar pacientes com suspeita de câncer de mama e quantificar os dados, mas numa oportunidade de exercício da Educação e Comunicação em Saúde e de desenvolvimento da relação médico-paciente. Ainda permitiu aos acadêmicos reconhecer e entender melhor as dificuldades das usuárias em relação à prevenção e promoção da saúde das mamas, sendo que se observou que diversas mulheres não estavam familiarizadas com os temas abordados. O estudante de Medicina precisa compreender que o conhecimento teórico-prático se reconstrói em cada paciente com contexto histórico específico e com diferentes visões e interpretações dos conceitos de saúde e doença. Além disso, o profissional médico deve exercitar, desde a graduação, habilidades que extrapolam o ortodoxo trabalho médico, assumindo também uma postura de multiplicador de cidadania, um agente propagador de direitos e deveres.

ABSTRACT The breast cancer can now be considered a public health problem due to its increasing incidence and lethality rates. In view of this, the October Rosa mobilization aims at drawing the population’s attention regarding this neoplasm in women from all over the world, so that their common objective is to perform the early diagnosis in order to reduce mortality due to this neoplasm. Thus, the following article describes the experiences of undergraduate medical students at the Universidade Estadual de Santa Cruz (Uesc) regarding the practice module on Integrated Teaching with Community Health and Service, as part of a joint initiative with a Family Health Team in the outskirts of Ilhéus, Bahia, Brazil, within the context of the “Pink October” movement, also aiming to share thoughts on the medical degree raised by the group on the experience described. As part of the Pink October initiative, the students were given the opportunity to take a clinical approach in the waiting room, collecting information and performing physical examinations on patients who appear at the Family Health Unit. This experience was not only intended to identify patients with suspected cancer and measure the data collected, but was also designed to provide the students the opportunity to put their health education and communication skills into practice, developing the doctor-patient relationship. It also allows academics to better recognize and understand users’ difficulties in preventing and promoting breast health. In this context, it was observed that several women were not familiar with the recommended techniques for the breast self-exam (???). Medical students must understand that practical and theoretical knowledge is reconstructed with every single patient according to their specific historical context and varying viewpoints and interpretations of the concepts of health and disease. In addition, the medical professional must exercise, from the undergraduate, skills that extrapolate the orthodox medical work, also assuming a position of multiplier of citizenship, a propagating agent of rights and duties.

https://doi.org/10.1590/1981-52712015v41n1rb20160005 11507 downloads

15.

Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy
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Aita, Giuliano Amorim

; Zequi, Stênio de Cássio

; Costa, Walter Henriques da

; Guimarães, Gustavo Cardoso

; Soares, Fernando Augusto

; Giuliangelis, Thais Safranov

International braz j urol

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Dez 2016, Volume 42 Nº 6 Páginas 1136 - 1143

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: The presence and extension of inguinal lymph node metastasis are the main prognostic factors in patients with penile cancer. Physical exam and image exams are not adequate to evaluate inguinal lymph nodes and many patients are submitted to non-therapeutic lymphadenectomies. However, it is known that not all patients with clinically or histologically negative inguinal lymph nodes evolve favorably. Casuistic and Methods: the authors evaluated the clinical and pathologic characteristics of 163 patients with penile carcinoma and clinically negative inguinal lymph nodes followed for three or more years and their impact on global survival (GS) and cancer-specific survival (CSS) in the 10-year follow-up. Primary pathologic tumor stage (p=0.025) and the presence of high grade of tumor differentiation (p=0.018) were predictive of CSS. The presence of high grade tumor was an independent specific prognostic factor of death risk (RR 14.08; p=0.019). Conclusion: high histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years.

https://doi.org/10.1590/s1677-5538.ibju.2015.0416 1724 downloads

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