A. Cordeiro, M. Conde, João Torres, Nuno Morais, Paulo Mota, A. Rocha, Giovanni Grimaldi, F. Botelho, V. H. Nogueira, Estevao Lima
Introdução: A hemostase é uma questão central na cirurgia laparoscópica. Não há diretrizes claras quando se trata de escolher qual o instrumento de energia a utilizar. Este estudo compara a eficiência e segurança entre EnSeal® e LigasureTM na selagem de artérias e veias em um modelo porcino ex-vivo. Métodos: Os instrumentos foram comparados entre si em relação à velocidade de corte e à pressão de ruptura (burst pressure - BP) após a colheita do vaso. Os níveis de coagulação e corte dos geradores foram configurados a um nível constante de energia. Um grupo de vasos foi enviado para análise histológica para avaliação do dano térmicos e selagem histológica. Resultados: Foram testados 124 vasos. No geral, o LigasureTM foi o instrumento mais rápido em todos os tipos de vasos e o EnSeal® foi o mais lento. Não houve diferenças estatisticamente significativas entre a BP, exceto para o grupo de artérias médias, onde a BP gerada pelo LigasureTM foi significativamente maior que a gerada pelo EnSeal®. No mesmo grupo de vasos, o LigasureTM foi o que apresentou a menor porcentagem de falhas de selagem. Não houve associação entre o número de falhas de selagem e o tamanho do vaso. Houve, no entanto, uma associação entre o número de falhas de selagem nas artérias versus veias, com maior número de falhas nas artérias em ambos os instrumentos, em comparação com nenhuma falha nas veias com LigasureTM. Embora não tenham sido encontradas diferenças estatisticamente significativas entre as selagens dos dois instrumentos, aquele com maior comprimento médio de selagem nas artérias e nas veias foi o LigasureTM, o que teoricamente pode significar uma selagem mais confiável. Conclusão: O LigasureTM fornece a selagem mais rápida e confiável, com BP superior em artérias médias comparativamente ao EnSeal® e com maior comprimento de selagem, tanto nas artérias como nas veias. No entanto, apresentou danos térmicos significativamente maiores que o EnSeal®.
{"title":"Estudo Comparativo da Eficácia e Segurança entre 2 Instrumentos de Energia Bipolar (EnSeal® e LigasureTM) na Selagem Vascular em Modelo Suíno Ex-Vivo","authors":"A. Cordeiro, M. Conde, João Torres, Nuno Morais, Paulo Mota, A. Rocha, Giovanni Grimaldi, F. Botelho, V. H. Nogueira, Estevao Lima","doi":"10.24915/AUP.35.1-2.79","DOIUrl":"https://doi.org/10.24915/AUP.35.1-2.79","url":null,"abstract":"Introdução: A hemostase é uma questão central na cirurgia laparoscópica. Não há diretrizes claras quando se trata de escolher qual o instrumento de energia a utilizar. Este estudo compara a eficiência e segurança entre EnSeal® e LigasureTM na selagem de artérias e veias em um modelo porcino ex-vivo. \u0000Métodos: Os instrumentos foram comparados entre si em relação à velocidade de corte e à pressão de ruptura (burst pressure - BP) após a colheita do vaso. Os níveis de coagulação e corte dos geradores foram configurados a um nível constante de energia. Um grupo de vasos foi enviado para análise histológica para avaliação do dano térmicos e selagem histológica. \u0000Resultados: Foram testados 124 vasos. No geral, o LigasureTM foi o instrumento mais rápido em todos os tipos de vasos e o EnSeal® foi o mais lento. Não houve diferenças estatisticamente significativas entre a BP, exceto para o grupo de artérias médias, onde a BP gerada pelo LigasureTM foi significativamente maior que a gerada pelo EnSeal®. No mesmo grupo de vasos, o LigasureTM foi o que apresentou a menor porcentagem de falhas de selagem. Não houve associação entre o número de falhas de selagem e o tamanho do vaso. Houve, no entanto, uma associação entre o número de falhas de selagem nas artérias versus veias, com maior número de falhas nas artérias em ambos os instrumentos, em comparação com nenhuma falha nas veias com LigasureTM. Embora não tenham sido encontradas diferenças estatisticamente significativas entre as selagens dos dois instrumentos, aquele com maior comprimento médio de selagem nas artérias e nas veias foi o LigasureTM, o que teoricamente pode significar uma selagem mais confiável. \u0000Conclusão: O LigasureTM fornece a selagem mais rápida e confiável, com BP superior em artérias médias comparativamente ao EnSeal® e com maior comprimento de selagem, tanto nas artérias como nas veias. No entanto, apresentou danos térmicos significativamente maiores que o EnSeal®.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81482394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Linhares, P. Garcia, Sara Goulart, C. Sebastião, Pedro Preto, A. Rodrigues
Introduction: Urinary stone disease is one of the most common disorders of the urinary tract. However, the main risk factors and chemical composition of urinary stones in the population of the Azores are unknown. The objective of this study was to define the most important factors associated with the formation of urinary calculi, investigating eating habits, family history and chemical composition of the calculi in the population of the Azores. Methods: The data were collected from 46 patients of the Hospital do Divino Espirito Santo and 48 healthy volunteers. A questionnaire was recorded on the medical and family history of the participants and on their life habits. The chemical composition of the calculi was evaluated by ICP-MS. Results: It was observed that the study group has a higher prevalence of diabetes and cases of urinary calculi in the family compared to the reference group. A positive correlation was found between calcium in the stones and the contents of sodium, magnesium, zinc, molybdenum and strontium. Conclusion: This study reveals that family history, diabetes and water consumption play an important role in the development of urinary calculi in the population of the Azores. The chemical content of the stones should also be considered since these data could help the medical community to understand the causes of urinary stone formation and adapt the medication and preventive measures to the patient and to the type of kidney stone produced.
{"title":"Risk Factors and Chemical Composition of Urinary Stones in the Azorean Population (São Miguel Island - Portugal): A Preliminary Study","authors":"D. Linhares, P. Garcia, Sara Goulart, C. Sebastião, Pedro Preto, A. Rodrigues","doi":"10.24915/AUP.35.1-2.67","DOIUrl":"https://doi.org/10.24915/AUP.35.1-2.67","url":null,"abstract":"Introduction: Urinary stone disease is one of the most common disorders of the urinary tract. However, the main risk factors and chemical composition of urinary stones in the population of the Azores are unknown. The objective of this study was to define the most important factors associated with the formation of urinary calculi, investigating eating habits, family history and chemical composition of the calculi in the population of the Azores. \u0000Methods: The data were collected from 46 patients of the Hospital do Divino Espirito Santo and 48 healthy volunteers. A questionnaire was recorded on the medical and family history of the participants and on their life habits. The chemical composition of the calculi was evaluated by ICP-MS. \u0000Results: It was observed that the study group has a higher prevalence of diabetes and cases of urinary calculi in the family compared to the reference group. A positive correlation was found between calcium in the stones and the contents of sodium, magnesium, zinc, molybdenum and strontium. \u0000Conclusion: This study reveals that family history, diabetes and water consumption play an important role in the development of urinary calculi in the population of the Azores. The chemical content of the stones should also be considered since these data could help the medical community to understand the causes of urinary stone formation and adapt the medication and preventive measures to the patient and to the type of kidney stone produced.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74942265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introdução: A infeção do trato urinário (ITU) é uma das infeções mais frequentes a nível comunitário, apresentando custos mais elevados para a sociedade e para o sistema de saúde. A publicação de estudos de avaliação epidemiológica dos agentes etiológicos responsáveis pela ITU e o seu perfil de resistências antimicrobianas constitui uma mais-valia para a elaboração de critérios de decisão para antibiótico-terapia empírica, bem como para alertar os responsáveis na área da saúde no que respeita aos benefícios de uma prescrição correta dos antimicrobianos. Material e Métodos: Estudo epidemiológico do tipo transversal, baseado nas uroculturas realizadas aos utentes externos do serviço de Patologia Clínica do Hospital da Horta EPER no ano de 2016. Sobre as uroculturas consideradas positivas foram analisados parâmetros como a idade, sexo, tipo de bactéria e perfil de suscetibilidade a antimicrobianos. Foram excluídos do estudo todos os registos com dados insuficientes para análise, bem como todos os pedidos de uroculturas em duplicado e do mesmo paciente num prazo inferior a 7 dias. Todos os dados utilizados foram disponibilizados pelo Serviço de Patologia Clínica do Hospital da Horta EPER. Resultados: Maior prevalência de uroculturas positivas nas mulheres comparativamente com os homens. Nas mulheres tendência bi-modal com primeiro pico a ocorrer na faixa etária dos 30 aos 39 anos, o segundo pico (mais elevado) na faixa dos 70 aos 79 anos. Nos homens, a tendência de aumento ocorre a partir da faixa etária dos 50 aos 59; a frequência das bactérias isoladas entre sexos é diferente. Predomínio da Escherichia coli como principal causadora de ITU, na mulher é mais alta do que no homem. A segunda e terceira bactéria mais frequentes foram a Klebsiella p. pneumoniae e Proteus mirabilis respetivamente, com maior frequência no homem do que na mulher em ambos os casos; maior frequência de beta lactamases de espectro estendido ocorre no homem; o estudo do perfil antimicrobiano nas estirpes de Escherichia coli apresentou elevada sensibilidade à fosfomicina (> 95%) e nitrofurantoína (> 95%). O timetroprim/sulfametoxazol e as fluoroquinolonas apresentaram resistências elevadas, (próxima dos 20%). A amoxicilina e amoxicilina/ácido clavulânico com resistências muito mais elevadas quando comparadas com a fosfomicina e nitrofurantoína. Excluindo a cefalotina, no grupo das cefalosporinas existe alguma heterogeneidade, mas com sensibilidades sempre superiores a 80%. Conclusão: Este tipo de estudos permite ajudar a determinar as linhas orientadoras para uma elaboração de antibiótico-terapia empírica.
{"title":"Infeções do Trato Urinário da Comunidade da Ilha do Faial, Determinadas no Hospital da Horta EPER - 2016","authors":"Rui Pedro Borges de Sousa","doi":"10.24915/aup.35.1-2.47","DOIUrl":"https://doi.org/10.24915/aup.35.1-2.47","url":null,"abstract":"Introdução: A infeção do trato urinário (ITU) é uma das infeções mais frequentes a nível comunitário, apresentando custos mais elevados para a sociedade e para o sistema de saúde. A publicação de estudos de avaliação epidemiológica dos agentes etiológicos responsáveis pela ITU e o seu perfil de resistências antimicrobianas constitui uma mais-valia para a elaboração de critérios de decisão para antibiótico-terapia empírica, bem como para alertar os responsáveis na área da saúde no que respeita aos benefícios de uma prescrição correta dos antimicrobianos. \u0000Material e Métodos: Estudo epidemiológico do tipo transversal, baseado nas uroculturas realizadas aos utentes externos do serviço de Patologia Clínica do Hospital da Horta EPER no ano de 2016. Sobre as uroculturas consideradas positivas foram analisados parâmetros como a idade, sexo, tipo de bactéria e perfil de suscetibilidade a antimicrobianos. Foram excluídos do estudo todos os registos com dados insuficientes para análise, bem como todos os pedidos de uroculturas em duplicado e do mesmo paciente num prazo inferior a 7 dias. Todos os dados utilizados foram disponibilizados pelo Serviço de Patologia Clínica do Hospital da Horta EPER. \u0000Resultados: Maior prevalência de uroculturas positivas nas mulheres comparativamente com os homens. Nas mulheres tendência bi-modal com primeiro pico a ocorrer na faixa etária dos 30 aos 39 anos, o segundo pico (mais elevado) na faixa dos 70 aos 79 anos. Nos homens, a tendência de aumento ocorre a partir da faixa etária dos 50 aos 59; a frequência das bactérias isoladas entre sexos é diferente. Predomínio da Escherichia coli como principal causadora de ITU, na mulher é mais alta do que no homem. A segunda e terceira bactéria mais frequentes foram a Klebsiella p. pneumoniae e Proteus mirabilis respetivamente, com maior frequência no homem do que na mulher em ambos os casos; maior frequência de beta lactamases de espectro estendido ocorre no homem; o estudo do perfil antimicrobiano nas estirpes de Escherichia coli apresentou elevada sensibilidade à fosfomicina (> 95%) e nitrofurantoína (> 95%). O timetroprim/sulfametoxazol e as fluoroquinolonas apresentaram resistências elevadas, (próxima dos 20%). A amoxicilina e amoxicilina/ácido clavulânico com resistências muito mais elevadas quando comparadas com a fosfomicina e nitrofurantoína. Excluindo a cefalotina, no grupo das cefalosporinas existe alguma heterogeneidade, mas com sensibilidades sempre superiores a 80%. \u0000 Conclusão: Este tipo de estudos permite ajudar a determinar as linhas orientadoras para uma elaboração de antibiótico-terapia empírica.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79931846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Transrectal ultrasound guided prostate biopsy (TRUS-Bx), according to the literature, can lead to urinary tract infections in up to 11% and sepsis in up to 2% of patients. We evaluate whether an original way to apply povidone-iodine rectal preparation just prior to TRUS-Bx can reduce infectious complications. Material and Methods: Between January 2014 and September 2016, 94 men in private office were prospectively randomized to two groups, before TRUS-Bx: • Rectal cleansing (an original transrectal “prostate massage” for about half a minute with 2.5 mL of betadine dermic solution 100 mg/mL) (n=47) or • No cleansing (n=47). All of the patients received prophylactic antibiotics: levofloxacin 500 mg PO for 7 days, beginning the day before procedure. Patients completed a telephone interview 4 days after undergoing the biopsy and went to the office 2 weeks after biopsy. The primary end point was the rate of infectious complications. An infectious complication when one or more of the following events occurred: 1) fever greater than 38.0Cº, 2) urinary tract infection or 3) sepsis (standardized definition). Student t test and multivariate regression analysis were used for data analysis. Results: Infectious complications developed in 6 cases (12.7%) in the non-rectal preparation group: five patients had fever without sepsis (11%) and one had sepsis (2%). In the povidone-iodine rectal preparation group there were no infectious complications (0.0%). Multivariate analysis did not identify any patient subgroups at significantly higher risk of infection after prostate biopsy. Of the 94 men who underwent TRUS-Bx 45 (47.9%) were diagnosed with prostate cancer and 3 (3.2%) had ASAP in the result. The hospital admission rate for urological complications within 30 days of the procedure was 1%, and only for infection related reasons (sepsis). Conclusion: The administration of quinolone-based prophylactic antibiotics and the simple use of 2.5 mL of povidone-iodine dermic solution in a transrectal prostate massage for Introduction: Transrectal ultrasound guided prostate biopsy (TRUS-Bx), according to the literature, can lead to urinary tract infections in up to 11% and sepsis in up to 2% of patients. We evaluate whether an original way to apply povidone-iodine rectal preparation just prior to TRUS-Bx can reduce infectious complications. Material and Methods: Between January 2014 and September 2016, 94 men in private office were prospectively randomized to two groups, before TRUS-Bx: • Rectal cleansing (an original transrectal “prostate massage” for about half a minute with 2.5 mL of betadine dermic solution 100 mg/mL) (n=47) or • No cleansing (n=47). All of the patients received prophylactic antibiotics: levofloxacin 500 mg PO for 7 days, beginning the day before procedure. Patients completed a telephone interview 4 days after undergoing the biopsy and went to the office 2 weeks after biopsy. The primary end point was the rate of infectious complicati
{"title":"Biópsia Prostática Transretal Após Preparação Profilática do Recto com Iodo-Povidona: Estudo Prospectivo Randomizado","authors":"José Pedro Cadilhe","doi":"10.24915/AUP.35.1-2.51","DOIUrl":"https://doi.org/10.24915/AUP.35.1-2.51","url":null,"abstract":"Introduction: Transrectal ultrasound guided prostate biopsy (TRUS-Bx), according to the literature, can lead to urinary tract infections in up to 11% and sepsis in up to 2% of patients. We evaluate whether an original way to apply povidone-iodine rectal preparation just prior to TRUS-Bx can reduce infectious complications. \u0000Material and Methods: Between January 2014 and September 2016, 94 men in private office were prospectively randomized to two groups, before TRUS-Bx: • Rectal cleansing (an original transrectal “prostate massage” for about half a minute with 2.5 mL of betadine dermic solution 100 mg/mL) (n=47) or • No cleansing (n=47). All of the patients received prophylactic antibiotics: levofloxacin 500 mg PO for 7 days, beginning the day before procedure. Patients completed a telephone interview 4 days after undergoing the biopsy and went to the office 2 weeks after biopsy. The primary end point was the rate of infectious complications. An infectious complication when one or more of the following events occurred: 1) fever greater than 38.0Cº, 2) urinary tract infection or 3) sepsis (standardized definition). Student t test and multivariate regression analysis were used for data analysis. \u0000Results: Infectious complications developed in 6 cases (12.7%) in the non-rectal preparation group: five patients had fever without sepsis (11%) and one had sepsis (2%). In the povidone-iodine rectal preparation group there were no infectious complications (0.0%). Multivariate analysis did not identify any patient subgroups at significantly higher risk of infection after prostate biopsy. Of the 94 men who underwent TRUS-Bx 45 (47.9%) were diagnosed with prostate cancer and 3 (3.2%) had ASAP in the result. The hospital admission rate for urological complications within 30 days of the procedure was 1%, and only for infection related reasons (sepsis). \u0000Conclusion: The administration of quinolone-based prophylactic antibiotics and the simple use of 2.5 mL of povidone-iodine dermic solution in a transrectal prostate massage for Introduction: Transrectal ultrasound guided prostate biopsy (TRUS-Bx), according to the literature, can lead to urinary tract infections in up to 11% and sepsis in up to 2% of patients. We evaluate whether an original way to apply povidone-iodine rectal preparation just prior to TRUS-Bx can reduce infectious complications. Material and Methods: Between January 2014 and September 2016, 94 men in private office were prospectively randomized to two groups, before TRUS-Bx: • Rectal cleansing (an original transrectal “prostate massage” for about half a minute with 2.5 mL of betadine dermic solution 100 mg/mL) (n=47) or • No cleansing (n=47). All of the patients received prophylactic antibiotics: levofloxacin 500 mg PO for 7 days, beginning the day before procedure. Patients completed a telephone interview 4 days after undergoing the biopsy and went to the office 2 weeks after biopsy. The primary end point was the rate of infectious complicati","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74350822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Charrua, R. Matos, T. Marczylo, I. Nagy, F. Cruz
Introduction: We aim to study the effect of fatty acid amide hydrolase (FAAH) blockade on bladder hyperactivity and on fatty acid amides levels during cystitis. Material and Methods: Cystitis was induced in female Wistar rats using 5 mg/mL lipopolysaccharide (LPS). Control group were intravesical instilled with saline. LPS and control groups received intravenously (caudal vein) during cystometry: URB 937 (URB; FAAH antagonist) in doses of 0.007, 0.07, 0.7 and 7 mg/kg (cumulative, with 10 minutes interval). Using the maximal effective dose of URB (0.7 mg/kg, see below) animals received 10 uM MJ15 (CB1 receptor antagonist) or 0.3 mg SR144528 /kg (SR; CB2 receptor antagonist). At dose of 7 mg/kg, animals receive 1.4 μg SB366791/kg (SB; TRPV1 antagonist). Control and inflamed (without and with 0.7 and 7 mg/kg URB) group were euthanized and the bladder was harvested for the determination of anandamide (AEA) and palmitoylethanolamide (PEA) by mass spectrometry. Results: Frequency of control was not changed by URB treatment at any dose. LPS increase bladder frequency. 0.007 mg and 0.07 mg URB decrease bladder frequency of LPS-inflamed rats. 0.7 URB reversed LPS-induced bladder hyperactivity. At 7 mg, URB was unable to reverse or reduce LPS-induced bladder hyperactivity. The administration of CB1, CB2 and TRPV1 antagonists did not change the frequency of voiding contractions of naive animals. CB1 antagonist reversed the effect of 0.7 URB while TRPV1 antagonist reduced the effect of 7 URB. AEA levels increase during inflammation. Treating LPS-inflamed animals with 0.7 mg URB brought AEA levels to control levels. Treating LPS-inflamed animals with 7 mg URB did not change AEA levels, compared to LPS-inflamed animals. PEA levels decrease during inflammation. Treating LPS-inflamed animals with 0.7 mg URB brought AEA levels to control levels. Treating LPS-inflamed animals with 7 mg URB, decreased PEA levels to values similar to the ones observed in LPS- -inflamed animals. Conclusion: During cystitis, the FAAH inhibitor raises the levels of PEA and reverses the urinary frequency by a CB1 receptor- mediated mechanism. When used in very high doses, the FAAH antagonist raises the levels of AEA and increases the urinary frequency by a TRPV1-dependent mechanism. Therefore, the choice of FAAH inhibitor dosage to be used in the clinics should consider the putative effects over the endocannabinoid levels in the system.
{"title":"FAAH Inhibitor Improves Function of Inflamed Bladders by Modulation of Anandamide and Palmitoylethanolamide","authors":"A. Charrua, R. Matos, T. Marczylo, I. Nagy, F. Cruz","doi":"10.24915/AUP.34.3-4.14","DOIUrl":"https://doi.org/10.24915/AUP.34.3-4.14","url":null,"abstract":"Introduction: We aim to study the effect of fatty acid amide hydrolase (FAAH) blockade on bladder hyperactivity and on fatty acid amides levels during cystitis. \u0000Material and Methods: Cystitis was induced in female Wistar rats using 5 mg/mL lipopolysaccharide (LPS). Control group were intravesical instilled with saline. LPS and control groups received intravenously (caudal vein) during cystometry: URB 937 (URB; FAAH antagonist) in doses of 0.007, 0.07, 0.7 and 7 mg/kg (cumulative, with 10 minutes interval). Using the maximal effective dose of URB (0.7 mg/kg, see below) animals received 10 uM MJ15 (CB1 receptor antagonist) or 0.3 mg SR144528 /kg (SR; CB2 receptor antagonist). At dose of 7 mg/kg, animals receive 1.4 μg SB366791/kg (SB; TRPV1 antagonist). Control and inflamed (without and with 0.7 and 7 mg/kg URB) group were euthanized and the bladder was harvested for the determination of anandamide (AEA) and palmitoylethanolamide (PEA) by mass spectrometry. \u0000Results: Frequency of control was not changed by URB treatment at any dose. LPS increase bladder frequency. 0.007 mg and 0.07 mg URB decrease bladder frequency of LPS-inflamed rats. 0.7 URB reversed LPS-induced bladder hyperactivity. At 7 mg, URB was unable to reverse or reduce LPS-induced bladder hyperactivity. The administration of CB1, CB2 and TRPV1 antagonists did not change the frequency of voiding contractions of naive animals. CB1 antagonist reversed the effect of 0.7 URB while TRPV1 antagonist reduced the effect of 7 URB. AEA levels increase during inflammation. Treating LPS-inflamed animals with 0.7 mg URB brought AEA levels to control levels. Treating LPS-inflamed animals with 7 mg URB did not change AEA levels, compared to LPS-inflamed animals. PEA levels decrease during inflammation. Treating LPS-inflamed animals with 0.7 mg URB brought AEA levels to control levels. Treating LPS-inflamed animals with 7 mg URB, decreased PEA levels to values similar to the ones observed in LPS- -inflamed animals. \u0000Conclusion: During cystitis, the FAAH inhibitor raises the levels of PEA and reverses the urinary frequency by a CB1 receptor- mediated mechanism. When used in very high doses, the FAAH antagonist raises the levels of AEA and increases the urinary frequency by a TRPV1-dependent mechanism. Therefore, the choice of FAAH inhibitor dosage to be used in the clinics should consider the putative effects over the endocannabinoid levels in the system.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87681535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human schistosomiasis, the second most devastating parasitic disease, is common in developing countries, but rare in Europe. Urogenital tract involvement is mainly due to Schistosoma haematobium infection. Schistosomiasis has long been associated with malignant neoplasia. Some authors have hypothesized a causal relationship between schistosomiasis and carcinoma of the bowel, kidney, bladder and prostate. To data only 17 cases of concomitant prostatic adenocarcinoma and gland schistosomiasis have been described. As an uncommon example of a potential complication of an untreated schistosomiasis, we report a case of an incidentally diagnosed urinary schistosomiasis after a radical prostatectomy for prostate adenocarcinoma in a 62-year-old African man living in a non-endemic area.
{"title":"Rare Association between Prostate Adenocarcinoma and Schistosomiasis: A Case Report","authors":"V. Metrogos, N. Ramos, C. Marialva, João Bastos","doi":"10.24915/aup.34.3-4.45","DOIUrl":"https://doi.org/10.24915/aup.34.3-4.45","url":null,"abstract":"Human schistosomiasis, the second most devastating parasitic disease, is common in developing countries, but rare in Europe. Urogenital tract involvement is mainly due to Schistosoma haematobium infection. Schistosomiasis has long been associated with malignant neoplasia. Some authors have hypothesized a causal relationship between schistosomiasis and carcinoma of the bowel, kidney, bladder and prostate. To data only 17 cases of concomitant prostatic adenocarcinoma and gland schistosomiasis have been described. As an uncommon example of a potential complication of an untreated schistosomiasis, we report a case of an incidentally diagnosed urinary schistosomiasis after a radical prostatectomy for prostate adenocarcinoma in a 62-year-old African man living in a non-endemic area.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85434406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Cabral, D. Carneiro, I. Braga, M. S. Campos, Vitor Cavadas
The micropercutaneous nephrolithotomy (microperc) is the ultimate technological advance in the treatment of urolithiasis. We describe a variation of the original technique and it´s additional advantages to this surgical approach. A woman of 67 years old with a body mass index of 28.6 kg/ m2 with a stone of 25 x 20 mm in the left renal pelvis was positioned in Valdivia - Galdakao decubitus. After retrograde pielography, it was placed a ureteral access sheath 11/13 F to the level of the ureteropelvic junction. The puncture of the kidney was performed under fluoroscopic guidance. The stone was disintegrated with holmium laser. At the end of the procedure it was performed a flexible nephroscopy to comprove the stone free status.
经皮肾镜取石术(microperc)是治疗尿石症的终极技术进步。我们描述了一种原始技术的变化，以及这种手术入路的额外优势。一名67岁女性，体重指数28.6 kg/ m2，左肾盂结石25 x 20 mm，位于Valdivia - Galdakao decubitus。逆行输尿管造影后，将输尿管通路鞘11/13 F置于输尿管肾盂连接处。肾穿刺在透视引导下进行。这块石头是用钬激光分解的。在手术结束时，进行了柔性肾镜检查以确认结石的游离状态。
{"title":"Micronefrolitotomia Percutânea: Descrição de uma Variante da Técnica Original","authors":"J. Cabral, D. Carneiro, I. Braga, M. S. Campos, Vitor Cavadas","doi":"10.24915/aup.34.3-4.63","DOIUrl":"https://doi.org/10.24915/aup.34.3-4.63","url":null,"abstract":"The micropercutaneous nephrolithotomy (microperc) is the ultimate technological advance in the treatment of urolithiasis. We describe a variation of the original technique and it´s additional advantages to this surgical approach. A woman of 67 years old with a body mass index of 28.6 kg/ m2 with a stone of 25 x 20 mm in the left renal pelvis was positioned in Valdivia - Galdakao decubitus. After retrograde pielography, it was placed a ureteral access sheath 11/13 F to the level of the ureteropelvic junction. The puncture of the kidney was performed under fluoroscopic guidance. The stone was disintegrated with holmium laser. At the end of the procedure it was performed a flexible nephroscopy to comprove the stone free status.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82511216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: In this study, we evaluated the initial results of this procedure in our hospital, aiming to evaluate retrograde intrarenal surgery efficacy and safety and possible success predictors of this technique. Material and Methods: After collecting data from the medical records and imaging studies of all patients undergoing retrograde intrarenal surgery in 2014 e 2015 at Centro Hospitalar de Sao Joao, and applying our exclusion criteria, we analyzed the data of 138 patients (total of 179 retrograde intrarenal surgery). The primary outcomes of our study were the immediate success rate, assessed by the surgeon’s perception intraoperatively, and postoperative success rate, assessed by image control. Residual lithiasis was considered significant in the presence of calculi > 3 mm. Results: The overall success rate was 67.0%, considering the surgeon’s perception. Considering the image control, the success rate was 66.7% for calculi smaller than 150 mm2 and located outside the ICG, but smaller in other locations or bigger calculi. In the univariate analysis, stone burden, calculi number and location were statistically significant predictors of retrograde intrarenal surgery success. Conclusion: Location in the ICG was considered a predictor of retrograde intrarenal surgery failure and, in this location, RIRS was more effective for calculi < 150 mm2; this differenced was not encountered for calculi outside the ICG. It is a safe intervention, which allows a staged use.
{"title":"Tratamento da Litíase Renal com Ureterorrenoscopia: Experiência de um centro","authors":"Luísa Cerqueira, R. J. Cerqueira, Paulo Dinis","doi":"10.24915/AUP.34.3-4.43","DOIUrl":"https://doi.org/10.24915/AUP.34.3-4.43","url":null,"abstract":"Introduction: In this study, we evaluated the initial results of this procedure in our hospital, aiming to evaluate retrograde intrarenal surgery efficacy and safety and possible success predictors of this technique. \u0000Material and Methods: After collecting data from the medical records and imaging studies of all patients undergoing retrograde intrarenal surgery in 2014 e 2015 at Centro Hospitalar de Sao Joao, and applying our exclusion criteria, we analyzed the data of 138 patients (total of 179 retrograde intrarenal surgery). The primary outcomes of our study were the immediate success rate, assessed by the surgeon’s perception intraoperatively, and postoperative success rate, assessed by image control. Residual lithiasis was considered significant in the presence of calculi > 3 mm. \u0000Results: The overall success rate was 67.0%, considering the surgeon’s perception. Considering the image control, the success rate was 66.7% for calculi smaller than 150 mm2 and located outside the ICG, but smaller in other locations or bigger calculi. In the univariate analysis, stone burden, calculi number and location were statistically significant predictors of retrograde intrarenal surgery success. \u0000Conclusion: Location in the ICG was considered a predictor of retrograde intrarenal surgery failure and, in this location, RIRS was more effective for calculi < 150 mm2; this differenced was not encountered for calculi outside the ICG. It is a safe intervention, which allows a staged use.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79166707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nuno Ramos, Celso Marialva, V. Metrogos, J. Rosa, N. Menezes
Objectives: Assess whether the neutrophil-lymphocyte ratio (RNL) can predict the risk of recurrence and progression of patients with the non–muscle-invasive bladder carcinoma (CBNMI). Material & Methods: It was performed a retrospective analysis of patients diagnosed with CBNMI after a resection of the bladder tumor (RTUV), between January 2013 and December 2014. Patients who had no white blood cell count prior to surgery and patients with synchronous tumors were excluded. It was subsequently performed a multivariate statistical analysis with SPSS 22.0® software, with the following variables: age, gender, time of recurrence or disease progression (in months), NLR, tumor size (≤ 3 or >3cm), multiple tumors, histology and tumor initial grade. Results: The sample consists of 84 patients, 79.8% were males and the average age was 69 years. In 67.9% of the patients the initial tumor histology was pTa and in 77.4% was a low-grade tumor. In 21.4% of patients the tumor was multiple and in 33.3% the tumor was larger than 3 cm. Nineteen-percent of patients had recurrence of tumor and progression was verifyed in 16.4%. Patients with RNL>3.32 presented pT1 as initial tumor histology more often (p=0.018). In a multivariate analysis, the RNL> 3.32 was found to be associated with a higher recurrence or progression of tumor (hazard ratio [HR] = 2.94; 95% CI: 1.27-6.8; p=0012.). Conclusions: In conclusion, this study states that RNL may be an useful predictor of recurrence or progression of tumor in patients with CBNMI, valuable in the clinical decision.
{"title":"Utilidade da Razão Neutrófilos/Linfócitos como Fator Preditor da Recorrência e da Progressão do Carcinoma da Bexiga Não Músculo Invasivo","authors":"Nuno Ramos, Celso Marialva, V. Metrogos, J. Rosa, N. Menezes","doi":"10.24915/AUP.34.3-4.46","DOIUrl":"https://doi.org/10.24915/AUP.34.3-4.46","url":null,"abstract":"Objectives: Assess whether the neutrophil-lymphocyte ratio (RNL) can predict the risk of recurrence and progression of patients with the non–muscle-invasive bladder carcinoma (CBNMI). \u0000Material & Methods: It was performed a retrospective analysis of patients diagnosed with CBNMI after a resection of the bladder tumor (RTUV), between January 2013 and December 2014. Patients who had no white blood cell count prior to surgery and patients with synchronous tumors were excluded. It was subsequently performed a multivariate statistical analysis with SPSS 22.0® software, with the following variables: age, gender, time of recurrence or disease progression (in months), NLR, tumor size (≤ 3 or >3cm), multiple tumors, histology and tumor initial grade. \u0000Results: The sample consists of 84 patients, 79.8% were males and the average age was 69 years. \u0000In 67.9% of the patients the initial tumor histology was pTa and in 77.4% was a low-grade tumor. In 21.4% of patients the tumor was multiple and in 33.3% the tumor was larger than 3 cm. \u0000Nineteen-percent of patients had recurrence of tumor and progression was verifyed in 16.4%. Patients with RNL>3.32 presented pT1 as initial tumor histology more often (p=0.018). In a multivariate analysis, the RNL> 3.32 was found to be associated with a higher recurrence or progression of tumor (hazard ratio [HR] = 2.94; 95% CI: 1.27-6.8; p=0012.). \u0000Conclusions: In conclusion, this study states that RNL may be an useful predictor of recurrence or progression of tumor in patients with CBNMI, valuable in the clinical decision.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77118840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Valente, H. Castro, Inês A. C. Pereira, F. Vila, P. T. Araujo, C. Vivas, Ana Silva, A. Oliveira, J. Lindoro
Objectives: To evaluate urinary stone composition in our institution, its gender and age, including variations and the evolution in the last 7 years. Material and Methods: The authors reviewed all urinary stone analysis performed since January 2009 to September 2015 in our hospital – Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal. Patients were stratified by gender, age and stone composition analyzing the evolution of stone composition in different years. The stone analysis method was infrared spectroscopy. Results: From 302 valid stone analysis reports, 55,3% were female and 44,7% were male patients. Mean patient age was 51±14 years old. A total of 7 different mineral components were identified. 51,6% (n=156) of all the stones had Calcium Oxalate, 41% (n=124) had Calcium Phosphate (33% of Apatite form), 37,7% (n=114) had Uric Acid, 22,1% (n=67) had Ammonium Urate, 9,6% (n=29) had Magnesium Ammonium Phosphate, 6,3% (n=19) had Sodium Urate, and 1,3% (n=4) had Cystine in its composition. Only 30,4% of stones had a single chemical compound. Of these 56% were pure stones of Calcium Oxalate, and 31% were pure stone of Uric Acid. The most frequent mixed stone was Calcium Oxalate + Calcium Phosphate (Apatite) followed by Uric Acid + Ammonium Urate comprehending 45% and 27% of all mixed stones respectively. Related to the ethology we divided stones into 3 groups, pure non-infection, pure infection, and mixed with component of infection, and the prevalence was 37,7%, 4,3% and 57,9% respectively. The distribution between genders was similar and the highest difference was in the Ammonium Urate compound with 28% prevalence in male and 17% in women. (p=0,379) Patients after 50 years old had more prevalence of Uric Acid component accounting for 49% of their stones.(p<0,001) . Along the 7 years of study we identified a significant reduction in the prevalence of mixed stones with component of infection, gradually decreasing from 89,6% in 2009 to 27% in 2015. Conclusions: Calcium Oxalate calculus were the most prevalent, but this difference was not as important as in other studies worldwide. This study highlights the importance of the development of National and European database to report all regional stone composition variations.
目的:评价我院泌尿系统结石组成、性别和年龄，包括近7年的变化和演变。材料和方法:作者回顾了2009年1月至2015年9月在我院(葡萄牙Penafiel Centro Hospitalar do t mega e Sousa)进行的所有尿路结石分析。按性别、年龄和结石组成对患者进行分层，分析不同年份结石组成的演变。分析方法为红外光谱法。结果:302例有效结石分析报告中，55.3%为女性，44.7%为男性。患者平均年龄51±14岁。共鉴定出7种不同的矿物成分。所有结石中有51.6% (n=156)含有草酸钙，41% (n=124)含有磷酸钙(33%的磷灰石形式)，37.7% (n=114)含有尿酸，22.1% (n=67)含有尿酸铵，9.6% (n=29)含有磷酸铵镁，6.3% (n=19)含有尿酸钠，1.3% (n=4)含有胱氨酸。只有30.4%的石头有单一的化合物。其中56%是纯草酸钙结石，31%是纯尿酸结石。最常见的混合结石是草酸钙+磷酸钙(磷灰石)，其次是尿酸+尿酸铵，分别占所有混合结石的45%和27%。结合行为学将结石分为纯非感染、纯感染和混合感染3组，患病率分别为37.7%、4.3%和57.9%。不同性别之间的分布相似，差异最大的是尿酸铵化合物，男性患病率为28%，女性为17%。(p= 0.379) 50岁以后的患者尿酸成分患病率更高，占结石的49% (p< 0.001)。在7年的研究中，我们发现混合结石与感染成分的患病率显著降低，从2009年的89.6%逐渐下降到2015年的27%。结论:草酸钙结石是最普遍的，但这种差异并不像世界范围内其他研究那样重要。这项研究强调了发展国家和欧洲数据库以报告所有区域石材成分变化的重要性。
{"title":"Urinary stone composition: Gender and age variations, and evolution in the last 7 years.","authors":"P. Valente, H. Castro, Inês A. C. Pereira, F. Vila, P. T. Araujo, C. Vivas, Ana Silva, A. Oliveira, J. Lindoro","doi":"10.24915/AUP.34.3-4.17","DOIUrl":"https://doi.org/10.24915/AUP.34.3-4.17","url":null,"abstract":"Objectives: To evaluate urinary stone composition in our institution, its gender and age, including variations and the evolution in the last 7 years. \u0000Material and Methods: The authors reviewed all urinary stone analysis performed since January 2009 to September 2015 in our hospital – Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal. Patients were stratified by gender, age and stone composition analyzing the evolution of stone composition in different years. The stone analysis method was infrared spectroscopy. \u0000Results: From 302 valid stone analysis reports, 55,3% were female and 44,7% were male patients. Mean patient age was 51±14 years old. A total of 7 different mineral components were identified. 51,6% (n=156) of all the stones had Calcium Oxalate, 41% (n=124) had Calcium Phosphate (33% of Apatite form), 37,7% (n=114) had Uric Acid, 22,1% (n=67) had Ammonium Urate, 9,6% (n=29) had Magnesium Ammonium Phosphate, 6,3% (n=19) had Sodium Urate, and 1,3% (n=4) had Cystine in its composition. Only 30,4% of stones had a single chemical compound. Of these 56% were pure stones of Calcium Oxalate, and 31% were pure stone of Uric Acid. The most frequent mixed stone was Calcium Oxalate + Calcium Phosphate (Apatite) followed by Uric Acid + Ammonium Urate comprehending 45% and 27% of all mixed stones respectively. \u0000Related to the ethology we divided stones into 3 groups, pure non-infection, pure infection, and mixed with component of infection, and the prevalence was 37,7%, 4,3% and 57,9% respectively. \u0000The distribution between genders was similar and the highest difference was in the Ammonium Urate compound with 28% prevalence in male and 17% in women. (p=0,379)\u2028Patients after 50 years old had more prevalence of Uric Acid component accounting for 49% of their stones.(p<0,001) . \u0000Along the 7 years of study we identified a significant reduction in the prevalence of mixed stones with component of infection, gradually decreasing from 89,6% in 2009 to 27% in 2015. \u0000Conclusions: Calcium Oxalate calculus were the most prevalent, but this difference was not as important as in other studies worldwide. This study highlights the importance of the development of National and European database to report all regional stone composition variations.","PeriodicalId":100020,"journal":{"name":"Acta Urológica Portuguesa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89366912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：