SUro - Serviço de Urologia
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- Acute scrotumPublication . OLIVEIRA, A.; DE CARVALHO, L.F.Acta Med Port. 1999 Jan-Mar;12(1-3):39-45. [Acute scrotum] [Article in Portuguese] Oliveira A, de Carvalho LF. Unidade de Andrologia, Hospital Geral de Santo António, Porto. Abstract Painful scrotum is a clinical entity that includes a variety of diseases, such as torsion of the spermatic cord, infectious conditions, injuries and oncology. This condition is more common in infants or youths. It is extremely important to recognize this condition and treat it promptly if the testicle is to be saved. PMID: 10423872 [PubMed - indexed for MEDLINE]
- Bladder exstrophy adenocarcinoma in an adult woman. Case reportPublication . PALACIOS, A.; VERSOS, R.; MASSÓ, P.; CAVADAS, V.; SOARES, J.; MARCELO, F.Arch Esp Urol. 2007 Mar;60(2):198-200. [Bladder exstrophy adenocarcinoma in an adult woman. Case report] [Article in Spanish] Palacios A, Versos R, Massó P, Cavadas V, Soares J, Marcelo F. Servicio de Urología, Hospital Geral de Santo Antonio, Porto, Portugal. aphmmx5@hotmail.com Abstract OBJECTIVE: To report a clinical case of bladder exstrophy adenocarcinoma. METHODS: 57-year-old female presenting with a hypogastric mass. The biopsy of the mass revealed bladder adenocarcinoma. We performed radical cystectomy. RESULTS: Pathologic study was compatible with moderately differentiated adenocarcinoma. CONCLUSIONS: After six months of follow-up patient is disease-free. PMID: 17484491 [PubMed - indexed for MEDLINE
- Calyceal migration of vascular embolization coils used to treat massive hemorrhage following percutaneous nephrolithotomy: an endoscopic finding during repeat percutaneous nephrolithotomyPublication . Nunes-Carneiro, Diogo; Xambre, Luís; Cavadas, Vítor
- Clinical, multicentric, and open study to evaluate the efficacy of and tolerance to sildenafil in patients with erectile dysfunctionPublication . PALHA, A.P.; GOMES, F.A.; MARTINS, A.S.; PIMENTA, A.; NEVES, J.; GONCALVES, R.; RAMOS, L.; ABRANTES, P.; CANHAO, A.; SANTOS, G.; CARVALHO, L.F.; SOARES, J.; LIMA, E.; ROSA, G.Acta Med Port. 2002 Jul-Aug;15(4):249-56. [Clinical, multicentric, and open study to evaluate the efficacy of and tolerance to sildenafil in patients with erectile dysfunction] [Article in Portuguese] Palha AP, Gomes FA, Martins AS, Pimenta A, Neves J, Gonçalves R, Ramos L, Abrantes P, Canhão A, Santos G, Carvalho LF, Soares J, Lima E, Rosa G. Serviço de Psiquiatria e Urologia do Hospital de S. João, Instututo de Ciências Bimédicas, Hospital Geral de S. António, Porto. Abstract Erectile dysfunction (ED), defined by the Impotence-NIH Consensus Conference as the "persistent inability to achieve and/or maintain erection sufficient for satisfactory sexual activity" affect more than 100 million men worldwide, at particular severity levels. The global prevalence of ED is estimated to affect about 10%, but has been found to increase significantly with age (39% in men 40 years of age and 67% at 70 years of age). In men aged 40 to 70 years, the severe ED prevalence increased of three folds, 5 to 15%. In order to evaluate the efficacy and tolerance of sildenafil, it was conducted a national open, multicentre study on a portuguese population affected by ED. Subjects under ambulatory treatment were recruited in Psychiatry/Sexology Clinical units and Urology/Andrology. The results of the study carried out on a group of 62 men with ED, demonstrate that sildenafil was effective in the recovering of erectile function, increasing the number of attempts to sexual activity and improving their success rates (mainly in severe dysfunction). Fifty one patients treated with sildenafil, at the end of the study referred a global improvement in their erections (92.2%). Doses of 50 mg and 100 mg sildenafil were used and were well tolerated and also effective in the treatment of this pathology (70% and 69% respectively). Being this study a flexible dose one and taking into consideration that the final dose used was found the more suitable to the patients, can be concluded that 43.1% of the patients elected dose of 50 mg whereas 56.9% elected the maximum prescribed dose of 100 mg. Over and above global efficacy experimented by patients, a significant improvement in the sexual activity with partners was occurred. These results make possible a final conclusion--in the studied patients group affected by Erectile Dysfunction, aside from associated somatic pathology, sildenafil use provided a remarkable clinical profit, in what concerns global efficacy, by erectile function mechanisms improvement, concerning patients sensitivity of improvement, occurring in the major part of them, being these of high importance to the lifting up of their self-esteem. PMID: 12525018 [PubMed - indexed for MEDLINE
- Corpus cavernosum from men with vasculogenic impotence is partially resistant to adenosine relaxation due to endothelial A(2B) receptor dysfunctionPublication . Faria, M.; Cardoso, T.; Lafuente-de-Carvalho, J.; Sá, P.ABSTRACT Although adenosine has been implicated in penile erection in human males, the receptor subtype responsible for adenosine regulation of human corpus cavernosum (HCC) smooth muscle tone is still a matter of debate. Using selective adenosine agonists and antagonists, we aimed at characterizing the adenosine receptors mediating relaxation of precontracted (with 1 M phenylephrine) HCC strips. HCC specimens were collected from control subjects (organ donors) and from patients with severe vasculogenic erectile dysfunction (ED). In control subjects, adenosine and 5 -N-ethyl-carboxamide adenosine (NECA) fully relaxed HCC. The selective A2A receptor agonist 2-[4-(2-p-carboxy ethyl)phenylamino]-5 -N-ethylcarboxamido adenosine (CGS21680C) produced only a partial relaxation (30–50%) of HCC, which could be further enhanced by simultaneous application of 100 M NECA. The selective A2B receptor antagonist N-(4-acetylphenyl)-2-[4-(2,3,6,7-tetrahydro- 2,6-dioxo-1,3-dipropyl-1H-purin-8-il)phenoxy] acetamida (MRS1706) (10 nM) attenuated NECA-induced relaxation without affecting CGS21680C action. The A2A receptor antagonist 4-{2-[7-amino-2-(2-furyl)[1,2,4]triazolo-[2,3-a][1,3,5]triazin-5- ylamino]ethyl}phenol (ZM241385) (50 nM) consistently reduced the actions of both agonists. In contrast to CGS21680C, NECAinduced relaxation was attenuated when endothelial production of NO and prostanoids was reduced by 100 M NG-nitro-Larginine and 10 M indomethacin, respectively. HCC strips from patients with vasculogenic ED were partially resistant to NECA but kept relaxation to CGS21680C; the remaining effect was sensitive to blockade of A2A receptors with 50 nM ZM241385. Data suggest that adenosine regulates HCC smooth muscle tone through the activation of two receptor populations, CGS21680C-sensitive (A2A) and -insensitive (A2B) receptors, located on smooth muscle fibers and on endothelial cells, respectively. Endothelial dysfunction may be correlated with a loss of adenosine A2B receptor activity in penile vessels from men with vasculogenic ED.
- eHealth and mHealth in prostate cancer detection and active surveillancePublication . Pereira-Azevedo, Nuno; Venderbos, L.eHealth and mobile health (mHealth) offer patients, healthcare providers, researchers, and policy makers new potential to improve wellness, practice prevention and reduce suffering from diseases. While the eHealth market is growing to an expected US $26 billion, its potential in the field of Urology is still underused. Research has shown that currently only 176 apps (of the 300,000 medical apps available) were found in the Apple App Store and Google Play Store, of which 20 were prostate cancer related. Three good examples of eHealth/mHealth applications are the Rotterdam Prostate Cancer Risk Calculator (RPCRC) website and app, the Prostate cancer Research International Active Surveillance (PRIAS) website and the Follow MyPSA app for men on active surveillance for prostate cancer: they are tools with a clear vision that offer true added value in daily clinical practice and which positively influence healthcare beyond borders. To increase the uptake of eHealth applications in the coming years, it is important to involve professionals in their design and development, and to guarantee the safety and privacy of its users and their data.
- Emergency ureteroscopic management of ureteral stones: why not?Publication . OSORIO, L.; LIMA, E.; SOARES, J.; AUTORINO, R.; VERSOS, R.; LHAMAS, A.; MARCELO, F.Urology. 2007 Jan;69(1):27-31; discussion 31-3. Emergency ureteroscopic management of ureteral stones: why not? Osorio L, Lima E, Soares J, Autorino R, Versos R, Lhamas A, Marcelo F. Department of Urology, Santo Antonio General Hospital, Oporto, Portugal. luis_osorio@netcabo.pt Abstract OBJECTIVES: To describe a single-center experience in the emergency ureteroscopic management of ureteral stones. METHODS: We retrospectively considered the data from 144 patients (mean age 49.6 years, range 23 to 82) who had had obstructive ureteral stones and had undergone emergency ureteroscopy with stone retrieval. Intracorporeal pneumatic lithotripsy was performed when necessary. At the end of the procedure, a ureteral catheter was systematically left in place in 100 patients (69.4%) and removed within 24 hours. In the remaining 44 patients, a double-J stent was preferred and was removed within 30 days, depending on the clinical course. Stone-free status was defined as the complete absence of fragments at 1 month of follow-up. RESULTS: The calculi were more frequently localized in the distal ureter than in the proximal one (90.3% versus 9.7%, respectively). The overall mean stone diameter was 9.1 mm (range 5 to 20). The overall stone-free rate was 92.4%. A greater stone-free rate was obtained in those with stones less than 10 mm (95.8%) than in those with stones larger than 10 mm (89%, P = 0.002). Similarly, a significantly better outcome occurred for those with stones located in the distal ureter (94.6%) than for those with stones in the proximal one (71.4%, P = 0.004). The overall complication rate was 4.2%. The mean hospital stay was 2.5 days (range 1 to 7). CONCLUSIONS: In our experience, emergency ureteroscopy in cases of obstructive ureteral stones proved to be safe and effective. It has the main advantage of offering both immediate relief from pain and stone fragmentation. Additional extensive studies are warranted to corroborate these findings. PMID: 17270606 [PubMed - indexed for MEDLINE
- Epigenome-wide DNA methylation profiling of periprostatic adipose tissue in prostate cancer patients with excess adiposity-a pilot studyPublication . Cheng, Y.; Monteiro, C.; Matos, A.; You, J.; Fraga, A.; Pereira, C.; Catalán, V.; Rodríguez, A.; Gómez-Ambrosi, J.; Frühbeck, G.; Ribeiro, R.; Hu, P.Background: Periprostatic adipose tissue (PPAT) has been recognized to associate with prostate cancer (PCa) aggressiveness and progression. Here, we sought to investigate whether excess adiposity modulates the methylome of PPAT in PCa patients. DNA methylation profiling was performed in PPAT from obese/overweight (OB/OW, BMI > 25 kg m-2) and normal weight (NW, BMI < 25 kg m-2) PCa patients. Significant differences in methylated CpGs between OB/OW and NW groups were inferred by statistical modeling. Results: Five thousand five hundred twenty-six differentially methylated CpGs were identified between OB/OW and NW PCa patients with 90.2% hypermethylated. Four hundred eighty-three of these CpGs were found to be located at both promoters and CpG islands, whereas the representing 412 genes were found to be involved in pluripotency of stem cells, fatty acid metabolism, and many other biological processes; 14 of these genes, particularly FADS1, MOGAT1, and PCYT2, with promoter hypermethylation presented with significantly decreased gene expression in matched samples. Additionally, 38 genes were correlated with antigen processing and presentation of endogenous antigen via MHC class I, which might result in fatty acid accumulation in PPAT and tumor immune evasion. Conclusions: Results showed that the whole epigenome methylation profiles of PPAT were significantly different in OB/OW compared to normal weight PCa patients. The epigenetic variation associated with excess adiposity likely resulted in altered lipid metabolism and immune dysregulation, contributing towards unfavorable PCa microenvironment, thus warranting further validation studies in larger samples.
- Evaluation of Patterns of Presentation, Practice, and Outcomes of Upper Tract Urothelial Cancer: Protocol for an Observational, International, Multicenter, Cohort Study by the Clinical Research Office of the Endourology SocietyPublication . Baard, Joyce; Celebi, Merve; de la Rosette, Jean; Alcaraz, Antonio; Shariat, Shahrokh; Cormio, Luigi; Cavadas, Vítor; Laguna, M PilarBackground: Available guidelines on the management of upper tract urothelial carcinoma (UTUC) are restricted due to the lack of strong evidence-based recommendations. Adequate, well-powered randomized trials are missing due to the rarity of the disease. To overcome this problem, we need alternative study designs to provide generalizable data. Objective: The primary aim of this registry is to provide a real-world overview on patterns of presentation and management of UTUC. Secondary objectives include comparison of outcomes of different treatments and tumor stages and evaluation of compliance with the current European Association of Urology recommendations for UTUC. Methods: For this observational, international, multicenter, cohort study, clinical data of consecutive patients suspected of having UTUC, irrespective of type of management, will be prospectively collected up to 5 years after inclusion. Data on the patterns of presentation, diagnostics, and treatment as well as short-, mid-, and long-term oncological and functional outcomes will be analyzed. Possible associations between variables, basal characteristics, and outcomes will be tested by multivariable analyses. The methodology will address potential sources of bias and confounders. Results: The registry was initiated in November 2014 after obtaining institutional review board approval. Data collection started in December 2014. At the time of submission of this manuscript, 2451 patients from 125 centers from 37 countries were included. Inclusion of patients will be closed 5 years after initiation of the registry. Quality checks will be performed centrally with continuous communication and feedback with the centers to ensure accuracy. The first results are expected in the first trimester of 2020. Conclusions: This large observational prospective cohort will generate landmark "real-world" data and hypotheses for further studies. We expect these data to optimize the management of UTUC, provide insights on harms and benefits of treatment, and serve as quality control.
- Genetic polymorphisms in key hypoxia-regulated downstream molecules and phenotypic correlation in prostate cancerPublication . Fraga, A.; Ribeiro, R.; Coelho, A.; Vizcaíno, J.; Coutinho, H.; Lopes, J.; Príncipe, P.; Lobato, C.; Lopes, C.; Medeiros, R.Background In this study we sought if, in their quest to handle hypoxia, prostate tumors express target hypoxia-associated molecules and their correlation with putative functional genetic polymorphisms. Methods Representative areas of prostate carcinoma (n = 51) and of nodular prostate hyperplasia (n = 20) were analysed for hypoxia-inducible factor 1 alpha (HIF-1α), carbonic anhydrase IX (CAIX), lysyl oxidase (LOX) and vascular endothelial growth factor (VEGFR2) immunohistochemistry expression using a tissue microarray. DNA was isolated from peripheral blood and used to genotype functional polymorphisms at the corresponding genes (HIF1A +1772 C > T, rs11549465; CA9 + 201 A > G; rs2071676; LOX +473 G > A, rs1800449; KDR – 604 T > C, rs2071559). Results Immunohistochemistry analyses disclosed predominance of positive CAIX and VEGFR2 expression in epithelial cells of prostate carcinomas compared to nodular prostate hyperplasia (P = 0.043 and P = 0.035, respectively). In addition, the VEGFR2 expression score in prostate epithelial cells was higher in organ-confined and extra prostatic carcinoma compared to nodular prostate hyperplasia (P = 0.031 and P = 0.004, respectively). Notably, for LOX protein the immunoreactivity score was significantly higher in organ-confined carcinomas compared to nodular prostate hyperplasia (P = 0.015). The genotype-phenotype analyses showed higher LOX staining intensity for carriers of the homozygous LOX +473 G-allele (P = 0.011). Still, carriers of the KDR−604 T-allele were more prone to have higher VEGFR2 expression in prostate epithelial cells (P < 0.006). Conclusions Protein expression of hypoxia markers (VEGFR2, CAIX and LOX) on prostate epithelial cells was different between malignant and benign prostate disease. Two genetic polymorphisms (LOX +473 G > A and KDR−604 T > C) were correlated with protein level, accounting for a potential gene-environment effect in the activation of hypoxia-driven pathways in prostate carcinoma. Further research in larger series is warranted to validate present findings.