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1.
IEEE Trans Vis Comput Graph ; 28(2): 1428-1442, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-32746276

RESUMEN

The majority of virtual reality (VR) applications rely on audiovisual stimuli and do not exploit the addition of other sensory cues that could increase the potential of VR. This systematic review surveys the existing literature on multisensory VR and the impact of haptic, olfactory, and taste cues over audiovisual VR. The goal is to identify the extent to which multisensory stimuli affect the VR experience, which stimuli are used in multisensory VR, the type of VR setups used, and the application fields covered. An analysis of the 105 studies that met the eligibility criteria revealed that 84.8 percent of the studies show a positive impact of multisensory VR experiences. Haptics is the most commonly used stimulus in multisensory VR systems (86.6 percent). Non-immersive and immersive VR setups are preferred over semi-immersive setups. Regarding the application fields, a considerable part was adopted by health professionals and science and engineering professionals. We further conclude that smell and taste are still underexplored, and they can bring significant value to VR applications. More research is recommended on how to synthesize and deliver these stimuli, which still require complex and costly apparatus be integrated into the VR experience in a controlled and straightforward manner.


Asunto(s)
Tecnología Háptica , Realidad Virtual , Gráficos por Computador , Motivación , Interfaz Usuario-Computador
2.
IEEE Trans Vis Comput Graph ; 27(5): 2702-2713, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33750693

RESUMEN

Hands are the most important tool to interact with virtual environments, and they should be available to perform the most critical tasks. For example, a surgeon in VR should keep his/her hands on the instruments and be able to do secondary tasks without performing a disruptive event to the operative task. In this common scenario, one can observe that hands are not available for interaction. The goal of this systematic review is to survey the literature and identify which hands-free interfaces are used, the performed interaction tasks, what metrics are used for interface evaluation, and the results of such evaluations. From 79 studies that met the eligibility criteria, the voice is the most studied interface, followed by the eye and head gaze. Some novel interfaces were brain interfaces and face expressions. System control and selection represent most of the interaction tasks studied and most studies evaluate interfaces for usability. Despite the best interface depending on the task and study, the voice was found to be versatile and showed good results amongst the studies. More research is recommended to improve the practical use of the interfaces and to evaluate the interfaces more formally.


Asunto(s)
Interfaz Usuario-Computador , Realidad Virtual , Gráficos por Computador , Humanos , Análisis y Desempeño de Tareas
4.
Med. clín (Ed. impr.) ; 154(4): 113-118, feb. 2020. tab
Artículo en Español | IBECS | ID: ibc-189067

RESUMEN

ANTECEDENTES Y OBJETIVO: El tromboembolismo pulmonar es una de las causas más comunes de muerte no quirúrgica en pacientes sometidos a cirugía urológica abdominopélvica. Desde el inicio de la profilaxis para la enfermedad tromboembólica venosa los episodios de trombosis venosa profunda y tromboembolia pulmonar han descendido considerablemente. Nuestro objetivo es analizar los predictores de la enfermedad tromboembólica, la variabilidad clínica en la utilización de la profilaxis farmacológica para esta enfermedad y los resultados de su aplicación. MATERIAL Y MÉTODOS: Estudio retrospectivo multicéntrico de 610 pacientes intervenidos mediante prostatectomía radical entre diciembre de 2013 y noviembre de 2014 en 7hospitales generales de España, Italia y Portugal. Se clasificó a los pacientes según sus características basales en grupos de riesgo trombótico y grupos de riesgo hemorrágico. Se evaluaron los eventos tromboembólicos venosos que se presentaron en los diferentes grupos. RESULTADOS: La edad media fue de 65,22años (48-78). El índice de masa corporal medio fue de 26,7 y la mediana del riesgo de ASA fue 2. En todos los pacientes se inició la deambulación en las primeras 24h. En el 4,1% se utilizó compresión neumática intermitente y en el 84,6%, profilaxis farmacológica con heparinas de bajo peso molecular. Solo en el 3,4% se utilizó la combinación de profilaxis mecánica con la farmacológica. Se observó disminución de la incidencia de eventos tromboembólicos en los pacientes que recibieron profilaxis farmacológica, con una reducción absoluta del riesgo del 6,8%. No se objetivó aumento del riesgo hemorrágico en los pacientes que recibieron profilaxis tromboembólica. CONCLUSIONES: En este estudio sobre pacientes sometidos a prostatectomía radical no hubo diferencia en las complicaciones hemorrágicas derivadas del uso de profilaxis farmacológica para la enfermedad tromboembólica venosa. La profilaxis farmacológica reduce el riesgo de presentar un evento tromboembólico en pacientes sometidos a prostatectomía radical, si bien este riesgo no se asocia con la técnica de abordaje


BACKGROUND AND AIM: Pulmonary thromboembolism is one of the most common causes of non-surgical death in patients following urological abdominopelvic surgery. Since the beginning of prophylaxis for venous thromboembolic disease, episodes of deep vein thrombosis and pulmonary thromboembolism have decreased. Our objective is to analyse the prognosis factors of thromboembolic disease, the clinical variability in the use of pharmacological prophylaxis and the results of its application. MATERIAL AND METHODS: Retrospective multicentric study of 610 patients undergoing radical prostatectomy between December 2013 and November 2014, in 7general hospitals in Spain, Italy and Portugal. Patients were classified according to their baseline characteristics into thrombotic risk groups and haemorrhagic risk groups. The venous thromboembolic events that occurred in the different groups were analysed. RESULTS: The average age was 65.22years (48-78). The average body mass index was 26.7 and the average ASA risk 2.1. In all patients, early mobilization began in the first 24hours. In 4.1% intermittent pneumatic compression was used and 84.6% received pharmacological prophylaxis with low molecular weight heparins. Only 3.4% used the combination of mechanical prophylaxis with pharmacological prophylaxis. We observed a decrease in the incidence of thromboembolic events in the patients who received pharmacological prophylaxis, with an absolute risk reduction of 6.8%. There was no increase in the risk of haemorrhage in the patients who received pharmacological prophylaxis. CONCLUSIONS: In this study on patients undergoing radical prostatectomy, there was no difference in haemorrhagic complications derived from the use of pharmacological prophylaxis for venous thromboembolic disease. Pharmacological prophylaxis reduces the risk of presenting a thromboembolic event in patients undergoing radical prostatectomy, although this risk is not associated with the approach technique


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Anciano , Profilaxis Antibiótica/métodos , Tromboembolia Venosa/diagnóstico , Valor Predictivo de las Pruebas , Prostatectomía , Estudios Retrospectivos , Italia , Portugal , España , Factores de Riesgo , Grupos de Riesgo
5.
Med Clin (Barc) ; 154(4): 113-118, 2020 02 28.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31272818

RESUMEN

BACKGROUND AND AIM: Pulmonary thromboembolism is one of the most common causes of non-surgical death in patients following urological abdominopelvic surgery. Since the beginning of prophylaxis for venous thromboembolic disease, episodes of deep vein thrombosis and pulmonary thromboembolism have decreased. Our objective is to analyse the prognosis factors of thromboembolic disease, the clinical variability in the use of pharmacological prophylaxis and the results of its application. MATERIAL AND METHODS: Retrospective multicentric study of 610 patients undergoing radical prostatectomy between December 2013 and November 2014, in 7general hospitals in Spain, Italy and Portugal. Patients were classified according to their baseline characteristics into thrombotic risk groups and haemorrhagic risk groups. The venous thromboembolic events that occurred in the different groups were analysed. RESULTS: The average age was 65.22years (48-78). The average body mass index was 26.7 and the average ASA risk 2.1. In all patients, early mobilization began in the first 24hours. In 4.1% intermittent pneumatic compression was used and 84.6% received pharmacological prophylaxis with low molecular weight heparins. Only 3.4% used the combination of mechanical prophylaxis with pharmacological prophylaxis. We observed a decrease in the incidence of thromboembolic events in the patients who received pharmacological prophylaxis, with an absolute risk reduction of 6.8%. There was no increase in the risk of haemorrhage in the patients who received pharmacological prophylaxis. CONCLUSIONS: In this study on patients undergoing radical prostatectomy, there was no difference in haemorrhagic complications derived from the use of pharmacological prophylaxis for venous thromboembolic disease. Pharmacological prophylaxis reduces the risk of presenting a thromboembolic event in patients undergoing radical prostatectomy, although this risk is not associated with the approach technique.


Asunto(s)
Complicaciones Posoperatorias/prevención & control , Prostatectomía/efectos adversos , Tromboembolia Venosa/prevención & control , Anciano , Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico , Heparina de Bajo-Peso-Molecular/efectos adversos , Heparina de Bajo-Peso-Molecular/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Hemorragia Posoperatoria/inducido químicamente , Estudios Retrospectivos
6.
Int J Cancer ; 144(7): 1676-1684, 2019 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-30350309

RESUMEN

In urothelial bladder cancer (UBC), risk stratification remains an important unmet need. Limitless self-renewal, governed by TERT expression and telomerase activation, is crucial for cancer progression. Thus, telomerase activation through the interplay of mutations (TERTpMut ) and epigenetic alterations in the TERT promoter may provide further insight into UBC behavior. Here, we investigated the combined effect of TERTpMut and the TERT Hypermethylated Oncological Region (THOR) status on telomerase activation and patient outcome in a UBC international cohort (n = 237). We verified that TERTpMut were frequent (76.8%) and present in all stages and grades of UBC. Hypermethylation of THOR was associated with higher TERT expression and higher-risk disease in nonmuscle invasive bladder cancers (NMIBC). TERTpMut alone predicted disease recurrence (HR: 3.18, 95%CI 1.84 to 5.51, p < 0.0001) but not progression in NMIBC. Combined THORhigh /TERTpMut increased the risk of disease recurrence (HR 5.12, p < 0.0001) and progression (HR 3.92, p = 0.025). Increased THOR hypermethylation doubled the risk of stage progression of both TERTpwt and TERTpMut NMIBC. These results highlight that both mechanisms are common and coexist in bladder cancer and while TERTpMut is an early event in bladder carcinogenesis THOR hypermethylation is a dynamic process that contributes to disease progression. While the absence of alterations comprises an extremely indolent phenotype, the combined genetic and epigenetic alterations of TERT bring additional prognostic value in NMIBC and provide a novel insight into telomere biology in cancer.


Asunto(s)
Metilación de ADN , Mutación , Telomerasa/genética , Neoplasias de la Vejiga Urinaria/genética , Progresión de la Enfermedad , Epigénesis Genética , Femenino , Perfilación de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Pronóstico , Regiones Promotoras Genéticas , Análisis de Secuencia de ARN , Regulación hacia Arriba
7.
Herpetol Notes, v. 12, p. 591-602, jun. 2019
Artículo en Inglés | Sec. Est. Saúde SP, SESSP-IBPROD, Sec. Est. Saúde SP | ID: bud-2792

RESUMEN

Brejos de altitude are found at high altitudes, generally over 600 meters above sea level, in mountainous and plateau regions throughout the Brazilian Northeast. These relict altitudinal forests display unique biota evolutionary characteristics, due to, mainly, the geological time they have spent isolated, where they serve as islands for biological specialization, with many registered endemisms. Studies that provide basic data on herpetofauna are important to understand the structure and composition of these communities. In this context, the present study aimed to compile an inventory of the herpetofauna of five brejos de altitude in the state of Pernambuco, Brazil, and compare its snake taxocenosis with that of other Caatinga localities in Northeastern Brazil. The areas were inventoried through different time, sampling and methodologies number of people and the use or not of traps. Literature data and scientific collections were used to complement the species list. A total of 88 species were recorded in all five study areas,: 32 amphibians (two orders, 8 families and 15 genera) and 56 reptiles (2 orders, 18 families and 44 genera). Four species of lizards found in the present study are endangered, and one tortoise and snake species are data deficient (DD).

8.
Herpetol. Notes ; 12: p. 591-602, 2019.
Artículo en Inglés | Sec. Est. Saúde SP, SESSP-IBPROD, Sec. Est. Saúde SP | ID: but-ib16096

RESUMEN

Brejos de altitude are found at high altitudes, generally over 600 meters above sea level, in mountainous and plateau regions throughout the Brazilian Northeast. These relict altitudinal forests display unique biota evolutionary characteristics, due to, mainly, the geological time they have spent isolated, where they serve as islands for biological specialization, with many registered endemisms. Studies that provide basic data on herpetofauna are important to understand the structure and composition of these communities. In this context, the present study aimed to compile an inventory of the herpetofauna of five brejos de altitude in the state of Pernambuco, Brazil, and compare its snake taxocenosis with that of other Caatinga localities in Northeastern Brazil. The areas were inventoried through different time, sampling and methodologies number of people and the use or not of traps. Literature data and scientific collections were used to complement the species list. A total of 88 species were recorded in all five study areas,: 32 amphibians (two orders, 8 families and 15 genera) and 56 reptiles (2 orders, 18 families and 44 genera). Four species of lizards found in the present study are endangered, and one tortoise and snake species are data deficient (DD).

9.
Arch Ital Urol Androl ; 89(1): 34-38, 2017 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-28403593

RESUMEN

OBJECTIVE: To study whether there are factors related to secondary diagnoses (SDg) present in patients with prostate cancer that influence the development of urinary incontinence after radical prostatectomy (RP). MATERIALS AND METHODS: A retrospective multicenter observational study was performed reviewing the medical records of 430 men who underwent RP due to organ-confined prostate cancer in 9 different hospitals. Two study groups were distinguished: Group A (GA): Patients without urinary incontinence after RP; Group B (GB): patients with any degree of post-surgical urinary incontinence. RESULTS: Average age at surgery was 63.42 years (range 45-73). 258 patients were continent after surgery and 172 patients complaint of any degree of incontinence after RP. A higher percentage of healthy patients was found in group A (continent after surgery) than in group B (p = 0.001). The most common SDg prior to surgery were hypertension, lower urinary tract symptoms, dyslipidemia, diabetes mellitus and erectile dysfunction, but none did show a greater trend towards post-surgical incontinence. CONCLUSIONS: A better health status prior to surgery is associated to a lower incidence of new-onset urinary incontinence after radical prostatectomy. However, no correlation was found between the most common medical disorders and the development of post-surgical urinary incontinence.


Asunto(s)
Estado de Salud , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Incontinencia Urinaria/etiología , Anciano , Diabetes Mellitus/epidemiología , Dislipidemias/epidemiología , Disfunción Eréctil/epidemiología , Humanos , Hipertensión/epidemiología , Incidencia , Síntomas del Sistema Urinario Inferior/epidemiología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Incontinencia Urinaria/epidemiología
10.
BMJ Case Rep ; 20162016 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-27707760

RESUMEN

A 70-year-old man with a history of prostate cancer, previously submitted to surgical castration and trans-urethral resection of the prostate, was admitted to Accident and Emergency department. He had been suffering from osteoarticular and abdominal pain, and recent weight loss. An abdominal and a pelvic CT showed multiple hepatic metastases and a pelvic mass, but his prostate-specific antigen values were low (0.26 n/mL). A biopsy of a hepatic metastasis and of the pelvic mass revealed a small-cell neuroendocrine prostate cancer, a rare and aggressive androgen-independent form of prostate cancer with a poor prognosis. Our purpose was to report a clinical case of a rare and aggressive variant of a common disease. A high index of suspicion is required to make an early diagnosis and to ensure a proper therapeutic approach.


Asunto(s)
Carcinoma Neuroendocrino/secundario , Carcinoma de Células Pequeñas/secundario , Neoplasias Hepáticas/secundario , Neoplasias Pélvicas/secundario , Neoplasias de la Próstata/patología , Anciano , Biopsia , Resultado Fatal , Humanos , Neoplasias Hepáticas/diagnóstico , Masculino , Neoplasias Pélvicas/diagnóstico , Antígeno Prostático Específico/sangre , Tomografía Computarizada por Rayos X
11.
Oncotarget ; 7(36): 57726-57736, 2016 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-27437772

RESUMEN

The identification of new biomarkers to differentiate between indolent and aggressive prostate tumors is an important unmet need. We examined the role of THOR (TERT Hypermethylated Oncological Region) as a diagnostic and prognostic biomarker in prostate cancer (PCa).We analyzed THOR in common cancers using genome-wide methylation arrays. Methylation status of the whole TERT gene in benign and malignant prostate samples was determined by MeDIP-Seq. The prognostic role of THOR in PCa was assessed by pyrosequencing on discovery and validation cohorts from patients who underwent radical prostatectomy with long-term follow-up data.Most cancers (n = 3056) including PCa (n = 300) exhibited hypermethylation of THOR. THOR was the only region within the TERT gene that is differentially methylated between normal and malignant prostate tissue (p < 0.0001). Also, THOR was significantly hypermethylated in PCa when compared to paired benign tissues (n = 164, p < 0.0001). THOR hypermethylation correlated with Gleason scores and was associated with tumor invasiveness (p = 0.0147). Five years biochemical progression free survival (BPFS) for PCa patients in the discovery cohort was 87% (95% CI 73-100) and 65% (95% CI 52-78) for THOR non-hypermethylated and hypermethylated cancers respectively (p = 0.01). Similar differences in BPFS were noted in the validation cohort (p = 0.03). Importantly, THOR was able to predict outcome in the challenging (Gleason 6 and 7 (3 + 4)) PCa (p = 0.007). For this group, THOR was an independent risk factor for BPFS with a hazard-ratio of 3.685 (p = 0.0247). Finally, THOR hypermethylation more than doubled the risk of recurrence across all PSA levels (OR 2.5, p = 0.02).


Asunto(s)
Neoplasias de la Próstata/genética , Neoplasias de la Próstata/patología , Telomerasa/genética , Anciano , Biomarcadores de Tumor/metabolismo , Diferenciación Celular , Metilación de ADN , Epigénesis Genética , Estudios de Seguimiento , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/genética , Pronóstico , Modelos de Riesgos Proporcionales , Prostatectomía , Neoplasias de la Próstata/cirugía , Estudios Retrospectivos
12.
BMJ Case Rep ; 20162016 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-26969358

RESUMEN

Arterioureteral fistulas (AUFs) are abnormal communications between a major artery and the mid to distal ureter. It is a rare but potentially life-threatening condition that is seldom recognised. We present a case of a 66-year-old man who was admitted to the surgical ward owing to infection of an aortic bifemoral bypass graft. During admission, the patient developed persistent haematuria with considerable loss of haemoglobin. He was submitted to urgent surgical exploration of the graft. An ascending pyelography performed at the beginning of the surgery clearly shows a communication between the left ureter and the vascular graft. Open surgical exploration was undertaken, the fistulised section of the ureter resected and an end-to-end ureteroplasty was performed. The vascular graft was removed and the patient later submitted to left supracondylar amputation. Urinary drainage remained intact.


Asunto(s)
Hematuria/diagnóstico , Fístula Urinaria/diagnóstico , Fístula Vascular/diagnóstico , Injerto Vascular/efectos adversos , Anciano , Aorta Abdominal/cirugía , Hematuria/etiología , Hematuria/cirugía , Humanos , Masculino , Uréter , Fístula Urinaria/etiología , Fístula Urinaria/cirugía , Fístula Vascular/etiología , Fístula Vascular/cirugía
13.
BMJ Case Rep ; 20162016 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-26912768

RESUMEN

A 77-year-old man presented with acute graft dysfunction 25 years after a renal transplant in the left iliac fossa. He also had an asymptomatic left inguinal hernia. Renal ultrasound showed a significant pyelocalicial dilation of the kidney graft and the patient was submitted to a percutaneous nephrostomy. An antegrade nephrostogram was performed, which showed a dilated ureter and the bladder included in the left inguinal hernia that caused the obstructive uropathy. Concomitant retrograde cystography also showed a significant portion of the bladder in the hernia sac. The patient was submitted to inguinal hernia repair, which resolved the obstruction. We present a rare and potentially curable cause of obstructive uropathy in a transplant recipient; it is possible to revert graft dysfunction and prevent graft loss if the condition is recognised early.


Asunto(s)
Hernia Inguinal/fisiopatología , Hernia Inguinal/cirugía , Trasplante de Riñón , Riñón/fisiopatología , Anciano , Hernia Inguinal/diagnóstico , Humanos , Masculino , Resultado del Tratamiento
14.
Acta Med Port ; 27(6): 787-9, 2014.
Artículo en Portugués | MEDLINE | ID: mdl-25641297

RESUMEN

Unclassified sex cord testis tumor is an extremely rare tumor, especially in the adult. It is characterized histologically for a nonspecific combination of testis stromal and epithelial elements, with varying degree of differentiation. Treatment usually consists of radical orchiectomy followed by clinical and imaging surveillance. The available literature about this pathology relies almost exclusively on clinical cases. It's our aim to describe the case of a 37 years old man with an unclassified sex cord testis tumor, the first case described in Portugal, and to review the literature about this issue.


O tumor dos cordões sexuais nÉo classificável do testículo eÌ um tumor extremamente raro, particularmente na idade adulta. Caracteriza-se histologicamente pela conjugaçaÌo inespeciÌfica de elementos estromais e epiteliais do testículo, com grau de diferenciaçÉo variável. A sua abordagem consiste na orquidectomia radical, geralmente realizada antes do diagnóstico, e posterior vigil'ncia clínica e imagioloÌgica. A literatura disponível sobre esta patologia baseia-se quase exclusivamente na descriçÉo de casos clínicos. O nosso objetivo é apresentar o caso de um doente de 37 anos com um tumor dos cordões sexuais nÉo classificável do testículo, o primeiro descrito em Portugal, e fazer uma revisÉo da literatura sobre o tema.


Asunto(s)
Tumores de los Cordones Sexuales y Estroma de las Gónadas/patología , Neoplasias Testiculares/patología , Adulto , Humanos , Masculino
15.
BMJ Case Rep ; 20132013 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-23598939

RESUMEN

Small renal or pararenal masses and retroperitoneum lesions are extremely difficult to diagnose. Imaging technology is a precious diagnostic tool; however, it places physicians in a difficult position since many lesions are not precisely diagnosed. Clinical and radiological findings can guide suspicion towards the diagnosis; however, in our current practice most diagnoses are based on histological findings. We aim to present a pararenal sclerosing perivascular epithelioid cell tumour (PEComa), a rare entity, whose diagnosis is only possible through invasive approaches and histological analysis. This rare lesion not only is difficult to diagnose but also has an uncertain behaviour, which is of major importance concerning its follow-up and prognosis. This case report is an attempt to add more data that will help establish criteria for diagnosis and follow-up of this rare disease.


Asunto(s)
Neoplasias Renales/diagnóstico , Neoplasias Renales/cirugía , Neoplasias de Células Epitelioides Perivasculares/diagnóstico , Neoplasias de Células Epitelioides Perivasculares/cirugía , Diagnóstico Diferencial , Diagnóstico por Imagen , Femenino , Humanos , Persona de Mediana Edad
16.
Curr Urol ; 7(3): 155-9, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24917779

RESUMEN

INTRODUCTION: Neuroendocrine carcinomas of the urinary bladder are relatively rare, accounting for less than 1% of all bladder carcinomas. These tumors can be divided into the more indolent typical or atypical carcinoid tumors and the aggressive small cell and large cell neuroendocrine carcinomas. OBJECTIVE: To report 2 clinical cases of large cell neuroendocrine carcinoma of the bladder (LCCB) and to review the epidemiology, prognosis, and current treatment algorithms for patients with bladder small and large cell neuroendocrine carcinomas. RESULTS: In both cases hematuria was the presenting symptom. One patient was submitted to partial cystectomy and the other to trans-urethral resection of the bladder tumor. The former patient died on the third month postoperatively. The latter patient had extensive liver metastasis at the time of diagnosis and died from acute liver failure on the 14th postoperative day. In review LCCB is associated with a more aggressive behavior and poorer prognosis than transitional cell bladder carcinoma. No standard approach exists. Surgery (transurethral ressection, partial cystectomy, radical cystectomy), chemotherapy and radiotherapy are current treatment modalities. CONCLUSION: LCCB is an aggressive tumor which usually presents itself in an advanced stage. Neoadjuvant chemotherapy with platinum regimen plus aggressive surgical approach should be the treatment of choice.

17.
Urology ; 79(6): 1412.e5-8, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22560433

RESUMEN

OBJECTIVE: Laparoscopic ureteropyeloplasty is a widely accepted treatment option for the obstructed ureteropelvic junction (UPJ). Although it is often a straightforward surgical procedure, there may be technical difficulties in the case of concomitant stone burden, with multiple calicial, small, mobile stones. The authors describe a modification to the classic coagulum pyelolitothomy, using a mixture based on commercially available fibrin sealant, first used in the laparoscopic era. METHODS: During a laparoscopic transperitoneal dismembered ureteropyeloplasty complemented with coagulum pyelolithotomy, the following steps are suggested: (1) Exposure of the UPJ; (2) ureter clamping with a vessel loop 2 cm distal to the UPJ (to allow pelvis filling); (3) transabdominal puncture of the pelvis with an 18-G, 20-cm needle (under laparoscopic vision) and urine aspiration; (4) recording the volume of urine aspirated; (5) preparing an equal volume of fibrin sealant (to avoid overdistention of the pelvis); (6) injecting the sealer protein solution through that needle + 1 mL of methylene blue (color the coagulum and facilitate its identification in the removal procedure); (7) insertion of another needle to inject the thrombin solution; (8) wait 5 minutes to allow coagulum cast formation; (9) circumferential excision of the UPJ; (10) coagulum removal; (11) pelvis plastic reduction (if needed) and ureter spatulation; (12) double-J stent placement; and (13) tension-free anastomosis completion. RESULTS: The procedure results in the extraction of a tenacious coagulum containing more stones than normally anticipated from the x-ray studies. CONCLUSIONS: This technique modification reduces the incidence of incomplete stone removal, when there are small, free stones lying in a large renal pelvis.


Asunto(s)
Adhesivo de Tejido de Fibrina/uso terapéutico , Cálculos Renales/cirugía , Laparoscopía/métodos , Procedimientos Quirúrgicos Urológicos/métodos , Humanos , Cálculos Renales/diagnóstico por imagen , Pelvis Renal/cirugía , Radiografía
18.
Brasília méd ; 48(2): 195-200, 2011.
Artículo en Inglés | LILACS-Express | LILACS | ID: lil-603927

RESUMEN

Os parênteses são sinais de pontuação em forma de semicírculos, usados para intercalar, em um enunciado,informações à parte, em forma de apostos, como explicações, definições, ideias subsidiárias, citação bibliográfica, comentários, ressalvas, introdução de siglas e casos similares. Podem significar também o próprio conteúdo entreeles. A variante parêntesis é termo não preferencial por ser forma alatinada. São usos questionáveis o excesso de parênteses em um texto e expressar informações importantes não subsidiárias em relação ao texto. Em dependência do contexto, podem ser substituídos por vírgulas, travessões, frases autônomas. Em redação científica, importa conservaras regras específicas de uso dos parênteses e evitar usos subjetivos que possam criar obscuridades e outras formas de incompreensões.


Parenthesis are punctuation marks shaped as semicircle signals and used in an statement to insert supplementary information such as explanations, clarifications, concepts, subsidiarie ideas, bibliographic citations, comments, restrictions and to introduce abbreviations and similar cases. The alternative word parêntesis is a non-preferential noun because of its latin aspect. Using an excess number of these marks in the same text is a questionable practice, and so it is to insert between them a very important piece of information that would not be auxiliary to the main text.According to the context, the parenthesis may be substituted by comas, dashes, autonomous phrases and other items. Scientific reports demand conserving specific grammar rules of usage and it is important to avoid subjective utilizations that might cause obscurities and other sort of misunderstandings.

19.
Rev. méd. Minas Gerais ; 14(4): 257-261, out.-dez. 2004. tab
Artículo en Portugués | LILACS | ID: lil-575143

RESUMEN

Objetivo: O objetivo deste artigo é identificar a resistência das mulheres de bairro de baixa renda a submeter-se ao exame preventivo do câncer de colo uterino. Métodos: O estudo foi realizado em Itajuba (MG), bairro de baixa renda, onde as mulheres com vida sexual ativa foram convidadas a responder a um questionário e a se submeter à coleta de material para a realização da citologia exfoliativa cérvico-vaginal. Resultados: 727 mulheres responderam ao questionário e 140 quiseram se submeter ao exame preventivo de câncer do colo uterino. A renda média das famílias do bairro é de 2.73 salários mínimos. Cerca de 37% das mulheres referiram nunca ter feito o exame, 24% responderam tê-lo feito há mais de dois anos e 38% disseram tê-lo há menos de dois anos. Em 3,5% das mulheres que se submeteram ao exame foram encontradas lesões precursoras do câncer de colo uterino. Conclusões: Existe forte resistência das mulheres em bairro de baixa renda à realização do exame preventivo de câncer de colo uterino.


Aim: To evaluate the resistance to carry out the Papanicolau (PAP) test in women living in a poor suburb, Itajubá, MG. Methods: Sexually active women were invited to answer several questions and to submit to the PAP Results: 727 women answered the questions and 140 were submitted to the PAP test. The mean income of the families was 2.73 minimum wage. Regarding the PAP test, 37% of women were never submitted to it, 24% were submited to it more than 2 years ago, and 38% were submitted to it in the last 2 years. In 3,5% of the women, intraepithelial lesions were found. Conclusions: There is a strong resistance of women in poor areas to submit to the PAP test.


Asunto(s)
Humanos , Femenino , Neoplasias del Cuello Uterino/prevención & control , Negativa del Paciente al Tratamiento , Brasil , Frotis Vaginal , Factores Socioeconómicos
20.
Acta amaz ; 23(1)jan.-mar. 1993.
Artículo en Portugués | LILACS-Express | LILACS, VETINDEX | ID: biblio-1454485

RESUMEN

Polen worker corbiculae of Apis melliferawere analised during a period of two years in the municipality of Ji-Paraná(RO). It was verified that of the 126 pollen types collected, only a small part (12,0%) was intensely exploited by the africanized honey bee, namely, Cecropiasp., Orbignya martiana,Poaceae tipo, Cosmos caudatus, Cocos nucifera, Cynometrasp., Mimosa pudica, Cissussp., etc. which had their polen collected for more than ten months. The pollen collected by Apis,at the study site, is not related to climatic change but rather to the flowering period of the sources. The workers collected most pollen types, a total of 41, in February of 1988; March, November of 1989 and January of 1989 were the months when the workers collected the least number of plant species, a total of eleven types.


Foram analisados os pólen corbiculares de operárias de Apis melliferadurante o período de dois anos, no Município de Ji-Parana(RO). Constatou-se que dos 126 tipos polínicos coletados, apenas uma pequena parte (12,0%) foram intensamente explorados pelas africanizadas, destacando-se entre eles: Cecropiasp., Orbignya martiana,Poaceae tipo, Cosmos caudaíus, Cocos nucifera, Cynometrasp., Mimosa pudica, Cissussp., etc. que tiveram seus pólen coletados em mais de dez meses. Observou-se que a coleta de pólen pelas Apis,na Amazônia, não está relacionada com as mudanças climáticas e sim com a época de floração das fontes. Fevereiro de 1989 foi o mês onde as operárias mais diversificaram, coletando 41 tipos de plantas. Os meses de março, novembro de 1988 e janeiro de 1990 foram os meses que apresentaram a menor diversificação num total de onze espécies de plantas coletadas pelas operárias.

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