Open testicular mapping: A less invasive multiple biopsy approach for testicular sperm extraction.

This study proposes a testicular sperm extraction technique that was inspired by testicular fine-needle aspiration. Here, we have described the technique of open testicular mapping (OTEM) and evaluated the successful sperm recovery in 92 patients with nonobstructive azoospermia (NOA). All patients underwent an OTEM biopsy. Patients were divided into two groups; group I included men with spermatozoa recovered and group 0 included men without spermatozoa recovered. Age, follicle-stimulating hormone (FSH) level and testicular volume were compared between the groups. In 50 of 92 men (54%), viable spermatozoa were found after OTEM. No differences were noted in age, FSH level or testicular volume. Using OTEM, it was possible to retrieve spermatozoa in 54% of the NOA men.

Is time since vasectomy more important as prognostic factor for pregnancy and live birth than female and laboratory variables when treating vasectomised man using ICSI?

Fatherhood after vasectomy can be done by vasectomy reversal or intracytoplasmic sperm injection (ICSI). Time since vasectomy is the best predictive factor for patency and live birth after a vasectomy reversal but has uncertain importance after ICSI with sperm retrieval. The present study examines the influence of male, female and laboratory variables on pregnancy and live birth. The study is based on 450 ICSI cycles from 332 patients performed on three infertility centres between 1994 and 2012. Interval time since vasectomy was divided in four groups GI-less than 3 years (n = 02); GII-3 to 8 years (n = 74); GIII-9 to 14 years (n = 161) and GIV-15 or more years (n = 213). The variables were tested for pregnancy rate and live birth for first and repeated cycles. Pregnancy and live birth rate were not statistically different among the study interval time groups for first or repeated cycles. Female and laboratory variables were statistically different for couples with pregnancy and live birth for the first cycles. The study suggests that variables coming from female and laboratory were more important than time since vasectomy when treating man with vasectomy using ICSI with sperm retrieval.

Tadalafil protector effect during ischemia-reperfusion in rats.

PURPOSE: To evaluate histological parameters in rat renal tissue after tadalafil use during hot ischemia for 45 minutes and reperfusion for 24 hours. METHODS: Twenty rats were divided into 2 groups. In the experimental group 10 mg/kg of tadalafil was used per gavage before the procedure. All cases underwent left partial nephrectomy, followed by 45 minutes of warm ischemia. Left nephrectomy of the remaining kidney was performed after 24 hours from the initial procedure. The histological parameters analyzed were: detachment of tubular cells, accumulation of desquamated cells in the proximal tubule, loss of brush border, tubular cylinders, interstitial edema, leukocyte infiltration, capillary congestion, vacuolization, tubular dilatation, necrosis and collapse of the capillary tuft. RESULTS: Two rats from each group died and were excluded from the study. Tadalafil significantly reduced leukocyte infiltration (p = 0.036). The remaining histological parameters did not show statistical difference between the groups. CONCLUSION: The use of tadalafil during warm ischemia and reperfusion demonstrates statistically significant reduction of leukocyte infiltration in the renal interstitium.

Tadalafil protector effect during ischemia-reperfusion in rats

Abstract Purpose: To evaluate histological parameters in rat renal tissue after tadalafil use during hot ischemia for 45 minutes and reperfusion for 24 hours. Methods: Twenty rats were divided into 2 groups. In the experimental group 10 mg/kg of tadalafil was used per gavage before the procedure. All cases underwent left partial nephrectomy, followed by 45 minutes of warm ischemia. Left nephrectomy of the remaining kidney was performed after 24 hours from the initial procedure. The histological parameters analyzed were: detachment of tubular cells, accumulation of desquamated cells in the proximal tubule, loss of brush border, tubular cylinders, interstitial edema, leukocyte infiltration, capillary congestion, vacuolization, tubular dilatation, necrosis and collapse of the capillary tuft. Results: Two rats from each group died and were excluded from the study. Tadalafil significantly reduced leukocyte infiltration (p = 0.036). The remaining histological parameters did not show statistical difference between the groups. Conclusion: The use of tadalafil during warm ischemia and reperfusion demonstrates statistically significant reduction of leukocyte infiltration in the renal interstitium.

Analysis of economic impact between the modality of renal replacement therapy / Análise do impacto econômico entre as modalidades de terapia renal substitutiva

Abstract Introduction: Chronic kidney disease (CKD) is a major health problem, determining the reduction in life expectancy and an increased risk of cardiovascular disease. Method: An observational, cohort, retrospective, based on patient's medical records data with CKD under hemodialysis, peritoneal dialysis and kidney transplantation in the city of Curitiba, in the period from January to June 2014, evacuativo the financial impact on the Unified Health System (SUS) and the supplementary health. Results: The lowest cost of a kidney transplant in the first year was R$ 40,743.03 when cyclosporine was used and the highest was R$ 48,388.17 with the use of tacrolimus. In the second year post-transplant, hemodialysis and peritoneal dialysis have a higher cost compared to kidney transplant. Transplantation with deceased donor, treated with tacrolimus: R$ 67,023.39; Hemodialysis R$ 71,717.51 and automated peritoneal dialysis automatic R$ 69,527.03. Conclusions: After the first two years of renal replacement therapy, transplantation demonstrates lower costs to the system when compared to other modalities evaluated. Based on that, this therapy justifies improvements in government policies in this sector.

Resumo Introdução: A doença renal crônica (DRC) é um grande problema de saúde, determina redução na expectativa de vida e aumento dos riscos de doenças cardiovasculares. Método: Estudo observacional, de coorte, retrospectivo, baseado em dados de prontuários de pacientes com DRC em hemodiálise, diálise peritoneal e transplante renal na cidade de Curitiba, no período de janeiro a junho de 2014, avaliando o impacto financeiro no Sistema Único de Saúde (SUS) e na saúde suplementar. Resultados: O menor custo de um transplante renal no primeiro ano foi de R$ 40.743,03, quando utilizada a ciclosporina, e o maior de R$ 48.388,17, com a utilização do tacrolimo. Já no segundo ano pós-transplante, a hemodiálise e a diálise peritoneal têm valor superior ao transplante renal. Transplante com doador falecido, com tacrolimo: R$ 67.023,39; hemodiálise R$ 71.717,51 e diálise peritoneal automática R$ 69.527,03. Conclusões: Após os dois primeiros anos da terapia renal substitutiva, o transplante demonstra menores custos ao sistema, quando comparado às outras modalidades avaliadas. Baseado nisso, esta terapia justifica melhorias nas políticas governamentais nesse setor.

Analysis of economic impact between the modality of renal replacement therapy.

INTRODUCTION: Chronic kidney disease (CKD) is a major health problem, determining the reduction in life expectancy and an increased risk of cardiovascular disease. METHOD: An observational, cohort, retrospective, based on patient's medical records data with CKD under hemodialysis, peritoneal dialysis and kidney transplantation in the city of Curitiba, in the period from January to June 2014, evacuativo the financial impact on the Unified Health System (SUS) and the supplementary health. RESULTS: The lowest cost of a kidney transplant in the first year was R$ 40,743.03 when cyclosporine was used and the highest was R$ 48,388.17 with the use of tacrolimus. In the second year post-transplant, hemodialysis and peritoneal dialysis have a higher cost compared to kidney transplant. Transplantation with deceased donor, treated with tacrolimus: R$ 67,023.39; Hemodialysis R$ 71,717.51 and automated peritoneal dialysis automatic R$ 69,527.03. CONCLUSIONS: After the first two years of renal replacement therapy, transplantation demonstrates lower costs to the system when compared to other modalities evaluated. Based on that, this therapy justifies improvements in government policies in this sector.