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1.
Int. braz. j. urol ; 45(3): 605-614, May-June 2019. tab
Artigo em Inglês | LILACS-Express | ID: biblio-1012315

RESUMO

ABSTRACT Objective: To cross-culturally adapt and check for the reliability and validity of the neurogenic bladder symptom score questionnaire to Brazilian Portuguese, in patients with spinal cord injury and multiple sclerosis. Materials and Methods: The questionnaire was culturally adapted according to international guidelines. The Brazilian version was applied in patients diagnosed with neurogenic bladder due to spinal cord injury or multiple sclerosis, twice in a range of 7 to 14 days. Psychometric properties were tested such as content validity, construct validity, internal consistency, and test-retest reliability. Results: Sixty-eight patients participated in the study. Good internal consistency of the Portuguese version was observed, with Cronbach α of 0.81. The test-retest reliability was also high, with an Intraclass Correlation Coefficient of 0.86 [0.76 - 0.92] (p<0.0001). In the construct validity, the Pearson Correlation revealed a moderate correlation between the Portuguese version of the NBSS and the Qualiveen-SF questionnaire (r = 0.66 [0.40-0.82]; p <0.0001). Conclusions: The process of cross-cultural adaptation and validation of the NBSS questionnaire for the Brazilian Portuguese in patients with neurogenic lower urinary tract dysfunction was concluded.

2.
Rev. Assoc. Med. Bras. (1992) ; 63(8): 681-684, Aug. 2017. graf
Artigo em Inglês | LILACS-Express | ID: biblio-896387

RESUMO

Summary Objective: To investigate the positive association between the presence of simple renal cysts (SRCs) and abdominal aortic aneurysm (AAA). Method: In a retrospective case-control study including subjects aged > 50 years, we evaluated the incidence of SRCs on computed tomography (CT) scan. We compared 91 consecutive patients with AAA referred from the Division of Vascular Surgery and 396 patients without AAA, randomly selected after being matched by age and gender from 3,186 consecutive patients who underwent abdominal CT. SRC was defined as a round or oval low-attenuation lesion with a thin wall and size > 4 mm on CT without obvious evidence of radiographic enhancement or septations. Patients were considered as having AAA if the size of aorta was greater than 3.0 cm. Results: Patients with AAA and without AAA were similar in terms of age (67.9± 8.41 vs. 68.5±9.13 years) (p=0.889) and gender (71.4 vs. 71.2% of male subjects, respectively) (p=0.999). There was no difference in the prevalence of SRC between case and controls. Among individuals with AAA, 38 (41.8%; [95CI 32.5-52.6]) had renal cysts compared to 148 (37.4%; [95CI 32.7-42.2]) in the control group (p=0.473), with a prevalence ratio (PR) of 1.16 (95CI 0.80-1.68). Conclusion: We found no significant differences in the prevalence of SRCs among patients with AAA and controls. Our findings suggest that the presence of SRCs is not a risk factor or a marker for AAA.


Resumo Objetivo: Avaliar uma possível associação entre presença de cistos renais simples (CRS) e aneurisma aórtico abdominal (AAA). Método: Em um estudo de caso versus controle com sujeitos com idade > 50 anos, avaliamos a prevalência de CRS detectados por tomografia computadorizada (TC). Comparamos os achados de 91 pacientes consecutivos com AAA oriundos da Divisão de Cirurgia Vascular com 396 pacientes sem AAA, randomicamente selecionados e ajustados por idade e gênero dentre 3.186 pacientes consecutivos que se submeteram a TC abdominal. Cisto simples foi definido como lesão hipodensa oval ou arredondada com paredes finas, maiores do que 4 mm em TC sem realce contrastual ou septação. Pacientes foram considerados com AAA quando o diâmetro da aorta era maior que 3,0 cm. Resultados: Pacientes com AAA e sem AAA eram semelhantes quanto a idade (67,9±8,41 vs. 68,5±9,13 anos) (p=0,889) e gênero (71,4 vs. 71,2% dos indivíduos masculinos, respectivamente) (p=0,999). Não havia diferença de prevalência de CRS entre casos e controles. Dentre indivíduos com AAA, 38 (41,8%; [IC95% 32,5-52,6]) tinham cistos renais, comparados com 148 (37,4%; [IC95% 32,7-42,2]) no grupo controle (p=0,473), com uma razão de prevalência (RP) de 1,16 (IC95% 0,80-1,68). Conclusão: Não observamos diferenças significativas na prevalência de CRS entre pacientes com AAA e controles. Nossos resultados sugerem que presença de CRS não é fator de risco ou preditor para AAA.

3.
Rev. Assoc. Med. Bras. (1992) ; 63(8): 693-696, Aug. 2017. graf
Artigo em Inglês | LILACS-Express | ID: biblio-896392

RESUMO

Summary Introduction: Cryptorchidism is a common and prevalent condition in patients with Down syndrome. Environmental factors, such as smoking, can be associated with malformations during fetal development. The study of the prevalence of cryptorchidism and its association with parental tobacco use in Down syndrome can contribute to alert health care professionals, patients and family members regarding the prevention of the harms caused by cryptorchidism and its possible predisposing factors. Objective: To evaluate the prevalence of cryptorchidism in Down syndrome and its association with maternal and paternal smoking. Method: Forty (40) patients of a public clinic specialized in Down syndrome were evaluated, using a semi-structured questionnaire for evaluation of antecedents and sociodemographic characteristics, as well as physical and complementary examinations. Results: Cryptorchidism was observed in 27.5% of the patients (95CI 15.98-42.96). Of these, 55% (5/9) were the children of mothers who smoked during pregnancy, and 19.35% (6/31) were the children of mothers who did not smoke during pregnancy (OR = 5.26 [95CI 1.06-25.41]; p=0.032). Similarly, paternal smoking was also observed in greater frequency among the parents of cryptorchid patients compared with subjects with descended testis, 63.36% (7/11) and 31.03% (9/29), respectively (OR = 3.89 [95CI 0.91-16.73]; p=0.060). Conclusion: The prevalence of cryptorchidism is high in patients with Down syndrome. We can show a strong association between smoking parents and the occurrence of cryptorchidism, especially when it comes to maternal smoking.


Resumo Introdução: A criptorquidia é uma condição comum e prevalente em pacientes com síndrome de Down. Fatores ambientais, como o tabagismo, estão associados a malformações fetais. A avaliação da prevalência do criptorquidismo e a associação com tabagismo dos pais na síndrome de Down podem contribuir para alertar os profissionais de saúde e familiares sobre a prevenção dos danos causados pelo criptorquidismo e os possíveis fatores predisponentes. Objetivo: Avaliar a prevalência de criptorquidismo na síndrome de Down e a associação com tabagismo materno e paterno. Método: Quarenta (40) pacientes acompanhados em um centro de referência para atendimento da síndrome de Down foram avaliados por meio de questionário semiestruturado para avaliação de antecedentes parentais e características sociodemográficas, bem como de exames físico e laboratoriais complementares. Resultados: Criptorquidia foi observada em 27,5% dos pacientes (IC95% 15,98-42,96). Nesses pacientes, o criptorquidismo foi encontrado em 55% (5/9) das crianças cujas mães fumavam e em 19,35% (6/31) daquelas cujas mães não fumavam (OR = 5,26 [IC95% 1,06-25,41]; p=0,032). Do mesmo modo, o tabagismo paterno foi observado com maior frequência entre crianças com criptorquidia, 63,36% (7/11) e 31,03% (9/29), respectivamente (OR = 3,89 [IC95% 0,91-16,73]; p=0,060). Conclusão: A prevalência de criptorquidismo é alta em pacientes com síndrome de Down. Podemos mostrar uma forte associação entre hábito tabágico dos pais e ocorrência de criptorquidismo, especialmente no caso de tabagismo materno.

4.
Neuroepidemiology ; 44(2): 85-90, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25765118

RESUMO

BACKGROUND: Epidemiological features of spinal cord injury (SCI) have been changing over the last decades. We evaluated the contemporary trends in the epidemiology of traumatic SCI patients from a rehabilitation center. METHODS: In a cross-sectional study, a consecutive series of 348 patients with traumatic SCI were evaluated. Variables were collected through an epidemiological form, which included gender, age at injury, duration and cause of SCI. We investigated SCI epidemiological trends over time including the association between gender and age at injury with SCI features such as etiology, injury severity and level. RESULTS: The mean age at SCI has increased from 26.0 ± 11.8 in patients with SCI before 2003 to 37.9 ± 15.7 in those with SCI after 2009 (p < 0.001). Gunshot wounds were the main cause of injury in patients with SCI before 2003, dropping from 40.6 to 16.9% after 2009 and being surpassed by road traffic injuries (38.6%) and falls (31.4%) after 2009 (p < 0.001). Gender, SCI severity and level have not changed significantly over the time. CONCLUSIONS: There was a major increase in the average age of patients as well as changes in the etiology of SCI over the past fifteen years, including a significant decrease in gunshot wounds and an increase in the frequency of road traffic injuries and falls. These changes and accompanying risk factors must be taken into consideration when planning measures to prevent SCI.


Assuntos
Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/etiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
5.
Clinics (Sao Paulo) ; 69(12): 817-22, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25627993

RESUMO

OBJECTIVES: To evaluate predictors of the response to doxazosin, a selective alpha-adrenoceptor antagonist, when used for the treatment of lower urinary tract symptoms in men with Parkinson's disease. METHODS: In a prospective study, 33 consecutive men (mean age 59.2 ± 7.0 years) with Parkinson's disease and lower urinary tract symptoms were evaluated. Neurological dysfunction was assessed with the Unified Parkinson's Disease Rating Scale. Urological assessment was performed at baseline and after 12 weeks of treatment with 4 mg/day of extended-release doxazosin, including symptom evaluation with the International Continence Society male short-form questionnaire, an assessment of the impact of lower urinary tract symptoms on quality of life and urodynamics. Clinical and urodynamic predictors of response were specifically evaluated. RESULTS: Compared with the score at baseline, the total International Continence Society male short-form score was reduced after doxazosin administration, from 17.4 ± 7.5 to 11.1 ± 6.9 (p<0.001). The impact of lower urinary tract symptoms on quality of life was also significantly reduced, from 1.8 ± 1.1 to 1.0 ± 1.0 (p<0.001) and the maximum urinary flow varied from 9.3 ± 4.4 to 11.2 ± 4.6 ml/s (p=0.025). The severity of neurological impairment was the only predictor of the clinical response. Additionally, patients with a Unified Parkinson's Disease Rating Scale score lower than 70 had a significantly higher chance of clinical improvement with doxazosin treatment than those with higher Unified Parkinson's Disease Rating Scale scores did (RR=3.10, 95% CI=[1.15 to 5.37], p=0.011). CONCLUSIONS: Doxazosin resulted in the improvement of lower urinary tract symptoms and the maximum flow rate and was well tolerated in men with Parkinson's disease. The response to treatment is dependent on the severity of neurological disability.


Assuntos
Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Doxazossina/uso terapêutico , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Sintomas do Trato Urinário Inferior/fisiopatologia , Doença de Parkinson/fisiopatologia , Adulto , Idoso , Antiparkinsonianos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/tratamento farmacológico , Estudos Prospectivos , Qualidade de Vida , Curva ROC , Índice de Gravidade de Doença , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Urodinâmica/fisiologia
6.
Clinics ; 69(12): 817-822, 2014. tab
Artigo em Inglês | LILACS | ID: lil-732385

RESUMO

OBJECTIVES: To evaluate predictors of the response to doxazosin, a selective alpha-adrenoceptor antagonist, when used for the treatment of lower urinary tract symptoms in men with Parkinson's disease. METHODS: In a prospective study, 33 consecutive men (mean age 59.2±7.0 years) with Parkinson's disease and lower urinary tract symptoms were evaluated. Neurological dysfunction was assessed with the Unified Parkinson's Disease Rating Scale. Urological assessment was performed at baseline and after 12 weeks of treatment with 4 mg/day of extended-release doxazosin, including symptom evaluation with the International Continence Society male short-form questionnaire, an assessment of the impact of lower urinary tract symptoms on quality of life and urodynamics. Clinical and urodynamic predictors of response were specifically evaluated. RESULTS: Compared with the score at baseline, the total International Continence Society male short-form score was reduced after doxazosin administration, from 17.4±7.5 to 11.1±6.9 (p<0.001). The impact of lower urinary tract symptoms on quality of life was also significantly reduced, from 1.8±1.1 to 1.0±1.0 (p<0.001) and the maximum urinary flow varied from 9.3±4.4 to 11.2±4.6 ml/s (p = 0.025). The severity of neurological impairment ...


Assuntos
Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Doxazossina/uso terapêutico , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Sintomas do Trato Urinário Inferior/fisiopatologia , Doença de Parkinson/fisiopatologia , Antiparkinsonianos/uso terapêutico , Estudos Prospectivos , Doença de Parkinson/tratamento farmacológico , Qualidade de Vida , Curva ROC , Índice de Gravidade de Doença , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Urodinâmica/fisiologia
7.
Int Braz J Urol ; 38(4): 536-43, 2012 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22951164

RESUMO

OBJECTIVE: To investigate the VEGF expression and collagen deposition using a latex biomembrane as bladder replacement in rabbits. MATERIALS AND METHODS: After partial cystectomy, a patch of a non-vulcanized latex biomembrane (2 x 2 cm) was sewn to the bladder of rabbits with 5/0 monofilament polydioxanone sulfate sutures in a watertight manner. Groups of 5 animals were killed at 15, 45 and 90 days after surgery and the bladder was removed. Sections of 5µm were cut and stained with picrosirius-red in order to estimate the amount of extracellular matrix in the graft. To confirm the presence of VEGF in tissues, protein expression was determined by immunohistochemistry. RESULTS: No death, urinary leakage or graft extrusion occurred in any group. All bladders showed a spherical shape. A progressive reduction in the amount of collagen occurred in the graft area and was negatively and linearly correlated with time (p < 0.001). VEGF expression was higher in grafted areas when compared to controls at 15 and 45 days after surgery and decreased with time (p < 0.001). CONCLUSION: The latex biomembrane as a matrix for partial bladder replacement in rabbits promotes temporary collagen deposition and stimulates the angiogenic process.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Colágeno/análise , Látex/uso terapêutico , Bexiga Urinária/cirurgia , Fator A de Crescimento do Endotélio Vascular/análise , Animais , Colágeno/metabolismo , Modelos Animais de Doenças , Imuno-Histoquímica , Masculino , Membranas Artificiais , Coelhos , Regeneração , Fatores de Tempo , Fator A de Crescimento do Endotélio Vascular/metabolismo
8.
Rev. bras. ecocardiogr. imagem cardiovasc ; 24(1): 34-41, jan.-mar. 2011. tab, graf
Artigo em Português | LILACS | ID: lil-571183

RESUMO

Introdução: O índice de volume do átrio esquerdo (IVAE) é um preditor independente para eventos cardiovasculares (CV), em pacientes que fazem hemodiálise (HD), há mais de 01 ano. Entretanto, a mortalidade desses pacientes é maior no primeiro ano de tratamento com HD. Objetivo: Avaliar o valor prognóstico do IVAE, como preditor de morte por causa CV, nos pacientes com IRC, dentro do primeiro ano de tratamento com HD. Métodos: Estudo prospectivo e observacional, incluindo pacientes com IRC e indicação imediata para iniciar tratamento do HD. Os participantes foram acompanhados durante 01 ano: 03 sessões de hemodiálise por semana, com 04 horas/sessão. Todos realizaram um ecocardiograma, até 24 horas após a primeira sessão de hemodiálise. Resultados: Foram incluídos 50 pacientes com média de 55 anos (18-94), sendo 30 (60%) homens. Houve 09 (18%) mortes por causa CV. O IVAE, antes de começar HD, era 38,2 +- 10,2ml/m2, sendo 47,7 +- 6,2ml/m2 nos pacientes que morreram por causa CV e 36,2 +- 9,8ml/m2, naqueles sem o desfecho preconizado (p valor=0,002). A curva ROC mostrou IVAE=37,5ml/m2, como o melhor ponto de corte para predição de morte CV (área abaixo da curva=0,85). Não houve morte por causa CV entre os 26 participantes que apresentavam IVAE<37,5ml/m2 antes de iniciar HD. Dos 24 pacientes com IVAE...


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Função Atrial , Átrios do Coração/lesões , Diálise Renal/mortalidade , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Ecocardiografia/métodos , Ecocardiografia , Estudos Observacionais como Assunto , Estudos Prospectivos , Fatores de Risco
9.
Rev. bras. ecocardiogr. imagem cardiovasc ; 22(2): 12-16, abr.-jun. 2009. tab, graf
Artigo em Português | LILACS | ID: lil-514951

RESUMO

Fundamentos e objetivos: Doença cardiovascular é a principal causa de morte de pacientes com insuficiência renal crônica (IRC). Embora a taxa de mortalidade seja muito alta, não são todos os pacientes que morrem durante o período de acompanhamento. Variáveis do Doppler Tecidual parecem sofrer pouca influência das variáveis de precarga, observadas nos pacientes que fazem hemodiálise. A relação E/E' é capaz de predizer pressão capilar pulmonar e surge como preditor independentemente de morte em algumas situações clínicas. O objetivo deste estudo foi verificar se a relação E/E' seria preditora de morte nos pacientes com IRC, em fase inicial de tratamento com hemodiálise (HD). Métodos: Foram estudados 50 pacientes com IRC, em uremia e com indicação imediata...


Assuntos
Humanos , Idoso , Diálise Renal/métodos , Diálise Renal , Ecocardiografia Doppler/métodos , Ecocardiografia Doppler , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/mortalidade , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/mortalidade
10.
Int. braz. j. urol ; 35(2): 217-226, Mar.-Apr. 2009. ilus, tab
Artigo em Inglês | LILACS | ID: lil-516963

RESUMO

PURPOSE: To investigate histological features and biocompatibility of a latex biomembrane for bladder augmentation using a rabbit model. MATERIAL AND METHODS: After a partial cystectomy, a patch of a non-vulcanized latex biomembrane (2x4 cm) was sewn to the bladder with 5/0 monofilament polydioxanone sulfate in a watertight manner. Groups of 5 animals were sacrificed at 15, 45 and 90 days after surgery and the bladder was removed. The 5-µm preparations obtained from grafted area and normal bladder were stained with hematoxylin-eosin. Immunohistochemical staining was performed with a primary antibody against alpha-actin to assess muscle regeneration. RESULTS: No death, urinary leakage or graft extrusion occurred in any group. All bladders showed a spherical shape. Macroscopically, after 90 days, the latex biomembrane was not identifiable and the patch was indistinguishable from normal bladder. A bladder stone was found in one animal (6.6 percent). On the 90th day, histology revealed continuity of transitional epithelium of host bladder tissue on the patch area. At this time, the muscle layers were well organized in a similar fashion to native bladder muscle layers. The inflammatory process was higher on grafted areas when compared to controls: 15 days - p < 0.0001, 45 days - p < 0.001, and 90 days - p < 0.01. The anti alpha-actin immunoexpression peaked at 45 days, when the graft was observed covered by muscle cells. CONCLUSION: The latex biomembrane is biocompatible and can be used in models for bladder augmentation in rabbits. It promotes epithelium and muscle regeneration without urinary leakage.


Assuntos
Animais , Masculino , Coelhos , Materiais Biocompatíveis , Matriz Extracelular/transplante , Látex , Músculo Liso/fisiologia , Regeneração , Bexiga Urinária , Modelos Animais de Doenças , Reação Hospedeiro-Enxerto/fisiologia , Mucosa Intestinal/transplante , Membranas Artificiais , Músculo Liso/citologia , Bexiga Urinária/fisiologia , Bexiga Urinária/cirurgia
11.
São Paulo; s.n; 2007. 101 p. ilus, tab, graf.
Tese em Português | LILACS | ID: lil-461242

RESUMO

O objetivo do estudo foi avaliar a aplicabilidade do estudo dos jatos ureterais como método diagnóstico na identificação das hidronefroses obstrutivas e não obstrutivas na população pediátrica.Foram estudadas 48 crianças com Hidronefrose Unilateral.Freqüência Relativa dos Jatos (FRJ) foi definida como o número de jatos ureterais no lado afetado dividido pela soma dos jatos ureterais observados bilateralmente.Observou-se que FRJ < 0,25 é o melhor valor que distingue as hidronefroses e o faz corretamente em 91,2 por cento dos casos, com uma Sensibilidade de 86,4 por cento e Especificidade de of 96.15 por cento. FRJ < 25 por cento mostrou ser indicador de obstrução nas hidronefroses unilaterais da infância e pode ser utilizado na diferenciação das hidronefroses obstrutivas e não obstrutivas na população pediátrica.


The aim of this study was to evaluate the Ureteral Jets(UJ) in the bladder as a diagnostic tool to distinguish obstructive from non-obstructive dilatations of the upper tract in pediatric population.We evaluated 48 patients who presented with unilateral hydronephrosis suspicious of pyeloureteral junction obstruction. Relative Jet Frequency (RJF) was defined as the UJ frequency of hydronephrotic side divided by total UJ frequency. RJF< 0.25 was the best threshold and it correctly discriminates obstruction in 91.2 per cent of the childrens with a sensitivity of 86.4 per cent and specificity of 96.15. In this study RJF < 25 per cent was found to be a good indicator of obstruction in children with unilateral hydronephrosis. CDUS evaluation of UJ can be used to differentiate obstructed from non-obstructed hydronephrosis in the pediatric population.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Técnicas de Diagnóstico Urológico , Hidronefrose/diagnóstico , Obstrução Ureteral , Sensibilidade e Especificidade , Ultrassonografia Doppler em Cores
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