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1.
Arch Womens Ment Health ; 27(4): 607-618, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38374485

RESUMO

PURPOSE: Return to work after maternity leave represents a radical change in women's lives. This paper aims to present a new metaphor categorization system based on two studies, which could assist working mothers in expressing the nuances of their experience when returning to work after maternity leave. METHODS: We carried out the analysis of the metaphors according to the method for thematic analysis, through a multistep, iterative coding process. To ensure the researchers encode the data similarly, inter-coder reliability was achieved through the judges' agreement method. The level of agreement between the two judges was measured by Cohen's kappa. RESULTS: In Study 1, we established a system comprising ten metaphor categories (namely, Natural event and/or element, Challenge and destination, Movement and/or action, Fresh start, Fight, Game and hobby, Animal, Alternate reality, Means of transport, Hostile place). In Study 2, we recognized the same metaphor categories observed in Study 1, except "Means of transport", even with data sourced from a distinct participant group, an indicator of credibility in terms of inter-coder reliability. CONCLUSION: Findings highlight the usefulness of this new metaphor categorization system (named Meta4Moms@Work-Metaphors system for Moms back to Work) to facilitate a more straightforward elicitation of the meanings employed by working mothers to depict their return to work after maternity leave. Leveraging these insights, researchers/practitioners can develop and execute primary and secondary interventions aimed to enhance working mothers' work-life balance, well-being, and mental health.


Assuntos
Metáfora , Mães , Licença Parental , Retorno ao Trabalho , Humanos , Feminino , Adulto , Retorno ao Trabalho/psicologia , Mães/psicologia , Mulheres Trabalhadoras/psicologia , Gravidez , Pesquisa Qualitativa , Reprodutibilidade dos Testes
2.
Int Braz J Urol ; 44(3): 645-646, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29064655

RESUMO

INTRODUCTION: Inguinal lymphadenectomy is an integral part in the management of penile cancer. Video endoscopic in-guinal lymphadenectomy (VEIL) is emerging as a minimally invasive treatment to reduce postoperative complications. MATERIALS AND METHODS: 62 years old man underwent glansectomy for a squamous cell carcinoma (pT1b). At the physical examination one left inguinal lymph node was detectable (cN1). The chest-abdomen-pelvis CT was negative for me-tastasis. A 10-mm optical trocar and two 5mm operating trocar were placed. The optical trocar was placed in the apex of Scarpa's triangle after a skin incision and after the creation of a subcutaneous space by blunt finger dissection. The pCO2 was 8-10mmHg. The surgical technique involved the removal of superficial lymph nodes according to the scheme described by Deseler and of the deep lymph nodes. Sparing main venous structures and closing lymphatic vessels is im-portant to reduce post operative complications. At the end of the procedure, a suction drain was placed per side. RESULTS: Operative time was 90 minutes per side. Drains were removed on the seventh postoperative day. Hospital stay was 8 days and no postoperative complications occurred. The total number of nodes removed was 16 (8 per side) with 2 superficial positive nodes on the left side. CONCLUSION: ILND is burned by a high complication rate. VEIL provides a less invasive approach and a saphenous-sparing technique ensures a lower complication rate, reducing lymphorrhea, skin necrosis and wound complications (1-3). In experienced laparoscopic hands, VEIL is a safe and effective treatment.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Canal Inguinal/cirurgia , Laparoscopia/métodos , Excisão de Linfonodo/métodos , Tratamentos com Preservação do Órgão/métodos , Neoplasias Penianas/cirurgia , Veia Safena , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Reprodutibilidade dos Testes , Resultado do Tratamento
3.
Front Glob Womens Health ; 5: 1266162, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38638326

RESUMO

Working mothers must often balance work and family responsibilities which can be affected by rigid and irrational beliefs about motherhood. The present study had two aims: (a) to provide psychometric evidence for a shortened Italian version of the Rigid Maternal Beliefs Scale (RMBS) and (b) to facilitate mothers' return to work after maternity leave by reducing perceptions of anxiety and stress related to rigid maternal beliefs (i.e., perceptions and societal expectations of mothers, maternal confidence, maternal dichotomy) and by teaching specific recovery strategies (e.g., relaxation, mastery experiences) to manage anxiety and stress through an online psychological intervention. Results replicated the three-factor structure of the original RMBS and showed good psychometric properties. The online psychological intervention resulted in decrease in the rigidity of maternal beliefs, perceived anxiety and stress, and increase in recovery strategies. These initial results are promising and encourage further investigation into online psychological interventions for improving the well-being of working mothers.

4.
J Basic Clin Physiol Pharmacol ; 34(1): 49-54, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35390245

RESUMO

OBJECTIVES: Stress urinary incontinence is defined by a complaint of any involuntary loss of urine on effort or physical exertion or on sneezing or coughing and represents a major complication after radical prostatectomy. According to surgical technique, incidence of post-prostatectomy incontinence varies from open (7-39.5%), laparoscopic (5-33.3%) or robotic-assisted (4-31%) approaches. The ProACT® device (Uromedica, Inc., MN) is a possible surgical option for the treatment of this condition. METHODS: We retrospectively analyzed surgical records of consecutive patients underwent ProACT® implantation in our department between January 2006 to November 2010. We collected data at 6 and 12 months after surgical approach about the daily pad use, International Prostatic Symptoms Score and its quality of life domain. RESULTS: 42 patients were included in the final analysis. Most patients (92.9%) received minimally invasive surgery for treating prostate cancer. During the follow up after 6 and 12 months, the daily pad, International Prostatic Symptom Score and its quality of life domain significantly improved compared to preoperative outcomes. The logistic regression analysis found that presence of comorbidities was the only predictive factor of low satisfaction rate (PGE-I > 2) in patients who underwent ProACT® implant. CONCLUSIONS: ProACT® implant represents an effective and safe treatment for post-prostatectomy stress urinary incontinence with a high satisfaction degree and a low rate of complications.


Assuntos
Neoplasias da Próstata , Incontinência Urinária por Estresse , Masculino , Humanos , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária por Estresse/cirurgia , Seguimentos , Qualidade de Vida , Estudos Retrospectivos , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Neoplasias da Próstata/complicações , Resultado do Tratamento
5.
J Basic Clin Physiol Pharmacol ; 34(3): 383-389, 2023 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-36933235

RESUMO

OBJECTIVES: To compare differences of operative outcomes, post-operative complications and survival outcomes between open and laparoscopic cases in a multicenter study. METHODS: This was a retrospective cohort study performed at three European centers from September 2011 to January 2019. The surgeon decision to perform open inguinal lymphadenectomy (OIL) or video endoscopic inguinal lymphadenectomy (VEIL) was done in each hospital after patient counselling. Inclusion criteria regarded a minimum follow-up of 9 months since the inguinal lymphadenectomy. RESULTS: A total of 55 patients with proven squamous cell penile cancer underwent inguinal lymphadenectomy. 26 of them underwent OIL, while 29 patients underwent VEIL. For the OIL and VEIL groups, the mean operative time was 2.5 vs. 3.4 h (p=0.129), respectively. Hospital stays were lower in the VEIL group with 4 vs. 8 days in OIL patients (p=0.053) while number of days requiring drains to remain in situ was 3 vs. 6 days (p=0.024). The VEIL group reported a lower incidence of major complications compared to the OIL group (2 vs. 17%, p=0.0067) while minor complications were comparable in both groups. In a median follow-up period of 60 months, the overall survival was 65.5 and 84.6% in OIL and VEIL groups, respectively (p=0.105). CONCLUSIONS: VEIL is comparable to OIL regarding safety, overall survival and post-operative outcomes.


Assuntos
Neoplasias Penianas , Masculino , Humanos , Estudos Retrospectivos , Neoplasias Penianas/cirurgia , Cirurgia Vídeoassistida , Canal Inguinal/cirurgia , Excisão de Linfonodo
6.
Minerva Urol Nephrol ; 73(1): 78-83, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32182227

RESUMO

BACKGROUND: Incidence of small renal masses (SRMs) has increased over the last decade: in order to reduce overtreatment of benign lesions, renal tumor biopsy (RTB) has been advocated. The primary aim of this study were to establish the rate of diagnostic biopsies and the concordance rate between RTB and surgical pathology with regard to tumor histology. The secondary aim was to identify what predictive factors are associated with an initial diagnostic biopsy. METHODS: We retrospectively analyzed RTB performed in our center in patients with SRMs between 2015 and 2017. We assessed patient demographics and clinical status, lesion characteristics and procedural factors. The categorical variables were tested with the chi-square test. We used univariate and multivariate analysis to identify what factors are indicative of non-diagnostic biopsies. We used the SPSS statistics v. 23. RESULTS: We performed a total of 100 RTBs to management 94 patients. The initial biopsy was diagnostic in 88 patients (67 malignant and 21 benign lesion). The six remaining patients had repeat biopsies, of which four were diagnostic. Complications rate was 5% prevalently local hematoma treated with surveillance. Agreement between biopsy and surgical histology was found in 94% of cases. On contingency analysis and on univariate and multivariate analysis, these factors (age, tumor size, exophytic location, and type of imaging used) were not predictive with diagnostic biopsy. CONCLUSIONS: RTB for SRMs helps establish pre-treatment diagnosis, reduce overtreatment, with a low risk of complications and high diagnostic rate. In our experience, we did not find predictive factors more likely associated with a diagnostic biopsy.


Assuntos
Biópsia/métodos , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Rim/patologia , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia/efeitos adversos , Carcinoma de Células Renais/diagnóstico , Feminino , Humanos , Achados Incidentais , Itália , Neoplasias Renais/terapia , Masculino , Uso Excessivo dos Serviços de Saúde , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos
7.
J Med Case Rep ; 15(1): 39, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33541425

RESUMO

BACKGROUND: Primary malignant melanoma (PMM) of the bladder represents a very rare clinic-pathologic entity. Given the rarity of the disease, the best treatment option is not well recognized. CASE PRESENTATION: We describe a case of neoplasm of the bladder in a 74 years-old Caucasian man presenting with massive hematuria. Based on clinical, instrumental and histological findings a diagnosis of PMM was made. The patient underwent trans urethral resection of bladder tumor plus intravesical Bacillus Calmette-Guérin. CONCLUSIONS: To make a correct diagnosis, clinical history, endoscopic evaluation, histopathological examination and immunohistochemistry, are necessary. Multidisciplinary evaluation is required to discriminate primary from metastatic malignant melanoma.


Assuntos
Melanoma , Neoplasias da Bexiga Urinária , Idoso , Tratamento Conservador , Hematúria/etiologia , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/tratamento farmacológico , Recidiva Local de Neoplasia , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/cirurgia
8.
Minerva Urol Nefrol ; 71(2): 181-184, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30230294

RESUMO

BACKGROUND: Androgen-deprivation therapy is one of the options available for treating both advanced and metastatic prostate cancer (PCa). It is used as an adjuvant or neoadjuvant therapy, either alone or in combination with radiotherapy (RT) or surgery. The aim of this study was to appraise adherence to androgen-deprivation therapy (ADT). METHODS: A total of 136 PCa patients on ADT (leuprorelin, triptorelin, and degarelix) were monitored between January 2008 and December 2015. Demographic, histopathological, and clinical data were collected. RESULTS: Mean age was 76 years and PSA was 91.9 ng/mL. Forty-six patients (34%) had a Gleason Score >7. One hundred and eight patients were treated exclusively with ADT (53 [49%] leuprorelin, 45 [42%] triptorelin, and 10 [9%] degarelix). Mean follow-up was 3.5 years, with a mean overall prescription time of 3.4 years. Adherence to ADT was 95%. Sixty-three patients are currently on therapy, while 45 have discontinued treatment. Reasons for discontinuation were death (56%), physician's choice (33%), and patient's preferences (11%). CONCLUSIONS: Adherence to ADT was optimal, probably owing to its balanced side effect and benefit profile. Patient's death was the most frequent reason for discontinuation.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Adesão à Medicação , Neoplasias da Próstata/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais , Humanos , Leuprolida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Gradação de Tumores , Oligopeptídeos/uso terapêutico , Prognóstico , Estudos Retrospectivos , Pamoato de Triptorrelina/uso terapêutico
9.
Minerva Urol Nefrol ; 71(6): 569-575, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30957474

RESUMO

INTRODUCTION: In the last decade therapeutic options for patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement (BPE) have constantly increased. Although transurethral resection of the prostate (TURP) is still considered the surgical gold standard, different lasers and advanced techniques have been introduced as alternatives to TURP. EVIDENCE ACQUISITION: A non-systematic Medline/Pubmed literature search was performed with different combination of terms including: "BPH," "M-TURP," "B-TURP" "bladder outlet obstruction," "YAG laser," "Diode laser," "Potassium titanyl phosphate," "KTP," "bladder outlet obstruction" (BOO), "BOO in small prostate". Only studies reporting prostate volume ≤40 cc were considered for this review. EVIDENCE SYNTESIS: Current evidence on the use of laser as a therapeutic modality as compared to TURP reported similar functional results of bipolar-TURP, Thulium laser and Greenlight. For prostate gland ≤40 cc, HoLEP can be technically more difficult while Holmium-TUIP seems to be a valid option but with a higher rate of retrograde ejaculation which is considerably higher than the rate in electrocautery series. The diode laser showed excellent intra-operatively haemostasis with clear endoscopic vision and durable improvements in functional results, but may produce greater passive thermal energy conduction that can cause scrotal edema and anal pain. However, conclusions need to be drawn after median to long term evaluation of patients and consideration of the economic implications, coupled with the potential for reducing morbidity. CONCLUSIONS: Evidence acquisition from the literature showed that mini-invasive surgeries, including Greenlight laser and Holmium laser incision represent valid alternatives to TURP in prostate ≤40 g. We reported effective results of laser therapy as therapeutic modalities as compared to TURP for the small prostate ≤40 mL, both for enucleation and excision or cauterization, however cost effective of laser in the current literature are still scarce and it should be implemented.


Assuntos
Terapia a Laser/métodos , Hiperplasia Prostática/cirurgia , Hiperplasia Prostática/terapia , Ressecção Transuretral da Próstata/métodos , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/cirurgia , Masculino , Hiperplasia Prostática/complicações , Resultado do Tratamento
10.
Clin Med Insights Case Rep ; 11: 1179547618765761, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29636637

RESUMO

Until 2018, 236 cases of acute pancreatitis have been reported in patients who underwent peritoneal dialysis. Here, we presented a patient with double renal transplantation with chronic renal failure, under renal replacement therapy by peritoneal dialysis, who developed acute pancreatitis with abdominal pain, nausea, vomiting, leukocytosis with neutrophil left shift which is complicated by pancreatic pseudocyst, candida peritonitis, fungal sepsis, overlapping of Acinetobacter baumannii sepsis, and pneumonitis. After the percutaneous cystogastrostomy drainage of pancreatic pseudocyst, changes from peritoneal dialysis to hemodialysis, various thoracentesis, and polyantibiotics therapy, the resolution of the sepsis state was seen. The particular aspect of our case is the various comorbidity risks, severe pancreatitis associated with candida and A baumannii sepsis, and treatment strategy that lead to heal this kind of the high mortality rate condition.

11.
Ther Adv Urol ; 10(10): 305-315, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30186368

RESUMO

BACKGROUND: To assess the efficacy and safety of treatment with abiraterone acetate (AA) in chemotherapy-naïve men with metastatic castration-resistant prostate cancer (mCRPC) in the 'real-life' setting. METHODS: Data acquisition on the outcomes of the use of AA in chemotherapy-naive patients with mCRPC was performed by a MEDLINE comprehensive systematic literature search using combinations of the following key words: 'prostate cancer', 'metastatic', 'castration resistant', 'abiraterone', 'real life', and excluding controlled clinical trials (phase II and III studies). Identification and selection of the studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) criteria. Outcomes of interest were overall survival (OS), progression-free survival (PFS), 12-week 50% reduction in prostate-specific antigen (PSA), and grade 3 and higher adverse events. Data were narratively synthesized in light of methodological and clinical heterogeneity. RESULTS: Within the eight identified studies that fulfilled the criteria, a total of 801 patients were included in the meta-analysis. Baseline PSA ranged between 9.5 and 212.0 ng/ml. Most of the patients had bone metastases. Duration of treatment with AA was longer in the studies with lower baseline PSA levels. The median OS ranged between 14 and 36.4 months. The PFS, assessed according to different definitions, ranged from 3.9 to 18.5 months. A 50% PSA reduction at 12 weeks was reached by a variable percentage of patients ranging from 36.0% to 62.1%. Finally, the rate of grade 3 and higher adverse events was reported in three studies and ranged from 4.4% to 15.5%. CONCLUSIONS: Despite the high grade of heterogeneity among studies, treatment with AA seems to ensure good survival outcomes in the 'real-life' setting. However, prospective studies based on patients' characteristics being more similar to 'real-life' patients are necessary.

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