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Search Results: 1 - 10 of 733724 matches for " Carlos A. L. D'Ancona "
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Renal cell carcinoma with thrombus in the inferior vena cava: extracorporeal circulation and deep hypothermia without open-chest surgery
D'Ancona, Carlos A. L.;Petrucci Jr, Orlando;Otsuka, Rodrigo;
International braz j urol , 2005, DOI: 10.1590/S1677-55382005000100009
Abstract: introduction: renal cell carcinoma with thrombus in the inferior vena cava and no apparent metastasis requires immediate surgical treatment. over the last few years, extracorporeal circulation with deep hypothermia and total circulatory arrest have played an increasingly important role in the treatment of diseases not associated with primary cardiovascular disorders, such as cavoatrial tumor thrombus in uterine tumors, adrenal tumors, wilms' tumor, as well as renal cell carcinoma. case report: a 78-year-old patient with renal cell carcinoma and tumoral thrombus in the inferior vena cava and above the supra-hepatic veins underwent right radical nephrectomy and removal of the thrombus from the vena cava with extracorporeal circulation and deep hypothermia with total circulatory arrest without opening the chest. the patient presented good post-operative evolution.
A Novel Intraurethral Device Diagnostic Index to Classify Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms
Leonardo O. Reis,Guilherme C. Barreiro,Alessandro Prudente,Cleide M. Silva,José W. M. Bassani,Carlos A. L. D'Ancona
Advances in Urology , 2009, DOI: 10.1155/2009/406012
Abstract: Objectives. Using a urethral device at the fossa navicularis, bladder pressure during voiding can be estimated by a minimal invasive technique. This study purposes a new diagnostic index for patients with lower urinary tract symptoms (LUTSs). Methods. Fifty one patients presenting with LUTSs were submitted to a conventional urodynamic and a minimal invasive study. The results obtained through the urethral device and invasive classic urodynamics were compared. The existing bladder outlet obstruction index (BOOI) equation that classifies men with LUTSs was modified to allow minimal invasive measurement of isovolumetric bladder pressure in place of detrusor pressure at maximum urine flow. Accuracy of the new equation for classifying obstruction was then tested in this group of men. Results. The modified equation identified men with obstruction with a positive predictive value of 68% and a negative predictive value of 70%, with an overall accuracy of 70%. Conclusions. The proposed equation can accurately classify over 70% of men without resorting to invasive pressure flow studies. We must now evaluate the usefulness of this classification for the surgical treatment of men with LUTSs. 1. Introduction Invasive pressure flow studies (PFSs) in urodynamics are still the gold standard method for objective classification of bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTSs). It is able to delineate patients for successful surgical approach [1], however, it is still costly, time-consuming, and associated with significant morbidity. The risks of complications after conventional urodynamic study in men with BOO are greater, and acute urinary retention, macroscopic hematuria, urinary tract infection, and/or fever can occur in over 19% of the cases [2]. During the past 14 years, many experts have raised minimal invasive possibilities as substitutes [3, 4]. Griffiths et al. have previously described and validated a minimal invasive technique based on controlled inflation of a penile cuff during voiding [5]. Others had attempted other types of penile cuffs and condoms with insufficient results [3, 6–9]. Trying to overcome these limitations, we developed, in association with the University’s Biomedical Engineering Department, a urethral device capable of extracting from the voiding patient measurements comparable to those achieved from invasive PFS [10]. We have published before that applying logistic regression fitting to the minimal invasive method utilizing this urethral device was able to detect most patients with BOO [10]. However, the
Responsiveness to the Portuguese version of the international consultation on incontinence questionnaire - short form (ICIQ-SF) after stress urinary incontinence surgery
Tamanini, Jose T. N.;Dambros, Miriam;D'Ancona, Carlos A. L.;Palma, Paulo C. R.;Rodrigues-Netto Jr, N.;
International braz j urol , 2005, DOI: 10.1590/S1677-55382005000500013
Abstract: objective: to evaluate the reliability and responsiveness (internal and external) of the portuguese version of the iciq-sf. we assessed the responsiveness of the iciq-sf after surgical procedures for the treatment of stress urinary incontinence. materials and methods: prospective open label study in 2 tertiary referral centers. sixty-one patients of both genders (54 female and 7 male) were enrolled. patients were treated using surgical procedures, mostly with synthetic sling (82%). patients were assessed before surgery and at least 1 month postoperatively using the iciq-sf in its translated and validated portuguese version. patients also underwent pre-operative urodynamic tests, stamey incontinence grading and pad usage assessments. after surgery, patients underwent stress tests, stamey incontinence grading and pad usage assessments. results: the mean age was 57.2 (± 11.6) years and the mean duration of follow-up was 7.2 months (± 4.5). objective parameters such as urodynamic tests (by means of vlpp) and pad usage had significant correlation with changes in post-treatment scores on the iciq-sf (p = 0.0062 and p < 0.0001 respectively). the responsiveness expressed in terms of standardized effect sizes (ses) and standardized response means (srm) was large for both questionnaires (p < 0.0001). conclusion: the results showed high responsiveness (large effect sizes i and ii) for the portuguese version of the iciq-sf, indicating that this instrument is suitable for measuring outcomes in clinical trials for brazilian patients with stress urinary incontinence.
Concurrent validity, internal consistency and responsiveness of the portuguese version of the king's health questionnaire (KHQ) in women after stress urinary incontinence surgery
Tamanini, Jose T. N.;Dambros, Miriam;D'ancona, Carlos A. L.;Palma, Paulo C. R.;Botega, Neury J.;Rios, Luis A. S.;Gomes, Cristiano M.;Baracat, Fabio;Bezerra, Carlos A.;Netto Jr, Nelson R.;
International braz j urol , 2004, DOI: 10.1590/S1677-55382004000600005
Abstract: objective: to evaluate the concurrent validity, internal consistency and responsiveness of king's health questionnaire (khq) in patients who underwent sling procedures for the treatment of stress urinary incontinence. materials and methods: we performed a prospective open label multicenter study in 4 tertiary referral centers. sixty-eight female patients were enrolled with urodynamically diagnosed urinary stress incontinence. patients were treated using surgical procedures, mostly (73%) with the synthetic sling procedure, which has been considered one of the gold standard methods for the treatment of urinary incontinence. the patients were assessed before and after one month of postoperative follow up, using the khq in its validated portuguese version. patients also underwent preoperative urodynamic test, stamey incontinence grading, pad usage and the assessment of number of pads used per day. after surgery, patients underwent stress test, stamey incontinence grading pad usage and the assessment of number of pads used per day. results: the concurrent validity showed good correlations in some domains of khq to clinical parameters. the internal consistency was higher after treatment compared to preoperative values. objective parameters, such as pad usage and the assessment of number of pads used per day, had significant correlation with changes in post-treatment scores on khq. the responsiveness expressed in terms of standardized effect size (ses) and standardized response mean (srm) was large. conclusion: the results showed moderate concurrent validity, strong internal consistency and high responsiveness for khq, indicating that it is suitable for measuring outcomes in clinical trials among female patients with stress urinary incontinence.
Intravesical protrusion of the prostate as a predictive method of bladder outlet obstruction
Reis, Leonardo O.;Barreiro, Guilherme C.;Baracat, Jamal;Prudente, Alessandro;D'Ancona, Carlos A.;
International braz j urol , 2008, DOI: 10.1590/S1677-55382008000500012
Abstract: objective: pressure-flow study is the gold standard for diagnosis of bladder outlet obstruction (boo). a prospective study was carried out to compare urodynamic evaluation and measurement of intravesical protrusion of the prostate for diagnosing boo. materials and methods: patients presenting with lower urinary tract symptoms (luts) associated with benign prostatic hyperplasia and suspected boo were prospectively evaluated through conventional urodynamics and classified according to the bladder outlet obstruction index (booi). they also underwent abdominal ultrasound measurement of the intravesical prostatic protrusion (ipp) and prostatic volume. the ipp was classified into three stages: grade i under 5 mm; grade ii, between 5 and 10 mm; and grade iii over 10 mm. results: forty-two patients, mean age 64.8 ± 8.5 years were enrolled. transabdominal ultrasound determined a mean prostatic volume of 45 ± 3.2 ml. achieved ipp's values were the following: grade i - 12 (28.5%), grade ii - 5 - (12%) and grade iii - 25 (59.5%). the results of prostate volume differed significantly between obstructed and non-obstructed men (p = 0.033) and for ipp among obstructed, inconclusive and non-obstructed men (p = 0.016). for ipp, the area under roc curve was 0.758 (95% confidence interval - 0.601 to 0.876), and the cutoff point to indicate boo was 5 mm with 95 % sensitivity (75.1 - 99.2) and 50 % specificity (28.2 - 71.8). conclusion: ipp and prostatic volume measured through abdominal ultrasound are noninvasive and accessible methods that significantly correlate to urinary boo, and are useful in the diagnosis of male urinary obstructive problems.
Feeding malnourished children with corn tortilla fortified with amino acids in Yucatán, México
Ramón Canul, L. G.,Betancur Ancona, D. A.,Castellanos Ruelas, A. F.,Chel Guerrero, L. A.
Nutrición Clínica y Dietética Hospitalaria , 2012,
Abstract: Caloric and protein malnutrition in children has led to the development of programs that design and distribute nutritionally enhanced products in México. That is why this study was conducted in order to evaluate the effect of consumption of corn tortillas fortified with lysine and tryptophan, on growth of malnourished preschool children in two rural areas of Yucatan. An original population of 156 pre-school children originated from two rural communities, Canicab and Ticopó, with ages between 36 and 71 months was selected. Two groups of 21 children each were chosen. They ate tortillas for twelve months: fortified with lysine and tryptophan (experimental group) and tortillas without fortification (control group). Weekly nutrient consumption was measured, also body weight and the following anthropometric indicators: weight / age, height / age and weight / height. Results were statistically analyzedestimating the mean, standard deviation, correlation and t Student test. Results showed at the end of the experimental period of 12 months, that there was an improvement in all the growing variables, but the difference did not reach the level of statistical significance(p> 0.05) among children who consumed fortified tortillas vs. those fed with tortillas without fortification.Possibly this was due to a low total energy intake in theexperimental group. It was concluded that consumption of tortillas fortified with lysine and tryptophan did not contribute significantly to improve the nutritional status of the pre-school children, because it is not the only factor that favors malnutrition, however fortification led to a better weight gain and all anthropometric indexes.
A comparative study of pelvic floor muscle training in women with multiple sclerosis: its impact on lower urinary tract symptoms and quality of life
Lúcio, Adélia Correia;Perissinoto, Maria Carolina;Natalin, Ricardo Aydar;Prudente, Alessandro;Damasceno, Benito Pereira;D'ancona, Carlos Arturo Levi;
Clinics , 2011, DOI: 10.1590/S1807-59322011000900010
Abstract: objective: to compare pelvic floor muscle training and a sham procedure for the treatment of lower urinary tract symptoms and quality of life in women with multiple sclerosis. methods: thirty-five female patients with multiple sclerosis were randomized into two groups: a treatment group (n = 18) and a sham group (n = 17). the evaluation included use of the overactive bladder questionnaire, medical outcomes study short form 36, international consultation on incontinence questionnaire short form, and qualiveen questionnaire. the intervention was performed twice per week for 12 weeks in both groups. the treatment group underwent pelvic floor muscle training with assistance from a vaginal perineometer and instructions to practice the exercises daily at home. the sham group received a treatment consisting of introducing a perineometer inside the vagina with no exercises required. pre- and post-intervention data were recorded. results: the evaluation results of the two groups were similar at baseline. at the end of the treatment, the treatment group reported fewer storage and voiding symptoms than the sham group. furthermore, the differences found between the groups were significant improvements in the following scores in the treatment group: overactive bladder questionnaire, international consultation on incontinence questionnaire short form, and the general quality of life, and specific impact of urinary problems domains of the qualiveen questionnaire. conclusions: the improvement of lower urinary tract symptoms had a positive effect on the quality of life of women with multiple sclerosis who underwent pelvic floor muscle training, as the disease-specific of quality of life questionnaires demonstrated. this study reinforces the importance of assessing quality of life to judge the effectiveness of a treatment intervention.
Enzimas miocárdicas na cirurgia de revasculariza??o sem circula??o extracorpórea
SOLTOSKI, Paulo Roberto;D'ANCONA, Giuseppe;BARROZO, Carlos Alberto Mussel;SANT'ANNA, Fernando Mendes;PEREIRA, Anderson Wilnes;BERGSLAND, Jacob;SALERNO, Tomas Ant?nio;PANOS, Anthony L.;
Revista Brasileira de Cirurgia Cardiovascular , 2000, DOI: 10.1590/S0102-76382000000200003
Abstract: background: cabg surgery on the beating heart (off-pump) is increasingly used to lessen injury to the brain, kidneys and other organs. however, the perioperative incidence of myocardial injury and its effect on outcome vs conventional cabg (on-pump) remains unclear. material and methods: retrospective study of 303 patients (122 off-pump, 181 on-pump) after isolated cabg from feb/97-feb/99. cpk and ekg were obtained pre and post-op, mb fraction and troponin t levels were measured postoperatively. complications were also recorded. the groups were comparable in terms of age (65 ± 10 vs 65 ± 9 yr), ccs and nyha class. results: mean number of grafts was 3.10 on-pump vs 2.26 off-pump. perioperative myocardial infarction, morbidity and mortality (7/181 vs 6/122) were also comparable. there were higher postoperative ck levels in the on-pump group compared to the off-pump (548 ± 420 vs 236 ± 365). mb fraction was slightly higher in the on-pump group, but not significantly different (62 ± 197 vs 29 ± 46) nor was troponin t levels (3.5 ± 16 vs 3.5 ± 17) were an inverse correlation between the number of grafts and troponin t release in the off-pump group occurred early during our off-pump experience. there was no correlation between graft location and the incidence of infarcts or troponin t release. conclusion: the higher troponin t release during our initial experience subsequently decreased. this suggests that improvements in operative technique (e.g. better exposure allowing more posterior grafts without surface trauma) may be responsible. current techniques make off-pump cabg a safe alternative for revascularization.
Resultados a largo plazo del estudio multicéntrico fase III del tratamiento de la incontinencia de orina post prostatectomía con un sling masculino ajustable: seguimiento mínimo 3 a?os
Romano,Salomon V.; Metrebian,Sergio E.; Vaz,Fernando; Muller,Valter; Levi DAncona,Carlos A.; Costa de Souza,Eugenio A.; Nakamura,Fabio;
Actas Urológicas Espa?olas , 2009, DOI: 10.4321/S0210-48062009000300015
Abstract: objective: to communicate long- term results of the multicentre phase iii trial post-prostatectomy urinary incontinence (ppi) treated with an adjustable male sling1. patients and methods: 48 ppi patients were included in this trial from april 2003 to september 2004. 39 post radical prostatectomy and 9 post adenomectomy. 19 wore 5 pads per day (3-8) each weight 83gr (17-198). 29 wore condom catheter or penile clamp. the argus was implanted through perineal approach. using needles, the sling was transferred to the abdominal wall where it was adjusted by washers. the adjustment was done with retrograde urethral pressure from 45 to 55 cm water. clinical data were up-dated till september 2007. the mean follow-up was 45 months (36-54) and median age was 67 years (52-77). the evaluation was: the iciq-sf score and qualification as dry: no pads, improved: 1 pad and failed: 2 or more pads in 24 hr, including those with slings removed. results: 47 were evaluated, resulting: 31 (66%) dry, 6 (12.8%) improved and 10 (21%) failed. the iciq-sf score changed from 19.5 to 6. of the 31 dry pts, 5 required one adjustment. 10 pts failed, 9 after sling removal, 6 due to erosion and 3 for infection. one patient failed with the sling in place, 6 erosions were registered: 4 in the urethra, 1 into the bladder and 1 through the abdominal wall. perineal pain persisted in 2. one patient was excluded, died in september 2006. conclusions: argus? has demonstrated its efficacy in long- term follow-up. the social continence rate was about 80%. the important complication was erosion or infection.
Ion-Chain Dynamics in Polymer Electrolytes
L. D. Carlos,A. L. L. Videira
Physics , 1996, DOI: 10.1016/S0009-2614(96)01288-2
Abstract: Representing polyether-salt systems by chains of interacting coordination shells, defined by the cation and by its nearest ligands, we derive the interaction potential between closest shells -- the inter-shells potential -- in terms of two-electron polarization effects. Values are presented for monovalent-based crystalline poly(ethylene oxide), PEO, electrolytes. For the eutectic composition $\text{PEO}_{12} \text{EuBr}_3$, the inter-shells energy is evaluated also by relating the empirical value of the nearest-ligands local-field potential with the variation of the $\text{Eu}^{3+}$ concentration. Both methods give the same results.
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