13 results on '"Thiago Camelo Mourão"'
Search Results
2. Epidemiology of Urological Cancers in Brazil: Trends in Mortality Rates Over More Than Two Decades
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Thiago Camelo Mourão, Maria Paula Curado, Renato Almeida Rosa de Oliveira, Thiago Borges Marques Santana, Ricardo de Lima Favaretto, and Gustavo Cardoso Guimarães
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Male ,Urologic Neoplasms ,Humans ,Female ,Mortality ,Brazil - Abstract
Background Considering the socioeconomic disparities and inequalities observed in the healthcare resources among the Brazilian regions, we aimed to analyze the mortality trends of urological cancers in Brazil to identify areas with differential risks. Methods Deaths related to prostate (PCa), bladder (BCa), kidney (KC), penile (PeC), and testis (TCa) cancers from 1996 to 2019 were retrieved from the Mortality Information System database (Brazil). Geographic and temporal patterns were analyzed using age-standardized mortality rates (ASMRs). A joinpoint regression model was used to identify changes in the trends and calculate the average annual percentage change (AAPC) for each region. Results In Brazil, the ASMRs (per 100,000 persons/year) were 11.76 for PCa; 1.37, BCa; 1.13, KC; 0.33, and PeC; 0.26, TCa over the period. Increasing mortality trends were registered for BCa (AAPC = 0.45 in men; 0.57 in women), KC (AAPC = 2.03 in men), PeC (AAPC = 1.01), and TCa (AAPC = 2.06). The PCa mortality presented a significant reduction after 2006. The Northeast and North regions showed the highest increases in the PCa mortality. The South registered the highest ASMRs for BCa and KC, but the highest increasing trends occurred in the men from the Northeast. The North presented the highest ASMR for PeC, while the South registered the highest ASMR for TCa. Conclusion Differences among regions may be partly explained by disparities in the healthcare systems. Over the study period, the North and Northeast regions presented more discrepant mortality rates. Efforts should be made to ensure access to the healthcare resources for people at risk, particularly in these regions.
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- 2022
3. Should obesity be associated with worse urinary continence outcomes after robotic-assisted radical prostatectomy? a propensity score matching analysis
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Carlos Alberto Ricetto Sacomani, Ricardo L. Favaretto, Thiago Borges Marques Santana, Renato Almeida Rosa de Oliveira, Gustavo Cardoso Guimarães, Thiago Camelo Mourão, Stênio de Cássio Zequi, and Wilson Bachega
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Subgroup analysis ,Urinary incontinence ,Overweight ,Prostate cancer ,Robotic Surgical Procedures ,medicine ,Humans ,Obesity ,Propensity Score ,Urinary Tract ,Prostatectomy ,Urinary continence ,business.industry ,Prostate ,Prostatic Neoplasms ,Perioperative ,Recovery of Function ,medicine.disease ,Diseases of the genitourinary system. Urology ,Obesity, Morbid ,Treatment Outcome ,Propensity score matching ,Original Article ,RC870-923 ,medicine.symptom ,business - Abstract
Purpose: To analyze the association between obesity and urinary incontinence rate in men submitted to robot-assisted radical prostatectomy (RARP) in a high-volume cancer center. Materials and Methods: We reported 1.077 men who underwent RARP as the primary treatment for localized prostate cancer from 2013 to 2017. Patients were classified as non-obese (normal BMI or overweight) or obese men (BMI ≥30kg/m2). They were grouped according to the age, PSA level, D’Amico risk group, Gleason score, ASA classification, pathological stage, prostate volume, salvage/adjuvant radiotherapy, perioperative complications, and follow-up time. Urinary continence was defined as the use of no pads. For the analysis of long-term urinary continence recovery, we conducted a 1:1 propensity-score matching to control confounders. Results: Among the obese patients, mean BMI was 32.8kg/m2, ranging 30 - 45.7kg/m2. Only 2% was morbidly obese. Obese presented more comorbidities and larger prostates. Median follow-up time was 15 months for the obese. Complications classified as Clavien ≥3 were reported in 5.6% of the obese and in 4.4% of the non-obese men (p=0.423). Median time for continence recovery was 4 months in both groups. In this analysis, HR was 0.989 for urinary continence recovery in obese (95%CI=0.789 - 1.240; p=0.927). Conclusions: Obese can safely undergo RARP with similar continence outcomes comparing to the non-obese men when performed by surgeons with a standardized operative technique. Future studies should perform a subgroup analysis regarding the association of obesity with other comorbidities, intending to optimize patient counseling.
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- 2022
4. Cost-effectiveness analysis of robotic-assisted versus retropubic radical prostatectomy: a single cancer center experience
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Thiago Camelo Mourão, Renato Almeida Rosa de Oliveira, Ademar Lopes, Stênio de Cássio Zequi, Thiago Borges Marques Santana, Ricardo L. Favaretto, and Gustavo Cardoso Guimarães
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Male ,medicine.medical_specialty ,Robotic assisted ,Cost-Benefit Analysis ,medicine.medical_treatment ,Treatment outcome ,030232 urology & nephrology ,Health Informatics ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Retropubic radical prostatectomy ,Humans ,Medicine ,Robotic surgery ,Retrospective Studies ,Prostatectomy ,business.industry ,General surgery ,Prostatic Neoplasms ,Cancer ,Cost-effectiveness analysis ,medicine.disease ,030220 oncology & carcinogenesis ,Laparoscopy ,Surgery ,business - Abstract
Prostate cancer (PCa) treatment has been greatly impacted by the robotic surgery. The economics literature about PCa is scarce. We aim to carry-out cost-effectiveness and cost-utility analyses of the robotic-assisted radical prostatectomy (RALP) using the "time-driven activity-based cost" methodology. Patients who underwent radical prostatectomy in 2013 were retrospectively analyzed in a cancer center over a 5-year period. Fifty-six patients underwent RALP and 149 patients underwent retropubic radical prostatectomy (RRP). The amounts were subject to a 5% discount as correction of monetary value considering time elapsed. Calculation of the Incremental Cost-Effectiveness Ratios (ICER) related to events avoided and the Incremental Cost-Utility Ratio (ICUR) related to "QALY saved" were performed. QALY was performed using values of utility and "disutility" weights from the "Cost-Effectiveness Analysis Registry". Hypothetical cohorts were simulated with 1000 patients in each group, based on the treatment outcomes. Total and average costs were R$1,903,671.93, and R$12,776.32 for the RRP group, and R$1,373,987.26, and R$24,535.49 for the RALP group, respectively. The costs to treat the hypothetical cohorts were R$10,010,582.35 for RRP, and R$19,224,195.90 for RALP. ICER calculation evidenced R$9,213,613.55 of difference between groups. ICUR was R$ 22,690.83 per QALY saved. Limitations were the lack of cost-effectiveness analyses related to re-hospitalization rates and complications, single center perspective, and currency-translation differences. Medical fees were not included. RALP showed advantages in cost-effectiveness and cost-utility over RRP in the long term. Despite the increased costs to the introduction of robotic technology, its adoption should be encouraged due to the gains.
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- 2021
5. Solitary Bone Metastasis as the First Presentation of Germ Cell Testicular Cancer Treated with Internal Hemipelvectomy: A Case Report
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Thiago Camelo Mourão, Ranyell Spencer Sobreira Batista, Ademar Lopes, Stênio de Cássio Zequi, and Samuel Aguiar
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Adult ,Male ,medicine.medical_specialty ,Neoplasm, Residual ,Biopsy ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Bone Neoplasms ,Asymptomatic ,Metastasis ,Bleomycin ,Hemipelvectomy ,03 medical and health sciences ,0302 clinical medicine ,Testicular Neoplasms ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Neoplasm Metastasis ,Pelvic Bones ,Testicular cancer ,Etoposide ,Chemotherapy ,business.industry ,Bone metastasis ,Neoplasms, Germ Cell and Embryonal ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Radiology ,Cisplatin ,medicine.symptom ,Presentation (obstetrics) ,business ,Orchiectomy ,Germ cell - Abstract
Solitary bone metastasis from testicular tumor is rare. In literature, only few cases of isolated bone metastasis at first presentation have been reported, and none of them have been treated with extended surgery of the pelvic bone. Case Presentation: We report the case of a 33-year-old man with an iliac bone osteolytic metastasis as the first presentation of a non-seminomatous germ-cell testis tumor (NSGCT), treated with post-chemotherapy en bloc resection of residual tumor in the left iliac bone (Type I + II internal hemipelvectomy). After a 72-month follow-up, the patient has been asymptomatic, with no signs of local recurrence or metastasis and negative serum tumor markers. Conclusions: In selected cases, testicular NSGCT with iliac bone metastasis and normal or normalizing tumor markers can be treated, in association with chemotherapy, by extended surgery, including bone resection, to obtain gain in survival and maintain limb function.
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- 2018
6. Prostate Cancer Screening in Brazil: a single center experience in the public health system
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Gustavo Cardoso Guimarães, Stênio de Cássio Zequi, Ademar Lopes, Renato Almeida Rosa de Oliveira, Thiago Camelo Mourão, Ricardo L. Favaretto, and Thiago Borges Marques Santana
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Adult ,Male ,medicine.medical_specialty ,Prostate biopsy ,Urology ,Biopsy ,Population ,030232 urology & nephrology ,Therapeutics ,urologic and male genital diseases ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Epidemiology ,Medicine ,Humans ,Mass Screening ,education ,Early Detection of Cancer ,familial [Supplementary Concept] ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Cancer ,Prostatic Neoplasms ,Rectal examination ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Diseases of the genitourinary system. Urology ,Prostate cancer screening ,Prostate cance ,030220 oncology & carcinogenesis ,Original Article ,Public Health ,RC870-923 ,business ,Brazil - Abstract
Purpose: Incidence and mortality of prostate cancer (PCa) are still increasing in developing countries. Limited access to the health system or more aggressive disease are potential reasons for this. Ethnic and social differences in developed countries seem to make inappropriate to extrapolate data from other centers. We aim to report the epidemiological profile of a PSA-screened population from a cancer center in Brazil. Materials and Methods: We retrospectively selected 9.692 men enrolled in a PCa prevention program, comprising total PSA level and digital rectal examination at the first appointment, associated with complementary tests when necessary. Men aged over 40 years-old were included after shared decision-making process. Prostate biopsy (TRUS) was performed when clinically suspected for PCa. After the diagnosis, patients underwent appropriate treatment. Results: TRUS was performed in 5.5% of men and PCa incidence was 2.6%. Overall ratio between number of patients who needed to be screened in order to diagnose one cancer was 38.9 patients, with 2.1 biopsies performed to diagnose a cancer. Positive predictive value (PPV) of TRUS biopsy in this strategy was 47.2%, varying from 38.5% (80 years-old). We evidenced 70 patients (27.9%) classified as low risk tumors, 74 (29.5%) as intermediate risk, and 107 (42.6%) as high-risk disease. Conclusions: PSA-screening remains controversial in literature. In front of a huge miscegenated people and considering the big proportion of high-risk PCa, even in young men diagnosed with the disease, it is imperative to inform patients and health providers about these data particularities in Brazil.
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- 2021
7. Cost-Effectiveness Analysis of Prostate Cancer Screening in Brazil
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Thiago Camelo Mourão, Renato Almeida Rosa de Oliveira, Gustavo Cardoso Guimarães, Stênio de Cássio Zequi, Ricardo L. Favaretto, and Thiago Borges Marques Santana
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Male ,medicine.medical_specialty ,Cost effectiveness ,medicine.medical_treatment ,Cost-Benefit Analysis ,Economics, Econometrics and Finance (miscellaneous) ,Population ,Androgen deprivation therapy ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,education ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,health care economics and organizations ,Early Detection of Cancer ,education.field_of_study ,business.industry ,030503 health policy & services ,Health Policy ,Prostatic Neoplasms ,Androgen Antagonists ,Cost-effectiveness analysis ,Prostate-Specific Antigen ,medicine.disease ,Prostate cancer screening ,Localized disease ,0305 other medical science ,business ,Watchful waiting ,Brazil - Abstract
Introduction: Prostate cancer is one of the most common malignancies among men worldwide. Prostate-specific antigen (PSA) screening shows uncertain benefits and harms from clinical and economic perspectives, resulting in an important impact on healthcare systems. Because of nonstandardized studies and substantial differences among populations, data are still inconclusive. Objective The objective of this study was to carry out long-term cost-effectiveness and cost-utility analysis on the PSA-screened population from the service provider’s perspective in the Brazilian population. Methods We performed a cost-effectiveness and cost-utility analysis using clinical outcomes obtained from 9692 men enrolled in the PSA screening program. Prostate cancer treatments, 5-year follow-up outcomes, and all related costs were examined. Data were compared with a nonscreened prostate cancer population to calculate incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR). ICER and ICUR were compared with the Brazilian-established willingness-to-pay (WTP) threshold (WTP = R$ 114 026.55). Results A total of 251 of 9692 men had a diagnosis of prostate cancer (2.6%), of which 90% had localized disease. Two hundred and five patients were treated as follows: surgery (45.37%); radiation therapy (11.22%); radiation plus androgen deprivation therapy (21.95%); active surveillance (13.17%); exclusive androgen deprivation therapy (7.32%); and watchful waiting (0.98%). Two simulated cohorts were compared based on screening and nonscreening groups. Values obtained were—ICER of R$ 44 491.39 per life saved and ICUR of R$ 10 851.56 per quality-adjusted life year (QALY) gained—below the Brazilian WTP threshold and showed cost-effectiveness and cost-utility advantages. Conclusion According to the Brazilian WTP, PSA screening is a cost-effective policy from a hospital and long-term perspective and should have more standardized studies developed in different populations and economies.
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- 2020
8. Small renal masses in Latin-American population: characteristics and prognostic factors for survival, recurrence and metastasis – a multi-institutional study from LARCG database
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Thiago Camelo Mourão, C. Scorticati, Ricardo Decia, Rubén G. Bengió, Francisco Rodríguez-Covarrubias, Agustin Rovegno, Diego Muguruza, Marcos Tobias Machado, Pablo Mingote, Sidney Glina, Vinicius Fernando Calsavara, Diego Abreu, Luis Meza-Montoya, Guillermo Gueglio, Ricardo Castillejos-Molina, Omar Clark, Walter Henriques da Costa, Stênio de Cássio Zequi, Carlos Ameri, Joan Palou, Fernando P. Secin, Gustavo Cardoso Guimarães, Hamilton de Campos Zampolli, Jorge Clavijo, Lucas Nogueira, Gustavo F. Carvalhal, Raúl Langenhin, J.G. Campos-Salcedo, Ana María Autran-Gómez, Oscar Rodriguez-Faba, and Alejandro Nolazco
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Male ,medicine.medical_specialty ,Databases, Factual ,Urology ,medicine.medical_treatment ,Population ,030232 urology & nephrology ,Nephron-sparing surgery ,lcsh:RC870-923 ,Logistic regression ,Nephrectomy ,Metastasis ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Internal medicine ,Humans ,Medicine ,education ,Carcinoma, Renal Cell ,Aged ,Retrospective Studies ,education.field_of_study ,business.industry ,Cancer ,Kidney cancer ,Retrospective cohort study ,General Medicine ,Middle Aged ,lcsh:Diseases of the genitourinary system. Urology ,Prognosis ,medicine.disease ,Kidney Neoplasms ,Survival Rate ,Latin America ,Reproductive Medicine ,030220 oncology & carcinogenesis ,Female ,Neoplasm Recurrence, Local ,business ,Research Article - Abstract
Background To evaluate demographic, clinical and pathological characteristics of small renal masses (SRM) (≤ 4 cm) in a Latin-American population provided by LARCG (Latin-American Renal Cancer Group) and analyze predictors of survival, recurrence and metastasis. Methods A multi-institutional retrospective cohort study of 1523 patients submitted to surgical treatment for non-metastatic SRM from 1979 to 2016. Comparisons between radical (RN) or partial nephrectomy (PN) and young or elderly patients were performed. Kaplan-Meier curves and log-rank tests estimated 10-year overall survival. Predictors of local recurrence or metastasis were analyzed by a multivariable logistic regression model. Results PN and RN were performed in 897 (66%) and 461 (34%) patients. A proportional increase of PN cases from 48.5% (1979–2009) to 75% (after 2009) was evidenced. Stratifying by age, elderly patients (≥ 65 years) had better 10-year OS rates when submitted to PN (83.5%), than RN (54.5%), p = 0.044. This disparity was not evidenced in younger patients. On multivariable model, bilaterality, extracapsular extension and ASA (American Society of Anesthesiologists) classification ≥3 were predictors of local recurrence. We did not identify significant predictors for distant metastasis in our series. Conclusions PN is performed in Latin-America in a similar proportion to developed areas and it has been increasing in the last years. Even in elderly individuals, if good functional status, sufficiently fit to surgery, and favorable tumor characteristics, they should be encouraged to perform PN. Intending to an earlier diagnosis of recurrence or distant metastasis, SRM cases with unfavorable characteristics should have a more rigorous follow-up routine.
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- 2020
9. Prostate Cancer – Local Treatment after Radiorecurrence: HIFU – High-Intensity Focused Ultrasound
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Thiago Camelo Mourão, Stênio de Cássio Zequi, and Gustavo Cardoso Guimarães
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Extracorporeal Shockwave Therapy ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,lcsh:RC870-923 ,Difference of Opinion ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,medicine ,Humans ,Salvage Therapy ,Radiotherapy ,business.industry ,Prostatic Neoplasms ,Reproducibility of Results ,Prostate-Specific Antigen ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,High-intensity focused ultrasound ,Radiation therapy ,Treatment Outcome ,030220 oncology & carcinogenesis ,High-Intensity Focused Ultrasound Ablation ,Radiology ,Neoplasm Recurrence, Local ,business - Published
- 2018
10. Pelvic Pseudoaneurysm as a Cause of Severe Hematuria After Robotic-assisted Radical Prostatectomy
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Ricardo L. Favaretto, Bruno Queiroz Lima Castelo, Thiago Camelo Mourão, Thiago Borges Marques Santana, Gustavo Cardoso Guimarães, and Renato Almeida Rosa de Oliveira
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Male ,medicine.medical_specialty ,Robotic assisted ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Ischemia ,Severity of Illness Index ,Bladder Irrigation ,03 medical and health sciences ,Pseudoaneurysm ,Postoperative Complications ,0302 clinical medicine ,Robotic Surgical Procedures ,medicine ,Humans ,cardiovascular diseases ,Embolization ,Hematuria ,Prostatectomy ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Surgery ,body regions ,030220 oncology & carcinogenesis ,Angiography ,cardiovascular system ,Complication ,business ,Aneurysm, False - Abstract
Objective To alert the medical society regarding that hematuria after radical prostatectomy can be caused by pelvic pseudoaneurysm. Methods Case report of a 61-year-old male underwent extraperitoneal robotic-assisted radical prostatectomy. He was readmitted on the 15th POD due to gross hematuria with resolution after bladder irrigation. It returned on the 21st POD. Results The CT angiography evidenced the pseudoaneurysm of the left internal iliac artery. Selective embolization was effectively performed, with no additional bleeding or pelvic ischemia. Endovascular therapy is the preferred method of treatment. Conclusion The pelvic pseudoaneurysm is a rare, but serious complication that can cause severe bleeding. In our experience, we had 3 cases of persistent hematuria caused by pelvic pseudoaneurysm after 1810 robotic-assisted radical prostatectomy.
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- 2021
11. Comparative Analysis of Functional Outcomes Between Two Different Techniques After 1088 Robotic-Assisted Radical Prostatectomies in a High-Volume Cancer Center: A Clipless Approach
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Mauricio Murce Rocha, Renato Almeida Rosa de Oliveira, Thiago Camelo Mourão, Stênio de Cássio Zequi, Gustavo Cardoso Guimarães, Rodrigo Campos, Thiago Borges Marques Santana, and Ricardo L. Favaretto
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Adult ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Logistic regression ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Postoperative Complications ,Robotic Surgical Procedures ,Medicine ,Humans ,Robotic surgery ,CLIPS ,computer.programming_language ,Aged ,Retrospective Studies ,Prostatectomy ,business.industry ,Univariate ,Cancer ,Prostatic Neoplasms ,Recovery of Function ,Middle Aged ,medicine.disease ,Surgical Instruments ,Surgery ,Logistic Models ,Urinary Incontinence ,030220 oncology & carcinogenesis ,business ,computer ,Body mass index - Abstract
Introduction: Robotic-Assisted Radical Prostatectomy (RARP) has largely replaced the open technique worldwide as the first surgical modality for prostate cancer. We aim at describing the experience of RARP at a high-volume single cancer center, proposing a modified technique of nerve-sparing prostatectomy and comparing functional outcomes throughout our experience. Materials and Methods: We retrospectively reviewed 1088 patients divided into group 1 (operated from May 2013 to November 2014), submitted to the standard transperitoneal robotic technique, and group 2 (operated from December 2014 to December 2017), submitted to extraperitoneal RARP with complete anterior peri-prostatic preservation technique and a clipless approach (no use of clips and cautious use of bipolar energy). We constructed a retrospective 1:2 matched-pair analysis considering age, body mass index, D'Amico risk classification, and American Society of Anesthesiologists classification as matching criteria. Univariate and multivariate Cox logistic regression analysis were used to identify predictors related to recovery of continence and erectile function. Results: Groups were comparable by clinical and demographic variables. There was no significant difference in overall continence rate. Mean time for continence recovery was 6.6 months in group 1 and 5.8 months in group 2. Erectile function recovery, with or without drugs, in 12 months was described in 53.5% in group 1 and 75% in group 2. Potency recovery was significantly earlier in group 2. Conclusions: In our experience, extraperitoneal RARP with complete anterior peri-prostatic preservation and a clipless approach is a feasible and reproducible technique. It demonstrated improved erectile function recovery and similar continence results. Prospective multicenter studies are needed to validate these results.
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- 2019
12. Antimicrobial resistance of uropathogens in women with acute uncomplicated cystitis from primary care settings
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Elizabeth De Francesco Daher, Thiago Camelo Mourão, Nicole A. A. Araujo, Igor F. S. Melo, Sônia M. H. A. Araújo, Samuel R. Araújo, Jobson Lopes de Oliveira, Matias Carvalho Aguiar Melo, and Constance A. A. Araujo
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Adult ,medicine.medical_specialty ,Adolescent ,Urology ,Microbial Sensitivity Tests ,Drug resistance ,Microbiology ,Young Adult ,Antibiotic resistance ,Ampicillin ,Internal medicine ,Cystitis ,Drug Resistance, Bacterial ,Humans ,Medicine ,Norfloxacin ,Retrospective Studies ,Primary Health Care ,business.industry ,Middle Aged ,Antimicrobial ,Nephrology ,Nitrofurantoin ,Acute Disease ,Urinary Tract Infections ,Ceftriaxone ,Female ,Gentamicin ,business ,medicine.drug - Abstract
We assessed the antimicrobial resistance patterns of all urine samples submitted for culture from outpatient women aged ≥14 years with diagnosis of uncomplicated cystitis over a 24-month period (2007-2009) in the city of Fortaleza, Brazil. Only bacterial growth of a single uropathogen with ≥10(5) CFU/mL was considered for analysis. The Pearson's chi-square test was used for bivariate correlations. Escherichia coli presented the highest prevalence (64.7%). Coagulase-negative staphylococcus was more common in younger than in older women (P = 0.003). Gentamicin presented the lowest overall resistance pattern (3.5% resistant), followed by ceftriaxone (5%) and norfloxacin (7.5%). Ampicillin and trimethoprim-sulfamethoxazole were the least active agents with 63.7% and 39.8% of resistance, respectively. The resistant rate to trimethoprim-sulfamethoxazole was significantly higher among E. coli than non-E. coli isolated. Among ciprofloxacin-resistant E. coli strains, only 3.4% were resistant to nitrofurantoin. We conclude that trimethoprim-sulfamethoxazole follows a worldwide tendency of antimicrobial increasing resistance and it should be avoided as first-line empirical treatment for urinary tract infections.
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- 2010
13. [Acute abdomen as initial manifestation of metastatic melanoma]
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Marcos Aurélio Pessoa, Barros, Nathalia Siqueira Robert, de Castro, and Thiago Camelo, Mourão
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Abdomen, Acute ,Adult ,Male ,Liver Neoplasms ,Humans ,Melanoma - Abstract
The malignant melanoma is a relatively common neoplasia, with origin generally in the melanocytics cells in the skin, but with presentation of other possible primary lesions, being presented in this, a case witnessed of liver and mesentery metastases with unknown primary sites.
- Published
- 2007
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