1
|
Costa AB, Fontanari AMV, Andreazza T, Salvador J, Koff WJ, Aguiar B, Ferrari P, Massuda R, Pedrini M, Silveira E, Belmonte-de-Abreu PS, Gama CS, Kauer-Sant'Anna M, Kapczinski F, Lobato MIR. BDNF: a biomarker for social vulnerability in individuals diagnosed with gender dysphoria. J Psychiatr Res 2014; 50:16-7. [PMID: 24332481 DOI: 10.1016/j.jpsychires.2013.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 11/20/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Angelo B Costa
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
| | - Anna-Martha V Fontanari
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Tahiana Andreazza
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Jaqueline Salvador
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Walter J Koff
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bianca Aguiar
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Postgraduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Pamela Ferrari
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Raffael Massuda
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Mariana Pedrini
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Esalba Silveira
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Paulo S Belmonte-de-Abreu
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Clarissa S Gama
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marcia Kauer-Sant'Anna
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Kapczinski
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Maria Ines R Lobato
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| |
Collapse
|
2
|
Fontanari AMV, Andreazza T, Costa ÂB, Salvador J, Koff WJ, Aguiar B, Ferrari P, Massuda R, Pedrini M, Silveira E, Belmonte-de-Abreu PS, Gama CS, Kauer-Sant'Anna M, Kapczinski F, Lobato MIR. Serum concentrations of brain-derived neurotrophic factor in patients with gender identity disorder. J Psychiatr Res 2013; 47:1546-8. [PMID: 23702250 DOI: 10.1016/j.jpsychires.2013.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 04/18/2013] [Accepted: 04/19/2013] [Indexed: 11/28/2022]
Abstract
Gender Identity Disorder (GID) is characterized by a strong and persistent cross-gender identification that affects different aspects of behavior. Brain-derived neurotrophic factor (BDNF) plays a critical role in neurodevelopment and neuroplasticity. Altered BDNF-signaling is thought to contribute to the pathogenesis of psychiatric disordersand is related to traumatic life events. To examine serum BDNF levels, we compared one group of DSM-IV GID patients (n = 45) and one healthy control group (n = 66). Serum BDNF levels were significantly decreased in GID patients (p = 0.013). This data support the hypothesis that the reduction found in serum BDNF levels in GID patients may be related to the psychological abuse that transsexuals are exposed during their life.
Collapse
Affiliation(s)
- Anna-Martha V Fontanari
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Westphalen AC, Koff WJ, Coakley FV, Muglia VF, Neuhaus JM, Marcus RT, Kurhanewicz J, Smith-Bindman R. Prostate cancer: prediction of biochemical failure after external-beam radiation therapy--Kattan nomogram and endorectal MR imaging estimation of tumor volume. Radiology 2011; 261:477-86. [PMID: 21873255 DOI: 10.1148/radiol.11110457] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE To determine whether magnetic resonance (MR) imaging and MR spectroscopic imaging findings can improve predictions made with the Kattan nomogram for radiation therapy. MATERIALS AND METHODS The institutional review board approved this retrospective HIPAA-compliant study. Ninety-nine men who underwent endorectal MR and MR spectroscopy before external-beam radiation therapy for prostate cancer (January 1998 to June 2007) were included. Linear predictors were calculated with input variables from the study sample and the Kattan original coefficients. The linear predictor is a single weighted value that combines information of all predictor variables in a model, where the weight of each value is its association with the outcome. Two radiologists independently reviewed all MR images to determine extent of disease; a third independent reader resolved discrepancies. Biochemical failure was defined as a serum prostate-specific antigen level of 2 ng/mL (2 μg/L) or more above nadir. Cox proportional hazard models were used to determine the probabilities of treatment failure (biochemical failure) in 5 years. One model included only the Kattan nomogram data; the other also incorporated imaging findings. The discrimination performance of all models was determined with receiver operating characteristics (ROC) curve analyses. These analyses were followed by an assessment of net risk reclassification. RESULTS The areas under the ROC curve for the Kattan nomogram and the model incorporating MR imaging findings were 61.1% (95% confidence interval: 58.1%, 64.0%) and 78.0% (95% confidence interval: 75.7%, 80.4%), respectively. Comparison of performance showed that the model with imaging findings performed significantly better than did the model with clinical variables alone (P < .001). Overall, the addition of imaging findings led to an improvement in risk classification of about 28%, ranging from approximately a minimum of 16% to a maximum of 39%, depending on the risk change considered important. CONCLUSION MR imaging data improve the prediction of biochemical failure with the Kattan nomogram after external-beam radiation therapy for prostate cancer. The number needed to image to improve the prediction of biochemical failure in one patient ranged from three to six.
Collapse
Affiliation(s)
- Antonio C Westphalen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, Box 0628, Room M-372, San Francisco, CA 94143-0628, USA.
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Silva Neto B, Koff WJ, Biolchi V, Brenner C, Biolo KD, Spritzer PM, Brum IS. Polymorphic CAG and GGC repeat lengths in the androgen receptor gene and prostate cancer risk: analysis of a Brazilian population. Cancer Invest 2008; 26:74-80. [PMID: 18181049 DOI: 10.1080/07357900701638251] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Variations in transcriptional activity of the androgen receptor (AR) are related to polymorphic CAG and GGC repeats in exon 1 of the AR gene. We investigated the association between CAG and GGC repeat length and the risk of prostate cancer in a case-control study from a Brazilian population. We evaluated 49 patients and 51 healthy controls. DNA was extracted from peripheral leukocytes and the AR gene was analyzed by fragment analysis (GeneMapper software, Applied Biosystems, Foster City, California, USA). CAG and GGC mean lengths were not different between cases and controls. The risk for prostate cancer was higher for CAG repeats < or = 21 (OR = 2.44 [95% CI 1.03-5.81]) as well as for total repeat lengths (CAG + GGC) < or = 37 (OR = 2.46 [95% CI 0.98-6.18]). GGC repeats (< or = 17 and > 17) were not associated with risk for prostate cancer (OR = 1.13 [95% CI 0.47-2.75]). In conclusion, fewer number of CAG repeats and total repeats (CAG + GGC) in the AR gene may be associated with increased risk for prostate cancer.
Collapse
Affiliation(s)
- Brasil Silva Neto
- Division of Urology, Hospital de Clinicas de Porto Alegre and Urology Department, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | | | | |
Collapse
|
5
|
Ferreira MD, Koff WJ, Espinel JO. 1611: Significant Prostate-Specific Antigen Reduction after Empirical Antibiotic Treatment: Is it Clinically Relevant for not Indicating Prostate Biopsy? J Urol 2007. [DOI: 10.1016/s0022-5347(18)31799-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
6
|
Pompeo ACL, Rosenblatt C, Bertero E, DA Ros CT, Cairoli CED, Damião R, Wroclawski ER, Koff WJ, Mesquita F, Pinheiro GE. A randomised, double-blind study comparing the efficacy and tolerability of controlled-release doxazosin and tamsulosin in the treatment of benign prostatic hyperplasia in Brazil. Int J Clin Pract 2006; 60:1172-7. [PMID: 16942589 PMCID: PMC1618820 DOI: 10.1111/j.1742-1241.2006.01107.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Brazilian patients with benign prostatic hyperplasia were randomised in a 12-week, double-blind, double-dummy study to receive doxazosin gastrointestinal therapeutic system (GITS) 4 mg q.i.d. (n = 82) or tamsulosin 0.4 q.i.d. (n = 83). Primary endpoints were the absolute and percentage change from baseline in symptoms measured by International Prostate Symptom Score (IPSS). Secondary endpoints included IPSS, quality-of-life (QOL) question from the IPSS, and questions 6 and 7 of the Sexual Function Abbreviated Questionnaire (SFAQ) at weeks 4 and 12. Doxazosin GITS and tamsulosin improved IPSS with no significant differences between groups at week 12. During weeks 4-8, tamsulosin-treated patients demonstrated a slower improvement (p < 0.001) in IPSS than doxazosin GITS-treated patients. The proportion of satisfied patients was observed earlier with doxazosin GITS (p = 0.006) vs. tamsulosin. At week 12, the proportion of patients with little or no difficulty at ejaculation (Q6 of SFAQ) was higher in the doxazosin GITS group (p = 0.019). Both treatments were well tolerated.
Collapse
|
7
|
Edinger MS, Koff WJ. Effect of the consumption of tomato paste on plasma prostate-specific antigen levels in patients with benign prostate hyperplasia. Braz J Med Biol Res 2006; 39:1115-9. [PMID: 16906286 DOI: 10.1590/s0100-879x2006000800014] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2005] [Accepted: 05/18/2006] [Indexed: 11/22/2022] Open
Abstract
The consumption of tomatoes and tomato products has been associated with a reduced risk of prostate cancer. We observed a decrease of 10.77% in prostate-specific antigen (PSA) levels in patients with benign prostate hyperplasia who were submitted to daily ingestion of tomato paste. This was an experimental rather than a controlled study with a sample of 43 men ranging in age from 45 to 75 years, all with histological diagnoses of benign prostate hyperplasia and plasma PSA levels of 4-10 ng/mL. All patients received 50 g of tomato paste once a day for 10 consecutive weeks and PSA levels were analyzed before, during and after the consumption of tomato paste. ANOVA for repeated measures was used to compare PSA levels before, during and after the consumption of tomato paste. The mean +/- SD PSA level was 6.51 +/- 1.48 ng/mL at baseline and 5.81 +/- 1.58 ng/mL (P = 0.005) after 10 weeks. Acceptance was good in 88.3, regular in 9.3, and poor in 2.3% of the patients. Dietary ingestion of 50 g of tomato paste per day for 10 weeks significantly reduced mean plasma PSA levels in patients with benign prostate hyperplasia, probably as a result of the high amount of lycopene in tomato paste. This was not a prostate cancer prevention study, but showed some action of tomato paste in prostate biology. The development of prostate cancer is typically accompanied by an increase in plasma PSA levels, thus any intervention that affects plasma PSA levels can suggest an impact in the progression of disease.
Collapse
Affiliation(s)
- M S Edinger
- Programa de Pós-Graduação em Medicina: Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
| | | |
Collapse
|
8
|
Abstract
OBJECTIVES To describe prevalence and features of prostate cancer in the sample. METHODS A five year long voluntary screening program was carried out in the "Hospital das Clínicas de Porto Alegre" with the participation of 3,056 patients in a cross sectional study. For statistical analysis the chi square test was used, considering a significance level of p < 0.05 RESULTS Mean age of the sample was of 60.4 years and prevalence of prostate cancer was of 2.61%, increasing with age. Sensitivity and specificity of PSA were respectively 93.8% (CI = 85.4% to 97.7%) and 82.5% (CI = 81.1% to 83.8%), considering 4 ng/ml as the cut-off point for PSA. Rectal examination had a sensitivity of 60% (CI = 48.4% to 70.6%) and a specificity of 83.3% (CI = 81.9% to 84.6%) The number of biopsies performed for the diagnosis of a patient with prostate cancer was 11.9 and varied according to age. As for clinical staging, 51.3% of patients were T1C and 83.75% of the tumors were clinically confined to the organ. CONCLUSION Screening programs can be performed in our environment and direct to a frequent diagnosis of patients with prostate cancer confined to the organ.
Collapse
Affiliation(s)
- Leonardo I Dini
- Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
| | | |
Collapse
|
9
|
Ferreira MD, Koff WJ. Assessment of serum level of prostate-specific antigen adjusted for the transition zone volume in early detection of prostate cancer. Int Braz J Urol 2005; 31:137-45; discussion 146. [PMID: 15877833 DOI: 10.1590/s1677-55382005000200008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Accepted: 03/17/2005] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To determine the clinical usefulness of prostate-specific antigen (PSA) density in the transition zone (PSADTZ) for increasing the specificity in early detection of prostate cancer (PCa) and reducing unnecessary biopsies in males with PSA between 4.0 and 10 ng/mL. MATERIALS AND METHODS This cross-sectional study obtained PSADTZ measurements in 68 patients with PSA between 4.0 and 10 ng/mL. All patients underwent transrectal ultrasonography (TRUS) with biopsies. PSADTZ was estimated by dividing the PSA value by the volume of the transition zone (TZ) obtained. We compared performance measurements for these parameters with those from the PSA itself, PSA density (PSAD) and free PSA/total PSA ratio (F/T PSA). The ability of the method in increasing PSA specificity was demonstrated and compared in univariate and multivariate analyses, and by Receiver Operating Characteristic Curves (ROC). RESULTS Of the 68 patients under study, 17 (25%) were diagnosed with PCa. The TZ volume (p = 0.001) and PSADTZ (p = 0.001) variables presented means that exhibited statistically significant differences. When compared with the area under the curve (AUC), ROC curves obtained by this method revealed that PSADTZ was the strongest predictor for PCa when considering the cut-off point provided by the curve; that is, 0.35 ng/mL/cc. When PSADTZ was employed, the detection failure would be close to 20%, and less than 45% of cases would undergo unnecessary biopsies. On the other hand, when F/T PSA was used, the loss would reach almost 40%; however less than 30% would undergo unnecessary biopsies. Nevertheless, PSADTZ had the only AUC presenting p < 0.05 in significance when compared with 50%, and was consequently discriminative. CONCLUSIONS PSADTZ increased PSA specificity in early detection of PCa in males with PSA between 4.0 and 10 ng/mL. However, it was shown to have lower predictive value and lower accuracy than the percentage of free PSA since it presents a higher negative predictive value than all other parameters assessed, and it can be considered clinically useful for reducing unnecessary indications for biopsy.
Collapse
Affiliation(s)
- Marcos D Ferreira
- Division of Urology, General Hospital of Porto Alegre, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | | |
Collapse
|
10
|
Abstract
Adenomatoid tumors of adrenal gland are rare, asymptomatic neoplasias, with benign behavior, and usually are diagnosed incidentally. We report a case of a voluminous adenomatoid tumor of left adrenal gland in a 42-year old man who sought evaluation because of renal colic due to left nephrolithiasis. During the investigation, a tumor localized in left adrenal gland was identified by ultrasonography (14.3 x 10.5 x 19.0). The patient underwent adrenalectomy and pyelolithotomy with histopathological and immunohistochemical diagnosis of adenomatoid tumor of adrenal gland, being the largest one described in the literature to the moment. The patient does not present any signs of recurring lesion after a 3-year follow-up.
Collapse
Affiliation(s)
- Nancy T Denicol
- Section of Urology, Porto Alegre General Hospital, Federal University of Rio Grande do Sul (UFRGS), Rio Grande do Sul, Brazil
| | | | | |
Collapse
|
11
|
Koff WJ, Bertero E, Pinheiro GE, Rosenblatt C, Damiao R, Janeiro RD, Da Ros CT, Wroclawski ER, Mesquita F, Pompeo AC, Cairoli CE. 1643: A Randomized, Double-Blind Study Comparing the Efficacy and Tolerability of Controlled-Release Doxazosin and Tamsulosin in the Treatment of Benign Prostatic Hyperplasia. J Urol 2005. [DOI: 10.1016/s0022-5347(18)35765-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
12
|
Petteffi L, Toniazzo GP, Sander GB, Stein AC, Koff WJ. Efficiency of short and long term antimicrobial therapy in transrectal ultrasound-guided prostate biopsies. Int Braz J Urol 2002; 28:526-32. [PMID: 15748401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2002] [Accepted: 12/02/2002] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVE Prostate biopsy is a frequent diagnostic measure to detect prostatic conditions, including primarily prostate cancer. Its performance does not follow a pattern, mainly regarding preparation for the examination through antimicrobial prophylaxis. The aim of this study is to compare the efficiency of short and long term antimicrobial prophylaxis in transrectal ultrasound-guided prostate biopsies. MATERIALS AND METHODS A clinical study was conducted with a total of 140 patients submitted to prostate biopsy with transrectal ultrasonographic control. Patients were randomly separated in two groups: Group 1 receiving norfloxacin 400mg single dose before the procedure and Group 2 receiving norfloxacin 400mg initiating before the procedure and then bid up to 6 doses. Efficiency control was determined by the incidence of urinary tract infection (UTI) and complications in both groups after statistical analysis. RESULTS The incidence of minor complications in our study was 75%, consistent with data found in the literature. Among the patients with diagnosis of simple UTI, 23% belonged to Group 1 and 8% to Group 2 (p=0.08). Among the patients with complicated UTI, 37% belonged to Group 1 and none belonged to Group 2 (p=0.44). CONCLUSIONS Several advances made transrectal ultrasound-guided prostate biopsies a useful and safe diagnostic tool in the workup of urologic patients. There is no optimal prophylactic preparation to the performance of this procedure. Long term antimicrobial prophylaxis presents a trend toward lower incidence of infectious complications.
Collapse
Affiliation(s)
- Leonardo Petteffi
- Division of Urology, Porto Alegre General Hospital, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | |
Collapse
|
13
|
Manfro RC, Comerlato L, Berdichevski RH, Ribeiro AR, Denicol NT, Berger M, Saitovitch D, Koff WJ, Gonçalves LF. Nephrotoxic acute renal failure in a renal transplant patient with recurrent lymphocele treated with povidone-iodine irrigation. Am J Kidney Dis 2002; 40:655-7. [PMID: 12200820 DOI: 10.1053/ajkd.2002.34930] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Povidone-iodine sclerosis has been suggested in the literature as a safe and effective treatment for post-renal transplant lymphoceles. No significant complications of this method have been described. We report on a kidney allograft recipient with recurrent lymphoceles treated with povidone-iodine instillations who developed acute renal failure secondary to iodine intoxication. Four days after the beginning of the povidone-iodine irrigations, metabolic acidosis was present, and renal function started to deteriorate. After a few days, despite the suspension of irrigations, the patient developed oliguria, and dialysis was needed. A renal biopsy was performed, and intense acute tubular necrosis was the only relevant finding. The lymphocele was corrected surgically, and the patient eventually recovered. As has been described in other settings, povidone-iodine instillation for the treatment of post-renal transplant lymphoceles may lead to iodine kidney toxicity and acute renal failure.
Collapse
Affiliation(s)
- Roberto C Manfro
- Renal Transplant Unit, Division of Nephrology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul School of Medicine, Porto Alegre, RS, Brazil.
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Lima CLM, Rabolini G, Menna-Barreto M, Dos Santos EB, Koff WJ. Urodynamic alterations in patients with HTLV-1 infection. Int Braz J Urol 2002; 28:452-6; discussion 456-7. [PMID: 15748372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2001] [Accepted: 10/03/2002] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES The HTLV-1 is a retrovirus that causes several diseases, including tropical spastic paraparesis or HTLV-1 associated myelopathy (or TSP/HAM, as designated by the World Health Organization - WHO) described in 1985. In Brazil, the first cases were reported in 1989. In order to evaluate the urodynamic alterations of infected patients, 48 cases were studied: 26 TSP/HAM and 22 non-TSP/HAM. MATERIAL AND METHOD Evaluation was performed by testing, cystometry, abdominal pressure, differential pressure, detrusor leak point pressure, maximum flow pressure, and electromyography. RESULTS 80.76% TSP/HAM patients showed hyperreflexic bladder, and 34.16% had detrusor-sphincter dyssinergia; 82.6% of this group had abnormal uroflow tests. Non-TSP/HAM patients had hyperreflexic bladders in 22.72% of the cases, and detrusor-sphincter dyssinergia was not assessed. For these patients, uroflow rate was normal in 70% of the cases. CONCLUSIONS Patients infected by the HTLV-1, with or without myelopathy, present significant urodynamic abnormalities and must have a complete urologic and urodynamic evaluation.
Collapse
Affiliation(s)
- Cláudio L M Lima
- Section of Urology, Porto Alegre General Hospital, Federal University of Rio Grande do Sul, Brazil
| | | | | | | | | |
Collapse
|
15
|
Abstract
Caliceal-cutaneous fistula is an uncommon complication of renal transplantation that frequently leads to graft resection. We report our experience with the successful conservative management of a case of caliceal-cutaneous fistula secondary to acute allograft rejection in a renal transplant recipient.
Collapse
Affiliation(s)
- C A Prompt
- Radiology Division, Hospital de Clinicas de Porto Alegre, Brazil
| | | | | | | |
Collapse
|
16
|
Abstract
Epididymal abnormalities in undescended testes are probably more common than suggested in the literature but only sporadic reports are found on this subject. For many years discussions have centered around the ideal age to operate on patients with undescended testes and consequently increase chances for future fertility. We analyzed 66 patients (82 testes) treated for undescended testis in our department, with special distinction between ectopia and cryptorchidism. Abnormalities ranged from simple epididymal elongation to more complex forms, such as complete disruption between the testis and epididymis. Among 49 ectopic testes the epididymides of 19 (38.8%) displayed more severe abnormalities in addition to elongation, while 16 (32.6%) showed only an elongated epididymis and 14 (28.6%) were normal. Among the 33 cryptorchid testes 29 (87.9%) showed the more complex anomalies and elongation, 3 (9.1%) were normal and only 1 (3%) was elongated. Our results demonstrate a much higher incidence of complex epididymal abnormalities in cryptorchidism (p less than 0.001). Elongated epididymis may present problems for sperm maturation and transportation, although with no other associated abnormality most can be regarded as patent. In our theory cases of elongation plus other major abnormalities probably are associated with severe impairment in sperm maturation and hindered transportation, with the future intrascrotal or extrascrotal position of the testis or early surgical repair being of little importance in terms of fertility.
Collapse
Affiliation(s)
- W J Koff
- Servico de Urologia, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil
| | | |
Collapse
|
17
|
Koff WJ, Roisenberg A, Busato O. [Mineralogic analysis of urinary calculi]. AMB Rev Assoc Med Bras 1984; 30:7-10. [PMID: 6610900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
18
|
Koff WJ. [Congenital anomalies of the urinary tract in patients with cryptorchism]. AMB Rev Assoc Med Bras 1982; 28:254-6. [PMID: 6133320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
19
|
Koff WJ, da Silva Moreira BF. [Functional classification of infertile men for treatment planning]. AMB Rev Assoc Med Bras 1982; 28:263-6. [PMID: 6820527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
20
|
Scott R, Koff WJ, Hudgins PT, McCullough D. Preoperative irradiation in the surgical treatment of transitional cell cancer of the bladder: preliminary report based on 12 years of experience. J Urol 1973; 109:405-8. [PMID: 4692374 DOI: 10.1016/s0022-5347(17)60436-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
21
|
Koff WJ, Mickelberg A. [Use of methochlopramide in the prevention of postanesthetic vomiting and nausea]. Braz J Anesthesiol 1968; 18:209-16. [PMID: 5669758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
|
22
|
Mickelberg A, Koff WJ, Corrêia G. [Clinical use of metoclopramide]. Rev Bras Gastroenterol 1968; 20:3-12. [PMID: 5716473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|