Papers by Aguinaldo Cesar Nardi
Medicina, May 4, 2022
Background: many doubts about the infection of SARS-CoV-2 were raised, such as sexual transmissio... more Background: many doubts about the infection of SARS-CoV-2 were raised, such as sexual transmission, sterility, and changes in fertility procedures; however, information is not clearly stated and organized. Purpose: to review and summarize scientific evidence on detection of SARS-CoV-2 in semen samples of Covid-19 patients. Methods: literature search in PubMed, Web of Science, Scopus, Medline and Embase databases, and followed Scoping Review protocol defined by Joanna Briggs Institute (JBI) after the guiding question "Is it possible to detect SARS-CoV-2 in the semen of adult patients with a confirmed diagnosis of Covid-19?" Results: 287 studies were identified, and, after discerning analysis, 9 studies published in the English language were selected. Three researchers analyzed the studies for SARS-CoV-2 presence in the seminal fluid, patients' severity, days since the onset of disease, diagnosis confirmation, semen collection method, viral analysis method, and sample numbers. Conclusions: it was not possible to find strong evidence to confirm the presence or absence of Covid-19 in the semen of adult patients. New studies on the subject should be better designed, taking into account the possible anatomical and functional conditions and changes of the male reproductive system during and after the infection by SARS-CoV-2. Objetivo: Revisar e resumir as evidências científicas em pesquisas realizadas para detectar a presença de SARS-CoV-2 em amostras de sêmen de pacientes com COVID-19. Métodos: A pesquisa de literatura foi conduzida nas bases de dados PubMed, Web of Science, Scopus, Medline e Embase. Seguiu o protocolo de revisão de escopo definido por Joanna Briggs Institute (JBI) e baseou-se na pergunta norteadora "É possível detectar SARS-CoV-2 no sêmen de pacientes adultos com diagnóstico confirmado de Covid-19?". Resultados: 287 estudos foram identificados, 9 estudos publicados em língua inglesa foram selecionados após análise minuciosa. Três pesquisadores analisaram os estudos em busca de presença de SARS-CoV-2 no fluído seminal, gravidade do paciente, dias desde o início da doença, confirmação diagnóstica, método de coleta de sêmen, método de análise viral e número de amostras. Conclusões: Não foi possível identificar fortes evidências para confirmar a presença ou ausência de COVID-19 no sêmen de pacientes adultos. Novos estudos sobre o tema devem ser melhor projetados, levando-se em conta as possíveis condições anatômicas e funcionais e mudanças no sistema reprodutor masculino durante e após a infecção por SARS-CoV-2.
ESTIMA, Brazilian Journal of Enterostomal Therapy, 2020
Objective: To identify the main difficulties reported by patients and caregivers in the use of cl... more Objective: To identify the main difficulties reported by patients and caregivers in the use of clean intermittent catheterization described in the scientific literature. Methods: Scoping review with studies published in Portuguese, English or Spanish, without date limit, in electronic databases and digital libraries, using descriptors and keywords. Results: 790 studies were identified, including 34 studies published between 1984 and 2019. The main difficulties reported in performing clean intermittent catheterization were related to catheter insertion, pain, discomfort, urethral trauma, public bathrooms with inadequate facilities, physical difficulties and lack of access to necessary inputs. Conclusion: The studies analyzed show the difficulties that patients who use clean intermittent catheterization and their caregivers face on a daily basis, which are related to intrinsic and extrinsic, institutional and governmental factors and can decrease satisfaction and adherence to rehabili...
ESTIMA, Brazilian Journal of Enterostomal Therapy, 2020
Objetivo: Identificar as principais dificuldades relatadas pelos pacientes e cuidadores no uso do... more Objetivo: Identificar as principais dificuldades relatadas pelos pacientes e cuidadores no uso do cateterismo intermitente limpo descritas na literatura científica. Métodos: Revisão de escopo com estudos publicados em português, inglês ou espanhol, sem limite de data, em base de dados eletrônicas e bibliotecas digitais, utilizando descritores e palavras-chave. Resultados: Foram identificados 790 estudos, sendo incluídos 34 estudos publicados entre 1984 e 2019. As principais dificuldades relatadas na realização do cateterismo intermitente limpo foram referentes a inserção do cateter, dor, desconforto, trauma uretral, banheiros públicos com instalações inadequadas, dificuldades físicas e falta de acesso aos insumos necessários. Conclusão: Os estudos analisados evidenciam as dificuldades que os pacientes usuários do cateterismo intermitente limpo e seus cuidadores enfrentam no dia a dia, que estão relacionadas à fatores intrínsecos e extrínsecos, institucionais e governamentais e podem...
BMJ, 1989
The treatment of benign prostatic hyperplasia (BPH) has implications which affect the majority of... more The treatment of benign prostatic hyperplasia (BPH) has implications which affect the majority of the adult male population. Although benign compared to prostate cancer, clinical symptoms can dramatically alter the quality of life. The hyperplastic tissue can cause constriction of the urethra and thus affect voiding of urine. Factors to consider for thermally-based treatments of the prostate include minimization of thermal injury to the urethra and rectum, and maximal delivery of thermal energy to target tissue. Minimizing temperature rise in the urethra allows for minimal or no anesthesia, and has been shown to reduce postoperative complications. Protection of the rectal wall is imperative since injury can lead to clinical complications as severe as a rectal fistula. Due to its location immediately dorsal to the prostate, the ventral aspect of the rectal wall is susceptible to overheating when a uniform radiating microwave heat source is applied transurethrally to treat the prostate. This paper summarizes the engineering technology, numerical modeling, and clinical results to date.
O Mundo da Saúde
Este estudo teve como objetivo comparar o desempenho do equipamento de ultrassonografia portátil ... more Este estudo teve como objetivo comparar o desempenho do equipamento de ultrassonografia portátil de bexiga Mobissom® com o equipamento de ultrassonografia de mesa para avaliar o volume de urina da bexiga. Foram analisadas 192 imagens de 16 pacientes adultos que realizaram o exame. Os volumes vesicais obtidos pelo equipamento portátil foram arquivados na forma de imagem e, posteriormente, comparados com o laudo ultrassonográfico da avaliação realizada por um aparelho ultrassonográfico de mesa. Os resultados obtidos foram comparados por meio do Teste t pareado e as diferenças foram distribuídas graficamente pelo método de Bland & Altmann. No resultado geral, não houve diferenças significativas entre os dois equipamentos. Conclui-se que o equipamento, apesar da limitação na visibilização de outros órgãos, é de fácil utilização e relevante para avaliação beira leito.
A litotripsia extracorporea por ondas de choque e um metodo seguro e eficaz no tratamento da liti... more A litotripsia extracorporea por ondas de choque e um metodo seguro e eficaz no tratamento da litiase renal, embora ainda existam duvidas sobre os seus efeitos nos tecidos em crescimento. Com o objetivo de avaliar os efeitos das ondas de choque de alta energia nos orgaos adjacentes ao rim, no rato em crescimento, foram estudados sessenta ratos Wistar, machos. Ao completarem trinta dias de vida, realizou-se a colocacao de marcador radiopaco na loja renal esquerda dos animais. Com quarenta dias de vida, apos confirmacao radiologica do posicionamento do marcador, os ratos foram divididos em dois grupos: grupo-controle - trinta ratos que nao receberam ondas de choque; grupo experimental trinta ratos expostos a 1000 ondas de choque de 17,2 kV de intensidade. Os ratos entao foram sacrificados apos sete, noventa e cento e oitenta dias apos a exposicao as ondas de choque de alta energia. Foi avaliado o crescimento corporeo e realizada a analise da morfologia macro e microscopica dos seguintes orgaos: figado, baco, pâncreas, pulmao direito e esquerdo, adrenal direita e esquerda. Nao houve diferenca estatistica no crescimento corporeo dos animais. A analise morfologica microscopica demonstrou alteracoes significativas no baco (alteracoes proliferativas da polpa vermelha) e figado (inchacao turva) dos animais submetidos as OCAE e sacrificados no setimo dia. Essas lesoes desapareceram completamente nos estudos posteriores Abstract
O objetivo deste trabalho foi o de estudar as alteracoes do trato geniturinario na Sindrome da Ec... more O objetivo deste trabalho foi o de estudar as alteracoes do trato geniturinario na Sindrome da Ectrodactilia com Displasia Ectodermica e Fissura Labio-Palatina (EEC), atraves de avaliacoes clinicas, laboratoriais e por imagem (ultra-sonografia, urografia excretora e uretrocistografia miccional) em 25 pacientes portadores desta sindrome. Foram detectadas anomalias do trato geniturinario em 13 (52%) pacientes, dos quais 8 (32%) necessitaram de correcao cirurgica e 5 (20%) de acompanhamento clinico periodico. Conclui-se que os pacientes portadores da Sindrome EEC devem ser submetidos a avaliacao radiologica e ultra-sonografica do trato geniturinario, visando a deteccao das anomalias destes orgaos. Abstract
JCO Global Oncology, 2021
PURPOSE To generate and present the survey results on critical issues relevant to screening, diag... more PURPOSE To generate and present the survey results on critical issues relevant to screening, diagnosis, and staging tools for prostate cancer (PCa) focused on developing countries. METHODS A total of 36 of 300 questions concern the main areas of interest of this paper: (1) screening, (2) diagnosis, and (3) staging for various risk levels of PCa in developing countries. A panel of 99 international multidisciplinary cancer experts voted on these questions to create recommendations for screening, diagnosing, and staging tools for PCa in areas of limited resources discussed in this manuscript. RESULTS The panel voted publicly but anonymously on the predefined questions. Each question was deemed consensus if 75% or more of the full panel had selected a particular answer. These answers are based on panelist opinion not a literature review or meta-analysis. For questions that refer to an area of limited resources, the recommendations consider cost-effectiveness and the possible therapies w...
International braz j urol, 2004
Objective: To assess the effects of high-energy shock waves (HESW) on organs adjacent to the kidn... more Objective: To assess the effects of high-energy shock waves (HESW) on organs adjacent to the kidney, in the growing rat. Materials and Methods: We studied 60 Wistar male rats. Upon completing 30 days of age, a radiopaque marker was placed in the animals' left renal cavity. With 40 days of age, after radiologically confirming the markers' position, the rats were divided into 2 groups: control-group-30 rats that did not receive shock waves; experimental group-30 rats exposed to 1000 shock waves of 17.2 KV in intensity. The rats were sacrificed 7, 90 and 180 days after exposure to HESW. The bodily growth was assessed and the analysis of macro-and microscopic morphology of liver, spleen, pancreas, lungs and adrenals. Results: There was no statistical difference in the animals' bodily growth. The microscopic morphologic analysis demonstrated significant alterations in spleen (proliferative changes in the red pulp) and liver (cloudy swelling) of the animals submitted to HESW and sacrificed on the seventh day. These changes completely disappeared in subsequent analyses. Conclusion: HESW applied to rat did not inhibit the animals' growth and caused transitory histological lesion in spleen (proliferative changes in the red pulp) and in liver (cloudy swelling of hepatocytes). Such changes were observed only in the group that was exposed to HESW and was sacrificed 7 days following the experiment, presenting spontaneous recovery.
International braz j urol, 2012
Objective: To describe the epidemiological features and patterns of initial care for prostate can... more Objective: To describe the epidemiological features and patterns of initial care for prostate cancer at public and private institutions in the State of Sao Paulo, Brazil. Materials and Methods: A total of 1,082 physicians affi liated to the Sao Paulo Section of the Brazilian Society of Urology were invited to participate in this cross-sectional, web-based survey. Between September 2004 and September 2005, participating urologists entered data on demographic, clinical and pathological characteristics of patients diagnosed with prostate cancer in their practice. Data on patients attended at public institutions were analyzed and compared with those patients attended at private practice. Results: One hundred and ten society members contributed with data from 1915 patients, 1026 (53.6%) of whom from public institutions. When compared with patients attended at private institutions, those attended at public institutions were older and more likely to be black, had higher serum prostate specifi c antigen (PSA) levels, had a higher probability of being diagnosed with metastatic disease, but were less likely to undergo prostatectomy (all P < 0.001). In multivariate analysis, age, biopsy Gleason score, and being attended at a public institution were independently associated with metastatic disease upon diagnosis. The signifi cant predictors of nonsurgical treatment were age, black race, and higher serum levels of PSA. Conclusions: A statewide registry provides valuable information regarding patient demographics, clinical features, and patterns of care. The results of this study suggest that signifi cant disparities exist for patients with prostate cancer attended at different health-care systems. The relative contribution of biological versus socioeconomic features remains uncertain.
International braz j urol, 2008
Objectives: To assess epidemiologic characteristics of penile cancer in Brazil. Materials and Met... more Objectives: To assess epidemiologic characteristics of penile cancer in Brazil. Materials and Methods: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease), the type of treatment performed and the present state of the patient. Results: 283 new cases of penile cancer in Brazil were recorded. The majority of these cases occurred in the north and northeast (53.02%) and southeast (45.54%) regions. The majority of patients (224, or 78.96%) were more than 46 years of age while only 21 patients (7.41%) were less than 35 years of age. Of the 283 patients presenting penile cancer, 171 (60.42%) had phimosis with the consequent impossibility to expose the glans. A prior medical history positive for HPV infection was reported in 18 of the 283 cases (6.36%). In 101 patients (35.68%) tobacco smoking was reported. The vast majority of the cases (n = 207; 73.14%) presented with tumors localized in the glans and prepuce. In 48 cases (16.96%) the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89%) the tumor affected the entire penis. The majority of the patients (n = 123; 75.26%) presented with T1 or T2; only 9 patients (3.18%) presented with T4 disease. Conclusion: Penile cancer is a very frequent pathology in Brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.
International braz j urol, 2010
Purpose: In Brazil, National data regarding the epidemiology of renal cell carcinoma (RCC) are sc... more Purpose: In Brazil, National data regarding the epidemiology of renal cell carcinoma (RCC) are scarce. The aim of this study was to describe the demographic, clinical, and pathologic characteristics of RCC diagnosed and treated by members of the SBU-Brazilian Society of Urology. Materials and Methods: For this cross-sectional study, data were collected through an on line questionnaire available to the members of the Brazilian Society of Urology (SBU). Between May 2007 and May 2008, voluntary participant urologists collected data on demographic, clinical and pathological characteristics from patients diagnosed with RCC in their practice. Results: Fifty SBU affiliated institutions contributed with patient information to the study. Of the 508 patients, 58.9% were male, 78.9% were white, and the mean age was 59.8 years. Smoking history, high blood pressure and a body mass index above 30 kg/m 2 were present in 14.8%, 46.1% and 17.9% of the patients, respectively. Abdominal ultrasound and computed tomography were the main diagnostic methods. The majority of the cases were localized tumors and metastasis were presented in 9.5% of the patients; 98.4% underwent nephrectomy. Clear cell carcinoma was the most common histological type. In comparison with private institutions, stage IV disease was less frequent among patients treated at public health services (P = 0.033). Conclusions: RCC in Brazil is more common in white men in their sixth decade of life. Ultrasound is the main diagnostic tool for the diagnosis of clear cell carcinoma and we found that localized disease was predominant. A national registry of RCC is feasible and may provide valuable information.
Urology, 2010
An extensive literature search was performed using the key words squamous cell carcinoma of the p... more An extensive literature search was performed using the key words squamous cell carcinoma of the penis, phimosis, circumcision, chronic balanitis, cigarette smoking, genital warts and human papillomavirus (HPV) infection. All selected studies were classified according to the level of evidence (LE). The final grades of recommendation were assigned after discussion by the full panel of the International Consultation on Penile Cancer in November 2008. The factors positively associated with invasive penile cancers include the presence of phimosis (LE 3a), tobacco smoking (LE 3a-4), chewing tobacco (LE 3a), injury to the penis (LE 3a), balanitis (LE 3a), genital warts (LE 3a), and high-risk HPV infection (LE 3a-4). UROLOGY 76 (Suppl 2A): S2-S6, 2010.
Urology, 2007
tions include tumors in the bladder neck, infiltration of the prostatic urethra, diffuse carcinom... more tions include tumors in the bladder neck, infiltration of the prostatic urethra, diffuse carcinoma in situ. Method: The patient is in the supine position. An 18 F Foley catheter, passed in the bladder, is sutured to the meatus, the distal part of the catheter is removed, and a circular incision of the meatus is done. The urethra is dissected using a midline incision at the base of the scrotum (or in the penoscrotal angle), incision of the Buck's fascia and isolation of the corpus spongiosum from the corpora cavernosa. Dissection is continued towards the glans penis, and inversion of the glans enables resection of the urethra up to the urethral meatus. The bulbous urethra is isolated both sharply and bluntly until the dissection is reached from above. The cystoprostatourethrectomy specimen is removed. A 20 Ch Foley catheter, passed in the pelvis, through the scrotal wound, with the balloon inflated with 30 cc saline solution, and a gently traction for a few hours provides a good quality of hemostasis. Results: We used this technique of urethrectomy in 6 cases; the postoperative evolution was uneventful. Conclusions: The lithotomy position and perineal wound can be avoided. The operative time is decreased (around 20 minutes). The cystoprostatourethral specimen can be removed en bloc; thus preventing the spillage and implantation of cancer cells.
American Journal of Medical Genetics, 1992
We have evaluated 25 patients (14 isolated and 11 familial cases) with the EEC syndrome for genit... more We have evaluated 25 patients (14 isolated and 11 familial cases) with the EEC syndrome for genitourinary (GU) tract anomalies through intravenous pyelogram (IVP), voiding urethrocystography, and sonographic examination. Fifty-two percent of the patients (7 isolated a n d 6 familial cases) had involvement of the urinary tract, with n o significant difference between isolated and familial cases. The present data seem to reflect the best estimate of the prevalence of genitourinary anomalies in patients with the EEC syndrome.
American Journal of Medical Genetics, 1992
We report on two unrelated Brazilian girls born to normal and nonconsanguineous parents and prese... more We report on two unrelated Brazilian girls born to normal and nonconsanguineous parents and presenting ectodermal dysplasia, ectrodactyly, clefting, tear duct anomalies, and micro/anophthalmia. The clinical picture presented by these patients suggests the diagnosis of Goltz-Gorlin (Focal dermal hypoplasia) syndrome and EEC syndrome.
Uploads
Papers by Aguinaldo Cesar Nardi