Biomedical subjects

Nelson Rodrigues Netto

Publications and source records attributed to Nelson Rodrigues Netto.

25 records · Page 2Linked to original sources

PubMed2004

Long-term followup of penile carcinoma treated with penectomy and bilateral modified inguinal lymphadenectomy.

PURPOSE: We evaluated modified inguinal lymphadenectomy in the treatment of penile carcinoma, analyzing the rate of complications compared to complete inguinal lymphadenectomy, the complications in performing lymphadenectomy and penectomy concomitantly, and the long-term locoregional recurrence rate. MATERIALS AND METHODS: A total of 26 patients with squamous cell carcinoma of the penis were clinically assessed, and underwent penectomy and bilateral modified inguinal lymphadenectomy at the same operative time. Frozen section analysis of lymph nodes was performed and if metastases were detected a complete ipsilateral inguinal dissection was performed. RESULTS: A total of 52 modified lymphadenectomies were performed. In 10 procedures lymph node metastasis was present. Clinical staging presented false-positive and false-negative rates of 50% and 7.9%, respectively. The complication rate for modified lymphadenectomy was 38.9% and for complete inguinal lymphadenectomy it was 87.5%. Followup ranged from 5 to 112 months and mean followup of recurrence-free cases was 78 months (range 38 to 112). A total of 18 patients underwent bilateral negative modified inguinal lymphadenectomy and 2 of these experienced locoregional recurrence within 2 years after surgery. CONCLUSIONS: Modified inguinal lymphadenectomy causes a lower complication rate than complete inguinal lymphadenectomy. Bilateral modified inguinal lymphadenectomy performed at the same time as penectomy does not increase the complication rate. When frozen section analysis is negative bilaterally, 5.5% of inguinal regions might still harbor occult metastasis. Modified inguinal lymphadenectomy is recommended as a staging procedure in all patients with T2-3 penile carcinoma. A straight followup is required for 2 years since all recurrence was within this period.

Adult↗

PubMed2003

[Validation of the Portuguese version of the King's Health Questionnaire for urinary incontinent women].

OBJECTIVE: To translate into Portuguese and evaluate the condition-specific quality of life King's Health Questionnaire (KHQ) for female urinary incontinence. METHODS: Two Brazilian translators, aware of the aim of the project, prepared two versions of the KHQ into Portuguese, which were back-translated into English by two other English translators. The differences were harmonized and pre-tested in a pilot study. The final version of the KHQ and the "Short-Form Health Survey" (SF-36), which has already been translated and validated into Portuguese were simultaneously administered to 156 and 119 women respectively. KHQ's psychometric properties such as reliability (internal consistency and retest) and construct validity were tested. A retest was performed within 2 weeks from the start date. RESULTS: The cultural adjustment process resulted in no changes in the KHQ Portuguese version, although for low schooling patients the questionnaire had to be read by the researcher during face-to-face interview. For all other patients, the KHQ was self-administered. KHQ's standardized Cronbach's alpha was 0.87 and when assessed by domains ranged from 0.49 to 0.92. Reliability measured by intraclass correlation (ICC) was considered moderate to strong for all domains and the severity measure scale ranged from 0.53 to 0.81. Pearson's correlation coefficient between KHQ and SF-36 was considered weak to moderate in the majority of the related domains, ranging from -0.27 to -0.53. CONCLUSIONS: The KHQ Portuguese version was translated and adjusted for Brazilian women with urinary incontinence complaints. It represents an important tool for the assessment of incontinent women in clinical trials.

Adolescent↗

PubMed2003

Telementoring between Brazil and the United States: initial experience.

BACKGROUND AND PURPOSE: To assess the safety and feasibility of transcontinental telementored and telepresence surgery, we report on two procedures carried out with participation by surgeons in Baltimore in the United States and São Paulo and Recife in Brazil. PATIENTS AND METHODS: Over a period of 3 months, a laparoscopic bilateral varicocelectomy and a percutaneous renal access for a percutaneous nephrolithotomy were performed. The mentoring surgeon (LRK) was the same for both procedures. He used a 650-MHz personal computer fitted with a Z360 video COder/ DECoder (CODEC) and a Z208 communication board (Zydacron Corp, Manchester, NH) that comprise the core of the telesurgical station. In the first case, a surgical robot, AESOP 3000 (Computer Motion Inc.), was attached to a laparoscope, and the remote surgeon drove the robot via a controller on the remote computer. In the second case, another robot (Percutaneous Access to the Kidney; PAKY) was used for percutaneous needle placement into the renal collecting system. RESULTS: The two procedures were completed successfully. In the first case, the operative time was 25 minutes, with minimal estimated blood loss. The patient was discharged home the next day. At 3-month follow-up, there was no scrotal pain or varicocele. In the second case, access to the urinary tract was achieved with the first needle pass, and percutaneous nephrolithotomy was uneventful. Blood loss was minimal, and the patient was discharged home on the second postoperative day. At 3-month follow-up, the patient was free of urinary stones and of symptoms. CONCLUSIONS: The first transcontinental telementored and telepresence urologic surgical procedures have been reported previously. The success observed with the novel surgical techniques has motivated great interest. The cases reported here demonstrate that several types of procedures can be mentored safely and effectively with telemedicine technology.

Adolescent↗

PubMed2003

Effect of purified collagen on lipograft survival: experimental basis for periurethral lipoinjections.

PURPOSE: To assess whether the use of collagens with lipografts improves graft survival. MATERIALS AND METHODS: Thirty isogenic New Zealand rabbits were injected in the auricular area with either autologous fat alone or autologous fat associated with collagen. The animals were evaluated at 7, 30, and 90 days by histologic and morphometric methods together with measurements of the graft area and the number of adipocytes. RESULTS: Addition of collagen to the lipoinjection reduced the local inflammatory reaction and improved the graft's survival; e.g., for stress urinary incontinence. CONCLUSION: These results suggest that it is possible to increase the survival rate of the lipografts and improve their clinical applicability.

Adipocytes↗

PubMed2003

Small-bowel perforation after shockwave lithotripsy.

A 51-year-old woman with a history of stone disease sustained two 3 x 2-mm ileal perforations during SWL (6000 shockwaves; 0.33-0.42 mJ/mm2) for a 14 x 8-mm left-sided midureteral stone. Low energy levels should be applied when ureteral stones are treated by SWL with the patient prone.

Female↗

PubMed2003

Macroplastique implantation system for the treatment of female stress urinary incontinence.

PURPOSE: We evaluated the 12-month followup outcome of the Macroplastique (Uroplasty, Minneapolis, Minnesota) implantation system for the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency using objective and subjective measures, including quality of life impact. MATERIALS AND METHODS: A total of 21 consecutive women with a mean age of 47.4 years and a mean body mass index of 25.65 kg./m.2 in whom intrinsic sphincter deficiency was urodynamically diagnosed were enrolled in the study. Patients were preoperatively assessed by physical examination, quality of life questionnaire, Stamey grading of incontinence, pad use, pad weight test and urodynamic testing. Patients underwent periurethral injection under local anesthesia with the Macroplastique implantation system. The mean volume of silicone elastomers injected was 6.3 ml. RESULTS: As assessed by the King health questionnaire, patient quality of life improved in all domains and in most lower urinary tract symptoms. Patient satisfaction and subjective surgeon evaluation were assessed by Stamey incontinence grading. From patient point of view 12 (57.1%) considered themselves cured, 4 (19%) were improved and 5 (23.8%) had failure. According to subjective surgeon grading 8 patients (38.1%) were considered cured 6 (28.6%) were improved and 7 (33.3%) had failure. Pad use decreased from a mean of 4.38 to 1.29 units daily. According to the pad weight test 13 patients (62%) were dry, 4 (19%) were improved and 4 (19%) had failure. Urodynamic testing demonstrated that 8 patients (40%) were dry and 1 (5%) was improved. CONCLUSIONS: The Macroplastique implantation system proved to have an acceptable outcome for patient and surgeon. The procedure can be done with local anesthesia and without cystoscopic guidance.

Adult↗

PubMed2002

Extracorporeal shock wave lithotripsy in children.

PURPOSE: We analyzed the efficacy of extracorporeal shock wave lithotripsy in children. MATERIALS AND METHODS: Between 1987 and 2000, 15,423 patients with urinary calculi were treated at our institution, of whom 86 (0.56%) children 3 to 14 years old underwent lithotripsy using the Siemens Lithostar Plus (Siemens Medical Systems, Iselin, New Jersey). A total of 121 calculi in 90 urinary tracts were treated requiring 149 extracorporeal shock wave lithotripsy sessions. The stones were caliceal in 62 cases, renal pelvic in 35, ureteral in 18 and staghorn in 6. Followup consisted of nephrotomogram or ultrasound 1 day and 1 to 3 months postoperatively. RESULTS: Complete removal of all stone fragments was achieved in 97.6% of the stones after 3 months. Re-treatment was necessary in 24 patients (27.9%). All patients were treated as outpatients with intravenous sedation in 54 (62.8%), general anesthesia in 13 (15.1%) and no anesthesia in 19 (22.1%). Complications were present in 8 patients (10.7%) who had colic and received medical treatment followed by uneventful recovery. CONCLUSIONS: Extracorporeal shock wave lithotripsy using the Lithostar Plus has been demonstrated to be an effective noninvasive procedure to treat radiopaque and even radiolucent or slightly opaque urinary calculi in children.

Adolescent↗