Thadeu Brenny Filho

Instituto Curitiba de Saúde, Curityba, Paraná, Brazil

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Publications (6)2.64 Total impact

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    ABSTRACT: Objective: To help students, residents, and general practitioners to improve the technique, skills, and reproducibility of their prostate examination. Methods: We developed a comprehensive guideline outlining prostate anatomy, indications, patient preparation, positioning, technique, findings, and limitations of this ancient art of urological evaluation. Results: The prostate exam was the first diagnostic test used for prostate cancer screening and other urological conditions. Although several alternative procedures have been developed in the past century, the prostate exam is still an important part of genital–pelvic evaluation because of its simplicity, cost and time effectiveness, and relatively minimal patient discomfort experienced. Conclusion: With an aging population and increasing incidence of prostate diseases, it is imperative that healthcare professionals possess the knowledge, skills, and attitudes to make the prostate exam a routine part of a complete physical examination.
    Health Education Journal 03/2012; 71(2):239-250. · 0.73 Impact Factor
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    ABSTRACT: To evaluate the preferred position used by Brazilian Urologists to perform DRE, the position that Brazilian patients prefer or think it is less embarrassing to have a DRE, and to evaluate the results of DRE with patients in left lateral decubitus, modified lithotomy, standing-up, or the physician will have them place their elbows on the table and squat down slightly. Brazilian Urologists were contacted by e-mail, and 200 patients answered a questionnaire while undergoing prostate cancer screening. The preferred position was modified lithotomy position reported by 63.4% of Urologists, and left lateral position reported by 42.7% of the patients. Total DRE time was lower in the standing-up position. Pain and urinary urgency scores were similar regardless of the position used, and bowel urgency score was higher in patients squatting down. Patients were similar in terms of age and PSA level, but there was a significant difference between the standard deviations of estimated prostate weight in left lateral position. There were no differences in prostate asymmetry, positive DRE, or incomplete palpation of the prostate rates among different examination positions. Despite individual subjective preferences, a faster examination time in the standing-up position, and higher bowel urgency scores in patients with their elbows placed on the table and squatting down slightly, there were similar rates of prostate asymmetry, positive DRE, and incomplete palpation of the prostate, and comparable patient tolerability among different examination techniques.
    International braz j urol: official journal of the Brazilian Society of Urology 06/2011; 37(3):371-7; discussion 377-9.
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    ABSTRACT: Renal replacement lipomatosis (RRL) is a relatively uncommon entity, but a major differential diagnosis of xanthogranulomatous pyelonephritis (XGP). We illustrate a case of renal lipomatosis in a 63 year-old female that was initially misdiagnosed as XGP, and a classic case of XGP in a 51 year-old female, highlighting similarities and differences in the clinical course, radiological features, intraoperative findings by laparoscopy, and pathological characteristics between them.
    Revista da Associação Médica Brasileira 06/2011; 57(3):262-5. · 0.77 Impact Factor
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    ABSTRACT: Well leg compartment syndrome is rare after laparoscopic radical prostatectomy. We report a 68-year-old man that developed compartment syndrome after laparoscopic radical prostatectomy for prostate cancer. There are several circumstantial risk factors associated with LRP that, when combined, may potentially predispose to the development of compartment syndrome, including: obesity, evidence of peripheral vascular disease (advanced age, hypertension, hyperlipidemia, and diabetes mellitus), thromboembolism prophylaxis with compressive leg wraps together with intermittent pneumatic devices, combined general-spinal anesthesia, prolonged operative time in Trendelenburg position, and systemic hypotension due to intraoperative bleeding. The pathogenesis of this serious complication is discussed and preventive measures are highlighted.
    Actas urologicas españolas 09/2009; 33(8):920-4. · 1.14 Impact Factor
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    ABSTRACT: Well leg compartment syndrome is rare after laparoscopic radical prostatectomy. We report a 68-year-old man that developed compartment syndrome after laparoscopic radical prostatectomy for prostate cancer. There are several circumstantial risk factors associated with LRP that, when combined, may potentially predispose to the development of compartment syndrome, including: obesity, evidence of peripheral vascular disease (advanced age, hypertension, hyperlipidemia, and diabetes mellitus), thromboembolism prophylaxis with compressive leg wraps together with intermittent pneumatic devices, combined general-spinal anesthesia, prolonged operative time in Trendelenburg position, and systemic hypotension due to intraoperative bleeding. The pathogenesis of this serious complication is discussed and preventive measures are highlighted.
    Revue Neurologique - REV NEUROL. 01/2009; 33(8):920-924.
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    ABSTRACT: To evaluate patients' perception of pain and discomfort during DRE, the impact of discomfort on potential future screening compliance, and if emptying the bladder immediately before DRE reduces patient discomfort. One-hundred patients undergoing DRE for prostate cancer screening answered an anonymous questionnaire regarding pain, urinary urgency and bowel urgency during DRE and its potential impact on future examination. Another group with 100 patients was randomized in two subgroups to analyze if urinating immediately before DRE reduces patient discomfort. Seventy-three (73%) patients reported moderate or higher discomfort for at least one of the domains evaluated: 61% complained of pain; 22% of urinary urgency; and 22% of bowel urgency. Emptying the bladder immediately before examination did not reduce pain (58% vs. 50%, p = 0.115), urinary urgency (22% vs. 16%, p = 0.151), or bowel urgency intensity (16% vs. 14%, p = 0.264). There was no difference in the number of patients that answered they will repeat the prostate exam next year (96% vs. 90%, p = 0.211) or in those that would encourage a friend that needs the prostate exam to do it (96% vs. 98%, p = 0.378). Pain and discomfort during DRE are not negligible but they do not affect intention to have a prostate exam in the future. Urinating immediately before examination does not significantly reduce the incidence of pain, urinary urgency, or bowel urgency during DRE.
    Archivos españoles de urología 10/2008; 61(7):850-4.