João Arthur Brunhara Alves Barbosa's research while affiliated with Hospital Israelita Albert Einstein and other places

Publications (22)

Article
Objective: To describe and compare the number of surgeries, mortality rate, length of hospital stay, and costs of transurethral resection of the prostate and open prostatectomy for the treatment of benign prostatic hyperplasia, between 2008 and 2018, in the Public Health System in São Paulo, Brazil. Methods: Ecological and retrospective study us...
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Background: The pandemic caused by the COVID-19 resulted in worldwide social isolation and leading to significant personal distress, particularly among health professionals on the front lines. Those factors' relevance and their impact on sexual function in this population have not yet been established. Aim: To evaluate the impact of the pandemic on...
Article
Objectives To systematically summarize the available evidence concerning the impact of pyeloplasty on symptoms and differential renal function (DRF) in adults with unilateral UPJO in poorly functioning kidneys (PFKs), and to identify potential predictors of kidney function recovery that could help clinicians select candidates for pyeloplasty. Meth...
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Objectives To evaluate outcomes of laparoscopic pyeloplasty (LP) in adults with poorly functioning kidney due to ureteropelvic junction obstruction (UPJO).MethodsA retrospective comparative analysis was performed between adult patients who underwent LP due to UPJO with differential renal function (DRF) ≤ 15% and DRF > 15%. LP success rate and compl...
Article
Objectives To compare symptom resolution and short-term renal function after pyeloplasty or nephrectomy in adults with ureteropelvic junction obstruction (UPJO) in poorly functioning renal units (PFRU). Methods Retrospective analysis of adult patients with UPJO and differential renal function (DRF) ≤ 15% who underwent laparoscopic pyeloplasty or n...
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PurposeThe TWIST (Testicular Work-up for Ischemia and Suspected Torsion) score was developed to allow for expedited diagnosis of testicular torsion (TT) in children based on clinical variables: edema (2 points), hard mass (2), absent cremasteric reflex (1), high-riding testis (1) and nausea/vomiting (1). We sought to validate the TWIST Score applie...
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Purpose: To evaluate the expression of urinary biomarkers of inflammation and tissue remodeling in patients with BPH undergoing surgery and evaluate the association of biomarkers with postoperative urodynamic outcomes MATERIALS AND METHODS: We analyzed urine samples from 71 patients treated with TURP from 2011 to 2017. Urinary levels of epidermal...
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Calcifying fibrous tumor of the tunica vaginalis is a rare fibrous proliferation, which can sometimes mimic a scrotal malignancy prompting surgical intervention. It has been recognized as a benign lesion, and no recurrence has been described after its resection. Its identification is essential to avoid overtreatment and unnecessary orchiectomy. We...
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Lesions of the skin and soft tissues of the penis and scrotum may be confusing in urological practice, since rare differential diagnoses can be challenging to providers with limited dermatological experience. Hidradenocarcinoma is one of such diagnoses, a rare and aggressive malignant tumor originating from sweat glands. A 61 year-old man presented...
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Purpose: To investigate risk factors for complications in patients undergoing adrenalectomy. Materials and methods: A retrospective search of our institutional database was performed of patients who underwent adrenalectomy, between 2014 and 2018. Clinical parameters and adrenal disorder characteristics were assessed and correlated to intra and p...
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Objective To evaluate the opinion of Holmium laser enucleation of the prostate (HoLEP)-naïve urologists about a surgical simulator and the level of difficulty at each step. Materials and Methods We evaluated 40 HoLEP-naïve urologists in a course involving 4 steps: lecture introducing Holmium laser basics and technique; live surgery; video explaini...
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A queda dos níveis séricos de testosterona em homens de idade avançada – conhecida como andropausa ou hipogonadismo tardio – pode ser responsável por vários aspectos no declínio da qualidade de vida de homens idosos: disfunção erétil, diminuição da libido, redução de força física e energia, sarcopenia, osteopenia, fadiga e até depressão. Muitos de...
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A hiperplasia prostática benigna (HPB) ocorre em até 80% dos homens acima de 70 anos. A prevalência da HPB aumenta com a idade, desde aproximadamente 25% dos homens com menos de 50 anos até 90% na oitava década de vida. Opções de tratamento para os sintomas de trato urinário inferior (STUI) secundários à HPB, por muito tempo, foram restritos a tera...
Article
Escroto agudo (EA) é uma síndrome caracterizada por dor escrotal aguda, frequentemente acompanhada por edema escrotal e outros sinais e sintomas locais e sistêmicos. EA pode ser a apresentação inicial de diversas doenças, incluindo torção testicular, orquite, epididimite, torção de hidátide, hérnia inguinal estrangulada e, menos frequentemente, hem...
Article
Background: Robot-assisted laparoscopic radical prostatectomy (RARP) presents consistent oncological outcomes for prostate cancer; yet continence and potency results are not uniform. We present a technical modification for RARP which preserves the nerves and vascular structures anterior to the prostate aiming to optimize functional outcomes. Obje...
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Objective: To evaluate the relation between serum total testosterone (TT) and prostate cancer (PCa) grade and the effect of race and demographic characteristics on such association. Method: We analyzed 695 patients undergoing radical prostatectomy (RP), of whom 423 had serum TT collected. Patients were classified as having hypogonadism or eugonadi...
Article
e16056 Background: Partial nephrectomy (PN) is the standard of care in the management of cT1a tumors, while radical nephrectomy (RN) is indicated in more advanced tumors. Recent studies provided evidence that PN could be performed in patients with tumors greater that 7 cm with complication rates and oncological outcomes comparable with those underg...
Article
Objective: to evaluate gene expression of Collagen, Matrix Metalloproteinases (MMP) and Inhibitors, Cholinergic Muscarinic Receptors (CHRM), Angiogenic and Nerve Growth Factors (NGF) in the bladder of patients with Bladder Outlet Obstruction due to Benign Prostatic Hyperplasia METHODS: We analyzed bladder specimens from 43 patients with obstructiv...
Article
Introduction: Failure after pyeloplasty for Ureteropelvic Junction Obstruction (UPJO) in children may occur in up to 10% of cases. Treatment options include double-J stent placement, endoscopic treatment and reoperation. Laparoscopic and robotic reoperative modalities seem safe and efficacious, although pediatric series are limited in the literatu...

Citations

... This was associated with a further decline during recovery, but normal levels of testosterone, LH, FSH, oestradiol, and prolactin. On the contrary, Neto et al. [117] observed an increased pornography consumption and masturbatory frequency among the studied population, although there was a marked decline in libido and general sexual satisfaction. The increased pornography consumption explains the upsurge in the statistics reported by pornography websites [118]. ...
... 8,9,18e28 Characteristics of included studies are summarized in Table 1. There were 7 prospective studies, 9,18,20,21,23,25,26 4 retrospective studies, 19,24,27,28 and 1 study with prospective and retrospective phases (treated as separate studies in meta-analysis). 8 Five corresponding authors were contacted for raw data; 19,21,22,27,28 this was successful in 4 instances. ...
... Повышенные до операции уровни фактора роста нервов и ММП-1 коррелировали с сохранением гиперактивности детрузора через 12 месяцев после операции. То есть уровень маркеров воспаления коррелировал с функциональным состоянием мочевого пузыря и прогнозом его восстановления [46]. К таким же выводам пришли I. Offiah и соавт., которые установили повышенную экспрессию генов FGF7 и CCL21, связанных с воспалением, у больных с выраженной дисфункцией мочевого пузыря, причем степень экспрессии коррелировала с выраженностью клинических симптомов расстройства мочеиспускания [47]. ...
... In line with our results, Srougi et al. [21] found that the mean Charlson score was 3.6 ± 1.3 in the older group and 0.89 ± 1.0 in the younger group, and elderly patients had a higher rate of postoperative complications (60% vs 18.9%, P = 0.01), but they did not adjusted the risk of complications for comorbidities as we did. Nevertheless, in a more recent study [22], the same authors included a larger number of patients, and they performed a multivariate analysis including age and comorbidities, observing that patients age (P = 0.004), comorbidities (P = 0.003) and pathological diagnosis (P = 0.003) were independent predictors of postoperative complications. In contrast with our results, a recent study comparing laparoscopic outcomes in elderly and young pheochromocytoma patients [23], did not find any difference in terms of haemodynamic changes during surgery and complications. ...
... Of them, 57% thought that simulation training programs enhance the operational safety of the patients. 23 Essential advantages include the prostate model's realistic appearance, irrigation, tactile feedback during the procedure, laser-tissue interaction, and subsequent bubbles produced. Also, feasible training and assessment components include anatomy identification, positioning the laser fiber, effective technique, avoiding damage to viscera, instrument damage, and blood loss. ...
... Data regarding the optimal type of ligation and sequence (delayed vs. en bloc) ligation of the DVC are inconsistent and need further investigation. Furthermore, Carvalho et al. reported outstanding functional outcomes (98.4% continence, 86% potency 1-year postsurgery) in a small case series of 128 patients who underwent RALP, relying on a retrograde release of the neurovascular bundle with complete preservation of the DVC and visceral endopelvic fascia (14). Whether these results are based on the surgical technique or due to a study/patient selection bias have controversially been discussed recently, and further, largerscaled studies are needed to evaluate the optimal surgical DVC approach (14)(15)(16). ...
... High definition scrotal Doppler Ultrasound (DUS) has demonstrated elevated accuracy rates, and is regarded as the standard imaging for the diagnosis of TT [7]. However, as TT is found in less than 30% of patients with acute scrotum [8,9], routine DUS may delay treatment to positive cases on one hand, and burden the system with unnecessary tests on the other. This can significantly impact services with limited availability of diagnostic resources, as well as busy EDs with prolonged wait times. ...
... DMII and obesity were associated with low serum testosterone levels and increased estrogen levels, correlated with high-grade PCa [23]. Some reports have suggested that low levels of testosterone were associated with aggressive PCa, inadequate treatment after radical prostatectomy, high-grade PCa (Gleason Score 8-10) and locally advanced prostate cancer (pT3 and pT4) [128][129][130][131]. These observations suggest a possible role of sex steroid hormones in the contribution of obesity and DMII in high-grade PCa. ...
... Previous studies [8,9] suggested a potential role of elevated pressure acting on bladder smooth muscle cells to increase collagen production in the obstructed bladder [36][37][38]. While that remains true, the present study contributed new findings that urothelial cells isolated from acute or chronic BOO rats express elevated levels of pro-fibrotic genes. ...
... Primary endpoint was success rate, which was defined as patient-reported symptom improvement, as reported in other series [12], and DRF improvement or stabilization (variation < 5%). Secondary endpoints were glomerular filtration rate (GFR) and complications with 90 days of surgery. ...