Carlos Silva - Academia.edu (original) (raw)
Papers by Carlos Silva
With this review article, we intend to demonstrate the importance of Computerized Tomography (CT)... more With this review article, we intend to demonstrate the importance of Computerized Tomography (CT) in healthcare quality and safety. The concept of safety in CT is wider than for general healthcare. Safe healthcare provided using CT must include diagnostic image quality and reliability, as this is the only way to ensure diagnostic accuracy. The images must be acquired with the most adequate protocols available and with the lowest achievable radiation dose. In this article we will focus primarily on the concepts of dose, since this variable strongly affects the image quality and the consequent diagnostic accuracy. In methodological terms, 73 papers and 6 catalogues issued by the manufacturers of CT equipment, that included the keywords low dose, ultra-low dose and dose reduction were analysed. After review of these articles we found that about 82% are chest exams, namely the lungs. The remaining were subdivided mainly by studies of the sinuses, heart and bone segments. After this revi...
The application of management tools to the radiology service can represent an important role in t... more The application of management tools to the radiology service can represent an important role in the improvement of the procedures executed, namely those of a digital mammography room, once by the efficient control of the processes, it´s possible to reach the goals of the radiology service. In this area, the audits, as well as their approach executed, have an increasing important role to the improvement of the healthcare provided, by the normalization and improvement of the audited processes. To reach this goal, it´s essential that all the standards and processes became a part of a quality manual, once this should represent a reference element and the standardization of the methods to apply in the quality management, namely on those that refers to the patients satisfaction and those that refers to the optimization of processes.
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Elaborado por la Comisión de Revisión de la Propuesta de Código Modelo de Cooperación Interjurisd... more Elaborado por la Comisión de Revisión de la Propuesta de Código Modelo de Cooperación Interjurisdiccional para Iberoamérica [Ada Pellegrini Grinover, Brasil ; Ricardo Perlingeiro Mendes da Silva, Brasil ; Abel Augusto Zamorano, Panamá; Ángel Landoni Sosa, Uruguay; Carlos Ferreira da Silva, Portugal; Eduardo Véscovi, Uruguay; Juan Antonio Robles Garzón, España; Luis Ernesto Vargas Silva, Colombia; Roberto Omar Berizonce, Argentina. Texto aprobado en la Reunión presencial ocurrida el 15 de setiembre de 2007, en el Hotel Pestana, Salvador / Bahía, en ocasión del XIII Congreso Mundial de Derecho Procesal de la Asociación Internacional de Derecho Procesal, revisado el 15 de octubre de 2007. Código aprobado en la Assemblea General do Instituto Iberoamericano de Derecho Procesal, ocorrida el 17 de octubre de 2008, por ocasión das XXI Jornadas Iberoamericanas de Derecho Procesal, Lima, Perú. Text drafted by the Review Committee for the Draft Model Code of Interjurisdictional Cooperation for...
Managing Organic Matter in Tropical Soils: Scope and Limitations, 2001
Because of cost reductions and soil erosion control, no-tillage is being rapidly adopted by farme... more Because of cost reductions and soil erosion control, no-tillage is being rapidly adopted by farmers in the Americas, particularly in the humid and sub-humid tropics. Compared to conventional tillage (tillage operations resulting in <30% cover of plant residue remaining on the surface), no-tillage combined with crop rotation involving cover crops increases soil organic matter content, whilst improving soil fertility. This was mostly evident at 0-5 cm depth. Further successful adoption by farmers, including smallholder farmers from different regions, depends on improvements of various aspects, from edaphological constraints (e.g. in Brazil) to social and infrastructural limitations (e.g. in West and Central Africa). Special emphasis is given to the effects of no-tillage on soil organic matter and the consequences on some chemical (e.g. subsoil acidity, fertilizer management) and physical properties of soils (e.g. soil compaction, aggregate stability). Research imperatives for regional improvement or adaptation of such a conservation tillage are emphasized together with social and economical aspects for its adoption.
Turning up the Heat on Pain: TRPV1 Receptors in Pain and Inflammation, 2005
... J Urol 155: 379385 44 Dasgupta P, Chandiramani V , Parkinson MC, Beckett A, Fowler CJ (1998)... more ... J Urol 155: 379385 44 Dasgupta P, Chandiramani V , Parkinson MC, Beckett A, Fowler CJ (1998) Treating the human bladder with capsaicin: is it ... BJU Int 94: 153157 47 Maggi CA, Barbanti G, Santicioli P, Beneforti P, Misuri D, Meli A, Turini D (1989) Cys-tometric evidence ...
Ciência e Agrotecnologia, 2004
Com este estudo, teve-se por objetivo avaliar os efeitos de densidades de plantio e de manejo da ... more Com este estudo, teve-se por objetivo avaliar os efeitos de densidades de plantio e de manejo da calagem sobre os atributos de fertilidade de Latossolo e sobre o estado nutricional e produtividade do cafeeiro (Coffea arabica L.). O estudo foi conduzido de fevereiro de 2000 a junho de 2003 na Fazenda Experimental da EPAMIG, em São Sebastião do Paraíso (MG). Os tratamentos testados consistiram da combinação de duas densidades populacionais (2.857 e 10.000 plantas ha-1) com três métodos de manejo de calagem (sem aplicação de calcário; calagem superficial e incorporação de calcário de 0 a 20 cm), além de um tratamento com aplicação de calcário (0 a 20 cm) e gesso. O solo foi amostrado nas camadas de 0 a 10, 10 a 20 e 20 a 40 cm de profundidade, em quatro épocas de amostragem, sendo realizadas as seguintes determinações analíticas: pH, Ca e Mg trocáveis, P (Mehlich-1), sulfato, nitrato e amônio, além da saturação por bases. Os métodos de manejo da calagem reduziram a acidez na camada de ...
Proceedings of the International Conference on Logistics, Engineering, Management and Computer Science, 2014
Revista Brasileira de Ciência do Solo, 2010
Neurotoxicology and Teratology, 2012
Methamphetamine leads to functional changes in basal ganglia that are linked to impairment in mot... more Methamphetamine leads to functional changes in basal ganglia that are linked to impairment in motor activity. Previous studies from our group and others have shown that a single high-methamphetamine injection induces striatal dopaminergic changes in rodents. However, striatal glutamatergic, GABAergic and serotoninergic changes remain elusive under this methamphetamine regimen. Moreover, nothing is known about the participation of the receptor for advanced glycation end-products (RAGE), which is overexpressed upon synaptic dysfunction and glial response, on methamphetamine-induced striatal dysfunction. The aim of this work was to provide an integrative characterization of the striatal changes in amino acids, monoamines and astroglia, as well as in the RAGE levels, and the associated motor activity profile of C57BL/6 adult mice, 72 h after a single-high dose of methamphetamine (30 mg/kg, i.p.). Our findings indicate, for the first time, that methamphetamine decreases striatal glutamine, glutamate and GABA levels, as well as glutamine/glutamate and GABA/glutamate ratios, while serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) levels remain unchanged. This methamphetamine regimen also produced dopaminergic terminal degeneration in the striatum, as evidenced by dopamine and tyrosine hydroxylase depletion. Consistently, methamphetamine decreased the locomotor activity of mice, in the open field test. In addition, increased levels of glutamine synthase and glial fibrillary acidic protein were observed. Nevertheless, methamphetamine failed to change RAGE levels. Our results show that acute methamphetamine intoxication induces pronounced changes in the striatal glutamatergic/GABAergic and dopaminergic homeostasis, along with astrocyte activation. These neurochemical and glial alterations are accompanied by impairment in locomotor activity.
Marine Environmental Research, 2013
Benzo(a)pyrene (BaP) is considered an important marine environmental contaminant, given its recog... more Benzo(a)pyrene (BaP) is considered an important marine environmental contaminant, given its recognised environmental persistence and toxicity. However, its effects in marine crustaceans are poorly studied, namely the accumulation and sub-cellular effects that might be linked to behavioural alterations and may lead to ecologically relevant consequences. This study aims to investigate behavioural and physiological responses of the common prawn (Palaemon serratus) after acute exposure to BaP and infer the potential effects for the population in the wild. The applied approach included the evaluation of swimming performance after exposure, and several biochemical biomarkers involved in biotransformation, oxidative damage, energy production and levels of BaP-type compounds in tissues (eye, digestive gland and muscle) in a 96 h acute bioassay with exposure to BaP (16-4096 μg/L). The objective was to establish a link between behaviour (swimming velocity) and biochemical responses in order to assess the ecological relevance of the effects induced by BaP in P. serratus and to select useful tools for environmental risk assessment. Results showed swimming velocity impairment (LOEC = 128 μg/L), lipid peroxidation (LPO) induction (LOEC = 4096 μg/L) and BaP-type compounds increase in eye (LOEC = 32 μg/L), digestive gland and muscle (LOEC = 512 μg/L) of prawn after exposure to BaP. This oxidative damage in lipids seems to be caused by the incapacity to activate detoxification and anti-oxidant enzymes, once glutathione-S-transferase (GST), catalase (CAT) and glutathione peroxidase (GPx) were not affected by the exposure. This could be also an explanation to the increased levels of BaP-type compounds observed in tissues. An inability to increase the activities of enzymes involved in the production of energy was also observed, which may help to explain the detoxification failure and consequent increased levels of lipid peroxidation. The inhibition of swimming velocity was negatively correlated with biochemical parameters, including the presence of BaP-type compounds in different tissues and LPO, and thus, these parameters might be used as ecologically relevant and early-warning tools to assess the effects of PAHs. This study also highlights the usefulness of the fixed wavelength fluorescence (FF) technique to quantify PAHs-type compounds in tissues as indicative of exposure of P. serratus to PAHs, namely the sensitivity of eyes, which might be used for monitoring purposes and in marine ecological risk assessment studies.
The Journal of Urology, 2010
European Urology, 2011
Background: Contemporary surgical treatment of female stress urinary incontinence (SUI) includes ... more Background: Contemporary surgical treatment of female stress urinary incontinence (SUI) includes retropubic and transobturator (TO) midurethral slings (MUS). Case series of single-incision slings (SIS) have shown similar outcomes with lower morbidity. Objective: Our aim was to assess the cure rates, complications, and quality-of-life impact of one standard TO MUS and two SIS. Design, setting, and participants: Ninety consecutive patients with clinically and urodynamically proven SUI were enrolled in an exploratory randomised phase 2 trial. Patients with previous SUI surgery, major pelvic organ prolapse, mixed incontinence, or detrusor overactivity were excluded. Interventions: Patients were treated randomly with TVT-O, TVT-Secur, or Mini-Arc. Measurements: Postoperative visits were scheduled at 6 and 12 mo. The King's Health Questionnaire (KHQ) was repeated at 6 mo. Cure was defined as the absence of urine leakage, no pad use, and a negative cough test at 12 mo. Pain and other complications were also investigated. Results and limitations: Cure rate was 83% after TVT-O, 67% after TVT-Secur, and 87% after Mini-Arc. Improvement was found in 10%, 13%, and 7% of the patients, respectively. Failures were 7% after TVT-O and Mini-Arc and 20% after TVT-Secur. TVT-O and Mini-Arc improved at least 15 points in >80% of the patients in six KHQ domains, whereas TVT-Secur could only achieve improvement in three of the nine domains. The pain score was lower in the Mini-Arc group. Complications were more numerous after TVT-O. This study has the limitations inherent in a phase 2 trial with a follow-up limited to 12 mo. Conclusions: Mini-Arc offers cure and improvement rates similar to TVT-O, whereas TVT-Secur may yield an inferior outcome. These findings recommend the urgent launch of large randomised phase 3 studies comparing conventional MUS with SIS, with Mini-Arc the advised option.
BJU International, 2010
Erectile Function-Short Form (IIEF-5) questionnaire. • Orgasmic/ejaculatory function and libido w... more Erectile Function-Short Form (IIEF-5) questionnaire. • Orgasmic/ejaculatory function and libido were evaluated using questions 9, 10, 11 and 12 of the IIEF-Long Form. Total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin were also investigated. RESULTS • The mean age was 73 ± 6 years. The IIEF-5 score was 16.5 ± 6 at baseline, 15.7 ± 6 at 1 month, 16.6 ± 6 at 3 months and 15.7 ± 5 at 6 months (differences nonsignificant). • The score for ejaculatory/orgasmic function (questions 9 and 10) remained fairly constant from baseline to the sixth month, 8.3 ± 1.9 and 8 ± 2.1 respectively. • The sexual desire score (questions 11 and 12 of the IIEF) also remained little changed from baseline (5.9 ± 1.6) to month 6 (6.1 ± 2). Total serum testosterone, LH, FSH and prolactin did not change during the study. CONCLUSIONS • Intraprostatic injection of BoNT/A in patients with BPE does not impair erectile, orgasmic or ejaculatory functions and does not change libido. • The male hormonal profile is not altered by BoNT/A injection. This facilitates the acceptance of BoNT/A as a treatment for BPH/BPE lower urinary tract symptoms (LUTS) refractory to standard medical management.
BMC Urology, 2007
Background Bladder desensitization has been investigated as an alternative treatment for refracto... more Background Bladder desensitization has been investigated as an alternative treatment for refractory detrusor overactivity. Most open and controlled clinical trials conducted with intravesical RTX showed that desensitization delays the appearance of involuntary detrusor contractions during bladder filling and decreases the number of episodes of urgency incontinence. Urgency is being recognised as the fundamental symptom of overactive bladder (OAB), a symptomatic complex which recent epidemiological studies have shown to affect more than 10% of the Western population. As anti-muscarinic drugs, the first line treatment for OAB, are far from being able to fully control urgency, the opportunity to test other therapeutic approaches is created. The present work was, therefore, designed as an exploratory investigation to evaluate the effect of bladder desensitization on urinary urgency. Methods Twenty-three OAB patients with refractory urgency entered, after given informed consent, a 30 day...
Proc. of the 4th IASME/ …, 2008
Abstract: There is a growing concern on environmental impacts resulted from construction activiti... more Abstract: There is a growing concern on environmental impacts resulted from construction activities. Environmental assessment is a tool for reviewing, monitoring, checking and evaluating environmental performance for the construction industry, has been advocated. ...
Page 1. Geometrical configuration of the Pareto frontier of bi-criteria {0,1}-knapsack problems C... more Page 1. Geometrical configuration of the Pareto frontier of bi-criteria {0,1}-knapsack problems Carlos Gomes da Silva(2;3), João Clímaco(1;3), José Figueira(1;3) (1) Faculdade de Economia da Universidade de Coimbra Av. ...
With this review article, we intend to demonstrate the importance of Computerized Tomography (CT)... more With this review article, we intend to demonstrate the importance of Computerized Tomography (CT) in healthcare quality and safety. The concept of safety in CT is wider than for general healthcare. Safe healthcare provided using CT must include diagnostic image quality and reliability, as this is the only way to ensure diagnostic accuracy. The images must be acquired with the most adequate protocols available and with the lowest achievable radiation dose. In this article we will focus primarily on the concepts of dose, since this variable strongly affects the image quality and the consequent diagnostic accuracy. In methodological terms, 73 papers and 6 catalogues issued by the manufacturers of CT equipment, that included the keywords low dose, ultra-low dose and dose reduction were analysed. After review of these articles we found that about 82% are chest exams, namely the lungs. The remaining were subdivided mainly by studies of the sinuses, heart and bone segments. After this revi...
The application of management tools to the radiology service can represent an important role in t... more The application of management tools to the radiology service can represent an important role in the improvement of the procedures executed, namely those of a digital mammography room, once by the efficient control of the processes, it´s possible to reach the goals of the radiology service. In this area, the audits, as well as their approach executed, have an increasing important role to the improvement of the healthcare provided, by the normalization and improvement of the audited processes. To reach this goal, it´s essential that all the standards and processes became a part of a quality manual, once this should represent a reference element and the standardization of the methods to apply in the quality management, namely on those that refers to the patients satisfaction and those that refers to the optimization of processes.
Elaborado por la Comisión de Revisión de la Propuesta de Código Modelo de Cooperación Interjurisd... more Elaborado por la Comisión de Revisión de la Propuesta de Código Modelo de Cooperación Interjurisdiccional para Iberoamérica [Ada Pellegrini Grinover, Brasil ; Ricardo Perlingeiro Mendes da Silva, Brasil ; Abel Augusto Zamorano, Panamá; Ángel Landoni Sosa, Uruguay; Carlos Ferreira da Silva, Portugal; Eduardo Véscovi, Uruguay; Juan Antonio Robles Garzón, España; Luis Ernesto Vargas Silva, Colombia; Roberto Omar Berizonce, Argentina. Texto aprobado en la Reunión presencial ocurrida el 15 de setiembre de 2007, en el Hotel Pestana, Salvador / Bahía, en ocasión del XIII Congreso Mundial de Derecho Procesal de la Asociación Internacional de Derecho Procesal, revisado el 15 de octubre de 2007. Código aprobado en la Assemblea General do Instituto Iberoamericano de Derecho Procesal, ocorrida el 17 de octubre de 2008, por ocasión das XXI Jornadas Iberoamericanas de Derecho Procesal, Lima, Perú. Text drafted by the Review Committee for the Draft Model Code of Interjurisdictional Cooperation for...
Managing Organic Matter in Tropical Soils: Scope and Limitations, 2001
Because of cost reductions and soil erosion control, no-tillage is being rapidly adopted by farme... more Because of cost reductions and soil erosion control, no-tillage is being rapidly adopted by farmers in the Americas, particularly in the humid and sub-humid tropics. Compared to conventional tillage (tillage operations resulting in <30% cover of plant residue remaining on the surface), no-tillage combined with crop rotation involving cover crops increases soil organic matter content, whilst improving soil fertility. This was mostly evident at 0-5 cm depth. Further successful adoption by farmers, including smallholder farmers from different regions, depends on improvements of various aspects, from edaphological constraints (e.g. in Brazil) to social and infrastructural limitations (e.g. in West and Central Africa). Special emphasis is given to the effects of no-tillage on soil organic matter and the consequences on some chemical (e.g. subsoil acidity, fertilizer management) and physical properties of soils (e.g. soil compaction, aggregate stability). Research imperatives for regional improvement or adaptation of such a conservation tillage are emphasized together with social and economical aspects for its adoption.
Turning up the Heat on Pain: TRPV1 Receptors in Pain and Inflammation, 2005
... J Urol 155: 379385 44 Dasgupta P, Chandiramani V , Parkinson MC, Beckett A, Fowler CJ (1998)... more ... J Urol 155: 379385 44 Dasgupta P, Chandiramani V , Parkinson MC, Beckett A, Fowler CJ (1998) Treating the human bladder with capsaicin: is it ... BJU Int 94: 153157 47 Maggi CA, Barbanti G, Santicioli P, Beneforti P, Misuri D, Meli A, Turini D (1989) Cys-tometric evidence ...
Ciência e Agrotecnologia, 2004
Com este estudo, teve-se por objetivo avaliar os efeitos de densidades de plantio e de manejo da ... more Com este estudo, teve-se por objetivo avaliar os efeitos de densidades de plantio e de manejo da calagem sobre os atributos de fertilidade de Latossolo e sobre o estado nutricional e produtividade do cafeeiro (Coffea arabica L.). O estudo foi conduzido de fevereiro de 2000 a junho de 2003 na Fazenda Experimental da EPAMIG, em São Sebastião do Paraíso (MG). Os tratamentos testados consistiram da combinação de duas densidades populacionais (2.857 e 10.000 plantas ha-1) com três métodos de manejo de calagem (sem aplicação de calcário; calagem superficial e incorporação de calcário de 0 a 20 cm), além de um tratamento com aplicação de calcário (0 a 20 cm) e gesso. O solo foi amostrado nas camadas de 0 a 10, 10 a 20 e 20 a 40 cm de profundidade, em quatro épocas de amostragem, sendo realizadas as seguintes determinações analíticas: pH, Ca e Mg trocáveis, P (Mehlich-1), sulfato, nitrato e amônio, além da saturação por bases. Os métodos de manejo da calagem reduziram a acidez na camada de ...
Proceedings of the International Conference on Logistics, Engineering, Management and Computer Science, 2014
Revista Brasileira de Ciência do Solo, 2010
Neurotoxicology and Teratology, 2012
Methamphetamine leads to functional changes in basal ganglia that are linked to impairment in mot... more Methamphetamine leads to functional changes in basal ganglia that are linked to impairment in motor activity. Previous studies from our group and others have shown that a single high-methamphetamine injection induces striatal dopaminergic changes in rodents. However, striatal glutamatergic, GABAergic and serotoninergic changes remain elusive under this methamphetamine regimen. Moreover, nothing is known about the participation of the receptor for advanced glycation end-products (RAGE), which is overexpressed upon synaptic dysfunction and glial response, on methamphetamine-induced striatal dysfunction. The aim of this work was to provide an integrative characterization of the striatal changes in amino acids, monoamines and astroglia, as well as in the RAGE levels, and the associated motor activity profile of C57BL/6 adult mice, 72 h after a single-high dose of methamphetamine (30 mg/kg, i.p.). Our findings indicate, for the first time, that methamphetamine decreases striatal glutamine, glutamate and GABA levels, as well as glutamine/glutamate and GABA/glutamate ratios, while serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) levels remain unchanged. This methamphetamine regimen also produced dopaminergic terminal degeneration in the striatum, as evidenced by dopamine and tyrosine hydroxylase depletion. Consistently, methamphetamine decreased the locomotor activity of mice, in the open field test. In addition, increased levels of glutamine synthase and glial fibrillary acidic protein were observed. Nevertheless, methamphetamine failed to change RAGE levels. Our results show that acute methamphetamine intoxication induces pronounced changes in the striatal glutamatergic/GABAergic and dopaminergic homeostasis, along with astrocyte activation. These neurochemical and glial alterations are accompanied by impairment in locomotor activity.
Marine Environmental Research, 2013
Benzo(a)pyrene (BaP) is considered an important marine environmental contaminant, given its recog... more Benzo(a)pyrene (BaP) is considered an important marine environmental contaminant, given its recognised environmental persistence and toxicity. However, its effects in marine crustaceans are poorly studied, namely the accumulation and sub-cellular effects that might be linked to behavioural alterations and may lead to ecologically relevant consequences. This study aims to investigate behavioural and physiological responses of the common prawn (Palaemon serratus) after acute exposure to BaP and infer the potential effects for the population in the wild. The applied approach included the evaluation of swimming performance after exposure, and several biochemical biomarkers involved in biotransformation, oxidative damage, energy production and levels of BaP-type compounds in tissues (eye, digestive gland and muscle) in a 96 h acute bioassay with exposure to BaP (16-4096 μg/L). The objective was to establish a link between behaviour (swimming velocity) and biochemical responses in order to assess the ecological relevance of the effects induced by BaP in P. serratus and to select useful tools for environmental risk assessment. Results showed swimming velocity impairment (LOEC = 128 μg/L), lipid peroxidation (LPO) induction (LOEC = 4096 μg/L) and BaP-type compounds increase in eye (LOEC = 32 μg/L), digestive gland and muscle (LOEC = 512 μg/L) of prawn after exposure to BaP. This oxidative damage in lipids seems to be caused by the incapacity to activate detoxification and anti-oxidant enzymes, once glutathione-S-transferase (GST), catalase (CAT) and glutathione peroxidase (GPx) were not affected by the exposure. This could be also an explanation to the increased levels of BaP-type compounds observed in tissues. An inability to increase the activities of enzymes involved in the production of energy was also observed, which may help to explain the detoxification failure and consequent increased levels of lipid peroxidation. The inhibition of swimming velocity was negatively correlated with biochemical parameters, including the presence of BaP-type compounds in different tissues and LPO, and thus, these parameters might be used as ecologically relevant and early-warning tools to assess the effects of PAHs. This study also highlights the usefulness of the fixed wavelength fluorescence (FF) technique to quantify PAHs-type compounds in tissues as indicative of exposure of P. serratus to PAHs, namely the sensitivity of eyes, which might be used for monitoring purposes and in marine ecological risk assessment studies.
The Journal of Urology, 2010
European Urology, 2011
Background: Contemporary surgical treatment of female stress urinary incontinence (SUI) includes ... more Background: Contemporary surgical treatment of female stress urinary incontinence (SUI) includes retropubic and transobturator (TO) midurethral slings (MUS). Case series of single-incision slings (SIS) have shown similar outcomes with lower morbidity. Objective: Our aim was to assess the cure rates, complications, and quality-of-life impact of one standard TO MUS and two SIS. Design, setting, and participants: Ninety consecutive patients with clinically and urodynamically proven SUI were enrolled in an exploratory randomised phase 2 trial. Patients with previous SUI surgery, major pelvic organ prolapse, mixed incontinence, or detrusor overactivity were excluded. Interventions: Patients were treated randomly with TVT-O, TVT-Secur, or Mini-Arc. Measurements: Postoperative visits were scheduled at 6 and 12 mo. The King's Health Questionnaire (KHQ) was repeated at 6 mo. Cure was defined as the absence of urine leakage, no pad use, and a negative cough test at 12 mo. Pain and other complications were also investigated. Results and limitations: Cure rate was 83% after TVT-O, 67% after TVT-Secur, and 87% after Mini-Arc. Improvement was found in 10%, 13%, and 7% of the patients, respectively. Failures were 7% after TVT-O and Mini-Arc and 20% after TVT-Secur. TVT-O and Mini-Arc improved at least 15 points in >80% of the patients in six KHQ domains, whereas TVT-Secur could only achieve improvement in three of the nine domains. The pain score was lower in the Mini-Arc group. Complications were more numerous after TVT-O. This study has the limitations inherent in a phase 2 trial with a follow-up limited to 12 mo. Conclusions: Mini-Arc offers cure and improvement rates similar to TVT-O, whereas TVT-Secur may yield an inferior outcome. These findings recommend the urgent launch of large randomised phase 3 studies comparing conventional MUS with SIS, with Mini-Arc the advised option.
BJU International, 2010
Erectile Function-Short Form (IIEF-5) questionnaire. • Orgasmic/ejaculatory function and libido w... more Erectile Function-Short Form (IIEF-5) questionnaire. • Orgasmic/ejaculatory function and libido were evaluated using questions 9, 10, 11 and 12 of the IIEF-Long Form. Total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin were also investigated. RESULTS • The mean age was 73 ± 6 years. The IIEF-5 score was 16.5 ± 6 at baseline, 15.7 ± 6 at 1 month, 16.6 ± 6 at 3 months and 15.7 ± 5 at 6 months (differences nonsignificant). • The score for ejaculatory/orgasmic function (questions 9 and 10) remained fairly constant from baseline to the sixth month, 8.3 ± 1.9 and 8 ± 2.1 respectively. • The sexual desire score (questions 11 and 12 of the IIEF) also remained little changed from baseline (5.9 ± 1.6) to month 6 (6.1 ± 2). Total serum testosterone, LH, FSH and prolactin did not change during the study. CONCLUSIONS • Intraprostatic injection of BoNT/A in patients with BPE does not impair erectile, orgasmic or ejaculatory functions and does not change libido. • The male hormonal profile is not altered by BoNT/A injection. This facilitates the acceptance of BoNT/A as a treatment for BPH/BPE lower urinary tract symptoms (LUTS) refractory to standard medical management.
BMC Urology, 2007
Background Bladder desensitization has been investigated as an alternative treatment for refracto... more Background Bladder desensitization has been investigated as an alternative treatment for refractory detrusor overactivity. Most open and controlled clinical trials conducted with intravesical RTX showed that desensitization delays the appearance of involuntary detrusor contractions during bladder filling and decreases the number of episodes of urgency incontinence. Urgency is being recognised as the fundamental symptom of overactive bladder (OAB), a symptomatic complex which recent epidemiological studies have shown to affect more than 10% of the Western population. As anti-muscarinic drugs, the first line treatment for OAB, are far from being able to fully control urgency, the opportunity to test other therapeutic approaches is created. The present work was, therefore, designed as an exploratory investigation to evaluate the effect of bladder desensitization on urinary urgency. Methods Twenty-three OAB patients with refractory urgency entered, after given informed consent, a 30 day...
Proc. of the 4th IASME/ …, 2008
Abstract: There is a growing concern on environmental impacts resulted from construction activiti... more Abstract: There is a growing concern on environmental impacts resulted from construction activities. Environmental assessment is a tool for reviewing, monitoring, checking and evaluating environmental performance for the construction industry, has been advocated. ...
Page 1. Geometrical configuration of the Pareto frontier of bi-criteria {0,1}-knapsack problems C... more Page 1. Geometrical configuration of the Pareto frontier of bi-criteria {0,1}-knapsack problems Carlos Gomes da Silva(2;3), João Clímaco(1;3), José Figueira(1;3) (1) Faculdade de Economia da Universidade de Coimbra Av. ...