WILLIAM CARLOS NAHAS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
137 resultados
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conferenceObject EXPERIENCE WITH COMPLETE TRIGONAL ELECTROFULGURATION FOR WOMEN WITH RECURRENT URINARY TRACT INFECTIONS: TWO YEARS FOLLOW-UP(2021) RIBEIRO-FILHO, Leopoldo; HIRASAKI, Felipe; MIRANDA, Eduardo; SIQUEIRA, Matheus; GOMES, Cristiano; SROUGI, Miguel; NAHAS, William- Correlation of a microRNA expression profile and the prognosis of penile cancer: A prospective study using microarray data analysis(2018) FURUYA, Tatiane K.; MURTA, Claudio B.; PONTES JR., Jose; UNO, Miyuki; CARRASCO, Alexis; SICHERO, Laura C.; VILLA, Luisa L.; COELHO, Rafael F.; GUGLIELMETTI, Giuliano B.; CORDEIRO, Mauricio D.; LEITE, Katia R.; SROUGI, Miguel; CHAMMAS, Roger; NAHAS, William C.
- Percutaneous nephrolithotomy in patients with spinal cord injury: should all these patients be automatically assigned a Guy's stone score of 4?(2021) TORRICELLI, Fabio C. M.; VICENTINI, Fabio C.; ZANETTI, Lucas; PERRELLA, Rodrigo; MARCHINI, Giovanni S.; DANILOVIC, Alexandre; BATAGELLO, Carlos A.; MURTA, Claudio B.; CLARO, Joaquim F. A.; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoPurpose To assess the complication and stone-free rates of PCNL in patients with spinal cord injury (SCI) and to evaluate whether this population should be assigned a Guy's stone score (GSS) of 4. Methods A case-control study was conducted, and electronic charts were reviewed to search for patients with SCI, bladder dysfunction, and kidney stones who had undergone PCNL. Control cases were randomly selected from among patients with complete staghorn calculus (GSS = 4). Results One hundred and seventeen patients were included. Patients with SCI had a significant shorter operative time (119 vs. 141 min;p = 0.018). There were no significant differences between the groups in terms of the patients' position, number of renal tracts, bleeding or transfusion rate; however, there was a significantly higher complication rate (23.1% vs. 7.8%;p = 0.009) and a longer hospital stay (5.8 vs. 3.1 days;p = 0.002) among patients with SCI. With regards to the stone-free rate in patients with different grades of GSS patients with SCI who had a GSS of 1 had a stone-free rate of 85.7%, while those with a GSS of 2, 3, or 4 had 50%, 50%, and 31.5%, respectively (p = 0.024). Only patients with a GSS of 4 in the SCI group had outcomes that were similar to those of control patients (31.5% vs. 31.6%). Conclusion Patients with SCI should not be automatically assigned GSS 4. Stone-free rate is related to stone burden in these patients, although they do show a higher complication rate and a longer hospital stay than non-neurological patients.
conferenceObject GLUT1 Expression Is Related to Tumor Recurrence and Survival in Renal Cell Carcinoma Clear Cell Type(2017) LEITE, Katia R. M.; CARVALHO, Paulo A.; PINHEIRO, Celine M.; REIS, Sabrina T.; SROUGI, Miguel; NAHAS, William C.conferenceObject GLUT1 Expression Is Related to Tumor Recurrence and Survival in Renal Cell Carcinoma Clear Cell Type(2017) LEITE, Katia R. M.; CARVALHO, Paulo A.; PINHEIRO, Celme M.; REIS, Sabrina T.; SROUGI, Miguel; NAHAS, William C.- Gene expression profile of renal cell carcinomas after neoadjuvant treatment with sunitinib: new pathways revealed(2017) DZIK, Carlos; REIS, Sabrina T.; VIANA, Nayara I.; BRITO, Glauber; PALOPPI, Isis; NAHAS, Willian; SROUGI, Miguel; LEITE, Katia R. M.Background: In renal cell carcinoma (RCC) of the clear cell type, inactivity of the VHL gene induces overexpression of HIF1 alpha and its targets, the tyrosine kinase receptors, promoting RCC development and progression. The discovery of tyrosine kinase inhibitors (TKIs) changed the treatment of these tumors. Other molecular pathways involved in the TKI mechanisms of action have not been described in the literature. The aim of our study was to elucidate alternative mechanisms of action of sunitinib in tumor tissue after neoadjuvant treatment of RCC. Methods: The gene expression profile was accessed using microarray (Affymetrix Human Genome U133 Plus 2.0 platform) and frozen RCC tissues collected from 5 patients with locally advanced non-metastatic tumors who underwent nephrectomy after being treated with 2 cycles of neoadjuvant sunitinib. The results were compared with matched controls comprising 6 patients with no neoadjuvant intervention. Results: There was underexpression of the majority of genes after sunitinib treatment. The lower expression levels of IGFBP1, CCL20, CXCL6 and FGB were confirmed by qRT-PCR in all cases. The downregulation of gene expression leads us to search for methylation as a mechanism of action of the TKI. IGFBP1 was shown to be methylated by methylation-sensitive high-resolution melting technique. Conclusions: The ultimate genetic effects of sunitinib may explain its actions as an antitumor drug that apparently suppresses the expression of important genes related to cell survival, adhesion, invasion and immunomodulation. The methylation of gene promoters was shown to be part of the mechanism of action of this class of drugs.
- Bilateral simultaneous percutaneous nephrolithotomy versus staged approach: a critical analysis of complications and renal function(2020) TORRICELLI, Fabio C. M.; CARVALHO, Regina S.; MARCHINI, Giovanni S.; DANILOVIC, Alexandre; VICENTINI, Fabio C.; BATAGELLO, Carlos A.; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoINTRODUCTION: Patients with bilateral kidney stones and burdened by large stones are challenging cases for endourologists. Simultaneous bilateral percutaneous nephrolithotomy (sbPCNL) is an option; however, it may be accompanied by important morbidity. An alternative is a staged PCNL, operating one side each time. Herein, we compare the impact of sbPCNL and staged PCNL on complication rates and renal function. METHODS: Patients who underwent sbPCNL or staged bilateral PCNL with a frame time of 6 months were searched in our prospectively collected kidney stone database. Groups were compared for age, gender, body mass index (BMI), comorbidities (classification by the American Society of Anesthesiology - ASA), stone size, Guy's score, stone-free status, renal function, blood loss, blood transfusion rate, complication rate, and length of hospital stay. RESULTS: Twenty-six patients and 52 kidney units were enrolled. The mean operative time was 134.7 min. Only 11.3% of cases had complications, all of them minor (Clavien <= 2). Overall, the stone-free rate was 61.50%. Comparing the groups, there was a significantly longer operative time in the sbPCNL group (172.5 vs. 126.3 min; p=0.016), as well as a higher transfusion rate (12.5% vs. 5.6%; p=0.036). There was no statistically significant difference in creatinine levels between the groups. Regarding the stone-free rate, there was a significantly higher proportion of patients in the staged PCNL group (64.9% vs. 43.8%; p=0.012). CONCLUSION: sbPCNL is a safe procedure; however, when compared to staged procedures it has a higher transfusion and lower stonefree rate.
- Detecting and grading prostate cancer in radical prostatectomy specimens through deep learning techniques(2021) MELO, Petronio Augusto de Souza; ESTIVALLET, Carmen Liane Neubarth; SROUGI, Miguel; NAHAS, William Carlos; LEITE, Katia Ramos MoreiraOBJECTIVES: This study aims to evaluate the ability of deep learning algorithms to detect and grade prostate cancer (PCa) in radical prostatectomy specimens. METHODS: We selected 12 whole-slide images of radical prostatectomy specimens. These images were divided into patches, and then, analyzed and annotated. The annotated areas were categorized as follows: stroma, normal glands, and Gleason patterns 3, 4, and 5. Two analyses were performed: i) a categorical image classification method that labels each image as benign or as Gleason 3, Gleason 4, or Gleason 5, and ii) a scanning method in which distinct areas representative of benign and different Gleason patterns are delineated and labeled separately by a pathologist. The Inception v3 Convolutional Neural Network architecture was used in categorical model training, and a Mask Region-based Convolutional Neural Network was used to train the scanning method. After training, we selected three new whole-slide images that were not used during the training to evaluate the model as our test dataset. The analysis results of the images using deep learning algorithms were compared with those obtained by the pathologists. RESULTS: In the categorical classification method, the trained model obtained a validation accuracy of 94.1% during training; however, the concordance with our expert uropathologists in the test dataset was only 44%. With the image-scanning method, our model demonstrated a validation accuracy of 91.2%. When the test images were used, the concordance between the deep learning method and uropathologists was 89%. CONCLUSION: Deep learning algorithms have a high potential for use in the diagnosis and grading of PCa. Scanning methods are likely to be superior to simple classification methods.
- Percutaneous thermoablation of small renal masses (T1a) in surgical candidate patients: oncologic outcomes(2021) ZANGIACOMO, Renato N.; MARTINS, Guilherme L. P.; VIANA, Publio C. C.; HORVAT, Natally; ARAP, Marco A.; NAHAS, William C.; SROUGI, Miguel; CERRI, Giovanni G.; MENEZES, Marcos R.Objective To evaluate the local tumour progression-free survival (LTPFS), metastasis-free survival (MFS), cancer-specific survival (CSS) and overall survival (OS) of healthy surgical candidates who underwent percutaneous thermoablation (TA) as a first-line therapy for small renal masses (T1a). Methods The institutional review board approved this bi-institutional retrospective study of 85 consecutive surgical candidates with 97 biopsy-proven malignant renal masses (T1a) treated with percutaneous TA from 2008 to 2016. The LTPFS, MFS, CSS and OS rates were calculated using the Kaplan-Meier method. Descriptive analysis was also performed. Results The median tumour size was 2.3 cm (range, 0.7-3.9 cm). The minimal and mean follow-up periods were 24 and 56 months, respectively. Local recurrence was detected in four patients (4.7%) at 8.5, 13.8, 58.0 and 64.0 months of follow-up and retreated successfully with percutaneous TA. No patient developed metastatic renal cell carcinoma, and none died due to renal oncologic complications. One patient died of heart attack. The 5-year LTPFS, OS, MFS and CSS rates were 93.0%, 98.4%, 100% and 100%, respectively. Only two patients (2.3%) had major complications (Clavien-Dindo grade > II), including ureteropelvic junction stenosis and urinary obstruction due to ureteral blood clots. Conclusions Our study demonstrates that percutaneous TA is a feasible and effective first-line therapy for healthy surgical candidates with small renal masses (T1a). The 5-year LTPFS, OS, CSS and MFS rates were 93.0%, 98.4%, 100% and 100%, respectively, with a major complication rate of only 2.3%.
conferenceObject ASSESSMENT OF THE MALE SEXUAL QUOTIENT SCALE RELIABILITY TO EVALUATE SEXUAL FUNCTION OF MEN WITH SPINAL CORD INJURY(2015) MIRANDA, Eduardo; GOMES, Cristiano; BESSA JUNIOR, Jose de; CASTRO FILHO, Jose de; BELLUCCI, Carlos; BATTISTELLA, Linamara; BARROS FILHO, Tarcisio; CARVALHO, Fabricio; ABDO, Carmita; BRUSCHINI, Homero; NAHAS, William; SROUGI, Miguel