HOMERO BRUSCHINI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
- Periurethral muscle-derived mononuclear cell injection improves urethral sphincter restoration in rats(2017) TURCO, Marcelo Pitelli; SOUZA, Alex Balduino de; SOUSA, Isida de Campos; FRATINI, Paula; VERAS, Mariana Matera; RODRIGUES, Marcio Nogueira; BESSA JR., Jose de; BROLIO, Marina Pandolphi; LEITE, Katia Ramos Moreira; BRUSCHINI, Homero; SROUGI, Miguel; MIGLINO, Maria Angelica; GOMES, Cristiano MendesAimsInvestigate the effect of a novel cell-based therapy with skeletal muscle-derived mononuclear cells (SMDMCs) in a rat model of stress urinary incontinence. MethodsMale Wistar-Kyoto rats' hind limb muscles were enzymatically dissociated, and SMDMCs were isolated without needing expansion. The cell population was characterized. Twenty female rats underwent urethrolysis. One week later, 10 rats received periurethral injection of 10(6) cells (SMDMC group), and 10 rats received saline injections (Saline group). Ten rats underwent sham surgery (Sham group). Four weeks after injection, animals were euthanized and the urethra was removed. The incorporation of SMDMCs in the female urethra was evaluated with fluorescence in situ hybridization for the detection of Y-chromosomes. Hematoxylin and eosin, Masson's trichrome staining, and immunohistochemistry for actin and myosin were performed. The muscle/connective tissue, actin and myosin ratios were calculated. Morphological evaluation of the urethral diameters and fractional areas of the lumen, mucosa, and muscular layer was performed. ResultsSMDMCs population was consistent with the presence of muscle cells, muscle satellite cells, perivascular cells, muscle progenitor cells, and endothelial cells. SMDMCs were incorporated into the urethra. A significant decrease in the muscle/connective tissue ratio was observed in the Saline group compared with the SMDMC and Sham groups. The proportions of actin and myosin were significantly decreased in the Saline group. No differences were observed in the morphometric parameters. ConclusionsSDMSC were incorporated into the rat urethra and promoted histological recovery of the damaged urethral sphincter, resulting in decreased connective tissue deposition and increased muscle content.
- Untitled(2019) GOMES, Cristiano M.; BESSA JR., Jose de; BRUSCHINI, Homero
conferenceObject VIRTUE MALE SLING FOR STRESS URINARY INCONTINENCE IN MEN WITH SPINAL CORD INJURY: A PROSPECTIVE EVALUATION AND SHORT-TERM OUTCOMES(2021) GOMES, Cristiano; HENRIQUES, Joao Victor; LAFERREIRA, Luccas; BESSA JUNIOR, Jose de; BRUSCHINI, Homero; BISSOLI, Julio; MOROMIZATO, Julyana- Empiric antimicrobial treatment in women with recurrent urinary tract infection(2021) HISANO, Marcelo; BRUSCHINI, Homero; GOMES, Cristiano M.
- Impact of a 1-day urodynamic course on knowledge, perceptions, and attitudes of urology residents(2021) GOMES, Cristiano M.; BESSA, Jose de; NUNES, Ricardo V.; PREZOTTI, Jose; BRUSCHINI, Homero; GOMES, Marcio M.Aims No evidence-informed educational curriculum is available for designing urodynamics (UDS) courses. We evaluated the learning outcomes of a short-lasting urodynamic course for urology residents. Methods Urology residents of postgraduate years 4 and 5 (n = 13 and n = 1316, respectively) attended a 1-day urodynamic course. Learning objectives included patient preparation, indication and technique, terminology, trace interpretation, and impact on patient management. Instructional methods consisted of short lectures (3 h) and case-based discussions (7.5 h). Learners' reactions, modifications of perceptions and attitudes, and acquisition of knowledge and skills were assessed by three written tests with a single group, pretest, posttest 1, and posttest 2 design. Tests were conducted precourse, 1 week after, and 4 months after the course. Results All participants felt more confident in several urodynamic competencies after the course, including patient preparation, urodynamic indication and technique, terminology, trace interpretation, and impact for patient management. These perceptions remained unchanged after 4 months. Most became stricter in the indication of UDS, including 20 (87.0%) at posttest 1 and 8 (66.7%) at posttest 2. The mean number of correct answers in the knowledge evaluation was 52.2% versus 61.4% versus 56.7%, respectively at pretest, posttest 1, and posttest 2; p = 0.535). All participants rated the course as very useful or useful in both posttest evaluations. Conclusions Our study demonstrates that a 1-day urodynamic course can promote lasting improvements in self-reported perceptions, attitudes, and urodynamic-related competencies of urology residents. Further studies using evidence-informed educational principles are needed to determine the effect of specific educational interventions on urodynamic competencies in different contexts.
conferenceObject FEMALE SEXUAL DYSFUNCTION AFTER SPINAL CORD INJURY: AN IMPORTANT FACTOR ASSOCIATED TO LIFE DISSATISFACTION(2013) GOMES, C.; JR, J. Castro; BELLUCCI, C.; JR, J. Bessa; PINHEIRO, M.; BARROS FILHO, T.; BATTISTELLA, L.; BRUSCHINI, H.; SROUGI, M.- A guideline for the management of bladder dysfunction in Parkinson's disease and other gait disorders(2016) SAKAKIBARA, Ryuji; PANICKER, Jalesh; FINAZZI-AGRO, Enrico; IACOVELLI, Valerio; BRUSCHINI, HomeroParkinson's disease (PD) is a common neurodegenerative disorder, and lower urinary tract (LUT) dysfunction is one of the most common autonomic disorders with an estimated incidence rate of 27-80%. Studies have shown that bladder dysfunction significantly influences quality-of-life (QOL) measures, early institutionalisation, and health economics. We review the pathophysiology of bladder dysfunction in PD, lower urinary tract symptoms (LUTS), objective assessment, and treatment options. In patients with PD, disruption of the dopamine D1-GABAergic direct pathway may lead to LUTS. Overactive bladder (OAB) is the most common LUT symptom in PD patients, and an objective assessment using urodynamics commonly shows detrusor overactivity (DO) in these patients. The post-void residual (PVR) volume is minimal in PD, which differs significantly from multiple system atrophy (MSA) patients who have a more progressive disease that leads to urinary retention. However, subclinical detrusor weakness during voiding may also occur in PD. Regarding bladder management, there are no large, double-blind, prospective studies in this area. It is well recognised that dopaminergic drugs can improve or worsen LUTS in PD patients. Therefore, an add-on therapy with anticholinergics is required. Beta-3 adrenergic agonists are a potential treatment option because there are little to no central cognitive events. Newer interventions, such as deep brain stimulation (DBS), are expected to improve bladder dysfunction in PD. Botulinum toxin injections can be used to treat intractable urinary incontinence in PD. Transurethral resection of the prostate gland (TURP) for comorbid BPH in PD is now recognised to be not contraindicated if MSA is excluded. Collaboration of urologists with neurologists is highly recommended to maximise a patients' bladder-associated QOL. Neurourol. Urodynam. 35:551-563, 2016. (c) 2015 Wiley Periodicals, Inc.
conferenceObject SEXUAL FUNCTION IN WOMEN WITH TRAUMATIC SPINAL CORD INJURY(2013) BELLUCCI, Carlos; GOMES, Cristiano; BESSA JR., Jose; CASTRO FILHO, Jose; BRUSCHINI, Homero; SROUGI, Miguel- Voiding Dysfunction in Patients With Neuromyelitis Optica Spectrum Disorders(2016) CARVALHO, Fabricio Leite de; GOMES, Cristiano Mendes; APOSTOLOS-PEREIRA, Samira L.; BESSA JR., Jose; PINHEIRO, Marcello; MARCHIORI, Paulo E.; BRUSCHINI, Homero; SROUGI, Miguel; CALLEGARO, DagobertoAims: We assessed the lower urinary tract symptoms (LUTS) and urodynamic findings in patients with neuromyelitis optica spectrum disorders (NMO-SD), a recently defined neurological disease. Methods: We prospectively evaluated seven men and 23 women (mean age 41.1 +/- 13.5 years) with an established diagnosis of NMO-SD who were invited to participate irrespective of the presence of LUTS. Neurological evaluation was assessed with the Expanded Disability Status Scale (EDSS) and LUTS were evaluated with the Overactive Bladder questionnaire (OAB-V8) and the International Prostate Symptom Score (I-PSS). All patients underwent videourodynamics, transabdominal urinary tract sonography, urine culture, and serum creatinine levels. Results: The mean time of disease duration was 33.8 +/- 30.8 months. Neurological evaluation showed a mean EDSS score of 5.3 +/- 1.8. The most frequent videourodynamic findings were detrusor-sphincter dyssynergia (DSD) and detrusor overactivity (DO) in 11 (36.6%) patients, DSD without DO in seven (23.3%) and DO without DSD in six (20.0%) patients. Voiding dysfunction assessed by I-PSS and OAB-V8 increased with the degree of neurological impairment (P = 0.018; r = 0.42 and P = 0.006; r = 0.48 respectively). Patients with DSD had higher I-PSS (18.5 +/- 11.4 vs 7.0 +/- 9.2; P = 0.029) and OAB-V8 scores (22.8 +/- 15.8vs 9.1 +/- 7.8; P = 0.008), and worse neurological impairment (mean EDSS 5.9 +/- 1.8 vs 4.5 +/- 1.5; P = 0.027). Conclusions: Most patients with NMO-SD have LUTS and voiding dysfunction, with DSD and DO as the main urodynamic findings. The severity of the neurological disease is a predictive factor for the occurrence of voiding dysfunction and detrusor-sphincter dyssynergia. (C) 2014 Wiley Periodicals, Inc.
conferenceObject URINARY INCONTINENCE AFFECTS SEXUAL FUNCTION AND SATISFACTION IN SPINAL CORD INJURED MEN(2013) GOMES, Cristiano; BESSA JR., Jose; CASTRO FILHO, Jose; BRUSCHINI, Homero; BELLUCCI, Carlos; SROUGI, MiguelIntroduction and Objectives: After spinal cord injury (SCI)sexual and voiding functions may be affected depending on the level and completeness of theneurological injury. In this study, we investigated sexual function and satisfaction in men with SCI, according to the urinary continence status. Methods: In a cross sectional study we evaluated 330 men with SCI (> 12 months) with a mean age of 41.2 14.8. Median time from SCI was 3.8 years [1–27]. The injury level was cervical, thoracic, lumbar and sacral in144 (43.6%), 152 (46.0%), 33 (10.0%) and 1 (0.3%), respectively. The American Spinal Injury Association (ASIA) impairment scale was A in 213 (63.4%), B in 34 (10.2%), C in 28 (8.4%), D in 43 (12.9%) and E in 11 (3.3%). Urinary incontinence was defined as any complaint of urinary leakage during the last month. Two groups were created, comprising 173 (52%) continent and 157 (48%) incontinent patients. A structured questionnaire was applied to all subjects including a detailed sexual anamnesis regarding orgasmic and ejaculatory functions, frequency of sexual intercourses and the subjective satisfaction with sexual life. In addition, the International Index of Erectile Function (IIEF–5) and the Male Sexual Quocient (MSQ) were applied to all subjects. Results: Ninety nine (57.2%) continent and 70 (44.6%) incontinent patients claimed to be sexually active (p = 0.003). Both groups demonstrated similar prevalence of anorgasmy (33.3% and 35.2% in continent and incontinent patients, respectively; p = 0.745). Of the incontinent patients, 72.8% had anejaculation as opposed to 52.5% of the continent subjects (OR 2.4, 95% IC 1.25–4.68, p = 0.010). Forty six (26.6%) continent patients and 23 (15.0%) incontinent patients considered their satisfaction with sexual life as ‘‘excellent’’or ‘‘good’’(OR 2.0, 95% IC 1.17–3.57, p = 0.01). Mean IIEF–5 was 9.7 ± 8.0 in continent and 7.7 ± 7.3 in incontinent patients (p = 0.01). However, both groups presented similar prevalence of erectile dysfunction, defined as IIEF–5 < 17 (72.3% in continent and 79.6% in incontinentpatients, p = 0.15). MedianMSQ was higher among continent patients (48 [8–69] and 20 [0–58] in continent and incontinent patients, respectively; p = 0.001). Conclusions: Erectile dysfunction and anorgasmy seem to similarly affect continent and incontinent SCI male patients. However, urinary incontinence had an independent negative impact in sexual function and satisfaction with sexual life in this population.