CLAUDIO BOVOLENTA MURTA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
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- Effectiveness of Intrarectal Povidone-iodine Cleansing Plus Formalin Disinfection of the Needle Tip in Decreasing Infectious Complications After Transrectal Prostate Biopsy: A Randomized Controlled Trial(2022) PONTES-JUNIOR, Jose; FREIRE, Tiago Magalhaes; PUGLIESI, Felipe Guimaraes; COSTA, Felipe Machado de Moura; SOUZA, Vinicius Meneguette Gomes De; GALUCCI, Fabio Pescarmona; ALBERTINI, Aline; COUTO, Adriano Borba; MURTA, Claudio Bovolenta; GUGLIELMETTI, Giuliano Betoni; NAHAS, William C.; JUNIOR, Adalberto Andriolo; NETO, Alcides Mosconi; CLARO, Joaquim Francisco de AlmeidaPurpose:Prostate biopsy is mostly performed through the transrectal route worldwide and infectious complications may occur in up to 7% of cases. Therefore, alternative strategies to decrease infectious complications are needed. Our aim was to evaluate the effectiveness of intrarectal povidone-iodine cleansing plus formalin disinfection of the needle tip in decreasing infectious complications after transrectal ultrasound guided prostate biopsy.Materials and Methods:We conducted a prospective, single-center, phase III trial in patients undergoing transrectal ultrasound guided prostate biopsy randomized 1:1 to rectal mucosa cleansing with gauze soaked in 10% povidone-iodine solution wrapped around the gloved index finger and needle tip disinfection by immersion in a 10% formalin solution before each puncture vs control group. The primary end point was the rate of infectious complications defined as 1 or more of the following events: fever, urinary tract infection, or sepsis.Results:Overall, 633 patients were randomized to the intervention group and 623 to the control group. The infectious complication rate was 3.9% in the intervention group and 6.4% in the control group (RR 0.61; 95% CI 0.36-0.99; P = .049). The rates of sepsis, urinary tract infection, and fever were 0.3% vs 0.5% (P = .646), 2.3% vs 4.1% (P = .071), and 1.3% vs 1.9% (P = .443), respectively. The positive urine culture rate was 5.2% in the intervention group and 9% in the control group (RR 0.57; P = .015). There was no statistically significant difference between the groups regarding the occurrence of noninfectious adverse events.Conclusions:Intrarectal povidone-iodine cleansing plus formalin disinfection of the biopsy needle tip was associated with a reduction in infectious complications after transrectal prostate biopsy.
- Impact of Obesity on Outcomes of Supine Percutaneous Nephrolithotomy(2020) FERREIRA, Thiago Augusto Cunha; DUTRA, Matheus Marques Guerra; VICENTINI, Fabio Carvalho; SZWARC, Marcelo; MOTA, Priscila Kuriki Vieira; EISNER, Brian; MURTA, Claudio Bovolenta; CLARO, Joaquim Francisco de AlmeidaObjectives:To determine whether obesity has an impact on the outcomes of supine percutaneous nephrolithotomy (PCNL). Patients and Methods:We retrospectively evaluated a prospectively created database of patients who underwent PCNL in the supine position from June 2009 to June 2014. The patients were divided into two groups according to their body mass index (BMI): <30 kg/m(2)(group 1, nonobese) and >= 30 kg/m(2)(group 2, obese). Pre, peri, and postoperative data were analyzed. Stone complexity was classified according to Guy's stone score. The primary endpoint was the absence of stone fragments of >= 4 mm on CT scans at postoperative day 1. Complications were graded according to the modified Clavien classification. Results:Of the 401 patients, 307 (76.6%) were nonobese and 94 (23.4%) were obese. Regarding demographic and stone characteristics, group 2 (BMI >= 30 kg/m(2)) had a higher percentage of female patients (67.3%vs50.4%,p = 0.002) and a higher mean BMI (34.8vs24.5 kg/m(2),p < 0.001) than group 1. Success rates were not statistically different between the groups (group 1 = 61.8%, group 2 = 51%,p = 0.08). There were no differences in the transfusion rate (group 1 = 2.9%, group 2 = 4.2%,p = NS) or total number of complications greater than Clavien grade 1 (group 1 = 13.6%, group 2 = 13.8%,p = NS). Conclusion:In a retrospective study of 400 patients undergoing PCNL, the outcomes were not different between nonobese and obese patients. To our knowledge, this is the first study evaluating these outcomes for PCNL performed in the supine position. Further multicenter and prospective studies are necessary to verify these findings.
- Disruption of miRNA-mRNA Networks Defines Novel Molecular Signatures for Penile Carcinogenesis(2021) FURUYA, Tatiane Katsue; MURTA, Claudio Bovolenta; CARRASCO, Alexis German Murillo; UNO, Miyuki; SICHERO, Laura; VILLA, Luisa Lina; CARDILLI, Leonardo; COELHO, Rafael Ferreira; GUGLIELMETTI, Giuliano Betoni; CORDEIRO, Mauricio Dener; LEITE, Katia Ramos Moreira; NAHAS, William Carlos; CHAMMAS, Roger; JR, Jose PontesSimple Summary: As there are still no biomarkers reported in clinical practice in penile cancer (PeC), we aimed to investigate and validate molecular signatures based on miRNA and mRNA profiles to identify molecular drivers and pathways involved in PeC tumorigenesis. We found eight DEmiRs and 37 DEGs comparing tumoral tissues (TT) paired with non-neoplastic tissues (NNT) of PeC patients. Four downregulated DEmiRs (miR-30a-5p, miR-432-5p, miR-487b-3p, and miR-145-5p) and six upregulated DEGs (IL1A, MCM2, MMP1, MMP12, SFN and VEGFA) were identified as potential biomarkers in PeC by their capacity of discriminating TT and NNT with accuracy. Furthermore, we performed an analysis of miRNA-mRNA interaction and found disruption in the dynamics of the regulation of eight pairs during tumor development that have never been described in PeC. Taken together, our findings contribute to a better understanding of the regulatory roles of miRNAs and altered transcripts levels in penile carcinogenesis. Penile cancer (PeC) carcinogenesis is not fully understood, and no biomarkers are reported in clinical practice. We aimed to investigate molecular signatures based on miRNA and mRNA and perform an integrative analysis to identify molecular drivers and pathways for PeC development. Affymetrix miRNA microarray was used to identify differentially expressed miRNAs (DEmiRs) comparing 11 tumoral tissues (TT) paired with non-neoplastic tissues (NNT) with further validation in an independent cohort (n = 13). We also investigated the mRNA expression of 83 genes in the total sample. Experimentally validated targets of DEmiRs, miRNA-mRNA networks, and enriched pathways were evaluated in silico. Eight out of 69 DEmiRs identified by microarray analysis were validated by qRT-PCR (miR-145-5p, miR-432-5p, miR-487b-3p, miR-30a-5p, miR-200a-5p, miR-224-5p, miR-31-3p and miR-31-5p). Furthermore, 37 differentially expressed genes (DEGs) were identified when comparing TT and NNT. We identified four downregulated DEmiRs (miR-30a-5p, miR-432-5p, miR-487b-3p, and miR-145-5p) and six upregulated DEGs (IL1A, MCM2, MMP1, MMP12, SFN and VEGFA) as potential biomarkers in PeC by their capacity of discriminating TT and NNT with accuracy. The integration analysis showed eight dysregulated miRNA-mRNA pairs in penile carcinogenesis. Taken together, our findings contribute to a better understanding of the regulatory roles of miRNAs and altered transcripts levels in penile carcinogenesis.