BRUNO CHIESA GOUVEIA NASCIMENTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, 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
33 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 33
- Sexual Headache(2018) NASCIMENTO, Bruno; MULHALL, John P.
bookPart Priapismo(2019) IVANOVIC, Renato Fidelis; CURY, José; NASCIMENTO, Bruno Gouveia- Predictors of Depression in Men With Peyronie's Disease Seeking Evaluation(2021) PUNJANI, Nahid; NASCIMENTO, Bruno; SALTER, Carolyn; MIRANDA, Eduardo; TERRIER, Jean; TANIGUCHI, Hisanori; JENKINS, Lawrence; MULHALL, John P.Background: Peyronie's disease (PD) has negative impacts on the psychosocial status of men including depression warranting clinical evaluation in up to 50% of men. Aim: To examine predictors of depression in patients with early PD seeking evaluation. Methods: All PD patients at a high-volume PD practice underwent screening and curvature assessment after intracavernosal injection. Complex deformity was defined as any degree of multiplanar curvature, curvature >60 degrees, or presence of hourglass deformity. Men completed the PD questionnaire (PDQ), a validated depression questionnaire (CES-D) as well as the Self-Esteem and Relationship (SEAR) questionnaire. Scores of >= 16 on CES-D were considered indicative of moderate/severe depression. Predictors of the presence of depression were defined using univariable and multivariable logistic regression. Outcomes: Demographic, bother and curve related predictors of depression in men with PD. Results: 408 men completed all questionnaires. Mean age was similar between depressed and nondepressed groups (57 +/- 10 years overall, P = .60 between groups). Proportions of erectile dysfunction were similar between groups (P = .96). Mean PD duration was similar between groups (19 +/- 35 months overall, P = .46 between groups). Mean degree of curvature was 38 +/- 2 degrees in the depressed vs 33 +/- 1 degrees in the nondepressed groups (P = .03). A complex deformity was seen in 64.5% in the depressed vs 61.5% in the nondepressed (P = .56). A total of 110 (27%) patients had CESD scores >= 16. 74% depressed men were in relationships compared to 84% nondepressed men (P < .01). Other characteristics including bother, pain, duration of disease, curve complexity and instability were similar between the two groups. On univariable analysis, factors protective against depression included being partnered (OR 0.42, 95%CI 0.24-0.75, P < .01) and higher total SEAR scores (OR 0.95, 95%CI 0.94-0.97, P < .01). Elevated PDQ domain scores were associated with depression (Psychologic Symptoms 1.05, 95%CI 1.02-1.10, P < .01; Pain 1.08, 95%CI 1.03-1.12, P < .01; Bother 1.11, 95% CI 1.05-1.68, P < .01) as well as baseline history of depression (OR 2.93, 95%CI 1.67-5.14, P < .001). On multivariable analysis, only total SEAR score remained protective against depression (OR 0.96, 95%CI 0.94-0.97, P < .001). Clinical Implications: Providers must recognize that men with PD seeking evaluation have meaningful rates of depression for which early recognition is necessary. Strengths and Limitations: Retrospective review of a large prospectively collected dataset from a single center of men with PD utilizing a validated screening tool for depression. Conclusion: While no significant demographic, bother or curve related factors predicted depression in early PD men seeking evaluation, it remains a significant problem warranting further prospective evaluation.
conferenceObject DO THE REGULATION OF MATRIX METALLOPROTEINASES AND TISSUE INHIBITORS OF MATRIX METALLOPROTEINASES HAVE ANY ASSOCIATION WITH PEYRONIE'S DISEASE?(2020) NETO, Cristovao Barbosa; REIS, Sabrina T.; ARANTES, Gabriel; NASCIMENTO, Bruno; SAYAO, Rogerio; LEITE, Katia Ramos; SROUGI, Miguel; NAHAS, William; CURY, JoseconferenceObject CORRELATION BETWEEN LIBIDO AND TESTOSTERONE: ESTRADIOL RATIO IN MEN WITH SEXUAL DYSFUNCTION(2023) NETO, R. Pedrenho; NASCIMENTO, B. Chiesa Gouveia; NUNES, R. Dos Santos Sobreira; GISMONDI, J. Pedro; BESSA JR., J. De; NAHAS, W. Carlos; HALLAK, J.conferenceObject CHRONOLOGY OF ENDOGENOUS TESTOSTERONE RECOVERY FOLLOWING ADT CESSATION - RESULTS FROM A PROSPECTIVE ANALYSIS(2023) NASCIMENTO, Bruno; PEDRENHO NETO, Rubens; ZANDONA, Pedro C. E.; BASTOS, Diogo Assed; COELHO, Rafael F.; BESSA JR., Jose; SANTANA, Feira De; NAHAS, William C.; HALLAK, Jorge; GOMES, Cristiano M.; MULHALL, John P.conferenceObject DEEP DORSAL VEIN BED PLICATION FOR VENTRAL PENILE CURVATURE(2023) ZANDONA, Pedro Caetano Edler; BARROS, Guilherme Garcia; COIMBRA, Igor Valente; GOES, Plinio Moreira De; PATO, Eduardo Zinoni Silva; NAHAS, William Carlos; NASCIMENTO, Bruno Chiesa Gouveia; HALLAK, Jorge- Laparoscopic pyeloplasty as an alternative to nephrectomy in adults with poorly functioning kidneys due to ureteropelvic junction obstruction(2021) NASCIMENTO, Bruno; ANDRADE, Hiury S.; MIRANDA, Eduardo P.; BARBOSA, Joao Arthur Brunhara Alves; MOSCARDI, Paulo R.; ARAP, Marco A.; I, Anuar Mitre; SROUGI, Miguel; SROUGI, Victor; DUARTE, Ricardo J.Objectives To evaluate outcomes of laparoscopic pyeloplasty (LP) in adults with poorly functioning kidney due to ureteropelvic junction obstruction (UPJO). Methods A 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 complications were assessed. LP success was defined as symptoms improvement and DRF improvement or stabilization. DRF and estimated glomerular filtration rate (eGFR) were analyzed before and 12 months after surgery to evaluate renal function recovery. DRF was estimated using Tc-99 m DMSA renal scintigraphy. Results Among 121 LP performed in the study period at our institution, 15 and 42 were included in the DRF <= 15% and DRF > 15% groups, respectively. At a median follow-up of 17.8 months, all patients with DRF <= 15% reported symptoms improvement. LP success rate was 86.7% and 90.5% (p = 0.65) for patients with DRF <= 15% and DRF > 15%, respectively. There were no complications in the DRF <= 15% group, while there were three complications recorded in the DRF > 15% group (Clavien 2 and 3b). In the DRF <= 15% group, mean pre-operative and post-operative DRF was 9.5% +/- 3.6 and 10.5% +/- 7.8 (p = 0.49), respectively. Median pre-operative and post-operative eGFR was 68.5 ml/min and 79.8 ml/min (p = 0.93), respectively. Two patients had DRF improvement after LP. Conclusions LP in adult patients with UPJO and poor function kidneys is an effective and safe procedure. DRF recovery is seen in a minority of the patients; however, LP is an alternative to nephrectomy.
- A Critical Analysis of Methodology Pitfalls in Duplex Doppler Ultrasound in the Evaluation of Patients With Erectile Dysfunction: Technical and Interpretation Deficiencies(2020) NASCIMENTO, Bruno; MIRANDA, Eduardo P.; TERRIER, Jean-Etienne; CARNEIRO, Felipe; MULHALL, John P.Background: Penile duplex Doppler ultrasound (PDDU) is a minimally invasive tool to evaluate erectile hemodynamics in patients with erectile dysfunction (ED). Despite decades of use, there is still a large variability in PDDU protocols, and a high rate of false diagnosis is reported. Aim: Review of PDDU methodology in the published literature addressing protocol heterogeneity, technical and interpretation challenges. Methods: A PubMed literature search was performed using the search terms ""penile doppler ultrasound"", ""penile duplex ultrasound"" or ""penile ultrasound"", and ""Erectile dysfunction"". Studies were analyzed for the presence of the following elements in reporting of the PDDU protocol: (i) intracavernosal vasoactive agents used, (ii) use of a redosing protocol, (iii) means of rigidity assessment, (iv) report of at-home best-quality erection, (v) normative criteria for peak systolic velocity (PSV) and end-diastolic velocity (EDV), and (vi) use of time-based hemodynamics assessment. Inclusion criteria were studies available in English, from 2005 onwards, and with full text. Exclusion criteria were review, descriptive or short communication articles, animal studies, and studies in populations other than those with ED. Outcomes: A critical review of the heterogeneity in published literature was performed to guide a structured discussion of methodological challenges and to create a list of recommendations. Results: Significant heterogeneity was seen in key methodological aspects. Fifty percent of studies reported the use of prostaglandin E1 only, and 12% of studies did not mention the agent used. Redosing as part of the PDDU protocol was mentioned in only 26% of studies. The majority (56%) did not mention any form of rigidity assessment. The most frequently used grading system was the Erection Hardness Score (14%). Overall, most studies (59%) used a timed-base protocol for hemodynamic assessment. No clear consensus was defined for normative criteria for PSV and EDV, 39% defining a normal PSV as >= 30 cm/s, and 57% using EDV values <= 5 cm/sec as normal. Clinical Implications: The absence of standardization has led to inadequate reporting of key factors which has rendered data interpretation and comparison between studies challenging. Strengths and Limitations: Our strengths include an extensive review of literature, with a structured analysis of the impact of each methodological pitfall. Our main limitation is the fact that protocol reporting, and not its application, was assessed. Conclusion: Despite its widespread use, analysis of the literature on PDDU use in the ED population shows marked protocol heterogeneity, rendering data interpretation a problem.
conferenceObject CHRONOLOGY OF ENDOGENOUS TESTOSTERONE RECOVERY FOLLOWING ANDROGEN DEPRIVATION THERAPY CESSATION - RESULTS FROM A PROSPECTIVE ANALYSIS(2023) NASCIMENTOL, B. C. G.; NETOL, R. Pedrenho; ZANDONAL, P.; BESSA, J. De; BASTOS, D.; CORDEIROL, M.; COELHOL, R.; NAHAS, W.; HALLAK, J.; MULHALL, J.; GOMES, C.