EDUARDO MURACCA YOSHINAGA
Índice h a partir de 2011
7
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
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- Risk Factors for Male Lower Urinary Tract Symptoms: The Role of Metabolic Syndrome and Androgenetic Alopecia in a Latin American Population(2013) BARBOSA, Joao Arthur B. A.; MURACCA, Eduardo; NAKANO, Elcio; PARANHOS, Mario; NATALINO, Renato; CORDEIRO, Paulo; SROUGI, Miguel; ANTUNES, Alberto AzoubelOBJECTIVE To evaluate the association of male lower urinary tract symptoms (LUTS) with metabolic syndrome (MetS) and androgenetic alopecia in a Latin American population. METHODS We enrolled 907 patients for prospective evaluation at a single institution. LUTS were evaluated with the International Prostate Symptom Score (IPSS). Subjects were evaluated with respect to hypertension, diabetes, dyslipidemia, previous cardiovascular events, body mass index (BMI), waist and hip circumference, and a laboratorial investigation including prostate-specific antigen (PSA), C-reactive protein (CRP), and gonadal steroids. Alopecia was classified according to the Norwood-Hamilton scale. RESULTS Mean patient age was 61.0 years; 57.5% of subjects had moderate/severe LUTS; MetS was present in 17.2% of subjects and 53.9% were classified as bald. Age, hypertension, diabetes, dyslipidemia, alopecia, previous cardiovascular event, and elevated waist-to-hip ratio (WHR) were associated with moderate/severe LUTS and with storage symptoms (P < .05). On multivariable analysis, age (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.63-3.25), cardiovascular events (OR 1.73, 95% CI 1.07-2.78), and WHR (OR 1.65, 95% CI 1.13-2.40) were independent predictors for LUTS. For storage symptoms, age (OR 1.80, 95% CI 1.28-2.54), cardiovascular event (OR 2.07, 95% CI 1.27-3.39), WHR (OR 1.54, 95% CI 1.06-2.25), and MetS (OR 1.70, 95% CI 1.01-2.86) were independent risk factors. Age and cardiovascular event were the only independent predictors for voiding symptoms. CONCLUSION Components of the MetS were strongly associated with moderate and severe LUTS. WHR and cardiovascular events were independent predictors of voiding and storage symptoms, and MetS was an independent predictor of storage symptoms. Alopecia was not an independent predictor of LUTS. UROLOGY 82: 182-188, 2013. (C) 2013 Elsevier Inc.
conferenceObject LONG-TERM EVALUATION OF TRANSURETHRAL INCISION OF THE PROSTATE FOR TREATMENT OF BENIGN PROSTATE HYPERPLASIA: ANALYSIS OF 75 CASES WITH A MEAN 8-YEAR FOLLOW-UP PERIOD(2015) CORDEIRO, Paulo; BARONE, Hugo; YOSHINAGA, Eduardo Muracca; NAKANO, Elcio; NAHAS, William C.; SROUGI, Miguel; ANTUNES, Alberto A.- Interactions between Lower Urinary Tract Symptoms and Cardiovascular Risk Factors Determine Distinct Patterns of Erectile Dysfunction: A Latent Class Analysis(2013) BARBOSA, Joao A. B. A.; MURACCA, Eduardo; NAKANO, Elcio; ASSALIN, Adriana R.; CORDEIRO, Paulo; PARANHOS, Mario; CURY, Jose E.; SROUGI, Miguel; ANTUNES, Alberto A.Purpose: An epidemiological association between lower urinary tract symptoms and erectile dysfunction is well established. However, interactions among multiple risk factors and the role of each in pathological mechanisms are not fully elucidated Materials and Methods: We enrolled 898 men undergoing prostate cancer screening for evaluation with the International Prostate Symptom Score (I-PSS) and simplified International Index of Erectile Function-5 (IIEF-5) questionnaires. Age, race, hypertension, diabetes, dyslipidemia, metabolic syndrome, cardiovascular disease, serum hormones and anthropometric parameters were also evaluated. Risk factors for erectile dysfunction were identified by logistic regression. The 333 men with at least mild to moderate erectile dysfunction (IIEF 16 or less) were included in a latent class model to identify relationships across erectile dysfunction risk factors. Results: Age, hypertension, diabetes, lower urinary tract symptoms and cardiovascular event were independent predictors of erectile dysfunction (p < 0.05). We identified 3 latent classes of patients with erectile dysfunction (R-2 entropy = 0.82). Latent class 1 had younger men at low cardiovascular risk and a moderate/high prevalence of lower urinary tract symptoms. Latent class 2 had the oldest patients at moderate cardiovascular risk with an increased prevalence of lower urinary tract symptoms. Latent class 3 had men of intermediate age with the highest prevalence of cardiovascular risk factors and lower urinary tract symptoms. Erectile dysfunction severity and lower urinary tract symptoms increased from latent class 1 to 3. Conclusions: Risk factor interactions determined different severities of lower urinary tract symptoms and erectile dysfunction. The effect of lower urinary tract symptoms and cardiovascular risk outweighed that of age. While in the youngest patients lower urinary tract symptoms acted as a single risk factor for erectile dysfunction, the contribution of vascular disease resulted in significantly more severe dysfunction. Applying a risk factor interaction model to prospective trials could reveal distinct classes of drug responses and help define optimal treatment strategies for specific groups.
conferenceObject LOW-VOLUME PROSTATE IN BENIGN PROSTATIC HYPERPLASIA (BPH): A RISK FACTOR FOR SYMPTOMATIC BLADDER DIVERTICULA REQUIRING SURGICAL TREATMENT(2015) YOSHINAGA, Eduardo Muracca; NAKANO, Elcio; MARCHINI, Giovanni S.; OYAMA, Renato Hajime; CORDEIRO, Paulo; NAHAS, William C.; SROUGI, Miguel; ANTUNES, Alberto A.conferenceObject THE PAINFUL PELVIC SYMPTOMS IN AGING MEN. THE RESULTS OF POPULATION-BASED SAMPLE OF MEN(2016) NAKANO, Elcio; CONTI, Paulo Sajovic de; YOSHINAGA, Eduardo Muracca; NAHAS, William C.; SROUGI, Miguel; ANTUNES, Alberto- Obesity may influence the relationship between sex hormones and lower urinary tract symptoms(2014) ANTUNES, Alberto A.; ARAUJO, Luiz Henrique; NAKANO, Elcio; MURACCA, Eduardo; SROUGI, MiguelPurpose: The effects of serum testosterone in the lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) are not well established. The objective of the study is to evaluate the association of sex hormones with LUTS and control the results by patient weight. Materials and Methods: The study comprised a cross-sectional analysis of 725 men included in a prostate cancer screening program at University of Sao Paulo Medical School. The serum concentrations of total testosterone (TT), free testosterone (FT) and sex hormone binding globulin (SHBG) were measured. Variables analyzed were age, American Urological Association (AUA) symptom score, storage symptoms, voiding symptoms, quality of life score, prostate specific antigen levels and prostate volume. Obesity was measured through the calculation of body mass index (BMI). A regression analysis model was performed. Results: Median patient age was 65 years (48 to 94). A higher TT level was significantly associated with a severe AUA symptom score only among patients with a BMI >= 25. Median TT was 371, 370 and 427ng/dL (p = 0.017) in patients with mild, moderate and severe LUTS respectively. The multivariate regression analysis in patients with BMI >= 25 showed that only age, TT and sex score were related to LUTS. Conclusions: A higher TT is associated with a severe AUA score symptom index only in obese patients. Further analysis are necessary to evaluate the mechanisms through which testosterone may influence LUTS in these patients.