FABIO CARVALHO VICENTINI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
- 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.
- Metabolic assessment in pure struvite stones formers: is it necessary?(2021) DANILOVIC, Alexandre; FERREIRA, Thiago Augusto Cunha; GOMES, Samirah Abreu; WEI, Isabela Akemi; VICENTINI, Fabio Carvalho; TORRICELLI, Fabio Cesar Miranda; MARCHINI, Giovanni Scala; MAZZUCCHI, Eduardo; SROUGI, Miguel; NAHAS, William CarlosAbstract Background and objective: Magnesium ammonium phosphate stones (MAP), also known as struvite stones, are associated with urinary infection and impairment of renal unit. The aim of this study is to evaluate the urinary metabolic risk factors for recurrence of renal calculi in patients submitted to nephrectomy due to MAP stones. Methods: We retrospectively reviewed the charts of patients > 18 years old submitted to total nephrectomy due to pure MAP stones and pure calcium oxalate (CaOx) stones from July 2006 to July 2016. Urinary metabolic parameters were assessed through 24-hour urine exams ≥ 3 months after nephrectomy. Urinary metabolic parameters and new event related to lithiasis were compared. Results: Twenty-eight and 39 patients were included in MAP and CaOx group, respectively. Abnormalities in 24-hour urine samples were similar between groups. Hypercalciuria occurred in 7.1 and 10.3% of patients in MAP and CaOx group, respectively (p = 0.66), whereas hypocitraturia was present in 65.2 and 59.0% of patients with MAP and CaOx group, respectively (p = 0.41). No significant difference in new events was found between MAP and CaOx groups (17.9 vs. 23.1%, respectively; p = 0.60). Conclusion: A 24-hour urine evaluation should be offered to patients submitted to nephrectomy due to pure MAP stones in order to detect metabolic risk, improve treatment, and prevent stone recurrence.
- Understanding urologic scientific publication patterns and general public interests on stone disease: lessons learned from big data platforms(2021) MARCHINI, Giovanni S.; FARIA, Kauy V. M.; NETO, Felippe L.; TORRICELLI, Fabio Cesar Miranda; DANILOVIC, Alexandre; VICENTINI, Fabio Carvalho; BATAGELLO, Carlos A.; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoPurpose To analyse patterns of stone disease online information-seeking behaviours in the United States and to correlate with urological literature publication aspects. Methods To compare Relative Search Volume (RSV) among different twelve preselected urologic keywords we chose ""United States"" as country and ""01/01/2009-31/12/2018"" as time range on Google Trends (GT). We defined ""ureteroscopy"" as a reference and compared RSV against it for each term. RSV was adjusted and normalized in a scale 0-100. Trend presence was evaluated by Mann-Kendall Test and magnitude by Sen's Slope Estimator (SS). Weather influence on RSV was also investigated by comparison of the ten hottest versus ten coldest states. Pearson correlation analysis was performed between number of Pubmed publications and RSV for each term over time. Results We found an upward tendency (p 0.01) for most terms. Higher temporal trends were seen for ""kidney stone"" (SS = 0.36), ""kidney pain"" (SS = 0.39) and ""tamsulosin"" (SS = 0.21). Technical treatment terms had little search volumes and no increasing trend. States with hotter weather showed higher mean RSV for ""kidney stone"" than colder ones. There was little correlation between GT and Pubmed for most terms, with the exception of ""kidney stone"" (R = 0.89; p 0.01), ""URS"" (R = 0.81; p 0.01), and ""laser lithotripsy"" (R = 0.74; p = 0.01). Conclusion There was a significant increase in online search for medical information related to stone disease. Citizens tend to look for generic terms related to symptoms or the disease itself. States with hotter weather show higher RSV than colder states. There is a discrepancy between public and medical community medical terms.
- The impact of COVID-19 in medical practice. A review focused on Urology(2021) MAZZUCCHI, Eduardo; TORRICELLI, Fabio C. M.; VICENTINI, Fabio C.; MARCHINI, Giovanni S.; DANILOVIC, Alexandre; BATAGELLO, Carlos A.; SROUGI, Miguel; NAHAS, William C.COVID-19 pandemic is a rapidly spreading virus that is changing the World and the way doctors are practicing medicine. The huge number of patients searching for medical care and needing intensive care beds led the health care system to a burnout status especially in places where the care system was already overloaded. In this setting, and also clue to the absence of a specific treatment for the disease, health authorities had to opt for recommending or imposing social distancing to relieve the health system and reduce deaths. All other medical specialties non directly related to the treatment of COVID-19 had to interrupt or strongly reduce their activities in order to give room to seriously ill patients, since no one knows so far the real extent of the virus damage on human body and the consequences of doing non deferrable procedures in this pandemic era. Despite not been a urological disease, the urologist needs to be updated on how to deal with these patients and how to take care of himself and of the medical team he works with. The aim of this article is to review briefly some practical aspects of COVID-19 and its implications in the urological practice in our country.
- Comparing public interest on stone disease between developed and underdeveloped nations: are search patterns on google trends similar?(2021) MARCHINI, Giovanni S.; FARIA, Kauy V. M.; NETO, Felippe L.; TORRICELLI, Fabio Cesar Miranda; DANILOVIC, Alexandre; VICENTINI, Fabio Carvalho; BATAGELLO, Carlos A.; SROUGI, Miguel; NAHAS, Willaim C.; MAZZUCCHI, EduardoObjective: The big data provided by Google Trends may reveal patterns in health information-seeking behavior on population from Brazil and United States (US). Our objective was to explore and compare patterns of stone disease online information-seeking behaviors in both nations. Materials and Methods: To compare Relative Search Volume (RSV) among different urologic key words we chose ""US"" and ""Brazil"" as country and ""01/01/2009 - 31/12/2018"" as time-range. The final selection included 12 key words in each language. We defined ""ureteroscopy"" as a reference and compared RSV against it for each term. RSV was adjusted by the reference and normalized in a scale from 0-100. Trend presence was evaluated by Mann Kendall Test and magnitude by Sen's Slope (SS) Estimator. Results: We found an upward trend (p < 0.01) in most of the researched terms in both countries. Higher temporal trends were seen for ""Kidney Stone"" (SS=0.36), ""Kidney Pain"" (SS=0.39) and ""Tamsulosin"" (SS=0.21) in the US. Technical treatment terms had little search volumes and no increasing trend. ""Kidney Stent"" and ""Double J"" had a significant increase in search trend over time and had a relevant search volume overall in 2018. In Brazil, ""Calculo Renal"", ""Colica Renal"", ""Dor no Rim"" and ""Pedra no Rim"" had a significant increase in RSV (p < 0.001). More common and popular terms as ""Kidney Stent"" and ""Tamsulosin"" were highly correlated with ""Kidney Pain"" and ""Kidney Stone"" in both countries. Conclusions: In the last decade, there was a significant increase in online search for medical information related to stone-disease. Population from both countries tend to look more for generic terms related to symptoms, the disease, medical management and kidney stent, than for technical treatment vocabulary.
conferenceObject IS SUPINE PERCUTANEOUS NEPHROLITHOTOMY FOR COMPLEX STONES WORSE THAN PRONE? A MULTICENTER RANDOMIZED CONTROLLED TRIAL.(2021) PERRELLA, Rodrigo; VICENTINI, Fabio; PARO, Eliane; MARCHINI, Giovani; TORRICELLI, Fabio; DANILOVIC, Alexandre; BATAGELLO, Carlos; MOTA, Priscila Kuriki; BELTRAME, Daniel; COHEN, David; MURTA, Claudio; CLARO, Joaquim; NAHAS, William; SROUGI, Miguel; MAZZUCCHI, Eduardo- Percutaneous Nephrolithotomy in Horseshoe Kidneys: Results of a Multicentric Study(2021) VICENTINI, Fabio Carvalho; MAZZUCCHI, Eduardo; GOKCE, Mehmet Ilker; SOFER, Mario; TANIDIR, Yiloren; SENER, Tarik Emre; MELO, Petronio Augusto de Souza; EISNER, Brian; BATTER, Timothy Hunt; CHI, Thomas; ARMAS-PHAN, Manuel; SCOFFONE, Cesare Marco; CRACCO, Cecilia Maria; PEREZ, Braulio Omar Manzo; ANGERRI, Oriol; EMILIANI, Esteban; MAUGERI, Orazio; STERN, Karen; BATAGELLO, Carlos Alfredo; MONGA, ManojObjective:To report the outcomes of percutaneous nephrolithotomy (PCNL) in horseshoe kidneys (HSK) in 12 institutions worldwide and evaluate the impact of patient position during operation. Methods:We carried out a retrospective analysis of PCNL procedures performed between 2008 and 2018 in patients with HSK. Pre-, peri-, and postoperative data were collected, and a subgroup analysis was performed according to patient position. Success was defined as an absence of >4-mm fragments. Values ofp < 0.05 were considered significant. Results:We analyzed 106 procedures. The transfusion, complication, and immediate success rates (ISRs) were 3.8%, 17.5%, and 54.7%, respectively. The final success rate (FSR) increased to 72.4% after a mean of 0.24 secondary procedures. Logistic regression showed that higher body mass index (BMI) and stone size were significantly associated with residual fragments >= 4 mm. Sixty-seven patients (63.2%) were treated in prone and 39 (36.8%) in supine position. The prone group had a significantly higher BMI than the supine group (30.1vs27.7,p = 0.024). The transfusion, complication, and ISRs between the prone and supine groups were 4.5%vs2.6% (p = 0.99), 16.9%vs18.4% (p = 0.99), and 52.5%vs69.2% (p = 0.151), respectively. Surgical time was significantly longer in the prone group (126.5vs100 minutes,p = 0.04). Upper pole was the preferred access in 80.3% of the prone group and 43.6% of the supine group (p < 0.001). The prone group had significantly more Clavien 2 complications than the supine (p = 0.013). The FSR in the prone and supine groups increased to 66.1% and 82.1% after 0.26 and 0.21 secondary procedures, respectively. No complications higher than Clavien 3 occurred. Conclusion:PCNL in patients with HSK is safe and effective with a low complication rate. Higher BMI and stone size negatively impacted outcomes. Supine PCNL may be an option for treating kidney stones in patients with HSK.
conferenceObject LAPAROSCOPIC AND ROBOT-ASSISTED LEVEL II AND III INFERIOR VENA CAVA TUMOR THROMBECTOMY(2021) SAWCZYN, Guilherme; CORDEIRO, Mauricio; GUGLIELMETTI, Giuliano; FAZOLI, Arnaldo; RODRIGUES, Gilberto; VILLAMIL, Wenceslao; MARCHINENA, Patricio; JURADO, Alberto; ROMEO, Agustin; ROMANELLI, Pedro; ARANTES, Paulo; NISTER, Matheus; TANURE, Luis; VICENTINI, Fabio; ALVES, Joao; DOURADO, Aurus; NAHAS, William; COELHO, Rafael- Residual Stone Fragments After Percutaneous Nephrolithotomy: Shockwave Lithotripsy vs Retrograde Intrarenal Surgery(2021) DANILOVIC, Alexandre; TORRICELLI, Fabio Cesar Miranda; MARCHINI, Giovanni Scala; BATAGELLO, Carlos; VICENTINI, Fabio Carvalho; TRAXER, Olivier; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoBackground: Despite technology incorporation to percutaneous nephrolithotomy (PCNL), residual stone fragments (RSFs) may still persist after PCNL and need to be addressed to avoid regrowth or ureteral obstruction. The objective of this study was to compare the outcomes of retrograde intrarenal surgery (RIRS) to extracorporeal shockwave lithotripsy (SWL) for treating patients with RSFs after a previous standard PCNL. Materials and Methods: Adult patients with RSF after a standard PCNL submitted to RIRS or SWL in our Institution from January 2017 to January 2020 were retrospectively studied. Stone-free rate (SFR) was evaluated on postoperative day (POD) 90 by noncontrast CT (NCCT) or ultrasound and kidney, ureter, and bladder radiograph (KUB) for each renal unit. Surgical complications based on Clavien-Dindo classification during the 90 days of follow-up were recorded. Sample size was calculated for a power of 80% and a significance level of 0.05, assuming SFR of 20% for SWL and 50% for RIRS. Results: Thirty-three patients treated by SWL were compared with 36 patients treated by RIRS. Hospitalization time was longer in the RIRS group (4.18 vs 12.33 hours, p = 0.001). SFR and success rate were lower in SWL than RIRS group (24.2% vs 58.3%, p = 0.007 and 30.3% vs 72.2%, p = 0.004, respectively), using POD 90 NCCT in 81.8% and ultrasound and KUB in 18.2% of the SWL group and using POD 90 NCCT in 100% of the RIRS group. Minor complications (Clavien-Dindo < III) occurred in 11 of 36 (30.6%) patients submitted to RIRS and in 2 of 33 (6.1%) patients submitted to SWL group (p = 0.025). Two patients (6.1%) of the SWL group had Clavien-Dindo IIIb complication owing to Steinstrasse and were submitted to ureteroscopy. Emergency room visits were similar between groups (6.1% vs 8.3%, p = 1.0). Conclusions: RIRS has better SFR, higher minor complications, and lower major complications than SWL for the treatment of RSFs after standard PCNL.
- Effect of a low-calorie diet on 24-hour urinary parameters of obese adults with idiopathic calcium oxalate kidney stones(2021) DANILOVIC, Alexandre; MARCHINI, Giovanni Scala; PUCCI, Nidia Denise; COIMBRA, Brian; TORRICELLI, Fabio Cesar Miranda; BATAGELLO, Carlos; VICENTINI, Fabio Carvalho; SROUGI, Miguel; NAHAS, William C.; MAZZUCCHI, EduardoPurpose: to evaluate the effect of low-calorie diet on 24-hour urinary metabolic parameters of obese adults with idiopathic calcium oxalate kidney stones. Materials and Methods: Adult idiopathic calcium oxalate stone formers, with body mass index (BMI) >= 30kg/m(2) and a known lithogenic metabolic abnormality, were submitted to low-calorie diet for twelve weeks. After enrolment, anthropometric measures, serum exams, 24-hour urinary metabolic parameters and body impedance were collected one month prior to dietary intervention and at the end of twelve weeks. Correlations between weight loss, waist circumference loss, fat loss and variation in 24-hour urinary lithogenic parameters and calcium oxalate urinary supersaturation (CaOx SS) as per Tiselius equation were analysed. Results: From January 2017 to January 2018, 39 patients were enrolled to participate in this study. Median (range) prescribed diet was 1300 (1100-2100) Kcal/day. Mean age was 51.7 +/- 11.0 (29-68) years old and 69.2% were female. 30.8% of the participants shifted from obesity to BMI <30kg/m(2) and none to BMI <25kg/m(2). A significant correlation was found between baseline 24-hour urinary oxalate and weight (p=0.018) and BMI (p=0.026). No correlation was found between variation of weight, waist circumference, fat mass and 24-h urinary stone risk factors or CaOx SS. Conclusions: Short-term modest weight loss induced by twelve weeks of low-calorie diet is not associated with a decrease of 24-hour urinary lithogenic parameters in idiopathic calcium oxalate stone formers. Calcium oxalate urinary stone formation is probably multifactorial and driven by other factors than weight.