Papers by Victor Paschoalin
Hormone Research in Paediatrics
Introduction: Adrenocortical carcinoma (ACC) is diagnosed in paediatric patients at 5 months afte... more Introduction: Adrenocortical carcinoma (ACC) is diagnosed in paediatric patients at 5 months after symptom onset on average, and 38% die during the first 2.5 years of follow-up. This study aimed to compare the accuracy of Weiss, Van Slooten, and Wieneke histopathological ACC classifications for predicting follow-up prognosis in a paediatric population. Methods: Data were retrieved from medical records of 57 patients aged <18 years who underwent surgical treatment for ACC with surgical follow-up over 6 months or death due to ACC. They were classified into either good (without recurrence/death due to ACC) or poor (with recurrence/death due to ACC) prognosis group. Two expert pathologists classified the ACC surgical specimens according to the Weiss, Van Slooten, and Wieneke criteria. Results: The median follow-up duration was 126 (18–225) months in 38 males (66.7%) and 19 females (33.3%) (median age: 3 [1–6.5] years). The good prognosis group was younger than the poor prognosis grou...
Copyright © 2012 Michel Platiny Mascarenhas et al. This is an open access article distributed und... more Copyright © 2012 Michel Platiny Mascarenhas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Intrauterine device (IUD) is a common contraceptive method, due to its cost-effectiveness and low complication rates. Uterine perforation is a possible complication and IUD migration to the bladder is a rare and morbid condition. The present report describes an interesting case in which the urinary manifestations started 13 years after insertion, and the main clinical finding was exercise-induced hematuria. 1.
Objetivo: Analise descritiva das caracteristicas clinicas e anatomopatologicas dos pacientes com ... more Objetivo: Analise descritiva das caracteristicas clinicas e anatomopatologicas dos pacientes com diagnostico de neoplasia de bexiga submetidos a cistectomia radical na Disciplina de Urologia do Departamento de Cirurgia da Santa Casa de Sao Paulo. Metodo: foi realizada analise retrospectiva de 100 prontuarios de pacientes submetidos consecutivamente a cistectomia radical, no periodo de 2000 a 2006, para o tratamento da neoplasia de bexiga. Resultados: dos 100 pacientes estudados, 76 eram do sexo masculino e 24 do sexo feminino. O tipo histologico mais comum foi o carcinoma de celulas transicionais (urotelial), encontrado em 92% dos casos. O estadio patologico dos tumores foi: pTa em 3%, pT1 em 12%, pT2 em 28%, pT3 em 30% and pT4 em 27% dos casos. Conclusao: Os pacientes com carcinoma vesical submetidos a cistectomia radical foram homens, na setima decada de vida, com carcinoma urotelial e infiltrativo na maioria dos casos. A incidencia de metastases foi elevada, sendo os sitios mais ...
The Journal of Urology
pain may all contribute. Couples should be adequately counselled before being offered vasectomy a... more pain may all contribute. Couples should be adequately counselled before being offered vasectomy as a means of permanent contraception.
Revista da Associacao Medica Brasileira (1992), 2017
To investigate the positive association between the presence of simple renal cysts (SRCs) and abd... more To investigate the positive association between the presence of simple renal cysts (SRCs) and abdominal aortic aneurysm (AAA). In a retrospective case-control study including subjects aged > 50 years, we evaluated the incidence of SRCs on computed tomography (CT) scan. We compared 91 consecutive patients with AAA referred from the Division of Vascular Surgery and 396 patients without AAA, randomly selected after being matched by age and gender from 3,186 consecutive patients who underwent abdominal CT. SRC was defined as a round or oval low-attenuation lesion with a thin wall and size > 4 mm on CT without obvious evidence of radiographic enhancement or septations. Patients were considered as having AAA if the size of aorta was greater than 3.0 cm. Patients with AAA and without AAA were similar in terms of age (67.9± 8.41 vs. 68.5±9.13 years) (p=0.889) and gender (71.4 vs. 71.2% of male subjects, respectively) (p=0.999). There was no difference in the prevalence of SRC between ...
The Journal of Urology
of T-dose). Stepwise multivariate Cox regression models revealed fundamental differences in inter... more of T-dose). Stepwise multivariate Cox regression models revealed fundamental differences in inter-individual effects: hazard ratios for loss of BMI/WC were significantly higher in those subjects with younger age, lower baseline T and higher ratios of delta testosterone over delta estradiol levels induced by treatment (all p<0.01). Advanced age, higher baseline BMI and higher delta estradiol levels resulted in significantly higher hazard ratios for prostate growth/increase in PSA or hematocrit (all p<0.01). Overall, effects were attenuated, but still significant, in subjects with androgen receptor gene CAG repeat length >24, in those with KS or men with non-classical hypogonadism (using non-KS primary hypogonadism as referent, all p<0.05). CONCLUSIONS: Major new findings regarding effects and safety of T substitution in hypogonadal men are provided. This longterm registry on T substitution in hypogonadal men of a wide age-range demonstrates a decrement of weight, factors influencing cardiovascular health and a low, manageable amount of risk factors. Effects are modulated by diagnosis, age and genetic background.
The Journal of Urology, 2012
dren treated at our institution for bilateral Wilms tumor without antecedent diagnostic biopsy. A... more dren treated at our institution for bilateral Wilms tumor without antecedent diagnostic biopsy. All received vincristine, actinomycin D, and doxorubicin for a minimum of 6 weeks prior to surgery. RESULTS: Age at clinical diagnosis ranged from 8 to 63 months. All 5 children had a palpable abdominal mass. Ultrasound failed to detect bilateral disease in 3. All diagnoses were made with cross-sectional imaging. Studies to rule out neuroblastoma were obtained in 4. Time from diagnosis to chemotherapy ranged from 2 to 8 days. After 6 weeks of chemotherapy, the average decrease in size of the largest tumor and the largest contralateral tumor was 41% (median 49%) and 47% (median 34%), respectively. In 2 cases where additional chemotherapy was given to further reduce tumor size preoperatively, the interval decrease in size of the largest tumor was 14-16% with no change in contralateral tumors; in one, all other ipsilateral tumors increased. Radical nephrectomy was required in 3 children on one side only; one whose multifocal tumors increased in size after additional chemotherapy, one who had the only mass to increase in size after initial chemotherapy (11.0 to 11.2 cm), and one who underwent conversion to radical nephrectomy due to an inability to spare the renal vein and collecting system. Renal function was preserved in all 3. In 2 kidneys, the largest tumors were reduced from 16.0 to 8.2 cm and from 6.7 to 3.0 cm; partial nephrectomies were achieved. Among all other partial nephrectomies, the largest tumor was 2.8 cm at diagnosis. Pathology confirmed Wilms tumor in all children. Only 2 who had pulmonary metastases at diagnosis had individual kidney staging greater than Stage I. After an average 5 months postoperative followup, monitoring of pulmonary lesions is ongoing in 3 children and 2 have no evidence of disease. CONCLUSIONS: In our series, biopsy-free management of bilateral Wilms tumors did not lead to misdiagnosis. While bilateral partial nephrectomies were achieved, neoadjuvant chemotherapy did not preclude radical nephrectomy in 3 children.
The Journal of Urology, 2015
INTRODUCTION AND OBJECTIVES: Over 18,000 Stem Cell Transplants (SCT) are performed each year. Suc... more INTRODUCTION AND OBJECTIVES: Over 18,000 Stem Cell Transplants (SCT) are performed each year. Such patients routinely receive gonadotoxic therapies. Chemotherapy, total body irradiation (TBI), and chronic steroid use are well-recognized causes of Leydig cell damage. Our aim was to characterize total testosterone (TT) profiles of men who underwent SCT, and identify any correlations between decline in T and subsequent diagnosis of decreased bone density.
The Journal of urology, Jan 25, 2015
The followup and treatment of children with vesicoureteral reflux has been debated for many years... more The followup and treatment of children with vesicoureteral reflux has been debated for many years. Antibiotic prophylaxis has a role for preventing urinary tract infection in these children. Recent studies and guidelines suggested that prophylaxis has little or no role in preventing urinary tract infection in those children, especially those with low grades (I and II) of reflux. We analyzed all published randomized, controlled trials comparing antibiotic prophylaxis vs no prophylaxis or placebo in children with vesicoureteral reflux. The children were divided into those with nondilated (grades I and II) and dilated (grades III and IV) vesicoureteral reflux. After data were analyzed the RIVUR study was published and, therefore, it was added to the analyzed data. After analyzing the first published studies we found that antibiotic prophylaxis would be beneficial only in children with high grade vesicoureteral reflux. With the addition of the data in the RIVUR study these results chang...
... Article]. Channel flickers and video speeders. Yorke, David A.; Kitchen, Philip J. Journal of... more ... Article]. Channel flickers and video speeders. Yorke, David A.; Kitchen, Philip J. Journal of Advertising Research, Vol 25(2), Apr-May 1985, 21-25. Abstract. Investigated to what extent video cassette recorders (VCRs) and remote-control (RC) TV are affecting consumer behavior ...
The Journal of Urology, 2012
The Journal of Urology, 2014
Purpose: The followup and treatment of children with vesicoureteral reflux has been debated for m... more Purpose: The followup and treatment of children with vesicoureteral reflux has been debated for many years. Antibiotic prophylaxis has a role for preventing urinary tract infection in these children. Recent studies and guidelines suggested that prophylaxis has little or no role in preventing urinary tract infection in those children, especially those with low grades (I and II) of reflux. Materials and Methods: We analyzed all published randomized, controlled trials comparing antibiotic prophylaxis vs no prophylaxis or placebo in children with vesicoureteral reflux. The children were divided into those with nondilated (grades I and II) and dilated (grades III and IV) vesicoureteral reflux. After data were analyzed the RIVUR study was published and, therefore, it was added to the analyzed data. Results: After analyzing the first published studies we found that antibiotic prophylaxis would be beneficial only in children with high grade vesicoureteral reflux. With the addition of the data in the RIVUR study these results changed. The new pooled data support antibiotic prophylaxis in all children with vesicoureteral reflux. Conclusions: Vesicoureteral reflux management is still controversial. In contrast to recently published studies and guidelines, this meta-analysis supports antibiotic prophylaxis in all children with vesicoureteral reflux regardless of reflux grade. More studies are needed to support this finding.
The Journal of Urology, 2009
growth, whereas finasteride or MK386 alone were able to reduce PCa proliferation by about 40%. A ... more growth, whereas finasteride or MK386 alone were able to reduce PCa proliferation by about 40%. A high correlation between the expression of SRD5A enzymes in cell culture extracts and in sections from the source tissue samples was observed. As demonstrated by western blot Pca epithelial cells expressed in culture, with variable ratios, both SRD5A isoforms. Finasteride effects were dependent on SRD5A-2 levels and they were significant only when the SRD5A-1:2 ratio was low. Conversely the effects of MK386 were dependent on the expression of high SRD5A-1 levels. On the contrary dutasteride antitumor effect was not influenced by the SRD5A-1:2 ratio. CONCLUSIONS: Our data may provide a rationale for the use of a dual SRD5A inhibitor rather than a mono specific inhibitor for the prevention or treatment of early Pca. This finding appears to confirm some preliminary clinical results and it could be due to the simultaneous presence of both isoforms of the SRD5A enzyme in Pca cells.
Case Reports in Urology, 2012
Intrauterine device (IUD) is a common contraceptive method, due to its cost-effectiveness and low... more Intrauterine device (IUD) is a common contraceptive method, due to its cost-effectiveness and low complication rates. Uterine perforation is a possible complication and IUD migration to the bladder is a rare and morbid condition. The present report describes an interesting case in which the urinary manifestations started 13 years after insertion, and the main clinical finding was exercise-induced hematuria.
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Papers by Victor Paschoalin