Frederico Branco

Prostate Cancer Prevention Trial and European Randomized Study of Screening for Prostate Cancer Risk Calculators: A Performance Comparison in a Contemporary Screened Cohort

BACKGROUND Several models can predict the risk of prostate cancer (PCa) on biopsy. OBJECTIVE To evaluate the performance of the Prostate Cancer Prevention Trial (PCPT) and European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculators in detecting PCa in a contemporary screened cohort. DESIGN, SETTING, AND PARTICIPANTS We analyzed prebiopsy characteristics of 525 consecutive screened patients submitted to biopsy, as required by the risk calculators, in one European center between 2006 and 2007. MEASUREMENTS Comparisons were done using tests of accuracy (area under the receiver operating characteristic curve [AUC-ROC]), calibration plots, and decision curve analysis. Biopsy predictors were identified by univariate and multivariate logistic regression. RESULTS AND LIMITATIONS PCa was detected in 35.2% of the subjects. Among predictors included in the calculators, the logarithmic transformations of prostate volume and prostate-specific antigen (PSA), digital rectal examination, previous biopsy status, and age were significantly associated with PCa; transrectal ultrasound abnormalities and family history were not. AUC-ROC for the ERSPC calculator was significantly higher than the PCPT calculator and PSA alone (80.1%, 74.4%, and 64.3%, respectively). Calibration plots showed better performance for the ERSPC calculator; nevertheless, ERSPC may underestimate risk, while PCPT tends to overestimate predictions. Decision curve analysis displayed higher net benefit for the ERSPC calculator; 9% and 23% unnecessary biopsies can be avoided if a threshold probability of 20% and 30%, respectively, is adopted. In contrast, the PCPT model displayed very limited benefit. Our findings apply to a screened European cohort submitted to extended biopsy schemes; consequently, caution should be exerted when considering different populations. CONCLUSIONS The ERSPC risk calculator, by incorporating several risks factors, can aid in the estimation of individual PCa risk and in the decision to perform biopsy. The ERSPC calculator outperformed the PCPT model, which is of very limited value, in a contemporary cohort of screened patients.

Transvesical peritoneoscopy with rigid scope: feasibility study in human male cadaver

BackgroundTransvesical port refers to the method of accessing the abdominal cavity through a natural orifice (i.e., urethra) under endoscopic visualization. Since its introduction in 2006, various reports have been published describing different surgical interventions using a rigid ureteroscope in a porcine model. The aim of this study was to test the access and feasibility of peritoneoscopy by using a rigid ureteroscope in a human male cadaver.MethodsTwo adult male cadavers were used to perform the procedures. A rigid ureteroscope was used for the creation of transvesical access into the peritoneal cavity. Peritoneoscopy, liver biopsy, and identification and manipulation of the ileocecal appendix were performed.ResultsTransvesical access into the peritoneal cavity was quickly established. The rigid ureteroscope easily allowed visualization of the abdominal cavity with good image quality. Liver biopsy and manipulation of ileocecal appendix were carried out without difficulties.ConclusionsPeritoneoscopy, liver biopsy, and ileocecal appendix manipulation using a rigid ureteroscope through a transvesical port is feasible in a cadaver model. The development of a specific rigid scope for the transvesical port might herald a promising future for this NOTES access.

Transvesical natural orifice transluminal endoscopic surgery (NOTES) nephrectomy with kidney morcellation: a proof of concept study

Study Type – Therapy (case series)

The quality of reporting of randomized controlled trials in pelvic organ prolapse

Introduction and hypothesisRandomized controlled trials (RCTs) must comply with the strict rules of design and conduct and their reporting should reflect it. Our aim was to evaluate how the quality of RCT reporting in pelvic organ prolapse (POP) has evolved.MethodsRCTs in POP published between 1997 and 2010 were retrieved through a PubMed search. The quality of reporting was assessed by applying the 2010 revised Consolidated Standards of Reporting Trials (CONSORT) statement. Appropriate statistical analysis was performed.ResultsForty-one RCTs were identified for review. The implementation of randomization, recruitment, blinding, outcomes with effect size and precision, trial registration, and full protocol availability were reported in less than half of the trials. Comparing two periods (1997–2006 and 2007–2010), there was no improvement in the quality of reporting for any of the CONSORT criteria.ConclusionsRCTs in POP are scarce. The quality of reporting is suboptimal in many aspects and has not improved in recent years.

Female Sexual Function and Depression After Kidney Transplantation: Comparison Between Deceased- and Living-Donor Recipients

Disturbances in sexual function and depression are a common feature in women with chronic renal failure. Living-donor kidney transplantation seems to warrant better results than its cadaveric counterpart in many aspects but its impact on post-transplantation sexual function remains unknown. This study aimed to compare post-transplantation sexual function and depression in women receiving kidney grafts from living and deceased donors. From a single-center prospective database of 2016 renal transplantations between June 2011 and June 2013, we enrolled 50 sexually active women after kidney transplantation. Female sexual function was evaluated with the Female Sexual Function Index Questionnaire (FSFI) and depression was assessed using the Beck Depression Inventory-II (BDI-II) scale. Thirty-four patients referred the questionnaires. The sexual domains of satisfaction and desire were significantly better in living-donor receptors; in all other domains evaluated by FSFI no statistically significant difference was encountered between groups, although living-donor receptors tended to report better function. Total BDI-II was well correlated with total FSFI score in our study cohort (Spearmans rho = -0.80, P < .001). Only 34.6% of women referred to have discussed sexual issues with their physicians before transplantation, whereas 73.1% stated it would have been important. In conclusion, living-donor transplantation exerted a positive effect on womens sexual function.

Creativity as a Key Ingredient of Information Systems

Resorting to creativity technique and their use to help innovation in the area of information systems had a growing interest. In fact, the global competitiveness and the organizations ability to make effective use of information technology and to focus on innovation and creativity are recognized as being important. So, the perspective of using creativity techniques seems to be promising. In this research work we argue that is possible in all IS areas to take advantages of the use of creative processes. We give a pragmatic reasoning and examples for the introduction of creative processes in all the main IS areas.

Endoscopic removal of an intravesical calcified sling using pneumatic lithotripsy and cystoscopic resection.

The transobturator tape procedure is a minimally invasive treatment for stress urinary incontinence. The widespread use of these slings has led to an increase in the number of rare complications, such as bladder erosion. Although in the last few years several minimally invasive techniques have been described, surgical management of such complications remains an open issue. We report a case of a bladder stone formed on a transobturator sling after unrecognized bladder perforation. Using pneumatic lithotripsy, the calculus was fragmented and the intravesical portion of the tape was successfully excised and removed by transurethral resection and endoscopic scissors. This minimally invasive transurethral technique is challenging but can be a safe and successful way to deal with such rare complications.

Innovation Management in Portuguese and Russian Agricultural Companies

Increasing the innovative activity of enterprises in current conditions while managing it properly is one of the most important parts of management. Implementation of new technologies, optimization of costs, entering new markets, launching of new products, and many other aspects – all of them should be considered when adopting the strategy for an enterprise’s activity, both from a short-term and from a long-term perspective. One of the most demanded innovative directions is the use of renewable energy sources. Among the most popular energy sources, solar panels make top of the list, and they can be installed on existing constructions. The reason for development in this direction is the permanent growth in demand for electricity produced through traditional sources and, as a result, the permanent growth of electricity cost for enterprises holding production lines; this ultimately leads to a growth in price for the final consumer. This research considers the opportunity to implement renewable energy sources on existing agricultural enterprises. As subjected enterprises, we will review APC “Bolshevik” of Moskalensky District of Omsk region of the Russian Federation and “Company B” LDA of Braganca Municipality of the Portuguese Republic. We will calculate financial and production results received after the implementation of new electricity-generating systems on both enterprises. The opportunity to sell the surplus of overproduced electricity to the citizens of nearby villages and cities or to the government will also be taken into account.

CRUDi Framework Application – Bank Company Case Study

The top management view of organizations tends not to reach consensus on the prioritization of investments in Information Systems, particularly when they must prioritize their impact on overall performance and budget constraints. This paper presents the results of applying CRUDi Framework to a bank. This allows to obtain new indicators to support the decision and alignment of investment priorities in the processes that support the business strategy. The Framework introduces a new method and tools that allow us to gauge the relative importance of Information Systems to the organizations’ businesses.

An Online Focus Group Approach to e-Government Acceptance and Use.

The emergence and widespread use of Information and Communication Technologies enabled government agencies to develop their capacity for citizens interaction, hence providing better public services. These electronic services, typically known as e-Government, have been undergoing significant development over the last few years. Information technologies have become one of the central elements in electronic governance today, and probably they will outstand in the future too.