Semen parameters in testicular tumor patients before orchiectomy: What is the impact of testicular tumor stage and histology?

Purpose: To evaluate the influence of testicular cancer histology and stage on sperm parameters in cryopreserved samples collected prior to orchiectomy. Materials and methods: We conducted a retrospective analysis of tumor histology, stage and sperm parameters of patients who underwent pre-orchiectomy sperm cryopreservation for testicular cancer between March 2010 and March 2023. The World Health Organization (WHO) 2010 sperm reference values were used to identify patients with subnormal semen parameters and to further categorize patients by sperm alteration. Localized disease was classified as Stage I, while metastatic disease encompassed Stages II and III. Continuous variables were compared using t-test or Mann Whitney U test, and categorical variables using Chi-square and Fisher´s exact test. Results: A total of 64 patients was identified, 48 (75%) classified as stage I and 16 (25%) classified as stage II/III. No difference was found in semen parameters between patients with seminoma and patients with non-seminoma germ cell tumor (NSGCT). Patients with stage II/III disease had significantly lower percentages of progressive motility (36% vs 53%, p = 0.021) and total motility (60% vs 69%, p = 0.015) than stage I patients. When categorizing by sperm alterations according to WHO 2010 reference values, patients with stage II/III disease had significantly higher proportions of asthenozoospermia (38% vs 15%, p = 0.048) and teratozoospermia (63% vs 31%, p = 0.027) than stage I patients. Elevated tumor markers were not associated with sperm abnormalities. Conclusions: Patients with metastatic testicular cancer present with worse sperm quality than patients with localized disease. Sperm cryopreservation should be offered to all patients with testicular cancer, and especially emphasized in patients with metastatic disease

Vitamin D Deficiency in a hospitalar population and its predictors: development of a Screening Questionnaire

Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaIntrodução: A elevada prevalência da deficiência de Vitamina D, reportada em diversos estudos, e o reconhecimento de potenciais consequências para a saúde do indivíduo, além das classicamente reconhecidas, têm aumentado o interesse dos clínicos pela Vitamina D condicionando um aumento dos doseamentos (e respetivos custos). Este estudo teve como objetivo principal desenvolver um questionário clínico para identificação de pessoas com risco de deficiência de Vitamina D. Pretendeu, ainda, avaliar a associação entre o status de Vitamina D, fatores sociodemográficos e determinadas manifestações, tanto clínicas como laboratoriais, potencialmente associadas à deficiência de Vitamina D. Métodos: Estudo observacional, transversal, unicêntrico realizado no Centro Hospitalar e Universitário de Coimbra (CHUC) de julho a novembro de 2016. A amostra estudada incluiu doentes seguidos nos Departamentos de Reumatologia, Medicina Interna, Neurologia, Endocrinologia e Infecciologia dos CHUC, cujo doseamento de Vitamina D foi realizado no Laboratório de Patologia Clínica dos CHUC. Os doentes foram identificados através de pesquisa eletrónica semanal no registo do mencionado laboratório. Os doentes identificados foram contactados telefonicamente e convidados a participar. Após consentimento, foi aplicado um questionário standardizado para recolha de dados. A análise estatística foi realizada utilizando o SPSS. Todas as análises foram realizadas para a amostra total e no subgrupo de doentes sem suplementação atual de Vitamina D. p<0.05 foi considerado estatisticamente significativo em todas as análises. Resultados: A prevalência de níveis baixos de vitamina D encontrada foi de 44%, sendo que 2% dos doentes apresentava deficiência severa, 10% apresentava deficiência e 32% apresentava insuficiência de vitamina D. Níveis baixos de vitamina D foram associados a peso elevado e IMC elevado, escassa prática de exercício físico e pouco tempo passado em pé e evicção da exposição solar durante o período de primavera e verão. Foi, ainda, encontrada relação estatisticamente significativa entre níveis baixos de vitamina D e prevalência de fibromialgia (na amostra total) e níveis altos de paratormona (não suplementados). Não foi encontrada relação estatisticamente significativa entre nenhuma das manifestações clínicas e os níveis de vitamina D.Discussão e Conclusão: Algumas das relações encontradas entre variáveis estudadas e níveis baixos de vitamina D corroboram estudos já elaborados com resultados semelhantes. No entanto, não foi possível encontrar um modelo preditor fiável de deficiência de vitamina D, ficando a faltar estudos de maiores dimensão e robustez.Introduction: The high prevalence of Vitamin D deficiency reported in several studies and the recognition of potential health consequences of the individual, in addition to the classically recognized ones, has increased the clinicians' interest in Vitamin D, resulting in increased dosages (and their costs). The main objective of this study was to develop a clinical questionnaire to identify people at high risk for vitamin D deficiency. It also aimed to evaluate the association between vitamin D status and sociodemographic factors and certain clinical and laboratory manifestations potentially associated with vitamin D deficiency. Methods: A cross-sectional, unicentric observational study was performed at the Centro Hospitalar e Universitário de Coimbra (CHUC) from July to November 2016. The sample included patients followed in the departments of Rheumatology, Internal Medicine, Neurology, Endocrinology and Infectious Diseases of CHUC with Vitamin D measures in the Laboratory of Clinical Pathology of the CHUC in the mentioned period and that were identified, retrospectively, by electronic research, in the database of computer records of the laboratory, with a weekly frequency. The identified patients were contacted by telephone and invited to participate. A standardized questionnaire was used to collect data. Statistical analysis was performed using SPSS. All analyses were performed for the whole sample and in the subgroup of patients without current Vitamin D supplementation. P <0.05 was considered statistically significant in all analyses.Results: The prevalence of low vitamin D levels was 44%; 2% of the patients had severe deficiency, 10% had deficiency and 32% had insufficient vitamin D. Low levels of vitamin D were associated with high weight and high BMI, poor exercise and little time spent standing and avoiding sun exposure during the spring and summer period. There was also a statistically significant relationship between low levels of vitamin D and prevalence of fibromyalgia (in the total sample) and high levels of parathormone (not supplemented). No statistically significant relationship was found between any of the clinical manifestations and vitamin D levels.Discussion and Conclusion: Some of the relationships found between studied variables and low levels of vitamin D corroborate studies already elaborated with similar results. However, it was not possible to find a reliable predictor model of vitamin D deficiency, lacking studies of greater size and robustness

Vitamin D Deficiency in a hospitalar population and its predictors: development of a Screening Questionnaire

Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaIntrodução: A elevada prevalência da deficiência de Vitamina D, reportada em diversos estudos, e o reconhecimento de potenciais consequências para a saúde do indivíduo, além das classicamente reconhecidas, têm aumentado o interesse dos clínicos pela Vitamina D condicionando um aumento dos doseamentos (e respetivos custos). Este estudo teve como objetivo principal desenvolver um questionário clínico para identificação de pessoas com risco de deficiência de Vitamina D. Pretendeu, ainda, avaliar a associação entre o status de Vitamina D, fatores sociodemográficos e determinadas manifestações, tanto clínicas como laboratoriais, potencialmente associadas à deficiência de Vitamina D. Métodos: Estudo observacional, transversal, unicêntrico realizado no Centro Hospitalar e Universitário de Coimbra (CHUC) de julho a novembro de 2016. A amostra estudada incluiu doentes seguidos nos Departamentos de Reumatologia, Medicina Interna, Neurologia, Endocrinologia e Infecciologia dos CHUC, cujo doseamento de Vitamina D foi realizado no Laboratório de Patologia Clínica dos CHUC. Os doentes foram identificados através de pesquisa eletrónica semanal no registo do mencionado laboratório. Os doentes identificados foram contactados telefonicamente e convidados a participar. Após consentimento, foi aplicado um questionário standardizado para recolha de dados. A análise estatística foi realizada utilizando o SPSS. Todas as análises foram realizadas para a amostra total e no subgrupo de doentes sem suplementação atual de Vitamina D. p<0.05 foi considerado estatisticamente significativo em todas as análises. Resultados: A prevalência de níveis baixos de vitamina D encontrada foi de 44%, sendo que 2% dos doentes apresentava deficiência severa, 10% apresentava deficiência e 32% apresentava insuficiência de vitamina D. Níveis baixos de vitamina D foram associados a peso elevado e IMC elevado, escassa prática de exercício físico e pouco tempo passado em pé e evicção da exposição solar durante o período de primavera e verão. Foi, ainda, encontrada relação estatisticamente significativa entre níveis baixos de vitamina D e prevalência de fibromialgia (na amostra total) e níveis altos de paratormona (não suplementados). Não foi encontrada relação estatisticamente significativa entre nenhuma das manifestações clínicas e os níveis de vitamina D.Discussão e Conclusão: Algumas das relações encontradas entre variáveis estudadas e níveis baixos de vitamina D corroboram estudos já elaborados com resultados semelhantes. No entanto, não foi possível encontrar um modelo preditor fiável de deficiência de vitamina D, ficando a faltar estudos de maiores dimensão e robustez.Introduction: The high prevalence of Vitamin D deficiency reported in several studies and the recognition of potential health consequences of the individual, in addition to the classically recognized ones, has increased the clinicians' interest in Vitamin D, resulting in increased dosages (and their costs). The main objective of this study was to develop a clinical questionnaire to identify people at high risk for vitamin D deficiency. It also aimed to evaluate the association between vitamin D status and sociodemographic factors and certain clinical and laboratory manifestations potentially associated with vitamin D deficiency. Methods: A cross-sectional, unicentric observational study was performed at the Centro Hospitalar e Universitário de Coimbra (CHUC) from July to November 2016. The sample included patients followed in the departments of Rheumatology, Internal Medicine, Neurology, Endocrinology and Infectious Diseases of CHUC with Vitamin D measures in the Laboratory of Clinical Pathology of the CHUC in the mentioned period and that were identified, retrospectively, by electronic research, in the database of computer records of the laboratory, with a weekly frequency. The identified patients were contacted by telephone and invited to participate. A standardized questionnaire was used to collect data. Statistical analysis was performed using SPSS. All analyses were performed for the whole sample and in the subgroup of patients without current Vitamin D supplementation. P <0.05 was considered statistically significant in all analyses.Results: The prevalence of low vitamin D levels was 44%; 2% of the patients had severe deficiency, 10% had deficiency and 32% had insufficient vitamin D. Low levels of vitamin D were associated with high weight and high BMI, poor exercise and little time spent standing and avoiding sun exposure during the spring and summer period. There was also a statistically significant relationship between low levels of vitamin D and prevalence of fibromyalgia (in the total sample) and high levels of parathormone (not supplemented). No statistically significant relationship was found between any of the clinical manifestations and vitamin D levels.Discussion and Conclusion: Some of the relationships found between studied variables and low levels of vitamin D corroborate studies already elaborated with similar results. However, it was not possible to find a reliable predictor model of vitamin D deficiency, lacking studies of greater size and robustness

The impact of the coronavirus disease 2019 pandemic on the utilisation of emergency urological services

Objectives: To compare the number of patients attending the Urology Emergency Department (ED) of the Centro Hospitalar Universitário do Porto (CHUP), as well as their demographic characteristics, the reasons for admission, the clinical severity under the Manchester triage system (MTS), and the need for emergency surgery or hospitalisation, during the coronavirus disease 2019 (COVID-19) pandemic and the equivalent period in 2019. Patients and methods: Data were collected from patients attending the Urology ED of the CHUP over 3 weeks, from 11 March to 1 April 2020, and from the same period in the previous year (from 11 March to 1 April 2019). Results: During the pandemic, 46.4% fewer patients visited our urological ED (122 vs 263). There was no significant difference in the mean age or the number of old patients (aged ≥65 years) between the two periods. However, significantly fewer female patients sought emergency urological services during the COVID-19 pandemic period (32.7% vs 14.8%, P < 0.05). No significant differences were noted between different clinical severity groups under the MTS. In 2019, significantly less patients required hospitalisation. The most common reasons for admission, during both periods, were haematuria, renal colic and urinary tract infections. The authors recognise that the study has several limitations, namely, those inherent to its retrospective nature. Conclusion: COVID-19 significantly influenced people's urological care-seeking behaviour. Understanding the present situation is helpful for predicting future urological needs. Based on the results of this study, we have reason to speculate that people's requirements for urological services might grow explosively in the post-COVID-19 period. There should be further studies about the real state of long-term urological services and the consequences that this pandemic may have in terms of morbimortality not directly related to the severe acute respiratory syndrome coronavirus 2.info:eu-repo/semantics/publishedVersio

Outcomes of Urinary Tract Endometriosis—Laparoscopic Treatment: A 10-Year Retrospective Study

Introduction: Urinary tract endometriosis (UTE), a rare manifestation, encompasses bladder and ureteral involvement. Surgical intervention is commonly recommended for UTE, though the optimal surgical approach remains a subject of debate. This study aims to report our centre’s experience with UTE. Methods: We conducted a retrospective cohort study of 55 patients who underwent surgical treatment for UTE at a single tertiary centre over a 10-year period (2012–2022). Patient data, including demographics, symptoms, intraoperative findings, and complications, were collected from medical records. Data were statistically analysed, and correlations were explored. Results: The study population had a mean age of 37.11 years, with dysmenorrhea (89.1%) being the most common symptom. Bladder endometriosis was present in 27 cases, ureteral endometriosis in 25, and mixed-location in 3. Laparoscopy was the primary surgical approach, with multidisciplinary teams involving urologists. There were six patients with postoperative complications, and there were six (10.9%) recurrences of endometriosis. A positive correlation was found between age and recurrence, but no significant predictors of recurrence were identified in our analysis. Conclusions: Laparoscopic treatment of urinary endometriosis is safe and effective. Multidisciplinary collaboration plays a pivotal role in addressing this challenging condition

Remaining kidney volume indexed to weight as a strong predictor of estimated glomerular filtration rate at 1 year and mid‐term renal function after living‐donor nephrectomy ‐ a retrospective observational study

The donors' estimated glomerular filtration rate (eGFR) after living nephrectomy has been a concern, particularly in donors with smaller kindeys. Therefore, we developed this retrospective observational study in 195 donors to determine the ability remaining kidney volume indexed to weight (RKV/W) to predict eGFR at 1 year through multivariate linear regression and to explore this relationship between annual eGFR change from 1 to 4 years postdonation evaluated by a linear mixed model. Comparing RKV/W tertiles (T1, T2, T3), RKV/W was a good predictor of 1-year eGFR which was significantly better in T3 donors. Gender, predonation eGFR, and RKV/W were independent predictors of eGFR at 1-year. In a subgroup with predonation eGFR < 90mL/min/1.73 m2 , a significant prediction of eGFR < 60mL/min/1.73 m2 was detected in males with RKV/W ≤ 2.51cm3 /kg. Annual eGFR (ml/min/year) change from 1 to 4 years was + 0.77. RKV/W divided by tertiles (T1-T3) was the only significant predictor: T2 and T3 donors had an annual eGFR improvement opposing to T1. RKV/W was a good predictor of eGFR at 1 year, independently from predonation eGFR. A higher RKV/W was associated with improved eGFR at 1 year. A decline in eGFR on the four years after surgery was only noticeable in donors with RKV/W ≤ 2.13cm3 /kg.info:eu-repo/semantics/publishedVersio