[Urology].

Over this last year, urology has progressed both in oncology and reconstructive surgery. Genomic tests have been since quite a few years foreseen as very promising prognostic factors of prostate cancer, however remaining not clearly convincing. At last, the present data available seem to favour their contribution to improve selecting patients for active surveillance.

[Chronic testicular pain: A multidisciplinary challenge].

Chronic testicular pain represents up to 5% of urological consultations. A simple workup can help identify an organic etiology in 50 to 75% of cases, leading to a targeted treatment. If this is not the case, chronic idiopathic orchialgia is diagnosed and multidisciplinary management is necessary.

Left ventricular reverse remodeling and function by strain analysis in aortic stenosis: A CMR analysis of the EPICHEART study.

Introduction And Objectives: In severe aortic stenosis (AS), the impact of aortic valve replacement (AVR) on left ventricular (LV) systolic function assessed by strain and measured by echocardiography or cardiac magnetic resonance (CMR) has been controversial. We aimed to investigate LV systolic myocardial function changes six months after AVR using global longitudinal (GLS), circumferential (GCS) and radial (GRS) strain derived from CMR imaging.

Methods: We included 39 severe AS patients (69.

Influence of EPICardial adipose tissue in HEART diseases (EPICHEART) study: Protocol for a translational study in coronary atherosclerosis.

Introduction: Accumulation of epicardial adipose tissue (EAT) is associated with coronary artery disease (CAD) and increased risk of coronary events in asymptomatic subjects and low-risk patients, suggesting that EAT promotes atherosclerosis in its early stage. Recent studies have shown that the presence of CAD affects the properties of adjacent EAT, leading to dynamic changes in the molecular players involved in the interplay between EAT and the coronary arteries over the history of the disease. The role of EAT in late-stage CAD has not been investigated.

Safety And Risk Factors For The Morbidity And Mortality Of Pneumonectomy: A Retrospective 10- Year Study In A Single Institution.

Objectives: Pneumonectomy is a procedure with high post-operative morbidity and mortality. This study aims to assess and identify possible risk factors that can affect post-operative outcome, therefore determining the safety of pneumonectomy in specific groups.

Methods: A total of 63 patients submitted to pneumonectomy at our centre, from February 2008 to February 2018, were included in our retrospective study.

Cardiac surgery in infective endocarditis and predictors of in-hospital mortality.

Introduction: Infective endocarditis (IE) is a serious disease with significant in-hospital mortality (15-30%) despite advances in medical and surgical therapy.

Aims: To perform a clinical characterization of patients undergoing cardiac surgery for IE and to identify factors that predict in-hospital mortality.

Methods: We retrospectively analyzed 145 patients with IE admitted between January 2006 and October 2017.

Total Aortic Arch Replacement With E-Vita OPEN PLUS Hybrid Prosthesis - Initial Experience From A Single Surgical Center.

We report a rare case of an advanced stage thymoma with right superior pulmonary lobe, superior vena cava, innominate vein and pericardium invasion in a patient with Good's syndrome. In a multidisciplinary discussion, surgical resection was deemed the best initial approach, since invaded structures could be safely managed. The tumor was fully resected and included partial resection of the superior pulmonary lobe, superior vena cava and innominate vein.

[Novelties in Urology 2019].

At the turn of the second decade of the 21st century, advances in urology are driven by technobiologic progress and the strive for minimally invasiveness. Prostate disease benefits above all, with significant improvement in benign prostatic hyperplasia mini-invasive surgery and metastatic prostate cancer imaging. Chronic micturition syndromes also benefit from this trend, so as robotic surgery, whose latest promising innovation, the single port model, will have to find its place and confirm its non-inferiority as compared with the current latest multi-arm da Vinci robot.

Epicardial adipose tissue volume and annexin A2/fetuin-A signalling are linked to coronary calcification in advanced coronary artery disease: Computed tomography and proteomic biomarkers from the EPICHEART study.

Background & Aims: The role of epicardial adipose tissue (EAT) in the pathophysiology of late stage-coronary artery disease (CAD) has not been investigated. We explored the association of EAT volume and its proteome with advanced coronary atherosclerosis.

Methods: The EPICHEART Study prospectively enrolled 574 severe aortic stenosis patients referred to cardiac surgery.

Uniportal Video-assisted Thoracic Surgery Anatomical Resections - Does Previous Tobacco Exposure Adversely Influence Post-Operative Outcomes?

A high percentage of patients presenting for lung surgery are either current or former smokers, which is typically associated with many anatomical and physiological pulmonary changes. The influence of tobacco on postoperative pulmonary complications remains controversial. The main goal of this study was to analyse the effects of smoking on the risk of post-operative complications and morbidity in patients submitted to lung resection surgery through uniportal VATS.

Predictors of Acute Kidney Injury Associated with Cardiopulmonary Bypass.

Objectives: To study the incidence of acute kidney injury (AKI) in the postoperative period of cardiac surgery in patients without preoperative renal insufficiency who underwent cardiac surgery with cardiopulmonary bypass (CPB), and to explore the association between the incidence of AKI and predictors related to CPB.

Methods: Observational, cross-sectional study. Participants were divided in two groups, those who developed AKI in the postoperative period and those who did not develop AKI.

Correction of adult-type VSD causing aortic valve endocarditis through aortotomy.

Ventricular septal defects are the most common congenital abnormality diagnosed in children but account for only 10 percent of congenital heart defects in adults. Although many defects close spontaneously before adulthood, many others persist, predisposing to endocarditis, and other complications. Herein, we report a case of a known, asymptomatic, perimembranous ventricular septal defects that has complicated at 53 years of age with the need for surgery due to native aortic valve endocarditis and concomitant severe aortic regurgitation.

Surgical treatment of concomitant severe heart disease and lung cancer.

The concomitant presentation of lung cancer and severe heart disease requiring intervention is a scenario that many clinicians have to face. Its common physiopathological substratum is unknown and it is believed that tobacco plays a role. From a surgical point of view, these patients pose various technical challenges and medical literature is scarce in providing solid answers.

Minimally invasive aortic coarctation correction and aortic valve replacement without syetnotomy.

Aortic coarctation and bicuspid aortic valve frequently coexist. Correction frequently require an aggressive, invasive approach. Here we present a case of a two-stage minimally invasive intervention without sternotomy to correct aortic coarctation and replace the native bicuspid aortic valve.

[In dubio pro malum - a clinical case to reflect].

Patients with cardiac pathology alone are already complex, when this is associated with oncologic pathology, or it's mere suspicion, the patient becomes even more complex. We present a clinical case of a patient with severe aortic stenosis with suspected cancer disease, whose diagnostic study could not be performed due to the patient's clinical condition. The option to intervene surgically was widely debated, never being a consensus among surgeons.

Predictors of Acute Kidney Injury in the Postoperative Period of Cardiac Surgery Associated with Cardiopulmonary Bypass.

Introduction: Acute kidney injury (AKI) in the postoperative period of cardiac surgery occurs in 1 to 30% of the patients, mainly caused by ischemia secondary to renal hypoperfusion. Cardiopulmonary bypass (CPB) has a deleterious effect on renal function, constituting an aggression to the patient's homeostasis.

Aim: To evaluate the incidence of AKI in the postoperative period of cardiac surgery in patients without preoperative renal insufficiency who underwent cardiac surgery with CPB, and explore the association between incidence of AKI and predictors related to CPB.

Uniportal Video-Assisted Thorascoscopic Surgery - The New Paradigm in the Surgical Treatment of Lung Cancer.

Introduction: The progressive development and improvement of minimally invasive approaches in the field of thoracic surgery allowed to establish video-assisted thoracoscopic (VATS) anatomic lung resections as the present technique of choice in the treatment of early stage lung cancer.

Methods: The purpose of this study was to evaluate the surgical outcomes of patients who performed uniportal VATS anatomic lung resections for the treatment of primary lung cancer. The patients' demographics, approach and type of surgery, postoperative morbidity and mortality and overall survival were analyzed.

Three-year Experience on 477 Patients Undergoing Uniportal Video-Assisted Thoracoscopic Surgery.

Introduction: Uniportal video-assisted thoracic surgery (VATS) technique has been described both for diagnostic and therapeutic indications. Outcomes after uniportal VATS have never been reported in Portuguese large series. We review the safety and efficiency of our initial experience with uniportal VATS.

Long-term Outcomes in Octogenarians Following Isolated Aortic Valve Replacement.

Introduction: Isolated aortic valve replacement (AVR) in elderly patients is associated with increased operative risk, due to higher prevalence of associated risk factors and other comorbidities, making outcome prediction essential. In patients with symptomatic severe aortic disease, advanced age is often a reason for a transcatheter rather than surgical aortic valve replacement. In the era of TAVI, there has been renewed interest in the outcomes of conventional AVR for high and intermediate risk patients.

Carotid Stenosis in Cardiac Surgery Patients.

Introduction: Ischemic stroke is a potential perioperative complication after an open heart surgery (OHS). Whether a carotid stenosis or occlusion is associated with an increased risk of perioperative stroke in patients or just a risk factor has been a concern of intense debate in the literature.

Methods: We retrospectively analyzed patients submitted to OHS between January and December2016 with known asymptomatic carotid disease.

Aortic Valve Replacement With Perceval® Bioprosthesis: Initial Single-Center Experience.

Introduction: Aortic valve replacement (AVR) is the gold standard for the treatment of severe or symptomatic aortic valve stenosis. Less invasive procedures have been developed as an alternative to the conventional technique of full sternotomy approach with stented prosthesis. The Perceval® aortic valve (LivaNova, Milan, Italy) is a sutureless bioprosthesis, of which several reports have shown promising results in terms of mortality, morbidity and hemodynamic performance, especially with a less invasive approach.

[Medical treatment of micturition problems in men : what the general practitioner needs to know].

Considering the high prevalence of lower urinary tract symptoms in men, and owing to the development of a better focused pharmacotherapy, general practitioners (GPs) have been already for a decade first in line to prescribe an initial medication. With the intent to improve this shared care, we give an overview of the two main syndromes, obstructive and irritative, and their medication, in order to reinforce knowledge transfer and optimize coordination between GPs and urologists.

Impaired Left Atrial Strain as a Predictor of New-onset Atrial Fibrillation After Aortic Valve Replacement Independently of Left Atrial Size.

Introduction And Objectives: Left atrial dysfunction in aortic stenosis may precede atrial enlargement and predict the occurrence of atrial fibrillation (AF). To test this hypothesis, we assessed left atrial function and determined its impact on the incidence of AF after aortic valve replacement.

Methods: A total of 149 severe aortic stenosis patients (74±8.