Urethral atrophy after artificial urinary sphincter placement:Is cuff downsizing effective?

<p>Purpose: We reviewed the outcome of cuff downsizing with an artificial urinary sphincter for treating recurrent incontinence due to urethral atrophy.</p><p>Materials and Methods: We analyzed the records of 17 patients in a 7-year period in whom clinical, radiological and urodynamic evidence of urethral atrophy was treated with cuff downsizing. Cuff downsizing was accomplished by removing the existing cuff and replacing it with a 4 cm. cuff within the established false capsule. Incontinence and satisfaction parameters before and after the procedure were assessed by a validated questionnaire.</p><p>Results: Mean patient age was 70 years (range 62 to 79). Average time to urethral atrophy was 31 months (range 5 to 96) after primary sphincter implantation. Mean followup after downsizing was 22 months (range 1 to 64). Cuff downsizing caused a mean decrease of 3.9 to 0.5 pads daily. The number of severe leakage episodes decreased from a mean of 5.4 to 2.1 The mean SEAPI (stress leakage, emptying, anatomy, protection, inhibition) score decreased from 8.2 to 2.4. Patient satisfaction increased from 15% to 80% after cuff downsizing. In 1 patient an infected cuff required complete removal of the device.</p><p>Conclusions: Patient satisfaction and continence parameters improved after cuff downsizing. We believe that this technique is a simple and effective method of restoring continence after urethral atrophy.</p>

The Politics of Observation:Radical Psychiatry and Social Documentary

How did the counter-cultural aims of Radical Psychiatry coincide with those of documentary filmmaking in the 1960s? Where the forms and structures of new approaches to the documentary necessarily complicit in promoting the clinical and anti-clinical practices, and wider political agenda, of Radical Psychiatry? How did the documentary deal with the ethical, aesthetic, and audience-related issues associated with filming personalities and environments associated with Radical Psychiatry? How did Radical Psychiatry and the documentary shape postwar discourses on trauma, especially within conflict and post-conflict (PTSD) contexts? What is the legacy of Radical Pschiatry today, and how has it been explored by contemporary documentray film? <br/><br/>This article addresses these question by examining a range of documentaries dealing with the radical and 'anti-psychiatric' ideas and methods of figures such as R.D.Laing, David Cooper, Jan Bastiaans, Timothy Leary, and Franco Basaglia. Films analysed include Peter Robinson's <i>Asylum</i> (1972) and <i>Psychiatry and Violence</i> (1973); <i>Ah, Sunflower</i> (Klinkert and Sinclair, 1967); <i>Anatomy of Violence</i> (Davis, 1967); <i>Turn On, Tune In, Drop Out</i> (Robin Clarke, 1967), <i>W. R. - Mysteries of the Organism</i> (Makavejev, 1971); Raymond Depardon's<i> San Clemente</i> (1980) and <i>Urgences</i> (1988); and Louis van Gasteren's trilogy <i>Now Do You Get it Why I am Crying </i>(1969), <i>The Price of Survival</i> (2003), and <i>There is No Plane to Zagreb </i>(2012). ���The article concludes with a discussion of Nicolas Philibert's <i>Every Little Thing</i> (1997) within the context of the French documentary tradition and the film's more immediate subject - the famous clinic at La Borde established by Jean Oury, and associated with the methods and theories of figures such as Jacques��� Lacan, Francesc Tosquelles, Franz Fanon, and F��lix Guattari.<br/>

A new sensory organ in "primitive" molluscs (Polyplacophora Lepidopleurida), and its context in the nervous system of chitons

<p>Introduction: Chitons (Polyplacophora) are molluscs considered to have a simple nervous system without cephalisation. The position of the class within Mollusca is the topic of extensive debate and neuroanatomical characters can provide new sources of phylogenetic data as well as insights into the fundamental biology of the organisms. We report a new discrete anterior sensory structure in chitons, occurring throughout Lepidopleurida, the order of living chitons that retains plesiomorphic characteristics.</p><p>Results: The novel "Schwabe organ" is clearly visible on living animals as a pair of streaks of brown or purplish pigment on the roof of the pallial cavity, lateral to or partly covered by the mouth lappets. We describe the histology and ultrastructure of the anterior nervous system, including the Schwabe organ, in two lepidopleuran chitons using light and electron microscopy. The oesophageal nerve ring is greatly enlarged and displays ganglionic structure, with the neuropil surrounded by neural somata. The Schwabe organ is innervated by the lateral nerve cord, and dense bundles of nerve fibres running through the Schwabe organ epithelium are frequently surrounded by the pigment granules which characterise the organ. Basal cells projecting to the epithelial surface and cells bearing a large number of ciliary structures may be indicative of sensory function. The Schwabe organ is present in all genera within Lepidopleurida (and absent throughout Chitonida) and represents a novel anatomical synapomorphy of the clade.</p><p>Conclusions: The Schwabe organ is a pigmented sensory organ, found on the ventral surface of deep-sea and shallow water chitons; although its anatomy is well understood, its function remains unknown. The anterior commissure of the chiton oesophagial nerve ring can be considered a brain. Our thorough review of the chiton central nervous system, and particularly the sensory organs of the pallial cavity, provides a context to interpret neuroanatomical homology and assess this new sense organ.</p>

'A Breath of Fresh Air': The experiences of undergraduate nursing students' participating in a creative learning project:This paper presents the experiences of undergraduate nursing students who participated in a creative learning project to explore the cells, tissues and organs of the human body through felt making.

Aim of the study <br/>This paper presents the experiences of undergraduate nursing students who participated in a creative learning project to explore the cells, tissues and organs of the human body through felt making. <br/><br/>Context and Background <br/>This project was funded by a Teaching Innovation Award from the School of Nursing and Midwifery, Queen���s University Belfast to explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology. The project was facilitated through collaboration between University Teaching staff and Arts Care, a unique arts and health charity in Northern Ireland. <br/><br/>Methodology <br/>Twelve year one students participated in four workshops designed to explore the cells, tissues and organs of the human body through the medium of felt. Facilitated by an Arts Care artist, students translated their learning into striking felt images. The project culminated in the exhibition of this unique collection of work which has been viewed by fellow students, teaching staff, nurses from practice, and artists from Arts Care, friends, family and members of the public. <br/><br/>Key Findings and conclusions <br/>The opportunity to learn in a more diverse way within a safe and non-judgmental environment was valued, with students��� reporting a greater confidence in life science knowledge. Self- reflection and group discussion revealed that the project was a unique creative learning experience for all involved ��� students, teaching staff and artist ��� resulting in individual and collective benefits far beyond knowledge acquisition. As individuals we each felt respected and recognised for our unique contribution to the project. Working in partnership with Arts Care enabled us to experience the benefits of creativity to well-being and reflect upon how engagement in creative activities can help healthcare professionals to focus on the individual patient���s needs and how this is fundamental to enhancing patient-centred care<br/>

A strategy towards professionalism in the dissecting room

The teaching and cultivation of professionalism is an integral part of medical education as professionalism is central to maintaining the public���s trust in the medical profession. Traditionally professional values would have been acquired through an informal process of socialisation and observation of role models. Recently, however, medical educators have accepted the responsibility to explicitly teach and effectively evaluate professionalism. A comprehensive working definition of the term professionalism and a universally agreed list of the constituent elements of professionalism are currently debated. The School of Medicine and Dentistry of The Queen���s University of Belfast uses an approach of self-directed learning for teaching anatomy, and students are given the opportunity to learn anatomy from human dissection. Self-directed learning teams have been found to be underutilised as educational strategies and presented an opportunity to utilise the first year dissection room teaching environment to nurture the development of the attributes of professionalism. An educational strategy based on role-playing was developed to engage all students around the dissection table. Students received comprehensive background reviews on professionalism, its attributes and the identification of such attributes in the context of the dissection room. Roles, with specific duties attached, were allocated to each team member. Circulating academic staff members directly observed student participation and gave formative feedback. Students were given the opportunity to reflect on their ability to identify the attributes and reflect on their own and their peer���s ability to develop and practise these attributes. This strategy indicated that small group learning teams in the dissection room utilise widely accepted principles of adult learning and offer an opportunity to create learning activities that will instil in students the knowledge, values, attitudes and behaviours that characterise medical professionalism. Anatomy faculty have a responsibility to nurture and exemplify professionalism and play a significant role in the early promotion and inculcation of professionalism. It remains imperative not only to assess this strategy but also to create opportunities for critical reflection and evaluation within the strategy. Key words: Medical Education ��� Professionalism ��� Anatomy - Reflective Practise ��� Role-play

Blending Art and Science in Nurse Education: The Benefits and Impact of Creative Partnerships

Blending Art and Science in Nurse Education: The Benefits and Impact of Creative Partnerships<br/><br/>This paper presents the benefits of an innovative education partnership between lecturers from the School of Nursing and Midwifery, Queens University Belfast and Arts Care, a unique Arts and Health Charity in Northern Ireland, to engage nursing students in life sciences<br/><br/>Nursing and Midwifery students often struggle to engage with life science modules because they lack confidence in their ability to study science.This project was funded by a Teaching Innovation Award from the School of Nursing and Midwifery, Queens University Belfast, to explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology. The project was facilitated through collaboration between Teaching staff from the School of Nursing and Midwifery and Arts Care, Northern Ireland. This unique Arts and Health Charity believes in the benefits of creativity to well being.<br/><br/>RESEARCH OBJECTIVE(S) <br/>To explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology. <br/><br/>METHODS AND METHODLOGY <br/>Students participated in a series of workshops designed to explore the cells, tissues and organs of the human body through the medium of felt. Facilitated by an Arts Care artist, and following self-directed preparation, students discussed and translated their learning of the cells, tissues and organs of the human body into striking felt images. During the project students kept a reflective journal of their experience to document how participation in the project enhanced their learning and professional development<br/><br/>RESULTS<br/>Creativity transformed and brought to life the students learning of the cells, tissues and organs of the human body.<br/><br/>The project culminated in the exhibition of a unique body of artwork which has been exhibited across Northern Ireland in hospitals and galleries and viewed by fellow students, teaching staff, nurses from practice, artists, friends, family and members of the public. <br/><br/>CONCLUSION<br/>The impact of creativity learning strategies in nurse education should be further explored.<br/><br/>REFERENCES<br/>Bennett, M and Rogers, K.MA. (2014) First impressions matter: an active, innovative and engaging method to recruit student volunteers for a pedagogic project. Reflections, Available online at: QUB, Centre for Educational Development / Publications / Reflections Newsletter, Issue 18, June 2014.<br/><br/>Chickering,A.W. and Gamson,Z.F. (1987) Seven principles for good practice in undergraduate education The American Association for Higher Education Bulletin, March. http://www.aahea.org/aahea/articles/sevenprinciples1987.htm, accessed 8th August 2014<br/><br/> Fell, P., Borland, G., Lynne, V. (2012) Lab versus lectures: can lab based practical sessions improve nursing students��� learning of bioscience? Health and Social Care Education 3:1, 33-38<br/>

The heart of a dragon: 3D anatomical reconstruction of the 'scaly-foot gastropod' (Mollusca: Gastropoda: Neomphalina) reveals its extraordinary circulatory system

<p>Introduction: The 'scaly-foot gastropod' (Chrysomallon squamiferum Chen et al., 2015) from deep-sea hydrothermal vent ecosystems of the Indian Ocean is an active mobile gastropod occurring in locally high densities, and it is distinctive for the dermal scales covering the exterior surface of its foot. These iron-sulfide coated sclerites, and its nutritional dependence on endosymbiotic bacteria, are both noted as adaptations to the extreme environment in the flow of hydrogen sulfide. We present evidence for other adaptations of the 'scaly-foot gastropod' to life in an extreme environment, investigated through dissection and 3D tomographic reconstruction of the internal anatomy.</p><p>Results: Our anatomical investigations of juvenile and adult specimens reveal a large unganglionated nervous system, a simple and reduced digestive system, and that the animal is a simultaneous hermaphrodite. We show that Chrysomallon squamiferum relies on endosymbiotic bacteria throughout post-larval life. Of particular interest is the circulatory system: Chrysomallon has a very large ctenidium supported by extensive blood sinuses filled with haemocoel. The ctenidium provides oxygen for the host but the circulatory system is enlarged beyond the scope of other similar vent gastropods. At the posterior of the ctenidium is a remarkably large and well-developed heart. Based on the volume of the auricle and ventricle, the heart complex represents approximately 4 % of the body volume. This proportionally giant heart primarily sucks blood through the ctenidium and supplies the highly vascularised oesophageal gland. Thus we infer the elaborate cardiovascular system most likely evolved to oxygenate the endosymbionts in an oxygen poor environment and/or to supply hydrogen sulfide to the endosymbionts.</p><p>Conclusions: This study exemplifies how understanding the autecology of an organism can be enhanced by detailed investigation of internal anatomy. This gastropod is a large and active species that is abundant in its hydrothermal vent field ecosystem. Yet all of its remarkable features-protective dermal sclerites, circulatory system, high fecundity-can be viewed as adaptations beneficial to its endosymbiont microbes. We interpret these results to show that, as a result of specialisation to resolve energetic needs in an extreme chemosynthetic environment, this dramatic dragon-like species has become a carrying vessel for its bacteria.</p>

Morphological and ecological studies on the phylum Cycliophora

Cycliophora �� um filo animal descrito recentemente que acomoda, apenas, duas esp��cies: Symbion pandora Funch e Kristensen, 1995 e S. americanus Obst, Funch e Kristensen, 2006. Este filo �� caracterizado por um ciclo de vida assaz complexo, cuja posi����o filogen��tica tem sido debatida desde a sua descoberta. Esta disserta����o visa aprofundar o conhecimento geral existente acerca destes enigm��ticos e pouco explorados metazo��rios. Assim, v��rios aspectos da morfologia e ecologia de cicli��foros foram estudados atrav��s de observa����es in vivo, t��cnicas de microscopia e reconstru����o tridimensional. A mioanatomia de v��rias fases do ciclo de vida �� descrita para S. pandora e S. americanus. Os nossos resultados revelam uma similaridade contundente entre a musculatura das duas esp��cies. A mioanatomia geral de Symbion ��, ainda, comparada �� de outros metazo��rios. A express��o de algumas subst��ncias imunorreactivas, como s��o exemplo a serotonina e as sinapsinas, �� investigada em v��rias formas do ciclo de vida. Quando comparados com outros representantes de Spiralia, conclui-se que a neuroanatomia geral dos cicli��foros se assemelha mais ��s formas larvares do que aos adultos. Apesar de possu��rem um plano corporal sofisticado, com extensas ��reas ciliadas e uma mioanatomia complexa, descobrimos que o macho de ambas as esp��cies Symbion �� composto por apenas algumas dezenas de c��lulas. Baseando-nos nestas observa����es, inferimos que a complexidade dos metazo��rios n��o se relaciona com o tamanho corporal nem com o n��mero de c��lulas de um organismo. Estudos sobre a ultra-estrutura da f��mea revelaram, entre outras estruturas, um putativo poro genital, extens��es citoplasm��ticas do o��cito e gl��ndulas posteriores. Morfologia e implica����es funcionais destas estruturas s��o aqui discutidas. A anatomia do protonefr��deo da larva cord��ide �� descrita. A arquitectura deste ��rg��o diverge daquela presente noutros representantes de Nephrozoa, particularmente ao n��vel da ��rea de filtra����o da c��lula terminal. As nossas observa����es s��o discutidas em termos filogen��ticos. A matura����o sexual em cicli��foros �� investigada. Os nossos resultados sugerem que a transi����o de reprodu����o assexual a sexual se relacione com a idade da forma s��ssil, a ���feeding stage���. A presen��a da larva Prometeus assente no tronco desta tamb��m poder�� influenciar o processo, embora mais estudos sejam desej��veis para o comprovar. Os nossos resultados s��o discutidos integrativa e comparativamente com o conhecimento pr��vio sobre Cycliophora. A cumula����o deste conhecimento ser�� essencial para a compreens��o da evolu����o e filogenia deste enigm��tico filo.

Sound Seam

A moving image work based on research with neurologists and audiologists, collectors and archivists. The film gives voice to the idea that every surface, in particular parts of our anatomy, is potentially inscribed with an unheard sound or echoes of voices from the past. The soundtrack���s musical composition is interlaced with a voice-over which draws on Rainer Maria Rilke���s text 'Primal Sound', where he reflects on the possibility of playing the coronal suture of a skull with a phonograph needle. The film uses microscopic photography, scanning electron microscopy, and sounds of otoacoustic emissions to uncover haunting aural bonescapes. The voiceovers too are recorded using old sound technology as a filter - writing and over-writing of wax cylinder to create unexpected scratches, glitches, loops and echoes. Exhibitions: shown as multi-channel sound/film installation AV festival (Newcastle 2010); solo exhibition at Wellcome Collection (London 2010-11); group exhibition ���Samsung Art+ Prize��� BFI Southbank (London 2012); group exhibition ���Transcendence���, Gertrude Contemporary, Melbourne (2014); solo exhibition as part of the International Rotterdam Film Festival (2013); group exhibition ���The Sight of Sound���, Deutsche Bank VIP Lounge, Frieze Art Fair, NY (2012). Screenings: mini-retrospective at the Lincoln Centre, NY, as part of the New York Film Festival (2013); Jarman Award Tour screenings (2012, venues included Whitechapel Gallery, London; FACT, Liverpool; CCA, Glasgow; The Northern Charter in partnership with CIRCA projects; Nottingham Contemporary, Nottingham; Watershed, Bristol; Duke of York Cinema, Brighton), Whitechapel Gallery, London; FACT, Liverpool; CCA, Glasgow; The Northern Charter in partnership with CIRCA projects, Newcastle (special Q&A Aura Satz with Rebecca Shatwell, director of AV festival); Nottingham Contemporary, Nottingham; Watershed, Bristol; Duke of York Cinema, Brighton; Mini-retrospective at Tate Britain (London 2014); Mini-retrospective screening, DIM Cinema, The Cinematheque (Vancouver 2015); Mini-retrospective at Whitechapel Gallery (London 2016). Publications: ���Sound Seam��� booklet with contributions by Steven Connor and Tom McCarthy (2010).

The social brain : how social stimuli are translated into neuroendocrine signals

Tese de doutoramento, Biologia (Ecofisiologia), Universidade de Lisboa, Faculdade de Ci��ncias, 2014

Micromorphology of the labellum and structure of the osmophore in a group of closely related species of the sexually deceptive Orchid genus Ophrys (orchidaceae)

Tese de doutoramento, Biologia (Biologia Celular), Universidade de Lisboa, Faculdade de Ci��ncias, 2016

Re-evaluation of a reported increased micronucleus frequency in lymphocytes of workers occupationally exposed to formaldehyde

A replicate evaluation of increased micronucleus (MN) frequencies in peripheral lymphocytes of workers occupationally exposed to formaldehyde (FA) was undertaken to verify the observed effect and to determine scoring variability. May���Gr��nwald���Giemsa-stained slides were obtained from a previously performed cytokinesis-block micronucleus test (CBMNT) with 56 workers in anatomy and pathology laboratories and 85 controls. The first evaluation by one scorer (scorer 1) had led to a highly significant difference between workers and controls (3.96 vs 0.81 MN per 1000 cells). The slides were coded before re-evaluation and the code was broken after the complete re-evaluation of the study. A total of 1000 binucleated cells (BNC) were analysed per subject and the frequency of MN (in ���) was determined. Slides were distributed equally and randomly between two scorers, so that the scorers had no knowledge of the exposure status. Scorer 2 (32 exposed, 36 controls) measured increased MN frequencies in exposed workers (9.88 vs 6.81). Statistical analysis with the two-sample Wilcoxon test indicated that this difference was not significant (p = 0.17). Scorer 3 (20 exposed, 46 controls) obtained a similar result, but slightly higher values for the comparison of exposed and controls (19.0 vs 12.89; p = 0.089). Combining the results of the two scorers (13.38 vs 10.22), a significant difference between exposed and controls (p = 0.028) was obtained when the stratified Wilcoxon test with the scorers as strata was applied. Interestingly, the re-evaluation of the slides led to clearly higher MN frequencies for exposed and controls compared with the first evaluation. Bland���Altman plots indicated that the agreement between the measurements of the different scorers was very poor, as shown by mean differences of 5.9 between scorer 1 and scorer 2 and 13.0 between scorer 1 and scorer 3. Calculation of the intra-class correlation coefficient (ICC) revealed that all scorer comparisons in this study were far from acceptable for the reliability of this assay. Possible implications for the use of the CBMNT in human biomonitoring studies are discussed.

Biomechanical modeling and simulation of the spider crab (maja brachydactyla)

Uma linha de pesquisa e desenvolvimento na ��rea da rob��tica, que tem recebido aten����o crescente nos ��ltimos anos, �� o desenvolvimento de rob��s biologicamente inspirados. A ideia �� adquirir conhecimento de seres biol��gicos, cuja evolu����o ocorreu ao longo de milh��es de anos, e aproveitar o conhecimento assim adquirido para implementar a locomo����o pelos mesmos m��todos (ou pelo menos usar a inspira����o biol��gica) nas m��quinas que se constroem. Acredita-se que desta forma �� poss��vel desenvolver m��quinas com capacidades semelhantes ��s dos seres biol��gicos em termos de capacidade e efici��ncia energ��tica de locomo����o. Uma forma de compreender melhor o funcionamento destes sistemas, sem a necessidade de desenvolver prot��tipos dispendiosos e com longos tempos de desenvolvimento �� usar modelos de simula����o. Com base nestas ideias, o objectivo deste trabalho passa por efectuar um estudo da biomec��nica da santola (Maja brachydactyla), uma esp��cie de caranguejo comest��vel pertencente �� fam��lia Majidae de artr��podes dec��podes, usando a biblioteca de ferramentas SimMechanics da aplica����o Matlab / Simulink. Esta tese descreve a anatomia e locomo����o da santola, a sua modela����o biomec��nica e a simula����o do seu movimento no ambiente Matlab / SimMechanics e SolidWorks.

Emboliza����o das art��rias prost��ticas no tratamento da hiperplasia benigna da pr��stata : estudo an��tomo-cl��nico

Resumo: A hiperplasia benigna da pr��stata (HBP) tem elevada preval��ncia nos homens entre os 50 e 79 anos de idade, sendo ubiquit��ria com o envelhecimento. Devido �� significativa morbi-mortalidade associada aos tratamentos m��dicos e cir��rgicos currentemente dispon��veis, s��o necess��rias novas tecnologias para melhorar os resultados e minimizar o desconforto dos doentes. Recentemente, estudos preliminares de experimenta����o animal e em 3 doentes tratados, sugeriram a emboliza����o arterial prost��tica selectiva (EAPS) como hip��tese terap��utica para a HBP. Decidimos investigar se a EAPS poderia ser um procedimento bem sucedido no tratamento da HBP gravemente sintom��tica. Para tal realiz��mos um estudo an��tomo-radiol��gico e cl��nico em 63 doentes com recurso a uma terap��utica inovadora minimamente invasiva guiada pela imagem. Avali��mos 126 hemip��lvis com recurso a Angio-RM, Angio-TC e Angiografia Digital de Subtrac����o, com o intuito de definir os padr��es b��sicos de bifurca����o das art��rias il��acas internas at�� agora apenas descritos em estudos cadav��ricos. Estud��mos ainda o suprimento vascular arterial prost��tico, identificando: 1 as art��rias prost��ticas; 2 origem e direc����o; 3 os ramos intra-prost��ticos; 4 anastomoses com outras art��rias. Em rela����o aos resultados anat��micos, identific��mos 181 art��rias prost��ticas, j�� que em 43.7% das hemip��lvis existiam dois ped��culos arteriais prost��ticos com origens independentes. A origem mais frequente foi a art��ria pudenda interna (39.7%), seguida do tronco comum gl��teo-pudendo (21%) e da art��ria vesical superior (18.2%). Origens menos frequentes foram a art��ria obturadora (12.1%), as art��rias gl��teas inferior (3.9%)ou superior (1.7%), ramos rectais provenientes da art��ria mesent��rica inferior (1.7%) e a art��ria pudenda acess��ria (1.7%). Identificaram-se anastomoses com as art��rias adjacentes em 57.9% dos casos: com a termina����o da art��ria pudenda interna (41.6%),art��rias prost��ticas contra-laterais (18.2%) e homo-laterais (11.7%), com ramos rectais (15.6%) e com art��rias vesicais (12.9%). Em rela����o ao estudo cl��nico trat��mos 63 doentes (idades compreendidas entre 52 - 82 anos, m��dia 69.5 anos) com HBP gravemente sintom��tica refract��ria �� terap��utica m��dica h�� mais de 6 meses. Foi poss��vel avalia����o ap��s o tratamento em 37 doentes: m��dia de seguimento de 4.7 meses (variando entre 1 e 12 meses). A EAPS unilateral foi poss��vel em todos os doentes, com emboliza����o bilateral em 73% dos casos. A emboliza����o bilateral n��o foi poss��vel em 27% dos casos devido a tortuosidade, altera����es ateroescler��ticas e pequeno calibre das art��rias il��acas e/ou prost��ticas. Em m��dia houve uma melhoria do International Prostate Symptom Score (IPSS) de 10.8 pontos, da QoL de 1.5 pontos e do Internationl Index of Erectile Function (IIEF) de 2.1 pontos. Houve uma redu����o m��dia do PSA de 30% (2.4 ng/mL), um aumento do pico de fluxo urin��rio (Qmax) de 3.1 - 3.85 mL/s e uma redu����o m��dia do volume prost��tico de 21% (18.5 mL). Registou-se uma complica����o major: pequena ��rea de isqu��mia da parede vesical tratada cirurgicamente. Em 75% dos doentes tratados obteve-se sucesso cl��nico com franca melhoria dos sintomas, enquanto 25% dos doentes foram considerados insucesso cl��nico por se ter registado uma fraca ou ausente melhoria sintom��tica ap��s a emboliza����o. Os restantes doentes tratados est��o sob controlo evolutivo, pararam toda a medica����o prost��tica, sem qualquer caso de disfun����o sexual associada com o tratamento. Este trabalho constitui o primeiro estudo anat��mico descritivo in vivo das art��rias prost��ticas, conseguido devido �� utiliza����o de t��cnicas de imagem nunca usadas para este fim. O uso cl��nico dos dados anat��micos acima referidos permitiu a implementa����o de t��cnicas de Radiologia de Interven����o no tratatamento de uma doen��a de elevada preval��ncia. ------------------------------- ABSTRACT: Benign prostatic hyperplasia (BPH) has high prevalence in men aged 50���79 years being ubiquitous with aging. Due to significant morbi-mortality associated with currently available medical and surgical treatments, there is the need for innovative technologies to continue to improve outcomes and minimize patient discomfort and morbidity. Recently, prostatic arterial embolization (PAE) was suggested as a treatmentoption for BPH based on preliminary results from animal studies and 3 treated patients. We decided to investigate if PAE might be a successful treatment option for severely symptomatic BPH patients. We performed a clinical and anatomical-radiological study in 63 patients with the use of an inovative image-guided minimally invasive technique. We evaluated 126 pelvic sides using Angio-MR or Angio-CT and Catheter Angiography before embolisation to treat symptomatic BPH. We aimed to define the main branching patterns of the male internal iliac arteries, so far only studied in the cadaver. We also evaluated the prostatic arterial supply, identifying: 1 the prostatic arteries; 2 origin and direction; 3 intra-prostatic branches; 4 anastomoses with surrounding arteries. Regarding the anatomical study we identified 181 prostatic arteries, because in 43.7% of pelvic sides 2 separate prostatic vascular pedicles were found. The most frequent origin was the internal pudendal artery (39.7%) with the common glutealpudendal trunk (21%) and superior vesical arteries (18.2%) the next commonest. Less frequent origins were the obturator artery (12.1%), the inferior (3.9%) or superior (1.7%) gluteal arteries, rectal branches from the inferior mesenteric artery (1.7%) and the accessory pudendal artery (1.7%). There were anastomoses with the surrounding arteries in 57.9% of cases: termination of the internal pudendal artery (41.6%), contralateral prostatic arteries (18.2%), same-side prostatic arteries (11.7%), rectal branches (15.6%), and vesical arteries (12.9%).Regarding the clinical study, we treated 63 patients aged 52���82 years (mean 69.5 years) who presented with symptomatic BPH refractory to medical treatment for at least 6 months. Follow-up evaluation (mean 4.7 months, range 1-12 months) was possible in 37 patients. PAE was achieved in all patients with bilateral embolization in 73%. In 27% PAE was performed unilaterally due to tortuosity, atherosclerotic changes and small size of iliac and prostatic arteries. There was a mean decrease in the IPSS of 10.8 points, a mean improvement in QoL of 1.5 points, and a mean increase in the sexual function score of 2.1 points. There was a mean PSA reduction of 30% (2.4 ng/mL), a Qmax increase of 3.1 to 3.85 mL/sec, and a mean prostate volume decrease of 21% (18.5 mL). There was one major complication: a small area of bladder wall ischemia treated by surgery. Overall, 75% of patients were considered clinical success with major improvement after PAE, while 25% of patients were considered clinical failure with little or no improvement after PAE. All remaining patients are under follow-up, stopped all prostatic medication, and reported no sexual dysfunction. This study is the first one to describe the radiological anatomy of the prostatic arteries, with the use of imaging techniques never used for this purpose before. The clinical use of the anatomical findings allowed the implementation of Interventional Radiology tehniques in the treatment of a disease with a high prevalence.