Tradução e adaptação cultural do global appraisal of individual needs - initial

Este estudo objetivou traduzir e adaptar culturalmente o instrumento Global Appraisal of Individual Needs - Initial e calcular seu Índice de Validade de Conteúdo. Trata-se de estudo metodológico, de adaptação cultural do instrumento. O instrumento foi traduzido para o português em duas versões que deram origem à síntese das traduções, submetida à avaliação de quatro juízes experts na área de álcool e outras drogas. Após modificações, foi retraduzido e ressubmetido aos juízes e autores do instrumento original, resultando na versão final do instrumento, Avaliação Global das Necessidades Individuais - Inicial O Índice de Validade de Conteúdo do instrumento foi de 0,91, considerado válido pela literatura. O instrumento Avaliação Global das Necessidades Individuais - Inicial é um instrumento adaptado culturalmente para o português falado no Brasil; entretanto, não foi submetido a testes com a população-alvo, o que sugere que sejam realizados estudos que testem sua confiabilidade e validade.

Robotic-assisted laparoscopic partial nephrectomy: initial experience in Brazil and a review of the literature

CONTEXT AND PURPOSE: Partial nephrectomy has become the standard of care for renal tumors less than 4 cm in diameter. Controversy still exists, however, regarding the best surgical approach, especially when minimally invasive techniques are taken into account. Robotic-assisted laparoscopic partial nephrectomy (RALPN) has emerged as a promising technique that helps surgeons achieve the standards of open partial nephrectomy care while offering a minimally invasive approach. The objective of the present study was to describe our initial experience with robotic-assisted laparoscopic partial nephrectomy and extensively review the pertinent literature. MATERIALS AND METHODS: Between August 2009 and February 2010, eight consecutive selected patients with contrast enhancing renal masses observed by CT were submitted to RALPN in a private institution. In addition, we collected information on the patients' demographics, preoperative tumor characteristics and detailed operative, postoperative and pathological data. In addition, a PubMed search was performed to provide an extensive review of the robotic-assisted laparoscopic partial nephrectomy literature. RESULTS: Seven patients had RALPN on the left or right sides with no intraoperative complications. One patient was electively converted to a robotic-assisted radical nephrectomy. The operative time ranged from 120 to 300 min, estimated blood loss (EBL) ranged from 75 to 400 mL and, in five cases, the warm ischemia time (WIT) ranged from 18 to 32 min. Two patients did not require any clamping. Overall, no transfusions were necessary, and there were no intraoperative complications or adverse postoperative clinical events. All margins were negative, and all patients were disease-free at the 6-month follow-up. CONCLUSIONS: Robotic-assisted laparoscopic partial nephrectomy is a feasible and safe approach to small renal cortical masses.Further prospective studies are needed to compare open partial nephrectomy with its minimally invasive counterparts.

Doppler-guided hemorrhoidal artery ligation with rectal mucopexy technique: initial evaluation of 42 cases

The treatment of hemorrhoidal disease (HD) by conventional hemorrhoidectomy is associated with significant morbidity, mainly represented by the postoperative pain and the late return to daily activities. Doppler-guided hemorrhoid artery ligation (DGHAL) is a minimal-invasive surgical treatment for HD that has been used as an alternative method in order to reduce these inconveniences. OBJECTIVE: To analyze the initial results of the DGHAL technique associated with rectal mucopexy in the treatment of HD. METHODS:Forty-two patients with stage I, III and IV hemorrhoids who were submitted to DGHAL were analyzed from December 2010 to August 2011. Eleven patients (26%) were stage II; 21 (50%), stage III; and 10 (24%), stage IV HD. All patients were operated by the same surgeon under spinal anesthesia and using the same equipment and technique to perform the procedure. The 42 patients underwent ligation of six arterial branches followed by rectal mucopexia by uninterrupted suture. Nine patients needed concomitant removal of perianal skin tag. In the postoperative, the following parameters were evaluated: pain, tenesmus, bleeding, itching, prolapse, mucus discharge and recurrence. The mean postoperative follow-up lasted four months (one to nine months). RESULTS: Tenesmus was the most common postoperative complaint for 85.7% of patients followed by pain, in 28.6%, perianal burning, in 12.3%, mucus discharge and perianal hematoma in 4.7%. Two patients had severe postoperative bleeding and required surgical haemostasis, one of which needed blood transfusion. Ninety-five percent of the patients declared to be satisfied with the method. CONCLUSION: Even though DGHAL has complications similar to those of other surgical methods, its results present less postoperative pain, allowing faster recovery and return to work. Studies with more cases and a longer follow-up are still necessary to assess the late recurrence.

An initial proposal for PDP of smes developing hospital furniture

A large percentage of the industrial SMEs has an organizational structure for product development too far from the adequate practices and models, elaborated by renowned authors with expertise in the theme of product development. On the other hand, the authors state that SMEs obtain considerable advantages by adopting a model of product development process (PDP) management. Healt is one of the most innovative sectors in the world, and countries like Brazil and Colombia are transitioning from a system that cares for contagious infecttions diseases where the drug product is the main form of treatment - to a system that cares for chronic degenerative conditions - where the equipment, including hospital furniture, has more relevance to the treatment. This change is offering better opportunities of specialized markets to hospital furniture SMEs that adopt an adquate PDF model. The present study proposes a first outline of a model of PDP management for industrial metal-mechanical SMEs that develop and manufacture hospital furniture, from a review of models proposed for great mechanical area.