50 resultados para Laparoscopic Instrument


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Laparoscopic Heller myotomy and fundoplication is considered today the treatment of choice for achalasia. The optimal treatment for end-stage achalasia with esophageal dilation is still controversial. This multicenter and retrospective study aims to evaluate the outcome of laparoscopic Heller myotomy in patients with a massively dilated esophagus. Eleven patients (mean age, 56 years; 6 men) with massively dilated esophagus (esophageal diameter greater than 10 cm) underwent a laparoscopic Heller myotomy and anterior fundoplication between 2000 and 2009 at three different institutions. Preoperative workup included upper endoscopy, esophagram, and esophageal manometry in all patients. Average follow-up was 31.5 months (range, 3 to 60 months). Two patients (18%) had severe dysphagia, four patients (36%) had mild and occasional dysphagia to solid food, and five patients (45%) were asymptomatic. All patients gained or kept body weight, except for the two patients with severe dysphagia. Of the two patients with severe dysphagia, one underwent esophageal dilatation and the other a laparoscopic esophagectomy. They are both doing well. Heller myotomy relieves dysphagia in the majority of patients even when the esophagus is massively dilated.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Purpose: The aim of this prospective study was to objectively evaluate inferior alveolar nerve (IAN) sensory disturbances in patients who underwent sagittal split ramus osteotomy (SSRO) by comparing 1 side treated with a reciprocating saw with the other side treated with a piezosurgery device.Materials and Methods: Clinical evaluation of IAN sensory disturbance was undertaken preoperatively and at 1 week, 4 weeks, 2 months, and 6 months postoperatively in 20 patients who underwent SSROat the Division of Oral and Maxillofacial Surgery, Araraquara Dental School, Sao Paulo State University. The 20 patients were examined at all periods for IAN functionality by Semmes-Weinstein testing; neither the patients nor the examiner knew which side was treated using piezosurgery or a reciprocating saw.Results: The mean age of the patients was 28.4 years (range, 20 to 48 yr). Before surgery, no patient had impaired function of the IAN in any of the 8 zones in the mental and inferior lip areas. All patients reported feeling the first monofilament at the time of the preoperative test. Seven days postoperatively, all patients reported some kind of altered sensitivity in at least 1 zone evaluated.Conclusions: The results of this study suggest there was no statistically significant difference in the sensitivity of the labiomental area regarding the instrument used to perform the osteotomy. Future studies will focus on enlarging the sample and evaluating the results. (C) 2014 American Association of Oral and Maxillofacial Surgeons

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Objective: This article describes the application and the performance of a cheap, simple and portable device that can be used for colorimetric quantitative determination of captopril (CPT) in pharmaceutical preparations. Methods: The sensor is a light detector resistor (LDR) placed into a black PTFE cell and coupled to a low cost multimeter (Ohmmeter). The instrument has been tested and is easy and fast to use. The quantitative study is based mainly on reduction of ammonium molybdate by captopril, in the presence of sulphuric acid, producing a green-yellow compound (max 407 nm). The calibration curves were obtained by plotting the electric resistance of the LDR against the CPT concentration on the range of 4.60 x 10-4 to 1.84 x 10-3 mol l-1 with a good coefficient of determination (R2 = 0.9962). Results: Statistical analysis of the obtained results showed no significant difference between the proposed methodology and the official reported method as evident from the t-test and variance ratio at 95% confidence level. Conclusion: The results of this study demonstrate that the instrument can be used for simple, accurate, precise, fast, in situ and low-cost colorimetric analysis of captopril in pharmaceuticals products.

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This study evaluated the effect of item inversion on the construct validity and reliability of psychometric scales and proposed a theoretical framework for the evaluation of the psychometric properties of data gathered with psychometric instruments. To this propose, we used the Maslach Burnout Inventory, which is the most used psychometric inventory to measure burnout in different professional context (Students, Teachers, Police, Doctors, Nurses, etc…). The version of the MBI used was the MBI-Student Survey (MBI-SS). This inventory is composed of three key dimensions: Exhaustion, Cynicism and Professional Efficacy. The two first dimensions—which have positive formulated items—are moderate to strong positive correlated, and show moderate to strong negative correlations with the 3rd dimension—which has negative formulated items. We tested the hypothesis that, in college students, formulating the 3rd dimension of burnout as Inefficacy (reverting the negatively worded items in the Efficacy dimension) improves the correlation of the 3rd dimension with the other two dimensions, improves its internal consistency, and the overall MBI-SS’ construct validity and reliability. Confirmatory factor analysis results, estimated by Maximum Likelihood, revealed adequate factorial fit for both forms of the MBI-SS (with Efficacy) vs. the MBI-SSi (with Inefficacy). Also both forms showed adequate convergent and discriminant related validity. However, reliability and convergent validity were higher for the MBI-SSi. There were also stronger (positive) correlations between the 3 factors in MBI-SSi than the ones observed in MBI-SS. Results show that positively rewording of the 3rd dimension of the MBI-SS improves its validity and reliability. We therefore propose that the 3rd dimension of the MBI-SS should be named Professional Inefficacy and its items should be positively worded.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)