Modified pubovaginal sling technique in the surgical management of female stress urinary incontinence

Objective: To assess the application of aponeurotic sling by a modified technique with direct visualization of needles in patients with stress urinary incontinence. Methods: we applied the Kings Health Questionnaire (KHQ) for quality of life, gynecological examination, urinalysis I and urine culture approximately seven days prior to the urodynamic study (UDS) and the one-hour PAD test in patients undergoing making aponeurotic sling with its passing through the retropubic route with direct visualization of the needle, PAD test and King's Helth Questionnaire before and after surgery. Results: The mean age was 50.6 years, BMI of 28 and Leak Pressure (LP) 58,5cm H2O; 89% were Caucasian. Forty-six of them were monitored for three and six months, 43 for 12 months. The objective cure rate at 12 months postoperatively was approximately 93.5%. In evaluating quality of life, we observed a significant improvement in 12 months postoperatively compared with the preoperative period. There was no no urethral/bladder injury. As adverse results, we had one persistent urinary retention (2.3%), who was submitted to urethrolysis, currently without incontinence. Conclusion: The proposed procedure is safe as for the risk of bladder or urethral injuries, promoting significant improvement in quality of life and objective cure.

Impacto dos investimentos em TI no resultado operacional dos bancos brasileiros

A TI transformou a indústria dos bancos nos últimos Central, e a pesquisa abrangeu o período de 1997 a anos e tornou-se estratégica e vital para o negócio. 2008. Após a especificação dos modelos econométri-Considerando essa premissa, o objetivo principal do cos, foram realizadas quatro análises sobre o impacto trabalho foi analisar o impacto dos investimentos em dos investimentos em TI: análise cross section (cortes TI no resultado operacional dos bancos que operam transversais anuais), análise longitudinal (dados em no Brasil. O modelo utilizado baseou-se em uma fun-painel), análise comparativa dos investimentos em TI ção de produção Cobb-Douglas com três variáveis, o pelos bancos nacionais e estrangeiros, e análise do resultado operacional, os investimentos em TI e os comportamento desses investimentos nos marcos do gastos com pessoal. Os dados são provenientes dos bug do milênio (Y2K) e da implantação do Sistema de saldos contábeis extraídos do sistema Cosif do Banco Pagamentos Brasileiro (SPB).

Recursos, controle e autonomia na gestão internacional de serviços de uma empresa de TI e subsidiárias

Este estudo analisa as características da Gestão de Serviços Globalmente Integrada (GSGI) de uma multinacional de tecnologia de informação e subsidiárias. O estudo também explora: 1) como a matriz gerencia os recursos e lida com o paradoxo do controle e autonomia das subsidiárias e 2) algumas diferenças entre a GSGI e outros modelos de gestão internacionais: exportação de serviços, multinacionais e transnacionais. Para realizar a pesquisa, foi acompanhada a implantação da GSGI na matriz e subsidiária de uma empresa do setor de tecnologia da informação. A metodologia da pesquisa é qualitativa, descritiva e exploratória, realizada por meio de um estudo de caso na matriz e subsidiária. A coleta de dados foi por meio de entrevistas realizada com 25 executivos da matriz americana e da subsidiária brasileira. Os resultados revelam que a adoção da GSGI gera um relativo aproveitamento dos recursos, estimulando competências locais, e ainda combina mecanismos de controle da matriz com a autonomia e independência das subsidiárias.

Conhecimento compartilhado, recursos de TI e desempenho de processos de negócios

Esta pesquisa investiga os efeitos de recursos e capacidades associados à Tecnologia da Informação (TI), e do conhecimento compartilhado entre gestores das áreas de TI e de negócios, no alinhamento operacional entre essas áreas e, por conseguinte, no desempenho de processos de negócios. O estudo baseia-se em dados coletados nas áreas de TI e de retaguarda (back office) de 39 empresas prestadoras de serviços do Rio de Janeiro. Resultados observados por meio da análise de equações estruturais sugerem que o alinhamento operacional afeta positivamente o desempenho de processos de back office, e este, a satisfação de seus clientes. Embora recursos e capacidades de TI, assim como o compartilhamento de conhecimento, não tenham efeito direto sobre o nível de alinhamento operacional, quanto maior o compartilhamento de conhecimento entre as áreas de TI e de negócio, mais intensa e positiva a associação entre a flexibilidade da infraestrutura de TI e o alinhamento operacional entre as áreas. O artigo discute as implicações teóricas e práticas dessas observações.

PROPENSIÓN A INNOVAR EN TI Y RECIPROCIDAD EN EL ÁMBITO DE LAS REDES SOCIALES

RESUMEN El objetivo de la investigación reside en la influencia de la propensión a la innovación en Tecnologías de la Información (TI) como rasgo personal específico, y la reciprocidad sobre el apoyo recibido (su percepción) y la integración social en las redes sociales online. La revisión de la literatura revela la ausencia de estudios concluyentes sobre los efectos de las diferencias personales en la integración social. Un modelo estructural se propone para valorar las relaciones entre los constructos, y el poder predictivo del modelo de investigación. Los resultados demuestran que mejorar la reciprocidad, el apoyo recibido y la promoción de la propensión a la innovación en TI son iniciativas relevantes para el bienestar del usuario y su integración social. La investigación amplía el poder explicativo de la teoría existente, y sugiere a los responsables de marketing estrategias que mejoren dichas variables fomentando la integración social y el éxito duradero de la red socialonline.

A percepção dos gestores operacionais sobre os impactos gerados nos processos de trabalho após a implementação das melhores práticas de governança de TI no TRE/SC

Este estudo objetivou compreender a percepção dos gestores operacionais da Secretaria de Tecnologia da Informação (STI) do TRE/SC acerca dos impactos gerados nos processos de trabalho internos do órgão após a implementação das melhores práticas de governança de TI. Em termos metodológicos, trata-se de um estudo de caso descritivo-avaliativo, de abordagem qualitativa no que concerne às características e ao modo de investigação. Como resultados, verificou-se que até março de 2013 foram implementados oito dos 24 processos de governança de TI baseados no modelo Cobit, versão 4.1, definidos como meta do Planejamento Estratégico de TI para 2013. Concluiu-se que a percepção dos gestores é positiva em relação à governança de TI, embora existam algumas falhas, como na comunicação intra e interáreas e na centralização de informações por alguns setores.

Active immunization against hepatitis B virus (HBV) with low-doses of plasma-derived vaccine by intradermal route

Schedule for vaccination against HBV infection has usually been based on three separate injections of 20 meg of the vaccine by intramuscular route. One of the main shortcomings to its use in large scale programs has been its high cost. Ninety out of 300 health workers were submitted to three injections of 2 meg of plasma-derived vaccine (PDV) by intradermal (ID) route on days 0, 30, and 180. Anti-HBs was detected in 74 (82.2%) after the second dose and in 80 (88.9%) after the third dose, a non-significant difference. However, levels above 10 times the cut-off were observed in 29 (32.2%) and 77 (85.5%), respectively (p < 0.001). The results showed that a low-dose schedule is effective when used in health workers and should be tried with other risk groups.

Quantitative toxoplasma gondii oocyst detection by a modified Kato Katz test using Kinyoun staining (KKK) in ME49 strain experimentally infected cats

We detected Toxoplasma gondii oocysts in feces of experimentally infected cats, using a Kato Katz approach with subsequent Kinyoun staining. Animals serologically negative to T. gondii were infected orally with 5x10² mice brain cysts of ME49 strain. Feces were collected daily from the 3rd to the 30th day after challenge. Oocysts were detected by qualitative sugar flotation and the quantitative modified Kato Katz stained by Kinyoun (KKK). In the experimentally infected cats, oocysts were detected from the 7th to 15th day through sugar flotation technique, but oocysts were found in KKK from the 6th to 16th day, being sensitive for a larger period, with permanent documentation. The peak of oocysts excretion occurred between the 8th to 11th days after challenge, before any serological positive result. KKK could be used in the screening and quantification of oocysts excretion in feces of suspected animals, with reduced handling of infective material, decreasing the possibility of environmental and operator contamination.

Trypanosoma (herpetosoma) Rangeli tejera, 1920: influence of host weight, size of inoculum, and route of infection upon experimental parasitemia

To study the influence of host age, inoculum size, and route of infection on Trypanosoma (Herpetosoma) rangeli, 12 lots of 6.0 g albino mice (NMRI strain) were infected up. with from 25x10¹ to 25x10(6) trypomastigotes/gram body weight harvested from LIT medium. The lower inocula produced low but persistent parasitemias, while the higher inocula produced high levels of parasitemia that fell quickly, suggesting the mobilization of resistance mechanisms. In other experiments, i.p. inoculation produced higher parasitemias than s.c. inoculation, and 6.0 g mice had higher parasitemias than 16.0 or 26.0 g mice. Thus, a standard methodology would seem to be necessary in the study of the various strains and/or species that may make up the T. rangeli complex.

Frequency of Blastocystis hominis and other intestinal parasites in stool samples examined at the Parasitology Laboratory of the School of Pharmaceutical Sciences at the São Paulo State University, Araraquara

Blastocystis homins is a protozoan that causes an intestinal infection known as human blastocystosis. This infection is diagnosed by means of parasitological examination of stools and by permanent staining techniques. The present study was developed to evaluate the frequency of Blastocystis hominis infection among inhabitants of the Araraquara region, State of São Paulo, and to compare different methods for investigating this protozoan in feces samples. Evaluations on 503 stool samples were performed by means of direct fresh examination and using the techniques of Faust et al., Lutz and Rugai et al. In addition, the iron hematoxylin, trichrome and modified Kinyoun staining techniques were used. Out of the 503 samples examined, 174 (34.6%) were found to be positive for the presence of intestinal parasites. The most frequent protozoa and helminths were Entamoeba coli (14.6%) and Strongyloides stercoralis (6.7%), respectively. Blastocystis hominis was present in 23 (4.6%) fecal samples, with a predominately pasty consistency and without characterizing a condition of diarrhea. Despite the low frequency of Blastocystis hominis found in the Araraquara region, compared with other regions of Brazil, it is important to perform laboratory diagnostic tests for this protozoan. Its finding in fecal material is indicative of food and drinking water contamination. Since the transmission route for this parasite is accepted to be oral-fecal, this implies that the population needs guidance regarding hygiene and basic sanitation measures as a means for controlling health problems caused by enteroparasites.

Investigation Route of the Coronary Patient in the Public Health System in Curitiba, São Paulo and in Incor - IMPACT Study

Background: The investigation of stable coronary artery disease (CAD) and its treatment depend on risk stratification for decision-making on the need for cardiac catheterization and revascularization. Objective: To analyze the procedures used in the diagnosis and invasive treatment of patients with CAD, at the Brazilian Unified Health System (SUS) in the cities of Curitiba, São Paulo and at InCor-FMUSP. Methods: Retrospective, descriptive, observational study of the diagnostic and therapeutic itineraries of the Brazilian public health care system patient, between groups submitted or not to prior noninvasive tests to invasive cardiac catheterization. Stress testing, stress echocardiography, perfusion scintigraphy, catheterization and percutaneous or surgical revascularization treatment procedures were quantified and the economic impact of the used strategies. Results: There are significant differences in the assessment of patients with suspected or known CAD in the metropolitan region in the three scenarios. Although functional testing procedures are most often used the direct costs of these procedures differ significantly (6.1% in Curitiba, 20% in São Paulo and 27% in InCor-FMUSP). Costs related to the procedures and invasive treatments represent 59.7% of the direct costs of SUS in São Paulo and 87.2% in Curitiba. In InCor-FMUSP, only 24.3% of patients with stable CAD submitted to CABG underwent a noninvasive test before the procedure. Conclusion: Although noninvasive functional tests are the ones most often requested for the assessment of patients with suspected or known CAD most of the costs are related to invasive procedures/treatments. In most revascularized patients, the documentation of ischemic burden was not performed by SUS.