715 resultados para Veterinary Practice Management


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Bone morphogenetic proteins (BMPs) are multi-functional growth factors belonging to the transforming growth factor ß superfamily. Family members are expressed during limb development, endochondral ossification, early fracture, and cartilage repair. The activity of BMPs was first identified in the 1960s but the proteins responsible for bone induction were unknown until the purification and cloning of human BMPs in the 1980s. To date, about 15 BMP family members have been identified and characterized. The signal triggered by BMPs is transduced through serine/threonine kinase receptors, type I and II subtypes. Three type I receptors have been shown to bind BMP ligands, namely: type IA and IB BMP receptors and type IA activin receptors. BMPs seem to be involved in the regulation of cell proliferation, survival, differentiation and apoptosis, but their hallmark is their ability to induce bone, cartilage, ligament, and tendon formation at both heterotopic and orthotopic sites. This suggests that, in the future, they may play a major role in the treatment of bone diseases. Several animal studies have illustrated the potential of BMPs to enhance spinal fusion, repair critical-size defects, accelerate union, and heal articular cartilage lesions. Difficulties in producing and purifying BMPs from bone tissue have prompted the attempts made by several laboratories, including ours, to express these proteins in the recombinant form in heterologous systems. This review focuses on BMP structure, molecular mechanisms of action and significance and potential applications in medical, dental and veterinary practice for the treatment of cartilage and bone-related diseases.

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Les effets cardiovasculaires des alpha-2 agonistes, particulièrement importants chez les chiens, limitent leur utilisation en pratique vétérinaire. La perfusion à débit constant (PDC) de ces drogues, comme la médétomidine (MED) permettrait un contrôle plus précis de ces effets. Les effets hémodynamiques de plusieurs doses de MED en PDC ont été évalués chez le chien. Lors de cette étude prospective, réalisée en double aveugle, 24 chiens en santé, ont reçu de façon aléatoire une des 6 doses de MED PDC (4 chiens par groupe). Les chiens ont été ventilés mécaniquement pendant une anesthésie minimale standardisée avec de l’isoflurane dans de l’oxygène. Une dose de charge (DC) de médétomidine a été administrée aux doses de 0.2, 0.5, 1.0, 1.7, 4.0 ou 12.0 µg/kg pendant 10 minutes, après laquelle la MED PDC a été injectée à une dose identique à celle de la DC pendant 60 minutes. L’isoflurane a été administré seul pendant une heure après l’administration d’une combinaison d’ISO et de MED PDC pendant 70 minutes. La fréquence cardiaque (FC), la pression artérielle moyenne (PAM) et l’index du débit cardiaque (IC) ont été mesurés. Des prélèvements sanguins ont permis d’évaluer le profil pharmacocinétique. D’après ces études, les effets hémodynamiques de la MED PDC pendant une anesthésie à l’isoflurane ont été doses-dépendants. L’IC a diminué progressivement alors que la dose de MED augmentait avec: 14.9 (12.7), 21.7 (17.9), 27.1 (13.2), 44.2 (9.7), 47.9 (8.1), and 61.2 (14.1) % respectivement. Les quatre doses les plus basses n’ont provoqué que des changements minimes et transitoires de la FC, de la PAM et de l’IC. La pharmacocinétique apparaît clairement dose-dépendante. De nouvelles expériences seront nécessaires afin d’étudier l’utilisation clinique de la MED PDC.

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Dans un contexte de mondialisation, les frontières géographiques et politiques se font de plus en plus diffuses et donnent lieu à un mélange des cultures tant au niveau local qu'international. Ce pluralisme culturel observé dans la population se transpose dans les milieux de soins, amenant son lot d'enjeux et de défis pour la pratique et la formation infirmière. Le développement de la compétence culturelle chez les professionnels de la santé est considéré comme l'une des solutions favorisant la qualité et l'équité dans les soins en contexte de diversité culturelle. La compétence culturelle fait l'objet de nombreux articles scientifiques en sciences infirmières, mais bon nombre d'entre eux sont issus d'une perspective essentialiste. À notre connaissance, aucune étude ne permet de représenter la trajectoire de développement de cette compétence sur un continuum intégrant des apprentissages réalisés à la fois chez des étudiantes et des infirmières selon une perspective constructiviste. Cette étude vise donc à formuler une proposition théorique constructiviste du développement de la compétence culturelle infirmière. L'approche de théorisation ancrée de Corbin et Strauss (2008) a permis de documenter le processus de développement de la compétence culturelle chez des infirmières et des étudiantes dans un Centre de santé et de services sociaux desservant une population qui présente une grande diversité culturelle. Une stratégie d'échantillonnage intentionnel a permis de recruter des infirmières identifiées par leurs pairs comme étant expertes du domaine des soins en contexte de diversité culturelle, des infirmières se disant intéressées par une pratique culturellement compétente et des étudiantes en dernière année d'un programme de baccalauréat en sciences infirmières. Un total de 24 participantes, dont 13 infirmières et 11 étudiantes ont pris part à cette étude. Un questionnaire sociodémographique, des périodes d'observation participante et des entrevues semi-structurées ont servi d'outils de collecte des données. La catégorie centrale « apprendre à réunir les différentes réalités afin d'offrir des soins efficaces en contexte de diversité culturelle » a été construite à partir d'une analyse inductive des données. Cette catégorie centrale se divise en trois sous-catégories : « construire la relation avec l'autre », « sortir du cadre habituel de pratique » et « réinventer sa pratique dans l'action ». La proposition théorique formulée présente l'évolution concomitante de ces trois sous-catégories en trois niveaux de développement de la compétence culturelle infirmière : « s'ouvrir aux différentes réalités entourant la pratique en contexte de diversité culturelle », « mettre à l'épreuve sa pratique » et « réunir les différentes réalités de la pratique en contexte de diversité culturelle de façon intégrée ». La proposition théorique constructiviste est ancrée dans les données empiriques, circonscrit des étapes de développement interreliées et met en contexte les apprentissages du début du développement de la compétence culturelle à l'expertise. Les éléments contextuels précisés suggèrent l'ajout des dimensions sociales et politiques dans la définition du concept de compétence culturelle. Les deux principales contributions théoriques de cette étude soulignent que l'interaction entre l'infirmière et l'environnement de même que l'expérience clinique sont constitutifs du développement de cette compétence. Les retombées de cette recherche se situent non seulement en formation, mais aussi dans la pratique, la gestion et la recherche en sciences infirmières.

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Travail dirigé présenté à la Faculté des études supérieures et postdoctorales en vue de l’obtention du grade de Maître ès sciences (M. Sc.) en sciences infirmières Option Expertise-Conseil

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Introducción: La obstrucción intestinal es una patología de alta prevalencia e impacto en los servicios de cirugía general a nivel mundial. El manejo de esta entidad puede ser médico o quirúrgico. Cuando se requiere intervención quirúrgica, se busca evitar el desarrollo de isquemia intestinal y resecciones intestinales; durante el postoperatorio, pueden existir complicaciones. El objetivo de este estudio es identificar los factores asociados al desarrollo de complicaciones post operatorias en un grupo de pacientes con obstrucción intestinal mecánica llevados a manejo quirúrgico. Metodología: Estudio analítico tipo casos y controles en un grupo de pacientes con diagnóstico de obstrucción intestinal mecánica llevados a manejo quirúrgico de su patología. Los casos corresponden a los pacientes con complicaciones postoperatorias y los controles aquellos que no presentaron complicaciones. Se identificaron factores asociados a complicación post operatoria mediante modelos estadísticos bivariados y multivariados de regresión logística para factores como edad, sexo, antecedente quirúrgico, presentación clínica, paraclínica y diagnóstico postoperatorio de malignidad, entre otras. Resultados: Se identificaron un total de 138 pacientes (54 casos y 129 controles). Los rangos de edad entre 55-66 años y mayor de 66 años fueron asociados con complicaciones postoperatorias (OR 3,87 IC95% 1,58-9,50 y OR 3,62 IC95% 1,45-9,08 respectivamente). El déficit de base inferior a 5 mEq/litro se relaciona con complicaciones postoperatorias (OR 2,64 IC95% 1.33-5,25) Otras pruebas de laboratorio, características radiológicas, hallazgos de malignidad en el postoperatorio y la evolución de los pacientes no fueron asociados con complicaciones. Conclusiones: Las disminución de las complicaciones durante el manejo quirúrgico de obstrucción intestinal mecánica continúa siendo un reto para la cirugía general. Factores no modificables como edad avanzada y modificables como el equilibrio ácido base deben ser tenidos en cuenta dada su correlación en el desarrollo de complicaciones postoperatorias.

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Contenido Introducción 1. Inteligencia emocional, liderazgo transformacional y género: factores que influencian el desempeño organizacional / Ana María Galindo Londoño, Sara Urrego Mayorga; Director: Juan Carlos Espinosa Méndez. 2. El rol de la mujer en el liderazgo / Andrea Patricia Cuestas Díaz; Directora: Francoise Venezia Contreras Torres. 3. Liderazgo transformacional, clima organizacional, satisfacción laboral y desempeño. Una revisión de la literatura / Juliana Restrepo Orozco, Ángela Marcela Ochoa Rodríguez; Directora: Françoise Venezia Contreras Torres. 4. “E-Leadership” una perspectiva al mundo de las compañías globalizadas / Ángela Beatriz Morales Morales, Mónica Natalia Aguilera Velandia; Director: Juan Carlos Espinosa. 5. Liderazgo y cultura. Una revisión / Daniel Alejandro Romero Galindo; Directora: Francoise Venezia Contreras Torres. 6. La investigación sobre la naturaleza del trabajo directivo: una revisión de la literatura / Julián Felipe Rodríguez Rivera, María Isabel Álvarez Rodríguez; Director: Juan Javier Saavedra Mayorga. 7. La mujer en la alta dirección en el contexto colombiano / Ana María Moreno, Juliana Moreno Jaramillo ; Directora: Françoise Venezia Contreras Torres. 8. Influencia de la personalidad en el discurso y liderazgo de George W. Bush después del 11 de septiembre de 2011 / Karen Eliana Mesa Torres; Director: Juan Carlos Espinosa. 9. La investigación sobre el campo del followership: una revisión de la literatura / Christian D. Báez Millán, Leidy J. Pinzón Porras; Director: Juan Javier Saavedra Mayorga. 10. El liderazgo desde la perspectiva del poder y la influencia. Una revisión de la literatura / Lina María García, Juan Sebastián Naranjo; Director: Juan Javier Saavedra Mayorga. 11. El trabajo directivo para líderes y gerentes: una visión integradora de los roles organizacionales / Lina Marcela Escobar Campos, Daniel Mora Barrero; Director: Rafael Piñeros. 12. Participación emocional en la toma de decisiones / Lina Rocío Poveda C., Gloria Johanna Rueda L.; Directora: Francoise Contreras T. 13. Estrés y su relación con el liderazgo / María Camila García Sierra, Diana Paola Rocha Cárdenas; Director: Juan Carlos Espinosa. 14. “Burnout y engagement” / María Paola Jaramillo Barrios, Natalia Rojas Mancipe; Director: Rafael Piñeros.

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There is an imminent need for conservation and best-practice management efforts in marine ecosystems where global-scale declines in the biodiversity and biomass of large vertebrate predators are increasing and marine communities are being altered. We examine two marine-based industries that incidentally take migratory birds in Canada: (1) commercial fisheries, through bycatch, and (2) offshore oil and gas exploration, development, and production. We summarize information from the scientific literature and technical reports and also present new information from recently analyzed data to assess the magnitude and scope of mortality. Fisheries bycatch was responsible for the highest levels of incidental take of migratory bird species; estimated combined take in the longline, gillnet, and bottom otter trawl fisheries within the Atlantic, including the Gulf of St. Lawrence, and Pacific regions was 2679 to 45,586 birds per year. For the offshore oil and gas sector, mortality estimates ranged from 188 to 4494 deaths per year due to the discharge of produced waters resulting in oil sheens and collisions with platforms and vessels; however these estimates for the oil and gas sector are based on many untested assumptions. In spite of the uncertainties, we feel levels of mortality from these two industries are unlikely to affect the marine bird community in Canada, but some effects on local populations from bycatch are likely. Further research and monitoring will be required to: (1) better estimate fisheries-related mortality for vulnerable species and populations that may be impacted by local fisheries, (2) determine the effects of oil sheens from produced waters, and attraction to platforms and associated mortality from collisions, sheens, and flaring, so that better estimates of mortality from the offshore oil and gas sector can be obtained, and (3) determine impacts associated with accidental spills, which are not included in our current assessment. With a better understanding of the direct mortality of marine birds from industry, appropriate mitigation and management actions can be implemented. Cooperation from industry for data collection, research to fill knowledge gaps, and implementation of mitigation approaches will all be needed to conserve marine birds in Canada.

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Soils play a pivotal role in major global biogeochemical cycles (carbon, nutrient and water), while hosting the largest diversity of organisms on land. Because of this, soils deliver fundamental ecosystem services, and management to change a soil process in support of one ecosystem service can either provide co-benefits to other services or can result in trade-offs. In this critical review, we report the state-of-the-art understanding concerning the biogeochemical cycles and biodiversity in soil, and relate these to the provisioning, regulating, supporting and cultural ecosystem services which they underpin. We then outline key knowledge gaps and research challenges, before providing recommendations for management activities to support the continued delivery of ecosystem services from soils. We conclude that although there are knowledge gaps that require further research, enough is known to start improving soils globally. The main challenge is in finding ways to share knowledge with soil managers and policy-makers, so that best-practice management can be implemented. A key element of this knowledge sharing must be in raising awareness of the multiple ecosystem services underpinned by soils, and the natural capital they provide. The International Year of Soils in 2015 presents the perfect opportunity to begin a step-change in how we harness scientific knowledge to bring about more sustainable use of soils for a secure global society.

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O tema Gestão sob o enfoque holístico surgiu a partir de uma leitura da revista HSM Management de setembro-outubro/2000. O artigo abordava o novo paradigma de gerenciar funcionários, que privilegia a busca do bem-estar, onde muitas empresas estão sendo obrigadas a revisar suas políticas de recursos humanos para enfocar as três dimensões de um indivíduo - corpo, mente e espírito. Segundo a reportagem, pesquisas da PricewaterhouseCoopers, Universum e outras organizações constataram que o equilíbrio trabalho/vida não é apenas uma demanda dos atuais empregados, mas também uma das principais prioridades dos formandos em universidades do mundo todo. A intensa luta para atrair funcionários de alto gabarito colocará a empresa com abordagem mais holística um degrau acima de suas concorrentes. Para as empresas, atender as verdadeiras necessidades individuais de seus funcionários é um novo paradigma na maneira de gerenciar seus negócios. O que mudou é a percepção de que o ser humano é fator primordial de competitividade e deixou de ser insumo. O ser humano passou a ser tendencialmente o centro, o foco das relações. Ainda que este conceito aparente estar longe da realidade organizacional brasileira, em função da distância entre o discurso e a prática de um modelo de gestão que considere o funcionário como um ser integral, já temos exemplos de empresas que estão adotando este princípio. A necessidade do equilíbrio entre os aspectos físico, mental, emocional e espiritual para ser feliz, tem levado as pessoas a superarem o medo do desconhecido e caminhar com detenninação em direção ao autodesenvolvimento. Este estudo analisou a utilização da gestão sob o enfoque holístico em duas diferentes empresas. Os resultados evidenciaram que a abordagem holística não está no âmbito da utopia, antes trata-se de um desafio para os gestores das organizações que, para um sucesso na adoção desta prática, precisam, mais do que implantá-la, adotá-la como filosofia de vida, incorporando-a a seus valores e visão de mundo. A prática cotidiana do modelo de gestão holística a partir do corpo diretivo é que vai possibilitar a verdadeira transformação da cultura organizacional tradicional para uma cultura organizacional holística, cuja conseqüência é o reflexo positivo nos resultados econômico-financeiros. C onstatamos, por outro lado, as limitações na utilização desse modelo de gestão tanto por parte dos funcionários quanto por parte dos altos executivos. Quanto aos funcionários, nem todos estão preparados para assumir novas responsabilidades ou preparados para o seu desenvolvimento pessoal, através do auto conhecimento. As crenças adquiridas no período educacional, tanto no lar quanto na escola, bem como suas recentes experiências profissionais podem inibir a descoberta de novas possibilidades, até que se sintam compelidos a lidar com os novos conhecimentos por necessidade de empregabilidade. Quanto aos executivos, por se tratar de um modelo de gestão relativamente novo, sem comprovação científica aliado à dificuldade de encontrar instrumentos de medição objetivos e ao elevado nível de exigência quanto a resultados crescentes no curto prazo, acabam priorizando a administração por objetivos, por se sentirem mais confortáveis quanto à certeza de obtenção de resultados econômico-financeiros no curto prazo. Esquecem-se, no entanto, dos efeitos desastrosos no clima organizacional, que vão comprometer os resultados de médio e longo prazos, seja pela possibilidade de elevado turnover como pela desmotivação generalizada, onde os funcionários só trabalham sob pressão. Por sua vez, cientes da importância do ser humano no novo cenário de elevada competitividade, não são poucos os empresários que já estão começando a trabalhar seus valores intrinsecos com a ajuda de terapeutas, filósofos, psicólogos, estimulando primeiro o auto conhecimento pessoal, para que possam futuramente empreender essa nova maneira de ver o mundo em suas respectivas empresas.

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O propósito deste trabalho foi compreender como a prática de um programa internacional de educação em gestão desvela a dominação do conhecimento ao se internacionalizar para países emergentes. O cenário utilizado leva em consideração as alterações ocorridas no contexto internacional contemporâneo, principalmente em termos da inserção de países emergentes tais como Índia, China e Brasil entre os parceiros acadêmicos dos programas de educação em gestão. Mais especificamente, a contribuição do artigo decorre da abordagem crítica focada em educação em gestão que reconhece o papel dos países periféricos tanto na produção quanto no consumo do conhecimento. A problematização do tema, de caráter qualitativo, está baseada na descrição e análise do caso IMPM (International Masters in Practice Management), com recentes parcerias acadêmicas na China e no Brasil. Os resultados obtidos indicam que os programas internacionais de educação em gestão estão interessados em realizar atividades em países emergentes, mas estas parceiras nem sempre resultam em um papel legítimo que desloque os parceiros de suas posições periféricas para o centro da produção de conhecimento em gestão. Por fim, levantamos o questionamento de que os programas internacionais de educação em gestão, mesmo que presentes nestes países pela realização de módulos locais e pela participação de indivíduos de diversas origens, continuam funcionando como instrumentos de disseminação do conhecimento em gestão universal.

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This work aims at investigating the strategies of management used by State School Joaquim Jose de Medeiros, located in the city of Cruzeta - RN, as award practice of "School of Reference in Management", with a state title in 1999 at the beginning of the decade from 2000, being "Outstanding Brazil" from best management strategies nationally. In 2005, it is ranked among the best experiences of the state. It has been become complex by experiencing in that institution, but at the same time an enjoyable practice, mainly by using a social research, in a qualitative and quantitative approach, and a analysis of the institutional performance of two management practices: from 1995 to 2002 and from 2003 to 2007 . To understand the object, a investigative questionnaire was used with representatives of the school community and carried out an analysis of assessment of institutional and documents of institutional organization of the periods above in order to identify management strategies and examine the influences of the share capital, public policies , the institutional evaluation, in the process of democratic construction that has allowed achievements, highlighting Cruzeta, in the Seridó in the state of Rio Grande do Norte, semi-arid northeast, in the national and international juncture of well-successful experiences in management in institutional categories and leadership. This study becomes relevant to allow understand that the cultural practices of seridoenses that symbolize a capital generated by principles of trust, reciprocity, civic culture, as a driving force in overcoming the problems community and the conquest of democratic principles, worked for the school become a national reference in educational administration. Another aspect that made it natural that school was the collective creation of educational project with the participation and civic culture of self-evaluation as a way to understand the institutional practice and establish guidelines to improve the teaching and practice management in its many dimensions educational, social, administrative - financial and legal

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The present study aimed to analyze metric data from the trachea of dogs and to correlate them with the thoracic girth, body length and weight. We used 48 dogs of unknown breed, 19 males and 29 females. The animals were weighed and then body length, thoracic girth, length and diameter of the trachea, and the number of tracheal rings were measured. The weight of dogs ranged from 4.2 to 21.5 kg, body length from 40.6 to 81.0 cm and thoracic girth from 36.0 to 63.5 cm. The trachea exhibited a total number of tracheal rings between 32 and 43, length between 13.0 and 23.4 cm, diameter of the cervical portion between 11.0 and 23.5 mm and in the thoracic portion between 8.2 and 20.9 mm. We also evaluated the tracheal termination skeletopy, which maintained relations with the 2nd (2.0%), 3 (6.3%), 4 (20.8%) or 5 (12.5%) intercostal spaces, and with the 3rd (6.3%), 4th (35.4%) or 5th (16.7%) ribs. Strong positive correlations of tracheal length with body weight (rS = 0.756, p <0.001), body length (r = 0.808, p <0.001) and thoracic girth (r = 0.735, p <0.001) were found. Therefore, the anatomical study of the trachea provides morphological subsidies for the realization of clinical and surgical procedures in this organ, being an important tool in veterinary practice.

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The calculation of tooth mass discrepancy, essential for good planning and a proper orthodontic finishing, when performed manually, besides being laborious, requires considerable time consumption. The aim of this study was to develop and test Bolton Freeware, a software for analysis of the tooth mass discrepancy of Bolton, aiming to minimize the consumption of time in a less onerous way. The digital analysis of the software was done by means of two-dimensional scanning of plaster study models and compared to manual evaluation (gold standard), using 75 pairs of stone plaster study models divided into two groups according to the magnitude of the Curve of Spee (group I from 0 to 2 mm, group II greater than 2 to 3mm). All the models had permanent dentition and were in perfect condition. The manual evaluation was performed with a digital caliper and a calculator, and the time required to perform the analysis for both methods was recorded and compared. In addition, the software was evaluated by orthodontists regarding its use, by means of questionnaires developed specifically for this purpose. Calibration was performed prior to manual analysis, and excellent levels of inter-rater agreement were achieved, with ICC > 0.75 and r > 0.9 for total and anterior proportion. It was observed in the evaluation of error of the digital method that some teeth showed a significant systematic error, being the highest measured at 0.08 mm. The analysis of total tooth mass discrepancy performed by Bolton Freeware, for those cases in which the curve of Spee is mild and moderate, differ from manual analysis, on average, 0.09 mm and 0.07 mm respectively, for each tooth evaluated, with r> 0, 8 for total and anterior proportion. According to the specificity and sensitivity test, Bolton Freeware has an improved ability to detect true negatives, i.e. the presence of discrepancy. The Bolton analysis digitally performed was faster, with an average difference of time consumed to perform the analysis of Bolton between the two methods of approximately 6 minutes. Most experts interviewed (93%) approved the usability of the software

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Urolithiasis is a disease that despite being a commonly observed problem in veterinary practice is uncommon in birds. Such disease was not reported in passeriforms to date. Accordingly, the aim of the present article is to describe a case of urolithiasis in an adult female lesser seed finch (Sporophila angolensis) pet bird which presented abdominal distension, respiratory distress, and apathy prior to death. The bird had history of being fed with a diet rich in protein. After the bird death, a necropsy was conducted in order to determine the cause of death. At necropsy, accentuated ascites, hydropericardium, and ureteral stones in the left ureter could be grossly observed. Additional tests related with viral and bacterial microbiological testing and with the determination of calculi composition could not be performed since the owner did not consent with the procedures because of the cost. Since the bird was fed on a high protein diet, a relationship between the ureteroliths and dietary imbalance was suggested with participation of protein in calculi development by providing the organic nuclei. Additionally, we conclude that the presence of calculi in the ureter resulted in urinary flow blockage, ascites, and consequent acute respiratory failure due to filling of air sacs with liquid.

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Background: Doppler ultrasonography is an important tool for evaluating hepatic portal hemodynamics. However, no study in dogs of different body weights, in the range encountered in routine clinical veterinary practice, has been reported. It can be difficult to obtain an ideal insonation angle when evaluating the main portal vein, so evaluation of the right portal vein branch has been described in humans as an alternative. The aim of this study was to analyze, through Doppler ultrasonography, the hemodynamics in the right portal vein branch in dogs of different body weights.Methods: Thirty normal dogs were divided in three groups by weight, in order to establish normal values for mean velocity, flow volume and portal congestion index of the right portal vein branch by means of Doppler ultrasonography.Results: In all dogs ideal insonation angles were obtained for the right portal vein branch. The average velocity was similar in the three groups, but the portal congestion index and the flow volume differed, showing that the weight of the dog can influence these values.Conclusion: Doppler ultrasonography for the evaluation of flow in the right branch of the portal vein could be a viable alternative, or complement, to examining the main vessel segment. This is especially so in those animals in which an ideal insonation angle for examination of the main portal vein is hard to obtain. In addition, the weight of the dog must be considered for the correct evaluation of the portal system hemodynamics, particularly for portal blood flow and the congestion index.