Objectives To validate an experimental non-animal model for training of vasectomy reversal.Materials and Methods The model consisted of two artificial vas deferens, made with silicon tubes, covered by a white resin, measuring 10 cm (length) and internal and external diameters of 0.5 and 1.5 mm, respectively. The holder of the ducts is made by a small box developed with polylactic acid, using a 3D print. The objective of the invention is to simulate the surgical field of vasovasostomy, when the vas deferens are isolated from other cord structures. For validation, it was verified the acquisition of microsurgical skills during its use, in a capacitation course with 5 urology residents from a Hospital of the region. Along the training sessions, it was analyzed the time (speed) of microsurgical sutures, and quantification of the performance using a checklist. Collected data were analyzed using de BioEstat®5.4 software.Results Medium time for the completion of microsurgical sutures improved considerably during the course, and reached a plateau after the third day of training (p=0.0365). In relation to the checklist, it was verified that during capacitation, there was significant improvement of the scores of each participant, that reached a plateau after the fourth day of training with the model (p=0.0035).Conclusion The developed model was able to allow the students that attended the course to gain skills in microsurgery, being considered appropriate for training vasectomy reversal.
sobre os casos notificados de LTA. Os dados foram agrupados segundo as variáveis idade, sexo, raça/cor e município de residência e analisados por meio do qui-quadrado, utilizando o programa BioEstat v5.3, observando o p-valor < 0,05. Para a confecção do mapa, utilizou-se o TabWin v.4.15. RESULTADOS: Foram notificados 34.609 casos confirmados. A incidência foi de 43,89 casos/100.000 habitantes. Houve predominância do sexo masculino (79,88%), idade entre 20 a 39 anos (48,82%) e pardos (71,77%). Registrou-se ocorrência significativa em mulheres, crianças menores de 10 anos de idade e idosos. A forma cutânea foi predominante em 97,39% dos casos, e 72,19% evoluíram para cura. CONCLUSÃO: A LTA ainda é um grave problema de saúde pública no Pará, apresentando alta incidência na população. A distribuição espacial dos casos não é homogênea no território paraense, possuindo maior concentração em áreas distantes da capital do estado. Sugere-se a existência de transmissão peri e intradomiciliar relacionada ao acometimento de crianças menores de 10 anos de idade e idosos.
Purpose: To study the anatomorphometry of the plexus brachialis (PB) of rats under a high-definition video system. Methods: Ten male Wistar rats discarded from other research that did not interfere in the morphology of the animal, respecting the principle of reduction, were used. All animals were submitted to the same protocol. Initially, the cervical region was shaved. The animals were placed in a dorsal position. A single elbow-to-elbow incision was performed and dissection started at the deltopectoral sulcus. The procedures were performed under a video system. To measure the structures, the Image J software was used. Results: All the PB evaluated originated from the C5-T1 spinal nerves. C5 and C6 converged to form the truncus superior, the root of C7 originated the truncus medius, and the confluence of C8 and T1 originated the truncus inferior. It was found the union of C7, C8, and T1 to form truncus inferomedialis instead of separate medial and inferior truncus. C8 (1.31 mm) was the thickest root, the truncus inferior (1.80 mm) and the nerve radialis (1.02 mm), were the thickest. Conclusions: The anatomy of the PB is comparable to humans, admitting variations. The videomagnification system is useful to perform microsurgical dissection.
Se pudo comprobar 884 óbitos maternos, correspondientes a la Razón de Mortalidad Materna 60,7 por 100 mil nacidos vivos de no indígenas y 135,8 de 100 mil nacidos vivos de indígenas. El edema, la proteinuria y los trastornos de hipertensión en el embarazo, parto y puerperio corresponden a 30,5% (n = 270). Conclusión e implicaciones para la práctica: La mortalidad materna es aún un grave problema de salud pública en el estado, demostrando claramente que las indígenas requieren de una mayor atención, ya que presentaron índices más elevados de mortalidad materna si lo compara con no indígenas.
Background There is a dearth of studies conducted to understand the socio-professional profile of the vascular surgery specialty and the population demands of specific regions, which are needed to support creation of care policies and direct infrastructure improvements in healthcare. Objectives The purpose of this study was to describe the socio-professional profile of vascular surgeons in the state of Pará, Brazil, to guide creation of tools for professional improvement. Methods A cross-sectional, self-report survey was conducted in Pará using a questionnaire comprising 30 questions covering six main topics. Results All vascular surgeons actively practicing in the state participated in this study. The total number of specialists was 59, with 71.2% working in the greater Belém area and 16.9% exclusively practicing in the interior of the state. The mean age of these professionals was 48 ± 11.1 years, 86.4% of respondents were men, 64.4% of surgeons had completed medical residency, and 96.6% (n=57) of the surgeons would like to improve their skills in venous surgery, echo-guided vascular access, and endovascular surgery. The method of professional improvement of greatest interest was simulation courses (hands-on), endorsed by 93% of the participants. Conclusions Pará has 59 vascular surgeons. These professionals mainly work in the greater Belém (71.2%), in hospitals (100%) or in private clinics or offices (94.9%), performing a wide range of procedures, including venous and arterial surgery, amputations, and provision of hemodialysis access. More than 90% of these surgeons were satisfied professionally and reported that they would choose the specialty again. However, 22% had a pessimistic view of the specialty’s future. The vast majority of professionals (96.6%) consider that training or a continuing education program are necessary.
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