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Importance-performance analysis: Revisiting a tool for the evaluation of clinical services

Health 2014年第5期6卷 285-291页

作者： Juliana Rocha Goncalves andres pinto Marilia Jesus Batista Antonio Carlos Pereira Glaucia Maria Bovi Ambrosano Department of Community Oral Health Piracicaba Dental SchoolUniversity of Campinas—UNICAMP PiracicabaBrazil Department of Oral and Maxillofacial Medicine and Diagnostic Sciences University Hospitals Case Medical Center and School of Dental MedicineCase Western Reserve UniversityClevelandUSA

The importance-performance analysis method (IPA) is used in market research in order to measure the level of customer satisfaction. The aim of this study was to evaluate and highlight the use of IPA as a management tool to measure quality of dental services. We suggest that this method can be easily implemented in a dental educational setting, as a performance outcome measure that includes patient input. The study was conducted in a dental service through a valid questionnaire, SERVQUAL. This instrument explores levels of service quality perceived by patients. It was conducted in four companies in Brazil in 2011 (derived from different industry segments;two from textiles, one from hospital care and the other from the manufacturing industry) in two States (S?o Paulo and Minas Gerais). These companies were covered by the same dental managed care organization which contracted with independent dentists to provide care. The study was divided into two stages: the first, in which beneficiaries answered the questionnaire prior to receiving dental treatment, and the second when the same beneficiaries answered after completing their dental treatment. Data obtained from SERVQUAL generated graphs that were used to characterize the IPA matrix using several dimensions of care. The Assurance Dimension had the highest average in both expectation and perception. The Reliability dimension showed the value of the most negative GAP among the dimensions, and the best value occurred in the Responsiveness dimension. The IPA tool may be effective in Dental Medicine since it highlights the key points to be improved in the delivery of dental services in a clinical setting.

关键词： Quality of Health Care Quality Indicators Health Care Dental Health Education Health Services Evaluation

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Use of the Scar Acceleration Method/Método de Aceleração Cicatricial—MAC®—in the Treatment of Capsular Contracture: Case Report

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Open Journal of Therapy and Rehabilitation 2020年第4期8卷 131-142页

作者： Carolina Macedo Alves Moreira Carolina Gonçalves Pinheiro Aline Ronis Sampaio Michele Paula dos Santos andres Felipe Mantilla Santamaria Miriam Viviane Baron Cristine Brandenburg Nathália Ken Pereira Iketani Mara Alessandra Porto dos Reis Oliveira Alexandre Sancho Esteban Fortuny Felice Picariello Marcus Vinicius de Mello pinto Dr. Daniel Thomaz Clinic Uberlandia Minas Gerais Brazil Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC (FMABC) The Vale do Salgado Faculty (FVS) Ceará Brazil Celulare Institute Petrópolis Rio de Janeiro Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil School of Medicine of the Industrial University of Santander (UIS) Bucaramanga Colombia School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Por-to Alegre Brazil Brazilian Education of the Federal University of Ceará (UFC) Fortaleza Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Clínica Instituto de Cirurgia Plástica Vênus Barreiras Bahia Brazil Unigranrio Rio de Janeiro Brazil Universidad Finis Terrae and CEO of Diagnostra Santiago Chile Università degli Studi di Napoli Federico II Napoli Italy Ph.D. and Creator of the MAC® Method CEO and Researcher of the Celulare Institute Petrópolis Rio de Janeiro Brazil

Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can progress to pain, distortion, and asymmetry of the breasts, requiring surgical revision. The present study is a case report. A 58-year-old woman with a medical diagnosis of capsular contracture of the right breast evidenced by ultrasound. She was referred to the physiotherapy clinic in October 2019 with an initial complaint of pain on palpation, swelling, and stiffness in her right breast. The patient was evaluated and the MACò method was used to treat capsular contracture. For this, 12 sessions of photodynamic therapy were carried out. The treatment included the use of LED by doping: red (300 s), violet (60 s) and blue (120 s), with the use of 1% methylene blue in target areas, three times a week. The patient had the beginning of symptoms’ remission in the fourth visit and total remission in the 12th visit. It was concluded that the use of photodynamic therapy using the MAC

关键词： Breast Implants Fibroses Methylene Blue Semiconductor Diode Laser Photodynamic Therapy

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A Study of Laser Effectiveness in Injured Tissues Regeneration

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Journal of Biosciences and Medicines 2021年第3期9卷 55-63页

作者： Marcus Vinicius de Mello pinto Aline Ronis Sampaio Miriam Viviane Baron Carolina Macedo Alves Moreira Carolina Gonçalves Pinheiro Michele Paula dos Santos andres Felipe Mantilla Santamaria Cristine Brandenburg Nathália Ken Pereira Iketani Mara Alessandra Porto dos Reis Oliveira Alexandre Sancho Felice Picariello Esteban Fortuny Juliano Tibola Nilton Petrone Vilardi Junior Celulare Institute Petrópolis Rio de Janeiro Brazil School of Medicine Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Dr. Daniel Thomaz Clinic Uberlandia Minas Gerais Brazil Faculty of Medicine of ABC (FMABC) Santo André Brazil Vale do Salgado Faculty (FVS) Ceará Brazil School of Medicine Industrial University of Santander (UIS) Bucaramanga Colombia Federal University of Ceará (UFC) Fortaleza Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Clínica Instituto de Cirurgia Plástica Vênus Barreiras Bahia Brazil Unigranrio Rio de Janeiro Brazil da Universita Federico II di Napoli Italia e Pesquisador do Internacional Research Group Rio Grande do Norte Brazil Universidad Finis Terrae Santiago Chile UDESC Florianopolis SC Brazil Fluminense Football Club Rio de Janeiro RJ Brazil

This study aimed to understand the use of low level laser in the regeneration of injured tissues. Also to design our own opinion on the subject, as chemists. Laser is nothing more than a light with very special characteristics that grant it therapeutic properties. We can observe the existence of three different types of laser, being one of them the therapeutic laser, which is used in substitution for medications or along with them. Another type of laser is the surgical one and, in addition to these, there is a diagnostic type. A great advantage is that, instead of taking the medicine, the patient’s own body can be activated by the laser to produce certain substances that can often replace the drugs. This is a literature review emphasizing the use of low level laser. Thus, the reflections from this study can contribute to the amplification of the production of knowledge that aims at the resignification of the use of laser in therapy. Greater attention was given to two types of laser radiation: He-Ne and As-Ga, both presenting a high therapeutic potential in superficial and deep injures. However, the He-Ne laser excels in superficial lesions, whereas the As-Ga laser does so in deep injures, such as articular, muscular, etc.

关键词： Laser Injury Regeneration

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Early Hepatic Encephalopathy after a Transjugular Intrahepatic Portosystemic Shunt Procedure: Case Report

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Open Journal of Gastroenterology 2021年第6期11卷 81-88页

作者： Miriam Viviane Baron Gabriela Di Lorenzo Garcia Scherer Michele Paula dos Santos andres Felipe Mantilla Santamaria Cristine Brandenburg Isabel Cristina Reinheimer Marcus Vinicius de Mello pinto Aline Ronis Sampaio Alexandre Gomes Sancho Alexandre Gomes Sancho Esteban Fortuny Pacheco Felice Picariello Danielle de Mello Florentino Joice Nedel Ott Carolina Gonçalves Pinheiro Nathália Ken Pereira Iketani Sonia Carvalho Patrícia Froes Meyer Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Rio Grande do Sul Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Rio Grande do Sul Brazil Industrial University of Santander (UIS) Bucaramanga Colombia University of Vale do Acaraú (IDJ/UVA) Ceará Brazil Celulare Institute Rio de Janeiro Brazil Unigranrio Rio de Janeiro Brazil Universidad Finis Terrae Santiago Chile Università degli Studi di Napoli Federico II Napoli Italy Uniredentor University Rio de Janeiro Brazil Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC (FABC) S&#227o Paulo Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Rigshospital Copenhagen East K&#248benhavn Denmark Centro Universitário do Rio Grande do Norte Natal Brazil

Patients with decompensated hepatic cirrhosis may present systemic alterations and dysfunction of multiple organs. Ascites, portal hypertension, esophageal varices, and hepatic encephalopathy are common complications arising from cirrhosis. The aim of this paper is to report a case of a patient with liver cirrhosis and the complications of a transjugular intrahepatic portosystemic shunt. Male, elderly, and ex-alcoholic, diagnosed with liver cirrhosis, ascites, and esophageal varices. He underwent transjugular intrahepatic portosystemic shunt due to portal hypertension and returned to the hospital after 24 hours with agitation and mental confusion. He had a bowel movement stop, neurological worsening, loss of renal function, hepatic hydrothorax, hepatic encephalopathy, hypernatremia, hypocalcemia, and hypophosphatemia. He underwent a new procedure to occlude the transjugular intrahepatic portosystemic shunt, showing improvement of the mental status and ascites. However, continued with decompensation and hydro-electrolytic disorders. He evolved with worsening of the ventilatory pattern, and neurological and renal function, with a fatal outcome. Esophageal varices due to portal hypertension can be corrected with the transjugular intrahepatic portosystemic shunt. However, complications such as hypernatremia, hepatic hydrothorax, and hepatic encephalopathy may occur. Therefore, there is a need for reintervention to shunt or reduce its caliber. Thus, for patients with advanced age and decompensated cirrhosis, the potential risks and benefits of this procedure should be carefully evaluated due to the risk of complications and death.

关键词： Ascites Hypernatremia Portasystemic Shunt Transjugular Intrahepatic Hepatic Encephalopathy

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79&PARK住宅区

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城市环境设计 2019年第2期118卷 198-209页

作者： H?gni Laksáfoss Agata Wozniczka Agne Tamasauskaite Alberto Herzog Borko Nikolic Christin Svensson Claudio Moretti Dominic Black Eva Seo-Andersen Frederik Wegener Gabrielle Nadeau Jacob Lykkefold Aaen Jaime Peiro Suso Jan Magasanik Jesper Boye Andersen Jonas Aars? Larsen Julian andres Ocampo Salazar Karl Johan Nyqvist Karol Bogdan Borkowski Katarina Mácková Katrine Juul Kristoffer Negendahl Lucian Racovitan Maria Teresa Fernandez Rojo Max Gabriel pinto Min Ter Lim Narisara Ladawal Schr?der Romea Muryn Ryohei Koike Sergiu Calacean Song He Taylor McNally-Anderson Terrence Chew Thomas Sebastian Krall Tiago Sá Tobias Vall? S?rensen Tore Banke Laurian Ghinitoiu 朱翰林

位于G?rdet国家公园边缘,Kullen有意识地塑造了一个尊重且适应环境的形式,并展现出与众不同的社区和壮丽的景色。为直接回应周围环境,建筑的西北和东南角高起至临近周边的高度;而距离公园最远、且本是视野最不好的东北角被拉高以使其拥... 详细信息

位于G?rdet国家公园边缘,Kullen有意识地塑造了一个尊重且适应环境的形式,并展现出与众不同的社区和壮丽的景色。为直接回应周围环境,建筑的西北和东南角高起至临近周边的高度;而距离公园最远、且本是视野最不好的东北角被拉高以使其拥有公园和港口最壮阔的景色。建筑西南角延伸至最远处的G?rdet国家公园;为了在建筑和自然之间创造一个人性化的柔和边缘,西南角被尽可能地压低,变成

关键词：住宅区

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