RESUMO
BACKGROUND: Endoscopic ultrasound (EUS) and endoscopic ultrasound elastography (EUS-E) simulation lessens the learning curve; however, models lack realism, diminishing competitiveness. AIM: To standardize the mechanical properties of polyvinyl alcohol (PVA) hydrogel for simulating organs and digestive lesions. METHODS: PVA hydrogel (Sigma Aldrich, degree of hydrolysis 99%) for simulating EUS/EUS-E lesions was investigated in Unidad de Investigación y Desarrollo Tecnológico at Hospital General de México "Dr. Eduardo Liceaga", Mexico City. We evaluated physical, contrast, elasticity and deformation coefficient characteristics in lesions, applying Kappa's concordance and satisfaction questionnaire (Likert 4-points). RESULTS: PVA hydrogel showed stable mechanical properties. Density depended on molecular weight (MW) and concentration (C). PVA bblocks with the greatest density showed lowest tensile strength (r = -0.8, P = 0.01). Lesions were EUS-graphically visible. Homogeneous and heterogeneous examples were created from PVA blocks or PVA phantoms, exceeding (MW2 = 146000-186000, C9 = 15% and C10 = 20%) with a density under (MW1 = 85000-124000, C1 = 7% and C2 = 9%). We calculated elasticity and deformation parameters of solid (blue) areas, contrasting with the norm (Kappa = 0.8; high degree of satisfaction). CONCLUSION: PVA hydrogels were appropriate for simulating organs and digestive lesions using EUS/EUS-E, facilitating practice and reducing risk. Repetition amplified skills, while reducing the learning curve.
Assuntos
Técnicas de Imagem por Elasticidade , Álcool de Polivinil , Humanos , México , Modelos TeóricosRESUMO
Introducción. El apego se define como aquel vínculo significativo que se establece entre personas. Cuando este se rompe, ocurre lo que se denomi-na una pérdida significativa seguida de un proceso de duelo, el cual con-siste en una reacción de dolor natural ante el desprendimiento de algo o de alguien. Durante este proceso, la espiritualidad es una estrategia central para sobreponerse a una experiencia dolorosa; sin embargo, esta también puede verse afectada por los significados que se le atribuyen. La terapia de aceptación y compromiso se emplea en distintos desórdenes psicológicos que involucran la evitación experiencial, incluyendo el duelo.Objetivo. Evaluar el duelo complicado espiritual en pacientes tratados con terapia de aceptación y compromiso, antes y después de la intervención.Materiales y métodos. Se aplicó el cuestionario Inventory of Complicated Spiritual Grief a pacientes con duelo antes y después de ser tratados con terapia de aceptación y compromiso en la Clínica del Duelo del Cen-tro Universitario de Ciencias de la Salud de la Universidad de Guadalaja-ra, México.Resultados y conclusiones. La terapia de aceptación y compromiso ha de-mostrado ser útil en el proceso del duelo, así como en el restablecimiento de la espiritualidad, toda vez que esta es resignificada y da sentido a las experiencias dolorosas.Palabras clave: Duelo; Apego; Espiritualidad; Terapia de aceptación y compromiso.
Introduction: Attachment refers to the significant bond we establish with a person, when this is broken, what we call a significant loss occurs, followed by a grieving process: natural pain reaction to the detachment of something or someone who had a It was worth it During this, spirituality appears as a cen-tral strategy to overcome painful experiences, but it can also be affected by the meanings attributed to it. Acceptance and commitment therapy has been used in different psychological disorders that involve experiential avoidance, including grief.Objectives: The central objective of the study is to evaluate the complicated spiritual duel. Material and methods: The Inven-tory of Complicated Spiritual Grief (ICSG) was applied in pa-tients with grief, before and after being treated with Acceptance and Commitment Therapy in the grief clinic of the University Center of Health Sciences.Results and Conclusions: Acceptance Therapy and commitment has proven to be useful in facilitating the elaboration of grief, as well as in restoring spirituality since it is resignified and gives meaning to painful experiences.
Introdução. O apego refere-se ao vínculo significativo estabe-lecido entre pessoas, se vier a quebrar acontece uma perda significativa, seguida de um processo de luto que envolve uma reação natural de dor ao desapego. Durante esse processo, a espiritualidade é uma estratégia central para superar uma expe-riência dolorosa, no entanto, esteja afetada pelos significados atribuídos a ela. A Terapia de aceitação e comprometimento é usada em várias circunsatâncias que envolvem evasão expe-riencial, incluindo luto.Objetivo. O principal objetivo do estudo é avaliar o luto com-plicado espiritual.Materiais e métodos. O questionário Inventory of Complicated Spiritual Grief foi aplicado em pacientes com perdas significa-tivas, antes e depois de serem tratados com a Terapia de acei-tação e compromisso na clínica de luto do Centro Universidade de Ciências da Saúde da Universidade de Guadalajara.Resultados e conclusões. Terapia de aceitação e compromisso mostrou ser útil no processo de luto, bem como na restauração da espiritualidade, uma vez que é ressignificada e dá sentido à experiências dolorosas
Assuntos
Humanos , Espiritualidade , Terapia de Aceitação e Compromisso , Suicídio , Pesar , Manobra PsicológicaRESUMO
CAPSULE: Clinical outcomes using INVOcell device with ICSI. OBJECTIVE: Intravaginal culture of oocytes (INVO) procedure is an intravaginal culture system that utilizes the INVOcell device in which the fertilization and embryo culture occur. In this procedure, the vaginal cavity serves as an incubator for oocyte fertilization and early embryonic development. The objective of this study was to evaluate the clinical outcomes of this intravaginal culture system in intracytoplasmic sperm injection (ICSI). METHODS: A total of 24 cycles INVO-ICSI (study group) and 74 cycles of ICSI (control group) were included in the study. The cleaved oocytes at day 3/total injected oocytes, embryo quality, pregnancy rate (PR), implantation rate (IR), and miscarriage rate (MR) were compared between both groups. RESULTS: At day 3, there was no difference in the cleaved oocyte rate (78.7 and 76.1%) and embryo quality (77 and 86.8%) for the study and control groups, respectively. In the study group, more embryos were significantly transferred compared to the control group (2.63 ± 0.58 versus 1.93 ± 0.25; P < 0.05). PRs, IRs, and MRs were similar for the study group compared with the control group (PR: 54.2% versus 58.1%; IR: 31.7% versus 33.6%; MR: 7.7% versus 20.9%). CONCLUSIONS: Good PR and IR can be obtained using the INVOcell device, and the INVO-ICSI procedure can be considered as an alternative option to infertile patients.