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  1. Article ; Online: Doctors for Brazil Program: first results.

    Santos, Caroline Martins José Dos / Andrade, Soraya Zacarias Drumond de / Wollmann, Lucas / Frade, Fernanda Valentim Conde de Castro / Andreato, Neiane da Silva Azevedo / Silveira Junior, Roberto Rosa da / Andrade, Polyanna Peres / Silva, Alexandre Pozza Urnau

    Ciencia & saude coletiva

    2023  Volume 28, Issue 11, Page(s) 3273–3279

    Abstract: Access to medical care is essential to achieve quality primary health care (PHC). In Brazil, access difficulties still persist. The Doctors for Brazil Program (PMpB in Portuguese) aims to expand the offer of medical services in places of difficult ... ...

    Title translation Programa Médicos pelo Brasil: primeiros resultados.
    Abstract Access to medical care is essential to achieve quality primary health care (PHC). In Brazil, access difficulties still persist. The Doctors for Brazil Program (PMpB in Portuguese) aims to expand the offer of medical services in places of difficult provision or high vulnerability. It innovates insofar as it prioritizes smaller and rather isolated cities, by selecting professionals through an isonomic process, offering them training in Family and Community Medicine and a chance to build their first federal medical career in PHC. The program offers competitive salaries, progression and financial incentives that value long-term commitment and performance. The PMpB is rolled out by the Agency for the Development of Primary Health Care (Adaps), which allows better management of public policies. The first nine months of the program showed promising results, as approximately 23,000 candidates seeking to join the program through its selection process, i.e., 97.1% vacancies were filled and retention rate after admittance was 95.4%. These results show to what extent PMpB has improved in quality compared to previous policies, as well as how essential it is to keep implementing the program so that it may reach its full PHC coverage potential within the Brazilian public health system.
    MeSH term(s) Humans ; Brazil ; Primary Health Care ; Physicians ; Quality of Health Care ; Public Health
    Language English
    Publishing date 2023-03-23
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2078799-6
    ISSN 1678-4561 ; 1678-4561
    ISSN (online) 1678-4561
    ISSN 1678-4561
    DOI 10.1590/1413-812320232811.00072023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Total Laparoscopic Approach for Transhiatal Esophagectomy and Gavriliu's Esophagoplasty in Children with Caustic Esophageal Injuries.

    Montalva, Louise / Viala, Jérôme / Michelet, Daphné / Frade, Fernanda / Lardy, Hubert / Vitoux, Christine / Bonnard, Arnaud

    Journal of laparoendoscopic & advanced surgical techniques. Part A

    2017  Volume 27, Issue 10, Page(s) 1085–1090

    Abstract: Background: Esophageal repair after caustic injury is a surgical challenge in children. The aim of this study was to report the first results of a total laparoscopic approach in transhiatal esophagectomy and esophageal replacement by an anisoperistaltic ...

    Abstract Background: Esophageal repair after caustic injury is a surgical challenge in children. The aim of this study was to report the first results of a total laparoscopic approach in transhiatal esophagectomy and esophageal replacement by an anisoperistaltic gastric tube.
    Patients and methods: A retrospective review of data from children operated on with a laparoscopic approach for transhiatal esophagectomy and Gavriliu's esophagoplasty between 2011 and 2015 was performed. Surgical techniques were related with variations for 2 cases, 1 case with robotic assistance and 1 with thoracoscopic assistance.
    Results: Seven patients were operated on. The median weight was 16 kg. Median duration of mechanical ventilation was 2 days. Total esophagectomy was achieved in all cases. Two patients could eat after a barium swallow 7 days after surgery. The most frequent immediate complication (57%) was anastomotic or gastric tube leakage treated successfully in 100% of the cases with self-expanding metallic stent placement. Seventy-one percent of children presented with stenosis, which responded to pneumatic dilatation in 67% of the cases. Redo surgery was required in 43%, either for anastomosis revision or nonfunctioning gastric tube. With an average follow-up of 51 months, 85.7% of children achieved oral feeding.
    Conclusions: Total laparoscopic approach for esophagectomy and esophageal replacement by Gavriliu's anisoperistaltic gastric tube is a feasible technique allowing to shorten the postoperative mechanical ventilation duration and save parietal damage often present in these patients requiring multiple surgery. It appears to have a good long-term tolerance, although the immediate postoperative complication rate remains as high as the open technique.
    Language English
    Publishing date 2017-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2608063-1
    ISSN 1557-9034 ; 1092-6429
    ISSN (online) 1557-9034
    ISSN 1092-6429
    DOI 10.1089/lap.2017.0053
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: ZORRO: Z Omphaloplasty Repair for Omphalocele.

    Michel, Jean-Luc / Kassir, Rani / Harper, Luke / Gavage, Laurent / Frade, Fernanda / Clermidi, Pauline / Sauvat, Frederique / Ramful, Duksha

    Journal of pediatric surgery

    2018  Volume 53, Issue 7, Page(s) 1424–1427

    Abstract: Purpose: To suggest a novel technique for omphalocele closure which uses the circular base of the umbilical cord, thus allowing for a more physiological healing process and natural-looking scar.: Methods: Among 16 neonates operated for omphalocele ... ...

    Abstract Purpose: To suggest a novel technique for omphalocele closure which uses the circular base of the umbilical cord, thus allowing for a more physiological healing process and natural-looking scar.
    Methods: Among 16 neonates operated for omphalocele between 2011 and 2016, 12 were closed with a one-stage procedure using a Z omphaloplasty (ZORRO). Median gestational age was 36.5 weeks; median birth weight was 3210 g. The umbilical arteries were divided and ligated outside the peritoneal cavity above the parietal musculocutaneous plane. The upper part of the defect was closed vertically in the midline, while the lower part was closed in a circular fashion by imbricating 2 lateral cutaneous Z flaps thus forming a new cordonal base.
    Results: The postoperative course was uneventful in all cases. The reconstructed cordonal bases healed as would a normal umbilical cord, with central umbilication surrounded by healthy skin. With a median follow-up period of 11 months, the umbilicus was in the normal position, with a 0.6 xyphoumbilical/xyphopubic ratio.
    Conclusions: This technique mimics the natural necrosis mechanism and physiological healing of the umbilicus thus allowing for an esthetic and "natural looking" umbilicus.
    MeSH term(s) Female ; Hernia, Umbilical/surgery ; Humans ; Infant, Newborn ; Male ; Reconstructive Surgical Procedures/methods ; Surgical Flaps ; Treatment Outcome ; Umbilicus/surgery ; Wound Healing
    Language English
    Publishing date 2018-04-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2018.04.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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