Rev Assoc Med Bras
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The authors show the clinical evaluation and follow-up results in 56 patients diagnosed with a failed back surgery pain syndrome. ⋯ In patients with a post-laminectomy syndrome, postoperative pain was more severe than preoperative pain from a herniated disk. A miofascial component was found in most patients.
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Review Comparative Study
Accreditation or accreditations? A comparative study about accreditation in France, United Kingdom and Cataluña.
This article analyzes the dynamics and changes in the accreditation process in three different places - France, UK and Cataluña (Spain) - based on documents about their health systems organizations, funding sources and regulations. The objective was to find out about the relevant aspects of the strategies of these countries' institutions that adapted accreditation to national circumstances in the healthcare policy arena. ⋯ Interests in accreditation can be driven by a number of different forces, which depend upon the model adopted. Therefore, it can only be understood in the policy arena of each country.
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Patients who have undergone bariatric surgery are at increased risk of developing nutritional deficiencies from limited food intake and absorption of different nutrients. A systematic review of several database websites (PubMed and ISI Web of Science) was conducted from September 1983 to April 2010 to identify literature related to micronutrient deficiencies occurring after bariatric surgery. Keywords used individually or in various combinations in the search were bariatric surgery, obesity, vitamin/mineral deficiencies, protein deficiency, nutrient absorption and nutrient supplementation. ⋯ The success of oral nutritional supplementation to correct or prevent nutritional deficiencies depends on several factors. Thus, to understand how nutrients can be administered is very important for clinical practice. This review aims to provide help for the best selection of nutrients to ensure an adequate replacement of nutrients in patients who have undergone bariatric surgery.
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To study extent of knowledge and acceptance of hemocomponents and hemoderivatives, fresh and stored, by Jehovah's Witnesses and also propose bioethical tools for any ethical and moral conflicts identified in their relationship with physicians and dentists. ⋯ Jehovah's Witnesses are seen by their "moral outsiders" (here physicians and dentists) as the religious group that simply "does not use blood". Although, several blood treatments are nowadays permitted, it does not deprive them from a free conviction to refuse blood treatments. Their particular understandings frequently extend the list of blood prohibitions and, consequently, the number of moral conflicts, when considering that physicians and dentists usually do not ask about a patient's religion.