Avaliação e classificação da estenose vaginal na braquiterapia: validação de conteúdo de instrumento para enfermeiros / Indicadores antropométricos como previsores del síndrome metabólico en los adolescentes / Evaluation and classification of vaginal stenosis in brachytherapy: instrument content validation for nurses

RESUMO Objetivo: validar os conteúdos de um instrumento elaborado para avaliação e classificação da estenose vaginal pós-braquiterapia para aplicação por enfermeiros. Método: estudo metodológico que incluiu dez enfermeiros experts em braquiterapia. A coleta de dados foi realizada entre dezembro de 2015 a abril de 2016 e ocorreu com a aplicação de formulário disponibilizado aos experts via ferramenta do Google Drive/Microsoft® em três rodadas de validação, conduzida pela Técnica Delphi; 12 conteúdos foram avaliados. A análise dos dados ocorreu pelo cálculo do Índice de Validade de Conteúdo - IVC. Resultados: na primeira rodada, o uso de absorventes íntimos (tampões) foi excluído (IVC=0,4), outros conteúdos foram ajustados, bem como a aparência do instrumento, de acordo com as recomendações dos experts. Os conteúdos na terceira rodada de avaliação atingiram o IVC=1. Conclusão: a validação de conteúdo de instrumento padroniza a técnica, consequentemente, incrementa e qualifica a prática clínica e o desenvolvimento de pesquisas.

RESUMEN Objetivo: prever el síndrome metabólico en adolescentes a partir de indicadores antropométricos por análisis de sensibilidad y especificidad de los puntos de corte. Método: estudio transversal y descriptivo en una muestra estratificada de 716 adolescentes de 10 a 19 años seleccionados por muestreo aleatorio simple en 30 escuelas públicas, municipales y estatales localizadas en Picos, Piauí, en la Región Noreste del Brasil. La obtención de datos se realizó en el período de Agosto hasta Diciembre del 2014 y en Marzo del 2015. Se investigaron los factores índice de masa corporal y el índice de conicidad. El síndrome metabólico se identificó a partir de los criterios adaptados para la edad. Resultados: se observó la prevalencia de estudiantes del sexo femenino (61,3%) y la prevalencia del síndrome metabólico fue del 3,2%. El área sobre la curva de Características de Operación del Receptor mostró que el índice de masa corporal y el índice de conicidad se mostraron eficientes para la previsión del síndrome metabólico tanto en la muestra total como en la estratificación por sexo. Conclusión: los indicadores antropométricos índice de masa corporal e índice de conicidad fueron buenos previsores del síndrome metabólico en esa población.

ABSTRACT Objective: to validate the content of an instrument prepared for evaluation and classification of vaginal stenosis after brachytherapy for its application by nurses. Method: a methodological study that included ten nurses who are experts in brachytherapy. The data collection was performed between December 2015 and April 2016 and it was carried out through the application form made available to experts via the Google Drive/Microsoft® tool in three validation rounds, conducted by the Delphi Technique; 12 contents were evaluated. The data analysis was performed by calculating the Content Validity Index - CVI. Results: in the first round, the use of intimate tampons was excluded (CVI=0.4), other contents have been adjusted, as well as the appearance of the instrument, according to the experts' recommendations. The content in the third round of evaluation reached the CVI=1. Conclusion: the instrument content validation standardizes the technique; consequently, it increases and qualifies the clinical practice and research development.

Four-dimensional flow MRI for evaluation of post-stenotic turbulent flow in a phantom: comparison with flowmeter and computational fluid dynamics.

OBJECTIVES: To validate 4D flow MRI in a flow phantom using a flowmeter and computational fluid dynamics (CFD) as reference. METHODS: Validation of 4D flow MRI was performed using flow phantoms with 75 % and 90 % stenosis. The effect of spatial resolution on flow rate, peak velocity and flow patterns was investigated in coronal and axial scans. The accuracy of flow rate with 4D flow MRI was evaluated using a flowmeter as reference, and the peak velocity and flow patterns obtained were compared with CFD analysis results. RESULTS: 4D flow MRI accurately measured the flow rate in proximal and distal regions of the stenosis (percent error ≤3.6 % in axial scanning with 1.6-mm resolution). The peak velocity of 4D flow MRI was underestimated by more than 22.8 %, especially from the second half of the stenosis. With 1-mm isotropic resolution, the maximum thickness of the recirculating flow region was estimated within a 1-mm difference, but the turbulent velocity fluctuations mostly disappeared in the post-stenotic region. CONCLUSION: 4D flow MRI accurately measures the flow rates in the proximal and distal regions of a stenosis in axial scan but has limitations in its estimation of peak velocity and turbulent characteristics. KEY POINTS: • 4D flow MRI accurately measures the flow rate in axial scan. • The peak velocity was underestimated by 4D flow MRI. •4D flow MRI demonstrates the principal pattern of post-stenotic flow.