Determinants of psychotherapists' attitudes to online psychotherapy.

Introduction: Online psychotherapy is a form of work that is becoming more and more popular. Public health problems, such as COVID-19, forced mental health professionals and patients to incorporate new methodologies such as the use of electronic media and internet to provide follow-up, treatment and also supervision. The aim of this study was to investigate which factors shape the therapists' attitudes toward online psychotherapy during a pandemic taking into account: (1) attitudes toward the COVID-19 pandemic (fear of contagion, pandemic fatigue, etc.), (2) personal characteristics of the psychotherapists (age, gender, feeling of efficacy, anxiety, depression, etc.), and (3) characteristics of the psychotherapeutic practice (guideline procedure, client age group, professional experience, etc). Materials and methods: Study participants were 177 psychotherapists from four European countries: Poland (n = 48), Germany (n = 44), Sweden (n = 49), and Portugal (n = 36). Data were collected by means of an individual online survey through the original questionnaire and the standardized scales: a modified version of the Attitudes toward Psychological Online Interventions Scale (APOI), Fear of Contagion by COVID-19 Scale (FCS COVID-19), Pandemic Fatigue Scale (PFS), Hospital Anxiety and Depression Scale (HADS), Social Support Questionnaire (F-SozU K-14), and the Sense of Efficiency Test (SET). Results: Determinants that impacted psychotherapists' attitudes toward online therapy were: COVID-19 belief in prevention-keeping distance and hand disinfection, pandemic behavioral fatigue, previous online therapy experience (including voice call), working with youth and adults. Our study showed that belief in the sense of prevention in the form of taking care of hand disinfection before the session, pandemic behavioral fatigue and experience in working with adults were significant predictors of negative attitudes of therapists toward online psychological interventions. On the other hand, belief in the sense of prevention in the form of keeping distance during the session had a positive effect on general attitudes toward therapy conducted via the internet. Discussion: The online therapy boom during the COVID-19 pandemic has spawned a powerful tool for psychotherapists. More research in this area and training of psychotherapists are needed for online psychological interventions to become an effective therapy format that is accepted by patients and therapists alike.

Non-invasive indirect monitoring of intra-abdominal pressure using microwave reflectometry: system design and proof-of-concept clinical trial.

Monitoring intra-abdominal pressure (IAP) has become a standard in intensive care units. Correlation between the abdominal wall's thickness (AWTh) and IAP has been reported previously. The abdominal wall can be modeled as a compound of parallel dielectric slabs; changes in their width have a direct effect on the reflection coefficient of the abdominal wall at microwave frequencies. This work describes the design of a reflectometry system and its proof-of-concept trial on five patients during laparoscopic surgery. The system complies with IEEE Std. C95.1-2005 concerning exposure of humans to microwave electromagnetic fields in controlled environments. The results putatively show an inverse correlation between IAP and the reflection coefficient, and a strong dependence on the body mass index. A better understanding of the dynamics in the changes of the AWTh (during intra-abdominal hypertension) will allow further development of a microwave-based technique for the continuous non-invasive indirect monitoring of IAP in critical patients.

The dielectric spectroscopy of human red blood cells during 37-day storage: ß-dispersion parameterization.

This study exploits dielectric spectroscopy to monitor the kinetics of red blood cells (RBC) storage lesions, focusing on those processes linked to cellular membrane interface known as ß-dispersion. The dielectric response of RBC suspensions, exposed to blood-bank cold storage for 37 days, was studied using time-domain dielectric spectroscopy in the frequency range 500 kHz to 200 MHz. The measured dielectric processes are characterized by their dielectric strength (Δε) and their relaxation times (τ). Changes in the dielectric properties of the RBC suspensions, due to storage-related biophysical changes, were evaluated. For a quantitative characterization of RBC vitality, we characterized the shape of fresh and stored RBC and measured their deformability as expressed by their average elongation ratio, which was achieved under a shear stress of 3.0 Pa. During the second week of storage, an increment in the evolution of the relaxation times and in the dielectric permittivity strength of about 25% was observed. We propose that the characteristic increment of ATP, during the second and third weeks of storage, is responsible for the raise of the specific capacitance of cell membrane, which in turn explains the changes observed in the dielectric response when combined with the influence of the shape changes.

Optimized electrical bioimpedance measurements of abdominal wall on a porcine model for the continuous non-invasive assessment of intra-abdominal pressure.

This work describes the optimization of electrical bioimpedance measurements for indirect intra-abdominal pressure (IAP) assessment. The experimental run was performed on a female Sus scrofa domesticus (domestic pig). Different values of IAP were induced by inflation of the abdominal cavity, using a trocar placed near the umbilicus over the linea alba. The whole experiment was run within 1 h of the subject being sacrificed. The abdominal wall thickness was measured at an IAP of 5 mmHg. An exponential trend linking between the bioimpedance values at 99.8 kHz and the IAP was found. Non-optimized electrode placement presented a strongly reduced sensitivity to IAP changes above 7 mmHg. Upon optimization and placing the electrodes with a separation of about 3.6 times the measured abdominal wall thickness, the sensitivity for high IAP drastically increased, allowing continuous non-invasive monitoring of IAP, confirming the optimization method proposed in this work.

The dielectric spectroscopy of human red blood cells: the differentiation of old from fresh cells.

OBJECTIVE: The objective of the study was to gauge the effect of storage lesions on the dielectric response of red blood cells (RBC), in particular those processes linked to deformations of the cellular membrane known as the ß-dispersion. APPROACH: The dielectric response of RBC suspensions, exposed to blood-bank cold storage, was studied using time-domain dielectric spectroscopy (TDDS) in the frequency range of 500 kHz up to 1 GHz. The measured dielectric processes are characterized by their dielectric strength (Δε) and relaxation time (τ). Changes in the dielectric properties of the RBC suspensions due to storage-related lesions were evaluated. For a quantitative characterization of RBC lesions, we measured the deformability of fresh and stored RBC as expressed by their elongation ratio (ER), which was achieved under a shear stress of 3.0 Pa. MAIN RESULT: The results show that the storage of RBC induced a statistically significant decrease of dielectric relaxation times. In addition, a sound correlation between the mean values of ER and the relaxation times was observed (Spearman's correlation coefficient ρ = 0.847). We draw the conclusion that those alterations in the relaxation time are induced by changes in the shape of the RBC that happen during cold-storage. SIGNIFICANCE: The evolution of the ß-dispersion of RBC opens new possibilities in the blood bank inventory management.

Dielectric Response of Cytoplasmic Water and Its Connection to the Vitality of Human Red Blood Cells. II. The Influence of Storage.

Maintaining an appropriate inventory of packaged blood products is a critical part of modern medicine. Consequently, the assessment of red blood cell (RBC) functionality is instrumental for the monitoring of the quality of stored RBC (sRBC) in the blood bank. We present a comprehensive study of sRBC lesion kinetics in SAGM (saline, adenine, glucose, mannitol) solution, using microwave dielectric spectroscopy (0.5-50 GHz) and cell deformability. As part of the research, we have isolated the microwave dielectric response of cytoplasmic water in sRBC. The extracted dielectric parameters are sensitive to the age of the cells and, in particular, to the critical moment of transition from discocyte to echinocyte. From the analysis of the dielectric relaxation as a function of storage-duration, we postulate that the behavior is rooted in the delicate interplay between bound and bulk water in the cellular interior. In particular, the microwave dielectric response reflects the moment when the continuous diffusion of oxygen to the cell and the oxygenation of hemoglobin affects the role played by water in the maintenance of cell integrity. These results open a possible new avenue for the noninvasive inspection of stored red blood cells, permitting a true inventory system for the modern blood bank.

Statistical analysis of the casuistry of a sample of metastatic disease in the spine / Análise estatística da casuística de uma amostra de doença metastática na coluna vertebral / Análisis estadístico de la casuística de una muestra de enfermedad metastásica en la columna vertebral

ABSTRACT Objective: The objective of this study is to present demographic data on the occurrence of spinal metastases in the service where the work was performed and to investigate the reliability of the modified Tokuhashi score in the decision making in patients with metastatic spinal cancer. Methods: We conducted a review of medical records of all cases of vertebral bone metastasis, confirmed by anatomopathological examination, from January 2009 to June 2012. Data review included demographic details, origin of the primary cancer, duration of symptoms, localization of metastases, Karnofsky performance scale and survival based on modified Tokuhashi score. We divided patients into three groups. Group A included patients with life expectancy of less than six months, group B included patients with life expectancy of between six and 12 months, and group C included patients with a life expectancy of more than 12 months. We compared the calculated survival with the current survival in the three groups with all patients followed-up to a minimum of 1 year or until death. Results: The predict survival in group A was 63.6% according to the modified Tokuhashi score, albeit group B had only 30% agreement. Conclusions: For patients in group A, the agreement rate of patient survival was better (63.4%) than that observed in patients in group B (30%). Our sample had no patient classified as group C.

RESUMO Objetivo: O objetivo do trabalho é apresentar dados demográficos sobre a ocorrência de metástases na coluna vertebral no serviço onde o trabalho foi realizado e investigar a confiabilidade do escore modificado de Tokuhashi no processo de decisão em pacientes com câncer metastático na coluna. Métodos: Realizamos uma revisão de prontuários de todos os casos de metástase óssea vertebral, confirmadas por exame anatomopatológico, no período de janeiro de 2009 a junho de 2012. A revisão de dados incluiu detalhes demográficos, origem do câncer primário, duração dos sintomas, localização das metástases, escala de performance de Karnofsky e cálculo da sobrevida com base no escore modificado de Tokuhashi. Dividimos os pacientes em três grupos. O grupo A incluiu pacientes com expectativa de vida menor do que seis meses, grupo B incluiu pacientes com expectativa de vida entre seis e 12 meses e grupo C incluiu pacientes com expectativa de vida maior que 12 meses. Comparamos a sobrevida calculada com a atual sobrevida nos três grupos, com todos pacientes acompanhados até o mínimo de um ano ou até a morte. Resultados: A sobrevida prevista nos pacientes do grupo A foi de 63,6% de acordo com o escore modificado de Tokuhashi, contudo pacientes do grupo B tiveram apenas 30% de concordância. Conclusões: Para pacientes do grupo A, a taxa de concordância da sobrevida dos pacientes foi melhor (63,4%) que o observado em pacientes do grupo B (30%). Nossa amostra não teve nenhum paciente classificado como do grupo C.

RESUMEN Objetivo: El objetivo de este estudio es presentar datos demográficos sobre la aparición de metástasis en la columna vertebral en el servicio donde se realizó el trabajo e investigar la fiabilidad de la escala modificada de Tokuhashi en la toma de decisiones en pacientes con cáncer metastásico en la columna vertebral. Métodos: Se realizó una revisión retrospectiva de todos los casos de metástasis ósea vertebral, confirmados por examen histopatológico, de enero 2009 a junio de 2012. La revisión de los datos incluyó datos demográficos, origen del cáncer primario, duración de los síntomas, localización de las metástasis, escala de rendimiento de Karnofsky y el cálculo de la supervivencia basado en la escala modificada de Tokuhashi. Dividimos a los pacientes tres grupos. El grupo A incluyó pacientes con una esperanza de vida inferior a 6 meses, el grupo B incluyó pacientes con una esperanza de vida de entre seis y 12 meses y el grupo C incluyó pacientes con esperanza de vida superior a 12 meses. Se comparó la supervivencia calculada con la supervivencia actual en los tres grupos, con todos los pacientes seguidos a un mínimo de un año o hasta la muerte. Resultados: La supervivencia esperada en el grupo A fue de 63,6%, según la escala modificada de Tokuhashi, pero los pacientes del grupo B tenían sólo un 30% de concordancia. Conclusiones: En los pacientes del grupo A, la tasa de concordancia de la supervivencia del paciente fue mejor (63,4%) que la observada en el grupo de pacientes en el grupo B (30%). En nuestra muestra no había ningún paciente clasificado como grupo C.

Conocimiento de los pacientes sobre el consentimiento informado en un hospital general / Patients' knowledge about informed consent in a general hospital

Resumen Introducción: El consentimiento informado es un documento escrito firmado por el paciente o su representante legal en el que acepta, bajo debida información otorgada por el médico, los riesgos y beneficios esperados. Objetivo: Determinar el grado de conocimiento del consentimiento informado en los pacientes de un hospital general de zona. Método: Encuesta transversal. Se estudiaron 220 pacientes (tamaño muestral determinado) hospitalizados por tamaño muestral, seleccionados por aleatorización sistemática en los servicios de cirugía, pediatría y medicina interna. Se construyó y aplicó un instrumento válido y consistente con 13 reactivos (validado por dos anestesiólogos, un pediatra, un urgenciólogo y un intensivista en dos rondas, miembros del Comité de Bioética) que indagaban edad, género, escolaridad, autorización y tipo de atención médica, responsable legal, lectura completa del documento, causas de no lectura, información médica previa firma. Variable dependiente: conocimiento general (una pregunta con 5 reactivos, un punto para cada uno si se conocía qué indagaban las características del consentimiento), los resultados se clasificaron como sabe mucho 5 puntos, sabe poco 2 a 3 puntos, y no sabe 0 a 1 puntos y además del trato del personal hospitalario. Encuesta autoaplicada. Se incluyeron documentos con las firmas del paciente, del médico, dos testigos y procedimiento a autorizar. Se eliminaron encuestas incompletas. Las encuestas se cotejaron con el expediente. Se determinó la consistencia del instrumento y se compararon las respuestas cualitativas por chi cuadrada. Resultados: Se estudiaron 74 pacientes por servicio; 26% ignoraba el consentimiento informado y 63% tuvo poco conocimiento, aun así 62% lo firmó. Sólo 56% de los expedientes tuvieron consentimiento considerado válido. Conclusiones: La mayoría de los pacientes ignora a qué se refiere el consentimiento informado, pero aun así lo firman. El índice de consentimientos informados en los expedientes fue deficiente.

Abstract Introduction: The informed consent is a written document signed by the patient or by his legal representative, in which risks and benefits are understood and accepted, once the physician has informed them about medical procedures to be performed. Objective: To determine the level of knowledge about the informed consent in patients from a general hospital. Methods: Transversal survey. 220 hospitalized patients of surgery from pediatrics and internal medicine wards were studied, sampling was chosen randomly, systematically and by ward. A validated and consistent instrument was applied consisting of 13 questions (validated by two anesthesiologists, one pediatrician, one emergency physician and one intensive care physician in two rounds, which were members of the Bioethics Committee), that explored age, genre, education, authorization and type of medical care, the legal responsible, full reading of the document, reasons for not reading, and medical information before signature. The general knowledge was the dependent variable (explored through a question with five possible answers, each one worth one point, that analyzed the document characteristics, classifying results as "knows a lot" with five points, "knows little" two to three points and "doesn't know" with 0 to one point. The survey was self-applied. A document was valid when it included the signatures of the patient, the physician, and two witnesses, as well as the proposed procedure. Incomplete surveys were eliminated. The surveys were compared to the clinical file. The consistency was determined and the qualitative answers were compared through chi-square. Results: 74 patients by service; 26% had no knowledge about the informed consent, 63% had limited knowledge, even though 62% signed the document. Only 56% of the clinical files had a valid informed consent. Conclusion: the majority of patients ignore the informed consent, although they still sign it. The rate of informed consents present in clinical files was deficient.

The role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 2: measurement techniques and management recommendations.

The recent definitions on intra-abdominal pressure (IAP), intra-abdominal volume (IAV) and abdominal compliance (Cab) are a step forward in understanding these important concepts. They help our understanding of the pathophysiology, aetiology, prognosis, and treatment of patients with low Cab. However, there is still a relatively poor understanding of the different methods used to measure IAP, IAV and Cab and how certain conditions may affect the results. This review will give a concise overview of the different methods to assess and estimate Cab; it will list important conditions that may affect baseline values and suggest some therapeutic options. Abdominal compliance (Cab), defined as a measure of the ease of abdominal expansion, is measured differently than IAP. The compliance of the abdominal wall is only a part of the total abdominal pressure-volume (PV) relationship. Measurement or estimation of Cab is difficult at the bedside and can only be done in a case of change (removal or addition) in IAV. The different measurement techniques will be discussed in relation to decreases (ascites drainage, haematoma evacuation, gastric suctioning) or increases in IAV (gastric insufflation, laparoscopy with CO2 pneumoperitoneum, peritoneal dialysis). More specific techniques using the interactions between the thoracic and abdominal compartment during positive pressure ventilation will also be discussed (low flow PV loop, respiratory IAP variations, respiratory abdominal variation test, mean IAP and abdominal pressure variation), together with the concept of the polycompartment model. The relation between IAV and IAP is linear at low IAV and becomes curvilinear and exponential at higher volumes. Specific conditions in relation to increased (previous pregnancy or laparoscopy, gynoid fat distribution, ellipse-shaped internal abdominal perimeter) or decreased Cab (obesity, fluid overload, android fat distribution, sphere-shaped internal abdominal perimeter) will be discussed as well as their impact on baseline IAV, IAP, reshaping capacity and abdominal workspace volume. Finally, we suggest possible treatment options in situations of unadapted IAV according to existing Cab, which results in high IAP. A large overlap exists between the treatment of patients with abdominal hypertension and those with low Cab. The Cab plays a key role in understanding the deleterious effects of unadapted IAV on IAP and end-organ perfusion and function. If we can identify patients with low Cab, we can anticipate and select the most appropriate surgical treatment to avoid complications such as IAH or ACS.

Magnetic induction of electroporation: numerical analysis and technical limitations.

Electric fields delivered across biological cells can cause structural and functional changes to the cell membrane, such as electroporation. An important application of electroporation is in the permeabilization of skin cells. Currently these cells are electroporated with contact electrodes. In this study we explore the feasibility of using electromagnetic induction for non-contact electroporation of skin cells, and the effect of various design parameters on the process. We derived a simple analytical solution that lends itself to a systematic study of design parameters and verified the solution with a numeric solution of the Maxwell equations using finite elements. A short feasibility study of the system implementation is done, concluding that there are technological limitations that must be met in the future in order to build such a device.

ELIGIBILITY FOR THE HIP-RESURFACING ARTHROPLASTY PROCEDURE: AN EVALUATION ON 592 HIPS.

OBJECTIVE: To investigate the percentage of ideal patients who would be eligible for hip-resurfacing surgery at a reference service for hip arthroplasty. METHODS: Out of all the cases of hip arthroplasty operated at Hospital do Servidor Público Estadual de São Paulo (HSPE) between January 2009 and December 2010, we assessed a total of 592 procedures that would fit the criteria for indication for resurfacing arthroplasty, after clinical and radiological evaluation according to the criteria established by the Food and Drug Administration (FDA) and by Seyler et al. RESULTS: Among the total number of hip replacement arthroplasty cases, 5.74% of the patients were eligible. Among the patients who underwent primary arthroplasty, we found that 8.23% presented ideal conditions for this procedure. CONCLUSION: The study demonstrated that this type of surgery still has a limited role among hip surgery methods.

Elegibilidade da cirurgia do tipo resurfacing na artroplastia do quadril: uma avaliação de 592 quadris / Eligibility for the hip-resurfacing arthroplasty procedure: an evaluation on 592 hips

OBJETIVO: Verificar a porcentagem de pacientes ideais elegíveis à cirurgia do tipo resurfacing do quadril em um serviço referência de artroplastias do quadril. MÉTODOS: Analisamos, dentre todos os casos de artroplastia do quadril realizadas no Hospital do Servidor Público Estadual de São Paulo (HSPE) entre janeiro de 2009 e dezembro de 2010, um total de 592 artroplastias, as quais se enquadrariam nos critérios de indicação ideal para artroplastia de resurfacing segundo avaliação clínica e radiológica preconizada com os critérios estabelecidos pela Food and Drug Administration (FDA) e por Seyler et al. RESULTADOS: Considerando o universo total das artroplastias de substituição do quadril, foram elegíveis 5,74% dos pacientes. Nos pacientes submetidos à artroplastia primária, encontrou-se 8,23% em condições ideais a este procedimento. CONCLUSÃO: Demonstra-se o papel ainda restrito desta modalidade cirúrgica entre as cirurgias do quadril.

OBJECTIVE: To investigate the percentage of ideal patients who would be eligible for hip-resurfacing surgery at a reference service for hip arthroplasty. METHODS: Out of all the cases of hip arthroplasty operated at Hospital do Servidor Público Estadual de São Paulo (HSPE) between January 2009 and December 2010, we assessed a total of 592 procedures that would fit the criteria for indication for resurfacing arthroplasty, after clinical and radiological evaluation according to the criteria established by the Food and Drug Administration (FDA) and by Seyler et al. RESULTS: Among the total number of hip replacement arthroplasty cases, 5.74% of the patients were eligible. Among the patients who underwent primary arthroplasty, we found that 8.23% presented ideal conditions for this procedure. CONCLUSION: The study demonstrated that this type of surgery still has a limited role among hip surgery methods.

ABDOPRE: dispositivo de aplicação externa para redução da pressão intra-abdominal: Experiencia clínica preliminar / ABDOPRE: dispositivo de aplicación externa para reducción de presión intraabdominal: Preliminary clinical experience / ABDOPRE: an external device for the reduction of intra-abdominal pressure

São descritos os objetivos de redução da pressão intra-abdominal e o projeto de um dispositivo que os atenda. O ABDO-PRE compreende, pela primeira vez, um mecanismo de servo-controle de aplicação externa que mede a pressão intravesical como variável de controle. São apresentados os resultados da aplicação em 4 pacientes com hipertensão intra-abdominal, produzindo uma redução de 16 por cento a 35 por cento em três casos e um aumento paradoxal da pressão em um dos casos, devido a um desajuste entre a geometria da câmara de vácuo e a alteração anatômica acarretada pela obesidade da paciente. Estes resultados são promissores em relação ao possível uso do ABDOPRE na prática clínica para redução da hipertensão intra-abdominal.

Se describen los objetivos de reducción de la presión intraabdominal y el proyecto de un dispositivo que los cumpla. ABDOPRE comprende por primera vez un mecanismo servcocontrolado de aplicación externa que toma la presión intravesical como variable de control. Se presenta el resultado de la aplicación en 4 pacientes afectados por hipertensión intraabdominal, con el resultado de una reducción de entre 16 por ciento y 35 por ciento en tres casos y de un aumento paradojal de presión en un caso debido a desajuste de la geometría de la campana de vacío a la anatomía obesa del paciente. Estos resultados prometen el posible uso de ABDOPRE para la reducción de la hipertensión intraabdominal en la práctica clínica.

This article describes a device for the reduction of intra-abdominal pressure. The device (ABDOPRE) includes a unique external servo-control mechanism, based on urinary bladder pressure measurement. The results of ABDOPRE use in the first four intra-abdominal hypertension patients are reported; the device resulted in a reduction of intra-abdominal pressure between 16 percent and 35 percent in 3 cases and in a paradoxical increase of the intra-abdominal pressure in an obese woman, likely due to inappropriate chamber size for the patient's anatomy. These results are promising and ABDOPRE may be useful in clinical practice.

ABDOPRE: an external device for the reduction of intra-abdominal pressure. / ABDOPRE: dispositivo de aplicação externa para redução da pressão intra-abdominal: Experiencia clínica preliminar.

This article describes a device for the reduction of intra-abdominal pressure. The device (ABDOPRE) includes a unique external servo-control mechanism, based on urinary bladder pressure measurement. The results of ABDOPRE use in the first four intra-abdominal hypertension patients are reported; the device resulted in a reduction of intra-abdominal pressure between 16% and 35% in 3 cases and in a paradoxical increase of the intra-abdominal pressure in an obese woman, likely due to inappropriate chamber size for the patient's anatomy. These results are promising and ABDOPRE may be useful in clinical practice.

Arthroscopic management of traumatic anterior shoulder instability in collision athletes: analysis of 204 cases with a 4- to 9-year follow-up and results with the suture anchor technique.

PURPOSE: The purpose of this study was to determine the effectiveness of arthroscopy in the selection of surgical procedure and treatment of both acute and recurrent traumatic anterior shoulder instability in rugby players by use of pre-established selection criteria. We describe the injury mechanisms, analyze the pathologic lesions and treatment indications based on surgical findings, and assess the results in patients treated with the arthroscopic suture anchor technique. METHODS: From November 1996 to November 2001, 204 rugby players with acute or recurrent traumatic anterior instability underwent an initial arthroscopic examination. Criteria such as type of Bankart lesion, tissue quality, and presence of bony defects were evaluated and used to determine the method of stabilization: arthroscopy or open stabilization. Open surgery was indicated in patients with bone humeral deficiencies greater than one fourth of the articular humeral head, bone glenoid deficiencies greater than 25% of the glenoid extension, capsular laxity with poor tissue quality, and humeral avulsion of the glenohumeral ligament; all other patients underwent arthroscopic reconstruction via the bone suture anchor technique. RESULTS: The mean follow-up was 5.9 years (range, 3.9 to 8.9 years). We performed arthroscopic stabilization in 39 cases of acute instability; only 1 case (2.5%) required the mini-open technique for reinsertion of humeral avulsion of the glenohumeral ligament. Of 158 cases of recurrent instability, 121 underwent arthroscopic stabilization, and 37 (23.4%) required reconstruction with open surgery. The main cause was bony deficiency (treated with the Latarjet procedure). The results of the arthroscopic reconstructions were evaluated by use of the Rowe scale and analyzed according to stability and range of motion. Good or excellent results were found in 94.9% of cases in the acute instability group and in 91.8% in the recurrent instability group, the poor results were due to instability recurrence. In the acute instability group there were 2 cases of recurrence (5.1%) while playing rugby. In the recurrent instability group there were 10 recurrences (8.3%). CONCLUSIONS: Arthroscopic stabilization was possible in 97.5% of our patients with acute instability and 76.6% of patients with recurrent instability based on the selection criteria for this population. We were able to obtain excellent results in 90% of cases using the suture anchor technique in rugby players with our selection criteria. LEVEL OF EVIDENCE: Level IV, therapeutic case series.