Objective: to translate, adapt and validate the contents of the Diabetes Medical Management Plan for the Brazilian context. This protocol was developed by the American Diabetes Association and guides the procedure of educators for the care of children and adolescents with diabetes in schools. Method: this methodological study was conducted in four stages: initial translation, synthesis of initial translation, back translation and content validation by an expert committee, composed of 94 specialists (29 applied linguists and 65 health professionals), for evaluation of the translated version through an online questionnaire. The concordance level of the judges was calculated based on the Content Validity Index. Data were exported into the R program for statistical analysis: Results: the evaluation of the instrument showed good concordance between the judges of the Health and Applied Linguistics areas, with a mean content validity index of 0.9 and 0.89, respectively, and slight variability of the index between groups (difference of less than 0.01). The items in the translated version, evaluated as unsatisfactory by the judges, were reformulated based on the considerations of the professionals of each group. Conclusion: a Brazilian version of Diabetes Medical Management Plan was constructed, called the Plano de Manejo do Diabetes na Escola.
key word unitermos abstractThe detection of hepatic nodules by imaging techniques in cirrhotic patients has increased and the growing consensus that these lesions may be premalignant increases their clinical importance and demands precise diagnostic criteria. The prevalence of macroscopic suspect hepatic nodule (MSHN) in cirrhotic livers was analyzed to identify macroregenerative nodule (MRN), dysplastic nodule and hepatocellular carcinoma (HCC) and to evaluate an association between MSHN and HCC. Hepatic nodules larger than 1cm and different from the surrounding nodules of the cirrhosis in color and texture were considered MSHN. Sixty-one cirrhotic liver explants were serially sectioned into 0.5 to 0.7cm slices and MSHN and protocol samples were examined histologically. Ninety-four MSHN were identified in 26 livers (histologically 11 were cirrhotic nodules, 61 MRN, 12 dysplastic nodules, and ten HCC). HCC was identified macroscopically in one liver and by light microscopy within MSHN in six other livers. The relation between HCC and MSHN, specifically MRN, was statistically significant. These findings suggest an association between MRN and MSHN with HCC in cirrhotic livers and reinforce the practical importance of histological classification of hepatic nodules in cirrhosis in order to guide the management of patients who are waiting for liver transplant or surgical treatment. Cirrhotic liver explants Macroregenerative nodule Dysplasia Hepatocellular carcinoma resumo A detecção de nódulos hepáticos por técnicas de imagem em pacientes com cirrose tem aumentado, e o consenso de que essas lesões podem ser pré-malignas aumenta sua importância clínica e demanda critério diagnóstico preciso. A prevalência de nódulos hepáticos macroscopicamente suspeitos (NHMS) em fígados com cirrose foi analisada para identificar macronódulo regenerativo (MNR), nódulo displásico e carcinoma hepatocelular (CHC) e para avaliar a associação de NHMS e CHC. Nódulos hepáticos maiores que 1cm com cor e textura diferentes dos demais nódulos da cirrose em cada peça foram definidos como NHMS. Sessenta e um fígados explantados por cirrose foram seccionados em fatias de 0,5 a 0,7cm e NHMS e amostras de áreas aleatórias do fígado foram examinadas histologicamente. Noventa e quatro NHMS foram identificados em 26 fígados (à histologia
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