194 results on '"surgical models"'
Search Results
2. Overview of Benchtop Models for Comparison of Surgical Treatments for Benign Prostatic Hyperplasia.
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Birdsall, Kevin and Gonzalez, Ricardo R.
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Purpose of Review: Benign prostatic hyperplasia (BPH) is a disease of the lower urinary tract which often requires surgical treatment. Recently, there has been a deluge of new treatment options, rarely validated or compared to current treatments on a benchtop model. The purpose of this review is to examine the literature and report which benchtop models are currently being used, which therapies have been tested on them, and what outcomes are being studied on each model. Recent Findings: There are various benchtop models to choose from, each with their unique benefits and drawbacks. Perfused porcine kidney models are used to assess bleeding on the benchtop, ex-vivo human prostate helps to see specific interactions of devices with the prostatic tissue, and all other models have evaluated tissue ablation rates and depth of coagulation. There are currently no synthetic or non-animal tissues being used for this purpose, and surgical techniques such as enucleation, water-jet ablation, prostate stents, and water vapor thermal therapy have no representation in these benchtop tests. Summary: Benchtop testing serves an important role in the evaluation and comparison of surgical treatments for BPH. This testing allows these therapies to be objectively compared to one another, helping novel medical devices in their path to market and urologists make treatment decisions. Future directions may include further validation of the animal models currently being used and development of synthetic models which mimic the prostate on the benchtop. [ABSTRACT FROM AUTHOR]
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- 2023
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3. Biomedical Applications of the Fused Filament Fabrication (FFF) Technology
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Buj-Corral, Irene, Herranz-Diez, Carolina, Tejo-Otero, Aitor, Otero, Jordi, Sheikh, Faheem Arjamend, editor, Majeed, Shafquat, editor, and Beigh, Mushtaq A., editor
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- 2023
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4. Patient‐specific 3D printed models for enhanced learning of immediate implant procedures and provisionalization.
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Hu, Liqun, Rong, Rong, Song, Wenjuan, Wu, Hongzhao, Jia, Shuqing, He, Zhixiao, and Sa, Yue
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TRAINING of surgeons , *STEREOLITHOGRAPHY , *WILCOXON signed-rank test , *DENTAL extraction , *SIMULATION methods & models , *OPERATIVE surgery - Abstract
Introduction: This study aimed to describe the fabrication, implementation and evaluation of 3D‐printed patient‐specific models for unskilled students to enhance learning in immediate implant procedures and provisionalization. Materials and Methods: The individualized simulation models were designed and processed based on CT and digital intraoral scanning of a patient. Thirty students performed simulation implant surgery and provisionalized the implant sites on the models and answered questionnaires to assess their perceptions before and after the training. The scores of the questionnaires were analysed using the Wilcoxon signed‐rank test. Results: Significant differences before and after training were found in the students' responses. Students reported better results in understanding of surgical procedures, knowledge in prosthetically driven implantology, understanding of minimally invasive tooth extraction, confirming the accuracy of surgical template, usage of the guide rings and usage of the surgical cassette after simulation training. The overall expenditure on the simulation training involving 30 students amounted to 342.5 USD. Conclusions: The patient‐specific and cost‐efficient 3D printed models are helpful for students to improve theoretical knowledge and practical skills. Such individualized simulation models have promising application prospects. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Effects of standardized language on remote ultrasound-guided percutaneous nephrolithotomy training: A mixed-methods explorative pilot study
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David Denisov, Coral Castro-Olmo, Leslie Bernal Charondo, Heiko Yang, Sandrijn Van Schaik, and David Bayne
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Surgical training ,Simulation training ,Telementoring ,Distance learning ,Communication ,Surgical models ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Background: Remote teaching of procedural skills has demonstrated equivalence in knowledge acquisition compared to in-person teaching. Variations in terminology for probe and needle movements may serve as a barrier in remote training of ultrasound (US)-guided renal access for percutaneous nephrolithotomy (PCNL). This pilot study investigated the utility of standardized terminology in remote training of US-guided renal access for PCNL. Hypothesis: Standardization of verbal terminology to describe US probe and needle movement instruction improves remote teaching of US-guided renal access. Methods: Fifteen urology residents (PGY1-6) were stratified by year and randomized into two groups. We provided participants with images illustrating US probe and needle movements labeled with predetermined standardized terminology for the intervention group and images without labels for the control group. Both groups were asked to perform US-guided renal access on a training mannequin with a remote faculty educator with (intervention) or without (control) use of standardized movement instructions. Quantitative outcomes included number of attempts and time to achieve access. All trainees completed pre- and post-session surveys and participated in focus groups; authors conducted thematic analysis of focus group transcripts. Results: Differences in primary outcomes between groups, including number of attempts and time to achieve access of the renal pole, were not statistically significant. Analysis of focus group interviews revealed that the use of standardized terminology in the setting of remote training can reduce trainee confusion by clarifying ambiguity in educator feedback. Discussion: Use of standardized terminology during remote surgical skills training allows for more effective feedback to trainees.
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- 2023
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6. Evaluation of veterinary students' confidence and competence with surgical entrustable professional activities after repeated use of low-fidelity training models.
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Thompson, Jamie-Leigh, MacKay, Jill, and Blacklock, Kelly Bowlt
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VETERINARY students ,COLLEGE curriculum ,CONFIDENCE ,PSYCHOLOGY of students ,STUDENT attitudes ,EYELIDS - Published
- 2023
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7. A review on experimental surgical models and anesthetic protocols of heart failure in rats
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Ahmed Farag, Ahmed S. Mandour, Hanan Hendawy, Asmaa Elhaieg, Ahmed Elfadadny, and Ryou Tanaka
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heart failure ,rats ,surgical models ,anesthesia ,myocardial infarction ,Veterinary medicine ,SF600-1100 - Abstract
Heart failure (HF) is a serious health and economic burden worldwide, and its prevalence is continuously increasing. Current medications effectively moderate the progression of symptoms, and there is a need for novel preventative and reparative treatments. The development of novel HF treatments requires the testing of potential therapeutic procedures in appropriate animal models of HF. During the past decades, murine models have been extensively used in fundamental and translational research studies to better understand the pathophysiological mechanisms of HF and develop more effective methods to prevent and control congestive HF. Proper surgical approaches and anesthetic protocols are the first steps in creating these models, and each successful approach requires a proper anesthetic protocol that maintains good recovery and high survival rates after surgery. However, each protocol may have shortcomings that limit the study's outcomes. In addition, the ethical regulations of animal welfare in certain countries prohibit the use of specific anesthetic agents, which are widely used to establish animal models. This review summarizes the most common and recent surgical models of HF and the anesthetic protocols used in rat models. We will highlight the surgical approach of each model, the use of anesthesia, and the limitations of the model in the study of the pathophysiology and therapeutic basis of common cardiovascular diseases.
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- 2023
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8. Use of wound edge inversion (epibole) to generate recalcitrant and inflamed diabetic wounds.
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Lee, Phoebe L., Loder, Shawn J., Guerrero, David T., Nerone, W. Vincent, Bengur, Fuat Baris, Rubin, J. Peter, and Kokai, Lauren E.
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DIABETES complications , *WOUND healing , *EXPERIMENTAL design , *FLOW cytometry , *CHRONIC wounds & injuries , *INFLAMMATION , *ANIMAL experimentation , *T-test (Statistics) , *GRANULATION tissue , *EPITHELIAL cells , *ANIMALS , *MICE , *WOUND care - Abstract
Robust and predictive pre‐clinical models of recalcitrant diabetic wounds are critical for advancing research efforts toward improving healing. Murine models have logistic and genetic benefits versus larger animals; however, native murine healing inadequately represents clinically recalcitrant wounds in humans. Furthermore, current humanization techniques employing devices, deleterious mutations or chemical agents each carry model‐specific limitations. To better replicate human wounds in a mouse, we developed a novel wound‐edge inversion (WEI) technique that mimics the architecture of epibole and mitigates contracture, epithelialization, and consequently wound closure. In this study, we evaluated the reliability and durability of the WEI model in wild‐type and obese diabetic mice and compared to healing after (i) punch biopsy, (ii) mechanical/silicone stenting or (iii) exogenous oxidative stressors. In wild‐type mice, WEI demonstrated favourable closure characteristics compared to both control and stented wounds, however, wounds progressed to closure by 4 weeks. In contrast, diabetic WEI wounds persisted for 6–10 weeks with reduced contracture and epithelialization. In both diabetic and wild‐type mice, WEI sites demonstrated persistence of inflammatory populations, absence of epithelialization, and histologic presence of alpha‐SMA positive granulation tissue when compared to controls. We conclude that the WEI technique is particularly valuable for modelling recalcitrant diabetic wounds with sustained inflammation and dysfunctional healing. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Evaluation of the Effectiveness and Reproducibility of Biological Models of Chronic Heart Failure.
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Bolotskikh, V. I., Makeeva, A. V., Lushchik, M. V., Mokasheva, Ek. N., Mokasheva, Ev. N., and Shishkina, V. V.
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Chronic heart failure (CHF) has attracted the attention of researchers and doctors for a long time, because, unfortunately, the number of patients with this pathology grows every year. The study of the etiology, pathogenesis, treatment methods, and possible consequences of CHF is important for effective therapy and prevention. Cardiac pathology is characterized by the appearance of shortness of breath, development of chronic fatigue, edema, decreased physical activity due to disruption of normal perfusion of organs and tissues, and the development of chronic hypoxia. In this regard, modeling of heart failure in animals seems to be very relevant and promising, as it makes it possible to study the etiopathogenetic features of the development of CHF and its complications in detail. The preclinical stage of the study of drugs on animals allows evaluation of the mechanism of action of the drug, choose the right dosage, and describe side effects. The use of small rodents in the creation of CHF models is less time-consuming and economically more feasible than conducting research on large animals. This article provides an analysis of the effectiveness and reproducibility of biological models of CHF. We describe the most common modern surgical and pharmacological models, experimental methods, crucial hemodynamic and histomorphological changes observed during the development of CHF in animals, and the disadvantages and advantages of different types of modeling. [ABSTRACT FROM AUTHOR]
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- 2022
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10. The state of remote learning in plastic surgery: A systematic review of modalities
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Akshilkumar Patel, Sameer Massand, and John Ingraham
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Systematic review ,Plastic surgery ,Virtual simulation ,Surgical models ,Online education ,Surgery ,RD1-811 - Abstract
Objective: To systematically review the published literature describing remote alternative educational modalities for plastic surgery residents. Design: Systematic review. Setting: Independent investigators performed searches in the PubMed and Cochrane Library databases using a variety of MeSH terms and search term combinations. These studies were evaluated for inclusion based on PRISMA criteria. Participants: Literature searches were performed from June to December 2020, and articles were collected if they met the inclusion criteria. Studies were also qualitatively assessed to determine whether the described education modality demonstrated high fidelity (anatomic accuracy and similarity to true surgery) and efficacy (improved trainee performance in a standardized skills evaluation). Results: Initial database searches resulted in 2,849 total articles. Of these, 451 articles were deemed relevant for screening, and after applying additional exclusion criteria, 202 articles were assessed for eligibility. Of these, 66 articles met the inclusion criteria and were included in the qualitative synthesis. Articles were organized into three broad categories: physical models (n = 42, 63.7%), virtual simulators (n = 16, 24.2%), and online resources (n = 8, 12.1%). Among the physical models, we identified 15 high fidelity, 20 high efficacy, 5 high fidelity and high efficacy, and 2 high efficacy but low fidelity models. Among the virtual simulators, 6 demonstrated high fidelity, 8 high efficacy, and 2 demonstrated both values. Among the online resources, 3 showed high fidelity and 3 showed high efficacy. Conclusions: A variety of remote training modalities have been published, including articles describing virtual surgical simulators, virtual and physical anatomic models, and online resources with video modules. Further investigation is needed to evaluate how effectively training received through remote means translates to practice in live clinical scenarios in the operating room. ACGME competency addressed: Practice-based Learning and Improvement.
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- 2022
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11. Preclinical models of acute liver failure: a comprehensive review.
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Hefler, Joshua, Marfil-Garza, Braulio A., Pawlick, Rena L., Freed, Darren H., Karvellas, Constantine J., Bigam, David L., and Shapiro, A. M. James
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LIVER failure ,ANIMAL models in research - Abstract
Acute liver failure is marked by the rapid deterioration of liver function in a previously well patient over period of days to weeks. Though relatively rare, it is associated with high morbidity and mortality. This makes it a challenging disease to study clinically, necessitating reliance on preclinical models as means to explore pathophysiology and novel therapies. Preclinical models of acute liver failure are artificial by nature, and generally fall into one of three categories: surgical, pharmacologic or immunogenic. This article reviews preclinical models of acute liver failure and considers their relevance in modeling clinical disease. [ABSTRACT FROM AUTHOR]
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- 2021
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12. Preclinical models of acute liver failure: a comprehensive review
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Joshua Hefler, Braulio A. Marfil-Garza, Rena L. Pawlick, Darren H. Freed, Constantine J. Karvellas, David L. Bigam, and A. M. James Shapiro
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Acute liver failure ,Preclinical models ,Surgical models ,Toxicity models ,Medicine ,Biology (General) ,QH301-705.5 - Abstract
Acute liver failure is marked by the rapid deterioration of liver function in a previously well patient over period of days to weeks. Though relatively rare, it is associated with high morbidity and mortality. This makes it a challenging disease to study clinically, necessitating reliance on preclinical models as means to explore pathophysiology and novel therapies. Preclinical models of acute liver failure are artificial by nature, and generally fall into one of three categories: surgical, pharmacologic or immunogenic. This article reviews preclinical models of acute liver failure and considers their relevance in modeling clinical disease.
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- 2021
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13. A fresh take: Surgical simulation for Mohs layers.
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Abdulhak, Abraham H. and Gillen, William S.
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- 2024
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14. Animal Models and Cardiac Extracellular Matrix Research
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Hacker, Timothy A., COHEN, IRUN R., Series Editor, LAJTHA, ABEL, Series Editor, LAMBRIS, JOHN D., Series Editor, PAOLETTI, RODOLFO, Series Editor, Rezaei, Nima, Series Editor, Schmuck, Eric G., editor, Hematti, Peiman, editor, and Raval, Amish N., editor
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- 2018
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15. Recent approaches in clinical applications of 3D printing in neonates and pediatrics.
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V S, Sukanya, Panigrahy, Nalinikanta, and Rath, Subha Narayan
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THREE-dimensional printing , *NEWBORN infants , *MEDICAL care , *CHILD mortality , *INFANT mortality - Abstract
Neonates and pediatric populations are vulnerable subjects in terms of health. Proper screening and early optimal treatment would reduce infant and child mortality, improving the quality of life. Researchers and clinicians all over the world are in pursuit of innovations to improve the medical care delivery system. Infant morphometrics changes drastically due to the rapid somatic growth in infancy and childhood, demanding for patient-specific customization of treatment intervention accordingly. 3D printing is a radical technology that allows the generation of physical 3D products from digital images and addresses the patient-specific requirement. The combination of cost-effective and on-demand customization offers a boundless opportunity for the enhancement of neonates and pediatric health. Conclusion: The advanced technology of 3D printing proposes a pioneering breakthrough in bringing physiologically and anatomically appropriate treatment strategies addressing the unmet needs of child health problems. What is Known: • The potential application of 3D printing is observed across a multitude of fields within medicine and surgery. • The unprecedented effect of this technology on pediatric healthcare is still very much a work in progress. What is New: • The recent clinical applications of 3D printing provide better treatment modalities to infants and children. • The review provides an overview of the comparison between conventional treatment methods and 3DP regarding specific applications [ABSTRACT FROM AUTHOR]
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- 2021
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16. Animal Models of Peripheral Pain: Biology Review and Application for Drug Discovery.
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PERIPHERAL nervous system , *PAIN measurement , *EMOTIONAL conditioning , *ANIMAL models in research , *CENTRAL nervous system , *BIOLOGY , *SYNAPSES - Abstract
Pain is a complex constellation of cognitive, unpleasant sensory, and emotional experiences that primarily serves as a survival mechanism. Pain arises in the peripheral nervous system and pain signals synapse with nerve tracts extending into the central nervous system. Several different schemes are used to classify pain, including the underlying mechanism, tissues primarily affected, and time-course. Numerous animal models of pain, which should be employed with appropriate Institutional Animal Care and Use approvals, have been developed to elucidate pathophysiology mechanisms and aid in identification of novel therapeutic targets. The variety of available models underscores the observations that pain phenotypes are driven by several distinct mechanisms. Pain outcome measurement encompasses both reflexive (responses to heat, cold, mechanical and electrical stimuli) and nonreflexive (spontaneous pain responses to stimuli) behaviors. However, the question of translatability to human pain conditions and potential treatment outcomes remains a topic of continued scrutiny. In this review we discuss the different types of pain and their mechanisms and pathways, available rodent pain models with an emphasis on type of pain stimulations and pain outcome measures and discuss the role of pathologists in assessing and validating pain models. [ABSTRACT FROM AUTHOR]
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- 2020
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17. Evaluation of surgical confidence and competence with surgical EPAs after repeated use of low-fidelity training models in veterinary students
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Thompson, Jamie-Leigh, MacKay, Jill R D, and Blacklock, Kelly
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surgical models ,entrustable professional activities ,veterinary education ,veterinary students ,surgical training - Abstract
Background: The study aimed to evaluate if low-fidelity surgical training models increased students’ surgical confidence and competence and decreased procedural stress relating to core surgical entrustable professional activities (EPAs).Methods: Final-year students repeatedly performed one of three surgical EPAs on a low-fidelity surgical training model (canine castration, subcutaneous lump removal and eyelid laceration repair) and completed a survey at set time-points. A grading rubric was used to assess participant competence in performing the assigned EPA at 2 different time-points. Survey results and competency gradings were compiled and analysed.Results: Student self-assessed confidence increased, and stress decreased significantly between assessment points on all 3 EPA surgical training models. Graded competence significantly improved on all training models between the assessment points and most students deemed the model’s to be realistic and helpful for student practices.Conclusions: Repeated exposure to low-fidelity surgical training models, increased final-year students’ surgical confidence, competence and reduced procedural stress relating to 3 key surgical EPAs. Assessment of competence using a grading rubric, was successful and could be incorporated into a competence-based veterinary education assessment framework to allow screening of competence prior to graduation.Limitations: Limitations relate to the study involving a single cohort from a single institute and the reliance on student self-assessment.
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- 2023
18. Surgical and physiological challenges in the development of left and right heart failure in rat models.
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Katz, Michael G., Fargnoli, Anthony S., Gubara, Sarah M., Chepurko, Elena, Bridges, Charles R., and Hajjar, Roger J.
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HEART failure ,RATS ,CORONARY arteries ,MYOCARDIAL infarction ,PROOF of concept ,VENTRICULAR ejection fraction - Abstract
Rodent surgical animal models of heart failure (HF) are critically important for understanding the proof of principle of the cellular alterations underlying the development of the disease as well as evaluating therapeutics. Robust, reproducible rodent models are a prerequisite to the development of pharmacological and molecular strategies for the treatment of HF in patients. Due to the absence of standardized guidelines regarding surgical technique and clear criteria for HF progression in rats, objectivity is compromised. Scientific publications in rats rarely fully disclose the actual surgical details, and technical and physiological challenges. This lack of reporting is one of the main reasons that the outcomes specified in similar studies are highly variable and associated with unnecessary loss of animals, compromising scientific assessment. This review details rat circulatory and coronary arteries anatomy, the surgical details of rat models that recreate the HF phenotype of myocardial infarction, ischemia/reperfusion, left and right ventricular pressure, and volume overload states, and summarizes the technical and physiological challenges of creating HF. The purpose of this article is to help investigators understand the underlying issues of current HF models in order to reduce variable results and ensure successful, reproducible models of HF. [ABSTRACT FROM AUTHOR]
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- 2019
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19. Limited impact of a top-down approach to improve enhanced recovery programme in French university hospitals: a before-after retrospective survey
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Dominique Fletcher, Nawal Derridj, Anissa Belbachir, Philippe Aegerter, Lionelle Nkam, Eva Battaglia, Hakim Harkouk, Perrine Capmas, and Laure Tharel
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medicine.medical_specialty ,Hysterectomy ,Post-operative complications ,RD1-811 ,business.industry ,medicine.medical_treatment ,General surgery ,Research ,Total knee arthroplasty ,University hospital ,Chart ,Enhanced recovery ,Retrospective survey ,Medicine ,Length of stay ,Surgical Models ,Surgery ,business ,Colectomy - Abstract
Background Enhanced recovery programme (ERP) after surgery needs development in Assistance Publique Hôpitaux de Paris (APHP). Methods A retrospective before-and-after study was performed in 2015 and 2017 on three surgical models (total knee arthroplasty (TKA), colectomy and hysterectomy) in 17 hospitals including 29 surgical departments. Data were collected in one control intervention (total hip arthroplasty (THA), gastrectomy and ovariectomy). In 2016, Massive Open Online Course on ERP and a day meeting information were developed by APHP. A national update on ERP was also organized by HAS and a regional professional partnership programme was started. Primary outcomes were length of stay (LOS) and complications after surgery. Data on ERP items were collected in the patients’ chart and in anaesthetist and surgeon interview. Seventy percent application rate reflects application of ERP procedure. Results 1321 patient’s files were analysed (812 in 2015 and 509 in 2017). The LOS (mean (SD)) is reduced by 1.6 day for TKA (2015, 8.7 (6.7) versus 7.1 (3.4) in 2017; p70% application) increased respectively from 5 to 7 out of 17 and 16 in 2015 and 2017. For colectomy, they were stable at 6 out of 21 in 2015 and 2017. The mean application rates of ERP items stayed below 50% in all cases in 2017. The LOS was negatively correlated with ERP items’ application when data collected in 2015 and 2017 were analysed together. Conclusion ERP application did not significantly improved between 2015 and 2017 for three surgical models after an institutional information and diffusion of recommendations in 29 surgical departments of seventeen French University hospitals underlining the limit of a top-down approach.
- Published
- 2021
20. Effects of standardized language on remote ultrasound-guided percutaneous nephrolithotomy training: A mixed-methods explorative pilot study.
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Denisov D, Castro-Olmo C, Charondo LB, Yang H, Van Schaik S, and Bayne D
- Abstract
Background: Remote teaching of procedural skills has demonstrated equivalence in knowledge acquisition compared to in-person teaching. Variations in terminology for probe and needle movements may serve as a barrier in remote training of ultrasound (US)-guided renal access for percutaneous nephrolithotomy (PCNL). This pilot study investigated the utility of standardized terminology in remote training of US-guided renal access for PCNL., Hypothesis: Standardization of verbal terminology to describe US probe and needle movement instruction improves remote teaching of US-guided renal access., Methods: Fifteen urology residents (PGY1-6) were stratified by year and randomized into two groups. We provided participants with images illustrating US probe and needle movements labeled with predetermined standardized terminology for the intervention group and images without labels for the control group. Both groups were asked to perform US-guided renal access on a training mannequin with a remote faculty educator with (intervention) or without (control) use of standardized movement instructions. Quantitative outcomes included number of attempts and time to achieve access. All trainees completed pre- and post-session surveys and participated in focus groups; authors conducted thematic analysis of focus group transcripts., Results: Differences in primary outcomes between groups, including number of attempts and time to achieve access of the renal pole, were not statistically significant. Analysis of focus group interviews revealed that the use of standardized terminology in the setting of remote training can reduce trainee confusion by clarifying ambiguity in educator feedback., Discussion: Use of standardized terminology during remote surgical skills training allows for more effective feedback to trainees., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:David Bayne reports financial support was provided by National Institute of Diabetes and Digestive and Kidney Disorders., (© 2023 The Authors.)
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- 2023
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21. 3D Printed Surgical Simulation Models as educational tool by maxillofacial surgeons.
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Werz, S. M., Zeichner, S. J., Berg, B.‐i., Zeilhofer, H.‐f., and Thieringer, F.
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SURGICAL technology , *THREE-dimensional printing , *SIMULATION methods in higher education , *VIRTUAL reality in medicine , *MAXILLOFACIAL surgery , *EDUCATION - Abstract
Abstract: Introduction: The aim of this study was to evaluate whether inexpensive 3D models can be suitable to train surgical skills to dental students or oral and maxillofacial surgery residents. Furthermore, we wanted to know which of the most common filament materials, acrylonitrile butadiene styrene (ABS) or polylactic acid (PLA), can better simulate human bone according to surgeons' subjective perceptions. Materials and Methods: Upper and lower jaw models were produced with common 3D desktop printers, ABS and PLA filament and silicon rubber for soft tissue simulation. Those models were given to 10 blinded, experienced maxillofacial surgeons to perform sinus lift and wisdom teeth extraction. Evaluation was made using a questionnaire. Results: Because of slightly different density and filament prices, each silicon‐covered model costs between 1.40‐1.60 USD (ABS) and 1.80‐2.00 USD (PLA) based on 2017 material costs. Ten experienced raters took part in the study. All raters deemed the models suitable for surgical education. No significant differences between ABS and PLA were found, with both having distinct advantages. Conclusion: The study demonstrated that 3D printing with inexpensive printing filaments is a promising method for training oral and maxillofacial surgery residents or dental students in selected surgical procedures. With a simple and cost‐efficient manufacturing process, models of actual patient cases can be produced on a small scale, simulating many kinds of surgical procedures. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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22. 3D Printing in Fiber-Device Technology
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Veda Narayana Koraganji, Meve Gokce Kurtoglu, Mengxin Zheng, Louis A. van der Elst, Camila Faccini de Lima, and Alexander Gumennik
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0303 health sciences ,business.industry ,Fiber (computer science) ,Mechanical engineering ,3D printing ,02 engineering and technology ,General Medicine ,021001 nanoscience & nanotechnology ,Direct digital manufacturing ,03 medical and health sciences ,Surgical Models ,0210 nano-technology ,business ,030304 developmental biology ,Electronic circuit - Abstract
Abstract Recent advances in additive manufacturing enable redesigning material morphology on nano-, micro-, and meso-scale, for achieving an enhanced functionality on the macro-scale. From non-planar and flexible electronic circuits, through biomechanically realistic surgical models, to shoe soles individualized for the user comfort, multiple scientific and technological areas undergo material-property redesign and enhancement enabled by 3D printing. Fiber-device technology is currently entering such a transformation. In this paper, we review the recent advances in adopting 3D printing for direct digital manufacturing of fiber preforms with complex cross-sectional architectures designed for the desired thermally drawn fiber-device functionality. Subsequently, taking a recursive manufacturing approach, such fibers can serve as a raw material for 3D printing, resulting in macroscopic objects with enhanced functionalities, from optoelectronic to bio-functional, imparted by the fiber-devices properties. Graphic abstract
- Published
- 2021
23. Security of 3D-printed polylactide acid piece sterilization in the operating room: a sterility test
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Oihana Sabalza-Baztán, Carolina De-La-Calva Ceinos, Jose Vicente Amaya-Valero, Manuel Ángel Angulo-Sánchez, Francisco Baixauli-García, Joan Ferràs-Tarragó, and Jose Miguel Sahuquillo-Arce
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Operating Rooms ,3d printed ,Polyesters ,Critical Care and Intensive Care Medicine ,Autoclave ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Polylactic acid ,Humans ,Medicine ,Sterility test ,Orthopedics and Sports Medicine ,030222 orthopedics ,business.industry ,Sterilization ,030208 emergency & critical care medicine ,Sterilization (microbiology) ,Mechanical resistance ,Culture Media ,Biological safety ,chemistry ,Infertility ,Printing, Three-Dimensional ,Emergency Medicine ,Gentian Violet ,Surgery ,Surgical Models ,business ,Biomedical engineering - Abstract
3D-printing technology has become very popular the last 10 years, and their advantages have been widely proved. However, its safety in the operating room after sterilization has not been evaluated. Thus, the use of 3D printing is still questioned. The aim of this work is to evaluate the security of polylactic acid (PLA) to print surgical models after its sterilization. One hundred and eighty-six PLA plates and 6 negative controls without microorganisms were seeded. After 10 days of culture, the PLA plates were randomized into three groups: A, B, and C. Group A underwent a sterilization process using an autoclave program at 134 °C. Group B was seeded in different culture media and group C was used to make crystal violet stains on the biofilms formed on the PLA. Mechanical properties of PLA after autoclave sterilization including, the breaking load, deformation and breaking load per surface were calculated. Hundred percent of the group B showed monomicrobial growth. Stains performed on group C PLA showed biofilms in all PLA pieces. After sterilization, no pathogen growth was observed in group A during the culture observation period showing 100% sterilization effectiveness. A filling percentage of 5% obtained a breaking load of 6.36 MPa, and its elastic limit occurred after an elongation of 167.4%. A 10% infill was mechanically safe. Autoclave sterilization of PLA-printed pieces is safe for the patient and mechanically strong for the surgeon. This is the first 3D-printing protocol described and evaluated to implement 3D-printing technology safely in the operating room. This is the first 3D-printing protocol described to print and sterilize 3D biomodels using an autoclave showing its biological safety and its mechanical resistance.
- Published
- 2021
24. Comparison of swallowing outcomes of laryngotracheal separation versus total laryngectomy in a validated ovine model of profound oropharyngeal dysphagia.
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Venkatesan, N N, Johnson, C M, Siddiqui, M T, Cates, D J, Kuhn, M A, Postma, G N, and Belafsky, P C
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ANIMAL experimentation , *BARIUM , *BIOLOGICAL models , *DEAD , *DEGLUTITION disorders , *FLUOROSCOPY , *LARYNGECTOMY , *SHEEP , *TRACHEOTOMY , *TREATMENT effectiveness , *DESCRIPTIVE statistics - Abstract
Objectives:To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy.Methods:Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre- and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model.Results:Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra- and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001).Conclusion:The ovine model displayed perfect intra- and inter- species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation. [ABSTRACT FROM PUBLISHER]
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- 2017
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25. USO DE MODELOS EXPERIMENTAIS ALTERNATIVOS NO TREINAMENTO DE TÉCNICAS DE MICROCIRURGIA PARA ALUNOS DE GRADUAÇÃO EM MEDICINA.
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HERRMANN, Fábio, PESENATTO, Gustavo Guthmann, GOLDANI, Eduardo, and SILVA, Jefferson Braga
- Abstract
In Brazil, there is a great lack of micro-surgeons due to the fact that the training is long, expensive and requires a lot of dedication. With the outbreak of Committee on Animal Research and Ethics, it becomes increasingly restricted the surgical training of academics using small and medium-sized animals. The objective of this work was to report the training of medical academics of the Pontifical Catholic University of Rio Grande do Sul (PUCRS) in microsurgery in the repair of peripheral nerve lesions by means of the tubulization technique. The 12-week training was carried out in a research laboratory of the PUCRS Hospital-School, using a low-cost commercial experimental model (cooled chicken thigh purchased in the local market of the city of Porto Alegre) and consisted in the execution of incision techniques Medial to the femur, dissection of the adjacent structures and exposure of the sciatic nerve, sciatic nerve section and tubulization by suturing the proximal and distal nerve at the ends of the silicone tube. The training provided an evolution in the skill of the trained technicians aswell as in the time necessary for its accomplishment demonstrating that commercialized chicken pieces are an excellent model for the microsurgical training. [ABSTRACT FROM AUTHOR]
- Published
- 2017
26. Accuracy of root-end resection using a digital guide in endodontic surgery: An in vitro study
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Yu-Hong Liang, Zu-Hua Wang, Li Peng, Jing Zhao, and Yu-Chun Sun
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business.industry ,Root-end resection ,Dentistry ,Root end resection ,030206 dentistry ,3D printing ,Endodontic surgery ,Optical scanning ,Confidence interval ,Resection ,lcsh:RK1-715 ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,lcsh:Dentistry ,Digital guide ,Medicine ,In vitro study ,Surgical Models ,Original Article ,business ,General Dentistry ,Anterior teeth ,Accuracy - Abstract
Background/Purpose It is difficult to achieve accurate root-end resection clinically. This in vitro study was conducted to evaluate the operation accuracy of a digital endodontic surgical guide. Materials and methods 56 extracted maxillary anterior teeth were prepared for endodontic surgical models. The models were randomly divided into 4 groups equally according to the guide (with guide/no guide) and the operator (experienced/inexperienced). Endodontic microsurgeries were performed on models in each group. The deviations in length and angle of the root-end resection were measured based on the optical scanning data of the pre- and postoperative teeth. The general linear model was performed to analyze the effect of a guide on root-end resection deviation. Results Using a guide, the mean length deviation for experienced/inexperienced operators reduced from 0.99 mm (95% CI [confidence interval, CI], 0.66–1.33 mm)/1.18 mm (95% CI, 0.50–1.86 mm) to 0.31 mm (95% CI, 0.20–0.42 mm)/0.31 mm (95% CI, 0.24–0.37 mm). The mean angle deviation for experienced/inexperienced operators reduced from 16.74° (95% CI, 10.61–22.86°)/15.06° (95% CI, 9.19–20.94°) to 5.04° (95% CI, 3.31–6.77°)/6.79° (95% CI, 4.91–8.67°). The difference was significant between procedures performed with and without a guide (P Conclusion Application of the digital guide in vitro endodontic surgery could improve the accuracy of root-end resection.
- Published
- 2020
27. Systematic review and meta-analysis of current risk models in predicting short-term mortality after transcatheter aortic valve replacement
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Milind Y. Desai, M. Hassan Murad, Deepak L. Bhatt, Haris Riaz, Clifford J. Kavinsky, Safi U. Khan, Rami Doukky, Muhammad Arbaz Arshad Khan, Muhammad Shahzeb Khan, Muhammad Usman, Ankur Kalra, and Tariq Jamal Siddiqi
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medicine.medical_specialty ,Transcatheter aortic ,medicine.medical_treatment ,MEDLINE ,Short term mortality ,030204 cardiovascular system & hematology ,Risk Assessment ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,Risk Factors ,Internal medicine ,medicine ,Humans ,Hospital Mortality ,030212 general & internal medicine ,business.industry ,Aortic Valve Stenosis ,Odds ratio ,Treatment Outcome ,Aortic Valve ,Meta-analysis ,Cardiology ,Surgical Models ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business - Abstract
AIMS The aim of this study was to evaluate the performance of risk stratification models (RSMs) in predicting short-term mortality after transcatheter aortic valve replacement (TAVR). METHODS AND RESULTS MEDLINE and Scopus were queried to identify studies which validated RSMs designed to assess 30-day or in-hospital mortality after TAVR. Discrimination and calibration were assessed using C-statistics and observed/expected ratios (OERs), respectively. C-statistics were pooled using a random-effects inverse-variance method, while OERs were pooled using the Peto odds ratio. A good RSM is defined as one with a C-statistic >0.7 and an OER close to 1.0. Twenty-four studies (n=68,215 patients) testing 11 different RSMs were identified. Discrimination of all RSMs was poor (C-statistic
- Published
- 2020
28. Experimental Abdominal Sepsis: Sticking to an Awkward but Still Useful Translational Model
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Lorenzo Cobianchi, Federica Murando, and Andrea Peloso
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Lipopolysaccharides ,0301 basic medicine ,medicine.medical_specialty ,Immunology ,MEDLINE ,Review Article ,Scientific literature ,Peritonitis ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Abdominal sepsis ,lcsh:Pathology ,Animals ,Humans ,Medicine ,Intensive care medicine ,business.industry ,Cell Biology ,medicine.disease ,Disease Models, Animal ,030104 developmental biology ,030220 oncology & carcinogenesis ,Surgical Models ,business ,lcsh:RB1-214 - Abstract
Animal models are widely used to replicate human intra-abdominal infections. Different methodologies have been described and proposed in the scientific literature, including injection and surgical models. The aim of this review is to recapitulate the advantages and disadvantages of each method to help choose the most appropriate model for individual experimental purposes.
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- 2019
29. Procedure Increasing the Accuracy of Modelling and the Manufacturing of Surgical Templates with the Use of 3D Printing Techniques, Applied in Planning the Procedures of Reconstruction of the Mandible
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Łukasz Przeszłowski, Sławomir Wolski, Grzegorz Budzik, Jan Frańczak, Paweł Turek, Bogumił Lewandowski, T. Dziubek, and Paweł Pakla
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Rapid prototyping ,Reverse engineering ,Reconstructive surgery ,medicine.medical_specialty ,3D printing ,CAD ,virtual surgical planning ,computer.software_genre ,Article ,Resection ,DICOM ,medicine ,optical coordinate measurement system ,Medical physics ,medical engineering ,reconstructive surgery ,mechanical engineering ,additive manufacturing ,accuracy ,surgical models ,polymer material ,fibular free flap ,business.industry ,Mandible ,General Medicine ,Medicine ,business ,computer - Abstract
The application of anatomical models and surgical templates in maxillofacial surgery allows, among other benefits, the increase of precision and the shortening of the operation time. Insufficiently precise anastomosis of the broken parts of the mandible may adversely affect the functioning of this organ. Applying the modern mechanical engineering methods, including computer-aided design methods (CAD), reverse engineering (RE), and rapid prototyping (RP), a procedure used to shorten the data processing time and increase the accuracy of modelling anatomical structures and the surgical templates with the use of 3D printing techniques was developed. The basis for developing and testing this procedure was the medical imaging data DICOM of patients treated at the Maxillofacial Surgery Clinic of the Fryderyk Chopin Provincial Clinical Hospital in Rzeszów. The patients were operated on because of malignant tumours of the floor of the oral cavity and the necrosis of the mandibular corpus, requiring an extensive resection of the soft tissues and resection of the mandible. Familiarity with and the implementation of the developed procedure allowed doctors to plan the operation precisely and prepare the surgical templates and tools in terms of the expected accuracy of the procedures. The models obtained based on this procedure shortened the operation time and increased the accuracy of performance, which accelerated the patient’s rehabilitation in the further course of events.
- Published
- 2021
30. A review on experimental surgical models and anesthetic protocols of heart failure in rats.
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Farag A, Mandour AS, Hendawy H, Elhaieg A, Elfadadny A, and Tanaka R
- Abstract
Heart failure (HF) is a serious health and economic burden worldwide, and its prevalence is continuously increasing. Current medications effectively moderate the progression of symptoms, and there is a need for novel preventative and reparative treatments. The development of novel HF treatments requires the testing of potential therapeutic procedures in appropriate animal models of HF. During the past decades, murine models have been extensively used in fundamental and translational research studies to better understand the pathophysiological mechanisms of HF and develop more effective methods to prevent and control congestive HF. Proper surgical approaches and anesthetic protocols are the first steps in creating these models, and each successful approach requires a proper anesthetic protocol that maintains good recovery and high survival rates after surgery. However, each protocol may have shortcomings that limit the study's outcomes. In addition, the ethical regulations of animal welfare in certain countries prohibit the use of specific anesthetic agents, which are widely used to establish animal models. This review summarizes the most common and recent surgical models of HF and the anesthetic protocols used in rat models. We will highlight the surgical approach of each model, the use of anesthesia, and the limitations of the model in the study of the pathophysiology and therapeutic basis of common cardiovascular diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Farag, Mandour, Hendawy, Elhaieg, Elfadadny and Tanaka.)
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- 2023
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31. Modelos animales de fallo hepético fulminante Animal models of fulminant hepatic failure
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M. J. Tuñón, M. Álvarez, J. M. Culebras, and J. González-Gallego
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Fallo hepático fulminante ,Modelos quirúrgicos ,Modelos químicos ,Modelos víricos ,Fulminant hepatic failure ,Surgical models ,Chemical models ,Viral models ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
El fallo hepático fulminante (FHF) es un síndrome clínico muy grave, asociado con alta mortalidad, a pesar de los grandes avances que se han producido en los últimos años en la terapia tanto del manejo de los cuidados intensivos mediante diversos soportes hepáticos bioartificiales como del trasplante hepático. Tanto el conocimiento como el tratamiento del FHF han estado limitados por la falta de modelos animales satisfactorios. Así, han sido muchos los intentos de desarrollar un modelo adecuado, entre los que se incluyen los modelos quirúrgicos, tales como la hepatectomía y desvascularización total y/o parcial, la utilización de sustancias químicas con toxicidad hepática tales como el acetaminofeno, azoximetano, galactosamina, tioacetamida, entre otras. Ahora bien, la mayor parte de estos modelos no reflejan de modo idóneo el patrón de la enfermedad humana de FHF y todos ellos presentan importantes limitaciones. A pesar de que la hepatitis vírica es una de las etiologías más frecuentes de FHF, el uso de agentes víricos para desarrollar modelos animales ha sido escaso y desafortunado. Nuestro grupo ha desarrollado recientemente un modelo animal mediante la inoculación de conejos con el virus de la enfermedad hemorrágica del conejo que presenta características bioquímicas, histológicas y signos clínicos compatibles con el FHF del hombre. En el trabajo se resumen los modelos animales más utilizados asi como las ventajas e inconvenientes más reseñables de cada uno de ellos.Fulminant hepatic failure (FHF) is a very serious clinical síndrome that, in spite of the important therapeutical advances that have taken place in the last years by means of bioartifical hepatic support devices and hepatic transplantation, is still associated to a high mortality. Knowledge and treatment of the FHF have been limited by the lack of satisfactory animal models. Among the attempts to develop a suitable model are surgical models, such as hepatectomy and total and/or partial devascularization, or the use of chemical substances with hepatic toxicity, such as acetaminophen, azoximethane, galactosamine or thioacetamide, among others. However, most of these models do not adequatly reflect the pattern of the human disease and all of them present important limitations. Although viral hepatitis is one of the most frequent causes of FHF, the use of viral agents to develop animal models has been little and unfortunate. Our group has recently developed a viral animal model of FHF by means of the inoculation of rabbits with the virus of the rabbit hemorrhagic disease. This model displays biochemical, and histological characteristics, and clinical signs that ressemble those in human FHF. In the present article, the most widely used animal models of FHF, together with their main advantages and disadvantages, are presented.
- Published
- 2007
32. Accuracy of open-source software segmentation and paper-based printed three-dimensional models.
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Szymor, Piotr, Kozakiewicz, Marcin, and Olszewski, Raphael
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OPEN source software ,IMAGE segmentation ,THREE-dimensional modeling ,CONE beam computed tomography ,OPTICAL scanners ,MAXILLOFACIAL surgery - Abstract
In this study, we aimed to verify the accuracy of models created with the help of open-source Slicer 3.6.3 software (Surgical Planning Lab, Harvard Medical School, Harvard University, Boston, MA, USA) and the Mcor Matrix 300 paper-based 3D printer. Our study focused on the accuracy of recreating the walls of the right orbit of a cadaveric skull. Cone beam computed tomography (CBCT) of the skull was performed (0.25-mm pixel size, 0.5-mm slice thickness). Acquired DICOM data were imported into Slicer 3.6.3 software, where segmentation was performed. A virtual model was created and saved as an .STL file and imported into Netfabb Studio professional 4.9.5 software. Three different virtual models were created by cutting the original file along three different planes (coronal, sagittal, and axial). All models were printed with a Selective Deposition Lamination Technology Matrix 300 3D printer using 80 gsm A4 paper. The models were printed so that their cutting plane was parallel to the paper sheets creating the model. Each model (coronal, sagittal, and axial) consisted of three separate parts (∼200 sheets of paper each) that were glued together to form a final model. The skull and created models were scanned with a three-dimensional (3D) optical scanner (Breuckmann smart SCAN) and were saved as .STL files. Comparisons of the orbital walls of the skull, the virtual model, and each of the three paper models were carried out with GOM Inspect 7.5SR1 software. Deviations measured between the models analysed were presented in the form of a colour-labelled map and covered with an evenly distributed network of points automatically generated by the software. An average of 804.43 ± 19.39 points for each measurement was created. Differences measured in each point were exported as a .csv file. The results were statistically analysed using Statistica 10, with statistical significance set at p < 0.05. The average number of points created on models for each measurement was 804.43 ± 19.39; however, deviation in some of the generated points could not be calculated, and those points were excluded from further calculations. From 94% to 99% of the measured absolute deviations were <1 mm. The mean absolute deviation between the skull and virtual model was 0.15 ± 0.11 mm, between the virtual and printed models was 0.15 ± 0.12 mm, and between the skull and printed models was 0.24 ± 0.21 mm. Using the optical scanner and specialized inspection software for measurements of accuracy of the created parts is recommended, as it allows one not only to measure 2-dimensional distances between anatomical points but also to perform more clinically suitable comparisons of whole surfaces. However, it requires specialized software and a very accurate scanner in order to be useful. Threshold-based, manually corrected segmentation of orbital walls performed with 3D Slicer software is accurate enough to be used for creating a virtual model of the orbit. The accuracy of the paper-based Mcor Matrix 300 3D printer is comparable to those of other commonly used 3-dimensional printers and allows one to create precise anatomical models for clinical use. The method of dividing the model into smaller parts and sticking them together seems to be quite accurate, although we recommend it only for creating small, solid models with as few parts as possible to minimize shift associated with gluing. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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33. 3D printing technology in healthcare: applications, regulatory understanding, IP repository and clinical trial status
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Dipak Kumar Gupta, Pooja Jain, Asad Ali, Mohd Humair Ali, Khalid Anwer, Zeenat Iqbal, and Mohd. Aamir Mirza
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Knowledge management ,Scope (project management) ,business.industry ,education ,Anatomical structures ,Pharmaceutical Science ,3D printing ,02 engineering and technology ,Patient specific ,021001 nanoscience & nanotechnology ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Manufacturing ,Health care ,Printing, Three-Dimensional ,Humans ,Surgical Models ,Business ,0210 nano-technology ,Delivery of Health Care ,Tablets - Abstract
Mass consumerization of three-dimensional (3D) printing innovation has revolutionised admittance of 3D-printing in an expansive scope of ventures. When utilised predominantly for industrial manufacturing, 3D-printing strategies have rapidly attained acquaintance in different parts of health care industry. 3D-printing is a moderately new technology that has discovered promising applications in the medication conveyance and clinical areas. This review intends to explore different parts of 3D- printing innovation concerning pharmaceutical and clinical applications. Review on pharmaceutical products like tablets, caplets, films, polypills, microdots, biodegradable patches, medical devices (uterine and subcutaneous), patient specific implants, cardiovascular stents, etc. and prosthetics/anatomical structures, surgical models, organs and tissues created utilising 3D-printing is being presented. In addition, the regulatory understanding and current IP and clinical trial status pertaining to 3D fabricated products/medical applications have also been funnelled, garnering information from different web portals of regulatory agencies and databases. It is additionally certain that for such new innovations, there would be difficulties and questions before these are acknowledged as protected and viable. The circumstance demands purposeful and wary endeavours to acquire regulations which would at last prompt the accomplishment of this progressive innovation, thus various regulatory challenges faced have been conscientiously discussed.
- Published
- 2021
34. Insights From a Short-Term Protein–Calorie Restriction Exploratory Trial in Elective Carotid Endarterectomy Patients
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C. Keith Ozaki, Jose H Trevino-Villareal, Ming Tao, Jack Ruske, Michael R MacArthur, Andrew Bolze, Jennifer M Giulietti, James R. Mitchell, Suzannah Patterson, James J. O'Leary, Kaspar Trocha, M. Furkan Burak, Rachel N. Carmody, Peter Kip, Raul J. Guzman, and Karen J. Ho
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Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Calorie restriction ,Psychological intervention ,Nutritional Status ,Pilot Projects ,Bilophila ,Carotid endarterectomy ,030204 cardiovascular system & hematology ,Feces ,03 medical and health sciences ,0302 clinical medicine ,Preoperative Care ,Diet, Protein-Restricted ,medicine ,Humans ,Carotid Stenosis ,Prospective Studies ,Intensive care medicine ,Beneficial effects ,Aged ,Caloric Restriction ,030304 developmental biology ,Endarterectomy, Carotid ,0303 health sciences ,Exploratory trial ,business.industry ,General Medicine ,Vascular surgery ,Gastrointestinal Microbiome ,Treatment Outcome ,Elective Surgical Procedures ,Female ,Surgery ,Surgical Models ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Boston - Abstract
Background: Open vascular surgery interventions are not infrequently hampered by complication rates and durability. Preclinical surgical models show promising beneficial effects in modulating the host response to surgical injury via short-term dietary preconditioning. Here, we explore short-term protein–calorie restriction preconditioning in patients undergoing elective carotid endarterectomy to understand patient participation dynamics and practicalities of robust research approaches around nutritional/surgical interventions. Methods: We designed a pilot prospective, multicenter, randomized controlled study in patients undergoing carotid endarterectomy. After a 3:2 randomization to a 3-day preoperative protein–calorie restriction regimen (30% calorie/70% protein restriction) or ad libitum group, blood, clinical parameters, and stool samples were collected at baseline, pre-op, and post-op days 1 and 30. Subcutaneous and perivascular adipose tissues were harvested periprocedurally. Samples were analyzed for standard chemistries and cell counts, adipokines. Bacterial DNA isolation and 16S rRNA sequencing were performed on stool samples and the relative abundance of bacterial species was measured. Results: Fifty-one patients were screened, 9 patients consented to the study, 5 were randomized, and 4 completed the trial. The main reason for non-consent was a 3-day in-hospital stay. All 4 participants were randomized to the protein–calorie restriction group, underwent successful endarterectomy, reported no compliance difficulties, nor were there adverse events. Stool analysis trended toward increased abundance of the sulfide-producing bacterial species Bilophila wadsworthia after dietary intervention ( P = .08). Conclusions: Although carotid endarterectomy patients held low enthusiasm for a 3-day preoperative inpatient stay, there were no adverse effects in this small cohort. Multidisciplinary longitudinal research processes were successfully executed throughout the nutritional/surgical intervention. Future translational endeavors into dietary preconditioning of vascular surgery patients should focus on outpatient approaches.
- Published
- 2019
35. Evaluation of surgical models for training veterinary students to perform enterotomies
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Janet A. Grimes, Chad W. Schmiedt, Mandy L. Wallace, and Andrew H. Parks
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Models, Anatomic ,Veterinary medicine ,Swine ,Enterotomy ,Tissue handling ,Dogs ,Cadaver ,Surveys and Questionnaires ,Intestine, Small ,Animals ,Humans ,Medicine ,Horses ,Prospective Studies ,Students ,Digestive System Surgical Procedures ,General Veterinary ,business.industry ,Internship and Residency ,Small intestine ,Intestinal surgery ,Knot tying ,medicine.anatomical_structure ,Surgical Models ,Clinical Competence ,Clinical competence ,Education, Veterinary ,business - Abstract
Objective To compare surgical models for teaching enterotomies to students. Study design Prospective, randomized study. Sample population Second-year veterinary students (n = 59) and faculty surgeons/surgery residents (n = 19). Methods Participants performed an enterotomy on each of 3 models (equine cadaver intestine, SurgiReal small intestine simulator, and SynDaver canine bowel) and completed a survey comparing them to either an enterotomy on an anesthetized pig (students) or intestinal surgery experience (faculty/residents). Surveys results were compiled and analyzed. Results Both student and faculty/resident groups rated cadaver intestine as more similar to live intestine compared with the synthetic models for incision, tissue handling, mucosal eversion, needle passage, knot tying, and best preparing for live intestine. Students rated SynDaver as more similar to live intestine than SurgiReal for incision and ranked SurgiReal as more similar to live intestine than SynDaver for mucosal eversion. There was no difference between the ranks assigned to SurgiReal and SynDaver for faculty/residents. Faculty/residents responded most often that cadaver intestine would be the model they recommend for training students. Conclusion Cadaver intestine was the model most similar to live intestine for all variables tested. SurgiReal and SynDaver models were comparable to each other but did not simulate live intestine as well as cadaver intestine. Clinical significance Cadaver intestine more closely approximated live intestine compared with either synthetic model. SurgiReal and SynDaver may be adequate alternatives if cadaver intestine is unavailable.
- Published
- 2019
36. Choosing a mouse model of venous thrombosis: a consensus assessment of utility and application
- Author
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Steven P. Grover, Olivia R. Palmer, Nigel Mackman, Thomas W. Wakefield, Alberto Smith, Brian C. Cooley, Peter K. Henke, Jose A. Diaz, Prakash Saha, and Brajesh K. Lal
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Consensus ,Computer science ,Deep vein ,030204 cardiovascular system & hematology ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Species Specificity ,medicine ,Animals ,Intensive care medicine ,Blood Coagulation ,Venous Thrombosis ,business.industry ,Model selection ,Reproducibility of Results ,Experimental Animal Models ,Hematology ,medicine.disease ,Thrombosis ,Disease Models, Animal ,Venous thrombosis ,030104 developmental biology ,medicine.anatomical_structure ,Surgical Models ,Cardiology and Cardiovascular Medicine ,business ,Venous thromboembolism - Abstract
Murine models are widely used valuable tools to study deep vein thrombosis. Leading experts in venous thrombosis research came together through the American Venous Forum to develop a consensus on maximizing the utility and application of available mouse models of venous thrombosis. In this work, we provide an algorithm for model selection, with discussion of the advantages, disadvantages, and applications of the main mouse models of venous thrombosis. Additionally, we provide a detailed surgical description of the models with guidelines to validate surgical technique.
- Published
- 2019
37. Challenges in creating dissectible anatomical 3D prints for surgical teaching
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Quentin A. Fogg, Michelle D. Lazarus, Paul G. McMenamin, John Crock, Ratheesraj Ratinam, and Michelle R. Quayle
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Models, Anatomic ,0301 basic medicine ,3d printed ,Histology ,Teaching Materials ,Computer science ,education ,Anatomical structures ,ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION ,3D printing ,Review Article ,Tissue handling ,Specialties, Surgical ,Biomechanical Phenomena ,03 medical and health sciences ,0302 clinical medicine ,Human–computer interaction ,Humans ,Simulation Training ,Molecular Biology ,Ecology, Evolution, Behavior and Systematics ,Biomedical and Dental Materials ,ComputingMethodologies_COMPUTERGRAPHICS ,Haptic technology ,Education, Medical ,business.industry ,Cell Biology ,Surgical training ,030104 developmental biology ,Printing, Three-Dimensional ,Surgical Models ,Anatomy ,business ,030217 neurology & neurosurgery ,Developmental Biology - Abstract
Three-dimensional (3D) printing, or additive manufacturing, is now a widely used tool in pre-operative planning, surgical teaching and simulator training. However, 3D printing technology that produces models with accurate haptic feedback, biomechanics and visuals for the training surgeon is not currently available. Challenges and opportunities in creating such surgical models will be discussed in this review paper. Surgery requires proper tissue handling as well as knowledge of relevant anatomy. To prepare doctors properly, training models need to take into account the biomechanical properties of the anatomical structures that will be manipulated in any given operation. This review summarises and evaluates the current biomechanical literature as it relates to human tissues and correlates the impact of this knowledge on developing high fidelity 3D printed surgical training models. We conclude that, currently, a printer technology has not yet been developed which can replicate many of the critical qualities of human tissue. Advances in 3D printing technology will be required to allow the printing of multi-material products to achieve the mechanical properties required.
- Published
- 2019
38. Bioprinting in ophthalmology: current advances and future pathways
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Paramasivam T. Perumal, Chander Prakash, Rajkumar V. Patil, Seeram Ramakrishna, Nataraj Poomathi, Sunpreet Singh, Veluchamy A Barathi, Kalpattu K. Balasubramanian, and N.U. Maheshwari
- Subjects
medicine.medical_specialty ,Computer science ,Mechanical Engineering ,Human life ,0206 medical engineering ,3d model ,02 engineering and technology ,021001 nanoscience & nanotechnology ,020601 biomedical engineering ,Medical care ,Industrial and Manufacturing Engineering ,Ophthalmology ,medicine ,Surgical Models ,0210 nano-technology - Abstract
Purpose Bioprinting is a promising technology, which has gained a recent attention, for application in all aspects of human life and has specific advantages in different areas of medicines, especially in ophthalmology. The three-dimensional (3D) printing tools have been widely used in different applications, from surgical planning procedures to 3D models for certain highly delicate organs (such as: eye and heart). The purpose of this paper is to review the dedicated research efforts that so far have been made to highlight applications of 3D printing in the field of ophthalmology. Design/methodology/approach In this paper, the state-of-the-art review has been summarized for bioprinters, biomaterials and methodologies adopted to cure eye diseases. This paper starts with fundamental discussions and gradually leads toward the summary and future trends by covering almost all the research insights. For better understanding of the readers, various tables and figures have also been incorporated. Findings The usages of bioprinted surgical models have shown to be helpful in shortening the time of operation and decreasing the risk of donor, and hence, it could boost certain surgical effects. This demonstrates the wide use of bioprinting to design more precise biological research models for research in broader range of applications such as in generating blood vessels and cardiac tissue. Although bioprinting has not created a significant impact in ophthalmology, in recent times, these technologies could be helpful in treating several ocular disorders in the near future. Originality/value This review work emphasizes the understanding of 3D printing technologies, in the light of which these can be applied in ophthalmology to achieve successful treatment of eye diseases.
- Published
- 2018
39. A pilot of the feasibility and usefulness of an aged obese model for use in stroke research
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Kevin C. F. Fone, Tracy D. Farr, Timothy J. England, Ryan Calmus, Saoirse E. O'Sullivan, Chelsea N Cunningham, David A. Kendall, Annastazia E. Learoyd, and Rebecca C. Trueman
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0301 basic medicine ,medicine.medical_specialty ,hypertension ,Medicine (miscellaneous) ,Type 2 diabetes ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Middle cerebral artery occlusion ,Obesity ,Stroke ,business.industry ,Animal models of Stroke ,Articles ,medicine.disease ,Ageing ,co-morbidities ,030104 developmental biology ,Standard diet ,Surgical Models ,Metabolic syndrome ,business ,030217 neurology & neurosurgery ,Research Article - Abstract
Background: Animal models of stroke have been criticised as having poor predictive validity, lacking risk factors prevalent in an aging population. This pilot study examined the development of comorbidities in a combined aged and high-fat diet model, and then examined the feasibility of modelling stroke in such rats. Methods: Twelve-month old male Wistar-Han rats (n=15) were fed a 60% fat diet for 8 months during which monthly serial blood samples were taken to assess the development of metabolic syndrome and pro-inflammatory markers. Following this, to pilot the suitability of these rats for undergoing surgical models of stroke, they underwent 30min of middle cerebral artery occlusion (MCAO) alongside younger controls fed a standard diet (n=10). Survival, weight and functional outcome were monitored, and blood vessels and tissues collected for analysis. Results: A high fat diet in aged rats led to substantial obesity. These rats did not develop type 2 diabetes or hypertension. There was thickening of the thoracic arterial wall and vacuole formation in the liver; but of the cytokines examined changes were not seen. MCAO surgery and behavioural assessment was possible in this model (with some caveats discussed in manuscript). Conclusions: This study shows MCAO is possible in aged, obese rats. However, this model is not ideal for recapitulating the complex comorbidities commonly seen in stroke patients.
- Published
- 2021
40. Calcium phosphate-based composite cement: Impact of starch type and starch pregelatinization on its physicochemical properties and performance in the vertebral fracture surgical models in vitro
- Author
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Haolin Sun, Chun Liu, Linwei He, Qifeng Lu, Yanjie Bai, Huan Zhou, Rui Zhang, Lei Yang, Dandan Chen, Hui Hu, Huilin Yang, Xuan Ma, Huiling Liu, Yixing Tian, and Ningqi Dang
- Subjects
Calcium Phosphates ,Models, Anatomic ,Materials science ,Starch ,Fracture (mineralogy) ,Composite number ,Biomedical Engineering ,chemistry.chemical_element ,macromolecular substances ,02 engineering and technology ,Calcium ,Maize starch ,Biomaterials ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Animals ,Food science ,Cement ,Sheep ,technology, industry, and agriculture ,Bone Cements ,food and beverages ,021001 nanoscience & nanotechnology ,Compressive strength ,chemistry ,Spinal Fractures ,Surgical Models ,0210 nano-technology ,030217 neurology & neurosurgery - Abstract
Calcium phosphate cement (CPC) modified with native and pregelatinized normal corn and waxy maize starches was studied. Effects of starch pregelatinization and starch type on the physicochemical properties of CPC were investigated. CPC modified with pregelatinized normal corn starch (CPB-PNC) or pregelatinized waxy maize starch (CPB-PW) was evaluated by two vertebral fracture surgical models in vitro. Both granular and pregelatinized starches significantly improved the setting times and injectability of CPC, but only the pregelatinized starches improved the anti-collapsibility and compressive strength of CPC significantly. CPB-PW, whose micro-structure was compact and uniform, showed the best physicochemical properties. Addition of starch did not inhibit the hydro-reaction of CPC. Unmodified CPC had very poor dispersibility and could not apply in the tests of the surgical models. Pregelatinized starch especially waxy maize starch improved the dispersibility of CPC and showed good dispersion area, volume, improved pull-out force and maximum torque in the Sawbones sponge model. Similarly, in the minimally invasive kyphoplasty model, CPB-PNC and CPB-PW could disperse in the osteoporotic sheep vertebrae and improve the compressive strength of the sheep vertebral body. In conclusion, starch pregelatinization and starch botanical source affect the physicochemical properties of CPC significantly. Bone cements modified by different starches also performed differently in surgical models for osteoporotic vertebral fracture. Pregelatinized waxy maize starch may be a better candidate for CPC modification comparing to the pregelatinized normal corn starch.
- Published
- 2021
41. Surgical animal models of neuropathic pain: Pros and Cons.
- Author
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Challa, Siva Reddy
- Subjects
- *
NEUROPATHY , *NERVOUS system injuries , *PAIN , *ANIMAL models in research , *PATIENTS , *THERAPEUTICS ,SCIATIC nerve surgery - Abstract
One of the biggest challenges for discovering more efficacious drugs for the control of neuropathic pain has been the diversity of chronic pain states in humans. It is now acceptable that different mechanisms contribute to normal physiologic pain, pain arising from tissue damage and pain arising from injury to the nervous system. To study pain transmission, spot novel pain targets and characterize the potential analgesic profile of new chemical entities, numerous experimental animal pain models have been developed that attempt to simulate the many human pain conditions. Among the neuropathic pain models, surgical models have paramount importance in the induction of pain states. Many surgical animal models exist, like the chronic constriction injury (CCI) to the sciatic nerve, partial sciatic nerve ligation (pSNL), spinal nerve ligation (SNL), spared nerve injury (SNI), brachial plexus avulsion (BPA), sciatic nerve transaction (SNT) and sciatic nerve trisection. Most of these models induce responses similar to those found in causalgia, a syndrome of sustained burning pain often seen in the distal extremity after partial peripheral nerve injury in humans. Researchers most commonly use these surgical models in both rats and mice during drug discovery to screen new chemical entities for efficacy in the area of neuropathic pain. However, there is scant literature that provides a comparative discussion of all these surgical models. Each surgical model has its own benefits and limitations. It is very difficult for a researcher to choose a suitable surgical animal model to suit their experimental set-up. Therefore, particular attention has been given in this review to comparatively provide the pros and cons of each model of surgically induced neuropathic pain. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
42. Accuracy of three-dimensional, paper-based models generated using a low-cost, three-dimensional printer.
- Author
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Olszewski, Raphael, Szymor, Piotr, and Kozakiewicz, Marcin
- Subjects
THREE-dimensional printing ,MANDIBLE ,CONE beam computed tomography ,IMAGE segmentation ,PROTOTYPES ,MAXILLOFACIAL surgery - Abstract
Our study aimed to determine the accuracy of a low-cost, paper-based 3D printer by comparing a dry human mandible to its corresponding three-dimensional (3D) model using a 3D measuring arm. One dry human mandible and its corresponding printed model were evaluated. The model was produced using DICOM data from cone beam computed tomography. The data were imported into Maxilim software, wherein automatic segmentation was performed, and the STL file was saved. These data were subsequently analysed, repaired, cut and prepared for printing with netfabb software. These prepared data were used to create a paper-based model of a mandible with an MCor Matrix 300 printer. Seventy-six anatomical landmarks were chosen and measured 20 times on the mandible and the model using a MicroScribe G2X 3D measuring arm. The distances between all the selected landmarks were measured and compared. Only landmarks with a point inaccuracy less than 30% were used in further analyses. The mean absolute difference for the selected 2016 measurements was 0.36 ± 0.29 mm. The mean relative difference was 1.87 ± 3.14%; however, the measurement length significantly influenced the relative difference. The accuracy of the 3D model printed using the paper-based, low-cost 3D Matrix 300 printer was acceptable. The average error was no greater than that measured with other types of 3D printers. The mean relative difference should not be considered the best way to compare studies. The point inaccuracy methodology proposed in this study may be helpful in future studies concerned with evaluating the accuracy of 3D rapid prototyping models. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
43. RELSA-A multidimensional procedure for the comparative assessment of well-being and the quantitative determination of severity in experimental procedures.
- Author
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Talbot SR, Struve B, Wassermann L, Heider M, Weegh N, Knape T, Hofmann MCJ, von Knethen A, Jirkof P, Häger C, and Bleich A
- Abstract
Good science in translational research requires good animal welfare according to the principles of 3Rs. In many countries, determining animal welfare is a mandatory legal requirement, implying a categorization of animal suffering, traditionally dominated by subjective scorings. However, how such methods can be objectified and refined to compare impairments between animals, subgroups, and animal models remained unclear. Therefore, we developed the RELative Severity Assessment (RELSA) procedure to establish an evidence-based method based on quantitative outcome measures such as body weight, burrowing behavior, heart rate, heart rate variability, temperature, and activity to obtain a relative metric for severity comparisons. The RELSA procedure provided the necessary framework to get severity gradings in TM-implanted mice, yielding four distinct RELSA thresholds L1<0.27, L2<0.59, L3<0.79, and L4<3.45. We show further that severity patterns in the contributing variables are time and model-specific and use this information to obtain contextualized between animal-model and subgroup comparisons with the severity of sepsis > surgery > restraint stress > colitis. The bootstrapped 95% confidence intervals reliably show that RELSA estimates are conditionally invariant against missing information but precise in ranking the quantitative severity information to the moderate context of the transmitter-implantation model. In conclusion, we propose the RELSA as a validated tool for an objective, computational approach to comparative and quantitative severity assessment and grading. The RELSA procedure will fundamentally improve animal welfare, data quality, and reproducibility. It is also the first step toward translational risk assessment in biomedical research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Talbot, Struve, Wassermann, Heider, Weegh, Knape, Hofmann, von Knethen, Jirkof, Häger and Bleich.)
- Published
- 2022
- Full Text
- View/download PDF
44. Surgical Models of Laboratory Animals
- Author
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R. K. Shakthi Devan
- Subjects
Regimen ,Distress ,medicine.medical_specialty ,business.industry ,Laparotomy ,medicine.medical_treatment ,Medicine ,Surgical Models ,business ,Intensive care medicine ,Management practices - Abstract
Animal models play a pivotal role in biomedical research. Surgical rodent models are widely used in the preclinical drug discovery process. A well-planned surgery with aseptic techniques including intraoperative as well as postoperative care is necessitated for the successful surgical outcomes and survivability of animals. Consideration should be given for the pre-emptive and postoperative analgesia of choice with appropriate dosage regimen to prevent pain and distress in the animals. Furthermore, good management practices, minimal handling, socialization, and environmental enrichment provide comfort by reducing the stress in the animals that underwent surgery.
- Published
- 2021
45. Experimental assessment of immunoreactivity indices and effectiveness of pharmacotherapy schemes in surgical models of acute pancreatitis of various severity
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Dmitrii P. Nazarenko, Viktor A. Lazarenko, Pavel K. Mikaelyan, Petr M. Nazarenko, and Alexey L. Loktionov
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Pharmacology ,medicine.medical_specialty ,acute pancreatitis ,business.industry ,experimental model of acute pancreatitis ,RM1-950 ,medicine.disease ,03 medical and health sciences ,pharmacological correction ,0302 clinical medicine ,Pharmacotherapy ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Acute pancreatitis ,030211 gastroenterology & hepatology ,Pharmacology (medical) ,Surgical Models ,Therapeutics. Pharmacology ,business ,immunoreactivity - Abstract
Introduction: The investigation was aimed at assessment of immunoreactivity in the experimental groups of animals and evaluation of effectiveness of different combinations of pharmacological drugs used in the surgical models for the treatment of acute pancreatitis (AP) of various degrees of severity. Materials and methods: As an object of research, sexually mature male individuals of mongrel white rats were used. Acute pancreatitis of various degrees of severity was caused by either a separate or simultaneous ligation of the pancreas ducts and an intraductal injection of the 50% bile solution in a dose of 0.2 mg/kg. Correction of immunoreactivity indices in the experimental animals was performed with the use of drug combinations producing immunomodulating, antioxidant and membrane protecting effects. Evaluation of the dynamics of immune parameters in rats was carried out using test systems from various manufacturers for laboratory analysis. The obtained findings were statistically processed with descriptive and variation techniques. Results and discussion: The rats developed AP of various degrees of severity, and differently expressed shifts in immunoreactivity indices were observed. Assessment of immune and oxidant indices in experimentally induced acute pancreatitis of moderate and severe states revealed metabolic and immune disorders with anti-inflammatory effects which had various degrees of expression. Combination of immunomodulators, antioxidants and membranoprotectors exerted positive effects on the immunoreactivity state, but insignificantly decreased the mortality rate in the groups of experimental animals. Conclusion: The combination of ferrovir, mexidol, phosphogliv, and its use for moderate and severe degrees of experimentally induced pancreatitis in rats decreases their mortality up to 12.9% and 19.8%. The combination of polyoxidonium, emoxipin and essentiale N exhibits positive clinico-laboratory effectiveness and lowers the mortality indices to statistically significant parameters – 11.8% и 19.6%, correspondingly, with p < 0.05.
- Published
- 2021
46. Design and Testing of a Robotic Articulating Laparoscopic Instrument using the Pig Model Simulation Approach
- Author
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Noelle Marie D. Espiritu, Renann G. Baldovino, Nilo T. Bugtai, Francisco Emmanuel T. Munsayac, Levi Joseph Abraham F. Tan, and Jeffrey Reyes
- Subjects
medicine.diagnostic_test ,Simulation test ,Procedural training ,010308 nuclear & particles physics ,040301 veterinary sciences ,Computer science ,Open surgery ,Pig model ,04 agricultural and veterinary sciences ,01 natural sciences ,0403 veterinary science ,Laparoscopy procedure ,0103 physical sciences ,medicine ,Surgical Models ,Operations management ,Laparoscopy ,Animal species - Abstract
Laparoscopy is a minimally-invasive surgical procedure which involves the patient that is operated upon by making small incision holes into the individual's body instead of the conventional open surgery. To address the ergonomic issues and economical expenses of traditional laparoscopy procedure, a robotic articulating laparoscopic instrument serves as an alternative option due to the ease of its manoeuvrability. To seek the device's efficiency towards its operation, a pig model simulation test was conducted. Swine are considered to be one of the major animal species used in translational research, surgical models, and procedural training.
- Published
- 2020
47. 7 Introduction of M&x0101;ori and Pacific nurse navigators to improve equity in surgical pathway in Auckand, New Zealand
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Pauline Fakalata, Dawson Ward, and Andrew Jones
- Subjects
Waiting time ,Service (business) ,lcsh:R5-920 ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Equity (finance) ,Health outcomes ,Qualitative feedback ,Nursing ,Early results ,Medicine ,Surgical Models ,lcsh:Medicine (General) ,business - Abstract
Background Health outcomes for Mxori and Pacific within New Zealand significantly poorer than for European New Zealanders. One identified inequity is the delay in receiving planned surgery. As a result of reduced surgery during the Covid-19 lockdown, these inequities were exacerbated. Objectives Improve key metrics for Mxori and Pacific patients receiving surgery (increase volume receiving surgery, decrease waiting times and decrease cancellation of surgery as well as identify systemic barriers to equitable care delivery. Methods Ten Mxori and ten Pacific nurse specialists were seconded to walk alongside patients awaiting surgery to identify and resolved immediate issues preventing progress. Care navigation by clinical staff, using Mxori and Pacific health models in their interactions, allows patients to progress through their pathway through active engagement with the services. It is also allows for the gathering of data (quantitative and narrative) to understand where processes need to change to ensure equitable and timely care is provided. Through the experiences of those currently on the surgical wait list, alternative surgical models of care can be defined. Results Early results suggest that the key metrics (days waiting, proportion of surgeries completed for Mxori and Pacific patients and proportion of surgeries proceeding as planned) are improving. Qualitative feedback from patients and staff is clearly identifying opportunities as well as demonstrating the early value of having clinical staff supporting patients through their journey applying culturally safe and appropriate support. Conclusions While still early in the development of the approach, initial results are highly promising and demonstrate that often what is missing in a patient‘s surgical journey is a consistent voice that provides certainty for patients and their families. Through the patient experiences gathered, service redesign will be possible that supports Mxori and Pacific patients to achieve the outcomes they want.
- Published
- 2020
48. Of mice and men: converging on a common molecular understanding of osteoarthritis
- Author
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Tonia L. Vincent
- Subjects
business.industry ,Immunology ,Inflammation ,Articular cartilage ,Review ,Disease ,Osteoarthritis ,medicine.disease ,Bioinformatics ,Rheumatology ,Rheumatoid arthritis ,medicine ,Immunology and Allergy ,Surgical Models ,medicine.symptom ,business - Abstract
Despite an increasing burden of osteoarthritis in developed societies, target discovery has been slow and there are currently no approved disease-modifying osteoarthritis drugs. This lack of progress is due in part to a series of misconceptions over the years: that osteoarthritis is an inevitable consequence of ageing, that damaged articular cartilage cannot heal itself, and that osteoarthritis is driven by synovial inflammation similar to that seen in rheumatoid arthritis. Molecular interrogation of disease through ex-vivo tissue analysis, in-vitro studies, and preclinical models have radically reshaped the knowledge landscape. Inflammation in osteoarthritis appears to be distinct from that seen in rheumatoid arthritis. Recent randomised controlled trials, using treatments repurposed from rheumatoid arthritis, have largely been unsuccessful. Genome-wide studies point to defects in repair pathways, which accords well with recent promise using growth factor therapies or Wnt pathway antagonism. Nerve growth factor has emerged as a robust target in osteoarthritis pain in phase 2–3 trials. These studies, both positive and negative, align well with those in preclinical surgical models of osteoarthritis, indicating that pathogenic mechanisms identified in mice can lead researchers to valid human targets. Several novel candidate pathways are emerging from preclinical studies that offer hope of future translational impact. Enhancing trust between industry, basic, and clinical scientists will optimise our collective chance of success.
- Published
- 2020
49. Effects of different metabolic states and surgical models on glucose metabolism and secretion of ileal L-Cell peptides: Results from the HIPER-1 study
- Author
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Sjaak Pouwels, Eylem Cagiltay, and Alper Celik
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Endocrinology ,Chemistry ,Internal medicine ,Cell ,HiPER ,medicine ,Secretion ,Surgical Models ,Carbohydrate metabolism - Published
- 2020
50. Surgical Models to Explore Acellular Liver Scaffold Transplantation: Step-by-Step
- Author
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Regina Coeli Dos Santos Goldenberg, Lanuza Alaby Pinheiro Faccioli, Victor J K Secomandi, Victoria R. S. Monteiro, Marlon Lemos Dias, Cintia Marina Paz Batista, and Alexandre Cerqueira da Silva
- Subjects
Male ,Models, Anatomic ,Embryology ,Scaffold ,medicine.medical_specialty ,Microsurgery ,Transplantation, Heterotopic ,medicine.medical_treatment ,0206 medical engineering ,Biomedical Engineering ,02 engineering and technology ,Liver transplantation ,Surgical methods ,03 medical and health sciences ,Medicine ,Animals ,Rats, Wistar ,030304 developmental biology ,0303 health sciences ,Transplantation ,Decellularization ,Tissue Engineering ,Tissue Scaffolds ,business.industry ,020601 biomedical engineering ,Surgery ,Extracellular Matrix ,Liver Transplantation ,Rats ,surgical procedures, operative ,Liver ,Surgical Models ,Female ,Acellular scaffold ,business ,Developmental Biology ,Research Article - Abstract
Acellular liver scaffolds (ALS) have arisen as potential candidates for transplantation. Until now, all reports involving ALS transplantation failed in surgical method descriptions and do not offer support to scientists to reproduce the procedures used in experimental microsurgery to make the results comparable to literature. To overcome the lack of detail information, we described surgical steps details to perform heterotopic and partial orthotopic surgical models to promote ALS transplantation. After preservation and vessel cannulation steps, the liver grafts were decellularized. In addition, ex vivo blood perfusion tests were performed to obtain a successful anticoagulation treatment prior in vivo transplantation. Then, methods of partial liver resection, combination of hand-suture and cuff techniques to complete end-to-end anastomosis between the scaffold and the recipient animal were performed. These procedures which take 30–60 min and were efficient to allow acellular liver scaffold viability and recellularization of different types of cell post-surgery. In conclusion, our methods are practical and simple promising approach that provides the opportunity to investigate ways to achieve sufficient liver function post-transplantation in vivo.
- Published
- 2020
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