Advancements in thyroid surgery: enhancing safety and efficacy through technological and clinical innovations
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PROVIDER: S-EPMC10839698 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Numerous calls at national and international level are leading some countries to seek to redesign the provision of healthcare and services. Care pathways have the potential to improve outcomes by providing a mechanism to coordinate care and reduce fragmentation and ultimately costs. However, their implementation still shows variable results, resulting in them being considered as complex interventions in complex systems. By mobilizing an emerging approach combining action research and grounded theory methodology, we conducted a pilot project on care pathways. We used a strongly inductive process, to mobilize comparison and continuous theoretical sampling to produce theories. Forty-two interviews were conducted, and participant observations were made throughout the project, including 60 participant observations at meetings, workshops and field observations. The investigators kept logbooks and recorded field notes. Thematic analysis was used with an inductive approach. The present model explains the factors that positively or negatively influence the implementation of innovations in care pathways. The model represents interactions between facilitating factors, favourable conditions for the emergence of innovation adoption, implementation process enablers and challenges or barriers including those related specifically to the local context. What seems to be totally new is the embodiment of the mobilizing shared objective of active patient-partner participation in decision-making, data collection and analysis and solution building. This allows, in our opinion, to transcend professional perspectives for the benefit of patient-oriented results. Finally, the pilot project has created expectations in terms of spread and scaling. Future research on care pathway implementation should go further in the evaluation of the multifactorial impacts and develop a methodological framework of care pathway implementation, as the only existing proposition seems limited. Furthermore, from a social science perspective, it would be interesting to analyse the modes of social valuation of the different actors to understand what allows the transformation of collective action.
| S-EPMC10637140 | biostudies-literature
Project description:Biofilm formation is an important survival strategy commonly used by bacteria and fungi, which are embedded in a protective extracellular matrix of organic polymers. They are ubiquitous in nature, including humans and other animals, and they can be surface- and non-surface-associated, making them capable of growing in and on many different parts of the body. Biofilms are also complex, forming polymicrobial communities that are difficult to eradicate due to their unique growth dynamics, and clinical infections associated with biofilms are a huge burden in the healthcare setting, as they are often difficult to diagnose and to treat. Our understanding of biofilm formation and development is a fast-paced and important research focus. This review aims to describe the advancements in clinical biofilm research, including both in vitro and in vivo biofilm models, imaging techniques and techniques to analyse the biological functions of the biofilm.
| S-EPMC10753778 | biostudies-literature
Project description:PurposeThe use of nondepolarizing neuromuscular blocking agents (NMBAs) may affect intraoperative neuromonitoring (IONM) during anesthesia used during thyroid and parathyroid surgery.MethodsThe use of sugammadex was evaluated in a prospective clinical study during thyroid surgery. Between July 2018 and January 2019, 129 patients were prospectively randomized to either the sugammadex group (group B) or the control group (group A). Group A patients underwent standardized IONM during thyroidectomy, while group B patients used an NMBA-reversal protocol comprised of rocuronium (0.6 mg/kg) in anesthesia induction and sugammadex (2 mg/kg) after first vagal stimulation (V0). A peripheral nerve stimulator was used to monitor the neuromuscular transmission.ResultsIn our clinical study, it took 26.07 ± 3.26 and 50.0 ± 8.46 minutes to reach 100% recovery of laryngeal electromyography at injection of the sugammadex group (2 mg/kg) and the control group, respectively (P < 0.001). The train-of-four ratio recovered from 0 to >0.9 within 4 minutes after administering 2 mg/kg of sugammadex at the beginning of resection. Surgery time was significantly shorter in group B than in group A (P < 0.001). Transient recurrent laryngeal nerve (RLN) paralysis was detected in 4 patients from group A and in 3 patients from group B (P = 0.681). There was no permanent RLN paralysis in the 2 groups.ConclusionOur clinical study showed that sugammadex effectively and rapidly improved the inhibition of neuromuscular function induced by rocuronium. The implementation of the nondepolarizing neuromuscular block recovery protocol may lead to tracheal intubation as well as favorable conditions for IONM in thyroid surgery.
| S-EPMC6893217 | biostudies-literature
Project description:Ocular drug delivery has been significantly advanced for not only pharmaceutical compounds, such as steroids, nonsteroidal anti-inflammatory drugs, immune modulators, antibiotics, and so forth, but also for the rapidly progressed gene therapy products. For conventional non-gene therapy drugs, appropriate surgical approaches and releasing systems are the main deliberation to achieve adequate treatment outcomes, whereas the scope of "drug delivery" for gene therapy drugs further expands to transgene construct optimization, vector selection, and vector engineering. The eye is the particularly well-suited organ as the gene therapy target, owing to multiple advantages. In this review, we will delve into three main aspects of ocular drug delivery for both conventional drugs and adeno-associated virus (AAV)-based gene therapy products: (1) the development of AAV vector systems for ocular gene therapy, (2) the innovative carriers of medication, and (3) administration routes progression.
| S-EPMC9506479 | biostudies-literature
Project description:About 92.1 million Americans suffer from at least one type of cardiovascular disease. Worldwide, cardiovascular diseases are the number one cause of death (about 31% of all global deaths). Recent technological advancements in cardiac ultrasound imaging are expected to aid in the clinical diagnosis of many cardiovascular diseases. This article provides an overview of such recent technological advancements, specifically focusing on tissue Doppler imaging, strain imaging, contrast echocardiography, 3D echocardiography, point-of-care echocardiography, 3D volumetric flow assessments, and elastography. With these advancements ultrasound imaging is rapidly changing the domain of cardiac imaging. The advantages offered by ultrasound imaging include real-time imaging, imaging at patient bed-side, cost-effectiveness and ionizing-radiation-free imaging. Along with these advantages, the steps taken towards standardization of ultrasound based quantitative markers, reviewed here, will play a major role in addressing the healthcare burden associated with cardiovascular diseases.
| S-EPMC5808891 | biostudies-literature
Project description:BackgroundMicro-propagation is the primary technique for the mass propagation of greenhouse orchids. However, various factors, including culture media and cultivation systems, influence the scaling-up and efficient commercialization of in vitro techniques. The utilization of liquid cultivation systems and bioreactors are relatively cost-effective and has attracted significant attention for mass production. In this study, we evaluated the effects of eight culture media, in both semi-solid and liquid forms, on the growth of in vitro mini-plantlets of Phalaenopsis orchids. We subsequently assessed the performance of four selected media: half-strength modified Murashige and Skoog (1/2 MMS), modified FAST (MFAST), and two simplified media (SM1 and SM2), across four types of cultivation systems, including semi-solid media in glass jars, liquid media in a permanent immersion system using Erlenmeyer flasks on a shaker (PIS), and a temporary immersion system (TIS) in two forms: FA-Bio bioreactor (TIS-FA-Bio) and RITA® bioreactor (TIS-RITA®).ResultsThe results indicated that the optimal culture medium for orchid growth depends on the cultivation system used. Among the eight evaluated semi-solid and liquid media, the highest plant growth was observed in the SM2 medium, attributed to the presence of additives (banana powder and activated charcoal), two types of sugar (with high carbon content), and small amounts of nickel and ascorbic acid. The high carbon content in the SM2 liquid medium, combined with the temporary immersion explants in a large volume of medium in the TIS-RITA®, resulted in the highest total carbohydrate content and enhanced plant growth. The maximum quantum efficiency of photosystem II (Fv/Fm) and the number of plantlets per liter in SM2 semi-solid medium were higher than those in the 1/2 MMS semi-solid medium (control), leading to a 61.6% reduction in production costs. Furthermore, the number of plantlets per liter in the TIS-FA-Bio containing SM2 (10.8 USD) was higher than in TIS-RITA® with 1/2 MMS (39.3 USD), resulting in a 72.5% decrease in production costs due to a lower volume of medium and the use of inexpensive equipment.ConclusionsWe recommend the use of SM2 in TIS-FA-Bio and TIS-RITA® for economical and efficient mass propagation of Phalaenopsis orchid.
| S-EPMC11619147 | biostudies-literature
Project description:Over the past decade, the surgical approach to treating thoracic disease has shifted to minimally invasive surgery. Without compromising the outcomes, this approach may lead to fewer resections and fewer incisions for those resections. Video-assisted thoracoscopic surgery (VATS) is a recent but major advancement that has become an established approach for major thoracic surgery. More recently, robotic surgery has been gaining recognition because it can overcome the limitations of VATS and encourage a minimally invasive approach. Indications and applications of many other innovative surgical techniques and strategies to improve overall survival have expanded rapidly. In this article, we do not represent all thoracic surgeries occurring in Korea and do not reflect the large active centers in the country. However, as one of the most innovative and active Korean centers for thoracic surgery and research, we reviewed our procedures and programs for thoracic surgery.
| S-EPMC5009074 | biostudies-literature
Project description:Genetics plays an important role in the pathophysiology of cardiovascular diseases, and is increasingly being integrated into clinical practice. Since 2008, both capacity and cost-efficiency of mutation screening of DNA have been increased magnificently due to the technological advancement obtained by next-generation sequencing. Hence, the discovery rate of genetic defects in cardiovascular genetics has grown rapidly and the financial threshold for gene diagnostics has been lowered, making large-scale DNA sequencing broadly accessible. In this review, the genetic variants, mutations and inheritance models are briefly introduced, after which an overview is provided of current clinical and technological applications in gene diagnostics and research for cardiovascular disease and in particular, dilated cardiomyopathy. Finally, a reflection on the future perspectives in cardiogenetics is given.
| S-EPMC4497982 | biostudies-literature
Project description:IntroductionPopulation aging increases the risk of dependency among older adults, which in turn necessitates care, primarily provided by family caregivers. This situation leads to physical and emotional strain on these caregivers. New technologies, such as tele-education, digital platforms, or mobile applications, can offer an accessible and equitable alternative for caregiver training and self-care support.ObjectiveThe objective of this review is to analyze interventions targeted at family caregivers, both for their own self-care and for the care of dependent individuals, using new technologies.DesignA scoping review was conducted, including a total of thirty-two articles extracted from three databases: CINAHL, Scopus, and PubMed. Articles in any language were included, with no fixed time limit, while articles with samples that included family caregivers of oncology patients were excluded.ResultsMost of the interventions were conducted via videoconference, showing outcomes that indicated a reduction in depressive symptoms among family caregivers.ConclusionsThe implementation of new technologies for the development of interventions presents a viable alternative to in-person sessions. These technologies have shown positive results, while also helping to overcome time and geographical barriers imposed by caregiving responsibilities.
| S-EPMC11641527 | biostudies-literature
Project description:The concept of personalized medicine, which aims to provide patients with targeted therapies while greatly reducing surgical trauma, is gaining popularity among Asian clinicians. Single port video-assisted thoracic surgery (VATS) has rapidly gained popularity in Hong Kong for major lung resections, despite bringing new challenges such as interference between surgical instruments and insertion of the optical source through a single incision. Novel types of endocutters and thoracoscopes can help reduce the difficulties commonly encountered during single-port VATS. Our region has been the testing ground and has led the development of many of these innovations. Performing VATS, in particular single-port VATS in hybrid operating theatre helps to localise small pulmonary lesions with real-time images, thus increasing surgical accuracy and pushes the boundaries in treating subcentimeter diseases. Such approach may be assisted by use of electromagnetic navigational bronchoscopy in the same setting. In addition, sublobar resection can also be more individualised according to pathologic tumour subtype that require rapid intraoperative diagnostic test to guide appropriate surgical therapy. A focus on technology and innovation for large tumours that require chest wall resection and reconstructions have also been on going, with new materials and prostheses that may be tailored to each individual needs. The current paper reviews the literature pertaining to the above topics and discusses recent related innovations in Hong Kong, highlighting the study results and future perspectives.
| S-EPMC5009073 | biostudies-literature