Medical micro- and nanomotors in the body

Attributed to the miniaturized body size and active mobility, micro- and nanomotors (MNMs) have demonstrated tremendous potential for medical applications. However, from bench to bedside, massive efforts are needed to address critical issues, such as cost-effective fabrication, on-demand integration of multiple functions, biocompatibility, biodegradability, controlled propulsion and in vivo navigation. Herein, we summarize the advances of biomedical MNMs reported in the past two decades, with particular emphasis on the design, fabrication, propulsion, navigation, and the abilities of biological barriers penetration, biosensing, diagnosis, minimally invasive surgery and targeted cargo delivery. Future perspectives and challenges are discussed as well. This review can lay the foundation for the future direction of medical MNMs, pushing one step forward on the road to achieving practical theranostics using MNMs.

Correction to: EGFR signaling augments TLR4 cell surface expression and function in macrophages via regulation of Rab5a activation

In the original publication the bands in Fig. 1J and Fig. 2B were not visible. The correct versions of Fig. 1J and Fig. 2B are provided in this correction.

Correction to: EGFR signaling augments TLR4 cell surface expression and function in macrophages via regulation of Rab5a activation

In the original publication the bands in Fig. 1J and Fig. 2B were not visible. The correct versions of Fig. 1J and Fig. 2B are provided in this correction.

Epidural Blood Patch Performed for Severe Intracranial Hypotension Following Lumbar Cerebrospinal Fluid Drainage for Intracranial Aneurysm Surgery. Retrospective Series and Literature Review

Intracranial hypotension (IH) can occur following lumbar drainage for clipping of an intracranial aneurysm. We observed 3 cases of IH, which were all successfully treated by epidural blood patch (EBP). Herein, the authors report our cases.

A Comparative Review of the Hemodynamics and Pathogenesis of Cerebral and Abdominal Aortic Aneurysms: Lessons to Learn From Each Other

OBJECTIVE: Cerebral aneurysms (CAs) and abdominal aortic aneurysms (AAAs) are degenerative vascular pathologies that manifest as abnormal dilations of the arterial wall. They arise with different morphologies in different types of blood vessels under different hemodynamic conditions. Although treated as different pathologies, we examine common pathways in their hemodynamic pathogenesis in order to elucidate mechanisms of formation. MATERIALS AND METHODS: A systematic review of the literature was performed. Current concepts on pathogenesis and hemodynamics were collected and compared. RESULTS: CAs arise as saccular dilations on the cerebral arteries of the circle of Willis under high blood flow, high wall shear stress (WSS), and high wall shear stress gradient (WSSG) conditions. AAAs arise as fusiform dilations on the infrarenal aorta under low blood flow, low, oscillating WSS, and high WSSG conditions. While at opposite ends of the WSS spectrum, they share high WSSG, a critical factor in arterial remodeling. This alone may not be enough to initiate aneurysm formation, but may ignite a cascade of downstream events that leads to aneurysm development. Despite differences in morphology and the structure, CAs and AAAs share many histopathological and biomechanical characteristics. Endothelial cell damage, loss of elastin, and smooth muscle cell loss are universal findings in CAs and AAAs. Increased matrix metalloproteinases and other proteinases, reactive oxygen species, and inflammation also contribute to the pathogenesis of both aneurysms. CONCLUSION: Our review revealed similar pathways in seemingly different pathologies. We also highlight the need for cross-disciplinary studies to aid in finding similarities between pathologies.

Sialoadenitis purulenta submaxilar producida por cuerpo extraño en el conducto de Wharton / Submandibular sialoadenitis due to a foreign body in the Wharton duct

Una causa frecuente de infección crónica de la glándula submaxilar es la obstrucción de su conducto excretor que puede ser causada por litiasis, tapones de moco o a por la presencia de un cuerpo extraño. En las tres circunstancias se desarrollan cuadros de inflamación crónica del conducto (sialodoquitis) y de la glándula (sialoadenitis). Los estudios de imágenes radiográficas adecuadas son de gran utilidad para el diagnóstico, puesto que revelan el elemento obstructivo La presencia dentro del conducto salival de un cuerpo extraño es extremadamente rara. En este reporte se presenta un caso inusual de un paciente masculino de 23 años de edad que presentaba secreción purulenta debajo de la lengua y dolor crónico en la región submaxilar izquierda, de diez años de duración, donde el examen radiográfico convencional y la tomografía espiral multicorte contribuyeron al diagnóstico, identificando un mondadientes de madera alojado dentro del con ducto de Wharton. Se discute la importancia de la anamnesis y la interpretación de las imágenes en el manejo del caso.

One of the more frequent causes of submandibular sialoadenitis is the obstruction of its duct. The obstruction can be caused by lithiasis, mucus plug or a foreign body. The three circumstances produce inflammation and infection of the duct and the gland. Appropriated radiographic image techniques are very useful to demonstrate the obstructive object. The presence of a foreign body in the salivary duct is extremely rare. In this article is reported an unusual case of a 23-year-old male patient that presented purulent secre tion in the floor of the mouth and complained of chronic pain in the submandibular salivary gland, both lasting for ten years. Conventional radiographies and computed radiographs allowed to identify a wood toothpick inside the WhartonÆs duct. Data obtained during anamnesis and interpretations of radiographic findings are discussed for the adequate management of the case.

Tromboembolismo venoso postoperatorio: grave riesgo prevenible / Postoperatory venous thromboembolism: a serious preventable risk

La trombosis venosa profunda y el tromboembolismo pulmonar postoperatorio son complicaciones que tienen influencia en la morbimortalidad. Múltiples investigaciones evidencian sus cifras y la reducción del riesgo con la tromboprofilaxis. Han sido evaluados diferentes medicamentos y su nivel de protección, pero el seguimiento de las guías de práctica clínica publicadas no es óptimo debido a la falta de claridad en el manejo de pacientes con factores de riesgo intermedio. La prevención demostrada por la tromboprofilaxis obliga a implementar estrategias para detectar pacientes en riesgo y seguir las guías.

Postoperative deep venous thrombosis and pulmonary thromboembolism are complications which have incidence on morbimortality. Many researches evidence their figures and how thromboprophylaxis can reduce these risks. Different drugs and their level of protection have been evaluated, but the adherence to the published clinical practice guidelines is not optimal because of the lack of clarity in the management of patients with intermediate risk factors. The proved prevention with thromboprophylaxis forces to implement strategies to detect the patients at risk and to follow the guidelines.

Trialling diagnosis-related groups classification in the Iranian health system: a case study examining the feasibility of introducing casemix

This paper examines the quality of routinely collected information in an Iranian hospital in a trial of casemix classification. Australian Refined Diagnosis Related Groups [AR-DRG] were used to classify patient episodes. There were 327 DRGs identified, of which 20% had only 1 case. The grouper program identified invalid records for 4% of total separations. Approximately 4.5% of cases were classified into error DRGs and 3.4% were ungroupable. No complication and comorbidity effects were identified with 93% of total cases. R[2] [variance in length of stay explained] was 44% for untrimmed cases, increasing to 63%, 57% and 58% after trimming by L3H3, IQR and 10th-95th percentile methods respectively

Casemix in the Islamic Republic of Iran: current knowledge and attitudes of health care staff

Casemix is a tool that classifies patients according to their clinical similarity and the homogeneity of resources required. A descriptive study was conducted to assess the level of knowledge and attitude toward the casemix-based funding system among staff working in the Iranian Social Security Organization in Tehran. The survey showed that knowledge of casemix and diagnosis-related groups [DRG] was poor among the study group and any attempt to implement the casemix system-which about three-quarters of high-level staff had never heard of would be likely to fail. This highlights the necessity for creating awareness of the casemix and DRG systems among the hospital staff before any action takes place

Métodos multivariantes para la clasificación de hospitales: el caso de los hospitales públicos de la comunidad valenciana / Multivariants methods for the classification of public hospitals: the case of public hospitals of the Valencian community

El objetivo del estudio es caracterizar y diferenciar los hospitales existentes en la comunidad Valenciana, en lo relativo a la producción de servicios sanitarios y consumo de recursos (sanitarios y económicos). Se muestran los problemas de asimetría de la información existente entre los agentes hospitalarios y el financiador, de modo que éste último no puede controlar la actividad y los gastos del hospital de forma efectiva.

Fibroma cemento osificante multicuadrante / Cement ossifing fibroma multiquadrant

En este artículo se reporta un caso de Fibroma Cemento Osificante que compromete los cuatro cuadrantes de los maxilares de un niño de trece años de edad. Los tumores estaban localizados alrededor de las raices de las molares deciduas y eran responsables de la retención de las premolares. Asímismo, se revisan los conceptos más importantes de la literatura relacionados con el fibroma cemento osificante y se discuten los hallazgos clínicos, radiográficos, histopatológicos y quirúrgicos particulares de este caso.

Paludismo: Estudio epidemiológico en un Hospital General (1976-1981). / Paludism:Epidemiological study in a General Hospital (1976-1981).

Son estudiadas las historias clínicas de 21,253 pacientes con diagnóstico de paludismo durante el período 1976-1981, en el Hospital General de Yurimaguas, Capital de la Provincia del Alto Amazonas, Departamento de Loreto. El trabajo es descriptivo y de carácter retrospectivo. Los objetivos fueron:Determinar la frecuencia, sus variables epidemiológicas, agentes etiológicos y tratamiento administrado. Los resultados fueron los siguientes:- La malaria constituye el 71.19% del total de las enfermedades transmisibles de la zona. -La frecuencia promedio por año es 3,036.14 casos. Se observan en todas la edades y sexos, con promedio en las tres primeras décadas de la vida y en el sexo masculino. -Los meses de febrero, marzo, abril son los de mayor frecuencia. -Los huéspedes proceden de las riberas del río Huallaga. -El diagnóstico etiológico se hizo con el examen de gota gruesa, constituyendo el P. vivax en 99.96%, el agente total de casos. -El tratamiento triconjugado se administró al 70.71% de los pacientes. Se concluyó que la malaria en la Región del Alto Amazonas una enfermedad endémico-epidémica de muy alta frecuencia.