Transforming P & O Care with 3D Printing-More than Meets the Eye.

Many within the prosthetics and orthotics (P&O) industry are embracing 3D printing technology to produce better devices more efficiently, cost-effectively and to improve patient outcomes. 3D printing is here to stay, but how much will it transform P&O practices? This paper explores the state-of 3D printing technology as it applies to P&O and aims to highlight important considerations for bringing 3D printing into mainstream practice. The paper draws from recent published literature, as well as experiences stemming from ongoing efforts focused on implementing digital workflows and 3D printing into P&O care. The paper examines the topic from the technological, research, economics, funding, and clinical perspectives. While 3D printing and digital workflows have advantages over traditional methods (i.e. ability to design more complex parts, reprinting and reproduction of parts, less labour intensive) there are also challenges limiting adoption. First, despite recent advancements in 3D printing technology, gaps still exist in terms of the materials and processes. For example, cost-effectively fabricating devices that are concurrently strong and durable, allow for colourful designs, and are thermoformable are still being developed. Cost-wise, 3D printing may currently be more viable for small, or paediatric devices. There are also limited technical standards to ensure safe and durable devices are produced, as well as a lack of evidence and information about patient outcomes and operating costs. Nevertheless, a great amount of enthusiasm and momentum exists within the industry to innovate, and with it the potential for 3D printing to one day be central to mainstream P&O care. Given the many aspects of the P&O industry, collaboration and partnerships will facilitate learning from each other to advance and realize the potential of 3D printing sooner.

The epidemiology of end stage renal disease at a centre in Trinidad / Epidemiología de la fase terminal de la enfermedad renal en un centro de Trinidad

OBJECTIVE: The aim of this study is to estimate the trends in prevalence of end stage renal disease (ESRD) during the period 1999-2007 at one site in Trinidad, the Eric Williams Medical Sciences Complex (EWMSC), and to describe the epidemiological features, age, gender, ethnicity and co-morbidities associated with ESRD. DESIGN AND METHODS: A retrospective cohort study design was used. There was a count of patients on haemodialysis at the EWMSC centre from 1999 - 2007 in order to demonstrate trends in prevalence but more detailed data were collected and analysed for patients with ESRD attending the nephrology clinic between January 2002 and December 2007. The data that were collected from the patients' records included: demographic data (age, gender and ethnicity), medical history (diabetes mellitus, hypertension, end stage renal disease and autoimmune disorders), history of dialysis (type of vascular access, frequency of dialysis), mortality and its cause. RESULTS: Records of 81 patients were retrieved. Their age range was 10-79 years. The survey showed that patients most affected in the study population were: males, aged 50-59 years, who were hypertensive and/or diabetic and of African descent. CONCLUSIONS: In conclusion, we provide epidemiological evidence of ESRD and the associated contributing factors at one hospital in Trinidad.

OBJETIVO: El objetivo de este estudio es estimar las tendencias de la prevalencia de la enfermedad renal en fase terminal (ERFT) durante el periodo 1999-2007 en el Complejo de Ciencias Médicas Eric Williams, en Trinidad, y describir los rasgos epidemiológicos - edad, género, etnicidad - y co-morbilidades asociadas con la ERFT. DISEÑO Y MÉTODOS: Se usó un diseño de estudio de cohorte retrospectivo. Se llevó a cabo un análisis de todos los pacientes que asistieron a las clínicas de nefrología de EWMSC, de enero de 2002 a diciembre de 2007. Los datos recogidos de las historias clínicas de los pacientes al final del período de estudio incluyeron: datos demográficos (edad, género y etnicidad), historia médica (diabetes mellitus, hipertensión, enfermedad renal en fase terminal, trastornos autoinmunes), historia de diálisis (tipo de acceso vascular, frecuencia de diálisis), mortalidad y causa. RESULTADOS: Se obtuvieron las historias clínicas de 81 pacientes, cuya edad fluctuaba de 10 a 79 años. La encuesta mostró que los pacientes más afectados en la población del estudio fueron varones, de 50-59 años de edad, que eran hipertensos y/o diabéticos, de ascendencia africana. CONCLUSIONES: En conclusión, se ofrece evidencia epidemiológica de la ERFT en un hospital en Trinidad y se señalan los factores asociados que contribuyen a la enfermedad.

The epidemiology of end stage renal disease at a centre in Trinidad.

OBJECTIVE: The aim of this study is to estimate the trends in prevalence of end stage renal disease (ESRD) during the period 1999-2007 at one site in Trinidad, the Eric Williams Medical Sciences Complex (EWMSC), and to describe the epidemiological features, age, gender, ethnicity and comorbidities associated with ESRD. DESIGN AND METHODS: A retrospective cohort study design was used. There was a count of patients on haemodialysis at the EWMSC centre from 1999-2007 in order to demonstrate trends in prevalence but more detailed data were collected and analysed for patients with ESRD attending the nephrology clinic between January 2002 and December 2007. The data that were collected from the patients' records included: demographic data (age, gender and ethnicity), medical history (diabetes mellitus, hypertension, end stage renal disease and autoimmune disorders), history of dialysis (type of vascular access, frequency of dialysis), mortality and its cause. RESULTS: Records of 81 patients were retrieved. Their age range was 10-79 years. The survey showed that patients most affected in the study population were: males, aged 50-59 years, who were hypertensive and/or diabetic and of African descent. CONCLUSIONS: In conclusion, we provide epidemiological evidence of ESRD and the associated contributing factors at one hospital in Trinidad.