Diseño y validación de un simulador para el entrenamiento en la capsulotomía circular continua en la facoemulsificación / Design and validation of a simulator for training in continuous circular capsulotomy for phacoemulsification

Introducción: Diseñar y validar un simulador para el aprendizaje y entrenamiento de la técnica de la capsulorrexis. Métodos: El sistema consiste en un soporte de metacrilato con inclinación de 15° para el apoyo de las manos del cirujano y una zona de papel aluminio comercial y otro de similares características donde el alumno realiza la técnica a través de unas hendiduras realizadas previamente en el soporte. Para evaluar la viabilidad de este simulador se toman los datos de 65 oftalmólogos que realizan la técnica durante actividades de formación, dividiéndolos aleatoriamente en un grupo de 30 especialistas que inician directamente su aprendizaje en ojos de cadáver de animal y en otro grupo de 35 especialistas que se inician previamente con este simulador. Resultados: Se desarrolla un simulador para entrenamiento de la técnica de capsulorrexis. El grupo de alumnos del grupo simulador consigue una reducción en el uso de ojos de cadáver y una mayor eficiencia en la realización de capsulorrexis correctas, a diferencia del grupo que se inicia directamente en ojos de cadáver. Conclusiones: Este simulador constituye una novedad en el entrenamiento de la técnica de capsulorrexis en cuanto a sencillez, coste y reutilización, frente a otros simuladores virtuales con equipos informáticos más costosos y más complicados de transportar. Es pieza clave como paso previo a la utilización de piezas de cadáver y de animales de experimentación, disminuyendo el número de ambos y, por tanto, el coste de la enseñanza (AU)

Introduction: To design and validate a simulator for learning and training in the capsulorhexis technique. Methods: The system consists of a methacrylate support inclined 15° for the surgeon's hand, an area of commercially available aluminum foil, and another one of similar characteristics, where the student performs the technique through some slots that are previously made in the support. In order to evaluate the feasibility of this simulator, data were collected from 65 ophthalmologists performing the technique during training activities. The ophthalmologists were randomly divided into one group of 30 specialists who start their learning on the eyes of an animal cadaver, and into another of 35 specialists who previously started with this simulator. Results: A simulator is developed for training in the capsulorhexis technique. The students from the simulator group achieved a reduction in the use of cadaver eyes, and a higher efficiency in correct capsulorhexis, unlike the group who started directly on the cadaver eyes. Conclusions: This simulator is an innovation in training of the capsulorhexis technique as regards simplicity, cost, and reuse, as compared to other virtual simulators with more expensive computer equipment (CE) equipment that are more difficult to transport. It is an important step prior to the use of cadaver parts and experimental animals, decreasing the number of both, and therefore the teaching costs (AU)

[Design and validation of a simulator for training in continuous circular capsulotomy for phacoemulsification]. / Diseño y validación de un simulador para el entrenamiento en la capsulotomía circular continua en la facoemulsificación.

INTRODUCTION: To design and validate a simulator for learning and training in the capsulorhexis technique. METHODS: The system consists of a methacrylate support inclined 15° for the surgeon's hand, an area of commercially available aluminum foil, and another one of similar characteristics, where the student performs the technique through some slots that are previously made in the support. In order to evaluate the feasibility of this simulator, data were collected from 65 ophthalmologists performing the technique during training activities. The ophthalmologists were randomly divided into one group of 30 specialists who start their learning on the eyes of an animal cadaver, and into another of 35 specialists who previously started with this simulator. RESULTS: A simulator is developed for training in the capsulorhexis technique. The students from the simulator group achieved a reduction in the use of cadaver eyes, and a higher efficiency in correct capsulorhexis, unlike the group who started directly on the cadaver eyes. CONCLUSIONS: This simulator is an innovation in training of the capsulorhexis technique as regards simplicity, cost, and reuse, as compared to other virtual simulators with more expensive computer equipment (CE) equipment that are more difficult to transport. It is an important step prior to the use of cadaver parts and experimental animals, decreasing the number of both, and therefore the teaching costs.

Importancia de las apoproteínas A1 y B como marcadores de riesgo cardiovascular / The importance of A1 and B apopproteins as cardiovascular risk

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Gammagrafía abdominal con leucocitos marcados en la isquemia intestinal / Abdominal scintigraphy using labelled leukocytes in intestinal ischaemia

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Direct activation of telomerase by GH via phosphatidylinositol 3'-kinase.

Telomerase is a ribonucleoprotein DNA polymerase that has been associated with cell proliferation, cell survival and apoptosis inhibition. Telomerase is regulated by specific growth factors, cytokines and hormones. The present study examines the effect of GH on telomerase activity and identifies the signal transduction pathway involved in this process in Chinese hamster ovary (CHO)4 cells, which express rat GH receptor cDNA. Telomeric repeat amplification protocol assays demonstrated that treating CHO4 cells with increasingly high doses of GH up-regulated telomerase activity with the maximum activation at 24 h. Similarly, GH activated telomerase in another cell system, primary cultures of rat hepatocytes. The telomerase activation in CHO4 cells was produced with an increase in hamster telomerase catalytic subunit (hamTERT) mRNA expression. The telomerase activity induced by GH was specifically blocked by the phosphatidylinositol 3'-kinase (PI3-K) inhibitor, LY294002, but not by the MAP kinase kinase inhibitor, PD98059. These findings suggest that GH could activate telomerase through the direct activation of TERT transcription, as well as through the PI3-K signalling pathway.

A telemedicine system for enabling teaching activities.

In order to improve the distance teaching of minimally invasive surgery techniques, an integrated system has been developed. It comprises a telecommunications system, a server, a workstation, some medical peripherals and several computer applications developed in the Minimally Invasive Surgery Centre. The latest peripherals, such as robotized teleoperating systems for telesurgery and virtual reality peripherals, have been added. The visualization of the zone to be treated, along with the teacher's explanations, enables the student to understand the procedures of the operation much better.

An integrated system of telemedicine for minimally invasive surgery.

We have developed a telemedicine project called Telesurgex, which is an integrated information system designed for several hospitals as well as the Minimally Invasive Surgery Centre. The project researches and develops telemedicine systems (both hardware and software) and their contents, ensuring that they are really useful and not just a videoconference with medical topics. Another aim of the project is the improvement of teleteaching systems as applied to medicine, mainly teleteaching of minimally invasive surgical techniques.