Endoscopy

Endoscopy is a fast moving field, and new techniques are continuously emerging. In recent decades, endoscopy has evolved and branched out from a diagnostic modality to enhanced video and computer assisting imaging with impressive interventional capabilities. The modern endoscopy has seen advances not only in types of endoscopes available, but also in types of interventions amenable to the endoscopic approach. To date, there are a lot more developments that are being trialed. Modern endoscopic equipment provides physicians with the benefit of many technical advances. Endoscopy is an effective and safe procedure even in special populations including pediatric patients and renal transplant patients. It serves as the tool for diagnosis and therapeutic interventions of many organs including gastrointestinal tract, head and neck, urinary tract and others

Anatomía endoscópica de la base del cráneo: la fisura orbitaria inferior y su implicancia quirúrgica

Tesis (Dr. en Medicina y Cirugía)--Universidad Nacional de Córdoba. Facultad de Ciencias Médicas, 2017220 p.OBJETIVOS: Proporcionar datos y conocimiento de la anatomía endoscópica de la Fisura Orbitaria Inferior (FOI) a fin de comprender sus relaciones con las aéreas que la rodean en función de los corredores endoscópicos quirúrgicos. HIPÓTESIS: La fisura orbitaria inferior (FOI) y sus segmentos pueden ser expuestos y analizados por vía endoscópica junto con su Músculo de Müller (MM), señalando reparos anatómicos de relevancia en la cirugía endoscópica. MATERIAL Y MÉTODOS: realizamos un análisis morfométrico y descriptivo óseo de la FOI en cráneos secos, disección y estudio bajo técnica anatómica, microquirúrgica, y principalmente endoscópica, de cabezas fijadas en formol y coloreadas. Medimos distancias y ángulos a forámenes relacionados con las áreas contiguas a la FOI (fosa pterigopalatina, fosa infratemporal y ápex orbitario). El análisis estadístico lo realizamos con el programa estadístico SPSS 17. RESULTADOS: Definimos a la FOI como un estrecho espacio entre la cara lateral y el piso de la órbita. Esta fisura tiene una dirección oblicua (antero-lateral) desde su origen posteromedial a nivel del pilar maxilar (maxillary strut) hasta el hueso cigomático. Pudimos dividir a la FOI en 3 segmentos con reparos anatómicos endoscópicos precisos (posteromedial, medio y anterolateral) cada uno relacionado con diferentes áreas o regiones de la base anterolateral del cráneo. La media de longitud total de la FOI fue de 29,1mm (rango intercuartil 28-30mm). La FOI siempre estuvo tapizada por un músculo liso llamado Músculo de Müller (MM). Este binomio o unidad estructural FOI/MM fue un reparo anatómico constante y visible bajo técnica endoscópica en todo el proceso de observación, investigación y análisis. Quirúrgicamente el MM nos da una orientación anatómica de la FOI: se trata de un reparo anatómico clave que permite generar corredores específicos a cada región de la base de cráneo relacionada con la FOI. Finalmente, el estudio histológico nos confirmó las relaciones vistas y analizadas endoscópicamente. Hallamos más tejido graso del esperado. CONCLUSIONES: Las disecciones anatómicas clásicas y las endoscópicas nos permitieron tener un concepto más completo de la anatomía de la FOI y de sus regiones contiguas, aportando datos sobre una estructura hasta ahora escasamente abordada. Podemos afirmar que la unidad estructural FOI/MM es un reparo anatómico de relevancia en cirugía endoscópica y que, desde un conocimiento firme de su morfología, puede ser utilizado para definir corredores endoscópicos a la región anterolateral de la base de cráneo. Dada la profusión y continuidad de su tejido graso, queda abierta la pregunta sobre el papel de esta estructura como vía o canal de difusión de patologías.OBJECTIVES: To provide data and knowledge of the endoscopic anatomy of the IOF, to understand its relationships with the surrounding areas, upon the surgical endoscopic pathways. HYPOTHESIS: The IOF and its segments can be exposed and analyzed endoscopically together with its Müller’s muscle (MM), pointing out relevant anatomical landmarks for endoscopic surgery. MATERIALS AND METHODS: We performed a morphometric and descriptive bone analysis of the IOF in dry skulls; as well as microsurgical (mainly endoscopic) dissection and anatomic technical study of formol-fixated and colored human heads. We also measured the distances and angles to the foramina related to areas adjacent to the IOF (Pterygopalatine fossa, infratemporal fossa and orbital apex). All statistical analysis was performed using statistical software, SPSS 17. RESULTS: The IOF was defined as a narrow space between the orbit’s lateral face and the orbit’s floor. This fissure has an oblique direction (antero-lateral) from its posterior-medial origin at the maxillary strut to the zygomatic bone We were able to divide the IOF in three segments with precise anatomical landmarks (posterior-medial, medial and anterolateral) each one related with different anterolateral regions of the skull base. The mean total length of the IOF was 29.1 mm (interquartile range: 28-30 mm). The IOF was always covered by the Müller’s muscle. This binomial, or structural unit, IOF/MM, was a constant anatomical landmark, visible under endoscopic technique during the whole process of observation, investigation and analysis. Surgically, MM provided anatomical orientation within the IOF, being a key landmark allowing to generate specific pathways to each region of the skull base in relation to the IOF. Finally, histologic study confirmed the relationships which had been endoscopically seen and analyzed. We found more fat tissue than expected. CONCLUSIONS: Classical and endoscopic anatomic dissections allowed us to have a more complete concept of the IOF’s anatomy and its adjacent regions, providing information about a structure which has been scarcely approached, until now. We can state that the structural unit IOF/MM is a relevant anatomical landmark for endoscopic surgery and through its firm morphologic knowledge it can be used to open endoscopic pathways to the anterolateral region of the skull base. An open question remains in relation to the structure’s function and its fat tissue, which could provide a way for pathology spread.Fil: De Battista, Juan Carlos. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.Peer reviewe

European position paper on rhinosinusitis and nasal polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included

A Textbook of Advanced Oral and Maxillofacial Surgery

The scope of OMF surgery has expanded; encompassing treatment of diseases, disorders, defects and injuries of the head, face, jaws and oral cavity. This internationally-recognized specialty is evolving with advancements in technology and instrumentation. Specialists of this discipline treat patients with impacted teeth, facial pain, misaligned jaws, facial trauma, oral cancer, cysts and tumors; they also perform facial cosmetic surgery and place dental implants. The contents of this volume essentially complements the volume 1; with chapters that cover both basic and advanced concepts on complex topics in oral and maxillofacial surgery

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com

Manual de simulación clínica en especialidades médicas

Manual sobre técnicas y modos de simulación clínica en diversas especialidades médicas.La enseñanza y formación en medicina necesita el uso de la simulación. Existen evidencias de su uso desde hace cientos de años, pero, en los últimos años se ha incrementado y diseminado. La simulación clínica está validada científicamente en múltiples contextos médicos y de otras áreas profesionales de la salud. Y es considerada de gran importancia como proceso de entrenamiento y de mejora de las competencias y adquisición de habilidades médicas en campos que incluye desde la historia clínica, comunicación con el paciente, exploración, diagnóstico terapéutica médica-farmacológica y quirúrgica y seguridad al tratar al paciente. Hoy en día, para muchas técnicas y situaciones clínicas es inaceptable llegar junto a los pacientes sin un dominio adquirido en simulación. La simulación puede ocurrir sin el uso de recursos adicionales, solo las personas, o utilizando pocos o muchos recursos de baja hasta alta tecnología y se puede adaptar a los recursos disponibles, abarcando todas las áreas de conocimiento, y dentro de ellas competencias técnicas o actitudes, solas o en conjunto. El uso racional y basado en evidencia de la simulación es de la mayor importancia por la necesidad de una mayor efectividad y eficiencia en la transformación de los profesionales de la salud para que puedan mejorar su capacidad de atender a los pacientes. La simulación es también una buena herramienta de evaluación de competencias y habilidades en Medicina y otras disciplinas de las Ciencias de la Salud Este manual incluye técnicas y modos de simulación clínica en diversas especialidades médicas, útiles, para quien busque un manual práctico y actualizado.Cátedra de Mecenazgo de la Universidad de Málaga. Cátedra de Terapias Avanzadas en Patología Cardiovascular Cátedra de Mecenazgo de la Universidad de Málaga. Cátedra de Investigación Biomédica Quirón Salu

XXII International Conference on Mechanics in Medicine and Biology - Abstracts Book

This book contain the abstracts presented the XXII ICMMB, held in Bologna in September 2022. The abstracts are divided following the sessions scheduled during the conference

Modeling of the human upper airway from multimodal 3D dentofacial images

Ph.DDOCTOR OF PHILOSOPH