RESUMEN

Background: Cranioplasty is a routine neurosurgery treatment used to correct cranial vault abnormalities. Utilization of 3D printing technology in the field of cranioplasty involving the reconstruction of cranial defects emerged as an advanced possibility of anatomical reshaping. The transformative impact of patient-specific 3D printed implants, focuses on their remarkable accuracy, customization capabilities, and enhanced biocompatibility. Methods: The precise adaptation of implants to patient-specific anatomies, even in complex cases we presented, result in improved aesthetic outcomes and reduced surgical complications. The ability to create highly customized implants addresses the functional aspects of cranial defects and considers the psychological impact on patients. Results: By combining technological innovation with personalized patient care, 3D printed cranioplasty emerges as a transformative avenue in cranial reconstruction, ultimately redefining the standards of success in neurosurgery. Conclusion: 3D printing allows an excellent cranioplasty cosmesis achieved at a reasonable price without sacrificing patient outcomes. Wider implementation of this strategy can lead to significant healthcare cost savings.

RESUMEN

Surgical tracheostomy is a life-saving procedure performed for emergent or expectant airway compromise. Morbidity in the pediatric population is higher than in adults due to smaller operating field, immaturity of tissues, anatomic specificities of the child's neck, or the presence of craniofacial dysmorphism. The procedure varies among surgeons regarding the position of the skin incision (vertical or horizontal), resection of the subcutaneous adipose tissue and isthmus of the thyroid gland, use of tracheal flaps, and use of maturation or stay sutures. Both early and late complications can be life-threatening, and include accidental decannulation, stomal plugging, bleeding, and difficult ventilating. Consistent tracheostomal care is crucial in avoiding complications. Primary caregivers must be included and educated about proper stomal care. Decannulation failures are common. Prerequisites for safe decannulation include non-dependence on mechanical ventilation and no recent aspiration events, positive endoscopic airway assessment, and successful daytime capping. The role of polysomnography in decannulation protocols is debated. Although seldom performed, tracheostomy is the procedure of choice in a selected group of pediatric patients. The risks and benefits of the procedure must be weighed for each patient. The education of medical personnel and caregivers is key to reducing serious complications.

Asunto(s)

Traqueostomía , Humanos , Traqueostomía/métodos , Traqueostomía/efectos adversos , Niño

RESUMEN

During the Middle Ages, the partition of the cadaver of the elite members was a current practice, with highly technical treatment given to symbolic organs such as the heart. Considered mostly from a theoretical point of view, this notion of dilaceratio corporis has never been biologically explored. To assess the exact kind of embalming reserved to the heart, we performed a full biomedical analysis of the mummified heart of the English King Richard I (1199 A.D.). Here we show among other aspects, that the organ has been embalmed using substances inspired by Biblical texts and practical necessities of desiccation. We found that the heart was deposed in linen, associated with myrtle, daisy, mint, frankincense, creosote, mercury and, possibly, lime. Furthermore, the goal of using such preservation materials was to allow long-term conservation of the tissues, and good-smelling similar to the one of the Christ (comparable to the odor of sanctity).

Asunto(s)

Embalsamiento/historia , Corazón/microbiología , Antropología , Historia Medieval , Humanos , Espectrometría de Masas , Momias/microbiología , Miocardio/química , Ácido Oleanólico/análogos & derivados , Ácido Oleanólico/química , Preservación Biológica/historia

RESUMEN

Amorphous aluminium oxide coatings were processed by metalorganic chemical vapour deposition (MOCVD); their structural characteristics were determined as a function of the processing conditions, the process was modelled considering appropriate chemical kinetic schemes, and the properties of the obtained material were investigated and were correlated with the nanostructure of the coatings. With increasing processing temperature in the range 350 degrees C-700 degrees C, subatmospheric MOCVD of alumina from aluminium tri-isopropoxide (ATI) sequentially yields partially hydroxylated amorphous aluminium oxides, amorphous Al2O3 (415 degrees C-650 degrees C) and nanostructured gamma-Al2O3 films. A numerical model for the process allowed reproducing the non uniformity of deposition rate along the substrate zone due to the depletion of ATI. The hardness of the coatings prepared at 350 degrees C, 480 degrees C and 700 degrees C is 6 GPa, 11 GPa and 1 GPa, respectively. Scratch tests on films grown on TA6V titanium alloy reveal adhesive and cohesive failures for the amorphous and nanocrystalline ones, respectively. Alumina coating processed at 480 degrees C on TA6V yielded zero weight gain after oxidation at 600 degrees C in lab air. The surface of such low temperature processed amorphous films is hydrophobic (water contact angle 106 degrees), while the high temperature processed nanocrystalline films are hydrophilic (48 degrees at a deposition temperature of 700 degrees C). It is concluded that amorphous Al2O3 coatings can be used as oxidation and corrosion barriers at ambient or moderate temperature. Nanostructured with Pt or Ag nanoparticles, they can also provide anti-fouling or catalytic surfaces.