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Thiel embalming in neonates: methodology and benefits in medical training.

ABSTRACT: Current teaching and training methods for surgical techniques in the pediatric population involve artificial models (manikins), animals or adult human cadavers embalmed using various techniques. We found no references in the literature concerning the use of the Thiel method in the pediatric population. The aim of this study, therefore, was to assess the viability of using pediatric human cadavers embalmed through Thiel's technique and to compare them with standard pediatric manikins. After donation of a 24-week stillborn, the Thiel technique was carried out for fixation following the usual protocol. A video recording with eye-tracking glasses was used to perform an examination, and techniques. The same procedures were conducted on a pediatric manikin. Medical students, medical residents and physicians were asked to respond to questions in an online survey after being shown the video. A total of 92 responses were obtained. The Thiel-embalmed stillborn was assessed as superior to the manikin in all items. Our study confirmed that this technique is feasible even with extremely small donors. The value of this form of preservation for medical training is not widely known though it is receiving increasing interest. Our results show that Thiel fixation in pediatrics is clearly more highly valued than a manikin and offers great potential. This innovative application of the Thiel method in the pediatric population is technically possible. It poses no additional difficulties and is very positively assessed for undergraduate and postgraduate teaching.

SUBMITTER: Sanchez-Ferrer F

PROVIDER: S-EPMC9167811 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Thiel embalming in neonates: methodology and benefits in medical training.

Sanchez-Ferrer Francisco F Grima-Murcia Maria Dolores MD Sánchez-Del-Campo Francisco F Sánchez-Ferrer Maria Luisa ML Fernández-Jover Eduardo E

Anatomical science international 20220208 3

Current teaching and training methods for surgical techniques in the pediatric population involve artificial models (manikins), animals or adult human cadavers embalmed using various techniques. We found no references in the literature concerning the use of the Thiel method in the pediatric population. The aim of this study, therefore, was to assess the viability of using pediatric human cadavers embalmed through Thiel's technique and to compare them with standard pediatric manikins. After donat ...[more]

PMID: 35137346

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Project description:The quality of tissue preservation in Thiel embalmed bodies varies. Research on the administered embalming volume and its vascular distribution may elucidate one of the mechanisms of tissue preservation and allow for new applications of Thiel embalming. Vascular embalming with (group 1, n = 15) or without (group 2, n = 20) contrast agent was initiated in pig kidneys. The distribution of Thiel embalming solution in group 1 was visualized using computed tomography. The kidneys in both groups were then immersed in concentrated salt solutions to reduce their weight and volume. Afterwards, to mimic a lifelike circulation in the vessels, group 2 underwent pump-driven reperfusion for 120 minutes with either paraffinum perliquidum or diluted polyethylene glycol. The circulation was imaged with computed tomography. All of the kidneys were adequately preserved. The embalming solution spread diffusely in the kidney, but fluid accumulation was present. Subsequent immersion in concentrated salt solutions reduced weight (P < 0.01) and volume (P < 0.01). Reperfusion for 120 minutes was established in group 2. Paraffinum perliquidum filled both major vessels and renal tissue, whereas diluted polyethylene glycol spread widely in the kidney. There were no increases in weight (P = 0.26) and volume (P = 0.79); and pressure further decreased (P = 0.032) after more than 60 minutes of reperfusion with paraffinum perliquidum, whereas there were increases in weight (P = 0.005), volume (P = 0.032) and pressure (P < 0.0001) after reperfusion with diluted polyethylene glycol. Arterial embalming of kidneys results in successful preservation due to complete parenchymatous spreading. More research is needed to determine whether other factors affect embalming quality. Dehydration is an effective method to regain the organs' initial status. Prolonged vascular reperfusion with paraffinum perliquidum can be established in this model without increases in weight, volume and pressure.

Project description:BackgroundRegional anaesthesia education, especially for ocular procedures, necessitates reliable surgical training models. While cadaveric models offer anatomical fidelity, conventional embalming methods may compromise tissue integrity. We aimed to assess the effectiveness of Thiel cadavers for training in sub-Tenon's blocks by evaluating ocular tissues and measuring insertion forces.MethodsExperimental design, using twenty eyes from ten Thiel cadaver heads. These cadavers were specifically prepared to test the administration of sub-Tenon's blocks. The research was conducted in a controlled laboratory setting appropriate for handling cadaveric materials and conducting precise measurements. Each cadaver eye underwent an initial ultrasound examination, and its axial length was noted. An intravitreal injection of heptastarch solution followed, to re-establish the eye's sphericity. After this volume injection, the axial length and intraocular pressure were measured again. Mock sub-Tenon's blocks were administered in 2 separate quadrants of the eye, with insertion forces measured using a pressure gauge. These were compared to a data set of insertion forces measured in a series of isolated pig's eyes on which STBs had been performed. Main outcome measurements were macroscopic assessment of the ocular tissue layers and the insertion forces required for the sub-Tenon's blocks. In a second set of 10 Thiel cadaver heads, 5 ml of sodium chloride were injected as sub-Tenon's blocks and the emergence of a periocular "T-sign" ascertained and measured by ultrasound.ResultsFour of twenty eyes (20%) retained near-natural sphericity, with the remaining requiring volume injection to approximate physiological shape and pressure. The conjunctiva and Tenon's layer were intact, and correct cannula placement was achieved in all cases. In 16 of 20 eyes where T-signs could be measured, the median thickness of the T-sign amounted to 2.72 mm (range 1.34 mm-5.28 mm). The average maximum cannula insertion force was 2.92 Newtons. Insertion forces in intact Thiel cadaver heads were consistently higher than in isolated pig's eyes (3.6 N vs 2.0 N).ConclusionThese findings suggest that Thiel cadavers are a promising model for training in sub-Tenon'sblocks, despite the challenge of often desiccated and involuted eyes.

Project description:Humans continuously categorise inputs, but only rarely receive explicit feedback as to whether or not they are correct. This implies that they may be integrating unsupervised information together with their sparse supervised data - a form of semi-supervised learning. However, experiments testing semi-supervised learning are rare, and are bedevilled with conflicting results about whether the unsupervised information affords any benefit. Here, we suggest that one important factor that has been paid insufficient attention is the alignment between subjects' internal representations of the stimulus material and the experimenter-defined representations that determine success in the tasks. Subjects' representations are shaped by prior biases and experience, and unsupervised learning can only be successful if the alignment suffices. Otherwise, unsupervised learning might harmfully strengthen incorrect assumptions. To test this hypothesis, we conducted an experiment in which subjects initially categorise items along a salient, but task-irrelevant, dimension, and only recover the correct categories when sufficient feedback draws their attention to the subtle, task-relevant, stimulus dimensions. By withdrawing feedback at different stages along this learning curve, we tested whether unsupervised learning improves or worsens performance when internal stimulus representations and task are sufficiently or insufficiently aligned, respectively. Our results demonstrate that unsupervised learning can indeed have opposing effects on subjects' learning. We also discuss factors limiting the degree to which such effects can be predicted from momentary performance. Our work implies that predicting and understanding human category learning in particular tasks requires assessment and consideration of the representational spaces that subjects entertain for the materials involved in those tasks. These considerations not only apply to studies in the lab, but could also help improve the design of tutoring systems and instruction.

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Thiel embalming in neonates: methodology and benefits in medical training.

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Thiel embalming in neonates: methodology and benefits in medical training.

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