[Regeneration - A New Therapeutic Dimension in Otorhinolaryngology].
ABSTRACT: Regeneration as a therapeutic priniciple and regenerative medicine in general are promising new strategies to add new therapeutic dimensions to our current treatment options. Today, reconstructive surgery, drugs and implants such as the cochlear implant can replace the functions of damaged tissues. In contrast, regenerative therapies aim at the replacement of the damaged tissues themselves while at the same time replacing their lost tissue function. In this review article new technologies such as 3D-bioprinting and the application of decellularised tissues as biomaterials are introduced and explained. A summary of current preclinical and clinical regenerative studies in otorhinolaryngology is complementing these basic aspects.
Project description:Specialty choices among medical graduates have undergone changes over time. We aimed to analyze status of otorhinolaryngology as specialty of choice among female medical graduates and factors affecting it. A total of 123 female medical graduates were surveyed during their internship over a period of 1 year in a tertiary-care hospital. Each intern was assessed using a questionnaire at the end of otorhinolaryngology rotation. The survey included nine questions about future career choices with special focus on ENT as a choice for specialization. Questions on choice of specialty, reason for choice, quality of undergraduate teaching and clinical postings were included. The post graduation specialty choices in descending order are Medicine, Pediatrics, Surgery, Obstetrics and Gynecology, Dermatology, Ophthalmology, Radiology, ENT, Anesthesia, Psychiatry followed by Physiology, Anatomy and Biochemistry. Among surgical branches most popular choice was General Surgery followed by Obstetrics and Gynecology, Ophthalmology, ENT and Orthopedics in descending order. Reason for the choice included advice from family and friends. Forty two interns (34.2%) followed advice of senior colleagues, 42 (34.2%) followed advice of relatives in the medical field, 25 (20.3%) took advice of non-medico parents while 14 (11.3%) followed their peer group. Regarding the opinion on the quality of undergraduate teaching and clinical postings, both were rated good by the majority. Otorhinolaryngology is less preferred than other general surgery, Obstetrics and Gynecology and ophthalmology by female medical graduates among surgical disciplines. Possible reasons and ways to improve status of Otorhinolaryngology are discussed.
Project description:Congenital disorders, cancer, trauma, or other conditions of the genitourinary tract can lead to significant organ damage or loss of function, necessitating eventual reconstruction or replacement of the damaged structures. However, current reconstructive techniques are limited by issues of tissue availability and compatibility. Physicians and scientists have begun to explore tissue engineering and regenerative medicine strategies for repair and reconstruction of the genitourinary tract. Tissue engineering allows the development of biological substitutes which could potentially restore normal function. Tissue engineering efforts designed to treat or replace most organs are currently being undertaken. Most of these efforts have occurred within the past decade. However, before these engineering techniques can be applied to humans, further studies are needed to ensure the safety and efficacy of these new materials. Recent progress suggests that engineered urologic tissues and cell therapy may soon have clinical applicability.
Project description:The need for organ and tissue regeneration in patients continues to increase because of a scarcity of donors, as well as biocompatibility issues in transplant immune rejection. To address this, scientists have investigated artificial tissues as an alternative to transplantation. Three-dimensional (3D) bioprinting technology is an additive manufacturing method that can be used for the fabrication of 3D functional tissues or organs. This technology promises to replicate the complex architecture of structures in natural tissue. To date, 3D bioprinting strategies have confirmed their potential practice in regenerative medicine to fabricate the transplantable hard tissues, including cartilage and bone. However, 3D bioprinting approaches still have unsolved challenges to realize 3D hard tissues. In this manuscript, the current technical development, challenges, and future prospects of 3D bioprinting for engineering hard tissues are reviewed.
Project description:Craniofacial disorders present markedly complicated problems in reconstruction because of the complex interactions of the multiple, simultaneously affected tissues. Regenerative medicine holds promise for new strategies to improve treatment of these disorders. This review addresses current areas of unmet need in craniofacial reconstruction and emphasizes how craniofacial tissues differ from their analogs elsewhere in the body. We present a problem-based approach to illustrate current treatment strategies for various craniofacial disorders, to highlight areas of need, and to suggest regenerative strategies for craniofacial bone, fat, muscle, nerve, and skin. For some tissues, current approaches offer excellent reconstructive solutions using autologous tissue or prosthetic materials. Thus, new "regenerative" approaches would need to offer major advantages in order to be adopted. In other tissues, the unmet need is great, and we suggest the greatest regenerative need is for muscle, skin, and nerve. The advent of composite facial tissue transplantation and the development of regenerative medicine are each likely to add important new paradigms to our treatment of craniofacial disorders.
Project description:OBJECTIVE:To evaluate the quality of clinical practice guidelines (CPGs) for otorhinolaryngology in China. MATERIALS AND METHODS:A systematic search of relevant literature databases (CBM, WANFANG, VIP, CNKI, China Guideline Clearinghouse) published between 1978 and March 2012 was undertaken to identify and select CPGs related to otorhinolaryngology. Four independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Their degree of agreement was evaluated using the intraclass correlation coefficient (ICC). RESULT:From 170 citations, 21 relevant guidelines were included. The overall agreement among reviewers was moderate (ICC?=?0.87; 95% confidence interval [CI], 0.78-0.91). The scores for each of the AGREE domains were the following: "scope and purpose" (mean ± standard error [SE]?=?45.4±4.4; ICC?=?0.92), "stakeholder involvement" (mean ± SE?=?30.4±3.1; ICC?=?0.81), "rigor of development" (mean ± SE?=?20.9±2.8; ICC?=?0.87), "clarity of presentation" (mean ± SE?=?48.8±3.7; ICC?=?0.80), "applicability" (mean ± SE?=?12.6±1.7; ICC?=?0.72), and "editorial independence" (mean ± SE?=?6.2±0.8; ICC?=?0.76). Three guidelines (14%) mentioned updates, and the average update frequency was 7 years. None used the GRADE system. CONCLUSION:The quality of otorhinolaryngology guidelines in China is low. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.
Project description:Patient-centred care has received considerable attention in the last few decades, but the patients' perspective remains underexposed. This study reports on an in-depth evaluation of patients' experiences and preferences at an otorhinolaryngology outpatient department.Qualitative research was conducted on patients' experiences and preferences at an otorhinolaryngology outpatient department in an academic hospital. The study comprised two phases. First, semi-structured interviews were held with 22 patients. Second, results from the interviews were verified and deepened in a focus group (N = 7).Overall, experience with patient-centred care was positive at the outpatient department. Three of the six dimensions of patient-centred care predominated in the interviews and the focus group: information, communication and education; coordination and integration of care; and respect for patients' values, preferences and expressed needs. The negative experiences were mostly in these dimensions. The dimensions physical comfort and involvement of family and friends were of lesser significance. Opinion on emotional support--relieving fear and anxiety differed as to whether this was the responsibility of the doctor or the patient.Qualitative research provided a deeper understanding of patients' experiences and preferences at an otorhinolaryngology outpatient department. Such an in-depth evaluation can be useful in the transition towards patient-centred care.
Project description:Research involving animal models is crucial for the advancement of science, provided that experiments are designed, performed, interpreted, and reported well. In order to investigate the quality of reporting of articles in otorhinolaryngology research using animal models, a PubMed database search was conducted to retrieve eligible articles. The checklist of the ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines was used to assess the quality of reporting of articles published in ear, nose and throat (ENT) and multidisciplinary journals. Two authors screened titles, abstracts, and full texts to select articles reporting otorhinolaryngology research using in vivo animal models. ENT journals ( n?=?35) reported a mean of 57.1% adequately scored ARRIVE items (median: 58.3%; 95% confidence interval [CI; 53.4-60.9%]), while articles published in multidisciplinary journals ( n?=?36) reported a mean of 49.1% adequately scored items (median: 50.0; 95% CI [46.2-52.0%]). Articles published in ENT journals showed better quality of reporting of animal studies based on the ARRIVE guidelines ( P?<?0.05). However, adherence to the ARRIVE guidelines is generally poor in otorhinolaryngology research using in vivo animal models. The endorsement of the ARRIVE guidelines by authors, research and academic institutes, editorial offices and funding agencies is recommended for improved reporting of scientific research using animal models.
Project description:Objective:The use of massive open online courses (MOOCs) in medical education and postgraduate education is becoming more and more widespread across the world. A survey study was carried out in Turkey to collect information and raise awareness about the use of MOOCs for educational and training purposes in the field of otorhinolaryngology after graduation. Method:The prepared survey questionnaire was published on the online communication platform of the Turkish Otorhinolaryngology-Head and Neck Surgery Association, and volunteers were asked to fill-out the questionnaire by clicking the given link. Results:A total of 210 volunteers participated in the survey study. Most of the volunteers (26.2%) were in the 36-40 age range. At the time of the study 53.8% of the volunteers were working as specialist doctors, 19.5% as residents, 10.5% as professors, 8.1% as associate professors, and 8.1% as assistant professors. Only 19 (9%) respondents ticked "yes" in response to the question "Are you familiar with the MOOC programs?" and only six (2.9%) of these respondents had attended a MOOC program. Evaluation of the correlation between academic title and awareness of MOOC programs showed that the instructors had a significantly higher level of MOOC awareness compared to the specialists and the residents (p=0.032). Conclusion:Results of the survey revealed that the use of MOOC programs in postgraduate otorhinolaryngology education was low and the volunteers were not well-informed about this practice.
Project description:OBJECTIVE:Review the published literature of telemedicine's use within otorhinolaryngology (ORL), highlight its successful implementation, and document areas with need of future research. METHODS:Three independent, comprehensive searches for articles published on the subject of telemedicine in otorhinolaryngology were conducted of literature available from January 2000-April 2020. Search terms were designed to identify studies which examined telemedicine use within ORL. Consensus among authors was used to include all relevant articles. RESULTS:While several, small reports document clinical outcomes, patient satisfaction, and the cost of telemedicine, much of the literature on telemedicine in ORL is comprised of preliminary, proof-of-concept reports. Further research will be necessary to establish its strengths and limitations. CONCLUSIONS:Particularly during the coronavirus disease of 2019 (COVID-19) pandemic, telemedicine can, and should, be used within ORL practice. This review can assist in guiding providers in implementing telemedicine that has been demonstrated to be successful, and direct future research. This article is protected by copyright. All rights reserved.
Project description:Hard tissues and organs, including the bones, teeth and cartilage, are the most extensively exploited and rapidly developed areas in regenerative medicine field. One prominent character of hard tissues and organs is that their extracellular matrices mineralize to withstand weight and pressure. Over the last two decades, a wide variety of 3D printing technologies have been adapted to hard tissue and organ engineering. These 3D printing technologies have been defined as 3D bioprinting. Especially for hard organ regeneration, a series of new theories, strategies and protocols have been proposed. Some of the technologies have been applied in medical therapies with some successes. Each of the technologies has pros and cons in hard tissue and organ engineering. In this review, we summarize the advantages and disadvantages of the historical available innovative 3D bioprinting technologies for used as special tools for hard tissue and organ engineering.