The blood-brain barrier (BBB) is constituted by a specialized vascular endothelium that interacts directly with astrocytes, neurons and pericytes. It protects the brain from the molecules of the systemic circulation but it has to be overcome for the proper treatment of brain cancer, psychiatric disorders or neurodegenerative diseases, which are dramatically increasing as the population ages. In the present work we have revised the current knowledge on the cellular structure of the BBB and the different procedures utilized currently and those proposed to cross it. Chemical modifications of the drugs, such as increasing their lipophilicity, turn them more prone to be internalized in the brain. Other mechanisms are the use of molecular tools to bind the drugs such as small immunoglobulins, liposomes or nanoparticles that will act as Trojan Horses favoring the drug delivery in brain. This fusion of the classical pharmacology with nanotechnology has opened a wide field to many different approaches with promising results to hypothesize that BBB will not be a major problem for the new generation of neuroactive drugs. The present review provides an overview of all state-of-the-art of the BBB structure and function, as well as of the classic strategies and these appeared in recent years to deliver drugs into the brain for the treatment of Central Nervous System (CNS) diseases.
Background: Over the past 60 years, no technique used for treating cartilage disorders has been completely successful. Bioprinting provides a highly anticipated, novel alternative solution to this problem. However, identifying barriers to this new technology is crucial in order to overcome them when bioprinting reaches the implementation stage. This kind of research has been declared essential because clinical efficacy and safety studies alone do not always lead to successful implementation.Objective: This qualitative study aimed to explore the stance of orthopedic surgeons on the use of bioprinted cartilage grafts for cartilaginous lesions. The study sought to summarize and classify the barriers and facilitators of this technique and to identify the key factors for successful implementation of bioprinted cartilage in routine clinical practice.Methods: A qualitative thematic analysis method was used to evaluate data obtained from semistructured interviews and from focus groups. Data were collected between June 2017 and February 2018. Interviews focused on the collection of expert opinions on bioprinted cartilage. Results:The perceived barriers to the adoption of this technology were (1) awareness of a lack of information on the status and possibilities of this technology, (2) uncertainty regarding compliance with current health care regulations and policies, and (3) demands for clinical evidence. The facilitators were (1) lack of surgical alternatives, (2) the perception that research is the basis of the current health system, and (3) the hope of offering a better quality of life to patients. Conclusions:The results of this study are preliminary in nature and cannot be generalized without a broader group of participants. However, the key factors identified provide a frame of reference to help understand the challenges of bioprinted cartilage and help facilitate the transition toward its clinical use. These findings will also provide information for use at multidisciplinary meetings in scientific societies; create bridges between researchers, orthopedic surgeons, and regulators; and open a debate on the funding of this technique and the business model that needs to be developed.
Background Traumatic and degenerative lesions in the cartilage are one of the most difficult and frustrating types of injuries for orthopedic surgeons and patients. Future developments in medical science, regenerative medicine, and materials science may allow the repair of human body parts using 3D bioprinting techniques and serve as a basis for new therapies for tissue and organ regeneration. One future possibility is the treatment of joint cartilage defects with in vivo 3D printing from biological/biocompatible materials to produce a suitable cell attachment and proliferation environment in the damaged site and employ the natural recovery potential of the body. This study focuses on the perspectives of orthopedic surgeons regarding the key factors/determinants and perceived clinical value of a new therapeutic option. Objective This study aimed to determine the knowledge and expectations of orthopedic surgeons regarding the clinical use of bioprinted cartilage. Methods The survey, conducted anonymously and self-managed, was sent to orthopedic surgeons from the Catalan Society of Orthopedic and Traumatology Surgery. In accordance with the method devised by Eysenbach, the Checklist for Reporting Results of Internet E-Surveys was used to analyze the results. The following factors were taken into consideration: the type and origin of the information received; its relevance; the level of acceptance of new technologies; and how the technology is related to age, years, and place of experience in the field. Results Of the 86 orthopedic surgeons included, 36 believed the age of the patient was a restriction, 53 believed the size of the lesion should be between 1 and 2 cm to be considered for this type of technology, and 51 believed that the graft should last more than 5 years. Surgeons over 50 years of age (38/86, 44%) gave more importance to clinical evidence as compared to surgeons from the other age groups. Conclusions The perspective of orthopedic surgeons depends highly on the information they receive and whether it is specialized and consistent, as this will condition their acceptance and implementation of the bioprinted cartilage.
El estado de excepción periodístico que se produce durante una crisis sanitaria se caracteriza por un incremento sustancial del número de noticias y una mayor probabilidad de cometer disfunciones periodísticas. Estas pueden aparecer de modo diferencial en función de la sección del periódico en el que se publican. En este trabajo se ha realizado un análisis de contenido inductivo de 124 portadas y 151 editoriales publicadas en los diarios El País, La Vanguardia, El Periódico y El Mundo entre el 17/04/2020 y el 17/05/2020. En el 26% de las portadas se han detectado disfunciones periodísticas de al menos uno de los 8 subtipos descritos por metodología inductiva. En el 14% de los editoriales se han encontrado disfunciones, la mayoría de entidad lingüística. Los editoriales suelen transmitir un mensaje de rigor, prudencia y sosiego. Se verifica el teorema periodístico que afirma que, en el curso de una crisis sanitaria grave, en los editoriales se encuentra la información periodística más veraz y tranquilizadora, en contraposición a las portadas, que tienden al alarmismo y al sensacionalismo. Se añade un corolario a este teorema: las disfunciones periodísticas en los editoriales se incrementan si se da en un contexto de polarización política.
The maxim of proponents of pseudoscience is to spread ignorance through false perceptions of its scientific status. One of its most attractive — and simultaneously harmful — manifestations is complementary and alternative medicine (CAM). Despite the scientific evidence against them, CAM has taken hold in today’s society as a therapeutic model for a growing segment of the population. We analysed 379 articles on homeopathy, acupuncture, reiki and Bach flower remedies published in mainstream Spanish newspapers (El País, El Mundo, La Vanguardia, El Periódico and ABC) for the period 2011-2016, finding that disinformation is participated in actively by the Spanish press. CAM content was detected in these newspapers, together with a lack of an editorial perspective. In most of the cases, the uncritical articles were found in the interpretive genre and the society section. We also characterized the pseudoscientific discourse aimed at the public, finding that it is irrational and fraudulent in sowing fear and distrust regarding science. On the basis of theories invalidated by the scientific method and on appeals to the emotions, pseudoscience not only threatens scientific knowledge, but directly undermines public health by encouraging the abandonment of conventional medicine. In order to remedy this situation, better scientific training, informative screening and editorial commitment is urgently needed in the Spanish press.
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