Summary
The rapid ascent of nanotechnology and regenerative therapeutics as applied to medicine and surgery has seen an exponential rise in the scale of research generated in this field. This is evidenced not only by the sheer volume of papers dedicated to nanotechnology but also in a large number of new journals dedicated to nanotechnology and regenerative therapeutics specifically to medicine and surgery. Aspects of nanotechnology that have already brought benefits to these areas include advanced drug delivery platforms, molecular imaging and materials engineering for surgical implants. Particular areas of interest include nerve regeneration, burns and wound care, artificial skin with nanoelectronic sensors and head and neck surgery. This study presents a review of nanotechnology and regenerative therapeutics, with focus on its applications and implications in plastic surgery.
Many inherited conditions cause cholestasis in the neonate or infant. Next-generation sequencing methods can facilitate a prompt diagnosis in some of these cases; application of these methods in patients with liver diseases of unknown cause has also uncovered novel gene-disease associations and improved our understanding of physiological bile secretion and flow. By helping to define the molecular basis of certain cholestatic disorders, these methods have also identified new targets for therapy as well patient subgroups more likely to benefit from specific therapies. At the same time, sequencing methods have presented new diagnostic challenges, such as the interpretation of single heterozygous genetic variants. This article discusses those challenges in the context of neonatal and infantile cholestasis, focusing on difficulties in predicting variant pathogenicity, the possibility of other causal variants not identified by the genetic screen used, and phenotypic variability among patients with variants in the same genes. A prospective, observational study performed between 2010–2013, which sequenced six important genes (ATP8B1, ABCB11, ABCB4, NPC1, NPC2 and SLC25A13) in an international cohort of 222 patients with infantile liver disease, is given as an example of potential benefits and challenges that clinicians could face having received a complex genetic result. Further studies including large cohorts of patients with paediatric liver disease are needed to clarify the spectrum of phenotypes associated with, as well as appropriate clinical response to, single heterozygous variants in cholestasis-associated genes.
Interaction between students and patients is a universal and essential component of a high-quality medical education. However, little work has been done to assess the attitudes of inpatients towards medical students on the ward. This study thus aimed to elicit patients' thoughts on the role and impact of medical students in the inpatient setting.
Nanotechnology has the power to transform neurosurgery by facilitating intervention at the cellular and subcellular level. The unique properties of nanomaterials will not only improve the management of conditions traditionally treated through neurosurgery, but also make neurosurgical intervention possible for diseases where there are currently limited treatment options. Specifically, nanotechnology appears to be a promising tool for improving molecular imaging, seamlessly integrating diagnosis and therapy in neuro-oncology, identifying targets for selective neuromodulation, as well as promoting neuroregeneration. Despite the vast potential benefits of nanotechnology in neurosurgery, problems related to neurotoxicity and the long-term medical and social consequences must be adequately addressed before nanotechnology becomes a component of surgical care.
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