An Overview of 3D Anatomical Model Printing in Orthopedic Trauma Surgery.

Introduction: 3D object printing technology is a resource increasingly used in medicine in recent years, mainly incorporated in surgical areas like orthopedics. The models made by 3D printing technology provide surgeons with an accurate analysis of complex anatomical structures, allowing the planning, training, and surgery simulation. In orthopedic surgery, this technique is especially applied in oncological surgeries, bone, and joint reconstructions, and orthopedic trauma surgeries. In these cases, it is possible to prototype anatomical models for surgical planning, simulating, and training, besides printing of instruments and implants. Purpose: The purpose of this paper is to describe the acquisition and processing from computed tomography images for 3D printing, to describe modeling and the 3D printing process of the biomodels in real size. This paper highlights 3D printing with the applicability of the 3D biomodels in orthopedic surgeries and shows some examples of surgical planning in orthopedic trauma surgery. Patients and Methods: Four examples were selected to demonstrate the workflow and rationale throughout the process of planning and printing 3D models to be used in a variety of situations in orthopedic trauma surgeries. In all cases, the use of 3D modeling has impacted and improved the final treatment strategy. Conclusion: The use of the virtual anatomical model and the 3D printed anatomical model with the additive manufacturing technology proved to be effective and useful in planning and performing the surgical treatment of complex articular fractures, allowing surgical planning both virtual and with the 3D printed anatomical model, besides being useful during the surgical time as a navigation instrument.

Study of the Pulse of Peristaltic Pumps for Use in 3D Extrusion Bioprinting.

Peristaltic pumps are used in healthcare for their ability to aseptically displace various fluids, including medium-density gels and suspended solids. However, they have the undesirable characteristic of pulsing at their output. Three-dimensional printing is becoming a reality in tissue engineering, and it generally uses syringes to extrude hydrogels. One of the problems to be solved is the microdosing of biomaterials or bioinks when it is necessary to print large volumes. The use of peristaltic pumps in bioprinting is desirable as it does not limit the volume to the contents of a syringe while achieving dosage control. A peristaltic pump was designed and implemented to avoid pulsation errors and microliter dosing while allowing a large amount of fluid displacement. Two pumps with equal displacement were built. The first uses the conventional profile and is the baseline for comparisons, while the second presents the profile studied and proposed. The concepts demonstrated by Bernoulli were used, fixing the height of a column of water, while the two pumps provide flow to the system asynchronously, allowing the reading of pressure as a function of the speed variation created by the pulsation of each pump. An approximately 100 times reduction in pulsation was observed during fluid displacement with the variance reduced from 2.64 to 0.025 s2. The two pumps were also installed on a modified Ultimaker FDM 3D printer, and a standard for comparison was printed using a water-based hydrogel, corn starch, and corn-derived triglyceride, showing that the proposed pump improves the deposition quality of the material. Three-dimensional prints, tubes 20 mm in diameter by 8 mm in height and 0.7 mm in wall width, were also produced. Videos obtained show that the first pump was not able to print more than 4 mm in height, while the second prints the model with high quality and without deficiency. The results show that the new pump profile is able to provide a sufficiently constant volume for three-dimensional printing with excellent deposition control, building a simple object but difficult to obtain for a common peristaltic pump.

Calcium Phosphate-Based Bioceramics in the Treatment of Osteosarcoma: Drug Delivery Composites and Magnetic Hyperthermia Agents.

The use of biomaterials in medicine is not recent, and in the last few decades, the research and development of biocompatible materials had emerged. Hydroxyapatite (HAp), a calcium phosphate that constitutes a large part of the inorganic composition of human bones and teeth, has been used as an interesting bioceramic material. Among its applications, HAp has been used to carry antitumor drugs, such as doxorubicin, cisplatin, and gemcitabine. Such HAp-based composites have an essential role in anticancer drug delivery systems, including the treatment of osteosarcoma. In addition, the association of this bioceramic with magnetic nanoparticles (MNPs) has also been used as an effective agent of local magnetic hyperthermia. Further, the combined approach of the aforementioned techniques (HAp scaffolds combined with anti-tumor drugs and MNPs) is also an attractive therapeutical alternative. Considering the promising role of the use of bioceramics in modern medicine, we proposed this review, presenting an updated perspective on the use of HAp in the treatment of cancer, especially osteosarcoma. Finally, after giving the current progress in this field, we highlight the urgent need for efforts to provide a better understanding of their potential applications.

Measurement of wound area for early analysis of the scar predictive factor.

OBJECTIVE: to evaluate the use of the 2D-FlexRuler as a facilitating tool for the early calculation of the predictive scar factor of chronic wounds. METHOD: a descriptive study with a quantitative, experimental, longitudinal and prospective approach. The sample consisted of 22 outpatients. 32 chronic wounds were analyzed. The wound edges were identified and drawn on the 2D-FlexRuler. The calculations of the areas of chronic wounds were obtained by manual, traditional methods, by software and Matlab algorithm. These areas were compared with each other to determine the efficiency of the proposed ruler in relation to traditional methods. RESULTS: the calculation of the wound area by the traditional method and Kundin's coefficient show average errors greater than 40%. The manual estimation of the area with the 2D-FlexRuler is more accurate in relation to traditional measurement methods, which were considered quantitatively disqualified. When compared with the reference method, for example, the Klonk software, the data obtained by 2D-FlexRuler resulted in an error of less than 1.0%. CONCLUSION: the 2D-FlexRuler is a reliable metric platform for obtaining the anatomical limits of chronic wounds. It facilitated the calculation of the wound area under monitoring and allowed to obtain the scar predictive factor of chronic wounds with precocity in two weeks.

The role of biomedical engineering in health system improvement and nation's development.

Biomedical Engineering (BME) undergraduate programs are incipient in Brazil and in other South American countries. Accreditation concerns and the Health system modernization make necessary for countries such as Brazil to plan the education and investments strategy for the next 15 years. BME curricula are not well defined in Brazil and this study intends to present the minimum needs. The importance of implantation of new BME programs in Brazil and other Latin American countries is also discussed.

Electrical characteristics of the sparks produced by electrosurgical devices.

The electrical characteristics of the sparks produced between the active electrode and the biological tissue during electrosurgical procedures have been experimentally investigated. The results have shown that the minimum voltage required to initiate a spark depends on the applied voltage polarity resulting in electrosurgical voltage asymmetry. This voltage asymmetry is capable of producing dc levels that can result in tissue electrostimulation or direct current burns as discussed in this paper. The experimental setup and the conditions, under which the results have been obtained, including the techniques used to improve experimental reproducibility, are reported in detail.