Home-care nursing controlled mobile robot with vital signal monitoring.

This study describes the development (design, construction, instrumentation, and control) of a nursing mobile robotic device to monitor vital signals in home-cared patients. The proposed device measures electrocardiography potentials, oxygen saturation, skin temperature, and non-invasive arterial pressure of the patient. Additionally, the nursing robot can supply assistance in the gait cycle for people who require it. The robotic device's structural and mechanical components were built using 3D-printed techniques. The instrumentation includes electronic embedded devices and sensors to know the robot's relative position with respect to the patient. With this information together with the available physiological measurements, the robot can work in three different scenarios: (a) in the first one, a robust control strategy regulates the mobile robot operation, including the tracking of the patient under uncertain working scenarios leading to the selection of an appropriate sequence of movements; (b) the second one helps the patients, if they need it, to perform a controlled gait-cycle during outdoors and indoors excursions; and (c) the third one verifies the state of health of the users measuring their vital signs. A graphical user interface (GUI) collects, processes, and displays the information acquired by the bioelectrical amplifiers and signal processing systems. Moreover, it allows easy interaction between the nursing robot, the patients, and the physician. The proposed design has been tested with five volunteers showing efficient assistance for primary health care. Graphical Abstract Main stages of the home-care nursing controlled mobile robot.

Minimally Invasive Removal of Extra- and Intradural Spinal Tumors Using Full Endoscopic Visualization.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To evaluate the clinical efficacy of minimally invasive endoscopic surgery in patients with spinal extradural and intradural-extramedullary tumors. METHODS: This was a study of 15 consecutive patients with spinal extradural or intradural-extramedullary tumors up to 2 levels treated by minimal invasive surgery using a full endoscopic visualization and Caspar's retraction system (for cervical, thoracic, and lumbar tumors) over a 4-year period between January 2015 to April 2019 at a tertiary center. RESULTS: A gross total remove was achieved in all patients (100%), determined by postoperative contrast computed tomography scans and magnetic resonance imaging. There was no postoperative spinal instability. All patients had equal or better neurologic functions after surgery at follow-up. The average preoperative Nurick's grade mean was 1.9 and the postoperative was 1.1. The average preoperative McCormick's grade mean was 2.9 versus 1.3 in the postoperative period. CONCLUSIONS: Selective extradural or intradural-extramedullary tumors well localized and up to 2 levels can be safely and effectively treated by minimally invasive surgery using a full endoscopic visualization and the Caspar's retractor. However, there is insufficient evidence to recommend this approach over the classical or other microsurgical approach described.

Endoscopic retrosigmoid keyhole approach in cerebellopontine angle tumors. A surgical cohort.

INTRODUCTION AND OBJECTIVES: To determine the safety and efficacy of endoscopic keyhole surgery in patients with cerebellopontine angle tumours. MATERIALS AND METHODS: This was a retrospective study of patients with cerebellopontine angled tumours treated by fully endoscopic retrosigmoid keyhole approach in a tertiary centre during a period of four years. Preoperative, transoperative and postoperative variables were analysed. RESULTS: A number of 40 patients were included. The age average was 49.4 years and male/female proportion was 0.4-1. We found 31 vestibular schwannomas (77.5%), five meningiomas (12.5%), two cholesteatomas (5.0%) and two metastases (5.0%). Vestibular schwannomas Hannover type IIIb, IVa and IVb predominated. The surgical resection was total or near-total 92.5% of patients. Hearing preservation rate was 62.5% and acceptable facial function nerve function rate was 80% after six months. Hospital stay was 7.5 days. The total or near total resection and functionally preservation rate was high. Complications were unusual. CONCLUSIONS: Endoscopic retrosigmoid keyhole approach represented a safe and efficient procedure in selected patients with cerebellopontine angle tumours.

Minimally Invasive 360-Degree Approach to Intraconal Orbital Tumors.

PURPOSE: To evaluate clinically the efficacy of 360-degree minimally invasive endoscopic surgery in patients with orbital intraconal tumors. DESIGN: Retrospective interventional case series. METHODS: A series of consecutive patients with orbital intraconal tumors were treated with minimally invasive surgery using an endonasal endoscopic approach or an anterior endoscopic orbitotomy over a 5-year period between January 2015 and January 2020 at the National Institute of Oncology and Radiobiology of Cuba. RESULTS: In 22 patients, the mean age was 52.3 ± 11 years (range 18-71 years) with a female to male ratio of 1.8:1. Visual loss was present in 3 patients and proptosis was present in 19 patients. The most common diagnosis was cavernous hemangioma (72.7%) followed by orbital sheet meningioma (9.1%). The lower-inner (type II) location was the most usual, followed by the lower-outer (type IV). A gross total resection was achieved in 95.5% of patients. In only 1 case with an orbital pseudotumor was the resection subtotal because of the fibrous consistency, irregularity, and adherences to the medial rectus muscle. All patients with visual loss improved to normal visual function after surgery at follow-up and orbital proptosis recovered in all patients with these symptoms. Both immediate and long-term morphologic and aesthetic results were good in all patients. CONCLUSION: The minimally invasive 360-degree surgical approach with a full endoscopic visualization can be safe and efficient in patients with select orbital intraconal tumors. Optic nerve location constitutes the main aspect in the surgical approach selection. A large case series is necessary to standardize this surgical philosophy.

Endoscopic retrosigmoid keyhole approach in cerebellopontine angle tumors. A surgical cohort. / Keyhole endoscópico retrosigmoideo en tumores del ángulo pontocerebeloso. Resultados de una serie.

INTRODUCTION AND OBJECTIVES: To determine the safety and efficacy of endoscopic keyhole surgery in patients with cerebellopontine angle tumors. MATERIALS AND METHODS: This was a retrospective study of patients with cerebellopontine angled tumors treated by fully endoscopic retrosigmoid keyhole approach in a tertiary center during a period of four years. Preoperative, transoperative and postoperative variables were analyzed. RESULTS: A number of 40 patients were included. The age average was 49.4 years and male/female proportion was 0.4-1. We found 31 vestibular schwannomas (77.5%), five meningiomas (12,5%), two cholesteatomas (5,0%) and two metastases (5.0%). Vestibular schwannomas Hannover type IIIb, IVa and IVb predominated. The surgical resection was total or near-total 92.5% of patients. Hearing preservation rate was 62.5% and acceptable facial function nerve function rate was 80% after six months. Hospital stay was 7.5 days. The total or near total resection and functionally preservation rate was high. Complications were unusual. CONCLUSIONS: Endoscopic retrosigmoid keyhole approach represented a safe and efficient procedure in selected patients with cerebellopontine angle tumors.

Comportamiento de portadores de VIH/sida en el municipio de II Frente / Behaviour of HIV/aids carriers in II Frente municipality

Se realizó un estudio descriptivo y transversal, durante el 2013, de los 16 pacientes con el virus de la inmunodeficiencia humana/sida en el municipio II Frente, provincia de Santiago de Cuba, con vistas a caracterizarles según variables de interés para la investigación. Entre los resultados principales predominaron: el sexo masculino (87,5 %), el grupo etario de 20-29 años (50,0 %), el nivel escolar universitario (43,7 %), los desocupados, los solteros, así como la vía sexual como la forma de contagio más común. La incidencia de VIH/sida en este municipio ha ascendido en los últimos años y los consejos populares de mayor tasa resultaron ser Mayarí y Loma Blanca.

A descriptive and cross sectional study was carried out during the 2013, on the 16 patients with the human immunodeficiency virus/aids in II Frente municipality, Santiago de Cuba province, with the aim of characterizing them according to variables of interest for the investigation. Among the main results there were: the male sex (87.5%), the age group 20-29 years (50.0%), the university school level (43.7%), the unemployed, the single persons, as well as the sexual pattern as the most common way of infection. The incidence of HIV/aids in this municipality has increased in the last years and the people's councils of higher rates were Mayarí and Loma Blanca.