Minimally Invasive Posterior Cervical Fusion: A Handsome Option.

Cervical spondylosis is the leading cause of cervical myelopathy. When surgery is indicated, it is commonly addressed through an anterior or posterior cervical approach, such as cervical discectomy and fusion (ACDF) or laminectomy and fusion (LMF). Besides their own merits, each one has specific approach- or device-related complications, such as dysphagia, significant postoperative pain, wound infection, adjacent segment degeneration (ASD), and pseudoarthrosis. Through a tissue-sparing minimally invasive technique, posterior cervical fusion (PCF) has shown unfolding compelling evidence of biomechanical stability, good clinical outcomes, and high fusion rates, with fewer complications and better econometrics. On the basis of our own experience, we discuss here the indications, advantages, and drawbacks of minimally invasive PCF.

Spinal Intradural Extramedullary Tumors: A Retrospective Analysis on Ten-Years' Experience of Minimally Invasive Surgery and a Comparison with the Open Approach.

Spinal intradural extramedullary (ID-EM) tumors are pathologies widely treated through a classical open approach. However, minimally invasive surgery is gaining traction as a comparable treatment option because it carries less morbidity and may reduce healthcare costs.This study aimed to compare the clinical and functional outcomes of open versus minimally invasive approaches for patients with ID-EM tumors. We performed a retrospective analysis on prospectively collected data from patients with ID-EM tumors submitted to surgery. Baseline features and operative variables were compared, including surgery duration and estimated blood loss (EBL). Postoperative data covered tumor histology, length of stay (LOS), complication(s), and neurological status (Medical Research Council (MRC) scale) at the last follow-up.In total, 46 patients were included: 30 (65.2%) operated through an open approach and 16 (34.8%) through a minimally invasive surgical (MIS) approach. The predominant histology type was schwannomas (43.5%). Lesions more frequently affected the lumbar spine (34.8%). The tumor dimensions were similar in both cohorts. The minimally invasive approach was on average 76.7 min faster and correlated positively with less EBL (140 mL less than that of the open approach). Patients in the MIS group had shorter LOSs (5.63 days vs. 17.27 days) and had fewer postoperative complications. No significant difference in functional outcome was found.MIS is as effective as the traditional approach in achieving comparable functional outcomes, with advantages such as shorter surgery durations, less blood loss, and shorter hospital LOSs.

Long-Term Clinical and Radiological Evaluation of Low-Grade Lumbar Spondylolisthesis Stabilization with Rigid Percutaneous Pedicle Screws.

The armamentarium of surgical treatment options for lumbar spondylolisthesis (LS) includes decompression alone, stabilization with interlaminar devices, or instrumented fusion, through open or minimally invasive approaches. Despite its safe profuse use in distinctive lumbar spine disorders, using percutaneous pedicle screws (PPSs) alone to stabilize LS has never been described before. We performed a retrospective study of prospectively collected data, enrolling 24 patients with LS and scrutinizing clinical and radiological outcomes. A statistically significant decrease in visual analog scale (VAS) scores (p < 0.001) and Oswestry Disability Index (ODI) scores (p < 0.001) was observed, as was a reduction in the intake of acetaminophen after surgery (p = 0.022). In the long-term, PPS effectively reduced the index-level range of motion (p < 0.001), reduced preoperative slippage (p = 0.03), and maintained foraminal height, thus accounting for the positive clinical outcomes. It induced a significant segmental kyphotic effect (p < 0.001) that was compensated for by a favorable increase in the pelvic incidence minus lumbar lordosis (PI-LL) index (0.028).

Association of Lower Age and Cardiorespiratory Events during Intra-Arterial Chemotherapy for Retinoblastoma: A Prospective Observational Study.

BACKGROUND AND PURPOSE: Retinoblastoma is the most common primary intraocular tumor in childhood. Intra-arterial chemotherapy is becoming the standard of care for both first-line and rescue therapy, thus improving survival rates and decreasing the adverse effects of retinoblastoma treatment. Cardiorespiratory adverse events during general anesthesia for intra-arterial chemotherapy, including decreased lung compliance and bradycardia, have been described, but data regarding associated factors are still lacking. We aimed to assess the characteristics of patients and procedures associated with cardiorespiratory events during intra-arterial chemotherapy. MATERIALS AND METHODS: We performed a prospective monocenter observational study in children diagnosed with retinoblastoma undergoing intra-arterial chemotherapy under general anesthesia. The occurrence of cardiorespiratory events was registered. We also assessed clinical and procedural characteristics potentially associated with these events. RESULTS: A cardiorespiratory event was observed in 22 (12.5%) procedures, predominantly a decrease in tidal volume observed in 16 (9%) procedures. The median age was lower in the procedures with a cardiorespiratory event (20.43 [SD, 11.76] months versus 30.11 [SD, 24.17] months) (P < .05). Other variables such as bilateral disease or a previous intra-arterial chemotherapy treatment were not associated with the occurrence of a cardiorespiratory event. CONCLUSIONS: In children undergoing intra-arterial chemotherapy for retinoblastoma treatment, cardiorespiratory events were observed in 12.5% of procedures. Lower age was associated with this complication. Although predominantly mild, these events should have prompt diagnosis and treatment to prevent further deterioration and worse outcomes.

Role of methyl jasmonate and salicylic acid in kiwifruit plants further subjected to Psa infection: biochemical and genetic responses.

The use of plant elicitors for controlling Pseudomonas syringae pv. actinidiae (Psa), the etiological agent of the kiwifruit bacterial canker (KBC), has been analysed in the past and, while salicylic acid (SA) seems to decrease disease susceptibility, methyl jasmonate (MJ) shows an opposite effect. However, the metabolic and genomic responses of Psa-infected plants following elicitation with these two compounds, as compared with non-elicited Psa-inoculated plants, are poorly understood, being the focus of this study. Micropropagated A. chinensis 'Hayward' plants were elicited with MJ or SA, and further inoculated with Psa. Fifteen days post-inoculation, Psa population in MJ-treated plants was increased by 7.4-fold, whereas SA elicitation led to decreased Psa colonization (0.5-fold), as compared with non-elicited inoculated plants. Additionally, elicitation with MJ or SA generally decreased polyphenols and lignin concentrations (by at least 20%) and increased total proteins (by at least 50%). MJ led to the upregulation of SOD, involved in plant antioxidant system, and reporter genes for the jasmonic acid (JA) (JIH and LOX1), abscisic acid (SnRK), SA (ICS1), and ethylene (ACAS1, ETR1 and SAM) pathways. Moreover, it increased ABA (40%) and decreased carotenoids (30%) concentrations. Contrastingly, comparing with non-elicited Psa-inoculated plants, SA application resulted in the downregulation of antioxidant system-related genes (SOD and APX) and of reporter genes for ethylene (ETR1) and JA (JIH and ETR1). This study contributes to the understanding of potential mechanisms involved in kiwifruit plant defences against Psa, highlighting the role of the JA, ABA and ethylene in plant susceptibility to the pathogen.

Laparoscopic Bilateral Adrenalectomy in a Young Female Patient with Recurrent Cushing's Disease.

INTRODUCTION: Synchronous bilateral adrenalectomy is undertaken less often due to numerous perioperative challenges and rare circumstances of patients needing this procedure. Bilateral adrenalectomy is an important second-line option for patients with persistent or recurrent hypercortisolism following transsphenoidal surgery for Cushing's disease. Here, we present a challenging case of synchronous laparoscopic bilateral adrenalectomy for a young female patient with recurrent Cushing's disease and fertility wishes. Case Presentation. A 21-year-old recently married patient who was diagnosed with Cushing's disease with a pituitary microadenoma had undergone two attempts of transsphenoidal excision of the pituitary tumour. Follow-up evaluation showed an unresectable residual tumour with invasion of the intracavernous part of the left internal carotid artery. As the patient had the hypothalamic-pituitary-ovarian axis intact with strong fertility wishes, she was offered bilateral adrenalectomy instead of radiotherapy. She was prepared for the surgery with close perioperative support from the endocrinology and anaesthesia teams. Intravenous hydrocortisone infusion was started at the induction of anaesthesia. Transperitoneal approach was used with the patient positioned in left and right lateral positions for right and left glands, respectively. A meticulous surgical technique was used for the identification of adrenal veins to clip them before division followed by handling of the glands. The patient had minimal haemodynamic disturbances during surgery. Intraoperative blood loss was less than 100 ml, and operative time was 220 minutes. She had a gradual recovery following postoperative respiratory distress due to basal atelectasis and consolidation. Cortisol levels were less than 20 nmol/L postoperatively, suggesting successful surgical intervention. Two months after surgery, she continued on maintenance therapy of oral hydrocortisone and fludrocortisone and was encouraged to go ahead with pregnancy. CONCLUSION: Although bilateral adrenalectomy is considered a high-risk procedure, these risks can be mitigated and performed safely while maintaining close multidisciplinary perioperative support.

Intestinal occlusion by stenotic neuroendocrine tumours of left colon and concomitant association with small bowel gastrointestinal stromal tumours: A case report.

INTRODUCTION: The association between Gastrointestinal Stromal Tumours (GIST) and Neuroendocrine Tumours (NET) is very rare. These tumours have various clinical expressions and sometimes are asymptomatic. Synchronous NETs and GISTs have been already described in literature in few case reports. On the other hand, there is no mention of concomitant presence of discending colon NEC-G3 and small intestinal GIST. PRESENTATION OF CASE: we presented a case of a patient with clinical evidence of intestinal occlusion and radiological and intraoperative aspects of an adenocarcinoma of the left colon with a single metastasis on small bowel. The pathology analysis of the tumour showed a stenotic left colon NEC-G3 and a small bowel GIST. DISCUSSION: In this case report GIST was surgically treated as a small bowel ripetitive lesion and NET as a left colon adenocarcinoma. These tumours may have a similar presentation in terms of symptoms, endoscopic findings and imaging results. CONCLUSION: Concomitant NEC and GIST is rare but it is important to investigate patients before surgery in order to distinguish these from other tumours because of the different prognosis.

Abordaje endoscópico al cavum de Meckel: resección endoscópica endonasal de schwannoma del nervio trigémino / Endoscopic approach to the Meckel's cave: endonasal endoscopic resection of a trigeminal schwannoma

RESUMEN El cavum de Meckel (CM) es un divertículo localizado en la fosa media adyacente al seno cavernoso. Las neoplasias de esta región son extremadamente raras y representan un desafío para el cirujano debido a las estructuras neurovasculares que se encuentran en la región. Para los tumores ubicados en esta área se han descrito diversos abordajes quirúrgicos, los cuales no logran una adecuada exposición a la porción anteromedial del CM. En la última década, se ha postulado el abordaje endoscópico endonasal extendido (AEE) como una alternativa quirúrgica para el manejo de lesiones ubicadas en esta región. Se presenta el caso de un paciente portador de un schwannoma del nervio trigémino situado en el CM derecho tratado mediante AEE.

ABSTRACT The Meckel's cave (CM) is a diverticulum located in the middle fossa adjacent to the cavernous sinus. The neoplasms of this region are extremely rare and represent a challenge for the surgeon due to the neurovascular structures that occupy and surround the parasellar region. For tumors located in this area, several surgical approaches have been described, all of which do not achieve an adequate exposure to the anteromedial portion of CM. In the last decade, the extended endonasal endoscopic approach (EEA) has been postulated as an alternative for the surgical management of tumors located in this region. We present the case of a patient with a trigeminal schwannoma located in the right CM treated by EEA.

A case of severe obstructive sleep apnoea in Madelung's disease treated by lateral pharyngoplasty.

BACKGROUND: Madelung's disease is a rare disorder characterised by the presence of multiple, symmetric, non-capsulated fat masses in the face, neck and other areas of upper extremities. In some cases, severe clinical complications such as upper airway compression can occur. CASE REPORT: A 56-year-old man affected by Madelung's disease complained of snoring and severe daytime sleepiness. Polysomnography revealed severe obstructive sleep apnoea. An attempt to treat sleep apnoea by continuous positive airway pressure failed because of poor compliance. Functional expansion pharyngoplasty was carried out as an initial treatment. Marked improvement of neck movements and normalisation of somnographic parameters were observed at six months' follow up. CONCLUSION: Patients with Madelung's disease should be examined carefully for potential obstructive sleep apnoea. Although continuous positive airway pressure remains the treatment of choice, specific surgery can be used in those patients who cannot tolerate continuous positive airway pressure therapy.

Use of 177Lu-dotatate in the treatment of iodine refractory thyroid carcinomas. / Uso del 177Lu-DOTATATE como terapia en carcinomas de tiroides yodorrefractarios.

In a patient with a differentiated thyroid cancer the standard treatment protocol to be followed is surgery, ablation of thyroid remnants with 131Iodine (131I), and TSH suppression. However, the treatment with 131I is not effective in some cases, and it no longer becomes a therapeutic option due to cell de-differentiation with loss of 131I uptake. Systemic treatment can be used as other options, although patients are not always responsive; thus, the disease may progress and therapeutic options may run out. Endocrine tumours may express somatostatin receptors,and this characteristic has been used, not only for diagnosis, but also for their treatment through somatostatin analogue labelling with radioactive isotopes. This was the case of a patient suffering from iodine-refractory follicular thyroid carcinoma, with somatostatin receptors expression, treated with 177Lu-DOTATATE, showing an excellent clinical and analytical response.

Beyond the Briganti nomogram: Individualisation of lymphadenectomy using selective sentinel node biopsy during radical prostatectomy for prostate cancer. / Más allá del nomograma de Briganti: individualización de la linfadenectomía utilizando la biopsia selectiva del ganglio centinela durante la prostatectomía radical por cáncer de próstata.

OBJECTIVE: To validate the technique of selective sentinel node biopsy for diagnosing and staging intermediate to high-risk prostate cancer by comparing the technique with conventional extended lymphadenectomy (eLFD) in a prospective, longitudinal comparative study. METHODS: We applied the technique to 45 patients. After an intraprostatic injection of 99mTc-nanocolloid and preoperative single-photon emission computed tomography (SPECT/CT), we extracted the sentinel lymph nodes, guided by a portable Sentinella® gamma camera and a laparoscopic gamma-ray detection probe. The eLFD was completed to establish the negative predictive value of the technique. RESULTS: SPECT/CT showed radiotracer deposits outside the eLFD territory in 73% of the patients and the laparoscopic gamma probe in 60%. The mean number of active foci per patient was 4.3 in the SPECT/CT and 3.2 in the laparoscopic gamma probe. The mean number of extracted sentinel lymph nodes was 4.3 (0-14), with 26% outside the eLFD territory. The lymph nodes were metastatic in 10 patients (22%), 6/40 (15%) when the prostatectomy was the primary treatment. In all cases with metastatic lymph nodes, there was at least one positive sentinel node. Metastatic sentinel lymph nodes were found outside the eLFD territory in 3/10 patients (30%). The sensitivity was 100%, the specificity was 94.73%, the positive predictive value was 81.81%, and the negative predictive value was 100%. CONCLUSION: Selective sentinel node biopsy is superior to eLFD for diagnosing lymph node involvement and can avoid eLFD when metastatic sentinel lymph nodes are not found (85%), with the consequent functional advantages.

Laparoscopic Resection of Pancreatic Tail Solid Pseudopapillary Tumour in a Young Male.

Background. Solid Pseudopapillary Tumours of the pancreas are a rare entity and more commonly seen in women than in men. These tumours have typically reached large sizes when clinically detected. Case Description. A 21-year-old male was found to have a left hypochondrial mass on physical examination following a trivial soft tissue injury. Contrast-enhanced computed topography (CT) of the abdomen showed a 10.3 × 7.6 × 10.3 cm size arising from the body and the tail of the pancreas. He underwent laparoscopic resection of distal pancreatic tumour en bloc with spleen. Large tumour was noted originating from the body and tail of the pancreas with dilated veins surrounding the tumour. Histology revealed a clear cell variant of solid pseudopapillary neoplasm with steatotic pattern. Resection margin was free of tumour. Discussion. Several studies have shown significant short term advantages using laparoscopic approach compared to open surgery, in terms of lower blood loss, resumption of oral intake, and hospital stay. This case and few other case reports published in world literature have shown that laparoscopic approach is safe and oncologically adequate.

PAK1 is involved in sensing the orientation of collagen stiffness gradients in mouse fibroblasts.

Migrating cells sense variations of stiffness in connective tissue matrices but how cells detect and respond to stiffness orientation is not defined. We examined cell extension formation on collagen with underlying support (vertical stiffness gradient) or on collagen laterally supported by nylon (lateral stiffness gradient). At 6 h after plating, cells plated on laterally-supported collagen exhibited >2-fold more abundant and ~2-fold longer cell extensions than cells plated on collagen with underlying support. We examined whether p21-activated kinase 1 (PAK1) influences extension formation that is dependent on the orientation of support. At 6 h after plating on collagen with underlying support, wild-type cell extensions were 40% shorter than PAK1 knockdown cells. In contrast, on laterally-supported collagen, wild-type cell extensions were 2-fold longer than PAK1 knockdown cells. In cells plated on laterally-supported collagen, there were ~2-fold reductions of collagen fiber alignment and compaction in PAK1 knockdown cells compared with wild-type cells. PAK1 knockdown did not affect collagen fiber alignment or compaction by cells plated on collagen with underlying support. Wild-type cells with lateral support of collagen exhibited 3-fold increases of phospho-myosin staining at 6h, which was 2-fold lower in PAK1 knockdown cells. In contrast, cells on collagen with underlying support showed no increase of phospho-myosin staining at any times. PAK1 knockdown did not affect α2 or ß1 integrin expression or function. We conclude that PAK1 is involved in the ability of cells to sense the orientation of stiffness in collagen substrates and generate contractile forces that affect cell extension formation.

La contribución de la ocupación en la construcción de la cultura en la feria libre de la comuna de Valdivia / Contribution of occupation in the construction of cultures in the street markets of Valdivia city

Estudio cualitativo de diseño narrativo. Las técnicas utilizadas fueron, la entrevista en profundidad semi estructurada y observación participante pasiva. Para ello se realizaron cuatro visitas de campo a la Feria libre Valdivia; se eligieron a cinco actores claves y a su vez, se aplicó una pauta de observación de forma y función del contexto, elaborada por las investigadoras. Los resultados fueron analizados y contrastados con elementos teóricos relacionados. El objeto de esta investigación guarda relación con la necesidad de abordar la complejidad contextual de esta comunidad bajo la intervención con relevancia cultural desde Terapia Ocupacional, y a su vez responder a la interrogante: ¿Contribuye la ocupación (productiva) a la conformación de cultura en la feria libre Valdivia? ¿Cómo? Los resultados dan cuenta de la relación de su ocupación productiva, tanto en forma, función y signifcado, con las características que lo constituyen como tal, y dan forma a la cultura feriante.

Qualitative study with narrative design. Theused techniques were a deep semi – structured interview and passive participant observation. For this, four feld visits were performed in Valdivia’s Fair, fve key players were selected and a context’s function and shape observation guideline made by the investigators was applied. The results was analyzed and compared with related theoretical elements. The purpose of this research is related with the need to approach to the contextual complexity of this community under the culturally relevant intervention from Occupational Therapy and in turn answer to the question: Does the occupation (productive occupation) contributes in culture’s conformation in the Valdivia’s fair? how?. The results show the relationship of their productive occupations, in form, function and meaning, with features that constitutes it as such and shape the culture in Valdivia’s fair.

Craniectomía descompresiva en encefalitis herpética: caso clínico / Decompressive craniectomy in herpes simplex encephalitis. Clinical case

Introduction: The morbidity and mortality of herpes simplex encephalitis (HSE) have decreased with the use of acyclovir. However, some patients develop focal hemorrhagic necrosis and edema in the temporal lobe, with a subsequent elevation of intracranial pressure. Clinical cases: We report the clinical outcomes of two children with HSE who developed severe intracranial hypertension and impending uncal herniation refractory to profound sedation, osmotic agents and moderate hyperventilation. Decompressive craniectomy allowed an effective control of intracranial pressure and a favorable neurological outcome at discharge in both patients. Conclusions: Decompressive craniectomy could be considered as a rescue treatment strategy in patients with life-threatening intracranial hypertension due to severe herpetic encephalitis.

Introducción: La morbimortalidad de la encefalitis herpética ha disminuido con el uso de aciclovir. Sin embargo, algunos pacientes pueden evolucionar con necrosis focal hemorrágica y edema cerebral con posterior elevación de la presión intracraneal. Casos clínicos: Reportamos el curso clínico de dos niños con encefalitis herpética complicada con hipertensión intracraneal refractaria al tratamiento con sedación profunda, agentes osmóticos e hiperventilación. Ambos pacientes desarrollaron signos de enclavamiento uncal por lo que se realizó una craniectomía descompresiva precoz, que permitió un control de la presión intracraneal y una evolución neurológica favorable al alta. Conclusiones: La craniectomía descompresiva podría ser considerada como una alternativa terapéutica de rescate en pacientes con encefalitis herpética e hipertensión endocraneana refractaria a la terapia medica.

Lesiones quísticas de línea media de base de cráneo anterior / Cystic lesions in midline of anterior skull base

Las lesiones quísticas en línea media del segmento posterior de la base de cráneo anterior corresponden mayoritariamente a malformaciones congénitas, cuya ubicación puede ser selar, supraselar o intraesfenoidal. Generalmente asintomáticas, pueden presentar síntomas determinados por su crecimiento y/o el compromiso mecánico sobre las estructuras adyacentes. Su diagnóstico suele realizarse producto de un hallazgo imagenológico o endoscópico, constituyendo la resonancia magnética la mejor alternativa ante una aproximación diagnóstica inicial. Estas lesiones quísticas presentan un comportamiento benigno y no todas requieren un manejo quirúrgico, siendo suficiente en la gran mayoría de ellas, un seguimiento clínico. La necesidad de cirugía deberá decidirse en cada caso y depende principalmente de la sintomatología producida por la compresión de estructuras vecinas e hipertensión endocraneana. El abordaje quirúrgico endoscópico extendido es el método resectivo de elección. Presentamos una serie de casos clínicos, correspondiente a cinco pacientes con lesiones quísticas en línea media de base de cráneo anterior. Tanto la sintomatología como el diagnóstico etiológico tuvieron una presentación diversa en la serie expuesta; independiente de lo cual, todos fueron manejados exitosamente por cirugía endoscópica. Presentamos finalmente, una propuesta de diagnóstico inicial, basado en el estudio imagenológico con resonancia magnética de estas lesiones.

Cystic lesions in the midline of the anterior skull base are rare and mostly congenital malformations. Usually asymptomatic, symptoms can be determined by their growth and/or mechanical compromise on adjacent structures. The diagnosis is usually the result of imaging or endoscopic findings, MRI is the best alternative for the initial diagnostic approach. These cystic lesions are benign xx and not all require a surgical management. Some of them require a watchfull follow up. If they need surgery the expanded endoscopic approach is the method of choice in our hands. We present a case series, correspondent to five patients with cystic lesions in the midline of the skull base. All these were successfully managed by an extended endoscopic approach. Finally, we presented a proposal for initial diagnosis approach, based on the MRI findings of these lesions.

AlphaScope vs lens-based hysteroscope for office polypectomy without anesthesia: randomized controlled study.

In this randomized controlled study, effectiveness, operative time, and acceptability of endometrial polypectomy were compared using an AlphaScope vs an office operative lens-based hysteroscope (LBH). One hundred fifty women with a diagnosis of endometrial polyp were operated on using an AlphaScope or LBH in the office setting. In 73 procedures using the AlphaScope (97.3%) and 68 using the LBH (90.7%), the polyp was successfully removed completely. In the AlphaScope group, 2 procedures were incomplete because of excessive endometrial mucosa thickness. In the LBH group, 3 procedures were incomplete because of difficulty in management of a large polyp, and 4 procedures were stopped because of patient pain and low compliance. Time to completion of the procedure and complete removal of the polyp was significantly shorter in the AlphaScope group than in the LBH group (p < .05). Similarly, the pain score at the end of the procedure was significantly lower in the AlphaScope group than in the LBH group (p < .05). The AlphaScope is an effective operative hysteroscope that increases the possibility of performing endometrial polypectomy in the office setting without anesthesia and improves the indications for and acceptability of office hysteroscopy.

Spectroscopic detection of gastrointestinal dysplasia using optical microsensors.

The detection of dysplasia in the gastrointestinal tract can be performed using optical microsensors based on thin-film optical filters and silicon photodiodes. This paper describes two optical microsensors that can be used for spectroscopy data collection in two different spectral bands (one in the violet/blue region and the other in the green region) for which two optical filters were designed and fabricated. An empirical analysis of gastrointestinal spectroscopic data using these specific spectral bands is performed. The obtained results show that it is possible to accurately differentiate dysplastic lesions from normal tissue, with a sensitivity and specificity of 77.8% and 97.6%, respectively. Therefore, the developed filters can be used as a tool to aid in diagnosis. The small size of the optical microsensors can enable, in the future, integration in endoscopic capsules.