ABSTRACT
Introduction: Clinical research has recently focused on developing diagnostic and therapeutic alternatives through nanomedicine, and it has become essential for both current and coming healthcare professionals, especially medical residents, to know about it to face actual challenges in the setup of their professional practice. Approach: This scoping review was conducted to show the relevance of nanomedicine in the formation of medical residents and to determine the educational strategies proposed worldwide for their teaching. Results: 12 records met the inclusion and exclusion criteria, including information related to the importance of teaching nanotechnology, possible educational approaches, or the best action strategies for incorporating said teaching. Discussion: Multiple studies showed the need for students in health-related programs to be trained and instructed in topics related to nanotechnology. Still, the students' perceptions highlight how inadequate or non-existent such education in this field is. Although a few studies have proposed strategies and approaches for incorporating nanotechnology in academic programs in different areas, it is still necessary to establish educational standards so that the training of future professionals will be uniform and of high quality. The concerned educational institutions' directives must try to ensure that their in-training staff receives an updated, full, and excellency education.
ABSTRACT
BACKGROUND: Tap test improves symptoms of idiopathic normal pressure hydrocephalus (iNPH); hence, it is widely used as a diagnostic procedure. However, it has a low sensitivity and there is no consensus on the parameters that should be used nor the volume to be extracted. We propose draining cerebrospinal fluid (CSF) during tap test until a closing pressure of 0 cm H2O is reached as a standard practice. We use this method with all our patients at our clinic. METHODS: This is a descriptive cross-sectional study where all patients with presumptive diagnosis of iNPH from January 2014 to December 2019 were included in the study. We used a univariate descriptive analysis and stratified analysis to compare the opening pressure and the volume of CSF extracted during the lumbar puncture, between patients in whom a diagnosis of iNPH was confirmed and those in which it was discarded. RESULTS: A total of 92 patients were included in the study. The mean age at the time of presentation was 79.4 years and 63 patients were male. The diagnosis of iNPH was confirmed in 73.9% patients. The mean opening pressure was 14.4 cm H2O mean volume of CSF extracted was 43.4 mL. CONCLUSION: CSF extraction guided by a closing pressure of 0 cm H2O instead of tap test with a fixed volume of CSF alone may be an effective method of optimizing iNPH symptomatic improvement and diagnosis.