syrcle_sloff mini symposium sr animal studies 30082012
TRANSCRIPT
![Page 1: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/1.jpg)
Writing a Systematic Review
a good start of a PhD-project
Marije Sloff
PhD-student Experimental Urology
Tissue Engineering
![Page 2: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/2.jpg)
Introduction
• Experimental Urology – internship 2009
• Polymer Chemistry – internship 2011 • Targeted Drug Delivery
• Hyaluronan
![Page 3: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/3.jpg)
PhD-project
• “Developing an artificial stoma for urinary diversion in
patients with extensive bladder disease”.
• Patients
• Bladder cancer
•73.000 new patients/2012 in US
•Muscle-invasive tumors
• Congenital malformations
•Spina bifida or bladder exstrophy
•Neurogenic/dyfunctional bladder
![Page 4: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/4.jpg)
Urinary Diversion (1/2)
![Page 5: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/5.jpg)
Urinary Diversion (2/2)
• Urinary Diversion
• Golden standard is Bricker ileal conduit
• Bowel surgery
• Placing Urostomy
![Page 6: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/6.jpg)
Problems
In 28-81% of the cases complications will occur, due to:
• Intestinal surgery (1-5%) • Leakage/rupture of the anastomosis
• Obstruction
• Fistula formation
• Infections
• Unsuitability of tissue • Necrosis
• Stenosis
• Obstruction
• Deformations
![Page 7: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/7.jpg)
Tissue engineering
• Aims to restore or replace diseased, affected or non-
functional tissues.
• In vitro and In vivo
• Synthetic/biological materials
• W/ or w/o cell technology
• Scaffold
• Temporal support
• Promotes tissue regeneration
• Replacement
![Page 8: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/8.jpg)
Artificial Urostomy (1/2)
• Structural protein Collagen
• (slow) Biodegradable Vypro® II
synthetic polymer mesh
• Porcine model
•Conclusion: A tubular construct can be
used for urinary diversion (although
improvement is needed)
![Page 9: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/9.jpg)
Artificial Urostomy (2/2)
• Problems
• Skin contraction
• Immunological reaction
• Tissue regeneration
• Improvement
• Material
• Animal model
•Porcine model
•Predictive value?
![Page 10: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/10.jpg)
Systematic Review
• “What is the current evidence for the efficacy of
tissue-engineered constructs for urinary diversion in
animal models?”
• PICO
Patient: Urinary diversion in animal models
Intervention: Tissue-engineered construct
Comparison: Classical method using GI tissue
Outcome: Survival/ regeneration/ inflammation/
integration/ functionality
![Page 11: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/11.jpg)
Search Strategy (in progress)
Based on Leenaars et al (2012) 45: 24-31.
![Page 12: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/12.jpg)
Inclusion/Exclusion
Used in Systematic Review
![Page 13: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/13.jpg)
Why start a PhD with systematic Review?
• To prevent unneccessary (animal) experimentation
• To collect information about materials/methods/models
• To generate a detailed overview of all relevant literature
• To learn how to make a comprehensive search strategy
![Page 14: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/14.jpg)
Experienced difficulties
• Commercial side of my research
• Unpublished information
• Negative results
• When to stop/continue
• Slow proces
![Page 15: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/15.jpg)
Conclusions
• Benefits and difficulties
• Do the benefits outweigh the difficulties?
• Time and effort
• Useful information
• Extensive overview
• Full-time focus at beginning of a project
• Use for grant application
![Page 16: SYRCLE_Sloff mini symposium sr animal studies 30082012](https://reader034.vdocuments.us/reader034/viewer/2022042907/587aebea1a28ab7f378b55e5/html5/thumbnails/16.jpg)
Acknowledgements
Department of Urology
Prof. Dr. Wout Feitz
Dr. Egbert Oosterwijk
Dr. Paul Geutjes
SYRCLE
Prof. Dr. Merel Ritskes-Hoitinga
Dr. Rob de Vries