Controlled Series Research Articles

The Effect of Autologous Platelet Rich Plasma on Endometrial Receptivity: A Narrative Review

Background and Objectives: Autologous platelet-rich plasma (PRP) transfusions are a relatively new treatment method used in different fields of medicine, including the field of reproductive medicine. One of the applications of these concentrated platelet infusions is the treatment of endometrial receptivity, which is a key factor for embryo implantation. There are implications that PRP infusions can lead to increased endometrial thickness, endometrial receptivity, and significantly elevated clinical pregnancy rates. Our objective is to briefly understand what PRP is and to, through a narrative review, summarize the findings from studies focused on evaluating the benefits of PRP infusions to treat thin endometrium with the goal of achieving better endometrial receptivity. Materials and Methods: Reference data was searched using Medline, PubMed, and EMBASE to identify reports from 2015 to 2024. The combination of search words used was “PRP” and “platelet-rich plasma” with “thin endometrium”, “endometrial receptivity”, “endometrial thickness”, and “endometrial implantation”. Obtained articles were screened, and suited studies (randomized controlled trials, case reports, case series, pilot studies, and reviews) were included in the present review. Reports not available in the English language were eliminated from the current review. Results: The results from most of the reviewed studies showed a positive effect of autologous PRP infusions on increasing endometrial thickness, enhancing endometrial receptivity, and elevating clinical pregnancy rates. The majority of the evaluated findings revealed endometrial thickness > 7 mm (increased endometrial thickness was observed in each evaluated study) following the PRP treatment. More than 50% of the evaluated studies resulted in enhanced endometrial thickness, increased endometrial receptivity, and an elevated pregnancy rate after the PRP application. Conclusions: Autologous PRP infusions for treating endometrium are a relatively new method that has shown promising results. Its major strengths are availability and proper application, which eliminates possible immunological reactions or disease transmission. The main drawbacks are not enough data on safety (i.e., its effect on endometriosis) and the lack of uniformity in the PRP preparation, which would provide optimal standardized quality and quantity of the PRP product and, thus, optimal treatment results.

Modified thoracoabdominal nerves block through perichondrial approach for surgical patients: a scoping review

BackgroundModified thoracoabdominal nerves block through perichondrial approach (M-TAPA) is a trunk block that has been gaining attention for managing postoperative pain following abdominal surgeries since its first report in 2019. We conducted a scoping review on M-TAPA, aiming to comprehensively evaluate existing research, identify the gaps in knowledge, and understand the implications of M-TAPA.MethodsThis scoping review was conducted using databases including PubMed, Embase, Cochrane, and CINAHL to evaluate the clinical efficacy of M-TAPA on April 19, 2024. Background and outcomes including anesthetized dermatomes, postoperative pain, opioid consumption, quality of recovery, duration to perform, and plasma local anesthetic concentrations were assessed. All reports involving patients, including randomized controlled trials, observational studies, case series, and case reports regarding M-TAPA, were included without language or age restrictions. The included studies were analyzed based on their methodology and clinical relevance.ResultsAnesthetized dermatomes were mainly observed in anterior cutaneous branch T7–11. Lateral cutaneous branch T8–10 also anesthetized; however, the probability was lower than anterior cutaneous branch area. M-TAPA has been investigated mostly in laparoscopic cholecystectomy; although its potential to outperform non-block and wound infiltration has been suggested, it did not clearly outperform the transversus abdominis plane block.ConclusionsM-TAPA may be considered a promising technique for postoperative pain management in upper abdominal laparoscopic surgeries. Further studies are warranted to elucidate the precise mechanisms and broader surgical applications.

The Role of Therapeutic Endoscopic Ultrasound in Management of Malignant Double Obstruction (Biliary and Gastric Outlet): A Comprehensive Review with Clinical Scenarios.

Endoscopic ultrasound (EUS)-guided interventions have revolutionized the management of malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), providing minimally invasive alternatives with improved outcomes. These procedures have significantly reduced the need for high-risk surgical interventions or percutaneous alternatives and have provided effective palliative care for patients with advanced gastrointestinal and bilio-pancreatic malignancies. EUS-guided biliary drainage (EUS-BD) techniques, including hepaticogastrostomy (EUS-HGS), choledochoduodenostomy (EUS-CDS), and antegrade stenting (EUS-AS), offer high technical and clinical success rates, with a good safety profile particularly when Endoscopic Retrograde Cholangiopancreatography (ERCP) is not feasible. EUS-HGS, which allows biliary drainage by trans-gastric route, is primarily used for proximal stenosis or in case of surgically altered anatomy; EUS-CDS with Lumen-Apposing Metal Stent (LAMS) for distal MBO (dMBO), EUS-AS as an alternative of EUS-HGS in the bridge-to-surgery scenario or when retrograde access is not possible and EUS-guided gallbladder drainage (EUS-GBD) with LAMS in case of dMBO with cystic duct patent without dilation of common bile duct (CDB). EUS-guided gastroenterostomy (EUS-GE) has already established its role as an effective alternative to surgical GE and enteral self-expandable metal stent, providing relief from GOO with fewer complications and faster recovery times. However, we do not yet have strong evidence on how to combine the different EUS-guided drainage techniques with EUS-GE in the setting of double obstruction. This comprehensive review aims to synthesize growing evidence on this topic by randomized controlled trials, cohort studies, and case series not only to summarize the efficacy, safety, and technical aspects of these procedures but also to propose a treatment algorithm based essentially on the anatomy and stage of the neoplasm to guide clinical decision-making, incorporating the principles of personalized medicine. This review also highlights the transformative impact of EUS-guided interventions on the treatment landscape for MBO and GOO. These techniques offer safer and more effective options than traditional approaches, with the potential for widespread clinical adoption. Further research is needed to refine these procedures, expand their applications, and improve patient care and quality of life.

Evaluation of Effect of Laser in Root Canal Disinfection in Pulp Regenerative Therapy: A Systematic Review.

Background: The evaluation of the effect of laser in disinfection of root canal in pulp regenerative therapy, if found effective laser can be used for root canal disinfection in cases of regenerative endodontic therapy. Objective: This study includes a systematic review addressing the question of whether laser is effective in root canal treatment in regenerative endodontic therapy. Methods: Randomized controlled trials (RCTs), case series, and animal studies evaluating the effect of laser-assisted endodontic irrigation in pulp regenerative therapy were included. Review articles, case reports, and in vitro studies were excluded. The data search covers all publications without limitation by year. The last search was conducted on December 31, 2023. An electronic search was performed using the following databases: PubMed, Cochrane Library, and Google Scholar. The result of this review was in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Assessment of risk of bias was done using the modified Cochrane Risk of Bias Tool. Results: The initial search resulted in 749 articles. Eleven duplicate articles were removed. Following the titles and abstracts screening, 11 articles were identified to form the basis of this systematic review. Three articles were excluded as full text was unavailable. Overall, eight studies evaluated the laser effect in root canal disinfection in pulp regenerative therapy, which were included in this systematic review. Of the included studies, a low risk of bias was shown by 7/8 studies, and a moderate risk of bias was shown by 1/8 studies. Conclusion: Laser can be used for root canal disinfection in cases of regenerative endodontic therapy. There is a need for further RCTs about individual laser groups and their disinfection effect on regenerative endodontic therapy for obtaining a higher level of evidence.

The Efficacy and Safety of Angiotensin II for Treatment of Vasoplegia in Critically Ill Patients: A Systematic Review.

To summarize evidence regarding intravenous angiotensin II administration in critical illness and provide an updated understanding of its effects on various organ dysfunction and renin-angiotensin system (RAS) biomarkers. A systematic review. A search of PubMed, Embase, and the Cochrane Library from inception to May 3, 2024. Randomized controlled trials (RCTs), nonrandomized trials, quasi-randomized trials, observational studies, case reports, and case series were included. Comparative studies (RCTs and observational studies with comparator) were used for the main analysis. Critically ill adults and children. Intravenous angiotensin II administration. Fifty-nine studies with a total of 2,918 participants (5 RCTs, 15 observational studies, and 39 case reports or case series) were analyzed. Septic shock and cardiac surgery were the most common clinical conditions (14 studies for each). In 14 comparative studies (5 RCTs and 9 observational studies), mortality was not different from that in controls, except in 1 observational study. Several studies reported decreased renal replacement therapy use, improved oxygenation and blood pressure response, and decreased rate of myocardial injury with angiotensin II therapy. There was no increase in thrombotic events or adverse events. Angiotensin II therapy reduced renin and angiotensin I levels without affecting other RAS biomarkers. Intravenous angiotensin II has been reported in almost 3000 critically ill patients with diverse types of shock. Despite unclear mortality impacts, angiotensin II seems to confer beneficial effects on several organ systems and RAS derangements, without increasing adverse events.

Efficacy and Safety of Systemic Thrombolysis and Catheter-Directed Therapy in Pulmonary Embolism: A Narrative Review.

Pulmonary embolism (PE) is the third most frequent cause of acute cardiovascular presentation after myocardial infarction and stroke. The treatment approach for PE consists of hemodynamic and respiratory support, anticoagulation, reperfusion treatment, and vena cava filters. Reperfusion treatment consists of systemic thrombolysis (recombinant tissue-type plasminogen activator, streptokinase, and urokinase); percutaneous catheter-directed therapy (CDT); and surgical embolectomy. CDT is an emerging treatment, with most data derived from randomized controlled trials (RCTs) or case series. Currently, there is a lack of data on clinical efficacy and safety outcomes and a lack of large studies that directly compare CDT with systemic thrombolysis or surgical embolectomy. This narrative review aims to explore the efficacy and safety of systemic thrombolysis and CDT in pulmonary embolism. Clinical trials have studied CDT for more than a decade now and have shown that CDT improves the post-procedural right ventricular (RV)/left ventricular (LV) ratio and has a reduced rate of bleeding episodes and all-cause mortality. However, there is a lack of large prospective RCTs studying the effects of CDT in intermediate-high-risk PE patients to determine which patients from this sub-group require CDT both in terms of improving short-term mortality risk and long-term morbidity (such as chronic thromboembolic pulmonary hypertension (CTEPH) and post-PE syndrome). Future clinical trials need to focus on identifying which patient groups will benefit from CDT over anticoagulation and if there are any advantages of using the EkoSonic endovascular system (EKOS) (ultrasound (US)-assisted CDT) over standard CDT. In addition, the scientific community needs to study the healthcare costs of CDT over traditional treatment, which is relevant for public health systems such as the National Health Service (NHS). Lastly, we need standardized guidelines for the use of thrombectomy systems since pulmonary embolism is a complex disease requiring a multifaceted and nuanced treatment approach.

The potential impact of COVID-19 vaccination on patients with immune thrombocytopenic purpura: A protocol for systematic review and meta-analysis.

Immune thrombocytopenic purpura (ITP) is a disease characterized by a decrease in platelet count, which can be triggered by various factors, including viral infections and vaccination. With the widespread vaccination against COVID-19, concerns have arisen regarding a possible link between the vaccine and the exacerbation of ITP. This study aims to comprehensively evaluate the impact of COVID-19 vaccination on ITP patients, including associated risks and outcomes. A comprehensive search will be conducted in multiple electronic databases (including PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, Wan Fang, VIP, and CBM) to identify relevant studies. This study will include randomized controlled trials, cohort studies, case-control studies, and case series evaluating the impact of COVID-19 vaccination on ITP patients. The primary outcome measure is the change in platelet count, while secondary outcome measures include the occurrence of thromboembolic events, bleeding complications, ITP recurrence rate, impact of ITP exacerbation, and adverse events. Data will be summarized and analyzed using Review Manager Software (RevMan) V.5.4. In addition, subgroup analyses will be performed to explore potential sources of heterogeneity. It is anticipated that different types of COVID-19 vaccines may have varying impacts on ITP patients, leading to potential differences in outcomes. This study aims to comprehensively evaluate the potential impact of COVID-19 vaccination on ITP patients and provide reference for clinical decision-making. The results of this systematic review and meta-analysis will provide crucial information on COVID-19 vaccination for ITP patients and clinicians, contributing to guiding vaccination decisions and monitoring potential impacts after vaccination.

Optimal Placement of TCSC and DPFC on Nigeria Power Transmission Network for Capacity Enhancement

The increasing demand for electrical energy and the high costs and challenges associated with building new transmission lines highlight the need to optimize existing power transmission networks. This study focuses on optimizing or enhancing Nigeria's 28-bus power transmission system using Flexible Alternating Current Transmission System (FACTS) devices, specifically, Dynamic Power Flow Controller (DPFC) and Thyristor-Controlled Series Compensator (TCSC). This research employed the Bacterial Foraging Optimization Algorithm (BFOA) in MATLAB to determine the optimal placement and sizing of DPFC and TCSC to minimize power losses, voltage deviations, and installation costs. Simulation results were compared, before and after incorporating the FACTS devices. In the base case, 32% of the buses had voltage profiles outside the acceptable range (0.95 to 1.05 p.u.), with real power loss of 602.91 kW and reactive power loss of 4559.69 kVAR. After optimally placing two DPFC and two TCSC devices in the system, all bus voltages were regulated to fall between 0.95 and 1.06 p.u., while real and reactive power losses were reduced by approximately 84.6% and 84.7%, respectively. This demonstrates a significant improvement in the efficiency and capacity of the power transmission network.

Morbidity among resettled refugees at arrival in Ontario, Canada (1994–2017): a controlled interrupted time series study examining the effect of the Immigration Refugee Protection Act, 2002

BackgroundImmigration inadmissibility on medical grounds is common among high-income countries. In Canada, the Immigrant and Refugee Protection Act (IRPA) became law in 2002. With humanitarian protection as a priority, IRPA...

Allergic Contact Dermatitis in Pediatric Practice.

Allergic contact dermatitis (ACD) is prevalent among pediatric population, adolescent and young adults. Patients with ACD experience a lot of sociopsychological and qualityof- life (QoL) difficulties. Children and their caregivers alike are vulnerable to the burden of ACD. We have, in this paper, provided an overview of ACD and discussed common and unusual causes of ACD. We performed an up-to-date literature review in the English language on "allergic contact dermatitis" via PubMed Clinical Queries, using the keywords "allergic contact dermatitis" in August 2022. The search included meta-analyses, randomized controlled trials, clinical trials, casecontrol studies, cohort studies, observational studies, clinical guidelines, case series, case reports, and reviews. The search was restricted to English literature and children. ACD may be acute or chronic and it affects more than 20% of children and adults with significant quality-of-life impairments. ACD is manifested by varying degrees of cutaneous edema, vesiculation, and erythema. The hypersensitivity reaction is one of the most prevalent forms of immunotoxicity in humans. Localized acute ACD lesions can be managed with high-potency topical steroids; if ACD is severe or extensive, systemic corticosteroid therapy is often required to provide relief within 24 hours. In patients with more severe dermatitis, oral prednisone should be tapered over 2-3 weeks. Rapid discontinuation of corticosteroids can result in rebound dermatitis. Patch testing should be performed if treatment fails and the specific allergen or diagnosis remains unknown. ACD is common and can be a physically, psychologically, and economically burdensome disease. Diagnosis of ACD is primarily based on history (exposure to an allergen) and physical examination (morphology and location of the eruption). Skin patch test can help determine the causative allergen. Allergen avoidance is the cornerstone of management. Topical mid- or highpotency corticosteroids are the mainstay of treatment for lesions on less than 20% of the body area. Severe cases of ACD may require treatment with systemic corticosteroids.

Female urethral stricture

ObjectiveThe aim of the present report was to provide an up-to-date overview of the existing literature on female urethral stricture (FUS) including its definition, epidemiology, risk factors, diagnostic and therapeutic approaches. MethodsA literature search was conducted in January 2024 using the MedLine and Embase databases, screening for randomized controlled trials (RCTs), prospective and retrospective series and reviews on female urethral stricture. ResultsUrethral stricture is a rare occurrence in female patients. However, as it can be responsible of any LUTS, a high level of suspicion is needed to avoid underdiagnosis which results in burdensome persisting LUTS in these patients, severely affecting their quality of life. PVR and uroflowmetry are the cornerstones of the screening process that should be used in every female patient with LUTS. Conversely, overdiagnosis and overuse of “random” urethral dilation could be equally harmful by generating FUS and a stringent and rigorous diagnostic process including urethrocystoscopy, urodynamics and fluoroscopy is needed to make the proper diagnosis. When FUS has been formally diagnosed, a single session of endoscopic treatment, ideally urethral dilation can be attempted. As in male patients, urethroplasty is the next step for any recurrence with various techniques being available (buccal mucosa vs vaginal flap; dorsal vs ventral onlay) with no robust evidence to support one over the other but which all yield satisfoactory outcomes with>85% of success. ConclusionFUS is a rare occurrence but should be ruled out in every female LUTS. While endoscopic treatment is the first line management, several successful female urethroplasty techniques can be used to treat patients with recurrent FUS. The level of evidence on the diagnosis and treatment of FUS is overall very low.

Efficacy of an erector spinae plane block for renal colic: a systematic review and meta-analysis

Background and aimThe passage of kidney stones through the ureter creates renal colic, a severe visceral abdominal pain. Renal colic is typically managed with non-steroidal anti-inflammatory drugs and opioids. Yet,...

The Importance of Patient-Reported Outcome Measures (PROMs) in Oncological Vulvoperineal Defect Reconstruction: A Systematic Review.

Patient-reported outcome measures (PROMs) have gained increased importance in assessing outcomes after reconstructive surgery. This also applies to the reconstruction of vulvoperineal defects after resection of gynecological or colorectal cancers in women. The objective of this study is to analyze the current state of PROM tool use within this patient population. By systematic literature searches in Embase, Medline, and Web of Science, English-language studies published after 1980, including randomized controlled trials, cohort studies, and case series reporting on vulvoperineal defect reconstruction, which were included if they also analyzed quality of life (QoL) and/or PROMs. The PROM tools used by each study were extracted, analyzed, and compared. The primary search yielded 2576 abstracts, of which 395 articles were retrieved in full text. Of these, 50 reported on vulvoperineal defect reconstruction, among which 27 studies analyzing QoL were found. Of those, 17 met the inclusion criteria for this systematic review. After full-text screening, 14 different PROM tools and 5 individual, non-standardized questionnaires were identified. Only 22% of studies used a validated PROM tool. Far too few studies currently use PROM tools to assess outcomes in oncological vulvoperineal defect reconstruction. Less than half of the used PROMs are validated. No PROM was designed to specifically measure QoL in this patient population. The standardized implementation of a validated PROM tool in the clinical treatment of this patient population is an essential step to improve outcomes, enable the comparison of research, and support evidence-based treatment approaches.

Efficacy of Gamma Knife Radiosurgery in Tumor Control of Cerebellopontine Angle Meningiomas: A Systematic Review

Abstract Background Meningiomas arising from the cerebellopontine angle are relatively uncommon, comprising only 1% of intracranial meningiomas and 6% to 15% of tumors occupying this anatomic region. Because of their intimate relationship with adjacent neurovascular structures, cerebellopontine angle (CPA) meningiomas represent a formidable surgical challenge. The morbidity and mortality associated with surgical resection of CPA meningiomas is not inconsequential. Radiosurgery has been demonstrated to provide high rates of tumor control for skull base meningiomas with acceptably low complication rates. The rarity of CPA meningiomas has limited the statistical power of previous radiosurgery series describing the outcomes for these lesions. Aim of the Work Evaluate the efficacy of gamma knife stereotactic radiosurgery (GK-SRS) in tumor control of CPA meningiomas and the effect of this control on the function of the facial muscles and hearing. Methodology This systematic review included a discussion of all available studies meeting the eligible criteria including randomized controlled studies, cohort studies, and case series and the literature of reviews. Results Mean tumor control rate was 94%, 259 cases had decreased tumor volume, 271 had stable tumor growth. Increased tumor volume occurred in 27 cases. As regard facial muscles function, 13 cases had improved function, 241 cases remained unchanged, and 8 cases experienced worse function. As regard auditory function, 25 cases had improved hearing, 256 cases remained unchanged, and 25 cases experienced worse hearing. Post GK-SRS hydrocephalus was reported in six cases, trigeminal dysfunction was reported in 114 cases, and peritumoral edema was observed in 19 cases. Conclusion GK-SRS for CPA meningiomas could be considered as a highly effective technique for the management of those lesions with acceptable rates of side effects.

Contemporary use of 3D printed jigs and guides for osteotomies around the knee: a systematic review

Background. With improved accessibility of imaging and additive manufacturing, custom targeting guides and jigs are now widely accepted across many areas of orthopaedics. During orthopedic surgery, patient-specific guides assist in the accurate drilling and cutting of bone in conjunction with meticulous pre-operative planning. Given their increased uptake, it is important to define the lessons learned from recent clinical experience, and to document the reported benefits when using this technology intra-operatively. The aim of this review is to evaluate the potential benefits of patient-specific guides for osteotomies about the knee, and to clarify what evidence currently exists to support their use. Methods. A systematic review of PubMed, Embase, and Web of Science was performed for studies investigating the use of intra-operative patient-specific guides for realignment osteotomies about the knee. Randomised controlled trials, non-randomised studies, observational studies, case series, and case reports, as well as in vitro studies, were included. Screening was conducted with the Covidence software, and risk of bias was assessed with the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool. Results. A total of 38 studies satisfied the inclusion criteria: 21 of these included patient-specific instrumentation (PSI) for high tibial osteotomy, 6 with distal femoral osteotomy, 4 — for combined tibial/femoral rotational corrective osteotomies, 4 — in double-level osteotomies, and 6 — for intra-articular osteotomies. The main outcomes reported were accuracy of surgical correction, typically with reference to pre-operative plans, and execution accuracy based on radiographic measurements. Other common outcomes were operative time, intra-operative fluoroscopy, and operative costs. Many studies were observational in nature, with no control groups available for suitable comparison. Conclusions. For corrective osteotomies about the knee, the literature suggests PSI has very strong potential to improve accuracy in achieving pre-operative targets. This was reported for both opening and closing wedge osteotomies of the femur, and for high tibial osteotomy. Some contradictory results have been reported for high tibial osteotomy, based on limited evidence from small studies that in many instances lacked controls for comparative analysis. Additional controlled trials are necessary to confirm the benefits of PSI for osteotomies about the knee, considering it has not yet been conclusively validated. The literature currently available indicates PSI can improve the accuracy of corrective osteotomies about the knee.

The novel impedance matching device realized by the structure of air-gap ring based on the doping method at microwave frequency

The doping method enabled the epsilon-near-zero (ENZ) medium to adjust its permeability effectively. In this study, we theoretically analyze that the gap ring structure formed by the ENZ medium doped with perfect electrical conductor (PEC) can be equivalent to the controllable series reactance. Based on this concept, a universal matching network that can match any complex impedance load by adjusting the gap ring spacing is constructed. We used the above universal matching network to carry out theoretical and simulation calculations on the matching effect of a random-sized stepped waveguide and horn antenna, and the results show that the impedance-matching technology has a good matching effect for different loads. Finally, experimental verification is carried out. Compared with traditional impedance-matching networks, the proposed structure has the characteristics of simplicity, reliability, low loss, high carrying power, low preparation requirements, and good application prospects. This work is a good example of the practicality of ENZ media and also provides a very meaningful idea for the development of new electromagnetic matching devices.

Artificial urinary sphincter and female stress urinary incontinence over the past 50 years: a narrative review.

The aim of the present report was to provide an overview of the use of the artificial urinary sphincter (AUS) in adult females with stress urinary incontinence (SUI) over the past 50 years. A literature search was conducted in December 2022 and January 2023 using the MEDLINE and Embase databases, screening for randomized controlled trials (RCTs), prospective and retrospective series and reviews on AUS. Only articles published in English or French were included. The search strategy involved a free text protocol and the narrative review reporting checklist was completed. The AUS is a device used over the past 50 years for SUI caused by intrinsic sphincter deficiency (ISD). It has the theoretical ability to simulate the function of a biological urinary sphincter. Although the role of the AUS for females with ISD remains heterogeneous from one part of the world to the other, the existing literature demonstrates that AUS yields satisfactory functional outcomes in female SUI patients, comparable or better to what has been reported in male AUS series. Hence, the main barrier to its adoption has so far been the technical challenge of its implantation at the bladder neck. Regarding the results of AUS implantation in females, we included in this review 3 reviews, retrospective studies and 1 prospective study. In recent years, robotic techniques of female AUS implantation have spread significantly with promising outcomes including numerous reports suggesting that it may decrease its morbidity. In the near future, the development of electromechanical devices may further expand the role of AUS in the management of female SUI. While the use of AUS in female patients provides excellent functional outcomes, it has been limited to scarce centers. However, due to the rise of minimally invasive approaches, it has started spreading again over the past few years. The future of AUS is likely to be bright, fed by technological advances of the device and robotic surgical system, high level of evidence studies and joint efforts of the urological community to facilitate its diffusion across the world.

COMPARAÇÃO DOS MÉTODOS DE FIXAÇÃO PARA FRATURAS SUPRACONDILIANAS DO ÚMERO EM CRIANÇAS: UMA REVISÃO CRÍTICA DA LITERATURA

Introduction: Supracondylar fractures are common in children, and appropriate treatment is crucial to avoid long-term complications. Methodology: The review included selected studies from SciELO, PubMed, and Scopus, covering randomized controlled trials, cohort studies, case series, and reviews, totaling 1,025 patients. Results: Nineteen studies were analyzed, showing significant variations in complication rates and efficacy between fixation methods such as crossed pins, plates, and intramedullary pins. Discussion: The comparison revealed that crossed pins have a lower risk of nerve injury, while plates offer better stability for complex fractures. However, all techniques have potential complications, including the need for early removal and infections. Conclusion: The choice of method should be individualized based on the fracture severity and patient profile, with rigorous follow-up to manage complications. Future research should explore new techniques and technologies to improve clinical outcomes and reduce complications.

Wind conversion systems effects on power grid and ability of thyristor controlled series capacitor and static synchronous series compensator devices for dynamic performance enhancing

Wind conversion systems effects on power grid and ability of thyristor controlled series capacitor and static synchronous series compensator devices for dynamic performance enhancing

Retinitis Pigmentosa and Therapeutic Approaches: A Systematic Review.

Background: Retinitis pigmentosa (RP) is a group of hereditary retinal dystrophies characterized by progressive degeneration of photoreceptor cells, which results in debilitating visual impairment. This systematic review aims to evaluate the efficacy and safety of emerging treatment modalities for RP, including gene therapy, mesenchymal-cell-based approaches, and supplementary interventions. Methods: A comprehensive search of electronic databases was conducted to identify relevant studies published up to February 2024. Studies reporting outcomes of treatment interventions for RP, including randomized controlled trials, non-randomized studies, and case series, were included. Data extraction and synthesis were performed according to predefined criteria, focusing on assessing the quality of evidence and summarizing key findings. Results: The search yielded 13 studies meeting inclusion criteria, encompassing diverse treatment modalities and study designs. Gene therapy emerged as a promising therapeutic approach, with several studies reporting favorable outcomes regarding visual function preservation and disease stabilization. Mesenchymal-cell-based therapies also demonstrated potential benefits, although evidence remains limited and heterogeneous. Supplementary interventions, including nutritional supplements and neuroprotective agents, exhibited variable efficacy, with conflicting findings across studies. Conclusions: Despite the lack of definitive curative treatments, emerging therapeutic modalities promise to slow disease progression and preserve visual function in individuals with RP. However, substantial gaps in evidence and heterogeneity in study methodologies underscore the need for further research to elucidate optimal treatment strategies, refine patient selection criteria, and enhance long-term outcomes. This systematic review provides a comprehensive synthesis of current evidence and highlights directions for future research to advance the care and management of individuals with RP.