Reduce Recovery Time Research Articles

Ultra minimally invasive surgical stabilization of Rib fractures (uMI-SSRF): reduction and fixation techniques to minimize the surgical wound.

Rib fractures are common in trauma patients, often leading to complications such as pneumonia and prolonged hospitalization. Surgical Stabilization of Rib Fractures (SSRF) has become increasingly prevalent in treating severe cases. However, traditional approaches, like posterolateral thoracotomy, are invasive and cause significant muscle damage. Recently, muscle-sparing minimally invasive techniques have been introduced, yet they still require advanced reduction and fixation techniques to avoid complications. This study presents an "ultra" minimally invasive SSRF (uMI-SSRF) technique designed to minimize surgical wounds and soft tissue damage while maintaining the benefits of rib fixation. This study involved 76 patients with multiple rib fractures treated using the uMI-SSRF technique between August 2021 and December 2023. Preoperative chest tomography with 3D reconstruction was used for surgical planning. The technique employed small incisions (3-5cm), muscle-sparing approaches, and advanced fixation techniques. Data on patient demographics, intraoperative details, and postoperative outcomes were collected. The mean patient age was 58 years, with 66% being male. On average, patients had 6.4 fractured ribs, and 3.5 ribs with 3.88 plates were fixed per surgery, achieving a fixation/fracture ratio of 59%. The average wound length was 4.2cm, with a mean operation time of 122min. Most patients required only one incision (74%). The median hospital length of stay was 7 days, with a pneumonia rate of 5%. No wound infections or implant-related complications were observed. The uMI-SSRF technique effectively reduces wound size and soft tissue damage in rib fracture stabilization while maintaining high fixation quality. This method shows promise for improving patient outcomes, reducing recovery time, and minimizing complications. Further studies with larger sample sizes and comparisons with other methods are warranted to verify the advantages of uMI-SSRF.

The Role of Robotics in Enhancing Precision and Outcomes in Orthopedic Surgery

The advent of robotics has significantly transformed orthopedic surgery, addressing challenges inherent in traditional manual techniques, such as variability in outcomes and precision limitations. Robotics enables millimeter-level accuracy, minimizes human error, and allows for personalized, minimally invasive procedures. Historical milestones, from the pioneering ROBODOC system in 1992 to advanced platforms like MAKO and ROSA, illustrate the progressive adoption of robotic systems, particularly in joint replacement and spine surgeries. Comparative studies demonstrate enhanced precision and reduced recovery times for robotic-assisted surgeries compared to conventional methods, with quantifiable improvements in alignment accuracy and postoperative outcomes. Key applications include joint arthroplasties, spinal surgeries, and complex trauma cases, where robotic assistance ensures accurate implant positioning, improved functional outcomes, and higher patient satisfaction rates. However, barriers such as cost, access disparities, and the learning curve persist. Emerging technologies, including artificial intelligence, augmented reality, and haptic feedback, are anticipated to further enhance robotic precision and broaden accessibility. As robotic systems become integral to orthopedic practice, ongoing advancements promise to elevate surgical standards, offering reliable, patient-specific solutions that improve both procedural consistency and quality of life.

Advances in Minimally Invasive Joint Replacement Techniques: Redefining Precision and Recovery

Minimally invasive joint replacement (MIJR) techniques have revolutionized orthopedic surgery by significantly reducing recovery times, hospital stays, and complication rates compared to traditional methods. Enhanced by innovations like robotics, augmented reality (AR), and patient-specific instrumentation (PSI), MIJR offers greater surgical precision with less trauma to surrounding tissues. This article explores the latest advancements in MIJR, demonstrating its impact on clinical outcomes and highlighting future trends such as AI-driven surgical planning and biologic implants. MIJR has become the gold standard in joint replacement, providing patients with faster recovery and improved long-term results. Minimally invasive joint replacement (MIJR) techniques have revolutionized orthopedic surgery by significantly reducing recovery times, hospital stays, and complication rates compared to traditional methods. Enhanced by innovations like robotics, augmented reality (AR), and patient-specific instrumentation (PSI), MIJR offers greater surgical precision with less trauma to surrounding tissues. This article explores the latest advancements in MIJR, demonstrating its impact on clinical outcomes and highlighting future trends such as AI-driven surgical planning and biologic implants. MIJR has become the gold standard in joint replacement, providing patients with faster recovery and improved long-term results.

Agmatine: An Emerging Approach for Neuroprotection in Recurrent Ischemic Stroke Events in a Murine Model.

This study investigates the effect of agmatine on reducing mortality, neurobehavioral alterations, infarct size, and expression of pro-inflammatory cytokines in mice subjected to bilateral carotid thrombosis. Under pentobarbital anesthesia, the left common carotid artery was exposed to 6% FeCl3. Thirty-two days later, the same procedure was performed on the right common carotid artery. Subsequently, Agmatine (100 mg/kg) was administered 15 min after the second procedure, and in another experimental group, the dose of Agmatine was repeated at 72 h. Administration of agmatine extended survival in ischemic animals up to 72 h for the single-dose group and up to 96 h for the repeated-dose group, without significant increases in neurological deficits or infarct area size. This neurobehavioral effect was also observed in sham animals treated with agmatine. In ischemic animals, agmatine administration improved digging behavior and reduced recovery times, consistently shorter in those animals treated with repeated doses. RT-PCR analyses revealed a positive regulation of the cytokine IL-1β in agmatine-treated animals, which has been associated with recovery stages. The results suggest that the observed effect may be attributed to the multiple interactions of agmatine with ischemic cascade events, highlighting its anti-inflammatory role.

Meta-analysis study on anesthetic sedation recovery and onset times in pediatric and elderly patients undergoing CT and MRI.

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are crucial diagnostic modalities that require patients to remain immobile for extended periods, with anesthesia sometimes used for comfort and image quality enhancement. The study compares dexmedetomidine and propofol in reducing recovery time and sedation onset in pediatric and elderly patients undergoing CT and MRI procedures. A meta-analysis of fifteen studies assessing recovery time, sedation onset, and failed sedation between dexmedetomidine and propofol in pediatric and elderly patients during CT and MRI was conducted. The study indicated that the administration of anaesthesia markedly improved patient compliance and reduced motion artefacts in both CT and MRI (P<0.00001, I2=94%). The meta-analysis indicated that the mean difference (MD) in the onset of sedation was significantly faster in the control group (P<0.00001, I2=96%). The study reveals that dexmedetomidine and propofol anesthesia can improve patient image quality during CT and MRI procedures by reducing motion artefacts. Dexmedetomidine sedated people more quickly than propofol, but no significant differences in sedation duration were observed.

Safety in Perioperative Period in Laparoscopic Surgery

Laparoscopic surgery has revolutionized the field of surgery, offering significant improvements in patient outcomes such as reduced recovery times, pain, and hospital stays compared to traditional open surgery. However, safety concerns arose with its introduction, prompting the need for advancements in technique and equipment. This article explores critical safety improvements in laparoscopic surgery, simulating a patient’s perioperative journey. Key topics include the importance of team briefings, proper patient positioning, ergonomics, optimal laparoscopic setup, safe port insertion techniques, pneumoperitoneum management, instrument handling, and hemostasis. The review highlights the ongoing need for research and consensus in patient safety practices within laparoscopic surgery.

Shape sensing endoscope fiber

Minimally invasive and robotic surgeries are growing areas that benefit patients through reduced recovery time. Medical fiber optics play an important role in these procedures by enabling instrument navigation, imaging, sensing, power delivery, and diagnostics in a small form factor. One route to further miniaturization is to combine these functions, or a subset of these functions, into a single strand of optical fiber. In this work, we present a fiber and fan-in device that enables shape sensing, imaging, power delivery, and potentially additional sensing capabilities, such as temperature and/or pressure, in the same waveguide. The refractive index profile of the multimode waveguide in our fiber is similar to step index fibers used in laser delivery and is suitable for imaging applications; however, it also contains seven single mode cores twisted in a helix and with quasi-continuous Bragg gratings along their entire length, such as are used in fiber shape sensing. We first calibrate the transmission matrix of the multimode waveguide to enable the formation of a focused spot at the distal end of the fiber with a spatial light modulator. A second calibration allows us to reconstruct the shape of the fiber using optical frequency domain reflectometry in the twisted shape sensing cores. We show that these multiple functions can be performed simultaneously with our device and that changes in the curvature of the fiber correlate with the quality of the distal spot produced through the fiber, which is an important step towards maintaining the imaging calibration as the fiber is manipulated.

Modified robotic simple prostatectomy technique: a retrospective analysis of a series of 162 surgeries performed by a high-volume surgeon.

Benign prostatic hyperplasia (BPH) affects up to 80% of men by age 80, with large-gland BPH often treated by simple prostatectomy (SP). This technique significantly improves symptoms but is associated with high rates of complications such as transfusions and infections. Minimally invasive techniques, including robotic-assisted laparoscopic simple suprapubic prostatectomy (RALSP), have emerged as alternatives. This study reports on 162 patients who underwent RALSP from May 2018 to June 2023. The mean age of the patients was 69years, mean prostate volume 144.8cm3, mean robot time 78.7min, and mean blood loss 183.1mL. Results demonstrated significant improvements in the results: prostate volume (mean decrease from 144.8 to 26.6cm3), mean PSA level decreased from 7.8 to 0.8 (p < 0.0001), mean IPSS decreased from 23.0 to 4.4 (p < 0.0001), and mean uroflowmetry increased from 6.3 to 22.6ml/s (p < 0.0001). No patient experienced worsening erectile function after surgery. All patients showed absence of stress urinary incontinence within 3months. Catheterization time decreased from 4.2 to 2.6days over the study period. The postoperative complication rate was 2.29%, with no need for surgical reintervention for complications. While RALSP showed promising results, further prospective studies are needed to compare it with other techniques. This study highlights RALSP as a viable minimally invasive option for treating large-volume BPH, offering reduced recovery times and fewer complications.

Ultrasound and Helium Plasma-Assisted Liposuction for Body Contouring: A Single-Retrospective Cohort Study of 639 Patients.

Over the past two decades, liposuction techniques have significantly evolved, moving from basic fat removal to sophisticated methods aimed at improving safety, efficiency, and cosmetic outcomes. This study evaluates the efficacy and safety of a combined approach using ultrasound-assisted liposuction (UAL) and helium plasma radiofrequency (HPRF) technology to enhance skin tightening without the need for extensive surgical interventions. We conducted a retrospective analysis of 639 patients who underwent the combined UAL and HPRF liposuction technique. The patient cohort had an average age of 31.5 years and a mean BMI of 27.9 kg/m2. The procedure predominantly targeted the abdomen, with an average of 2.4 body areas treated per patient. Surgical duration averaged 118 minutes, with a mean aspirate volume of 1698 mL. Minimal residual skin laxity was observed in 87% of patients, and 91% achieved excellent improvement in body contouring. The complication rates were low, with minor occurrences of seroma (5.6%) and a very low incidence of infection (0.3%). This combined technique demonstrated safety and efficacy, providing significant skin tightening and reducing recovery time compared to more invasive procedures. The combined use of UAL and HPRF technology offers a safe and effective method for enhancing skin tightening and improving body contouring outcomes. Despite the promising results, this study acknowledges the limitations of its retrospective design. Future prospective, multicenter studies are recommended to further validate these findings. This technique represents a significant advancement in the field of cosmetic surgery, emphasizing minimally invasive solutions with substantial esthetic benefits. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The effect of Amantadine on recovery, postoperative cognitive dysfunction and pain after propofol anesthesia in mice

IntroductionPostoperative cognitive dysfunction (POCD) encompasses a spectrum of cognitive impairments following surgery, attributed to disruptions in brain homeostasis. The pathogenesis involves glutamate toxicity, GABA receptor dysfunction, and alterations in NMDA and AMPA receptors. This study aimed to investigate the impact of pre-anesthetic amantadine administration on postoperative recovery time, POCD, and stress-related pain levels when combined with propofol anesthesia. MethodsTwenty-four adult male BALB/C mice were divided into four groups: Control, Propofol, Amantadine, and Amantadine+Propofol. Amantadine and propofol doses were administered intraperitoneally based on previous literature. Recovery time, pain levels (assessed via tail pinch and hot plate tests), cognitive functions (evaluated through Morris Water Maze), and locomotor activity (measured via Open Field Test) were recorded. ResultsAmantadine administration significantly reduced recovery time from propofol anesthesia, prolonged pain perception, and preserved cognitive functions compared to propofol alone. The time spent in the target quadrant in the Morris Water Maze was significantly longer in groups receiving amantadine. Additionally, the distance covered until finding the platform was significantly shorter in the propofol-only group. DiscussionAmantadine's neuroprotective effects, attributed to its antagonistic action on glutamate and NMDA receptors, mitigate the detrimental effects of propofol on cognitive function and pain perception. This study highlights the potential of combining amantadine with propofol to enhance postoperative outcomes. ConclusionAmantadine administration before propofol anesthesia positively influenced postoperative recovery, cognitive function preservation, and stress-related pain perception in mice. These findings suggest a potential therapeutic strategy to mitigate POCD and pain associated with surgery.

Simultaneous unilateral thoracoscopic resection of bilateral pulmonary sequestration

BackgroundIntra-lobar (ILS) and extra-lobar lung (ELS) sequestrations represent rare congenital lung malformations. Despite their benign nature, the lesions pose risks such as recurrent pulmonary infections, hemoptysis, congestive heart failure, and tumor development. Pulmonary sequestration (PS) typically manifests in two forms, ILS and ELS, with bilateral occurrence being exceptionally rare and mostly requiring bilateral thoracic surgery.Case presentationA 9-year-old child, who initially presented with bilateral lung lesions without respiratory symptoms, was diagnosed with PS following a chest computed tomography scan. The surgical approach was determined based on the absence of inflammation and the clear demarcation of the lesions from normal lung tissue, highlighted by a unique tissue connection between the ILS and ELS across the chest cavities. We used a novel method wherein the left ELS was successfully pulled into the right chest cavity and both sequestrations were concurrently resected. Postoperative recovery was smooth, with no complications or residual lesions.ConclusionsOur findings highlight the importance of thorough preoperative planning with enhanced computed tomography. Simultaneous unilateral thoracoscopic surgery can be a viable, less invasive option for treating bilateral PS, offering benefits such as reduced recovery time and better cosmetic outcomes.

Thoracic Trauma: Diagnosis And Treatment

The study of chest injuries which profoundly impact quality of life, life expectancy, disability rates, and mortality is of significant importance. In clinical research, the authors analyzed diagnostic results from 527 patients aged 18 to 85 with closed chest trauma, consisting of 82% men and 18% women. The study confirms that traumatic chest injuries are severe conditions that necessitate strict adherence to well-defined diagnostic and treatment guidelines. It is advisable to utilize thoracoscopy and video-assisted thoracoscopy for managing hemothoraxes with small volumes of bleeding, as these minimally invasive techniques can enhance patient outcomes and reduce recovery times. The incorporation of advanced three-dimensional (3D) printing technologies into medical practice for chest injuries is also recommended, as it can improve surgical planning and enable personalized treatment strategies. Moreover, 3D printing can aid in the fabrication of patient-specific implants and prosthetics, thereby enhancing the effectiveness of reconstructive surgeries. Further research is needed on pharmacotherapy when using medications in accordance with the codes of the 11th revision of the International Classification of Diseases, to optimize therapeutic efficacy. Additionally, an in-depth study of the integrated ABC/VEN-analysis of drug prescriptions in pharmacotherapeutic regimens for thoracic trauma treatment dynamics in both inpatient and outpatient healthcare facilities is recommended. This could lead to better resource allocation, improved patient care, and the development of more effective treatment protocols. Emphasizing interdisciplinary collaboration among surgeons, radiologists, and pharmacologists is crucial to advance the management of chest trauma, ensuring that patients receive comprehensive and holistic care throughout their recovery process.

Current trends and future directions in surgery: A brief scoping review

Surgery is undergoing rapid transformation due to advancements in technology, innovative techniques, and a shift toward patient-centered care. This review explores current trends and future directions in the field of surgery, focusing on five major areas: minimally invasive surgery (MIS), robotic-assisted surgery, personalized medicine, enhanced recovery after surgery (ERAS) protocols, and the use of telemedicine. MIS techniques, including laparoscopy and NOTES, continue to evolve, offering benefits such as reduced recovery times and fewer complications. Robotic-assisted surgery has advanced with systems such as the da Vinci Surgical System, which enhances surgical precision and has expanded into new specialties. Personalized medicine, driven by genomics and bioinformatics, aims to tailor surgical interventions to individual patient profiles, improving treatment outcomes. ERAS protocols represent a significant shift toward optimizing perioperative care, with a focus on multimodal pain management and early mobilization to improve recovery. Additionally, the rise of telemedicine and remote monitoring has facilitated preoperative and postoperative care, mostly in the context of the COVID-19 pandemic. The future of surgery promises continued technological advancements, with potential developments including enhanced robotic systems, AI integration, and expanded applications of ERAS principles. However, challenges such as high costs, the need for ongoing training, and the integration of new technologies into healthcare systems must be addressed to fully realize these advancements. This review provides an overview of these trends and highlights areas for future research and development in the surgical field.

Effect of L-Citrulline on Creatine Kinase MM (CK-MM) Isoenzymes in Mice: An In Vivo Study Focusing on Immunohistochemistry Analysis

Highlights:1. This study elucidates the effect of L-citrulline supplementation on creatine kinase MM (CK-MM) expression post-eccentric exercise, offering novel insights into its potential role in mitigating muscle damage.2. The findings demonstrate that L-citrulline administration significantly reduces CK-MM expression levels in skeletal muscle tissue, suggesting its therapeutic potential in enhancing muscle recovery and performance following exercise-induced damage.3. This study contributes valuable insights into the multifaceted benefits of L-citrulline supplementation for supporting overall muscle health and performance by identifying its protective effects under different mechanisms, including improved blood flow, antioxidant activity, enhanced mitochondrial function, and promotion of muscle protein synthesis. Abstract Eccentric exercise often induces muscle injuries in athletes, resulting in impaired performance and prolonged recovery time. Creatine kinase MM (CK-MM) is a biomarker for assessing muscle damage, with elevated levels indicating injury. L-citrulline, an amino acid, has shown promise in enhancing performance and reducing recovery time. However, its specific effect on CK-MM remains unclear. This study utilized immunohistochemistry analysis to investigate the effect of L-citrulline supplementation on CK-MM expression post-eccentric exercise in male BALB/c mice. This in vivo study was conducted with a post-test-only design. A total of 25 mice were divided into two control groups (normal/C1 and negative/C2) and three treatment groups (T1, T2, and T3), each containing five mice. The T1, T2, and T3 groups were daily administered 250, 500, and 1,000 mg/kg bw of L-citrulline for seven days, respectively. All mice, except the C1 group, performed a downhill running procedure. The CK-MM expression in skeletal muscle tissue post-eccentric exercise was assessed using immunohistochemistry analysis. The statistical analysis included the Shapiro-Wilk test for data distribution and the Kruskal-Wallis and Mann-Whitney post-hoc tests for significant differences (p&lt;0.05). The results showed that CK-MM expression in the C2 group (91.00±2.24%) was significantly higher (p=0.008) than that of the C1 group (70.00±10.0%). Subsequently, the T1 (68.00±9.08%, p=0.008), T2 (72.00±7.58%, p=0.008), and T3 (67.00±9.75%, p=0.008) groups exhibited significantly lower expressions than the C2 group. These results were consistent with the role of CK-MM as a marker for muscle damage, and they indicated that L-citrulline might have a protective effect against muscle damage post-eccentric exercise. However, no significant differences were observed among the C1, T1, T2, and T3 groups. In conclusion, L-citrulline supplementation demonstrates promise in attenuating muscle damage following eccentric exercise, as evidenced by reduced CK-MM expression levels. These findings highlight the potential therapeutic role of L-citrulline in enhancing muscle recovery and performance.

COMPARAÇÃO ENTRE ABORDAGENS CIRÚRGICAS PARA REPARO DE HÉRNIA ABDOMINAL

This systematic review aims to compare open, laparoscopic, and robotic surgical techniques for abdominal hernia repair, evaluating their efficacy, benefits, and drawbacks. A comprehensive search of PubMed and ScienceDirect was conducted using terms related to "abdominal hernia repair" and "surgical techniques". The review included studies published from 2020 to 2024, focusing on randomized controlled trials, meta-analyses, and systematic reviews. The analysis revealed that laparoscopic and robotic repairs generally offer reduced recovery times, less postoperative pain, and lower complication rates compared to open surgery. However, robotic repairs, while offering precision and ergonomic advantages, come with higher costs and longer setup times. Open repairs, though associated with higher complication rates and longer recovery periods, are still preferred in certain complex cases due to their straightforward execution. This review highlights that laparoscopic and robotictechniques present notable advantages over traditional open surgery, particularly in terms of postoperative outcomes and patient recovery. The findings support the use of minimally invasive approaches where feasible but also underscore the importance of considering individual patient circumstances and the complexity of the hernia when selecting the most appropriate surgical technique.

Anti-coronavirus and anti-pulmonary inflammation effects of iridoids, the common component from Chinese herbal medicines for the treatment of COVID-19.

The practice of Chinese herbal medicines for the treatment of COVID-19 in China played an essential role for the control of mortality rate and reduction of recovery time. The iridoids is one of the main constituents of many heat-clearing and detoxifying Chinese medicines that were largely planted and frequently used in clinical practice. Twenty-three representative high content iridoids from several staple Chinese medicines were obtained and tested by a SARS-CoV-2 pseudo-virus entry-inhibition assay on HEK-293T/ACE2 cells, a live HCoV-OC43 virus infection assay on HRT-18 cells, and a SARS-CoV-2 3CL protease inhibitory FRET assay followed by molecular docking simulation. The anti-pulmonary inflammation activities were further evaluated on a TNF-α induced inflammation model in A549 cells and preliminary SARs were concluded. The results showed that specnuezhenide (7), cornuside (12), neonuezhenide (15), and picroside III (21) exhibited promising antiviral activities, and neonuezhenide (15) could inhibit 3CL protease with an IC50 of 14.3μM. Docking computation showed that compound 15 could bind to 3CL protease through a variety of hydrogen bonding and hydrophobic interactions. In the anti-pulmonary inflammation test, cornuside (12), aucubin (16), monotropein (17), and shanzhiside methyl ester (18) could strongly decrease the content of IL-1β and IL-8 at 10μM. Compound 17 could also upregulate the expression of the anti-inflammatory cytokine IL-10 significantly. The iridoids exhibited both anti-coronavirus and anti-pulmonary inflammation activities for their significance of existence in Chinese herbal medicines, which also provided a theoretical basis for their potential utilization in the pharmaceutical and food industries.

EVALUATION OF WOUND HEALING AND EPITHELIALIZATION USING TOLUIDINE BLUE DYE INDICATOR IN DIODE LASER FRENECTOMY WITH AND WITHOUT SURGICAL MICROSCOPE

Objective: The study aimed to evaluate the wound healing and epithelialization in diode laser frenectomy using toluidine blue dye as an indicator, comparing outcomes between procedures performed with and without the use of a surgical microscope at 1- and 2-weeks post-operatIvely. Materials and Methods: This controlled clinical trial involved patients undergoing diode laser frenectomy, divided into two groups: one group underwent the procedure with the aid of a surgical microscope, while the other group did not use a microscope. Wound healing and epithelialization were assessed using toluidine blue dye at 1 and 2 weeks following the procedure. Results: The group that received diode laser frenectomy with the use of a surgical microscope demonstrated significantly faster and more complete wound healing and epithelialization at both 1 and 2 weeks compared to the group that did not use the surgical microscope. The toluidine blue stain uptake showed similar results. Conclusion: The use of a surgical microscope in diode laser frenectomy appears to enhance wound healing and epithelialization, as evidenced by the results at both 1 and 2 weeks. This suggests that incorporating a surgical microscope into the procedure may improve clinical outcomes and reduce recovery time. Further research is needed to confirm these findings across larger and more diverse patient populations.

ADVANCES AND CHALLENGES IN MINIMALLY INVASIVE SURGERY FOR THE TREATMENT OF HERNIAS

Minimally invasive surgery has revolutionized the treatment of various medical conditions, offering significant benefits in terms of recovery and fewer complications. In the field of hernia surgery, technological advances and innovative techniques have provided a less invasive approach that minimizes pain, reduces recovery time and improves aesthetic results. However, despite notable advances, there are still challenges and limitations that need to be addressed in order to optimize results and expand the use of these techniques. This summary examines the main advances in minimally invasive surgery for the treatment of hernias and discusses the challenges that remain in this field. The aim of this paper is to review recent advances in minimally invasive surgery for the treatment of hernias, highlighting technological innovations, improved techniques and clinical benefits. It also aims to identify the challenges and limitations associated with these techniques, providing a comprehensive overview of the positive and negative aspects of minimally invasive surgery in current clinical practice. This is a bibliographic review, using qualitative and quantitative assumptions, using the PubMed, Scopus and Web of Science databases. The health descriptors “Abdominal Hernia”, “Minimally Invasive Surgery”, “Hernia Repair”, “Hernia Mesh” and “Technological Advances” were used to refine the research. The time frame covers the years 2015 to 2021. Advances in minimally invasive hernia surgery have been driven by the development of advanced technologies such as laparoscopy and robotics. Laparoscopy, which uses small incisions and a camera to guide the surgery, has established itself as the standard technique for treating inguinal and umbilical hernias. This approach offers several advantages over traditional open surgery, including less post-operative pain, a lower risk of infection, reduced hospitalization time and a faster recovery. Laparoscopy allows the surgeon to accurately visualize and repair the hernia, while the small incisions result in smaller scars and a better aesthetic appearance. Recently, robotic surgery has emerged as a significant innovation in the field of minimally invasive surgery. Robotic systems offer a three-dimensional view and greater precision during the operation, allowing for more delicate and complex maneuvers. This technology is particularly useful in cases of complex or recurrent hernias, where precision and control are critical. Studies have shown that robotic surgery can further reduce post-operative pain and recovery time, although the high cost and need for specialized training are challenges associated with this technology. However, the adoption and effectiveness of minimally invasive techniques for hernias face several challenges. One of the main challenges is the learning curve associated with new technologies. Laparoscopy and robotic surgery require advanced technical skills and extensive training, which can limit access to these techniques in some medical centers and regions. Furthermore, although minimally invasive surgery offers significant advantages, patient selection is crucial. Patients with very large hernias, additional complications or medical conditions that increase surgical risk may not benefit as much from these techniques. Another challenge is cost. The advanced technologies and equipment required for minimally invasive surgery are generally more expensive than traditional approaches. These costs can be a barrier to widespread adoption, especially in settings with limited budgets or where access to cutting-edge technologies is restricted. It is concluded that advances in minimally invasive surgery for the treatment of hernias have provided significant benefits, including less post-operative pain, faster recovery and better aesthetic results. Technologies such as laparoscopy and robotic surgery have revolutionized the surgical approach, offering new opportunities for treatment with less impact on the patient. However, challenges such as the learning curve, high cost and the need for careful patient selection need to be addressed in order to optimize practice and expand access to these techniques. As technology continues to evolve and more data becomes available, minimally invasive surgery is expected to become even more effective and affordable, offering continuous improvements in care and outcomes for hernia patients.

Core-shell bioactive capsule for aquaculture wastewater denitrification

The lack of denitrifying bacteria and organic carbon sources, and the inhibition of dissolved oxygen (DO) result in nitrate accumulation in aquaculture wastewater. In order to solve this problem, an encapsulation method was introduced to prepare a novel bioactive capsule, which can provide organic carbon source, denitrifying bacteria, and anoxic microenvironment for aquaculture wastewater denitrification. And can reduce the recovery time of the enclosed denitrifying bacteria. The morphology of the capsule, its nitrate removal rate, and nitrogen conversion pathway in synthetic aquaculture wastewater were investigated. The capsule had a porous surface and the pore diameter ranged from 150.0 nm to 300.0 nm. The enclosed denitrifying bacteria had a reduced recovery time and excellent denitrification performance. The nitrate removal rate reached 86.2 % on the first day and was maintained at 99.7 %. Nitrogen conversion pathways in the capsule include denitrification, assimilatory/dissimilatory nitrate reduction, and nitrogen fixation. The denitrifying capsule has short recovery time and good denitrification performance, which would help to achieve denitrification in aquaculture wastewater or other low C/N wastewater.

Food-Intolerance Genetic Testing: A Useful Tool for the Dietary Management of Chronic Gastrointestinal Disorders.

The rise in food intolerances and celiac disease, along with advanced diagnostic techniques, has prompted health professionals to seek effective and economical testing methods. This study evaluates combining genetic tests with routine carbohydrate-absorption breath tests to classify patients with chronic gastrointestinal disorders into therapeutic groups, enhancing dietary management and improving gut health and quality of life. Forty-nine patients with suspected carbohydrate intolerance underwent genetic testing for lactase non-persistence, hereditary fructose intolerance, and celiac disease risk. Simultaneously, breath tests assessed lactose and fructose absorption. The lactase non-persistence genotype appeared in 36.7% of cases, with one hereditary fructose-intolerance case in a heterozygous condition. Celiac disease risk markers (HLA-DQ2/8 haplotypes) were found in 49.0% of the population. Secondary lactose and/or fructose malabsorption was present in 67.3% of patients, with 66.1% of lactase non-persistence individuals showing secondary lactose malabsorption. Fructose malabsorption was prevalent in 45.8% of patients at risk for celiac disease. Two main treatment groups were defined based on genetic results, indicating primary and irreversible gastrointestinal disorder causes, followed by a sub-classification using breath test results. Genetic testing is a valuable tool for designing dietary management plans, avoiding unnecessary diet restrictions, and reducing recovery times.