Cura por vacío (VAC), a propósito de un caso en Atención Primaria / Vacuum assisted closure (VAC), about a case in primary care

El síndrome compartimental agudo requiere de la descompresión quirúrgica, mediante fasciotomía, esta técnica debe ser urgente y será clave para evitar la instauración de graves secuelas. El posterior abordaje de estas heridas de difícil y lenta cicatrización suponen un reto para los profesionales de la salud y un problema para la salud pública debido a los altos costes y elevada morbilidad. La terapia de presión negativa (TPN) o cura por vacío (VAC, "vacuum assisted closure") es un tratamiento no invasivo que consigue la curación de las heridas favoreciendo la vascularización, la aparición del tejido de granulación y eliminación del exceso de exudado[AU]

Acute compartment syndrome requires surgical decompression by fasciotomy, this technique must be urgent and will be key to avoid the establishment of serious sequels. The subsequent approach to these wounds, which are difficult and slow to heal, is a challenge for health professionals and a problem for public health due to high costs and high morbidity. Negative pressure therapy (NPWT) or vacuum assisted closure (VAC) is a non-invasive treatment that achieves wound healing by promoting vascularization, the appearance of granulation tissue and elimination of excess exudate[AU]

A síndrome compartimental aguda requer descompressão cirúrgica, por fasciotomia, esta técnica deve ser urgente e será fundamental para evitar o estabelecimento de sequelas graves. O tratamento subsequente destas feridas difíceis e de cicatrização lenta é um desafio para os profissionais de saúde e um problema desaúde pública devido aos elevados custos e à elevada morbilidade. A terapia por pressão negativa (NPWT) ou o encerramento assistido por vácuo (VAC) é um tratamento não invasivo que permite a cicatrização de feridas através da promoção da vascularização, do aparecimento de tecido de granulação e da remoção do excesso de exsudado[AU]

Endoscopic vacuum assisted closure therapy for esophagopericardial fistula in a 16-year-old male: A case report.

BACKGROUND: Esophagopericardial fistula (EPF) is a rare, life-threatening condition with limited scientific literature and no established management guidelines. This case report highlights a successful multidisciplinary approach and the innovative use of endoscopic vacuum assisted closure (endoVAC) therapy in treating this complex condition. CASE SUMMARY: A 16-year-old male with a history of esophageal atresia and colon interposition presented with progressive chest pain, fever, and dyspnea. Imaging revealed an EPF with associated pleural and pericardial effusions. Initial management with an esophageal stent failed, prompting the use of an endoVAC system. The patient underwent multiple endoVAC device changes and received broad-spectrum antibiotics and nutritional support. The fistula successfully closed, and the patient recovered, demonstrating no new symptoms at a 6-month follow-up. CONCLUSION: EndoVAC therapy can effectively manage EPF, providing a minimally invasive treatment option.

Deactivation and regeneration dynamics in hierarchical zeolites: Coke characterization and impact on catalytic cracking of vacuum gas oil.

This study investigated the deactivation and regeneration of hierarchical zeolites in vacuum gas oil conversion, aiming to reach the equilibrium state seen in fluidized bed catalytic cracking (FCC). The research utilized various characterization techniques to analyze the properties of zeolites before and after coking and regeneration. Zeolite Y-0.20-S was found to have the highest gasoline selectivity and quality, mirroring industrial yields, and displayed notable stability across deactivation/regeneration cycles. Higher mesopore concentration in zeolites led to increased coke selectivity and better resistance to deactivation. The study observed a dominance of aromatic coke with a higher degree of condensation in these zeolites. Despite coke deposition affecting acid and textural properties, the regeneration process effectively restored these characteristics, proving its efficiency. The zeolites with greater mesoporosity retained their fundamental properties responsible for activity and selectivity, highlighting the importance of selecting materials that provide high conversions and maintain stability and product selectivity over multiple cycles. The Y-0.20-S zeolite, in particular, was identified as a promising candidate for commercial catalyst development for gasoline production, contributing to the FCC process's energy efficiency.

Endoscopic vacuum therapy: pitfalls, tips and tricks, insights, and perspectives.

This article provides a comprehensive review of the use of endoscopic vacuum therapy (EVT) in the management of transmural gastrointestinal (GI) defects (TGIDs) and its future perspectives, such as pre-emptive EVT and novel indications, including GI bleeding and large gastroduodenal ulcers management. This review is based on the available literature data and personal experience to demystify the mentioned limitations of EVT as technical difficulties related to the procedure, possible patients' complaints, and institutions' concerns, by sharing several tips and tricks to overcome EVT-related challenges that may discourage endoscopists from using this live-saving technique, and consequently, restricting patients to receive this therapy, which may lead to undesired outcomes. Several factors, such as placement techniques, EVT type selection, management during its use, EVT system exchanges, device removal, type of anesthesia, and how to avoid EVT-related adverse events are described in detail. Additionally, this review discusses good ways to promote effective communication with patients and relatives, surgeons, and multidisciplinary team. EVT possesses a unique mechanism of action including macro/micro deformation, changes in perfusion (stimulating angioneogenesis), exudate control, and bacterial clearance, promoting healing. EVT has an adequate safety profile and higher clinical success rate compared to any other endoscopic therapy for TGID. Additionally, pre-emptive EVT and its novel indications are promising due to its satisfactory effectiveness in initial studies. Therefore, detailing some practical solutions obtained by years of experience may collaborate to widespread EVT adoption, providing less-invasive treatment for several critical conditions to more patients worldwide.

Development of an Apple Snack Enriched with Probiotic Lacticaseibacillus rhamnosus: Evaluation of the Refractance Window Drying Process on Cell Viability.

The objective of this study was to develop a dried apple snack enriched with probiotics, evaluate its viability using Refractance Window (RWTM) drying, and compare it with conventional hot air drying (CD) and freeze-drying (FD). Apple slices were impregnated with Lacticaseibacillus rhamnosus and dried at 45 °C using RWTM and CD and FD. Total polyphenol content (TPC), color (∆E*), texture, and viable cell count were measured, and samples were stored for 28 days at 4 °C. Vacuum impregnation allowed for a probiotic inoculation of 8.53 log CFU/gdb. Retention values of 6.30, 6.67, and 7.20 log CFU/gdb were observed for CD, RWTM, and FD, respectively; the population in CD, RWTM remained while FD showed a decrease of one order of magnitude during storage. Comparing RWTM with FD, ∆E* was not significantly different (p < 0.05) and RWTM presented lower hardness values and higher crispness than FD, but the RWTM-dried apple slices had the highest TPC retention (41.3%). Microstructural analysis showed that RWTM produced a smoother surface, facilitating uniform moisture diffusion and lower mass transfer resistance. The effective moisture diffusion coefficient was higher in RWTM than in CD, resulting in shorter drying times. As a consequence, RWTM produced dried apple snacks enriched with probiotics, with color and TPC retention comparable to FD.

Vacuum-assisted excision: a safe minimally invasive option for benign phyllodes tumor diagnosis and treatment-a systematic review and meta-analysis.

Synopsis: This is a systematic review and meta-analysis comparing surgical excision with percutaneous ultrasound-guided vacuum-assisted excision (US-VAE) for the treatment of benign phyllodes tumor (PT) using local recurrence (LR) as the endpoint. Objective: To determine the frequency of local recurrence (LR) of benign phyllodes tumor (PT) after ultrasound-guided vacuum-assisted excision (US-VAE) compared to the frequency of LR after surgical excision. Method: A systematic review and meta-analysis [following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard] was conducted by comparing LR in women older than 18 years treated for benign PT by US-VAE compared with local surgical excision with at least 12 months of follow-up. Studies were retrieved from PubMed, Scopus, Web of Science, and Embase. The pooled effect measure used was the odds ratio (OR) of recurrence. Results: Five comparative prospective or retrospective observational studies published between January 1, 1992, and January 10, 2022, comparing surgical excision with percutaneous US-VAE for LR of benign PT met the selection criteria. Four were retrospective observational cohorts, and one was a prospective observational cohort. A total of 778 women were followed up. Of them, 439 (56.4%) underwent local surgical excision, and 339 (43.6%) patients had US-VAE. The median age of patients in the five studies ranged from 33.7 to 39 years; the median size ranged from 1.5 cm to 3.0 cm, and the median follow-up ranged from 12 months to 46.6 months. The needle gauge ranged from 7G to 11G. LR rates were not statically significant between US-VAE and surgical excision (41 of 339 versus 34 of 439; OR 1.3; p = 0.29). Conclusion: This meta-analysis suggests that using US-VAE for the removal of benign PT does not increase local regional recurrence and is a safe minimally invasive therapeutic option. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022309782.

Endoscopic self-expandable metal stent versus endoscopy vacuum therapy for traumatic esophageal perforations: a retrospective cohort study.

BACKGROUND: Traumatic esophageal perforations (TEP) are a grave medical condition and require immediate intervention. Techniques such as Esophageal Self-Expandable Metal Stent (E-SEMS) and Endoscopic Vacuum Therapy (EVT) show promise in reducing tissue damage and controlling esophageal leakage. The present study aims to compare the application of EVT to E-SEMS placement in TEP. METHODS: Retrospective cohort study valuated 30 patients with TEP. The E-SEMS and EVT groups were assessed for time of hospitalization, treatment duration, costs, and clinical outcome. RESULTS: Patients treated with EVT (24.4 ± 13.2) demonstrated significantly shorter treatment duration (p < 0.005) compared to the group treated with E-SEMS (45.8 ± 12.9) and patients submitted to E-SEMS demonstrated a significant reduction (p = 0.02) in the time of hospitalization compared to the EVT (34 ± 2 vs 82 ± 5 days). Both groups demonstrated a satisfactory discharge rate (E-SEMS 93.7% vs EVT 71.4%) but did not show statistically significant difference (p = 0.3155). E-SEMS treatment had a lower mean cost than EVT (p < 0.05). Descriptive statistics were utilized, arranged in table form, where frequencies, percentages, mean, median, and standard deviation of the study variables were calculated and counted. The Fisher's Exact Test was used to evaluate the relationship between two categorical variables. To evaluate differences between means and central points, the parametric t-test was utilized. Comparisons with p value up to 0.05 were considered significant. CONCLUSION: E-SEMS showed a shorter time of hospitalization, but a longer duration of treatment compared to EVT. The placement of E-SEMS and EVT had the same clinical outcome. Treatment with E-SEMS had a lower cost compared with EVT.

Experiencia de parto instrumental con vacuum en Hospital Público de Santiago de Chile / Experience of vacuum-assisted instrumental delivery in a Public Hospital in Santiago, Chile

Introducción: El vacuum es el instrumento de elección para asistir el parto instrumental en países desarrollados. Objetivo: El objetivo del estudio es exponer los resultados maternos y fetales del uso del vacuum en población chilena y promover su disponibilidad y uso en nuestro país y Latinoamérica. Método: El estudio se realizó entre octubre de 2017 y diciembre de 2021, incluyendo a pacientes que tuvieron parto instrumental con vacuum en el Hospital San Juan de Dios de Chile. Se compararon los partos exitosos con vacuum y los partos en los que se requirió el uso de otro instrumento o una cesárea posterior al uso del instrumento. Resultados: Se realizaron 153 vacuum, correspondientes al 28,59% del total de partos instrumentales. El 79,74% tuvo éxito. El 5,88% no recibió anestesia o se aplicó anestesia local. Solo el 3,27% presentó desgarro perineal con compromiso del esfínter anal. El 91,5% de los recién nacidos no tuvieron complicaciones fetales. Un 20,3% requirió reanimación neonatal. Conclusiones: El estudio muestra que el vacuum es una opción segura y efectiva de parto instrumental en nuestra población. La correcta capacitación y protocolos adecuados son necesarios para garantizar resultados exitosos.

Introduction: Vacuum extraction is the instrument of choice for assisting instrumental delivery in developed countries. Objective: The aim of the study is to present the maternal and fetal outcomes of vacuum use in the Chilean population and promote its availability and usage in our country and Latin America. Method: The study was performed between October 2017 and December 2021, including patients who underwent instrumental delivery with a vacuum extraction at the Hospital San Juan de Dios in Chile. Successful vacuum deliveries were compared with deliveries where another instrument was required, or a cesarean section was performed after instrument use. Results: A total of 153 vacuum deliveries were carried out, accounting for 28.59% of all instrumental deliveries. 79.74% were successful. 5.88% did not receive anesthesia or received local anesthesia. Only 3.27% experienced perineal tear with involvement of the anal sphincter. 91.5% of newborns had no fetal complications. 20.3% required neonatal resuscitation. Conclusions: The study demonstrates that the vacuum is a safe and effective option for instrumental delivery in our population. Proper training and appropriate protocols are necessary to ensure successful outcomes.

Effect of packaging thickness and muscle type on ultrasound-assisted beef quality.

High-intensity ultrasound (HIU) can modify muscle structure, leading to improvements in tenderness. However, factors such as packing type and muscle complexity may attenuate the acoustic cavitation. In this research, the effect of packing thickness (40.6-70 µm) on the quality of bovine Gluteus medius and Biceps femoris treated with HIU (37 kHz, 90 W/cm2, 40 min) was evaluated. The hardness of G. medius decreased significantly as the thickness of the packing bag decreased. The wide interfibrillar and intermyofibrillar spaces corroborated the tenderizing effect. These effects are related to damage of cell structure and changes in the collagen content (3.37 ± 0.1 µg/mL). In addition, the HIU decrease the variability in the water holding capacity of the muscle produced by the use of low thickness bags during storage. The trained sensory panel described the sonicated samples in 50.8 µm bags as less hard and juicier. Contrarily, in B. femoris no significant effects were reported in the variables evaluated. B. femoris is a white muscle, with a high amount of collagen (3.59 ± 0.1 µg/mL) and little intramuscular fat. Consequently, the effect of the HIU on muscle quality is associated with the composition of the muscle fibers and the thickness of the packing bag. HIU application is recommended to improve the quality of leg muscles whenever low-thickness bags (50.8 µm or less) are used.

Bacterial microbiota shifts in vacuum-packed beef during storage at different temperatures: Impacts on blown pack spoilage.

We aimed to evaluate the bacterial growth and diversity in vacuum-packed beef bags stored at different temperatures and to monitor blown-pack spoilage. We used culture-based methods and high-throughput sequencing to study the development of the main bacterial groups naturally present in beef stored at 4 and 15 °C for 28 days. The growth of sulfite-reducing clostridium (SRC) was impaired in beef bags stored at 4 °C; significant differences among SRC counts were observed in beef bags stored at 4 and 15 °C on days 14, 21, and 28 (P = 0.001). Blown pack was observed in most beef bags stored at 15 °C, from day 14 to day 28, but not in beef bags stored at 4 °C. A storage temperature of 4 °C was able to maintain a stable bacterial microbiota (most prevalent: Photobacterium, Hafnia-Obesumbacterium, and Lactococcus). Remarkable changes in microbial abundance occurred at 15 °C from day 14 to day 28, with a predominance of strict anaerobes (Bacteroides) and the presence of Clostridium spp. The relative frequencies of strict anaerobes and Clostridium were statistically higher in the beef bags stored at 15 °C (P < 0.001 and P = 0.004, respectively). The temperature influenced the microbial counts and relative abundance of spoilage bacteria, leading to blown pack spoilage.

Negative Pressure Wound Therapy After Intestinal Anastomosis: A Risk Factor Analysis for Dehiscence.

INTRODUCTION: Negative pressure wound therapy (NPWT) is part of the temporary abdominal closure in the treatment of patients with traumatic, inflammatory, or vascular disease. However, the use of NPWT when performing an intestinal anastomosis has been controversial. This study aimed to describe the patients managed with NPWT therapy and identify the risk factors for anastomotic dehiscence when intestinal anastomosis was performed. METHODS: A single-center cohort study with prospectively collected databases was performed. Patients who required NPWT therapy from January 2014 to December 2018 were included. Patients were stratified according to the performance of intestinal anastomosis and according to the presence of dehiscence. Bivariate and multivariate analyses were performed for anastomotic dehiscence and mortality. RESULTS: A total of 97 patients were included. Median age was 52 y old [interquartile range 24.5-70]. Male patients corresponded to 75.6% (n = 34) of the population. Delayed fascial closure was performed in 80% (n = 36). The risk of anastomotic dehiscence was higher in females (odds ratio (OR) 11.52 [confidence interval (CI) 1.29-97.85], P = 0.030), delayed fascial closure (OR 18.18 [CI 2.02-163.5], P = 0.010) and use of vasopressors (OR 12.04 [CI 1.22-118.47], P = 0.033). NPWT pressures >110 mmHg were evidenced in the dehiscence group with statistically significant value (OR 1.2 [0.99-2.26] p 0.04) CONCLUSIONS: There is still controversy in the use of NPWT when performing intestinal anastomosis. According to our data, the risk of dehiscence is higher in females, delayed fascial closure, use of vasopressors, and NPWT pressures >110 MMHG.

Treatment of depressed skull fractures with vacuum devices in the neonatal period: A case series.

PURPOSE: The management of depressed skull fractures in infants can be either conservative or surgical. This study aimed to examine the outcomes of management with a negative-pressure vacuum device on depressed skull fractures in newborns. METHODS: Twenty-eight patients (aged 1-6 days) with simple depressed skull fractures underwent skull elevation using negative-pressure vacuum devices. A protocol for nonsurgical management was adopted for infants with such fractures between 2010 and 2023. All patients were initially evaluated with neurological examination and complementary assessments-hematological and coagulation studies, transfontanel transcranial ultrasound, skull radiography, and computed tomography scanning with three-dimensional reconstruction-according to availability and clinical needs. Gentle (negative) extraction pressure was applied with one of several devices (according to institutional availability) for a maximum duration of 60 s; this was performed as soon as possible after diagnosis, preferably within 72 h. Follow-up data, available in the clinical records, were reported. RESULTS: All patients exhibited satisfactory elevation of the depressed bone without associated injuries, except one patient who presented with an associated cephalohematoma which prevented optimal device coupling to generate sufficient vacuum pressure for correction. Neither neurological deficits nor development of epilepsy was noted; normal neurological assessment and oral alimentation tolerance were confirmed within 24 h post procedure. CONCLUSIONS: According to our data, ping-pong skull fracture elevation using the vacuum method is a safe and satisfactory treatment in the neonatal period. Early treatment allows for quick resolution, and in our opinion is the strategy of choice for depressed skull fractures in newborns.

Potential role of vacuum-assisted procedures in resecting breast cancers and highlighting selection criteria to support future trials.

Purpose: The purpose of this study was to evaluate the role of vacuum-assisted biopsy (VAB) in resecting breast cancers. Methods: Retrospective database analysis of 116 cancers [both invasive breast cancers (IC) and ductal carcinoma in situ (DCIS)] diagnosed by VAB submitted to standard surgical treatment with complete histological data from VAB and surgery. Excision following VAB was defined as complete resection (CR) if there was no residual tumor in the surgical specimen, minimal residual disease (MRD) if residual tumor ≤ 3 mm, gross residual disease (GRD) if residual tumor > 3 mm, and upgrade from DCIS on VAB to IC. CR and MRD were combined as potentially resected percutaneously (PRP). GRD and those with upgrade to IC were determined not eligible for percutaneous resection (NPR). Factors predictive of PRP were evaluated. Results: Mean age was 55.6 years (20-91; SD: 12,27). CR was seen in 29 of 116 cases (25%), MRD in 18 of 116 cases (15.5%), GRD in 64 of 116 cases (55.2%), and five of 116 cases (4.3%) were upgraded from DCIS to IC, and those groups combined represented 47 cases of PRP (40.5%) and 69 (59,5%) of NPR. For 77 tumors ≤ 10 mm, 45 (58.5%) were PRP. Multivariate analysis reveals significance for enlarged VAB (EVAB) (p = 0.008, OR: 4.4, 95% CI), low/intermediate nuclear grade (p < 0.001, OR: 12.5, 95% CI) and final tumor size (T) ≤ 10 mm (p = 0.001, OR: 50.1, 95% CI) for PRP. Conclusions: This study showed that lesions completely excised with VAB that were cancer could have been treated with VAB rather than surgery but tumor selection in terms of subtype and size is important.

Association between Modic changes and intervertebral vacuum phenomenon severity in patients undergoing percutaneous cement discoplasty.

BACKGROUND: Modic changes and intervertebral vacuum phenomenon (IVP) are considered spinal degenerative changes. The correlation between Modic and IVP has not been analyzed in the literature. PURPOSE: To analyze the correlation between IVP severity, Modic changes, and subchondral sclerosis across the lumbar spine in patients with lumbar degeneration. MATERIAL AND METHODS: This is a retrospective study analyzing patients who underwent percutaneous cement discoplasty at a single institution between 2015 and 2020. Preoperative magnetic resonance imaging and computed tomography scans were analyzed to make the measurements. Modic type and grade as well as severity of IVP were preoperatively measured. The association between Modic type, grade, subchondral sclerosis, and the presence of IVP was analyzed. RESULTS: In total, 110 patients (mean age = 77.03 ± 7.1 years) were finally included in the study. Per level correlation analysis showed a significant positive association between IVP and Modic type, IVP and Modic grade, and IVP and subchondral sclerosis. Moreover, subchondral sclerosis was significantly associated with Modic type and grade. CONCLUSION: Our study showed a significant positive correlation among Modic changes, IVP, and subchondral sclerosis throughout the lumbar spine. Our findings support the theory that endplate degeneration parameters are associated with the presence and severity of IVP.

Processing of Enriched Pear Slices with Blueberry Juice: Phenolics, Antioxidant, and Color Characteristics.

This study evaluated the effectiveness of phenolic compound incorporation from blueberry juice into pear slices (PS) using a combination of ohmic heating (OH) and vacuum impregnation (VI), followed by air-drying (AD) or freeze-drying (FD). Our results showed that OH increased the content of bioactive compounds and antioxidant capacity of blueberry juice, with the optimal OH condition set at 50 °C for 20 min under an electric field of 13 V·cm-1. Furthermore, the combination of VI and OH was efficient in enriching PS with bioactive compounds from blueberry juice (such as cyanidin and epigallocatechin), with the optimal VI/OH condition set at 50 °C for 90 min under an electric field of 7.8 V·cm-1. Moreover, anthocyanin pigments from blueberry juice affected the color parameters of PS by increasing the a* parameter and decreasing the b* and L* parameters. However, both FD and AD (at 40, 50, and 60 °C) negatively affected (p ≤ 0.05) the phenolic content and antioxidant capacity. Notably, AD at 60 °C showed the highest levels of phenolic compounds and antioxidant potential for both impregnated and non-impregnated PS.

Flash vacuum expansion, a low-cost and energy-efficient alternative process to produce high-quality fruit puree: Application to Physalis peruviana.

Goldenberry has great potential for the development of high-quality products due to its attractive sensory attributes, bioactive compounds, and health benefits. However, postharvest losses are high due to the lack of processing technologies that can both be adapted to rural conditions in producing countries to generate high-quality products. Flash vacuum expansion coupled with vacuum pulping is a new process that can meet these requirements. In the process, the steam holding time (30, 40, and 50 s/130 kPa) and flash vacuum expansion (5 ± 1.2 kPa) were studied. The logarithmic reduction of microbial load and some quality indicators were analyzed during the process and during storage to assess the shelf life of fruit purées. The FVE process with 40 s steam blanching led to a microbial reduction of over 6 log colony forming units (CFU)/g, increased yield and ß-carotene content, and preserved most of the AA content (4-12%). Based on the half-lives of the quality indicators, the shelf life of the purées was between 16 d (20 °C) and 90 d (4 °C). The energy consumption was estimated at approximately 0.30 kWh/kg of product. These results demonstrate that the FVE process, although it includes heat treatment, allows a short exposure to heat of the whole fruits to obtain a high-quality puree with an adequate shelf life in a single step, with a relatively low equipment investment and moderate energy consumption.

A comprehensive study of product distributions and coke deposition during catalytic cracking of vacuum gas oil over hierarchical zeolites.

In this study, zeolites (Z) were used as catalysts in the cracking of a Colombian vacuum gas oil (VGO), with a focus on product distribution and coke deposition. The catalytic tests were carried out in a MAT-type reactor under typical conditions. The zeolites were subjected to alkaline treatment with NaOH at concentrations ranging from 0.05 to 0.4 mol/L, resulting in the creation of several samples (Z-0.05, Z-0.10, Z-0.20, Z-0.30 and Z-0.40) that were then hydrothermally stabilized (Z-0.05-M, Z-0.10-M, Z-0.20-M, Z-0.30-M and Z-0.40-M) to increase mesoporosity and reduced crystallinity. The increase in mesoporosity was accompanied by an improvement in acidity. Despite Z-0.30-M having higher acidity, Z-0.00-M and Z-0.10-M exhibited the highest activity due to their high crystallinity and microporosity, yielding the highest gas yields. Gasoline was the main product, with maximum yields exceeding 30%. Z-0.20-M produced more aromatic and olefin compounds than the others, resulting in higher quality gasoline. Coke formation followed the trend: Z-0.00-M < Z-0.10-M < Z-0.20-M < Z-0.30-M. The higher intracrystalline mesoporosity in the zeolites favored the formation of a more condensed coke.

Effects of Red and Infrared Laser Therapy in Patients with Tinnitus: A Double-Blind, Clinical, Randomized Controlled Study Combining Light with Ultrasound, Drugs and Vacuum Therapy.

BACKGROUND: tinnitus is a symptom with no specific cause known to date, and there are no associated pharmacogenomics of hearing disorders and no FDA-approved drugs for tinnitus treatment. The effectiveness of drug treatments is not reproducible on idiopathic patients and inexistent in refractory patients. Personalized treatments for these patients are a great clinical need. Our study investigated the outcome of potential alternative and complementary treatment modalities for idiopathic and refractory tinnitus patients. METHODS: we were the first to evaluate the tinnitus handicap inventory (THI) score changes over the course of treatment up to 15 days after complete cessation of treatment for novel transmeatal low-level laser therapy (LLLT) modalities using light alone, as well as LLLT combined with vacuum therapy (VT), ultrasound (US), Ginkgo biloba (GB) and flunarizine dihydrochloride (FD), while also comparing all treatment outcomes with laser puncture (LP), FD alone and GB alone. RESULTS: a positive treatment outcome (superior to a placebo effect) was achieved by using either LP or transmeatal LLLT, whereas short-term antagonistic effects of VT, US, GB and FD when combined with LLLT. For transmeatal LLLT, an improvement in the treatment outcome was observed by increasing the irradiation time from 6 min to 15 min (with 100-mW of applied laser power at 660 nm). Finally, a lasting therapeutic effect higher than the placebo was observed at 15 days after treatment upon combining LLLT with VT, GB or by using FD alone, by using the transmeatal LLLT alone or by using LP. CONCLUSIONS: LP and Transmeatal LLLT can be promising alternative treatments for idiopathic and refractory tinnitus patients. Future studies should investigate the long-term effects of LLLT in tinnitus patients, as well as the dosimetry and wavelength of transmeatal LLLT.

Tube-in-tube endoscopic vacuum therapy for treatment of colorectal anastomotic leaks: A low-cost, patient-friendly, feasible and efficient technical modification of sponge-based endoscopic vacuum therapy.

BACKGROUND AND AIMS: Colorectal endoscopic vacuum therapy (CR EVT) is usually performed using sponges passed through the anus. It may be associated with patient discomfort and displacement of the aspiration tube. METHODS: With the tube-in-tube endoscopic vacuum therapy modification (CR TT-EVT), it is possible to position the aspiration tube in the pelvic cavity through the abdominal wall. In addition, it allows frequent cleaning of the fistula, eliminates the need for programmed device changes, and enables a standardized approach to such a wide variety of fistulas, leaks, and perforations. RESULTS: Here is a technical note on how to perform CR TT-EVT, while we are at the early phase of our case series we have reached 100% of technical success.

Effects of mango peel ethanolic extract as antioxidant in quail diets on performance, carcass traits, and meat lipid stability.

The purpose of this study was to evaluate the inclusion of mango peel ethanolic extract (MPEE) as antioxidant in quail diets containing two lipid sources, on performance, carcass characteristics, and lipid stability of in natura and frozen meat. A total of 432 meat quails were used, males and females, from 7 to 42 days of age, distributed in a completely randomized design in a 3 × 2 factorial arrangement, with 3 levels of MPEE (0, 500, and 1000 mg/kg) and 2 lipid sources (soybean and sunflower oil), totaling 6 treatments with 6 replications of 12 birds. In order to evaluate the meat lipid stability, carcass samples were used in a 2 × 2 × 2 × 3 factorial arrangement, with 2 levels of MPEE (0 and 1000 mg/kg), 2 lipid sources (soybean and sunflower oil), 2 types of packaging (conventional and vacuum), and 3 storage times (0, 60, and 120 days), totaling 16 treatments with 6 replications. There was no effect of interaction (P > 0.05) between the factors on the performance variables and carcass characteristics. Oil types and MPEE levels did not influence (P > 0.05) performance. For carcass characteristics, it was found to be increased (P < 0.05) in breast meat yield due to the inclusion of MPEE. For the meat lipid stability, there was only an effect of interaction (P < 0.05) between type of packaging and storage time. The inclusion of 1000 mg/kg of MPEE provided greater meat lipid stability, enabling the use of common packaging for the storage of quail meat for up to 120 days.