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New suction endoscopes, ureteral access sheaths (UAS) and catheters aim to improve the efficacy of flexible ureteroscopy and optimize its safety. Suction UAS with non-flexible tips have shown promising results, especially in maintaining low intrarenal pressure, but also in removing small debris and reducing the "snow globe" effect. In addition, suctioning UAS with a flexible tip offers the advantage of being able to be navigated through the pyelocaliceal system to where the laser lithotripsy is performed. It can also remove small stone fragments when the flexible ureteroscope is retracted, using the Venturi effect. Direct in-scope suction (DISS) involves aspirating dust and small stone debris through the working channel of a flexible ureteroscope, thus regulating intrarenal pressure and improving visibility. Steerable aspiration catheters are other devices designed to increase stone clearance of the pyelocaliceal system. They are inserted under fluoroscopic guidance into every calyx after retraction of the flexible ureteroscope, alternating irrigation and aspiration to remove dust and small gravels. Combining flexible-tip suction UAS and the DISS technique may offer some advantages worth evaluating. The advantage of using these instruments to achieve a low intrarenal pressure was demonstrated. The true practical impact on the long-term stone-free status is a matter requiring further studies. [ABSTRACT FROM AUTHOR]

Anisakiasis, a zoonotic disease that can lead to small intestine obstruction, has seen a significant rise in Spain. The country has become the first in Europe with an annual incidence of 8000 cases, primarily due to the popularity of consuming exotic dishes of undercooked or raw fish and the impact of climate change. The clinical presentation of anisakiasis can mimic symptoms of acute appendicitis or intestinal obstruction, leading to potential misdiagnosis. This case report describes a 37-year-old patient with no significant medical history who presented abdominal distension and intense pain in the right lower quadrant. The patient underwent surgery and received physiotherapy treatment, including therapeutic exercises and pulsed-pressure myofascial vacuum therapy, to facilitate functional recovery. The increasing incidence of anisakiasis in Spain underscores the need to consider it in the differential diagnosis of digestive diseases, given the high consumption of poorly prepared or raw fish in the region. [ABSTRACT FROM AUTHOR]

Closed-incision negative-pressure wound therapy (iNPWT) is known to enhance wound healing and tissue regeneration. The main aim of the present study is to investigate its effectiveness on enhancing wound healing under tension. An animal study was designed using a swine model by removing a skin flap to create a wound that could be closed primarily under tension, and iNPWT was applied. The enhancement of angiogenesis, lymphangiogenesis, collagen deposition, and tissue proliferation with reduced inflammation by iNPWT was confirmed by histology. The effect of iNPWT was further verified in patients receiving a profunda artery perforator (PAP) free flap for breast reconstruction. iNPWT was applied on the transversely designed donor site in continuous mode for 7 days, in which the wound was always closed under tension. A significant improvement in off-bed time was noted with the application of iNPWT (4.6 ± 1.1st and 5.5 ± 0.8th postoperative days in the iNPWT and control groups, respectively, p = 0.028). The control group (without iNPWT treatment) presented more cases of poor wound healing in the acute (23.1% vs. 0%) and wound breakdown in the late (23.1% vs. 8.3%) stages. The treatment of closed incisions under tension with iNPWT clinically enhances wound healing and tissue regeneration and with histological evidence. [ABSTRACT FROM AUTHOR]

Non-specific low back pain is defined as pain located in the lumbar region; this condition is the most frequent musculoskeletal disorder. Negative pulsed-pressure myofascial vacuum therapy (vacuum treatment (VT)) devices mobilize tissue according to previously programmed parameters of force, time and frequency. The purpose of this study was to compare the effects of VT combined with core therapeutic exercise versus a physical therapy program (PTP) based only on core therapeutic exercise. Fifty participants with chronic non-specific low back pain were randomly assigned to two treatment groups, the VT group (n = 25) or the PTP group (n = 25). Pain, pressure-pain threshold, range of motion, functionality and quality of life were measured before treatment, at the end of treatment, and at one-month and three-month follow-ups. Both groups received 15 therapy sessions over 5 weeks. Statistically significant differences in favor of the VT group were shown in the results. In conclusion, the intervention based on myofascial vacuum therapy improved pain, mobility, pressure pain threshold, functionality and quality of life. [ABSTRACT FROM AUTHOR]