Upgrading hazelnut skins: Green extraction of polyphenols from lab to semi-industrial scale.

Hazelnut skins (HS) are usually managed as waste; however, this by-product is a source of bioactive compounds, with potential applications in feed and food sectors. Phenolic compounds can be extracted using green protocols combining enabling technologies and green solvents. This work investigates subcritical water extraction (SWE) of bioactive compounds from HS. A laboratory-scale study was performed on four different batches, with significant batch-to-batch heterogeneity. The evaluation of polyphenolic profiles and antioxidant activities afforded promising results compared to the benchmark of reflux maceration. To evaluate process effectiveness, the extraction protocol was replicated on a semi-industrial plant that processed 8 kg of matrix. Downstream processes have been optimized for scale-up, demonstrating the effectiveness of SWE in retaining product concentration and bioactivity avoiding excipients in spray-drying phase. Hazelnut extracts exhibited antibacterial properties against animal- and food-borne pathogens, supporting their potential use as sustainable feed ingredients for improved hazelnut production and animal farming practices.

Multi-parameter simultaneous extraction with a novel microwave sensor based on coupled resonators.

This work presents a microwave resonant multi-parameter sensor devoted to the simultaneous extraction of three characteristics of a homogeneous solid sample: its dielectric permittivity, its loss tangent and its thickness. The device is composed of three coupled resonators in two different substrate boards, having the sample between the boards, in a sandwich configuration. Presence of the sample impacts the electrical response of the device, not only influencing resonators, but also by affecting inter-resonator couplings. A method to analyse the response of the device, allowing for the extraction of the desired characteristics of the sample is proposed, as well as an experimental calibration procedure. The model is built upon 990 simulations, calibrated with three reference-samples measurements and then tested over 18 experimental measurements, with good results, thereby validating the multi-parameter sensing approach.

Activated Iron-Porous Carbon Nanomaterials as Adsorbents for Methylene Blue and Congo Red.

The adsorption properties of microporous carbon materials modified with iron citrate were investigated. The carbon materials were produced based on resorcinol-formaldehyde resin, treated in a microwave assisted solvothermal reactor, and next carbonized in the tube furnace at a temperature of 700 °C under argon atmosphere. Iron citrate was applied as a modifier, added to the material precursor before the synthesis in the reactor, in the quantity enabling to obtain the nanocomposites with C:Fe mass ratio equal to 10:1. Some samples were additionally activated using potassium oxalate or potassium hydroxide. The phase composition of the produced nanocomposites was determined using the X-ray diffraction method. Scanning and transmission electron microscopy was applied to characterize the changes in samples' morphology resulting from the activation process and/or the introduction of iron into the carbon matrix. The adsorption of nitrogen from gas phase and dyes (methylene blue and congo red) from water solution on the obtained materials was investigated. In the case of methylene blue, the adsorption equilibrium isotherms followed the Langmuir isotherm model. However, in the case of congo red, a linear dependency of adsorption and concentration in a broad equilibrium concentration range was found and well-described using the Henry equation. The most efficient adsorption of methylene blue was noticed for the sample activated with potassium hydroxide and modified with iron citrate, and a maximum adsorption capacity of 696 mg/g was achieved. The highest congo red adsorption was noticed for the non-activated sample modified with iron citrate, and the partition coefficient for this material equaled 171 dm3/g.

CT-Guided Microwave Ablation with Vertebral Augmentation for Spinal Metastases with Posterior Wall Defects.

Purpose: To evaluate the efficacy and safety of combined microwave ablation (MWA) and vertebral augmentation (VA) in the treatment of spinal metastases with posterior wall defects. Patients and Methods: A retrospective review was conducted for 67 patients (42 men, 25 women) with painful spine metastases and posterior wall defects who underwent MWA combined with VA. Among these patients, 52 vertebrae had no epidural invasion and 33 had mild invasion but did not compress the spinal cord. Procedural effectiveness was determined by comparing visual analog scale (VAS) scores and Oswestry disability index (ODI) scores before the procedure and during the follow-up period. Results: The procedure was technically successful in all patients. The mean VAS score declined significantly from 6.85 ± 1.81 before the procedure to 3.27 ± 1.97 at 24 h, 1.96 ± 1.56 at 1 week, 1.84 ± 1.50 at 4 weeks, 1.73 ± 1.45 at 12 weeks, and 1.71 ± 1.52 at 24 weeks post-procedure (p < 0.01). The mean ODI score was lower post-procedure than before the procedure (p < 0.001). Transient nerve injury occurred in two patients (SIR classification D), and the incidence of asymptomatic bone cement (SIR classification A) was 43.5% (37/85). Conclusion: MWA combined with VA is an effective and safe treatment for painful spine metastases with posterior wall defects.

Efficient Solution-Phase Dipeptide Synthesis Using Titanium Tetrachloride and Microwave Heating.

Microwaves have been successfully employed in the Lewis acid titanium tetrachloride-assisted synthesis of peptide systems. Dipeptide systems with their amino function differently protected with urethane protecting groups have been synthesized in short periods of time and with high yields. The formation of the peptide bond between the two reacting amino acids was achieved in pyridine by using titanium tetrachloride as a condensing agent and heating the reaction mixture with a microwave reactor. The reaction conditions are compatible with amino acids featuring various side chains and different protecting groups on both the amino function and side chains. Additionally, the substrates retain their chiral integrity after reaction.

Characterization of dielectric properties and their impact on MAS-DNP NMR applications.

The dielectric properties of materials play a crucial role in the propagation and absorption of microwave beams employed in Magic Angle Spinning - Dynamic Nuclear Polarization (MAS-DNP) NMR experiments. Despite ongoing optimization efforts in sample preparation, routine MAS-DNP NMR applications often fall short of theoretical sensitivity limits. Offering a different perspective, we report the refractive indices and extinction coefficients of diverse materials used in MAS-DNP NMR experiments, spanning a frequency range from 70 to 960 GHz. Knowledge of their dielectric properties enables the accurate simulation of electron nutation frequencies, thereby guiding the design of more efficient hardware and sample preparation of biological or material samples. This is illustrated experimentally for four different rotor materials (sapphire, yttria-stabilized zirconia (YSZ), aluminum nitride (AlN), and SiAlON ceramics) used for DNP at 395 GHz/1H 600 MHz. Finally, electromagnetic simulations and state-of-the-art MAS-DNP numerical simulations provide a rational explanation for the observed magnetic field dependence of the enhancement when using nitroxide biradicals, offering insights that will improve MAS-DNP NMR at high magnetic fields.

Accuracy of 3D real-time MRI temperature mapping in gel phantoms during microwave heating.

BACKGROUND: Interventional magnetic resonance imaging (MRI) can provide a comprehensive setting for microwave ablation of tumors with real-time monitoring of the energy delivery using MRI-based temperature mapping. The purpose of this study was to quantify the accuracy of three-dimensional (3D) real-time MRI temperature mapping during microwave heating in vitro by comparing MRI thermometry data to reference data measured by fiber-optical thermometry. METHODS: Nine phantom experiments were evaluated in agar-based gel phantoms using an in-room MR-conditional microwave system and MRI thermometry. MRI measurements were performed for 700 s (25 slices; temporal resolution 2 s). The temperature was monitored with two fiber-optical temperature sensors approximately 5 mm and 10 mm distant from the microwave antenna. Temperature curves of the sensors were compared to MRI temperature data of single-voxel regions of interest (ROIs) at the sensor tips; the accuracy of MRI thermometry was assessed as the root-mean-squared (RMS)-averaged temperature difference. Eighteen neighboring voxels around the original ROI were also evaluated and the voxel with the smallest temperature difference was additionally selected for further evaluation. RESULTS: The maximum temperature changes measured by the fiber-optical sensors ranged from 7.3 K to 50.7 K. The median RMS-averaged temperature differences in the originally selected voxels ranged from 1.4 K to 3.4 K. When evaluating the minimum-difference voxel from the neighborhood, the temperature differences ranged from 0.5 K to 0.9 K. The microwave antenna and the MRI-conditional in-room microwave generator did not induce relevant radiofrequency artifacts. CONCLUSION: Accurate 3D real-time MRI temperature mapping during microwave heating with very low RMS-averaged temperature errors below 1 K is feasible in gel phantoms. RELEVANCE STATEMENT: Accurate MRI-based volumetric real-time monitoring of temperature distribution and thermal dose is highly relevant in clinical MRI-based interventions and can be expected to improve local tumor control, as well as procedural safety by extending the limits of thermal (e.g., microwave) ablation of tumors in the liver and in other organs. KEY POINTS: Interventional MRI can provide a comprehensive setting for the microwave ablation of tumors. MRI can monitor the microwave ablation using real-time MRI-based temperature mapping. 3D real-time MRI temperature mapping during microwave heating is feasible. Measured temperature errors were below 1 °C in gel phantoms. The active in-room microwave generator did not induce any relevant radiofrequency artifacts.

Thermal and/or Microwave Treatment: Insight into the Preparation of Titania-Based Materials for CO2 Photoreduction to Green Chemicals.

Titanium dioxide was synthesized via hydrolysis of titanium (IV) isopropoxide using a sol-gel method, under neutral or basic conditions, and heated in the microwave-assisted solvothermal reactor and/or high-temperature furnace. The phase composition of the prepared samples was determined using the X-ray diffraction method. The specific surface area and pore volumes were determined through low-temperature nitrogen adsorption/desorption studies. The photoactivity of the samples was tested through photocatalytic reduction of carbon dioxide. The composition of the gas phase was analyzed using gas chromatography, and hydrogen, carbon oxide, and methane were identified. The influence of pH and heat treatment on the physicochemical properties of titania-based materials during photoreduction of carbon dioxide have been studied. It was found that the photocatalysts prepared in neutral environment were shown to result in a higher content of hydrogen, carbon monoxide, and methane in the gas phase compared to photocatalysts obtained under basic conditions. The highest amounts of hydrogen were detected in the processes using photocatalysts heated in the microwave reactor, and double-heated photocatalysts.

Thermoablation Using Radiofrequency and Microwaves of Autonomous Thyroid Nodules: Our Experience

Introduction: Significant results have been achieved using ultrasound-guided and ultrasound-assisted ablative techniques, such as Laser Thermal Ablation (LTA), Radiofrequency Ablation (RFA), High-Intensity Focused Ultrasound (HIFU), and Microwave Ablation (MWA). These techniques are ideally suited for the treatment of normally functioning benign thyroid nodes with local compressive symptoms or aesthetic problems. These treatments have been applied to hyperfunctioning "hot" nodes. LTA and RFA are the most commonly used. From January 2021 to July 2023 at our Center, a total of 160 patients with benign thyroid nodules were treated, of which 35 had autonomous nodules [1-4]. Our analysis focused on evaluating the locoregional treatment of the latter. Based on the volume and ultrasound-vascular characteristics, patients were selected for thermoablative treatment with either RFA or MWA (Amica Gen HS - Hospital Service) starting in July 2022. Results: No complications were documented. However, one patient was referred for surgery and 1 patient was re-treated with MWA. Conclusion: In the light of personal experience ultrasound-guided thermal ablation treatment with RFA in patients with a single pretoxic or toxic thyroid nodule with or without associated compressive or aesthetic symptoms has proven to be very effective and satisfactory. The treatment must be preceded by adequate information regarding the advantages and disadvantages of the various procedures and the methods of the treatment session. MWA proved to be more effective than RFA with no functional recovery of the treated nodules even if they were relatively larger in size. We obtained the suspension of thyrostatic therapy with normalization of the TSH level in the third month after treatment.

A low-cost, portable device for the study of the malaria parasite's growth inhibition via microwave exposure.

Recently, a novel method for the growth inhibition of malaria parasites using microwaves was proposed. However, the apparatuses used to demonstrate this method are high-cost and immovable, hindering the progression in this field of research, which is still in its early stages. This paper presents the redesign, construction, and validation of an equivalent system, converting it into a portable and low-cost system, capable of replacing the existing one. The proposed system is mainly composed of an RF generator (MAX2870), an RF amplifier (SKYWORKS 66292-11) and a graphical user interface. Likewise, the RF applicator proposed by the original study was redesigned, resulting in a five-fold improvement in return loss. The obtained results indicate that the proposed system achieves 90% parasite growth inhibition, matching the performance of its counterpart at less than 1% of its cost. These results represent a breakthrough for the creation of smaller, enhanced devices that open new possibilities for an alternative treatment to combat this devastating disease.

Extraction of polyphenols and essential oils from herbs with green extraction methods - An insightful review.

The demand for polyphenols and essential oils (EOs) on the food market is high and grows every year. Its partially the result of the fact that these compounds can be used in formulation of clean label foods, a fast growing food sector. A significant share of polyphenols and EOs are extracted from herbs. The quality of the extracts is determined mainly by the extraction method. Conventional extraction techniques of phytochemicals are time-consuming, operate at high temperatures, and require usage of organic solvents and energy in large quantities. According to the United Nations Sustainability Development Plan, chemical processes should be replaced by green alternatives that would reduce the use of solvents and energy. Ultrasound-Assisted Extraction (UAE), Microwave-Assisted Extraction (MAE) and Cold Plasma-Assisted Extraction (CPAE) meets these criteria. The review shows that each of these techniques seems to be a great alternative for conventional extraction methods ensuring higher yields of bioactive compounds.

A green Heck reaction protocol towards trisubstituted alkenes, versatile pharmaceutical intermediates.

The Heck reaction is widely employed to build a variety of biologically relevant scaffolds and has been successfully implemented in the production of active pharmaceutical ingredients (APIs). Typically, the reaction with terminal alkenes gives high yields and stereoselectivity toward the trans-substituted alkenes product, and many green variants of the original protocol have been developed for such substrates. However, these methodologies may not be applied with the same efficiency to reactions with challenging substrates, such as internal olefins, providing trisubstituted alkenes. In the present work, we have implemented a Heck reaction protocol under green conditions to access trisubstituted alkenes as final products or key intermediates of pharmaceutical interest. A set of preliminary experiments performed on a model reaction led to selecting a simple and green setup based on a design of experiments (DoE) study. In such a way, the best experimental conditions (catalyst loading, equivalents of alkene, base and tetraalkylammonium salt, composition, and amount of solvent) have been identified. Then, a second set of experiments were performed, bringing the reaction to completion and considering additional factors. The protocol thus defined involves using EtOH as the solvent, microwave (mw) irradiation to achieve short reaction times, and the supported catalyst Pd EnCat®40, which affords an easier recovery and reuse. These conditions were tested on different aryl bromides and internal olefines to evaluate the substrate scope. Furthermore, with the aim to limit as much as possible the production of waste, a simple isomerization procedure was developed to convert the isomeric byproducts into the desired conjugated E alkene, which is also the thermodynamically favoured product. The approach herein disclosed represents a green, efficient, and easy-to-use handle towards different trisubstituted alkenes via the Heck reaction.

Microwave ablation followed by cTACE in 5-cm HCC lesions: does a single-session approach affect liver function?

PURPOSE: Microwave ablation (MWA) and conventional transarterial chemoembolization (cTACE) are locoregional treatments commonly performed in very early, early and intermediate stages of hepatocellular carcinoma (HCC). Despite combined locoregional approaches have shown encouraging results in obtaining complete tumor necrosis, their application in a single session is poorly described. Our aim was to evaluate the safety and efficacy of single-session MWA and cTACE treatment in 5-cm HCCs and its influence on liver function. MATERIALS AND METHODS: All 5-cm HCCs treated by MWA and cTACE performed in a single-session in our Interventional Radiology unit between January 2020 and December 2022 were retrospectively recorded and analyzed. Patients with poor or missing pre- and post-treatment imaging were excluded. Technical success, clinical success, and complications rate were examined as primary endpoints. Pre- and post-treatment liver function laboratory parameters were also evaluated. RESULTS: A total of 15 lesions (mean lesion diameter, 5.0 ± 1.4 cm) in 15 patients (11 men; mean age, 67.1 ± 8.9 years) were retrospectively evaluated. Technical and clinical success were 100% and 73%, respectively. Four (27%) cases of partial response and no cases of progressive or stable disease were recorded. AST and ALT values have found to be significantly higher in post-treatment laboratory tests. No other significant differences between pre- and post-treatment laboratory values were registered. AST and ALT pre- and post-treatment higher differences (ΔAST and ΔALT) were significantly associated with a lower clinical success rate. CONCLUSION: MWA and cTACE single-session approach is safe and effective for 5-cm HCCs, without significant liver function impairment. A post-treatment increase in AST and ALT values may be a predictor for clinical failure.

Comparative efficacy and safety of radiofrequency ablation and microwave ablation in benign thyroid nodule treatment: a systematic review and meta-analysis.

OBJECTIVE: Ultrasound-guided thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), has become one of the main options for treating benign thyroid nodules (BTNs). To assess the efficacy of thermal ablation of BTNs, we performed a systematic review and meta-analysis of relevant studies. MATERIALS AND METHODS: A comprehensive search of MEDLINE, EMBASE, and COCHRANE databases was performed up to September 25, 2023, to identify studies directly comparing RFA and MWA for pathologically proven BTNs and reporting clinical outcomes and complications. Data extraction and quality assessment were independently performed by two radiologists according to PRISMA guidelines. The analysis yielded the serial volume reduction ratios (VRRs) of ablated nodules for up to 12 months, symptom and cosmetic scores, and complications. RESULTS: This analysis included nine studies with 1305 BTNs treated by RFA and 1276 by MWA. VRRs at 1 month, 3 months, and 6 months were similar between RFA and MWA, but RFA showed a significantly higher VRR (83.3%) than MWA (76.9%) at 12 months (p = 0.02). Complication rates showed no significant difference between the two methods. Symptom and cosmetic scores significantly decreased after ablation, without a significant difference between the methods. Subgroup analysis indicated a significantly higher VRR at 12 months for RFA than for MWA for less experienced investigators (≤ 10 years), but no significant difference for more experienced investigators (> 10 years). CONCLUSION: RFA and MWA are both effective and safe methods for treating BTNs. RFA showed a higher VRR at 12 months and seems more suitable for less experienced investigators. CLINICAL RELEVANCE STATEMENT: RFA and MWA are both effective and safe treatments for BTNs, with RFA showing a higher VRR at 12 months. Both methods offer minimally invasive and reliable treatment for thyroid nodules. KEY POINTS: The most effective thermal ablation technique for BTNs remains undetermined. RFA showed a higher VRR at 12 months than MWA. Both techniques are effective for treating thyroid nodules; RFA offers greater benefits, particularly for less experienced investigators.

Sustainable Extraction Protocols for the Recovery of Bioactive Compounds from By-Products of Pomegranate Fruit Processing.

This study investigates sustainable extraction protocols for the recovery of bioactive compounds from by-products of various pomegranate (Punica granatum L.) cultivars, including Acco, Hicaz, Jolly Red, Parfianka, Valenciana, and Wonderful, generated during the industrial processing of the fruits. Advanced extraction technologies, including ultrasounds, microwaves, and hydrodynamic cavitation, have been compared to conventional extraction procedures and utilized to enhance extraction efficiency while also minimizing environmental impact. Water-based extraction methods have been utilized to promote the development of sustainable and eco-friendly processes. The comparison between conventional extractions and ultrasound-assisted extractions (UAEs) and microwave-assisted extractions (MAEs) demonstrated notable improvements in extraction yields, particularly for ellagitannins (punicalins, punicalagins, and ellagic acid) and total polyphenols, with increases ranging from about 45 to 200%. However, the increases directly comparing UAEs to MAEs ranged from about 4 to 6%. This indicates that while both UAEs and MAEs offer notable improvements over conventional extractions, the differences in extraction efficiency between the two advanced methods were relatively modest. These advancements were observed across various pomegranate cultivars, highlighting the versatility and effectiveness of these methods. Notably, hydrodynamic cavitation-based extractions (HC) emerged as particularly promising, consistently yielding the highest levels of bioactive compounds (ellagitannins and total polyphenols), especially when operated at higher frequencies. Compared to conventional extractions, HC exhibited substantial increases in extraction yields for Wonderful pomegranate by-products, surpassing the efficiency of both UAEs and MAEs (approximately 45 and 57% for UAE and MAE, respectively, versus about 80% for HC). Among these advanced techniques, HC has emerged as particularly promising, yielding the most favorable results and leading to significant improvements in the yield of bioactive compounds. When directly compared to UAEs and MAEs, HC increased extraction yields by over 20%. Furthermore, HC allowed for shorter extraction times. The Wonderful cultivar consistently exhibited the highest levels of ellagitannins and the highest total polyphenol content among all types of extraction procedures used, whether conventional or advanced. This highlights the great potential of the Wonderful cultivar in terms of bioactive compound extraction and underscores its significance in research and applications related to pomegranate processing and utilization. This study suggests that the implementation of these advanced technologies into extraction processes represents a significant advancement in the field, offering a promising avenue for the development of efficient and environmentally friendly extraction methods for obtaining valuable bioactive compounds from pomegranate processing by-products.

Development of a Simple Setup to Measure Shielding Effectiveness at Microwave Frequencies.

Testing the shielding effectiveness of materials is a key step for many applications, from the industrial to the biomedical field. This task is very relevant for high-sensitivity sensors, whose performance can be greatly affected by electromagnetic fields. However, the available testing procedures often require expensive, bulky, and heavy measurement chambers. In this paper, a cost-effective and reliable measurement procedure for testing the shielding effectiveness of materials is proposed. It exploits a lab-scale anechoic shielded chamber, which is lightweight, compact, and cost-effective if compared to the available commercial solutions. The measurement procedure employs a vector network analyzer to allow an accurate and fast characterization setup. The chamber realization phases and the measurement procedure are described. The shielding capability of the chamber is measured up to 26 GHz, whereas the performance of commercial shielding coatings is tested to demonstrate the measurement's effectiveness.

Microwave treatment ameliorates beaded eyelid papules caused by lipoid proteinosis.

An 8-year-old girl presented with white papules on the eyelid margins due to lipoid proteinosis. Microwave therapy resulted in significant reduction of the lesions. The case highlights a safe and effective treatment for eyelid lesions associated with lipoid proteinosis. In addition, we report two novel heterozygous variants in the extracellular matrix protein 1 (ECM1) gene.

Rapid, Point-of-Care Microwave Lysis and Electrochemical Detection of Clostridioides difficile Directly from Stool Samples.

The rapid detection of the spore form of Clostridioides difficile has remained a challenge for clinicians. To address this, we have developed a novel, precise, microwave-enhanced approach for near-spontaneous release of DNA from C. difficile spores via a bespoke microwave lysis platform. C. difficile spores were microwave-irradiated for 5 s in a pulsed microwave electric field at 2.45 GHz to lyse the spore and bacteria in each sample, which was then added to a screen-printed electrode and electrochemical DNA biosensor assay system to identify presence of the pathogen's two toxin genes. The microwave lysis method released both single-stranded and double-stranded genome DNA from the bacterium at quantifiable concentrations between 0.02 µg/mL to 250 µg/mL allowing for subsequent downstream detection in the biosensor. The electrochemical bench-top system comprises of oligonucleotide probes specific to conserved regions within tcdA and tcdB toxin genes of C. difficile and was able to detect 800 spores of C. difficile within 300 µL of unprocessed human stool samples in under 10 min. These results demonstrate the feasibility of using a solid-state power generated, pulsed microwave electric field to lyse and release DNA from human stool infected with C. difficile spores. This rapid microwave lysis method enhanced the rapidity of subsequent electrochemical detection in the development of a rapid point-of-care biosensor platform for C. difficile.

Microwave Scissors-Based Sutureless Laparoscopic Partial Nephrectomy Versus Conventional Open Partial Nephrectomy in a Porcine Model: Usefulness and Complications.

BACKGROUND: This study aimed to compare the benefits and safety of microwave scissors-based sutureless laparoscopic partial nephrectomy (MSLPN) with those of conventional open partial nephrectomy (cOPN). METHODS: Each kidney in nine pigs underwent MSLPN using microwave scissors (MWS) via transperitoneal laparoscopy or cOPN via retroperitoneal open laparotomy. The kidney's lower and upper poles were resected under temporary hilar-clamping. The renal calyces exposed during renal resections were sealed and transected using MWS in MSLPN and were sutured in cOPN. For MWS, the generator's power output was 60 W. Data on procedure time (PT), ischemic time (IT), blood loss (BL), normal nephron loss (NNL), and extravasation during retrograde pyelogram were compared between the two techniques. RESULTS: The authors successfully performed 22 MSLPNs and 10 cOPNs. Compared with cOPN, MSLPN was associated with significantly lower PT (median, 9.2 vs 13.0 min; p = 0.026), IT (median, 5.9 vs 9.0 min; p < 0.001), BL (median, 14.4 vs 38.3 mL; p = 0.043), and NNL (median, 7.6 vs 9.4 mm; p = 0.004). However, the extravasation rate was higher in the MSLPN group than in the cOPN group (54.5 % [n = 12] vs 30.0 % [n = 3]), albeit without a significant difference (p = 0.265). Pelvic stenosis occurred in one MSLPN procedure that involved deep lower pole resection near the kidney hilum. CONCLUSIONS: The study data show that MSLPN can improve intraoperative outcomes while reducing technical demands for selected patients with non-hilar-localized renal tumors. However, renal calyces, if violated, should be additionally sutured to prevent urine leakage.

Management of low-risk papillary thyroid cancer. Minimally-invasive treatments dictate a further paradigm shift?

BACKGROUND: Current management options for PTMC include lobo-isthmectomy and active surveillance (AS). Recently, ultrasound-guided minimally invasive procedures (MITs) are offered as a nonsurgical therapy for PTMC because they do not require hospitalization and general anaesthesia, and do not result in loss of thyroid function or cosmetic damage. MITs are reported to consistently provide, mostly in large retrospective series of patients, a rapid, safe, and cost-effective way to eradicate low-risk thyroid malignancies. However, conclusive data from well-conducted prospective studies on the histologically-proven completeness of tumor ablation and the long-term clinical advantages versus AS are still lacking. OBJECTIVES: This study aimed to evaluate the efficacy and safety of ultrasound-guided minimally invasive treatments (MITs) for PTMC in comparison to traditional surgical methods and active surveillance, and to assess their role in current clinical practice. METHODS: A structured literature review was conducted using keywords related to PTMC, MIT, and comparative techniques. Studies were evaluated based on treatment modality, patient selection, follow-up duration, complication rates, and clinical outcomes. RESULTS: MITs have shown promising results in the management of PTMC. These treatments offer several advantages over surgery, such as reduced use of surgical resources, lower costs, minimal work disruption, and fewer major complications. However, there are still limitations, including the need for long-term surveillance and the potential risk of incomplete tumor ablation. CONCLUSIONS: MITs represent a promising non-surgical option for managing low-risk PTMC, especially for patients ineligible for or refusing surgery. Despite favorable outcomes, more robust prospective data are needed to confirm their long-term benefits and completeness of tumor ablation. Interdisciplinary discussions and thorough patient education on the advantages and limitations of MITs are crucial for informed decision-making.