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Background: Video-assisted thoracic surgery (VATS) has become the gold-standard approach for lung resections. Given the impossibility of digital palpation, we witnessed the progressive development of peri-centimetric and deeply located pulmonary nodule alternative detection techniques. Intra-operative lung ultrasound is an increasingly effective diagnostic method, although only a few small studies have evaluated its accuracy. This study analyzed the effectiveness and sensitivity of uniportal VATS with intra-operative lung ultrasound (ILU), in comparison to multiportal VATS, for visualizing solitary and deep-sited pulmonary nodules. Methods: Patient data from October 2021 to October 2023, from a single center, were retrospectively gathered and analyzed. In total, 31 patients who received ILU-aided uniportal VATS (Group A) were matched for localization time, operative time, sensitivity, and post-operative complications, with 33 undergoing nodule detection with conventional techniques, such as manual or instrumental palpation, in multiportal VATS (Group B). Surgeries were carried out by the same team and ILU was performed by a certified operator. Results: Group A presented a significantly shorter time for nodule detection [median (IQR): 9 (8-10) vs. 14 (12.5-15) min; p < 0.001] and operative time [median (IQR): 33 (29-38) vs. 43 (39-47) min; p < 0.001]. All nodules were correctly localized and resected in Group A (sensitivity 100%), while three were missed in Group B (sensitivity 90.9%). Two patients in Group B presented with a prolonged air leak that was conservatively managed, compared to none in Group A, resulting in a post-operative morbidity rate of 6.1% vs. 0% (p = 0.16). Conclusions: ILU-aided uniportal VATS was faster and more effective than conventional techniques in multiportal VATS for nodule detection.
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Ultrasound (US) is a promising tool for skeletal muscle assessment; however, US studies have scarcely focused on Arabic populations. This study examined the association of handheld US indicators and bioelectrical impedance analysis (BIA) parameters in healthy Arabic females. A cross-sectional study was conducted on 60 healthy Arabic females whose muscle thickness (MT) and cross-sectional area (CSA) of the rectus femoris (RF) were measured alongside their MT and pennation angle (PA) of the medial gastrocnemius (MG) muscle (both muscles on the dominant side). Anthropometric and body composition analyses quantified fat-free mass (FFM) and appendicular skeletal muscle mass (ASMM). Muscle strength was assessed using a handgrip dynamometer, and physical activity levels were recorded with the Global Physical Activity Questionnaire (GPAQ). The CSA of the RF and the MT of both the RF and MG correlated significantly with FFM and ASMM. The PA of MG showed no significant correlations with ASMM, FFM, or handgrip strength. The CSA of RF was significantly correlated with handgrip strength (r = 0.313, p = 0.015), while the PA of MG correlated positively with GPAQ score (r = 0.346, p = 0.007). The CSA of RF significantly predicted both ASMM (ß = 0.883, p = 0.0002) and FFM (ß = 1.935, p = 0.0001). In conclusion, handheld US parameters, especially the RF's CSA, correlate with and can predict BIA-based FFM and ASMM in healthy females.
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The study aimed to evaluate the chemical composition, antioxidant activity and techno-functionality of brewers' spent grain (BSG) treated with two-steps treatment involving 5, 15, and 25 min bath-ultrasonication (USB) continued with autoclave (AH) at 90, 110, and 130 °C and/or water-bath (CWH) at 80, 90, and 100 °C. The two-steps treatments slightly affected the water- and oil-holding capacity and extractable fat content. Most of the two-steps treatments increased the amount of flavan-3-ols and phenolic acids, up to 4 times higher compared to its control. The two-steps treatment involving CWH had no significant (p > 0.05) impact on fat content, antioxidants and techo-functionality of BSG. Up to 15 min USB increased the poly-unsaturated fatty acids and lowered the amount of saturated fatty acids. In conclusion, the two-steps treatment consists of USB (up to 15 min) continued with AH and CWH increased the amount of nutritional-related chemical composition such as UFA and phenolic acids as well as antioxidant activity of BSG.
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Transient synovitis (TS) is a self-limiting inflammatory condition of the joints, predominantly affecting children and characterized by symptoms such as pain, swelling, warmth, and erythema. It is often triggered by an immune response to a viral infection, leading to acute inflammatory arthritis. Diagnosis involves a combination of patient history, physical examinations, imaging techniques, and laboratory tests, although there are no specific laboratory tests for TS. Treatment primarily consists of symptom management through rest, analgesics, and nonsteroidal anti-inflammatory drugs. The condition underscores the importance of distinguishing TS from more serious joint diseases to prevent unnecessary interventions and to ensure appropriate management.
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Sinovitis , Humanos , Sinovitis/diagnóstico , Sinovitis/etiología , Antiinflamatorios no Esteroideos/uso terapéutico , Diagnóstico DiferencialRESUMEN
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.
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Tecnología Química Verde , Aceites Volátiles , Extractos Vegetales , Polifenoles , Aceites Volátiles/química , Aceites Volátiles/aislamiento & purificación , Polifenoles/aislamiento & purificación , Polifenoles/química , Polifenoles/análisis , Extractos Vegetales/química , Extractos Vegetales/aislamiento & purificación , Fraccionamiento Químico/métodos , Fraccionamiento Químico/instrumentación , Microondas , Plantas Medicinales/químicaRESUMEN
Biomaterials, like hydroxyapatite (HAp), are the subject of many scientific investigations. Their specific application, however, is determined by the form and some characteristic features of the resulting material. Synthesis methods and optimization procedures leading to a product of predetermined characteristics are therefore of great interest. To broaden the existing knowledge, sonoprecipitation was investigated as a potential method for the production of nanosized HAp particles. The research was carried out in a static mixer (STM) immersed in the ultrasonic bath. The influence of operating conditions, e.g., ultrasonic power PUS (εUS), ultrasonic frequency (fUS), and unit mixing power (εmix), was investigated in terms of nucleation intensity, product quality, and characteristics (particle size distribution (PSD), mean size, shape, etc.). As a result, the optimal conditions for the HAp nanoparticles synthesis (mean size: d~150 nm; length: L1~250 nm; width: L2~80 nm) in the form of needles/whiskers/rods-similar to the shape of the HAp present in natural human bones, free from agglomerates, with negligible signs of particle destruction-were determined. The formation of HAp of smaller sizes (d ≤ 100 nm) and more compact shapes (L1~155 nm, L2~90 nm), useful in bone regeneration processes, was also discussed.
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Doxorubicin is a prototypical inducer of immunogenic cell death (ICD) that sensitizes to subsequent immunotherapy by PD-1 blockade. However, this systemic drug combination fails against glioblastoma, hidden behind the blood-brain barrier (BBB). A recent work delineates a biophysical method for BBB permeabilization that yields effective preclinical effects of chemoimmunotherapy.
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Barrera Hematoencefálica , Neoplasias Encefálicas , Doxorrubicina , Glioblastoma , Inmunoterapia , Receptor de Muerte Celular Programada 1 , Glioblastoma/tratamiento farmacológico , Glioblastoma/patología , Glioblastoma/metabolismo , Glioblastoma/inmunología , Humanos , Barrera Hematoencefálica/metabolismo , Barrera Hematoencefálica/efectos de los fármacos , Doxorrubicina/farmacología , Doxorrubicina/uso terapéutico , Doxorrubicina/administración & dosificación , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Receptor de Muerte Celular Programada 1/metabolismo , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/inmunología , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/terapia , Inmunoterapia/métodos , Inhibidores de Puntos de Control Inmunológico/farmacología , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Animales , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologíaRESUMEN
AIMS: Uric acid has been associated with several metabolic conditions, including bone diseases. Our objective here was to consider the relationship between serum uric acid levels and various bone parameters (bone mineral density, ultrasonographic parameters, vitamin D, PTH and serum calcium), as well as the prevalence and risk of fragility fracture. METHODS: An observational and cross-sectional study carried out on 679 postmenopausal women, classified into 3 groups according to their serum uric acid levels, in whom bone densitometry, calcaneus ultrasounds, PTH, vitamin D and serum calcium analysis were done. Bone fractures were collected through the clinical history and lateral spinal X-ray. RESULTS: Higher uric acid levels were found in women with older age, high BMI, diabetes, and high blood pressure. Higher levels of PTH and serum calcium were also observed, but did not effect on vitamin D. Serum uric acid was positively related to densitometric and ultrasonic parameters and negatively associated with vertebral fractures. CONCLUSIONS: In the population of postmenopausal women studied, sUA levels were correlated with BMD, BUA, and QUI-Stiffness, and this correlation was independent of age and BMI. In addition, sUA was associated with a decrease in vertebral fractures. These results imply a beneficial influence of sUA on bone metabolism, with both a quantitative and qualitative positive effect, reflected in the lower prevalence of vertebral fractures.
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Densidad Ósea , Posmenopausia , Ácido Úrico , Humanos , Femenino , Ácido Úrico/sangre , Posmenopausia/sangre , Estudios Transversales , Persona de Mediana Edad , Anciano , Fracturas Óseas/sangre , Fracturas Óseas/epidemiología , Vitamina D/sangre , Calcio/sangre , Factores de Riesgo , Hormona Paratiroidea/sangre , Ultrasonografía , Osteoporosis Posmenopáusica/sangre , Fracturas de la Columna Vertebral/sangre , Fracturas de la Columna Vertebral/epidemiología , Fracturas de la Columna Vertebral/diagnóstico por imagenRESUMEN
Objectives: This narrative review aims to update the current evidence and offer insight into the new non-invasive ultrasound techniques used to early identify degenerative vascular changes in subjects with periodontitis and to investigate if these methodologies could be useful to identify subclinical cardiovascular disease (CVD) dysfunction in periodontitis patients and to monitor changes in CVD risk after periodontal treatment. Methods: Studies examining the assessment of vascular endothelial function through the latest methodologies were analyzed. Systematic reviews, observational studies, and clinical trials in the English language were identified using PubMed, Web of Science, and Google Scholar databases with key search terms such as "periodontitis," "endothelial dysfunction (ED)," "arterial stiffness," and "periodontal therapy." Results: Several mechanisms are involved in the association between periodontitis and CVD. The key players are periodontal bacteria and their toxins, which can enter the circulation and infiltrate blood vessel walls. The increase in proinflammatory molecules such as interleukins and chemokines, c-reactive protein, fibrinogen, and oxidative stress also plays a decisive role. In addition, an increase in parameters of ED, arterial stiffness, and atherosclerosis, such as carotid intima-media thickness, pulse wave velocity, and flow-mediated dilatation, has been shown in periodontal patients. Conclusions: The literature today agrees on the association of periodontitis and CVD and the positive role of periodontal therapy on systemic inflammatory indices and cardiovascular outcomes. Hopefully, these non-invasive methodologies could be extended to periodontal patients to provide a comprehensive understanding of the CVD-periodontitis link from the perspective of a personalized medicine approach in periodontology.
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Implantable medical devices (IMDs), like pacemakers regulating heart rhythm or deep brain stimulators treating neurological disorders, revolutionize healthcare. However, limited battery life necessitates frequent surgeries for replacements. Ultrasound power transfer (UPT) emerges as a promising solution for sustainable IMD operation. Current research prioritizes implantable materials, with less emphasis on sound field analysis and maximizing energy transfer during wireless power delivery. This review addresses this gap. A comprehensive analysis of UPT technology, examining cutting-edge system designs, particularly in power supply and efficiency is provided. The review critically examines existing efficiency models, summarizing the key parameters influencing energy transmission in UPT systems. For the first time, an energy flow diagram of a general UPT system is proposed to offer insights into the overall functioning. Additionally, the review explores the development stages of UPT technology, showcasing representative designs and applications. The remaining challenges, future directions, and exciting opportunities associated with UPT are discussed. By highlighting the importance of sustainable IMDs with advanced functions like biosensing and closed-loop drug delivery, as well as UPT's potential, this review aims to inspire further research and advancements in this promising field.
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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.
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In this study, a two-stage cascade extraction process utilizing pulsed electric fields (PEF) (3 kV/cm, 10 kJ/kg) for initial extraction, followed by ultrasound (US) (200 W, 20 min)-assisted extraction (UAE) in a 50% (v/v) ethanol-water mixture (T = 50 °C, t = 60 min), was designed for the efficient release of valuable intracellular compounds from industrial cherry pomace. The extracted compounds were evaluated for total phenolic content (TPC), flavonoid content (FC), total anthocyanin content (TAC), and antioxidant activity (FRAP), and were compared with conventional solid-liquid extraction (SLE). Results showed that the highest release of bioactive compounds occurred in the first stage, which was attributed to the impact of PEF pre-treatment, resulting in significant increases in TPC (79%), FC (79%), TAC (83%), and FRAP values (80%) of the total content observed in the post-cascade PEF-UAE process. The integration of UAE into the cascade process further augmented the extraction efficiency, yielding 21%, 49%, 56%, and 26% increases for TPC, FC, TAC, and FRAP, respectively, as compared to extracts obtained through a second-stage conventional SLE. HPLC analysis identified neochlorogenic acid, 4-p-coumaroylquinic, and cyanidin-3-O-rutinoside as the predominant phenolic compounds in both untreated and cascade-treated cherry pomace extracts, and no degradation of the specific compounds occurred upon PEF and US application. SEM analysis revealed microstructural changes in cherry pomace induced by PEF and UAE treatments, enhancing the porosity and facilitating the extraction process. The study suggests the efficiency of the proposed cascade PEF-UAE extraction approach for phenolic compounds from industrial cherry pomace with potential applications to other plant-based biomasses.
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Abnormal uterine bleeding (AUB) poses a multifaceted challenge in women's health, necessitating an integrated approach that addresses its diverse etiologies and clinical presentations. The International Federation of Gynecology and Obstetrics PALM-COEIN classification system provides a systematic approach to the diagnosis of AUB in non-pregnant women, based on clinical and imaging-based categorization of causes into structural (Polyps, Adenomyosis, Leiomyomas and Malignancy; PALM), and non-structural causes (Coagulopathies, Ovulatory disorders, primary Endometrial disorders, Iatrogenic and Not otherwise classified; COEIN). On the other hand, placental disorders, uterine rupture, ectopic pregnancy and retained products of conceptions are the main causes of uterine bleeding during pregnancy and in the peripartum period. Ultrasound is usually the first-line imaging technique for the differential diagnosis of causes of AUB. Computed Tomography may be useful if ultrasound findings are unclear, especially in emergency settings. Magnetic resonance imaging, when indicated, is an excellent second-line diagnostic tool for a better non-invasive characterization of the underlying cause of AUB. This pictorial review aims to illustrate the main causes of AUB from the point of view of diagnostic imaging and to show not-so-common cases that can be treated by means of interventional radiology.
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BACKGROUND: The first feasibility study of the OdonAssist inflatable device for use in clinically indicated assisted vaginal birth reported a success rate of 48% with no significant safety concerns. Additional studies exploring the device performance in other clinical settings are warranted before definitive conclusions can be drawn about its safety and efficacy in current practice. OBJECTIVE: This study aimed to investigate the safety and efficacy of the OdonAssist before conducting a randomized controlled trial. STUDY DESIGN: This was an open-label, nonrandomized study of 104 women with a clinically indicated assisted vaginal birth using the OdonAssist at the Besancon University Hospital, France. Data, including those of a nested cohort group of women who had an assisted vaginal birth using vacuum or spatulas because a trained OdonAssist device operator was not available at the time of delivery, were collected. The primary outcome measure was the proportion of successful assisted vaginal births using the OdonAssist. Neonatal outcome data were reviewed at days 1 and 28, and maternal outcomes were investigated up to day 90. RESULTS: Between December 2019 and May 2021, 2191 pregnant women were approached, and 83% (1636/1973) of them consented to participate in the study. Among them, 10.7% (176/1636) required an assisted vaginal birth owing to a vertex presentation at +1 and below. The OdonAssist was used in 59% of births (104/176), and 41.1% (72/176) of the participants were included in the nested cohort group. The rate of successful assisted vaginal births using the OdonAssist was 88.5% (92/104). No emergency cesarean deliveries were performed in the OdonAssist group. There were no serious adverse maternal or neonatal reactions related to the use of the device. The rate of third- and fourth-degree perineal tears with the OdonAssist was 3.8% (4/104). The maternal perception ratings of the birth experience with the OdonAssist (collected on days 1, 7, and 28 using a 15-point scale) were high. In addition, the operators reported a positive perception of the device, with ease of use across the different steps of the procedure. One single technique was used for all vertex fetal head positions. CONCLUSION: The OdonAssist is a safe and effective alternative to other current devices for assisted vaginal births. The high acceptance rate (83%) among pregnant women and the high rate of successful assisted vaginal births using the OdonAssist confirm the feasibility of a future randomized controlled trial.
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Cesárea , Instrumentos Quirúrgicos , Recién Nacido , Embarazo , Femenino , Humanos , FranciaRESUMEN
Sonochemical synthesis can be a facile, fast, efficient, versatile and economical way to prepare a large variety of conventional or novel nanostructured materials (metallic, magnetic, semiconducting, polymeric, etc.). In this work, zinc oxide nanocrystals were synthesized by irradiating and heating at 90 °C in a commercial ultrasonic bath a water solution of zinc nitrate hexahydrate and ammonia solution or hexamethylenetetramine as base catalysts. The evolution of the powder morphology and its crystalline structure were investigated at different times of ultrasonic irradiation (0-9â hours) and compared with those of samples obtained by only heating the solutions in a muffle furnace in order to enlighten the growth mechanism. It resulted that: i) the crystal morphology depends on the selected base, ii) for samples obtained by using ultrasounds, the homogeneity of the powders depends on the irradiation time, iii) by comparing all samples obtained at 7â hours of heating, the aspect ratio of the crystals is higher for those that also underwent to ultrasounds.
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Skin laxity and Oedematous Fibrosclerotic Panniculopathy are common issues affecting the women population. Finding and developing treatments to counteract ageing indications and conform to social norms of beauty has been increasingly important in aesthetic medicine in recent times. Many non-invasive techniques, including radiofrequency, lasers, and ultrasounds, have been created. This study used a multi-handpiece device with laser (808 nm) and ultrasound (37 kHz) handpieces, as well as radiofrequency and various temperature-controlling applicators depending on the body site (3 or 6 tips). Based on their clinical features, 12 women with skin laxity on their arms, face/neck area, or lower limbs at phases I-III were divided evenly into two study groups. The majority of patients reported 'Excellent-3' treatment outcomes after it was over, and their impression of the course of treatment was generally better than the investigators. An objective analysis of the anthropometric measurement data shows a progressive decrease in circumferences, tight plicometry and body weight. In summary, the specific use of an radiofrequency handpiece with a temperature sensor decreased the likelihood of side effects, even with a small study population group. This increased patient compliance with treatment and overall satisfaction with the outcomes.
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The horizon of nanomedicine research is moving toward the design of therapeutic tools able to be completely safe per se, and simultaneously be capable of becoming toxic when externally activated by stimuli of different nature. Among all the stimuli, ultrasounds come to the fore as an innovative approach to produce cytotoxicity on demand in presence of NPs, without invasiveness, with high biosafety and low cost. In this context, zinc oxide nanoparticles (NPs) are among the most promising metal oxide materials for theranostic application due to their optical and semi-conductor properties, high surface reactivity, and their response to ultrasound irradiation. Here, ZnO nanocrystals constitute the stimuli-responsive core with a customized biomimicking lipidic shielding, resembling the composition of natural extracellular vesicles. This core-shell hybrid structure provides high bio- and hemocompatibility towards healthy cells and is here proofed for the treatment of Burkitt's Lymphoma. This is a very common haematological tumor, typically found in children, for which consolidated therapies are so far the combination of chemo-therapy drugs and targeted immunotherapy. In this work, the proposed safe-by-design antiCD38-targeted hybrid nanosystem exhibits an efficient selectivity toward cancerous cells, and an on-demand activation, leading to a significant killing efficacy due to the synergistic interaction between US and targeted hybrid NPs. Interestingly, this innovative treatment does not significantly affect healthy B lymphocytes nor a negative control cancer cell line, a CD38- acute myeloid leukemia, being thus highly specific and targeted. Different characterization and analyses confirmed indeed the effective formation of targeted hybrid ZnO NPs, their cellular internalization and the damages produced in Burkitt's Lymphoma cells only with respect to the other cell lines. The presented work holds promises for future clinical applications, as well as translation to other tumor types.
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Point-of-Care Ultrasound (POCUS) is a rapid and valuable diagnostic tool available in emergency and intensive care units. In the context of cardiac arrest, POCUS application can help assess cardiac activity, identify causes of arrest that could be reversible (such as pericardial effusion or pneumothorax), guide interventions like central line placement or pericardiocentesis, and provide real-time feedback on the effectiveness of resuscitation efforts, among other critical applications. Its use, in addition to cardiovascular life support maneuvers, is advocated by all resuscitation guidelines. The purpose of this narrative review is to summarize the key applications of POCUS in cardiac arrest, highlighting, among others, its prognostic, diagnostic, and forensic potential. We conducted an extensive literature review utilizing PubMed by employing key search terms regarding ultrasound and its use in cardiac arrest. Apart from its numerous advantages, its limitations and challenges such as the potential for interruption of chest compressions during image acquisition and operator proficiency should be considered as well and are discussed herein.
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Carotenoids are ubiquitous and versatile isoprenoid compounds. The intake of foods rich in these pigments is often associated with health benefits, attributable to the provitamin A activity of some of them and different mechanisms. The importance of carotenoids and their derivatives for the production of foods and health-promotion through the diet is beyond doubt. In the new circular economy paradigm, the recovery of carotenoids in the biorefinery process is highly desirable, for which greener processes and solvents are being advocated for, considering the many studies being conducted at the laboratory scale. This review summarizes information on different extraction technologies (ultrasound, microwaves, pulsed electric fields, pressurized liquid extraction, sub- and supercritical fluid extraction, and enzyme-assisted extraction) and green solvents (ethyl lactate, 2-methyltetrahydrofuran, natural deep eutectic solvents, and ionic liquids), which are potential substitutes for more toxic and less environmentally friendly solvents. Additionally, it discusses the results of the latest studies on the sustainable green extraction of carotenoids. The conclusions drawn from the review indicate that while laboratory results are often promising, the scalability to real industrial scenarios poses a significant challenge. Furthermore, incorporating life cycle assessment analyses is crucial for a comprehensive evaluation of the sustainability of innovative extraction processes compared to industry-standard methods.
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Extramammary Paget disease (EMPD) is a rare skin tumor that manifests as poorly delimited lesions located mainly in genital area. Prognosis correlates with thickness and dermal invasion. The gold standard for diagnosis is the histopathological study of a biopsy. However, this technique is invasive and only shows a small area of the tumor. A good correlation has been reported between ultrasounds (US) and histopathologic finding. Moreover, a US examination has the advantages of wide availability, noninvasiveness, low cost, ease of use, and real-time scanning. We review the ultrasound signs described for this disease.