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Antonio Coviello,1,&ast; Carmine Iacovazzo,1,&ast; Dario Cirillo,1 Alessio Bernasconi,2 Annachiara Marra,1 Francesco Squillacioti,1 Marco Martone,1 Eleonora Garone,1 Filomena Coppola,1 Andrea Uriel de Siena,1 Maria Vargas,1 Giuseppe Servillo1 1Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy; 2Department of Public Health, School of Medicine, University of Naples “Federico II”, Unit of Orthopedics and Traumatology, Naples, Italy&ast;These authors contributed equally to this workCorrespondence: Antonio Coviello, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Sergio Pansini, 5, Napoli NA, Naples, 80131, Italy, Tel +39 3497013533, Fax +39 0817462281, Email antonio_coviello@live.itBackground and Aim: Ultrasound popliteal sciatic nerve block (UPSNB) is commonly performed in foot and ankle surgery. This study aims to assess the use of dexmedetomidine and dexamethasone as adjuvants in UPSNB for hallux valgus (HV) surgery, comparing their efficacy in producing motor and sensory block and controlling postoperative pain. The adverse event rate was also evaluated.Methods: This mono-centric retrospective study included 62 adult patients undergoing HV surgery: 30 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg and dexamethasone 4 mg (Group 1), whereas 32 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg, and dexmedetomidine 1 mcg/Kg (Group 2). At first, the visual analogue scale (VAS) was evaluated after 48 hours. The other outcomes were time to motor block regression, evaluation of the first analgesic drug intake, analgesic effect, adverse effects (hemodynamic disorders, postoperative nausea and vomiting (PONV)) and patient satisfaction. The continuous data were analyzed with student’s t-test and the continuous one with χ2. Statistical significance was set at a p-value lower than 0.05.Results: No significant difference was found in VAS after 48 hours (4.5 ± 1.6 vs 4.7 ± 1.7, p = 0.621) to motor block regression (18.9 ± 6.0 vs 18.7 ± 6, p = 0.922). The number of patients that took their first analgesic drug in the first 48 h (p = 0.947 at 6 hours; p = 0.421 at 12 hours; p = 0.122 at 24 hours and p = 0.333 at 48 hours) were not significant. A low and similar incidence of intraoperative hemodynamic disorders was recorded in both groups (hypotension p = 0.593; bradycardia p = 0.881). Neither PONV nor other complication was found. Patients in Group 1 reported a lower degree of interference with sleep (p = 0.001), less interference with daily activities (P = 0.002) and with the affective sphere (P = 0.015) along with a more satisfactory postoperative pain management (p < 0.001) as compared to Group 2.Conclusion: No significant differences were observed in the duration of motor and sensory blockade between patients in both groups. Additionally, both groups showed good pain control with a low rate of adverse effects, even if there was no clinical difference between the groups. However, patients who received dexamethasone reported experiencing less interference with their sleep, daily activities and overall emotional well-being, and overall pain control.Keywords: ultrasound popliteal sciatic nerve block, dexamethasone, dexmedetomidine, Hallux valgus, adjuvants in peripheral nerve blocks

In this study, we present Integral Field Unit observations of the galaxy SDSSJ0859 + 3923, utilizing the MEGARA (Multi Espectrógrafo en GTC de Alta Resolución para Astronomía) instrument on the GTC (Gran Telescopio Canarias) 10.4m telescope. These observations were conducted in two distinct spectral ranges: 4332–5222 Å and 6097–7345 Å, with a high resolving power (R |$_\mathrm{FWHM}$| |$\sim 6\, 000$|⁠), and spatial resolution of 25 pc, considering the galaxy's distance of 8.5 Mpc. Our observations have identified five H  ii regions, whose precise positions were determined using data from the Wide Field Camera 3 (ultraviolet and visible) of the Hubble Space Telescope , WFC3-UVIS/ HST , archive images, where we also detected the associated blue underlying continuum linked to the ionized knots. A detailed kinematic analysis of these regions revealed low-velocity dispersion values (around 10 km s |$^{-1}$|⁠) in four H  ii regions, indicating a lack of significant turbulent events. In the fifth region, we observed a peak in velocity dispersion reaching 40 km s |$^{-1}$|⁠ , which we interpret as the result of hot star winds and/or a recent type-II supernova explosion. We have conducted a comprehensive spectral analysis of the H  ii regions, obtaining emission-line fluxes that enabled us to confirm the oxygen abundance (12  +  log(O/H)  =  7.41 |$\pm$|  0.15) and, using popstar models, to constrain the age and mass of the ionizing young clusters. [ABSTRACT FROM AUTHOR]

The main objective of this video is to illustrate how you can practice in an economical and ethical way the use of the hysteroscope. A cost-effective training model for hysteroscopy was developed using commonly available materials, addressing the high cost associated with traditional simulators. The simulation employed everyday materials such as gloves, straws, a cardboard box, small objects (pills), scissors, a knife, containers, glue, chopsticks, a pen, and a ruler. N/A 1. Grid Formation on Gloves 2. Lesion Simulation on Second Glove 3. Combining Gloves 4. Knots and Straw Insertion 5. Creating Uterus Simulation 6. Building Simulation Box The simulator, constructed using everyday materials, provides a practical and economical solution for training. The grid formation on the gloves aids in orientation within the uterine cavity, and the small objects simulate various lesions for practice in identification. The simulator's design allows for the realistic representation of the cervix, fallopian tube ostia, and irregularities in the uterine wall, offering a valuable tool for hysteroscopy training. The purpose of this simulator is educational. We referred to ethics as well, since you don't practice with a real person. Therefore, students, physicians, and fellows have the opportunity to orient themselves in this non-expensive simulator before practicing in a patient. This could be a very useful and practical tool. Easy to make and to use. [ABSTRACT FROM AUTHOR]

To comprehensively evaluate the complications associated with morcellation in Total Laparoscopic Hysterectomy (TLH) procedures, providing evidence-based insights to enhance patient safety and surgical efficacy. This study follows a systematic review design based on Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. N/ A. Following registration in PROSPERO, the research includes thirteen studies describing female patients undergoing TLH for various medical reasons, such as uterine fibroids, abnormal bleeding, and pelvic organ prolapse. There are no restrictions based on demographic factors like age, race, or ethnicity. Article selection and data extraction was conducted by two independent reviewers, and the Newcastle-Ottawa Scale used to assess quality. N/A. Our electronic search identified 178 studies. After a rigorous process of reviewing, a total of 13 studies were included. The findings revealed significant variability in outcomes. For instance, estimated blood loss ranged from 32.2 to 256 mL, with power morcellation associated with greater blood loss compared to manual morcellation (164.7 ± 435.1 vs. 32.2 ± 27.6, respectively). Length of hospital stay varied from 1 to 4 days. Regarding bag integrity, while some studies reported no injuries, others documented cases of tissue spillage and bag tears during power morcellation. Additionally, morcellation times were variable, with manual morcellation being faster than power morcellation (9.6 ± 8.1 vs. 30.2 ± 22.4 minutes). Operative times also exhibited variability, ranging from 112.5 to 229.5 minutes, with no statistically significant difference between manual and power morcellation. Complications, categorized using the Clavien-Dindo classification, included ureter injuries, infections, and bladder injuries, with varying degrees of severity. These findings have significant implications for clinical decision-making, safety protocol enhancements, and the potential development of guidelines to improve outcomes for patients undergoing TLH. [ABSTRACT FROM AUTHOR]