ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

Patterns of invasive ctenophore Mnemiopsis leidyi distribution and variability in different recipient environments of the Eurasian seas: A review

Harmful invader ctenophore Mnemiopsis leidyi's expansions in the Eurasian Seas, its spatio-temporal population dynamics depending on environmental conditions in recipient habitats have been synthesized. M. leidyi found suitable temperature, salinity and productivity conditions in the temperate and subtropical environments of the semi-enclosed seas, in the coastal areas of open basins and in closed water bodies, where it created autonomous populations. M. leidyi changes its phenology depending on seasonal temperature regime in different environments. We assessed ranges of sea surface temperature, sea surface salinity and sea surface chlorophyll values, sufficient for M. leidyi general occurrence and reproduction based on comprehensive long-term datasets, contributed by co-authors. This assessment revealed that there are at least two eco-types (Southern and Northern) in the recipient seas of Eurasia with features specific for their donor areas. The range of thresholds for M. leidyi establishment, occurrence and life cycle in both eco-types depends on variability of environmental parameters in their native habitats.

Prostate cancer with an unusual metastatic affinity for the appendix, inducing acute appendicitis

Acute appendicitis induced by metastatic disease is uncommon. We present the case of an 82-year-old man with known bony metastases secondary to prostatic cancer who presents with a short history of acute abdominal pain. A CT scan was indicative of acute appendicitis and the patient underwent a laparoscopic appendicectomy; a phlegmonous mass seen intraoperatively was suspicious for malignancy, and histopathology confirmed acute appendicitis as well as metastases of prostate cancer. Metastatic disease should be considered as an important differential in all patients with a known history of malignancy, as this may in turn complicate their presenting surgical complaint.

A MSFD complementary approach for the assessment of pressures, knowledge and data gaps in Southern European Seas: The PERSEUS experience

PERSEUS project aims to identify the most relevant pressures exerted on the ecosystems of the Southern European Seas (SES), highlighting knowledge and data gaps that endanger the achievement of SES Good Environmental Status (GES) as mandated by the Marine Strategy Framework Directive (MSFD). A complementary approach has been adopted, by a meta-analysis of existing literature on pressure/impact/knowledge gaps summarized in tables related to the MSFD descriptors, discriminating open waters from coastal areas. A comparative assessment of the Initial Assessments (IAs) for five SES countries has been also independently performed. The comparison between meta-analysis results and IAs shows similarities for coastal areas only. Major knowledge gaps have been detected for the biodiversity, marine food web, marine litter and underwater noise descriptors. The meta-analysis also allowed the identification of additional research themes targeting research topics that are requested to the achievement of GES.

Non-involuting congenital haemangioma of the eyelid: successful treatment with fluroscopic ultrasound guided sclerotherapy and surgical excision

We present a case of non-involuting congenital haemangioma (NICH) of the right eyelid which was present at birth as a purpuric macule but increased in size to cause significant obstruction of vision. At four years of age the lesion was treated with fluroscopic ultrasound-guided sclerotherapy using 0.5% sodium tetradecyl suphate foam and surgically debulked 16 days later. Histopathology was negative for glucose transporter-1 stain confirming the diagnosis. The residual segments were subsequently treated in three further sessions of sclerotherapy in the ensuing three years. This treatment approach resulted in a good cosmetic and functional outcome with no associated complications. To our knowledge, this is the first published case of a histologically confirmed NICH treated primarily with sclerotherapy.

Surveillance and control of aflatoxins B1, B2, G1, G2, and M1 in foodstuffs in the Republic of Cyprus: 1992-1996

Aflatoxins (AFs) B1, B2, G1, and G2 in locally produced and imported foodstuffs (nuts, cereals, oily seeds, pulses, etc.) were monitored and controlled systematically and effectively from 1992-1996. Samples (peanuts, pistachios, etc.) with total AFs above the Cyprus maximum level (ML) of 10 micrograms/kg fluctuated between 0.7 and 6.9%. The results indicate the effectiveness of monitoring, as well as the need for constant surveillance and control, especially at critical control points (sites of import, primary storage, etc.), to prevent unfit products from entering the Cyprus market. The control included sampling, retainment, analysis, and destruction of foodstuff lots with AF levels above MLs. The highest incidence of aflatoxin contamination was observed in peanut butter (56.7%) and the highest level of AF B1 was found in peanuts (700 micrograms/kg). Levels of AF M1 in raw and pasteurized milk analyzed in 1993, 1995, and 1996 were within both the Cyprus ML (0.5 microgram/L) and the lower ML (0.05 microgram/L) of some European countries. Only 12% of samples had detectable levels of AF M1. Analyses were performed by immunochemical methods. When recoveries were lower than 80%, the AF levels were corrected for recovery.