Cancer represents one of the leading causes of morbidity and mortality worldwide, imposing an urgent need to develop more efficient treatment alternatives. In this respect, much attention has been drawn from conventional cancer treatments to more modern approaches, such as the use of nanotechnology. Extensive research has been done for designing innovative nanoparticles able to specifically target tumor cells and ensure the controlled release of anticancer agents. To avoid the potential toxicity of synthetic materials, natural nanoparticles started to attract increasing scientific interest. In this context, this paper aims to review the most important natural nanoparticles used as active ingredients (e.g., polyphenols, polysaccharides, proteins, and sterol-like compounds) or as carriers (e.g., proteins, polysaccharides, viral nanoparticles, and exosomes) of various anticancer moieties, focusing on their recent applications in treating diverse malignancies.

Background. Sepsis presents significant diagnostic and prognostic challenges, and traditional scoring systems, such as SOFA and APACHE, show limitations in predictive accuracy. Machine learning (ML)-based predictive survival models can support risk assessment and treatment decision-making in the intensive care unit (ICU) by accounting for the numerous and complex factors that influence the outcome in the septic patient. Methods. A systematic literature review of studies published from 2014 to 2024 was conducted using the PubMed database. Eligible studies investigated the development of ML models incorporating commonly available laboratory and clinical data for predicting survival outcomes in adult ICU patients with sepsis. Study selection followed the PRISMA guidelines and relied on predefined inclusion criteria. All records were independently assessed by two reviewers, with conflicts resolved by a third senior reviewer. Data related to study design, methodology, results, and interpretation of the results were extracted in a predefined grid. Results. Overall, 19 studies were identified, encompassing primarily logistic regression, random forests, and neural networks. Most used datasets were US-based (MIMIC-III, MIMIC-IV, and eICU-CRD). The most common variables used in model development were age, albumin levels, lactate levels, and ventilator. ML models demonstrated superior performance metrics compared to conventional methods and traditional scoring systems. The best-performing model was a gradient boosting decision tree, with an area under curve of 0.992, an accuracy of 0.954, and a sensitivity of 0.917. However, several critical limitations should be carefully considered when interpreting the results, such as population selection bias (i.e., single center studies), small sample sizes, limited external validation, and model interpretability. Conclusions. Through real-time integration of routine laboratory and clinical data, ML-based tools can assist clinical decision-making and enhance the consistency and quality of sepsis management across various healthcare contexts, including ICUs with limited resources.

The prevalence of intestinal endometriosis has been estimated to be between 3% and 37% of all endometriosis cases. Cases of intestinal occlusion due to endometriosis foci on the small bowel and on the large bowel are even rarer, with a reported prevalence of 0.1–0.7%. The aim of this literature review was to summarize the available published evidence on the diagnosis, characteristics, and management of intestinal occlusion due to endometriosis. The search on PubMed retrieved 295 records, of which 158 were rejected following a review of the title and After reviewing the full text, 97 studies met the Population, Intervention, Comparator, Outcomes, and Study (PICOS) criteria and were included in the analysis. The total number of patients with bowel occlusion due to endometriosis included in the studies was 107. The occlusive endometrial foci were localized on the ileum in 38.3% of the cases, on the rectosigmoid in 34.5% of the cases, at the ileocecal junction and the appendix in 14.9% of the cases, and at the rectum in 10.2% of the cases. Only one case reported large bowel obstruction by endometriosis of the hepatic flexure of the colon extending to the transverse colon (0.9%), and in one case the obstruction was caused by an omental giant endometrioid cyst compressing the intestines. We identified six cases of postmenopausal females with acute bowel obstruction due to endometriosis. Malignant degeneration of endometriosis was also identified as a cause of intestinal occlusion. The mechanisms of obstruction include the presence of a mass in the lumen of the intestine or in the wall of the intestine, extrinsic compression, adhesions, or intussusception.

Compartment syndrome occurs when increased pressure inside a closed anatomical space compromises tissue perfusion. The sudden increase in pressure inside these spaces requires rapid decompression by means of surgical intervention. In the case of abdominal compartment syndrome (ACS), surgical decompression consists of a laparostomy. The aim of this review is to identify the landmarks and indications for the appropriate moment to perform decompression laparotomy in patients with ACS based on available published data. A targeted literature review was conducted on indications for decompression laparotomy in ACS. The search was focused on three conditions characterized by a high ACS prevalence, namely acute pancreatitis, ruptured abdominal aortic aneurysm and severe burns. There is still a debate around the clinical characteristics which require surgical intervention in ACS. According to the limited data published from observational studies, laparotomy is usually performed when intra-abdominal pressure reaches values ranging from 25 to 36 mmHg on average in the case of acute pancreatitis. In cases of a ruptured abdominal aortic aneurysm, there is a higher urgency to perform decompression laparotomy for ACS due to the possibility of continuous hemorrhage. The most conflicting recommendations on whether surgical treatment should be delayed in favor of other non-surgical interventions come from studies involving patients with severe burns. The results of the review must be interpreted in the context of the limited available robust data from observational studies and clinical trials.

The purpose of our research is to synthesize the risk factors quoted in the literature which predispose to intra-abdominal hypertension occurrence following surgical repair of incisional hernias. We used for our research the Web of Science, Scopus and PubMed research platforms and we used the following search formula: ("Intra-abdominal hypertension" OR "intra-abdominal pressure" OR "abdominal compartment syndrome") AND "risk factors" AND "incisional hernia". The results were filtered according to the following criteria: language (English), publish year (>2000) and access (in extenso). In this context, we chose to classify the risk factors for IAP increase in the following categories: (1) those related body habitus and anthropometry; (2) those associated with the presence of comorbidities; (3) those related to the defect of the abdominal wall; (4) those associated with the surgical management. Among the most important risk factors we mention: elevated BMI, chronic obstructive pulmonary disease, large incisional hernias with loss of domain, surgical technique used, prolonged surgeries and repeated attempts to close the defect.