Multiple giant cutaneous metastasis and ileal intussusception from an unknown melanoma: A case report.

Intestinal intussusception is one of the most common causes of intestinal obstruction in children; however, the incidence in adults is lower, and is caused by tumors in the majority of cases. Melanoma of the gastrointestinal tract is relatively rare, with only a small number of cases having been reported. The majority of cases occur as metastasis from cutaneous primary lesions, and the small bowel is the most common location of melanoma metastases in the gastrointestinal tract. The present study describes the case of a 47-year-old male patient with multiple soft tissue tumors, the largest one located in the left gluteal region, measuring 14x15x20 cm. This tumor was biopsied and a differential diagnosis was made between clear cell sarcoma and melanoma. The patient was evaluated by a dermatologist, without identifying any skin lesions compatible with cutaneous melanomas and was admitted to the emergency room due to an ileo-ileal intussusception. The results of the pathological analysis confirmed the final diagnosis of melanoma. On the whole, these lesions are usually diagnosed with the onset of symptoms, presenting an ominous prognosis.

High-resolution density assessment assisted by deep learning of Dendrophyllia cornigera (Lamarck, 1816) and Phakellia ventilabrum (Linnaeus, 1767) in rocky circalittoral shelf of Bay of Biscay.

This study presents a novel approach to high-resolution density distribution mapping of two key species of the 1170 "Reefs" habitat, Dendrophyllia cornigera and Phakellia ventilabrum, in the Bay of Biscay using deep learning models. The main objective of this study was to establish a pipeline based on deep learning models to extract species density data from raw images obtained by a remotely operated towed vehicle (ROTV). Different object detection models were evaluated and compared in various shelf zones at the head of submarine canyon systems using metrics such as precision, recall, and F1 score. The best-performing model, YOLOv8, was selected for generating density maps of the two species at a high spatial resolution. The study also generated synthetic images to augment the training data and assess the generalization capacity of the models. The proposed approach provides a cost-effective and non-invasive method for monitoring and assessing the status of these important reef-building species and their habitats. The results have important implications for the management and protection of the 1170 habitat in Spain and other marine ecosystems worldwide. These results highlight the potential of deep learning to improve efficiency and accuracy in monitoring vulnerable marine ecosystems, allowing informed decisions to be made that can have a positive impact on marine conservation.

Redo Surgery after Failure of Antireflux Surgery.

Surgery for refractory gastroesophageal reflux disease (GERD) has a satisfactory outcome for most patients; however, sometimes redo surgery is required. The Outcome and morbidity of a redo are suggested to be less successful than those of primary surgery. The aim of this study was to describe our experience, long-term results, and complications in redo surgery. From 2000 to 2016, 765 patients were operated on for GERD at our hospital. A retrospective analysis of 56 patients (7.3%) who underwent redo surgery was conducted. Large symptomatic recurrent hiatal hernia (50%) and dysphagia (28.6%) were the most frequent indications for redo. An open approach was chosen in 64.5 per cent of patients. Intraoperative and postoperative complication rates were 18 per cent and 14.3 per cent, respectively. Mortality rate was 1.8 per cent. Symptomatic outcome was successful in 71.4 per cent. Patients reoperated because of dysphagia and large recurrent hiatal hernia had a significantly higher failure rate (32.3% and 31.2%, respectively; P = 0.001). Complication rate was significantly lower in the laparoscopic group (0% vs 22.2%; P = 0.04). There were no statistical differences between expert and nonexpert surgeons. Laparoscopic approach has increased to 83.3 per cent in the last five years. Symptomatic outcome after redo surgery was less satisfactory than that after primary surgery. Complications were lower if a minimally invasive surgical approach was used.