WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.Peer reviewe

The 2010 Hans Cloos lecture : the contribution of urban geology to the development, regeneration and conservation of cities

Urban geology began to develop in the 1950s, particularly in California in relation to land-use planning, and led to Robert Legget publishing his seminal book “Cities and geology” in 1973. Urban geology has now become an important part of engineering geology. Research and practice has seen the evolution from single theme spatial datasets to multi-theme and multi-dimensional outputs for a wide range of users. In parallel to the development of these new outputs to aid urban development, regeneration and conservation, has been the growing recognition that city authorities need access to extensive databases of geo-information that are maintained in the long-term and renewed regularly. A further key advance has been the recognition that, in the urban environment, knowledge and understanding of the geology need to be integrated with those of other environmental topics (for example, biodiversity) and, increasingly, with the research of social scientists, economists and others. Despite these advances, it is suggested that the value of urban geology is not fully recognised by those charged with the management and improvement of the world’s cities. This may be because engineering geologists have failed to adequately demonstrate the benefits of urban geological applications in terms of cost and environmental improvement, have not communicated these benefits well enough and have not clearly shown the long-term contribution of geo-information to urban sustainability. Within this context future actions to improve the situation are proposed