Search

Your search keyword '"Claudia Filisetti"' showing total 20 results
Start Over Author "Claudia Filisetti" Database OpenAIRE
20 results on '"Claudia Filisetti"'

1. Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Author

Cobianchi, Lorenzo, Piccolo, Daniele, Dal Mas, Francesca, Agnoletti, Vanni, Ansaloni, Luca, Balch, Jeremy, Biffl, Walter, Butturini, Giovanni, Catena, Fausto, Coccolini, Federico, Denicolai, Stefano, De Simone, Belinda, Frigerio, Isabella, Fugazzola, Paola, Marseglia, Gianluigi, Marseglia, Giuseppe Roberto, Martellucci, Jacopo, Modenese, Mirko, Previtali, Pietro, Ruta, Federico, Venturi, Alessandro, Kaafarani, Haytham M, Loftus, Tyler J, Kenneth Lyle Abbott, Abubaker Abdelmalik, Nebyou Seyoum Abebe, Fikri Abu-Zidan, Yousif Abdallah Yousif Adam, Harissou Adamou, Dmitry Mikhailovich Adamovich, Ferdinando Agresta, Antonino Agrusa, Emrah Akin, Mario Alessiani, Henrique Alexandrino, Syed Muhammad Ali, Vasilescu Alin Mihai, Pedro Miguel Almeida, Mohammed Mohammed Al-Shehari, Michele Altomare, Francesco Amico, Michele Ammendola, Jacopo Andreuccetti, Elissavet Anestiadou, Peter Angelos, Alfredo Annicchiarico, Amedeo Antonelli, Daniel Aparicio-Sanchez, Antonella Ardito, Giulio Argenio, Catherine Claude Arvieux, Ingolf Harald Askevold, Boyko Tchavdarov Atanasov, Goran Augustin, Selmy Sabry Awad, Giulia Bacchiocchi, Carlo Bagnoli, Hany Bahouth, Efstratia Baili, Lovenish Bains, Gian Luca Baiocchi, Miklosh Bala, Carmen Balagué, Dimitrios Balalis, Edoardo Baldini, Oussama Baraket, Suman Baral, Mirko Barone, Alberto Gonzãlez Barranquero, Jorge Arturo Barreras, Gary Alan Bass, Zulfu Bayhan, Giovanni Bellanova, Offir Ben-Ishay, Fabrizio Bert, Valentina Bianchi, Helena Biancuzzi, Chiara Bidoli, Raluca Bievel Radulescu, Mark Brian Bignell, Alan Biloslavo, Daniele Bissacco, Roberto Bini, Paolo Boati, Guillaume Boddaert, Branko Bogdanic, Cristina Bombardini, Luigi Bonavina, Luca Bonomo, Andrea Bottari, Konstantinos Bouliaris, Gioia Brachini, Antonio Brillantino, Giuseppe Brisinda, Maloni Mamada Bulanauca, Luis Antonio Buonomo, Jakob Burcharth, Salvatore Buscemi, Francesca Calabretto, Giacomo Calini, Valentin Calu, Fabio Cesare Campanile, Riccardo Campo Dall Orto, Andrea Campos-Serra, Stefano Campostrini, Recayi Capoglu, Joao Miguel Carvas, Marco Cascella, Gianmaria Casoni Pattacini, Valerio Celentano, Danilo Corrado Centonze, Marco Ceresoli, Dimitrios Chatzipetris, Antonella Chessa, Maria Michela Chiarello, Mircea Chirica, Serge Chooklin, Christos Chouliaras, Sharfuddin Chowdhury, Pasquale Cianci, Nicola Cillara, Stefania Cimbanassi, Stefano Piero Bernardo Cioffi, Elif Colak, Enrique Colás Ruiz, Luigi Conti, Alessandro Coppola, Tiago Correia De Sa, Silvia Dantas Costa, Valerio Cozza, Giuseppe Curro', Kirsten Felicia Ann-Sophie Aimee Dabekaussen, Fabrizio D'Acapito, Dimitrios Damaskos, Giancarlo D'Ambrosio, Koray Das, Richard Justin Davies, Andrew Charles De Beaux, Sara Patricia De Lebrusant Fernandez, Alessandro De Luca, Francesca De Stefano, Luca Degrate, Zaza Demetrashvili, Andreas Kyriacou Demetriades, Dzemail Smail Detanac, Agnese Dezi, Giuseppe Di Buono, Isidoro Di Carlo, Pierpaolo Di Lascio, Marcello Di Martino, Salomone Di Saverio, Bogdan Diaconescu, Jose J Diaz, Rigers Dibra, Evgeni Nikolaev Dimitrov, Vincenza Paola Dinuzzi, Sandra Dios-Barbeito, Jehangir Farman Ali Diyani, Agron Dogjani, Maurizio Domanin, Mario D'Oria, Virginia Duran Munoz-Cruzado, Barbora East, Mikael Ekelund, Gerald Takem Ekwen, Adel Hamed Elbaih, Muhammed Elhadi, Natalie Enninghorst, Mairam Ernisova, Juan Pablo Escalera-Antezana, Sofia Esposito, Giuseppe Esposito, Mercedes Estaire, Camilla Nikita Farè, Roser Farre, Francesco Favi, Luca Ferrario, Antonjacopo Ferrario di Tor Vajana, Claudia Filisetti, Francesco Fleres, Vinicius Cordeiro Fonseca, Alexander Forero-Torres, Francesco Forfori, Laura Fortuna, Evangelos Fradelos, Gustavo P Fraga, Pietro Fransvea, Simone Frassini, Giuseppe Frazzetta, Erica Pizzocaro, Maximos Frountzas, Mahir Gachabayov, Rita Galeiras, Alain A Garcia Vazquez, Simone Gargarella, Ibrahim Umar Garzali, Wagih Mommtaz Ghannam, Faiz Najmuddin Ghazi, Lawrence Marshall Gillman, Rossella Gioco, Alessio Giordano, Luca Giordano, Carlo Giove, Giorgio Giraudo, Mario Giuffrida, Michela Giulii Capponi, Emanuel Gois Jr, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonsaga, Emre Gonullu, Jacques Goosen, Tatjana Goranovic, Raquel Gracia-Roman, Giorgio Maria Paolo Graziano, Ewen Alexander Griffiths, Tommaso Guagni, Dimitar Bozhidarov Hadzhiev, Muad Gamil Haidar, Hytham K S Hamid, Timothy Craig Hardcastle, Firdaus Hayati, Andrew James Healey, Andreas Hecker, Matthias Hecker, Edgar Fernando Hernandez Garcia, Adrien Montcho Hodonou, Eduardo Cancio Huaman, Martin Huerta, Aini Fahriza Ibrahim, Basil Mohamed Salabeldin Ibrahim, Giuseppe Ietto, Marco Inama, Orestis Ioannidis, Arda Isik, Nizar Ismail, Azzain Mahadi Hamid Ismail, Ruhi Fadzlyana Jailani, Ji Young Jang, Christos Kalfountzos, Sujala Niatarika Rajsain Kalipershad, Emmanouil Kaouras, Lewis Jay Kaplan, Yasin Kara, Evika Karamagioli, Aleksandar Karamarkovia, Ioannis Katsaros, Alfie J Kavalakat, Aristotelis Kechagias, Jakub Kenig, Boris Juli Kessel, Jim S Khan, Vladimir Khokha, Jae Il Kim, Andrew Wallace Kirkpatrick, Roberto Klappenbach, Yoram Kluger, Yoshiro Kobe, Efstratios Kofopoulos Lymperis, Kenneth Yuh Yen Kok, Victor Kong, Dimitris P Korkolis, Georgios Koukoulis, Bojan Kovacevic, Vitor Favali Kruger, Igor A Kryvoruchko, Hayato Kurihara, Akira Kuriyama, Aitor Landaluce-Olavarria, Pierfrancesco Lapolla, Ari Leppäniemi, Leo Licari, Giorgio Lisi, Andrey Litvin, Aintzane Lizarazu, Heura Llaquet Bayo, Varut Lohsiriwat, Claudia Cristina Lopes Moreira, Eftychios Lostoridis, Agustãn Tovar Luna, Davide Luppi, Gustavo Miguel Machain V, Marc Maegele, Daniele Maggiore, Stefano Magnone, Ronald V Maier, Piotr Major, Mallikarjuna Manangi, Andrea Manetti, Baris Mantoglu, Chiara Marafante, Federico Mariani, Athanasios Marinis, Evandro Antonio Sbalcheiro Mariot, Gennaro Martines, Aleix Martinez Perez, Costanza Martino, Pietro Mascagni, Damien Massalou, Maurizio Massaro, Belen Matías-García, Gennaro Mazzarella, Giorgio Mazzarolo, Renato Bessa Melo, Fernando Mendoza-Moreno, Serhat Meric, Jeremy Meyer, Luca Miceli, Nikolaos V Michalopoulos, Flavio Milana, Andrea Mingoli, Tushar S Mishra, Muyed Mohamed, Musab Isam Eldin Abbas Mohamed, Ali Yasen Mohamedahmed, Mohammed Jibreel Suliman Mohammed, Rajashekar Mohan, Ernest E Moore, Dieter Morales-Garcia, Mã Ns Muhrbeck, Francesk Mulita, Sami Mohamed Siddig Mustafa, Edoardo Maria Muttillo, Mukhammad David Naimzada, Pradeep H Navsaria, Ionut Negoi, Luca Nespoli, Christine Nguyen, Melkamu Kibret Nidaw, Giuseppe Nigri, Ioannis Nikolopoulos, Donal Brendan O'Connor, Habeeb Damilola Ogundipe, Cristina Oliveri, Stefano Olmi, Ernest Cun Wang Ong, Luca Orecchia, Aleksei V Osipov, Muhammad Faeid Othman, Marco Pace, Mario Pacilli, Leonardo Pagani, Giuseppe Palomba, Desire' Pantalone, Arpad Panyko, Ciro Paolillo, Mario Virgilio Papa, Dimitrios Papaconstantinou, Maria Papadoliopoulou, Aristeidis Papadopoulos, Davide Papis, Nikolaos Pararas, Jose Gustavo Parreira, Neil Geordie Parry, Francesco Pata, Tapan Patel, Simon Paterson-Brown, Giovanna Pavone, Francesca Pecchini, Veronica Pegoraro, Gianluca Pellino, Maria Pelloni, Andrea Peloso, Eduardo Perea Del Pozo, Rita Goncalves Pereira, Bruno Monteiro Pereira, Aintzane Lizarazu Perez, Silvia Pérez, Teresa Perra, Gennaro Perrone, Antonio Pesce, Lorenzo Petagna, Giovanni Petracca, Vorapong Phupong, Biagio Picardi, Arcangelo Picciariello, Micaela Piccoli, Edoardo Picetti, Emmanouil Pikoulis Pikoulis, Tadeja Pintar, Giovanni Pirozzolo, Francesco Piscioneri, Mauro Podda, Alberto Porcu, Francesca Privitera, Clelia Punzo, Silvia Quaresima, Martha Alexa Quiodettis, Niels Qvist, Razrim Rahim, Filipe Ramalho de Almeida, Rosnelifaizur Bin Ramely, Huseyin Kemal Rasa, Martin Reichert, Alexander Reinisch-Liese, Angela Renne, Camilla Riccetti, Maria Rita Rodriguez-Luna, Daniel Roizblatt, Andrea Romanzi, Luigi Romeo, Francesco Pietro Maria Roscio, Ramely Bin Rosnelifaizur, Stefano Rossi, Andres M Rubiano, Elena Ruiz-Ucar, Boris Evgeniev Sakakushev, Juan Carlos Salamea, Ibrahima Sall, Lasitha Bhagya Samarakoon, Fabrizio Sammartano, Alejandro Sanchez Arteaga, Sergi Sanchez-Cordero, Domenico Pietro Maria Santoanastaso, Massimo Sartelli, Diego Sasia, Norio Sato, Artem Savchuk, Robert Grant Sawyer, Giacomo Scaioli, Dimitrios Schizas, Simone Sebastiani, Barbara Seeliger, Helmut Alfredo Segovia Lohse, Charalampos Seretis, Giacomo Sermonesi, Mario Serradilla-Martin, Vishal G Shelat, Sergei Shlyapnikov, Theodoros Sidiropoulos, Romeo Lages Simoes, Leandro Siragusa, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Gabriele Soldini, Andrey Sopuev, Kjetil Soreide, Apostolos Sovatzidis, Philip Frank Stahel, Matt Strickland, Mohamed Arif Hameed Sultan, Ruslan Sydorchuk, Larysa Sydorchuk, Syed Muhammad Ali Muhammad Syed, Luis Tallon-Aguilar, Andrea Marco Tamburini, Nicolò Tamini, Edward C T H Tan, Jih Huei Tan, Antonio Tarasconi, Nicola Tartaglia, Giuseppe Tartaglia, Dario Tartaglia, John Vincent Taylor, Giovanni Domenico Tebala, Michel Teuben, Alexis Theodorou, Matti Tolonen, Giovanni Tomasicchio, Adriana Toro, Beatrice Torre, Tania Triantafyllou, Giuseppe Trigiante Trigiante, Marzia Tripepi, Julio Trostchansky, Konstantinos Tsekouras, Victor Turrado-Rodriguez, Roberta Tutino, Matteo Uccelli, Petar Angelov Uchikov, Bakarne Ugarte-Sierra, Mika Tapani Ukkonen, Michail Vailas, Panteleimon G Vassiliu, Alain Garcia Vazquez, Rita Galeiras Vazquez, George Velmahos, Juan Ezequiel Verde, Juan Manuel Verde, Massimiliano Veroux, Jacopo Viganò, Ramon Vilallonga, Diego Visconti, Alessandro Vittori, Maciej Waledziak, Tongporn Wannatoop, Lukas Werner Widmer, Michael Samuel James Wilson, Sarah Woltz, Ting Hway Wong, Sofia Xenaki, Byungchul Yu, Steven Yule, Sanoop Koshy Zachariah, Georgios Zacharis, Claudia Zaghi, Andee Dzulkarnaen Zakaria, Diego A Zambrano, Nikolaos Zampitis, Biagio Zampogna, Simone Zanghì, Maristella Zantedeschi, Konstantinos Zapsalis, Fabio Zattoni, Monica Zese, Lorenzo, Cobianchi, Daniele, Piccolo, Francesca, Dal Ma, Vanni, Agnoletti, Luca, Ansaloni, Jeremy, Balch, Walter, Biffl, Giovanni, Butturini, Fausto, Catena, Federico, Coccolini, Stefano, Denicolai, Belinda, De Simone, Isabella, Frigerio, Paola, Fugazzola, Gianluigi, Marseglia, Giuseppe Roberto, Marseglia, Jacopo, Martellucci, Mirko, Modenese, Pietro, Previtali, Federico, Ruta, Alessandro, Venturi, Haytham M, Kaafarani, Tyler J, Loftu, Lyle Abbott, Kenneth, Abdelmalik, Abubaker, Seyoum Abebe, Nebyou, Abu-Zidan, Fikri, Abdallah Yousif Adam, Yousif, Adamou, Harissou, Mikhailovich Adamovich, Dmitry, Agresta, Ferdinando, Agrusa, Antonino, Akin, Emrah, Alessiani, Mario, Alexandrino, Henrique, Muhammad Ali, Syed, Alin Mihai, Vasilescu, Miguel Almeida, Pedro, Mohammed Al-Shehari, Mohammed, Altomare, Michele, Amico, Francesco, Ammendola, Michele, Andreuccetti, Jacopo, Anestiadou, Elissavet, Angelos, Peter, Annicchiarico, Alfredo, Antonelli, Amedeo, Aparicio-Sanchez, Daniel, Ardito, Antonella, Argenio, Giulio, Claude Arvieux, Catherine, Harald Askevold, Ingolf, Tchavdarov Atanasov, Boyko, Augustin, Goran, Sabry Awad, Selmy, Bacchiocchi, Giulia, Bagnoli, Carlo, Bahouth, Hany, Baili, Efstratia, Bains, Lovenish, Luca Baiocchi, Gian, Bala, Miklosh, Balagué, Carmen, Balalis, Dimitrio, Baldini, Edoardo, Baraket, Oussama, Baral, Suman, Barone, Mirko, Gonzãlez Barranquero, Alberto, Arturo Barreras, Jorge, Alan Bass, Gary, Bayhan, Zulfu, Bellanova, Giovanni, Ben-Ishay, Offir, Bert, Fabrizio, Bianchi, Valentina, Biancuzzi, Helena, Bidoli, Chiara, Bievel Radulescu, Raluca, Brian Bignell, Mark, Biloslavo, Alan, Bissacco, Daniele, Bini, Roberto, Boati, Paolo, Boddaert, Guillaume, Bogdanic, Branko, Bombardini, Cristina, Bonavina, Luigi, Bonomo, Luca, Bottari, Andrea, Bouliaris, Konstantino, Brachini, Gioia, Brillantino, Antonio, Brisinda, Giuseppe, Mamada Bulanauca, Maloni, Antonio Buonomo, Lui, Burcharth, Jakob, Buscemi, Salvatore, Calabretto, Francesca, Calini, Giacomo, Calu, Valentin, Cesare Campanile, Fabio, Campo Dall Orto, Riccardo, Campos-Serra, Andrea, Campostrini, Stefano, Capoglu, Recayi, Miguel Carvas, Joao, Cascella, Marco, Casoni Pattacini, Gianmaria, Celentano, Valerio, Corrado Centonze, Danilo, Ceresoli, Marco, Chatzipetris, Dimitrio, Chessa, Antonella, Michela Chiarello, Maria, Chirica, Mircea, Chooklin, Serge, Chouliaras, Christo, Chowdhury, Sharfuddin, Cianci, Pasquale, Cillara, Nicola, Cimbanassi, Stefania, Piero Bernardo Cioffi, Stefano, Colak, Elif, Colás Ruiz, Enrique, Conti, Luigi, Coppola, Alessandro, Correia De Sa, Tiago, Dantas Costa, Silvia, Cozza, Valerio, Curro', Giuseppe, Felicia Ann-Sophie Aimee Dabekaussen, Kirsten, D'Acapito, Fabrizio, Damaskos, Dimitrio, D'Ambrosio, Giancarlo, Das, Koray, Justin Davies, Richard, Charles De Beaux, Andrew, Patricia De Lebrusant Fernandez, Sara, De Luca, Alessandro, De Stefano, Francesca, Degrate, Luca, Demetrashvili, Zaza, Kyriacou Demetriades, Andrea, Smail Detanac, Dzemail, Dezi, Agnese, Di Buono, Giuseppe, Di Carlo, Isidoro, Di Lascio, Pierpaolo, Di Martino, Marcello, Di Saverio, Salomone, Diaconescu, Bogdan, J Diaz, Jose, Dibra, Riger, Nikolaev Dimitrov, Evgeni, Paola Dinuzzi, Vincenza, Dios-Barbeito, Sandra, Farman Ali Diyani, Jehangir, Dogjani, Agron, Domanin, Maurizio, D'Oria, Mario, Duran Munoz-Cruzado, Virginia, East, Barbora, Ekelund, Mikael, Takem Ekwen, Gerald, Hamed Elbaih, Adel, Elhadi, Muhammed, Enninghorst, Natalie, Ernisova, Mairam, Pablo Escalera-Antezana, Juan, Esposito, Sofia, Esposito, Giuseppe, Estaire, Mercede, Nikita Farè, Camilla, Farre, Roser, Favi, Francesco, Ferrario, Luca, Ferrario di Tor Vajana, Antonjacopo, Filisetti, Claudia, Fleres, Francesco, Cordeiro Fonseca, Viniciu, Forero-Torres, Alexander, Forfori, Francesco, Fortuna, Laura, Fradelos, Evangelo, P Fraga, Gustavo, Fransvea, Pietro, Frassini, Simone, Frazzetta, Giuseppe, Pizzocaro, Erica, Frountzas, Maximo, Gachabayov, Mahir, Galeiras, Rita, A Garcia Vazquez, Alain, Gargarella, Simone, Umar Garzali, Ibrahim, Mommtaz Ghannam, Wagih, Najmuddin Ghazi, Faiz, Marshall Gillman, Lawrence, Gioco, Rossella, Giordano, Alessio, Giordano, Luca, Giove, Carlo, Giraudo, Giorgio, Giuffrida, Mario, Giulii Capponi, Michela, Gois Jr, Emanuel, Augusto Gomes, Carlo, Couto Gomes, Felipe, Alessandro Teixeira Gonsaga, Ricardo, Gonullu, Emre, Goosen, Jacque, Goranovic, Tatjana, Gracia-Roman, Raquel, Maria Paolo Graziano, Giorgio, Alexander Griffiths, Ewen, Guagni, Tommaso, Bozhidarov Hadzhiev, Dimitar, Gamil Haidar, Muad, S Hamid, Hytham K, Craig Hardcastle, Timothy, Hayati, Firdau, James Healey, Andrew, Hecker, Andrea, Hecker, Matthia, Fernando Hernandez Garcia, Edgar, Montcho Hodonou, Adrien, Cancio Huaman, Eduardo, Huerta, Martin, Fahriza Ibrahim, Aini, Mohamed Salabeldin Ibrahim, Basil, Ietto, Giuseppe, Inama, Marco, Ioannidis, Oresti, Isik, Arda, Ismail, Nizar, Mahadi Hamid Ismail, Azzain, Fadzlyana Jailani, Ruhi, Young Jang, Ji, Kalfountzos, Christo, Niatarika Rajsain Kalipershad, Sujala, Kaouras, Emmanouil, Jay Kaplan, Lewi, Kara, Yasin, Karamagioli, Evika, Karamarkovia, Aleksandar, Katsaros, Ioanni, J Kavalakat, Alfie, Kechagias, Aristoteli, Kenig, Jakub, Juli Kessel, Bori, S Khan, Jim, Khokha, Vladimir, Il Kim, Jae, Wallace Kirkpatrick, Andrew, Klappenbach, Roberto, Kluger, Yoram, Kobe, Yoshiro, Kofopoulos Lymperis, Efstratio, Yuh Yen Kok, Kenneth, Kong, Victor, P Korkolis, Dimitri, Koukoulis, Georgio, Kovacevic, Bojan, Favali Kruger, Vitor, A Kryvoruchko, Igor, Kurihara, Hayato, Kuriyama, Akira, Landaluce-Olavarria, Aitor, Lapolla, Pierfrancesco, Leppäniemi, Ari, Licari, Leo, Lisi, Giorgio, Litvin, Andrey, Lizarazu, Aintzane, Llaquet Bayo, Heura, Lohsiriwat, Varut, Cristina Lopes Moreira, Claudia, Lostoridis, Eftychio, Tovar Luna, Agustãn, Luppi, Davide, V, Gustavo Miguel Machain, Maegele, Marc, Maggiore, Daniele, Magnone, Stefano, V Maier, Ronald, Major, Piotr, Manangi, Mallikarjuna, Manetti, Andrea, Mantoglu, Bari, Marafante, Chiara, Mariani, Federico, Marinis, Athanasio, Antonio Sbalcheiro Mariot, Evandro, Martines, Gennaro, Martinez Perez, Aleix, Martino, Costanza, Mascagni, Pietro, Massalou, Damien, Massaro, Maurizio, Matías-García, Belen, Mazzarella, Gennaro, Mazzarolo, Giorgio, Bessa Melo, Renato, Mendoza-Moreno, Fernando, Meric, Serhat, Meyer, Jeremy, Miceli, Luca, V Michalopoulos, Nikolao, Milana, Flavio, Mingoli, Andrea, S Mishra, Tushar, Mohamed, Muyed, Isam Eldin Abbas Mohamed, Musab, Yasen Mohamedahmed, Ali, Jibreel Suliman Mohammed, Mohammed, Mohan, Rajashekar, E Moore, Ernest, Morales-Garcia, Dieter, Ns Muhrbeck, Mã, Mulita, Francesk, Mohamed Siddig Mustafa, Sami, Maria Muttillo, Edoardo, David Naimzada, Mukhammad, H Navsaria, Pradeep, Negoi, Ionut, Nespoli, Luca, Nguyen, Christine, Kibret Nidaw, Melkamu, Nigri, Giuseppe, Nikolopoulos, Ioanni, Brendan O'Connor, Donal, Damilola Ogundipe, Habeeb, Oliveri, Cristina, Olmi, Stefano, Cun Wang Ong, Ernest, Orecchia, Luca, V Osipov, Aleksei, Faeid Othman, Muhammad, Pace, Marco, Pacilli, Mario, Pagani, Leonardo, Palomba, Giuseppe, Pantalone, Desire', Panyko, Arpad, Paolillo, Ciro, Virgilio Papa, Mario, Papaconstantinou, Dimitrio, Papadoliopoulou, Maria, Papadopoulos, Aristeidi, Papis, Davide, Pararas, Nikolao, Gustavo Parreira, Jose, Geordie Parry, Neil, Pata, Francesco, Patel, Tapan, Paterson-Brown, Simon, Pavone, Giovanna, Pecchini, Francesca, Pegoraro, Veronica, Pellino, Gianluca, Pelloni, Maria, Peloso, Andrea, Perea Del Pozo, Eduardo, Goncalves Pereira, Rita, Monteiro Pereira, Bruno, Lizarazu Perez, Aintzane, Pérez, Silvia, Perra, Teresa, Perrone, Gennaro, Pesce, Antonio, Petagna, Lorenzo, Petracca, Giovanni, Phupong, Vorapong, Picardi, Biagio, Picciariello, Arcangelo, Piccoli, Micaela, Picetti, Edoardo, Pikoulis Pikoulis, Emmanouil, Pintar, Tadeja, Pirozzolo, Giovanni, Piscioneri, Francesco, Podda, Mauro, Porcu, Alberto, Privitera, Francesca, Punzo, Clelia, Quaresima, Silvia, Alexa Quiodettis, Martha, Qvist, Niel, Rahim, Razrim, Ramalho de Almeida, Filipe, Bin Ramely, Rosnelifaizur, Kemal Rasa, Huseyin, Reichert, Martin, Reinisch-Liese, Alexander, Renne, Angela, Riccetti, Camilla, Rita Rodriguez-Luna, Maria, Roizblatt, Daniel, Romanzi, Andrea, Romeo, Luigi, Pietro Maria Roscio, Francesco, Bin Rosnelifaizur, Ramely, Rossi, Stefano, M Rubiano, Andre, Ruiz-Ucar, Elena, Evgeniev Sakakushev, Bori, Carlos Salamea, Juan, Sall, Ibrahima, Bhagya Samarakoon, Lasitha, Sammartano, Fabrizio, Sanchez Arteaga, Alejandro, Sanchez-Cordero, Sergi, Pietro Maria Santoanastaso, Domenico, Sartelli, Massimo, Sasia, Diego, Sato, Norio, Savchuk, Artem, Grant Sawyer, Robert, Scaioli, Giacomo, Schizas, Dimitrio, Sebastiani, Simone, Seeliger, Barbara, Alfredo Segovia Lohse, Helmut, Seretis, Charalampo, Sermonesi, Giacomo, Serradilla-Martin, Mario, G Shelat, Vishal, Shlyapnikov, Sergei, Sidiropoulos, Theodoro, Lages Simoes, Romeo, Siragusa, Leandro, Siribumrungwong, Boonying, Slavchev, Mihail, Solaini, Leonardo, Soldini, Gabriele, Sopuev, Andrey, Soreide, Kjetil, Sovatzidis, Apostolo, Frank Stahel, Philip, Strickland, Matt, Arif Hameed Sultan, Mohamed, Sydorchuk, Ruslan, Sydorchuk, Larysa, Muhammad Ali Muhammad Syed, Syed, Tallon-Aguilar, Lui, Marco Tamburini, Andrea, Tamini, Nicolò, H Tan, Edward C T, Huei Tan, Jih, Tarasconi, Antonio, Tartaglia, Nicola, Tartaglia, Giuseppe, Tartaglia, Dario, Vincent Taylor, John, Domenico Tebala, Giovanni, Teuben, Michel, Theodorou, Alexi, Tolonen, Matti, Tomasicchio, Giovanni, Toro, Adriana, Torre, Beatrice, Triantafyllou, Tania, Trigiante Trigiante, Giuseppe, Tripepi, Marzia, Trostchansky, Julio, Tsekouras, Konstantino, Turrado-Rodriguez, Victor, Tutino, Roberta, Uccelli, Matteo, Angelov Uchikov, Petar, Ugarte-Sierra, Bakarne, Tapani Ukkonen, Mika, Vailas, Michail, G Vassiliu, Panteleimon, Garcia Vazquez, Alain, Galeiras Vazquez, Rita, Velmahos, George, Ezequiel Verde, Juan, Manuel Verde, Juan, Veroux, Massimiliano, Viganò, Jacopo, Vilallonga, Ramon, Visconti, Diego, Vittori, Alessandro, Waledziak, Maciej, Wannatoop, Tongporn, Werner Widmer, Luka, Samuel James Wilson, Michael, Woltz, Sarah, Hway Wong, Ting, Xenaki, Sofia, Yu, Byungchul, Yule, Steven, Koshy Zachariah, Sanoop, Zacharis, Georgio, Zaghi, Claudia, Dzulkarnaen Zakaria, Andee, A Zambrano, Diego, Zampitis, Nikolao, Zampogna, Biagio, Zanghì, Simone, Zantedeschi, Maristella, Zapsalis, Konstantino, Zattoni, Fabio, Zese, Monica, Cobianchi L., Piccolo D., Mas F.D., Agnoletti V., Ansaloni L., Balch J., Biffl W., Butturini G., Catena F., Coccolini F., Denicolai S., De Simone B., Frigerio I., Fugazzola P., Marseglia G., Marseglia G.R., Martellucci J., Modenese M., Previtali P., Ruta F., Venturi A., Kaafarani H.M., Loftus T.J., Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Team Dynamics Study Group, Cobianchi, L, Piccolo, D, Dal Mas, F, Agnoletti, V, Ansaloni, L, Balch, J, Biffl, W, Butturini, G, Catena, F, Coccolini, F, Denicolai, S, De Simone, B, Frigerio, I, Fugazzola, P, Marseglia, G, Martellucci, J, Modenese, M, Previtali, P, Ruta, F, Venturi, A, Kaafarani, H, Loftus, T, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Angelos, P, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balague, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Bidoli, C, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Dall'Orto, R, Campos-Serra, A, Campostrini, S, Capoglu, R, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Ruiz, E, Conti, L, Coppola, A, De Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, De Beaux, A, Fernandez, S, De Luca, A, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, D, Dezi, A, Di Buono, G, Di Carlo, I, Di Lascio, P, Di Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire, M, Fare, C, Farre, R, Favi, F, Ferrario, L, Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Pizzocaro, E, Frountzas, M, Gachabayov, M, Galeiras, R, Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kluger, Y, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Leppaniemi, A, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, V, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Massaro, M, Matias-Garcia, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, Mishra, T, Mohamed, M, Mohamedahmed, A, Mohammed, M, Mohan, R, Moore, E, Morales-Garcia, D, Muhrbeck, M, Mulita, F, Mustafa, S, Muttillo, E, Naimzada, M, Navsaria, P, Negoi, I, Nespoli, L, Nguyen, C, Nidaw, M, Nigri, G, Nikolopoulos, I, O'Connor, D, Ogundipe, H, Oliveri, C, Olmi, S, Ong, E, Orecchia, L, Osipov, A, Othman, M, Pace, M, Pacilli, M, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papa, M, Papaconstantinou, D, Papadoliopoulou, M, Papadopoulos, A, Papis, D, Pararas, N, Parreira, J, Parry, N, Pata, F, Patel, T, Paterson-Brown, S, Pavone, G, Pecchini, F, Pegoraro, V, Pellino, G, Pelloni, M, Peloso, A, Del Pozo, E, Pereira, R, Pereira, B, Perez, S, Perra, T, Perrone, G, Pesce, A, Petagna, L, Petracca, G, Phupong, V, Picardi, B, Picciariello, A, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Piscioneri, F, Podda, M, Porcu, A, Privitera, F, Punzo, C, Quaresima, S, Quiodettis, M, Qvist, N, Rahim, R, de Almeida, F, Ramely, R, Rasa, H, Reichert, M, Reinisch-Liese, A, Renne, A, Riccetti, C, Rodriguez-Luna, M, Roizblatt, D, Romanzi, A, Romeo, L, Roscio, F, Rosnelifaizur, R, Rossi, S, Rubiano, A, Ruiz-Ucar, E, Sakakushev, B, Salamea, J, Sall, I, Samarakoon, L, Sammartano, F, Arteaga, A, Sanchez-Cordero, S, Santoanastaso, D, Sartelli, M, Sasia, D, Sato, N, Savchuk, A, Sawyer, R, Scaioli, G, Schizas, D, Sebastiani, S, Seeliger, B, Lohse, H, Seretis, C, Sermonesi, G, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Sidiropoulos, T, Simoes, R, Siragusa, L, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Sopuev, A, Soreide, K, Sovatzidis, A, Stahel, P, Strickland, M, Sultan, M, Sydorchuk, R, Sydorchuk, L, Syed, S, Tallon-Aguilar, L, Tamburini, A, Tamini, N, Tan, E, Tan, J, Tarasconi, A, Tartaglia, N, Tartaglia, G, Tartaglia, D, Taylor, J, Tebala, G, Teuben, M, Theodorou, A, Tolonen, M, Tomasicchio, G, Toro, A, Torre, B, Triantafyllou, T, Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, R, Velmahos, G, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Woltz, S, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zanghi, S, Zantedeschi, M, Zapsalis, K, Zattoni, F, and Zese, M

Subjects
Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Artificial intelligence, Settore SECS-P/07 - Economia Aziendale, Decision aid, Emergency Medicine, Decision aids, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Trauma and emergency surgery, Clinical decision-making, Survey
Abstract

Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.

Published
2023
Full Text
View/download PDF

2. Hand in hand: A multistakeholder approach for co-production of surgical care

Author

Helena Biancuzzi, Claudia Filisetti, Maurizio Massaro, Ester Orlandi, Luca Miceli, Lorenzo Cobianchi, Francesca Dal Mas, Peter Angelos, Rym Bednarova, and Amelia Barcellini

Subjects
business.industry, Surgical care, media_common.quotation_subject, General Medicine, medicine.disease, Specialties, Surgical, Settore MED/18 - Chirurgia Generale, Breast cancer, Nursing, Settore SECS-P/07 - Economia Aziendale, Stakeholder Participation, Health care, Humans, Medicine, Production (economics), Surgery, Quality (business), Patient Participation, business, media_common
Abstract

Starting from a recent experience with breast cancer patients, our paper argues how co-production may represent a successful strategy to empower patients and reach better surgical outcomes, especially when a multistakeholder approach is employed. Co-production, where clinicians and other meaningful stakeholders like citizens, patient's associations, and policymakers are "hand in hand" with the patients, stands as one of the pillars of modern healthcare ecosystems. There is a call for the surgical community to investigate the benefit of creating programs of co-production with the patients and other meaningful stakeholders to improve the quality and outcomes of surgical care.

Published
2022

3. Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19

Author

Monica Osti, Gloria Pelizzo, Armando De Angelis, Anna Camporesi, Valeria Calcaterra, Claudia Filisetti, Giulia Del Re, Elettra Vestri, Dario Rizzo, Paola Tommasi, Gian Vincenzo Zuccotti, and Elena Zoia

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Referral, Leadership and Management, pediatric burns, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Secondary infection, Health Informatics, macromolecular substances, Article, 03 medical and health sciences, burns, 0302 clinical medicine, Health Information Management, Medicine, management strategies, Severe burn, 030212 general & internal medicine, Pediatric intensive care unit, business.industry, Health Policy, COVID-19, 030208 emergency & critical care medicine, Burn treatment, Emergency medicine, business, Total body surface area
Abstract

Considerable reorganization of the regional network for pediatric burn treatment during the pandemic was required to cope with severe burn injuries in small children. In support of the emergency network for burns during the COVID-19 pandemic, we referred to regional indications for centralization in our hospital for all children aged less than 5 years who presented with severe burns, &gt, 15% of total body surface area (TBSA), or who necessitated admittance to the pediatric intensive care unit (PICU). A new service with a dedicated management protocol was set up to treat pediatric burns in our SARS-CoV-2 pediatric hospital during the lockdown period. A multidisciplinary burn treatment team was set up to offer compassionate and comprehensive burn care. Patient’s clinical data, burn features, treatment and follow up were recorded. A higher number of admissions was recorded from February to December 2020 compared with the same period in 2019 (52 vs. 32 admissions). Eighteen patients were admitted to the COVID-19 Service (10 M/8 F, 3.10 ± 2.6 yrs), ten children (55.5%) were hospitalized in the ward and eight in the ICU (44.5%). Fifty percent of the cases presented with lesions extending over &gt, 15% TBSA, in one case, TBSA was 35%. All patients suffered 2nd-degree burns, while five patients also had 3rd degree lesions covering more than 15% TBSA. All of the injuries occurred at home. No major secondary infections were recorded. Successful treatment was achieved in 94.4% of cases. The average length of stay was 15.2 ± 12.6 days. A proactive, carefully planned service, involving a multidisciplinary team, was created to ensure appropriate care in a pediatric hospital during the COVID-19 period, despite the effective pandemic associated challenges. Better health promotion in pediatric burn cases should also include dedicated TBSA assessment and a database of children’s burn characteristics.

Published
2021

4. The First Reported Pediatric Case of Primary Myoepithelial Carcinoma Involving the Whole Lung: Surgical Radical Treatment and Prosthesis Implant

Author

Andrea Pansini, Tiziana Russo, Giovanna Riccipetitoni, Camilla Viglio, Claudio Vella, and Claudia Filisetti

Subjects
medicine.medical_specialty, medicine.medical_treatment, lcsh:Surgery, Case Report, Atelectasis, 030204 cardiovascular system & hematology, 03 medical and health sciences, Pneumonectomy, 0302 clinical medicine, medicine.artery, Pediatric surgery, Biopsy, medicine, pediatric surgery, myoepithelial carcinoma, Pericardium, cancer, Lung, medicine.diagnostic_test, business.industry, Extracorporeal circulation, lcsh:RJ1-570, lcsh:Pediatrics, lcsh:RD1-811, medicine.disease, medicine.anatomical_structure, pediatric, 030220 oncology & carcinogenesis, Pulmonary artery, Radiology, business
Abstract

Primary myoepithelial carcinoma of the lung (PMC-L) arising from the bronchial glands in lower respiratory tract is exceedingly rare. Thus far, few cases in adults and only one in a pediatric patient have been recorded. To our knowledge, this is the first report of PMC-L successfully removed in a child, focusing on the importance of multidisciplinary primary surgery for the treatment of this tumor. A 7-year-old girl was admitted for persistent cough and fever; she was unresponsive to oral antibiotics. Chest radiography showed loss of volume of left lung sustained by almost total atelectasis. After routine clinical investigations, she was referred for computed tomography scan and magnetic resonance imaging that documented the presence of a mass occupying the entire left upper lobe, infiltrating the pulmonary hilum (main bronchus, pulmonary artery, superior pulmonary vein, and pericardium). After multidisciplinary evaluation, the histopathologic diagnosis of PMC-L was established using ultrasonography-guided transthoracic core needle biopsy and bronchoscopic biopsies. She was then subjected to left pneumonectomy under extracorporeal circulation and positioning of a thoracic expander filled with 200 mL of saline solution. The postoperative course was uneventful. With TREP (very Rare Tumor in Pediatric Age) consent radiotherapy was performed (61.2 Gy). At the 10-month follow-up, the patient was alive, breathing normally without any oxygen support, without recurrence of PMC-L or metastasis, and without any chest deformity. To our knowledge, this is the first case where a pediatric patient was successfully operated for PMC-L involving the whole lung. Extracorporeal circulation enabled us to perform radical primary surgery. Prosthesis implant not only maintained normal chest expansion but also allowed focused radiotherapy, thus enabling us to prevent damage to vital organs.

Published
2020
Full Text
View/download PDF

5. Severe Dumping Syndrome in a 6-year-old Girl with Congenital Microgastria Treated by Hunt-Lawrence Pouch

Author

Milena Meroni, Luciano Maestri, Giovanna Riccipetitoni, Federica Marinoni, and Claudia Filisetti

Subjects
medicine.medical_specialty, Hunt lawrence pouch, media_common.quotation_subject, lcsh:Surgery, Case Report, 03 medical and health sciences, 0302 clinical medicine, hunt-lawrence pouch, 030225 pediatrics, dumping syndrome, medicine, Girl, media_common, business.industry, lcsh:RJ1-570, lcsh:Pediatrics, Microgastria, lcsh:RD1-811, medicine.disease, Surgery, Congenital microgastria, congenital microgastria, 030220 oncology & carcinogenesis, Dumping syndrome, Pouch, business
Abstract

Microgastria is a rare congenital condition often associated with other anomalies. In the present report we describe the case of a 6-year-old girl with isolated CM who presented with dumping syndrome successfully treated by a Hunt-Lawrence pouch.

Published
2017
Full Text
View/download PDF

6. Effectiveness and properties of the biological prosthesis Permacol™ in pediatric surgery: A large single center experience

Author

Claudia Filisetti, Catherine Klersy, Giovanna Riccipetitoni, Claudio Vella, Federica Marinoni, and Sara Costanzo

Subjects
medicine.medical_specialty, Permacol, medicine.medical_treatment, Pediatric patients, Biological prosthesis, Diaphragmatic breathing, 030230 surgery, Single Center, Prosthesis, Abdominal wall, 03 medical and health sciences, Abdominal wall closure, 0302 clinical medicine, Pediatric surgery, medicine, Original Research, business.industry, Pediatric age, General Medicine, Surgery, medicine.anatomical_structure, 030211 gastroenterology & hepatology, Implant, business
Abstract

Introduction The use of prosthetic patches of non-absorbable materials represents a valid tool in the treatment of abdominal wall and diaphragmatic defects in pediatric age. In recent years research has developed biological dermal scaffolds made from a sheet of acellular matrix that can provide the desired support and reduce the occurrence of complications from non-absorbable implant. We present our experience and a systematic review to evaluate the use of biologic prosthesis for abdominal wall closure in pediatric patients. Methods The study from January 2009 to January 2015 involved 20 patients treated with Permacol™ implant. We observed postoperative complications only in patients treated for abdominal wall closure, which is the major indication for the use of Permacol™. We conducted a systematic review and meta-analysis (according to PRISMA) on PubMed/Medline, Scopus and EMBASE regarding the use of biological prosthesis in pediatric population considering the incidence of complications as the primary outcome. Results 3/20 patients experienced complications: 2 patients with skin necrosis healed conservatively and 1 of them developed laparocele. Thus only 1 patient with incisional hernia had significant surgery complication. In patients who were permanently implanted with Permacol™ it has not determined adverse reactions with optimal functional outcome. Conclusions In accordance with the few data (case reports and case series) reported in literature about pediatric patients, our experience in different pathologies and applications has shown the effectiveness of Permacol™, in particular for the non-occurrence of infections, that often affect the use of prosthesis., Highlights • Use of biological prosthesis is well known for the treatment of complicated abdominal defects in adults surgery but not in pediatric surgery. • We analyzed the largest case series present in the literature in pediatric surgery. • Looking at our results the use of Permacol™ seems to be safe and feasible in pediatric complicated abdominal wall closure.

Published
2016
Full Text
View/download PDF

7. In vitro and in vivo quantification of chloroprocaine release from an implantable device in a piglet postoperative pain model

Author

Nora Bloise, Dario Bugada, Mariadelfina Molinaro, Simona De Gregori, Massimo Allegri, Manuela De Gregori, Michael E Schatman, Lorenzo Cobianchi, and Claudia Filisetti

Subjects
chloroprocaine, medicine.drug_class, Metabolite, Cmax, 02 engineering and technology, postoperative outcome, 03 medical and health sciences, chemistry.chemical_compound, Cmin, 0302 clinical medicine, Pharmacokinetics, In vivo, medicine, ACBA, Journal of Pain Research, Original Research, Local anesthetic, business.industry, 021001 nanoscience & nanotechnology, In vitro, Anesthesiology and Pain Medicine, chemistry, Anesthesia, hydrogel device, 0210 nano-technology, business, pharmacokinetics, 030217 neurology & neurosurgery, Chloroprocaine, medicine.drug
Abstract

Simona De Gregori,1 Manuela De Gregori,1–4 Nora Bloise,5,6 Dario Bugada,3,4,7 Mariadelfina Molinaro,1 Claudia Filisetti,8 Massimo Allegri,3,9 Michael E Schatman,3,10,11 Lorenzo Cobianchi12,13 1Clinical and Experimental Pharmacokinetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 2Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 3Study in Multidisciplinary Pain Research Group, Parma, Italy; 4Young Against Pain Group, Parma, Italy; 5Department of Molecular Medicine, Centre for Health Technologies, INSTM UdR of Pavia, University of Pavia, Pavia, Italy; 6Department of Occupational Medicine, Toxicology and Environmental Risks, Istituti Clinici Scientifici Maugeri, IRCCS, Lab of Nanotechnology, Pavia, Italy; 7Emergency and Intensive Care Department – ASST Papa Giovanni XXIII, Bergamo, Italy; 8“V. Buzzi” Children Hospital, Pediatric Surgery, Milan, Italy; 9Anesthesia and Intensive Care Service, IRCCS MultiMedica Hospital, Sesto San Giovanni, Milano, Italy; 10Research and Network Development, Boston Pain Care, Waltham, MA, USA; 11Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; 12General Surgery Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 13Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy Background: The pharmacokinetic properties and clinical advantages of the local anesthetic chloroprocaine are well known. Here, we studied the pharmacokinetic profile of a new hydrogel device loaded with chloroprocaine to investigate the potential advantages of this new strategy for postoperative pain (POP) relief. Materials and methods: We performed both in vitro and in vivo analyses by considering plasma samples of four piglets receiving slow-release chloroprocaine. To quantify chloroprocaine and its inactive metabolite 4-amino-2-chlorobenzoic acid (ACBA), a HPLC–tandem mass spectrometry (HPLC-MS/MS) analytical method was used. Serial blood samples were collected over 108hours, according to the exposure time to the device. Results: Chloroprocaine was consistently found to be below the lower limit of quantification, even though a well-defined peak was observed in every chromatogram at an unexpected retention time. Concerning ACBA, we found detectable plasma concentrations between T0 and T12h, with a maximum plasma concentration (Cmax) observed 3hours after the device application. In the in vitro analyses, the nanogel remained in contact with plasma at 37°C for 90minutes, 3hours, 1day, and 7days. Chloroprocaine Cmax was identified 1day following exposure and Cmin after 7days, respectively. Additionally, ACBA reached the Cmax following 7days of exposure. Conclusion: A thorough review of the literature indicates that this is the first study analyzing both in vivo and in vitro pharmacokinetic profiles of a chloroprocaine hydrogel device and is considered as a pilot study on the feasibility of including this approach to the management of POP. Keywords: postoperative outcome, hydrogel device, chloroprocaine, ACBA, pharmacokinetics

Published
2018

8. Analysis of Hand Size and Ergonomics of Instruments in Pediatric Minimally Invasive Surgery

Author

Amulya K. Saxena, Alexander Cho, Giovanna Riccipetitoni, and Claudia Filisetti

Subjects
Adult, Male, medicine.medical_specialty, Physicians, Surveys and Questionnaires, medicine, Humans, Minimally Invasive Surgical Procedures, Gloves, Surgical, Child, Retrospective Studies, Needle holder, business.industry, General surgery, Hand size, Reproducibility of Results, Human factors and ergonomics, Hand surgery, Pediatric Surgeon, Retrospective cohort study, Equipment Design, Glove use, Hand, Surgical Instruments, equipment and supplies, Surgery, Invasive surgery, Body Constitution, Female, Ergonomics, business
Abstract

Moving from the study conducted in 2004 on adult surgeons we want to analyze the ergonomics applied in pediatric minimally invasive surgery. An online survey was conducted among the members of the European Paediatric Surgeons' Association that included 14 questions pertaining to demographic, surgical glove size, double glove use, prior hand surgery, and the ease or difficulty in using different types of laparoscopic instruments. A total of 138 pediatric surgeons completed the survey. The difficulty score (DS) was similar between the 3.5- and 5-mm instruments. Other specialized instruments such as Ligasure, Ultracision, Clip applicators, endobags, and staplers were found to have higher DS. The needle holder was the only instrument that is part of the normal 5-mm operating sets, which was found to have a higher DS. Our survey found increased DS with the endobag and stapler, but this was not significant. Also prior hand surgery or double glove use was not associated with difficulty in usage of minimally invasive instruments when compared with normal hands in this survey.

Published
2015
Full Text
View/download PDF

9. Continuous wound infusion with chloroprocaine in a pig model of surgical lesion: drug absorption and effects on inflammatory response

Author

Maria Antonietta Avanzini, Manuela De Gregori, Antonia Icaro Cornaglia, Annalisa De Silvestri, Angelo Sala, Anna Petroni, Massimo Allegri, Claudia Filisetti, Lorenzo Cobianchi, and Dario Bugada

Subjects
chloroprocaine, continuous wound infusion, medicine.medical_treatment, Inflammation, Systemic inflammation, 03 medical and health sciences, 0302 clinical medicine, Pharmacokinetics, 030202 anesthesiology, Medicine, Journal of Pain Research, Saline, pig model, Original Research, business.industry, Anesthesiology and Pain Medicine, inflammation, Anesthesia, Hyperalgesia, medicine.symptom, business, postoperative pain, pharmacokinetics, 030217 neurology & neurosurgery, Ex vivo, Blood sampling, Chloroprocaine, medicine.drug
Abstract

Massimo Allegri,1,2 Dario Bugada,1–3 Manuela De Gregori,2,4 Maria A Avanzini,5 Annalisa De Silvestri,6 Anna Petroni,7 Angelo Sala,7,8 Claudia Filisetti,9–11 Antonia Icaro Cornaglia,12 Lorenzo Cobianchi13,14 1Department of Medicine and Surgery, University of Parma, Parma 2SIMPAR Group (Study in Multidisciplinary PAin Research), 3Department of Anaesthesia and ICU, ASST Papa Giovanni XXIII, Bergamo, 4Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo, 5Laboratory of Transplant Immunology/Cell Factory, IRCCS Foundation Policlinico San Matteo, 6Clinical epidemiology and Biometrics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, 7Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, 8I.B.I.M., C.N.R., Palermo, 9PhD School, University of Pavia, 10Department of Pediatric Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, 11Department of Pediatric Surgery, “V. Buzzi” Children’s Hospital, Milan, 12Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 13Department of Surgical, Clinical, Paediatric and Diagnostic Science, University of Pavia, 14General Surgery 1, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy Abstract: Continuous wound infusion (CWI) may protect from inflammation, hyperalgesia and persistent pain. Current local anesthetics display suboptimal pharmacokinetic profile during CWI; chloroprocaine (CP) has ideal characteristics, but has never been tested for CWI. We performed an animal study to investigate the pharmacokinetic profile and anti-inflammatory effect of CP during CWI. A total of 14 piglets received an infusion catheter after pararectal laparotomy and were randomly allocated to one of three groups: 5mL/h infusion of saline (group A), CP 1.5% (group B) and CP 0.5% (group C). Blood sampling was performed to assess absorption and systemic inflammation at 0, 3, 6, 12, 24, 48, 72, 96, 102 and 108hours. The wound and contralateral healthy abdominal wall were sampled for histological analyses. Absorption of CP from the site of infusion, evaluated as the plasmatic concentrations of CP and its metabolite, 4-amino-2-chlorobenzoic acid (CABA), showed a peak during the first 6hours, but both CP and its metabolite rapidly disappeared after stopping CP infusion. Local inflammation was reduced in groups B and C (CP-treated p < 0.001), in a CP dose-dependent fashion. While CP inhibited in a dose-dependent manner pig mononuclear cells (MNCs) in vitro proliferation to a polyclonal activator, no effect on systemic cytokines’ concentrations or on ex vivo monocytes’ responsiveness was observed, suggesting the lack of systemic effects, in line with the very short half-life of CP in plasma. CP showed a very good profile for use in CWI, with dose-dependent local anti-inflammatory effects, limited absorption and rapid clearance from the bloodstream upon discontinuation. No cytotoxicity or side effects were observed. CP, therefore, may represent an optimal choice for clinical CWI, adaptable to each patient’s need, and protective on wound inflammatory response (and hyperalgesia) after surgery. Keywords: continuous wound infusion, pig model, chloroprocaine, pharmacokinetics, inflammation, postoperative pain

Published
2017

10. Serum lactate level as a useful predictor of clinical outcome after surgery: an unfulfilled potential?

Author

Lorenzo Cobianchi, Andrea Peloso, Fabio Sciutti, Claudia Filisetti, and Francesco Mojoli

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Septic shock, Context (language use), medicine.disease, Intensive care unit, 030218 nuclear medicine & medical imaging, Surgery, law.invention, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, law, Shock (circulatory), Commentary, Blood gas test, Medicine, Hyperlactatemia, Clinical significance, medicine.symptom, business, Intensive care medicine, Anaerobic exercise
Abstract

The worldwide diffusion of point-of-care testing has made it possible to assess blood lactate easy and fast, but the use of blood lactate monitoring for risk assessment in the critically ill patient remains controversial. The different policies between hospitals and departments reflect the controversy regarding the usefulness of the blood sample (1). Lately, interesting papers about blood lactate level as a predictor of clinical outcomes have been published, but if we consider the whole literature scenario we do not have enough data to consider lactate a totally reliable prognostic index, or at least not in all the clinical settings (2-8). Lactic acid is normally considered a molecule with an excellent sensitivity for the cellular damage caused by anaerobiosis due to an oxygen debit during a shock status. In this context, the lactate is an extremely sensitive parameter but not so specific, in other words, if a state of shock is always, by definition, associated with hyperlactatemia, this relation is not bijective. In current practice, lactate is frequently measured in many kinds of patients, usually with the goal of detecting tissue hypoxia. However, given the metabolism of lactate and the effect of acute illness on glucose metabolism, increased lactate levels can reflect more than only tissue hypoxia (9). The lactate is at all times the result between the cellular lactate production and its clearance by enzymatic activity. There are many causes of hyperlactatemia (10,11), that are particularly common in critically patients hospitalized in intensive care unit (ICU) ward; in those patients the lactate measurement is undoubtedly considered routine “point-of-care” analysis. It follows that the retrospective statistical analysis of this biomarker is particularly delicate and difficult if not placed in a precise clinical context. The study by Creagh-Brown et al. (12) has addressed this issue with a very careful design: large cohort; relevant number of participating centers from the same country, well selected inclusion criteria, precise end-point, and multivariate data analysis. The increase in mortality of patients with high lactacidemia in the 24 hours after major gastrointestinal surgery represents an expected result already reported in other studies (13). The use of the recorded blood lactate peak in the first 24 hours is the first peculiarity of the present analysis, this fact is relevant and useful for a consistent statistical analysis but it does not reflect the behavior during the 24 hours. In other words, the same blood lactate peak could be recorded at the beginning of the 24 hours and then decreases or recorded at the end of the period of observation with a diametrical different clinical significance. This technical “bug” reflects the main limitation of a retrospective study with a “point of care” parameter analysis, routinely measured in ICU as included in a simple blood gas test. The elaboration of a risk-predictor-model involving lactacidemia in patients admitted in ICU after major surgery has to consider a similar scheme reported in Figure 1. Furthermore, the most unexpected data is the same behavior of the mortality rate related to the lactate peak in both study groups (elective and emergency). This would consider the lactate as an absolute predictor of poor outcome even in situations in which the high blood lactate level is caused by the hyper-activation of the glycolytic pathway leading to stressful situations. Moreover, Creagh-Brown and coworkers observed that, when restricting the analysis to patients with lactate peak levels within the reference range (0.1–2 mmol/L), lactate still remained an independent predictor of in-hospital mortality. This finding confirms previous observations in septic shock patients (14) and suggests mortality is proportional to the level of blood lactate without a clear safe threshold (15,16). Figure 1 Possible behavior and causes of the lactic acid plasma level in the postoperative patient admitted in ICU after major surgery. The lactacidemia is divided in three groups at the admission in ICU: inferior to 2 mmol/L; between 2 and 5 mmol/L and superior ... In substance blood lactate level remains only a partially understood biomarker, for sure it would be able to reveal much more than a cellular oxygen deficit due to a shock condition. The mitochondrial enzymatic systems are responsible of the production of the lactic acid in the cells, lactacidemia is the result of the synthesis/clearance of the lactic acid, it follows that high blood lactate levels are always expression of adverse biochemical changes and, anaerobiosis due to a shock condition represents just one possible mechanism of these adverse biochemical changes. As we said, increased blood lactate levels are common in critically ill patients. Although hyperlactacidemia is frequently used to diagnose inadequate tissue oxygenation, other processes not related to tissue oxygenation may increase lactate levels. Especially in critically ill patients, for instance increased glycolysis may be an important cause of hyperlactatemia (Figure 1). In conclusion, many variables measured in critically ill patients have been used to estimate severity of disease, prognosticate morbidity and mortality, evaluate costs of treatment, indicate specific treatment, and finally monitoring the adequacy of treatment and its timing. To understand the importance of an increased lactate level, it is crucial not only to consider anaerobic production but also aerobic mechanisms and changes in lactate clearance. Despite this complex evaluation, increased lactate levels usually reflect increased morbidity and high mortality. We believe lactate monitoring is a valuable tool in critically ill patients but we need further studies to systematize the use of this parameter with an unfulfilled potential.

Published
2016

11. Pain Management in Pediatric Surgery: New Horizons

Author

Giovanna Riccipetitoni, Lorenzo Cobianchi, Dario Bugada, Claudia Filisetti, Manuela De Gregori, and Massimo Allegri

Subjects
medicine.medical_specialty, New horizons, business.industry, Postoperative pain, Alternative medicine, Surgical procedures, Pain management, Surgery, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Pediatric surgery, Medicine, business, Intensive care medicine, 030217 neurology & neurosurgery
Abstract

The pain management in pediatric surgery is a very complex and relevant problem with many clinical implications. Pain in children requires special considerations due to physical and psychological immaturity. The enhancement in pain management results in a reduction of recovery time and complications. Few studies are available in the literature focused on postoperative pain and analgesia requirements in children following surgical procedures. In the present brief review we summarize the current strategies of pain management in pediatric surgery and we envision the new hypothetical horizons in this field.

Published
2016
Full Text
View/download PDF

12. Ventriculoperitoneal shunt and the need to remove a gallbladder: Time to definitely overcome the feeling that laparoscopic surgery is contraindicated

Author

Paolo Dionigi, Claudia Filisetti, Mario Alessiani, Tommaso Dominioni, Lorenzo Cobianchi, Sandro Zonta, and Marcello Maestri

Subjects
Laparoscopic surgery, medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Gallbladder, Case Report, General Medicine, Miniinvasive surgery, Surgery, Shunt (medical), Catheter, medicine.anatomical_structure, medicine, Entriculoperitoneal shunt, In patient, business, Laparoscopy, Contraindication, Laparoscopic cholecystectomy
Abstract

Since Baskin et al. reported the first documented case of failure of a laparoscopically-induced ventriculoperitoneal shunt (VP) in 1998, the cerebrospinal fluid shunt has been generally considered a relative contraindication to laparoscopy. Although the literature is limited there is a small body of evidence indicating that it is safe to perform laparoscopic surgery on these patients with routine anaesthetic monitoring. In this study we report the case of a laparoscopic cholecystectomy in the presence of a ventriculoperitoneal shunt. A review of the literature suggests that laparoscopic cholecystectomy can be safely performed in patients with a ventriculoperitoneal shunt. The only related contraindication should be if a catheter has recently been placed.

Published
2014
Full Text
View/download PDF

14. The challenge of extraabdominal desmoid tumour management in patients with Gardner's syndrome: radiofrequency ablation, a promising option

Author

Claudia Filisetti, Paolo Dionigi, Francesca Torello Viera, Barbara Siri, Edoardo Segalini, Mario Alessiani, Valentina Ravetta, Tommaso Dominioni, Lorenzo Cobianchi, Sandro Rossi, and Marcello Maestri

Subjects
Adult, Male, medicine.medical_specialty, Radiofrequency ablation, medicine.medical_treatment, Case Report, Desmoid tumours, law.invention, Familial adenomatous polyposis, Abdominal wall, Gardner Syndrome, law, Medicine, Humans, Colectomy, Gardner’s syndrome, business.industry, Fibromatosis, Disease Management, medicine.disease, Prognosis, Surgery, Gardner's syndrome, body regions, Fibromatosis, Aggressive, medicine.anatomical_structure, Oncology, Catheter Ablation, business, Thoracic wall
Abstract

Desmoid tumours are benign, myofibroblastic stromal neoplasms common in Gardner’s syndrome, which is a subtype of familial adenomatous polyposis characterized by colonic polyps, osteomas, thyroid cancer, epidermoid cysts, fibromas and sebaceous cysts. The primary treatment is surgery, followed by adjuvant radiotherapy, but the local recurrence rate is high, and wide resection can result in debilitating loss of function. We report the case of a 39-year-old man with Gardner’s syndrome who had already undergone a total prophylactic colectomy. He developed desmoid tumours localized in the mesenteric root, abdominal wall and dorsal region, which were treated from 2003 through 2013 with several surgical procedures and percutaneous radiofrequency ablation. In 2008 and 2013, RFA was applied under ultrasonographic guidance to two desmoid tumours localized in the dorsal thoracic wall. The outcomes were low-grade pain and one case of superficial skin necrosis, but so far there has been no recurrence of desmoid tumours in these locations. Surgical resection remains the first-line therapy for patients with desmoid tumours, but wide resection may lead to a poor quality of life. Radiofrequency ablation is less invasive and expensive and is a possible therapeutic option for desmoid tumours in patients with Gardner’s syndrome.

Published
2014

15. Pulmonary Malformations: Predictors of Neonatal Respiratory Distress and Early Surgery

Author

Claudio Vella, P. Fontana, Mariangela Rustico, Salvatore Zirpoli, Marcello Napolitano, Claudia Filisetti, Sara Costanzo, Giovanna Riccipetitoni, and Gianluca Lista

Subjects
Pediatrics, medicine.medical_specialty, Prenatal diagnosis, lcsh:Surgery, Asymptomatic, 03 medical and health sciences, Early surgery, 0302 clinical medicine, 030225 pediatrics, medicine, Pulmonary malformations, CPAM volume ratio, Fetal therapy, Fetus, Respiratory distress, business.industry, lcsh:RJ1-570, Congenital pulmonary airway malformation, lcsh:Pediatrics, lcsh:RD1-811, medicine.disease, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Original Article, Surgery, Neonatal resuscitation, medicine.symptom, business
Abstract

Objectives: The objective of our study is to retrospectively analyze a single-centre series of antenatally detected pulmonary malformations (PM) and to evaluate their postnatal outcome. Materials and Methods: We retrospectively reviewed all prenatally diagnosed PM patients referred to our Centre in the period between January 1999 and December 2014. All cases were diagnosed by one of our Maternal-Fetal Specialists by US examination. Congenital pulmonary airway malformation (CPAM) volume ratio (CVR), development of fetal complications, need for fetal therapy, need for neonatal resuscitation and timing of surgery were analyzed. Results: A total of 70 fetuses were diagnosed with a PM in the period of study. An initial CVR higher than 1.6 was found in 16/70 patients (22.8%); 14/16 developed fetal complications (p less than .0001). Fifty-six fetuses (80%) did not develop any complications during pregnancy. To all complicated cases a prenatal treatment was offered, carried out in 12 (1 termination, 1 refusal). Survival rate was 100%. Sixty-three fetuses (90%) were asymptomatic at birth and did not require any neonatal resuscitation. Six patients submitted to fetal therapy and one untreated presented with neonatal respiratory distress, required mechanical ventilation at birth and early surgery in the neonatal period (7/70, 10%). Conclusion: CVR > 1.6 and the presence of fetal complications can be considered as predictors of respiratory distress at birth and of the need for early surgery. Nevertheless, the vast majority of PM are asymptomatic at birth and only a small group of fetuses require prenatal and postnatal treatment and support.

Published
2016
Full Text
View/download PDF

17. Experimental small bowel transplantation from non-heart-beating donors: a large-animal study

Author

E. Vicini, Tommaso Dominioni, Sandro Zonta, M. De Martino, Patrizia Morbini, Paolo Dionigi, Ivan Botrugno, Mario Alessiani, Lorenzo Cobianchi, A. Bottazzi, R. Ciccocioppo, M. Mazzilli, J. Viganò, and Claudia Filisetti

Subjects
Homologous, medicine.medical_specialty, Brain Death, Time Factors, Swine, medicine.medical_treatment, Liver transplantation, Small, Intestinal mucosa, Ischemia, Models, Laparotomy, Intestine, Small, medicine, Living Donors, Transplantation, Homologous, Animals, Intestinal Mucosa, Body Weight, Graft Survival, Heart Arrest, Immunosuppressive Agents, Models, Animal, Potassium, Tissue Donors, Xylose, Kidney, Transplantation, business.industry, Animal, Immunosuppression, Tacrolimus, Surgery, Intestine, medicine.anatomical_structure, business, Perfusion
Abstract

Introduction The shortage of organs in the last 20 years is stimulating the development of new strategies to expand the pool of donors. The harvesting of a graft from non–heart-beating donors (NHBDs) has been successfully proposed for kidney and liver transplantation. To our knowledge, no studies are available for small bowel transplantation using NHBDs. In an experimental setting of small bowel transplantation, we studied the feasibility of using intestinal grafts retrieved from NHBDs. Materials and Methods Twenty five Large White piglets underwent total orthotopic small bowel transplantation and were randomly divided as follow: NHBD group (n = 15) received grafts from NHBDs; heart-beating donor (HBD) group (n = 10) received grafts from HBDs. The NHBD pigs were sacrificed inducing the cardiac arrest by a lethal potassium injection. After 20 minutes (no touch period = warm ischemia), they underwent cardiac massage, laparotomy, and aorta cannulation for flushing and cooling the abdominal organs. In HBDs, the cardiac arrest was induced at the time of organ cold perfusion. In both groups, immunosuppression was based on tacrolimus oral monotherapy. The animals were observed for 30 days. The graft absorptive function was studied at day 30 using the D-xylose absorption test. Histological investigation included HE (Hematoxilin and Eosin) microscopical analysis and immunohistological staining. Results Animals in the NHBD group died due to infection (n = 3), acute cellular rejection (n = 2), technical complications (n = 2), and intestinal failure (n = 8). In the HBD group, all animals but two were alive at the end of the study. The D-xylose absorption was significantly lower among the NHBD compared with the HBD group (P Conclusions This study confirmed that intestinal mucosa is sensitive to ischemic injury. When the intestinal graft is harvested from NHBDs, the infectious-related mortality was higher and the absorptive function lower. Histological examination confirmed a higher grade of ischemic injury in the NHBD grafts that correlated with the clinical data. Therefore, this experimental study suggested that non–heart-beating donation may not be indicated for small bowel transplantation.

Published
2009

18. Prolonged survival with FK778 (malononitrilamide) monotherapy after small bowel transplantation: a large animal study

Author

E. Vicini, Paolo Dionigi, M. Scaglione, M. De Martino, Sandro Zonta, Claudia Filisetti, Tommaso Dominioni, Patrizia Morbini, A. Biroli, J. Viganò, M. Bardone, C. Villa, Mario Alessiani, A. Bottazzi, and M. Doni

Subjects
medicine.medical_specialty, Swine, medicine.medical_treatment, Peritonitis, Gastroenterology, Sepsis, Postoperative Complications, Adjuvants, Immunologic, Internal medicine, Cause of Death, Intestine, Small, Nitriles, medicine, Animals, Transplantation, Homologous, Leflunomide, Transplantation, business.industry, Immunosuppression, Bacterial Infections, Isoxazoles, medicine.disease, Survival Analysis, Tacrolimus, Surgery, Pneumonia, Alkynes, Models, Animal, business, Complication, medicine.drug
Abstract

Malononitrilamide 715 (FK778) is a new class of immunosuppressant, derived from the active metabolite of leflunomide A77 1726. We investigated the efficacy of two different immunosuppressive induction protocols with tacrolimus plus FK778 followed by FK778 monotherapy. In a swine model of small bowel transplantation, we observed three groups, divided by different therapy regimens: group 1 (n = 5): no immunosuppressant (control group); group 2 (n = 10): oral tacrolimus (from postoperative day [POD] 0 to 30) and FK778 (from POD 0 to 60); group 3 (n = 8): oral tacrolimus, as group 2, and FK778 (from POD 7 to POD 60). Median survival was 11, 60, and 21 days in groups 1, 2, and 3, respectively. In group 1 all animals died of acute rejection; in group 2 the causes of death were technical complication (n = 1) and sepsis (n = 1); in group 3, one animal died from obstruction, two from pneumonia, one from peritonitis, one from sepsis. Group 2 accounted for 0.5 infection episode/animal versus 0.62 in group 3 (P < .05). Acute rejection was absent or mild in 66% and 75% of group 3 and 2 biopsies, respectively (P < .05). The D-xylose absorption curves from groups 2 and 3 were similar to those of the nontransplanted healthy animals. In conclusion, FK778 monotherapy after a consistent induction period with tacrolimus combined immunosuppression is able to extend survival and preserve optimal absorptive capacity of the small bowel allograft in our pig model. The association of tacrolimus and FK778 from day 1, compared to the delayed administration of FK778 from day 7, results in a significant reduction of infections and postoperative complications.

Published
2007

19. Erratum

Author

C. Villa, Patrizia Morbini, A. Biroli, E. Vicini, M. De Martino, A. Bottazzi, Claudia Filisetti, M. Doni, Tommaso Dominioni, M. Bardone, Paolo Dionigi, M. F. Scaglioni, J. Viganò, Mario Alessiani, and Sandro Zonta

Subjects
Transplantation, medicine.medical_specialty, business.industry, medicine, Physiology, Surgery, business, Large animal
Published
2014
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results