Search

Your search keyword '"Elena Belloni"' showing total 15 results
Start Over Author "Elena Belloni" Publication Year Range Last 3 years
15 results on '"Elena Belloni"'

1. PIK3CA mutation analysis in circulating tumor cells of patients with hormone receptor positive metastatic breast cancer

Author

Elena Marino, Cristian Mauro, Elena Belloni, Marco Picozzi, Valentina Favalli, Maria Cristina Cassatella, Laura Zorzino, Luciano Giacò, Pier Giuseppe Pelicci, Massimo Barberis, Maria Teresa Sandri, and Loris Bernard

Subjects
Circulating tumor cells, (CTCs), Liquid biopsy, Next generation sequencing, (NGS), Biology (General), QH301-705.5, Biochemistry, QD415-436
Abstract

In metastatic breast cancer (MBC), blood is a source of circulating tumor cells (CTCs). CTCs may serve as a ‘‘real-time liquid biopsy” as they represent metastatic tumor genetics better than primary tumor. PIK3CA is one of the most important oncogenes in treatment-unresponsive breast cancers. The aim of this study was to detect PIK3CA mutations and hereditary cancer variants in CTCs from MBC patients. Forty-seven blood samples were obtained from 20 MBC patients from at least 1/3 consecutive time points. CTCs were quantified using the CellSearch system and isolated from 11/20 patients with ≥5/7.5 ml CTCs (14/47 blood samples) using the DEPArray system. DNA was extracted and amplified to perform Sanger sequencing on PIK3CA gene. Sequencing revealed a pathogenic PIK3CA mutation in 2/11 (18 %) cases. Subsequently, we evaluated a 26-target hereditary gene panel by Next Generation Sequencing and identified a concomitant pathogenic mutation in the TP53 gene in a patient with a PIK3CA mutation. No pathogenic germline variants were found. Our data support the conclusion that CTCs analysis may be used to identify mutations in patients to identify those more likely to metastasize.

Published
2024
Full Text
View/download PDF

2. Small non‐coding RNA profiling in patients with gastrointestinal cancer

Author

Alessio Molfino, Marc Beltrà, Maria Ida Amabile, Roberta Belli, Giovanni Birolo, Elena Belloni, Serena De Lucia, Lorena Garcia‐Castillo, Fabio Penna, Giovanni Imbimbo, Giuseppe Nigri, Barbara Pardini, Paola Costelli, and Maurizio Muscaritoli

Subjects
Biomarkers, Gastrointestinal cancer, miRNAs, Muscularity, piRNAs, Skeletal muscle, Diseases of the musculoskeletal system, RC925-935, Human anatomy, QM1-695
Abstract

Abstract Background Small non‐coding (snc)RNAs, including microRNAs and P‐element induced wimpy testis (PIWI)‐interacting‐RNAs (piRNAs), crucially regulate gene expression in both physiological and pathological conditions. In particular, some muscle‐specific microRNAs (myomiRs) have been involved in the pathogenesis of cancer‐induced muscle wasting. The aims of the present study were (i) to profile sncRNAs in both skeletal muscle and plasma of gastrointestinal cancer patients and (ii) to investigate the association among differentially expressed sncRNAs and the level of muscularity at body composition analysis. Methods Surgical patients with gastrointestinal cancer or benign disease were recruited. Blood samples and muscle biopsies (rectus abdominis) were collected during surgery. Low muscularity patients were those at the lowest tertile of skeletal muscle index (SMI; CT‐scan), whereas moderate/high muscularity patients were in the middle and highest SMI tertiles. SncRNAs in the muscle were assessed by RNAseq, circulating microRNAs were evaluated by qPCR. Results Cancer patients (n = 25; 13 females, 52%) showed a mean age of 71.6 ± 11.2 years, a median body weight loss of 4.2% and a mean BMI of 27.0 ± 3.2 kg/m2. Control group (n = 15; 9 females, 60%) showed a mean age 58.1 ± 13.9 years and a mean BMI of 28.0 ± 4.3 kg/m2. In cancer patients, the median L3‐SMI (cm2/m2) was 42.52 (34.42; 49.07). Males showed a median L3‐SMI of 46.08 (41.17–51.79) and females a median L3‐SMI of 40.77 (33.73–42.87). Moderate‐high and low muscularity groups included 17 and 8 patients, respectively. As for circulating microRNAs, miR‐21‐5p and miR‐133a‐3p were up‐regulated in patients compared with controls, whereas miR‐15b‐5p resulted down‐regulated in the same comparison (about 30% of control values). Sample clustering by muscularity and sex revealed increased miR‐133a‐3p and miR‐206 only in moderate‐high muscularity males. SncRNA profiling in the muscle identified 373 microRNAs and 190 piRNAs (72.5% and 18.7% of raw reads, respectively). As for microRNAs, 10 were up‐regulated, and 56 were down‐regulated in cancer patients versus controls. Among the 24 dysregulated piRNAs, the majority were down‐regulated, including the top two most expressed piRNAs in the muscle (piR‐12790 and piR‐2106). Network analysis on validated mRNA targets of down‐regulated microRNAs revealed miR‐15b‐5p, miR‐106a‐5p and miR‐106b‐5p as main interactors of genes related to ubiquitin ligase/transferase activities. Conclusions These results show dysregulation of both muscle microRNAs and piRNAs in cancer patients compared with controls, the former following a sex‐specific pattern. Changes in circulating microRNAs are associated with the degree of muscularity rather than body weight loss.

Published
2023
Full Text
View/download PDF

3. miRNome profiling of lung cancer metastases revealed a key role for miRNA-PD-L1 axis in the modulation of chemotherapy response

Author

Roberto Cuttano, Tommaso Colangelo, Juliana Guarize, Elisa Dama, Maria Pia Cocomazzi, Francesco Mazzarelli, Valentina Melocchi, Orazio Palumbo, Elena Marino, Elena Belloni, Francesca Montani, Manuela Vecchi, Massimo Barberis, Paolo Graziano, Andrea Pasquier, Julian Sanz-Ortega, Luis M. Montuenga, Cristiano Carbonelli, Lorenzo Spaggiari, and Fabrizio Bianchi

Subjects
Lung cancer, NSCLC, microRNA, Gene expression, Chemotherapy, PD-L1, Diseases of the blood and blood-forming organs, RC633-647.5, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Locally advanced non-small cell lung cancer (NSCLC) is frequent at diagnosis and requires multimodal treatment approaches. Neoadjuvant chemotherapy (NACT) followed by surgery is the treatment of choice for operable locally advanced NSCLC (Stage IIIA). However, the majority of patients are NACT-resistant and show persistent lymph nodal metastases (LNmets) and an adverse outcome. Therefore, the identification of mechanisms and biomarkers of NACT resistance is paramount for ameliorating the prognosis of patients with Stage IIIA NSCLC. Here, we investigated the miRNome and transcriptome of chemo-naïve LNmets collected from patients with Stage IIIA NSCLC (N = 64). We found that a microRNA signature accurately predicts NACT response. Mechanistically, we discovered a miR-455-5p/PD-L1 regulatory axis which drives chemotherapy resistance, hallmarks metastases with active IFN-γ response pathway (an inducer of PD-L1 expression), and impacts T cells viability and relative abundances in tumor microenvironment (TME). Our data provide new biomarkers to predict NACT response and add molecular insights relevant for improving the management of patients with locally advanced NSCLC.

Published
2022
Full Text
View/download PDF

4. Patient-Reported Outcomes and Return to Intended Oncologic Therapy After Colorectal Enhanced Recovery Pathway

Author

The Italian ColoRectal Anastomotic Leakage (iCral3) study group, Marco Catarci, MD, FACS, Giacomo Ruffo, MD, Massimo Giuseppe Viola, MD, Ferdinando Ficari, MD, Paolo Delrio, MD, Felice Pirozzi, MD, Felice Borghi, MD, Raffaele De Luca, MD, Alberto Patriti, MD, Gianluca Garulli, MD, Walter Siquini, MD, Stefano D’Ugo, MD, PhD, FEBS, FACS, Stefano Scabini, MD, Marco Caricato, MD, FACS, Giusto Pignata, MD, Andrea Liverani, MD, Roberto Campagnacci, MD, Pierluigi Marini, MD, Ugo Elmore, MD, Francesco Corcione, MD, Roberto Santoro, MD, Massimo Carlini, MD, FACS, Antonio Giuliani, MD, Mario Sorrentino, MD, Giovanni Ferrari, MD, Gianandrea Baldazzi, MD, Alberto Di Leo, MD, Augusto Verzelli, MD, Giuseppe Sica, MD, Stefano Rausei, MD, Davide Cavaliere, MD, Gian Luca Baiocchi, MD, FACS, Marco Milone, MD, Giovanni Ciaccio, MD, Giovanni Domenico Tebala, MD, FACS, FRCS, Marco Scatizzi, MD, Luigi Boni, MD, FACS, Stefano Mancini, MD, Mario Guerrieri, MD, Roberto Persiani, MD, Andrea Lucchi, MD, FACS, Dario Parini, MD, Antonino Spinelli, MD, Michele Genna, MD, Vincenzo Bottino, MD, Andrea Coratti, MD, Dario Scala, MD, Andrea Muratore, MD, Maurizio Pavanello, MD, Umberto Rivolta, MD, Micaela Piccoli, MD, FACS, Carlo Talarico, MD, Alessandro Carrara, MD, Stefano Guadagni, MD, Mauro Totis, MD, Franco Roviello, MD, Alessandro Anastasi, MD, Gianluca Guercioni, MD, Giuseppe Maria Ettorre, MD, Mauro Montuori, MD, Pierpaolo Mariani, MD, Nicolò de Manzini, MD, Annibale Donini, MD, Mariano Fortunato Armellino, MD, Lucio Taglietti, MD, Gabriele Anania, MD, Mariantonietta Di Cosmo, MD, Carlo Vittorio Feo, MD, Paolo Millo, MD, Corrado Pedrazzani, MD, Silvio Guerriero, MD, Andrea Costanzi, MD, Nereo Vettoretto, MD, Federico Marchesi, MD, Massimo Basti, MD, Graziano Longo, MD, Moreno Cicetti, MD, Paolo Ciano, MD, Michele Benedetti, MD, Leonardo Antonio Montemurro, MD, Maria Sole Mattei, MD, Elena Belloni, MD, Elisa Bertocchi, MD, Gaia Masini, MD, Amedeo Altamura, MD, Francesco Rubichi, MD, Francesco Giudici, MD, Fabio Cianchi, MD, Gabriele Baldini, MD, Ugo Pace, MD, Andrea Fares Bucci, MD, Antonio Sciuto, MD, Desirée Cianflocca, MD, Marco Migliore, MD, Michele Simone, MD, Marcella Lodovica Ricci, MD, Francesco Monari, MD, Alessandro Cardinali, MD, Massimo Sartelli, MD, Marcello Spampinato, MD, PhD, FEBS (HPB), Alessandra Aprile, MD, Domenico Soriero, MD, Gabriella Teresa Capolupo, MD, FACS, Jacopo Andreuccetti, MD, Ilaria Canfora, MD, Andrea Scarinci, MD, Angela Maurizi, MD, Grazia Maria Attinà, MD, Giulia Maggi, MD, Umberto Bracale, MD, Roberto Peltrini, MD, Pietro Amodio, MD, Domenico Spoletini, MD, PhD, FACS, Rosa Marcellinaro, MD, Giovanni Del Vecchio, MD, Massimo Stefanoni, MD, Carmelo Magistro, MD, Diletta Cassini, MD, Lorenzo Crepaz, MD, Andrea Budassi, MD, Bruno Sensi, MD, Silvia Tenconi, MD, Leonardo Solaini, MD, Giorgio Ercolani, MD, Sarah Molfino, MD, Giovanni Domenico De Palma, MD, Paolo Locurto, MD, Antonio Di Cintio, MD, Lorenzo Pandolfini, MD, Alessandro Falsetto, MD, Elisa Cassinotti, MD, Andrea Sagnotta, MD, PhD, Monica Ortenzi, MD, Alberto Biondi, MD, Giacomo Martorelli, MD, Maurizio De Luca, MD, Francesco Carrano, MD, Annalisa Maroli, PhD, Francesca Fior, MD, Antonio Ferronetti, MD, Giuseppe Giuliani, MD, Roberto Benigni, MD, Graziella Marino, MD, Patrizia Marsanic, MD, Nicoletta Sveva Pipitone Federico, MD, Carlo Di Marco, MD, Camillo Leonardo Bertoglio, MD, PhD, Francesca Pecchini, MD, Vincenzo Greco, MD, Michele Motter, MD, Giuseppe Tirone, MD, Marco Clementi, MD, Nicolò Tamini, MD, Riccardo Piagnerelli, MD, Giuseppe Canonico, MD, Simone Cicconi, MD, Marco Colasanti, MD, Enrico Pinotti, MD, Roberta Carminati, MD, Edoardo Osenda, MD, Luigina Graziosi, MD, Ciro De Martino, MD, Giovanna Ioia, MD, Arianna Birindelli, MD, Matteo Chiozza, MD, Daniele Zigiotto, MD, Fioralba Pindozzi, MD, Manuela Grivon, MD, Cristian Conti, MD, Lorenzo Organetti, MD, Michela Monteleone, MD, Emanuele Botteri, MD, Giorgio Dalmonte, MD, Diletta Frazzini, MD, Simone Santoni, MD, Gabriele La Gioia, MD, and Diana Giannarelli, MS, PhD

Subjects
Surgery, RD1-811
Abstract

Objective:. To evaluate the influence of enhanced recovery pathway (ERP) on patient-reported outcome measures (PROMs) and return to intended oncologic therapy (RIOT) after colorectal surgery. Background:. ERP improves early outcomes after colorectal surgery; however, little is known about its influence on PROMs and on RIOT. Methods:. Prospective multicenter enrollment of patients who underwent colorectal resection with anastomosis was performed, recording variables related to patient-, institution-, procedure-level data, adherence to the ERP, and outcomes. The primary endpoints were PROMs (administered before surgery, at discharge, and 6 to 8 weeks after surgery) and RIOT after surgery for malignancy, defined as the intended oncologic treatment according to national guidelines and disease stage, administered within 8 weeks from the index operation, evaluated through multivariate regression models. Results:. The study included 4529 patients, analyzed for PROMs, 1467 of which were analyzed for RIOT. Compared to their baseline preoperative values, all PROMs showed significant worsening at discharge and improvement at late evaluation. PROMs values at discharge and 6 to 8 weeks after surgery, adjusted through a generalized mixed regression model according to preoperative status and other variables, showed no association with ERP adherence rates. RIOT rates (overall 54.5%) were independently lower by aged > 69 years, ASA Class III, open surgery, and presence of major morbidity; conversely, they were independently higher after surgery performed in an institutional ERP center and by ERP adherence rates > median (69.2%). Conclusions:. Adherence to the ERP had no effect on PROMs, whereas it independently influenced RIOT rates after surgery for colorectal cancer.

Published
2023
Full Text
View/download PDF

5. Histomorphological and inflammatory changes of white adipose tissue in gastrointestinal cancer patients with and without cachexia

Author

Alessio Molfino, Raffaella Carletti, Giovanni Imbimbo, Maria Ida Amabile, Roberta Belli, Cira R.T. diGioia, Elena Belloni, Francesco Spinelli, Veronica Rizzo, Carlo Catalano, Giuseppe Nigri, and Maurizio Muscaritoli

Subjects
Cachexia, Cancer, Adipose tissue, Fibrosis, Inflammation, Body composition, Diseases of the musculoskeletal system, RC925-935, Human anatomy, QM1-695
Abstract

Abstract Background During cancer cachexia, several alterations occur in peripheral tissues, and the adipose tissue may be involved during the catabolic state. We aimed at investigating histological rearrangement and infiltration of inflammatory cells in subcutaneous adipose tissue (SAT) of patients with cancer undergoing surgery, according to the presence/absence of cachexia. Methods We considered gastrointestinal cancer patients and controls with non‐malignant diseases undergoing surgery. We collected SAT samples and performed histomorphological analyses [cross‐sectional area (CSA) and per cent of fibrosis] and immunohistochemistry to characterize the inflammatory cells. By computed tomography (CT) scan, we calculated SAT and visceral adipose tissue (VAT). Results We enrolled 51 participants (31 gastrointestinal cancer patients and 20 controls). In cancer patients, cachexia was present in 13/31 (42%). The CSA (μm2) of the adipocytes from SAT was reduced in cancer patients vs. controls (3148, inter‐quartile range 2574–3755 vs. 4474, inter‐quartile range 3654–5183) (P

Published
2022
Full Text
View/download PDF

6. Odontogenic-Like Pain in Partial Edentulism: An Unusual Presentation of Diffuse Large B-Cell Lymphoma of the Mandible

Author

Roberta Catania, Elena Belloni, Lorenzo Preda, Chandra Bortolotto, Paola Scagnelli, and Fabrizio Calliada

Subjects
computed tomography, diffuse large B-cell lymphoma, magnetic resonance, mandible, orthopantomography, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Primary bone lymphoma is a rare entity and it usually occurs in long bones. Primary mandibular involvement is very rare, and it usually shows unspecific features, mimicking odontogenic inflammatory lesions. We present the unusual case of a diffuse large B-cell lymphoma (DLBCL) of the right mandibular body in a 91-year-old woman, who presented with acute pain in the mandibular region initially suspicious for odontogenic abscess. No significant findings were seen on orthopantomography (OPG) and her almost complete edentulism made the diagnosis of abscess unlikely. Computed tomography and magnetic resonance images showed an expansive mass around the right mandibular body with erosion of cortical bone and involving the right mandibular canal and nerve. Final diagnosis of DLBCL was pathologically proven. The presence of odontogenic-like pain in nearly complete edentulism should be suspicious for malignancy, and it needs further diagnostic workup despite the absence of signs on OPG.

Published
2021
Full Text
View/download PDF

7. Blunt Trauma Associated With Bilateral Diaphragmatic Rupture: A Case Report

Author

Marco Pace, Damiano Vallati, Elena Belloni, Marco Cavallini, Mohsen Ibrahim, Erino Angelo Rendina, and Giuseppe Nigri

Subjects
emergency surgery, blunt trauma, bilateral diaphragmatic rupture, COVID-19, repair of diaphragm, case report, Surgery, RD1-811
Abstract

Background: A bilateral diaphragmatic rupture is a rare event that occurs in cases of blunt thoracic-abdominal trauma.Case Presentation: We report the case of a 56-year-old female patient with pelvic fracture and second-stage bilateral rupture of the diaphragm due to a car accident. After a chest and abdominal contrast-enhanced computed tomography (CT) scan, the patient underwent emergency suturing of the left hemidiaphragm. On postoperative day (POD) 4, a CT scan performed due to the sudden onset of dyspnea revealed rupture of the right hemidiaphragm, which was not detected on the preoperative CT scan. On POD 9, the right hemidiaphragm was repaired with mesh during a right thoracotomy. The patient recovered 14 days after surgery. However, the postoperative course was complicated by an asymptomatic COVID-19 infection that significantly delayed her discharge from the hospital.Conclusions: Difficulties in preoperative diagnosis and treatment, together with the lack of data in the literature, make this type of trauma a challenge for all acute care and general surgeons.

Published
2021
Full Text
View/download PDF

8. The Role of Indocyanine Green Fluorescence in Rectal Cancer Robotic Surgery: A Narrative Review

Author

Elena Belloni, Edoardo Maria Muttillo, Salomone Di Saverio, Marcello Gasparrini, Antonio Brescia, and Giuseppe Nigri

Subjects
rectal cancer, robotic rectal cancer, fluorescence surgery, anastomotic leakage, robotic surgery, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background: In rectal cancer surgery, anastomotic leakage (AL) remains the most feared complication, with a frequency of up to 30% in non-high-volume centers. The preservation of proper vascularization is a key factor for successful anastomosis. The use of fluorescence with indocyanine green (ICG) as an intraoperative method to verify optimal perfusion is becoming an interesting tool in rectal surgery. Today, robotic surgery, together with the use of the intraoperative evaluation of the perfusion with ICG, could be a real strategy to deal with AL, allowing for a more delicate and less traumatic surgical technique. This strategy may allow for an extremely accurate surgery, and for optimal control of the proper vascularization of the rectum. Methods: The purpose of this descriptive review is to analyze the impact of fluorescence and robotic surgery on short-term surgical outcomes for rectal cancer. Results: We performed a systematic literature search using the PubMed, Embase and Cochrane library databases. The primary endpoints were to evaluate the application of ICG fluorescence in robotic rectal surgery and the rate of anastomotic leakage when using these technological implementations. The secondary endpoints were to evaluate the dosage of ICG and the timing of application by different surgeons. Conclusions: ICG fluorescence is an inexpensive and quick method to assess bowel perfusion, providing immediate feedback to the surgeon, even if its role has not been proven. A quantitative system must be systematically introduced to minimize the subjectiveness of the visualized image.

Published
2022
Full Text
View/download PDF

9. Evaluation of Browning Markers in Subcutaneous Adipose Tissue of Newly Diagnosed Gastrointestinal Cancer Patients with and without Cachexia

Author

Alessio Molfino, Roberta Belli, Giovanni Imbimbo, Raffaella Carletti, Maria Ida Amabile, Federica Tambaro, Cira R. T. di Gioia, Elena Belloni, Elisabetta Ferraro, Giuseppe Nigri, and Maurizio Muscaritoli

Subjects
cachexia, cancer, browning, subcutaneous adipose tissue, wasting, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

We assessed the molecular phenotype of the browning of white adipose tissue in newly diagnosed cancer patients and controls undergoing surgery for gastrointestinal tumors and for non-malignant diseases, respectively. We collected subcutaneous adipose tissue (SAT) samples and using RT-PCR, we analyzed the expression of markers of browning and using Western blot the protein levels of UCP1 and PGC1α. The Ucp1 mRNA levels were lower in cancer patients vs. controls (p = 0.01), whereas Cidea and Tmem26 mRNA levels were higher in cancer patients. We found higher PGC1α protein levels in patients vs. controls, while no differences were seen for UCP1. The Ucp1 expression was lower in cachectic and non-cachectic patients vs. controls, whereas Cidea expression was higher in cachectic and non-cachectic patients vs. controls. Pgc1α mRNA levels were higher in cachectic vs. non-cachectic patients (p = 0.03) vs. controls (p = 0.016). According to type of tumors, we did not observe differences in Cidea expression, whereas Pgc1α was higher in pancreatic cancer vs. colorectal and vs. controls. We observed the lower expression of Ucp1 in pancreatic and colorectal cancer vs. controls. We documented higher UCP1 protein levels in pancreatic cancer patients vs. colorectal (p = 0.002) and vs. controls (p = 0.031). PGC1α protein levels were higher in pancreatic cancer patients vs. controls. Different markers of the browning of SAT are modulated, and pancreatic cancer showed changes in UCP1 and PGC1α; PGC1α was highly expressed in cachectic patients, with clinical implications that should be further clarified.

Published
2022
Full Text
View/download PDF

10. Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

Author

Podda, Mauro, Pellino, Gianluca, Di Saverio, Salomone, Coccolini, Federico, Pacella, Daniela, Cioffi, Stefano Piero Bernardo, Virdis, Francesco, Balla, Andrea, Ielpo, Benedetto, Pata, Francesco, Poillucci, Gaetano, Ortenzi, Monica, Damaskos, Dimitrios, De Simone, Belinda, Sartelli, Massimo, Leppaniemi, Ari, Jayant, Kumar, Catena, Fausto, Giuliani, Antonio, Di Martino, Marcello, Pisanu, Adolfo, Chiara Gerardi, Stavros Gourgiotis, Cristiana Riboni, Alessio Giordano, Luca Ferrario, Vanni Agnoletti, Yoram Kruger, Damian Mole, Ferdinando Agresta, Mikel Prieto Calvo, Michael Wilson, Fiammetta Soggiu, Alaa Hamdan, Carlos Augusto Gomes, Gustavo Fraga, Argyrios Ioannidis, Zaza Demetrashvili, Saaz Sahani, Lovenish Bains, Almu'atasim Khamees, Hazim Ababneh, Osama Aljaiuossi, Samuel Pimentel, Ikhwan Sani Mohamad, Ahmad Ramzi Yusoff, Narcis Octavian Zarnescu, Valentin Calu, Andrey Litvin, Dusan Lesko, Ahmed Elmehrath, Mohamedraed Elshami, Martin de Santibañes, Justin Gundara, Kamel Alawadhi, Rashid Lui, Alexander Julianov, Sergio Ralon, Ibrahim-Umar Garzali, Gustavo M Machain, Ibabe Villalabeitia, Darwin Artidoro Quispe-Cruz, Abigail Cheska C Orantia, Maciej Walędziak, Tiago Correia de Sá, Syed Muhammad Ali, Bojan Kovacevic, Colin Noel, Haidar M Abdalah, Ali Kchaou, Arda Isik, Luca Ansaloni, Walter Biffl, Mario Guerrieri, Alberto Sartori, Manuel Abradelo, Giuseppe Nigri, Nicola Di Lorenzo, Andrea Mingoli, Massimo Chiarugi, Juliana Di Menno Stavron, Oscar Mazza, José Ignacio Valenzuela, Diana Alejandra Pantoja Pachajoa, Fernando Andrés Alvarez, Julian Ezequiel Liaño, Joan Tefay, Abdulrahman Alshaikh, Layla Hasan, Felipe Couto Gomes, Thiago R A Calderan, Elcio S Hirano, Dragomir Dardanov, Azize Saroglu, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, Shannon Melissa Chan, Hon-Ting Lok, Diego Salcedo, Diana Robayo, María Alejandra Triviño, Jan Manak, Jorann de Araujo, Ananya Sethi, Ahmed Awad, Merihan Elbadawy, Ahmed Farid, Asmaa Hanafy, Ahmed Nafea, Ghozy Sherief, Abbas Salah Alzhraa, Wafaa Abdelsalam, Sameh Emile, Ahmed Elfallal, Hossam Elfeki, Hosam Elghadban, Ashraf Shoma, Mohamed Shetiwy, Mohamed Elbahnasawy, Salem Mohamed, Emad Fawzi Hamed, Usama Ahmed Khalil, Elie Chouillard, Andrew Gumbs, Andrea Police, Andrea Mabilia, Kakhi Khutsishvili, Anano Tvaladze, Orestis Ioannidis, Elissavet Anestiadou, Lydia Loutzidou, Konstantinis Konstantinidis, Sofia Konstantinidou, Dimitrios Manatakis, Vasileios Acheimastos, Nikolaos Tasis, Nikolaos Michalopoulos, Panagiotis Kokoropoulos, Maria Papadoliopoulou, Maria Sotiropoulou, Stylianos Kapiris, Panagiotis Metaxas, Ioannis Tsouknidas, Despoina Kefili, George Petrakis, Eirini Synekidou, Konstantinos Dakis, Eirini Alexandridou, Aristeidis Papadopoulos, Christos Chouliaras, Odysseas Mouzakis, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Tania Triantafyllou, Dimitrios Theodorou, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Paraskevi Tourountzi, Efstratia Baili, Alexandros Charalabopoulos, Theodore Liakakos, Dimitrios Schizas, Alexandros Kozadinos, Athanasios Syllaios, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Spiros Delis, Christos Farazi-Chongouki, Evangelos Kalaitzakis, Miltiadis Giannarakis, Konstantinos Lasithiotakis, Giorgia Petra, Amit Gupta, Noushif Medappil, Vijayanand Muthukrishnan, Jubin Kamar, Pawan Lal, Rajendra Agarwal, Matteo Magnoli, Paolo Aonzo, Alberto Serventi, Pierpaolo Di Lascio, Margherita Pinto, Carlo Bergamini, Andrea Bottari, Laura Fortuna, Jacopo Martellucci, Atea Cicako, Claudio Miglietta, Mario Morino, Daniele Delogu, Andrea Picchetto, Marco Assenza, Giancarlo D'Ambrosio, Giulio Argenio, Mariano Fortunato Armellino, Giovanna Ioia, Savino Occhionorelli, Dario Andreotti, Lacavalla Domenico, Davide Luppi, Massimiliano Casadei, Luca Di Donato, Farshad Manoochehri, Tiziana Rita Lucia Marchese, William Sergi, Roberto Manca, Raimondo Murgia, Enrico Piras, Lorenzo Conti, Simone Gianazza, Andrea Rizzi, Edoardo Segalini, Marco Monti, Elena Iiritano, Nicolò Maria Mariani, Enrico De Nicola, Giovanna Scifo, Giusto Pignata, Jacopo Andreuccetti, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Alan Biloslavo, Paola Germani, Manuela Mastronardi, Selene Bogoni, Silvia Palmisano, Nicolo' De Manzini, Marco Vito Marino, Gennaro Martines, Giuseppe Trigiante, Elpiniki Lagouvardou, Gabriele Anania, Cristina Bombardini, Dario Oppici, Tiziana Pilia, Valentina Murzi, Emanuela Gessa, Umberto Bracale, Maria Michela Di Nuzzo, Roberto Peltrini, Francesco Salvetti, Jacopo Viganò, Gabriele Sganga, Valentina Bianchi, Pietro Fransvea, Tommaso Fontana, Giuliano Sarro, Vincenza Paola Dinuzzi, Luca Scaravilli, Mario Virgilio Papa, Elio Jovine, Giulia Ciabatti, Laura Mastrangelo, Matteo Rottoli, Claudio Ricci, Iris Shari Russo, Alberto Aiolfi, Davide Bona, Francesca Lombardo, Pasquale Cianci, Mariagrazia Sederino, Roberto Bini, Osvaldo Chiara, Stefano Cioffi, Stefano Cantafio, Guido Coretti, Edelweiss Licitra, Grazia Savino, Sergio Grimaldi, Raffaele Porfidia, Elisabetta Moggia, Mauro Garino, Chiara Marafante, Antonio Pesce, Nicolò Fabbri, Carlo Vittorio Feo, Ester Marra, Marina Troian, Davide Drigo, Carlo Nagliati, Andrea Muratore, Riccardo Danna, Alessandra Murgese, Michele Crespi, Claudio Guerci, Alice Frontali, Luca Ferrari, Francesco Favi, Erika Picariello, Alessia Rampini, Fabrizio D'Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Palmieri, Matteo Calì, Francesco Ferrara, Irnerio Angelo Muttillo, Edoardo Maria Muttillo, Biagio Picardi, Raffaele Galleano, Ali Badran, Omar Ghazouani, Maurizio Cervellera, Gaetano Campanella, Gennaro Papa, Annamaria Di Bella, Gennaro Perrone, Gabriele Luciano Petracca, Concetta Prioriello, Mario Giuffrida, Federico Cozzani, Matteo Rossini, Marco Inama, Giovanni Butturini, Gianluigi Moretto, Luca Morelli, Giulio Candio, Simone Guadagni, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Valerio Genovese, Nicola Cillara, Alessandro Cannavera, Antonello Deserra, Arcangelo Picciariello, Vincenzo Papagni, Leonardo Vincenti, Giulia Bagaglini, Giuseppe Sica, Pierfrancesco Lapolla, Gioia Brachini, Dario Bono, Antonella Nicotera, Marcello Zago, Fabrizio Sammartano, Laura Benuzzi, Marco Stella, Stefano Rossi, Alessandra Cerioli, Caterina Puccioni, Stefano Olmi, Carolina Rubicondo, Matteo Uccelli, Anna Guida, Pasquale Lepiane, Diego Sasia, Giorgio Giraudo, Sara Salomone, Elena Belloni, Alessandra Cossa, Francesco Lancellotti, Roberto Caronna, Piero Chirletti, Paolina Saullo, Raffaele Troiano, Felice Mucilli, Mirko Barone, Massimo Ippoliti, Michele Grande, Bruno Sensi, Leandro Siragusa, Andrea Santini, Isidoro Di Carlo, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Giuseppe Currò, Michele Ammendola, Iman Komaei, Giuseppe Navarra, Valeria Tonini, Lodovico Sartarelli, Marco Ceresoli, Stefano Perrone, Linda Roccamatisi, Paolo Millo, Riccardo Brachet Contul, Elisa Ponte, Matteo Zuin, Giuseppe Portale, Alice Sabrina Tonello, Geri Fratini, Matteo Bianchini, Bruno Perotti, Emanuele Doria, Elia Giuseppe Lunghi, Diego Visconti, Khayry Al-Shami, Sajeda Awadi, Mohammad Musallam Khalil Buwaitel, Mo'taz Fawzat Naief Naffa', Ahmad Samhouri, Hatem Sawalha, Mohd Firdaus Che Ani, Ida Nadiah Ahmed Fathil, Jih Huei, Jose-Luis Beristain-Hernandez, Alejandro Garcia-Meza, Rafael Sepulveda-Rdriguez, Edgard Efren Lozada Hernández, Camilo Levi Acuña Pinzón, Jefferson Nieves Condoy, Francisco C Becerra García, Mohammad Sadik, Bushra Kadir, Jalpa Devi, Nandlal Seerani, Zainab, Mohammad Sohail-Asghar, Ameer Afzal, Ali Akbar, Helmut Segovia Lohse, Herald Segovia Lohse, Zamiara Solange Leon Cabrera, Gaby Susana Yamamoto Seto, José Ríos Chiuyari, Jorge Ordemar, Martha Rodríguez, Abigail Cheska C Orantia-Carlos, Margie Antionette Quitoy, Andrzej Kwiatkowski, Maciej Mawlichanów, Mónica Rocha, Carlos Soares, Alexandru Rares Stoian, Andreea Diana Draghici, Valentin Titus Grigorean, Raluca Bievel Radulescu, Radu Virgil Costea, Eugenia Claudia Zarnescu, Mikhail Kurtenkov, George Gendrikson, Volovich Alla-Angelina, Tsurbanova Arina, Ayrat Kaldarov, Mahir Gachabayov, Abakar Abdullaev, Milica Milentijevic, Milovan Karamarkovic, Arpád Panyko, Jozef Radonak, Marek Soltes, Laura Álvarez Morán, Haydée Calvo García, Pilar Suárez Vega, Sergio Estevez, Fabio Ausania, Jordi Farguell, Carolina González-Abós, Santiago Sánchez-Cabús, Belén Martín, Víctor Molina, Luis Oms, Lucas Ilzarbe, Eva Pont Feijóo, Elena Sofia Perra, Noel Rojas-Bonet, Rafael Penalba-Palmí, Susana Pérez-Bru, Jaume Tur-Martínez, Andrea Álvarez-Torrado, Marta Domingo-Gonzalez, Javier Tejedor-Tejada, Yaiza García Del Alamo, Fernando Mendoza-Moreno, Francisca García-Moreno-Nisa, Belén Matías-García, Manuel Durán, Rafael Calleja-Lozano, José Manuel Perez de Villar, Luis Sánchez-Guillén, Iban Caravaca, Daniel Triguero-Cánovas, Antonio Carlos Maya Aparicio, Blas Durán Meléndez, Andrea Masiá Palacios, Aitor Landaluce-Olavarria, Mario De Francisco, Begoña Estraviz-Mateos, Felipe Alconchel, Tatiana Nicolás-López, Pablo Ramírez, Virginia Duran Muñoz-Cruzado, Felipe Parej Ciuró, Eduardo Perea Del Pozo, Sergio Olivares Pizarro, Vicente Herrera Cabrera, Jose Muros Bayo, Hytham K S Hamid, Raffaello Roesel, Alessandra Cristaudi, Kinan Abbas, Iyad Ali, Ahmed Tlili, Hüseyin Bayhan, Mehmet Akif Türkoğlu, Mustafa Yener Uzunoglu, Ibrahim Fethi Azamat, Nail Omarov, Derya Salim Uymaz, Fatih Altintoprak, Emrah Akin, Necattin First, Koray Das, Nazmi Ozer, Ahmet Seker, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Semra Demirli Atici, Murat Akalin, Bulent Calik, Elif Colak, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Victoria Hudson, Jean-Luc Duval, Mansoor Khan, Ahmed Saad, Mandeep Kaur, Alison Bradley, Katherine Fox, Ivan Tomasi, Daniel Beasley, Alekhya Kotta Prasanti, Pinky Kotecha, Husam Ebied, Michaela Paul, Hemant Sheth, Ioannis Gerogiannis, Mohannad Gaber, Zara Sheikh, Shatadru Seth, Maria Kunitsyna, Cosimo Alex Leo, Vittoria Bellato, Noman Zafar, Amr Elserafy, Giles Bond-Smith, Giovanni Tebala, Pawan Mathur, Izza Abid, Nnaemeka Chidumije, Pardip Sandhar, Syed Osama Zohaib Ullah, Tamara Lezama, Muhammad Hassan Anwaar, Conor Magee, Salma Ahmed, Brooke Davies, Jeyakumar Apollos, Kieran McCormack, Hasham Choudhary, Triantafyllos Doulias, Tamsin Morrison, Anna Palepa, Fernando Bonilla Cal, Lianet Sánchez, Fabiana Domínguez, Ibrahim Al-Raimi, Haneen Alshargabi, Abdullah Meead, Serge Chooklin, Serhii Chuklin, Andriy Bilyak, Institut Català de la Salut, [Podda M] Emergency Surgery Unit, Department of Surgical Science, Policlinico Universitario 'D. Casula', Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy. [Pellino G] Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy. Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Di Saverio S] Department of Surgery, 'Madonna del Soccorso' Hospital, San Benedetto del Tronto, Italy. [Coccolini F] General, Emergency and Trauma Surgery Unit, Pisa University Hospital, Pisa, Italy. [Pacella D] Department of Public Health, University of Naples Federico II, Naples, Italy. [Cioffi SPB] Trauma and Acute Care Surgery Unit, 'Niguarda Ca Granda' Hospital, Milan, Italy, Vall d'Hebron Barcelona Hospital Campus, Podda, Mauro, Pellino, Gianluca, Di Saverio, Salomone, Coccolini, Federico, Pacella, Daniela, Cioffi, Stefano Piero Bernardo, Virdis, Francesco, Balla, Andrea, Ielpo, Benedetto, Pata, Francesco, Poillucci, Gaetano, Ortenzi, Monica, Damaskos, Dimitrio, De Simone, Belinda, Sartelli, Massimo, Leppaniemi, Ari, Jayant, Kumar, Catena, Fausto, Giuliani, Antonio, Di Martino, Marcello, Pisanu, Adolfo, Chiara Gerardi, Stavros Gourgiotis, Cristiana Riboni, Alessio Giordano, Luca Ferrario, Vanni Agnoletti, Yoram Kruger, Damian Mole, Ferdinando Agresta, Mikel Prieto Calvo, Michael Wilson, Fiammetta Soggiu, Alaa Hamdan, Carlos Augusto Gomes, Gustavo Fraga, Argyrios Ioannidis, Zaza Demetrashvili, Saaz Sahani, Lovenish Bains, Almu'atasim Khamees, Hazim Ababneh, Osama Aljaiuossi, Samuel Pimentel, Ikhwan Sani Mohamad, Ahmad Ramzi Yusoff, Narcis Octavian Zarnescu, Valentin Calu, Andrey Litvin, Dusan Lesko, Ahmed Elmehrath, Mohamedraed Elshami, Martin de Santibañes, Justin Gundara, Kamel Alawadhi, Rashid Lui, Alexander Julianov, Sergio Ralon, Ibrahim-Umar Garzali, Gustavo M Machain, Ibabe Villalabeitia, Darwin Artidoro Quispe-Cruz, Abigail Cheska C Orantia, Maciej Walędziak, Tiago Correia de Sá, Syed Muhammad Ali, Bojan Kovacevic, Colin Noel, Haidar M Abdalah, Ali Kchaou, Arda Isik, Luca Ansaloni, Walter Biffl, Mario Guerrieri, Alberto Sartori, Manuel Abradelo, Giuseppe Nigri, Nicola Di Lorenzo, Andrea Mingoli, Massimo Chiarugi, Juliana Di Menno Stavron, Oscar Mazza, José Ignacio Valenzuela, Diana Alejandra Pantoja Pachajoa, Fernando Andrés Alvarez, Julian Ezequiel Liaño, Joan Tefay, Abdulrahman Alshaikh, Layla Hasan, Felipe Couto Gomes, Thiago R A Calderan, Elcio S Hirano, Dragomir Dardanov, Alexander Julianov, Azize Saroglu, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, Shannon Melissa Chan, Hon-Ting Lok, Diego Salcedo, Diana Robayo, María Alejandra Triviño, Jan Manak, Saaz Sahani, Jorann de Araujo, Ananya Sethi, Ahmed Awad, Merihan Elbadawy, Ahmed Farid, Asmaa Hanafy, Ahmed Nafea, Ghozy Sherief, Abbas Salah Alzhraa, Wafaa Abdelsalam, Sameh Emile, Ahmed Elfallal, Hossam Elfeki, Hosam Elghadban, Ashraf Shoma, Mohamed Shetiwy, Mohamed Elbahnasawy, Salem Mohamed, Emad Fawzi Hamed, Usama Ahmed Khalil, Elie Chouillard, Andrew Gumbs, Andrea Police, Andrea Mabilia, Kakhi Khutsishvili, Anano Tvaladze, Orestis Ioannidis, Elissavet Anestiadou, Lydia Loutzidou, Konstantinis Konstantinidis, Sofia Konstantinidou, Dimitrios Manatakis, Vasileios Acheimastos, Nikolaos Tasis, Nikolaos Michalopoulos, Panagiotis Kokoropoulos, Maria Papadoliopoulou, Maria Sotiropoulou, Stylianos Kapiris, Panagiotis Metaxas, Ioannis Tsouknidas, Despoina Kefili, George Petrakis, Eirini Synekidou, Konstantinos Dakis, Eirini Alexandridou, Aristeidis Papadopoulos, Christos Chouliaras, Odysseas Mouzakis, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Tania Triantafyllou, Dimitrios Theodorou, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Paraskevi Tourountzi, Efstratia Baili, Alexandros Charalabopoulos, Theodore Liakakos, Dimitrios Schizas, Alexandros Kozadinos, Athanasios Syllaios, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Spiros Delis, Christos Farazi-Chongouki, Evangelos Kalaitzakis, Miltiadis Giannarakis, Konstantinos Lasithiotakis, Giorgia Petra, Evangelos Kalaitzakis, Amit Gupta, Noushif Medappil, Vijayanand Muthukrishnan, Jubin Kamar, Pawan Lal, Rajendra Agarwal, Matteo Magnoli, Paolo Aonzo, Alberto Serventi, Pierpaolo Di Lascio, Margherita Pinto, Carlo Bergamini, Andrea Bottari, Laura Fortuna, Jacopo Martellucci, Atea Cicako, Claudio Miglietta, Mario Morino, Daniele Delogu, Andrea Picchetto, Marco Assenza, Giancarlo D'Ambrosio, Giulio Argenio, Mariano Fortunato Armellino, Giovanna Ioia, Savino Occhionorelli, Dario Andreotti, Lacavalla Domenico, Davide Luppi, Massimiliano Casadei, Luca Di Donato, Farshad Manoochehri, Tiziana Rita Lucia Marchese, William Sergi, Roberto Manca, Raimondo Murgia, Enrico Piras, Lorenzo Conti, Simone Gianazza, Andrea Rizzi, Edoardo Segalini, Marco Monti, Elena Iiritano, Nicolò Maria Mariani, Enrico De Nicola, Giovanna Scifo, Giusto Pignata, Jacopo Andreuccetti, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Alan Biloslavo, Paola Germani, Manuela Mastronardi, Selene Bogoni, Silvia Palmisano, Nicolo' De Manzini, Marco Vito Marino, Gennaro Martines, Giuseppe Trigiante, Elpiniki Lagouvardou, Gabriele Anania, Cristina Bombardini, Dario Oppici, Tiziana Pilia, Valentina Murzi, Emanuela Gessa, Umberto Bracale, Maria Michela Di Nuzzo, Roberto Peltrini, Francesco Salvetti, Jacopo Viganò, Gabriele Sganga, Valentina Bianchi, Pietro Fransvea, Tommaso Fontana, Giuliano Sarro, Vincenza Paola Dinuzzi, Luca Scaravilli, Mario Virgilio Papa, Elio Jovine, Giulia Ciabatti, Laura Mastrangelo, Matteo Rottoli, Claudio Ricci, Iris Shari Russo, Alberto Aiolfi, Davide Bona, Francesca Lombardo, Pasquale Cianci, Mariagrazia Sederino, Roberto Bini, Osvaldo Chiara, Stefano Cioffi, Stefano Cantafio, Guido Coretti, Edelweiss Licitra, Grazia Savino, Sergio Grimaldi, Raffaele Porfidia, Elisabetta Moggia, Mauro Garino, Chiara Marafante, Antonio Pesce, Nicolò Fabbri, Carlo Vittorio Feo, Ester Marra, Marina Troian, Davide Drigo, Carlo Nagliati, Andrea Muratore, Riccardo Danna, Alessandra Murgese, Michele Crespi, Claudio Guerci, Alice Frontali, Luca Ferrari, Claudio Guerci, Francesco Favi, Erika Picariello, Alessia Rampini, Fabrizio D'Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Palmieri, Matteo Calì, Francesco Ferrara, Irnerio Angelo Muttillo, Edoardo Maria Muttillo, Biagio Picardi, Raffaele Galleano, Ali Badran, Omar Ghazouani, Maurizio Cervellera, Gaetano Campanella, Gennaro Papa, Annamaria Di Bella, Gennaro Perrone, Gabriele Luciano Petracca, Concetta Prioriello, Mario Giuffrida, Federico Cozzani, Matteo Rossini, Marco Inama, Giovanni Butturini, Gianluigi Moretto, Luca Morelli, Giulio Candio, Simone Guadagni, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Valerio Genovese, Nicola Cillara, Alessandro Cannavera, Antonello Deserra, Arcangelo Picciariello, Vincenzo Papagni, Leonardo Vincenti, Giulia Bagaglini, Giuseppe Sica, Pierfrancesco Lapolla, Gioia Brachini, Dario Bono, Antonella Nicotera, Marcello Zago, Fabrizio Sammartano, Laura Benuzzi, Marco Stella, Stefano Rossi, Alessandra Cerioli, Caterina Puccioni, Stefano Olmi, Carolina Rubicondo, Matteo Uccelli, Anna Guida, Pasquale Lepiane, Diego Sasia, Giorgio Giraudo, Sara Salomone, Elena Belloni, Alessandra Cossa, Francesco Lancellotti, Roberto Caronna, Piero Chirletti, Paolina Saullo, Raffaele Troiano, Felice Mucilli, Mirko Barone, Massimo Ippoliti, Michele Grande, Bruno Sensi, Leandro Siragusa, Andrea Santini, Isidoro Di Carlo, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Giuseppe Currò, Michele Ammendola, Iman Komaei, Giuseppe Navarra, Valeria Tonini, Lodovico Sartarelli, Marco Ceresoli, Stefano Perrone, Linda Roccamatisi, Paolo Millo, Riccardo Brachet Contul, Elisa Ponte, Matteo Zuin, Giuseppe Portale, Alice Sabrina Tonello, Geri Fratini, Matteo Bianchini, Bruno Perotti, Emanuele Doria, Elia Giuseppe Lunghi, Diego Visconti, Khayry Al-Shami, Sajeda Awadi, Mohammad Musallam Khalil Buwaitel, Mo'taz Fawzat Naief Naffa', Ahmad Samhouri, Hatem Sawalha, Mohd Firdaus Che Ani, Ida Nadiah Ahmed Fathil, Jih Huei, Ikhwan Sani Mohamad, Jose-Luis Beristain-Hernandez, Alejandro Garcia-Meza, Rafael Sepulveda-Rdriguez, Edgard Efren Lozada Hernández, Camilo Levi Acuña Pinzón, Jefferson Nieves Condoy, Francisco C Becerra García, Mohammad Sadik, Bushra Kadir, Jalpa Devi, Nandlal Seerani, Zainab, Mohammad Sohail-Asghar, Ameer Afzal, Ali Akbar, Helmut Segovia Lohse, Herald Segovia Lohse, Zamiara Solange Leon Cabrera, Gaby Susana Yamamoto Seto, José Ríos Chiuyari, Jorge Ordemar, Martha Rodríguez, Abigail Cheska C Orantia-Carlos, Margie Antionette Quitoy, Andrzej Kwiatkowski, Maciej Mawlichanów, Mónica Rocha, Carlos Soares, Alexandru Rares Stoian, Andreea Diana Draghici, Valentin Titus Grigorean, Raluca Bievel Radulescu, Narcis Octavian Zarnescu, Radu Virgil Costea, Eugenia Claudia Zarnescu, Mikhail Kurtenkov, George Gendrikson, Volovich Alla-Angelina, Tsurbanova Arina, Ayrat Kaldarov, Ayrat Kaldarov, Mahir Gachabayov, Abakar Abdullaev, Milica Milentijevic, Milovan Karamarkovic, Arpád Panyko, Jozef Radonak, Marek Soltes, Laura Álvarez Morán, Haydée Calvo García, Pilar Suárez Vega, Sergio Estevez, Fabio Ausania, Jordi Farguell, Carolina González-Abós, Santiago Sánchez-Cabús, Belén Martín, Víctor Molina, Luis Oms, Lucas Ilzarbe, Eva Pont Feijóo, Elena Sofia Perra, Noel Rojas-Bonet, Rafael Penalba-Palmí, Susana Pérez-Bru, Jaume Tur-Martínez, Andrea Álvarez-Torrado, Marta Domingo-Gonzalez, Javier Tejedor-Tejada, Yaiza García Del Alamo, Fernando Mendoza-Moreno, Francisca García-Moreno-Nisa, Belén Matías-García, Manuel Durán, Rafael Calleja-Lozano, José Manuel Perez de Villar, Luis Sánchez-Guillén, Iban Caravaca, Daniel Triguero-Cánovas, Antonio Carlos Maya Aparicio, Blas Durán Meléndez, Andrea Masiá Palacios, Aitor Landaluce-Olavarria, Mario De Francisco, Begoña Estraviz-Mateos, Felipe Alconchel, Tatiana Nicolás-López, Pablo Ramírez, Virginia Duran Muñoz-Cruzado, Felipe Parej Ciuró, Eduardo Perea Del Pozo, Sergio Olivares Pizarro, Vicente Herrera Cabrera, Jose Muros Bayo, Hytham K S Hamid, Raffaello Roesel, Alessandra Cristaudi, Kinan Abbas, Iyad Ali, Ahmed Tlili, Hüseyin Bayhan, Mehmet Akif Türkoğlu, Mustafa Yener Uzunoglu, Ibrahim Fethi Azamat, Nail Omarov, Derya Salim Uymaz, Fatih Altintoprak, Emrah Akin, Necattin First, Koray Das, Nazmi Ozer, Ahmet Seker, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Semra Demirli Atici, Murat Akalin, Bulent Calik, Elif Colak, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Victoria Hudson, Jean-Luc Duval, Mansoor Khan, Ahmed Saad, Mandeep Kaur, Alison Bradley, Katherine Fox, Ivan Tomasi, Daniel Beasley, Alekhya Kotta Prasanti, Pinky Kotecha, Husam Ebied, Michaela Paul, Hemant Sheth, Ioannis Gerogiannis, Mohannad Gaber, Zara Sheikh, Shatadru Seth, Maria Kunitsyna, Cosimo Alex Leo, Vittoria Bellato, Noman Zafar, Amr Elserafy, Giles Bond-Smith, Giovanni Tebala, Pawan Mathur, Izza Abid, Nnaemeka Chidumije, Pardip Sandhar, Syed Osama Zohaib Ullah, Tamara Lezama, Muhammad Hassan Anwaar, Conor Magee, Salma Ahmed, Brooke Davies, Jeyakumar Apollos, Kieran McCormack, Hasham Choudhary, Triantafyllos Doulias, Tamsin Morrison, Anna Palepa, Fernando Bonilla Cal, Lianet Sánchez, Fabiana Domínguez, Ibrahim Al-Raimi, Haneen Alshargabi, Abdullah Meead, Serge Chooklin, Serhii Chuklin, Andriy Bilyak, HUS Abdominal Center, II kirurgian klinikka, Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di Martino, M, Pisanu, A, Gerardi, C, Gourgiotis, S, Riboni, C, Giordano, A, Ferrario, L, Agnoletti, V, Kruger, Y, Mole, D, Agresta, F, Prieto Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Villalabeitia, I, Quispe-Cruz, D, Orantia, A, Waledziak, M, de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Couto Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief, G, Salah Alzhraa, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Synekidou, E, Dakis, K, Alexandridou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, Germani, P, Mastronardi, M, Bogoni, S, Palmisano, S, De Manzini, N, Marino, M, Martines, G, Trigiante, G, Lagouvardou, E, Anania, G, Bombardini, C, Oppici, D, Pilia, T, Murzi, V, Gessa, E, Bracale, U, Di Nuzzo, M, Peltrini, R, Salvetti, F, Vigano, J, Sganga, G, Bianchi, V, Fransvea, P, Fontana, T, Sarro, G, Dinuzzi, V, Scaravilli, L, Papa, M, Jovine, E, Ciabatti, G, Mastrangelo, L, Rottoli, M, Ricci, C, Russo, I, Aiolfi, A, Bona, D, Lombardo, F, Cianci, P, Sederino, M, Bini, R, Chiara, O, Cantafio, S, Coretti, G, Licitra, E, Savino, G, Grimaldi, S, Porfidia, R, Moggia, E, Garino, M, Marafante, C, Pesce, A, Fabbri, N, Feo, C, Marra, E, Troian, M, Drigo, D, Nagliati, C, Muratore, A, Danna, R, Murgese, A, Crespi, M, Guerci, C, Frontali, A, Ferrari, L, Favi, F, Picariello, E, Rampini, A, D'Acapito, F, Ercolani, G, Solaini, L, Palmieri, F, Cali, M, Ferrara, F, Muttillo, I, Muttillo, E, Picardi, B, Galleano, R, Badran, A, Ghazouani, O, Cervellera, M, Campanella, G, Papa, G, Di Bella, A, Perrone, G, Petracca, G, Prioriello, C, Giuffrida, M, Cozzani, F, Rossini, M, Inama, M, Butturini, G, Moretto, G, Morelli, L, Candio, G, Guadagni, S, Cicuttin, E, Cremonini, C, Tartaglia, D, Genovese, V, Cillara, N, Cannavera, A, Deserra, A, Picciariello, A, Papagni, V, Vincenti, L, Bagaglini, G, Sica, G, Lapolla, P, Brachini, G, Bono, D, Nicotera, A, Zago, M, Sammartano, F, Benuzzi, L, Stella, M, Rossi, S, Cerioli, A, Puccioni, C, Olmi, S, Rubicondo, C, Uccelli, M, Guida, A, Lepiane, P, Sasia, D, Giraudo, G, Salomone, S, Belloni, E, Cossa, A, Lancellotti, F, Caronna, R, Chirletti, P, Saullo, P, Troiano, R, Mucilli, F, Barone, M, Ippoliti, M, Grande, M, Sensi, B, Siragusa, L, Santini, A, Di Carlo, I, Veroux, M, Gioco, R, Veroux, G, Curro, G, Ammendola, M, Komaei, I, Navarra, G, Tonini, V, Sartarelli, L, Ceresoli, M, Perrone, S, Roccamatisi, L, Millo, P, Brachet Contul, R, Ponte, E, Zuin, M, Portale, G, Tonello, A, Fratini, G, Bianchini, M, Perotti, B, Doria, E, Lunghi, E, Visconti, D, Al-Shami, K, Awadi, S, Buwaitel, M, Naffa', M, Samhouri, A, Sawalha, H, Ani, M, Fathil, I, Huei, J, Beristain-Hernandez, J, Garcia-Meza, A, Sepulveda-Rdriguez, R, Hernandez, E, Pinzon, C, Condoy, J, Garcia, F, Sadik, M, Kadir, B, Devi, J, Seerani, N, Zainab, Sohail-Asghar, M, Afzal, A, Akbar, A, Lohse, H, Cabrera, Z, Seto, G, Chiuyari, J, Ordemar, J, Rodriguez, M, Orantia-Carlos, A, Quitoy, M, Kwiatkowski, A, Mawlichanow, M, Rocha, M, Soares, C, Stoian, A, Draghici, A, Grigorean, V, Radulescu, R, Costea, R, Zarnescu, E, Kurtenkov, M, Gendrikson, G, Alla-Angelina, V, Arina, T, Kaldarov, A, Gachabayov, M, Abdullaev, A, Milentijevic, M, Karamarkovic, M, Panyko, A, Radonak, J, Soltes, M, Moran, L, Garcia, H, Vega, P, Estevez, S, Ausania, F, Farguell, J, Gonzalez-Abos, C, Sanchez-Cabus, S, Martin, B, Molina, V, Oms, L, Ilzarbe, L, Feijoo, E, Perra, E, Rojas-Bonet, N, Penalba-Palmi, R, Perez-Bru, S, Tur-Martinez, J, Alvarez-Torrado, A, Domingo-Gonzalez, M, Tejedor-Tejada, J, del Alamo, Y, Mendoza-Moreno, F, Garcia-Moreno-Nisa, F, Matias-Garcia, B, Duran, M, Calleja-Lozano, R, de Villar, J, Sanchez-Guillen, L, Caravaca, I, Triguero-Canovas, D, Aparicio, A, Melendez, B, Palacios, A, Landaluce-Olavarria, A, De Francisco, M, Estraviz-Mateos, B, Alconchel, F, Nicolas-Lopez, T, Ramirez, P, Munoz-Cruzado, V, Ciuro, F, del Pozo, E, Pizarro, S, Cabrera, V, Bayo, J, Hamid, H, Roesel, R, Cristaudi, A, Abbas, K, Ali, I, Tlili, A, Bayhan, H, Turkoglu, M, Uzunoglu, M, Azamat, I, Omarov, N, Uymaz, D, Altintoprak, F, Akin, E, First, N, Das, K, Ozer, N, Seker, A, Kara, Y, Bozkurt, M, Kocatas, A, Atici, S, Akalin, M, Calik, B, Colak, E, Altinel, Y, Meric, S, Aktimur, Y, Hudson, V, Duval, J, Khan, M, Saad, A, Kaur, M, Bradley, A, Fox, K, Tomasi, I, Beasley, D, Prasanti, A, Kotecha, P, Ebied, H, Paul, M, Sheth, H, Gerogiannis, I, Gaber, M, Sheikh, Z, Seth, S, Kunitsyna, M, Leo, C, Bellato, V, Zafar, N, Elserafy, A, Bond-smith, G, Tebala, G, Mathur, P, Abid, I, Chidumije, N, Sandhar, P, Ullah, S, Lezama, T, Anwaar, M, Magee, C, Ahmed, S, Davies, B, Apollos, J, Mccormack, K, Choudhary, H, Doulias, T, Morrison, T, Palepa, A, Cal, F, Sanchez, L, Dominguez, F, Al-Raimi, I, Alshargabi, H, Meead, A, Chooklin, S, Chuklin, S, Bilyak, A, MANCTRA-1 Collaborative, Group, Palmisano, Silvia, and de Manzini, Nicolo'

Subjects
Infected pancreatic necrosi, Digestive System Diseases::Pancreatic Diseases::Pancreatitis::Pancreatitis, Acute Necrotizing [DISEASES], Infected pancreatic necrosis, Pàncrees - Infecció, 3126 Surgery, anesthesiology, intensive care, radiology, enfermedades del sistema digestivo::enfermedades pancreáticas::pancreatitis::pancreatitis aguda necrotizante [ENFERMEDADES], técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Acute pancreatitis, infecciones bacterianas y micosis::infección::infecciones intraabdominales [ENFERMEDADES], Pancreatitis, International study, Organ failure, Surgery, Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Mortality, Acute pancreatiti, Pàncrees - Necrosi, Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [DISEASES]
Abstract

The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990). Graphical abstract

Published
2023

12. coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit

Author

Mauro Podda, Daniela Pacella, Gianluca Pellino, Federico Coccolini, Alessio Giordano, Salomone Di Saverio, Francesco Pata, Benedetto Ielpo, Francesco Virdis, Dimitrios Damaskos, Belinda De Simone, Ferdinando Agresta, Massimo Sartelli, Ari Leppaniemi, Cristiana Riboni, Vanni Agnoletti, Damian Mole, Yoram Kluger, Fausto Catena, Adolfo Pisanu, Chiara Gerardi, Salomone di Saverio, Dimitris Damaskos, Stavros Gourgiotis, Gaetano Poillucci, Kumar Jayant, Luca Ferrario, Mikel Prieto Calvo, Michael Wilson, Fiammetta Soggiu, Alaa Hamdan, Carlos Augusto Gomes, Gustavo Fraga, Argyrios Ioannidis, Zaza Demetrashvili, Saaz Sahani, Lovenish Bains, Almu'atasim Khamees, Hazim Ababneh, Osama Aljaiuossi, Samuel Pimentel, Ikhwan Sani Mohamad, Ahmad Ramzi Yusoff, Narcis Octavian Zarnescu, Valentin Calu, Andrey Litvin, Dusan Lesko, Ahmed Elmehrath, Mohamedraed Elshami, Martin de Santibañes, Justin Gundara, Kamel Alawadhi, Rashid Lui, Alexander Julianov, Sergio Ralon, Ibrahim-Umar Garzali, Gustavo M. Machain, Darwin Artidoro Quispe-Cruz, Abigail Cheska C. Orantia, Maciej Walędziak, Tiago Correia de Sá, Syed Muhammad Ali, Bojan Kovacevic, Colin Noel, Haidar M. Abdalah, Ali Kchaou, Arda Isik, Luca Ansaloni, Walter Biffl, Mario Guerrieri, Alberto Sartori, Manuel Abradelo, Giuseppe Nigri, Nicola Di Lorenzo, Andrea Mingoli, Massimo Chiarugi, Juliana Di Menno Stavron, Oscar Mazza, José Ignacio Valenzuela, Diana Alejandra Pantoja Pachajoa, Fernando Andrés Alvarez, Julian Ezequiel Liaño, Joan Tefay, Abdulrahman Alshaikh, Layla Hasan, Felipe Couto Gomes, Gustavo P. Fraga, Thiago R.A. Calderan, Elcio S. Hirano, Dragomir Dardanov, Azize Saroglu, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, Shannon Melissa Chan, Hon-Ting Lok, Diego Salcedo, Diana Robayo, María Alejandra Triviño, Jan Manak, Jorann de Araujo, Ananya Sethi, Ahmed Awad, Merihan Elbadawy, Ahmed Farid, Asmaa Hanafy, Ahmed Nafea, null Sherief-Ghozy, Alzhraa Salah – Abbas, Wafaa Abdelsalam, Sameh Emile, Ahmed Elfallal, Hossam Elfeki, Hosam Elghadban, Ashraf Shoma, Mohamed Shetiwy, Mohamed Elbahnasawy, Salem- Mohamed, Emad Fawzi Hamed, Usama Ahmed Khalil, Elie Chouillard, Andrew Gumbs, Andréa Police, Andrea Mabilia, Kakhi Khutsishvili, Anano Tvaladze, Orestis Ioannidis, Elissavet Anestiadou, Lydia Loutzidou, Konstantinis Konstantinidis, Sofia Konstantinidou, Dimitrios Manatakis, Vasileios Acheimastos, Nikolaos Tasis, Nikolaos Michalopoulos, Panagiotis Kokoropoulos, Maria Papadoliopoulou, Maria Sotiropoulou, Stylianos Kapiris, Panagiotis Metaxas, Ioannis Tsouknidas, Despoina Kefili, George Petrakis, Konstantinos Dakis, Eirini Alexandridou, Eirini Synekidou, Kostas Dakis, Aristeidis Papadopoulos, Christos Chouliaras, Odysseas Mouzakis, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Tania Triantafyllou, Dimitrios Theodorou, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Paraskevi Tourountzi, Efstratia Baili, Alexandros Charalabopoulos, Theodore Liakakos, Dimitrios Schizas, Alexandros Kozadinos, Athanasios Syllaios, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Spiros Delis, Christos Farazi-Chongouki, Evangelos Kalaitzakis, Miltiadis Giannarakis, Konstantinos Lasithiotakis, Giorgia Petra, Amit Gupta, Noushif Medappil, Vijayanand Muthukrishnan, Jubin Kamar, Pawan Lal, Rajendra Agarwal, Matteo Magnoli, Paolo Aonzo, Alberto Serventi, Antonio Giuliani, Pierpaolo Di Lascio, Margherita Pinto, Carlo Bergamini, Andrea Bottari, Laura Fortuna, Jacopo Martellucci, Atea Cicako, Claudio Miglietta, Mario Morino, Daniele Delogu, Andrea Picchetto, Marco Assenza, Giancarlo D'Ambrosio, Giulio Argenio, Mariano Fortunato Armellino, Giovanna Ioia, Savino Occhionorelli, Dario Andreotti, Lacavalla Domenico, Davide Luppi, Massimiliano Casadei, Luca Di Donato, Farshad Manoochehri, Tiziana Rita Lucia Marchese, William Sergi, Roberto Manca, Raimondo Murgia, Enrico Piras, Lorenzo Conti, Simone Gianazza, Andrea Rizzi, Edoardo Segalini, Marco Monti, Elena Iiritano, Nicolò Maria Mariani, Enrico De Nicola, Giovanna Scifo, Giusto Pignata, Jacopo Andreuccetti, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Alan Biloslavo, Paola Germani, Manuela Mastronardi, Selene Bogoni, Silvia Palmisano, Nicolo’ De Manzini, Marco Vito Marino, Gennaro Martines, Giuseppe Trigiante, Elpiniki Lagouvardou, Gabriele Anania, Cristina Bombardini, Dario Oppici, Tiziana Pilia, Valentina Murzi, Emanuela Gessa, Umberto Bracale, Maria Michela Di Nuzzo, Roberto Peltrini, Francesco Salvetti, Jacopo Viganò, Gabriele Sganga, Valentina Bianchi, Pietro Fransvea, Tommaso Fontana, Giuliano Sarro, Vincenza Paola Dinuzzi, Luca Scaravilli, Mario Virgilio Papa, Elio Jovine, Giulia Ciabatti, Laura Mastrangelo, Matteo Rottoli, Claudio Ricci, Iris Shari Russo, Alberto Aiolfi, Davide Bona, Francesca Lombardo, Pasquale Cianci, Roberto Bini, Osvaldo Chiara, Stefano Cioffi, Stefano Cantafio, Guido Coretti, Edelweiss Licitra, Grazia Savino, Sergio Grimaldi, Raffaele Porfidia, Elisabetta Moggia, Mauro Garino, Chiara Marafante, Antonio Pesce, Nicolò Fabbri, Carlo Vittorio Feo, Ester Marra, Marina Troian, Davide Drigo, Carlo Nagliati, Muratore Andrea, Riccardo Danna, Alessandra Murgese, Michele Crespi, Claudio Guerci, Alice Frontali, Luca Ferrari, Francesco Favi, Erika Picariello, Alessia Rampini, Fabrizio D'Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Palmieri, Matteo Calì, Francesco Ferrara, Irnerio Angelo Muttillo, Edoardo Maria Muttillo, Biagio Picardi, Raffaele Galleano, Ali Badran, Omar Ghazouani, Maurizio Cervellera, Gaetano Campanella, Gennaro Papa, Annamaria Di Bella, Gennaro Perrone, Gabriele Luciano Petracca, Concetta Prioriello, Mario Giuffrida, Federico Cozzani, Matteo Rossini, Marco Inama, Giovanni Butturini, Gianluigi Moretto, Luca Morelli, Giulio Di Candio, Simone Guadagni, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Valerio Genovese, Nicola Cillara, Alessandro Cannavera, Antonello Deserra, Arcangelo Picciariello, Vincenzo Papagni, Leonardo Vincenti, Giulia Bagaglini, Giuseppe Sica, Pierfrancesco Lapolla, Gioia Brachini, Dario Bono, Antonella Nicotera, Marcello Zago, Fabrizio Sammartano, Laura Benuzzi, Marco Stella, Stefano Rossi, Alessandra Cerioli, Caterina Puccioni, Stefano Olmi, Carolina Rubicondo, Matteo Uccelli, Andrea Balla, Anna Guida, Pasquale Lepiane, Diego Sasia, Giorgio Giraudo, Sara Salomone, Elena Belloni, Alessandra Cossa, Francesco Lancellotti, Roberto Caronna, Piero Chirletti, Paolina Saullo, Raffaele Troiano, Felice Mucilli, Mirko Barone, Massimo Ippoliti, Michele Grande, Bruno Sensi, Leandro Siragusa, Monica Ortenzi, Andrea Santini, Isidoro Di Carlo, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Giuseppe Currò, Michele Ammendola, Iman Komaei, Giuseppe Navarra, Valeria Tonini, Lodovico Sartarelli, Samuele Vaccari, Marco Ceresoli, Stefano Perrone, Linda Roccamatisi, Paolo Millo, Riccardo Brachet Contul, Elisa Ponte, Matteo Zuin, Giuseppe Portale, Alice Sabrina Tonello, Geri Fratini, Matteo Bianchini, Bruno Perotti, Emanuele Doria, Elia Giuseppe Lunghi, Diego Visconti, Khayry Al-Shami, Sajeda Awadi, Mohammad Musallam Khalil Buwaitel, Mo'taz Fawzat Naief Naffa', Ahmad Samhouri, Hatem Sawalha, Mohd Firdaus Che Ani, Ida Nadiah Ahmed Fathil, Jih Huei, Andee Dzulkarnaen Zakaria, Mohammad Zawawi Ya'acob, Jose-Luis Beristain-Hernandez, Alejandro Garcia-Meza, Rafael Sepulveda-Rdriguez, Edgard Efren Lozada Hernández, Camilo Levi Acuña Pinzón, Jefferson Nieves Condoy, Francisco C. Becerra García, Mohammad Sadik, null Jalpa, Bushra kadir, Jalpa Devi, Nandlal Seerani, null Zainab, Mohammad Sohail- Asghar, Ameer Afzal, Ali Akbar, Helmut Segovia Lohse, Herald Segovia Lohse, Zamiara Solange Leon Cabrera, Gaby Susana Yamamoto Seto, José Ríos Chiuyari, Jorge Ordemar, Martha Rodríguez, Abigail Cheska C. Orantia-Carlos, Margie Antionette Quitoy, Andrzej Kwiatkowski, Maciej Mawlichanów, Mónica Rocha, Carlos Soares, Alexandru Rares Stoian, Andreea Diana Draghici, Valentin Titus Grigorean, Raluca Bievel Radulescu, Radu Virgil Costea, Eugenia Claudia Zarnescu, Mikhail Kurtenkov, George Gendrikson, Volovich Alla-Angelina, Tsurbanova Arina, Ayrat Kaldarov, Mahir Gachabayov, Abakar Abdullaev, Milica Milentijevic, Milovan Karamarkovic, Arpád Panyko, Jozef Radonak, Marek Soltes, Laura Álvarez Morán, Haydée Calvo García, Pilar Suárez Vega, Sergio Estevez, Fabio Ausania, Jordi Farguell, Carolina González-Abós, Santiago Sánchez-Cabús, Belén Martín, Víctor Molina, Luis Oms, Lucas Ilzarbe, Eva Pont Feijóo, Elena Sofia Perra, Noel Rojas-Bonet, Rafael Penalba-Palmí, Susana Pérez-Bru, Jaume Tur-Martínez, Andrea Álvarez-Torrado, Marta Domingo-Gonzalez, Javier Tejedor-Tejada, Marcello Di Martino, Yaiza García del Alamo, Fernando Mendoza-Moreno, Francisca García-Moreno-Nisa, Belén Matías-García, Manuel Durán, Rafael Calleja-Lozano, José Manuel Perez de Villar, Luis Sánchez-Guillén, Iban Caravaca, Daniel Triguero-Cánovas, Antonio Carlos Maya Aparicio, Blas Durán Meléndez, Andrea Masiá Palacios, Aitor Landaluce-olavarria, Mario De Francisco, Begoña Estraviz-Mateos, Felipe Alconchel, Tatiana Nicolás-López, Pablo Ramírez, Virginia Duran Muñoz-Cruzado, Felipe Pareja Ciuró, Eduardo Perea del Pozo, Sergio Olivares Pizarro, Vicente Herrera Cabrera, Jose Muros Bayo, Hytham K.S. Hamid, Raffaello Roesel, Alessandra Cristaudi, Kinan Abbas, Iyad Ali, Ahmed Tlili, Hüseyin Bayhan, Mehmet Akif Türkoğlu, Mustafa Yener Uzunoglu, Ibrahim Fethi Azamat, Nail Omarov, Derya Salim Uymaz, Fatih Altintoprak, Emrah Akin, Necattin First, Koray Das, Nazmi Ozer, Ahmet Seker, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Semra Demirli Atici, Murat Akalin, Bulent Calik, Elif Colak, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Victoria Hudson, Jean-Luc Duval, Mansoor Khan, Ahmed Saad, Mandeep Kaur, Alison Bradley, Katherine Fox, Ivan Tomasi, Daniel Beasley, Alekhya Kotta Prasanti, Pinky Kotecha, Husam Ebied, Michaela Paul, Hemant Sheth, Ioannis Gerogiannis, Mohannad Gaber, Zara Sheikh, Shatadru Seth, Maria Kunitsyna, Cosimo Alex Leo, Vittoria Bellato, Noman - Zafar, Amr Elserafy, Giles Bond-smith, Giovanni Tebala, Pawan Mathur, Izza Abid, Nnaemeka Chidumije, Pardip Sandhar, Syed Osama Zohaib Ullah, Tamara Lezama, Muhammad Hassan Anwaar, Conor Magee, Salma Ahmed, Brooke Davies, Jeyakumar Apollos, Kieran McCormack, Hasham Choudhary, Triantafyllos Doulias, Tamsin Morrison, Anna Palepa, Fernando Bonilla Cal, Lianet Sánchez, Fabiana Domínguez, Ibrahim Al-Raimi, Haneen Alshargabi, Abdullah Meead, Podda, Mauro, Pacella, Daniela, Pellino, Gianluca, Coccolini, Federico, Giordano, Alessio, Di Saverio, Salomone, Pata, Francesco, Ielpo, Benedetto, Virdis, Francesco, Damaskos, Dimitrio, De Simone, Belinda, Agresta, Ferdinando, Sartelli, Massimo, Leppaniemi, Ari, Riboni, Cristiana, Agnoletti, Vanni, Mole, Damian, Kluger, Yoram, Catena, Fausto, Pisanu, Adolfo, de Manzini, Nicolo', Palmisano, Silvia, Podda, M, Pacella, D, Pellino, G, Coccolini, F, Giordano, A, Di Saverio, S, Pata, F, Ielpo, B, Virdis, F, Damaskos, D, De Simone, B, Agresta, F, Sartelli, M, Leppaniemi, A, Riboni, C, Agnoletti, V, Mole, D, Kluger, Y, Catena, F, Pisanu, A, Gerardi, C, Gourgiotis, S, Poillucci, G, Jayant, K, Ferrario, L, Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Quispe-Cruz, D, Orantia, A, Waledziak, M, Correia de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pantoja Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Augusto Gomes, C, Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief-Ghozy, Salah - Abbas, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Dakis, K, Alexandridou, E, Synekidou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Giuliani, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Lucia Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, Germani, P, Mastronardi, M, Bogoni, S, Palmisano, S, De Manzini, N, Marino, M, Martines, G, Trigiante, G, Lagouvardou, E, Anania, G, Bombardini, C, Oppici, D, Pilia, T, Murzi, V, Gessa, E, Bracale, U, Di Nuzzo, M, Peltrini, R, Salvetti, F, Vigano, J, Sganga, G, Bianchi, V, Fransvea, P, Fontana, T, Sarro, G, Dinuzzi, V, Scaravilli, L, Papa, M, Jovine, E, Ciabatti, G, Mastrangelo, L, Rottoli, M, Ricci, C, Russo, I, Aiolfi, A, Bona, D, Lombardo, F, Cianci, P, Bini, R, Chiara, O, Cioffi, S, Cantafio, S, Coretti, G, Licitra, E, Savino, G, Grimaldi, S, Porfidia, R, Moggia, E, Garino, M, Marafante, C, Pesce, A, Fabbri, N, Feo, C, Marra, E, Troian, M, Drigo, D, Nagliati, C, Andrea, M, Danna, R, Murgese, A, Crespi, M, Guerci, C, Frontali, A, Ferrari, L, Favi, F, Picariello, E, Rampini, A, D'Acapito, F, Ercolani, G, Solaini, L, Palmieri, F, Cali, M, Ferrara, F, Muttillo, I, Muttillo, E, Picardi, B, Galleano, R, Badran, A, Ghazouani, O, Cervellera, M, Campanella, G, Papa, G, Di Bella, A, Perrone, G, Petracca, G, Prioriello, C, Giuffrida, M, Cozzani, F, Rossini, M, Inama, M, Butturini, G, Moretto, G, Morelli, L, Di Candio, G, Guadagni, S, Cicuttin, E, Cremonini, C, Tartaglia, D, Genovese, V, Cillara, N, Cannavera, A, Deserra, A, Picciariello, A, Papagni, V, Vincenti, L, Bagaglini, G, Sica, G, Lapolla, P, Brachini, G, Bono, D, Nicotera, A, Zago, M, Sammartano, F, Benuzzi, L, Stella, M, Rossi, S, Cerioli, A, Puccioni, C, Olmi, S, Rubicondo, C, Uccelli, M, Balla, A, Guida, A, Lepiane, P, Sasia, D, Giraudo, G, Salomone, S, Belloni, E, Cossa, A, Lancellotti, F, Caronna, R, Chirletti, P, Saullo, P, Troiano, R, Mucilli, F, Barone, M, Ippoliti, M, Grande, M, Sensi, B, Siragusa, L, Ortenzi, M, Santini, A, Di Carlo, I, Veroux, M, Gioco, R, Veroux, G, Curro, G, Ammendola, M, Komaei, I, Navarra, G, Tonini, V, Sartarelli, L, Vaccari, S, Ceresoli, M, Perrone, S, Roccamatisi, L, Millo, P, Contul, R, Ponte, E, Zuin, M, Portale, G, Tonello, A, Fratini, G, Bianchini, M, Perotti, B, Doria, E, Lunghi, E, Visconti, D, Al-Shami, K, Awadi, S, Khalil Buwaitel, M, Naief Naffa', M, Samhouri, A, Sawalha, H, Ramzi Yusoff, A, Che Ani, M, Ahmed Fathil, I, Huei, J, Zakaria, A, Ya'Acob, M, Beristain-Hernandez, J, Garcia-Meza, A, Sepulveda-Rdriguez, R, Lozada Hernandez, E, Acuna Pinzon, C, Condoy, J, Becerra Garcia, F, Sadik, M, Jalpa, Kadir, B, Devi, J, Seerani, N, Zainab, Asghar, M, Afzal, A, Akbar, A, Lohse, H, Artidoro Quispe-Cruz, D, Leon Cabrera, Z, Yamamoto Seto, G, Chiuyari, J, Ordemar, J, Rodriguez, M, Orantia-Carlos, A, Quitoy, M, Kwiatkowski, A, Mawlichanow, M, Rocha, M, Soares, C, Muhammad Ali, S, Stoian, A, Diana Draghici, A, Draghici, A, Grigorean, V, Radulescu, R, Costea, R, Zarnescu, E, Kurtenkov, M, Gendrikson, G, Alla-Angelina, V, Arina, T, Kaldarov, A, Gachabayov, M, Abdullaev, A, Milentijevic, M, Karamarkovic, M, Panyko, A, Radonak, J, Soltes, M, Alvarez Moran, L, Garcia, H, Vega, P, Estevez, S, Ausania, F, Farguell, J, Gonzalez-Abos, C, Sanchez-Cabus, S, Martin, B, Molina, V, Oms, L, Ilzarbe, L, Feijoo, E, Perra, E, Rojas-Bonet, N, Penalba-Palmi, R, Perez-Bru, S, Tur-Martinez, J, Alvarez-Torrado, A, Domingo-Gonzalez, M, Tejedor-Tejada, J, Di Martino, M, Garcia del Alamo, Y, Mendoza-Moreno, F, Garcia-Moreno-Nisa, F, Matias-Garcia, B, Duran, M, Calleja-Lozano, R, Perez de Villar, J, Sanchez-Guillen, L, Caravaca, I, Triguero-Canovas, D, Maya Aparicio, A, Melendez, B, Palacios, A, Landaluce-olavarria, A, De Francisco, M, Estraviz-Mateos, B, Alconchel, F, Nicolas-Lopez, T, Ramirez, P, Munoz-Cruzado, V, Ciuro, F, Perea del Pozo, E, Pizarro, S, Cabrera, V, Bayo, J, Hamid, H, Roesel, R, Cristaudi, A, Abbas, K, Ali, I, Tlili, A, Bayhan, H, Turkoglu, M, Uzunoglu, M, Azamat, I, Omarov, N, Uymaz, D, Altintoprak, F, Akin, E, First, N, Das, K, Ozer, N, Seker, A, Kara, Y, Bozkurt, M, Kocatas, A, Atici, S, Akalin, M, Calik, B, Colak, E, Altinel, Y, Meric, S, Aktimur, Y, Hudson, V, Duval, J, Khan, M, Saad, A, Kaur, M, Bradley, A, Fox, K, Tomasi, I, Beasley, D, Prasanti, A, Kotecha, P, Ebied, H, Paul, M, Sheth, H, Gerogiannis, I, Gaber, M, Sheikh, Z, Seth, S, Kunitsyna, M, Leo, C, Bellato, V, Zafar, N, Elserafy, A, Bond-smith, G, Tebala, G, Mathur, P, Abid, I, Chidumije, N, Sandhar, P, Zohaib Ullah, S, Lezama, T, Anwaar, M, Magee, C, Ahmed, S, Davies, B, Apollos, J, Mccormack, K, Choudhary, H, Doulias, T, Morrison, T, Palepa, A, Cal, F, Sanchez, L, Dominguez, F, Al-Raimi, I, Alshargabi, H, and Meead, A

Subjects
Acute pancreatitis, Biliary pancreatitis, Global surgery, Guidelines compliance, International audit, Hepatology, Endocrinology, Diabetes and Metabolism, Gastroenterology, Settore MED/18, Hospitalization, Enteral Nutrition, Pancreatitis, Acute Disease, Humans, Biliary pancreatiti, Cholecystectomy, Acute pancreatiti, Human
Abstract

Background/objectives: Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines. Methods: All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data. Results: Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P < 0.00001), early enteral feeding (33.2%, χ2 11.51, P = 0.009), and the implementation of early cholecystectomy strategies (29%, χ2 354.64, P < 0.00001), with wide variability based on the admitting speciality. Conclusions: The results of this study showed an overall poor compliance with evidence-based guidelines in the management of ABP, with wide variability based on the admitting speciality. Study protocol registered in ClinicalTrials.Gov (ID Number NCT04747990).

Published
2022

13. Blunt Trauma Associated With Bilateral Diaphragmatic Rupture: A Case Report

Author

Giuseppe Nigri, Mohsen Ibrahim, Marco Pace, Erino A. Rendina, Marco Cavallini, Elena Belloni, and Damiano Vallati

Subjects
medicine.medical_specialty, Diaphragmatic rupture, blunt trauma, bilateral diaphragmatic rupture, RD1-811, business.industry, medicine.medical_treatment, COVID-19, medicine.disease, Asymptomatic, Diaphragm (structural system), Surgery, repair of diaphragm, Blunt, Blunt trauma, Acute care, Pelvic fracture, case report, Medicine, Thoracotomy, emergency surgery, medicine.symptom, business
Abstract

Background: A bilateral diaphragmatic rupture is a rare event that occurs in cases of blunt thoracic-abdominal trauma.Case Presentation: We report the case of a 56-year-old female patient with pelvic fracture and second-stage bilateral rupture of the diaphragm due to a car accident. After a chest and abdominal contrast-enhanced computed tomography (CT) scan, the patient underwent emergency suturing of the left hemidiaphragm. On postoperative day (POD) 4, a CT scan performed due to the sudden onset of dyspnea revealed rupture of the right hemidiaphragm, which was not detected on the preoperative CT scan. On POD 9, the right hemidiaphragm was repaired with mesh during a right thoracotomy. The patient recovered 14 days after surgery. However, the postoperative course was complicated by an asymptomatic COVID-19 infection that significantly delayed her discharge from the hospital.Conclusions: Difficulties in preoperative diagnosis and treatment, together with the lack of data in the literature, make this type of trauma a challenge for all acute care and general surgeons.

Published
2021

14. Histomorphological and inflammatory changes of white adipose tissue in gastrointestinal cancer patients with and without cachexia

Author

Alessio Molfino, Raffaella Carletti, Giovanni Imbimbo, Maria Ida Amabile, Roberta Belli, Cira R.T. di Gioia, Elena Belloni, Francesco Spinelli, Veronica Rizzo, Carlo Catalano, Giuseppe Nigri, and Maurizio Muscaritoli

Subjects
Inflammation, Cachexia, QM1-695, Subcutaneous Fat, Diseases of the musculoskeletal system, Intra-Abdominal Fat, Fibrosis, Body composition, RC925-935, Adipose Tissue, Physiology (medical), Human anatomy, Humans, Orthopedics and Sports Medicine, adipose tissue, body composition, cachexia, cancer, fibrosis, inflammation, Cancer, Gastrointestinal Neoplasms
Abstract

Background During cancer cachexia, several alterations occur in peripheral tissues, and the adipose tissue may be involved during the catabolic state. We aimed at investigating histological rearrangement and infiltration of inflammatory cells in subcutaneous adipose tissue (SAT) of patients with cancer undergoing surgery, according to the presence/absence of cachexia. Methods We considered gastrointestinal cancer patients and controls with non‐malignant diseases undergoing surgery. We collected SAT samples and performed histomorphological analyses [cross‐sectional area (CSA) and per cent of fibrosis] and immunohistochemistry to characterize the inflammatory cells. By computed tomography (CT) scan, we calculated SAT and visceral adipose tissue (VAT). Results We enrolled 51 participants (31 gastrointestinal cancer patients and 20 controls). In cancer patients, cachexia was present in 13/31 (42%). The CSA (μm2) of the adipocytes from SAT was reduced in cancer patients vs. controls (3148, inter‐quartile range 2574–3755 vs. 4474, inter‐quartile range 3654–5183) (P

Published
2021

Catalog

Books, media, physical & digital resources
See catalog results