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201 results on '"Bravi F"'

1. Needs of breast cancer survivors: a systematic review of quantitative data

Author: Paltrinieri, S., Cavuto, S., Contri, A., Bassi, M.C., Bravi, F., Schiavi, M., Fugazzaro, S., Guberti, M., and Costi, S.
Published: 2024
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2. Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Author: Perrone, G, Giuffrida, M, Abu-Zidan, F, Kruger, V, Livrini, M, Petracca, G, Rossi, G, Tarasconi, A, Tian, B, Bonati, E, Mentz, R, Mazzini, F, Campana, J, Gasser, E, Kafka-Ritsch, R, Felsenreich, D, Dawoud, C, Riss, S, Gomes, C, Gomes, F, Gonzaga, R, Canton, C, Pereira, B, Fraga, G, Zem, L, Cordeiro-Fonseca, V, de Mesquita Tauil, R, Atanasov, B, Belev, N, Kovachev, N, Melendez, L, Dimova, A, Dimov, S, Zelic, Z, Augustin, G, Bogdanic, B, Moric, T, Chouillard, E, Bajul, M, De Simone, B, Panis, Y, Esposito, F, Notarnicola, M, Lauka, L, Fabbri, A, Hentati, H, Fnaiech, I, Aurelien, V, Bougard, M, Roulet, M, Demetrashvili, Z, Pipia, I, Merabishvili, G, Bouliaris, K, Koukoulis, G, Doudakmanis, C, Xenaki, S, Chrysos, E, Kokkinakis, S, Vassiliu, P, Michalopoulos, N, Margaris, I, Kechagias, A, Avgerinos, K, Katunin, J, Lostoridis, E, Nagorni, E, Pujante, A, Mulita, F, Maroulis, I, Vailas, M, Marinis, A, Siannis, I, Bourbouteli, E, Manatakis, D, Tasis, N, Acheimastos, V, Maria, S, Stylianos, K, Kuzeridis, H, Korkolis, D, Fradelos, E, Kavalieratos, G, Petropoulou, T, Polydorou, A, Papacostantinou, I, Triantafyllou, T, Kimpizi, D, Theodorou, D, Toutouzas, K, Chamzin, A, Frountzas, M, Schizas, D, Karavokyros, I, Syllaios, A, Charalabopoulos, A, Boura, M, Baili, E, Ioannidis, O, Loutzidou, L, Anestiadou, E, Tsouknidas, I, Petrakis, G, Polenta, E, Bains, L, Gupta, R, Singh, S, Khanduri, A, Bala, M, Kedar, A, Pisano, M, Podda, M, Pisanu, A, Martines, G, Trigiante, G, Lantone, G, Agrusa, A, Di Buono, G, Buscemi, S, Veroux, M, Gioco, R, Veroux, G, Oragano, L, Zonta, S, Lovisetto, F, Feo, C, Pesce, A, Fabbri, N, Marino, F, Perrone, F, Vincenti, L, Papagni, V, Picciariello, A, Rossi, S, Picardi, B, Del Monte, S, Visconti, D, Osella, G, Petruzzelli, L, Pignata, G, Andreuccetti, J, D'Alessio, R, Buonfantino, M, Guaitoli, E, Spinelli, S, Sampietro, G, Corbellini, C, Lorusso, L, Frontali, A, Pezzoli, I, Bonomi, A, Chierici, A, Cotsoglou, C, Manca, G, Delvecchio, A, Musa, N, Casati, M, Letizia, L, Abate, E, Ercolani, G, D'Acapito, F, Solaini, L, Guercioni, G, Cicconi, S, Sasia, D, Borghi, F, Giraudo, G, Sena, G, Castaldo, P, Cardamone, E, Portale, G, Zuin, M, Spolverato, Y, Esposito, M, Isernia, R, Di Salvo, M, Manunza, R, Esposito, G, Agus, M, Asti, E, Bernardi, D, Tonucci, T, Luppi, D, Casadei, M, Bonilauri, S, Pezzolla, A, Panebianco, A, Laforgia, R, De Luca, M, Zese, M, Parini, D, Jovine, E, De Sario, G, Lombardi, R, Aprea, G, Palomba, G, Capuano, M, Argenio, G, Orio, G, Armellino, M, Troian, M, Guerra, M, Nagliati, C, Biloslavo, A, Germani, P, Aizza, G, Monsellato, I, Chahrour, A, Anania, G, Bombardini, C, Bagolini, F, Sganga, G, Fransvea, P, Bianchi, V, Boati, P, Ferrara, F, Palmieri, F, Cianci, P, Gattulli, D, Restini, E, Cillara, N, Cannavera, A, Nita, G, Sarnari, J, Roscio, F, Clerici, F, Scandroglio, I, Berti, S, Cadeo, A, Filippelli, A, Conti, L, Grassi, C, Cattaneo, G, Pighin, M, Papis, D, Gambino, G, Bertino, V, Schifano, D, Prando, D, Fogato, L, Cavallo, F, Ansaloni, L, Picheo, R, Pontarolo, N, Depalma, N, Spampinato, M, D'Ugo, S, Lepre, L, Capponi, M, Campa, R, Sarro, G, Dinuzzi, V, Olmi, S, Uccelli, M, Ferrari, D, Inama, M, Moretto, G, Fontana, M, Favi, F, Picariello, E, Rampini, A, Barberis, A, Azzinnaro, A, Oliva, A, Totaro, L, Benzoni, I, Ranieri, V, Capolupo, G, Carannante, F, Caricato, M, Ronconi, M, Casiraghi, S, Casole, G, Pantalone, D, Alemanno, G, Scheiterle, M, Ceresoli, M, Cereda, M, Fumagalli, C, Zanzi, F, Bolzon, S, Guerra, E, Lecchi, F, Cellerino, P, Ardito, A, Scaramuzzo, R, Balla, A, Lepiane, P, Tartaglia, N, Ambrosi, A, Pavone, G, Palini, G, Veneroni, S, Garulli, G, Ricci, C, Torre, B, Russo, I, Rottoli, M, Tanzanu, M, Belvedere, A, Milone, M, Manigrasso, M, De Palma, G, Piccoli, M, Pattacini, G, Magnone, S, Bertoli, P, Massucco, P, Palisi, M, Luzzi, A, Fleres, F, Clarizia, G, Spolini, A, Kobe, Y, Toma, T, Shimamura, F, Parker, R, Ranketi, S, Mitei, M, Svagzdys, S, Pauzas, H, Zilinskas, J, Poskus, T, Kryzauskas, M, Jakubauskas, M, Zakaria, A, Zakaria, Z, Wong, M, Jusoh, A, Zakaria, M, Cruz, D, Elizalde, A, Reynaud, A, Hernandez, E, Monroy, J, Hinojosa-Ugarte, D, Quiodettis, M, Du Bois, M, Latorraca, J, Major, P, Pedziwiatr, M, Pisarska-Adamczyk, M, Waledziak, M, Kwiatkowski, A, Czyzykowski, L, da Costa, S, Ferreira, A, Almeida, F, Rocha, R, Carneiro, C, Perez, D, Carvas, J, Rocha, C, Ferreira, C, Marques, R, Fernandes, U, Leao, P, Goulart, A, Pereira, R, Patrocinio, S, de Mendonca, N, Manso, M, Morais, H, Cardoso, P, Calu, V, Miron, A, Toma, E, Gachabayov, M, Abdullaev, A, Litvin, A, Nechay, T, Tyagunov, A, Yuldashev, A, Bradley, A, Wilson, M, Panyko, A, Lateckova, Z, Lacko, V, Lesko, D, Soltes, M, Radonak, J, Turrado-Rodriguez, V, Termes-Serra, R, Morales-Sevillano, X, Lapolla, P, Mingoli, A, Brachini, G, Degiuli, M, Sofia, S, Reddavid, R, de Manzoni Garberini, A, Buffone, A, del Pozo, E, Aparicio-Sanchez, D, Dos Barbeito, S, Estaire-Gomez, M, Viton-Herrero, R, de los Angeles Gil Olarte-Marquez, M, Gil-Martinez, J, Alconchel, F, Nicolas-Lopez, T, Rahy-Martin, A, Pelloni, M, Banolas-Suarez, R, Mendoza-Moreno, F, Nisa, F, Diez-Alonso, M, Rodas, M, Agundez, M, Andres, M, Moreira, C, Perez, A, Ponce, I, Gonzalez-Castillo, A, Membrilla-Fernandez, E, Salvans, S, Serradilla-Martin, M, Pardo, P, Rivera-Alonso, D, Dziakova, J, Huguet, J, Valle, N, Ruiz, E, Valcarcel, C, Moreno, C, Salazar, Y, Garcia, J, Mico, S, Lopez, J, Farre, S, Gomez, M, Petit, N, Titos-Garcia, A, Aranda-Narvaez, J, Romacho-Lopez, L, Sanchez-Guillen, L, Aranaz-Ostariz, V, Bosch-Ramirez, M, Martinez-Perez, A, Martinez-Lopez, E, Sebastian-Tomas, J, Jimenez-Riera, G, Jimenez-Vega, J, Cuellar, J, Campos-Serra, A, Munoz-Campana, A, Gracia-Roman, R, Alegre, J, Pinto, F, O'Sullivan, S, Antona, F, Jimenez, B, Lopez-Sanchez, J, Carmona, Z, Fernandez, R, Sierra, I, de Leon, L, Moreno, V, Iglesias, E, Cumplido, P, Bravo, A, Simo, I, Dominguez, C, Caamano, A, Lozano, R, Martinez, M, Torres, A, de Quiros, J, Pellino, G, Cloquell, M, Moller, E, Jalal-Eldin, S, Abdoun, A, Hamid, H, Lohsiriwat, V, Mongkhonsupphawan, A, Baraket, O, Ayed, K, Abbassi, I, Ali, A, Ammar, H, Kchaou, A, Tlili, A, Zribi, I, Colak, E, Polat, S, Koylu, Z, Guner, A, Usta, M, Reis, M, Mantoglu, B, Gonullu, E, Akin, E, Altintoprak, F, Bayhan, Z, Firat, N, Isik, A, Memis, U, Bayrak, M, Altintas, Y, Kara, Y, Bozkurt, M, Kocatas, A, Das, K, Seker, A, Ozer, N, Atici, S, Tuncer, K, Kaya, T, Ozkan, Z, Ilhan, O, Agackiran, I, Uzunoglu, M, Demirbas, E, Altinel, Y, Meric, S, Hacim, N, Uymaz, D, Omarov, N, Balik, E, Tebala, G, Khalil, H, Rana, M, Khan, M, Florence, C, Swaminathan, C, Leo, C, Liasis, L, Watfah, J, Trostchansky, I, Delgado, E, Pontillo, M, Latifi, R, Coimbra, R, Edwards, S, Lopez, A, Velmahos, G, Dorken, A, Gebran, A, Palmer, A, Oury, J, Bardes, J, Seng, S, Coffua, L, Ratnasekera, A, Egodage, T, Echeverria-Rosario, K, Armento, I, Napolitano, L, Sangji, N, Hemmila, M, Quick, J, Austin, T, Hyman, T, Curtiss, W, Mcclure, A, Cairl, N, Biffl, W, Truong, H, Schaffer, K, Reames, S, Banchini, F, Capelli, P, Coccolini, F, Sartelli, M, Bravi, F, Vallicelli, C, Agnoletti, V, Baiocchi, G, Catena, F, Perrone G., Giuffrida M., Abu-Zidan F., Kruger V. F., Livrini M., Petracca G. L., Rossi G., Tarasconi A., Tian B. W. C. A., Bonati E., Mentz R., Mazzini F. N., Campana J. P., Gasser E., Kafka-Ritsch R., Felsenreich D. M., Dawoud C., Riss S., Gomes C. A., Gomes F. C., Gonzaga R. A. T., Canton C. A. B., Pereira B. M., Fraga G. P., Zem L. G., Cordeiro-Fonseca V., de Mesquita Tauil R., Atanasov B., Belev N., Kovachev N., Melendez L. J. J., Dimova A., Dimov S., Zelic Z., Augustin G., Bogdanic B., Moric T., Chouillard E., Bajul M., De Simone B., Panis Y., Esposito F., Notarnicola M., Lauka L., Fabbri A., Hentati H., Fnaiech I., Aurelien V., Bougard M., Roulet M., Demetrashvili Z., Pipia I., Merabishvili G., Bouliaris K., Koukoulis G., Doudakmanis C., Xenaki S., Chrysos E., Kokkinakis S., Vassiliu P., Michalopoulos N., Margaris I., Kechagias A., Avgerinos K., Katunin J., Lostoridis E., Nagorni E. -A., Pujante A., Mulita F., Maroulis I., Vailas M., Marinis A., Siannis I., Bourbouteli E., Manatakis D. K., Tasis N., Acheimastos V., Maria S., Stylianos K., Kuzeridis H., Korkolis D., Fradelos E., Kavalieratos G., Petropoulou T., Polydorou A., Papacostantinou I., Triantafyllou T., Kimpizi D., Theodorou D., Toutouzas K., Chamzin A., Frountzas M., Schizas D., Karavokyros I., Syllaios A., Charalabopoulos A., Boura M., Baili E., Ioannidis O., Loutzidou L., Anestiadou E., Tsouknidas I., Petrakis G., Polenta E., Bains L., Gupta R., Singh S. K., Khanduri A., Bala M., Kedar A., Pisano M., Podda M., Pisanu A., Martines G., Trigiante G., Lantone G., Agrusa A., Di Buono G., Buscemi S., Veroux M., Gioco R., Veroux G., Oragano L., Zonta S., Lovisetto F., Feo C. V., Pesce A., Fabbri N., Marino F., Perrone F., Vincenti L., Papagni V., Picciariello A., Rossi S., Picardi B., Del Monte S. R., Visconti D., Osella G., Petruzzelli L., Pignata G., Andreuccetti J., D'Alessio R., Buonfantino M., Guaitoli E., Spinelli S., Sampietro G. M., Corbellini C., Lorusso L., Frontali A., Pezzoli I., Bonomi A., Chierici A., Cotsoglou C., Manca G., Delvecchio A., Musa N., Casati M., Letizia L., Abate E., Ercolani G., D'Acapito F., Solaini L., Guercioni G., Cicconi S., Sasia D., Borghi F., Giraudo G., Sena G., Castaldo P., Cardamone E., Portale G., Zuin M., Spolverato Y., Esposito M., Isernia R. M., Di Salvo M., Manunza R., Esposito G., Agus M., Asti E. L. G., Bernardi D. T., Tonucci T. P., Luppi D., Casadei M., Bonilauri S., Pezzolla A., Panebianco A., Laforgia R., De Luca M., Zese M., Parini D., Jovine E., De Sario G., Lombardi R., Aprea G., Palomba G., Capuano M., Argenio G., Orio G., Armellino M. F., Troian M., Guerra M., Nagliati C., Biloslavo A., Germani P., Aizza G., Monsellato I., Chahrour A. C., Anania G., Bombardini C., Bagolini F., Sganga G., Fransvea P., Bianchi V., Boati P., Ferrara F., Palmieri F., Cianci P., Gattulli D., Restini E., Cillara N., Cannavera A., Nita G. E., Sarnari J., Roscio F., Clerici F., Scandroglio I., Berti S., Cadeo A., Filippelli A., Conti L., Grassi C., Cattaneo G. M., Pighin M., Papis D., Gambino G., Bertino V., Schifano D., Prando D., Fogato L., Cavallo F., Ansaloni L., Picheo R., Pontarolo N., Depalma N., Spampinato M., D'Ugo S., Lepre L., Capponi M. G., Campa R. D., Sarro G., Dinuzzi V. P., Olmi S., Uccelli M., Ferrari D., Inama M., Moretto G., Fontana M., Favi F., Picariello E., Rampini A., Barberis A., Azzinnaro A., Oliva A., Totaro L., Benzoni I., Ranieri V., Capolupo G. T., Carannante F., Caricato M., Ronconi M., Casiraghi S., Casole G., Pantalone D., Alemanno G., Scheiterle M., Ceresoli M., Cereda M., Fumagalli C., Zanzi F., Bolzon S., Guerra E., Lecchi F., Cellerino P., Ardito A., Scaramuzzo R., Balla A., Lepiane P., Tartaglia N., Ambrosi A., Pavone G., Palini G. M., Veneroni S., Garulli G., Ricci C., Torre B., Russo I. S., Rottoli M., Tanzanu M., Belvedere A., Milone M., Manigrasso M., De Palma G. D., Piccoli M., Pattacini G. C., Magnone S., Bertoli P., Massucco P., Palisi M., Luzzi A. -P., Fleres F., Clarizia G., Spolini A., Kobe Y., Toma T., Shimamura F., Parker R., Ranketi S., Mitei M., Svagzdys S., Pauzas H., Zilinskas J., Poskus T., Kryzauskas M., Jakubauskas M., Zakaria A. D., Zakaria Z., Wong M. P. -K., Jusoh A. C., Zakaria M. N., Cruz D. R., Elizalde A. B. R., Reynaud A. B., Hernandez E. E. L., Monroy J. M. V. P., Hinojosa-Ugarte D., Quiodettis M., Du Bois M. E., Latorraca J., Major P., Pedziwiatr M., Pisarska-Adamczyk M., Waledziak M., Kwiatkowski A., Czyzykowski L., da Costa S. D., Pereira B., Ferreira A. R. O., Almeida F., Rocha R., Carneiro C., Perez D. P., Carvas J., Rocha C., Ferreira C., Marques R., Fernandes U., Leao P., Goulart A., Pereira R. G., Patrocinio S. D. D., de Mendonca N. G. G., Manso M. I. C., Morais H. M. C., Cardoso P. S., Calu V., Miron A., Toma E. A., Gachabayov M., Abdullaev A., Litvin A., Nechay T., Tyagunov A., Yuldashev A., Bradley A., Wilson M., Panyko A., Lateckova Z., Lacko V., Lesko D., Soltes M., Radonak J., Turrado-Rodriguez V., Termes-Serra R., Morales-Sevillano X., Lapolla P., Mingoli A., Brachini G., Degiuli M., Sofia S., Reddavid R., de Manzoni Garberini A., Buffone A., del Pozo E. P., Aparicio-Sanchez D., Dos Barbeito S., Estaire-Gomez M., Viton-Herrero R., de los Angeles Gil Olarte-Marquez M. a., Gil-Martinez J., Alconchel F., Nicolas-Lopez T., Rahy-Martin A. C., Pelloni M., Banolas-Suarez R., Mendoza-Moreno F., Nisa F. G. -M., Diez-Alonso M., Rodas M. E. V., Agundez M. C., Andres M. I. P., Moreira C. C. L., Perez A. L., Ponce I. A., Gonzalez-Castillo A. M., Membrilla-Fernandez E., Salvans S., Serradilla-Martin M., Pardo P. S., Rivera-Alonso D., Dziakova J., Huguet J. M., Valle N. P., Ruiz E. C., Valcarcel C. R., Moreno C. R., Salazar Y. T. M., Garcia J. J. R., Mico S. S., Lopez J. R., Farre S. P., Gomez M. S., Petit N. M., Titos-Garcia A., Aranda-Narvaez J. M., Romacho-Lopez L., Sanchez-Guillen L., Aranaz-Ostariz V., Bosch-Ramirez M., Martinez-Perez A., Martinez-Lopez E., Sebastian-Tomas J. C., Jimenez-Riera G., Jimenez-Vega J., Cuellar J. A. N., Campos-Serra A., Munoz-Campana A., Gracia-Roman R., Alegre J. M., Pinto F. L., O'Sullivan S. N., Antona F. B., Jimenez B. M., Lopez-Sanchez J., Carmona Z. G., Fernandez R. T., Sierra I. B., de Leon L. R. G., Moreno V. P., Iglesias E., Cumplido P. L., Bravo A. A., Simo I. R., Dominguez C. L., Caamano A. G., Lozano R. C., Martinez M. D., Torres A. N., de Quiros J. T. M. B., Pellino G., Cloquell M. M., Moller E. G., Jalal-Eldin S., Abdoun A. K., Hamid H. K. S., Lohsiriwat V., Mongkhonsupphawan A., Baraket O., Ayed K., Abbassi I., Ali A. B., Ammar H., Kchaou A., Tlili A., Zribi I., Colak E., Polat S., Koylu Z. A., Guner A., Usta M. A., Reis M. E., Mantoglu B., Gonullu E., Akin E., Altintoprak F., Bayhan Z., Firat N., Isik A., Memis U., Bayrak M., Altintas Y., Kara Y., Bozkurt M. A., Kocatas A., Das K., Seker A., Ozer N., Atici S. D., Tuncer K., Kaya T., Ozkan Z., Ilhan O., Agackiran I., Uzunoglu M. Y., Demirbas E., Altinel Y., Meric S., Hacim N. A., Uymaz D. S., Omarov N., Balik E., Tebala G. D., Khalil H., Rana M., Khan M., Florence C., Swaminathan C., Leo C. A., Liasis L., Watfah J., Trostchansky I., Delgado E., Pontillo M., Latifi R., Coimbra R., Edwards S., Lopez A., Velmahos G., Dorken A., Gebran A., Palmer A., Oury J., Bardes J. M., Seng S. S., Coffua L. S., Ratnasekera A., Egodage T., Echeverria-Rosario K., Armento I., Napolitano L. M., Sangji N. F., Hemmila M., Quick J. A., Austin T. R., Hyman T. S., Curtiss W., McClure A., Cairl N., Biffl W. L., Truong H. P., Schaffer K., Reames S., Banchini F., Capelli P., Coccolini F., Sartelli M., Bravi F., Vallicelli C., Agnoletti V., Baiocchi G. L., Catena F., Perrone, G, Giuffrida, M, Abu-Zidan, F, Kruger, V, Livrini, M, Petracca, G, Rossi, G, Tarasconi, A, Tian, B, Bonati, E, Mentz, R, Mazzini, F, Campana, J, Gasser, E, Kafka-Ritsch, R, Felsenreich, D, Dawoud, C, Riss, S, Gomes, C, Gomes, F, Gonzaga, R, Canton, C, Pereira, B, Fraga, G, Zem, L, Cordeiro-Fonseca, V, de Mesquita Tauil, R, Atanasov, B, Belev, N, Kovachev, N, Melendez, L, Dimova, A, Dimov, S, Zelic, Z, Augustin, G, Bogdanic, B, Moric, T, Chouillard, E, Bajul, M, De Simone, B, Panis, Y, Esposito, F, Notarnicola, M, Lauka, L, Fabbri, A, Hentati, H, Fnaiech, I, Aurelien, V, Bougard, M, Roulet, M, Demetrashvili, Z, Pipia, I, Merabishvili, G, Bouliaris, K, Koukoulis, G, Doudakmanis, C, Xenaki, S, Chrysos, E, Kokkinakis, S, Vassiliu, P, Michalopoulos, N, Margaris, I, Kechagias, A, Avgerinos, K, Katunin, J, Lostoridis, E, Nagorni, E, Pujante, A, Mulita, F, Maroulis, I, Vailas, M, Marinis, A, Siannis, I, Bourbouteli, E, Manatakis, D, Tasis, N, Acheimastos, V, Maria, S, Stylianos, K, Kuzeridis, H, Korkolis, D, Fradelos, E, Kavalieratos, G, Petropoulou, T, Polydorou, A, Papacostantinou, I, Triantafyllou, T, Kimpizi, D, Theodorou, D, Toutouzas, K, Chamzin, A, Frountzas, M, Schizas, D, Karavokyros, I, Syllaios, A, Charalabopoulos, A, Boura, M, Baili, E, Ioannidis, O, Loutzidou, L, Anestiadou, E, Tsouknidas, I, Petrakis, G, Polenta, E, Bains, L, Gupta, R, Singh, S, Khanduri, A, Bala, M, Kedar, A, Pisano, M, Podda, M, Pisanu, A, Martines, G, Trigiante, G, Lantone, G, Agrusa, A, Di Buono, G, Buscemi, S, Veroux, M, Gioco, R, Veroux, G, Oragano, L, Zonta, S, Lovisetto, F, Feo, C, Pesce, A, Fabbri, N, Marino, F, Perrone, F, Vincenti, L, Papagni, V, Picciariello, A, Rossi, S, Picardi, B, Del Monte, S, Visconti, D, Osella, G, Petruzzelli, L, Pignata, G, Andreuccetti, J, D'Alessio, R, Buonfantino, M, Guaitoli, E, Spinelli, S, Sampietro, G, Corbellini, C, Lorusso, L, Frontali, A, Pezzoli, I, Bonomi, A, Chierici, A, Cotsoglou, C, Manca, G, Delvecchio, A, Musa, N, Casati, M, Letizia, L, Abate, E, Ercolani, G, D'Acapito, F, Solaini, L, Guercioni, G, Cicconi, S, Sasia, D, Borghi, F, Giraudo, G, Sena, G, Castaldo, P, Cardamone, E, Portale, G, Zuin, M, Spolverato, Y, Esposito, M, Isernia, R, Di Salvo, M, Manunza, R, Esposito, G, Agus, M, Asti, E, Bernardi, D, Tonucci, T, Luppi, D, Casadei, M, Bonilauri, S, Pezzolla, A, Panebianco, A, Laforgia, R, De Luca, M, Zese, M, Parini, D, Jovine, E, De Sario, G, Lombardi, R, Aprea, G, Palomba, G, Capuano, M, Argenio, G, Orio, G, Armellino, M, Troian, M, Guerra, M, Nagliati, C, Biloslavo, A, Germani, P, Aizza, G, Monsellato, I, Chahrour, A, Anania, G, Bombardini, C, Bagolini, F, Sganga, G, Fransvea, P, Bianchi, V, Boati, P, Ferrara, F, Palmieri, F, Cianci, P, Gattulli, D, Restini, E, Cillara, N, Cannavera, A, Nita, G, Sarnari, J, Roscio, F, Clerici, F, Scandroglio, I, Berti, S, Cadeo, A, Filippelli, A, Conti, L, Grassi, C, Cattaneo, G, Pighin, M, Papis, D, Gambino, G, Bertino, V, Schifano, D, Prando, D, Fogato, L, Cavallo, F, Ansaloni, L, Picheo, R, Pontarolo, N, Depalma, N, Spampinato, M, D'Ugo, S, Lepre, L, Capponi, M, Campa, R, Sarro, G, Dinuzzi, V, Olmi, S, Uccelli, M, Ferrari, D, Inama, M, Moretto, G, Fontana, M, Favi, F, Picariello, E, Rampini, A, Barberis, A, Azzinnaro, A, Oliva, A, Totaro, L, Benzoni, I, Ranieri, V, Capolupo, G, Carannante, F, Caricato, M, Ronconi, M, Casiraghi, S, Casole, G, Pantalone, D, Alemanno, G, Scheiterle, M, Ceresoli, M, Cereda, M, Fumagalli, C, Zanzi, F, Bolzon, S, Guerra, E, Lecchi, F, Cellerino, P, Ardito, A, Scaramuzzo, R, Balla, A, Lepiane, P, Tartaglia, N, Ambrosi, A, Pavone, G, Palini, G, Veneroni, S, Garulli, G, Ricci, C, Torre, B, Russo, I, Rottoli, M, Tanzanu, M, Belvedere, A, Milone, M, Manigrasso, M, De Palma, G, Piccoli, M, Pattacini, G, Magnone, S, Bertoli, P, Massucco, P, Palisi, M, Luzzi, A, Fleres, F, Clarizia, G, Spolini, A, Kobe, Y, Toma, T, Shimamura, F, Parker, R, Ranketi, S, Mitei, M, Svagzdys, S, Pauzas, H, Zilinskas, J, Poskus, T, Kryzauskas, M, Jakubauskas, M, Zakaria, A, Zakaria, Z, Wong, M, Jusoh, A, Zakaria, M, Cruz, D, Elizalde, A, Reynaud, A, Hernandez, E, Monroy, J, Hinojosa-Ugarte, D, Quiodettis, M, Du Bois, M, Latorraca, J, Major, P, Pedziwiatr, M, Pisarska-Adamczyk, M, Waledziak, M, Kwiatkowski, A, Czyzykowski, L, da Costa, S, Ferreira, A, Almeida, F, Rocha, R, Carneiro, C, Perez, D, Carvas, J, Rocha, C, Ferreira, C, Marques, R, Fernandes, U, Leao, P, Goulart, A, Pereira, R, Patrocinio, S, de Mendonca, N, Manso, M, Morais, H, Cardoso, P, Calu, V, Miron, A, Toma, E, Gachabayov, M, Abdullaev, A, Litvin, A, Nechay, T, Tyagunov, A, Yuldashev, A, Bradley, A, Wilson, M, Panyko, A, Lateckova, Z, Lacko, V, Lesko, D, Soltes, M, Radonak, J, Turrado-Rodriguez, V, Termes-Serra, R, Morales-Sevillano, X, Lapolla, P, Mingoli, A, Brachini, G, Degiuli, M, Sofia, S, Reddavid, R, de Manzoni Garberini, A, Buffone, A, del Pozo, E, Aparicio-Sanchez, D, Dos Barbeito, S, Estaire-Gomez, M, Viton-Herrero, R, de los Angeles Gil Olarte-Marquez, M, Gil-Martinez, J, Alconchel, F, Nicolas-Lopez, T, Rahy-Martin, A, Pelloni, M, Banolas-Suarez, R, Mendoza-Moreno, F, Nisa, F, Diez-Alonso, M, Rodas, M, Agundez, M, Andres, M, Moreira, C, Perez, A, Ponce, I, Gonzalez-Castillo, A, Membrilla-Fernandez, E, Salvans, S, Serradilla-Martin, M, Pardo, P, Rivera-Alonso, D, Dziakova, J, Huguet, J, Valle, N, Ruiz, E, Valcarcel, C, Moreno, C, Salazar, Y, Garcia, J, Mico, S, Lopez, J, Farre, S, Gomez, M, Petit, N, Titos-Garcia, A, Aranda-Narvaez, J, Romacho-Lopez, L, Sanchez-Guillen, L, Aranaz-Ostariz, V, Bosch-Ramirez, M, Martinez-Perez, A, Martinez-Lopez, E, Sebastian-Tomas, J, Jimenez-Riera, G, Jimenez-Vega, J, Cuellar, J, Campos-Serra, A, Munoz-Campana, A, Gracia-Roman, R, Alegre, J, Pinto, F, O'Sullivan, S, Antona, F, Jimenez, B, Lopez-Sanchez, J, Carmona, Z, Fernandez, R, Sierra, I, de Leon, L, Moreno, V, Iglesias, E, Cumplido, P, Bravo, A, Simo, I, Dominguez, C, Caamano, A, Lozano, R, Martinez, M, Torres, A, de Quiros, J, Pellino, G, Cloquell, M, Moller, E, Jalal-Eldin, S, Abdoun, A, Hamid, H, Lohsiriwat, V, Mongkhonsupphawan, A, Baraket, O, Ayed, K, Abbassi, I, Ali, A, Ammar, H, Kchaou, A, Tlili, A, Zribi, I, Colak, E, Polat, S, Koylu, Z, Guner, A, Usta, M, Reis, M, Mantoglu, B, Gonullu, E, Akin, E, Altintoprak, F, Bayhan, Z, Firat, N, Isik, A, Memis, U, Bayrak, M, Altintas, Y, Kara, Y, Bozkurt, M, Kocatas, A, Das, K, Seker, A, Ozer, N, Atici, S, Tuncer, K, Kaya, T, Ozkan, Z, Ilhan, O, Agackiran, I, Uzunoglu, M, Demirbas, E, Altinel, Y, Meric, S, Hacim, N, Uymaz, D, Omarov, N, Balik, E, Tebala, G, Khalil, H, Rana, M, Khan, M, Florence, C, Swaminathan, C, Leo, C, Liasis, L, Watfah, J, Trostchansky, I, Delgado, E, Pontillo, M, Latifi, R, Coimbra, R, Edwards, S, Lopez, A, Velmahos, G, Dorken, A, Gebran, A, Palmer, A, Oury, J, Bardes, J, Seng, S, Coffua, L, Ratnasekera, A, Egodage, T, Echeverria-Rosario, K, Armento, I, Napolitano, L, Sangji, N, Hemmila, M, Quick, J, Austin, T, Hyman, T, Curtiss, W, Mcclure, A, Cairl, N, Biffl, W, Truong, H, Schaffer, K, Reames, S, Banchini, F, Capelli, P, Coccolini, F, Sartelli, M, Bravi, F, Vallicelli, C, Agnoletti, V, Baiocchi, G, Catena, F, Perrone G., Giuffrida M., Abu-Zidan F., Kruger V. F., Livrini M., Petracca G. L., Rossi G., Tarasconi A., Tian B. W. C. A., Bonati E., Mentz R., Mazzini F. N., Campana J. P., Gasser E., Kafka-Ritsch R., Felsenreich D. M., Dawoud C., Riss S., Gomes C. A., Gomes F. C., Gonzaga R. A. T., Canton C. A. B., Pereira B. M., Fraga G. P., Zem L. G., Cordeiro-Fonseca V., de Mesquita Tauil R., Atanasov B., Belev N., Kovachev N., Melendez L. J. J., Dimova A., Dimov S., Zelic Z., Augustin G., Bogdanic B., Moric T., Chouillard E., Bajul M., De Simone B., Panis Y., Esposito F., Notarnicola M., Lauka L., Fabbri A., Hentati H., Fnaiech I., Aurelien V., Bougard M., Roulet M., Demetrashvili Z., Pipia I., Merabishvili G., Bouliaris K., Koukoulis G., Doudakmanis C., Xenaki S., Chrysos E., Kokkinakis S., Vassiliu P., Michalopoulos N., Margaris I., Kechagias A., Avgerinos K., Katunin J., Lostoridis E., Nagorni E. -A., Pujante A., Mulita F., Maroulis I., Vailas M., Marinis A., Siannis I., Bourbouteli E., Manatakis D. K., Tasis N., Acheimastos V., Maria S., Stylianos K., Kuzeridis H., Korkolis D., Fradelos E., Kavalieratos G., Petropoulou T., Polydorou A., Papacostantinou I., Triantafyllou T., Kimpizi D., Theodorou D., Toutouzas K., Chamzin A., Frountzas M., Schizas D., Karavokyros I., Syllaios A., Charalabopoulos A., Boura M., Baili E., Ioannidis O., Loutzidou L., Anestiadou E., Tsouknidas I., Petrakis G., Polenta E., Bains L., Gupta R., Singh S. K., Khanduri A., Bala M., Kedar A., Pisano M., Podda M., Pisanu A., Martines G., Trigiante G., Lantone G., Agrusa A., Di Buono G., Buscemi S., Veroux M., Gioco R., Veroux G., Oragano L., Zonta S., Lovisetto F., Feo C. V., Pesce A., Fabbri N., Marino F., Perrone F., Vincenti L., Papagni V., Picciariello A., Rossi S., Picardi B., Del Monte S. R., Visconti D., Osella G., Petruzzelli L., Pignata G., Andreuccetti J., D'Alessio R., Buonfantino M., Guaitoli E., Spinelli S., Sampietro G. M., Corbellini C., Lorusso L., Frontali A., Pezzoli I., Bonomi A., Chierici A., Cotsoglou C., Manca G., Delvecchio A., Musa N., Casati M., Letizia L., Abate E., Ercolani G., D'Acapito F., Solaini L., Guercioni G., Cicconi S., Sasia D., Borghi F., Giraudo G., Sena G., Castaldo P., Cardamone E., Portale G., Zuin M., Spolverato Y., Esposito M., Isernia R. M., Di Salvo M., Manunza R., Esposito G., Agus M., Asti E. L. G., Bernardi D. T., Tonucci T. P., Luppi D., Casadei M., Bonilauri S., Pezzolla A., Panebianco A., Laforgia R., De Luca M., Zese M., Parini D., Jovine E., De Sario G., Lombardi R., Aprea G., Palomba G., Capuano M., Argenio G., Orio G., Armellino M. F., Troian M., Guerra M., Nagliati C., Biloslavo A., Germani P., Aizza G., Monsellato I., Chahrour A. C., Anania G., Bombardini C., Bagolini F., Sganga G., Fransvea P., Bianchi V., Boati P., Ferrara F., Palmieri F., Cianci P., Gattulli D., Restini E., Cillara N., Cannavera A., Nita G. E., Sarnari J., Roscio F., Clerici F., Scandroglio I., Berti S., Cadeo A., Filippelli A., Conti L., Grassi C., Cattaneo G. M., Pighin M., Papis D., Gambino G., Bertino V., Schifano D., Prando D., Fogato L., Cavallo F., Ansaloni L., Picheo R., Pontarolo N., Depalma N., Spampinato M., D'Ugo S., Lepre L., Capponi M. G., Campa R. D., Sarro G., Dinuzzi V. P., Olmi S., Uccelli M., Ferrari D., Inama M., Moretto G., Fontana M., Favi F., Picariello E., Rampini A., Barberis A., Azzinnaro A., Oliva A., Totaro L., Benzoni I., Ranieri V., Capolupo G. T., Carannante F., Caricato M., Ronconi M., Casiraghi S., Casole G., Pantalone D., Alemanno G., Scheiterle M., Ceresoli M., Cereda M., Fumagalli C., Zanzi F., Bolzon S., Guerra E., Lecchi F., Cellerino P., Ardito A., Scaramuzzo R., Balla A., Lepiane P., Tartaglia N., Ambrosi A., Pavone G., Palini G. M., Veneroni S., Garulli G., Ricci C., Torre B., Russo I. S., Rottoli M., Tanzanu M., Belvedere A., Milone M., Manigrasso M., De Palma G. D., Piccoli M., Pattacini G. C., Magnone S., Bertoli P., Massucco P., Palisi M., Luzzi A. -P., Fleres F., Clarizia G., Spolini A., Kobe Y., Toma T., Shimamura F., Parker R., Ranketi S., Mitei M., Svagzdys S., Pauzas H., Zilinskas J., Poskus T., Kryzauskas M., Jakubauskas M., Zakaria A. D., Zakaria Z., Wong M. P. -K., Jusoh A. C., Zakaria M. N., Cruz D. R., Elizalde A. B. R., Reynaud A. B., Hernandez E. E. L., Monroy J. M. V. P., Hinojosa-Ugarte D., Quiodettis M., Du Bois M. E., Latorraca J., Major P., Pedziwiatr M., Pisarska-Adamczyk M., Waledziak M., Kwiatkowski A., Czyzykowski L., da Costa S. D., Pereira B., Ferreira A. R. O., Almeida F., Rocha R., Carneiro C., Perez D. P., Carvas J., Rocha C., Ferreira C., Marques R., Fernandes U., Leao P., Goulart A., Pereira R. G., Patrocinio S. D. D., de Mendonca N. G. G., Manso M. I. C., Morais H. M. C., Cardoso P. S., Calu V., Miron A., Toma E. A., Gachabayov M., Abdullaev A., Litvin A., Nechay T., Tyagunov A., Yuldashev A., Bradley A., Wilson M., Panyko A., Lateckova Z., Lacko V., Lesko D., Soltes M., Radonak J., Turrado-Rodriguez V., Termes-Serra R., Morales-Sevillano X., Lapolla P., Mingoli A., Brachini G., Degiuli M., Sofia S., Reddavid R., de Manzoni Garberini A., Buffone A., del Pozo E. P., Aparicio-Sanchez D., Dos Barbeito S., Estaire-Gomez M., Viton-Herrero R., de los Angeles Gil Olarte-Marquez M. a., Gil-Martinez J., Alconchel F., Nicolas-Lopez T., Rahy-Martin A. C., Pelloni M., Banolas-Suarez R., Mendoza-Moreno F., Nisa F. G. -M., Diez-Alonso M., Rodas M. E. V., Agundez M. C., Andres M. I. P., Moreira C. C. L., Perez A. L., Ponce I. A., Gonzalez-Castillo A. M., Membrilla-Fernandez E., Salvans S., Serradilla-Martin M., Pardo P. S., Rivera-Alonso D., Dziakova J., Huguet J. M., Valle N. P., Ruiz E. C., Valcarcel C. R., Moreno C. R., Salazar Y. T. M., Garcia J. J. R., Mico S. S., Lopez J. R., Farre S. P., Gomez M. S., Petit N. M., Titos-Garcia A., Aranda-Narvaez J. M., Romacho-Lopez L., Sanchez-Guillen L., Aranaz-Ostariz V., Bosch-Ramirez M., Martinez-Perez A., Martinez-Lopez E., Sebastian-Tomas J. C., Jimenez-Riera G., Jimenez-Vega J., Cuellar J. A. N., Campos-Serra A., Munoz-Campana A., Gracia-Roman R., Alegre J. M., Pinto F. L., O'Sullivan S. N., Antona F. B., Jimenez B. M., Lopez-Sanchez J., Carmona Z. G., Fernandez R. T., Sierra I. B., de Leon L. R. G., Moreno V. P., Iglesias E., Cumplido P. L., Bravo A. A., Simo I. R., Dominguez C. L., Caamano A. G., Lozano R. C., Martinez M. D., Torres A. N., de Quiros J. T. M. B., Pellino G., Cloquell M. M., Moller E. G., Jalal-Eldin S., Abdoun A. K., Hamid H. K. S., Lohsiriwat V., Mongkhonsupphawan A., Baraket O., Ayed K., Abbassi I., Ali A. B., Ammar H., Kchaou A., Tlili A., Zribi I., Colak E., Polat S., Koylu Z. A., Guner A., Usta M. A., Reis M. E., Mantoglu B., Gonullu E., Akin E., Altintoprak F., Bayhan Z., Firat N., Isik A., Memis U., Bayrak M., Altintas Y., Kara Y., Bozkurt M. A., Kocatas A., Das K., Seker A., Ozer N., Atici S. D., Tuncer K., Kaya T., Ozkan Z., Ilhan O., Agackiran I., Uzunoglu M. Y., Demirbas E., Altinel Y., Meric S., Hacim N. A., Uymaz D. S., Omarov N., Balik E., Tebala G. D., Khalil H., Rana M., Khan M., Florence C., Swaminathan C., Leo C. A., Liasis L., Watfah J., Trostchansky I., Delgado E., Pontillo M., Latifi R., Coimbra R., Edwards S., Lopez A., Velmahos G., Dorken A., Gebran A., Palmer A., Oury J., Bardes J. M., Seng S. S., Coffua L. S., Ratnasekera A., Egodage T., Echeverria-Rosario K., Armento I., Napolitano L. M., Sangji N. F., Hemmila M., Quick J. A., Austin T. R., Hyman T. S., Curtiss W., McClure A., Cairl N., Biffl W. L., Truong H. P., Schaffer K., Reames S., Banchini F., Capelli P., Coccolini F., Sartelli M., Bravi F., Vallicelli C., Agnoletti V., Baiocchi G. L., and Catena F.
Abstract: Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann’s procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann’s procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment’s choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception.
Published: 2024

3. Management of complicated diaphragmatic hernia in the acute setting: a WSES position paper

Author: Giuffrida, M, Perrone, G, Abu-Zidan, F, Agnoletti, V, Ansaloni, L, Baiocchi, G, Bendinelli, C, Biffl, W, Bonavina, L, Bravi, F, Carcoforo, P, Ceresoli, M, Chichom-Mefire, A, Coccolini, F, Coimbra, R, De'Angelis, N, de Moya, M, De Simone, B, Di Saverio, S, Fraga, G, Galante, J, Ivatury, R, Kashuk, J, Kelly, M, Kirkpatrick, A, Kluger, Y, Koike, K, Leppaniemi, A, Maier, R, Moore, E, Peitzmann, A, Sakakushev, B, Sartelli, M, Sugrue, M, Tian, B, Broek, R, Vallicelli, C, Wani, I, Weber, D, Docimo, G, Catena, F, Giuffrida M., Perrone G., Abu-Zidan F., Agnoletti V., Ansaloni L., Baiocchi G. L., Bendinelli C., Biffl W. L., Bonavina L., Bravi F., Carcoforo P., Ceresoli M., Chichom-Mefire A., Coccolini F., Coimbra R., de'Angelis N., de Moya M., De Simone B., Di Saverio S., Fraga G. P., Galante J., Ivatury R., Kashuk J., Kelly M. D., Kirkpatrick A. W., Kluger Y., Koike K., Leppaniemi A., Maier R. V., Moore E. E., Peitzmann A., Sakakushev B., Sartelli M., Sugrue M., Tian B. W. C. A., Broek R. T., Vallicelli C., Wani I., Weber D. G., Docimo G., Catena F., Giuffrida, M, Perrone, G, Abu-Zidan, F, Agnoletti, V, Ansaloni, L, Baiocchi, G, Bendinelli, C, Biffl, W, Bonavina, L, Bravi, F, Carcoforo, P, Ceresoli, M, Chichom-Mefire, A, Coccolini, F, Coimbra, R, De'Angelis, N, de Moya, M, De Simone, B, Di Saverio, S, Fraga, G, Galante, J, Ivatury, R, Kashuk, J, Kelly, M, Kirkpatrick, A, Kluger, Y, Koike, K, Leppaniemi, A, Maier, R, Moore, E, Peitzmann, A, Sakakushev, B, Sartelli, M, Sugrue, M, Tian, B, Broek, R, Vallicelli, C, Wani, I, Weber, D, Docimo, G, Catena, F, Giuffrida M., Perrone G., Abu-Zidan F., Agnoletti V., Ansaloni L., Baiocchi G. L., Bendinelli C., Biffl W. L., Bonavina L., Bravi F., Carcoforo P., Ceresoli M., Chichom-Mefire A., Coccolini F., Coimbra R., de'Angelis N., de Moya M., De Simone B., Di Saverio S., Fraga G. P., Galante J., Ivatury R., Kashuk J., Kelly M. D., Kirkpatrick A. W., Kluger Y., Koike K., Leppaniemi A., Maier R. V., Moore E. E., Peitzmann A., Sakakushev B., Sartelli M., Sugrue M., Tian B. W. C. A., Broek R. T., Vallicelli C., Wani I., Weber D. G., Docimo G., and Catena F.
Abstract: BACKGROUND: Diaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable. METHODS: A bibliographic search using major databases was performed using the terms "emergency surgery" "diaphragmatic hernia," "traumatic diaphragmatic rupture" and "congenital diaphragmatic hernia." GRADE methodology was used to evaluate the evidence and give recommendations. RESULTS: CT scan of the chest and abdomen is the diagnostic gold standard to evaluate complicated DH. Appropriate preoperative assessment and prompt surgical intervention are important for a clinical success. Complicated DH repair is best performed via the use of biological and bioabsorbable meshes which have proven to reduce recurrence. The laparoscopic approach is the preferred technique in hemodynamically stable patients without significant comorbidities because it facilitates early diagnosis of small diaphragmatic injuries from traumatic wounds in the thoraco-abdominal area and reduces postoperative complications. Open surgery should be reserved for situations when skills and equipment for laparoscopy are not available, where exploratory laparotomy is needed, or if the patient is hemodynamically unstable. Damage Control Surgery is an option in the management of critical and unstable patients. CONCLUSIONS: Complicated diaphragmatic hernia is a rare life-threatening condition. CT scan of the chest and abdomen is the gold standard for diagnosing the diaphragmatic hernia. Laparoscopic repair is the best treatment option for stable patients with complicated diaphragmatic hernias. Open repair is considered necessary in majority of unstable patients in whom Damage Control Surgery can be life-saving.
Published: 2023

4. Assessing and managing frailty in emergency laparotomy: a WSES position paper

Author: Tian, B, Stahel, P, Picetti, E, Campanelli, G, Di Saverio, S, Moore, E, Bensard, D, Sakakushev, B, Galante, J, Fraga, G, Koike, K, Di Carlo, I, Tebala, G, Leppaniemi, A, Tan, E, Damaskos, D, De'Angelis, N, Hecker, A, Pisano, M, Yunfengcui, Maier, R, De Simone, B, Amico, F, Ceresoli, M, Pikoulis, M, Weber, D, Biffl, W, Beka, S, Abu-Zidan, F, Valentino, M, Coccolini, F, Kluger, Y, Sartelli, M, Agnoletti, V, Chirica, M, Bravi, F, Sall, I, Catena, F, Tian B. W. C. A., Stahel P. F., Picetti E., Campanelli G., Di Saverio S., Moore E., Bensard D., Sakakushev B., Galante J., Fraga G. P., Koike K., Di Carlo I., Tebala G. D., Leppaniemi A., Tan E., Damaskos D., De'Angelis N., Hecker A., Pisano M., YunfengCui, Maier R. V., De Simone B., Amico F., Ceresoli M., Pikoulis M., Weber D. G., Biffl W., Beka S. G., Abu-Zidan F. M., Valentino M., Coccolini F., Kluger Y., Sartelli M., Agnoletti V., Chirica M., Bravi F., Sall I., Catena F., Tian, B, Stahel, P, Picetti, E, Campanelli, G, Di Saverio, S, Moore, E, Bensard, D, Sakakushev, B, Galante, J, Fraga, G, Koike, K, Di Carlo, I, Tebala, G, Leppaniemi, A, Tan, E, Damaskos, D, De'Angelis, N, Hecker, A, Pisano, M, Yunfengcui, Maier, R, De Simone, B, Amico, F, Ceresoli, M, Pikoulis, M, Weber, D, Biffl, W, Beka, S, Abu-Zidan, F, Valentino, M, Coccolini, F, Kluger, Y, Sartelli, M, Agnoletti, V, Chirica, M, Bravi, F, Sall, I, Catena, F, Tian B. W. C. A., Stahel P. F., Picetti E., Campanelli G., Di Saverio S., Moore E., Bensard D., Sakakushev B., Galante J., Fraga G. P., Koike K., Di Carlo I., Tebala G. D., Leppaniemi A., Tan E., Damaskos D., De'Angelis N., Hecker A., Pisano M., YunfengCui, Maier R. V., De Simone B., Amico F., Ceresoli M., Pikoulis M., Weber D. G., Biffl W., Beka S. G., Abu-Zidan F. M., Valentino M., Coccolini F., Kluger Y., Sartelli M., Agnoletti V., Chirica M., Bravi F., Sall I., and Catena F.
Abstract: Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty—an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions.
Published: 2023

5. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author: De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., and Catena F.
Abstract: Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classificat
Published: 2023

6. Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper

Author: De'Angelis, N, Marchegiani, F, Schena, C, Khan, J, Agnoletti, V, Ansaloni, L, Barria Rodriguez, A, Bianchi, P, Biffl, W, Bravi, F, Ceccarelli, G, Ceresoli, M, Chiara, O, Chirica, M, Cobianchi, L, Coccolini, F, Coimbra, R, Cotsoglou, C, D'Hondt, M, Damaskos, D, De Simone, B, Di Saverio, S, Diana, M, Espin-Basany, E, Fichtner-Feigl, S, Fugazzola, P, Gavriilidis, P, Gronnier, C, Kashuk, J, Kirkpatrick, A, Ammendola, M, Kouwenhoven, E, Laurent, A, Leppaniemi, A, Lesurtel, M, Memeo, R, Milone, M, Moore, E, Pararas, N, Peitzmann, A, Pessaux, P, Picetti, E, Pikoulis, M, Pisano, M, Ris, F, Robison, T, Sartelli, M, Shelat, V, Spinoglio, G, Sugrue, M, Tan, E, Van Eetvelde, E, Kluger, Y, Weber, D, Catena, F, de'Angelis N., Marchegiani F., Schena C. A., Khan J., Agnoletti V., Ansaloni L., Barria Rodriguez A. G., Bianchi P. P., Biffl W., Bravi F., Ceccarelli G., Ceresoli M., Chiara O., Chirica M., Cobianchi L., Coccolini F., Coimbra R., Cotsoglou C., D'Hondt M., Damaskos D., De Simone B., Di Saverio S., Diana M., Espin-Basany E., Fichtner-Feigl S., Fugazzola P., Gavriilidis P., Gronnier C., Kashuk J., Kirkpatrick A. W., Ammendola M., Kouwenhoven E. A., Laurent A., Leppaniemi A., Lesurtel M., Memeo R., Milone M., Moore E., Pararas N., Peitzmann A., Pessaux P., Picetti E., Pikoulis M., Pisano M., Ris F., Robison T., Sartelli M., Shelat V. G., Spinoglio G., Sugrue M., Tan E., Van Eetvelde E., Kluger Y., Weber D., Catena F., De'Angelis, N, Marchegiani, F, Schena, C, Khan, J, Agnoletti, V, Ansaloni, L, Barria Rodriguez, A, Bianchi, P, Biffl, W, Bravi, F, Ceccarelli, G, Ceresoli, M, Chiara, O, Chirica, M, Cobianchi, L, Coccolini, F, Coimbra, R, Cotsoglou, C, D'Hondt, M, Damaskos, D, De Simone, B, Di Saverio, S, Diana, M, Espin-Basany, E, Fichtner-Feigl, S, Fugazzola, P, Gavriilidis, P, Gronnier, C, Kashuk, J, Kirkpatrick, A, Ammendola, M, Kouwenhoven, E, Laurent, A, Leppaniemi, A, Lesurtel, M, Memeo, R, Milone, M, Moore, E, Pararas, N, Peitzmann, A, Pessaux, P, Picetti, E, Pikoulis, M, Pisano, M, Ris, F, Robison, T, Sartelli, M, Shelat, V, Spinoglio, G, Sugrue, M, Tan, E, Van Eetvelde, E, Kluger, Y, Weber, D, Catena, F, de'Angelis N., Marchegiani F., Schena C. A., Khan J., Agnoletti V., Ansaloni L., Barria Rodriguez A. G., Bianchi P. P., Biffl W., Bravi F., Ceccarelli G., Ceresoli M., Chiara O., Chirica M., Cobianchi L., Coccolini F., Coimbra R., Cotsoglou C., D'Hondt M., Damaskos D., De Simone B., Di Saverio S., Diana M., Espin-Basany E., Fichtner-Feigl S., Fugazzola P., Gavriilidis P., Gronnier C., Kashuk J., Kirkpatrick A. W., Ammendola M., Kouwenhoven E. A., Laurent A., Leppaniemi A., Lesurtel M., Memeo R., Milone M., Moore E., Pararas N., Peitzmann A., Pessaux P., Picetti E., Pikoulis M., Pisano M., Ris F., Robison T., Sartelli M., Shelat V. G., Spinoglio G., Sugrue M., Tan E., Van Eetvelde E., Kluger Y., Weber D., and Catena F.
Abstract: Background: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. Methods: This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. Results: Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20–107) depending on the initial surgeon’s experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon’s proficiency. Conclusions: Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.
Published: 2023

7. Canned Fish Consumption and Upper Digestive Tract Cancers

Author: D'Avanzo, B, Ardoino, I, Negri, E, Serraino, D, Crispo, A, Giacosa, A, Garavello, W, Bravi, F, Turati, F, Bosetti, C, Fattore, E, La Vecchia, C, Franchi, C, D'Avanzo B., Ardoino I., Negri E., Serraino D., Crispo A., Giacosa A., Garavello W., Bravi F., Turati F., Bosetti C., Fattore E., La Vecchia C., Franchi C., D'Avanzo, B, Ardoino, I, Negri, E, Serraino, D, Crispo, A, Giacosa, A, Garavello, W, Bravi, F, Turati, F, Bosetti, C, Fattore, E, La Vecchia, C, Franchi, C, D'Avanzo B., Ardoino I., Negri E., Serraino D., Crispo A., Giacosa A., Garavello W., Bravi F., Turati F., Bosetti C., Fattore E., La Vecchia C., and Franchi C.
Abstract: Canned fish is a widely consumed and affordable food whose effect on cancer risk has been little investigated. We studied its effect on risk of upper digestive tract cancers using data from a network of hospital-based case-control studies from Northern Italy providing information about canned fish consumption as a separate item and including a total of 946 patients with oral cavity and pharynx cancer, 304 patients with esophageal cancer, 230 patients with gastric cancer and 3273 controls. Twenty-three percent of patients with cancer of the oral cavity or pharynx and 26% of those with cancer of the stomach consumed ≥1 serving per week of canned fish, compared to 40% and 49% of the respective control group. Among cases of esophageal cancer and controls 22% consumed ≥1 serving per week of canned fish. Odds ratios for ≥1 vs <1 portion per week were 0.79 (95% Confidence Interval, CI: 0.64–0.97) for cancer of the oral cavity and pharynx, and 0.59 (95% CI: 0.41–0.86) for stomach cancer, whereas there was no inverse association with esophageal cancer. These findings suggest a favorable role of canned fish for selected upper digestive tract cancers.
Published: 2023

8. Diet Quality as Measured by the Healthy Eating Index 2015 and Oral and Pharyngeal Cancer Risk

Author: Edefonti, V, Di Maso, M, Tomaino, L, Parpinel, M, Garavello, W, Serraino, D, Ferraroni, M, Crispo, A, La Vecchia, C, Bravi, F, Edefonti V., Di Maso M., Tomaino L., Parpinel M., Garavello W., Serraino D., Ferraroni M., Crispo A., La Vecchia C., Bravi F., Edefonti, V, Di Maso, M, Tomaino, L, Parpinel, M, Garavello, W, Serraino, D, Ferraroni, M, Crispo, A, La Vecchia, C, Bravi, F, Edefonti V., Di Maso M., Tomaino L., Parpinel M., Garavello W., Serraino D., Ferraroni M., Crispo A., La Vecchia C., and Bravi F.
Abstract: Background: Alcohol and tobacco are the major risk factors for oral and pharyngeal cancer, but diet is likely to have a role, too. Objective: The objective was to analyze the relationship between adherence to the 2015-2020 Dietary Guidelines for Americans (DGA), as measured by the Healthy Eating Index 2015 (HEI-2015), and oral and pharyngeal cancer risk. Moreover, this work aimed to quantify the number of avoidable cases under different scenarios of increased adherence to the DGA, with the use of the potential impact fraction. This estimates the proportion of cases that would occur if the distribution of the risk factor in the population followed an alternative distribution. Design: A multicenter, case–control study was conducted in Italy between 1991 and 2009. Participants’ usual diet for the 2 years preceding study enrolment was assessed using a food frequency questionnaire. Participants and setting: Cases were 946 patients admitted to major hospitals with incident, histologically confirmed oral and pharyngeal cancer. Controls were 2,492 patients admitted to the same hospitals for acute non neoplastic conditions. Main outcome measures: The adherence to the DGA was assessed using the HEI-2015 score (range = 0 to 100), based on 13 components. The outcome was oral and pharyngeal cancer. Statistical analyses performed: Odds ratios and the corresponding 95% CIs were estimated using multiple logistic regression models adjusted for tobacco, alcohol, and other relevant covariates. The potential impact fraction was estimated under different scenarios of adherence to the DGA. Results: In this Italian population the HEI-2015 score ranged from 33.4 to 97.5. A higher HEI-2015 score was associated with a lower risk of oral and pharyngeal cancer, with an odds ratio of 0.70 (95% CI 0.62 to 0.79) for a 10-point increment of the score. The estimated potential impact fraction was 64.8% under the maximum achievable reduction scenario, and it ranged from 9% to 27% following other more
Published: 2022

9. Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper.

Author: De'Angelis, N., Marchegiani, F., Schena, C.A., Khan, J., Agnoletti, V., Ansaloni, L., arría Rodríguez, A.G. B, Bianchi, P.P., Biffl, W., Bravi, F., Ceccarelli, G., Ceresoli, M., Chiara, O., Chirica, M., Cobianchi, L., Coccolini, F., Coimbra, R., Cotsoglou, C., D'Hondt, M., Damaskos, D., Simone, B. De, Saverio, S. Di, Diana, M., Espin-Basany, E., Fichtner-Feigl, S., Fugazzola, P., Gavriilidis, P., Gronnier, C., Kashuk, J., Kirkpatrick, A.W., Ammendola, M., Kouwenhoven, E.A., Laurent, A., Leppaniemi, A., Lesurtel, M., Memeo, R., Milone, M., Moore, E., Pararas, N., Peitzmann, A., Pessaux, P., Picetti, E., Pikoulis, M., Pisano, M., Ris, F., Robison, T., Sartelli, M., Shelat, V.G., Spinoglio, G., Sugrue, M., Tan, E.C.T.H., Eetvelde, E. Van, Kluger, Y., Weber, D., Catena, F., De'Angelis, N., Marchegiani, F., Schena, C.A., Khan, J., Agnoletti, V., Ansaloni, L., arría Rodríguez, A.G. B, Bianchi, P.P., Biffl, W., Bravi, F., Ceccarelli, G., Ceresoli, M., Chiara, O., Chirica, M., Cobianchi, L., Coccolini, F., Coimbra, R., Cotsoglou, C., D'Hondt, M., Damaskos, D., Simone, B. De, Saverio, S. Di, Diana, M., Espin-Basany, E., Fichtner-Feigl, S., Fugazzola, P., Gavriilidis, P., Gronnier, C., Kashuk, J., Kirkpatrick, A.W., Ammendola, M., Kouwenhoven, E.A., Laurent, A., Leppaniemi, A., Lesurtel, M., Memeo, R., Milone, M., Moore, E., Pararas, N., Peitzmann, A., Pessaux, P., Picetti, E., Pikoulis, M., Pisano, M., Ris, F., Robison, T., Sartelli, M., Shelat, V.G., Spinoglio, G., Sugrue, M., Tan, E.C.T.H., Eetvelde, E. Van, Kluger, Y., Weber, D., and Catena, F.
Abstract: Item does not contain fulltext, BACKGROUND: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. METHODS: This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. RESULTS: Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20-107) depending on the initial surgeon's experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon's proficiency. CONCLUSIONS: Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.
Published: 2023

10. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study.

Author: Simone, B. De, Kluger, Y., Moore, E.E., Sartelli, M., Abu-Zidan, F.M., Coccolini, F., Ansaloni, L., Tebala, G.D., Saverio, S. Di, Carlo, I. Di, Sakakushev, B.E., Bonavina, L., Sugrue, M., Galante, J.M., Ivatury, R., Picetti, E., Chirica, M., Wani, I., Bala, M., Sall, I., Kirkpatrick, A.W., Shelat, V.G., Pikoulis, E., Leppäniemi, A., Tan, E., Broek, R.P.G ten, Gurmu Beka, S., Litvin, A., Chouillard, E., Coimbra, R., Cui, Y., De' Angelis, N., Sganga, G., Stahel, P.F., Agnoletti, V., Rampini, A., Testini, M., Bravi, F., Maier, R.V., Biffl, W.L., Catena, F., Simone, B. De, Kluger, Y., Moore, E.E., Sartelli, M., Abu-Zidan, F.M., Coccolini, F., Ansaloni, L., Tebala, G.D., Saverio, S. Di, Carlo, I. Di, Sakakushev, B.E., Bonavina, L., Sugrue, M., Galante, J.M., Ivatury, R., Picetti, E., Chirica, M., Wani, I., Bala, M., Sall, I., Kirkpatrick, A.W., Shelat, V.G., Pikoulis, E., Leppäniemi, A., Tan, E., Broek, R.P.G ten, Gurmu Beka, S., Litvin, A., Chouillard, E., Coimbra, R., Cui, Y., De' Angelis, N., Sganga, G., Stahel, P.F., Agnoletti, V., Rampini, A., Testini, M., Bravi, F., Maier, R.V., Biffl, W.L., and Catena, F.
Abstract: Item does not contain fulltext, BACKGROUND: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The "timing in acute care surgery" (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. METHODS: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4-5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. RESULTS: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. CONCLUSION: The new TACS classificat
Published: 2023

11. Management of complicated diaphragmatic hernia in the acute setting: a WSES position paper.

Author: Giuffrida, M., Perrone, G., Abu-Zidan, F., Agnoletti, V., Ansaloni, L., Baiocchi, G.L., Bendinelli, C., Biffl, W.L., Bonavina, L., Bravi, F., Carcoforo, P., Ceresoli, M., Chichom-Mefire, A., Coccolini, F., Coimbra, R., De'Angelis, N., Moya, M. de, Simone, B. De, Saverio, S. Di, Fraga, G.P., Galante, J., Ivatury, R., Kashuk, J., Kelly, M.D., Kirkpatrick, A.W., Kluger, Y., Koike, Kaoru, Leppaniemi, A., Maier, R.V., Moore, E.E., Peitzmann, A., Sakakushev, B., Sartelli, M., Sugrue, M., Tian, B.W.C.A., Broek, R.P.G ten, Vallicelli, C., Wani, I., Weber, D.G., Docimo, G., Catena, F., Giuffrida, M., Perrone, G., Abu-Zidan, F., Agnoletti, V., Ansaloni, L., Baiocchi, G.L., Bendinelli, C., Biffl, W.L., Bonavina, L., Bravi, F., Carcoforo, P., Ceresoli, M., Chichom-Mefire, A., Coccolini, F., Coimbra, R., De'Angelis, N., Moya, M. de, Simone, B. De, Saverio, S. Di, Fraga, G.P., Galante, J., Ivatury, R., Kashuk, J., Kelly, M.D., Kirkpatrick, A.W., Kluger, Y., Koike, Kaoru, Leppaniemi, A., Maier, R.V., Moore, E.E., Peitzmann, A., Sakakushev, B., Sartelli, M., Sugrue, M., Tian, B.W.C.A., Broek, R.P.G ten, Vallicelli, C., Wani, I., Weber, D.G., Docimo, G., and Catena, F.
Abstract: Contains fulltext : 296002.pdf (Publisher’s version ) (Open Access), BACKGROUND: Diaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable. METHODS: A bibliographic search using major databases was performed using the terms "emergency surgery" "diaphragmatic hernia," "traumatic diaphragmatic rupture" and "congenital diaphragmatic hernia." GRADE methodology was used to evaluate the evidence and give recommendations. RESULTS: CT scan of the chest and abdomen is the diagnostic gold standard to evaluate complicated DH. Appropriate preoperative assessment and prompt surgical intervention are important for a clinical success. Complicated DH repair is best performed via the use of biological and bioabsorbable meshes which have proven to reduce recurrence. The laparoscopic approach is the preferred technique in hemodynamically stable patients without significant comorbidities because it facilitates early diagnosis of small diaphragmatic injuries from traumatic wounds in the thoraco-abdominal area and reduces postoperative complications. Open surgery should be reserved for situations when skills and equipment for laparoscopy are not available, where exploratory laparotomy is needed, or if the patient is hemodynamically unstable. Damage Control Surgery is an option in the management of critical and unstable patients. CONCLUSIONS: Complicated diaphragmatic hernia is a rare life-threatening condition. CT scan of the chest and abdomen is the gold standard for diagnosing the diaphragmatic hernia. Laparoscopic repair is the best treatment option for stable patients with complicated diaphragmatic hernias. Open repair is considered necessary in majority of unstable patients in whom Damage Control Surgery can be life-saving.
Published: 2023

12. Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies and abdominal trauma.

Author: Sermonesi, G., Tian, B.W.C.A., Vallicelli, C., Abu-Zidan, F.M., Damaskos, D., Kelly, M.D., Leppäniemi, A., Galante, J.M., Tan, E.C.T.H., Kirkpatrick, A.W., Khokha, V., Romeo, O.M., Chirica, M., Pikoulis, M., Litvin, A., Shelat, V.G., Sakakushev, B., Wani, I., Sall, I., Fugazzola, P., Cicuttin, E., Toro, A., Amico, F., Mas, F.D., Simone, B. De, Sugrue, M., Bonavina, L., Campanelli, G., Carcoforo, P., Cobianchi, L., Coccolini, F., Chiarugi, M., Carlo, I. Di, Saverio, S. Di, Podda, M., Pisano, M., Sartelli, M., Testini, M., Fette, A., Rizoli, S., Picetti, E., Weber, D., Latifi, R., Kluger, Y., Balogh, Z.J., Biffl, W., Jeekel, H., Civil, I., Hecker, A., Ansaloni, L., Bravi, F., Agnoletti, V., Beka, S.G., Moore, E.E., Catena, F., Sermonesi, G., Tian, B.W.C.A., Vallicelli, C., Abu-Zidan, F.M., Damaskos, D., Kelly, M.D., Leppäniemi, A., Galante, J.M., Tan, E.C.T.H., Kirkpatrick, A.W., Khokha, V., Romeo, O.M., Chirica, M., Pikoulis, M., Litvin, A., Shelat, V.G., Sakakushev, B., Wani, I., Sall, I., Fugazzola, P., Cicuttin, E., Toro, A., Amico, F., Mas, F.D., Simone, B. De, Sugrue, M., Bonavina, L., Campanelli, G., Carcoforo, P., Cobianchi, L., Coccolini, F., Chiarugi, M., Carlo, I. Di, Saverio, S. Di, Podda, M., Pisano, M., Sartelli, M., Testini, M., Fette, A., Rizoli, S., Picetti, E., Weber, D., Latifi, R., Kluger, Y., Balogh, Z.J., Biffl, W., Jeekel, H., Civil, I., Hecker, A., Ansaloni, L., Bravi, F., Agnoletti, V., Beka, S.G., Moore, E.E., and Catena, F.
Abstract: Contains fulltext : 300061.pdf (Publisher’s version ) (Open Access), BACKGROUND: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma. Emergency laparotomy continues to carry a high morbidity and mortality. In recent years, there has been a growing interest from emergency and trauma surgeons in adopting minimally invasive surgery approaches in the acute surgical setting. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a review of the literature to reach a consensus on the indications and benefits of a laparoscopic-first approach in patients requiring emergency abdominal surgery for general surgery emergencies or abdominal trauma. METHODS: This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of 54 experts then critically revised the manuscript and discussed it in detail, to develop a consensus on a position statement. RESULTS: A total of 323 studies (systematic review and meta-analysis, randomized clinical trial, retrospective comparative cohort studies, case series) have been selected from an initial pool of 7409 studies. Evidence demonstrates several benefits of the laparoscopic approach in stable patients undergoing emergency abdominal surgery for general surgical emergencies or abdominal trauma. The selection of a stable patient seems to be of paramount importance for a safe adoption of a laparoscopic approach. In hemodynamically stable patients, the laparoscopic approach was found to be safe, feasible and effective as a therapeutic tool or helpful to identify further management steps and n
Published: 2023

13. Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Author: Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawrylux, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A., Bala, Miklosh, Balogh, Zsolt J., Bertuccio, Alessandro, Biffl, Walt L., Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M., Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M., Hawrylux, Gregory W. J., Helbok, Raimund, Hutchinson, Peter J. A., Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W., Martin, Matthew J., Meyfroidt, Geert, Okonkwo, David O., Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G., Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E., Sartelli, Massimo, Weber, Dieter, Robba, Chiara, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawrylux, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A., Bala, Miklosh, Balogh, Zsolt J., Bertuccio, Alessandro, Biffl, Walt L., Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M., Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M., Hawrylux, Gregory W. J., Helbok, Raimund, Hutchinson, Peter J. A., Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W., Martin, Matthew J., Meyfroidt, Geert, Okonkwo, David O., Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G., Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E., Sartelli, Massimo, Weber, Dieter, and Robba, Chiara
Abstract: Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.
Published: 2023

14. Correction: Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Author: Picetti, Edoardo, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawryluk, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A, Bala, Miklosh, Balogh, Zsolt J, Bertuccio, Alessandro, Biffl, Walt L, Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M, Hawryluk, Gregory W J, Helbok, Raimund, Hutchinson, Peter J A, Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W, Martin, Matthew J, Meyfroidt, Geert, Okonkwo, David O, Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G, Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F, Taccone, Fabio S, Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E, Sartelli, Massimo, Weber, Dieter, Robba, Chiara, Picetti, Edoardo, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawryluk, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A, Bala, Miklosh, Balogh, Zsolt J, Bertuccio, Alessandro, Biffl, Walt L, Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M, Hawryluk, Gregory W J, Helbok, Raimund, Hutchinson, Peter J A, Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W, Martin, Matthew J, Meyfroidt, Geert, Okonkwo, David O, Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G, Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F, Taccone, Fabio S, Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E, Sartelli, Massimo, Weber, Dieter, and Robba, Chiara
Published: 2023

15. Lessons learned from the INHANCE consortium: An overview of recent results on head and neck cancer

Author: Bravi, F, Lee, Y, Hashibe, M, Boffetta, P, Conway, D, Ferraroni, M, La Vecchia, C, Edefonti, V, Agudo, A, Ahrens, W, Benhamou, S, Boccia, S, Brennan, P, Brenner, H, Cadoni, G, Canova, C, Chen, C, Chuang, S, Curado, M, Dal Maso, L, Daudt, A, D'Souza, G, Fabianova, E, Fernandez, L, Franceschi, S, Garavello, W, Gillison, M, Gross, N, Hayes, R, Healy, C, Herrero, R, Holcatova, I, Kelsey, K, Kjaerheim, K, Koifman, R, Lagiou, P, Lazarus, P, Levi, F, Li, G, Lissowska, J, Luce, D, Macfarlane, G, Mates, D, Matsuo, K, Mcclean, M, Menezes, A, Menvielle, G, Morgenstern, H, Moyses, R, Moysich, K, Muscat, J, Negri, E, Olshan, A, Pandics, T, Polesel, J, Purdue, M, Radoi, L, Ramroth, H, Richiardi, L, Schantz, S, Schwartz, S, Serraino, D, Shangina, O, Smith, E, Sturgis, E, Swiatkowska, B, Thomson, P, Toporcov, T, Vaughan, T, Vilensky, M, Winn, D, Wunsch-Filho, V, Yu, G, Zevallos, J, Zhang, Z, Zheng, T, Znaor, A, Bravi F., Lee Y. -C. A., Hashibe M., Boffetta P., Conway D. I., Ferraroni M., La Vecchia C., Edefonti V., Agudo A., Ahrens W., Benhamou S., Boccia S., Brennan P., Brenner H., Cadoni G., Canova C., Chen C., Chuang S. -C., Curado M. P., Dal Maso L., Daudt A. W., D'Souza G., Fabianova E., Fernandez L., Franceschi S., Garavello W., Gillison M., Gross N. D., Hayes R. B., Healy C., Herrero R., Holcatova I., Kelsey K., Kjaerheim K., Koifman R., Lagiou P., Lazarus P., Levi F., Li G., Lissowska J., Luce D., Macfarlane G. J., Mates D., Matsuo K., McClean M., Menezes A., Menvielle G., Morgenstern H., Moyses R. A., Moysich K., Muscat J., Negri E., Olshan A. F., Pandics T., Polesel J., Purdue M. P., Radoi L., Ramroth H., Richiardi L., Schantz S., Schwartz S. M., Serraino D., Shangina O., Smith E., Sturgis E. M., Swiatkowska B., Thomson P., Toporcov T. N., Vaughan T. L., Vilensky M., Winn D. M., Wunsch-Filho V., Yu G. -P., Zevallos J. P., Zhang Z. -F., Zheng T., Znaor A., Bravi, F, Lee, Y, Hashibe, M, Boffetta, P, Conway, D, Ferraroni, M, La Vecchia, C, Edefonti, V, Agudo, A, Ahrens, W, Benhamou, S, Boccia, S, Brennan, P, Brenner, H, Cadoni, G, Canova, C, Chen, C, Chuang, S, Curado, M, Dal Maso, L, Daudt, A, D'Souza, G, Fabianova, E, Fernandez, L, Franceschi, S, Garavello, W, Gillison, M, Gross, N, Hayes, R, Healy, C, Herrero, R, Holcatova, I, Kelsey, K, Kjaerheim, K, Koifman, R, Lagiou, P, Lazarus, P, Levi, F, Li, G, Lissowska, J, Luce, D, Macfarlane, G, Mates, D, Matsuo, K, Mcclean, M, Menezes, A, Menvielle, G, Morgenstern, H, Moyses, R, Moysich, K, Muscat, J, Negri, E, Olshan, A, Pandics, T, Polesel, J, Purdue, M, Radoi, L, Ramroth, H, Richiardi, L, Schantz, S, Schwartz, S, Serraino, D, Shangina, O, Smith, E, Sturgis, E, Swiatkowska, B, Thomson, P, Toporcov, T, Vaughan, T, Vilensky, M, Winn, D, Wunsch-Filho, V, Yu, G, Zevallos, J, Zhang, Z, Zheng, T, Znaor, A, Bravi F., Lee Y. -C. A., Hashibe M., Boffetta P., Conway D. I., Ferraroni M., La Vecchia C., Edefonti V., Agudo A., Ahrens W., Benhamou S., Boccia S., Brennan P., Brenner H., Cadoni G., Canova C., Chen C., Chuang S. -C., Curado M. P., Dal Maso L., Daudt A. W., D'Souza G., Fabianova E., Fernandez L., Franceschi S., Garavello W., Gillison M., Gross N. D., Hayes R. B., Healy C., Herrero R., Holcatova I., Kelsey K., Kjaerheim K., Koifman R., Lagiou P., Lazarus P., Levi F., Li G., Lissowska J., Luce D., Macfarlane G. J., Mates D., Matsuo K., McClean M., Menezes A., Menvielle G., Morgenstern H., Moyses R. A., Moysich K., Muscat J., Negri E., Olshan A. F., Pandics T., Polesel J., Purdue M. P., Radoi L., Ramroth H., Richiardi L., Schantz S., Schwartz S. M., Serraino D., Shangina O., Smith E., Sturgis E. M., Swiatkowska B., Thomson P., Toporcov T. N., Vaughan T. L., Vilensky M., Winn D. M., Wunsch-Filho V., Yu G. -P., Zevallos J. P., Zhang Z. -F., Zheng T., and Znaor A.
Abstract: Objective: To summarize the latest evidence on head and neck cancer epidemiology from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Subjects and Methods: INHANCE was established in 2004 to elucidate the etiology of head and neck cancer through pooled analyses of individual-level data on a large scale. We summarize results from recent INHANCE-based publications updating our 2015 overview. Results: Seventeen papers were published between 2015 and May 2020. These studies further define the nature of risks associated with tobacco and alcohol, and occupational exposures on head and neck cancer. The beneficial effects on incidence of head and neck cancer were identified for good oral health, endogenous and exogenous hormonal factors, and selected aspects of diet related to fruit and vegetables. INHANCE has begun to develop risk prediction models and to pool follow-up data on their studies, finding that ~30% of cases had cancer recurrence and 9% second primary cancers, with overall- and disease-specific 5-year-survival of 51% and 57%, respectively. Conclusions: The number and importance of INHANCE scientific findings provides further evidence of the advantages of large-scale internationally collaborative projects and will support the development of prevention strategies.
Published: 2021

16. Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens

Author: Bravi, F, Flacco, M, Carradori, T, Volta, C, Cosenza, G, De Togni, A, Acuti Martellucci, C, Parruti, G, Mantovani, L, Manzoli, L, Bravi F., Flacco M. E., Carradori T., Volta C. A., Cosenza G., De Togni A., Acuti Martellucci C., Parruti G., Mantovani L., Manzoli L., Bravi, F, Flacco, M, Carradori, T, Volta, C, Cosenza, G, De Togni, A, Acuti Martellucci, C, Parruti, G, Mantovani, L, Manzoli, L, Bravi F., Flacco M. E., Carradori T., Volta C. A., Cosenza G., De Togni A., Acuti Martellucci C., Parruti G., Mantovani L., and Manzoli L.
Abstract: AIMS: This retrospective case-control study was aimed at identifying potential independent predictors of severe/lethal COVID-19, including the treatment with Angiotensin-Converting Enzyme inhibitors (ACEi) and/or Angiotensin II Receptor Blockers (ARBs). METHODS AND RESULTS: All adults with SARS-CoV-2 infection in two Italian provinces were followed for a median of 24 days. ARBs and/or ACEi treatments, and hypertension, diabetes, cancer, COPD, renal and major cardiovascular diseases (CVD) were extracted from clinical charts and electronic health records, up to two years before infection. The sample consisted of 1603 subjects (mean age 58.0y; 47.3% males): 454 (28.3%) had severe symptoms, 192 (12.0%) very severe or lethal disease (154 deaths; mean age 79.3 years; 70.8% hypertensive, 42.2% with CVD). The youngest deceased person aged 44 years. Among hypertensive subjects (n = 543), the proportion of those treated with ARBs or ACEi were 88.4%, 78.7% and 80.6% among patients with mild, severe and very severe/lethal disease, respectively. At multivariate analysis, no association was observed between therapy and disease severity (Adjusted OR for very severe/lethal COVID-19: 0.87; 95% CI: 0.50-1.49). Significant predictors of severe disease were older age (with AORs largely increasing after 70 years of age), male gender (AOR: 1.76; 1.40-2.23), diabetes (AOR: 1.52; 1.05-2.18), CVD (AOR: 1.88; 1.32-2.70) and COPD (AOR: 1.88; 1.11-3.20). Only gender, age and diabetes also predicted very severe/lethal disease. CONCLUSION: No association was found between COVID-19 severity and treatment with ARBs and/or ACEi, supporting the recommendation to continue medication for all patients unless otherwise advised by their physicians.
Published: 2020

17. Dietary patterns and oral and pharyngeal cancer using latent class analysis

Author: Dalmartello, M, Decarli, A, Ferraroni, M, Bravi, F, Serraino, D, Garavello, W, Negri, E, Vermunt, J, La Vecchia, C, Dalmartello M., Decarli A., Ferraroni M., Bravi F., Serraino D., Garavello W., Negri E., Vermunt J., La Vecchia C., Dalmartello, M, Decarli, A, Ferraroni, M, Bravi, F, Serraino, D, Garavello, W, Negri, E, Vermunt, J, La Vecchia, C, Dalmartello M., Decarli A., Ferraroni M., Bravi F., Serraino D., Garavello W., Negri E., Vermunt J., and La Vecchia C.
Abstract: The methods traditionally used to identify a posteriori dietary patterns are principal components, factor and cluster analysis. The aim of our study is to assess the relationship between dietary patterns derived with latent class analysis (LCA) and oral/pharyngeal cancer risk (OPC), highlighting the strengths of this method compared to traditional ones. We analyzed data from an Italian multicentric case–control study on OPC including 946 cases and 2,492 hospital controls. Dietary patterns were derived using LCA on 25 food groups. A multiple logistic regression model was used to derive odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for OPC according to the dietary patterns identified. We identified four dietary patterns. The first one was characterized by a high intake of leafy and fruiting vegetable and fruits (Prudent pattern), the second one showed a high intake of red meat and low intake of selected fruits and vegetables (Western pattern). The last two patterns showed a combination-type of diet. We labeled “Lower consumers-combination pattern” the cluster that showed a low intake of the majority of foods, and “Higher consumers-combination pattern” the one characterized by a high intake of various foods. Compared to the “Prudent pattern”, the “Western” and the “Lower consumers-combination” ones were positively related to the risk of OPC (OR = 2.56, 95% CI: 1.90–3.45 and OR = 2.23, 95% CI: 1.64–3.02). No difference in risk emerged for the “Higher consumers-combination pattern” (OR = 1.28, 95% CI: 0.92–1.77).
Published: 2020

18. Dietary patterns and upper aerodigestive tract cancers: an overview and review

Author: Bravi, F., Edefonti, V., Randi, G., Ferraroni, M., La Vecchia, C., and Decarli, A.
Published: 2012
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19. Nutrient-based dietary patterns and the risk of head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology consortium

Author: Edefonti, V., Hashibe, M., Ambrogi, F., Parpinel, M., Bravi, F., Talamini, R., Levi, F., Yu, G., Morgenstern, H., Kelsey, K., McClean, M., Schantz, S., Zhang, Z., Chuang, S., Boffetta, P., La Vecchia, C., and Decarli, A.
Published: 2012
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20. Dietary intake of selected micronutrients and the risk of pancreatic cancer: an Italian case–control study

Author: Bravi, F., Polesel, J., Bosetti, C., Talamini, R., Negri, E., Dal Maso, L., Serraino, D., and La Vecchia, C.
Published: 2011
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21. Tobacco vs. electronic cigarettes. Absence of harm reduction after six years of follow-uA

Author: Flacco, M E, Fiore, M, Acuti Martellucci, C, Ferrante, M, Gualano, M R, Liguori, G, Bravi, F, Pirone, G M, Marzuillo, C, Manzoli, L, Flacco, M E, Fiore, M, Acuti Martellucci, C, Ferrante, M, Gualano, M R, Liguori, G, Bravi, F, Pirone, G M, Marzuillo, C, and Manzoli, L
Subjects: Adult, Male, Time Factors, adverse health effects, Socio-culturale, Electronic Nicotine Delivery Systems, Middle Aged, heat-not-burn products, Electronic cigarettes, Traditional smoking devices, Heat-not-burn products, Smoking cessation, Harm reduction, Tobacco smoking, Adverse health effects, smoking cessation, electronic cigarettes, traditional smoking devices, harm reduction, tobacco smoking, Heat-not-burn product, Tobacco, Traditional smoking device, Humans, Female, Electronic cigarette, Aged, Follow-Up Studies
Abstract: OBJECTIVE: Information on the long-term safety of electronic cigarettes (e-cig) is still limited. We report the results after six years of follow-up of the first observational study assessing e-cig long-term effectiveness and safety. PATIENTS AND METHODS: Participants were adults who smoked ≥1 tobacco cigarette/day (tobacco smokers); or used any type of e-cig inhaling ≥50 puffs weekly (e-cig users); or used both (dual users). Participants were contacted directly or by phone and/or internet interviews. Hospital discharge abstract data and carbon monoxide level tests were also used. RESULTS: Data were available for 228 e-cig users (all ex-smokers), 469 tobacco smokers, 215 dual users. A possibly smoking-related disease (PSRD) was recorded in 90 subjects (9.9%); 11 deceased (1.2%). No differences were observed across groups in PSRD rates, with minor changes in self-reported health. Among e-cig users, 64.0% remained tobacco abstinent. Dual users and tobacco smokers did not significantly differ in the rate of cessation of tobacco (38.6% vs. 33.9%, respectively) and all products (23.7% vs. 26.4%). A comparable decrease in daily cigarettes was also observed. 39.5% of the sample switched at least once (tobacco smokers: 15.1%; dual users: 83.3%). CONCLUSIONS: After six years, no evidence of harm reduction was found among e-cig or dual users. The complete switch to e-cig might support tobacco quitters remain abstinent, but the use of e-cig in addition to tobacco did not improve smoking cessation or reduction.
Published: 2020

22. Lessons learned from the INHANCE consortium: An overview of recent results on head and neck cancer

Author: Bravi, F., Lee, Y. -C. A., Hashibe, M., Boffetta, Paolo, Conway, D. I., Ferraroni, M., La Vecchia, C., Edefonti, V., Agudo, A., Ahrens, W., Benhamou, S., Boccia, Stefania, Brennan, P., Brenner, H., Cadoni, Gabriella, Canova, C., Chen, Chen, Chuang, S. -C., Curado, M. P., Dal Maso, L., Daudt, A. W., D'Souza, G., Fabianova, E., Fernandez, L., Franceschi, S., Garavello, W., Gillison, M., Gross, N. D., Hayes, R. B., Healy, C., Herrero, R., Holcatova, I., Kelsey, K., Kjaerheim, K., Koifman, R., Lagiou, Pagona, Lazarus, P., Levi, F., Li, G., Lissowska, J., Luce, D., Macfarlane, G. J., Mates, D., Matsuo, K., Mcclean, M., Menezes, A., Menvielle, G., Morgenstern, H., Moyses, R. A., Moysich, K., Muscat, J., Negri, Erica, Olshan, A. F., Pandics, T., Polesel, J., Purdue, M. P., Radoi, L., Ramroth, H., Richiardi, L., Schantz, S., Schwartz, S. M., Serraino, D., Shangina, O., Smith, E., Sturgis, E. M., Swiatkowska, B., Thomson, P., Toporcov, T. N., Vaughan, T. L., Vilensky, M., Winn, D. M., Wunsch-Filho, V., Yu, G. -P., Zevallos, J. P., Zhang, Z. -F., Zheng, T., Znaor, A., Boffetta P., Boccia S. (ORCID:0000-0002-1864-749X), Cadoni G. (ORCID:0000-0001-8244-784X), Chen C., Lagiou P., Negri E., Bravi, F., Lee, Y. -C. A., Hashibe, M., Boffetta, Paolo, Conway, D. I., Ferraroni, M., La Vecchia, C., Edefonti, V., Agudo, A., Ahrens, W., Benhamou, S., Boccia, Stefania, Brennan, P., Brenner, H., Cadoni, Gabriella, Canova, C., Chen, Chen, Chuang, S. -C., Curado, M. P., Dal Maso, L., Daudt, A. W., D'Souza, G., Fabianova, E., Fernandez, L., Franceschi, S., Garavello, W., Gillison, M., Gross, N. D., Hayes, R. B., Healy, C., Herrero, R., Holcatova, I., Kelsey, K., Kjaerheim, K., Koifman, R., Lagiou, Pagona, Lazarus, P., Levi, F., Li, G., Lissowska, J., Luce, D., Macfarlane, G. J., Mates, D., Matsuo, K., Mcclean, M., Menezes, A., Menvielle, G., Morgenstern, H., Moyses, R. A., Moysich, K., Muscat, J., Negri, Erica, Olshan, A. F., Pandics, T., Polesel, J., Purdue, M. P., Radoi, L., Ramroth, H., Richiardi, L., Schantz, S., Schwartz, S. M., Serraino, D., Shangina, O., Smith, E., Sturgis, E. M., Swiatkowska, B., Thomson, P., Toporcov, T. N., Vaughan, T. L., Vilensky, M., Winn, D. M., Wunsch-Filho, V., Yu, G. -P., Zevallos, J. P., Zhang, Z. -F., Zheng, T., Znaor, A., Boffetta P., Boccia S. (ORCID:0000-0002-1864-749X), Cadoni G. (ORCID:0000-0001-8244-784X), Chen C., Lagiou P., and Negri E.
Abstract: Objective: To summarize the latest evidence on head and neck cancer epidemiology from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Subjects and Methods: INHANCE was established in 2004 to elucidate the etiology of head and neck cancer through pooled analyses of individual-level data on a large scale. We summarize results from recent INHANCE-based publications updating our 2015 overview. Results: Seventeen papers were published between 2015 and May 2020. These studies further define the nature of risks associated with tobacco and alcohol, and occupational exposures on head and neck cancer. The beneficial effects on incidence of head and neck cancer were identified for good oral health, endogenous and exogenous hormonal factors, and selected aspects of diet related to fruit and vegetables. INHANCE has begun to develop risk prediction models and to pool follow-up data on their studies, finding that ~30% of cases had cancer recurrence and 9% second primary cancers, with overall- and disease-specific 5-year-survival of 51% and 57%, respectively. Conclusions: The number and importance of INHANCE scientific findings provides further evidence of the advantages of large-scale internationally collaborative projects and will support the development of prevention strategies.
Published: 2021

23. Adherence to the European food safety authority's dietary recommendations and colorectal cancer risk

Author: Turati, F, Edefonti, V, Bravi, F, Ferraroni, M, Talamini, R, Giacosa, A, Montella, M, Parpinel, M, La Vecchia, C, and Decarli, A
Published: 2012
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24. Costs of irritable bowel syndrome in European countries with universal healthcare coverage: a meta-analysis

Author: Flacco, M E, Manzoli, Lamberto, De Giorgio, Andrea, Gasbarrini, Antonio, Cicchetti, Americo, Bravi, F, Altini, M, Caio, G P, Ursini, F, Flacco, ME, Manzoli, L, De Giorgio, R, Gasbarrini, A, Cicchetti, A, Bravi, F, Altini, M, Caio, GP, and Ursini, F
Subjects: Irritable bowel syndrome, Direct costs, Indirect costs, Meta-analysis, Italy, Settore MED/12 - GASTROENTEROLOGIA, Socio-culturale, Health Care Costs, Direct cost, Indirect costs, Europe, Meta-analysis, Irritable bowel syndrome, Italy, Indirect cost, Direct costs, Costs of irritable bowel syndrome, Humans, Universal Health Care, Meta-analysi
Abstract: OBJECTIVE: To provide an overall estimate of the direct, indirect and total costs of irritable bowel syndrome (IBS) for the adult population of the European countries with universal healthcare coverage.MATERIALS AND METHODS: We searched MedLine and Scopus databases (up to September 2018) to identify the European studies that evaluated the economic impact of IBS. Mean annual direct, indirect and total per-capita IBS costs were estimated using random-effect single-group meta-analyses of continuous data. All analyses were stratified by payer category (governments, insurance, societal), and the results were expressed as summary mean and 95% CI.RESULTS: A total of 24 studies were included in the meta-analyses. Only two studies evaluated IBS costs in Italy. The pooled summary of direct IBS per-capita cost, obtained from 23 European datasets (n=15,157), was (sic)1837/year (95% CI: 1480-2195), with large differences across payers (from (sic)1183 to (sic)3358, in countries with publicly-funded and insurance-based health systems, respectively). The mean indirect cost, extracted from 13 datasets (n=3978), was (sic)2314/year (95% CI: 1811-2817), again with wide differences across payers. Finally, the meta-analysis estimating the total annual cost, based upon 11 European datasets (n=2757), yielded a summary estimate of (sic)2889/year (95% CI: 2318-3460) per patient, ranging from (sic)1602 (insurance-based health systems) to (sic)3909 (studies adopting a societal perspective).CONCLUSIONS: Considering a conservative estimate of 2,736,700 Italian adults affected by the syndrome, the minimum costs due to IBS in Italy - likely underestimated - range from 6 to 8 billion euro per year. Given the substantial economic burden for patients, healthcare systems and society, IBS should be included among the priorities of the public health agenda.
Published: 2019

25. Cohort study of electronic cigarette use. Safety and effectiveness after 4 years of follow-up

Author: Flacco, M E, Ferrante, M, Fiore, M, Marzuillo, C, La Vecchia, C, Gualano, M R, Liguori, G, Fragassi, G, Carradori, T, Bravi, F, Siliquini, R, Ricciardi, W, Villari, P, Manzoli, L, Flacco, M E, Ferrante, M, Fiore, M, Marzuillo, C, La Vecchia, C, Gualano, M R, Liguori, G, Fragassi, G, Carradori, T, Bravi, F, Siliquini, R, Ricciardi, W, Villari, P, and Manzoli, L
Subjects: Adult, Male, Time Factors, Electronic cigarettes, Electronic nicotine delivery devices, Smoking cessation, Harm reduction, Tobacco smoking, Electronic Nicotine Delivery Systems, Smoking cessation, Electronic nicotine delivery device, Humans, Longitudinal Studies, Electronic cigarette, Settore MED/42 - IGIENE GENERALE E APPLICATA, Aged, Pharmacology, Harm reduction, Vaping, Ambientale, Middle Aged, Tobacco smoking, Italy, Electronic cigarettes, Electronic nicotine delivery devices, Female, Self Report, electronic cigarettes, electronic nicotine delivery devices, smoking cessation, harm reduction, tobacco smoking, Follow-Up Studies
Abstract: OBJECTIVE: More than a decade after e-cigarette (e-cig) market launch, limited information are available on their safety after 24 months of use. In 2013, we started the first observational study assessing e-cig long-term effectiveness and safety, directly comparing tobacco smokers and e-cig users. Here we report the results after four years of follow-up. PATIENTS AND METHODS: Adults (30-75 years) were included if: smokers of =1 tobacco cigarette/day (tobacco smokers); users of any type of e-cig inhaling =50 puffs weekly (e-cig users); users of both tobacco and e-cig (dual users). Data were collected by phone and/or internet, and carbon monoxide levels tested in 50% of those declaring tobacco abstinence. Main outcomes were: possibly smoking-related diseases (PSRD; validated through hospital discharge data or visit in 62.6% of the sample); 4-year tobacco abstinence; number of tobacco cigarettes/day. RESULTS: Data were available for 228 e-cig users (all ex-smokers), 471 tobacco smokers, 216 dual users. A PSRD was observed in 73 subjects (8.0%). No differences emerged across groups in PSRD rates, with negligible variations in self-reported health. Of e-cig users, 63.6% remained tobacco abstinent; dual users and tobacco smokers showed non-significantly different rates of tobacco (33.8% vs. 26.8%) and all-product (20.2% vs. 19.4%) cessation, and a similar decrease in cigarettes/day. Almost 40% of the sample switched at least once (tobacco smokers: 17.2%; dual users: 81.9%). CONCLUSIONS: After four years, a scarce, non-significant harm reduction was observed among e-cig or dual users. Given the long-lasting health effects of tobacco smoking, the benefits of e-cig use may start being detectable at the next follow-up (six years). The complete switch to e-cig may help tobacco quitters remain abstinent, but e-cig use in addition to tobacco did not increase the likelihood of smoking cessation or reduction.
Published: 2019

26. Severe Acute Respiratory Syndrome Coronavirus 2 Lethality Did not Change Over Time in Two Italian Provinces

Author: Flacco, M, Acuti Martellucci, C, Bravi, F, Parruti, G, Mascitelli, A, Mantovani, L, Boccia, S, Manzoli, L, Flacco, Maria Elena, Acuti Martellucci, Cecilia, Bravi, Francesca, Parruti, Giustino, Mascitelli, Alfonso, Mantovani, Lorenzo, Boccia, Stefania, Manzoli, Lamberto, Flacco, M, Acuti Martellucci, C, Bravi, F, Parruti, G, Mascitelli, A, Mantovani, L, Boccia, S, Manzoli, L, Flacco, Maria Elena, Acuti Martellucci, Cecilia, Bravi, Francesca, Parruti, Giustino, Mascitelli, Alfonso, Mantovani, Lorenzo, Boccia, Stefania, and Manzoli, Lamberto
Abstract: This retrospective cohort study included all the subjects diagnosed with severe acute respiratory syndrome coronavirus 2 infection (n=2493) in 2 Italian provinces. Two hundred fifty-eight persons died, after a median of 14.0±11.0 days. Adjusting for age, gender, and main comorbidities, the ≥28-day case-fatality rate did not decrease from March to April 2020 (adjusted hazard ratio, 0.93; P=.6).
Published: 2020

27. SARS-CoV-2 pandemic: An overview

Author: Acuti Martellucci, C, Flacco, M, Cappadona, R, Bravi, F, Mantovani, L, Manzoli, L, Acuti Martellucci, Cecilia, Flacco, Maria Elena, Cappadona, Rosaria, Bravi, Francesca, Mantovani, Lorenzo, Manzoli, Lamberto, Acuti Martellucci, C, Flacco, M, Cappadona, R, Bravi, F, Mantovani, L, Manzoli, L, Acuti Martellucci, Cecilia, Flacco, Maria Elena, Cappadona, Rosaria, Bravi, Francesca, Mantovani, Lorenzo, and Manzoli, Lamberto
Abstract: By the end of May 2020, SARS-CoV-2 pandemic caused more than 350,000 deaths worldwide. In the first months, there have been uncertainties on almost any area: infection transmission route, virus origin and persistence in the environment, diagnostic tests, therapeutic approach, high-risk subjects, lethality, and containment policies. We provide an updated summary of the current knowledge on the pandemic, discussing the available evidence on the effectiveness of the adopted mitigation strategies.
Published: 2020

28. Treatment with ACE inhibitors or ARBs and risk of severe/lethal COVID-19: a meta-analysis

Author: Flacco, M, Acuti Martellucci, C, Bravi, F, Parruti, G, Cappadona, R, Mascitelli, A, Manfredini, R, Mantovani, L, Manzoli, L, Flacco, Maria Elena, Acuti Martellucci, Cecilia, Bravi, Francesca, Parruti, Giustino, Cappadona, Rosaria, Mascitelli, Alfonso, Manfredini, Roberto, Mantovani, Lorenzo G, Manzoli, Lamberto, Flacco, M, Acuti Martellucci, C, Bravi, F, Parruti, G, Cappadona, R, Mascitelli, A, Manfredini, R, Mantovani, L, Manzoli, L, Flacco, Maria Elena, Acuti Martellucci, Cecilia, Bravi, Francesca, Parruti, Giustino, Cappadona, Rosaria, Mascitelli, Alfonso, Manfredini, Roberto, Mantovani, Lorenzo G, and Manzoli, Lamberto
Abstract: Objective: It has been hypothesised that the use of ACE inhibitors and angiotensin receptor blockers (ARBs) might either increase or reduce the risk of severe or lethal COVID-19. The findings from the available observational studies varied, and summary estimates are urgently needed to elucidate whether these drugs should be suspended during the pandemic, or patients and physicians should be definitely reassured. This meta-analysis of adjusted observational data aimed to summarise the existing evidence on the association between these medications and severe/lethal COVID-19. Methods: We searched MedLine, Scopus and preprint repositories up to 8 June 2020 to retrieve cohort or case-control studies comparing the risk of severe/fatal COVID-19 (either mechanical ventilation, intensive care unit admission or death), among hypertensive subjects treated with: (1) ACE inhibitors, (2) ARBs and (3) both, versus untreated subjects. Data were combined using a random-effect generic inverse variance approach. Results: Ten studies, enrolling 9890 hypertensive subjects were included in the analyses. Compared with untreated subjects, those using either ACE inhibitors or ARBs showed a similar risk of severe or lethal COVID-19 (summary OR: 0.90; 95% CI 0.65 to 1.26 for ACE inhibitors; 0.92; 95% CI 0.75 to 1.12 for ARBs). The results did not change when both drugs were considered together, when death was the outcome and excluding the studies with significant, divergent results. Conclusion: The present meta-analysis strongly supports the recommendation of several scientific societies to continue ARBs or ACE inhibitors for all patients, unless otherwise advised by their physicians who should thus be reassured.
Published: 2020

29. Severe Acute Respiratory Syndrome Coronavirus 2 Lethality Did not Change over Time in Two Italian Provinces

Author: Flacco, M. E., Acuti Martellucci, C., Bravi, F., Parruti, G., Mascitelli, A., Mantovani, L., Boccia, Stefania, Manzoli, Lamberto, Boccia S. (ORCID:0000-0002-1864-749X), Manzoli L., Flacco, M. E., Acuti Martellucci, C., Bravi, F., Parruti, G., Mascitelli, A., Mantovani, L., Boccia, Stefania, Manzoli, Lamberto, Boccia S. (ORCID:0000-0002-1864-749X), and Manzoli L.
Abstract: This retrospective cohort study included all the subjects diagnosed with severe acute respiratory syndrome coronavirus 2 infection (n=2493) in 2 Italian provinces. Two hundred fifty-eight persons died, after a median of 14.0±11.0 days. Adjusting for age, gender, and main comorbidities, the ≥28-day case-fatality rate did not decrease from March to April 2020 (adjusted hazard ratio, 0.93; P=.6).
Published: 2020

30. Self-reported history of hypercholesterolaemia and gallstones and the risk of prostate cancer

Author: Bravi, F., Scotti, L., Bosetti, C., Talamini, R., Negri, E., Montella, M., Franceschi, S., and La Vecchia, C.
Published: 2006
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31. Dietary patterns and the risk of esophageal cancer

Author: Bravi, F., Edefonti, V., Randi, G., Garavello, W., La Vecchia, C., Ferraroni, M., Talamini, R., Franceschi, S., and Decarli, A.
Published: 2012
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32. Adherence to the Mediterranean diet and nasopharyngeal cancer risk in Italy

Author: Turati, F, Bravi, F, Polesel, J, Bosetti, C, Negri, E, Garavello, W, Taborelli, M, Serraino, D, Libra, M, Montella, M, Decarli, A, Ferraroni, M, La Vecchia, C, Turati F., Bravi F., Polesel J., Bosetti C., Negri E., Garavello W., Taborelli M., Serraino D., Libra M., Montella M., Decarli A., Ferraroni M., La Vecchia C., Turati, F, Bravi, F, Polesel, J, Bosetti, C, Negri, E, Garavello, W, Taborelli, M, Serraino, D, Libra, M, Montella, M, Decarli, A, Ferraroni, M, La Vecchia, C, Turati F., Bravi F., Polesel J., Bosetti C., Negri E., Garavello W., Taborelli M., Serraino D., Libra M., Montella M., Decarli A., Ferraroni M., and La Vecchia C.
Abstract: Purpose: Few studies investigated the role of diet on nasopharyngeal cancer (NPC) risk in non-endemic areas. The aim of this study was to assess the association between adherence to the traditional Mediterranean diet and NPC risk in a southern European low-risk population. Methods: We conducted a hospital-based case-control study in Italy, including 198 histologically confirmed NPC cases and 594 matched controls. Dietary habits were collected by means of a validated food-frequency questionnaire, including 83 foods, food groups, or beverages. Adherence to the traditional Mediterranean diet was assessed through a Mediterranean Diet Score (MDS), based on nine dietary components characterizing this dietary profile, i.e., high intake of vegetables, fruits and nuts, cereals, legumes, and fish; low intake of dairy products and meat; high monounsaturated to saturated fatty acid ratio; and moderate alcohol intake. We estimated odds ratios (ORs) of NPC, and the corresponding 95% confidence intervals (CIs), for increasing MDS (i.e., increasing adherence) using multiple logistic regression models, adjusted for major confounding factors. Results: As compared to MDS ≤ 4, the ORs of NPC were 0.83 (95% CI: 0.54–1.25) for MDS of 5 and 0.66 (95% CI: 0.44–0.99) for MDS ≥ 6, with a significant trend of decreasing risk (p 0.043). The corresponding population attributable fraction was 22%, indicating that 22% of NPC cases in this population would be avoided by shifting all subjects to a score ≥6. Conclusions: Our study supports a favorable role of the Mediterranean diet on NPC risk.
Published: 2017

33. Citrus fruit intake and gastric cancer: The stomach cancer pooling (StoP) project consortium

Author: Bertuccio, P. Alicandro, G. Rota, M. Pelucchi, C. Bonzi, R. Galeone, C. Bravi, F. Johnson, K.C. Hu, J. Palli, D. Ferraroni, M. López-Carrillo, L. Lunet, N. Ferro, A. Malekzadeh, R. Zaridze, D. Maximovitch, D. Vioque, J. Navarrete-Munoz, E.M. Pakseresht, M. Hernández-Ramírez, R.U. López-Cervantes, M. Ward, M. Pourfarzi, F. Tsugane, S. Hidaka, A. Zhang, Z.-F. Kurtz, R.C. Lagiou, P. Lagiou, A. Boffetta, P. Boccia, S. Negri, E. La Vecchia, C.
Subjects: food and beverages
Abstract: Diets rich in vegetables and fruit have been associated with reduced risk of gastric cancer, and there is suggestive evidence that citrus fruits have a protective role. Our study aimed at evaluating and quantifying the association between citrus fruit intake and gastric cancer risk. We conducted a one-stage pooled analysis including 6,340 cases and 14,490 controls from 15 case–control studies from the stomach cancer pooling (StoP) project consortium. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of gastric cancer across study-specific tertiles of citrus fruit intake (grams/week) were estimated by generalized linear mixed effect models, with logistic link function and random intercept for each study. The models were adjusted for sex, age, and the main recognized risk factors for gastric cancer. Compared to the first third of the distribution, the adjusted pooled OR (95% CI) for the highest third was 0.80 (0.73–0.87). The favourable effect of citrus fruits increased progressively until three servings/week and leveled off thereafter. The magnitude of the association was similar between cancer sub-sites and histotypes. The analysis by geographic area showed no association in studies from the Americas. Our data confirm an inverse association between citrus fruits and gastric cancer and provide precise estimates of the magnitude of the association. However, the null association found in studies from America and in some previous cohort studies prevent to draw definite conclusions on a protective effect of citrus fruit consumption. © 2018 UICC
Published: 2019

34. Appropriatezza della tardiva dimissione: un audit clinico nell’Azienda Ospedaliero-Universitaria di Ferrara

Author: Bolognesi, N., Masetti, G., Bernardini, D., Pellegrini, M., Stefanati, A., Bravi, F., Valpiani, G., Franchino, G., Bentivegna, R., DI RUSCIO, E., and Carradori, T.
Subjects: Socio-culturale
Published: 2019

35. Physical activity in breast cancer survivors: A systematic review and meta-analysis on overall and breast cancer survival

Author: Spei, M.-E. Samoli, E. Bravi, F. La Vecchia, C. Bamia, C. Benetou, V.
Subjects: skin and connective tissue diseases
Abstract: Aim: To further quantify the association between physical activity (PA) after breast cancer diagnosis and all-cause mortality, breast cancer mortality and/or breast cancer recurrence. Methods and results: PubMed was searched until November 2017 for observational studies investigating any type of PA in association with total mortality, breast cancer mortality and/or breast cancer recurrence among women with breast cancer diagnosis. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using random-effects models for highest versus lowest categories of PA. Ten studies were included in the meta-analysis. During an average follow-up ranging from 3.5 to 12.7 years there were 23,041 breast cancer survivors, 2,522 deaths from all causes, 841 deaths from breast cancer and 1,398 recurrences/remissions. Compared to women in the lowest recreational PA level (lowest quintile/quartile), women in the highest level had a lower risk of all-cause mortality (HR = 0.58, 95% CIs: 0.45–0.75; 8 studies), of death from breast cancer (HR = 0.60, 95% CIs 0.36–0.99; 5 studies) and a lower, albeit non-significant, risk of recurrence (HR = 0.79, 95% CIs 0.60–1.05; 5 studies). There was evidence of heterogeneity between the studies evaluating recreational PA and total mortality (Ι2 = 52.4%) and even higher for breast cancer mortality (Ι2 = 77.7%) or recurrence (Ι2 = 66.4%). Conclusion: Highest recreational PA after breast cancer diagnosis was associated with lower all-cause and breast cancer mortality. This finding probably reflects the favorable impact of PA on cardiovascular mortality, and a possible favorable role on breast cancer survival, though reverse causation cannot be excluded. © 2019 Elsevier Ltd
Published: 2019

36. Cohort study of electronic cigarette use: Safety and effectiveness after 4 years of follow-up

Author: Flacco, M. E., Ferrante, M., Fiore, M., Marzuillo, C., La Vecchia, C., Gualano, M. R., Liguori, G., Fragassi, G., Carradori, T., Bravi, F., Siliquini, R., Ricciardi, Walter, Villari, Paolo, Manzoli, Lamberto, Ricciardi, W. (ORCID:0000-0002-5655-688X), Villari, P., Manzoli, L., Flacco, M. E., Ferrante, M., Fiore, M., Marzuillo, C., La Vecchia, C., Gualano, M. R., Liguori, G., Fragassi, G., Carradori, T., Bravi, F., Siliquini, R., Ricciardi, Walter, Villari, Paolo, Manzoli, Lamberto, Ricciardi, W. (ORCID:0000-0002-5655-688X), Villari, P., and Manzoli, L.
Abstract: OBJECTIVE: More than a decade after e-cigarette (e-cig) market launch, limited information are available on their safety after 24 months of use. In 2013, we started the first observational study assessing e-cig long-term effectiveness and safety, directly comparing tobacco smokers and e-cig users. Here we report the results after four years of follow-up. PATIENTS AND METHODS: Adults (30-75 years) were included if: smokers of =1 tobacco cigarette/day (tobacco smokers); users of any type of e-cig inhaling =50 puffs weekly (e-cig users); users of both tobacco and e-cig (dual users). Data were collected by phone and/or internet, and carbon monoxide levels tested in 50% of those declaring tobacco abstinence. Main outcomes were: possibly smoking-related diseases (PSRD; validated through hospital discharge data or visit in 62.6% of the sample); 4-year tobacco abstinence; number of tobacco cigarettes/day. RESULTS: Data were available for 228 e-cig users (all ex-smokers), 471 tobacco smokers, 216 dual users. A PSRD was observed in 73 subjects (8.0%). No differences emerged across groups in PSRD rates, with negligible variations in self-reported health. Of e-cig users, 63.6% remained tobacco abstinent; dual users and tobacco smokers showed non-significantly different rates of tobacco (33.8% vs. 26.8%) and all-product (20.2% vs. 19.4%) cessation, and a similar decrease in cigarettes/day. Almost 40% of the sample switched at least once (tobacco smokers: 17.2%; dual users: 81.9%). CONCLUSIONS: After four years, a scarce, non-significant harm reduction was observed among e-cig or dual users. Given the long-lasting health effects of tobacco smoking, the benefits of e-cig use may start being detectable at the next follow-up (six years). The complete switch to e-cig may help tobacco quitters remain abstinent, but e-cig use in addition to tobacco did not increase the likelihood of smoking cessation or reduction.
Published: 2019

37. Mediterranean diet and bladder cancer risk in Italy

Author: Bravi, F. Spei, M.-E. Polesel, J. Di Maso, M. Montella, M. Ferraroni, M. Serraino, D. Libra, M. Negri, E. La Vecchia, C. Turati, F.
Abstract: Previous studies have reported that Mediterranean diet is inversely related to the risk of several neoplasms; however, limited epidemiological data are available for bladder cancer. Thus, we examined the association between Mediterranean diet and this neoplasm in an Italian multicentric case-control study consisting of 690 bladder cancer cases and 665 controls. We assessed the adherence to the Mediterranean diet via a Mediterranean Diet Score (MDS), which represents the major characteristics of the Mediterranean diet and ranges from 0 to 9 (from minimal to maximal adherence, respectively). We derived odds ratios (ORs) of bladder cancer according to the MDS score from multiple logistic regression models, allowing for major confounding factors. The ORs of bladder cancer were 0.72 (95% confidence interval, CI, 0.54–0.98) for MDS of 4–5 and 0.66 (95% CI, 0.47–0.93) for MDS of 6–9 (p for trend = 0.02) compared to MDS = 0–3. Results were similar in strata of sex, age, and education, while the risk appeared somewhat lower in never-smokers and patients with pT1–pT4 bladder carcinomas. Among individual components of the MDS, we observed inverse associations for greater consumption of legumes, vegetables, and fish. In our study, which was carried out on an Italian population, the higher adherence to the Mediterranean diet was related to a lower risk of bladder cancer. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
Published: 2018

38. Daylight saving time and acute myocardial infarction: a meta-analysis

Author: Manzoli, L, primary, Flacco, M E, primary, Bravi, F, primary, Carradori, T, primary, Cappadona, R, primary, Fabbian, F, primary, De Giorgi, A, primary, and Manfredini, R, primary
Published: 2019
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39. Nutrient-based dietary patterns and the risk of head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology consortium

Author: Edefonti, V., Hashibe, M., Ambrogi, F., Parpinel, M., Bravi, F., Talamini, R., Levi, F., Yu, G., Morgenstern, H., Kelsey, K., McClean, M., Schantz, S., Zhang, Z., Chuang, S., Boffetta, P., La Vecchia, C., Decarli, A., Edefonti, V., Hashibe, M., Ambrogi, F., Parpinel, M., Bravi, F., Talamini, R., Levi, F., Yu, G., Morgenstern, H., Kelsey, K., McClean, M., Schantz, S., Zhang, Z., Chuang, S., Boffetta, P., La Vecchia, C., and Decarli, A.
Abstract: Background The association between dietary patterns and head and neck cancer has rarely been addressed. Patients and methods We used individual-level pooled data from five case-control studies (2452 cases and 5013 controls) participating in the International Head and Neck Cancer Epidemiology consortium. A posteriori dietary patterns were identified through a principal component factor analysis carried out on 24 nutrients derived from study-specific food-frequency questionnaires. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using unconditional logistic regression models on quintiles of factor scores. Results We identified three major dietary patterns named ‘animal products and cereals', ‘antioxidant vitamins and fiber', and ‘fats'. The ‘antioxidant vitamins and fiber' pattern was inversely related to oral and pharyngeal cancer (OR= 0.57, 95% CI 0.43-0.76 for the highest versus the lowest score quintile). The ‘animal products and cereals' pattern was positively associated with laryngeal cancer (OR= 1.54, 95% CI 1.12-2.11), whereas the ‘fats' pattern was inversely associated with oral and pharyngeal cancer (OR= 0.78, 95% CI 0.63-0.97) and positively associated with laryngeal cancer (OR= 1.69, 95% CI 1.22-2.34). Conclusions These findings suggest that diets rich in animal products, cereals, and fats are positively related to laryngeal cancer, and those rich in fruit and vegetables inversely related to oral and pharyngeal cancer
Published: 2017

40. Ferrara Open Health, Engaging all actors to improve local health services through shared information

Author: Bravi, F, primary, Bazzarin, V, additional, Castellari, S, additional, Rubertini, B Curcio, additional, Fiorini, F, additional, Carradori, T, additional, and Lalli, P, additional
Published: 2017
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41. Beyond gender stereotypes. Towards new diagnostic and treatment relationships

Author: Sighinolfi, L, primary, Bravi, F, additional, and Matarazzo, T, additional
Published: 2017
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42. A complex case patients with Amyotrophic Lateral Sclerosis using administrative record linkage

Author: Bravi, F, primary and Carradori, T, additional
Published: 2017
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43. Localized Management of Sinus Floor Technique for Implant Placement in Fresh Molar Sockets

Author: Bruschi GB, Crespi R, CAPPARE' , PAOLO, Bravi F, Bruschi E, GHERLONE , FELICE ENRICO, Bruschi, Gb, Crespi, R, Cappare', Paolo, Bravi, F, Bruschi, E, and Gherlone, FELICE ENRICO
Abstract: Background: The use of osteotome for vertical bone augmentation and localized sinus elevation with minimal surgical trauma represents a suitable procedure to increase the vertical dimension of available bone for implant placement. Purpose: The aim of this study was to report clinical and radiographic results of localized management of sinus floor (LMSF) in fresh molar sockets at 13-year follow-up. Materials and Methods: Fifty-three patients, needing one or two maxillary molar extraction, were enrolled in this study. LMFS procedure was performed and 68 implants were positioned. A presurgical distance from the alveolar crest to the floor of the maxillary sinus and the amount of new radiopacity between the sinus floor and alveolar crest were measured from the mesial and distal surfaces of each dental implant surface. Results: After a mean follow-up period of 9.76 ± 5.27 years (ranged from 4 to 17 years) a survival rate of 100% was reported. Mean bone height at temporary prosthesis placement was 7.99 ± 1.16 mm. They were stable over time, reporting a mean value of 8.01 ± 1.46 mm at 13-year follow-up. Conclusions: The results of this study demonstrated that LMSF procedure in fresh molar sockets allowed to expand the dimensions of resorbed posterior maxillary alveolar bone both vertically and horizontally with a success rate of 100% of implant osseointegration over time.
Published: 2013

44. Mediterranean diet and hepatocellular carcinoma

Author: Turati, F. Trichopoulos, D. Polesel, J. Bravi, F. Rossi, M. Talamini, R. Franceschi, S. Montella, M. Trichopoulou, A. La Vecchia, C. Lagiou, P.
Abstract: Background & Aims Hepatocellular carcinoma (HCC) has a very poor prognosis and any effort to identify additional risk factors, besides those already established, would be important for the prevention of the disease. Data on the role of diet on HCC risk are still controversial. Methods We have evaluated the association of adherence to the Mediterranean diet with HCC risk, as well as the interaction of this dietary pattern with chronic hepatitis infection, by combining two case-control studies undertaken in Italy and Greece, including overall 518 cases of HCC and 772 controls. Adherence to the traditional Mediterranean diet was assessed through the Mediterranean diet score (MDS), which ranges between 0 (lowest adherence) and 9 (highest adherence). Odds ratios (OR) for HCC were obtained through multiple logistic regression models, controlling for potentially confounding factors, including chronic infection with hepatitis B/C viruses. Results Compared to MDS of 0-3, the ORs for HCC were 0.66 (95% confidence interval (CI), 0.41-1.04) for MDS equal to 4 and 0.51 (95% CI, 0.34-0.75) for MDS ≥5, with a significant trend (p
Published: 2014

45. Nutrient-based dietary patterns and nasopharyngeal cancer: Evidence from an exploratory factor analysis

Author: Edefonti, V, Nicolussi, F, Polesel, J, Bravi, F, Bosetti, C, Garavello, W, La Vecchia, C, Bidoli, E, Decarli, A, Serraino, D, Calza, S, Ferraroni, M, Ferraroni, M., NICOLUSSI, FEDERICA, GARAVELLO, WERNER, DECARLI, ADRIANO, Edefonti, V, Nicolussi, F, Polesel, J, Bravi, F, Bosetti, C, Garavello, W, La Vecchia, C, Bidoli, E, Decarli, A, Serraino, D, Calza, S, Ferraroni, M, Ferraroni, M., NICOLUSSI, FEDERICA, GARAVELLO, WERNER, and DECARLI, ADRIANO
Abstract: Background:To our knowledge, no study assessed the association between dietary patterns and nasopharyngeal carcinoma (NPC) in low-incidence areas.Methods:We examined this association in a hospital-based case-control study carried out in Italy between 1992 and 2008, including 198 incident NPC cases and 594 controls. A posteriori dietary patterns were identified through principal component factor analysis performed on 28 nutrients and minerals derived from a 78-item food-frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional multiple logistic regression models on tertiles of factor scores.Results:We identified five dietary patterns named Animal products, Starch-rich, Vitamins and fibre, Animal unsaturated fatty acids (AUFAs), and Vegetable unsaturated fatty acids (VUFAs). The Animal product (OR=2.62, 95% CI=1.67-4.13, for the highest vs lowest score tertile), Starch-rich (OR=2.05, 95% CI=1.27-3.33), and VUFA (OR=1.90, 95% CI=1.22-2.96) patterns were positively associated with NPC. The AUFA pattern showed a positive association of borderline significance, whereas the Vitamins and fibre pattern was nonsignificantly but inversely associated with NPC.Conclusions:These findings suggest that diets rich in animal products, starch, and fats are positively related to NPC risk in this low-incidence country.
Published: 2015

46. A new Italian instrument for the assessment of irritability in patients with epilepsy

Author: Piazzini, A, Turner, K, Edefonti, V, Bravi, F, Canevini, M. P., Chifari, R, Romeo, A, Viri, M, La Neve, A, Francavilla, T, Lamberti, P, Mecarelli, O, Magaudda, Adriana, Gugliotta, SIMONA CORINNA, Gambardella, A, Labate, A, Ferlazzo, E, Rocchi, R, Pucci, B, Vatti, G, Sicilia, I, Iudice, A, Pelliccia, V, and Ferrarono, M.
Subjects: Adult, Male, medicine.medical_specialty, Psychometrics, Population, MEDLINE, psychometric properties, Irritability, External validity, Behavioral Neuroscience, Epilepsy, Disability Evaluation, new italian instrument, Surveys and Questionnaires, medicine, Humans, irritability, In patient, Psychiatry, education, education.field_of_study, epilepsy, Adult patients, Aggression, Reproducibility of Results, Middle Aged, medicine.disease, Irritable Mood, Neurology, Italy, Female, Neurology (clinical), medicine.symptom, Psychology, Clinical psychology
Abstract: The purpose of the work described in this article was to analyze the psychometric properties of a new Italian instrument for the assessment of irritability in adult patients with epilepsy (I-Epi). Five hundred four patients from nine secondary and tertiary Italian centers for the care of epilepsy were recruited and interviewed. Each patient was evaluated on a series of demographic and clinical variables recorded before administration of the I-Epi and the AQ (Aggression Questionnaire), used for external validity. The final results supported the reliability and validity of the I-Epi as a measure of irritability in the adult epilepsy population. The psychometric characteristics of the I-Epi seemed fairly good. We believe that adoption of this new instrument could be very useful in both clinical and research management of patients with epilepsy.
Published: 2011

47. La percezione dei pazienti sul progetto del medico di riferimento del caso nelle strutture di ricovero: l’esperienza dell’Azienda USL di Ravenna

Author: Carradori, T., Bravi, F., Carretta, E., Caruso, B., Murante, ANNA MARIA, Nuti, Sabina, and Fantini, M. P.
Published: 2011

48. Nutrient-based dietary patterns and nasopharyngeal cancer: evidence from an exploratory factor analysis

Author: Edefonti, V, primary, Nicolussi, F, additional, Polesel, J, additional, Bravi, F, additional, Bosetti, C, additional, Garavello, W, additional, La Vecchia, C, additional, Bidoli, E, additional, Decarli, A, additional, Serraino, D, additional, Calza, S, additional, and Ferraroni, M, additional
Published: 2014
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49. Intake of specific flavonoids and risk of acute myocardial infarction in Italy

Author: Tavani, A Spertini, L Bosetti, C Parpinel, M and Gnagnarella, P Bravi, F Peterson, J Dwyer, J Lagiou, P and Negri, E La Vecchia, C
Abstract: Objective: As intake of flavonoids has been associated with reduced risk of coronary heart disease but data on the relation with specific classes of flavonoids are scarce, we assessed the relation between dietary intake of specific classes of flavonoids and the risk of acute myocardial infarction (AMI) in an Italian population. Design: Case-control study. Dietary information was collected by interviewers on a questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple logistic regression models including terms for energy and alcohol intake, as well as sociodemographic factors, tobacco and other major recognised risk factors for AMI. Setting: Milan, Italy, between 1995 and 2003. Subjects: Cases were 760 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 682 patients admitted to hospital for acute conditions unrelated to diet. Results: A reduced risk of AMI was found for increasing intake of anthocyanidins (OR=0.45, 95% CI 0.26-0.78 for the highest vs. the lowest quintile, P-trend=0.003) and flavonols (OR=0.65, 95% CI 0.41-1.02, P-trend=0.02). A tendency towards reduced risks, although not significant, was observed for flavan-3-ols (OR=0.73, 95% CI 0.48-1.10) and total flavonoids (OR=0.74, 95% CI 0.49-1.14). No meaningful heterogeneity was found between the sexes. No association emerged for other flavonoids, including isoflavones, flavanones and flavones. Conclusions: High intake of anthocyanidins reduced the risk of AMI even after allowance for alcohol, fruit and vegetables, supporting a real inverse association between this class of flavonoids and AMI risk.
Published: 2006

50. Dietary patterns and the risk of esophageal cancer

Author: Bravi, F, Edefonti, V, Randi, G, Garavello, W, La Vecchia, C, Ferraroni, M, Talamini, R, Franceschi, S, Decarli, A, Decarli, A., GARAVELLO, WERNER, Bravi, F, Edefonti, V, Randi, G, Garavello, W, La Vecchia, C, Ferraroni, M, Talamini, R, Franceschi, S, Decarli, A, Decarli, A., and GARAVELLO, WERNER
Abstract: BACKGROUND: The role of dietary habits on esophageal cancer risk has been rarely considered in terms of dietary patterns. PATIENTS AND METHODS: We analyzed data from an Italian case-control study, including 304 cases with squamous cell carcinoma of the esophagus and 743 hospital controls. Dietary habits were evaluated using a food frequency questionnaire. A posteriori dietary patterns were identified through principal component factor analysis performed on 28 selected nutrients. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from multiple logistic regression models applied on quartiles of factor scores, adjusting for potential confounding variables. RESULTS: We identified five major dietary patterns, named 'animal products and related components', 'vitamins and fiber', 'starch-rich', 'other polyunsaturated fatty acids and vitamin D', and 'other fats'. The 'animal products and related components' pattern was positively related to esophageal cancer (OR = 1.64, 95% CI:1.06-2.55, for the highest versus the lowest quartile of factor scores category). The 'vitamins and fiber' (OR = 0.50, 95% CI: 0.32-0.78) and the 'other polyunsaturated fatty acids and vitamin D' (OR = 0.48, 95% CI: 0.31-0.74) were inversely related to esophageal cancer. No significant association was observed for the other patterns. CONCLUSION: Our findings suggest that a diet rich in foods from animal origin and poor in foods containing vitamins and fiber increase esophageal cancer risk.
Published: 2012

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