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1. Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper.

Author

Sermonesi, Giacomo, Bertelli, Riccardo, Pieracci, Fredric, Balogh, Zsolt, Coimbra, Raul, Galante, Joseph, Hecker, Andreas, Weber, Dieter, Bauman, Zachary, Kartiko, Susan, Patel, Bhavik, Whitbeck, SarahAnn, White, Thomas, Harrell, Kevin, Perrina, Daniele, Rampini, Alessia, Tian, Brian, Amico, Francesco, Beka, Solomon, Bonavina, Luigi, Ceresoli, Marco, Cobianchi, Lorenzo, Coccolini, Federico, Cui, Yunfeng, Dal Mas, Francesca, De Simone, Belinda, Di Carlo, Isidoro, Di Saverio, Salomone, Dogjani, Agron, Fette, Andreas, Fraga, Gustavo, Gomes, Carlos, Khan, Jim, Kirkpatrick, Andrew, Kruger, Vitor, Leppäniemi, Ari, Litvin, Andrey, Mingoli, Andrea, Navarro, David, Passera, Eliseo, Pisano, Michele, Podda, Mauro, Russo, Emanuele, Sakakushev, Boris, Santonastaso, Domenico, Sartelli, Massimo, Shelat, Vishal, Tan, Edward, Wani, Imtiaz, Abu-Zidan, Fikri, Biffl, Walter, Civil, Ian, Latifi, Rifat, Marzi, Ingo, Picetti, Edoardo, Pikoulis, Manos, Agnoletti, Vanni, Bravi, Francesca, Vallicelli, Carlo, Ansaloni, Luca, Moore, Ernest, and Catena, Fausto

Subjects
Consensus, Flail chest, Guidelines, Minimally invasive plating osteosynthesis (MIPO), Multiple rib fractures, Operative reduction and internal fixation (ORIF), Rib fixation, Rib fractures, Surgical stabilization of rib fractures (SSRF), Thoracic/chest trauma injury, Video-assisted thoracoscopy surgery (VATS), Rib Fractures, Humans, Fracture Fixation
Abstract

BACKGROUND: Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. 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 experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. RESULTS: A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. CONCLUSION: This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.

Published
2024

2. The 2023 WSES guidelines on the management of trauma in elderly and frail patients.

Author

De Simone, Belinda, Chouillard, Elie, Podda, Mauro, Pararas, Nikolaos, de Carvalho Duarte, Gustavo, Fugazzola, Paola, Birindelli, Arianna, Coccolini, Federico, Polistena, Andrea, Sibilla, Maria, Kruger, Vitor, Fraga, Gustavo, Montori, Giulia, Russo, Emanuele, Pintar, Tadeja, Ansaloni, Luca, Avenia, Nicola, Di Saverio, Salomone, Leppäniemi, Ari, Lauretta, Andrea, Sartelli, Massimo, Puzziello, Alessandro, Carcoforo, Paolo, Agnoletti, Vanni, Bissoni, Luca, Isik, Arda, Kluger, Yoram, Moore, Ernest, Romeo, Oreste, Abu-Zidan, Fikri, Beka, Solomon, Weber, Dieter, Tan, Edward, Paolillo, Ciro, Cui, Yunfeng, Kim, Fernando, Picetti, Edoardo, Di Carlo, Isidoro, Toro, Adriana, Sganga, Gabriele, Sganga, Federica, Testini, Mario, Di Meo, Giovanna, Kirkpatrick, Andrew, Marzi, Ingo, déAngelis, Nicola, Kelly, Michael, Wani, Imtiaz, Sakakushev, Boris, Bala, Miklosh, Bonavina, Luigi, Galante, Joseph, Shelat, Vishal, Cobianchi, Lorenzo, Mas, Francesca, Pikoulis, Manos, Damaskos, Dimitrios, Coimbra, Raul, Dhesi, Jugdeep, Hoffman, Melissa, Stahel, Philip, Maier, Ronald, Litvin, Andrey, Latifi, Rifat, Biffl, Walter, and Catena, Fausto

Subjects
Ageing, Antibiotics, Delirium, Direct oral anticoagulants management, Elderly, End of life, Frailty, Geriatric patient, Imaging, Laboratory test, Pain control, Palliative care, Resuscitation, Thrombo-prophylaxis, Trauma management, Trauma score, Vitamin K antagonists anticoagulants management, Humans, Wounds and Injuries, Aged, Frail Elderly, Frailty, Aged, 80 and over, Practice Guidelines as Topic, Geriatric Assessment
Abstract

BACKGROUND: The trauma mortality rate is higher in the elderly compared with younger patients. Ageing is associated with physiological changes in multiple systems and correlated with frailty. Frailty is a risk factor for mortality in elderly trauma patients. We aim to provide evidence-based guidelines for the management of geriatric trauma patients to improve it and reduce futile procedures. METHODS: Six working groups of expert acute care and trauma surgeons reviewed extensively the literature according to the topic and the PICO question assigned. Statements and recommendations were assessed according to the GRADE methodology and approved by a consensus of experts in the field at the 10th international congress of the WSES in 2023. RESULTS: The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage, including drug history, frailty assessment, nutritional status, and early activation of trauma protocol to improve outcomes. Acute trauma pain in the elderly has to be managed in a multimodal analgesic approach, to avoid side effects of opioid use. Antibiotic prophylaxis is recommended in penetrating (abdominal, thoracic) trauma, in severely burned and in open fractures elderly patients to decrease septic complications. Antibiotics are not recommended in blunt trauma in the absence of signs of sepsis and septic shock. Venous thromboembolism prophylaxis with LMWH or UFH should be administrated as soon as possible in high and moderate-risk elderly trauma patients according to the renal function, weight of the patient and bleeding risk. A palliative care team should be involved as soon as possible to discuss the end of life in a multidisciplinary approach considering the patients directives, family feelings and representatives desires, and all decisions should be shared. CONCLUSIONS: The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage based on assessing frailty and early activation of trauma protocol to improve outcomes. Geriatric Intensive Care Units are needed to care for elderly and frail trauma patients in a multidisciplinary approach to decrease mortality and improve outcomes.

Published
2024

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

Author

Sermonesi, Giacomo, Tian, Brian, Vallicelli, Carlo, Abu-Zidan, Fikri, Damaskos, Dimitris, Kelly, Michael, Leppäniemi, Ari, Galante, Joseph, Tan, Edward, Kirkpatrick, Andrew, Khokha, Vladimir, Romeo, Oreste, Chirica, Mircea, Pikoulis, Manos, Litvin, Andrey, Shelat, Vishal, Sakakushev, Boris, Wani, Imtiaz, Sall, Ibrahima, Fugazzola, Paola, Cicuttin, Enrico, Toro, Adriana, Amico, Francesco, Mas, Francesca, De Simone, Belinda, Sugrue, Michael, Bonavina, Luigi, Campanelli, Giampiero, Carcoforo, Paolo, Cobianchi, Lorenzo, Coccolini, Federico, Chiarugi, Massimo, Di Carlo, Isidoro, Di Saverio, Salomone, Podda, Mauro, Pisano, Michele, Sartelli, Massimo, Testini, Mario, Fette, Andreas, Rizoli, Sandro, Picetti, Edoardo, Weber, Dieter, Latifi, Rifat, Kluger, Yoram, Balogh, Zsolt, Biffl, Walter, Jeekel, Hans, Civil, Ian, Hecker, Andreas, Ansaloni, Luca, Bravi, Francesca, Agnoletti, Vanni, Beka, Solomon, Moore, Ernest, and Catena, Fausto

Subjects
Acute appendicitis, Acute care surgery, Acute cholecystitis, Acute diverticulitis, Acute pancreatitis, Acute peritonitis, Adhesive small bowel obstruction, Colo–rectal emergencies, Emergency general surgery, Guidelines, Incarcerated/complicated ventral/inguinal hernia, Laparoscopic approach, Laparoscopy, Mesenteric ischemia, Minimally invasive surgery/approach, Penetrating/blunt abdominal trauma, Perforated peptic ulcer, Recommendations, Trauma surgery hemodynamic stability, Humans, Emergencies, Retrospective Studies, Laparoscopy, Abdomen, Abdominal Injuries, Randomized Controlled Trials as Topic
Abstract

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 needs, resulting in improved outcomes, regardless of conversion. Appropriate patient selection, surgeon experience and rigorous minimally invasive surgical training, remain crucial factors to increase the adoption of laparoscopy in emergency general surgery and abdominal trauma. CONCLUSIONS: The WSES expert panel suggests laparoscopy as the first approach for stable patients undergoing emergency abdominal surgery for general surgery emergencies and abdominal trauma.

Published
2023

4. Enhanced perioperative care in emergency general surgery: the WSES position paper.

Author

Ceresoli, Marco, Braga, Marco, Zanini, Nicola, Abu-Zidan, Fikri, Parini, Dario, Langer, Thomas, Sartelli, Massimo, Damaskos, Dimitrios, Biffl, Walter, Amico, Francesco, Ansaloni, Luca, Balogh, Zsolt, Bonavina, Luigi, Civil, Ian, Cicuttin, Enrico, Chirica, Mircea, Cui, Yunfeng, De Simone, Belinda, Di Carlo, Isidoro, Fette, Andreas, Foti, Giuseppe, Fogliata, Michele, Fraga, Gustavo, Fugazzola, Paola, Galante, Joseph, Beka, Solomon, Hecker, Andreas, Jeekel, Johannes, Kirkpatrick, Andrew, Koike, Kaoru, Leppäniemi, Ari, Marzi, Ingo, Moore, Ernest, Picetti, Edoardo, Pikoulis, Emmanouil, Pisano, Michele, Podda, Mauro, Sakakushev, Boris, Shelat, Vishal, Tan, Edward, Tebala, Giovanni, Velmahos, George, Weber, Dieter, Agnoletti, Vanni, Kluger, Yoram, Baiocchi, Gianluca, Catena, Fausto, and Coccolini, Federico

Subjects
Humans, Perioperative Care, Elective Surgical Procedures
Abstract

Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available. The present position paper illustrates the existing evidence about perioperative care in emergency surgery patients with a focus on each perioperative intervention in the preoperative, intraoperative and postoperative phase. For each item was proposed and approved a statement by the WSES collaborative group.

Published
2023

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

Author

Giuffrida, Mario, Perrone, Gennaro, Abu-Zidan, Fikri, Agnoletti, Vanni, Ansaloni, Luca, Baiocchi, Gian, Bendinelli, Cino, Biffl, Walter, Bonavina, Luigi, Bravi, Francesca, Carcoforo, Paolo, Ceresoli, Marco, Chichom-Mefire, Alain, Coccolini, Federico, Coimbra, Raul, deAngelis, Nicola, de Moya, Marc, De Simone, Belinda, Di Saverio, Salomone, Fraga, Gustavo, Ivatury, Rao, Kashuk, Jeffry, Kelly, Michael, Kirkpatrick, Andrew, Kluger, Yoram, Koike, Kaoru, Leppaniemi, Ari, Maier, Ronald, Moore, Ernest, Peitzmann, Andrew, Sakakushev, Boris, Sartelli, Massimo, Sugrue, Michael, Tian, Brian, Broek, Richard, Vallicelli, Carlo, Wani, Imtaz, Weber, Dieter, Docimo, Giovanni, Catena, Fausto, and Galante, Joseph

Subjects
Congenital, Diaphragm hernia, Emergency surgery, Guidelines, Rupture, Trauma, Humans, Diaphragm, Hernias, Diaphragmatic, Congenital, Tomography, X-Ray Computed, Thorax, Hernia, Hiatal, Thoracic Injuries
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

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

Author

Tian, Brian, Stahel, Philip, Picetti, Edoardo, Campanelli, Giampiero, Di Saverio, Salomone, Moore, Ernest, Bensard, Denis, Sakakushev, Boris, Galante, Joseph, Fraga, Gustavo, Koike, Kaoru, Di Carlo, Isidoro, Tebala, Giovanni, Leppaniemi, Ari, Tan, Edward, Damaskos, Dimitris, DeAngelis, Nicola, Hecker, Andreas, Pisano, Michele, Maier, Ron, De Simone, Belinda, Amico, Francesco, Ceresoli, Marco, Pikoulis, Manos, Weber, Dieter, Biffl, Walt, Beka, Solomon, Abu-Zidan, Fikri, Valentino, Massimo, Coccolini, Federico, Kluger, Yoram, Sartelli, Massimo, Agnoletti, Vanni, Chirica, Mircea, Bravi, Francesca, Sall, Ibrahima, and Catena, Fausto

Subjects
Elderly, Emergency surgery, Frail, Frailty, Laparotomy, Humans, Aged, Aged, 80 and over, Frailty, Laparotomy, Frail Elderly, Consensus, Comorbidity
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

7. WSES consensus guidelines on sigmoid volvulus management.

Author

Tian, Brian, Vigutto, Gabriele, Tan, Edward, van Goor, Harry, Bendinelli, Cino, Abu-Zidan, Fikri, Ivatury, Rao, Sakakushev, Boris, Di Carlo, Isidoro, Sganga, Gabriele, Maier, Ronald, Coimbra, Raul, Leppäniemi, Ari, Litvin, Andrey, Damaskos, Dimitrios, Broek, Richard, Biffl, Walter, Di Saverio, Salomone, De Simone, Belinda, Ceresoli, Marco, Picetti, Edoardo, Tebala, Giovanni, Beka, Solomon, Bonavina, Luigi, Cui, Yunfeng, Khan, Jim, Cicuttin, Enrico, Amico, Francesco, Kenji, Inaba, Hecker, Andreas, Ansaloni, Luca, Sartelli, Massimo, Moore, Ernest, Kluger, Yoram, Testini, Mario, Weber, Dieter, Agnoletti, Vanni, Angelis, Nicola, Coccolini, Federico, Sall, Ibrahima, Catena, Fausto, and Galante, Joseph

Subjects
Humans, Aged, Intestinal Volvulus, Decompression, Surgical, Lumbar Vertebrae, Colonic Diseases
Abstract

Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy. The World Society of Emergency Surgery united a worldwide group of international experts to review the current evidence and propose a consensus guidelines on the management of sigmoid volvulus.

Published
2023

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

Author

De Simone, Belinda, Kluger, Yoram, Moore, Ernest, Sartelli, Massimo, Abu-Zidan, Fikri, Coccolini, Federico, Ansaloni, Luca, Tebala, Giovanni, Di Saverio, Salomone, Di Carlo, Isidoro, Sakakushev, Boris, Bonavina, Luigi, Sugrue, Michael, Galante, Joseph, Ivatury, Rao, Picetti, Edoardo, Chirica, Mircea, Wani, Imtiaz, Bala, Miklosh, Sall, Ibrahima, Kirkpatrick, Andrew, Shelat, Vishal, Pikoulis, Emmanouil, Leppäniemi, Ari, Tan, Edward, Broek, Richard, Gurmu Beka, Solomon, Litvin, Andrey, Chouillard, Elie, Coimbra, Raul, Cui, Yunfeng, De Angelis, Nicola, Sganga, Gabriele, Stahel, Philip, Agnoletti, Vanni, Rampini, Alessia, Testini, Mario, Bravi, Francesca, Maier, Ronald, Biffl, Walter, and Catena, Fausto

Subjects
Classification, Delay in surgery, Delphi method, Emergency surgery, Healthcare system, Operating room management, Priority, Time to surgery, Timing in acute care surgery (TACS), Triage, Humans, Delphi Technique, Triage, Consensus, Surgeons, Operating Rooms
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 classification is a comprehensive, simple, clear and reproducible triage system which can be used to assess the severity of the patient and the surgical disease, to reduce the time to access to the operating room, and to manage the emergency surgical patients within a safe timeframe. By including well-defined surgical diseases in the different colour-code classes of priority, validated through a Delphi consensus, the new TACS improves communication among surgeons, between surgeons and anaesthesiologists and decreases conflicts and waste and waiting time in accessing the operating room for emergency surgical patients.

Published
2023

9. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery.

Author

Bala, Miklosh, Catena, Fausto, Kashuk, Jeffry, De Simone, Belinda, Gomes, Carlos, Weber, Dieter, Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Abu-Zidan, Fikri, Picetti, Edoardo, Ansaloni, Luca, Augustin, Goran, Biffl, Walter, Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Coimbra, Raul, Cui, Yunfeng, Damaskos, Dimitris, Di Saverio, Salomone, Khokha, Vladimir, Kirkpatrick, Andrew, Inaba, Kenji, Leppäniemi, Ari, Litvin, Andrey, Peitzman, Andrew, Shelat, Vishal, Sugrue, Michael, Tolonen, Matti, Rizoli, Sandro, Sall, Ibrahima, Beka, Solomon, Di Carlo, Isidoro, Ten Broek, Richard, Mircea, Chirika, Tebala, Giovanni, Pisano, Michele, van Goor, Harry, Maier, Ronald, Jeekel, Hans, Civil, Ian, Hecker, Andreas, Tan, Edward, Soreide, Kjetil, Lee, Matthew, Wani, Imtiaz, Bonavina, Luigi, Malangoni, Mark, Koike, Kaoru, Velmahos, George, Fraga, Gustavo, Fette, Andreas, deAngelis, Nicola, Balogh, Zsolt, Scalea, Thomas, Sganga, Gabriele, Kelly, Michael, Khan, Jim, Stahel, Philip, Moore, Ernest, and Galante, Joseph

Subjects
Bowel ischemia, Guidelines, Mesenteric arterial occlusion, Mesenteric artery stenting, Mesenteric ischemia, Recommendations, World Society of Emergency Surgery, Humans, Mesenteric Ischemia, Mesenteric Vascular Occlusion, Endovascular Procedures, Ischemia, Intestines
Abstract

Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions, but increases with age. Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques is evolving and provides new treatment options. Lastly, a focused multidisciplinary approach based on early diagnosis and individualized treatment is essential. Thus, we believe that updated guidelines from World Society of Emergency Surgery are warranted, in order to provide the most recent and practical recommendations for diagnosis and treatment of AMI.

Published
2022

10. Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document.

Author

Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Virdis, Francesco, Favi, Francesco, Wiik Larsen, Johannes, Coccolini, Federico, Sartelli, Massimo, Pararas, Nikolaos, Beka, Solomon, Bonavina, Luigi, Bova, Raffaele, Pisanu, Adolfo, Abu-Zidan, Fikri, Balogh, Zsolt, Chiara, Osvaldo, Wani, Imtiaz, Stahel, Philip, Di Saverio, Salomone, Scalea, Thomas, Soreide, Kjetil, Sakakushev, Boris, Amico, Francesco, Martino, Costanza, Hecker, Andreas, deAngelis, Nicola, Chirica, Mircea, Kirkpatrick, Andrew, Pikoulis, Emmanouil, Kluger, Yoram, Bensard, Denis, Ansaloni, Luca, Fraga, Gustavo, Civil, Ian, Tebala, Giovanni, Di Carlo, Isidoro, Cui, Yunfeng, Coimbra, Raul, Agnoletti, Vanni, Sall, Ibrahima, Tan, Edward, Picetti, Edoardo, Litvin, Andrey, Damaskos, Dimitrios, Inaba, Kenji, Leung, Jeffrey, Maier, Ronald, Biffl, Walt, Leppaniemi, Ari, Moore, Ernest, Gurusamy, Kurinchi, Catena, Fausto, and Galante, Joseph

Subjects
Consensus, Conservative treatment, Diagnostic imaging, Embolization, Follow-up, Nonoperative management, Spleen, Trauma, Abdominal Injuries, Adult, Child, Consensus, Follow-Up Studies, Hemoglobins, Heparin, Low-Molecular-Weight, Humans, Prospective Studies, Wounds, Nonpenetrating
Abstract

BACKGROUND: In 2017, the World Society of Emergency Surgery published its guidelines for the management of adult and pediatric patients with splenic trauma. Several issues regarding the follow-up of patients with splenic injuries treated with NOM remained unsolved. METHODS: Using a modified Delphi method, we sought to explore ongoing areas of controversy in the NOM of splenic trauma and reach a consensus among a group of 48 international experts from five continents (Africa, Europe, Asia, Oceania, America) concerning optimal follow-up strategies in patients with splenic injuries treated with NOM. RESULTS: Consensus was reached on eleven clinical research questions and 28 recommendations with an agreement rate ≥ 80%. Mobilization after 24 h in low-grade splenic trauma patients (WSES Class I, AAST Grades I-II) was suggested, while in patients with high-grade splenic injuries (WSES Classes II-III, AAST Grades III-V), if no other contraindications to early mobilization exist, safe mobilization of the patient when three successive hemoglobins 8 h apart after the first are within 10% of each other was considered safe according to the panel. The panel suggests adult patients to be admitted to hospital for 1 day (for low-grade splenic injuries-WSES Class I, AAST Grades I-II) to 3 days (for high-grade splenic injuries-WSES Classes II-III, AAST Grades III-V), with those with high-grade injuries requiring admission to a monitored setting. In the absence of specific complications, the panel suggests DVT and VTE prophylaxis with LMWH to be started within 48-72 h from hospital admission. The panel suggests splenic artery embolization (SAE) as the first-line intervention in patients with hemodynamic stability and arterial blush on CT scan, irrespective of injury grade. Regarding patients with WSES Class II blunt splenic injuries (AAST Grade III) without contrast extravasation, a low threshold for SAE has been suggested in the presence of risk factors for NOM failure. The panel also suggested angiography and eventual SAE in all hemodynamically stable adult patients with WSES Class III injuries (AAST Grades IV-V), even in the absence of CT blush, especially when concomitant surgery that requires change of position is needed. Follow-up imaging with contrast-enhanced ultrasound/CT scan in 48-72 h post-admission of trauma in splenic injuries WSES Class II (AAST Grade III) or higher treated with NOM was considered the best strategy for timely detection of vascular complications. CONCLUSION: This consensus document could help guide future prospective studies aiming at validating the suggested strategies through the implementation of prospective trauma databases and the subsequent production of internationally endorsed guidelines on the issue.

Published
2022

11. Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines.

Author

De Simone, Belinda, Chouillard, Elie, Ramos, Almino, Donatelli, Gianfranco, Pintar, Tadeja, Gupta, Rahul, Renzi, Federica, Mahawar, Kamal, Madhok, Brijesh, Maccatrozzo, Stefano, Abu-Zidan, Fikri, E Moore, Ernest, Weber, Dieter, Coccolini, Federico, Di Saverio, Salomone, Kirkpatrick, Andrew, Shelat, Vishal, Amico, Francesco, Pikoulis, Emmanouil, Ceresoli, Marco, Wani, Imtiaz, De Angelis, Nicola, Hecker, Andreas, Sganga, Gabriele, Tan, Edward, Balogh, Zsolt, Bala, Miklosh, Coimbra, Raul, Damaskos, Dimitrios, Ansaloni, Luca, Sartelli, Massimo, Pararas, Nikolaos, Kluger, Yoram, Chahine, Elias, Agnoletti, Vanni, Fraga, Gustavo, Biffl, Walter, Catena, Fausto, and Galante, Joseph

Subjects
Abdominal pain, Acute abdomen, Bariatric surgery, Bleeding, Emergency surgery, Gastric bypass, Long-term complication, Occlusion, Perforation, Peritonitis, Sleeve gastrectomy, Abdomen, Acute, Bariatric Surgery, Humans, Meta-Analysis as Topic, Obesity, Morbid, Systematic Reviews as Topic, Weight Loss
Abstract

BACKGROUND: Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. METHOD: A working group of experienced general, acute care, and bariatric surgeons was created to carry out a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and to answer the PICO questions formulated after the Operative management in bariatric acute abdomen survey. The literature search was limited to late/long-term complications following laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. CONCLUSIONS: The acute abdomen after bariatric surgery is a common cause of admission in emergency departments. Knowledge of the most common late/long-term complications (> 4 weeks after surgical procedure) following sleeve gastrectomy and Roux-en-Y gastric bypass and their anatomy leads to a focused management in the emergency setting with good outcomes and decreased morbidity and mortality rates. A close collaboration between emergency surgeons, radiologists, endoscopists, and anesthesiologists is mandatory in the management of this group of patients in the emergency setting.

Published
2022

12. Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines.

Author

Coccolini, Federico, Corradi, Francesco, Sartelli, Massimo, Coimbra, Raul, Kryvoruchko, Igor, Leppaniemi, Ari, Doklestic, Krstina, Bignami, Elena, Biancofiore, Giandomenico, Bala, Miklosh, Marco, Ceresoli, Damaskos, Dimitris, Biffl, Walt, Fugazzola, Paola, Santonastaso, Domenico, Agnoletti, Vanni, Sbarbaro, Catia, Nacoti, Mirco, Hardcastle, Timothy, Mariani, Diego, De Simone, Belinda, Tolonen, Matti, Ball, Chad, Podda, Mauro, Di Carlo, Isidoro, Di Saverio, Salomone, Navsaria, Pradeep, Bonavina, Luigi, Abu-Zidan, Fikri, Soreide, Kjetil, Fraga, Gustavo, Carvalho, Vanessa, Batista, Sergio, Hecker, Andreas, Cucchetti, Alessandro, Ercolani, Giorgio, Tartaglia, Dario, Wani, Imtiaz, Kurihara, Hayato, Tan, Edward, Litvin, Andrey, Melotti, Rita, Sganga, Gabriele, Zoro, Tamara, Isirdi, Alessandro, DeAngelis, Nicola, Weber, Dieter, Hodonou, Adrien, tenBroek, Richard, Parini, Dario, Khan, Jim, Sbrana, Giovanni, Coniglio, Carlo, Giarratano, Antonino, Gratarola, Angelo, Zaghi, Claudia, Romeo, Oreste, Kelly, Michael, Forfori, Francesco, Chiarugi, Massimo, Moore, Ernest, Catena, Fausto, Malbrain, Manu, and Galante, Joseph

Subjects
Acute, Emergency, Morbidity, Pain, Surgery, Treatment, Abdomen, Analgesics, Anesthesia, Humans, Pain, Postoperative, Perioperative Care, United States
Abstract

BACKGROUND: Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. MATERIAL AND METHODS: An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. CONCLUSION: Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.

Published
2022

13. The LIFE TRIAD of emergency general surgery.

Author

Coccolini, Federico, Sartelli, Massimo, Kluger, Yoram, Osipov, Aleksei, Cui, Yunfeng, Beka, Solomon, Kirkpatrick, Andrew, Sall, Ibrahima, Moore, Ernest, Biffl, Walter, Litvin, Andrey, Pisano, Michele, Magnone, Stefano, Picetti, Edoardo, de Angelis, Nicola, Stahel, Philip, Ansaloni, Luca, Tan, Edward, Abu-Zidan, Fikri, Ceresoli, Marco, Hecker, Andreas, Chiara, Osvaldo, Sganga, Gabriele, Khokha, Vladimir, di Saverio, Salomone, Sakakushev, Boris, Campanelli, Giampiero, Fraga, Gustavo, Wani, Imtiaz, Broek, Richard, Cicuttin, Enrico, Cremonini, Camilla, Tartaglia, Dario, Soreide, Kjetil, de Moya, Marc, Koike, Kaoru, De Simone, Belinda, Balogh, Zsolt, Amico, Francesco, Shelat, Vishal, Pikoulis, Emmanouil, Di Carlo, Isidoro, Bonavina, Luigi, Leppaniemi, Ari, Marzi, Ingo, Ivatury, Rao, Khan, Jim, Maier, Ronald, Hardcastle, Timothy, Isik, Arda, Podda, Mauro, Tolonen, Matti, Rasa, Kemal, Navsaria, Pradeep, Demetrashvili, Zaza, Tarasconi, Antonio, Carcoforo, Paolo, Sibilla, Maria, Baiocchi, Gian, Pararas, Nikolaos, Weber, Dieter, Chiarugi, Massimo, Catena, Fausto, and Galante, Joseph

Subjects
Data, Effectiveness, Emergency General Surgery, Formation, Learning, Outcomes, Planning, Hospitals, Humans, Registries, Surgeons
Abstract

Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.

Published
2022

14. The acute phase management of spinal cord injury affecting polytrauma patients: the ASAP study.

Author

Picetti, Edoardo, Iaccarino, Corrado, Coimbra, Raul, Abu-Zidan, Fikri, Tebala, Giovanni, Balogh, Zsolt, Biffl, Walter, Coccolini, Federico, Gupta, Deepak, Maier, Ronald, Marzi, Ingo, Robba, Chiara, Sartelli, Massimo, Servadei, Franco, Stahel, Philip, Taccone, Fabio, Unterberg, Andreas, Antonini, Marta, Ansaloni, Luca, Kirkpatrick, Andrew, Rizoli, Sandro, Leppaniemi, Ari, Chiara, Osvaldo, De Simone, Belinda, Chirica, Mircea, Shelat, Vishal, Fraga, Gustavo, Ceresoli, Marco, Cattani, Luca, Minardi, Francesco, Tan, Edward, Wani, Imtiaz, Petranca, Massimo, Domenichelli, Francesco, Cui, Yunfeng, Malchiodi, Laura, Sani, Emanuele, Litvin, Andrey, Hecker, Andreas, Montanaro, Vito, Beka, Solomon, Di Saverio, Salomone, Rossi, Sandra, Catena, Fausto, and Galante, Joseph

Subjects
Management, Polytrauma, Traumatic spinal cord injury, Cerebrospinal Fluid Pressure, Humans, Multiple Trauma, Neurosurgical Procedures, Spinal Cord Injuries
Abstract

BACKGROUND: Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic. METHODS: The survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia. RESULTS: There were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80-90 mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7 g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80-100 mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35-40 mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count > 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT)

Published
2022

15. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections.

Author

Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Agastra, Ervis, Abu-Zidan, Fikri, Abbas, Ashraf, Ansaloni, Luca, Adesunkanmi, Abdulrashid, Augustin, Goran, Bala, Miklosh, Baraket, Oussama, Biffl, Walter, Ceresoli, Marco, Cerutti, Elisabetta, Chiara, Osvaldo, Cicuttin, Enrico, Chiarugi, Massimo, Coimbra, Raul, Corsi, Daniela, Cortese, Francesco, Cui, Yunfeng, Damaskos, Dimitris, deAngelis, Nicola, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, de Jonge, Stijn, Di Bella, Stefano, Di Saverio, Salomone, Duane, Therese, Fugazzola, Paola, Ghnnam, Wagih, Gkiokas, George, Gomes, Carlos, Griffiths, Ewen, Hardcastle, Timothy, Hecker, Andreas, Herzog, Torsten, Karamarkovic, Aleksandar, Khokha, Vladimir, Kim, Peter, Kim, Jae, Kirkpatrick, Andrew, Kong, Victor, Koshy, Renol, Inaba, Kenji, Isik, Arda, Ivatury, Rao, Labricciosa, Francesco, Lee, Yeong, Leppäniemi, Ari, Litvin, Andrey, Luppi, Davide, Maier, Ronald, Marinis, Athanasios, Marwah, Sanjay, Mesina, Cristian, Moore, Ernest, Moore, Frederick, Negoi, Ionut, Olaoye, Iyiade, Ordoñez, Carlos, Ouadii, Mouaqit, Peitzman, Andrew, Perrone, Gennaro, Pintar, Tadeja, Pipitone, Giuseppe, Podda, Mauro, Raşa, Kemal, Ribeiro, Julival, Rodrigues, Gabriel, Rubio-Perez, Ines, Sall, Ibrahima, Sato, Norio, Sawyer, Robert, Shelat, Vishal, Sugrue, Michael, Tarasconi, Antonio, Tolonen, Matti, Viaggi, Bruno, Celotti, Andrea, Casella, Claudio, Pagani, Leonardo, Dhingra, Sameer, Baiocchi, Gian, Catena, Fausto, and Galante, Joseph

Subjects
Necrotizing infections, Necrotizing soft-tissue infections, Skin and soft-tissue infections, Critical Pathways, Humans, Soft Tissue Infections, United States
Abstract

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections.Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs.An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.

Published
2022

16. Liver trauma: WSES 2020 guidelines.

Author

Coccolini, Federico, Coimbra, Raul, Ordonez, Carlos, Kluger, Yoram, Vega, Felipe, Moore, Ernest, Biffl, Walt, Peitzman, Andrew, Horer, Tal, Abu-Zidan, Fikri, Sartelli, Massimo, Fraga, Gustavo, Cicuttin, Enrico, Ansaloni, Luca, Parra, Michael, Millán, Mauricio, DeAngelis, Nicola, Inaba, Kenji, Velmahos, George, Maier, Ron, Khokha, Vladimir, Sakakushev, Boris, Augustin, Goran, di Saverio, Salomone, Pikoulis, Emanuil, Chirica, Mircea, Reva, Viktor, Leppaniemi, Ari, Manchev, Vassil, Chiarugi, Massimo, Damaskos, Dimitrios, Weber, Dieter, Parry, Neil, Demetrashvili, Zaza, Civil, Ian, Napolitano, Lena, Corbella, Davide, and Catena, Fausto

Subjects
Adult, Classification, Guidelines, Hemorrhage, Intensive care, Interventional, Liver trauma, Minor, Moderate, Non-operative management, Operative management, Pediatric, Radiology, Severe, Surgery, Abdominal Injuries, Evidence-Based Medicine, Hemodynamics, Humans, Injury Severity Score, Liver, Patient Care Management
Abstract

Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines.

Published
2020

17. Kidney and uro-trauma: WSES-AAST guidelines.

Author

Coccolini, Federico, Moore, Ernest, Kluger, Yoram, Biffl, Walter, Leppaniemi, Ari, Matsumura, Yosuke, Kim, Fernando, Peitzman, Andrew, Fraga, Gustavo, Sartelli, Massimo, Ansaloni, Luca, Augustin, Goran, Kirkpatrick, Andrew, Abu-Zidan, Fikri, Wani, Imitiaz, Weber, Dieter, Pikoulis, Emmanouil, Larrea, Martha, Arvieux, Catherine, Manchev, Vassil, Reva, Viktor, Coimbra, Raul, Khokha, Vladimir, Mefire, Alain, Ordonez, Carlos, Chiarugi, Massimo, Machado, Fernando, Sakakushev, Boris, Matsumoto, Junichi, Maier, Ron, di Carlo, Isidoro, and Catena, Fausto

Subjects
Adult, Bladder, Classification, Conservative, Embolization, Endovascular trauma management, Flow chart, Guidelines, Kidney, Non-operative, Operative, Pediatric, Stenting, Surgery, Trauma, Ureter, Urethra, Urogenital, Urological, Acute Kidney Injury, General Surgery, Guidelines as Topic, Hemodynamics, Humans, Injury Severity Score, Kidney, Triage, Urinary Tract
Abstract

Renal and urogenital injuries occur in approximately 10-20% of abdominal trauma in adults and children. Optimal management should take into consideration the anatomic injury, the hemodynamic status, and the associated injuries. The management of urogenital trauma aims to restore homeostasis and normal physiology especially in pediatric patients where non-operative management is considered the gold standard. As with all traumatic conditions, the management of urogenital trauma should be multidisciplinary including urologists, interventional radiologists, and trauma surgeons, as well as emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and the American Association for the Surgery of Trauma (AAST) kidney and urogenital trauma management guidelines.

Published
2019

18. Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines.

Author

Coccolini, Federico, Kobayashi, Leslie, Kluger, Yoram, Moore, Ernest, Ansaloni, Luca, Biffl, Walt, Leppaniemi, Ari, Augustin, Goran, Reva, Viktor, Wani, Imitiaz, Kirkpatrick, Andrew, Abu-Zidan, Fikri, Cicuttin, Enrico, Fraga, Gustavo, Ordonez, Carlos, Pikoulis, Emmanuil, Sibilla, Maria, Maier, Ron, Matsumura, Yosuke, Masiakos, Peter, Khokha, Vladimir, Mefire, Alain, Ivatury, Rao, Favi, Francesco, Manchev, Vassil, Sartelli, Massimo, Machado, Fernando, Matsumoto, Junichi, Chiarugi, Massimo, Arvieux, Catherine, Catena, Fausto, and Coimbra, Raul

Subjects
Adult, Ampulla, Bile duct, Biliary tree, Classification, Conservative, Duodenum, Endoscopic retrograde cholangiopancreatography (ERCP), Endoscopy, Guidelines, Injury, Non-operative, Operative, Pancreas, Pediatric, Surgery, Trauma, Abdominal Injuries, Bile Ducts, Extrahepatic, Duodenum, Focused Assessment with Sonography for Trauma, General Surgery, Guidelines as Topic, Humans, Pancreas, Tomography, X-Ray Computed, Trauma Centers, Triage, Ultrasonography
Abstract

Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines.

Published
2019

19. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Author

ten Broek, Richard PG, Krielen, Pepijn, Di Saverio, Salomone, Coccolini, Federico, Biffl, Walter L, Ansaloni, Luca, Velmahos, George C, Sartelli, Massimo, Fraga, Gustavo P, Kelly, Michael D, Moore, Frederick A, Peitzman, Andrew B, Leppaniemi, Ari, Moore, Ernest E, Jeekel, Johannes, Kluger, Yoram, Sugrue, Michael, Balogh, Zsolt J, Bendinelli, Cino, Civil, Ian, Coimbra, Raul, De Moya, Mark, Ferrada, Paula, Inaba, Kenji, Ivatury, Rao, Latifi, Rifat, Kashuk, Jeffry L, Kirkpatrick, Andrew W, Maier, Ron, Rizoli, Sandro, Sakakushev, Boris, Scalea, Thomas, Søreide, Kjetil, Weber, Dieter, Wani, Imtiaz, Abu-Zidan, Fikri M, De’Angelis, Nicola, Piscioneri, Frank, Galante, Joseph M, Catena, Fausto, and van Goor, Harry

Subjects
Patient Safety, Prevention, Digestive Diseases, Clinical Research, Evaluation of treatments and therapeutic interventions, 7.3 Management and decision making, 6.4 Surgery, Management of diseases and conditions, Oral and gastrointestinal, Disease Management, General Surgery, Guidelines as Topic, Humans, Intestinal Obstruction, Tissue Adhesions, Treatment Outcome, Small bowel obstruction, Adhesions, Surgery, Laparoscopy, Laparotomy
Abstract

BackgroundAdhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups.MethodsThe guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion.RecommendationsAdhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO.Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention.DiscussionThis guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.

Published
2018

20. The open abdomen in trauma and non-trauma patients: WSES guidelines

Author

Coccolini, Federico, Roberts, Derek, Ansaloni, Luca, Ivatury, Rao, Gamberini, Emiliano, Kluger, Yoram, Moore, Ernest E, Coimbra, Raul, Kirkpatrick, Andrew W, Pereira, Bruno M, Montori, Giulia, Ceresoli, Marco, Abu-Zidan, Fikri M, Sartelli, Massimo, Velmahos, George, Fraga, Gustavo Pereira, Leppaniemi, Ari, Tolonen, Matti, Galante, Joseph, Razek, Tarek, Maier, Ron, Bala, Miklosh, Sakakushev, Boris, Khokha, Vladimir, Malbrain, Manu, Agnoletti, Vanni, Peitzman, Andrew, Demetrashvili, Zaza, Sugrue, Michael, Di Saverio, Salomone, Martzi, Ingo, Soreide, Kjetil, Biffl, Walter, Ferrada, Paula, Parry, Neil, Montravers, Philippe, Melotti, Rita Maria, Salvetti, Francesco, Valetti, Tino M, Scalea, Thomas, Chiara, Osvaldo, Cimbanassi, Stefania, Kashuk, Jeffry L, Larrea, Martha, Hernandez, Juan Alberto Martinez, Lin, Heng-Fu, Chirica, Mircea, Arvieux, Catherine, Bing, Camilla, Horer, Tal, De Simone, Belinda, Masiakos, Peter, Reva, Viktor, DeAngelis, Nicola, Kike, Kaoru, Balogh, Zsolt J, Fugazzola, Paola, Tomasoni, Matteo, Latifi, Rifat, Naidoo, Noel, Weber, Dieter, Handolin, Lauri, Inaba, Kenji, Hecker, Andreas, Kuo-Ching, Yuan, Ordoñez, Carlos A, Rizoli, Sandro, Gomes, Carlos Augusto, De Moya, Marc, Wani, Imtiaz, Mefire, Alain Chichom, Boffard, Ken, Napolitano, Lena, and Catena, Fausto

Subjects
Rare Diseases, Physical Injury - Accidents and Adverse Effects, Clinical Research, Cardiovascular, Abdomen, Abdominal Cavity, Abdominal Wound Closure Techniques, Guidelines as Topic, Humans, Intra-Abdominal Hypertension, Negative-Pressure Wound Therapy, Postoperative Complications, Prophylactic Surgical Procedures, Resuscitation, Open abdomen, Laparostomy, Non-trauma, Trauma, Peritonitis, Pancreatitis, Vascular emergencies, Intra-abdominal infection, Fistula, Nutrition, Re-exploration, Reintervention, Closure, Biological, Synthetic, Mesh, Technique, Timing, Guidelines, Surgery
Abstract

Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.

Published
2018

21. Splenic trauma: WSES classification and guidelines for adult and pediatric patients

Author

Coccolini, Federico, Montori, Giulia, Catena, Fausto, Kluger, Yoram, Biffl, Walter, Moore, Ernest E, Reva, Viktor, Bing, Camilla, Bala, Miklosh, Fugazzola, Paola, Bahouth, Hany, Marzi, Ingo, Velmahos, George, Ivatury, Rao, Soreide, Kjetil, Horer, Tal, ten Broek, Richard, Pereira, Bruno M, Fraga, Gustavo P, Inaba, Kenji, Kashuk, Joseph, Parry, Neil, Masiakos, Peter T, Mylonas, Konstantinos S, Kirkpatrick, Andrew, Abu-Zidan, Fikri, Gomes, Carlos Augusto, Benatti, Simone Vasilij, Naidoo, Noel, Salvetti, Francesco, Maccatrozzo, Stefano, Agnoletti, Vanni, Gamberini, Emiliano, Solaini, Leonardo, Costanzo, Antonio, Celotti, Andrea, Tomasoni, Matteo, Khokha, Vladimir, Arvieux, Catherine, Napolitano, Lena, Handolin, Lauri, Pisano, Michele, Magnone, Stefano, Spain, David A, de Moya, Marc, Davis, Kimberly A, De Angelis, Nicola, Leppaniemi, Ari, Ferrada, Paula, Latifi, Rifat, Navarro, David Costa, Otomo, Yashuiro, Coimbra, Raul, Maier, Ronald V, Moore, Frederick, Rizoli, Sandro, Sakakushev, Boris, Galante, Joseph M, Chiara, Osvaldo, Cimbanassi, Stefania, Mefire, Alain Chichom, Weber, Dieter, Ceresoli, Marco, Peitzman, Andrew B, Wehlie, Liban, Sartelli, Massimo, Di Saverio, Salomone, and Ansaloni, Luca

Subjects
Physical Injury - Accidents and Adverse Effects, Childhood Injury, Emergency Care, Patient Safety, Pediatric, Hematology, Injuries and accidents, Abdominal Injuries, Adult, Conservative Treatment, Guidelines as Topic, Hemodynamics, Humans, Spleen, Wounds and Injuries, Trauma, Classification, Guidelines, Embolization, Surgery, Non-operative, Conservative
Abstract

Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.

Published
2017

22. Workflows and Outcomes in Patients With Suspected Large Vessel Occlusion Stroke Triaged in Urban and Nonurban Areas

Author

Alvaro Garcia-Tornel, Monica Millan, Marta Rubiera, Alejandro Bustamante, Manuel Requena, Laura Dorado, Marta Olivé-Gadea, Xavier Jiménez, Angels Soto, Marisol Querol, Maria Hernández-Pérez, Meritxell Gomis, Pere Cardona, Xabier Urra, Francesc Purroy, Yolanda Silva, Xavier Ustrell, Patricia Esteve, Mercè Salvat-Plana, Miquel Gallofré, Carlos Molina, Antoni Dávalos, Tudor Jovin, Sonia Abilleira, Marc Ribo, Natalia Pérez de la Ossa, Marc Ribó Jacobi, Estela Sanjuan, Katherine Santana, Noelia Rodríguez, Jorge Pagola, David Rodriguez-Luna, Olga Maisterra, Estevo Santamarina, Marian Muchada, Jesús Juega, Sandra Boned, Antonio Palasi Franco, Álvaro García -Tornel, Matías Deck, Victoria Sala, Lucía Muñoz, Mónica Millán, Elena López-Cancio, María Hernández-Pérez, Jordi Ciurans, Daniela Samaniego, Tamara Canento, Lorena Martin, Anna Planas, Joaquin Broto, Agustín Sorrentino, Martí Paré, Nuole Zhu, Alicia Garrido, Laia Grau, Ane Miren Crespo, Silvia Presas, Miriam Almendrote, Alba Ramos, Giuseppe Lucente, Lourdes Ispierto, Manuel Lozano, Juan Luis Becerra, Marta Jiménez, Dolores Vilas Rolán, Nicolas Guanyabens, Josep Sanchez-Ojanguren, Alicia Martínez-Piñeiro, Sara Forcén, Mireia Gea, Marta Álvarez, Anna Ramos, Manuel Domínguez Lizarbe, Sara, Rubio Guerra, Irene Bragado, Andrea Arbex, Luis Rodríguez, Pere Cardona Portela, Helena Quesada García, Blanca Lara Rodríguez, Nuria Cayuela, Julia Miró, Clara Marzal, Andrés Paipa, Sergio Campoy, Ana Núñez, Pablo Arroyo, Sarah Besora, Vanessa Adell, Jaume Campdelacreu, Montse Alemany Martí, Belén González, Laura Bau Vila, Marta Fiter Crespo, Anna Berbel, Ma. Cristina Villaescusa Urbaneja, Núria Guillen, Nuria Vidal, Patricia Valentina Vérez Santamaria, Diego Herrero Navarro, Marta Simó, Mercedes Falip, Elisabeth Matas, Neus Mongay Ochoa, Ariadna Gifreu, Albert Muñoz, Lucía Romero, Eduard Portell, Guillermo Hernández Perez, F. Ruiz Esteve, Silvia Teixidor, Augusto Salazar Talavera, Roser Gómez, Xabier Urra Nuin, Martha Vargas, Ángel Chamorro, Sergio Amaro, Laura Llull, Arturo Renú, Salvatore Rudilosso, Raquel Sánchez del Valle, Helena Ariño, Nuria Solà, Delón la Puma, Francisco Gil, Juan Bernardo Gómez, Nuria Matos, Neus Falgàs, Sergi Borrego, Almudena Sánchez, Mircea Balasa, Carmen Montejo, Mar Guasp, David Reyes, Pablo Sánchez Cervilla, Jose Miguel Contador, Victor Augusto Vera Monge, Oscar Ramos, Alejandro Rodríguez, Ana Rodríguez Campello, Gemma Romeral Ballester, Mireia Llop Trujillano, Eva Giralt Steinhauer, Elisa Cuadrado Godia, Angel Javier Ois Santiago, Jordi Jimenez Conde, Joan Martí Fábregas, Daniel Guisado, Luís Prats, Pol Camps, Raquel Delgado, Alejandro Martínez Domeño, Rebeca Marín, David Cànovas, Jordi Estela, Marta Ros, Sonsoles Aranceta, Jordi Espinosa, Marta Rubio, Cristina Lafuente, Oriol Barrachina, Alicia Anguita, Anna Reverter, Carmen García, Gemma Sansa, Mariona Hervas, Monica Crosas, Tania Delgado, Jerzy Krupinski, Sonia Huertas Folch, Gemma Muñoz Gamito, Josep Trenado Alvarez, Teresa Subirana, Jessica Molina, Laura Comes Romero, Gemma Guardia Valls, Miriam Jover, Javier Joaquín Sotova, Sonia Mª García Sánchez, Sebastian Valenzuela (intensivista), Manuel Gómez-Choco, Juan José Mengual, M. Àngels Font, Mª Isabel Gómez Ruiz, Irati Zubizarreta, Susana Fernández González, Laura Gubieras, Carmen E. Cobos, Luis Mena Romo, Nuria Caballol, Luis Cano, Joaquín Serena Leal, Mikel Terceño Izarra, Irene Bragado Trigo, Saima Bashir Viturro, Laura Pardo Albiñana, Montserrat Reina Garrido, Carla Marco Cazcarra, Karol Enrique Uscamaita, Fabian Márquez, Cristina Coll, Mar Irida Lloret Villlas, Berta Solano Vila, Berta Alemany Perna, Daniel López Domínguezl, Mercedes de Lera, Anna Cots Foraster, Urszula Bojaryn, Ikram Benabdelhak, Gerard Mauri Capdevila, Jordi Sanahuja Montesinos, Daniel Vázquez, José Vicente Hervás, Cristina González, Alejandro Quílez, Mikel Vicente Pascual, María Ruiz, Yolanda Riba, M. Pilar Gil Villar, Cristina García, Xavier Ustrell Roig, Mònica Baldrich Mora, Anna Pellisé Guinjoan, Judit Borras, Alba Mañé Martínez, Rafael Marés, Jaume Viñas i Gaya, Laia Seró, Alan Flores, Paula Rodríguez, Gislaine Castilho, Angela Monterde Ortega, Silvia Reverté, Josep Zaragoza, Joan Josep Baiges, Gisela Martín Ozaeta, Sonia Escalante, Iago Payo, Júlia Saura Salvado, Natalia Mas Sala, Josep M Soler Insa, Ester Tio Vilamala, Josep Abos Navarro, Héctor Cruz Tabuenca, Tamara Canento Sánchez, Elisabet Roldán, Elsa Puiggrós Rubiol, Elisabet Franquet, Lidia Fuentes, Javier Donaire, Elena Martí, Laura Giménez, Junior Gil Vázquez, Eloisa Nieto Clara Gris Ambrós, Puri Rodríguez, José Félix Oletta, Pilar Pons Mellado, Catena, Bárbara Gómez, Vergilin Raileau, Esther Catena Ruíz, Oscar Pardina, Jordi Mercadal, María López-Diéguez, Pilar Pérez, Lourdes Gabarró, María Orriols, Joan Josep Canet, Mireia Roca, Muriel Álvaro, Francesc Boneu, Georgina Giménez, Jaume Albà, Francesc Gibert, Jéssica Garcia, Patricia Barragan, Gustavo Jurado, Josep Sabaté Ortega, Joan Amaurys Martínez Solano, Víctor Fernández, Mónica Torres, Ana Belén Montero Alvaredo, Laura Redondo Parejo, Josep Maria Aragonés, Anna Bullón, Cora Loste, Paula González, Neker Bejarano, Francisco Sanchez, Gianni Lucchetti, Xavier Pla, Javier Gimeno, Esteban Reynaga, Montse Barcons, Gabriel Celedón, Juan Ortiz, Goran Anastasovski, Oscar Mascaró, Javier Diez de los Ríos, Meritxell Feliu, Anna Ribera, Cristhian Ruiz, Gerard Corominas, Daniella Nunes, Claudia Roca, Nadina Latorre, Lizbeth Yataco, Maricelys Cruz, Nerea Blanco, Santiago Castejón, Dolores Cocho Calderón, Claustre Pont Sunyer, Jordi Espinosa Garcia, Rodrigo Paz Martin, Albert de Luis Sanchez, Dolores Espinosa Vivas, Juan Valencia Molina, Gemma, Planels Palome, Laia Tomas Chaume, Ares Villagrasa Vilella, Marco Bustamante, Anunciación Boltes, Fernando Rodríguez, Itziar Arrieta, Jordi Ciurans Molist, Barnés Andreu, Ernest Palomeras Soler, Nicolau Guanyabens Buscà, Manuel Daza López, Jordi Bigas Farreres, Virginia Casado Ruiz, Desiree Muriana Batiste, Mª Pilar Sanz Cartagena, Eulalia Cabot de Vega, Josep Bassa Real, Hector Pelaez Roman, César Socolich, Josep Mª Alonso Camp, Antonio Tomás Cano Orgaz, Mª Pilar Fossas Felip, Nicolás Morón, Sandra Bacca, Mauricio Molina, Francesc Casarramona, Lorena Elias, Muhammad Zidane Bukaei, Jose Antonio Martos Gutierrez, Judith Lopez Escuin, Cristina Olaizola, Yolexis López Vargas, Juan Jiménez Oyonarte, Rashida Soultana, Eduardo Sanjurjo Golpe, Esther Salvador, Guillem Vila, Marcos Serrano, Matilde Nuria López Claverol, Marian Lamolla, Miquel Amate, Adriana Rodriguez, Ruth Romero, Montgomery del Carpio, Ana Isabel Hernandez, Julián Martín, M Carmen Rosas, Antonio Nogueroles, Sorilandy Encarnación, Augusto Robles, Jose Antonio Herrera, Roger Gavilán, Toghrol Mameghani, Gastón Araujo, M.Angeles Garrido Morales, Enric Ramon Albert Segui, Eva Fernandez Climent, Francesc Paris Pujol, Mireia Judit Garrofé Seira, Lucía Gómez Pía, Fernando Salleres Nuñez, Cristina Aguar Peñalver, Cristina Vaz Lopes, Elisenda Ribera Tasa, Carmen Repullo Vilchez, Modesto Sánchez Zambrana, Beatriu Suescun Ribas, Inés Vilà Panés, Montserrat Vila Planavila, Alicia Vaqueiro Lorenzo, Meritxell Sabartés Guixes, Jorge Medina, David Sambrano, Javi Zamarreño, Carmen Pirela, Paola Vélez, Luis Cajamarca, Honey Pérez, Yarles Martínez, Jesus Alexander Gonçalves, Carles Regordosa, Claudia Mormeneo, Laura Griu, Maria Francia Colina, Enric Farik, Dolors Carrión Duch, Carles Badenas, Oscar Bernal, Núria Agramunt, Shyrlei Morales, Victoria Reynoso, Miguel Guerrero, Primitivo Romera Cid, Mònica Folqué, Claudia Pedroza, Adnan Hachem, Íñigo Soteras Martínez, Xavier Verdera García, Mercè López Amorós, Xavier Costa Subirós, Marta Cufí Benet, Cecile Van Eendenburg, Teresa Osuna, Dra Gina Santos, Mireia Pallisera, Lluís Gonzalo Oliva, Gemma Sanchez, Xavier Basurto, Ludgi Vivoda, Richard Van der Kleyn, Laura Robles, Ana Cabanelas Barranco, Mª Cruz Almendros, Marc Pérez Oliveras, Amelia Fernández Álvarez, Maria Rybyeva, Antoni Viñas, Maria Barcons, Joaquim Danès Alberto Tavera, Pablo Burbano, Cintie López, David Cruz, Paula Bisbe, Nora Fernández, Juan Carlos Palacio, Eduardo Fraiz, Oriol Aguiló, Rollmy Amorodjo, John Velázquez, Elena Sánchez, Jaume Español, Judit Perez de Celis, Anna Coll, Glòria Díaz, Margarida Vergés i Sala, Mª Ángels Casas Capdevila, Yosmairy Yoselin Ferrini, Aitor Gorriz, Diego-Javier Cucurell Navarro, Dulce Velásquez, Jaume Pla Soler, Josep González, Julian David Higuera, Lina Cuellar, Liza Margarita Miniello, Lluis Pujol, Sorin Cracan, Mora Vives, M Angela, Lopez Lopez, null Anabel, Montse Gorchs Molist, Delofeu Anna, Silvia Solà Muñoz, Ferreres Yolanda, Carol Pujalte, Elisabeth Téllez Marín, Yolanda Font Casas, Sara Hernández Luque, Joaquim Mejias Sendra, Francesca Mellado Valero, Campos Escala, Galup De Lacanal, Lopez Diaz, Castillo Paramio, Català Estopà, Español Moreda, Calafell Majo, Carballo Almeida, Castro Naval, M Elena, Cregut Ruiz, Pere Lluis, Deulofeu Font, Fabregat Sanjuan, Joan Pere, Fontquerni Gorchs, Forés Bellés, Joan Antoni, Gomez Herrera, Juan Carlos, Hijazo Prades, Itzaina Torvisco, Marti Rovira, Obiols Gonzalez, Olive Cavero, Querol Gil, M Soledad, Rico Rodriguez, Rios Sambernardo, Ropero Molina, Jose Ramon, Sanchez Valero, Santos Arevalo, Maria Jose, Soto Garcia, Maria Angeles, Tebar Escribano, Torres Garcia, Pedro José, Verdes Carrion, M Isabel, Verge Lopez, Juan Jose, Lopez Canela, M Angeles, Lucas Guarque, Morales Alvarez, Jorge Arnulfo, Morell Fornieles, Subirats Gomez, Maria Teresa, Torello Masa, Val Lopez, Maria Mercedes, Palmero Reyes, Juan Manuel, Rodriguez Forne, Ruana Turiel, Sanchez Gonzalez, Sebastia Gornals, Abrio Rico, Albert Gual Falip, Aznar Oliveros, Brugues Perotti, Calvet Molinero, Catells Franco, Corrales Medina, Daroca Miro, Duran Marquez, Feliu Pradas, Figueras Casanova, Garcia Tortajada, Grajera Gallego, Azahara del Mar, Las Arroyo, Dulcenombre de Jesus, Laserreta Sanz, Llambrich Vidal, Monllao Corral, Morales de la Cruz, Moreno Blanco, Orejuela Orgaz, Piñana Suazo, Pons Minguillon, Rodríguez Gómez, José Carlos, Rodriguez Pereira, Sedo Porcel, Sevil Villar, Sierra Lopez, Torres Romero, Trepat Calveres, Ventura Arnella, Acera Gil, M Teresa, Biesot Vico, Castro Galea, Rosa Maria, Escorcia Chafer, Juan Antonio, Gil Faure, Hernandez Luque, Jimenez Delgado, Mallafre Gay, M. Angel, Olivares Sanzo, Pubill Fondevila, Sabate Fort, Segovia Agámez, Antonio Carlos, Turata Longaretti, Valle Hernandez, Trayner Guixens, Aguilar Valor, Aguirre Alvarez, Alastrue Naval, Alferez Baquero, Alonso Marne, Cristina, Aloy Orozco, Alvarez Colino, Alvarez Peñuela, Ameller Cirilo, Maria Vanessa, Andujar Guerrero, Estefania Remedios, Auladell Sillero, Azcarate Sorbet, Basany Genesca, Benavent Barduena, Benito Tudela, Blanch Pardo, Boluda Pla, Bonilla Gonzalez, Bru Serramalera, Burnat Andreu, Caballero Calvo-Rayo, Calvo Casellas, Camps Mombiela, Cano Bresme, Carcelen Fernandez, Caro Solà, Casasas Matavacas, Castanedo Bolado, Cerdeña Cortina, Abella Jane, Laia Collado Borrego, Colom Orri, Comellas Vilanova, Conillera Sole, Cots Torres, Cuchi Estepa, de Sostoa Graell, del Rio Lopez, Delgado Compte, Diaz Bueno, Diaz Maneiro, Andrea Lucia, Domenech Palau, M. Carme, Duran Carasso, Pablo Javier, El Abidi, Escoda Martin, Esteve Casanovas, Fernandez Perez, Ferre Quintero, Flores Escobar, Fontcuberta Abad, Fortes del Valle, Mª Luisa, Franco Quesada, Sara Maria, Franco Romero, Gallego Francisco, Gamiz Gala, Alicia, Garcia Castañeda, Garcia Rodriguez, Casajuana Gemma, Gomez Arroyo, Gomez Girbau, Gonzalez Fernandez, Gonzalez Gonzalez, Gonzalez Lopez, Gual Obeso, Guerrero Blanco, Guillemas Roca, Guillermo Eudaldo, Hernandez Sebastia, Homar Covas, Hostench Alvarez, Huerta Royo, Ibañez Barcelo, Izquiero Cruz, Jaione Urdangarin Etxetxikia, Juárez Gimenez, Khlifi Alami, Laparra Gasco, Lara Moreales, Lasaosa Medina, Maria Lourdes, Lazaro Cava, Leon Berrar, López Maturana, Lopez Ramirez, López Romero, Lorente Marco, Lorenzo Martin, Lozano Casals, Lujan Nicola, Madrid Diaz, Jose Antonio, Maria Teresa Peris Morales, Marti Clemente, Martinez Castaño, David Natanael, Martinez Gamez, Martinez Gonzalez, Martinez Quesada, Maria de la Cabeza, Marzà Fusté, Mireia, M Conillera, Melendo Lasheras, Miralles Mestre, Montserrat Puig Pastalle, Montserrate Vidal, Mora Mellado, Morales Ponce, Morera Cabre, Morera Vivet, Mundi Souza, Muñoz Quiles, Navea Rosa, Neira Iglesias, M Asuncion, Nuñez Manrique, Mª Pilar, Obiols Martinez, Pallares Reig, Partegas Torres, Pascual Berengueras, Perez Gamez, Perez Oset, Perez Restrepo, Maria Alejandra, Planas Yeste, Planells Mangado, Puertas Carbonell, Quinteiro Blanco, Rebollar Benavente, Recasens Fernandez, Reyes Gomez, Maria del Carmen, Roca Pou, Rodriguez Ferrer, Rodriguez Franco, Rodriguez Fuertes, Rodriguez Muñoz, Rodriguez Navarro, Roig Iniesta, Romero Gracia, Rovira Brunet, Rovira de Eugenio, Rubio Baena, Ruiz Llorens, Sala Llamazares, San Juan Alaez, Sanchez Segura, Santasusana Soldevilla, Sanz Salmeron, Segura Perez, Serra Balcells, Sorina Dumitras, Teixidor Montoya, Tena Vicente, Tierno Salinas, Ester Ines, Toledo Testa, Tomàs Figueras, Tomas Ruperez, Torrano Garcia-Penche, Torres Esparza, Florenc Uku, Vazquez Blanco, Vazquez De la Paz, Vazquez Gil, Vazquez Gonzalez, Vidal Meler, Vilalta Cots, Vilches Jimenez, Visser Fernandez, Viu Gavin, Vives Vives, Carmona Jimenez, Francisco Jose, Galobardes Vilches, Gonzalez Gomez, Jodar Manzanera, Marimon Cortes, Marrodan Orive, Martin Bosch, Martorell Lopez, Millares Roca, M Jesus, Miralles Guri, Muliterno Hernandez, Muñoz Oliva, Pons Pujol, Postius Conde, Prieto Arruñada, Quintana Mathé, Rosell Mata, Alvarin Alvarez, Arrufat Flores, Bañuelos Pago, Campo Vilar, Cardus Hidalgo, Castello Gil, Maria Gloria, Castrillo Montsesinos, Clave Garces, Comes Sanroma, Descalzo Sequi, Errando Ricol, Escudero Campillo, Maria del Mar, Fernandez Alvarez, Fernandez Gomez, Franch Espinosa, Freixes Graells, Garcia Plaza, Garcia-Marron Gallego, Hernandez Simancas, Jaraba Armas, Jimenez Ramos, Lopez Oganissian, Madrona Romero, M Rosa, Martinez Millan, Martínez Morón, Merchan Encinas, Moreno Jimenez, Muñoz Rico, Navarro Rodriguez, Nogales Ibañez, Rita Maria, Novillo Viera, Parella Torrabadella, Mari Alba, Pera Villar, Carla Montserrat, Rabella Miralles, Ramis Trilles, Ribera Ortiz, Sastre Perez, Soro Borrega, Tapia Fores, Tellez Bernad, Trenado Alvarez, Felix Martin, Herrero Perez, Lanau Fuster, Lopez Gomariz, Pardo Lozano, Quintana Altimiras, Ventosa Lopez, Almodovar Damian, Alvarez Monterroso, Arambudo Comas, Boullon Garzon, Burgos Capella, Campuzano Garcia, Maria Del Mar, Capdevila Olivas, Carre Marti, Clara Isabel, Carretero Bacaicoa, Cazorla Calderon, Chacon Osuna, Cortes Planas, Cortit Olio, Delhomme Estany, Fructuos Martinez, Garcia Lopez, Pascual Luis, Genis Amill Vallve, Gonzalez Muñoz, Hernaez Ventura, Lavernia Gimenez, Martin Rojo, Martínez Medina, Mayol Barrera, Mercader Pi, Merino Dalmau, Miguel Campodarbe, Moreno Sanchez, Francisco Javier, Alba Mari, Penela Barrameda, Prieto Ajenjo, Rodriguez Pareja, Rodríguez Piñar, Javier Francisco, Rodriguez Tello, Romero Pereda, Sainz Saborido, Santacana Martin, Santos Martinez, Sierra Chavez, Turbau Torres, Vicente Domenech, Villena Esteo, Vives Pertegaz, Baena Gonzalez, Bagaria Pont, Beltran Sanchez, Bonet Alarcon, Borch Ballescà, Buhils Clanchet, Closa Garcia, Colomina Carril, Cristina Fernandez Sanchez, Fernandez Toledo Edurne Judith, Espases Rodriguez, Espert Resa, F Xavier, Fernández Sol, Gonzalez Lugo, Gracia Llesera, Herrada Lendinez, Juliench Liesa, Sandra Alicia, Lopez Ortega, Lopez Yuste, Lozano Villanueva, Lucia Sola Soto, Madrid Castellano, Megias Cano, Daniel Jesus, Montasell Ponce, Montesinos Sospedra, Moya Martinez, Muñoz Herrera, Ocaña Fernandez, Palau Bernal, Perez Sole, Ramon Carbonell, Ribas Lop, Rubio López, Rueda Lopez, Sabat Castaño, Sabata Lara, Salmerón Ramírez, Serra Creus, Serrano Dalmau, Sumasi Mainero, Gonzalo Gabriel, Valencia Primo, Ana Maria Viñuales Muñoz, Josep Roig, and Verònica Hidalgo.

Subjects
Stroke, Advanced and Specialized Nursing, Treatment Outcome, Endovascular Procedures, Humans, Neurology (clinical), Cardiology and Cardiovascular Medicine, Brain Ischemia, Ischemic Stroke, Thrombectomy, Workflow
Abstract

Background: We aim to compare the outcome of patients from urban areas, where the referral center is able to perform thrombectomy, with patients from nonurban areas enrolled in the RACECAT trial (Direct Transfer to an Endovascular Center Compared to Transfer to the Closest Stroke Center in Acute Stroke Patients With Suspected Large Vessel Occlusion). Methods: Patients with suspected large vessel occlusion stroke, as evaluated by a Rapid Arterial Occlusion Evaluation score of ≥5, from urban catchment areas of thrombectomy-capable centers during RACECAT trial enrollment period were included in the Stroke Code Registry of Catalonia. Primary outcome was disability at 90 days, as assessed by the shift analysis on the modified Rankin Scale score, in patients with an ischemic stroke. Secondary outcomes included mortality at 90 days, rate of thrombolysis and thrombectomy, time from onset to thrombolysis, and thrombectomy initiation. Propensity score matching was used to assemble a cohort of patients with similar characteristics. Results: The analysis included 1369 patients from nonurban areas and 2502 patients from urban areas. We matched 920 patients with an ischemic stroke from urban areas and nonurban areas based on their propensity scores. Patients with ischemic stroke from nonurban areas had higher degrees of disability at 90 days (median [interquartle range] modified Rankin Scale score, 3 [2–5] versus 3 [1–5], common odds ratio, 1.25 [95% CI, 1.06–1.48]); the observed average effect was only significant in patients with large vessel stroke (common odds ratio, 1.36 [95% CI, 1.08–1.65]). Mortality rate was similar between groups(odds ratio, 1.02 [95% CI, 0.81–1.28]). Patients from nonurban areas had higher odds of receiving thrombolysis (odds ratio, 1.36 [95% CI, 1.16–1.67]), lower odds of receiving thrombectomy(odds ratio, 0.61 [95% CI, 0.51–0.75]), and longer time from stroke onset to thrombolysis (mean difference 38 minutes [95% CI, 25–52]) and thrombectomy(mean difference 66 minutes [95% CI, 37–95]). Conclusions: In Catalonia, Spain, patients with large vessel occlusion stroke triaged in nonurban areas had worse neurological outcomes than patients from urban areas, where the referral center was able to perform thrombectomy. Interventions aimed at improving organizational practices and the development of thrombectomy capabilities in centers located in remote areas should be pursued. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02795962.

Published
2022
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23. 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

Edoardo Picetti, Fausto Catena, Fikri Abu-Zidan, Luca Ansaloni, Rocco A. Armonda, Miklosh Bala, Zsolt J. Balogh, Alessandro Bertuccio, Walt L. Biffl, Pierre Bouzat, Andras Buki, Davide Cerasti, Randall M. Chesnut, Giuseppe Citerio, Federico Coccolini, Raul Coimbra, Carlo Coniglio, Enrico Fainardi, Deepak Gupta, Jennifer M. Gurney, Gregory W. J. Hawryluk, Raimund Helbok, Peter J. A. Hutchinson, Corrado Iaccarino, Angelos Kolias, Ronald W. Maier, Matthew J. Martin, Geert Meyfroidt, David O. Okonkwo, Frank Rasulo, Sandro Rizoli, Andres Rubiano, Juan Sahuquillo, Valerie G. Sams, Franco Servadei, Deepak Sharma, Lori Shutter, Philip F. Stahel, Fabio S. Taccone, Andrew Udy, Tommaso Zoerle, Vanni Agnoletti, Francesca Bravi, Belinda De Simone, Yoram Kluger, Costanza Martino, Ernest E. Moore, Massimo Sartelli, Dieter Weber, Chiara Robba, Apollo - University of Cambridge Repository, 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, Institut Català de la Salut, [Picetti E] Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy. [Catena F] Department of General and Emergency Surgery, Bufalini Hospital, Cesena, Italy. [Abu-Zidan F] The Research Ofce, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. [Ansaloni L] Unit of General Surgery, San Matteo Hospital Pavia, University of Pavia, Pavia, Italy. [Armonda RA] Department of Neurosurgery, 71541MedStar Georgetown University Hospital, Washington, DC, USA. Department of Neurosurgery, 8405MedStar Washington Hospital Center, Washington, DC, USA. [Bala M] Acute Care Surgery and Trauma Unit, Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem Kiriat Hadassah, Jerusalem, Israel. [Sahuquillo J] Servei de Neurocirurgia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, and Citerio, Giuseppe [0000-0002-5374-3161]

Subjects
Hub, Health Occupations::Medicine::Specialties, Surgical::Neurosurgery [DISCIPLINES AND OCCUPATIONS], profesiones sanitarias::medicina::especialidades quirúrgicas::neurocirugía [DISCIPLINAS Y OCUPACIONES], Dany cerebral, Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus [PSYCHIATRY AND PSYCHOLOGY], conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso [PSIQUIATRÍA Y PSICOLOGÍA], Neurosurgical Procedures, Wounds and Injuries::Trauma, Nervous System::Craniocerebral Trauma::Brain Injuries::Brain Injuries, Traumatic [DISEASES], Traumatic brain injury, heridas y lesiones::traumatismos del sistema nervioso::traumatismos craneocerebrales::lesiones encefálicas::lesiones encefálicas traumáticas [ENFERMEDADES], Brain Injuries, Traumatic, Humans, Cervell - Ferides i lesions, Research, Presa de decisions, Brain, Otros calificadores::Otros calificadores::/cirugía [Otros calificadores], Management, Spoke, Transfer, Hospitals, Other subheadings::Other subheadings::/surgery [Other subheadings], Hospitalization, Emergency Medicine, Surgery, Sistema nerviós - Cirurgia
Abstract

Acknowledgements: We would like to thank WSES for the support., 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

24. Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Author

Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthias, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andreas, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Surgery, AMS - Musculoskeletal Health, Other Research, APH - Quality of Care, Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthia, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andrea, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Reichert, M, Sartelli, M, Weigand, M, Hecker, M, Oppelt, P, Noll, J, Askevold, I, Liese, J, Padberg, W, Coccolini, F, Catena, F, Hecker, A, Peckham-Cooper, A, Camacho-Ortiz, A, Mastoraki, A, Landaluce-Olavarria, A, Pal, A, Kuriyama, A, Chichom-Mefire, A, Porcu, A, Martinez-Perez, A, Karamarkovic, A, Osipov, A, Coppola, A, Cucchetti, A, Spolini, A, Giordano, A, Reinisch-Liese, A, Kavalakat, A, Vasilescu, A, Alamin, A, Gupta, A, Dascalu, A, Musina, A, Bakopoulos, A, Zakaria, A, Vereczkei, A, Balla, A, Bottari, A, Baumann, A, Fette, A, Litvin, A, Reichert, A, Guariniello, A, Paspala, A, Schneck, A, Brillantino, A, Pesce, A, Isik, A, Leppaniemi, A, Papadopoulos, A, Kechagias, A, Mohamed, A, Mitul, A, Marinis, A, Syllaios, A, Mantoglu, B, De Simone, B, Weiss, B, Posentrup, B, Picardi, B, Zampogna, B, Sakakushev, B, Atanasov, B, Nardo, B, Calik, B, Cremonini, C, Ordonez, C, Seretis, C, Cascone, C, Chouliaras, C, Bendinelli, C, Lopes, C, Guerci, C, Weber, C, Nastos, C, Mesina, C, Caputo, D, Massalou, D, Cavaliere, D, Mcnamara, D, Demetriades, D, Pantalone, D, Coletta, D, Sasia, D, Visconti, D, Weber, D, Corallino, D, Chatzipetris, D, Manatakis, D, Ntourakis, D, Papaconstantinou, D, Schizas, D, Chrysikos, D, Adamovich, D, Elkafrawy, D, Seban, D, Garcia, E, Baldini, E, Picetti, E, Tan, E, Baili, E, Lostoridis, E, Toma, E, Colak, E, Cerutti, E, Steyn, E, Hsabo, E, Kapetanakis, E, Kaouras, E, Schneck, E, Akin, E, Gonullu, E, Celik, E, Cicuttin, E, Pinotti, E, Johnsson, E, Moore, E, Agastra, E, Dimitrov, E, Griffiths, E, D'Acapito, F, Saraceno, F, Alconchel, F, Zeppernick, F, Rodriguez, F, Abu-Zidan, F, Pecchini, F, Favi, F, Ferrara, F, Fleres, F, Pata, F, Roscio, F, Mulita, F, Dor, F, Linder, F, Dimofte, G, Rodrigues, G, Nita, G, Sganga, G, Martines, G, Mazzarella, G, Perrone, G, Velmahos, G, Lianos, G, Tomadze, G, Baiocchi, G, D'Ambrosio, G, Pellino, G, Pattacini, G, Giraudo, G, Lisi, G, Tebala, G, Pirozzolo, G, Montori, G, Argenio, G, Brisinda, G, Curro, G, Giuliani, G, Palomba, G, Roscitano, G, Avsar, G, Augustin, G, Clarizia, G, Vega, G, Fraga, G, Sethi, H, Eltyeb, H, Lohse, H, Bayhan, H, Hamid, H, Kryvoruchko, I, Iannone, I, Wani, I, Lazaridis, I, Katsaros, I, Nikolopoulos, I, Negoi, I, Reccia, I, Di Carlo, I, Olaoye, I, Czepiel, J, Kim, J, Meyer, J, Terrazas, J, Tochie, J, Galante, J, Davies, J, Sugand, K, Gonfa, K, Rasa, K, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Angamuthu, K, Akhmeteli, L, Sydorchuk, L, Fortuna, L, Siragusa, L, Pagani, L, Solaini, L, Miller, L, Bains, L, Ansaloni, L, Ferrario, L, Bonavina, L, Conti, L, Buonomo, L, Tallon-Aguilar, L, Tomczyk, L, Widmer, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Malbrain, M, Maegele, M, Catarci, M, Ceresoli, M, Ranucci, M, Antonopoulou, M, Papadoliopoulou, M, Valenti, M, Sotiropoulou, M, D'Oria, M, Martin, M, Hirschburger, M, Veroux, M, Fantoni, M, Nardi, M, Tolonen, M, Montuori, M, Podda, M, Scheiterle, M, Frountzas, M, Sarikaya, M, Yildirim, M, Bender, M, Vailas, M, Teuben, M, Campanelli, M, Ammendola, M, Malerba, M, Pisano, M, Pertea, M, Slavchev, M, Ukkonen, M, Bala, M, Chirica, M, Barone, M, Shaat, M, Mohammed, M, Abuelgasim, M, Gureh, M, Ouadii, M, Balkan, M, Mohamed, M, Hakseven, M, Velenciuc, N, Cillara, N, De'Angelis, N, Tamini, N, Zavras, N, Machairas, N, Michalopoulos, N, Koliakos, N, Pararas, N, Donlon, N, Medappil, N, Ben-Ishay, O, Stefano, O, Islam, O, Tammo, O, Ioannidis, O, Aparicio, O, Baraket, O, Kumar, P, Cianci, P, Ortenwall, P, Uchikov, P, de Reuver, P, Stahel, P, Barie, P, Piccoli, M, Major, P, Navsaria, P, Sasmal, P, Coimbra, R, Rahim, R, Capoglu, R, Koshy, R, Gonsaga, R, Pertile, R, Mohamed, R, Deryol, R, Sawyer, R, Angelico, R, Ragozzino, R, Bini, R, Cammarata, R, Scaramuzzo, R, Gioco, R, Sydorchuk, R, Ahmed, S, Di Saverio, S, Emile, S, Delibegovic, S, Marwah, S, Symeonidis, S, Thomas, S, Demir, S, Awad, S, Atici, S, Chooklin, S, Meric, S, Sarikaya, S, Chowdhury, S, Mirghani, S, Wren, S, Gargarella, S, Del Monte, S, Esposito, S, Xenaki, S, Mohamed, S, Beka, S, Lunca, S, Delis, S, Dritsas, S, Morarasu, S, Magnone, S, Rossi, S, Bitsianis, S, Kykalos, S, Baral, S, Jain, S, Ali, S, Pintar, T, Triantafyllou, T, Delko, T, Perra, T, Sidiropoulos, T, Scalea, T, Vilz, T, Hardcastle, T, Wannatoop, T, Herzog, T, Mishra, T, Boggi, U, Calu, V, Tomajer, V, Agnoletti, V, Lohsiriwat, V, Kong, V, Munoz-Cruzado, V, Shelat, V, Khokha, V, Ghannam, W, Biffl, W, Zuidema, W, Kara, Y, Kobe, Y, Demetrashvili, Z, Memish, Z, Madrazo, Z, Balogh, Z, and Bayhan, Z

Subjects
Cross-Sectional Studie, ddc:610, Capacity, Pandemic, SARS-CoV-2, COVID-19, WSES, Time to intervention, Appendicitis, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Cross-Sectional Studies, Emergency, Quarantine, Emergency Medicine, Emergency surgery, Humans, Surgery, Appendiciti, COVID-19, SARS-CoV-2, Pandemic, Emergency surgery, Emergency, Appendicitis, WSES, Time to intervention, Capacity, Quarantine, Pandemics, Diverticulitis, Human
Abstract

Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.

Published
2022
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25. A first update on mapping the human genetic architecture of COVID-19

Author

COVID-19 Host Genetics Initiative, Pathak, GA, Karjalainen, J, Stevens, C, Neale, BM, Daly, M, Ganna, A, Andrews, SJ, Kanai, M, Cordioli, M, Polimanti, R, Harerimana, N, Pirinen, M, Liao, RG, Chwialkowska, K, Trankiem, A, Balaconis, MK, Nguyen, H, Solomonson, M, Veerapen, K, Wolford, B, Roberts, G, Park, D, Ball, CA, Coignet, M, McCurdy, S, Knight, S, Partha, R, Rhead, B, Zhang, M, Berkowitz, N, Gaddis, M, Noto, K, Ruiz, L, Pavlovic, M, Hong, EL, Rand, K, Girshick, A, Guturu, H, Baltzell, AH, Niemi, MEK, Rahmouni, S, Guntz, J, Beguin, Y, Pigazzini, S, Nkambule, L, Georges, M, Moutschen, M, Misset, B, Darcis, G, Guiot, J, Azarzar, S, Gofflot, S, Claassen, S, Malaise, O, Huynen, P, Meuris, C, Thys, M, Jacques, J, Leonard, P, Frippiat, F, Giot, J-B, Sauvage, A-S, Frenckell, CV, Belhaj, Y, Lambermont, B, Nakanishi, T, Morrison, DR, Mooser, V, Richards, JB, Butler-Laporte, G, Forgetta, V, Li, R, Ghosh, B, Laurent, L, Belisle, A, Henry, D, Abdullah, T, Adeleye, O, Mamlouk, N, Kimchi, N, Afrasiabi, Z, Rezk, N, Vulesevic, B, Bouab, M, Guzman, C, Petitjean, L, Tselios, C, Xue, X, Afilalo, J, Afilalo, M, Oliveira, M, Brenner, B, Brassard, N, Durand, M, Schurr, E, Lepage, P, Ragoussis, J, Auld, D, Chassé, M, Kaufmann, DE, Lathrop, GM, Adra, D, Hayward, C, Glessner, JT, Shaw, DM, Campbell, A, Morris, M, Hakonarson, H, Porteous, DJ, Below, J, Richmond, A, Chang, X, Polikowski, H, Lauren, PE, Chen, H-H, Wanying, Z, Fawns-Ritchie, C, North, K, McCormick, JB, Glessner, JR, Gignoux, CR, Wicks, SJ, Crooks, K, Barnes, KC, Daya, M, Shortt, J, Rafaels, N, Chavan, S, Timmers, PRHJ, Wilson, JF, Tenesa, A, Kerr, SM, D’Mellow, K, Shahin, D, El-Sherbiny, YM, von Hohenstaufen, KA, Sobh, A, Eltoukhy, MM, Nkambul, L, Elhadidy, TA, Abd Elghafar, MS, El-Jawhari, JJ, Mohamed, AAS, Elnagdy, MH, Samir, A, Abdel-Aziz, M, Khafaga, WT, El-Lawaty, WM, Torky, MS, El-shanshory, MR, Yassen, AM, Hegazy, MAF, Okasha, K, Eid, MA, Moahmed, HS, Medina-Gomez, C, Ikram, MA, Uitterlinden, AG, Mägi, R, Milani, L, Metspalu, A, Laisk, T, Läll, K, Lepamets, M, Esko, T, Reimann, E, Naaber, P, Laane, E, Pesukova, J, Peterson, P, Kisand, K, Tabri, J, Allos, R, Hensen, K, Starkopf, J, Ringmets, I, Tamm, A, Kallaste, A, Alavere, H, Metsalu, K, Puusepp, M, Batini, C, Tobin, MD, Venn, LD, Lee, PH, Shrine, N, Williams, AT, Guyatt, AL, John, C, Packer, RJ, Ali, A, Free, RC, Wang, X, Wain, LV, Hollox, EJ, Bee, CE, Adams, EL, Palotie, A, Ripatti, S, Ruotsalainen, S, Kristiansson, K, Koskelainen, S, Perola, M, Donner, K, Kivinen, K, Kaunisto, M, Rivolta, C, Bochud, P-Y, Bibert, S, Boillat, N, Nussle, SG, Albrich, W, Quinodoz, M, Kamdar, D, Suh, N, Neofytos, D, Erard, V, Voide, C, Friolet, R, Vollenweider, P, Pagani, JL, Oddo, M, zu Bentrup, FM, Conen, A, Clerc, O, Marchetti, O, Guillet, A, Guyat-Jacques, C, Foucras, S, Rime, M, Chassot, J, Jaquet, M, Viollet, RM, Lannepoudenx, Y, Portopena, L, Bochud, PY, Desgranges, F, Filippidis, P, Guéry, B, Haefliger, D, Kampouri, EE, Manuel, O, Munting, A, Papadimitriou-Olivgeris, M, Regina, J, Rochat-Stettler, L, Suttels, V, Tadini, E, Tschopp, J, Van Singer, M, Viala, B, Boillat-Blanco, N, Brahier, T, Hügli, O, Meuwly, JY, Pantet, O, Gonseth Nussle, S, Bochud, M, D’Acremont, V, Estoppey Younes, S, Albrich, WC, Cerny, A, O’Mahony, L, von Mering, C, Frischknecht, M, Kleger, G-R., Filipovic, M, Kahlert, CR, Wozniak, H, Negro, TR, Pugin, J, Bouras, K, Knapp, C, Egger, T, Perret, A, Montillier, P, di Bartolomeo, C, Barda, B, de Cid, R, Carreras, A, Moreno, V, Kogevinas, M, Galván-Femenía, I, Blay, N, Farré, X, Sumoy, L, Cortés, B, Mercader, JM, Guindo-Martinez, M, Torrents, D, Garcia-Aymerich, J, Castaño-Vinyals, G, Dobaño, C, Gori, M, Renieri, A, Mari, F, Mondelli, MU, Castelli, F, Vaghi, M, Rusconi, S, Montagnani, F, Bargagli, E, Franchi, F, Mazzei, MA, Cantarini, L, Tacconi, D, Feri, M, Scala, R, Spargi, G, Nencioni, C, Bandini, M, Caldarelli, GP, Canaccini, A, Ognibene, A, D’Arminio Monforte, A, Girardis, M, Antinori, A, Francisci, D, Schiaroli, E, Scotton, PG, Panese, S, Scaggiante, R, Monica, MD, Capasso, M, Fiorentino, G, Castori, M, Aucella, F, Biagio, AD, Masucci, L, Valente, S, Mandalà, M, Zucchi, P, Giannattasio, F, Coviello, DA, Mussini, C, Tavecchia, L, Crotti, L, Rizzi, M, Rovere, MTL, Sarzi-Braga, S, Bussotti, M, Ravaglia, S, Artuso, R, Perrella, A, Romani, D, Bergomi, P, Catena, E, Vincenti, A, Ferri, C, Grassi, D, Pessina, G, Tumbarello, M, Pietro, MD, Sabrina, R, Luchi, S, Furini, S, Dei, S, Benetti, E, Picchiotti, N, Sanarico, M, Ceri, S, Pinoli, P, Raimondi, F, Biscarini, F, Stella, A, Zguro, K, Capitani, K, Tanfoni, M, Fallerini, C, Daga, S, Baldassarri, M, Fava, F, Frullanti, E, Valentino, F, Doddato, G, Giliberti, A, Tita, R, Amitrano, S, Bruttini, M, Croci, S, Meloni, I, Mencarelli, MA, Rizzo, CL, Pinto, AM, Beligni, G, Tommasi, A, Sarno, LD, Palmieri, M, Carriero, ML, Alaverdian, D, Busani, S, Bruno, R, Vecchia, M, Belli, MA, Mantovani, S, Ludovisi, S, Quiros-Roldan, E, Antoni, MD, Zanella, I, Siano, M, Emiliozzi, A, Fabbiani, M, Rossetti, B, Bergantini, L, D’Alessandro, M, Cameli, P, Bennett, D, Anedda, F, Marcantonio, S, Scolletta, S, Guerrini, S, Conticini, E, Frediani, B, Spertilli, C, Donati, A, Guidelli, L, Corridi, M, Croci, L, Piacentini, P, Desanctis, E, Cappelli, S, Verzuri, A, Anemoli, V, Pancrazzi, A, Lorubbio, M, Miraglia, FG, Venturelli, S, Cossarizza, A, Vergori, A, Gabrieli, A, Riva, A, Paciosi, F, Andretta, F, Gatti, F, Parisi, SG, Baratti, S, Piscopo, C, Russo, R, Andolfo, I, Iolascon, A, Carella, M, Merla, G, Squeo, GM, Raggi, P, Marciano, C, Perna, R, Bassetti, M, Sanguinetti, M, Giorli, A, Salerni, L, Parravicini, P, Menatti, E, Trotta, T, Coiro, G, Lena, F, Martinelli, E, Mancarella, S, Gabbi, C, Maggiolo, F, Ripamonti, D, Bachetti, T, Suardi, C, Parati, G, Bottà, G, Domenico, PD, Rancan, I, Bianchi, F, Colombo, R, Barbieri, C, Acquilini, D, Andreucci, E, Segala, FV, Tiseo, G, Falcone, M, Lista, M, Poscente, M, Vivo, OD, Petrocelli, P, Guarnaccia, A, Baroni, S, van Heel, DA, Hunt, KA, Trembath, RC, Huang, QQ, Martin, HC, Mason, D, Trivedi, B, Wright, J, Finer, S, Akhtar, S, Anwar, M, Arciero, E, Ashraf, S, Breen, G, Chung, R, Curtis, CJ, Chowdhury, M, Colligan, G, Deloukas, P, Durham, C, Griffiths, C, Hurles, M, Hussain, S, Islam, K, Khan, A, Lavery, C, Lee, SH, Lerner, R, MacArthur, D, MacLaughlin, B, Martin, H, Miah, S, Newman, B, Safa, N, Tahmasebi, F, Griffiths, CJ, Smith, AV, Boughton, AP, Li, KW, LeFaive, J, Annis, A, Niavarani, A, Aliannejad, R, Sharififard, B, Amirsavadkouhi, A, Naderpour, Z, Tadi, HA, Aleagha, AE, Ahmadi, S, Moghaddam, SBM, Adamsara, A, Saeedi, M, Abdollahi, H, Hosseini, A, Chariyavilaskul, P, Jantarabenjakul, W, Hirankarn, N, Chamnanphon, M, Suttichet, TB, Shotelersuk, V, Pongpanich, M, Phokaew, C, Chetruengchai, W, Putchareon, O, Torvorapanit, P, Puthanakit, T, Suchartlikitwong, P, Nilaratanakul, V, Sodsai, P, Brumpton, BM, Hveem, K, Willer, C, Zhou, W, Rogne, T, Solligard, E, Åsvold, BO, Franke, L, Boezen, M, Deelen, P, Claringbould, A, Lopera, E, Warmerdam, R, Vonk, JM, van Blokland, I, Lanting, P, Ori, APS, Feng, Y-CA, Mercader, J, Weiss, ST, Karlson, EW, Smoller, JW, Murphy, SN, Meigs, JB, Woolley, AE, Green, RC, Perez, EF, Zöllner, S, Wang, J, Beck, A, Sloofman, LG, Ascolillo, S, Sebra, RP, Collins, BL, Levy, T, Buxbaum, JD, Sealfon, SC, Jordan, DM, Thompson, RC, Gettler, K, Chaudhary, K, Belbin, GM, Preuss, M, Hoggart, C, Choi, S, Underwood, SJ, Salib, I, Britvan, B, Keller, K, Tang, L, Peruggia, M, Hiester, LL, Niblo, K, Aksentijevich, A, Labkowsky, A, Karp, A, Zlatopolsky, M, Zyndorf, M, Charney, AW, Beckmann, ND, Schadt, EE, Abul-Husn, NS, Cho, JH, Itan, Y, Kenny, EE, Loos, RJF, Nadkarni, GN, Do, R, O’Reilly, P, Huckins, LM, Ferreira, MAR, Abecasis, GR, Leader, JB, Cantor, MN, Justice, AE, Carey, DJ, Chittoor, G, Josyula, NS, Kosmicki, JA, Horowitz, JE, Baras, A, Gass, MC, Yadav, A, Mirshahi, T, Hottenga, JJ, Bartels, M, de geus, EEJC, Nivard, MMG, Verma, A, Ritchie, MD, Rader, D, Li, B, Verma, SS, Lucas, A, Bradford, Y, Abedalthagafi, M, Alaamery, M, Alshareef, A, Sawaji, M, Massadeh, S, AlMalik, A, Alqahtani, S, Baraka, D, Harthi, FA, Alsolm, E, Safieh, LA, Alowayn, AM, Alqubaishi, F, Mutairi, AA, Mangul, S, Almutairi, M, Aljawini, N, Albesher, N, Arabi, YM, Mahmoud, ES, Khattab, AK, Halawani, RT, Alahmadey, ZZ, Albakri, JK, Felemban, WA, Suliman, BA, Hasanato, R, Al-Awdah, L, Alghamdi, J, AlZahrani, D, AlJohani, S, Al-Afghani, H, AlDhawi, N, AlBardis, H, Alkwai, S, Alswailm, M, Almalki, F, Albeladi, M, Almohammed, I, Barhoush, E, Albader, A, Alotaibi, S, Alghamdi, B, Jung, J, fawzy, MS, Alrashed, M, Zeberg, H, Frithiof, R, Hultström, M, Lipcsey, M, Tardif, N, Rooyackers, O, Grip, J, Maricic, T, Helgeland, Ø, Magnus, P, Trogstad, L-IS, Lee, Y, Harris, JR, Mangino, M, Spector, TD, Emma, D, Moutsianas, L, Caulfield, MJ, Scott, RH, Kousathanas, A, Pasko, D, Walker, S, Stuckey, A, Odhams, CA, Rhodes, D, Fowler, T, Rendon, A, Chan, G, Arumugam, P, Karczewski, KJ, Martin, AR, Wilson, DJ, Spencer, CCA, Crook, DW, Wyllie, DH, O’Connell, AM, Atkinson, EG, Tsuo, K, Baya, N, Turley, P, Gupta, R, Walters, RK, Palmer, DS, Sarma, G, Cheng, N, Lu, W, Churchhouse, C, Goldstein, JI, King, D, Seed, C, Daly, MJ, Finucane, H, Bryant, S, Satterstrom, FK, Band, G, Earle, SG, Lin, S-K, Arning, N, Koelling, N, Armstrong, J, Rudkin, JK, Callier, S, Cusick, C, Soranzo, N, Zhao, JH, Danesh, J, Angelantonio, ED, Butterworth, AS, Sun, YV, Huffman, JE, Cho, K, O’Donnell, CJ, Tsao, P, Gaziano, JM, Peloso, G, Ho, Y-L, Smieszek, SP, Polymeropoulos, C, Polymeropoulos, V, Polymeropoulos, MH, Przychodzen, BP, Fernandez-Cadenas, I, Planas, AM, Perez-Tur, J, Llucià-Carol, L, Cullell, N, Muiño, E, Cárcel-Márquez, J, DeDiego, ML, Iglesias, LL, Soriano, A, Rico, V, Agüero, D, Bedini, JL, Lozano, F, Domingo, C, Robles, V, Ruiz-Jaén, F, Márquez, L, Gomez, J, Coto, E, Albaiceta, GM, García-Clemente, M, Dalmau, D, Arranz, MJ, Dietl, B, Serra-Llovich, A, Soler, P, Colobrán, R, Martín-Nalda, A, Martínez, AP, Bernardo, D, Rojo, S, Fiz-López, A, Arribas, E, de la Cal-Sabater, P, Segura, T, González-Villa, E, Serrano-Heras, G, Martí-Fàbregas, J, Jiménez-Xarrié, E, de Felipe Mimbrera, A, Masjuan, J, García-Madrona, S, Domínguez-Mayoral, A, Villalonga, JM, Menéndez-Valladares, P, Chasman, DI, Sesso, HD, Manson, JE, Buring, JE, Ridker, PM, Franco, G, Davis, L, Lee, S, Priest, J, Sankaran, VG, van Heel, D, Biesecker, L, Kerchberger, VE, Baillie, JK, Pathak, Gita A., Karjalainen, Juha, Stevens, Christine, Neale, Benjamin M., Daly, Mark, Ganna, Andrea, Andrews, Shea J., Kanai, Masahiro, Cordioli, Mattia, Polimanti, Renato, Harerimana, Nadia, Pirinen, Matti, Liao, Rachel G., Chwialkowska, Karolina, Trankiem, Amy, Balaconis, Mary K., Nguyen, Huy, Solomonson, Matthew, Veerapen, Kumar, Wolford, Brooke, Roberts, Genevieve, Park, Danny, Ball, Catherine A., Coignet, Marie, McCurdy, Shannon, Knight, Spencer, Partha, Raghavendran, Rhead, Brooke, Zhang, Miao, Berkowitz, Nathan, Gaddis, Michael, Noto, Keith, Ruiz, Luong, Pavlovic, Milo, Hong, Eurie L., Rand, Kristin, Girshick, Ahna, Guturu, Harendra, Baltzell, Asher Haug, Niemi, Mari E. K., Rahmouni, Souad, Guntz, Julien, Beguin, Yve, Pigazzini, Sara, Nkambule, Lindokuhle, Georges, Michel, Moutschen, Michel, Misset, Benoit, Darcis, Gille, Guiot, Julien, Azarzar, Samira, Gofflot, Stéphanie, Claassen, Sabine, Malaise, Olivier, Huynen, Pascale, Meuris, Christelle, Thys, Marie, Jacques, Jessica, Léonard, Philippe, Frippiat, Frederic, Giot, Jean-Baptiste, Sauvage, Anne-Sophie, Frenckell, Christian Von, Belhaj, Yasmine, Lambermont, Bernard, Nakanishi, Tomoko, Morrison, David R., Mooser, Vincent, Richards, J. Brent, Butler-Laporte, Guillaume, Forgetta, Vincenzo, Li, Rui, Ghosh, Biswarup, Laurent, Laetitia, Belisle, Alexandre, Henry, Danielle, Abdullah, Tala, Adeleye, Olumide, Mamlouk, Noor, Kimchi, Nofar, Afrasiabi, Zaman, Rezk, Nardin, Vulesevic, Branka, Bouab, Meriem, Guzman, Charlotte, Petitjean, Loui, Tselios, Chri, Xue, Xiaoqing, Afilalo, Jonathan, Afilalo, Marc, Oliveira, Maureen, Brenner, Bluma, Brassard, Nathalie, Durand, Madeleine, Schurr, Erwin, Lepage, Pierre, Ragoussis, Jianni, Auld, Daniel, Chassé, Michaël, Kaufmann, Daniel E., Lathrop, G. Mark, Adra, Darin, Hayward, Caroline, Glessner, Joseph T., Shaw, Douglas M., Campbell, Archie, Morris, Marcela, Hakonarson, Hakon, Porteous, David J., Below, Jennifer, Richmond, Anne, Chang, Xiao, Polikowski, Hannah, Lauren, Petty E., Chen, Hung-Hsin, Wanying, Zhu, Fawns-Ritchie, Chloe, North, Kari, McCormick, Joseph B., Glessner, Joseph R., Gignoux, Christopher R., Wicks, Stephen J., Crooks, Kristy, Barnes, Kathleen C., Daya, Michelle, Shortt, Jonathan, Rafaels, Nichola, Chavan, Sameer, Timmers, Paul R. H. J., Wilson, James F., Tenesa, Albert, Kerr, Shona M., D’Mellow, Kenton, Shahin, Doaa, El-Sherbiny, Yasser M., von Hohenstaufen, Kathrin Aprile, Sobh, Ali, Eltoukhy, Madonna M., Nkambul, Lindokuhle, Elhadidy, Tamer A., Abd Elghafar, Mohamed S., El-Jawhari, Jehan J., Mohamed, Attia A. S., Elnagdy, Marwa H., Samir, Amr, Abdel-Aziz, Mahmoud, Khafaga, Walid T., El-Lawaty, Walaa M., Torky, Mohamed S., El-shanshory, Mohamed R., Yassen, Amr M., Hegazy, Mohamed A. F., Okasha, Kamal, Eid, Mohammed A., Moahmed, Hanteera S., Medina-Gomez, Carolina, Ikram, M. Arfan, Uitterlinden, Andre G., Mägi, Reedik, Milani, Lili, Metspalu, Andre, Laisk, Triin, Läll, Kristi, Lepamets, Maarja, Esko, Tõnu, Reimann, Ene, Naaber, Paul, Laane, Edward, Pesukova, Jaana, Peterson, Pärt, Kisand, Kai, Tabri, Jekaterina, Allos, Raili, Hensen, Kati, Starkopf, Joel, Ringmets, Inge, Tamm, Anu, Kallaste, Anne, Alavere, Helene, Metsalu, Kristjan, Puusepp, Mairo, Batini, Chiara, Tobin, Martin D., Venn, Laura D., Lee, Paul H., Shrine, Nick, Williams, Alexander T., Guyatt, Anna L., John, Catherine, Packer, Richard J., Ali, Altaf, Free, Robert C., Wang, Xueyang, Wain, Louise V., Hollox, Edward J., Bee, Catherine E., Adams, Emma L., Palotie, Aarno, Ripatti, Samuli, Ruotsalainen, Sanni, Kristiansson, Kati, Koskelainen, Sami, Perola, Marku, Donner, Kati, Kivinen, Katja, Kaunisto, Mari, Rivolta, Carlo, Bochud, Pierre-Yve, Bibert, Stéphanie, Boillat, Noémie, Nussle, Semira Gonseth, Albrich, Werner, Quinodoz, Mathieu, Kamdar, Dhryata, Suh, Noémie, Neofytos, Dionysio, Erard, Véronique, Voide, Cathy, Friolet, R., Vollenweider, P., Pagani, J. L., Oddo, M., zu Bentrup, F. Meyer, Conen, A., Clerc, O., Marchetti, O., Guillet, A., Guyat-Jacques, C., Foucras, S., Rime, M., Chassot, J., Jaquet, M., Viollet, R. Merlet, Lannepoudenx, Y., Portopena, L., Bochud, P. Y., Desgranges, F., Filippidis, P., Guéry, B., Haefliger, D., Kampouri, E. E., Manuel, O., Munting, A., Papadimitriou-Olivgeris, M., Regina, J., Rochat-Stettler, L., Suttels, V., Tadini, E., Tschopp, J., Van Singer, M., Viala, B., Boillat-Blanco, N., Brahier, T., Hügli, O., Meuwly, J. Y., Pantet, O., Gonseth Nussle, S., Bochud, M., D’Acremont, V., Estoppey Younes, S., Albrich, W. C., Suh, N., Cerny, A., O’Mahony, L., von Mering, C., Frischknecht, M., Kleger, G-R., Filipovic, M., Kahlert, C. R., Wozniak, H., Negro, T. Rochat, Pugin, J., Bouras, K., Knapp, C., Egger, T., Perret, A., Montillier, P., di Bartolomeo, C., Barda, B., de Cid, Rafael, Carreras, Anna, Moreno, Victor, Kogevinas, Manoli, Galván-Femenía, Iván, Blay, Natalia, Farré, Xavier, Sumoy, Lauro, Cortés, Beatriz, Mercader, Josep Maria, Guindo-Martinez, Marta, Torrents, David, Garcia-Aymerich, Judith, Castaño-Vinyals, Gemma, Dobaño, Carlota, Gori, Marco, Renieri, Alessandra, Mari, Francesca, Mondelli, Mario Umberto, Castelli, Francesco, Vaghi, Massimo, Rusconi, Stefano, Montagnani, Francesca, Bargagli, Elena, Franchi, Federico, Mazzei, Maria Antonietta, Cantarini, Luca, Tacconi, Danilo, Feri, Marco, Scala, Raffaele, Spargi, Genni, Nencioni, Cesira, Bandini, Maria, Caldarelli, Gian Piero, Canaccini, Anna, Ognibene, Agostino, D’Arminio Monforte, Antonella, Girardis, Massimo, Antinori, Andrea, Francisci, Daniela, Schiaroli, Elisabetta, Scotton, Pier Giorgio, Panese, Sandro, Scaggiante, Renzo, Monica, Matteo Della, Capasso, Mario, Fiorentino, Giuseppe, Castori, Marco, Aucella, Filippo, Biagio, Antonio Di, Masucci, Luca, Valente, Serafina, Mandalà, Marco, Zucchi, Patrizia, Giannattasio, Ferdinando, Coviello, Domenico A., Mussini, Cristina, Tavecchia, Luisa, Crotti, Lia, Rizzi, Marco, Rovere, Maria Teresa La, Sarzi-Braga, Simona, Bussotti, Maurizio, Ravaglia, Sabrina, Artuso, Rosangela, Perrella, Antonio, Romani, Davide, Bergomi, Paola, Catena, Emanuele, Vincenti, Antonella, Ferri, Claudio, Grassi, Davide, Pessina, Gloria, Tumbarello, Mario, Pietro, Massimo Di, Sabrina, Ravaglia, Luchi, Sauro, Furini, Simone, Dei, Simona, Benetti, Elisa, Picchiotti, Nicola, Sanarico, Maurizio, Ceri, Stefano, Pinoli, Pietro, Raimondi, Francesco, Biscarini, Filippo, Stella, Alessandra, Zguro, Kristina, Capitani, Katia, Tanfoni, Marco, Fallerini, Chiara, Daga, Sergio, Baldassarri, Margherita, Fava, Francesca, Frullanti, Elisa, Valentino, Floriana, Doddato, Gabriella, Giliberti, Annarita, Tita, Rossella, Amitrano, Sara, Bruttini, Mirella, Croci, Susanna, Meloni, Ilaria, Mencarelli, Maria Antonietta, Rizzo, Caterina Lo, Pinto, Anna Maria, Beligni, Giada, Tommasi, Andrea, Sarno, Laura Di, Palmieri, Maria, Carriero, Miriam Lucia, Alaverdian, Diana, Busani, Stefano, Bruno, Raffaele, Vecchia, Marco, Belli, Mary Ann, Mantovani, Stefania, Ludovisi, Serena, Quiros-Roldan, Eugenia, Antoni, Melania Degli, Zanella, Isabella, Siano, Matteo, Emiliozzi, Arianna, Fabbiani, Massimiliano, Rossetti, Barbara, Bergantini, Laura, D’Alessandro, Miriana, Cameli, Paolo, Bennett, David, Anedda, Federico, Marcantonio, Simona, Scolletta, Sabino, Guerrini, Susanna, Conticini, Edoardo, Frediani, Bruno, Spertilli, Chiara, Donati, Alice, Guidelli, Luca, Corridi, Marta, Croci, Leonardo, Piacentini, Paolo, Desanctis, Elena, Cappelli, Silvia, Verzuri, Agnese, Anemoli, Valentina, Pancrazzi, Alessandro, Lorubbio, Maria, Miraglia, Federica Gaia, Venturelli, Sophie, Cossarizza, Andrea, Vergori, Alessandra, Gabrieli, Arianna, Riva, Agostino, Paciosi, Francesco, Andretta, Francesca, Gatti, Francesca, Parisi, Saverio Giuseppe, Baratti, Stefano, Piscopo, Carmelo, Russo, Roberta, Andolfo, Immacolata, Iolascon, Achille, Carella, Massimo, Merla, Giuseppe, Squeo, Gabriella Maria, Raggi, Pamela, Marciano, Carmen, Perna, Rita, Bassetti, Matteo, Sanguinetti, Maurizio, Giorli, Alessia, Salerni, Lorenzo, Parravicini, Pierpaolo, Menatti, Elisabetta, Trotta, Tullio, Coiro, Gabriella, Lena, Fabio, Martinelli, Enrico, Mancarella, Sandro, Gabbi, Chiara, Maggiolo, Franco, Ripamonti, Diego, Bachetti, Tiziana, Suardi, Claudia, Parati, Gianfranco, Bottà, Giordano, Domenico, Paolo Di, Rancan, Ilaria, Bianchi, Francesco, Colombo, Riccardo, Barbieri, Chiara, Acquilini, Donatella, Andreucci, Elena, Segala, Francesco Vladimiro, Tiseo, Giusy, Falcone, Marco, Lista, Mirjam, Poscente, Monica, Vivo, Oreste De, Petrocelli, Paola, Guarnaccia, Alessandra, Baroni, Silvia, van Heel, David A., Hunt, Karen A., Trembath, Richard C., Huang, Qin Qin, Martin, Hilary C., Mason, Dan, Trivedi, Bhavi, Wright, John, Finer, Sarah, Akhtar, Shaheen, Anwar, Mohammad, Arciero, Elena, Ashraf, Samina, Breen, Gerome, Chung, Raymond, Curtis, Charles J., Chowdhury, Maharun, Colligan, Grainne, Deloukas, Pano, Durham, Ceri, Griffiths, Chri, Hurles, Matt, Hussain, Shapna, Islam, Kamrul, Khan, Ahsan, Khan, Amara, Lavery, Cath, Lee, Sang Hyuck, Lerner, Robin, MacArthur, Daniel, MacLaughlin, Bev, Martin, Hilary, Miah, Shefa, Newman, Bill, Safa, Nishat, Tahmasebi, Farah, Griffiths, Christopher J., Smith, Albert V., Boughton, Andrew P., Li, Kevin W., LeFaive, Jonathon, Annis, Aubrey, Niavarani, Ahmadreza, Aliannejad, Rasoul, Sharififard, Bahareh, Amirsavadkouhi, Ali, Naderpour, Zeinab, Tadi, Hengameh Ansari, Aleagha, Afshar Etemadi, Ahmadi, Saeideh, Moghaddam, Seyed Behrooz Mohseni, Adamsara, Alireza, Saeedi, Morteza, Abdollahi, Hamed, Hosseini, Abdolmajid, Chariyavilaskul, Pajaree, Jantarabenjakul, Watsamon, Hirankarn, Nattiya, Chamnanphon, Monpat, Suttichet, Thitima B., Shotelersuk, Vorasuk, Pongpanich, Monnat, Phokaew, Chureerat, Chetruengchai, Wanna, Putchareon, Opa, Torvorapanit, Pattama, Puthanakit, Thanyawee, Suchartlikitwong, Pintip, Nilaratanakul, Voraphoj, Sodsai, Pimpayao, Brumpton, Ben M., Hveem, Kristian, Willer, Cristen, Zhou, Wei, Rogne, Tormod, Solligard, Erik, Åsvold, Bjørn Olav, Franke, Lude, Boezen, Marike, Deelen, Patrick, Claringbould, Annique, Lopera, Esteban, Warmerdam, Robert, Vonk, Judith. M., van Blokland, Irene, Lanting, Pauline, Ori, Anil P. S., Feng, Yen-Chen Anne, Mercader, Josep, Weiss, Scott T., Karlson, Elizabeth W., Smoller, Jordan W., Murphy, Shawn N., Meigs, James B., Woolley, Ann E., Green, Robert C., Perez, Emma F., Zöllner, Sebastian, Wang, Jiongming, Beck, Andrew, Sloofman, Laura G., Ascolillo, Steven, Sebra, Robert P., Collins, Brett L., Levy, Te, Buxbaum, Joseph D., Sealfon, Stuart C., Jordan, Daniel M., Thompson, Ryan C., Gettler, Kyle, Chaudhary, Kumardeep, Belbin, Gillian M., Preuss, Michael, Hoggart, Clive, Choi, Sam, Underwood, Slayton J., Salib, Irene, Britvan, Bari, Keller, Katherine, Tang, Lara, Peruggia, Michael, Hiester, Liam L., Niblo, Kristi, Aksentijevich, Alexandra, Labkowsky, Alexander, Karp, Avromie, Zlatopolsky, Menachem, Zyndorf, Marissa, Charney, Alexander W., Beckmann, Noam D., Schadt, Eric E., Abul-Husn, Noura S., Cho, Judy H., Itan, Yuval, Kenny, Eimear E., Loos, Ruth J. F., Nadkarni, Girish N., Do, Ron, O’Reilly, Paul, Huckins, Laura M., Ferreira, Manuel A. R., Abecasis, Goncalo R., Leader, Joseph B., Cantor, Michael N., Justice, Anne E., Carey, Dave J., Chittoor, Geetha, Josyula, Navya Shilpa, Kosmicki, Jack A., Horowitz, Julie E., Baras, Ari, Gass, Matthew C., Yadav, Ashish, Mirshahi, Tooraj, Hottenga, Jouke Jan, Bartels, Meike, de geus, Eco E. J. C., Nivard, Michel M. G., Verma, Anurag, Ritchie, Marylyn D., Rader, Daniel, Li, Binglan, Verma, Shefali S., Lucas, Anastasia, Bradford, Yuki, Abedalthagafi, Malak, Alaamery, Manal, Alshareef, Abdulraheem, Sawaji, Mona, Massadeh, Salam, AlMalik, Abdulaziz, Alqahtani, Saleh, Baraka, Dona, Harthi, Fawz Al, Alsolm, Ebtehal, Safieh, Leen Abu, Alowayn, Albandary M., Alqubaishi, Fatimah, Mutairi, Amal Al, Mangul, Serghei, Almutairi, Mansour, Aljawini, Nora, Albesher, Nour, Arabi, Yaseen M., Mahmoud, Ebrahim S., Khattab, Amin K., Halawani, Roaa T., Alahmadey, Ziab Z., Albakri, Jehad K., Felemban, Walaa A., Suliman, Bandar A., Hasanato, Rana, Al-Awdah, Laila, Alghamdi, Jahad, AlZahrani, Deema, AlJohani, Sameera, Al-Afghani, Hani, AlDhawi, Nouf, AlBardis, Hadeel, Alkwai, Sarah, Alswailm, Moneera, Almalki, Faisal, Albeladi, Maha, Almohammed, Iman, Barhoush, Eman, Albader, Anoud, Alotaibi, Sara, Alghamdi, Bader, Jung, Junghyun, fawzy, Mohammad S., Alrashed, May, Zeberg, Hugo, Nkambul, Lindo, Frithiof, Robert, Hultström, Michael, Lipcsey, Miklo, Tardif, Nicola, Rooyackers, Olav, Grip, Jonathan, Maricic, Tomislav, Helgeland, Øyvind, Magnus, Per, Trogstad, Lill-Iren S., Lee, Yunsung, Harris, Jennifer R., Mangino, Massimo, Spector, Tim D., Emma, Duncan, Moutsianas, Louka, Caulfield, Mark J., Scott, Richard H., Kousathanas, Athanasio, Pasko, Dorota, Walker, Susan, Stuckey, Alex, Odhams, Christopher A., Rhodes, Daniel, Fowler, Tom, Rendon, Augusto, Chan, Georgia, Arumugam, Prabhu, Karczewski, Konrad J., Martin, Alicia R., Wilson, Daniel J., Spencer, Chris C. A., Crook, Derrick W., Wyllie, David H., O’Connell, Anne Marie, Atkinson, Elizabeth G., Tsuo, Kristin, Baya, Nikola, Turley, Patrick, Gupta, Rahul, Walters, Raymond K., Palmer, Duncan S., Sarma, Gopal, Cheng, Nathan, Lu, Wenhan, Churchhouse, Claire, Goldstein, Jacqueline I., King, Daniel, Seed, Cotton, Daly, Mark J., Finucane, Hilary, Bryant, Sam, Satterstrom, F. Kyle, Band, Gavin, Earle, Sarah G., Lin, Shang-Kuan, Arning, Nicola, Koelling, Nil, Armstrong, Jacob, Rudkin, Justine K., Callier, Shawneequa, Cusick, Caroline, Soranzo, Nicole, Zhao, Jing Hua, Danesh, John, Angelantonio, Emanuele Di, Butterworth, Adam S., Sun, Yan V., Huffman, Jennifer E., Cho, Kelly, O’Donnell, Christopher J., Tsao, Phil, Gaziano, J. Michael, Peloso, Gina, Ho, Yuk-Lam, Smieszek, Sandra P., Polymeropoulos, Christo, Polymeropoulos, Vasilio, Polymeropoulos, Mihael H., Przychodzen, Bartlomiej P., Fernandez-Cadenas, Israel, Planas, Anna M., Perez-Tur, Jordi, Llucià-Carol, Laia, Cullell, Natalia, Muiño, Elena, Cárcel-Márquez, Jara, DeDiego, Marta L., Iglesias, Lara Lloret, Soriano, Alex, Rico, Veronica, Agüero, Daiana, Bedini, Josep L., Lozano, Francisco, Domingo, Carlo, Robles, Veronica, Ruiz-Jaén, Francisca, Márquez, Leonardo, Gomez, Juan, Coto, Eliecer, Albaiceta, Guillermo M., García-Clemente, Marta, Dalmau, David, Arranz, Maria J., Dietl, Beatriz, Serra-Llovich, Alex, Soler, Pere, Colobrán, Roger, Martín-Nalda, Andrea, Martínez, Alba Parra, Bernardo, David, Rojo, Silvia, Fiz-López, Aida, Arribas, Elisa, de la Cal-Sabater, Paloma, Segura, Tomá, González-Villa, Esther, Serrano-Heras, Gemma, Martí-Fàbregas, Joan, Jiménez-Xarrié, Elena, de Felipe Mimbrera, Alicia, Masjuan, Jaime, García-Madrona, Sebastian, Domínguez-Mayoral, Anna, Villalonga, Joan Montaner, Menéndez-Valladares, Paloma, Chasman, Daniel I., Sesso, Howard D., Manson, JoAnn E., Buring, Julie E., Ridker, Paul M., Franco, Giulianini, Davis, Lea, Lee, Sulggi, Priest, Jame, Sankaran, Vijay G., van Heel, David, Biesecker, Le, Kerchberger, V. Eric, Baillie, J. Kenneth, APH - Personalized Medicine, APH - Health Behaviors & Chronic Diseases, Biological Psychology, APH - Mental Health, AMS - Sports, AMS - Ageing & Vitality, APH - Methodology, Mccurdy, Shannon, Mccormick, Joseph B., Macarthur, Daniel, Maclaughlin, Bev, Lefaive, Jonathon, Almalik, Abdulaziz, Alzahrani, Deema, Aljohani, Sameera, Aldhawi, Nouf, Albardis, Hadeel, Fawzy, Mohammad S., Dediego, Marta L., Stem Cell Aging Leukemia and Lymphoma (SALL), Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Life Course Epidemiology (LCE), Groningen Research Institute for Asthma and COPD (GRIAC), University of Zurich, COVID-19 Host Genetics Initiative, Barcelona Supercomputing Center, COVID-19 Genetics Initiative, including authors, Institute for Molecular Medicine Finland, and Data Science Genetic Epidemiology Lab

Subjects
Informàtica::Aplicacions de la informàtica::Bioinformàtica [Àrees temàtiques de la UPC], Quantitative Trait Loci, MUC5B PROMOTER POLYMORPHISM, Genome-wide association studies, COVID-19 (Malaltia), UFSP13-7 Evolution in Action: From Genomes to Ecosystems, COVID-19 (Disease), Settore BIO/12 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA, SDG 3 - Good Health and Well-being, Humans, genetics, Genetic variation, Genomes, Medicinsk genetik, 1000 Multidisciplinary, Multidisciplinary, Chromosome Mapping, COVID-19, Human Genetics, 10124 Institute of Molecular Life Sciences, covid-19, 3121 General medicine, internal medicine and other clinical medicine, 570 Life sciences, biology, Medical Genetics
Abstract

Matters arising from: Mapping the human genetic architecture of COVID-19 Original Article published on 08 July 2021 https://www.nature.com/articles/s41586-021-03767-x The COVID-19 pandemic continues to pose a major public health threat, especially in countries with low vaccination rates. To better understand the biological underpinnings of SARS-CoV-2 infection and COVID-19 severity, we formed the COVID-19 Host Genetics Initiative1. Here we present a genome-wide association study meta-analysis of up to 125,584 cases and over 2.5 million control individuals across 60 studies from 25 countries, adding 11 genome-wide significant loci compared with those previously identified2. Genes at new loci, including SFTPD, MUC5B and ACE2, reveal compelling insights regarding disease susceptibility and severity. Here we present meta-analyses bringing together 60 studies from 25 countries (Fig. 1 and Supplementary Table 1) for three COVID-19-related phenotypes: (1) individuals critically ill with COVID-19 on the basis of requiring respiratory support in hospital or who died as a consequence of the disease (9,376 cases, of which 3,197 are new in this data release, and 1,776,645 control individuals); (2) individuals with moderate or severe COVID-19 defined as those hospitalized due to symptoms associated with the infection (25,027 cases, 11,386 new and 2,836,272 control individuals); and (3) all cases with reported SARS-CoV-2 infection regardless of symptoms (125,584 cases, 76,022 new and 2,575,347 control individuals). Most studies have reported results before the roll out of the COVID-19 vaccination campaign. An overview of the study design is provided in Supplementary Fig. 1. We found a total of 23 genome-wide significant loci (P

Published
2022
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26. Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines

Author

Belinda De Simone, Elie Chouillard, Almino C. Ramos, Gianfranco Donatelli, Tadeja Pintar, Rahul Gupta, Federica Renzi, Kamal Mahawar, Brijesh Madhok, Stefano Maccatrozzo, Fikri M. Abu-Zidan, Ernest E. Moore, Dieter G. Weber, Federico Coccolini, Salomone Di Saverio, Andrew Kirkpatrick, Vishal G. Shelat, Francesco Amico, Emmanouil Pikoulis, Marco Ceresoli, Joseph M. Galante, Imtiaz Wani, Nicola De’ Angelis, Andreas Hecker, Gabriele Sganga, Edward Tan, Zsolt J. Balogh, Miklosh Bala, Raul Coimbra, Dimitrios Damaskos, Luca Ansaloni, Massimo Sartelli, Nikolaos Pararas, Yoram Kluger, Elias Chahine, Vanni Agnoletti, Gustavo Fraga, Walter L. Biffl, Fausto Catena, De Simone, B, Chouillard, E, Ramos, A, Donatelli, G, Pintar, T, Gupta, R, Renzi, F, Mahawar, K, Madhok, B, Maccatrozzo, S, Abu-Zidan, F, E. Moore, E, Weber, D, Coccolini, F, Di Saverio, S, Kirkpatrick, A, Shelat, V, Amico, F, Pikoulis, E, Ceresoli, M, Galante, J, Wani, I, De' Angelis, N, Hecker, A, Sganga, G, Tan, E, Balogh, Z, Bala, M, Coimbra, R, Damaskos, D, Ansaloni, L, Sartelli, M, Parasas, N, Kluger, Y, Chahine, E, Agnoletti, V, Fraga, G, Biffl, W, Catena, F, De Simone B., Chouillard E., Ramos A.C., Donatelli G., Pintar T., Gupta R., Renzi F., Mahawar K., Madhok B., Maccatrozzo S., Abu-Zidan F.M., E. Moore E., Weber D.G., Coccolini F., Di Saverio S., Kirkpatrick A., Shelat V.G., Amico F., Pikoulis E., Ceresoli M., Galante J.M., Wani I., De' Angelis N., Hecker A., Sganga G., Tan E., Balogh Z.J., Bala M., Coimbra R., Damaskos D., Ansaloni L., Sartelli M., Parasas N., Kluger Y., Chahine E., Agnoletti V., Fraga G., Biffl W.L., Catena F., De Simone, Belinda, Chouillard, Elie, Ramos, Almino C., Donatelli, Gianfranco, Pintar, Tadeja, Gupta, Rahul, Renzi, Federica, Mahawar, Kamal, Madhok, Brijesh, Maccatrozzo, Stefano, Abu-Zidan, Fikri M., E. Moore, Ernest, Weber, Dieter G., Coccolini, Federico, Di Saverio, Salomone, Kirkpatrick, Andrew, Shelat, Vishal G., Amico, Francesco, Pikoulis, Emmanouil, Ceresoli, Marco, Galante, Joseph M., Wani, Imtiaz, De’ Angelis, Nicola, Hecker, Andrea, Sganga, Gabriele, Tan, Edward, Balogh, Zsolt J., Bala, Miklosh, Coimbra, Raul, Damaskos, Dimitrio, Ansaloni, Luca, Sartelli, Massimo, Parasas, Nikolao, Kluger, Yoram, Chahine, Elia, Agnoletti, Vanni, Fraga, Gustavo, Biffl, Walter L., and Catena, Fausto

Subjects
Sleeve gastrectomy, Abdomen, Acute, Bariatric surgery, Abdominal pain, Perforation, Occlusion, Peritoniti, Bleeding, Obesity, Morbid, Acute abdomen, Meta-Analysis as Topic, Gastric bypa, Long-term complication, Weight Loss, Emergency surgery, Emergency Medicine, Humans, Surgery, Systematic Reviews as Topic
Abstract

Background Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Method A working group of experienced general, acute care, and bariatric surgeons was created to carry out a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and to answer the PICO questions formulated after the Operative management in bariatric acute abdomen survey. The literature search was limited to late/long-term complications following laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Conclusions The acute abdomen after bariatric surgery is a common cause of admission in emergency departments. Knowledge of the most common late/long-term complications (> 4 weeks after surgical procedure) following sleeve gastrectomy and Roux-en-Y gastric bypass and their anatomy leads to a focused management in the emergency setting with good outcomes and decreased morbidity and mortality rates. A close collaboration between emergency surgeons, radiologists, endoscopists, and anesthesiologists is mandatory in the management of this group of patients in the emergency setting.

Published
2022
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27. Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project

Author

Fabio Rondelli, Francesco Pata, Francesco Gabrielli, Federica Gaiani, Michael Sugrue, Tiziana Meschi, Simona Bui, Ernest E. Moore, Patricia Tejedor, Antonio Crucitti, Monica Ortenzi, Dario Parini, Ari Leppäniemi, Fabio Cesare Campanile, Mauro Podda, Antonio Biondi, Walter L. Biffl, Salomone Di Saverio, Neil J. Smart, Belinda De Simone, Vanni Agnoletti, Massimo Sartelli, Andrea Polistena, Massimo De Filippo, Gustavo Pereira Fraga, Andrea Loffredo, Adolfo Pisanu, Paolo Carcoforo, Gilberto Poggioli, Gian Luigi de’Angelis, Justin Davies, Gian Luca Baiocchi, Michel Adamina, Marco Vacante, Alessandro Puzziello, Mario Guerrieri, Angelo Guttadauro, Luca Ansaloni, Fausto Catena, Nicola Avenia, Claudia Commisso, Ferdinando Agresta, Giorgio Ercolani, Nicola de’Angelis, Yoram Kluger, Patricia Sylla, Alberto Arezzo, Federico Coccolini, Podda, M, Sylla, P, Baiocchi, G, Adamina, M, Agnoletti, V, Agresta, F, Ansaloni, L, Arezzo, A, Avenia, N, Biffl, W, Biondi, A, Bui, S, Campanile, F, Carcoforo, P, Commisso, C, Crucitti, A, De'Angelis, N, De'Angelis, G, De Filippo, M, De Simone, B, Di Saverio, S, Ercolani, G, Fraga, G, Gabrielli, F, Gaiani, F, Guerrieri, M, Guttadauro, A, Kluger, Y, Leppaniemi, A, Loffredo, A, Meschi, T, Moore, E, Ortenzi, M, Pata, F, Parini, D, Pisanu, A, Poggioli, G, Polistena, A, Puzziello, A, Rondelli, F, Sartelli, M, Smart, N, Sugrue, M, Tejedor, P, Vacante, M, Coccolini, F, Davies, J, Catena, F, Podda M., Sylla P., Baiocchi G., Adamina M., Agnoletti V., Agresta F., Ansaloni L., Arezzo A., Avenia N., Biffl W., Biondi A., Bui S., Campanile F.C., Carcoforo P., Commisso C., Crucitti A., De'Angelis N., De'Angelis G.L., De Filippo M., De Simone B., Di Saverio S., Ercolani G., Fraga G.P., Gabrielli F., Gaiani F., Guerrieri M., Guttadauro A., Kluger Y., Leppaniemi A.K., Loffredo A., Meschi T., Moore E.E., Ortenzi M., Pata F., Parini D., Pisanu A., Poggioli G., Polistena A., Puzziello A., Rondelli F., Sartelli M., Smart N., Sugrue M.E., Tejedor P., Vacante M., Coccolini F., Davies J., and Catena F.

Subjects
medicine.medical_specialty, Consensus, RD1-811, Population, Consensu, Review, 030230 surgery, NO, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Elderly, Multidisciplinary approach, Epidemiology, Multidisciplinary management, medicine, Rectal cancer, humans, education, Research question, LS7_4, Geriatrics, education.field_of_study, Frailty, business.industry, RC86-88.9, elderly, frailty, multidisciplinary management, rectal cancer, aged, disease management, Italy, rectal neoplasms, Medical emergencies. Critical care. Intensive care. First aid, Colorectal surgery, 3. Good health, Geriatric oncology, 030220 oncology & carcinogenesis, Family medicine, Emergency Medicine, Surgery, business, Human
Abstract

Background and aims Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for the elderly and address only partially the associated specific challenges encountered in this population. This results in a wide variation and disparity in delivering a standard of care to this subset of patients. As the burden of rectal cancer in the elderly population continues to increase, it is crucial to assess whether current recommendations on treatment strategies for the general population can be adopted for the older adults, with the same beneficial oncological and functional outcomes. This multidisciplinary experts’ consensus aims to refine current rectal cancer-specific guidelines for the elderly population in order to help to maximize rectal cancer therapeutic strategies while minimizing adverse impacts on functional outcomes and quality of life for these patients. Methods The discussion among the steering group of clinical experts and methodologists from the societies’ expert panel involved clinicians practicing in general surgery, colorectal surgery, surgical oncology, geriatric oncology, geriatrics, gastroenterologists, radiologists, oncologists, radiation oncologists, and endoscopists. Research topics and questions were formulated, revised, and unanimously approved by all experts in two subsequent modified Delphi rounds in December 2020–January 2021. The steering committee was divided into nine teams following the main research field of members. Each conducted their literature search and drafted statements and recommendations on their research question. Literature search has been updated up to 2020 and statements and recommendations have been developed according to the GRADE methodology. A modified Delphi methodology was implemented to reach agreement among the experts on all statements and recommendations. Conclusions The 2021 SICG-SIFIPAC-SICE-WSES consensus for the multidisciplinary management of elderly patients with rectal cancer aims to provide updated evidence-based statements and recommendations on each of the following topics: epidemiology, pre-intervention strategies, diagnosis and staging, neoadjuvant chemoradiation, surgery, watch and wait strategy, adjuvant chemotherapy, synchronous liver metastases, and emergency presentation of rectal cancer.

Published
2021

28. Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry

Author

Salvatore, Corrao, Alessandro, Nobili, Giuseppe, Natoli, Pier Mannuccio Mannucci, Francesco, Perticone, Antonello, Pietrangelo, Christiano, Argano, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Alessandra, Marengoni, Francesco, Salerno, Matteo, Cesari, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Laura, Cortesi, Gabriella, Miglio, Ilaria, Ardoino, Alessio, Novella, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Cenci, Caterina, Gianni, Biolo, Michela, Zanetti, Martina, Guadagni, Michele, Zaccari, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Graziana, Lupattelli, Elmo, Mannarino, Vanessa, Bianconi, Francesco, Paciullo, Riccardo, Alcidi, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Floriana, Cocita, Vincenza, Beneduce, Lidia, Plances, Salvatore, Mularo, Massimo, Raspanti, Marco, Zoli, Ilaria, Lazzari, Mattia, Brunori, Elisa, Fabbri, Donatella, Magalotti, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Diletta, Maira, Valeria Di Stefano, Giovanna, Fabio, Sonia, Seghezzi, Marta, Mancarella, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Federica, Conti, Giulia, Bonini, Barbara Brignolo Ottolini, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Emanuele, Valeriani, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Chiara, Pes, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Gabriella, D'Aurizio, Giuseppe, Romanelli, Alberto, Zucchelli, Francesca, Manzoni, Andrea, Volpini, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Chiara, Dell'Unto, Giorgio, Annoni, Maurizio, Corsi, Giuseppe, Bellelli, Sara, Zazzetta, Paolo, Mazzola, Hajnalka, Szabo, Alessandra, Bonfanti, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Bruno, Tassone, Giorgio, Sesti, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Elisabetta, Cosi, Paolo, Scarinzi, Annalisa, Amabile, Elisabetta, Omenetto, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Boari, Benedetta, DE GIORGI, Alfredo, Tiseo, Ruana, DE GIORGIO, Roberto, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Andrea, Schilardi, Francesca, Loparco, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Luigi, Fenoglio, Andrea, Falcetta, Christian, Bracco, Anna, L Fracanzani Silvia Fargion, Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Barbara, Ferrari, Giulia, Colombo, Pasquale, Agosti, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Giuliana, Ceriani, Giada, Pallini, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Lara, Caserza, Kassem, Salam, Nicola Lucio Liberato, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Elena, Spazzini, Camillo, Ferrandina, Giuseppe, Montrucchio, Paolo, Petitti, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Raffaella, Salmi, Piergiorgio, Gaudenzi, 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Cittadini, Carlo, Vigorito, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesca, Gasparini, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Giuseppe, Scattolin, Sergio, Martinelli, Mauro, Turrin, Leonardo, Sechi, Cristina, Catena, Gianluca, Colussi, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Stefano Del Giacco, Davide, Firinu, Francesca, Losa, Giovanni, Paoletti, Giulia, Costanzo, Giuseppe, Montalto, Anna, Licata, Valentina, Malerba, Filippo Alessandro Montalto, Antonino, Lasco, Giorgio, Basile, Antonino, Catalano, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Fulvio, Lauretani, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Alberto, Tedeschi, Lucia, Trotta, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Mara, Cattaneo, Federico, Napoli., Corrao S, Nobili A, Natoli G, Mannucci PM, Perticone F, Pietrangelo A, Argano C, REPOSI Investigator, Borghi C, Corrao S., Nobili A., Natoli G., Mannucci P.M., Perticone F., Pietrangelo A., Argano C., Licata G., Violi F., Corazza G.R., Marengoni A., Salerno F., Cesari M., Tettamanti M., Pasina L., Franchi C., Cortesi L., Miglio G., Ardoino I., Novella A., Prisco D., Silvestri E., Emmi G., Bettiol A., Caterina C., Biolo G., Zanetti M., Guadagni M., Zaccari M., Chiuch M., Vanoli M., Grignani G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Lupattelli G., Mannarino E., Bianconi V., Paciullo F., Alcidi R., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Girelli D., Busti F., Marchi G., Barbagallo M., Dominguez L., Cocita F., Beneduce V., Plances L., Mularo S., Raspanti M., Zoli M., Lazzari I., Brunori M., Fabbri E., Magalotti D., Arno R., Pasini F.L., Capecchi P.L., Palasciano G., Modeo M.E., Di Gennaro C., Cappellini M.D., Maira D., Di Stefano V., Fabio G., Seghezzi S., Mancarella M., De Amicis M.M., De Luca G., Scaramellini N., Rossi P.D., Damanti S., Clerici M., Conti F., Bonini G., Ottolini B.B., Di Sabatino A., Miceli E., Lenti M.V., Pisati M., Dominioni C.C., Murialdo G., Marra A., Cattaneo F., Pontremoli R., Beccati V., Nobili G., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Cipollone F., Guagnano M.T., Valeriani E., Rossi I., Mancuso G., Calipari D., Bartone M., Delitala G., Berria M., Pes C., Delitala A., Muscaritoli M., Molfino A., Petrillo E., Zuccala G., D'Aurizio G., Romanelli G., Zucchelli A., Manzoni F., Volpini A., Picardi A., Gentilucci U.V., Gallo P., Dell'Unto C., Annoni G., Corsi M., Bellelli G., Zazzetta S., Mazzola P., Szabo H., Bonfanti A., Arturi F., Succurro E., Rubino M., Tassone B., Sesti G., Serra M.G., Bleve M.A., Gasbarrone L., Sajeva M.R., Brucato A., Ghidoni S., Fabris F., Bertozzi I., Bogoni G., Rabuini M.V., Cosi E., Scarinzi P., Amabile A., Omenetto E., Prandini T., Manfredini R., Fabbian F., Boari B., De Giorgi A., Tiseo R., De Giorgio R., Paolisso G., Rizzo M.R., Borghi C., Strocchi E., Ianniello E., Soldati M., Sabba C., Vella F.S., Suppressa P., Schilardi A., Loparco F., De Vincenzo G.M., Comitangelo A., Amoruso E., Fenoglio L., Falcetta A., Bracco C., Fargion A.L.F.S., Tiraboschi S., Cespiati A., Oberti G., Sigon G., Peyvandi F., Rossio R., Ferrari B., Colombo G., Agosti P., Monzani V., Savojardo V., Folli C., Ceriani G., Pallini G., Dallegri F., Ottonello L., Liberale L., Caserza L., Salam K., Liberato N.L., Tognin T., Bianchi G.B., Giaquinto S., Purrello F., Di Pino A., Piro S., Rozzini R., Falanga L., Spazzini E., Ferrandina C., Montrucchio G., Petitti P., Peasso P., Favale E., Poletto C., Salmi R., Gaudenzi P., Perri L., Landolfi R., Montalto M., Mirijello A., Guasti L., Castiglioni L., Maresca A., Squizzato A., Campiotti L., Grossi A., Bertolotti M., Mussi C., Lancellotti G., Libbra M.V., Dondi G., Pellegrini E., Carulli L., Galassi M., Grassi Y., Perticone M., Battaglia R., FIlice M., Maio R., Stanghellini V., Ruggeri E., del Vecchio S., Salvi A., Leonardi R., Damiani G., Capeci W., Gabrielli A., Mattioli M., Martino G.P., Biondi L., Pettinari P., Ghio R., Col A.D., Minisola S., Colangelo L., Cilli M., Labbadia G., Afeltra A., Marigliano B., Pipita M.E., Castellino P., Zanoli L., Pignataro S., Gennaro A., Blanco J., Saracco V., Fogliati M., Bussolino C., Mete F., Gino M., Cittadini A., Vigorito C., Arcopinto M., Salzano A., Bobbio E., Marra A.M., Sirico D., Moreo G., Gasparini F., Prolo S., Pina G., Ballestrero A., Ferrando F., Berra S., Dassi S., Nava M.C., Graziella B., Baldassarre S., Fragapani S., Gruden G., Galanti G., Mascherini G., Petri C., Stefani L., Girino M., Piccinelli V., Nasso F., Gioffre V., Pasquale M., Scattolin G., Martinelli S., Turrin M., Sechi L., Catena C., Colussi G., Passariello N., Rinaldi L., Berti F., Famularo G., Tarsitani P., Castello R., Pasino M., Ceda G.P., Maggio M.G., Morganti S., Artoni A., Del Giacco S., Firinu D., Losa F., Paoletti G., Costanzo G., Montalto G., Licata A., Malerba V., Montalto F.A., Lasco A., Basile G., Catalano A., Malatino L., Stancanelli B., Terranova V., Di Marca S., Di Quattro R., La Malfa L., Caruso R., Mecocci P., Ruggiero C., Boccardi V., Meschi T., Lauretani F., Ticinesi A., Nouvenne A., Minuz P., Fondrieschi L., Pirisi M., Fra G.P., Sola D., Porta M., Riva P., Quadri R., Larovere E., Novelli M., Scanzi G., Mengoli C., Provini S., Ricevuti L., Simeone E., Scurti R., Tolloso F., Tarquini R., Valoriani A., Dolenti S., Vannini G., Tedeschi A., Trotta L., Volpi R., Bocchi P., Vignali A., Harari S., Lonati C., Cattaneo M., Napoli F., Corrao, S., Nobili, A., Natoli, G., Mannucci, P. M., Perticone, F., Pietrangelo, A., Argano, C., Licata, G., Violi, F., Corazza, G. R., Marengoni, A., Salerno, F., Cesari, M., Tettamanti, M., Pasina, L., Franchi, C., Cortesi, L., Miglio, G., Ardoino, I., Novella, A., Prisco, D., Silvestri, E., Emmi, G., Bettiol, A., Caterina, C., Biolo, G., Zanetti, M., Guadagni, M., Zaccari, M., Chiuch, M., Vanoli, M., Grignani, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Lupattelli, G., Mannarino, E., Bianconi, V., Paciullo, F., Alcidi, R., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Girelli, D., Busti, F., Marchi, G., Barbagallo, M., Dominguez, L., Cocita, F., Beneduce, V., Plances, L., Mularo, S., Raspanti, M., Zoli, M., Lazzari, I., Brunori, M., Fabbri, E., Magalotti, D., Arno, R., Pasini, F. L., Capecchi, P. L., Palasciano, G., Modeo, M. E., Di Gennaro, C., Cappellini, M. D., Maira, D., Di Stefano, V., Fabio, G., Seghezzi, S., Mancarella, M., De Amicis, M. M., De Luca, G., Scaramellini, N., Rossi, P. D., Damanti, S., Clerici, M., Conti, F., Bonini, G., Ottolini, B. B., Di Sabatino, A., Miceli, E., Lenti, M. V., Pisati, M., Dominioni, C. C., Murialdo, G., Marra, A., Cattaneo, F., Pontremoli, R., Beccati, V., Nobili, G., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Cipollone, F., Guagnano, M. T., Valeriani, E., Rossi, I., Mancuso, G., Calipari, D., Bartone, M., Delitala, G., Berria, M., Pes, C., Delitala, A., Muscaritoli, M., Molfino, A., Petrillo, E., Zuccala, G., D'Aurizio, G., Romanelli, G., Zucchelli, A., Manzoni, F., Volpini, A., Picardi, A., Gentilucci, U. V., Gallo, P., Dell'Unto, C., Annoni, G., Corsi, M., Bellelli, G., Zazzetta, S., Mazzola, P., Szabo, H., Bonfanti, A., Arturi, F., Succurro, E., Rubino, M., Tassone, B., Sesti, G., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Fabris, F., Bertozzi, I., Bogoni, G., Rabuini, M. V., Cosi, E., Scarinzi, P., Amabile, A., Omenetto, E., Prandini, T., Manfredini, R., Fabbian, F., Boari, B., De Giorgi, A., Tiseo, R., De Giorgio, R., Paolisso, G., Rizzo, M. R., Borghi, C., Strocchi, E., Ianniello, E., Soldati, M., Sabba, C., Vella, F. S., Suppressa, P., Schilardi, A., Loparco, F., De Vincenzo, G. M., Comitangelo, A., Amoruso, E., Fenoglio, L., Falcetta, A., Bracco, C., Fargion, A. L. F. S., Tiraboschi, S., Cespiati, A., Oberti, G., Sigon, G., Peyvandi, F., Rossio, R., Ferrari, B., Colombo, G., Agosti, P., Monzani, V., Savojardo, V., Folli, C., Ceriani, G., Pallini, G., Dallegri, F., Ottonello, L., Liberale, L., Caserza, L., Salam, K., Liberato, N. L., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Ferrandina, C., Montrucchio, G., Petitti, P., Peasso, P., Favale, E., Poletto, C., Salmi, R., Gaudenzi, P., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Campiotti, L., Grossi, A., Bertolotti, M., Mussi, C., Lancellotti, G., Libbra, M. V., Dondi, G., Pellegrini, E., Carulli, L., Galassi, M., Grassi, Y., Perticone, M., Battaglia, R., Filice, M., Maio, R., Stanghellini, V., Ruggeri, E., del Vecchio, S., Salvi, A., Leonardi, R., Damiani, G., Capeci, W., Gabrielli, A., Mattioli, M., Martino, G. P., Biondi, L., Pettinari, P., Ghio, R., Col, A. D., Minisola, S., Colangelo, L., Cilli, M., Labbadia, G., Afeltra, A., Marigliano, B., Pipita, M. E., Castellino, P., Zanoli, L., Pignataro, S., Gennaro, A., Blanco, J., Saracco, V., Fogliati, M., Bussolino, C., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Gasparini, F., Prolo, S., Pina, G., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Gruden, G., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Passariello, N., Rinaldi, L., Berti, F., Famularo, G., Tarsitani, P., Castello, R., Pasino, M., Ceda, G. P., Maggio, M. G., Morganti, S., Artoni, A., Del Giacco, S., Firinu, D., Losa, F., Paoletti, G., Costanzo, G., Montalto, G., Licata, A., Malerba, V., Montalto, F. A., Lasco, A., Basile, G., Catalano, A., Malatino, L., Stancanelli, B., Terranova, V., Di Marca, S., Di Quattro, R., La Malfa, L., Caruso, R., Mecocci, P., Ruggiero, C., Boccardi, V., Meschi, T., Lauretani, F., Ticinesi, A., Nouvenne, A., Minuz, P., Fondrieschi, L., Pirisi, M., Fra, G. P., Sola, D., Porta, M., Riva, P., Quadri, R., Larovere, E., Novelli, M., Scanzi, G., Mengoli, C., Provini, S., Ricevuti, L., Simeone, E., Scurti, R., Tolloso, F., Tarquini, R., Valoriani, A., Dolenti, S., Vannini, G., Tedeschi, A., Trotta, L., Volpi, R., Bocchi, P., Vignali, A., Harari, S., Lonati, C., Cattaneo, M., Napoli, F., Corrao, S, Nobili, A, Natoli, G, Mannucci, P, Perticone, F, Pietrangelo, A, Argano, C, Licata, G, Violi, F, Corazza, G, Marengoni, A, Salerno, F, Cesari, M, Tettamanti, M, Pasina, L, Franchi, C, Cortesi, L, Miglio, G, Ardoino, I, Novella, A, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Mularo, S, Raspanti, M, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arno, R, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Di Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, M, De Luca, G, Scaramellini, N, Rossi, P, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, B, Di Sabatino, A, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccala, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Manzoni, F, Volpini, A, Picardi, A, Gentilucci, U, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabba, C, Vella, F, Suppressa, P, Schilardi, A, Loparco, F, De Vincenzo, G, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fargion, A, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Agosti, P, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, N, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, F, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, and Napoli, F

Subjects
Registrie, Male, Comorbidity, Diabetes, Disability, Elderly, Hyperglycemia, Mortality, Aged, Aged, 80 and over, Female, Hospital Mortality, Hospitals, Humans, Internal Medicine, Registries, Hospitalization, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Socio-culturale, Renal function, 030204 cardiovascular system & hematology, Diabete, Hospital, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Rating scale, Internal medicine, Diabetes mellitus, 80 and over, medicine, LS4_4, 030212 general & internal medicine, Class III obesity, business.industry, Mortality rate, Comorbidity, Diabetes, Disability, Elderly, Hyperglycemia, Mortality, General Medicine, medicine.disease, Mood disorders, Geriatric Depression Scale, Original Article, business, Human
Abstract

Aims The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged ≥ 65 years. Methods Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge. Results Of the 4714 elderly patients hospitalized, 361 had a glycemia level ≥ 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia ≥ 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia ≥ 250 and p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia ≥ 250 mg/dL (OR 2.07; [95% CI 1.34–3.19]), Barthel Index ≤ 40 (3.28[2.44–4.42]), CIRS-SI (1.87[1.27–2.77]), and male sex (1.54[1.16–2.03]). Conclusions The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level ≥ 250 mg/dL, Barthel Index ≤ 40, CIRS-SI, and male sex.

Published
2021

29. Early versus delayed defunctioning ileostomy closure after low anterior resection for rectal cancer: a meta-analysis and trial sequential analysis of safety and functional outcomes

Author

Mauro Podda, Federico Coccolini, Chiara Gerardi, Greta Castellini, Michael Samuel James Wilson, Massimo Sartelli, Daniela Pacella, Fausto Catena, Roberto Peltrini, Umberto Bracale, Adolfo Pisanu, Podda, Mauro, Coccolini, Federico, Gerardi, Chiara, Castellini, Greta, Wilson, Michael Samuel Jame, Sartelli, Massimo, Pacella, Daniela, Catena, Fausto, Peltrini, Roberto, Bracale, Umberto, and Pisanu, Adolfo

Subjects
Low anterior resection, Rectal Neoplasm, Rectal Neoplasms, Ileostomy, Gastroenterology, Surgical Stomas, Trial sequential analysi, Syndrome, Late ileostomy closure, Postoperative Complications, Early ileostomy closure, Humans, Meta-analysi, Postoperative Complication, Rectal cancer, Human
Abstract

Purpose We performed a systematic review and meta-analysis with trial sequential analysis (TSA) to answer whether early closure of defunctioning ileostomy may be suitable after low anterior resection. Methods MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched, up to October 2021, for RCTs comparing early closure (EC ≤ 30 days) and delayed closure (DC ≥ 60 days) of defunctioning ileostomy. The risk ratio (RR) with 95% CI was calculated for dichotomous variables and the mean difference (MD) with 95% CI for continuous variables. The GRADE methodology was implemented for assessing Quality of Evidence (QoE). TSA was implemented to address the risk of random error associated with sparse data and/or multiple testing. Results Seven RCTs were included for quantitative synthesis. 599 patients were allocated to either EC (n = 306) or DC (n = 293). EC was associated with a higher rate of wound complications compared to DC (RR 2.56; 95% CI 1.33 to 4.93; P = 0.005; I2 = 0%, QoE High), a lower incidence of postoperative small bowel obstruction (RR 0.46; 95% CI 0.24 to 0.89; P = 0.02; I2 = 0%, QoE moderate), and a lower rate of stoma-related complications (RR 0.26; 95% CI 0.16 to 0.42; P I2 = 0%, QoE moderate). The rate of minor low anterior resection syndrome (LARS) (RR 1.13; 95% CI 0.55 to 2.33; P = 0.74; I2 = 0%, QoE low) and major LARS (RR 0.80; 95% CI 0.59 to 1.09; P = 0.16; I2 = 0%, QoE low) did not differ between the two groups. TSA demonstrated inconclusive evidence with insufficient sample sizes to detect the observed effects. Conclusion EC may confer some advantages compared with a DC. However, TSA advocated a cautious interpretation of the results. Prospero Register ID CRD42021276557

Published
2022
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30. Influence of Gestational Diabetes and Pregestational Maternal BMI on the Brain of Six-Year-Old Offspring

Author

Jordi Manuello, Juan Verdejo-Román, Francisco Torres Espínola, Mireia Escudero-Marín, Andrés Catena, Franco Cauda, and Cristina Campoy

Subjects
Brain, Overweight, Body Mass Index, Diabetes, Gestational, Transgenerational effects, Developmental Neuroscience, Neurology, Pregnancy, Pediatrics, Perinatology and Child Health, Brain structure, Humans, Female, Obesity, Neurology (clinical), Child, Body mass index, Gestational diabetes
Abstract

Background: Gestational diabetes (GD) and maternal excess weight are common pregnancy conditions that increase the risk of future complications for both the mother and her offspring. Their consequences on neurodevelopment are widely described in the literature, but less is known concerning the potential transgenerational influence on the brain structure. Methods: We used a combination of support vectors machine and hierarchical clustering to investigate the potential presence of anatomical brain differences in a sample of 109 children aged six years, born to mothers with overweight or obesity, or to mothers diagnosed with GD during pregnancy. Results: Significant effects are visible in the brain of children born to mothers with GD associated with pregestational excess weight, especially overweight instead of obesity. No differences in children's brain were observed when considering those born to normal-weight mothers. Conclusions: Our study highlights the need for clinical attention of pregnant women at risk to develop GD, and especially those with pregestational excess weight, since this status was found to be associated with detectable transgenerational brain changes. These effects may be due to the absence of specific and individualized intervention in these mothers during pregnancy., Spanish Ministry of Innovation and Science. Junta de Andalucía: Excellence Projects (P06-CTS-02341), Spanish Ministry of Economy and Competitiveness (BFU2012-40254-C03-01), DynaHEALTH EU Project - HORIZON 2020 Research and Innovation Programme, Grant Agreement No 633595, Spanish Ministry of Science, Innovation and Universities (FJCI-2017-33396)

Published
2022
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31. Emilia-Romagna Surgical Colorectal Cancer Audit (ESCA): a value-based healthcare retro-prospective study to measure and improve the quality of surgical care in colorectal cancer

Author

Ilaria, Massa, Federico, Ghignone, Giampaolo, Ugolini, Giorgio, Ercolani, Isacco, Montroni, Patrizio, Capelli, Gianluca, Garulli, Fausto, Catena, Andrea, Lucchi, Luca, Ansaloni, Nicola, Gentili, Valentina, Danesi, Maria Teresa, Montella, Mattia, Altini, and Gianluca, Senatore

Subjects
Postoperative Complications, Gastroenterology, Humans, Prospective Studies, Colorectal Neoplasms, Colorectal Surgery, Delivery of Health Care
Abstract

Purpose Surgery is the main treatment for non-metastatic colorectal cancer. Despite huge improvements in perioperative care, colorectal surgery is still associated with a significant burden of postoperative complications and ultimately costs for healthcare organizations. Systematic clinical auditing activity has already proven to be effective in measuring and improving clinical outcomes, and for this reason, we decided to evaluate its impact in a large area of northern Italy. Methods The Emilia-Romagna Surgical Colorectal Audit (ESCA) is an observational, multicentric, retro-prospective study, carried out by 7 hospitals located in the Emilia-Romagna region. All consecutive patients undergoing surgery for colorectal cancer during a 54-month study period will be enrolled. Data regarding baseline conditions, preoperative diagnostic work-up, surgery and postoperative course will be collected in a dedicated case report form. Primary outcomes regard postoperative complications and mortality. Secondary outcomes include each center’s adherence to the auditing (enrolment rate) and evaluation of the systematic feedback activity on key performance indicators for the entire perioperative process. Conclusion This protocol describes the methodology of the Emilia-Romagna Surgical Colorectal Audit. The study will provide real-world clinical data essential for benchmarking and feedback activity, to positively impact outcomes and ultimately to improve the entire healthcare process of patients undergoing colorectal cancer surgery. Clinical trial registration The study ESCA is registered on the clinicaltrials.gov platform (Identifier: NCT03982641).

Published
2022
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32. Acute cholecystitis during COVID-19 pandemic: a multisocietary position statement

Author

Roberto Luca Meniconi, Paolo Bianchi, Alessandro Puzziello, Mario Guerrieri, Federico Coccolini, Sara Federici, Irnerio Angelo Muttillo, Mauro Podda, Gianfranco Silecchia, Fabio Cesare Campanile, Wanda Petz, Alberto Sartori, Belinda De Simone, Salomone Di Saverio, Antonino Agrusa, M. Pisano, Massimo Carlini, Valerio Caracino, Piero Narilli, Andrea Mazzari, Carlo Bergamini, Giancarlo D'Ambrosio, Adelona Salaj, Marco E. Allaix, Elisa Cassinotti, Marco Milone, Fausto Catena, Gabriele Anania, Diego Cuccurullo, Alberto Arezzo, Emanuele Botteri, Salvatore Casarano, Ferdinando Agresta, Caterina Cicala, Giovanni Terrosu, Riccardo Brachet Contul, Alessandro M. Paganini, Campanile F.C., Podda M., Arezzo A., Botteri E., Sartori A., Guerrieri M., Cassinotti E., Muttillo I., Pisano M., Brachet Contul R., D'Ambrosio G., Cuccurullo D., Bergamini C., Allaix M.E., Caracino V., Petz W.L., Milone M., Silecchia G., Anania G., Agrusa A., Di Saverio S., Casarano S., Cicala C., Narilli P., Federici S., Carlini M., Paganini A., Bianchi P.P., Salaj A., Mazzari A., Meniconi R.L., Puzziello A., Terrosu G., De Simone B., Coccolini F., Catena F., Agresta F., Campanile, F. C., Podda, M., Arezzo, A., Botteri, E., Sartori, A., Guerrieri, M., Cassinotti, E., Muttillo, I., Pisano, M., Brachet Contul, R., D'Ambrosio, G., Cuccurullo, D., Bergamini, C., Allaix, M. E., Caracino, V., Petz, W. L., Milone, M., Silecchia, G., Anania, G., Agrusa, A., Di Saverio, S., Casarano, S., Cicala, C., Narilli, P., Federici, S., Carlini, M., Paganini, A., Bianchi, P. P., Salaj, A., Mazzari, A., Meniconi, R. L., Puzziello, A., Terrosu, G., De Simone, B., Coccolini, F., Catena, F., and Agresta, F.

Subjects
Acute cholecystitis, COVID-19 pandemic, Emergency surgery, New coronavirus, Position statement, Betacoronavirus, COVID-19, Cholecystectomy, Cholecystitis, Acute, Coronavirus Infections, Humans, Infection Control, Pandemics, Pneumonia, Viral, SARS-CoV-2, Societies, Medical, Practice Guidelines as Topic, medicine.medical_treatment, 030230 surgery, 0302 clinical medicine, Pandemic, Cholecystitis, Infection control, 030212 general & internal medicine, Viral, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Emergency Medicine, Acute cholecystitis, Emergency surgery, COVID-19 pandemic, New coronavirus, Position statement, Human, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), lcsh:Surgery, New coronaviru, Acute, Acute cholecystiti, acute cholecystitis, emergency surgery, Nnew coronavirus, position statement, betacoronavirus, cholecystectomy, cholecystitis, acute, coronavirus infections, humans, infection control, pandemics, pneumonia, viral, societies, medical, practice guidelines as topic, NO, 03 medical and health sciences, Medical, medicine, Betacoronaviru, business.industry, Coronavirus Infection, General surgery, Pneumonia, lcsh:RD1-811, lcsh:RC86-88.9, Settore MED/18 - Chirurgia Generale, Invasive surgery, Commentary, Surgery, business, Societies
Abstract

Following the spread of the infection from the new SARS-CoV2 coronavirus in March 2020, several surgical societies have released their recommendations to manage the implications of the COVID-19 pandemic for the daily clinical practice. The recommendations on emergency surgery have fueled a debate among surgeons on an international level.We maintain that laparoscopic cholecystectomy remains the treatment of choice for acute cholecystitis, even in the COVID-19 era. Moreover, since laparoscopic cholecystectomy is not more likely to spread the COVID-19 infection than open cholecystectomy, it must be organized in such a way as to be carried out safely even in the present situation, to guarantee the patient with the best outcomes that minimally invasive surgery has shown to have.

Published
2020
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33. The weekend effect on the provision of Emergency Surgery before and during the COVID-19 pandemic: case-control analysis of a retrospective multicentre database

Author

Tebala G. D., Milani M. S., Cirocchi R., Bignell M., Bond-Smith G., Lewis C., Agnoletti V., Catarci M., Di Saverio S., Luridiana G., Catena F., Scatizzi M., Marini P., Lo Dico R., Stracqualursi A., Russo G., D'Errico S., Cianci P., Restini E., Scialandrone G., Guercioni G., Martinez G., Pezzolla A., Altomare D. F., Picciariello A., Trigiante G., Dibra R., Papagni V., Righetti C., Polastri R., Andreuccetti J., Pignata G., D'Alessio R., Arici E., Canfora I., Cillara N., Deserra A., Sechi R., Bianco F., Gili S., Cappiello A., Incollingo P., Biloslavo A., Bellio G., Germani P., De Manzini N., Buiatti M., Paladino F. P., Sasia D., Borghi F., Testa V., Giraudo G., Allisiardi F., Giuffrida M. C., Gerosa M., Fogliati A., Maggioni D., Fabbri N., Feo C. V., Bianchini E., Panzini I., Lizzi V., Tricarico F. G., Di Gioia G., Melino R., Tartaglia N., Ambrosi A., Pavone G., Pacilli M., Vovola F., Belli F., Barberis A., Azzinnaro A., Coratti A., Benigni R., Berti S., Saracco M., Gennai A., Dova L., Farfaglia R., Pata G., Arizzi V., Pandolfo G., Frontali A., Danelli P., Ferrario L., Guerci C., Mariani N. M., Pisani Ceretti A., Nicastro V., Opocher E., Gozzo D., Casoni Pattacini G., Castriconi M., Amendola A., Gaudiello M., Palomba G., Petracca G. L., Perrone G., Giuffrida M., Moretto G., Impellizzeri H., Casaril A., Filosa M., Caizzone A., Agrusti S., Cattaneo G. M., Capelli P., Muratore A., Calabro M., Pipitore Federico N., Cuzzola B., Danna R., Murgese A., Coccolini F., Pieroni E., Chiarugi M., Tartaglia D., Giannessi S., Somigli R., Trafeli M., Fedi M., De Vincenti R., Guariniello A., Grande M., Bagaglini G., Pirozzi B., Guida A. M., Ingallinella S., Don C. P., Siragusa L., Capone O., Cerbo D., Santoro E., Pende V., Fassari A., Mingoli A., Brachini G., Cirillo B., Zambon M., Cicerchia P., Meneghini S., Sapienza P., Puzzovio A., La Torre F., Fransvea P., Di Grezia M., Sganga G., Armellino M. F., Ioia G., Rampone B., Della Corte M., Fleres F., Clarizia G., Bordoni P., Spolini A., Franzini M., Grechi A., Suppo M., Bono D., Scaglione D., Cotsoglou C., Paleini S., Chierici A. P., Uccelli M., Olmi S., Cesana G., Tenreiro N., Marcal A., Martins D., Leal C., Vieira B., Ugarte-Sierra B., Vincene-Rodriguez I., Duran-Ballesteros M., Sanz-Larrainzar A., Ibanez-Aguirre F. J., Yanez-Benites C., Talal I., Blas J. L., Garau R., Clark-Stuart S., Wallace A., Di Carlo A., Wisnia E., Ehsan K., Beck-Sanders K., Godson E., Campbell P., Ahmad R., Ali R., Aswani S. S., Barza A., Carrillo C., Dawani A., Dey A., Elserafy A., Gaspar D., Lazzareschi L., Patel M., Shabana A., Shams M., Shams O., Slack Z., Tebala, Giovanni D, Milani, Marika S, Cirocchi, Roberto, Bignell, Mark, Bond-Smith, Gile, Lewis, Christopher, Agnoletti, Vanni, Catarci, Marco, Di Saverio, Salomone, Luridiana, Gianluigi, Catena, Fausto, Scatizzi, Marco, Marini, Pierluigi, de Manzini, Nicolo', Tebala G.D., Milani M.S., Cirocchi R., Bignell M., Bond-Smith G., Lewis C., Agnoletti V., Catarci M., Di Saverio S., Luridiana G., Catena F., Scatizzi M., Marini P., Lo Dico R., Stracqualursi A., Russo G., D'Errico S., Cianci P., Restini E., Scialandrone G., Guercioni G., Martinez G., Pezzolla A., Altomare D.F., Picciariello A., Trigiante G., Dibra R., Papagni V., Righetti C., Polastri R., Andreuccetti J., Pignata G., D'Alessio R., Arici E., Canfora I., Cillara N., Deserra A., Sechi R., Bianco F., Gili S., Cappiello A., Incollingo P., Biloslavo A., Bellio G., Germani P., De Manzini N., Buiatti M., Paladino F.P., Sasia D., Borghi F., Testa V., Giraudo G., Allisiardi F., Giuffrida M.C., Gerosa M., Fogliati A., Maggioni D., Fabbri N., Feo C.V., Bianchini E., Panzini I., Lizzi V., Tricarico F.G., Di Gioia G., Melino R., Tartaglia N., Ambrosi A., Pavone G., Pacilli M., Vovola F., Belli F., Barberis A., Azzinnaro A., Coratti A., Benigni R., Berti S., Saracco M., Gennai A., Dova L., Farfaglia R., Pata G., Arizzi V., Pandolfo G., Frontali A., Danelli P., Ferrario L., Guerci C., Mariani N.M., Pisani Ceretti A., Nicastro V., Opocher E., Gozzo D., Casoni Pattacini G., Castriconi M., Amendola A., Gaudiello M., Palomba G., Petracca G.L., Perrone G., Giuffrida M., Moretto G., Impellizzeri H., Casaril A., Filosa M., Caizzone A., Agrusti S., Cattaneo G.M., Capelli P., Muratore A., Calabro M., Pipitore Federico N., Cuzzola B., Danna R., Murgese A., Coccolini F., Pieroni E., Chiarugi M., Tartaglia D., Giannessi S., Somigli R., Trafeli M., Fedi M., De Vincenti R., Guariniello A., Grande M., Bagaglini G., Pirozzi B., Guida A.M., Ingallinella S., Don C.P., Siragusa L., Capone O., Cerbo D., Santoro E., Pende V., Fassari A., Mingoli A., Brachini G., Cirillo B., Zambon M., Cicerchia P., Meneghini S., Sapienza P., Puzzovio A., La Torre F., Fransvea P., Di Grezia M., Sganga G., Armellino M.F., Ioia G., Rampone B., Della Corte M., Fleres F., Clarizia G., Bordoni P., Spolini A., Franzini M., Grechi A., Suppo M., Bono D., Scaglione D., Cotsoglou C., Paleini S., Chierici A.P., Uccelli M., Olmi S., Cesana G., Tenreiro N., Marcal A., Martins D., Leal C., Vieira B., Ugarte-Sierra B., Vincene-Rodriguez I., Duran-Ballesteros M., Sanz-Larrainzar A., Ibanez-Aguirre F.J., Yanez-Benites C., Talal I., Blas J.L., Garau R., Clark-Stuart S., Wallace A., Di Carlo A., Wisnia E., Ehsan K., Beck-Sanders K., Godson E., Campbell P., Ahmad R., Ali R., Aswani S.S., Barza A., Carrillo C., Dawani A., Dey A., Elserafy A., Gaspar D., Lazzareschi L., Patel M., Shabana A., Shams M., Shams O., and Slack Z.

Subjects
Hot gallbladder, education, Weekend effect, COVID-19, Settore MED/18 - Chirurgia Generale, Retrospective Studie, Case-Control Studies, Emergency surgery, Hospital Mortality, Humans, Retrospective Studies, Pandemics, Emergency Medicine, Surgery, Case-Control Studie, Human
Abstract

Introduction The concept of “weekend effect”, that is, substandard healthcare during weekends, has never been fully demonstrated, and the different outcomes of emergency surgical patients admitted during weekends may be due to different conditions at admission and/or different therapeutic approaches. Aim of this international audit was to identify any change of pattern of emergency surgical admissions and treatments during weekends. Furthermore, we aimed at investigating the impact of the COVID-19 pandemic on the alleged “weekend effect”. Methods The database of the CovidICE-International Study was interrogated, and 6263 patients were selected for analysis. Non-trauma, 18+ yo patients admitted to 45 emergency surgery units in Europe in the months of March–April 2019 and March–April 2020 were included. Demographic and clinical data were anonymised by the referring centre and centrally collected and analysed with a statistical package. This study was endorsed by the Association of Italian Hospital Surgeons (ACOI) and the World Society of Emergency Surgery (WSES). Results Three-quarters of patients have been admitted during workdays and only 25.7% during weekends. There was no difference in the distribution of gender, age, ASA class and diagnosis during weekends with respect to workdays. The first wave of the COVID pandemic caused a one-third reduction of emergency surgical admission both during workdays and weekends but did not change the relation between workdays and weekends. The treatment was more often surgical for patients admitted during weekends, with no difference between 2019 and 2020, and procedures were more often performed by open surgery. However, patients admitted during weekends had a threefold increased risk of laparoscopy-to-laparotomy conversion (1% vs. 3.4%). Hospital stay was longer in patients admitted during weekends, but those patients had a lower risk of readmission. There was no difference of the rate of rescue surgery between weekends and workdays. Subgroup analysis revealed that interventional procedures for hot gallbladder were less frequently performed on patients admitted during weekends. Conclusions Our analysis revealed that demographic and clinical profiles of patients admitted during weekends do not differ significantly from workdays, but the therapeutic strategy may be different probably due to lack of availability of services and skillsets during weekends. The first wave of the COVID-19 pandemic did not impact on this difference.

Published
2022

34. Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

Author

Rottoli, Matteo, Gori, Alice, Pellino, Gianluca, Flacco, Maria Elena, Martellucci, Cecilia, Spinelli, Antonino, Poggioli, Gilberto, Romano, Angela, Belvedere, Angela, Lanci Lanci, Antonio, Parlanti, Daniele, Vago, Gabriele, Pezzuto, Paola, Canavese, Anna, Dajti, Gerti, Cardelli, Stefano, Catalioto, Caterina, Russo, Iris S, Violante, Tommaso, Morezzi, Daniele, Maurino, Ludovica, Filippone, Eleonora, Cuicchi, Dajana, Bernante, Paolo, Jovine, Elio, Lombardi, Raffaele, Masetti, Michele, Cipressi, Chiara, Offi, Maria F, Larotonda, Cristina, Puglisi, Silvana B, Barbosa, Augusto, Vaiana, Roberto, Bianchi, Paolo M, Tonti, Carlo, Codignola, Claudio, Zorcolo, Luigi, Restivo, Angelo, Deidda, Simona, Marchetti, Marcello E, Ippolito, Luca, Spolverato, Gaya, Pucciarelli, Salvatore, Marchegiani, Francesco, Ghio, Giacomo, Zagolin, Gaya, Glavas, Dajana, Tomassi, Monica, Rosati, Riccardo, Elmore, Ugo, Gozzini, Lorenzo, Calef, Riccardo, Puccetti, Francesco, Cossu, Andrea, Vignali, Andrea, Morino, Mario, Allaix, Marco E, Cannata, Gaspare, Lombardi, Erica, Ammirati, Carlo A, Piceni, Chiara, Buccianti, Piero, Balestri, Riccardo, Puccini, Marco, Pezzati, Daniele, d'Ischia, Roberto, Asta, Vito F, Sargenti, Benedetta, Taddei, Giacomo, Bonari, Federica, Boni, Giulia, Ferrero, Alessandro, Mineccia, Michela, Gonella, Federica, Palisi, Marco, Danese, Francesco, Cherubini, Valeria, Perotti, Serena, Carvello, Michele, Carbone, Fabio, Luberto, Antonio, Calafiore, Eleonora, De Lucia, Francesca, Sacchi, Matteo, Sasia, Diego, Giuffrida, Maria C, Ballauri, Edoardo, Cardile, Mathieu, Armentano, Serena, Beltrami, Elsa, Preve, Gabriele, Vercellone, Barbara, Mozzon, Marta, Folliero, Cristina, Lirusso, Chiara, Vecchiato, Massimo, Ziccarelli, Antonio, Gattesco, Davide, Moretti, Luisa, Crestale, Sara, Banchini, Filippo, Capelli, Patrizio, Romboli, Andrea, Palmieri, Gerardo, Conti, Luigi, Rizzi, Nicholas, Bonfili, Deborah, de Manzini, Nicolò, Germani, Paola, Osenda, Edoardo, Cortinovis, Sara, Giunta, Carlotta, Fracon, Stefano, Abdallah, Hussein, Bogoni, Selene, Portolani, Nazario, Nascimbeni, Riccardo, Molfino, Sarah, Tiberio, Guido A M, Garosio, Ilenia, Lamperti, Giulia, Rigosa, Diego, Ercolani, Giorgio, Solaini, Leonardo, Cavaliere, Davide, Avanzolini, Andrea, D'Acapito, Fabrizio, Chiarella, Leonardo L, Di Pietrantonio, Daniela, Annunziata, Domenico, Piccolo, Roberta, Sorrentino, Mario, Pansini, Mauro, Cojutti, Alessandro, Graziano, Michele, Callegari, Francesco, Balzarotti, Laura, Dameno, Vitale R, Cattaneo, Antonio, Santolamazza, Giuliano, Altieri, Caterina, Magarini, Riccardo, Pietrabissa, Andrea, Dominioni, Tommaso, Pugliese, Luigi, Peri, Andrea, Botti, Marta, Salvetti, Francesco, Cassinotti, Elisa, Baldari, Ludovica, Boni, Luigi, Messina, Valentina, D'Abrosca, Vera, Cianci, Pasquale, Tumolo, Rocco, Gattulli, Domenico, Restini, Enrico, Minafra, Marina, Sederino, Maria G, Bottalico, Bernardino, Pilati, Pierluigi, Franzato, Boris, Mattara, Genny, De Simoni, Ottavia, Barina, Andrea, Tonello, Marco, Muratore, Andrea, Calabrò, Marcello, Federico Pipitone, Nicoletta S, Cuzzola, Bruno, Herranz van Nood, Elena, Passuello, Nicola, Frasson, Alvise, Mammano, Enzo, Faccio, Luca, Vittadello, Fabrizio, Bressan, Alice, Sarzo, Giacomo, Tamini, Nicolò, Oldani, Massimo, Cigagna, Luca, Carissimi, Francesca, De Carlo, Giulia, Baccalini, Edoardo, Nespoli, Luca, Giordano, Alessio, Cantafio, Stefano, Grifoni, Lucrezia, Matani, Davide, Livi, Serena, Delogu, Daniele, Scognamillo, Fabrizio, Marrosu, Antonio, Guerrini, Luca, Ugolini, Giampaolo, Ghignone, Federico, Frascaroli, Giacomo, Albertini, Nicola, Zattoni, Davide, Taffurelli, Giovanni, Montroni, Isacco, Colombo, Francesco, Danelli, Piergiorgio, Bondurri, Andrea, Maffioli, Anna, Bonomi, Alessandro, Pezzoli, Isabella, Cammarata, Francesco, Goletti, Orlando, Molteni, Mattia, Assisi, Alberto, Quartierini, Giorgio, Da Lio, Corrado, Verdi, Daunia, Mondi, Isabella, Peluso, Claudia, Macchi, Lorenzo, Tanzanu, Marta, Zanzi, Federico, Pellegrini, Sara, Andreuccetti, Jacopo, D'Alessio, Rossella, Pignata, Giusto, De Capua, Michele, Canfora, Ilaria, Ottaviani, Luca, Lepiane, Pasquale, Balla, Andrea, De Carlo, Antonio, Saraceno, Federica, Scaramuzzo, Rosa, Guida, Anna, Aguzzi, Daniele, Bellora, Paolo, Gentilli, Sergio, Monni, Manuela, Nikaj, Herald, Cillara, Nicola, Cannavera, Alessandro, Deserra, Antonello, Margiani, Carla, Cabula, Roberta, Dettori, Manuela, Gramignano, Giulia, Lezoche, Giovanni, Ortenzi, Monica, Orlandoni, Elena S, Curzi, Federica, Vitali, Francesca, Capomagi, Perla, Palmieri, Miriam, Giuffrida, Mario, Del Rio, Paolo, Bonati, Elena, Loderer, Tommaso, Cozzani, Federico, Rossini, Matteo, Agnesi, Stefano, Capolupo, Gabriella T, Caricato, Marco, Carannante, Filippo, Mascianà, Gianluca, Marrelli, Martina, Miacci, Valentina, Lauricella, Sara, Tonini, Valeria, Cervellera, Maurizio, Pisconti, Salvatore, Lozito, Concetta, Shahu, Juliana, Mongelli, Claudia, Morelli, Giulia, Sartarelli, Lodovico, Sica, Giuseppe 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Scolaro, Roberta, Milanesi, Maria, Rossi, Fabrizio, Canonico, Giuseppe, Anastasi, Alessandro, Nelli, Tommaso, Barlettai, Marco, Fratarcangeli, Riccardo, Di Martino, Carmela, Damigella, Andrea, Adinolfi, Elvira, Birindelli, Arianna, Taglietti, Lucio, Dester, Sara E, Fleres, Francesco, Cucinotta, Eugenio, Viscosi, Francesca, Biondo Santino, Antonio, Badessi, Giorgio, Catarsini, Nivia, Mazzeo, Carmelo, Rega, Daniela, Delrio, Paolo, Cervone, Carmela, Aversano, Alessia, De Franciscis, Silvia, Di Marzo, Massimiliano, Marra, Bruno, Pace, Ugo, Amato, Antonio, Batistotti, Paola, Mina, Elisa, Serventi, Alberto, Lapolla, Pierfrancesco, Mingoli, Andrea, Sapienza, Paolo, Brachini, Gioia, Cirillo, Bruno, Fiori, Enrico, Crocetti, Daniele, Clementi, Ilaria, Martines, Gennaro, Picciariello, Arcangelo, Tomasicchio, Giovanni, Dibra, Rigers, Trigiante, Giuseppe, Rinaldi, Marcella, Lantone, Giuliano, Porcu, Alberto, Perra, Teresa, Scanu, Antonio M, Feo, Claudio F, Fancellu, Alessandro, Cossu, Maria L, Ginesu, Giorgio C, Patriti, Alberto, Coletta, Diego, Petrelli, Filippo, Greco, Paola A, Spadoni, Claudia, Cassiani, Giovanna, Bianchini, Federica, Arganini, Marco, Bianchini, Matteo, Perotti, Bruno, Palmeri, Matteo, Scabini, Stefano, Deiana, Selene, Carganico, Giacomo, Pertile, Davide, Soriero, Domenico, Fioravanti, Emanuela, Sperotto, Beatrice, Nardo, Bruno, Paglione, Daniele, Crocco, Veronica, Doni, Marco, Osso, Mariasara, Perri, Roberto, Sampietro, Gianluca M, Corbellini, Carlo, Lorusso, Leonardo, Manzo, Carlo A, Cigognini, Maria, Baldi, Caterina, Palomba, Giuseppe, Aprea, Giovanni, Capuano, Marianna, Basile, Raffaele, Tutino, Roberta, Massani, Marco, Marinelli, Laura, Canitano, Nicola, Pilia, Tiziana, Podda, Mauro, Pisanu, Adolfo, Murzi, Valentina, Incani, Silvia, Frongia, Federica, Esposito, Giuseppe, Luglio, Gaetano, Tropeano, Francesca P, Pagano, Gianluca, Spina, Eduardo, De Simone, Giuseppe, Cricrì, Michele, Catena, Fausto, Vallicelli, Carlo, Zanini, Nicola, Ronconi, Diana, Favi, Francesco, Mazzucchelli, Carlo, Convertini, Girolamo, Vincenti, Leonardo, Andriola, Valeria, Bizzoca, Cinzia, Feo, Carlo V, Fabbri, Nicolò, Fazzin, Marta, Pesce, Antonio, Gennari, Silvia, Torchiaro, Marco, Severi, Silvia, Frontali, Alice, Bracchetti, Greta, Granieri, Stefano, Cotsoglou, Christian, Carlini, Massimo, Lisi, Giorgio, Spoletini, Domenico, Mastrangeli, Maria R, Campanelli, Michela, Manigrasso, Michele, Milone, Marco, De Palma, Giovanni D, Vertaldi, Sara, Chini, Alessia, Maione, Francesco, Marello, Alessandra, Selvaggi, Francesco, Sciaudone, Guido, Selvaggi, Lucio, Menegon Tasselli, Francesco, Fuschillo, Giacomo, Oddis, Lidia, Grande, Simona, Grande, Michele, Ascanelli, Simona, Chimisso, Laura, Aisoni, Filippo, Rossin, Eleonora, Pepe, Francesco, Marchetti, Francesco, Picardi, Biagio, Rossi, Stefano, Rossi Del Monte, Simone, Picarelli, Matteo, Muttillo, Irnerio A, Ratto, Carlo, Marra, Angelo A, Parello, Angelo, Litta, Francesco, Campennì, Paola, De Simone, Veronica, Pata, Francesco, Riboni, Cristiana, Rausa, Emanuele, Celentano, Valerio, Institut Català de la Salut, [Rottoli M, Gori A, Pellino G] Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, Italy. Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, Italy. [Pellino G] Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy. Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Flacco ME, Martellucci C] Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy. [Spinelli A] Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. Colorectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy, Vall d'Hebron Barcelona Hospital Campus, Rottoli, Matteo, Gori, Alice, Pellino, Gianluca, Flacco, Maria Elena, Martellucci, Cecilia, Spinelli, Antonino, Poggioli, Gilberto, Romano, Angela, Belvedere, Angela, Lanci Lanci, Antonio, Parlanti, Daniele, Vago, Gabriele, Pezzuto, Paola, Canavese, Anna, Dajti, Gerti, Cardelli, Stefano, Catalioto, Caterina, Russo, Iris S, Violante, Tommaso, Morezzi, Daniele, Maurino, Ludovica, Filippone, Eleonora, Cuicchi, Dajana, Bernante, Paolo, Jovine, Elio, Lombardi, Raffaele, Masetti, Michele, Cipressi, Chiara, Offi, Maria F, Larotonda, Cristina, Puglisi, Silvana B, Barbosa, Augusto, Vaiana, Roberto, Bianchi, Paolo M, Tonti, Carlo, Codignola, Claudio, Zorcolo, Luigi, Restivo, Angelo, Deidda, Simona, Marchetti, Marcello E, Ippolito, Luca, Spolverato, Gaya, Pucciarelli, Salvatore, Marchegiani, Francesco, Ghio, Giacomo, Zagolin, Gaya, Glavas, Dajana, Tomassi, Monica, Rosati, 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Luigi, Rizzi, Nichola, Bonfili, Deborah, de Manzini, Nicolò, Germani, Paola, Osenda, Edoardo, Cortinovis, Sara, Giunta, Carlotta, Fracon, Stefano, Abdallah, Hussein, Bogoni, Selene, Portolani, Nazario, Nascimbeni, Riccardo, Molfino, Sarah, Tiberio, Guido A M, Garosio, Ilenia, Lamperti, Giulia, Rigosa, Diego, Ercolani, Giorgio, Solaini, Leonardo, Cavaliere, Davide, Avanzolini, Andrea, D'Acapito, Fabrizio, Chiarella, Leonardo L, Di Pietrantonio, Daniela, Annunziata, Domenico, Piccolo, Roberta, Sorrentino, Mario, Pansini, Mauro, Cojutti, Alessandro, Graziano, Michele, Callegari, Francesco, Balzarotti, Laura, Dameno, Vitale R, Cattaneo, Antonio, Santolamazza, Giuliano, Altieri, Caterina, Magarini, Riccardo, Pietrabissa, Andrea, Dominioni, Tommaso, Pugliese, Luigi, Peri, Andrea, Botti, Marta, Salvetti, Francesco, Cassinotti, Elisa, Baldari, Ludovica, Boni, Luigi, Messina, Valentina, D'Abrosca, Vera, Cianci, Pasquale, Tumolo, Rocco, Gattulli, Domenico, Restini, Enrico, Minafra, Marina, Sederino, Maria G, Bottalico, Bernardino, Pilati, Pierluigi, Franzato, Bori, Mattara, Genny, De Simoni, Ottavia, Barina, Andrea, Tonello, Marco, Muratore, Andrea, Calabrò, Marcello, Federico Pipitone, Nicoletta S, Cuzzola, Bruno, Herranz van Nood, Elena, Passuello, Nicola, Frasson, Alvise, Mammano, Enzo, Faccio, Luca, Vittadello, Fabrizio, Bressan, Alice, Sarzo, Giacomo, Tamini, Nicolò, Oldani, Massimo, Cigagna, Luca, Carissimi, Francesca, De Carlo, Giulia, Baccalini, Edoardo, Nespoli, Luca, Giordano, Alessio, Cantafio, Stefano, Grifoni, Lucrezia, Matani, Davide, Livi, Serena, Delogu, Daniele, Scognamillo, Fabrizio, Marrosu, Antonio, Guerrini, Luca, Ugolini, Giampaolo, Ghignone, Federico, Frascaroli, Giacomo, Albertini, Nicola, Zattoni, Davide, Taffurelli, Giovanni, Montroni, Isacco, Colombo, Francesco, Danelli, Piergiorgio, Bondurri, Andrea, Maffioli, Anna, Bonomi, Alessandro, Pezzoli, Isabella, Cammarata, Francesco, Goletti, Orlando, Molteni, Mattia, Assisi, Alberto, Quartierini, Giorgio, Da Lio, Corrado, Verdi, Daunia, Mondi, Isabella, Peluso, Claudia, Macchi, Lorenzo, Tanzanu, Marta, Zanzi, Federico, Pellegrini, Sara, Andreuccetti, Jacopo, D'Alessio, Rossella, Pignata, Giusto, De Capua, Michele, Canfora, Ilaria, Ottaviani, Luca, Lepiane, Pasquale, Balla, Andrea, De Carlo, Antonio, Saraceno, Federica, Scaramuzzo, Rosa, Guida, Anna, Aguzzi, Daniele, Bellora, Paolo, Gentilli, Sergio, Monni, Manuela, Nikaj, Herald, Cillara, Nicola, Cannavera, Alessandro, Deserra, Antonello, Margiani, Carla, Cabula, Roberta, Dettori, Manuela, Gramignano, Giulia, Lezoche, Giovanni, Ortenzi, Monica, Orlandoni, Elena S, Curzi, Federica, Vitali, Francesca, Capomagi, Perla, Palmieri, Miriam, Giuffrida, Mario, Del Rio, Paolo, Bonati, Elena, Loderer, Tommaso, Cozzani, Federico, Rossini, Matteo, Agnesi, Stefano, Capolupo, Gabriella T, Caricato, Marco, Carannante, Filippo, Mascianà, Gianluca, Marrelli, Martina, Miacci, Valentina, Lauricella, Sara, Tonini, Valeria, Cervellera, Maurizio, Pisconti, Salvatore, Lozito, Concetta, Shahu, Juliana, Mongelli, Claudia, Morelli, Giulia, Sartarelli, Lodovico, Sica, Giuseppe S, Siragusa, Leandro, Bagaglini, Giulia, Sensi, Bruno, Guida, Andrea M, Franceschilli, Marzia, Vinci, Danilo, Taddei, Antonio, Risaliti, Matteo, Bartolini, Ilenia, Ringressi, Maria N, Tirloni, Luca, Laface, Letizia, Abate, Emmanuele, Casati, Massimiliano, Gobbi, Pietro, Opocher, Enrico, Mariani, Nicolò M, Pisani Ceretti, Andrea, Giovenzana, Marco, Giuliani, Beatrice, Sironi, Martina, Grossi, Ugo, Zanus, Giacomo, Aniello Santoro, Giulio, Brizzolari, Marco, De Leo, Eugenio, Novello, Simone, Aquilino, Krizia, Milardi, Francesco, Olmi, Stefano, Uccelli, Matteo, Bonaldi, Marta, Cesana, Giovanni C, Bindi, Marco, Galleano, Raffaele, Langone, Antonio, Botto, Massimiliano, Franceschi, Angelo, Gambino, Elena, Ronconi, Maurizio, Casiraghi, Silvia, Casole, Giovanni, Ciulla, Salvatore L, Terrosu, Giovanni, Calandra, Sergio, Scarpa, Edoardo, Cherchi, Vittorio, Calini, Giacomo, Martinuzzo, Lisa, Clocchiatti, Lucrezia, Muschitiello, Davide, Romanzi, Andrea, Vignati, Barbara, Vannelli, Alberto, Scolaro, Roberta, Milanesi, Maria, Rossi, Fabrizio, Canonico, Giuseppe, Anastasi, Alessandro, Nelli, Tommaso, Barlettai, Marco, Fratarcangeli, Riccardo, Di Martino, Carmela, Damigella, Andrea, Adinolfi, Elvira, Birindelli, Arianna, Taglietti, Lucio, Dester, Sara E, Fleres, Francesco, Cucinotta, Eugenio, Viscosi, Francesca, Biondo Santino, Antonio, Badessi, Giorgio, Catarsini, Nivia, Mazzeo, Carmelo, Rega, Daniela, Delrio, Paolo, Cervone, Carmela, Aversano, Alessia, De Franciscis, Silvia, Di Marzo, Massimiliano, Marra, Bruno, Pace, Ugo, Amato, Antonio, Batistotti, Paola, Mina, Elisa, Serventi, Alberto, Lapolla, Pierfrancesco, Mingoli, Andrea, Sapienza, Paolo, Brachini, Gioia, Cirillo, Bruno, Fiori, Enrico, Crocetti, Daniele, Clementi, Ilaria, Martines, Gennaro, Picciariello, Arcangelo, Tomasicchio, Giovanni, Dibra, Riger, Trigiante, Giuseppe, Rinaldi, Marcella, Lantone, Giuliano, Porcu, Alberto, Perra, Teresa, Scanu, Antonio M, Feo, Claudio F, Fancellu, Alessandro, Cossu, Maria L, Ginesu, Giorgio C, Patriti, Alberto, Coletta, Diego, Petrelli, Filippo, Greco, Paola A, Spadoni, Claudia, Cassiani, Giovanna, Bianchini, Federica, Arganini, Marco, Bianchini, Matteo, Perotti, Bruno, Palmeri, Matteo, Scabini, Stefano, Deiana, Selene, Carganico, Giacomo, Pertile, Davide, Soriero, Domenico, Fioravanti, Emanuela, Sperotto, Beatrice, Nardo, Bruno, Paglione, Daniele, Crocco, Veronica, Doni, Marco, Osso, Mariasara, Perri, Roberto, Sampietro, Gianluca M, Corbellini, Carlo, Lorusso, Leonardo, Manzo, Carlo A, Cigognini, Maria, Baldi, Caterina, Palomba, Giuseppe, Aprea, Giovanni, Capuano, Marianna, Basile, Raffaele, Tutino, Roberta, Massani, Marco, Marinelli, Laura, Canitano, Nicola, Pilia, Tiziana, Podda, Mauro, Pisanu, Adolfo, Murzi, Valentina, Incani, Silvia, Frongia, Federica, Esposito, Giuseppe, Luglio, Gaetano, Tropeano, Francesca P, Pagano, Gianluca, Spina, Eduardo, De Simone, Giuseppe, Cricrì, Michele, Catena, Fausto, Vallicelli, Carlo, Zanini, Nicola, Ronconi, Diana, Favi, Francesco, Mazzucchelli, Carlo, Convertini, Girolamo, Vincenti, Leonardo, Andriola, Valeria, Bizzoca, Cinzia, Feo, Carlo V, Fabbri, Nicolò, Fazzin, Marta, Pesce, Antonio, Gennari, Silvia, Torchiaro, Marco, Severi, Silvia, Frontali, Alice, Bracchetti, Greta, Granieri, Stefano, Cotsoglou, Christian, Carlini, Massimo, Lisi, Giorgio, Spoletini, Domenico, Mastrangeli, Maria R, Campanelli, Michela, Manigrasso, Michele, Milone, Marco, De Palma, Giovanni D, Vertaldi, Sara, Chini, Alessia, Maione, Francesco, Marello, Alessandra, Selvaggi, Francesco, Sciaudone, Guido, Selvaggi, Lucio, Menegon Tasselli, Francesco, Fuschillo, Giacomo, Oddis, Lidia, Grande, Simona, Grande, Michele, Ascanelli, Simona, Chimisso, Laura, Aisoni, Filippo, Rossin, Eleonora, Pepe, Francesco, Marchetti, Francesco, Picardi, Biagio, Rossi, Stefano, Rossi Del Monte, Simone, Picarelli, Matteo, Muttillo, Irnerio A, Ratto, Carlo, Marra, Angelo A, Parello, Angelo, Litta, Francesco, Campennì, Paola, De Simone, Veronica, Pata, Francesco, Riboni, Cristiana, Rausa, Emanuele, and Celentano, Valerio

Subjects
Adult, Male, Settore MED/18 - CHIRURGIA GENERALE, Otros calificadores::/diagnóstico [Otros calificadores], Hospitals, Community, colorectal cancer, Community, advanced stage, COVID-19 (Malaltia), Cohort Studies, Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [DISEASES], Retrospective Studie, Other subheadings::/diagnosis [Other subheadings], virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Humans, Pandemics, Aged, Retrospective Studies, Pandemic, SARS-CoV-2, COVID-19, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], General Medicine, neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias intestinales::neoplasias colorrectales [ENFERMEDADES], Hospitals, Recte - Càncer - Diagnòstic, Settore MED/18, Italy, Còlon - Càncer - Diagnòstic, Cohort Studie, Colorectal Neoplasms, Human
Abstract

ImportanceDelays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis.ObjectiveTo evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer.Design, Setting, and ParticipantsThis retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery.ExposuresAny type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections.Main Outcomes and MeasuresThe primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable.ResultsA total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95% CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95% CI, 1.15-1.53; P P = .03).Conclusions and RelevanceThis cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients.

Published
2022

35. Treatment of Advanced Coats' Disease With Combination Therapy of Laser Photocoagulation, Intravitreal Ranibizumab, and Sub-Tenon Methylprednisolone Acetate

Author

Sergio Petroni, Gino Catena, Giancarlo Iarossi, Matteo Federici, Gaetano Zinzanella, Rosa Parrilla, Paola Valente, and Luca Buzzonetti

Subjects
Vascular Endothelial Growth Factor A, Laser Coagulation, Lasers, Angiogenesis Inhibitors, General Medicine, Acetates, Methylprednisolone Acetate, Ophthalmology, Ranibizumab, Intravitreal Injections, Pediatrics, Perinatology and Child Health, Humans, Retinal Telangiectasis, Follow-Up Studies, Retrospective Studies
Abstract

Purpose: To investigate the efficacy of combination therapy with laser photocoagulation, intravitreal ranibizumab, and sub-Tenon methylprednisolone acetate in patients presenting with advanced Coats' disease. Methods: This was a retrospective analysis of 16 patients who underwent laser photocoagulation combined with intravitreal ranibizumab and sub-Tenon methylprednisolone acetate between 2008 and 2017. The primary outcome was anatomic success and the secondary outcomes were globe preservation and final visual acuity. Results: The average age at surgery was 5.12 ± 2.7 years (range: 3 to 10 years). The mean follow-up time was 45.43 ± 29.01 months (range: 12 to 108 months). Of the 16 patients (16 eyes) reviewed, 6 patients had stage 3A and 10 patients had stage 3B Coats' disease. The mean number of applications was 10 (range: 4 to 18). Globe preservation was achieved in all patients. Final visual acuity outcomes were satisfactory: 20/20 to 20/50 in 2 patients, 20/60 to 20/100 in 1 patient, and 20/200 or worse in 13 patients. Conclusions: Intravitreal ranibizumab used in combination with laser photocoagulation and sub-Tenon methylprednisolone acetate could be an effective treatment option for patients with advanced Coats' disease. The combined therapy achieved anatomical success, globe preservation, and reasonable visual acuity outcomes. [ J Pediatr Ophthalmol Strabismus . 2022;59(3):187–191.]

Published
2022
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36. Effects of Prone Position on Lung Recruitment and Ventilation-Perfusion Matching in Patients With COVID-19 Acute Respiratory Distress Syndrome: A Combined CT Scan/Electrical Impedance Tomography Study*

Author

Tommaso Fossali, Bertrand Pavlovsky, Davide Ottolina, Riccardo Colombo, Maria Cristina Basile, Antonio Castelli, Roberto Rech, Beatrice Borghi, Andrea Ianniello, Nicola Flor, Elena Spinelli, Emanuele Catena, and Tommaso Mauri

Subjects
Respiratory Distress Syndrome, atelectrauma, Settore MED/41 - Anestesiologia, COVID-19, Critical Care and Intensive Care Medicine, pulmonary perfusion, X-Ray Computed, Perfusion, Positive-Pressure Respiration, recruitment, Electric Impedance, Prone Position, Humans, Tomography, X-Ray Computed, electrical impedance tomography, prone position, Lung, Tomography
Abstract

Prone positioning allows to improve oxygenation and decrease mortality rate in COVID-19-associated acute respiratory distress syndrome (C-ARDS). However, the mechanisms leading to these effects are not fully understood. The aim of this study is to assess the physiologic effects of pronation by the means of CT scan and electrical impedance tomography (EIT).Experimental, physiologic study.Patients were enrolled from October 2020 to March 2021 in an Italian dedicated COVID-19 ICU.Twenty-one intubated patients with moderate or severe C-ARDS.First, patients were transported to the CT scan facility, and image acquisition was performed in prone, then supine position. Back to the ICU, gas exchange, respiratory mechanics, and ventilation and perfusion EIT-based analysis were provided toward the end of two 30 minutes steps (e.g., in supine, then prone position).Prone position induced recruitment in the dorsal part of the lungs (12.5% ± 8.0%; p0.001 from baseline) and derecruitment in the ventral regions (-6.9% ± 5.2%; p0.001). These changes led to a global increase in recruitment (6.0% ± 6.7%; p0.001). Respiratory system compliance did not change with prone position (45 ± 15 vs 45 ± 18 mL/cm H2O in supine and prone position, respectively; p = 0.957) suggesting a decrease in atelectrauma. This hypothesis was supported by the decrease of a time-impedance curve concavity index designed as a surrogate for atelectrauma (1.41 ± 0.16 vs 1.30 ± 0.16; p = 0.001). Dead space measured by EIT was reduced in the ventral regions of the lungs, and the dead-space/shunt ratio decreased significantly (5.1 [2.3-23.4] vs 4.3 [0.7-6.8]; p = 0.035), showing an improvement in ventilation-perfusion matching.Several changes are associated with prone position in C-ARDS: increased lung recruitment, decreased atelectrauma, and improved ventilation-perfusion matching. These physiologic effects may be associated with more protective ventilation.

Published
2022
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37. Predictors of Functional Outcome After Thrombectomy in Patients With Prestroke Disability in Clinical Practice

Author

Mònica Millán, Anna Ramos-Pachón, Laura Dorado, Alejandro Bustamante, María Hernández-Pérez, Luís Rodríguez-Esparragoza, Meritxell Gomis, Sebastia Remollo, Carlos Castaño, Mariano Werner, Denisse Wenger, Sara Rubio, Manuel Domínguez-Lizarbe, Mikel Terceño, Andrés Julián Paipa, Alejandro Rodríguez-Vázquez, Sandra Boned, Pol Camps-Renom, David Cánovas, Eva Giralt, Elena López-Cancio, Antoni Dávalos, Josep Ros-Roig, Natalia Pérez de la Ossa, Pere Cardona, Helena Quesada, Blanca Lara, Ana Nuñez Guillen, Roger Barranco, Lucia Aja, Paloma Mora, Oscar Chirife, Sonia Aixut, Maria Angeles de Miquel, Toni Martínez-Yelamos, Carlos Molina, Marta Rubiera, Jorge Pagola, David Rodríguez-Luna, Marian Muchada, Alejandro Tomasello, Marc Ribó, Carlos Piñana, Manuel Requena, Matías Deck, Alvaro Garcia-Tornel, Marta Olivé, Noelia Rodriguez, Jesus Jueg, Ángel Chamorro, Sergio Amaro, Xabier Urra, Laura Llull, Arturo Renú, Salvatore Rudiloso, Juan M. Macho, Jordi Blasco, Luis San Roman Manzanera, Antonio López, Federico Zarco, Ramón Torné, Ricard Valero, Víctor Obach, Víctor Vera, Martha Vargas, Carlos Laredo, Joan Martí-Fàbregas, Raquel Delgado-Mederos, Alejandro Martínez-Domeño, Luis Prats-Sánchez, Daniel Guisado-Alonso, Marina Guasch-Jiménez, Rebeca Marín Bueno, Jordi Branera-Pujol, José Pablo Martínez, Lavinia Dinia, Anna Pellisé, Xavier Ustrell, Alan Flores, Laia Seró, Joaquín Serena, Yolanda Silva, Saima Bashir, Alan Murillo, Jerzy Krupinski, Sonia Huertas, Jessica Molina, Georgina Figueras, Sarah Besora, Ana Rodríguez-Campello, Jaume Roquer, Ángel Ois, Elisa cuadrado-Godia, Jordi Jiménez-Conde, Elio Vivas, Polo Guimaraens, Maria del Carmen Garcia, Jordi Estela, Joan Perendreu, Nicolas Romero, Roberto Eduardo Correa, Oriol Barrachina, Moisès Broggi, Manuel Gómez-Choco, Sonia M. García, Maria Àngels Font Padrós, Juan José Mengual Chirife, Luis Mena Romo, Ernest Palomeras, Virginia Casado, Nicolau Guanyabens, Marta Álvarez, Esther Catena, José Luis Camacho Velasquez, Francisco Purroy, Gerard Mauri, Cristina Garcia, Jessica García Alhama, Irene Bragado Trigo, Jordi Monedero, Mònica Perecaula, Luis Guillermo Casanovas, Carla Colom, Dolores Cocho, Adela Rios González, Juanjo Baiges, Josep Zaragoza, Gisela Martin, Sonia Escalante, Patricia Esteve, Iago Payo, Lidia Binela, Josep Maria Aragonés, Núria Matos, Josep Maria Soler-Insa, Natalia Mas, Glòria Diaz, Margarida Vergés, Xavier Costa, Liseth Molina, M. Cruz Almendros, Marc Pérez, Ana Cabanelas, Olga Belchi, Maria Rybyeba, Miquel Barceló, Dolors Carrión, Carmen Repullo, Eduard Sanjurjo, Mercè Salvat-Plana, Josep Roig, Verònica Hidalgo, Olga Fagúndez, Victòria Sala, Anabel Alonso, Marisol Querol, Montse Gorchs, Xavier Jiménez, and Maria Àngels Mora

Subjects
Male, medicine.medical_specialty, Treatment outcome, Outcome (game theory), Humans, Medicine, Disabled Persons, In patient, Prospective Studies, Registries, Stroke, Aged, Ischemic Stroke, Thrombectomy, Aged, 80 and over, Advanced and Specialized Nursing, business.industry, Middle Aged, medicine.disease, Mechanical thrombectomy, Clinical Practice, Spain, Ischemic stroke, Physical therapy, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business
Abstract

Background and Purpose: Mechanical thrombectomy (MT) in ischemic stroke patients with poor prestroke conditions remains controversial. We aimed to analyze the frequency of previously disabled patients treated with MT in clinical practice, the safety and clinical response to MT of patients with preexisting disability, and the disabled patient characteristics associated with a better response to MT. Methods: We studied all consecutive patients with anterior circulation occlusion treated with MT from January 2017 to December 2019 included in the Codi Ictus Catalunya registry—a government-mandated, prospective, hospital-based data set. Prestroke disability was defined as modified Rankin Scale score 2 or 3. Functional outcome at 90 days was centrally assessed by a blinded evaluator of the Catalan Stroke Program. Favorable outcome (to return at least to prestroke modified Rankin Scale at 90 days) and safety and secondary outcomes were compared with patients without previous disability. Logistic regression analysis was used to assess the association between prestroke disability and outcomes and to identify a disabled patient profile with favorable outcome after MT. Results: Of 2487 patients included in the study, 409 (17.1%) had prestroke disability (313 modified Rankin Scale score 2 and 96 modified Rankin Scale score 3). After adjustment for covariates, prestroke disability was not associated with a lower chance of achieving favorable outcome at 90 days (24% versus 30%; odds ratio, 0.79 [0.57–1.08]), whereas it was independently associated with a higher risk of symptomatic intracranial hemorrhage (5% versus 3%; odds ratio, 2.04 [1.11–3.72]) and long-term mortality (31% versus 18%; odds ratio, 1.74 [1.27–2.39]) compared with patients without disability. Prestroke disabled patients without diabetes, Alberta Stroke Program Early CT Score >8 and National Institutes of Health Stroke Scale score Conclusions: Despite a higher mortality and risk of symptomatic intracranial hemorrhage, prestroke-disabled patients return as often as independent patients to their prestroke level of function, especially those nondiabetic patients with favorable early ischemic signs profile. These data support a potential benefit of MT in patients with previous mild or moderate disability after large anterior vessel occlusion stroke.

Published
2022
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38. Cancer awareness in older adults: Results from the Spanish Onco-barometer cross-sectional survey

Author

Dafina Petrova, Marina Pollán, Rocio Garcia-Retamero, Miguel Rodríguez-Barranco, Andrés Catena, Lucia Castillo Portellano, Maria-José Sánchez, Asociación Española Contra el Cáncer, Instituto de Salud Carlos III, Ministerio de Ciencia (España), Centro de Investigación Biomédica en Red - CIBERESP (Epidemiología y Salud Pública), and Agencia Estatal de Investigación (España)

Subjects
National survey, Male, Health Knowledge, Attitudes, Practice, Help‐seeking, Cancer awareness, Beliefs, Cáncer, Help-seeking, Anxiety, Patient Acceptance of Health Care, Cross-Sectional Studies, Older adults, Neoplasms, Humans, General Nursing, Barriers, Early Detection of Cancer, Cancer, Aged
Abstract

Background: About half of all cancers are diagnosed in adults older than 65, making them the age group at highest risk of developing this disease. Nurses from different specialties can support individuals and communities in the prevention and early detection of cancer and should be aware of the common knowledge gaps and perceived bar riers among older adults. Objectives: The goal of the current research was to investigate personal characteristics, perceived barriers, and be liefs related to cancer awareness in older adults, with a special focus on perceptions about the influence of cancer risk factors, knowledge of cancer symptoms, and anticipated help-seeking. Design: Descriptive cross-sectional study. Participants: Participants were 1213 older adults (≥65 years old) from the representative national Onco barometer survey conducted in 2020 in Spain. Methods: Questions on the perceived influence of cancer risk factors, knowledge of cancer symptoms, and the Span ish version of the Awareness and Beliefs about Cancer (ABC) questionnaire were administered in computer-assisted telephone interviews. Results: Knowledge of cancer risk factors and symptoms was strongly related to personal characteristics and was lim ited among males and older individuals. Respondents from lower socio-economic background recognized fewer can cer symptoms. Having personal or family history of cancer had opposite effects on cancer awareness: It was related to more accurate symptom knowledge but also to lower perceptions about the influence of risk factors and more delayed help-seeking. Anticipated help-seeking times were strongly influenced by perceived barriers to help-seeking and be liefs about cancer. Worry about wasting the doctor's time (48% increase, 95% CI [25%–75%]), about what the doctor might find (21% increase [3%–43%]) and not having enough time to go to the doctor (30% increase [5%–60%]) were related to more delayed help-seeking intentions. In contrast, beliefs that reflected higher perceived seriousness of a potential cancer diagnosis were related to shorter anticipated help-seeking times (19% decrease [5%–33%]). Conclusions: These results suggest that older adults could benefit from interventions informing them about how to re duce their cancer risk and addressing emotional barriers and beliefs associated with help-seeking delays. Nurses can contribute to educating this vulnerable group and are in a unique position to address some barriers to help-seeking. Study registration: Not registered., Cancer Observatory of the Spanish Association against Cancer (Asociacion Espanola contrael Cancer), Cancer Epidemiological Surveillance Subprogram (VICA) of the CIBER of Epidemiology and Public Health, Carlos III Health Institute, Madrid, Spain, Spanish State Research Agency (MCIN/AEI) JC2019-039691-I

Published
2023

39. Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Author

Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J. M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A. A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Healey A. J., Hecker M., Hernandez Garcia E. F., Huaman E. C., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kaafarani H. M. A., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T. J., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Luna A. T., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Marseglia G. R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R. B., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nguyen C., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Ruta F., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Simoes R. L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zakaria A. D., Zambrano D. A., Zese M., Cobianchi, L, Dal Mas, F, Massaro, M, Biffl, W, Catena, F, Coccolini, F, Dionigi, B, Dionigi, P, Di Saverio, S, Fugazzola, P, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Velmahos, G, Woltz, S, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Campostrini, S, Carvas, J, Casoni Pattacini, G, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Healey, A, Hecker, M, Hernandez Garcia, E, Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kaafarani, H, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Loftus, T, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Marseglia, G, Martellucci, J, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nguyen, C, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Ruta, F, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Spada, F, Stahel, P, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tan, E, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E.E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N.S., Abu-Zidan F.M., Adam Y.A.Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S.M., Almeida P.M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I.H., Atanasov B.T., Augustin G., Awad S.S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J.A., Bellanova G., Biancuzzi H., Bignell M.B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L.A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J.M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S.P.B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R.J., De Beaux A.C., De Simone B., Demetrashvili Z., Demetriades A.K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G.T., Elbaih A.H., Escalera-Antezana J.P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G.P., Fransvea P., Gachabayov M., Garcia Vazquez A.A., Ghannam W.M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C.A., Teixeira Gonsaga R.A., Gonullu E., Goosen J., Goranovic T., Griffiths E.A., Haidar M.G., Hamid H.K.S., Harddastle T.C., Healey A.J., Hecker M., Hernandez Garcia E.F., Huaman E.C., Hutan M., Ioannidis O., Isik A., Ismail A.M.H., Ismail N., Jang J.Y., Kaafarani H.M.A., Kalipershad S.N.R., Kaplan L.J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A.J., Kechagias A., Kenig J., Khan J.S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T.J., Lohsiriwat V., Lopes Moreira C.C., Lostoridis E., Luna A.T., Luppi D., Machain G.M., Maegele M., Maggiore D., Maier R.V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E.A., Marseglia G.R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R.B., Miceli L., Mingoli A., Mishra T.S., Mohamedahmed A.Y.Y., Mohan R., Morales-Garcia D., Mustafa S.M.S., Naimzada M.D., Negoi I., Nguyen C., Nidaw M.K., Nigri G., Ogundipe H.D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M.A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M.R., Roizblatt D., Roscio F.P.M., Rossi S., Ruta F., Sakakushev B.E., Salamea J.C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R.G., Seretis C., Serradilla-Martin M., Shelat V.G., Shlyapnikov S., Simoes R.L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A.M., Tallon-Aguilar L., Tan J.H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G.D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P.G., Verde J.M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L.W., Wilson M.S.J., Wong T.H., Xenaki S., Yu B., Yule S., Zakaria A.D., Zambrano D.A., Zese M., HUS Abdominal Center, II kirurgian klinikka, and Helsinki University Hospital Area

Subjects
Ethics, Patient Care Team, Diversity, Acute care surgery, 3126 Surgery, anesthesiology, intensive care, radiology, Trauma surgery, Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Settore SECS-P/07 - Economia Aziendale, Surveys and Questionnaires, Emergency Medicine, Humans, Surveys and Questionnaire, Surgery, Team dynamics, Ethic, Team dynamic, Human
Abstract

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance.

Published
2022

40. It is time to define an organizational model for the prevention and management of infections along the surgical pathway : a worldwide cross-sectional survey

Author

Massimo Sartelli, Francesco M. Labricciosa, Federico Coccolini, Raul Coimbra, Fikri M. Abu-Zidan, Luca Ansaloni, Majdi N. Al-Hasan, Shamshul Ansari, Philip S. Barie, Miguel Angel Caínzos, Marco Ceresoli, Massimo Chiarugi, Jeffrey A. Claridge, Enrico Cicuttin, Evan Patchen Dellinger, Donald E. Fry, Xavier Guirao, Timothy Craig Hardcastle, Andreas Hecker, Ari K. Leppäniemi, Andrey Litvin, Sanjay Marwah, Emilio Maseda, John E. Mazuski, Ziad Ahmed Memish, Andrew W. Kirkpatrick, Leonardo Pagani, Mauro Podda, Huseyin Kemal Rasa, Boris E. Sakakushev, Robert G. Sawyer, Fabio Tumietto, Yonghong Xiao, Wedad Faraj Aboubreeg, Harissou Adamou, Lali Akhmeteli, Emrah Akin, Maria Grazia Alberio, Felipe Alconchel, Ibrahim Amadou Magagi, Ana Belén Araúz, Giulio Argenio, Boyko C. Atanasov, Semra Demirli Atici, Selmy Sabry Awad, Efstratia Baili, Lovenish Bains, Miklosh Bala, Oussama Baraket, Suman Baral, Vladislav A. Belskii, Moussa Benboubker, Offir Ben-Ishay, Pierpaolo Bordoni, Abdalia Boumédiène, Giuseppe Brisinda, Laura Cavazzuti, Sujith J. Chandy, Maria Michela Chiarello, Nicola Cillara, Guglielmo Clarizia, Maria-Elena Cocuz, Iuliu Gabriel Cocuz, Luigi Conti, Raffaella Coppola, Yunfeng Cui, Jacek Czepiel, Fabrizio D’Acapito, Dimitrios Damaskos, Koray Das, Belinda De Simone, Samir Delibegovic, Zaza Demetrashvili, Dzemail S. Detanac, Sameer Dhingra, Stefano Di Bella, Evgeni N. Dimitrov, Agron Dogjani, Mario D’Oria, Irina Magdalena Dumitru, Mutasim M. Elmangory, Octavian Enciu, Massimo Fantoni, Daniela Filipescu, Francesco Fleres, Domitilla Foghetti, Pietro Fransvea, Mahir Gachabayov, Rita Galeiras, Gianni Gattuso, Wagih M. Ghannam, Valeria Ghisetti, Giorgio Giraudo, Kebebe Bekele Gonfa, Emre Gonullu, Yousif Tag Elsir Y. Hamad, Matthias Hecker, Arda Isik, Nizar Ismail, Azzain Ismail, Sumita Agarwal Jain, Souha S. Kanj, Garima Kapoor, Ilias Karaiskos, Alfie J. Kavalakat, Jakub Kenig, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Jae Il Kim, Yoshiro Kobe, Kenneth Yuh Yen Kok, Bojan M. Kovacevic, Igor Andreevich Kryvoruchko, Akira Kuriyama, Aitor Landaluce-Olavarria, Konstantinos Lasithiotakis, Varut Lohsiriwat, Eftychios Lostoridis, Davide Luppi, Gustavo Miguel Machain Vega, Marc Maegele, Athanasios Marinis, Gennaro Martines, Aleix Martínez-Pérez, Damien Massalou, Cristian Mesina, Gökhan Metan, María Guadalupe Miranda-Novales, Shyam Kumar Mishra, Mohaned Ibrahim Hussein Mohamed, Ali Yasen Y. Mohamedahmed, Ismael Mora-Guzmán, Francesk Mulita, Ana-Maria Musina, Pradeep H. Navsaria, Ionut Negoi, Gabriela Elisa Nita, Donal B. O’Connor, Carlos Alberto Ordoñez, Desiré Pantalone, Arpád Panyko, Aristeidis Papadopoulos, Nikolaos Pararas, Francesco Pata, Tapan Patel, Gianluca Pellino, Teresa Perra, Gennaro Perrone, Antonio Pesce, Tadeja Pintar, Georgi Ivanov Popivanov, Alberto Porcu, Martha Alexa Quiodettis, Razrim Rahim, Ashrarur Rahman Mitul, Martin Reichert, Miran Rems, Glendee Yolande Reynolds Campbell, Nuno Rocha-Pereira, Gabriel Rodrigues, Gustavo Eduardo Roncancio Villamil, Stefano Rossi, Ibrahima Sall, Hossein Samadi Kafil, Diego Sasia, Jeremiah Seni, Charalampos Seretis, Mario Serradilla-Martín, Vishal G. Shelat, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Boun Kim Tan, Antonio Tarasconi, Dario Tartaglia, Elena Adelina Toma, Gia Tomadze, Adriana Toro, Marcos Roberto Tovani-Palone, Harry van Goor, Alin Vasilescu, Andras Vereczkei, Massimiliano Veroux, Sergio Alberto Weckmann, Lukas Werner Widmer, AliIbrahim Yahya, Sanoop K. Zachariah, Andee Dzulkarnaen Zakaria, Nadezhda Zubareva, Wietse P. Zuidema, Isidoro Di Carlo, Francesco Cortese, Gian Luca Baiocchi, Ronald V. Maier, Fausto Catena, Surgery, Other Research, AMS - Musculoskeletal Health, APH - Quality of Care, HUS Abdominal Center, II kirurgian klinikka, Sartelli M., Labricciosa F.M., Coccolini F., Coimbra R., Abu-Zidan F.M., Ansaloni L., Al-Hasan M.N., Ansari S., Barie P.S., Cainzos M.A., Ceresoli M., Chiarugi M., Claridge J.A., Cicuttin E., Dellinger E.P., Fry D.E., Guirao X., Hardcastle T.C., Hecker A., Leppaniemi A.K., Litvin A., Marwah S., Maseda E., Mazuski J.E., Memish Z.A., Kirkpatrick A.W., Pagani L., Podda M., Rasa H.K., Sakakushev B.E., Sawyer R.G., Tumietto F., Xiao Y., Aboubreeg W.F., Adamou H., Akhmeteli L., Akin E., Alberio M.G., Alconchel F., Magagi I.A., Arauz A.B., Argenio G., Atanasov B.C., Atici S.D., Awad S.S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V.A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S.J., Chiarello M.M., Cillara N., Clarizia G., Cocuz M.-E., Cocuz I.G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D.S., Dhingra S., Di Bella S., Dimitrov E.N., Dogjani A., D'Oria M., Dumitru I.M., Elmangory M.M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W.M., Ghisetti V., Giraudo G., Gonfa K.B., Gonullu E., Hamad Y.T.E.Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S.A., Kanj S.S., Kapoor G., Karaiskos I., Kavalakat A.J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J.I., Kobe Y., Kok K.Y.Y., Kovacevic B.M., Kryvoruchko I.A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G.M.M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M.G., Mishra S.K., Mohamed M.I.H., Mohamedahmed A.Y.Y., Mora-Guzman I., Mulita F., Musina A.-M., Navsaria P.H., Negoi I., Nita G.E., O'Connor D.B., Ordonez C.A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G.I., Porcu A., Quiodettis M.A., Rahim R., Mitul A.R., Reichert M., Rems M., Campbell G.Y.R., Rocha-Pereira N., Rodrigues G., Villamil G.E.R., Rossi S., Sall I., Kafil H.S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V.G., Siribumrungwong B., Slavchev M., Solaini L., Tan B.K., Tarasconi A., Tartaglia D., Toma E.A., Tomadze G., Toro A., Tovani-Palone M.R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S.A., Widmer L.W., Yahya A.I., Zachariah S.K., Zakaria A.D., Zubareva N., Zuidema W.P., Di Carlo I., Cortese F., Baiocchi G.L., Maier R.V., Catena F., Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli, Massimo, Labricciosa, Francesco M, Coccolini, Federico, Coimbra, Raul, Abu-Zidan, Fikri M, Ansaloni, Luca, Al-Hasan, Majdi N, Ansari, Shamshul, Barie, Philip S, Caínzos, Miguel Angel, Ceresoli, Marco, Chiarugi, Massimo, Claridge, Jeffrey A, Cicuttin, Enrico, Dellinger, Evan Patchen, Fry, Donald E, Guirao, Xavier, Hardcastle, Timothy Craig, Hecker, Andrea, Leppäniemi, Ari K, Litvin, Andrey, Marwah, Sanjay, Maseda, Emilio, Mazuski, John E, Memish, Ziad Ahmed, Kirkpatrick, Andrew W, Pagani, Leonardo, Podda, Mauro, Rasa, Huseyin Kemal, Sakakushev, Boris E, Sawyer, Robert G, Tumietto, Fabio, Xiao, Yonghong, Aboubreeg, Wedad Faraj, Adamou, Harissou, Akhmeteli, Lali, Akin, Emrah, Alberio, Maria Grazia, Alconchel, Felipe, Magagi, Ibrahim Amadou, Araúz, Ana Belén, Argenio, Giulio, Atanasov, Boyko C, Atici, Semra Demirli, Awad, Selmy Sabry, Baili, Efstratia, Bains, Lovenish, Bala, Miklosh, Baraket, Oussama, Baral, Suman, Belskii, Vladislav A, Benboubker, Moussa, Ben-Ishay, Offir, Bordoni, Pierpaolo, Boumédiène, Abdalia, Brisinda, Giuseppe, Cavazzuti, Laura, Chandy, Sujith J, Chiarello, Maria Michela, Cillara, Nicola, Clarizia, Guglielmo, Cocuz, Maria-Elena, Cocuz, Iuliu Gabriel, Conti, Luigi, Coppola, Raffaella, Cui, Yunfeng, Czepiel, Jacek, D'Acapito, Fabrizio, Damaskos, Dimitrio, Das, Koray, De Simone, Belinda, Delibegovic, Samir, Demetrashvili, Zaza, Detanac, Dzemail S, Dhingra, Sameer, Di Bella, Stefano, Dimitrov, Evgeni N, Dogjani, Agron, D'Oria, Mario, Dumitru, Irina Magdalena, Elmangory, Mutasim M, Enciu, Octavian, Fantoni, Massimo, Filipescu, Daniela, Fleres, Francesco, Foghetti, Domitilla, Fransvea, Pietro, Gachabayov, Mahir, Galeiras, Rita, Gattuso, Gianni, Ghannam, Wagih M, Ghisetti, Valeria, Giraudo, Giorgio, Gonfa, Kebebe Bekele, Gonullu, Emre, Hamad, Yousif Tag Elsir Y, Hecker, Matthia, Isik, Arda, Ismail, Nizar, Ismail, Azzain, Jain, Sumita Agarwal, Kanj, Souha S, Kapoor, Garima, Karaiskos, Ilia, Kavalakat, Alfie J, Kenig, Jakub, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Jae Il, Kobe, Yoshiro, Kok, Kenneth Yuh Yen, Kovacevic, Bojan M, Kryvoruchko, Igor Andreevich, Kuriyama, Akira, Landaluce-Olavarria, Aitor, Lasithiotakis, Konstantino, Lohsiriwat, Varut, Lostoridis, Eftychio, Luppi, Davide, Vega, Gustavo Miguel Machain, Maegele, Marc, Marinis, Athanasio, Martines, Gennaro, Martínez-Pérez, Aleix, Massalou, Damien, Mesina, Cristian, Metan, Gökhan, Miranda-Novales, María Guadalupe, Mishra, Shyam Kumar, Mohamed, Mohaned Ibrahim Hussein, Mohamedahmed, Ali Yasen Y, Mora-Guzmán, Ismael, Mulita, Francesk, Musina, Ana-Maria, Navsaria, Pradeep H, Negoi, Ionut, Nita, Gabriela Elisa, O'Connor, Donal B, Ordoñez, Carlos Alberto, Pantalone, Desiré, Panyko, Arpád, Papadopoulos, Aristeidi, Pararas, Nikolao, Pata, Francesco, Patel, Tapan, Pellino, Gianluca, Perra, Teresa, Perrone, Gennaro, Pesce, Antonio, Pintar, Tadeja, Popivanov, Georgi Ivanov, Porcu, Alberto, Quiodettis, Martha Alexa, Rahim, Razrim, Mitul, Ashrarur Rahman, Reichert, Martin, Rems, Miran, Campbell, Glendee Yolande Reynold, Rocha-Pereira, Nuno, Rodrigues, Gabriel, Villamil, Gustavo Eduardo Roncancio, Rossi, Stefano, Sall, Ibrahima, Kafil, Hossein Samadi, Sasia, Diego, Seni, Jeremiah, Seretis, Charalampo, Serradilla-Martín, Mario, Shelat, Vishal G, Siribumrungwong, Boonying, Slavchev, Mihail, Solaini, Leonardo, Tan, Boun Kim, Tarasconi, Antonio, Tartaglia, Dario, Toma, Elena Adelina, Tomadze, Gia, Toro, Adriana, Tovani-Palone, Marcos Roberto, van Goor, Harry, Vasilescu, Alin, Vereczkei, Andra, Veroux, Massimiliano, Weckmann, Sergio Alberto, Widmer, Lukas Werner, Yahya, Aliibrahim, Zachariah, Sanoop K, Zakaria, Andee Dzulkarnaen, Zubareva, Nadezhda, Zuidema, Wietse P, Di Carlo, Isidoro, Cortese, Francesco, Baiocchi, Gian Luca, Maier, Ronald V, Catena, Fausto, Department of Medicine, and Faculty of Health Sciences

Subjects
Anti-Infective Agent, Infection prevention and control, Antibiotic resistance, Settore MED/18 - CHIRURGIA GENERALE, 610 Medicine & health, Antimicrobial stewardship, Cross-sectional survey, Antimicrobial stewardship, Antibiotic prescribing, Antibiotic resistance, Infection prevention and control, Organizational, Antibiotic prescribing, Cross-sectional survey, Anti-Infective Agents, Models, Anti-Bacterial Agent, Humans, Pandemics, Cross-Sectional Studie, ANTIMICROBIAL RESISTANCE, Pandemic, COVID-19, 3126 Surgery, anesthesiology, intensive care, radiology, Anti-Bacterial Agents, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Cross-Sectional Studies, Models, Organizational, HEALTH-CARE, Emergency Medicine, Surgery, Human
Abstract

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.

Published
2022
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41. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Author

Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Goran Augustin, Miklosh Bala, Oussama Baraket, Walter L. Biffl, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola de’Angelis, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Stijn W. de Jonge, Stefano Di Bella, Salomone Di Saverio, Therese M. Duane, Paola Fugazzola, Joseph M. Galante, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Kenji Inaba, Arda Isik, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Ronald V. Maier, Athanasios Marinis, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Vishal G. Shelat, Michael Sugrue, Antonio Tarasconi, Matti Tolonen, Bruno Viaggi, Andrea Celotti, Claudio Casella, Leonardo Pagani, Sameer Dhingra, Gian Luca Baiocchi, Fausto Catena, Sartelli, M, Coccolini, F, Kluger, Y, Agastra, E, Abu-Zidan, F, Abbas, A, Ansaloni, L, Adesunkanmi, A, Augustin, G, Bala, M, Baraket, O, Biffl, W, Ceresoli, M, Cerutti, E, Chiara, O, Cicuttin, E, Chiarugi, M, Coimbra, R, Corsi, D, Cortese, F, Cui, Y, Damaskos, D, De'Angelis, N, Delibegovic, S, Demetrashvili, Z, De Simone, B, de Jonge, S, Di Bella, S, Di Saverio, S, Duane, T, Fugazzola, P, Galante, J, Ghnnam, W, Gkiokas, G, Gomes, C, Griffiths, E, Hardcastle, T, Hecker, A, Herzog, T, Karamarkovic, A, Khokha, V, Kim, P, Kim, J, Kirkpatrick, A, Kong, V, Koshy, R, Inaba, K, Isik, A, Ivatury, R, Labricciosa, F, Lee, Y, Leppaniemi, A, Litvin, A, Luppi, D, Maier, R, Marinis, A, Marwah, S, Mesina, C, Moore, E, Moore, F, Negoi, I, Olaoye, I, Ordonez, C, Ouadii, M, Peitzman, A, Perrone, G, Pintar, T, Pipitone, G, Podda, M, Rasa, K, Ribeiro, J, Rodrigues, G, Rubio-Perez, I, Sall, I, Sato, N, Sawyer, R, Shelat, V, Sugrue, M, Tarasconi, A, Tolonen, M, Viaggi, B, Celotti, A, Casella, C, Pagani, L, Dhingra, S, Baiocchi, G, Catena, F, Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Agastra, Ervi, Abu-Zidan, Fikri M, Abbas, Ashraf El Sayed, Ansaloni, Luca, Adesunkanmi, Abdulrashid Kayode, Augustin, Goran, Bala, Miklosh, Baraket, Oussama, Biffl, Walter L, Ceresoli, Marco, Cerutti, Elisabetta, Chiara, Osvaldo, Cicuttin, Enrico, Chiarugi, Massimo, Coimbra, Raul, Corsi, Daniela, Cortese, Francesco, Cui, Yunfeng, Damaskos, Dimitri, De'Angelis, Nicola, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, de Jonge, Stijn W, Di Bella, Stefano, Di Saverio, Salomone, Duane, Therese M, Fugazzola, Paola, Galante, Joseph M, Ghnnam, Wagih, Gkiokas, George, Gomes, Carlos Augusto, Griffiths, Ewen A, Hardcastle, Timothy C, Hecker, Andrea, Herzog, Torsten, Karamarkovic, Aleksandar, Khokha, Vladimir, Kim, Peter K, Kim, Jae Il, Kirkpatrick, Andrew W, Kong, Victor, Koshy, Renol M, Inaba, Kenji, Isik, Arda, Ivatury, Rao, Labricciosa, Francesco M, Lee, Yeong Yeh, Leppäniemi, Ari, Litvin, Andrey, Luppi, Davide, Maier, Ronald V, Marinis, Athanasio, Marwah, Sanjay, Mesina, Cristian, Moore, Ernest E, Moore, Frederick A, Negoi, Ionut, Olaoye, Iyiade, Ordoñez, Carlos A, Ouadii, Mouaqit, Peitzman, Andrew B, Perrone, Gennaro, Pintar, Tadeja, Pipitone, Giuseppe, Podda, Mauro, Raşa, Kemal, Ribeiro, Julival, Rodrigues, Gabriel, Rubio-Perez, Ine, Sall, Ibrahima, Sato, Norio, Sawyer, Robert G, Shelat, Vishal G, Sugrue, Michael, Tarasconi, Antonio, Tolonen, Matti, Viaggi, Bruno, Celotti, Andrea, Casella, Claudio, Pagani, Leonardo, Dhingra, Sameer, Baiocchi, Gian Luca, Catena, Fausto, HUS Abdominal Center, II kirurgian klinikka, and University of Helsinki

Subjects
MESH, FOURNIERS GANGRENE, RD1-811, Soft Tissue Infections / surgery, Necrotizing infections, Necrotizing soft-tissue infections, Skin and soft-tissue infections, Critical Pathways, Humans, United States, Soft Tissue Infections, Review, DIAGNOSIS, NECROTIZING FASCIITIS, Skin and soft-tissue infection, MANAGEMENT, INTRAVENOUS IMMUNOGLOBULIN, RISK, HERNIA REPAIR, RC86-88.9, RESISTANT STAPHYLOCOCCUS-AUREUS, Medical emergencies. Critical care. Intensive care. First aid, Necrotizing infection, 3126 Surgery, anesthesiology, intensive care, radiology, ENDOSONOGRAPHY, Necrotizing soft-tissue infection, Emergency Medicine, Surgery
Abstract

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections.Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs.An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.

Published
2022

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

Author

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

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

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

Published
2022

43. Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Author

Spiers H. V. M., Kouli O., Ahmed W. U., Varley R., Ahari D., Argus L., McLean K. A., Kamarajah S. K., Coe P., Griffiths E. A., Chan A. K. C., Macutkiewicz C., Jamdar S., Wilson M., Fullwood C., Toogood G., McLean K., Ahmed W., Gilchrist A., Goldsworthy M., Rashid M., Pockney P., Varela J., Brindl N., Ramirez J., Marafante C., Iwao Y., Ghzawi A., Elhadi M., Gacaferi H., Varghese C., Adeyeye A., Alser O., Teh C., Prieto M., Hasan A., Al-Naggar H., Salgado R., Veracierto F., Lancelotti T., Solinas D., Oddi R., Garcia F. W., Mazza Diez E., Andrade Ramirez M. R., Bracco R., Fernandez D., Maraschio M. A., Obeide L., Giordano E., Alcaraz A., Marani M. A., Aguirre N., Luna F., Francesconi M., Chiham F., Ramos Cossio R., Alvarez F. A., Pantoja Pachajoa D. A., Mandojana F., Merlo I. G., Gonzalez M. H., Cervelo G., Puma R., Vardaro G. F., Davis A., Jurat D., Guenoff C., Raubenheimer K., Goddard K., Brown K., Wegrecki K. J., Cheung H. Y. C., Yang M., Cheung H., Siddiqui J., Ahn J. H., Huynh R., Lam Y. H., Afzal M., Ong B. S., Chua M. Y. M., Ly K., Thomson J. E., Watson D., Dawson A. C., Drane A., Van Ruyven S., Lun E. W. Y., Ferguson M., Jeong J. Y., De Silva C., Wills V., Gundara J., McCourt E., Bong C., Tabone R., Wong W. J., Gray A., Koh D., Pollock M., Singhal S., Smith R., Dudi-Venkata N. N., Kanhere H., Stranz C., Seow W., Mansour L. T., Wormald J., Loveday B. P. T., Thomson B., O'Donnell T., Milenkovski N., Herath M., Trochsler M., Farfus A., Maddern G., Bunjo Z., Kuan L. L., Atanasov G., Dawson A., Lun E., Samadov E., Namazov I., Asgarov M., Ibrahimli A., Srinivasan M., Saeed M. F., Aljawder H., Juma I., Coimbra F. J., Marques N., Casteleins W. A., Petruzziello A., Jabur G., Rodriguez J. F. P., Buso P. L., Mackenzie S., Hsiao M., Sljivic I., Tecson A., Karanicolas P. J., Roke R., Moon J., Butler E. V., Riquelme F., Yanez M., Catan F., Uribe M., Carriel F., Oppliger F., Paredes A., Daroch D., Aguayo J. C., Perez Rivera C. J., Acosta Buitrago L. M., Kadamani Abiyomaa A., Mosquera Paz M. S., Cabrera P., Corso J., Ozcay N., Ozant A., Arslan K., Besim H., Almezghwi H., Azzam A. Y., Bessa S., El-Sayes I., Badawy A., Wael M., El-Gendi A., Azab M. A., Fayed M., El Kassas M., Gamal M., Tawheed A., Al Shafie A., Emile S., Elfallal A., Elfeki H., Shalaby M., Sakr A., Elbahnasawy M., Shama M., Abdel-Elsalam W., Abd-Elsalam S., Escobar Dominguez J. E., Medrano F., Gaitan S., Escalon Gonzalez O. M., Alfaro Varela J. C., Cea M., Interiano M., Cabrera B., Lakkis Z., Georges P., Antonot C., Magnin J., Kamphues C., Lauscher J. C., Schineis C., Loch F. N., Lee L. D., Beyer K., Bouchagier K., Galanis I., Bartziotas D., Lostoridis E., Tourountzi P., Nagorni E. A., Charalabopoulos A., Baili E., Kyros E., Vagios I., Skotsimara A., Liakakos T., Alexandrou A., Papalampros A., Papadopolous V., Tooulias A., Kentarchos I., Christou C., Tsoulfas G., Tale-Rosales L. F., Lopez Muralles I., Melendez H., Bran G., Monroy Mahecha F. A., Contreras J. R., Porras D. E., Paiz E., Soto E. R., Ixcayau Hernandez J. R., Gupta A., Rajput D., Kumar N., Mani R., Kant R., Sonkar A. A., Anand A., Agrawal M. K., Gaurav K., Tripathi M., Sikora S., Bharathy K., Kumar Rangapa M., Khuller D. S., Bhojwwani R., Ayyar S., Jain N., Mehraj A., Hussain F., Nazir I., Shah M., Chowdri N. A., Hilmi A., Argenio G., Atelli P., Palladino E., Armellino M. F., Tamini N., Nespoli L. C., Degrate L., Angrisani M., Carissimi F., Bordoni P., Fleres F., Clarizia G., Spolini A., Franzini M., Cucinotta E., Badessi G., Mazzeo C., Viscosi F., Pintabona G., Campagnaro T., Poletto E., Turri G., Ruzzenente A., Conci S., Guglielmi A., Feo C., Fabbri N., Fazzin M., Giaccari S., Feo C. V., Massani M., Pelizzo P., Colella M., Tutino R., Cappellacci F., Medas F., Canu G. L., Erdas E., Calo P. G., Porcu A., Perra T., Scanu A. M., Feo C. 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A., Cervellera M., Lapolla P., Sapienza P., Brachini G., Cirillo B., Zambon M., Mingoli A., Pascariello A., Boccia L., Benedetti S., Mantovani G., De Angelis M., Ferrara F., Testa V., Borghi F., Maione F., Pruiti Ciarello V., Giraudo G., Agresta F., Cestaro G., Prando D., Cavallo F., Zese M., Cillara N., Sechi R., Cardia R., Cannavera A., Putzu G., Frongia F., Pisanu A., Delogu D., Esposito G., Podda M., Iossa A., De Angelis F., Boru C., Silecchia G., Palini G.M., Garulli G., Veneroni S., Tammaro P., Maida P., Leake P.A., Wanliss M.G., Sato K., Chiyonobu N., Imamura H., Yamazaki S., Watanabe M., Qasem A., Ayasra F., Al Dahabrh S., Khaled A., Alsaafin S., Al-Thunaibat A., Olaywah D., Alqudah S., Alqawasmi S., Khamees A., Guboug A., Es Salim M., Althwabteh T., Bani Khaled H., El-Hammuri N., Aljesrawi A., Alamaadany F., Eljareh M., Al Gasi A.E.J., Alsaeiti S., Alkhafeefi A.S., Suliaman T., Alanasri A.H.A., Haroun A.B.A., Haron A., Kilani A.I., Ahmed M., Alawami M., Alawami A., Albashri M., Abusannuga M., Malek A., Jwaili N., Aldenfria A., Elzwawi F., Almugaddami A., Egdeer A.S.A., Masoud M., Alazzabi B., Alezabi B., Shuwayyah A., Alkamkhe A.A.S., Aboulqasim I., Atiyah H., Alfagi R.A.A., Abdulmula A., Bouhuwaish A., Samer A., Salim R., Aboazamazem H., Almiqlash B., Biala M., Alganimi W., Ghamgh R., Ben Omar N., Alsoufi A., Aldreawi M., Saleim N., Sowan F., Saleem H., Ahmed A., Samalavicius N.E., Aliosin O., Dailidenas S., Dulskas A., Buckus B., Kuliesius Z., Bradunaite R., Dominguez-Rosado I., Buerba G.A., Posadas-Trujillo O.E., Alfaro-Goldaracena A., Cortes R., Mercado M.A., Beristain-Hernandez J.L., Mora-Munoz V.S., Mena-Bedolla J.M., Palacios Ramirez A.R., Astorga Medina M.M., Van Aert G., Ombashi S., Spillenaar Bilgen R., Vos D., Besselink M., Alberts V., Busch O., Bemelman W., Boermeester M., Daams F., Gordinou De Gouberville M., Van Duijvendijk P., De Graaff M., Baaij J., Gans S., Bos K., Goudsmit B., Den Dekker B., Braat A., Kuijpers A., Breukers S., Borel 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S., Radenkovic, D., Aleksic, L., Markovic, V., Pejovic, I., Antic, A., Kalkan, M., Vujanovic Gadjanski, O., Dusan, S., Marčetić, B., Thiruchelvam, N., Chiow, Akh, Lee, L S, Mun, Dyc, Tan, E K, Koh, Y X, Loh, W L, Wang, Z., Chan, C Y, Ibrahim, M., Hamid, Hks, Idres, R., Idris, M., Mohammed, O., Ayran, S., Sinan, A H, Ozben, V., Aytac, E., Aliyeva, Z., Mutlu, A U, Bilgin, I A, Karahasanoglu, T., Hamzaoglu, I., Bozkirli, B., Uprak, T K, Kotan, T., Coskun, M., Kara, Y., Somuncu, E., Kocatas, A., Bozkurt, M A, Demirli Atici, S., Kaya, T., Sert, I., Emiroglu, M., Jaffar, M., Younis, M U, Aziz, T., Ikram, F., Sandal, M., Al Madhloum Al Suwaidi, F., Alshaikh, M O, Saber, A., Khammas, A., Nessa, A., Jardine, R., Nicol, L., Clark, C., Mcgee, A., Alkari, B., Feretis, M., Antakia, R., Georgiades, F., Moneim, J., O'Neill, R., Balakrishnan, A., Lunevicius, R., Sud, A., Moutsos, I., Gomez, D., Shahid, S., Majeed, T., Ibrahim, Wkg, Kadum, K., Melia, R., Magee, C., Chicken, D W, Kumar, S., Alshibshoubi, M., van Laarhoven, S., Dewi, F., Williams, J., Byrne, B., Wilkerson, P., Tang, C B, Farhangmehr, N., Jonas, A., Charavanamuttu, V., Almeida, K., Efthimiou, E., Boardley, J., White, A., Butt, M A, Menzies, D., Gundkalli, Z., Hassanzadeh-Baboli, D., Jones, O., Mistry, P., Saha, S., Gerrard, A., Evans, J., Rajeev, S., Ali, W., Ross, E., Gilliam, A., Hitchins, C., Emslie, K., Spellar, K., Sked, H., Briggs, C., Brown, L., A Hemadasa, N., Apollos, J R, Belgaumkar, A., Tawfik, A., Brewin, L., Oyewole, B., Wadhawan, H., Massie, E., Rutherford, D., Mcgivern, K., Mcelroy, L., De'Ath, H D, Tobbal, M., Nagendram, S., Patel, P., Handa, S., Houghton, G., Sundaralingam, S S, Parker, J., Morgan, R., Gala, T., Ibrahim, S., Mithany, R., Abdelkarim, M., Holroyd, D., Thomas, R., Mclennan, E., Boardley, R., Jamieson, N B, Ebied, H., Gossage, J., Davies, A., Wheatstone, S., Jawad, Z., Jiao, L., Rajagopal, P., Sodergren, M., Lami, M., Wiberg, A., Bond-Smith, G., Gemmill, E., Lenzi, E., Sapre, D., Herrod, P., Boyd-Carson, H., Garcea, G., Issa, E., Jackson, A., Fashina, T., Pan, H., Farquharson, B., Shafiq, H., Emanuel, O., Mahdi, S., Jeyarajah, S., Finch, L., Whiting, G., Pigott, L., Martin, J., Siriwardena, A., Beatson, K., Abawi, L., Lam, W., Rea, W., Andrews, B., Al-Sarireh, B., Soliman, F., Burridge, J., Jenvey, C., Hammoda, M., Hollyman, M., Merker, L., Richards, J., Sukumaran, V., Rogers, S., Payne, C., Bibi, S., Raza, K., Ul Ain, N., Dronamraju, S., Patil, S., Nachimuthu, S., Ravindran, S., Patel, S., Ivanov, B., Patel, M., Ejtehadi, F., Jebamani, J., Akhter Rahman, M M, Woodun, H., De Prendergast, A., Afzal, A., Bota, E., Abdul, S R, Karmarkar, R., Crockett, E., Evans, L., Appleton, B., Griffiths, E., Dada, O., Kulkarni, R., Albirnawi, H., Gravestock, P., Vincenti, C., Taribagil, S., Dent, B., Tse, C., Clayton, B., Burdekin, E., Bannister, L., Alam, I., Gray, J., Mactier, M., Pollock, A., Gough, V., Kanchustambam, S R, Ridgway, M., Arujunan, K., Gopalswamy, S., Monteiro De Barros, J., Lyons, T., Griffith, D., Awan, A K, Latif, J., Bandlamudi, N., Bhatti, I., Raptis, D A, Machairas, N., Pissanou, T., Mestre-Costa, J., Hidalgo Salinas, C., Pollok, J M, Al-Ardah, M., Watson-Jones, E., Rontree-Carey, T., Boyce, T., Hawkin, P., Elmaradny, A., Ross, K., Adu-Peprah, E., Pinto, K., Dunne, D., Mccready, R., Nita, G., Szatmary, P., Tay, V L, Rajput, K., Rajendran, I., Chaudhury, M., Zambas, G., Swaminathan, C., Atif, Qaa, Barrow, T., Williams, O., Malik, A., Conroy, S., Lindley, S., Gilmore, K., Boden, E., Richards, S K, Hraishawi, I., Polak, P., Mclaughlin, D., Deeny, D., Shuttleworth, R., Harris, A., Peilober-Richardson, A., Morris, G C, Sara, X., Almourad, H., Ang, Y., Smyth, R., Ding, D., Foster, J., Bond, A., Kumar, Y., Ahmad, A., Radoi, D., Alkaili-Alyamani, A., Balakrishnan, S., Satchidanand, R Y, Danwaththa Liyanage, A S, Blake, I., Ransome, M., Weerasinghe, C., Kenington, C., Mayo, K., Mohammed, M., Cockbain, A J, Peckham-Cooper, A., Mccauley, G., Gordon, C., Smith, A., Hawkins, W., Chakravartty, S., Baillie, C., Kenny, R., Kumar, A., Koimtzis, G., Bellamy, E., Menon, A., Kanakala, A., Nevins, E J, Madhavan, A., Thulasiraman, S., France, K., O'Connor, A., Idama, D., Raslan, C., Sridhar, S., Parveen, M., Mubashar, T., Jarvis, S., Cakmak, I., Wright, C., Andrews, S., Abdelsaid K Abdul Aal, Y., Jayasankar, B., Morilla, J., Shehata, M., Subba, N., Tewari, N., El-Sayed, C., Somaie, D., Beheiry, N., Douka, E., Arumugam, S., Wijetunga, I., Leivers, E., Ibrahim, B., Khan, K., Wheat, J., Christopher, J., Barnett, R., Elberm, H., Booker, J., Ashai, S., Berry, D., Luhmann, A., Sgro, A., Rashid, M M, Galea, M., Jeyakumar, J., Marriott, P., Zafar, S., Baker, A., Yershov, D., Galanopoulos, G., Jordan, R., Peinado Garcia, C., Anyaugo, N., Bath, M F, Omatseye, J., Roberts, L., Argyriou, E O, Machesney, M., Parmar, C., Clark, S., Khalil, H., Unsworth, S., Mlotshwa, M., Ayoub, N., Aboelkhair, A., Iosif, E., Mohamed, N., Reynolds, E., Mackender, E., Robinson, D., Mufti, W., Fischkoff, K., Coleman, N., Anantha Sathyanarayana, S., Deutsch, G., Giangola, M., Lin, D., Weiss, M., Chung, C., Nguyen, A., Mueller, J., Dabit, M., Gordon, J., McGuire, E., Rashid, O., Georgi, E., Gallo, M., Kunstman, J W, Peters, N V, O'Connor, R., Bhattacharya, B., Onkendi, E., Santos, A P, Richmond, R., Warren, M., Zhang, K., Broderick, R., Clary, B., Horgan, S., Doucet, J., Liepert, A., Harmon, L., McCall, C., Sham, J G, Williams, E., Labadie, K P, Clark, N M, Dickerson, L K, Hammill, C W, Williams, G., Kushner, B., Cos, H., Zarate Rodriguez, J., Bailey, K., Al-Raimi, Imn, Al-Zazay, K., Ahmed Mohammed Al-Mahdi, S., Mohammed Aldowbli, S., Al-Shehari, M., Shream, S., Al-Ameri, S., Aeed, M., Aldawbali, M., Alsayadi, R., and Alsayadi, M.

Subjects
Pandemic, SARS-CoV-2, acute cholecystitis, COVID-19, management, Cholecystitis, Acute, acute, General Medicine, pandemics, cholecystectomy, humans, cholecystitis, Cholecystectomy, Humans, Pandemics, Settore MED/18 - Chirurgia Generale, Human
Abstract

Background This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic.

Published
2022

44. Mortality among Italians and immigrants with COVID-19 hospitalised in Milan, Italy: data from the Luigi Sacco Hospital registry

Author

Andrea, Giacomelli, Anna Lisa, Ridolfo, Cecilia, Bonazzetti, Letizia, Oreni, Federico, Conti, Laura, Pezzati, Matteo, Siano, Cinzia, Bassoli, Giacomo, Casalini, Marco, Schiuma, Alice, Covizzi, Matteo, Passerini, Marco, Piscaglia, Fabio, Borgonovo, Claudia, Galbiati, Riccardo, Colombo, Emanuele, Catena, Giuliano, Rizzardini, Laura, Milazzo, Massimo, Galli, Antonio, Brucato, and Spinello, Antinori

Subjects
Asia, SARS-CoV-2, Research, COVID-19, Emigrants and Immigrants, Outcomes, Infectious and parasitic diseases, RC109-216, Middle Aged, South America, Hospitals, Europe, Italy, Immigrants, Africa, Humans, Registries, Country of origin, Aged, Retrospective Studies
Abstract

Background To compare differences in the probability of COVID-19-related death between native Italians and immigrants hospitalised with COVID-19. Methods This retrospective study of prospectively collected data was conducted at the ASST Fatebenefratelli-Sacco Hospital in Milan, Italy, between 21 February and 31 November 2020. Uni- and multivariable Cox proportional hazard models were used to assess the impact of the patients' origin on the probability of COVID-19-related death. Results The study population consisted of 1,179 COVID-19 patients: 921 Italians (78.1%) and 258 immigrants (21.9%) who came from Latin America (99, 38%), Asia (72, 28%), Africa (50, 19%) and central/eastern Europe (37, 14%). The Italians were significantly older than the immigrants (median age 70 years, interquartile range (IQR) 58–79 vs 51 years, IQR 41–60; p

Published
2022

45. Early life factors and white matter microstructure in children with overweight and obesity: The ActiveBrains project

Author

Andrés Catena, Irene Esteban-Cornejo, Juan Verdejo-Román, Idoia Labayen, Patricio Solis-Urra, Francisco B. Ortega, María Rodriguez-Ayllon, and Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa. ISFOOD - Institute for Innovation and Sustainable Development in Food Chain

Subjects
Male, Pediatric Obesity, Birth weight, Breastfeeding, Overweight, Academic achievement, Critical Care and Intensive Care Medicine, 030218 nuclear medicine & medical imaging, White matter, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Academic Performance, Fractional anisotropy, Humans, Medicine, Child, Nutrition and Dietetics, Anthropometry, business.industry, Brain morphometry, Infant, Newborn, Brain, medicine.disease, Childhood, Obesity, Body Height, 3. Good health, Diffusion Tensor Imaging, medicine.anatomical_structure, Anisotropy, Female, medicine.symptom, business, Head, 030217 neurology & neurosurgery, Demography
Abstract

This study was supported by the Spanish Ministry of Economy and Competitiveness (DEP2013-47540, DEP2016-79512-R, and DEP2017-91544-EXP), the European Regional Development Fund, the European Commission (No 667302) and the Alicia Koplowitz Foundation. This study was partially funded by the UGR Research and Knowledge Transfer Fund (PPIT) 2016, Excellence Actions Programme. Units of Scientific Excellence; Scientific Unit of Excellence on Exercise and Health (UCEES) and by the Regional Government of Andalusia, Regional Ministry of Economy, Knowledge, Entreprises and University and European Regional Development Fund (ERDF), ref. SOMM17/6107/UGR. In addition, this study was further supported by the SAMID III network, RETICS, funded by the PN IthornDthornI 2017-2021 (Spain). Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Funds (ERDF in English, FEDER in Spanish, project ref: B-CTS-355-UGR18). PS-U is supported by a grant from ANID/BECAS Chile/72180543. IE-C is supported by the Spanish Ministries of Economy and Competitiveness (RTI2018-095284-J-100), and Science and Innovation (RYC2019-027287-I). JV-R is supported by a grant from the Spanish Ministry of Science, Innovation and Universities (FJCI-2017-33396). Funding for open access charge: Universidad de Granada/CBUA. We would like to thank all the families participating in the ActiveBrains. We are grateful to Ms. Ana Yara Postigo-Fuentes for her assistance with the English language. We also acknowledge everyone who helped with the data collection and all of the members involved in the fieldwork for their effort, enthusiasm, and support. This work is part of Ph.D. Thesis conducted in the Biomedicine Doctoral Studies of the University of Granada, Spain., Background & aims: Exposure to a suboptimal environment during the fetal and early infancy period's results in long-term consequences for brain morphology and function. We investigated the associations of early life factors such as anthropometric neonatal data (i.e., birth length, birth weight and birth head circumference) and breastfeeding practices (i.e., exclusive and any breastfeeding) with white matter (WM) microstructure, and ii) we tested whether WM tracts related to early life factors are associated with academic performance in children with overweight/obesity. Methods: 96 overweight/obese children (10.03 +/- 1.16 years; 38.7% girls) were included from the ActiveBrains Project. WM microstructure indicators used were fractional anisotropy (FA) and mean diffusivity (MD), derived from Diffusion Tensor Imaging. Academic performance was evaluated with the Battery III Woodcock-Munoz Tests of Achievement. Regression models were used to examine the associations of the early life factors with tract-specific FA and MD, as well as its association with academic performance. Results: Head circumference at birth was positively associated with FA of the inferior fronto-occipital fasciculus tract (0.441; p = 0.005), as well as negatively associated with MD of the cingulate gyrus part of cingulum (-0.470; p = 0.006), corticospinal (-0.457; p = 0.005) and superior thalamic radiation tract (-0.476; p = 0.001). Association of birth weight, birth length and exclusive breastfeeding with WM microstructure did not remain significant after false discovery rate correction. None tract related to birth head circumference was associated with academic performance (all p > 0.05). Conclusions: Our results highlighted the importance of the perinatal growth in WM microstructure later in life, although its possible academic implications remain inconclusive., Spanish Government DEP2013-47540 DEP2016-79512-R DEP2017-91544-EXP, European Commission European Commission European Commission Joint Research Centre 667302, Alicia Koplowitz Foundation, UGR Research and Knowledge Transfer Fund (PPIT) 2016, Excellence Actions Programme, European Commission SOMM17/6107/UGR, SAMID III network, RETICS - PN I+D+I 2017-2021 (Spain), Andalusian Operational Programme - European Regional Development Funds B-CTS-355-UGR18, ANID/BECAS Chile 72180543, Spanish Government RTI2018-095284-J-100 FJCI-2017-33396 RYC2019-027287-I

Published
2022
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46. Surgical Management of Polymethylmethacrylate-Collagen Gel Complications in the Lower Eyelid: A Case Series

Author

Alan James Durkin, Dominique Catena, Nick Woltjen, Kathleen Boyle, Maxwell Polling, John Weng, and Jimmy H. Chim

Subjects
Male, Granuloma, Dermal Fillers, Humans, Polymethyl Methacrylate, Eyelids, Rejuvenation, Surgery, Female, Collagen, Cosmetic Techniques, Middle Aged
Abstract

As nonsurgical rejuvenation with fillers continues to grow in popularity, patients are increasingly interested in more durable results. Polymethylmethacrylate (PMMA)-collagen gel is unique among fillers in that the PMMA microspheres are not completely absorbed and phagocytosed by the body. This durability coupled with the biophysical properties of PMMA makes it a poor choice for periorbital rejuvenation, an unforgiving and highly complex anatomic area.Between 2011 and 2018, 14 patients with PMMA granulomas in various facial areas self-referred to the senior author's practice. Of these patients, 11 were managed nonsurgically; however, all 3 patients who presented with granulomas in the infraorbital area required surgery to remove the filler and restore a natural aesthetic.The 3 patients with significant swelling and PMMA filler nodules in the infraorbital area with unacceptable cosmetic appearance were females between the ages of 50 and 55 years. Nonsurgical protocols were unsuccessful, and surgical removal was required. All subjects have been followed for a minimum of 2 years with no immediate- or long-term postoperative complications secondary to PMMA removal. Patients remain satisfied with the outcome of the surgery.Despite the evidence that the periorbital area is prone to adverse events when injected with particulate fillers, misguided enthusiasm for PMMA-collagen gel as a durable treatment continues to lead to unnecessary and severe complications in patients. The case studies presented here highlight that this product should not be introduced into the periorbital area. We also describe a surgical treatment approach for its removal if complications arise.

Published
2022

47. Capillaroscopy, microangiopathy, and HIV. Descriptive study of capillaroscopy findings in HIV positive patients

Author

Guillermo, Verdejo-Muñoz, César, Gálvez-Barrón, Borja, Gracia Tello, Sara, Gamarra Calvo, Isabel, Sanjoaquín Conde, Andrés, Catena, and José Ramón, Blanco Ramos

Subjects
Male, Adult, Cross-Sectional Studies, Heart Diseases, Hypertension, Humans, Female, HIV Infections, Microscopic Angioscopy
Abstract

In this study, we aim to evaluate microangiopathy in HIV positive patients by using capillaroscopy. To date, few studies have been published on the topic. Capillaroscopy may be a tool for early diagnosis of cardiovascular involvement in this patient population.Cross-sectional study with HIV positive patients18 years. The enrolment period was set from January to June 2018. The following data were collected: demographic (sex, age), laboratory tests (duration of infection, CD4 cell count, CD4:CD8 ratio, coinfection with other viruses), antiretroviral treatment, dyslipidemia, and comorbidities (active smoking, alcoholism, high blood pressure, dyslipidaemia, diabetes, cardiopathy). The capillaroscopy and blood tests were performed simultaneously. The following alterations were evaluated in the capillaroscopy: congestion, tortuosity, haemorrhage, dilations, capillary loss, and presence of megacapillaries.One hundred and two patients were included; 73.5% were male, mean age was 40 years (SD: 10), and mean duration of infection 4.5 years (SD: 3.1). At diagnosis, mean CD4 cell count was 408/mm3 and CD4/CD8 ratio 0.4. A number of patients (14.7%) were coinfected with the hepatitis B virus; 31.3% were active smokers and 13.7% alcoholics. Capillaroscopy alterations were found in most study patients (93.1%): congestion (78.5%), tortuosity (77.5%), haemorrhage (13.8%), dilations (11.8%), capillary loss (5%), and megacapillaries (1%). Capillary tortuosity was associated with age and smoking; and haemorrhage with age, CD4, antiretroviral treatment, and hypertension.Prevalence of capillaroscopy alterations is high in HIV positive patients, particularly tortuosity and congestion. To the best of our knowledge, the later alteration has not been previously reported in this group of patients.

Published
2022
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48. American Association for the Surgery of Trauma–World Society of Emergency Surgery guidelines on diagnosis and management of abdominal vascular injuries

Author

Leslie Kobayashi, Raul Coimbra, Adenauer M.O. Goes, Viktor Reva, Jarrett Santorelli, Ernest E. Moore, Joseph M. Galante, Fikri Abu-Zidan, Andrew B. Peitzman, Carlos A. Ordonez, Ronald V. Maier, Salomone Di Saverio, Rao Ivatury, Nicola De Angelis, Thomas Scalea, Fausto Catena, Andrew Kirkpatrick, Vladimir Khokha, Neil Parry, Ian Civil, Ari Leppaniemi, Mircea Chirica, Emmanouil Pikoulis, Gustavo P. Fraga, Massimo Chiarugi, Dimitrios Damaskos, Enrico Cicuttin, Marco Ceresoli, Belinda De Simone, Felipe Vega-Rivera, Massimo Sartelli, Walt Biffl, Luca Ansaloni, Dieter G. Weber, Federico Coccolini, Kobayashi, L, Coimbra, R, Goes, A, Reva, V, Santorelli, J, Moore, E, Galante, J, Abu-Zidan, F, Peitzman, A, Ordonez, C, Maier, R, Di Saverio, S, Ivatury, R, De Angelis, N, Scalea, T, Catena, F, Kirkpatrick, A, Khokha, V, Parry, N, Civil, I, Leppaniemi, A, Chirica, M, Pikoulis, E, Fraga, G, Chiarugi, M, Damaskos, D, Cicuttin, E, Ceresoli, M, De Simone, B, Vega-Rivera, F, Sartelli, M, Biffl, W, Ansaloni, L, Weber, D, and Coccolini, F

Subjects
Hemorrhage, Wounds, Penetrating, abdominal aorta, 030208 emergency & critical care medicine, Shock, Hemorrhagic, Vascular System Injuries, Wounds, Nonpenetrating, Critical Care and Intensive Care Medicine, United States, 03 medical and health sciences, 0302 clinical medicine, Abdomen, Practice Guidelines as Topic, Abdominal vascular trauma, Humans, celiac artery, Surgery, Military Medicine, inferior vena cava, Societies, Medical, portal vein
Abstract

Abdominal vascular trauma accounts for a small percentage of military and a moderate percentage of civilian trauma, affecting all age ranges and impacting young adult men most frequently. Penetrating causes are more frequent than blunt in adults, while blunt mechanisms are more common among pediatric populations. High rates of associated injuries, bleeding, and hemorrhagic shock ensure that, despite advances in both diagnostic and therapeutic technologies, immediate open surgical repair remains the mainstay of treatment for traumatic abdominal vascular injuries. Because of their devastating nature, abdominal vascular injuries remain a significant source of morbidity and mortality among trauma patients. The American Association for the Surgery of Trauma in conjunction with the World Society of Emergency Surgery seek to summarize the literature to date and provide guidelines on the presentation, diagnosis, and treatment of abdominal vascular injuries. LEVEL OF EVIDENCE: Review study, level IV.

Published
2020
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49. Management of intra-abdominal-infections: 2017 World Society of Emergency Surgery guidelines summary focused on remote areas and low-income nations

Author

Elena Bonati, Yoram Kluger, Fausto Catena, Andrew W. Kirkpatrick, Francesco M. Labricciosa, Alain Chichom-Mefire, Vladimir Khokha, Federico Coccolini, Luca Ansaloni, Fikri M. Abu-Zidan, George C. Velmahos, Salomone Di Saverio, Ernest E. Moore, Gustavo Pereira Fraga, Marco Ceresoli, Raul Coimbra, Ionut Negoi, Massimo Sartelli, Helmut Alfredo Segovia Lohse, Giuffrida Mario, Ronald V. Maier, Zaza Demetrashvili, Carlos A. Ordoñez, Dieter G. Weber, Ari Leppäniemi, Walter L. Biffl, Boris Sakakushev, Imtaz Wani, Gennaro Perrone, Perrone, G, Sartelli, M, Giuffrida, M, Chichom-Mefire, A, Labricciosa, F, Abu-Zidan, F, Ansaloni, L, Biffl, W, Ceresoli, M, Coccolini, F, Coimbra, R, Demetrashvili, Z, Di Saverio, S, Fraga, G, Khokha, V, Kirkpatrick, A, Kluger, Y, Leppaniemi, A, Maier, R, Moore, E, Negoi, I, Ordonez, C, Sakakushev, B, Lohse, H, Velmahos, G, Wani, I, Weber, D, Bonati, E, Catena, F, and HUS Abdominal Center

Subjects
0301 basic medicine, Microbiology (medical), Low income, Standardization, 030106 microbiology, MEDLINE, Global Health, Acute cholecystiti, Antimicrobial resistance, Diagnostic tools, Remote area, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Intra-abdominal infection, 0302 clinical medicine, Anti-Infective Agents, Emergency surgery, Intra-abdominal infections, Health care, Acute appendicitis, Acute cholecystitis, Acute diverticulitis, Remote areas, Humans, Medicine, lcsh:RC109-216, 030212 general & internal medicine, Ultrasonography, business.industry, Abdominal Infection, General Medicine, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, Triage, 3. Good health, Infectious Diseases, Acute diverticuliti, Income, Intraabdominal Infections, Acute appendiciti, Medical emergency, business
Abstract

Background: Most remote areas have restricted access to healthcare services and are too small andremote to sustain specialist services. In 2017, the World Society of Emergency Surgery (WSES) published guidelines for the management of intra-abdominal infections. Many hospitals, especially those in remote areas, continue to face logistical barriers, leading to an overall poorer adherence to international guidelines. Methods: The aim of this paper is to report and amend the 2017 WSES guidelines for the management of intra-abdominal infections, extending these recommendations for remote areas and low-income countries. A literature search of the PubMed/MEDLINE databases was conducted covering the period up until June 2020. Results: The critical shortages of healthcare workers and material resources in remote areas require the use of a robust triage system. A combination of abdominal signs and symptoms with early warning signs may be used to screen patients needing immediate acute care surgery. A tailored diagnostic step-up approach based on the hospital's resources is recommended. Ultrasound and plain X-ray may be useful diagnostic tools in remote areas. The source of infection should be totally controlled as soon as possible. Conclusions: The cornerstones of effective treatment for intra-abdominal infections in remote areas include early diagnosis, prompt resuscitation, early source control, and appropriate antimicrobial therapy. Standardization in applying the guidelines is mandatory to adequately manage intra-abdominal infections. (c) 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Published
2020
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50. Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study

Author

Coccolini F., Gubbiotti F., Ceresoli M., Tartaglia D., Fugazzola P., Ansaloni L., Sartelli M., Kluger Y., Kirkpatrick A., Amico F., Catena F., Chiarugi M., Montori G., Salvetti F., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Sugrue M., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Ben-Ishay O., Lippi A., Improta M., Zharikov A., Dubuisson V., Coccolini, F, Gubbiotti, F, Ceresoli, M, Tartaglia, D, Fugazzola, P, Ansaloni, L, Sartelli, M, Kluger, Y, Kirkpatrick, A, Amico, F, Catena, F, Chiarugi, M, Montori, G, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Sugrue, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Ben-Ishay, O, Lippi, A, Improta, M, Zharikov, A, and Dubuisson, V

Subjects
Adult, Male, medicine.medical_specialty, Original Scientific Report, Fistula, medicine.medical_treatment, open abdomen, Peritonitis, 030230 surgery, NO, 03 medical and health sciences, 0302 clinical medicine, Sepsis, peritoneal resuscitation, Negative-pressure wound therapy, Abdomen, medicine, Humans, Surgical Wound Infection, Prospective Studies, fascial closure, peritoneal resuscitation, management, therapy, fascial closure, Digestive System Surgical Procedures, Aged, therapy, business.industry, Peritoneal fluid, Abdominal Cavity, Abdominal Wound Closure Techniques, Middle Aged, medicine.disease, Surgery, Cardiac surgery, Treatment Outcome, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, fluid instillation, Fluid Therapy, Female, business, Negative-Pressure Wound Therapy, management, Abdominal surgery
Abstract

Background Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.

Published
2020
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