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1. Colorectal neoplastic emergencies in immunocompromised patients: preliminary result from the Web-based International Register of Emergency Surgery and Trauma (WIRES-T trial)

Author: Coccolini, F, Mazzoni, A, Cremonini, C, Cobuccio, L, Pucciarelli, M, Vetere, G, Borelli, B, Strambi, S, Musetti, S, Miccoli, M, Cremolini, C, Salvetti, F, Fugazzola, P, Ceresoli, M, Elisa, N, Litvin, A, Lostoridis, E, Ahmed, A, Manatakis, D, Negoi, I, Ioannidis, O, Uzunoglu, M, Tochie, J, Cillara, N, Tomadze, G, Bala, M, Isik, A, Fonseca, V, Bellanova, G, Ghannam, W, Yalkin, O, Garcia, F, Altintoprak, F, Hadzhiev, D, Chirica, M, Zese, M, Balalis, D, Cui, Y, Luppi, D, Romeo, L, Muratore, A, Lunghi, E, Yovtchev, Y, Nikolopoulos, I, Omerovic, M, Zizzo, M, Ugoletti, L, Costa, G, Scalzone, R, Perrone, S, Occhionorelli, S, Nardi, M, Gubbiotti, F, Catena, F, Muhtaroglu, A, Scaramuzzo, R, Corte, H, Yanez, C, Zakaria, A, Seretis, C, Gelmini, R, Pappalardo, V, Paratore, F, Sydorchuk, R, Mulita, F, Kara, Y, Toma, E, Vailas, M, Sotiropoulou, M, Benedetti, F, Elbahnasawy, M, Sibilla, M, Martines, G, Goksoy, B, Parini, D, Zaghi, C, Podda, M, Osipov, A, Brisinda, G, Gambino, G, Akhmeteli, L, Doklestic, K, Loncar, Z, Micic, D, Lesevic, I, D'Agostino, F, Garzali, I, Caicedo, Y, Marcela, L, Marin, P, Perivoliotis, K, Ntentas, I, Kuptsov, A, Dimitrov, E, Chowdhury, S, Patel, T, Sartelli, M, Tartaglia, D, Chiarugi, M, Coccolini F., Mazzoni A., Cremonini C., Cobuccio L., Pucciarelli M., Vetere G., Borelli B., Strambi S., Musetti S., Miccoli M., Cremolini C., Salvetti F., Fugazzola P., Ceresoli M., Elisa N. G., Litvin A., Lostoridis E., Ahmed A. Y. Y. M., Manatakis D., Negoi I., Ioannidis O., Uzunoglu M. Y., Tochie J. N., Cillara N., Tomadze G., Bala M., Isik A., Fonseca V. C., Bellanova G., Ghannam W., Yalkin O., Garcia F. H., Altintoprak F., Hadzhiev D., Chirica M., Zese M., Balalis D., Cui Y., Luppi D., Romeo L., Muratore A., Lunghi E. G., Yovtchev Y., Nikolopoulos I., Omerovic M., Zizzo M., Ugoletti L., Costa G., Scalzone R., Perrone S., Occhionorelli S., Nardi M., Gubbiotti F., Catena F., Muhtaroglu A., Scaramuzzo R., Corte H., Yanez C., Zakaria A. D., Seretis C., Gelmini R., Pappalardo V., Paratore F., Sydorchuk R., Mulita F., Kara Y., Toma E. A., Vailas M., Sotiropoulou M., Benedetti F., Elbahnasawy M., Sibilla M. G., Martines G., Goksoy B., Parini D., Zaghi C., Podda M., Osipov A., Brisinda G., Gambino G., Akhmeteli L., Doklestic K., Loncar Z., Micic D., Lesevic I., D'Agostino F., Garzali I. U., Caicedo Y., Marcela L., Marin P. A. G., Perivoliotis K., Ntentas I., Kuptsov A., Dimitrov E., Chowdhury S., Patel T., Sartelli M., Tartaglia D., Chiarugi M., Coccolini, F, Mazzoni, A, Cremonini, C, Cobuccio, L, Pucciarelli, M, Vetere, G, Borelli, B, Strambi, S, Musetti, S, Miccoli, M, Cremolini, C, Salvetti, F, Fugazzola, P, Ceresoli, M, Elisa, N, Litvin, A, Lostoridis, E, Ahmed, A, Manatakis, D, Negoi, I, Ioannidis, O, Uzunoglu, M, Tochie, J, Cillara, N, Tomadze, G, Bala, M, Isik, A, Fonseca, V, Bellanova, G, Ghannam, W, Yalkin, O, Garcia, F, Altintoprak, F, Hadzhiev, D, Chirica, M, Zese, M, Balalis, D, Cui, Y, Luppi, D, Romeo, L, Muratore, A, Lunghi, E, Yovtchev, Y, Nikolopoulos, I, Omerovic, M, Zizzo, M, Ugoletti, L, Costa, G, Scalzone, R, Perrone, S, Occhionorelli, S, Nardi, M, Gubbiotti, F, Catena, F, Muhtaroglu, A, Scaramuzzo, R, Corte, H, Yanez, C, Zakaria, A, Seretis, C, Gelmini, R, Pappalardo, V, Paratore, F, Sydorchuk, R, Mulita, F, Kara, Y, Toma, E, Vailas, M, Sotiropoulou, M, Benedetti, F, Elbahnasawy, M, Sibilla, M, Martines, G, Goksoy, B, Parini, D, Zaghi, C, Podda, M, Osipov, A, Brisinda, G, Gambino, G, Akhmeteli, L, Doklestic, K, Loncar, Z, Micic, D, Lesevic, I, D'Agostino, F, Garzali, I, Caicedo, Y, Marcela, L, Marin, P, Perivoliotis, K, Ntentas, I, Kuptsov, A, Dimitrov, E, Chowdhury, S, Patel, T, Sartelli, M, Tartaglia, D, Chiarugi, M, Coccolini F., Mazzoni A., Cremonini C., Cobuccio L., Pucciarelli M., Vetere G., Borelli B., Strambi S., Musetti S., Miccoli M., Cremolini C., Salvetti F., Fugazzola P., Ceresoli M., Elisa N. G., Litvin A., Lostoridis E., Ahmed A. Y. Y. M., Manatakis D., Negoi I., Ioannidis O., Uzunoglu M. Y., Tochie J. N., Cillara N., Tomadze G., Bala M., Isik A., Fonseca V. C., Bellanova G., Ghannam W., Yalkin O., Garcia F. H., Altintoprak F., Hadzhiev D., Chirica M., Zese M., Balalis D., Cui Y., Luppi D., Romeo L., Muratore A., Lunghi E. G., Yovtchev Y., Nikolopoulos I., Omerovic M., Zizzo M., Ugoletti L., Costa G., Scalzone R., Perrone S., Occhionorelli S., Nardi M., Gubbiotti F., Catena F., Muhtaroglu A., Scaramuzzo R., Corte H., Yanez C., Zakaria A. D., Seretis C., Gelmini R., Pappalardo V., Paratore F., Sydorchuk R., Mulita F., Kara Y., Toma E. A., Vailas M., Sotiropoulou M., Benedetti F., Elbahnasawy M., Sibilla M. G., Martines G., Goksoy B., Parini D., Zaghi C., Podda M., Osipov A., Brisinda G., Gambino G., Akhmeteli L., Doklestic K., Loncar Z., Micic D., Lesevic I., D'Agostino F., Garzali I. U., Caicedo Y., Marcela L., Marin P. A. G., Perivoliotis K., Ntentas I., Kuptsov A., Dimitrov E., Chowdhury S., Patel T., Sartelli M., Tartaglia D., and Chiarugi M.
Abstract: Association of advanced age, neoplastic disease and immunocompromission (IC) may lead to surgical emergencies. Few data exist about this topic. Present study reports the preliminary data from the WIRES-T trial about patients managed for colorectal neoplastic emergencies in immunocompromised patients. The required data were taken from a prospective observational international register. The study was approved by the Ethical Committee with approval n. 17575; ClinicalTrials.gov Identifier: NCT03643718. 839 patients were collected; 753 (80.7%) with mild–moderate IC and 86 (10.3%) with severe. Median age was 71.9 years and 73 years, respectively, in the two groups. The causes of mild–moderate IC were reported such malignancy (753–100%), diabetes (103–13.7%), malnutrition (26–3.5%) and uremia (1–0.1%), while severe IC causes were steroids treatment (14–16.3%); neutropenia (7–8.1%), malignancy on chemotherapy (71–82.6%). Preoperative risk classification were reported as follow: mild–moderate: ASA 1–14 (1.9%); ASA 2–202 (26.8%); ASA 3–341 (45.3%); ASA 4–84 (11.2%); ASA 5–7 (0.9%); severe group: ASA 1-1 patient (1.2%); ASA 2–16 patients (18.6%); ASA 3–41 patients (47.7%); ASA 4–19 patients (22.1%); ASA 5–3 patients (3.5%); lastly, ASA score was unavailable for 105 cases (13.9%) in mild–moderate group and in 6 cases (6.9%) in severe group. All the patients enrolled underwent urgent/emergency surgery Damage control approach with open abdomen was adopted in 18 patients. Mortality was 5.1% and 12.8%, respectively, in mild–moderate and severe groups. Long-term survival data: in mild–moderate disease-free survival (median, IQR) is 28 (10–91) and in severe IC, it is 21 (10–94). Overall survival (median, IQR) is 44 (18–99) and 26 (20–90) in mild–moderate and severe, respectively; the same is for post-progression survival (median, IQR) 29 (16–81) and 28, respectively. Univariate and multivariate analyses showed as the only factor influencing mortality in mild–moderate and severe IC is
Published: 2023

2. Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T)

Author: Tartaglia, D, Cremonini, C, Annunziata, E, Catena, F, Sartelli, M, Kirkpatrick, A, Musetti, S, Strambi, S, Chiarugi, M, Coccolini, F, Salvetti, F, Fugazzola, P, Ceresoli, M, Benedetti, F, Elisa, N, Litvin, A, Lostoridis, E, Ahmed, A, Manatakis, D, Negoi, I, Ioannidis, O, Uzunoglu, M, Tochie, J, Cillara, N, Tomadze, G, Bala, M, Isik, A, Fonseca, V, Bellanova, G, Ghannam, W, Yalkin, O, Garcia, F, Altintoprak, F, Hadzhiev, D, Chirica, M, Zese, M, Balalis, D, Cui, Y, Luppi, D, Romeo, L, Muratore, A, Lunghi, E, Yovtchev, Y, Dimitrov, E, Nikolopoulos, I, Omerovic, M, Zizzo, M, Ugoletti, L, Costa, G, Scalzone, R, Perrone, S, Occhionorelli, S, Nardi, M, Gubbiotti, F, Muhtaroglu, A, Scaramuzzo, R, Corte, H, Yanez, C, Zakaria, A, Seretis, C, Gelmini, R, Pappalardo, V, Paratore, F, Sydorchuk, R, Mulita, F, Kara, Y, Toma, E, Vailas, M, Sotiropoulou, M, Elbahnasawy, M, Sibilla, M, Martines, G, Goksoy, B, Parini, D, Zaghi, C, Podda, M, Osipov, A, Brisinda, G, Gambino, G, Doklestic, L, Loncar, Z, Micic, D, Lesevic, I, D'Agostino, F, Garzali, I, Caicedo, Y, Marcela, L, Marin, P, Perivoliotis, K, Ntentas, I, Kuptsov, A, Chowdhury, S, Patel, T, Tartaglia D., Cremonini C., Annunziata E., Catena F., Sartelli M., Kirkpatrick A. W., Musetti S., Strambi S., Chiarugi M., Coccolini F., Salvetti F., Fugazzola P., Ceresoli M., Benedetti F., Elisa N. G., Litvin A., Lostoridis E., Ahmed A. Y. Y. M., Manatakis D., Negoi I., Ioannidis O., Uzunoglu M. Y., Tochie J. N., Cillara N., Tomadze G., Bala M., Isik A., Fonseca V. C., Bellanova G., Ghannam W., Yalkin O., Garcia F. H., Altintoprak F., Hadzhiev D., Chirica M., Zese M., Balalis D., Cui Y., Luppi D., Romeo L., Muratore A., Lunghi E. G., Yovtchev Y., Dimitrov E., Nikolopoulos I., Omerovic M., Zizzo M., Ugoletti L., Costa G., Scalzone R., Perrone S., Occhionorelli S., Nardi M., Gubbiotti F., Muhtaroglu A., Scaramuzzo R., Corte H., Yanez C., Zakaria A. D., Seretis C., Gelmini R., Pappalardo V., Paratore F., Sydorchuk R., Mulita F., Kara Y., Toma E. A., Vailas M., Sotiropoulou M., Elbahnasawy M., Sibilla M. G., Martines G., Goksoy B., Parini D., Zaghi C., Podda M., Osipov A., Brisinda G., Gambino G., Doklestic L. A. K., Loncar Z., Micic D., Lesevic I., D'Agostino F., Garzali I. U., Caicedo Y., Marcela L., Marin P. A. G., Perivoliotis K., Ntentas I., Kuptsov A., Chowdhury S., Patel T., Tartaglia, D, Cremonini, C, Annunziata, E, Catena, F, Sartelli, M, Kirkpatrick, A, Musetti, S, Strambi, S, Chiarugi, M, Coccolini, F, Salvetti, F, Fugazzola, P, Ceresoli, M, Benedetti, F, Elisa, N, Litvin, A, Lostoridis, E, Ahmed, A, Manatakis, D, Negoi, I, Ioannidis, O, Uzunoglu, M, Tochie, J, Cillara, N, Tomadze, G, Bala, M, Isik, A, Fonseca, V, Bellanova, G, Ghannam, W, Yalkin, O, Garcia, F, Altintoprak, F, Hadzhiev, D, Chirica, M, Zese, M, Balalis, D, Cui, Y, Luppi, D, Romeo, L, Muratore, A, Lunghi, E, Yovtchev, Y, Dimitrov, E, Nikolopoulos, I, Omerovic, M, Zizzo, M, Ugoletti, L, Costa, G, Scalzone, R, Perrone, S, Occhionorelli, S, Nardi, M, Gubbiotti, F, Muhtaroglu, A, Scaramuzzo, R, Corte, H, Yanez, C, Zakaria, A, Seretis, C, Gelmini, R, Pappalardo, V, Paratore, F, Sydorchuk, R, Mulita, F, Kara, Y, Toma, E, Vailas, M, Sotiropoulou, M, Elbahnasawy, M, Sibilla, M, Martines, G, Goksoy, B, Parini, D, Zaghi, C, Podda, M, Osipov, A, Brisinda, G, Gambino, G, Doklestic, L, Loncar, Z, Micic, D, Lesevic, I, D'Agostino, F, Garzali, I, Caicedo, Y, Marcela, L, Marin, P, Perivoliotis, K, Ntentas, I, Kuptsov, A, Chowdhury, S, Patel, T, Tartaglia D., Cremonini C., Annunziata E., Catena F., Sartelli M., Kirkpatrick A. W., Musetti S., Strambi S., Chiarugi M., Coccolini F., Salvetti F., Fugazzola P., Ceresoli M., Benedetti F., Elisa N. G., Litvin A., Lostoridis E., Ahmed A. Y. Y. M., Manatakis D., Negoi I., Ioannidis O., Uzunoglu M. Y., Tochie J. N., Cillara N., Tomadze G., Bala M., Isik A., Fonseca V. C., Bellanova G., Ghannam W., Yalkin O., Garcia F. H., Altintoprak F., Hadzhiev D., Chirica M., Zese M., Balalis D., Cui Y., Luppi D., Romeo L., Muratore A., Lunghi E. G., Yovtchev Y., Dimitrov E., Nikolopoulos I., Omerovic M., Zizzo M., Ugoletti L., Costa G., Scalzone R., Perrone S., Occhionorelli S., Nardi M., Gubbiotti F., Muhtaroglu A., Scaramuzzo R., Corte H., Yanez C., Zakaria A. D., Seretis C., Gelmini R., Pappalardo V., Paratore F., Sydorchuk R., Mulita F., Kara Y., Toma E. A., Vailas M., Sotiropoulou M., Elbahnasawy M., Sibilla M. G., Martines G., Goksoy B., Parini D., Zaghi C., Podda M., Osipov A., Brisinda G., Gambino G., Doklestic L. A. K., Loncar Z., Micic D., Lesevic I., D'Agostino F., Garzali I. U., Caicedo Y., Marcela L., Marin P. A. G., Perivoliotis K., Ntentas I., Kuptsov A., Chowdhury S., and Patel T.
Abstract: Background: Immunocompromised patients with acute diverticulitis are at increased risk of morbidity and mortality. The aim of this study was to compare clinical presentations, types of treatment, and outcomes between immunocompromised and immunocompetent patients with acute diverticulitis. Methods: We compared the data of patients with acute diverticulitis extracted from the Web-based International Registry of Emergency Surgery and Trauma (WIRES-T) from January 2018 to December 2021. First, two groups were identified: medical therapy (A) and surgical therapy (B). Each group was divided into three subgroups: nonimmunocompromised (grade 0), mildly to moderately (grade 1), and severely immunocompromised (grade 2). Results: Data from 482 patients were analyzed—229 patients (47.5%) [M:F = 1:1; median age: 60 (24–95) years] in group A and 253 patients (52.5%) [M:F = 1:1; median age: 71 (26–94) years] in group B. There was a significant difference between the two groups in grade distribution: 69.9% versus 38.3% for grade 0, 26.6% versus 51% for grade 1, and 3.5% versus 10.7% for grade 2 (p < 0.00001). In group A, severe sepsis (p = 0.027) was more common in higher grades of immunodeficiency. Patients with grade 2 needed longer hospitalization (p = 0.005). In group B, a similar condition was found in terms of severe sepsis (p = 0.002), quick Sequential Organ Failure Assessment score > 2 (p = 0.0002), and Mannheim Peritonitis Index (p = 0.010). A Hartmann’s procedure is mainly performed in grades 1–2 (p < 0.0001). Major complications increased significantly after a Hartmann’s procedure (p = 0.047). Mortality was higher in the immunocompromised patients (p = 0.002). Conclusions: Immunocompromised patients with acute diverticulitis present with a more severe clinical picture. When surgery is required, immunocompromised patients mainly undergo a Hartmann’s procedure. Postoperative morbidity and mortality are, however, higher in immunocompromised patients, who also requ
Published: 2023

3. Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T)

Author: Tartaglia, D., Cremonini, C., Annunziata, E., Catena, F., Sartelli, M., Kirkpatrick, A. W., Musetti, S., Strambi, S., Chiarugi, M., Coccolini, F., Salvetti, F., Fugazzola, P., Ceresoli, M., Benedetti, F., Elisa, N. G., Litvin, A., Lostoridis, E., Ahmed, A. Y. Y. M., Manatakis, D., Negoi, I., Ioannidis, O., Uzunoglu, M. Y., Tochie, J. N., Cillara, N., Tomadze, G., Bala, M., Isik, A., Fonseca, V. C., Bellanova, G., Ghannam, W., Yalkin, O., Garcia, F. H., Altintoprak, F., Hadzhiev, D., Chirica, M., Zese, M., Balalis, D., Cui, Y., Luppi, D., Romeo, L., Muratore, A., Lunghi, E. G., Yovtchev, Y., Dimitrov, E., Nikolopoulos, I., Omerovic, M., Zizzo, M., Ugoletti, L., Costa, G., Scalzone, R., Perrone, S., Occhionorelli, S., Nardi, M., Gubbiotti, F., Muhtaroglu, A., Scaramuzzo, R., Corte, H., Yanez, C., Zakaria, A. D., Seretis, C., Gelmini, R., Pappalardo, V., Paratore, F., Sydorchuk, R., Mulita, F., Kara, Y., Toma, E. A., Vailas, M., Sotiropoulou, M., Elbahnasawy, M., Sibilla, M. G., Martines, G., Goksoy, B., Parini, D., Zaghi, C., Podda, M., Osipov, A., Brisinda, G., Gambino, G., Doklestic, L. A. K., Loncar, Z., Micic, D., Lesevic, I., D'Agostino, F., Garzali, I. U., Caicedo, Y., Marcela, L., Marin, P. A. G., Perivoliotis, K., Ntentas, I., Kuptsov, A., Chowdhury, S., Patel, T., Tartaglia, D, Cremonini, C, Annunziata, E, Catena, F, Sartelli, M, Kirkpatrick, A, Musetti, S, Strambi, S, Chiarugi, M, Coccolini, F, Salvetti, F, Fugazzola, P, Ceresoli, M, Benedetti, F, Elisa, N, Litvin, A, Lostoridis, E, Ahmed, A, Manatakis, D, Negoi, I, Ioannidis, O, Uzunoglu, M, Tochie, J, Cillara, N, Tomadze, G, Bala, M, Isik, A, Fonseca, V, Bellanova, G, Ghannam, W, Yalkin, O, Garcia, F, Altintoprak, F, Hadzhiev, D, Chirica, M, Zese, M, Balalis, D, Cui, Y, Luppi, D, Romeo, L, Muratore, A, Lunghi, E, Yovtchev, Y, Dimitrov, E, Nikolopoulos, I, Omerovic, M, Zizzo, M, Ugoletti, L, Costa, G, Scalzone, R, Perrone, S, Occhionorelli, S, Nardi, M, Gubbiotti, F, Muhtaroglu, A, Scaramuzzo, R, Corte, H, Yanez, C, Zakaria, A, Seretis, C, Gelmini, R, Pappalardo, V, Paratore, F, Sydorchuk, R, Mulita, F, Kara, Y, Toma, E, Vailas, M, Sotiropoulou, M, Elbahnasawy, M, Sibilla, M, Martines, G, Goksoy, B, Parini, D, Zaghi, C, Podda, M, Osipov, A, Brisinda, G, Gambino, G, Doklestic, L, Loncar, Z, Micic, D, Lesevic, I, D'Agostino, F, Garzali, I, Caicedo, Y, Marcela, L, Marin, P, Perivoliotis, K, Ntentas, I, Kuptsov, A, Chowdhury, S, and Patel, T
Subjects: Medical therapy, Acute diverticuliti, Gastroenterology, Acute diverticulitis, Surgery, Immunocompromised
Abstract: Background Immunocompromised patients with acute diverticulitis are at increased risk of morbidity and mortality. The aim of this study was to compare clinical presentations, types of treatment, and outcomes between immunocompromised and immunocompetent patients with acute diverticulitis. Methods We compared the data of patients with acute diverticulitis extracted from the Web-based International Registry of Emergency Surgery and Trauma (WIRES-T) from January 2018 to December 2021. First, two groups were identified: medical therapy (A) and surgical therapy (B). Each group was divided into three subgroups: nonimmunocompromised (grade 0), mildly to moderately (grade 1), and severely immunocompromised (grade 2). Results Data from 482 patients were analyzed—229 patients (47.5%) [M:F = 1:1; median age: 60 (24–95) years] in group A and 253 patients (52.5%) [M:F = 1:1; median age: 71 (26–94) years] in group B. There was a significant difference between the two groups in grade distribution: 69.9% versus 38.3% for grade 0, 26.6% versus 51% for grade 1, and 3.5% versus 10.7% for grade 2 (p p = 0.027) was more common in higher grades of immunodeficiency. Patients with grade 2 needed longer hospitalization (p = 0.005). In group B, a similar condition was found in terms of severe sepsis (p = 0.002), quick Sequential Organ Failure Assessment score > 2 (p = 0.0002), and Mannheim Peritonitis Index (p = 0.010). A Hartmann’s procedure is mainly performed in grades 1–2 (p p = 0.047). Mortality was higher in the immunocompromised patients (p = 0.002). Conclusions Immunocompromised patients with acute diverticulitis present with a more severe clinical picture. When surgery is required, immunocompromised patients mainly undergo a Hartmann’s procedure. Postoperative morbidity and mortality are, however, higher in immunocompromised patients, who also require a longer hospital stay.
Published: 2023

4. Colorectal neoplastic emergencies in immunocompromised patients: preliminary result from the Web-based International Register of Emergency Surgery and Trauma (WIRES-T trial)

Author: Coccolini F., Mazzoni A., Cremonini C., Cobuccio L., Pucciarelli M., Vetere G., Borelli B., Strambi S., Musetti S., Miccoli M., Cremolini C., Salvetti F., Fugazzola P., Ceresoli M., Elisa N. G., Litvin A., Lostoridis E., Ahmed A. Y. Y. M., Manatakis D., Negoi I., Ioannidis O., Uzunoglu M. Y., Tochie J. N., Cillara N., Tomadze G., Bala M., Isik A., Fonseca V. C., Bellanova G., Ghannam W., Yalkin O., Garcia F. H., Altintoprak F., Hadzhiev D., Chirica M., Zese M., Balalis D., Cui Y., Luppi D., Romeo L., Muratore A., Lunghi E. G., Yovtchev Y., Nikolopoulos I., Omerovic M., Zizzo M., Ugoletti L., Costa G., Scalzone R., Perrone S., Occhionorelli S., Nardi M., Gubbiotti F., Catena F., Muhtaroglu A., Scaramuzzo R., Corte H., Yanez C., Zakaria A. D., Seretis C., Gelmini R., Pappalardo V., Paratore F., Sydorchuk R., Mulita F., Kara Y., Toma E. A., Vailas M., Sotiropoulou M., Benedetti F., Elbahnasawy M., Sibilla M. G., Martines G., Goksoy B., Parini D., Zaghi C., Podda M., Osipov A., Brisinda G., Gambino G., Akhmeteli L., Doklestic K., Loncar Z., Micic D., Lesevic I., D'Agostino F., Garzali I. U., Caicedo Y., Marcela L., Marin P. A. G., Perivoliotis K., Ntentas I., Kuptsov A., Dimitrov E., Chowdhury S., Patel T., Sartelli M., Tartaglia D., Chiarugi M., Coccolini, F, Mazzoni, A, Cremonini, C, Cobuccio, L, Pucciarelli, M, Vetere, G, Borelli, B, Strambi, S, Musetti, S, Miccoli, M, Cremolini, C, Salvetti, F, Fugazzola, P, Ceresoli, M, Elisa, N, Litvin, A, Lostoridis, E, Ahmed, A, Manatakis, D, Negoi, I, Ioannidis, O, Uzunoglu, M, Tochie, J, Cillara, N, Tomadze, G, Bala, M, Isik, A, Fonseca, V, Bellanova, G, Ghannam, W, Yalkin, O, Garcia, F, Altintoprak, F, Hadzhiev, D, Chirica, M, Zese, M, Balalis, D, Cui, Y, Luppi, D, Romeo, L, Muratore, A, Lunghi, E, Yovtchev, Y, Nikolopoulos, I, Omerovic, M, Zizzo, M, Ugoletti, L, Costa, G, Scalzone, R, Perrone, S, Occhionorelli, S, Nardi, M, Gubbiotti, F, Catena, F, Muhtaroglu, A, Scaramuzzo, R, Corte, H, Yanez, C, Zakaria, A, Seretis, C, Gelmini, R, Pappalardo, V, Paratore, F, Sydorchuk, R, Mulita, F, Kara, Y, Toma, E, Vailas, M, Sotiropoulou, M, Benedetti, F, Elbahnasawy, M, Sibilla, M, Martines, G, Goksoy, B, Parini, D, Zaghi, C, Podda, M, Osipov, A, Brisinda, G, Gambino, G, Akhmeteli, L, Doklestic, K, Loncar, Z, Micic, D, Lesevic, I, D'Agostino, F, Garzali, I, Caicedo, Y, Marcela, L, Marin, P, Perivoliotis, K, Ntentas, I, Kuptsov, A, Dimitrov, E, Chowdhury, S, Patel, T, Sartelli, M, Tartaglia, D, and Chiarugi, M
Subjects: Survival, Colon, Emergency, Acute care, Surgery, Morbidity, Mortality, Immunosuppression, Cancer
Abstract: Association of advanced age, neoplastic disease and immunocompromission (IC) may lead to surgical emergencies. Few data exist about this topic. Present study reports the preliminary data from the WIRES-T trial about patients managed for colorectal neoplastic emergencies in immunocompromised patients. The required data were taken from a prospective observational international register. The study was approved by the Ethical Committee with approval n. 17575; ClinicalTrials.gov Identifier: NCT03643718. 839 patients were collected; 753 (80.7%) with mild–moderate IC and 86 (10.3%) with severe. Median age was 71.9 years and 73 years, respectively, in the two groups. The causes of mild–moderate IC were reported such malignancy (753–100%), diabetes (103–13.7%), malnutrition (26–3.5%) and uremia (1–0.1%), while severe IC causes were steroids treatment (14–16.3%); neutropenia (7–8.1%), malignancy on chemotherapy (71–82.6%). Preoperative risk classification were reported as follow: mild–moderate: ASA 1–14 (1.9%); ASA 2–202 (26.8%); ASA 3–341 (45.3%); ASA 4–84 (11.2%); ASA 5–7 (0.9%); severe group: ASA 1-1 patient (1.2%); ASA 2–16 patients (18.6%); ASA 3–41 patients (47.7%); ASA 4–19 patients (22.1%); ASA 5–3 patients (3.5%); lastly, ASA score was unavailable for 105 cases (13.9%) in mild–moderate group and in 6 cases (6.9%) in severe group. All the patients enrolled underwent urgent/emergency surgery Damage control approach with open abdomen was adopted in 18 patients. Mortality was 5.1% and 12.8%, respectively, in mild–moderate and severe groups. Long-term survival data: in mild–moderate disease-free survival (median, IQR) is 28 (10–91) and in severe IC, it is 21 (10–94). Overall survival (median, IQR) is 44 (18–99) and 26 (20–90) in mild–moderate and severe, respectively; the same is for post-progression survival (median, IQR) 29 (16–81) and 28, respectively. Univariate and multivariate analyses showed as the only factor influencing mortality in mild–moderate and severe IC is the ASA score. Colorectal neoplastic emergencies in immunocompromised patients are more frequent in elderly. Sigmoid and right colon are the most involved. Emergency surgery is at higher risk of complication and mortality; however, management in dedicated emergency surgery units is necessary to reduce disease burden and to optimize results by combining oncological and acute care principles. This approach may improve outcomes to obtain clinical advantages for patients like those observed in elective scenario. Lastly, damage control approach seems feasible and safe in selected patients.
Published: 2023

5. Noise level in intensive care units of a public university hospital in Santa Marta (Colombia)

Author: Garrido Galindo, A.P., Camargo Caicedo, Y., and Vélez-Pereira, A.M.
Published: 2016
Full Text: View/download PDF

6. Nivel continuo equivalente de ruido en la unidad de cuidado intensivo neonatal asociado al síndrome de burnout

Author: Garrido Galindo, A.P., Camargo Caicedo, Y., and Vélez-Pereira, A.M.
Published: 2015
Full Text: View/download PDF

7. Early Transmission Dynamics, Spread, and Genomic Characterization of SARS-CoV-2 in Panama

Author: Franco, D, Gonzalez, C, Abrego, LE, Carrera, J-P, Diaz, Y, Caicedo, Y, Moreno, A, Chavarria, O, Gondola, J, Castillo, M, Valdespino, E, Gaitán, M, Martínez-Mandiche, J, Hayer, L, Gonzalez, P, Lange, C, Molto, Y, Mojica, D, Ramos, R, Mastelari, M, Cerezo, L, Moreno, L, Donnelly, CA, Pascale, JM, Faria, NR, Lopez-Verges, S, Martinez, AA, Gorgas COVID19 team and Panama COVID19 Laboratory Network, Medical Research Council-São Paulo Research Foundation (FAPESP), and Wellcome Trust
Subjects: Male, epidemic dynamics, Time Factors, Epidemiology, viruses, Early Transmission Dynamics, Spread, and Genomic Characterization of SARS-CoV-2 in Panama, Bayesian analysis, lcsh:Medicine, Genetic analysis, Genome, early cryptic transmission, genomic diversity, 0302 clinical medicine, 1108 Medical Microbiology, COVID-19 transmission, 030212 general & internal medicine, Statistics & numerical data, Phylogeny, Panama, Transmission (medicine), Dispatch, Middle Aged, Infectious Diseases, coronavirus disease, outbreaks, COVID-19 Nucleic Acid Testing, Population Surveillance, Female, Microbiology (medical), Adult, Adolescent, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030231 tropical medicine, Genome, Viral, Biology, Microbiology, Virus, 1117 Public Health and Health Services, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, respiratory infections, Young Adult, Gorgas COVID19 team and Panama COVID19 Laboratory Network, Disease Transmission, Infectious, Humans, lcsh:RC109-216, Aged, SARS-CoV-2, lcsh:R, Outbreak, COVID-19, 1103 Clinical Sciences, Virology
Abstract: We report an epidemiologic analysis of 4,210 cases of infection with severe acute respiratory syndrome coronavirus 2 and genetic analysis of 313 new near-complete virus genomes in Panama during March 9-April 16, 2020. Although containment measures reduced R0 and Rt, they did not interrupt virus spread in the country.
Published: 2021

8. The epidemiology of Mayaro virus in the Americas: A systematic review and key parameter estimates for outbreak modelling

Author: Caicedo, Y, Charniga, K, Rueda, A, Dorigatti, I, Hamlet, A, Mendez, Y, Carrera, J-P, Cucunuba, Cucunuba Perez, Z, Medical Research Council (MRC), and Wellcome Trust
Subjects: RNA viruses, 0301 basic medicine, Viral Diseases, Epidemiology, RC955-962, Disease Vectors, Pathology and Laboratory Medicine, Mosquitoes, Geographical locations, Disease Outbreaks, law.invention, Mayaro Virus, Medical Conditions, 0302 clinical medicine, law, Arctic medicine. Tropical medicine, Medicine and Health Sciences, 11 Medical and Health Sciences, Mammals, Chikungunya Virus, Yellow fever, Eukaryota, Biological Evolution, Insects, Infectious Diseases, Geography, Transmission (mechanics), Medical Microbiology, Arboviral Infections, Viral Pathogens, Viruses, Vertebrates, Enzootic, Pathogens, Public aspects of medicine, RA1-1270, Brazil, Research Article, Neglected Tropical Diseases, Primates, medicine.medical_specialty, Arthropoda, Alphaviruses, 030231 tropical medicine, Alphavirus, Microbiology, Models, Biological, Arbovirus, Togaviruses, 03 medical and health sciences, Tropical Medicine, medicine, Animals, Humans, Seroprevalence, Microbial Pathogens, Biology and life sciences, Alphavirus Infections, Organisms, Public Health, Environmental and Occupational Health, Chikungunya Infection, Outbreak, South America, 06 Biological Sciences, Tropical Diseases, medicine.disease, Invertebrates, Insect Vectors, Species Interactions, 030104 developmental biology, Amniotes, People and places, Zoology, Entomology, Basic reproduction number, Demography
Abstract: Mayaro virus (MAYV) is an arbovirus that is endemic to tropical forests in Central and South America, particularly within the Amazon basin. In recent years, concern has increased regarding MAYV’s ability to invade urban areas and cause epidemics across the region. We conducted a systematic literature review to characterise the evolutionary history of MAYV, its transmission potential, and exposure patterns to the virus. We analysed data from the literature on MAYV infection to produce estimates of key epidemiological parameters, including the generation time and the basic reproduction number, R0. We also estimated the force-of-infection (FOI) in epidemic and endemic settings. Seventy-six publications met our inclusion criteria. Evidence of MAYV infection in humans, animals, or vectors was reported in 14 Latin American countries. Nine countries reported evidence of acute infection in humans confirmed by viral isolation or reverse transcription-PCR (RT-PCR). We identified at least five MAYV outbreaks. Seroprevalence from population based cross-sectional studies ranged from 21% to 72%. The estimated mean generation time of MAYV was 15.2 days (95% CrI: 11.7–19.8) with a standard deviation of 6.3 days (95% CrI: 4.2–9.5). The per-capita risk of MAYV infection (FOI) ranged between 0.01 and 0.05 per year. The mean R0 estimates ranged between 2.1 and 2.9 in the Amazon basin areas and between 1.1 and 1.3 in the regions outside of the Amazon basin. Although MAYV has been identified in urban vectors, there is not yet evidence of sustained urban transmission. MAYV’s enzootic cycle could become established in forested areas within cities similar to yellow fever virus., Author summary Each year, diseases that are transmitted by mosquitoes cause substantial deaths and disability across the world. We performed a systematic literature review of Mayaro virus (MAYV) and estimated key epidemiological parameters that can be used to improve future outbreak response. We estimated the generation time and basic reproduction number for a historical outbreak. Our results suggest that the force-of-infection of MAYV in endemic settings is low. We did not find evidence of substantial urban transmission of MAYV. Nevertheless, similarities between MAYV and yellow fever virus epidemiology suggest that MAYV could emerge in urban areas. Local transmission of MAYV has never been reported outside of Central and South America. Our results highlight the need to continue monitoring emerging arboviruses in the Americas.
Published: 2020

9. La educación como recontextualización: Un punto de vista sobre la educación y los educadores

Author: José Granés S. and Luz Marina Caicedo Y.
Subjects: educación, educadores, recontextualización, producción de conocimiento, educación formal, Physics, QC1-999, Optics. Light, QC350-467
Abstract: A partir de una caracterización de la circulación de conocimientos que enfatiza la transformación de estos últimos para adaptarlos a los contextos culturales que los apropian, se desarrolla un punto de vista que considera la educación como un proceso de permanente reubicación de conocimientos y saberes en contextos distintos.
Published: 1997

10. Evaluation of preliminary plant design for Chlorella vulgaris microalgae production focused on cosmetics purposes

Author: Caicedo, Y, primary, Suarez, C, additional, and Gelves, G, additional
Published: 2020
Full Text: View/download PDF

11. Nivel de ruido en unidades de cuidado intensivo de un hospital público universitario en Santa Marta (Colombia)

Author: Garrido Galindo, A.P., primary, Camargo Caicedo, Y., additional, and Vélez-Pereira, A.M., additional
Published: 2016
Full Text: View/download PDF

12. De la producción de conocimientos a la enseñanza: análisis de una experiencia pedagógica

Author: Caicedo Y., Luz Marina and Granés, José
Subjects: Análisis de textos, Epistemología, Óptica de los colores, Crítica textual, Newton (1672), Conocimiento científico
Abstract: En este texto se analiza el trabajo adelantado en un seminario de posgrado en Física para maestros de la escuela secundaria, en el cual se estudió detalladamente el artículo original de Newton (1672) sobre la óptica de los colores. El trabajo en el seminario permitió analizar problemas epistemológicos actuales sobre la producción del conocimiento científico, reflexionar sobre el papel de la historia en la enseñanza de las ciencias y contrastar el desarrollo newtoniano de la óptica de los colores con el tratamiento del mismo tema en los textos de enseñanza.
Published: 2011

13. Noticia biográfica de Joaquín Caicedo i Cuero

Author: Ortíz, José Joaquín, 1814-1892, Caicedo y Camacho, Fernando, 1807-1873, Ortíz, José Joaquín, 1814-1892, and Caicedo y Camacho, Fernando, 1807-1873
Abstract: vii, 25 p., Mención de responsabilidad tomada del cuerpo de la obra., Incluye: Apéndices: p. 21-25.
Published: 2013

14. De la Producción de Conocimientos a la Enseñanza: Análisis de una Experiencia Pedagógica

Author: Granés S., José, primary and Caicedo Y., Luz Marina, primary
Published: 2011
Full Text: View/download PDF

15. Strenghts [sic] and weaknesses in the management of central catheters in a neonatal intensive care unit.

Author: Chamorro EM, Plaza LD, Valencia CP, and Caicedo Y
Abstract: Copyright of Colombia Medica is the property of Universidad del Valle and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Published: 2005

16. Gastos del Colegio Mayor del Rosario entre 1663 – 1798

Author: Achuri, Juan de, Acosta, Juan Miguel de, Agudelo Arias de Bolívar, Francisco de, Alarcón y Castro Agustín, Manuel de, Almeida, Juan de, Ángeles, Juana de los, Ardila, Joseph de, Ardila, Luis de, Bello de Mayorga, Basilio, Bernabé, Berrío y Mendoza de Berrío, Juan de, Berrío y Mendoza de Castrillón, Luis Antonio de, Bonilla, Juan de, Borja y Espeleta de Montenegro, Gregorio de, Bravo de Torres, Juan, Bravo, Nicolás, Bustamante, Juan, Caballero González, Juan, Caicedo y Flórez, Fernando de, Caicedo y Vélez Ladrón de Guevara, Manuel de, Caicedo, Cristóbal de, Caicedo, Francisco, Caldas Barbosa, Tomás de, Caldas, Tomás de, Calderón, Juan Andrés, Camacho de Guzmán y Rojas, Fernando Antonio, Cardona, Luis de, Cascante, Joseph, Castañeda, Isabel de, Castañeda, Juan de, Castillo y Guevara, Luis del, Castillo, Antonio del, Chinchilla y Cañizares, Juan de, Córdoba Lasso de la Vega, Diego de, Correa de Ocampo, Antonio, Correa, Félix, Cruz, Agustín de la, Cruz, Francisca Antonia de la, Cruz, Juan de la, Díaz Quijano, Joseph Gregorio, Enríquez, Antonio, Escobar, Nepomuceno, Esparza, Andrés de, Esparza, Antonio de, Espinosa, Blas de, Esquivel, Tomás de, Félix Beltrán, Francisco, Flórez de Acuña, Jacinto Roque, Florido, Diego, Galeano de Ortega, Luis, Galeano, Cathalina, García, Alejandro, García, Jacinta, Garzón, Vicente, Godoy de Bergaño, Diego, Gómez de Abreu, José Gabriel, Gómez de Vargas, Juan, González, Ignacio, Guzmán y Franqui, José Joaquín de, Henríquez, Antonio, Henríquez, Joseph, Hernández de Heredia, Cristóbal, Hurtado, Joseph, Ignacia, Jacinto, Jiménez, Juan, Lasprilla y Guzmán, Joseph Antonio de, Lázaro, León Castañeda de López, Juan, León López, Juan Félix de, León y Herrera, José Joaquín de, Leyva y la Madrid, Pedro José de, Longas, Manuel de, López Rebollo, Lorenzo, López, Miguel, Luengas, Luis Antonio de, Manrique, Francisco, Martínez de los Ríos, Francisco, Martínez, Ana, Martínez, Francisco, Masústegui y Archer Calzada, Miguel José, Masústegui, Pedro, Mendoza Espeleta, Fernando de, Mendoza, Tomás de, Mogueynies, Francisco de, Montaña, Nicolás, Morato, Joseph, Moya, Ignacio, Ortiz, José, Ortiz, Pedro, Osorio Nieto de Paz y Herrera, Francisco, Osorio Nieto de Paz, Francisco, Osorio, Francisco, Pacheco de López, Sebastián, Palomino y Losada, Juan, Paniagua y Fajardo, Antonio de, Peláez Sotelo, Juan, Peláez, Alonso Matías, Perdigón de los Ríos, Lope, Pérez Manrique, Francisco, Pérez Manrique, Joseph, Pérez, Miguel, Ramírez Maldonado de la Parra, Bartolomé, Rejón de Silva y Urquijo, José de, Río, Andrés del, Rodríguez de León, Francisco, Rodríguez Vidal, Joseph, Rodríguez Alvira, Francisco José, Romero, Diego, Sacramento, Francisca Gertrudis del, Salazar Falcón, Antonio de, Salgado de Castro, Juan, Salinas, Alejandro de, Salvador de Herrera, Joseph, San Agustín, Andrés de, Sánchez, Joaquín, Sánchez, Joseph, Sánchez, Pascual, Santiago, Solís Galván, Pedro, Sorza y Mena Miguel Carlos de, Soto López, Andrés, Sotomayor, Andrés de, Téllez de las Peñas, Lorenzo, Tijero, Pedro, Torres Bravo, Cristóbal de, Torres y Motones, Cristóbal de, Trejo, Jacinto, Trinidad, Antonia de la, Trujillo y Saravia, Juan, Urosandi, Joseph de, Urquijo, Martín de, Vargas, Simón de, Vásquez, Juan, Vergara, Francisco de, Villalba y Toledo, Diego de, Villavez, Joseph de, Zapata, Luis, Caldas Barbosa y Santiago, Enrique de, Mosquera Nuguerol y Sotelo, Juan de, Guzmán y Solanilla, Nicolás de, Achuri, Juan de, Acosta, Juan Miguel de, Agudelo Arias de Bolívar, Francisco de, Alarcón y Castro Agustín, Manuel de, Almeida, Juan de, Ángeles, Juana de los, Ardila, Joseph de, Ardila, Luis de, Bello de Mayorga, Basilio, Bernabé, Berrío y Mendoza de Berrío, Juan de, Berrío y Mendoza de Castrillón, Luis Antonio de, Bonilla, Juan de, Borja y Espeleta de Montenegro, Gregorio de, Bravo de Torres, Juan, Bravo, Nicolás, Bustamante, Juan, Caballero González, Juan, Caicedo y Flórez, Fernando de, Caicedo y Vélez Ladrón de Guevara, Manuel de, Caicedo, Cristóbal de, Caicedo, Francisco, Caldas Barbosa, Tomás de, Caldas, Tomás de, Calderón, Juan Andrés, Camacho de Guzmán y Rojas, Fernando Antonio, Cardona, Luis de, Cascante, Joseph, Castañeda, Isabel de, Castañeda, Juan de, Castillo y Guevara, Luis del, Castillo, Antonio del, Chinchilla y Cañizares, Juan de, Córdoba Lasso de la Vega, Diego de, Correa de Ocampo, Antonio, Correa, Félix, Cruz, Agustín de la, Cruz, Francisca Antonia de la, Cruz, Juan de la, Díaz Quijano, Joseph Gregorio, Enríquez, Antonio, Escobar, Nepomuceno, Esparza, Andrés de, Esparza, Antonio de, Espinosa, Blas de, Esquivel, Tomás de, Félix Beltrán, Francisco, Flórez de Acuña, Jacinto Roque, Florido, Diego, Galeano de Ortega, Luis, Galeano, Cathalina, García, Alejandro, García, Jacinta, Garzón, Vicente, Godoy de Bergaño, Diego, Gómez de Abreu, José Gabriel, Gómez de Vargas, Juan, González, Ignacio, Guzmán y Franqui, José Joaquín de, Henríquez, Antonio, Henríquez, Joseph, Hernández de Heredia, Cristóbal, Hurtado, Joseph, Ignacia, Jacinto, Jiménez, Juan, Lasprilla y Guzmán, Joseph Antonio de, Lázaro, León Castañeda de López, Juan, León López, Juan Félix de, León y Herrera, José Joaquín de, Leyva y la Madrid, Pedro José de, Longas, Manuel de, López Rebollo, Lorenzo, López, Miguel, Luengas, Luis Antonio de, Manrique, Francisco, Martínez de los Ríos, Francisco, Martínez, Ana, Martínez, Francisco, Masústegui y Archer Calzada, Miguel José, Masústegui, Pedro, Mendoza Espeleta, Fernando de, Mendoza, Tomás de, Mogueynies, Francisco de, Montaña, Nicolás, Morato, Joseph, Moya, Ignacio, Ortiz, José, Ortiz, Pedro, Osorio Nieto de Paz y Herrera, Francisco, Osorio Nieto de Paz, Francisco, Osorio, Francisco, Pacheco de López, Sebastián, Palomino y Losada, Juan, Paniagua y Fajardo, Antonio de, Peláez Sotelo, Juan, Peláez, Alonso Matías, Perdigón de los Ríos, Lope, Pérez Manrique, Francisco, Pérez Manrique, Joseph, Pérez, Miguel, Ramírez Maldonado de la Parra, Bartolomé, Rejón de Silva y Urquijo, José de, Río, Andrés del, Rodríguez de León, Francisco, Rodríguez Vidal, Joseph, Rodríguez Alvira, Francisco José, Romero, Diego, Sacramento, Francisca Gertrudis del, Salazar Falcón, Antonio de, Salgado de Castro, Juan, Salinas, Alejandro de, Salvador de Herrera, Joseph, San Agustín, Andrés de, Sánchez, Joaquín, Sánchez, Joseph, Sánchez, Pascual, Santiago, Solís Galván, Pedro, Sorza y Mena Miguel Carlos de, Soto López, Andrés, Sotomayor, Andrés de, Téllez de las Peñas, Lorenzo, Tijero, Pedro, Torres Bravo, Cristóbal de, Torres y Motones, Cristóbal de, Trejo, Jacinto, Trinidad, Antonia de la, Trujillo y Saravia, Juan, Urosandi, Joseph de, Urquijo, Martín de, Vargas, Simón de, Vásquez, Juan, Vergara, Francisco de, Villalba y Toledo, Diego de, Villavez, Joseph de, Zapata, Luis, Caldas Barbosa y Santiago, Enrique de, Mosquera Nuguerol y Sotelo, Juan de, and Guzmán y Solanilla, Nicolás de
Abstract: Gastos del Colegio Mayor del Rosario entre 1663 – 1798 siendo rectores: Enrique de Caldas Barbosa y Santiago (1667-1668, 1670-1672, 1680-1682), Nicolás de Guzmán y Solanilla (1669 - 1670), Juan de Mosquera Nuguerol y Sotelo (1666-1667,1673-1676), Francisco de Agudelo Arias de Bolívar (1692-1693), Cristóbal de Torres Bravo (1683-1684, 1698-1701), Luis Antonio de Berrio y Mendoza de Castrillón (1715-1717, 1725-1728), Fernando Antonio Camacho de Guzmán y Rojas (1711-1714, 1728-1733), José Joaquín de León y Herrera (1759- 1763), Miguel José Masústegui y Archer Calzada (1745, 1763-1766, 1769-1773, 1778-1780), Bartolomé Ramírez Maldonado de la Parra (1766-1769), Manuel de Caicedo y Vélez Ladrón de Guevara (1772-1775), Pedro José de Leyva y la Madrid (1722-1725), José Joaquín de Guzmán y Franqui (1775-1778), Fernando de Caicedo Y Flórez (1793-1796, 1799-1802).

17. De la Producción de Conocimientos a la Enseñanza: Análisis de una Experiencia Pedagógica.

Author: Granés S., José and Caicedo Y., Luz Marina
Subjects: *SEMINARS, *HIGH school teachers, *OPTICS, *THEORY of knowledge, *SCIENTIFIC knowledge, *SCIENCE education
Abstract: In this text, the work done in a postgraduate seminar for secondary school teachers is analyzed During this seminar a detailed study of the original article of Newton (1672) on color optics was undertaken. This study allowed an analysis of actual epistemological problems on the production of scientific knowledge, a reflection on the role of history in science teaching and a comparison between the newtonian development of color optics and the presentation of the same subject in modern teaching texts. [ABSTRACT FROM AUTHOR]
Published: 1998

18. Noticia biográfica de Joaquín Caicedo i Cuero

Author: Ortíz, José Joaquín, 1814-1892 and Caicedo y Camacho, Fernando, 1807-1873
Subjects: Heroes of the Independence of Colombia, Caicedo y Cuero, Joaquín, 1773-1813, Próceres de la Independencia de Colombia, Persons in political science and politics, History of Popayan, Colombia, Historia de Popayán, Persons in social sciences
Abstract: vii, 25 p., Mención de responsabilidad tomada del cuerpo de la obra., Incluye: Apéndices: p. 21-25.
Published: 1853

19. ISO/IEC 29110 para procesos software en las pequeñas empresas

Author: Francisco J. Pino, Andrés F. Pino, Andrés M. Caicedo y Mario Piattini, Francisco J. Pino, Francisco J. Pino, Andrés F. Pino, Andrés M. Caicedo y Mario Piattini, and Francisco J. Pino
Abstract: Este libro es la respuesta para todas aquellas pequeñas empresas TIC que quieran implantar sus propios procesos de software.

20. ISO/IEC 29110 para procesos software en las pequeñas empresas

Author: Francisco J. Pino, Andrés F. Pino, Andrés M. Caicedo y Mario Piattini, Francisco J. Pino, Francisco J. Pino, Andrés F. Pino, Andrés M. Caicedo y Mario Piattini, and Francisco J. Pino
Abstract: Este libro es la respuesta para todas aquellas pequeñas empresas TIC que quieran implantar sus propios procesos de software.

21. ISO/IEC 29110 para procesos software en las pequeñas empresas

Author: Francisco J. Pino, Andrés F. Pino, Andrés M. Caicedo y Mario Piattini, Francisco J. Pino, Francisco J. Pino, Andrés F. Pino, Andrés M. Caicedo y Mario Piattini, and Francisco J. Pino
Abstract: Este libro es la respuesta para todas aquellas pequeñas empresas TIC que quieran implantar sus propios procesos de software.

22. Expugnatio appellationis, vel appellantis a decreto, & executione decreti ... Cardinalis Patriarchae Antiocheni ... D. Caroli de Tournon, emanati die 25 Fanuary 1707

Author: Caicedo y Velasco, Agustín de and Caicedo y Velasco, Agustín de
Abstract: https://patrimoniodigital.ucm.es/r/thumbnail/713804, https://patrimoniodigital.ucm.es/r/item/5325310770

23. ISO/IEC 29110 para procesos software en las pequeñas empresas

Author: Francisco J. Pino, Andrés F. Pino, Andrés M. Caicedo y Mario Piattini, Francisco J. Pino, Francisco J. Pino, Andrés F. Pino, Andrés M. Caicedo y Mario Piattini, and Francisco J. Pino
Abstract: Este libro es la respuesta para todas aquellas pequeñas empresas TIC que quieran implantar sus propios procesos de software.

24. IL-7-dependent and -independent lineages of IL-7R-dependent human T cells.

Author: Arango-Franco CA, Ogishi M, Unger S, Delmonte OM, Orrego JC, Yatim A, Velasquez-Lopera MM, Zea-Vera AF, Bohlen J, Chbihi M, Fayand A, Sánchez JP, Rojas J, Seeleuthner Y, Le Voyer T, Philippot Q, Payne KJ, Gervais A, Erazo-Borrás LV, Correa-Londoño LA, Cederholm A, Gallón-Duque A, Goncalves P, Doisne JM, Horev L, Charmeteau-de Muylder B, Álvarez JÁ, Arboleda DM, Pérez-Zapata L, Vásquez-Echeverri E, Moncada-Vélez M, López JA, Caicedo Y, Palterer B, Patiño PJ, Montoya CJ, Chaldebas M, Zhang P, Nguyen T, Ma CS, Jeljeli M, Alzate JF, Cabarcas F, Khan T, Rinchai D, Prétet JL, Boisson B, Marr N, Ibrahim R, Molho-Pessach V, Boisson-Dupuis S, Kiritsi D, Barata JT, Landegren N, Neven B, Abel L, Lisco A, Béziat V, Jouanguy E, Bustamante J, Di Santo JP, Tangye SG, Notarangelo LD, Cheynier R, Natsuga K, Arias AA, Franco JL, Warnatz K, Casanova JL, and Puel A
Subjects: Humans, Adult, Male, Female, Middle Aged, Severe Combined Immunodeficiency immunology, Severe Combined Immunodeficiency genetics, Severe Combined Immunodeficiency pathology, Cell Lineage immunology, T-Lymphocytes immunology, Interleukin-7 Receptor alpha Subunit, Interleukin-7 immunology, Interleukin-7 genetics, Interleukin-7 metabolism, Receptors, Interleukin-7 genetics, Receptors, Interleukin-7 immunology, Receptors, Interleukin-7 metabolism
Abstract: Infants with biallelic IL7R loss-of-function variants have severe combined immune deficiency (SCID) characterized by the absence of autologous T lymphocytes, but normal counts of circulating B and NK cells (T-B+NK+ SCID). We report 6 adults (aged 22 to 59 years) from 4 kindreds and 3 ancestries (Colombian, Israeli Arab, Japanese) carrying homozygous IL7 loss-of-function variants resulting in combined immunodeficiency (CID). Deep immunophenotyping revealed relatively normal counts and/or proportions of myeloid, B, NK, and innate lymphoid cells. By contrast, the patients had profound T cell lymphopenia, with low proportions of innate-like adaptive mucosal-associated invariant T and invariant NK T cells. They also had low blood counts of T cell receptor (TCR) excision circles, recent thymic emigrant T cells and naive CD4+ T cells, and low overall TCR repertoire diversity, collectively indicating impaired thymic output. The proportions of effector memory CD4+ and CD8+ T cells were high, indicating IL-7-independent homeostatic T cell proliferation in the periphery. Intriguingly, the proportions of other T cell subsets, including TCRγδ+ T cells and some TCRαβ+ T cell subsets (including Th1, Tfh, and Treg) were little affected. Peripheral CD4+ T cells displayed poor proliferation, but normal cytokine production upon stimulation with mitogens in vitro. Thus, inherited IL-7 deficiency impairs T cell development less severely and in a more subset-specific manner than IL-7R deficiency. These findings suggest that another IL-7R-binding cytokine, possibly thymic stromal lymphopoietin, governs an IL-7-independent pathway of human T cell development.
Published: 2024
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25. Biodeterioration Risk Assessment in Libraries by Airborne Fungal Spores.

Author: Camargo-Caicedo Y, Borja Pérez H, Muñoz Fuentes M, Vergara-Vásquez E, and Vélez-Pereira AM
Abstract: Fungal growth on cellulose-based materials in libraries can have detrimental effects on books and documents. This biodeterioration affects their physical, chemical, and esthetical characteristics. Thus, this work aimed to assess fungal aerosols' concentrations and biodeterioration risk in two public libraries with artificial ventilation: the Banco de la República and CAJAMAG libraries. Air sampling was performed using a two-stage viable Andersen cascade impactor with Sabouraud dextrose agar at 4% on Petri dishes. Also, the temperature and relative humidity were measured with a digital thermo-hygrometer HOBO U12 Data Logger. The concentrations were low, with values of around 35 CFU/m 3 . Aspergillus , Cladosporium , and Penicillium were the predominant genera in the two libraries, with A. niger being the most abundant species. The thermo-hygrometric conditions inside the libraries were stable, with a mean temperature of 25.2 °C and a mean relative humidity of 52.1%. The calculated potential risk associated with fungal aerosols was seen to be medium in both libraries, where Aspergillus genera reported the highest cellulosic activity and hence had a higher risk of biodeterioration.
Published: 2024
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26. Airborne particulate matter integral assessment in Magdalena department, Colombia: Patterns, health impact, and policy management.

Author: Vergara-Vásquez E, Hernández Beleño LM, Castrillo-Borja TT, Bolaño-Ortíz TR, Camargo-Caicedo Y, and Vélez-Pereira AM
Abstract: The relevance of atmospheric particulate matter (PM) to health and the environment is widely known. Long-term studies are necessary for understanding current and future trends in air quality management. This study aimed to assess the long-term PM concentration in the Magdalena department (Colombia). It focused on the following aspects: i) spatiotemporal patterns, ii) correlation with meteorology, iii) compliance with standards, iv) temporal trends over time, v) impact on health, and vi) impact of policy management. Fifteen stations from 2003 to 2021 were analyzed. Spearman-Rho and Mann-Kendall methods were used to correlate concentration with meteorology. The temporal and five-year moving trends were determined, and the trend magnitude was calculated using Teil-Sen. Acute respiratory infection odd ratios and risk of cancer associated with PM concentration were used to assess the impact on health. The study found that the maximum PM 10 concentration was 194.5 μg/m 3 , and the minimum was 3 μg/m 3 . In all stations, a negative correlation was observed between PM 10 and atmospheric water content, while the wind speed and temperature showed a positive correlation. The global trends indicated an increasing value, with five fluctuations in five-year moving trends, consistent with PM sources and socio-economic behavior. PM concentrations were found to comply with national standard; however, the results showed a potential impact on population health. The management regulation had a limited impact on increasing concentration. Considering that national regulations tend to converge towards WHO standards, the study area must create a management program to ensure compliance., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)
Published: 2024
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27. Digital Transformation and Its Relationship to the Job Performance of Employees at a Private University in Peru.

Author: Hilda Paola AG, Morán Santamaría RO, Lizana Guevara NP, Pedro Otoniel MS, Yasser Jackson SL, Llonto Caicedo Y, Cúneo Fernández FE, Castro Mejía PJ, and Pérez Pérez MJ
Subjects: Universities, Humans, Peru, Male, Female, Adult, Faculty, Surveys and Questionnaires, Middle Aged, Work Performance
Abstract: Background: Private universities in Peru still need to implement digital transformation models to enhance the job performance of faculty and staff, achieving consistent improvement in the performance levels of university teachers by deploying technological and didactic tools for students. Therefore, the study aims to determine the relationship between digital transformation and the job performance of employees at a Private University., Methods: The research approach was quantitative, employing a non-experimental, longitudinal correlational design. The technique used was a survey, applied to a sample of 104 employees (school heads, faculty, and a director) from the university on a national level from a total population of 144., Results: Descriptive results reveal that the university has regularly adopted tools related to digital transformation. In particular, it has efficiently employed agile technologies, Big Data, and various technological means, benefiting 90% (52% and 38%) of the staff. The study also showed a high positive correlation (0.92>0.7) between digital transformation and the job performance of staff at the Private University, confirming that there is a significant connection between the variables studied., Conclusions: Therefore, creating an innovative culture across all hierarchical levels and identifying key technologies that add value to the learning flow can meet the needs of an increasingly demanding society., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Hilda Paola AG et al.)
Published: 2024
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28. Is REBOA the Last Card to Control a Massive Gastrointestinal Bleeding?

Author: Rodríguez-Holguín F, Salcedo A, Leib P, Caicedo Y, Serna JJ, Toro L, Carvajal S, Riascos M, Parra MW, García A, and Ordoñez CA
Subjects: Humans, Aorta, Resuscitation, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage therapy, Injury Severity Score, Shock, Hemorrhagic therapy, Balloon Occlusion, Endovascular Procedures, Hemostatics
Abstract: Introduction: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potential tool for the management of massive gastrointestinal bleeding (MGB). This study aims to describe the experience of the use of REBOA as adjunctive therapy in patients with MGB and to evaluate its effectiveness., Methods: Serial cases of patients with hemorrhagic shock secondary to MGB in whom REBOA was placed were collected. Patient demographics, bleeding severity, etiology, management, and clinical outcomes were recorded., Results: Between 2017 and 2020, five cases were analyzed. All patients had a severe gastrointestinal bleeding (Glasgow Blatchford Bleeding Score range 12-17; Clinical Rockal Score range 5-9). The etiologies of MGB were perforated gastric or duodenal ulcers, esophageal varices, and vascular lesions. Systolic blood pressure increased after REBOA placement and total occlusion time was 25-60 min. REBOA provided temporary hemorrhage control in all cases and allowed additional hemostatic maneuvers to be performed. Three patients survived more than 24 h. All patients died in index hospitalization. The main cause of death was related to hemorrhagic shock., Conclusions: Endovascular aortic occlusion can work as a bridge to further resuscitation and attempts at hemostasis in patients with MGB. REBOA provides hemodynamic support and may be used simultaneously with other hemostatic maneuvers, facilitating definitive hemorrhage control., (Copyright © 2024 Elsevier Inc. All rights reserved.)
Published: 2024
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29. Critical systolic blood pressure threshold for endovascular aortic occlusion-A multinational analysis to determine when to place a REBOA.

Author: Ordoñez CA, Parra MW, Caicedo Y, Rodríguez-Holguín F, García AF, Serna JJ, Serna C, Franco MJ, Salcedo A, Padilla-Londoño N, Herrera-Escobar JP, Zogg C, Orlas CP, Palacios H, Saldarriaga L, Granados M, Scalea T, McGreevy DT, Kessel B, Hörer TM, Dubose J, and Brenner M
Subjects: Humans, Male, Adult, Middle Aged, Female, Blood Pressure, Aorta injuries, Injury Severity Score, Resuscitation, Retrospective Studies, Balloon Occlusion, Shock, Hemorrhagic therapy, Arterial Occlusive Diseases, Endovascular Procedures
Abstract: Background: Systolic blood pressure (SBP) is a potential indicator that could guide when to use a resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma patients with life-threatening injuries. This study aims to determine the optimal SBP threshold for REBOA placement by analyzing the association between SBP pre-REBOA and 24-hour mortality in severely injured hemodynamically unstable trauma patients., Methods: We performed a pooled analysis of the aortic balloon occlusion (ABO) trauma and AORTA registries. These databases record the details related to the use of REBOA and include data from 14 countries worldwide. We included patients who had suffered penetrating and/or blunt trauma. Patients who arrived at the hospital with a SBP pre-REBOA of 0 mm Hg and remained at 0 mm Hg after balloon inflation were excluded. We evaluated the impact that SBP pre-REBOA had on the probability of death in the first 24 hours., Results: A total of 1,107 patients underwent endovascular aortic occlusion, of these, 848 met inclusion criteria. The median age was 44 years (interquartile range [IQR], 27-59 years) and 643 (76%) were male. The median injury severity score was 34 (IQR, 25-45). The median SBP pre-REBOA was 65 mm Hg (IQR, 49-88 mm Hg). Mortality at 24 hours was reported in 279 (32%) patients. Math modeling shows that predicted probabilities of the primary outcome increased steadily in SBP pre-REBOA below 100 mm Hg. Multivariable mixed-effects analysis shows that when SBP pre-REBOA was lower than 60 mm Hg, the risk of death was more than 50% (relative risk, 1.5; 95% confidence interval, 1.17-1.92; p = 0.001)., Discussion: In patients who do not respond to initial resuscitation, the use of REBOA in SBPs between 60 mm Hg and 80 mm Hg may be a useful tool in resuscitation efforts before further decompensation or complete cardiovascular collapse. The findings from our study are clinically important as a first step in identifying candidates for REBOA., Level of Evidence: Prognostic and Epidemiological; Level IV., (Copyright © 2023 American Association for the Surgery of Trauma.)
Published: 2024
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30. Assessment of livestock greenhouse gases in Colombia between 1995 and 2015.

Author: Garrido AP, Tovar Bernal F, Fontanilla JD, Camargo Caicedo Y, and Vélez-Pereira AM
Abstract: The livestock sector in Colombia significantly participates in national economic dynamics but makes significant worldwide contributions to greenhouse gas emissions. Hence, climate change mitigation in this sector is essential. This study aims to assess the greenhouse gas in the livestock sector. The results are reported in methane emissions (CH 4 ) and nitrous oxide (N 2 O) from enteric fermentation, and N 2 O by manure management based on the information from the Emission Database for Global Atmospheric Research (EDGAR), in all cases expressed as dioxide of carbon (CO 2eq ). The emissions obtained from the EDGAR database for 2015 were proportional to the values of the National Inventory of Greenhouse Gases published by the Institute of Hydrology, Meteorology, and Environmental Studies (IDEAM) in 2016. Colombia is the 12th on global, 4th in America and 2nd in South America position by livestock GHG emission, and is the dominant source in all economic sector. The results showed higher records for CH 4 emissions during the years 2010 and 2015, while the N 2 O emissions were higher during 2015. The regions with the highest emissions of CH 4 and N 2 O corresponded to the northwestern area of Colombia. The Spearman correlation test showed a positive correlation between the CH 4 emissions, and the age groups studied. The post hoc analysis of the Kruskal-Wallis test showed a more significant influence on CH 4 emissions., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)
Published: 2022
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31. Maternal hemodynamics during aortic occlusion with REBOA in patients with placenta accreta spectrum disorder.

Author: Nieto-Calvache AJ, López-Girón MC, Burgos-Luna JM, Messa-Bryon A, Monroy A, López LJ, Rodríguez F, Caicedo Y, Brenner M, and Ordoñez CA
Subjects: Female, Humans, Prospective Studies, Resuscitation, Aorta, Hemodynamics, Placenta Accreta therapy, Balloon Occlusion, Shock, Hemorrhagic
Abstract: Introduction: The effectiveness of resuscitative endovascular balloon occlusion of the aorta (REBOA) in controlling pelvic bleeding has been reported with increasing frequency during surgical management of placenta accreta spectrum (PAS). The deployment of REBOA may lead to significant variations in vital signs requiring special care by anesthesiology during surgery. These modifications of blood pressure by REBOA in PAS patients have not been accurately documented. We report the changes in blood pressure that occur when the aorta is occluded and then released in patients with PAS., Methodology: This prospective, observational study includes 10 patients with preoperative PAS suspicion who underwent prophylactic REBOA device insertion between April 2018 and October 2019. REBOA procedural-related data and blood pressure fluctuations under invasive monitoring before and after inflation and deflation were recorded in the operating room., Results: After prophylactic REBOA deployment in zone 3 of the aorta in PAS patients, we observed a transitory increase in blood pressure (median increase of 22.5 mmHg in SBP and 9.5 mmHg in DBP), which reached severe hypertension (SBP >160 mmHg) in 50% of patients. All patients presented a decrease in blood pressure after the removal of the aortic occlusion (median decrease of 23 mmHg in SBP and 10.5 mmHg in DBP), and 50% (five patients) required the administration of vasopressor drugs., Conclusion: Immediately after aortic occlusion is applied in zone 3 in PAS patients and after the occlusion is removed, significant hemodynamic changes occur, which often lead to therapeutic interventions.
Published: 2022
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32. Resuscitative endovascular balloon occlusion of the aorta in civilian pre-hospital care: a systematic review of the literature.

Author: Caicedo Y, Gallego LM, Clavijo HJ, Padilla-Londoño N, Gallego CN, Caicedo-Holguín I, Guzmán-Rodríguez M, Meléndez-Lugo JJ, García AF, Salcedo AE, Parra MW, Rodríguez-Holguín F, and Ordoñez CA
Subjects: Aorta, Hospitals, Humans, Resuscitation methods, Retrospective Studies, Balloon Occlusion methods, Endovascular Procedures adverse effects, Endovascular Procedures methods, Shock, Hemorrhagic etiology, Shock, Hemorrhagic therapy
Abstract: Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a damage control tool with a potential role in the hemodynamic resuscitation of severely ill patients in the civilian pre-hospital setting. REBOA ensures blood flow to vital organs by early proximal control of the source of bleeding. However, there is no consensus on the use of REBOA in the pre-hospital setting. This article aims to perform a systematic review of the literature about the feasibility, survival, indications, complications, and potential candidates for civilian pre-hospital REBOA., Methods: A literature search was conducted using Medline, EMBASE, LILACS and Web of Science databases. Primary outcome variables included overall survival and feasibility. Secondary outcome variables included complications and potential candidates for endovascular occlusion., Results: The search identified 8 articles. Five studies described the use of REBOA in pre-hospital settings, reporting a total of 47 patients in whom the procedure was attempted. Pre-hospital REBOA was feasible in 68-100% of trauma patients and 100% of non-traumatic patients with cardiac arrest. Survival rates and complications varied widely. Pre-hospital REBOA requires a coordinated and integrated emergency health care system with a well-trained and equipped team. The remaining three studies performed a retrospective analysis identifying 784 potential REBOA candidates., Conclusions: Pre-hospital REBOA could be a feasible intervention for a significant portion of severely ill patients in the civilian setting. However, the evidence is limited. The impact of pre-hospital REBOA should be assessed in future studies., (© 2022. The Author(s).)
Published: 2022
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33. Risk factors for posttraumatic empyema in diaphragmatic injuries.

Author: García AF, Rodríguez F, Sánchez Á, Caicedo-Holguín I, Gallego-Navarro C, Naranjo MP, Caicedo Y, Burbano D, Currea-Perdomo DF, Ordoñez CA, and Puyana JC
Subjects: Adult, Humans, Male, Risk Factors, Thoracotomy adverse effects, Thoracotomy methods, Empyema complications, Empyema surgery, Thoracic Injuries complications, Thoracic Injuries surgery, Wounds, Penetrating surgery
Abstract: Background: Penetrating diaphragmatic injuries are associated with a high incidence of posttraumatic empyema. We analyzed the contribution of trauma severity, specific organ injury, contamination severity, and surgical management to the risk of posttraumatic empyema in patients who underwent surgical repair of diaphragmatic injuries at a level 1 trauma center., Methods: This is a retrospective review of the patients who survived more than 48 h. Univariate OR calculations were performed to identify potential risk factors. Multiple logistic regression was used to calculate adjusted ORs and identify independent risk factors., Results: We included 192 patients treated from 2011 to 2020. There were 169 (88.0) males. The mean interquartile range, (IQR) of age, was 27 (22-35) years. Gunshot injuries occurred in 155 subjects (80.7%). Mean (IQR) NISS and ATI were 29 (18-44) and 17 (10-27), respectively. Thoracic AIS was > 3 in 38 patients (19.8%). Hollow viscus was injured in 105 cases (54.7%): stomach in 65 (33.9%), colon in 52 (27.1%), small bowel in 42 (21.9%), and duodenum in 10 (5.2%). Visible contamination was found in 76 patients (39.6%). Potential thoracic contamination was managed with a chest tube in 128 cases (66.7%), with transdiaphragmatic pleural lavage in 42 (21.9%), and with video-assisted thoracoscopy surgery or thoracotomy in 22 (11.5%). Empyema occurred in 11 patients (5.7%). Multiple logistic regression identified thoracic AIS > 3 (OR 6.4, 95% CI 1.77-23. 43), and visible contamination (OR 5.13, 95% IC 1.26-20.90) as independent risk factors. The individual organ injured, or the method used to manage the thoracic contamination did not affect the risk of posttraumatic empyema., Conclusion: The severity of the thoracic injury and the presence of visible abdominal contamination were identified as independent risk factors for empyema after penetrating diaphragmatic trauma., (© 2022. The Author(s).)
Published: 2022
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34. Intra-abdominal hypertension and hypoxic respiratory failure together predict adverse outcome - A sub-analysis of a prospective cohort.

Author: Regli A, Reintam Blaser A, De Keulenaer B, Starkopf J, Kimball E, Malbrain MLNG, Van Heerden PV, Davis WA, Palermo A, Dabrowski W, Siwicka-Gieroba D, Barud M, Grigoras I, Ristescu AI, Blejusca A, Tamme K, Maddison L, Kirsimägi Ü, Litvin A, Kazlova A, Filatau A, Pracca F, Sosa G, Santos MD, Kirov M, Smetkin A, Ilyina Y, Gilsdorf D, Ordoñez CA, Caicedo Y, Greiffenstein P, Morgan MM, Bodnar Z, Tidrenczel E, Oliveira G, Albuquerque A, and Pereira BM
Subjects: Blood Gas Analysis, Humans, Prospective Studies, Risk Factors, Intra-Abdominal Hypertension epidemiology, Respiratory Insufficiency
Abstract: Purpose: To assess whether the combination of intra-abdominal hypertension (IAH, intra-abdominal pressure ≥ 12 mmHg) and hypoxic respiratory failure (HRF, PaO2/FiO2 ratio < 300 mmHg) in patients receiving invasive ventilation is an independent risk factor for 90- and 28-day mortality as well as ICU- and ventilation-free days., Methods: Mechanically ventilated patients who had blood gas analyses performed and intra-abdominal pressure measured, were included from a prospective cohort. Subgroups were defined by the absence (Group 1) or the presence of either IAH (Group 2) or HRF (Group 3) or both (Group 4). Mixed-effects regression analysis was performed., Results: Ninety-day mortality increased from 16% (Group 1, n = 50) to 30% (Group 2, n = 20) and 27% (Group 3, n = 100) to 49% (Group 4, n = 142), log-rank test p < 0.001. The combination of IAH and HRF was associated with increased 90- and 28-day mortality as well as with fewer ICU- and ventilation-free days. The association with 90-day mortality was no longer present after adjustment for independent variables. However, the association with 28-day mortality, ICU- and ventilation-free days persisted after adjusting for independent variables., Conclusions: In our sub-analysis, the combination of IAH and HRF was not independently associated with 90-day mortality but independently increased the odds of 28-day mortality, and reduced the number of ICU- and ventilation-free days., Competing Interests: Declaration of Competing Interest ARB received honoraria for advisory board meetings or speaker fees from Nestlé and Fresenius and Nutricia and is a member of executive committee of the Abdominal Compartment Society (WSACS). University of Tartu received study grant from Fresenius. MLNGM is co-founder, past-President and current Treasurer of WSACS (The Abdominal Compartment Society, http://www.wsacs.org), he is member of the medical advisory Board of Pulsion Medical Systems (part of Getinge group) and Serenno Medical, and consults for ConvaTec, Acelity, Spiegelberg, and Holtech Medical. He is co-founder of the International Fluid Academy (IFA). The IFA is integrated within the not-for-profit charitable organization iMERiT, International Medical Education and Research Initiative, under Belgian law. No other authors have any conflict of interest to report., (Copyright © 2021 Elsevier Inc. All rights reserved.)
Published: 2021
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35. Reinterventions after damage control surgery.

Author: Mejia D, Warr SP, Delgado-López CA, Salcedo A, Rodríguez-Holguín F, Serna JJ, Caicedo Y, Pino LF, González-Hadad A, Herrera MA, Parra MW, García A, and Ordoñez CA
Subjects: Anastomosis, Surgical, Colombia, Humans, Retrospective Studies, Postoperative Complications epidemiology, Postoperative Complications etiology
Abstract: Damage control has well-defined steps. However, there are still controversies regarding whom, when, and how re-interventions should be performed. This article summarizes the Trauma and Emergency Surgery Group (CTE) Cali-Colombia recommendations about the specific situations concerning second interventions of patients undergoing damage control surgery. We suggest packing as the preferred bleeding control strategy, followed by unpacking within the next 48-72 hours. In addition, a deferred anastomosis is recommended for correction of intestinal lesions, and patients treated with vascular shunts should be re-intervened within 24 hours for definitive management. Furthermore, abdominal or thoracic wall closure should be attempted within eight days. These strategies aim to decrease complications, morbidity, and mortality., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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36. Damage control in penetrating carotid artery trauma: changing a 100-year paradigm.

Author: Serna JJ, Ordoñez CA, Parra MW, Serna C, Caicedo Y, Rosero A, Velásquez F, Serna C, Salcedo A, González-Hadad A, García A, Herrera MA, Pino LF, Franco MJ, and Rodríguez-Holguín F
Subjects: Humans, Carotid Artery Injuries etiology, Carotid Artery Injuries surgery
Abstract: Carotid artery trauma carries a high risk of neurological sequelae and death. Surgical management of these injuries has been controversial because it entails deciding between repair or ligation of the vessel, for which there is still no true consensus either way. This article proposes a new management strategy for carotid artery injuries based on the principles of damage control surgery which include endovascular and/or traditional open repair techniques. The decision to operate immediately or to perform further imaging studies will depend on the patient's hemodynamic status. If the patient presents with massive bleeding, an expanding neck hematoma or refractory hypovolemic shock, urgent surgical intervention is indicated. An altered mental status upon arrival is a potentially poor prognosis marker and should be taken into account in the therapeutic decision-making. We describe a step-by-step algorithmic approach to these injuries, including open and endovascular techniques. In addition, conservative non-operative management has also been included as a potentially viable strategy in selected patients, which avoids unnecessary surgery in many cases., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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37. Damage control surgery for thoracic outlet vascular injuries: the new resuscitative median sternotomy plus REBOA.

Author: Parra MW, Ordoñez CA, Pino LF, Millán M, Caicedo Y, Buchelli VR, García A, González-Hadad A, Salcedo A, Serna JJ, Quintero L, Herrera MA, Hernández F, and Rodríguez-Holguín F
Subjects: Aorta, Humans, Resuscitation, Sternotomy, United States, Balloon Occlusion, Vascular System Injuries surgery
Abstract: Thoracic vascular trauma is associated with high mortality and is the second most common cause of death in patients with trauma following head injuries. Less than 25% of patients with a thoracic vascular injury arrive alive to the hospital and more than 50% die within the first 24 hours. Thoracic trauma with the involvement of the great vessels is a surgical challenge due to the complex and restricted anatomy of these structures and its association with adjacent organ damage. This article aims to delineate the experience obtained in the surgical management of thoracic vascular injuries via the creation of a practical algorithm that includes basic principles of damage control surgery. We have been able to show that the early application of a resuscitative median sternotomy together with a zone 1 resuscitative endovascular balloon occlusion of the aorta (REBOA) in hemodynamically unstable patients with thoracic outlet vascular injuries improves survival by providing rapid stabilization of central aortic pressure and serving as a bridge to hemorrhage control. Damage control surgery principles should also be implemented when indicated, followed by definitive repair once the correction of the lethal diamond has been achieved. To this end, we have developed a six-step management algorithm that illustrates the surgical care of patients with thoracic outlet vascular injuries according to the American Association of the Surgery of Trauma (AAST) classification., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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38. Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm.

Author: Parra MW, Ordoñez CA, Mejia D, Caicedo Y, Lobato JM, Castro OJ, Uribe JA, and Velásquez F
Subjects: Algorithms, Humans, Resuscitation, Balloon Occlusion, Endovascular Procedures, Shock, Hemorrhagic therapy
Abstract: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It has also been performed for patients with neurogenic shock to support the central aortic pressure necessary for cerebral, coronary and spinal cord perfusion. Although volume replacement and vasopressors are the cornerstones of the management of neurogenic shock, we believe that a REBOA can be used as an adjunct in carefully selected cases to prevent prolonged hypotension and the risk of further anoxic spinal cord injury. This manuscript aims to propose a new damage control algorithmic approach to refractory neurogenic shock that includes the use of a REBOA in Zone 3. There are still unanswered questions on spinal cord perfusion and functional outcomes using a REBOA in Zone 3 in trauma patients with refractory neurogenic shock. However, we believe that its use in these case scenarios can be beneficial to the overall outcome of these patients., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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39. Primary repair: damage control surgery in esophageal trauma.

Author: Millán M, Parra MW, Sanchez-Restrepo B, Caicedo Y, Serna C, González-Hadad A, Pino LF, Herrera MA, Hernández F, Rodríguez-Holguín F, Salcedo A, Serna JJ, García A, and Ordoñez CA
Subjects: Colombia, Humans, Intensive Care Units
Abstract: Esophageal trauma is a rare but life-threatening event associated with high morbidity and mortality. An inadvertent esophageal perforation can rapidly contaminate the neck, mediastinum, pleural space, or abdominal cavity, resulting in sepsis or septic shock. Higher complications and mortality rates are commonly associated with adjacent organ injuries and/or delays in diagnosis or definitive management. This article aims to delineate the experience obtained by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia, on the surgical management of esophageal trauma following damage control principles. Esophageal injuries should always be suspected in thoracoabdominal or cervical trauma when the trajectory or mechanism suggests so. Hemodynamically stable patients should be radiologically evaluated before a surgical correction, ideally with computed tomography of the neck, chest, and abdomen. While hemodynamically unstable patients should be immediately transferred to the operating room for direct surgical control. A primary repair is the surgical management of choice in all esophageal injuries, along with endoscopic nasogastric tube placement and immediate postoperative care in the intensive care unit. We propose an easy-to-follow surgical management algorithm that sticks to the philosophy of "Less is Better" by avoiding esophagostomas., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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40. Evolution of damage control surgery in non-traumatic abdominal pathology: a light in the darkness.

Author: Ordoñez CA, Caicedo Y, Parra MW, Rodríguez-Holguín F, Serna JJ, Salcedo A, Franco MJ, Toro LE, Pino LF, Guzmán-Rodríguez M, Orlas C, Herrera-Escobar JP, González-Hadad A, Herrera MA, Aristizábal G, and García A
Subjects: Humans, Abdomen surgery
Abstract: Damage control surgery is based on temporal control of the injury, physiologic recovery and posterior deferred definitive management. This strategy began in the 1980s and became a formal concept in 1993. It has proven to be a strategy that reduces mortality in severely injured trauma patients. Nevertheless, the concept of damage control in non-traumatic abdominal pathology remains controversial. This article aims to gather historical experiences in damage control surgery performed in non-traumatic abdominal emergency pathology patients and present a novel management algorithm. This strategy could be a surgical option to treat hemodynamically unstable patients in catastrophic scenarios such as hemorrhagic and septic shock caused by peritonitis, pancreatitis, acute mesenteric ischemia, among others. Therefore, damage control surgery is light amid better short- and long-term results., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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41. Damage control in the intensive care unit: what should the intensive care physician know and do?

Author: Vargas M, García A, Caicedo Y, Parra MW, and Ordoñez CA
Subjects: Critical Care, Humans, Intensive Care Units, Resuscitation, Blood Coagulation Disorders etiology, Blood Coagulation Disorders therapy, Physicians, Wounds and Injuries therapy
Abstract: Damage control surgery has transformed the management of severely injured trauma patients. It was initially described as a three-step process that included bleeding control, abdominal cavity contamination, and resuscitation in the intensive care unit (ICU) before definitive repair of the injuries. When the patient is admitted into the ICU, the physician should identify all the physiological alterations to establish resuscitation management goals. These strategies allow an early correction of trauma-induced coagulopathy and hypoperfusion increasing the likelihood of survival. The objective of this article is to describe the physiological alterations in a severely injured trauma patient who undergo damage control surgery and to establish an adequate management approach. The physician should always be aware and correct the hypothermia, acidosis, coagulopathy and hypocalcemia presented in the severely injured trauma patients., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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42. Abdominal and thoracic wall closure: damage control surgery's cinderella.

Author: Rodríguez-Holguín F, González Hadad A, Mejia D, García A, Cevallos C, Himmler AN, Caicedo Y, Salcedo A, Serna JJ, Herrera MA, Pino LF, Parra MW, and Ordoñez CA
Subjects: Colombia, Humans, Abdominal Injuries surgery, Thoracic Wall
Abstract: Damage control surgery principles allow delayed management of traumatic lesions and early metabolic resuscitation by performing abbreviated procedures and prompt resuscitation maneuvers in severely injured trauma patients. However, the initial physiological response to trauma and surgery, along with the hemostatic resuscitation efforts, causes important side effects on intracavitary organs such as tissue edema, increased cavity pressure, and hemodynamic collapse. Consequently, different techniques have been developed over the years for a delayed cavity closure. Nonetheless, the optimal management of abdominal and thoracic surgical closure remains controversial. This article aims to describe the indications and surgical techniques for delayed abdominal or thoracic closure following damage control surgery in severely injured trauma patients, based on the experience obtained by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia. We recommend negative pressure dressing as the gold standard technique for delayed cavity closure, associated with higher wall closure success rates and lower complication and mortality rates., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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43. Damage control in the emergency department, a bridge to life.

Author: Quintero L, Meléndez-Lugo JJ, Palacios-Rodríguez HE, Caicedo Y, Padilla N, Gallego LM, Pino LF, García A, González-Hadad A, Herrera MA, Salcedo A, Serna JJ, Rodríguez-Holguín F, Parra MW, and Ordoñez CA
Subjects: Colombia, Femoral Vein, Hemostatic Techniques, Humans, Injury Severity Score, Practice Guidelines as Topic, Vascular Access Devices, Advanced Trauma Life Support Care methods, Emergency Service, Hospital, Hemorrhage therapy, Resuscitation methods
Abstract: Patients with hemodynamic instability have a sustained systolic blood pressure less or equal to 90 mmHg, a heart rate greater or equal to 120 beats per minute and an acute compromise of the ventilation/oxygenation ratio and/or an altered state of consciousness upon admission. These patients have higher mortality rates due to massive hemorrhage, airway injury and/or impaired ventilation. Damage control resuscitation is a systematic approach that aims to limit physiologic deterioration through strategies that address the physiologic debt of trauma. This article aims to describe the experience earned by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia in the management of the severely injured trauma patient in the emergency department following the basic principles of damage control surgery. Since bleeding is the main cause of death, the management of the severely injured trauma patient in the emergency department requires a multidisciplinary team that performs damage control maneuvers aimed at rapidly controlling bleeding, hemostatic resuscitation, and/or prompt transfer to the operating room, if required., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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44. Rectal damage control: when to do and not to do.

Author: Saldarriaga LG, Palacios-Rodríguez HE, Pino LF, Hadad AG, Caicedo Y, Capre J, García A, Rodríguez-Holguín F, Salcedo A, Serna JJ, Herrera MA, Parra MW, Ordoñez CA, and Kestenberg-Himelfarb A
Subjects: Humans, Colombia, Colon injuries, Conservative Treatment, Digital Rectal Examination, Proctoscopy, Tomography, X-Ray Computed methods, Algorithms, Colostomy, Consensus, Rectum injuries, Rectum surgery, Wounds, Penetrating diagnosis, Wounds, Penetrating surgery, Wounds, Penetrating therapy
Abstract: Rectal trauma is uncommon, but it is usually associated with injuries in adjacent pelvic or abdominal organs. Recent studies have changed the paradigm behind military rectal trauma management, showing better morbidity and mortality. However, damage control techniques in rectal trauma remain controversial. This article aims to present an algorithm for the treatment of rectal trauma in a patient with hemodynamic instability, according to damage control surgery principles. We propose to manage intraperitoneal rectal injuries in the same way as colon injuries. The treatment of extraperitoneal rectum injuries will depend on the percentage of the circumference involved. For injuries involving more than 25% of the circumference, a colostomy is indicated. While injuries involving less than 25% of the circumference can be managed through a conservative approach or primary repair. In rectal trauma, knowing when to do or not to do it makes the difference., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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45. Damage Control for renal trauma: the more conservative the surgeon, better for the kidney.

Author: Salcedo A, Ordoñez CA, Parra MW, Osorio JD, Leib P, Caicedo Y, Guzmán-Rodríguez M, Padilla N, Pino LF, Herrera MA, Hadad AG, Serna JJ, García A, Coccolini F, and Catena F
Subjects: Humans, Algorithms, Colombia, Consensus, Embolization, Therapeutic, Hematoma diagnosis, Hematoma therapy, Hemorrhage therapy, Kidney diagnostic imaging, Kidney injuries, Laparotomy, Medical Illustration, Conservative Treatment, Surgeons, Urinary Tract diagnostic imaging, Urinary Tract injuries, Wounds, Penetrating classification, Wounds, Penetrating diagnostic imaging, Wounds, Penetrating surgery, Wounds, Penetrating therapy
Abstract: Urologic trauma is frequently reported in patients with penetrating trauma. Currently, the computerized tomography and vascular approach through angiography/embolization are the standard approaches for renal trauma. However, the management of renal or urinary tract trauma in a patient with hemodynamic instability and criteria for emergency laparotomy, is a topic of discussion. This article presents the consensus of the Trauma and Emergency Surgery Group (CTE) from Cali, for the management of penetrating renal and urinary tract trauma through damage control surgery. Intrasurgical perirenal hematoma characteristics, such as if it is expanding or actively bleeding, can be reference for deciding whether a conservative approach with subsequent radiological studies is possible. However, if there is evidence of severe kidney trauma, surgical exploration is mandatory and entails a high probability of requiring a nephrectomy. Urinary tract damage control should be conservative and deferred, because this type of trauma does not represent a risk in acute trauma management., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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46. Damage control surgery in lung trauma.

Author: García A, Millán M, Ordoñez CA, Burbano D, Parra MW, Caicedo Y, González Hadad A, Herrera MA, Pino LF, Rodríguez-Holguín F, Salcedo A, Franco MJ, Ferrada R, and Puyana JC
Subjects: Acidosis diagnosis, Aorta, Blood Coagulation Disorders diagnosis, Hemorrhage etiology, Humans, Hypothermia diagnosis, Lung Injury classification, Lung Injury complications, Lung Injury epidemiology, Medical Illustration, Photography, Therapeutic Occlusion, Wound Closure Techniques, Hemorrhage therapy, Hemostatic Techniques, Lung Injury surgery, Thoracotomy methods
Abstract: Damage control techniques applied to the management of thoracic injuries have evolved over the last 15 years. Despite the limited number of publications, information is sufficient to scatter some fears and establish management principles. The severity of the anatomical injury justifies the procedure of damage control in only few selected cases. In most cases, the magnitude of the physiological derangement and the presence of other sources of bleeding within the thoracic cavity or in other body compartments constitutes the indication for the abbreviated procedure. The classification of lung injuries as peripheral, transfixing, and central or multiple, provides a guideline for the transient bleeding control and for the definitive management of the injury: pneumorraphy, wedge resection, tractotomy or anatomical resection, respectively. Identification of specific patterns such as the need for resuscitative thoracotomy, or aortic occlusion, the existence of massive hemothorax, a central lung injury, a tracheobronchial injury, a major vascular injury, multiple bleeding sites as well as the recognition of hypothermia, acidosis or coagulopathy, constitute the indication for a damage control thoracotomy. In these cases, the surgeon executes an abbreviated procedure with packing of the bleeding surfaces, primary management with packing of some selected peripheral or transfixing lung injuries, and the postponement of lung resection, clamping of the pulmonary hilum in the most selective way possible. The abbreviation of the thoracotomy closure is achieved by suturing the skin over the wound packed, or by installing a vacuum system. The management of the patient in the intensive care unit will allow identification of those who require urgent reintervention and the correction of the physiological derangement in the remaining patients for their scheduled reintervention and definitive management., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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47. Damage control surgery for splenic trauma: "preserve an organ - preserve a life".

Author: Serna C, Serna JJ, Caicedo Y, Padilla N, Gallego LM, Salcedo A, Rodríguez-Holguín F, González-Hadad A, García A, Herrera MA, Parra MW, and Ordoñez CA
Subjects: Abdominal Injuries complications, Abdominal Injuries surgery, Advanced Trauma Life Support Care standards, Colombia, Computed Tomography Angiography, Embolization, Therapeutic, Endotamponade methods, Hemostatic Techniques, Humans, Negative-Pressure Wound Therapy, Spleen blood supply, Spleen diagnostic imaging, Spleen surgery, Splenectomy, Splenic Artery injuries, Splenic Artery surgery, Algorithms, Conservative Treatment, Organ Sparing Treatments, Spleen injuries
Abstract: The spleen is one of the most commonly injured solid organs of the abdominal cavity and an early diagnosis can reduce the associated mortality. Over the past couple of decades, management of splenic injuries has evolved to a prefered non-operative approach even in severely injured cases. However, the optimal surgical management of splenic trauma in severely injured patients remains controversial. This article aims to present an algorithm for the management of splenic trauma in severely injured patients, that includes basic principles of damage control surgery and is based on the experience obtained by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia. The choice between a conservative or a surgical approach depends on the hemodynamic status of the patient. In hemodynamically stable patients, a computed tomography angiogram should be performed to determine if non-operative management is feasible and if angioembolization is required. While hemodynamically unstable patients should be transferred immediately to the operating room for damage control surgery, which includes splenic packing and placement of a negative pressure dressing, followed by angiography with embolization of any ongoing arterial bleeding. It is our recommendation that both damage control principles and emerging endovascular technologies should be applied to achieve splenic salvage when possible. However, if surgical bleeding persists a splenectomy may be required as a definitive lifesaving maneuver., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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48. Hybrid trauma service: on the leading edge of damage Control.

Author: Palacios-Rodríguez HE, Hiroe N, Guzmán-Rodríguez M, Caicedo Y, Saldarriaga L, Ordoñez CA, and Funabiki T
Subjects: Colombia, Diagnostic Imaging methods, Hemostatic Techniques, Hospital Rapid Response Team organization & administration, Humans, Advanced Trauma Life Support Care, Hemorrhage therapy, Operating Rooms organization & administration, Patient Care Team organization & administration, Resuscitation methods
Abstract: Trauma damage control seeks to limit life-threatening bleeding. Sequential diagnostic and therapeutic approaches are the current standard. Hybrid Room have reduced hemostasis time by integrating different specialties and technologies. Hybrid Rooms seek to control bleeding in an operating room equipped with specialized personnel and advanced technology including angiography, tomography, eFAST, radiography, endoscopy, infusers, cell retrievers, REBOA, etc. Trauma Hybrid Service is a concept that describes a vertical work scheme that begins with the activation of Trauma Code when admitting a severely injured patient, initiating a continuous resuscitation process led by the trauma surgeon who guides transfer to imaging, angiography and surgery rooms according to the patient's condition and the need for specific interventions. Hybrid rooms integrate different diagnostic and therapeutic tools in one same room, reducing the attention time and increasing all interventions effectiveness., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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49. Damage control in penetrating duodenal trauma: less is better - the sequel.

Author: Ordoñez CA, Parra MW, Millán M, Caicedo Y, Padilla N, García A, Franco MJ, Aristizábal G, Toro LE, Pino LF, González-Hadad A, Herrera MA, Serna JJ, Rodríguez-Holguín F, Salcedo A, Orlas C, Guzmán-Rodríguez M, Hernández F, Ferrada R, and Ivatury R
Subjects: Hemorrhage therapy, Humans, Medical Illustration, Wounds, Penetrating classification, Wounds, Penetrating complications, Wounds, Penetrating diagnosis, Algorithms, Duodenum injuries, Wounds, Penetrating surgery
Abstract: The overall incidence of duodenal injuries in severely injured trauma patients is between 0.2 to 0.6% and the overall prevalence in those suffering from abdominal trauma is 3 to 5%. Approximately 80% of these cases are secondary to penetrating trauma, commonly associated with vascular and adjacent organ injuries. Therefore, defining the best surgical treatment algorithm remains controversial. Mild to moderate duodenal trauma is currently managed via primary repair and simple surgical techniques. However, severe injuries have required complex surgical techniques without significant favorable outcomes and a consequential increase in mortality rates. This article aims to delineate the experience in the surgical management of penetrating duodenal injuries via the creation of a practical and effective algorithm that includes basic principles of damage control surgery that sticks to the philosophy of "Less is Better". Surgical management of all penetrating duodenal trauma should always default when possible to primary repair. When confronted with a complex duodenal injury, hemodynamic instability, and/or significant associated injuries, the default should be damage control surgery. Definitive reconstructive surgery should be postponed until the patient has been adequately resuscitated and the diamond of death has been corrected., Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest., (Copyright © 2021 Colombia Medica.)
Published: 2021
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50. Damage control surgical management of combined small and large bowel injuries in penetrating trauma: Are ostomies still pertinent?

Author: Ordoñez CA, Parra MW, Caicedo Y, Padilla N, Angamarca E, Serna JJ, Rodríguez-Holguín F, García A, Salcedo A, Pino LF, González-Hadad A, Herrera MA, Quintero L, Hernández F, Franco MJ, Aristizábal G, Toro LE, Guzmán-Rodríguez M, Coccolini F, Ferrada R, and Ivatury R
Subjects: Adult, Colombia, Female, Hemorrhage etiology, Hemorrhage surgery, Humans, Intestine, Large surgery, Intestine, Small surgery, Laparotomy, Male, Medical Illustration, Retrospective Studies, Wounds, Gunshot complications, Wounds, Gunshot surgery, Wounds, Penetrating classification, Wounds, Penetrating complications, Young Adult, Anastomosis, Surgical methods, Consensus, Enterostomy statistics & numerical data, Intestine, Large injuries, Intestine, Small injuries, Wounds, Penetrating surgery
Abstract: Hollow viscus injuries represent a significant portion of overall lesions sustained during penetrating trauma. Currently, isolated small or large bowel injuries are commonly managed via primary anastomosis in patients undergoing definitive laparotomy or deferred anastomosis in patients requiring damage control surgery. The traditional surgical dogma of ostomy has proven to be unnecessary and, in many instances, actually increases morbidity. The aim of this article is to delineate the experience obtained in the management of combined hollow viscus injuries of patients suffering from penetrating trauma. We sought out to determine if primary and/or deferred bowel injury repair via anastomosis is the preferred surgical course in patients suffering from combined small and large bowel penetrating injuries. Our experience shows that more than 90% of all combined penetrating bowel injuries can be managed via primary or deferred anastomosis, even in the most severe cases requiring the application of damage control principles. Applying this strategy, the overall need for an ostomy (primary or deferred) could be reduced to less than 10%., (Copyright © 2021 Colombia Medica.)
Published: 2021
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