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1. Textbook outcome in urgent early cholecystectomy for acute calculous cholecystitis: results post hoc of the S.P.Ri.M.A.C.C study

Author: Fugazzola, P, Carbonell-Morote, S, Cobianchi, L, Coccolini, F, Rubio-Garcia, J, Sartelli, M, Biffl, W, Catena, F, Ansaloni, L, Ramia, J, Augustin, G, Moric, T, Awad, S, Alzahrani, A, Elbahnasawy, M, Massalou, D, De Simone, B, Demetrashvili, Z, Kimpizi, A, Schizas, D, Balalis, D, Tasis, N, Papadoliopoulou, M, Georgios, P, Lasithiotakis, K, Ioannidis, O, Bains, L, Magnoli, M, Cianci, P, Conversano, N, Pasculli, A, Andreuccetti, J, Arici, E, Pignata, G, Tiberio, G, Podda, M, Murru, C, Veroux, M, Distefano, C, Centonze, D, Favi, F, Agnoletti, V, Bova, R, Convertini, G, Balla, A, Sasia, D, Giraudo, G, Gabriele, A, Tartaglia, N, Pavone, G, D'Acapito, F, Fabbri, N, Ferrara, F, Cimbanassi, S, Ferrario, L, Ciof, S, Ceresoli, M, Fumagalli, C, Degrate, L, Degiuli, M, Sofa, S, Licari, L, Tomasoni, M, Dominioni, T, Fare, C, Maestri, M, Vigano, J, Sargenti, B, Anderloni, A, Musella, V, Frassini, S, Gambini, G, Improta, M, Patriti, A, Coletta, D, Conti, L, Malerba, M, Andrea, M, Calabro, M, De Zolt, B, Bellio, G, Giordano, A, Luppi, D, Corbellini, C, Sampietro, G, Marafante, C, Rossi, S, Mingoli, A, Lapolla, P, Cicerchia, P, Siragusa, L, Grande, M, Arcudi, C, Antonelli, A, Vinci, D, De Martino, C, Armellino, M, Bisogno, E, Visconti, D, Santarelli, M, Montanari, E, Biloslavo, A, Germani, P, Zaghi, C, Oka, N, Fathi, M, Rios-Cruz, D, Hernandez, E, Garzali, I, Duarte, L, Negoi, I, Litvin, A, Chowdhury, S, Alshahrani, S, Moreira, C, Ponce, I, Mendoza-Moreno, F, Campana, A, Bayo, H, Serra, A, Landaluce, A, Estraviz-Mateos, B, Markinez-Gordobil, I, Serradilla-Martin, M, Cano-Paredero, A, Dobon-Rascon, M, Hamid, H, Baraket, O, Gonullu, E, Leventoglu, S, Turk, Y, Buyukkasap, C, Aday, U, Kara, Y, Kabuli, H, Atici, S, Colak, E, Chooklin, S, Chuklin, S, Ruta, F, Di Martino, M, Dal Mas, F, Abu-Zidan, F, Di Saverio, S, Leppaniemi, A, Martin-Perez, E, de la Hoz Rodriguez, A, Moore, E, Peitzman, A, Fugazzola P., Carbonell-Morote S., Cobianchi L., Coccolini F., Rubio-Garcia J. J., Sartelli M., Biffl W., Catena F., Ansaloni L., Ramia J. M., Augustin G., Moric T., Awad S., Alzahrani A. M., Elbahnasawy M., Massalou D., De Simone B., Demetrashvili Z., Kimpizi A. -D., Schizas D., Balalis D., Tasis N., Papadoliopoulou M., Georgios P., Lasithiotakis K., Ioannidis O., Bains L., Magnoli M., Cianci P., Conversano N. I., Pasculli A., Andreuccetti J., Arici E., Pignata G., Tiberio G. A. M., Podda M., Murru C., Veroux M., Distefano C., Centonze D., Favi F., Agnoletti V., Bova R., Convertini G., Balla A., Sasia D., Giraudo G., Gabriele A., Tartaglia N., Pavone G., D'Acapito F., Fabbri N., Ferrara F., Cimbanassi S., Ferrario L., Ciof S., Ceresoli M., Fumagalli C., Degrate L., Degiuli M., Sofa S., Licari L., Tomasoni M., Dominioni T., Fare C. N., Maestri M., Vigano J., Sargenti B., Anderloni A., Musella V., Frassini S., Gambini G., Improta M., Patriti A., Coletta D., Conti L., Malerba M., Andrea M., Calabro M., De Zolt B., Bellio G., Giordano A., Luppi D., Corbellini C., Sampietro G. M., Marafante C., Rossi S., Mingoli A., Lapolla P., Cicerchia P. M., Siragusa L., Grande M., Arcudi C., Antonelli A., Vinci D., De Martino C., Armellino M. F., Bisogno E., Visconti D., Santarelli M., Montanari E., Biloslavo A., Germani P., Zaghi C., Oka N., Fathi M. A., Rios-Cruz D., Hernandez E. E. L., Garzali I. U., Duarte L., Negoi I., Litvin A., Chowdhury S., Alshahrani S. M., Moreira C. C. L., Ponce I. A., Mendoza-Moreno F., Campana A. M., Bayo H. L., Serra A. C., Landaluce A., Estraviz-Mateos B., Markinez-Gordobil I., Serradilla-Martin M., Cano-Paredero A., Dobon-Rascon M. A., Hamid H., Baraket O., Gonullu E., Leventoglu S., Turk Y., Buyukkasap C., Aday U., Kara Y., Kabuli H. A., Atici S. D., Colak E., Chooklin S., Chuklin S., Ruta F., Di Martino M., Dal Mas F., Abu-Zidan F. M., Di Saverio S., Leppaniemi A., Martin-Perez E., de la Hoz Rodriguez A., Moore E. E., Peitzman A. B., Fugazzola, P, Carbonell-Morote, S, Cobianchi, L, Coccolini, F, Rubio-Garcia, J, Sartelli, M, Biffl, W, Catena, F, Ansaloni, L, Ramia, J, Augustin, G, Moric, T, Awad, S, Alzahrani, A, Elbahnasawy, M, Massalou, D, De Simone, B, Demetrashvili, Z, Kimpizi, A, Schizas, D, Balalis, D, Tasis, N, Papadoliopoulou, M, Georgios, P, Lasithiotakis, K, Ioannidis, O, Bains, L, Magnoli, M, Cianci, P, Conversano, N, Pasculli, A, Andreuccetti, J, Arici, E, Pignata, G, Tiberio, G, Podda, M, Murru, C, Veroux, M, Distefano, C, Centonze, D, Favi, F, Agnoletti, V, Bova, R, Convertini, G, Balla, A, Sasia, D, Giraudo, G, Gabriele, A, Tartaglia, N, Pavone, G, D'Acapito, F, Fabbri, N, Ferrara, F, Cimbanassi, S, Ferrario, L, Ciof, S, Ceresoli, M, Fumagalli, C, Degrate, L, Degiuli, M, Sofa, S, Licari, L, Tomasoni, M, Dominioni, T, Fare, C, Maestri, M, Vigano, J, Sargenti, B, Anderloni, A, Musella, V, Frassini, S, Gambini, G, Improta, M, Patriti, A, Coletta, D, Conti, L, Malerba, M, Andrea, M, Calabro, M, De Zolt, B, Bellio, G, Giordano, A, Luppi, D, Corbellini, C, Sampietro, G, Marafante, C, Rossi, S, Mingoli, A, Lapolla, P, Cicerchia, P, Siragusa, L, Grande, M, Arcudi, C, Antonelli, A, Vinci, D, De Martino, C, Armellino, M, Bisogno, E, Visconti, D, Santarelli, M, Montanari, E, Biloslavo, A, Germani, P, Zaghi, C, Oka, N, Fathi, M, Rios-Cruz, D, Hernandez, E, Garzali, I, Duarte, L, Negoi, I, Litvin, A, Chowdhury, S, Alshahrani, S, Moreira, C, Ponce, I, Mendoza-Moreno, F, Campana, A, Bayo, H, Serra, A, Landaluce, A, Estraviz-Mateos, B, Markinez-Gordobil, I, Serradilla-Martin, M, Cano-Paredero, A, Dobon-Rascon, M, Hamid, H, Baraket, O, Gonullu, E, Leventoglu, S, Turk, Y, Buyukkasap, C, Aday, U, Kara, Y, Kabuli, H, Atici, S, Colak, E, Chooklin, S, Chuklin, S, Ruta, F, Di Martino, M, Dal Mas, F, Abu-Zidan, F, Di Saverio, S, Leppaniemi, A, Martin-Perez, E, de la Hoz Rodriguez, A, Moore, E, Peitzman, A, Fugazzola P., Carbonell-Morote S., Cobianchi L., Coccolini F., Rubio-Garcia J. J., Sartelli M., Biffl W., Catena F., Ansaloni L., Ramia J. M., Augustin G., Moric T., Awad S., Alzahrani A. M., Elbahnasawy M., Massalou D., De Simone B., Demetrashvili Z., Kimpizi A. -D., Schizas D., Balalis D., Tasis N., Papadoliopoulou M., Georgios P., Lasithiotakis K., Ioannidis O., Bains L., Magnoli M., Cianci P., Conversano N. I., Pasculli A., Andreuccetti J., Arici E., Pignata G., Tiberio G. A. M., Podda M., Murru C., Veroux M., Distefano C., Centonze D., Favi F., Agnoletti V., Bova R., Convertini G., Balla A., Sasia D., Giraudo G., Gabriele A., Tartaglia N., Pavone G., D'Acapito F., Fabbri N., Ferrara F., Cimbanassi S., Ferrario L., Ciof S., Ceresoli M., Fumagalli C., Degrate L., Degiuli M., Sofa S., Licari L., Tomasoni M., Dominioni T., Fare C. N., Maestri M., Vigano J., Sargenti B., Anderloni A., Musella V., Frassini S., Gambini G., Improta M., Patriti A., Coletta D., Conti L., Malerba M., Andrea M., Calabro M., De Zolt B., Bellio G., Giordano A., Luppi D., Corbellini C., Sampietro G. M., Marafante C., Rossi S., Mingoli A., Lapolla P., Cicerchia P. M., Siragusa L., Grande M., Arcudi C., Antonelli A., Vinci D., De Martino C., Armellino M. F., Bisogno E., Visconti D., Santarelli M., Montanari E., Biloslavo A., Germani P., Zaghi C., Oka N., Fathi M. A., Rios-Cruz D., Hernandez E. E. L., Garzali I. U., Duarte L., Negoi I., Litvin A., Chowdhury S., Alshahrani S. M., Moreira C. C. L., Ponce I. A., Mendoza-Moreno F., Campana A. M., Bayo H. L., Serra A. C., Landaluce A., Estraviz-Mateos B., Markinez-Gordobil I., Serradilla-Martin M., Cano-Paredero A., Dobon-Rascon M. A., Hamid H., Baraket O., Gonullu E., Leventoglu S., Turk Y., Buyukkasap C., Aday U., Kara Y., Kabuli H. A., Atici S. D., Colak E., Chooklin S., Chuklin S., Ruta F., Di Martino M., Dal Mas F., Abu-Zidan F. M., Di Saverio S., Leppaniemi A., Martin-Perez E., de la Hoz Rodriguez A., Moore E. E., and Peitzman A. B.
Abstract: Introduction: A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis. Objetive: The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis. and to identify which factors are related to achieving TO. Materials and methods: This is a post hoc study of the SPRiMACC study. It ́s a prospective multicenter observational study run by WSES. The criteria to define TO in urgent early cholecystectomy (TOUEC) were no 30-day mortality, no 30-day postoperative complications, no readmission within 30 days, and hospital stay ≤ 7 days (75th percentile), and full laparoscopic surgery. Patients who met all these conditions were taken as presenting a TOUEC. Outcomes: 1246 urgent early cholecystectomies for ACC were included. In all, 789 patients (63.3%) achieved all TOUEC parameters, while 457 (36.6%) failed to achieve one or more parameters and were considered non-TOUEC. The patients who achieved TOUEC were younger had significantly lower scores on all the risk scales analyzed. In the serological tests, TOUEC patients had lower values for in a lot of variables than non-TOUEC patients. The TOUEC group had lower rates of complicated cholecystitis. Considering operative time, a shorter duration was also associated with a higher probability of reaching TOUEC. Conclusion: Knowledge of the factors that influence the TOUEC can allow us to improve our results in terms of textbook outcome.
Published: 2024

2. Prospective validation of the Israeli Score for the prediction of common bile duct stones in patients with acute calculous cholecystitis

Author: Fugazzola, P, Cobianchi, L, Dal Mas, F, Cicuttin, E, Dominioni, T, Frassini, S, Tomasoni, M, Vigano, J, Catena, F, Ansaloni, L, Augustin, G, Moric, T, Awad, S, Alzahrani, A, Elbahnasawy, M, Massalou, D, De Simone, B, Demetrashvili, Z, Kimpizi, A, Schizas, D, Balalis, D, Tasis, N, Papadoliopoulou, M, Georgios, P, Lasithiotakis, K, Ioannidis, O, Bains, L, Magnoli, M, Cianci, P, Conversano, N, Pasculli, A, Andreuccetti, J, Arici, E, Pignata, G, Tiberio, G, Podda, M, Murru, C, Veroux, M, Distefano, C, Centonze, D, Favi, F, Bova, R, Convertini, G, Agnoletti, V, Balla, A, Sasia, D, Giraudo, G, Gabriele, A, Tartaglia, N, Pavone, G, D'Acapito, F, Fabbri, N, Ferrara, F, Cimbanassi, S, Ferrario, L, Cioffi, S, Ceresoli, M, Fumagalli, C, Degrate, L, Degiuli, M, Sofia, S, Licari, L, Anderloni, A, Maestri, M, Fare, C, Sargenti, B, Improta, M, Musella, V, Gambini, G, Patriti, A, Coletta, D, Conti, L, Malerba, M, Andrea, M, Calabro, M, De Zolt, B, Bellio, G, Giordano, A, Luppi, D, Corbellini, C, Sampietro, G, Marafante, C, Rossi, S, Mingoli, A, Lapolla, P, Cicerchia, P, Siragusa, L, Grande, M, Arcudi, C, Antonelli, A, Vinci, D, De Martino, C, Armellino, M, Bisogno, E, Visconti, D, Santarelli, M, Montanari, E, Biloslavo, A, Germani, P, Zaghi, C, Oka, N, Fathi, M, Rios-Cruz, D, Hernandez, E, Garzali, I, Duarte, L, Negoi, I, Litvin, A, Chowdhury, S, Alshahrani, S, Carbonell-Morote, S, Rubio-Garcia, J, Moreira, C, Ponce, I, Mendoza-Moreno, F, Campana, A, Bayo, H, Serra, A, Estraviz-Mateos, B, Markinez-Gordobil, I, Landaluce-Olavarria, A, Serradilla-Martin, M, Cano-Paredero, A, Dobon-Rascon, M, Hamid, H, Baraket, O, Gonullu, E, Leventoglu, S, Turk, Y, Buyukkasap, C, Aday, U, Kara, Y, Kabuli, H, Atici, S, Colak, E, Chooklin, S, Chuklin, S, Martin-Perez, E, de la Hoz Rodriguez, A, Di Martino, M, Di Saverio, S, Leppaniemi, A, Moore, E, Peitzman, A, Sartelli, M, Biffl, W, Fugazzola P., Cobianchi L., Dal Mas F., Cicuttin E., Dominioni T., Frassini S., Tomasoni M., Vigano J., Catena F., Ansaloni L., Augustin G., Moric T., Awad S., Alzahrani A. M., Elbahnasawy M., Massalou D., De Simone B., Demetrashvili Z., Kimpizi A. -D., Schizas D., Balalis D., Tasis N., Papadoliopoulou M., Georgios P., Lasithiotakis K., Ioannidis O., Bains L., Magnoli M., Cianci P., Conversano N. I., Pasculli A., Andreuccetti J., Arici E., Pignata G., Tiberio G. A. M., Podda M., Murru C., Veroux M., Distefano C., Centonze D., Favi F., Bova R., Convertini G., Agnoletti V., Balla A., Sasia D., Giraudo G., Gabriele A., Tartaglia N., Pavone G., D'Acapito F., Fabbri N., Ferrara F., Cimbanassi S., Ferrario L., Cioffi S., Ceresoli M., Fumagalli C., Degrate L., Degiuli M., Sofia S., Licari L., Anderloni A., Maestri M., Fare C. N., Sargenti B., Improta M., Musella V., Gambini G., Patriti A., Coletta D., Conti L., Malerba M., Andrea M., Calabro M., De Zolt B., Bellio G., Giordano A., Luppi D., Corbellini C., Sampietro G. M., Marafante C., Rossi S., Mingoli A., Lapolla P., Cicerchia P. M., Siragusa L., Grande M., Arcudi C., Antonelli A., Vinci D., De Martino C., Armellino M. F., Bisogno E., Visconti D., Santarelli M., Montanari E., Biloslavo A., Germani P., Zaghi C., Oka N., Fathi M. A., Rios-Cruz D., Hernandez E. E. L., Garzali I. U., Duarte L., Negoi I., Litvin A., Chowdhury S., Alshahrani S. M., Carbonell-Morote S., Rubio-Garcia J. J., Moreira C. C. L., Ponce I. A., Mendoza-Moreno F., Campana A. M., Bayo H. L., Serra A. C., Estraviz-Mateos B., Markinez-Gordobil I., Landaluce-Olavarria A., Serradilla-Martin M., Cano-Paredero A., Dobon-Rascon M. A., Hamid H., Baraket O., Gonullu E., Leventoglu S., Turk Y., Buyukkasap C., Aday U., Kara Y., Kabuli H. A., Atici S. D., Colak E., Chooklin S., Chuklin S., Martin-Perez E., de la Hoz Rodriguez A., Di Martino M., Di Saverio S., Leppaniemi A., Moore E. E., Peitzman A. B., Sartelli M., Biffl W., Fugazzola, P, Cobianchi, L, Dal Mas, F, Cicuttin, E, Dominioni, T, Frassini, S, Tomasoni, M, Vigano, J, Catena, F, Ansaloni, L, Augustin, G, Moric, T, Awad, S, Alzahrani, A, Elbahnasawy, M, Massalou, D, De Simone, B, Demetrashvili, Z, Kimpizi, A, Schizas, D, Balalis, D, Tasis, N, Papadoliopoulou, M, Georgios, P, Lasithiotakis, K, Ioannidis, O, Bains, L, Magnoli, M, Cianci, P, Conversano, N, Pasculli, A, Andreuccetti, J, Arici, E, Pignata, G, Tiberio, G, Podda, M, Murru, C, Veroux, M, Distefano, C, Centonze, D, Favi, F, Bova, R, Convertini, G, Agnoletti, V, Balla, A, Sasia, D, Giraudo, G, Gabriele, A, Tartaglia, N, Pavone, G, D'Acapito, F, Fabbri, N, Ferrara, F, Cimbanassi, S, Ferrario, L, Cioffi, S, Ceresoli, M, Fumagalli, C, Degrate, L, Degiuli, M, Sofia, S, Licari, L, Anderloni, A, Maestri, M, Fare, C, Sargenti, B, Improta, M, Musella, V, Gambini, G, Patriti, A, Coletta, D, Conti, L, Malerba, M, Andrea, M, Calabro, M, De Zolt, B, Bellio, G, Giordano, A, Luppi, D, Corbellini, C, Sampietro, G, Marafante, C, Rossi, S, Mingoli, A, Lapolla, P, Cicerchia, P, Siragusa, L, Grande, M, Arcudi, C, Antonelli, A, Vinci, D, De Martino, C, Armellino, M, Bisogno, E, Visconti, D, Santarelli, M, Montanari, E, Biloslavo, A, Germani, P, Zaghi, C, Oka, N, Fathi, M, Rios-Cruz, D, Hernandez, E, Garzali, I, Duarte, L, Negoi, I, Litvin, A, Chowdhury, S, Alshahrani, S, Carbonell-Morote, S, Rubio-Garcia, J, Moreira, C, Ponce, I, Mendoza-Moreno, F, Campana, A, Bayo, H, Serra, A, Estraviz-Mateos, B, Markinez-Gordobil, I, Landaluce-Olavarria, A, Serradilla-Martin, M, Cano-Paredero, A, Dobon-Rascon, M, Hamid, H, Baraket, O, Gonullu, E, Leventoglu, S, Turk, Y, Buyukkasap, C, Aday, U, Kara, Y, Kabuli, H, Atici, S, Colak, E, Chooklin, S, Chuklin, S, Martin-Perez, E, de la Hoz Rodriguez, A, Di Martino, M, Di Saverio, S, Leppaniemi, A, Moore, E, Peitzman, A, Sartelli, M, Biffl, W, Fugazzola P., Cobianchi L., Dal Mas F., Cicuttin E., Dominioni T., Frassini S., Tomasoni M., Vigano J., Catena F., Ansaloni L., Augustin G., Moric T., Awad S., Alzahrani A. M., Elbahnasawy M., Massalou D., De Simone B., Demetrashvili Z., Kimpizi A. -D., Schizas D., Balalis D., Tasis N., Papadoliopoulou M., Georgios P., Lasithiotakis K., Ioannidis O., Bains L., Magnoli M., Cianci P., Conversano N. I., Pasculli A., Andreuccetti J., Arici E., Pignata G., Tiberio G. A. M., Podda M., Murru C., Veroux M., Distefano C., Centonze D., Favi F., Bova R., Convertini G., Agnoletti V., Balla A., Sasia D., Giraudo G., Gabriele A., Tartaglia N., Pavone G., D'Acapito F., Fabbri N., Ferrara F., Cimbanassi S., Ferrario L., Cioffi S., Ceresoli M., Fumagalli C., Degrate L., Degiuli M., Sofia S., Licari L., Anderloni A., Maestri M., Fare C. N., Sargenti B., Improta M., Musella V., Gambini G., Patriti A., Coletta D., Conti L., Malerba M., Andrea M., Calabro M., De Zolt B., Bellio G., Giordano A., Luppi D., Corbellini C., Sampietro G. M., Marafante C., Rossi S., Mingoli A., Lapolla P., Cicerchia P. M., Siragusa L., Grande M., Arcudi C., Antonelli A., Vinci D., De Martino C., Armellino M. F., Bisogno E., Visconti D., Santarelli M., Montanari E., Biloslavo A., Germani P., Zaghi C., Oka N., Fathi M. A., Rios-Cruz D., Hernandez E. E. L., Garzali I. U., Duarte L., Negoi I., Litvin A., Chowdhury S., Alshahrani S. M., Carbonell-Morote S., Rubio-Garcia J. J., Moreira C. C. L., Ponce I. A., Mendoza-Moreno F., Campana A. M., Bayo H. L., Serra A. C., Estraviz-Mateos B., Markinez-Gordobil I., Landaluce-Olavarria A., Serradilla-Martin M., Cano-Paredero A., Dobon-Rascon M. A., Hamid H., Baraket O., Gonullu E., Leventoglu S., Turk Y., Buyukkasap C., Aday U., Kara Y., Kabuli H. A., Atici S. D., Colak E., Chooklin S., Chuklin S., Martin-Perez E., de la Hoz Rodriguez A., Di Martino M., Di Saverio S., Leppaniemi A., Moore E. E., Peitzman A. B., Sartelli M., and Biffl W.
Abstract: Background: Existing guidelines for predicting common bile duct stones (CBDS) are not specific for acute calculous cholecystitis (ACC). This paper is a posthoc analysis of the S.P.Ri.M.A.C.C study aiming to prospectively validate on a large independent cohort of patients the Israeli Score (IS) in predicting CBDS in patients with ACC. Methods: The S.P.Ri.M.A.C.C. study is an observational multicenter prospective study endorsed by the World Society of Emergency Surgery (WSES). Between September 1st, 2021, and September 1st, 2022, 1201 participants were included. The Chi-Square test was used to compare categorical data. A Cochran-Armitage test was run to determine whether a linear trend existed between the IS and the presence of CBDS. To assess the accuracy of the prediction model, the receiver operating characteristic (ROC) curve was generated, and the area under the ROC curve (AUC) was calculated. Logistic regression was run to obtain Odds Ratio (OR). A two-tailed p < 0.05 was considered statistically significant. Results: The rate of CBDS was 1.8% in patients with an IS of 0, 4.2% in patients with an IS of 1, 24.5% in patients with 2 and 56.3% in patients with 3 (p < 0.001). The Cochran-Armitage test of trend showed a statistically significant linear trend, p < 0.001. Patients with an IS of 3 had 64.4 times (95% CI 24.8–166.9) higher odds of having associated CBDS than patients with an IS of 0. The AUC of the ROC curve of IS for the prediction of CBDS was 0.809 (95% CI 0.752–0.865, p < 0.001). By applying the highest cut-off point (3), the specificity reached 99%, while using the lowest cut-off value (0), the sensitivity reached 100%. Conclusion: The IS is a reliable tool to predict CBDS associated with ACC. The algorithm derived from the IS could optimize the management of patients with ACC.
Published: 2023

3. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Author: Fugazzola, P, Ceresoli, M, Coccolini, F, Gabrielli, F, Puzziello, A, Monzani, F, Amato, B, Sganga, G, Sartelli, M, Menichetti, F, Puglisi, G, Tartaglia, D, Carcoforo, P, Avenia, N, Kluger, Y, Paolillo, C, Zago, M, Leppaniemi, A, Tomasoni, M, Cobianchi, L, Dal Mas, F, Improta, M, Moore, E, Peitzman, A, Sugrue, M, Agnoletti, V, Fraga, G, Weber, D, Damaskos, D, Abu-Zidan, F, Wani, I, Kirkpatrick, A, Pikoulis, M, Pararas, N, Tan, E, Broek, R, Maier, R, Davies, R, Kashuk, J, Shelat, V, Mefire, A, Augustin, G, Magnone, S, Poiasina, E, De Simone, B, Chiarugi, M, Biffl, W, Baiocchi, G, Catena, F, Ansaloni, L, Fugazzola P., Ceresoli M., Coccolini F., Gabrielli F., Puzziello A., Monzani F., Amato B., Sganga G., Sartelli M., Menichetti F., Puglisi G. A., Tartaglia D., Carcoforo P., Avenia N., Kluger Y., Paolillo C., Zago M., Leppaniemi A., Tomasoni M., Cobianchi L., Dal Mas F., Improta M., Moore E. E., Peitzman A. B., Sugrue M., Agnoletti V., Fraga G. P., Weber D. G., Damaskos D., Abu-Zidan F. M., Wani I., Kirkpatrick A. W., Pikoulis M., Pararas N., Tan E., Broek R. T., Maier R. V., Davies R. J., Kashuk J., Shelat V. G., Mefire A. C., Augustin G., Magnone S., Poiasina E., De Simone B., Chiarugi M., Biffl W., Baiocchi G. L., Catena F., Ansaloni L., Fugazzola, P, Ceresoli, M, Coccolini, F, Gabrielli, F, Puzziello, A, Monzani, F, Amato, B, Sganga, G, Sartelli, M, Menichetti, F, Puglisi, G, Tartaglia, D, Carcoforo, P, Avenia, N, Kluger, Y, Paolillo, C, Zago, M, Leppaniemi, A, Tomasoni, M, Cobianchi, L, Dal Mas, F, Improta, M, Moore, E, Peitzman, A, Sugrue, M, Agnoletti, V, Fraga, G, Weber, D, Damaskos, D, Abu-Zidan, F, Wani, I, Kirkpatrick, A, Pikoulis, M, Pararas, N, Tan, E, Broek, R, Maier, R, Davies, R, Kashuk, J, Shelat, V, Mefire, A, Augustin, G, Magnone, S, Poiasina, E, De Simone, B, Chiarugi, M, Biffl, W, Baiocchi, G, Catena, F, Ansaloni, L, Fugazzola P., Ceresoli M., Coccolini F., Gabrielli F., Puzziello A., Monzani F., Amato B., Sganga G., Sartelli M., Menichetti F., Puglisi G. A., Tartaglia D., Carcoforo P., Avenia N., Kluger Y., Paolillo C., Zago M., Leppaniemi A., Tomasoni M., Cobianchi L., Dal Mas F., Improta M., Moore E. E., Peitzman A. B., Sugrue M., Agnoletti V., Fraga G. P., Weber D. G., Damaskos D., Abu-Zidan F. M., Wani I., Kirkpatrick A. W., Pikoulis M., Pararas N., Tan E., Broek R. T., Maier R. V., Davies R. J., Kashuk J., Shelat V. G., Mefire A. C., Augustin G., Magnone S., Poiasina E., De Simone B., Chiarugi M., Biffl W., Baiocchi G. L., Catena F., and Ansaloni L.
Abstract: Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1° Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.
Published: 2022

4. Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study

Author: Coccolini F., Gubbiotti F., Ceresoli M., Tartaglia D., Fugazzola P., Ansaloni L., Sartelli M., Kluger Y., Kirkpatrick A., Amico F., Catena F., Chiarugi M., Montori G., Salvetti F., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Sugrue M., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Ben-Ishay O., Lippi A., Improta M., Zharikov A., Dubuisson V., Coccolini, F, Gubbiotti, F, Ceresoli, M, Tartaglia, D, Fugazzola, P, Ansaloni, L, Sartelli, M, Kluger, Y, Kirkpatrick, A, Amico, F, Catena, F, Chiarugi, M, Montori, G, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Sugrue, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Ben-Ishay, O, Lippi, A, Improta, M, Zharikov, A, and Dubuisson, V
Subjects: Adult, Male, medicine.medical_specialty, Original Scientific Report, Fistula, medicine.medical_treatment, open abdomen, Peritonitis, 030230 surgery, NO, 03 medical and health sciences, 0302 clinical medicine, Sepsis, peritoneal resuscitation, Negative-pressure wound therapy, Abdomen, medicine, Humans, Surgical Wound Infection, Prospective Studies, fascial closure, peritoneal resuscitation, management, therapy, fascial closure, Digestive System Surgical Procedures, Aged, therapy, business.industry, Peritoneal fluid, Abdominal Cavity, Abdominal Wound Closure Techniques, Middle Aged, medicine.disease, Surgery, Cardiac surgery, Treatment Outcome, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, fluid instillation, Fluid Therapy, Female, business, Negative-Pressure Wound Therapy, management, Abdominal surgery
Abstract: Background Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.
Published: 2020
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5. Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines

Author: Coccolini, F, Improta, M, Sartelli, M, Rasa, K, Sawyer, R, Coimbra, R, Chiarugi, M, Litvin, A, Hardcastle, T, Forfori, F, Vincent, J, Hecker, A, Ten Broek, R, Bonavina, L, Chirica, M, Boggi, U, Pikoulis, E, Di Saverio, S, Montravers, P, Augustin, G, Tartaglia, D, Cicuttin, E, Cremonini, C, Viaggi, B, De Simone, B, Malbrain, M, Shelat, V, Fugazzola, P, Ansaloni, L, Isik, A, Rubio, I, Kamal, I, Corradi, F, Tarasconi, A, Gitto, S, Podda, M, Pikoulis, A, Leppaniemi, A, Ceresoli, M, Romeo, O, Moore, E, Demetrashvili, Z, Biffl, W, Wani, I, Tolonen, M, Duane, T, Dhingra, S, Deangelis, N, Tan, E, Abu-Zidan, F, Ordonez, C, Cui, Y, Labricciosa, F, Perrone, G, Di Marzo, F, Peitzman, A, Sakakushev, B, Sugrue, M, Boermeester, M, Nunez, R, Gomes, C, Bala, M, Kluger, Y, Catena, F, Coccolini F., Improta M., Sartelli M., Rasa K., Sawyer R., Coimbra R., Chiarugi M., Litvin A., Hardcastle T., Forfori F., Vincent J. -L., Hecker A., Ten Broek R., Bonavina L., Chirica M., Boggi U., Pikoulis E., Di Saverio S., Montravers P., Augustin G., Tartaglia D., Cicuttin E., Cremonini C., Viaggi B., De Simone B., Malbrain M., Shelat V. G., Fugazzola P., Ansaloni L., Isik A., Rubio I., Kamal I., Corradi F., Tarasconi A., Gitto S., Podda M., Pikoulis A., Leppaniemi A., Ceresoli M., Romeo O., Moore E. E., Demetrashvili Z., Biffl W. L., Wani I., Tolonen M., Duane T., Dhingra S., DeAngelis N., Tan E., Abu-Zidan F., Ordonez C., Cui Y., Labricciosa F., Perrone G., Di Marzo F., Peitzman A., Sakakushev B., Sugrue M., Boermeester M., Nunez R. M., Gomes C. A., Bala M., Kluger Y., Catena F., Coccolini, F, Improta, M, Sartelli, M, Rasa, K, Sawyer, R, Coimbra, R, Chiarugi, M, Litvin, A, Hardcastle, T, Forfori, F, Vincent, J, Hecker, A, Ten Broek, R, Bonavina, L, Chirica, M, Boggi, U, Pikoulis, E, Di Saverio, S, Montravers, P, Augustin, G, Tartaglia, D, Cicuttin, E, Cremonini, C, Viaggi, B, De Simone, B, Malbrain, M, Shelat, V, Fugazzola, P, Ansaloni, L, Isik, A, Rubio, I, Kamal, I, Corradi, F, Tarasconi, A, Gitto, S, Podda, M, Pikoulis, A, Leppaniemi, A, Ceresoli, M, Romeo, O, Moore, E, Demetrashvili, Z, Biffl, W, Wani, I, Tolonen, M, Duane, T, Dhingra, S, Deangelis, N, Tan, E, Abu-Zidan, F, Ordonez, C, Cui, Y, Labricciosa, F, Perrone, G, Di Marzo, F, Peitzman, A, Sakakushev, B, Sugrue, M, Boermeester, M, Nunez, R, Gomes, C, Bala, M, Kluger, Y, Catena, F, Coccolini F., Improta M., Sartelli M., Rasa K., Sawyer R., Coimbra R., Chiarugi M., Litvin A., Hardcastle T., Forfori F., Vincent J. -L., Hecker A., Ten Broek R., Bonavina L., Chirica M., Boggi U., Pikoulis E., Di Saverio S., Montravers P., Augustin G., Tartaglia D., Cicuttin E., Cremonini C., Viaggi B., De Simone B., Malbrain M., Shelat V. G., Fugazzola P., Ansaloni L., Isik A., Rubio I., Kamal I., Corradi F., Tarasconi A., Gitto S., Podda M., Pikoulis A., Leppaniemi A., Ceresoli M., Romeo O., Moore E. E., Demetrashvili Z., Biffl W. L., Wani I., Tolonen M., Duane T., Dhingra S., DeAngelis N., Tan E., Abu-Zidan F., Ordonez C., Cui Y., Labricciosa F., Perrone G., Di Marzo F., Peitzman A., Sakakushev B., Sugrue M., Boermeester M., Nunez R. M., Gomes C. A., Bala M., Kluger Y., and Catena F.
Abstract: Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary. This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients.
Published: 2021

6. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation

Author: Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, Coccolini F., Kluger Y., Moore E. E., Maier R. V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A. W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G. P., Otomo Y., Baiocchi G. L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J. G., Consani H., Russello D., Bortul M., Maurel T. G., Kaf H. S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C. A., Kong V., Zakaria A. D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J. G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V. M. D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A. Y. Y. M., Gonsaga R. A. T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C. G. L., Podda M., Mingoli A., Delgado R. C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K. Y. Y., Jusoh A. C., Amato B., Nita G. E., de Beaux A., Demetrashvili Z., Davies R. J., Kim J. I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F. M., Berardi L., Florio M. G., Hecker M., Dubuisson V., O'Connor D. B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W. P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L. B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L. A., Adeleye A. O., Kim D., Veroux M., Hardcastle T. C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G. M. M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C. -J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G. A. M., Santini M., Mellace L., Enoksen C. H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., Romeo L., Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, Coccolini F., Kluger Y., Moore E. E., Maier R. V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A. W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G. P., Otomo Y., Baiocchi G. L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J. G., Consani H., Russello D., Bortul M., Maurel T. G., Kaf H. S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C. A., Kong V., Zakaria A. D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J. G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V. M. D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A. Y. Y. M., Gonsaga R. A. T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C. G. L., Podda M., Mingoli A., Delgado R. C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K. Y. Y., Jusoh A. C., Amato B., Nita G. E., de Beaux A., Demetrashvili Z., Davies R. J., Kim J. I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F. M., Berardi L., Florio M. G., Hecker M., Dubuisson V., O'Connor D. B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W. P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L. B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L. A., Adeleye A. O., Kim D., Veroux M., Hardcastle T. C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G. M. M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C. -J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G. A. M., Santini M., Mellace L., Enoksen C. H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., and Romeo L.
Abstract: Introduction: Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods: A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results: An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion: Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.
Published: 2021

7. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation

Author: Coccolini, F., Kluger, Y., Moore, E. E., Maier, R. V., Coimbra, R., Ordonez, C., Ivatury, R., Kirkpatrick, A. W., Biffl, W., Sartelli, M., Hecker, A., Ansaloni, L., Leppaniemi, A., Reva, V., Civil, I., Vega, F., Chiarugi, M., Chichom-Mefire, A., Sakakushev, B., Peitzman, A., Chiara, O., Abu-Zidan, F., Maegele, M., Miccoli, M., Chirica, M., Khokha, V., Sugrue, M., Fraga, G. P., Otomo, Y., Baiocchi, G. L., Catena, F., Kuliesius, Z., Conti, L., Dogjani, A., Lee, J. G., Consani, H., Russello, D., Bortul, M., Maurel, T. G., Kaf, H. S., Adamou, H., Alin, V., Robustelli, U., Sato, N., Seretis, C., Quiodettis, M., Gomes, C. A., Kong, V., Zakaria, A. D., Guner, A., Gachabayov, M., Chowdhury, S., Pata, F., Garcia, A., Rems, M., Das, K., Riedel, J. G., Lasithiotakis, K., Sydorchuk, R., Sydorchuk, L., Lostoridis, E., Buia, A., Mcfarlane, M., Ciani, R., Munoz-Cruzado, V. M. D., Tartaglia, D., Ioannidis, O., Muhrbeck, M., Reicher, M., Roscio, F., Ceresoli, M., Tsiftsis, D., Kavalakat, A., Pintar, T., Georgiou, G., Ricci, G., Mohan, R., Saar, S., Di Carlo, I., Isik, A., Ahmed, A. Y. Y. M., Gonsaga, R. A. T., Sammartano, F., Tallon-Aguilar, L., Shoko, T., Hsu, J., Kobe, Y., Romeo, C. G. L., Podda, M., Mingoli, A., Delgado, R. C., Ekwen, G., Aude, V., Olona, C., Boati, P., Magnone, S., Capaldi, M., Bala, M., Picetti, E., Negoi, I., Kok, K. Y. Y., Jusoh, A. C., Amato, B., Nita, G. E., de Beaux, A., Demetrashvili, Z., Davies, R. J., Kim, J. I., Pereira, A., Fattori, L., Paolillo, C., Ghannam, W., Rodriguez, F. M., Berardi, L., Florio, M. G., Hecker, M., Dubuisson, V., O'Connor, D. B., De'Angelis, N., Dobric, I., Massalou, D., Ortenwall, P., Pikoulis, E., Ugarte-Sierra, B., Zuidema, W. P., Kechagias, A., Marwah, S., Litvin, A., Nikolopoulos, I., Pesce, A., Uranues, S., Luppi, D., Flohe, S., Martinez-Perez, A., Lorenzo, M., Vergano, L. B., Manca, M., Malacarne, P., Kurihara, H., Widder, S., Pucciarelli, M., Monzani, F., Brambillasca, P., Corbella, D., Agresta, F., Moore, L., Buonomo, L. A., Adeleye, A. O., Kim, D., Veroux, M., Hardcastle, T. C., Di Saverio, S., Recordare, A., Rubio-Perez, I., Shlyapnikov, S., Rahim, R., Vega, G. M. M., Boris, K., Sawyer, R., Baraket, O., Soreide, K., Weber, C., Seak, C. -J., Herman, S., Gamberini, E., Costa, S., Mazzocconi, G., Lozada, E., Manatakis, D., Lohsiriwat, V., Ahmed, A., Elbery, B., Tiberio, G. A. M., Santini, M., Mellace, L., Enoksen, C. H., Major, P., Parini, D., Improta, M., Fugazzola, P., Pini, S., Liberti, G., Martino, C., Cobianchi, L., Canzi, G., Cicuttin, E., Kenig, J., Zago, M., Giannessi, S., Scaglione, M., Orsitto, E., Cioni, R., Ghiadoni, L., Menichetti, F., Agnoletti, V., Sganga, G., Prosperi, P., Roviello, F., De Paolis, P., Gordini, G., Forfori, F., Ruscelli, P., Gabrielli, F., Puglisi, A., Bertolucci, A., Marchi, S., Bellini, M., Casagli, S., De Simone, B., Carmassi, F., Marchetti, S., Accorsini, M., Cremonini, C., Morelli, F., Romeo, L., Coccolini F., Kluger Y., Moore E.E., Maier R.V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A.W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G.P., Otomo Y., Baiocchi G.L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J.G., Consani H., Russello D., Bortul M., Maurel T.G., Kaf H.S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C.A., Kong V., Zakaria A.D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J.G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V.M.D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A.Y.Y.M., Gonsaga R.A.T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C.G.L., Podda M., Mingoli A., Delgado R.C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K.Y.Y., Jusoh A.C., Amato B., Nita G.E., de Beaux A., Demetrashvili Z., Davies R.J., Kim J.I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F.M., Berardi L., Florio M.G., Hecker M., Dubuisson V., O'Connor D.B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W.P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L.B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L.A., Adeleye A.O., Kim D., Veroux M., Hardcastle T.C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G.M.M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C.-J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G.A.M., Santini M., Mellace L., Enoksen C.H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., Romeo L., Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, and HUS Abdominal Center
Subjects: System, Consensus, Internationality, Delphi Technique, Accrual, Process (engineering), media_common.quotation_subject, Performance, education, lcsh:Surgery, 030230 surgery, Analysis, Data, Morbidity, Mortality, Outcome, Planning, Product, World, 03 medical and health sciences, 0302 clinical medicine, Trauma management, Health care, Medicine, Humans, Operations management, Quality (business), Product (category theory), media_common, Quality Indicators, Health Care, Core set, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Analysi, lcsh:RD1-811, lcsh:RC86-88.9, CARE, 3126 Surgery, anesthesiology, intensive care, radiology, Core (game theory), Traumatology, Emergency Medicine, Surgery, business, Research Article
Abstract: Introduction Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.
Published: 2021

8. Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study

Author: Coccolini, F, Gubbiotti, F, Ceresoli, M, Tartaglia, D, Fugazzola, P, Ansaloni, L, Sartelli, M, Kluger, Y, Kirkpatrick, A, Amico, F, Catena, F, Chiarugi, M, Montori, G, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Sugrue, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Ben-Ishay, O, Lippi, A, Improta, M, Zharikov, A, Dubuisson, V, Coccolini F., Gubbiotti F., Ceresoli M., Tartaglia D., Fugazzola P., Ansaloni L., Sartelli M., Kluger Y., Kirkpatrick A., Amico F., Catena F., Chiarugi M., Montori G., Salvetti F., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Sugrue M., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Ben-Ishay O., Lippi A., Improta M., Zharikov A., Dubuisson V., Coccolini, F, Gubbiotti, F, Ceresoli, M, Tartaglia, D, Fugazzola, P, Ansaloni, L, Sartelli, M, Kluger, Y, Kirkpatrick, A, Amico, F, Catena, F, Chiarugi, M, Montori, G, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Sugrue, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Ben-Ishay, O, Lippi, A, Improta, M, Zharikov, A, Dubuisson, V, Coccolini F., Gubbiotti F., Ceresoli M., Tartaglia D., Fugazzola P., Ansaloni L., Sartelli M., Kluger Y., Kirkpatrick A., Amico F., Catena F., Chiarugi M., Montori G., Salvetti F., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Sugrue M., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Ben-Ishay O., Lippi A., Improta M., Zharikov A., and Dubuisson V.
Abstract: Background: Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods: A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results: A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion: We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.
Published: 2020

9. Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study

Author: Rausei, S, Pappalardo, V, Ceresoli, M, Catena, F, Sartelli, M, Chiarugi, M, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Coccolini, F, Montori, G, Salvetti, F, Fugazzola, P, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Lippi, A, Improta, M, Gubbiotti, F, Zharikov, A, Dubuisson, V, Sugrue, M, Rausei S., Pappalardo V., Ceresoli M., Catena F., Sartelli M., Chiarugi M., Kluger Y., Kirkpatrick A., Ansaloni L., Coccolini F., Montori G., Salvetti F., Fugazzola P., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Lippi A., Improta M., Gubbiotti F., Zharikov A., Dubuisson V., Sugrue M., Rausei, S, Pappalardo, V, Ceresoli, M, Catena, F, Sartelli, M, Chiarugi, M, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Coccolini, F, Montori, G, Salvetti, F, Fugazzola, P, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Lippi, A, Improta, M, Gubbiotti, F, Zharikov, A, Dubuisson, V, Sugrue, M, Rausei S., Pappalardo V., Ceresoli M., Catena F., Sartelli M., Chiarugi M., Kluger Y., Kirkpatrick A., Ansaloni L., Coccolini F., Montori G., Salvetti F., Fugazzola P., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Lippi A., Improta M., Gubbiotti F., Zharikov A., Dubuisson V., and Sugrue M.
Abstract: Background: Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection. Methods: Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up. Results: A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality. Conclusions: This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.
Published: 2020

10. Routine prophylactic ureteral stenting before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Safety and usefulness from a single-center experience

Author: Fugazzola, P, Coccolini, F, Tomasoni, M, Cicuttin, E, Sibilla, M, Gubbiotti, F, Lippi, A, Improta, M, Montori, G, Ceresoli, M, Pisano, M, Ansaloni, L, Fugazzola P., Coccolini F., Tomasoni M., Cicuttin E., Sibilla M. G., Gubbiotti F., Lippi A., Improta M., Montori G., Ceresoli M., Pisano M., Ansaloni L., Fugazzola, P, Coccolini, F, Tomasoni, M, Cicuttin, E, Sibilla, M, Gubbiotti, F, Lippi, A, Improta, M, Montori, G, Ceresoli, M, Pisano, M, Ansaloni, L, Fugazzola P., Coccolini F., Tomasoni M., Cicuttin E., Sibilla M. G., Gubbiotti F., Lippi A., Improta M., Montori G., Ceresoli M., Pisano M., and Ansaloni L.
Abstract: Objective: There are very few evidences about safety and usefulness of routine prophylactic ureteral stenting (PUS) before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Material and methods: An analysis of prospectively collected data about patients who underwent CRS and HIPEC for different sites of primary disease was carried out focusing on ureteral complications. Results: A total of 138 patients who underwent CRS and HIPEC between December 2010 and June 2017 were considered. All patients underwent PUS before CRS and HIPEC. Of them, 91 (66.4%) patients received pelvic peritonectomy, 49 (35.8%) pelvic lymphadenectomy, 31 (22.6%) left hemicolectomy, 44 (32.4%) right hemicolectomy, 46 (33.6%) rectal resection, 56 (40.9%) hysteroannessiectomy, and 39 (28.5%) appendectomy. There was one (0.7%) postoperative ureteral fistula. The cumulative risk of ureteral stent-related major complications was 4.3% (two patients (1.4%) had protracted gross hematuria, two patients (1.4%) had urinary sepsis, and three patients (2.9%) developed hydronephrosis after a period from removing ureteral stents and required restenting. Morbidity due to ureteral stenting was associated with a longer length of stay (LOS) (p=0.053). A total of 52 patients (44.1%) developed renal dysfunction according to the RIFLE (Risk, Injury, Failure, Loss of kidney function, End-stage kidney-disease) criteria: 19.5% were in risk class, 10.2% in acute renal injury class, and 14.4% in acute renal failure class. Conclusion: PUS could be a useful tool for reducing iatrogenic ureteral injury, but it is associated with a non-negligible morbidity, which implies longer LOS. A more accurate patient selection for PUS is necessary.
Published: 2019

11. Endothelial microparticles correlate with erectile dysfunction in diabetic men

Author: Esposito, K, Ciotola, M, Giugliano, F, Schisano, B, Improta, L, Improta, M R, Beneduce, F, Rispoli, M, De Sio, M, and Giugliano, D
Published: 2007
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12. Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines

Author: Coccolini, F., Improta, M., Sartelli, M., Rasa, K., Sawyer, R., Coimbra, R., Chiarugi, M., Litvin, A., Hardcastle, T., Forfori, F., Vincent, J.L., Hecker, A., Broek, R.P.G ten, Bonavina, L., Chirica, M., Boggi, U., Pikoulis, E., Saverio, S. Di, Montravers, P., Augustin, G., Tartaglia, D., Cicuttin, E., Cremonini, C., Viaggi, B., Simone, B. De, Malbrain, M., Shelat, V.G., Fugazzola, P., Ansaloni, L., Isik, A., Rubio, I., Kamal, I., Corradi, F., Tarasconi, A., Gitto, S., Podda, M., Pikoulis, A., Leppaniemi, A., Ceresoli, M., Romeo, O., Moore, E.E., Demetrashvili, Z., Biffl, W.L., Wani, I., Tolonen, M., Duane, T., Dhingra, S., DeAngelis, N., Tan, E.C.T.H., Abu-Zidan, F., Ordonez, C., Cui, Y., Labricciosa, F., Perrone, G., Marzo, F. Di, Peitzman, A., Sakakushev, B., Sugrue, M., Boermeester, M., Nunez, R.M., Gomes, C.A., Bala, M., Kluger, Y., Catena, F., Coccolini, F., Improta, M., Sartelli, M., Rasa, K., Sawyer, R., Coimbra, R., Chiarugi, M., Litvin, A., Hardcastle, T., Forfori, F., Vincent, J.L., Hecker, A., Broek, R.P.G ten, Bonavina, L., Chirica, M., Boggi, U., Pikoulis, E., Saverio, S. Di, Montravers, P., Augustin, G., Tartaglia, D., Cicuttin, E., Cremonini, C., Viaggi, B., Simone, B. De, Malbrain, M., Shelat, V.G., Fugazzola, P., Ansaloni, L., Isik, A., Rubio, I., Kamal, I., Corradi, F., Tarasconi, A., Gitto, S., Podda, M., Pikoulis, A., Leppaniemi, A., Ceresoli, M., Romeo, O., Moore, E.E., Demetrashvili, Z., Biffl, W.L., Wani, I., Tolonen, M., Duane, T., Dhingra, S., DeAngelis, N., Tan, E.C.T.H., Abu-Zidan, F., Ordonez, C., Cui, Y., Labricciosa, F., Perrone, G., Marzo, F. Di, Peitzman, A., Sakakushev, B., Sugrue, M., Boermeester, M., Nunez, R.M., Gomes, C.A., Bala, M., Kluger, Y., and Catena, F.
Abstract: Contains fulltext : 245653.pdf (Publisher’s version ) (Open Access), Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary.This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients.
Published: 2021

13. Sexual dysfunction in type 2 diabetes at diagnosis: Progression over time and drug and non-drug correlated factors

Author: Corona, G., Giorda, Carlo B., Cucinotta, Domenico, Guida, Piero, Nada, Elisa, Aglialoro, A., Albanese, V., Albano, S., Antonangelo, C., Baccetti, F., Bulzomi, R., Calatola, P., Capano, F., Clemente, G., Corigliano, G., Cucinotta, D., De Fazio, C., DE FRANCESCO, Claudia, De Joannon, U., Del Buono, A., Fontana, L., Fornengo, R., Fraticelli, E., Gaviglio, D., Gentile, S., Giorda, C. B., Giorgianni, Letterio, Guarino, G., Iannarelli, R., Improta, L., Improta, M., Leotta, S., Magro, G., Maiani, L., Mastroiacovo, D., Mingardi, R., Morviducci, L., Nada, E., Nosso, G., Nuzzi, A., Ocelli, C., Paciotti, V., Pata, P., Rampini, P. A., Rovere, M., Sabbatini, A., Sciarrafia, M., Sciarretta, F., Sforza, A., Starnone, V., Testori, G., Trevisan, F., Turco, S., Viviani, G., and Zavaroni, D.
Subjects: Male, Cross-sectional study, Aged, Cross-Sectional Studies, Depressive Disorder, Diabetes Mellitus, Type 2, Erectile Dysfunction, Follow-Up Studies, Humans, Hypoglycemic Agents, Interviews as Topic, Life Style, Middle Aged, Phosphodiesterase 5 Inhibitors, Prevalence, Prospective Studies, Severity of Illness Index, Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), 030232 urology & nephrology, lcsh:Medicine, Type 2 diabetes, Biochemistry, 0302 clinical medicine, Endocrinology, Drug Metabolism, Medicine and Health Sciences, Testosterone, Lipid Hormones, lcsh:Science, Prospective cohort study, 030219 obstetrics & reproductive medicine, Multidisciplinary, Pharmaceutics, Depression, Obstetrics and Gynecology, Type 2 Diabetes, Androgens, medicine.symptom, sexual disfunction, Research Article, medicine.medical_specialty, Sexual Dysfunction, Endocrine Disorders, Urology, PDE5i, 03 medical and health sciences, Drug Therapy, Internal medicine, Severity of illness, Mental Health and Psychiatry, medicine, Diabetes Mellitus, Pharmacokinetics, Pharmacology, business.industry, Mood Disorders, Hypogonadism, lcsh:R, Type 2 Diabetes Mellitus, Biology and Life Sciences, medicine.disease, Hormones, Surgery, Erectile dysfunction, Sexual dysfunction, Metabolic Disorders, Women's Health, lcsh:Q, Sexual function, business
Abstract: Aims To present the longitudinal data of the SUBITO-DE study, a prospective survey involving male patients with new or recently diagnosed type 2 diabetes mellitus (T2DM) (
Published: 2016
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14. The SUBITO-DE study: sexual dysfunction in newly diagnosed type 2 diabetes male patients

Author: Corona G1, Giorda CB, Cucinotta D, Guida P, Nada E, SUBITO DE study g.r.o.u.p. CollaboratorsAglialoro A, Albanese V, Albano S, Antonangelo C, Baccetti F, Bulzomì R, Calatola P, Capano F, Clemente G, Corigliano G, Corona G, De Fazio C, De Francesco C, De Joannon U, Del Buono A, Fontana L, Fornengo R, Fraticelli E, Gaviglio D, GENTILE, Sandro, Giorgianni L, GUARINO, Giuseppina, Iannarelli R, Improta L, Improta M, Leotta S, Magro G, Maiani L, Mingardi R, Morviducci L, Nosso G, Nuzzi A, Ocelli C, Paciotti V, Pata P, Rampini PA, Rovere M, Sabbatini A, Sciarrafia M, Sciarretta F, Sforza A, Starnone V, Testori G, Trevisan F, Turco S, Viviani G, Zavaroni D., Corona, G1, Giorda, Cb, Cucinotta, D, Guida, P, Nada, E, CollaboratorsAglialoro A, SUBITO DE study g. r. o. u. p., Albanese, V, Albano, S, Antonangelo, C, Baccetti, F, Bulzomì, R, Calatola, P, Capano, F, Clemente, G, Corigliano, G, Corona, G, De Fazio, C, De Francesco, C, De Joannon, U, Del Buono, A, Fontana, L, Fornengo, R, Fraticelli, E, Gaviglio, D, Gentile, Sandro, Giorgianni, L, Guarino, Giuseppina, Iannarelli, R, Improta, L, Improta, M, Leotta, S, Magro, G, Maiani, L, Mingardi, R, Morviducci, L, Nosso, G, Nuzzi, A, Ocelli, C, Paciotti, V, Pata, P, Rampini, Pa, Rovere, M, Sabbatini, A, Sciarrafia, M, Sciarretta, F, Sforza, A, Starnone, V, Testori, G, Trevisan, F, Turco, S, Viviani, G, and Zavaroni, D.
Subjects: Male, Depression, Hypogonadism, Comorbidity, Middle Aged, Prognosis, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Erectile Dysfunction, Risk Factors, Humans, Testosterone, Longitudinal Studies, Prospective Studies, Follow-Up Studies
Abstract: No data on the prevalence of erectile dysfunction (ED) in subjects with newly diagnosed Type 2 diabetes mellitus (T2DM) are currently available.The aim of the present study was to estimate the prevalence of ED and its associated causes in a sample of male patients with recently diagnosed DM (24 months) attending a diabetes care center.The study comprised two phases: a cross-sectional analysis and a longitudinal reassessment of the data collected during the first phase. During the first phase, 1503 subjects (mean age 58.7±8.9 yr) from 27 centers were interviewed: 666 (43.3%) reported experiencing ED, 499 of which (mean age 58.8±8.8 yr) agreed to participate in the study (final enrolment rate, 33.3%). Concurrent morbidities were hypertension (55.3%), dyslipidemia (39.5%), and coronary heart disease (7.8%); chronic complications were neuropathy (8.9%), nephropathy (12.6%) and retinopathy (7.6%) in about one third of the sample at enrolment.Overall, about 20% of the patients reported having used ED drugs, but more than 50% had abandoned therapy because of the drug's ineffectiveness or high cost. The prevalence of hypogonadism was 46.9% (total testosterone level, 3.5 ng/ml). Some 20% of patients reported symptoms suggestive of depression.The present study provides data showing a high prevalence of ED, hypogonadism and depressive symptoms among male patients with newly diagnosed T2DM. Further analysis of the data will elucidate the specific determinants of such conditions and their longitudinal significance.
Published: 2013

15. Sexual dysfunction at the onset of type 2 diabetes: the interplay of depression, hormonal and cardiovascular factors

Author: Corona G., Giorda C.B., Cucinotta D., Guida P., Nada E., Aglialoro A., Albanese V., Albano S., Antonangelo C., Baccetti F., Bulzomi' R., Calatola P., Capano F., Clemente G., Corigliano G., De Fazio C., De Francesco C., De Joannon U., Del Buono A., Fontana L., Fornengo R., Fraticelli E., Gaviglio D., Gentile S., Giorgianni L., Guarino G., Iannarelli R., Improta L., Improta M., Leotta S., Magro G., Maiani L., Mingardi R., Morviducci L., Nosso G., Nuzzi A., Ocelli C., Paciotti V., Pata P., Rampini P.A., Rovere M., Sabbatini A., Sciarrafia M., Sciarretta F., Sforza A., Starnone V., Testori G., Trevisan F., Turco S., Viviani G., Zavaroni D., Gentile, Sandro, Giorda, C. B., Giorgianni, L., and Guarino, Giuseppina
Subjects: Male, medicine.medical_specialty, Urology, Endocrinology, Diabetes and Metabolism, Libido, Type 2 diabetes, Endocrinology, Diabetes mellitus, Erectile Dysfunction, Testosterone, Diabetes Mellitus, Internal medicine, Premature ejaculation, medicine, Prevalence, Humans, Ejaculation, Prospective Studies, Premature Ejaculation, Depression (differential diagnoses), Depressive Disorder, business.industry, Hypogonadism, Delayed ejaculation, Middle Aged, medicine.disease, Psychiatry and Mental health, Sexual desire, Sexual Dysfunction, Physiological, Sexual dysfunction, Erectile dysfunction, Reproductive Medicine, Diabetes Mellitus, Type 2, Italy, medicine.symptom, business, Sexual function
Abstract: Introduction: Several data have emphasized the importance of early diagnosis of erectile dysfunction (ED) and meticulous cardiovascular investigation in the type 2 diabetic mellitus (T2DM) patients. Aim: To estimate the prevalence of ED and its associated determinants in a sample of male patients with new or recently diagnosed T2DM. Methods: The SUBITO-DE study is an observational, multicenter, prospective study involving 27 Italian diabetes centers. Male patients recently diagnosed with T2DM were consecutively interviewed by their attending physician at the diabetes care centers and asked whether they had experienced a change in their sexual function or found it unsatisfactory. Those responding positively were then invited to participate in the study. Main Outcome Measure: Several hormonal and biochemical parameters were studied. Results: A nonselected series of 1,503 patients was interviewed, 499 of which (mean age, 58.8±8.8 years) entered the study, yielding a final enrolment rate of 33.3%. ED was classified as mild in 19.4%, mild-to-moderate in 15.4%, moderate in 10.4%, and severe in 21.6% of patients, respectively. In addition, premature ejaculation, delayed ejaculation, and hypoactive sexual desire (HSD) were comorbid in 28.3%, 32.9%, and 58.4%, respectively. Finally, hypogonadism, showed an estimated prevalence of almost 20%. Both organic (at least one chronic DM-associated complication) and psychological factors (severe depressive symptoms) increased the risk of ED. Severe depressive symptoms were also associated with ejaculatory problems, HSD, and hypogonadism. Conclusions: A high prevalence of sexual dysfunction in men with recently diagnosed T2DM was detected. Early diagnosis of ED could help prevent emotional and physical discomfort in men and aid in identifying reversible cardiovascular risk factors. Screening of sexual dysfunction should become a part of routine care in the management of T2DM patients. Corona G, Giorda CB, Cucinotta D, Guida P, Nada E, and Gruppo di studio SUBITO-DE. Sexual dysfunction at the onset of type 2 diabetes: The interplay of depression, hormonal and cardiovascular factors. J Sex Med 2014;11:2065-2073. © 2014 International Society for Sexual Medicine.
Published: 2014
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16. La campagna diagnostica sul pulpito di Giovanni Pisano nella chiesa di Sant’Andrea a Pistoia: una necessaria premessa al restauro conservativo

Author: Aldrovandi, A., Balzani, M., Cagnini, A., Censini, G., De Luca, D., Fratini, F., Garzonio, C. A., Giamello, Marco, Hoyte, J., Improta, M. C., Mugnaini, Sonia, Porcinai, S., Scala, Andrea, and Sorella, F.
Published: 2011

17. Basal Supplementation of Insulin Lispro Protamine Suspension Versus Insulin Glargine and Detemir for Type 2 Diabetes: Meta-analysis of randomized controlled trials

Author: Esposito, K., primary, Chiodini, P., additional, Capuano, A., additional, Petrizzo, M., additional, Improta, M. R., additional, and Giugliano, D., additional
Published: 2012
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18. Endothelial microparticles correlate with erectile dysfunction in diabetic men

Author: Esposito, K, primary, Ciotola, M, additional, Giugliano, F, additional, Schisano, B, additional, Improta, L, additional, Improta, M R, additional, Beneduce, F, additional, Rispoli, M, additional, De Sio, M, additional, and Giugliano, D, additional
Published: 2006
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19. MEDICAL SCIENCE. GISSI-2: A factorial randomised trial of alteplase versus streptokinase and heparin versus no heparin among 12 490 patients with acute myocardial infarction

Author: Feruglio, G. A., Lotto, A., Rovelli, F., Solinas, P., Tavazzi, L., Tognoni, G., De Vita, C., Franzosi, M. G., Maggiom, A. P., Mauri, F., Volpi, A., Selvini, A., Donato, L., Garattmi, S., Loi, U., Sirchia, G., Ambrosioni, E., Camerini, F., Campolo, L., Donati, M. B., Ferrari, M., Farchi, G., Geraci, E., Mannucci, P. M., Marubini, E., Neri Semeri, G. G., Peto, R., Prati, P. L., Specchia, G., Vecchio, C., Visani, L., Yusuf, S., Mezzanotte, G., Santoro, E., Bruno, M., Cappello, T., Coppini, A., Fincati, F., Mantovani, G., Pangrazzi, J., Pogna, M., Turazza, F. M., Ansehni, M., Barbonaglia, L., Bigi, R., Cavalli, A., Frigerio, M., Giordano, A., Gualtierotti, C., Torta, D., Vinci, P., Bossi, M., Furlanello, F., Braito, E., Giulia, V., Palmieri, M., Majoimo, P., Pinelli, G., Papi, L., Nardelli, A., Capestro, F., Rossi, A., Ricci, D., Mininni, N., Bianco, G., Barbuzzi, S., Plastina, F., Di Giovanna, F., Mereu, D., Giordano, F., Barlotti, R., Loparco, G., Boscarino, S., Ruggeri, G., Anastasi, R., Paciaroni, E., Tomassini, P. F., Purcaro, A., Francesconi, M., Figliolia, S., Tesse, S., Devoti, G., Giometti, R., Teoni, P., Burali, A., Zucconelli, V., Iervoglini, A., Amabili, S., Caratti, C. A., Zola, G., Ferraguto, P., Sagci, G., Rotiroti, D., Genovese, M., Da€™amato, N., Taurino, L., Colonna, L., Bovenzi, F., Messina, D., Sarcina, G., Compostella, L., Cucchini, F., Malacrida, R., Gradel, C., Bridda, A., Pellegrini, P., Acone, L., Bruno, A., Tespili, M., Guaghurrii, G., Casari, A., Bobba, F., Scaramuzzino, G., Berardi, C., De Castro, U., Fulvi, M., Lintner, W., Erlicher, A., Pitscheider, W., Scola Gagliardi, R., Bonizzato, G., Roggero, C., Perrini, A., Tsialtas, D., Straneo, U., Storelli, A., Verrienti, A., Albonico, B., Corradi, L., De Petra, V., Villani, C., Maxia, P., Bianco, A., Crabu, E., Centamore, G., Di Stefano, G., Vancheri, F., Amico, C., Baldini, F., Santopuoli, G., Pantaleoni, A., Contessotto, F., Terlizzi, R., Turchi, E., Teglio, V., Pignatti, F., Aletto, C., Gozzelino, G., Pettinati, G., De Santis, F., Correale, E., Romano, S., Perrotta, R., Tritto, C., May, L., Achilli, G., Suzzi, G., Cemetti, C., Longobardi, R., Somma, G., Palumbo, C., Gallone, P., Sorrentino, F., Dato, A., Della Monica, R., Pagano, L., Alberti, A., Orselli, L., Negrini, M., De Ponti, C., Acito, P., Capelletti, D., Bortolini, F., Coppola, V., Ciglia, C., De Cesare, M., De Lio, U., Maiolino, P., Giannini, R., Niccolini, A., Marinoni, C., Guasconi, C., Sonnino, S., Pagliei, M., Ferrari, G., Politi, A., Galli, M., De Rinaldis, G., Calcagnile, A., Bendinelli, S., Lusetti, L., Mollaioli, M., Cosmi, F., Venneri, N., Feraco, E., Lauro, A., Catelli, P., Poluzzi, C., Distante, S., Pedroni, P., Zampaglione, G., Lumare, R., Bruna, C., De Benedictis, N., Ziacchi, V., Lomanto, B., Riva, D., Bertocchi, P., Tirella, G., Tessitori, M., Bini, A., Peruzzi, F., Maresta, A., Pirazzini, L., Gaggi, S., Frausini, G., Malacame, C., Codeca, L., Cappato, R., Andreoli, L., Bastoni, L. A., Pucci, P., Sarro, F., Vergassola, R., Barchielli, M., De Matteis, D., Carrone, M., Liberati, R., Meniconi, L., Radogna, M., Tallone, M., Ieri, A., Ferreri, A., Guidali, P., Canziani, R., Mariello, F., Minelli, C., Muzio, L., Rota Baldini, M., Lupi, G., Cecchi, A., Giuliano, G., Bellotti, S., Livi, S., Corti, E., Rossi, P., Delfino, R., Iannetti, M., Pastorini, C., Pennesi, A., Di Giacinto, N., Bertolo, L., Slomp, L., Cresti, A., Svetoni, N., Distefano, S., Veneri, L., Moretti, S., Palermo, R., Giovanelli, N., Parchi, C., Dethomads, M., Paparella, N., Carrino, C., Aquaro, G., Idone, P., Marsili, P., Sideri, F., Valerio, A., Tullio, D., Ragazzini, G., Gramenzi, S., De Pasquale, B., Gelfo, P. G., Rosselli, P., De Marchi, E., Greco, M. R., Fazio, A. M., Savoia, M. T., Gerosa, C., Barbiero, M., Barbaresi, F., Volta, G., Da€™urbano, M., Passoni, F., Parola, G., Lanzini, A., Baldini, U., Del Bene, P., Orlandi, M., Oddone, A., Lazzari, M., Ballerini, B., Bozzi, L., Moccetti, T., Bemasconi, E., Sanguinetti, M., Tognoli, T., Bardelli, G., Maggi, A., Turato, R., Piva, M., Izzo, A., Tantalo, L., Rizzi, A., Scilabra, G., Varvaro, F., Colombo, G., Grieco, A., Dovico, E., Belluzzi, F., Casellato, F., Lecchi, G., Maugeri Sacci, C., Consolo, A., Piccolo, E., Zuin, G., Zappa, C., Sanna, G. P., Dossena, M. G., Corsini, C., Lettino, M., Marconi, M., Mafrici, A., Leonardi, G., Moreo, A., Seregni, R., Pastine, I., Casazza, F., Regalia, F., Maggiolini, S., Benenati, P. M., Rigo, R., Pascotto, P., Zanocco, A., Artusi, L., Cappelli, C., Bernardi, C., Pahnieri, M., Zilio, G., Sandri, R., Neri, G., Valagussa, F., Osculati, G., Cira, A., Da€™aniello, L., Piantadosi, F. R., Improta, M., Severino, S., Bisconti, C., Mostacci, M., Randon, L., Boschello, M., Allegri, M., Freggiaro, V., Mureddu, V., Soro, F., Marras, E., Marchi, S. M., De Luca, C., Manetta, M., Dalla Volta, S., Maddalena, F., Donzelli, M., Vitrano, M. G., Canonico, A., Ledda, A., Bellomare, D., Carrubba, A., Da€™antonio, E., Scardulla, C., Raineri, A., Traina, M., La Calce, C., Cirincione, V., Montanar, F., Strizzolo, L., Di Gregorio, D., Mantini, L., Chiriatti, G., Gazzola, U., Rosi, A., Mellini, M., Piazza, R., Micheli, G., Bechi, S., Martines, C., Marchese, D., Bigalli, A., Davini, P., Boem, A., Del Citerna, F., Giomi, A., Codeluppi, P., Negrelli, M., Brieda, M., Charmet, P. A., Petrella, A., Bardazzi, L., Bianco, G. A., Marco, A., Licitra, R., Lettica, G. V., Tumiotto, G., Bosi, S., Spitali, G., Casali, G., Bottoni, N., Parenti, G. F., Triulzi, E., Brighi, F., Benati, A., De Sanctis, A., Mene, A., Pesaresi, A., Bologna, F., Lumia, F., Barbato, G., Milazzotto, F., Proietti, F., Angrisani, G., Azzolini, P., Coppola, E., Trani, Carlo, Masini, V., Rocchi, M., Borgia, M. C., Luciani, C., Vitucci, N. C., Giuliani, P., Tugnoli, F., Vetta, C., Altieri, T., Gimigliano, F., Striano, U., Salituri, S., Zanazzi, G., Zonzin, P., Bugatti, U., Ravera, B., Allemano, P., Reynaud, S., Sanson, A., Milani, L., De Simone, M. V., Villella, A., Grazzini, M., Amidei, S., Ansehni, L., Benza, G., Tagliamonte, A., Messina, V., Etro, M. D., Vivaldi, F., Cortese, R., Ibba, G. V., Sannia, L., Pedrazzini, F., Gazzotti, G. L., Pizzuti, A., Antonielli, E., Becchi, G., Filice, A., Salmoiraghi, A., Caramanno, G., Caporicci, D., Brun, M., Ferrario, G., Giani, P., Ronconi, G., Douglas, S., Bianchi, C., Cucchi, G., Marieni, M., Marcellini, G., Speca, G., Beato, E., Serabni, N., Bazzucchi, M., Coronelli, R., Rossi, L., Basso, G., Presbitero, P., Bevilacqua, R., Pallisco, O., Di Leo, M., Golzio, P. G., Parigi, A., Belli, R., Trinchero, R., Gaschino, G., Barenghi, M., Poggio, G. L., Braschi, G. B., Sciacca, R., Sammartano, A., Braito, G., Cuzzato, V., Frigo, G., Perissinono, F., Galati, A., Accogli, M., Morgera, T., Barbieri, L., Slavich, G. A., Fresco, C., Cuda, A., Liguori, A., Cozzi, A., Caico, S., Alberio, M., Di Marco, G., De Vito, G., Valente, S., Zagatti, G., Zardini, P., Nidasio, G. P., Girardi, P., Mazzini, C., Nava, S., Achilli, A., Bisogno, A., Pasotti, C., Ballestra, A. M., and Giustarini, C.
Subjects: Aspirin, medicine.medical_specialty, business.industry, Streptokinase, acute myocardial infarction, General Medicine, Heparin, medicine.disease, Atenolol, Surgery, Anistreplase, Anesthesia, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine, Myocardial infarction, business, Stroke, medicine.drug, Killip class
Abstract: A multicentre, randomised, open trial with a 2 x 2 factorial design was conducted to compare the benefits and risks of two thrombolytic agents, streptokinase (SK, 1·5 MU infused intravenously over 30-60 min) and alteplase (tPA, 100 mg infused intravenously over 3 h) in patients with acute myocardial infarction admitted to coronary care units within 6 h from onset of symptoms. The patients were also randomised to receive heparin (12 500 U subcutaneously twice daily until discharge from hospital, starting 12 h after beginning the tPA or SK infusion) or usual therapy. All patients without specific contraindications were given atenolol (5-10 mg iv) and aspirin (300-325 mg a day). The end-point of the study was the combined estimate of death plus severe left ventricular damage. 12 490 patients were randomised to four treatment groups (SK alone, SK plus heparin, tPA alone, tPA plus heparin). No specific differences between the two thrombolytic agents were detected as regards the combined end-point (tPA 23·1%; SK 22·5%; relative risk 1·04, 95% Cl 0·95-1·13), nor after the addition of heparin to the aspirin treatment (hep 22·7%, no hep 22·9%; RR 0·99, 95% Cl 0·91-1·08). The outcome of patients allocated to the four treatment groups was similar with respect to baseline risk factors such as age, Killip class, hours from onset of symptoms, and site and type of infarct. The rates of major in-hospital cardiac complications (reinfarction, post-infarction angina) were also similar. The incidence of major bleeds was significantly higher in SK and heparin treated patients (respectively, tPA 0·5%, SK 1·0%, RR 0·57, 95% Cl 0·38-0·85; hep 1·0%, no hep 0·6%, RR 1·64, 95% Cl 1·09-2·45), whereas the overall incidence of stroke was similar in all groups. SK and tPA appear equally effective and safe for use in routine conditions of care, in all infarct patients who have no contraindications, with or without post-thrombolytic heparin treatment. The 8·8% hospital mortality of the study population (compared with approximately 13% in the control cohort of the GISSI-1 trial) indicates the beneficial impact of the proven acute treatments for AMI.
Published: 1990

20. Is pizza sutable to type 1 diabetes? A real life identification of best compromise between taste and low glycemic index in patients on insulin pump

Author: T. Della-Corte, S. Gentile, V. Di Blasi, G. Guarino, M. Corigliano, G. Cozzolino, A. Fasolino, C. Martino, M.R. Improta, D. Oliva, C. Lamberti, A. Vecchiato, S. Vaia, E. Satta, C. Romano, C. Alfarone, F. Strollo, C. Brancato, C. Lambersi, C. Mosca, L.A. Stile, A. Vetrano, E. Visconti, D. Battipaglia, I. Cecco, E. Della Monica, M.G. Di Capua, C. Palmieri, R. Procida, F. Viesti, Della-Corte, T., Gentile, S., Di Blasi, V., Guarino, G., Corigliano, M., Cozzolino, G., Fasolino, A., Martino, C., Improta, M. R., Oliva, D., Lamberti, C., Vecchiato, A., Vaia, S., Satta, E., Romano, C., Alfarone, C., Strollo, F., Brancato, C., Lambersi, C., Mosca, C., Stile, L. A., Vetrano, A., Visconti, E., Battipaglia, D., Cecco, I., Della Monica, E., Di Capua, M. G., Palmieri, C., Procida, R., and Viesti, F.
Subjects: Adult, Blood Glucose, Dietary Fiber, Male, 0301 basic medicine, Insulin pump, medicine.medical_specialty, Taste, Adolescent, endocrine system diseases, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Diabete, Low glycemic index, Glucomannan, Gastroenterology, Kamut, Young Adult, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Dietary Carbohydrates, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, In patient, Type 1 diabetes, 030109 nutrition & dietetics, business.industry, food and beverages, nutritional and metabolic diseases, General Medicine, Middle Aged, Whole wheat, medicine.disease, Diabetes Mellitus, Type 1, Treatment Outcome, Glycemic Index, Pizza, Female, business
Abstract: Opposed to whole wheat (WWP), traditional pizza (TP) is loved by patients with type 1 diabetes mellitus (T1DM) despite causing hyperglycemia. 50 well-trained T1DM patients had higher glucose levels after TP than after WWP or mixed flour pizza, which however was tasty, digestible and metabolically appropriate to break diet monotony.
Published: 2020
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21. Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines

Author: Federico Coccolini, Enrico Cicuttin, E Pikoulis, Belinda De Simone, Ugo Boggi, Antonio Tarasconi, Luigi Bonavina, Bruno Viaggi, Camilla Cremonini, Robert G. Sawyer, Gennaro Perrone, Jean Louis Vincent, Ines Rubio, Paola Fugazzola, Itani Kamal, Arda Isik, Fikri M. Abu-Zidan, Massimo Sartelli, Philippe Montravers, Timothy Craig Hardcastle, Vishal G Shelat, Francesco Corradi, Ramiro Manzano Nunez, Goran Augustin, Ernest E. Moore, Richard P. G. ten Broek, Andrew B. Peitzman, Matti Tolonen, Marco Ceresoli, Fausto Catena, Stefano Gitto, Raul Coimbra, Sameer Dhingra, Miklosh Bala, Yoram Kluger, Manu L N G Malbrain, Andreas Hecker, Boris Sakakushev, Francesco Di Marzo, Dario Tartaglia, Salomone Di Saverio, Edward C.T.H. Tan, Imitiaz Wani, Carlos Augusto Gomes, Therese M. Duane, Francesco Forfori, Mauro Podda, Zaza Demetrashvili, Nicola de’Angelis, Mario Improta, Francesco M. Labricciosa, Yunfeng Cui, Kemal Rasa, Andrey Litvin, Luca Ansaloni, Mircea Chirica, Ari Leppäniemi, Michael Sugrue, Walter L. Biffl, Oreste Romeo, Marja A. Boermeester, Massimo Chiarugi, Carlos A. Ordoñez, Anastasia Pikoulis, Coccolini, F, Improta, M, Sartelli, M, Rasa, K, Sawyer, R, Coimbra, R, Chiarugi, M, Litvin, A, Hardcastle, T, Forfori, F, Vincent, J, Hecker, A, Ten Broek, R, Bonavina, L, Chirica, M, Boggi, U, Pikoulis, E, Di Saverio, S, Montravers, P, Augustin, G, Tartaglia, D, Cicuttin, E, Cremonini, C, Viaggi, B, De Simone, B, Malbrain, M, Shelat, V, Fugazzola, P, Ansaloni, L, Isik, A, Rubio, I, Kamal, I, Corradi, F, Tarasconi, A, Gitto, S, Podda, M, Pikoulis, A, Leppaniemi, A, Ceresoli, M, Romeo, O, Moore, E, Demetrashvili, Z, Biffl, W, Wani, I, Tolonen, M, Duane, T, Dhingra, S, Deangelis, N, Tan, E, Abu-Zidan, F, Ordonez, C, Cui, Y, Labricciosa, F, Perrone, G, Di Marzo, F, Peitzman, A, Sakakushev, B, Sugrue, M, Boermeester, M, Nunez, R, Gomes, C, Bala, M, Kluger, Y, and Catena, F
Subjects: Oncologic, Lymphoma, Cytomegalovirus, Review, Postoperative Complications, Cholecystitis, Medicine, Cholecystiti, Anesthesia, Appendiciti, Perioperative, Diverticuliti, Cancer, Abdomen, Acute, education.field_of_study, Leukemia, Perforation, Peritoniti, Medical emergencies. Critical care. Intensive care. First aid, Diverticulitis, Transplanted, Acute abdomen, Emergency Medicine, medicine.symptom, Emergency Service, Hospital, Infection, Immunocompetence, medicine.medical_specialty, RD1-811, Appendicitis, Hematologic, Immunocompromise, Immunosuppression, Infections, Intra-abdominal, Peritonitis, Tuberculosis, Tuberculosi, Perforation (oil well), Population, Immunocompromised Host, Humans, education, RC86-88.9, business.industry, General surgery, Cytomegaloviru, Pseudomembranous colitis, Emergency department, medicine.disease, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Surgery, business
Abstract: Contains fulltext : 245653.pdf (Publisher’s version ) (Open Access) Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary.This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients.
Published: 2021

22. Premessa

Author: Chirico Maria Luisa, AA.VV., T. D’Urso, A. Improta, M. G. Mansi, F. Toscano, and Chirico, Maria Luisa
Published: 2021

23. A randomized, open-label, comparative, crossover trial on preference, efficacy, and safety profiles of lispro insulin u-100 versus concentrated lispro insulin u-200 in patients with type 2 diabetes mellitus: a possible contribution to greater treatment adherence

Author: Caterina Colella, Domenica Oliva, Luigia Miretto, Gerardo Corigliano, Giuseppina Guarino, Alessandra Fusco, Viviana Russo, Marco Piscopo, Felice Strollo, Maria Rosaria Improta, Giampiero Marino, Antonietta Santorelli, Sandro Gentile, Alessandra D’Alessandro, Marco Corigliano, Sara Colarusso, Armando Giammarco, Rosa Simonetti, Emilia Martedì, Gentile, S., Fusco, A., Colarusso, S., Piscopo, M., Improta, M. R., Corigliano, M., Martedi, E., Oliva, D., Santorelli, A., Simonetti, R., Giammarco, A., Colella, C., Miretto, L., D'Alessandro, A., Russo, V., Guarino, G., Marino, G., Corigliano, G., and Strollo, F.
Subjects: Blood Glucose, Male, insulin, Injection, medicine.medical_specialty, Glycated Hemoglobin A, Treatment adherence, medicine.medical_treatment, 030209 endocrinology & metabolism, macromolecular substances, 030204 cardiovascular system & hematology, Injections, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Internal medicine, Diabetes mellitus, medicine, Surveys and Questionnaire, Humans, Hypoglycemic Agents, Insulin lispro, Lispro U-200, Pharmacology (medical), In patient, adherence, device, Aged, Glycated Hemoglobin, Cross-Over Studies, Insulin Lispro, Hypoglycemic Agent, business.industry, Insulin, Type 2 Diabetes Mellitus, Patient Preference, General Medicine, Cross-Over Studie, Middle Aged, medicine.disease, Crossover study, Preference, Diabetes Mellitus, Type 2, diabete, Female, business, Human, medicine.drug
Abstract: Background: Several outstanding pharmacological advances making innovative drugs sophisticateddevices available during the last few years. Nevertheless too many patients still disappointingly fail to meetthe metabolic targets suggested by current guidelines. Incorrect insulin administration techniques may greatly affect metabolic control in T2DM people. The aim of our study was to compare glycemic control associated with a concentrated insulin analog preparation (U-200 lispro) in people with T2DM to the one observed with standard U-100 lispro. The secondary endpoint of our study was patients’ preference and performance ratings of U-200 lispro. Methods: 126 patients with T2DM were enrolled. They were also assessed for limited joint mobility syndrome (LJMS),defined as limitation in at least two anatomical areas of the dominant upper extremity. After a 4-weekstructured insulin injection education period. Half of them were randomized to U-100 lispro, half to U-200 and after 12weeks they were switched to the other preparation for 12weeks. At the end a questionnaire was also administered to investigate patient preference. Results: No significant variation in fasting blood glucose, HbA1c, severe or mild hypoglycemic rate and daily fast-acting insulin analog dose was observed with U-100 lispro while U-200 lispro treatment was associated with a significant improvement of all the above mentioned parameters and with around 20% decrease in insulin requirement. Moreover patients’ answers to the questionnaire pointed out a higher preference for U-200 lispro for continuing treatment due to fewer difficulties completing injection. Discussion: The explanation of better metabolic results with the U-200 device might be the lower inner piston inertia and volume and shorter duration of a complete injection. Conclusions: Checking for LJIMS before insulin prescription could be adopted as a standard practiceaimed at choosing the most suitable device for patient's specific characteristics and abilities. The use of U-200 lispro might improve treatment adherence and metabolic control. This would also result intocost reduction by saving about half the amount of pens per year and of time spent to both fill prescriptionand dump the pharmacy.
Published: 2018
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24. Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study

Author: Stefano Rausei, Vincenzo Pappalardo, Marco Ceresoli, Fausto Catena, Massimo Sartelli, Massimo Chiarugi, Yoram Kluger, Andrew Kirkpatrick, Luca Ansaloni, Federico Coccolini, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Ionut Negoi, Monica Zese, Savino Occhionorelli, Sergei Shlyapnikov, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M. Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federico Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Rao Ivatury, Jimmy Xiao, Andrea Lippi, Mario Improta, Francesca Gubbiotti, Andrey Zharikov, Vincent Dubuisson, Michael Sugrue, Rausei, S, Pappalardo, V, Ceresoli, M, Catena, F, Sartelli, M, Chiarugi, M, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Coccolini, F, Montori, G, Salvetti, F, Fugazzola, P, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Lippi, A, Improta, M, Gubbiotti, F, Zharikov, A, Dubuisson, V, and Sugrue, M
Subjects: Male, medicine.medical_specialty, Sepsi, Peritonitis, NO, Sepsis, 03 medical and health sciences, Elderly, Intra-abdominal infection, Open abdomen management, Source control, 0302 clinical medicine, Postoperative Complications, Abdomen, Medicine, Humans, Prospective Studies, Registries, Open abdomen, Aged, Aged, 80 and over, Univariate analysis, business.industry, Potential risk, Age Factors, Mean age, General Medicine, medicine.disease, Surgery, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Observational study, Female, business, Cohort study
Abstract: Background Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection. Methods Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up. Results A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality. Conclusions This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.
Published: 2020

25. Routine prophylactic ureteral stenting before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Safety and usefulness from a single-center experience

Author: Federico Coccolini, Maria Grazia Sibilla, Paola Fugazzola, Giulia Montori, Enrico Cicuttin, Mario Improta, Michele Pisano, Francesca Gubbiotti, Matteo Tomasoni, Luca Ansaloni, Marco Ceresoli, Andrea Lippi, Fugazzola, P, Coccolini, F, Tomasoni, M, Cicuttin, E, Sibilla, M, Gubbiotti, F, Lippi, A, Improta, M, Montori, G, Ceresoli, M, Pisano, M, and Ansaloni, L
Subjects: General Urology, medicine.medical_specialty, HIPEC, Hydronephrosi, business.industry, Urinary system, Renal function, Hydronephrosis, Cytoreductive surgery, Peritoneal carcinomatosis, Prophylactic ureteral stenting, urologic and male genital diseases, medicine.disease, Single Center, Surgery, Sepsis, Peritoneal carcinomatosi, Peritonectomy, medicine, Rifle, Hyperthermic intraperitoneal chemotherapy, business
Abstract: Objective There are very few evidences about safety and usefulness of routine prophylactic ureteral stenting (PUS) before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Material and methods An analysis of prospectively collected data about patients who underwent CRS and HIPEC for different sites of primary disease was carried out focusing on ureteral complications. Results A total of 138 patients who underwent CRS and HIPEC between December 2010 and June 2017 were considered. All patients underwent PUS before CRS and HIPEC. Of them, 91 (66.4%) patients received pelvic peritonectomy, 49 (35.8%) pelvic lymphadenectomy, 31 (22.6%) left hemicolectomy, 44 (32.4%) right hemicolectomy, 46 (33.6%) rectal resection, 56 (40.9%) hysteroannessiectomy, and 39 (28.5%) appendectomy. There was one (0.7%) postoperative ureteral fistula. The cumulative risk of ureteral stent-related major complications was 4.3% (two patients (1.4%) had protracted gross hematuria, two patients (1.4%) had urinary sepsis, and three patients (2.9%) developed hydronephrosis after a period from removing ureteral stents and required restenting. Morbidity due to ureteral stenting was associated with a longer length of stay (LOS) (p=0.053). A total of 52 patients (44.1%) developed renal dysfunction according to the RIFLE (Risk, Injury, Failure, Loss of kidney function, End-stage kidney-disease) criteria: 19.5% were in risk class, 10.2% in acute renal injury class, and 14.4% in acute renal failure class. Conclusion PUS could be a useful tool for reducing iatrogenic ureteral injury, but it is associated with a non-negligible morbidity, which implies longer LOS. A more accurate patient selection for PUS is necessary.
Published: 2019

26. Why are so huge differences reported in the occurrence rate of skin lipohypertrophy? Does it depend on method defects or on lack of interest?

Author: A. Murano, A. Raffaele, R. Simonetti, G. Garofalo, A. Fasolino, M. Egidio, Giuseppina Guarino, A. Vecchiato, A. Vetrano, A. Meo, R. Procida, A. Del Sorbo, D. Oliva, C. Lamberti, M.R. Improta, A. Stile, Sandro Gentile, C. Martino, G. Durazzo, F. Vietsi, Felice Strollo, A. Selleri, Mirko Corigliano, M. Lapice, C. Brancario, P. Volpe, L. Grasso, G. Caputo, M.G. Di Capua, G. Cozzolino, L. Perillo, Gentile, S., Strollo, F., Guarino, G., Brancario, C., Corigliano, M., Cozzolino, G., Improta, M. R., Fasolino, A., Lamberti, C., Lapice, M., Martino, C., Oliva, D., Raffaele, A., Selleri, A., Simonetti, R., Stile, A., Vecchiato, A., Vetrano, A., Volpe, P., Caputo, G., Del Sorbo, A., Di Capua, M. G., Durazzo, G., Egidio, M., Garofalo, G., Grasso, L., Meo, A., Murano, A., Perillo, L., Procida, R., and Vietsi, F.
Subjects: medicine.medical_specialty, Lipodystrophy, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Hypoglycemia, Diabete, Injection technique, Injections, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Internal Medicine, medicine, Insulin, Humans, Intensive care medicine, business.industry, Lipohypertrophy, General Medicine, Hypertrophy, medicine.disease, Injection Site Reaction, Pharmacodynamics, Metabolic control analysis, business, Complication, Human
Abstract: Lipohypertophy (LH) is the most common skin complication of incorrect injection technique which does not only represent an aesthetic defect but also severely disrupts insulin pharmacokinetics/pharmacodynamics. As a consequence of that, hormone release is delayed and unexplained/unpredictable hypoglycemia occurs, both deteriorating metabolic control while negatively affecting adherence to treatment and quality of life. The economic burden due to unwanted intra-LH injections is accounted for by inappropriately high insulin requirements, increased emergency-related hospitalizations, and loss of work days. Greater attention has to be paid by diabetes care teams to education programs with periodic refreshers to achieve better metabolic control and reduce the economic burden of diabetes.
Published: 2018

27. Treatment satisfaction and glycemic control in young Type 1 diabetic patients in transition from pediatric health care: CSII versus MDI

Author: Maria Ida Maiorino, Michela Petrizzo, Maria Rosaria Improta, Filomena Castaldo, Katherine Esposito, Giuseppe Bellastella, Clementina Brancario, Dario Giugliano, Laura Olita, Maiorino, M. I., Bellastella, Giuseppe, Petrizzo, M., Improta, M. R., Brancario, C., Castaldo, F., Olita, L., Giugliano, Dario, and Esposito, Katherine
Subjects: Adult, Blood Glucose, Male, medicine.medical_specialty, Transition to Adult Care, Adolescent, Endocrinology, Diabetes and Metabolism, Hypoglycemia, Drug Administration Schedule, Treatment satisfaction, Young Adult, Endocrinology, Patient satisfaction, Insulin Infusion Systems, Internal medicine, Diabetes mellitus, Surveys and Questionnaires, medicine, Humans, Hypoglycemic Agents, Insulin, Young adult, Glycemic, Glycated Hemoglobin, Type 1 diabetes, business.industry, medicine.disease, Surgery, Diabetes Mellitus, Type 1, Patient Satisfaction, Population study, Female, business
Abstract: To evaluate whether continuous subcutaneous insulin infusion (CSII) may have any advantage over multiple daily injections (MDI) on glycemic control and treatment satisfaction in young patients with Type 1 diabetes in transition to an adult diabetes center. The study population consisted of 125 patients on MDI; 38 out of the 43 patients considered eligible for CSII completed the study and the 82 remaining on MDI served as control group. Glycemic control and treatment satisfaction [diabetes treatment satisfaction questionnaire (DTSQ)] were evaluated in all patients at baseline and after 12 weeks. At baseline, the two groups were well matched for demographic characteristics and glycemic control. DTSQ score was lower in CSII group (21.1 ± 8.8 vs. 25.1 ± 7.1, P = 0.011). After 12 weeks, a similar decrease in HbA1C was observed in both groups [difference −0.3 % (95 % CI −0.6 to 0.1, P = 0.847)]. Mean amplitude glucose excursions, blood glucose standard deviation, and overall hypoglycemia were significantly reduced in CSII group. DTSQ overall score increased in CSII and decreased in MDI (difference between groups = 9.9, 95 % CI 8.0–12.0, P
Published: 2013

28. Use and Efficacy of I-gel in Complicated Intubations in Newborn Infants: A Review of Case Reports in the Literature.

Author: Barbieri E, Giordano M, Sorgente G, Borgia G, Improta M, Colonna M, Crisci V, Fattorusso V, Barbieri F, Buonocore G, and De Bernardo G
Subjects: Humans, Infant, Newborn, Airway Management methods, Airway Management instrumentation, Intubation, Intratracheal methods, Intubation, Intratracheal instrumentation, Laryngeal Masks
Abstract: Introduction: Current guidelines for neonatal resuscitation suggest the use of a laryngeal mask when ventilation with both facemask and endotracheal tube has failed in newborns weighing >2000 g or delivered ≥ 34 weeks of gestation age. Paediatric I-gel ® is one of the latest supraglottic airway management devices suitable for children and newborns. I-gel ® use was effective in guaranteeing adequate ventilation in patients with anatomic abnormalities in case of respiratory impairment or during surgical procedures after the induction of anaesthesia., Objective: The purpose of our review was to evaluate the use and efficacy of I-gel ® in case of complicated intubations., Methods: In July 2023, two authors of this paper independently conducted searches of the MEDLINE, Web of Science, and Scopus databases without imposing any time constraints or other restrictions. Three case reports were included, each describing the use of I-gel ® device in difficult intubations in newborns with anatomical abnormalities., Results: No difficulties were reported in the insertion of the device, which was placed even by inexperienced clinicians., Conclusion: The data collected highlighted the possibility of using I-gel ® not only as a rescue device after attempted and failed endotracheal placement but also as a first choice in selected patients. Studies on larger cohorts would be needed. Further research involving larger patient cohorts of multicentre NICUs is necessary to confirm the use of laryngeal masks in neonates weighing less than 2000 grams., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
Published: 2024
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29. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly.

Author: Fugazzola P, Ceresoli M, Coccolini F, Gabrielli F, Puzziello A, Monzani F, Amato B, Sganga G, Sartelli M, Menichetti F, Puglisi GA, Tartaglia D, Carcoforo P, Avenia N, Kluger Y, Paolillo C, Zago M, Leppäniemi A, Tomasoni M, Cobianchi L, Dal Mas F, Improta M, Moore EE, Peitzman AB, Sugrue M, Agnoletti V, Fraga GP, Weber DG, Damaskos D, Abu-Zidan FM, Wani I, Kirkpatrick AW, Pikoulis M, Pararas N, Tan E, Broek RT, Maier RV, Davies RJ, Kashuk J, Shelat VG, Mefire AC, Augustin G, Magnone S, Poiasina E, De Simone B, Chiarugi M, Biffl W, Baiocchi GL, Catena F, and Ansaloni L
Subjects: Aged, Humans, Italy, Diverticulitis, Colonic diagnosis, Diverticulitis, Colonic surgery, Surgeons
Abstract: Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1° Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy., (© 2022. The Author(s).)
Published: 2022
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30. Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines.

Author: Coccolini F, Improta M, Sartelli M, Rasa K, Sawyer R, Coimbra R, Chiarugi M, Litvin A, Hardcastle T, Forfori F, Vincent JL, Hecker A, Ten Broek R, Bonavina L, Chirica M, Boggi U, Pikoulis E, Di Saverio S, Montravers P, Augustin G, Tartaglia D, Cicuttin E, Cremonini C, Viaggi B, De Simone B, Malbrain M, Shelat VG, Fugazzola P, Ansaloni L, Isik A, Rubio I, Kamal I, Corradi F, Tarasconi A, Gitto S, Podda M, Pikoulis A, Leppaniemi A, Ceresoli M, Romeo O, Moore EE, Demetrashvili Z, Biffl WL, Wani I, Tolonen M, Duane T, Dhingra S, DeAngelis N, Tan E, Abu-Zidan F, Ordonez C, Cui Y, Labricciosa F, Perrone G, Di Marzo F, Peitzman A, Sakakushev B, Sugrue M, Boermeester M, Nunez RM, Gomes CA, Bala M, Kluger Y, and Catena F
Subjects: Abdomen, Acute mortality, Emergency Service, Hospital, Humans, Postoperative Complications prevention & control, Abdomen, Acute diagnosis, Abdomen, Acute surgery, Immunocompromised Host
Abstract: Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary.This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients., (© 2021. The Author(s).)
Published: 2021
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31. Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature.

Author: Coccolini F, Improta M, Cicuttin E, Catena F, Sartelli M, Bova R, De' Angelis N, Gitto S, Tartaglia D, Cremonini C, Ordonez C, Baiocchi GL, and Chiarugi M
Subjects: Antibiotic Prophylaxis, Calcineurin Inhibitors therapeutic use, Humans, TOR Serine-Threonine Kinases antagonists & inhibitors, Wound Closure Techniques, Immunocompromised Host, Surgical Wound Infection prevention & control
Abstract: Background: Immunocompromised patients are at higher risk of surgical site infection and wound complications. However, optimal management in the perioperative period is not well established. Present systematic review aims to analyse existing strategies and interventions to prevent and manage surgical site infections and other wound complications in immunocompromised patients., Methods: A systematic review of the literature was conducted., Results: Literature review shows that partial skin closure is effective to reduce SSI in this population. There is not sufficient evidence to definitively suggest in favour of prophylactic negative pressure wound therapy. The use of mammalian target of rapamycin (mTOR) and calcineurin inhibitors (CNI) in transplanted patient needing ad emergent or undeferrable abdominal surgical procedure must be carefully and multidisciplinary evaluated. The role of antibiotic prophylaxis in transplanted patients needs to be assessed., Conclusion: Strict adherence to SSI infection preventing bundles must be implemented worldwide especially in immunocompromised patients. Lastly, it is necessary to elaborate a more widely approved definition of immunocompromised state. Without such shared definition, it will be hard to elaborate the needed methodologically correct studies for this fragile population.
Published: 2021
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32. Timing of surgical intervention for compartment syndrome in different body region: systematic review of the literature.

Author: Coccolini F, Improta M, Picetti E, Branca Vergano L, Catena F, de 'Angelis N, Bertolucci A, Kirkpatrick AW, Sartelli M, Fugazzola P, Tartaglia D, and Chiarugi M
Subjects: Humans, Compartment Syndromes surgery, Decompression, Surgical methods
Abstract: Compartment syndrome can occur in many body regions and may range from homeostasis asymptomatic alterations to severe, life-threatening conditions. Surgical intervention to decompress affected organs or area of the body is often the only effective treatment, although evidences to assess the best timing of intervention are lacking. Present paper systematically reviewed the literature stratifying timings according to the compartmental syndromes which may beneficiate from immediate, early, delayed, or prophylactic surgical decompression. Timing of decompression have been stratified into four categories: (1) immediate decompression for those compartmental syndromes whose missed therapy would rapidly lead to patient death or extreme disability, (2) early decompression with the time burden of 3-12 h and in any case before clinical signs of irreversible deterioration, (3) delayed decompression identified with decompression performed after 12 h or after signs of clinical deterioration has occurred, and (4) prophylactic decompression in those situations where high incidence of compartment syndrome is expected after a specific causative event.
Published: 2020
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33. Routine prophylactic ureteral stenting before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Safety and usefulness from a single-center experience.

Author: Fugazzola P, Coccolini F, Tomasoni M, Cicuttin E, Sibilla MG, Gubbiotti F, Lippi A, Improta M, Montori G, Ceresoli M, Pisano M, and Ansaloni L
Abstract: Objective: There are very few evidences about safety and usefulness of routine prophylactic ureteral stenting (PUS) before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)., Material and Methods: An analysis of prospectively collected data about patients who underwent CRS and HIPEC for different sites of primary disease was carried out focusing on ureteral complications., Results: A total of 138 patients who underwent CRS and HIPEC between December 2010 and June 2017 were considered. All patients underwent PUS before CRS and HIPEC. Of them, 91 (66.4%) patients received pelvic peritonectomy, 49 (35.8%) pelvic lymphadenectomy, 31 (22.6%) left hemicolectomy, 44 (32.4%) right hemicolectomy, 46 (33.6%) rectal resection, 56 (40.9%) hysteroannessiectomy, and 39 (28.5%) appendectomy. There was one (0.7%) postoperative ureteral fistula. The cumulative risk of ureteral stent-related major complications was 4.3% (two patients (1.4%) had protracted gross hematuria, two patients (1.4%) had urinary sepsis, and three patients (2.9%) developed hydronephrosis after a period from removing ureteral stents and required restenting. Morbidity due to ureteral stenting was associated with a longer length of stay (LOS) (p=0.053). A total of 52 patients (44.1%) developed renal dysfunction according to the RIFLE (Risk, Injury, Failure, Loss of kidney function, End-stage kidney-disease) criteria: 19.5% were in risk class, 10.2% in acute renal injury class, and 14.4% in acute renal failure class., Conclusion: PUS could be a useful tool for reducing iatrogenic ureteral injury, but it is associated with a non-negligible morbidity, which implies longer LOS. A more accurate patient selection for PUS is necessary.
Published: 2019
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34. Lessons learned from an unusual case of severe hypoglycemia.

Author: Improta MR, Strollo F, and Gentile S
Subjects: Adult, Biomarkers analysis, Blood Glucose analysis, Female, Glycated Hemoglobin analysis, Humans, Hypertrophy, Hypoglycemia metabolism, Hypoglycemia pathology, Hypoglycemic Agents administration & dosage, Prognosis, Diabetes Mellitus, Type 1 drug therapy, Hypoglycemia etiology, Hypoglycemic Agents adverse effects, Injection Site Reaction complications, Injections adverse effects
Abstract: We are hereby reporting on a woman with type 1 diabetes getting insulin, 4 shots a day, and referring to us for an episode of severe hypoglycemia occurred after vigorously rubbing a lipo-hypertrophy (LH). She had always injected insulin into an abdominal LH area but had never suffered from any hypoglycemic event (Hypo) during the last period. Nevertheless her history included frequent Hypos, mostly mild-to-moderate but sometimes severe and eventually ending into unconsciousness and her glycemic control was poor (HbA1c 8.3%, mean FPG 161 ± 22 mg/dl, mean PPG 218 ± 51 mg/dl, glycemic variability (106 ± 44 mg/dl). In fact, all of a sudden she rubbed vigorously the LH area trying to get rid of the abdominal skin thickening and soon after a severe Hypo occurred causing her to need for emergency medical assistance. When back at home, she corrected her technique and carefully refrained from inject insulin into the LH so that after six months the lesion disappeared, glycemic control improved and no Hypo occurred any more. Based on the recent publication reporting on a woman with a large LH consisting of thickened skin surrounding some fluid containing insulin at concentrations 13 fold those in blood, we hypothesize that such severe depended on massive insulin release from rubbed skin stores into the blood stream., (Copyright © 2019. Published by Elsevier Ltd.)
Published: 2019
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35. [Clinical cases of keratinized fibromucous free autografts].

Author: Gennai A, Chicco G, Collini P, Improta M, and Agostino R
Subjects: Adult, Epithelial Attachment, Humans, Keratins, Gingiva transplantation, Gingival Diseases surgery, Gingival Recession surgery
Abstract: In this work the problems due to shortage of proper or adherent gum have been analyzed, further has been referred the clinical cases corresponding to the periodontal indications, which foresee the reconstruction of an insufficient superficial periodontium. Moreover have been described the surgical techniques of the free graft.
Published: 1990

36. [Paget's degeneration of the juxta-alveolar portion of the mandible in subjects with generalized osteoporosis. Clinical study].

Author: Tanzi VG, Chicco G, Pallassini A, Improta M, and Asti O
Subjects: Calcitonin therapeutic use, Female, Humans, Mandibular Diseases surgery, Mastication, Middle Aged, Osteitis Deformans drug therapy, Osteitis Deformans complications, Osteoporosis complications
Abstract: After the description of the etiopathogenetic aspects and of the pathologic anatomy lesion more typical of the Paget's disease, the A.A. describe a interesting case of the mandible's degeneration in a patient with chronic osteoporosis. The patient does not masticate. The treatment has been to remodelling of the mandible. We made a scrupulous check of laboratory research and the radiographical, biological and histological reports to exclude osteosarcoma and gigantic cells tumour.
Published: 1989

37. [Use of trimethoxy-benzoyl-aminocaproate sodium (C-3) in the initial phase of myocardial infarct].

Author: Napolitano D, Improta M, Cuomo A, and Bonagura A
Subjects: Adult, Aged, Aminocaproates administration & dosage, Aminocaproates pharmacology, Electrocardiography, Evaluation Studies as Topic, Female, Humans, Male, Middle Aged, Pulse drug effects, Time Factors, Water-Electrolyte Balance, Aminocaproates therapeutic use, Benzoates therapeutic use, Myocardial Infarction drug therapy
Published: 1971

38. [Spontaneous hemopneumothorax: report of 3 cases].

Author: Lobello R, Improta M, and Bronzo M
Subjects: Drainage, Hemopneumothorax surgery, Humans, Male, Radiography, Hemopneumothorax diagnostic imaging
Published: 1972

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