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3. Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

Author

Knoph, Cecilie Siggaard, Lucocq, James, Kamarajah, Sivesh Kathir, Olesen, Søren Schou, Jones, Michael, Samanta, Jayanta, Talukdar, Rupjyoti, Capurso, Gabriele, de‐Madaria, Enrique, Yadav, Dhiraj, Siriwardena, Ajith K., Windsor, John, Drewes, Asbjørn Mohr, Nayar, Manu, Cark, Neil, Pius, Riinu, Houghton, Eduardo, Gimenéz, Mariano, Uribe, Karla, Rodriguez, Florencia, Gundara, Justin, Mackay, Thomas, Phan, Huynh, Lewin, Joel, McElhatton, Claire, Siriwardhane, Mehan, Hodgson, Russell, Malik, Hassan, Ward, Ryan, Young, Kerilee, Bappayya, Shaneel, Loveday, Benjamin, Samra, Jaswinder, Gall, Tamara, Mittal, Anubhav, Chan, Ting Ting, Lo, Vincent Wing‐ho, Liang, Hui, Wang, Cong, Huang, Wei, Jin, Tao, Wu, Yongzi, Xia, Qing, Georgio, Nikolaou, Koronakis, Nikolaos, Davidsen, Line, Hamed, Emad, Mohamed, Salem, Demetrashvili, Zaza, Tvaladze, Ana, Kachakhidze, Irakli, Zurabashvili, Tea, Ioannidis, Orestis, Kapiris, Stylianos, Mavrodimitraki, Eleni, Sotiropoulou, Maria, Machairas, Nikolaos, Schizas, Dimitrios, Syllaios, Athanasios, Vailas, Michail, Chlorakis, Georgios, Kalaitzakis, Evangelos, Tsafaridou, Maria, Mulita, Francesk, Verras, Georgios‐Ioannis, Gupta, Amit, Rajput, Deepak, Sharma, Oshin, Goud, Rajesh, Unnisa, Misbah, Bains, Lovenish, Singh, Nishu, Dhar, Jahnvi, Abdelmoeti, Mahmoud, Súilleabháin, Criostóir Ó, O'Connell, Robert, Calabro, Marcello, La Terra, Antonio, Muretore, Andrea, Contul, Riccardo Brachet, Diotallevi, Margherita, Mascaro, Annamaria, Millo, Paolo, Biondo, Santino Antonio, Mazzeo, Carmelo, Cucinotta, Eugenio, Fleres, Francesco, Marinak, AOUG, Brocco, Veronica, Ceresoli, Marco, Rennis, Maria, Centonze, Danilo, Distefano, Coatanza, Veroux, Massimiliano, Zerbo, Domenico, Bogoni, Selene, Biloslavo, Alan, Bianchi, Velentina, Candelli, Marcello, Franceschi, Francesco, Gasbarrini, Antonio, Nista, Enrico, Sganga, Gabriele, Tropeano, Giuseppe, Policlinico, Fondazione, Altieri, Caterina, Dinuzzi, Vincenza, Marconi, Matteo, Rivolta, Umberto, Dameno, Vitale Roberto, Papa, Mario V., Balla, Andrea, Lepiane, Pasquale, Saraceno, Federica, Aiolfi, Alberto, Bona, Davide, Sozzi, Andrea, Cianci, Pasquale, Varesano, Marco, Conversano, Ivana, Abete, Roberta, D'Avino, Raffaele, Marra, Ester, Marte, Gianpaolo, Tammaro, Pasquale, Gobatti, Davide, Marmaggi, Serena, Palmieri, Francesco, Sampietro, Roberto, Manca, Roberto, Pilla, Federica, Piras, Enrico, Pignata, Giusto, Canfora, Ilaria, Andreuccetti, Jacopo, D'Alessio, Rossella, Armellin, Claudia, Grossi, Ugo, Massani, Marco, Pontin, Alessandro, Stecca, Tommaso, Pilia, Tiaizna, Pisanu, Adolfo, Podda, Mauro, Giuffrida, Mario, Perrone, Gennaro, Guadagni, Simone, Morelli, Luca, Frontali, Alice, Basurto, Francesca, D'Ugo, Stefano, Manoochehri, Farshad, Spampinato, Marcello, Apadula, Laura, Preatoni, Paoletta, Sartarelli, Lodovico, Al‐Jaiuossi, Osama, Ernisova, Mairam, Sopuev, Andrey, Sua, Bruce, Farfus, Anthony, Teo, Keith, Smith, Brittany, Ratnayake, Bathiya, Buchanan, Jayvee, Clark, Elinor, Connor, Saxon, Hore, Todd, Attari, Salman, Kadir, Bushra, Memon, Sadik, Abbas, Zaigham, Quadeer, Muhammad Ali, Altaf, Abeer, Ameet, Pooja, Devi, Jalpa, Seerani, Nandlal, Afzal, Ameer, Akbar, Ali, Asghar, Mohammad Sohail, Sa, Tiago, Barreira, Ana Lucia, Carvalho, Numo, Cismasiu, Brigitta, Henriques, Susana, Luiz, Francisco Vara, Draghici, Andreea, Grigorean, Valentin, Porojan, Vlad, Stoian, Alexandru‐Rares, Teaca, Lucia, Arbutina, Dragana, Cuk, Vladica, Kovacevic, Bojan, Mandic, Luka, Bonney, Glenn, Gao, Yujia, Pang, Ning Qi, Bellil, Abdalla, Devar, John, Khan, Zafar, Khumalo, Vusi, Smith, Martin, Estevez‐Fernandez, Sergio, Mosquera, Beatriz Romero, Rodriguez, Sergio, Garcia‐Rayado, Guillermo, Piñerua‐Gonsalvez, Jean Felix, Ruiz Rebollo, M Lourdes, Olmos, Jose M., Tejedor‐Tejada, Javier, Diez‐Alonso, Manuel, Matias‐Garcia, Belen, Moreno, Fernando Mendoza, Vera‐Mansilla, Cristina, Roses, Helena Salvador, Gómez, Diego Vázquez, Oballe, Juan Rodriguez, Jayarajah, Umesh, Nandasena, Malith, Pathirana, Aloka, Galal‐Eldin, Sami, Hajibandeh, Shahab, Hamid, Hytham, Colak, Elif, Sydorchuk, Larysa, Knut, Ruslan, Voronyuk, Ksenia, Chooklin, Serge, Baryskyi, Vitalii, Sydorchuk, Ruslan, Mukherjee, Samrat, Patel, Maitreyi, Akhtar, Amina, Asarbakhsh, Miriam, Nolan, Frances, Schuijtvlot, Nicholaas, Prem, Sandhya, Thrikandiyur, Anuradha, Morris, Millicent, Mroczek, Thomas, Sgourakis, George, Sultana, Asma, Varley, Rebecca, Groot‐Wassink, Thomas, Labinoti, Roland, Packham, Brett, Seebah, Keving, Allen, Sophie, Mokhtassi, Shiva, Belgaumkar, Ajay, De'Ath, Henry, Cook, Amy, Delaney, Christopher, Johnson, Roisin, Azibaodinami, Becky Olali, Sartini, Ashley, Stanfield, Mea, Tomasi, Ivan, Kanakala, Venkat, Mbarushimana, Simon, McKeever, Mark, Batilli, Mamata, Bhatta, Gakul, Rai, Subash, Bond‐smith, Giles, Elserafy, Amr, Shams, Mohamed, Al Saoudi, Tareq, Bhardwaj, Neil, Hussain, Wajith, Lancellotti, Francesco, Montagnini, Greta, Cairns, George, Hollyman, Marianne, Rakin, Asef, Shahid, Mishal, Barbour, Fraser, Hawkyard, Jake, McTeer, Matthew, Pandanaboyana, Sanjay, Taylor, Ellie, Kuzman, Matta, Dyer, Sarah, Hopkins, James, Pournaras, Dimitri, Sudlow, Alexis, Kumar, SK, Aujayeb, Avinash, Leo, Alex, Senra, Fatima Lorenzana, Watfah, Josef, Barrie, Jenifer, Brown, Chris, Gomez, Dhanny, Aroori, Somaiah, Ciprani, Debora, Karmarkar, Rahi, Almomani, Eyas, Roberts, Keith, Fale, Madeleine, Gupta, Ajay, Marsden, Max, Seet, Chris, Soni, Lakshya, Hamdan, Mohammed, Sadera, Rohan, Sud, Vikas, Chinnah, Edith, Di Mauro, Davide, Manzelli, Antonio, Orabi, Amira, Presa, Roberto, Reece‐Smith, Alex, Wajed, Shahjehan, Fingret, Jacob, Shah, Nehal, Jatania, Jignesh, Krishna, Arun, Berry, David, Kitsikosta, Loukiani, Helliwell, Jack, Huntley, Benjamin, Pine, James, Yau, Jih‐Dar, Lee, Shiela, Mahawar, Kamal, Shetty, Neehar, Britton, Emily, Shaw, Alice, Laarhoven, Stijn, Gahunia, Sukhpreet, Ortega, Miguel Gargia, Lee, Adam, Ng, Cho Ee, El Kafsi, Jihene, Mason, John, Vithlani, Gauri, Benhmida, Rami, Gunell, James, Parmar, Chetan, Dorkeh, Da‐Costa, Elnagar, Mohamed, Lee, Jih Ian, Nessa, Ashrafun, Yeap, Zhu Hui, Hemadasa, Niroshini, Javed, Saria, Sami, Sharuk, Damaskos, Dimitrios, Healey, Andrew, Soupashi, Maria, Triantafyllou, Tania, Coats, Maria, Douglass, Benjamin, Hendry, Brid, Hussain, Yasmin, Javid, Zhara, Mantyla, Mia, Rajkumar, Khaman, Chin, Carven, Hajibandeh, Shahab, Kumar, Nagappan, Gerogiannis, Ioannis, Kapsampelis, Panagiotis, Gerge, Farid, Anderson, Gulsum, Dinh, Vu, Phillips, Anna, Yadav, Dhiraj, and Pandanaboyana, Sanjay

Abstract

Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1‐month follow‐up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p< 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p< 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre‐admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p< 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p= 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre‐admission pain duration, acute necrotic collections, and walled‐off necrosis also increased the likelihood of opioid prescription at discharge. There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP.

Published
2024
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6. La chirurgia tiroidea transorale

Author

Pontin, Alessandro, Cannavò, Salvatore, Catalfamo, Antonina, Famà, Fausto, Pergolizzi, Francesca Pia, Pino, Antonella, Caruso, Ettore, Carcoforo, Paolo, and Dionigi, Gianlorenzo

Published
2018
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8. Sustainability of an Open-Loop GWHP System in an Italian Alpine Valley.

Author

Cappellari, Davide, Piccinini, Leonardo, Pontin, Alessandro, and Fabbri, Paolo

Abstract

Shallow geothermal systems (SGSs) for building climatization represent an advantageous alternative to traditional air-conditioning systems, resulting in economic and environmental benefits. Installation of these systems requires knowledge of site-specific geological and hydrogeological conditions, which in feasibility studies are often evaluated only at the single plant scale, lacking a comprehensive view and risking not to guarantee the system sustainability over time. In this paper a methodology for the sustainable design of SGSs is presented. The methodology is developed from an example on the aquifer scale in Longarone (Belluno, Italy), where three groundwater heat pumps (GWHPs) were installed in an industrial area located in a mountain basin hosting a coarse-grained phreatic aquifer, characterized by sediments with high hydraulic conductivity and proximal to a large river (Piave River). Open-loop systems were first analyzed through numerical modeling using FEFLOW software, identifying peculiar features of the aquifer, due to its interaction with surface waters, and suggesting the possibility of its greater geothermal exploitation. Subsequently, a relationship between flow rates and thermal plume extensions was obtained, which is useful to providing support in the evaluation of potential interference with neighboring systems. The study at the aquifer scale proved representative of the system, highlighting the criticalities of the area, such as trends of aquifer temperature alteration, interference between plants, and thermal feedback. [ABSTRACT FROM AUTHOR]

Published
2023
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11. Lessons from animal studies on recurrent laryngeal nerve monitoring

Author

Catalfamo, Antonia, Famà, Fausto, Pergolizzi, Francesca Pia, Caruso, Ettore, Pino, Antonella, Pontin, Alessandro, Dionigi, Gianlorenzo, and Wu, Che Wei

Subjects
lcsh:Biology (General), Intraoperative neural monitoring (IONM), lcsh:R, lcsh:Medicine, animal study, Intraoperative neural monitoring (IONM), recurrent laryngeal nerve (RLN), thyroid surgery, animal study, translation research, thyroid surgery, ntraoperative neural monitoring (ionm), recurrent laryngeal nerve (rln), thyroid surgery, animal study, translation research, lcsh:QH301-705.5, translation research, recurrent laryngeal nerve (RLN)
Abstract

Recurrent laryngeal nerve (RLN) injury is a significant morbidity associated with thyroid surgery. Surgeons have increasingly used intraoperative neural monitoring (IONM) as an adjunct technique for identifying the RLNand predicting the outcome of vocal cord function. Many animal studies have investigated limits, adjournments and new applications of IONM. The advent of animal studies has substantially improved understanding of IONM technology and the electrophysiology of RLN. Lessons learned from animal studies have clinical applications in establishing proper strategies for preventing nerve injury., Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche, Vol 107, No 1 (2019)

Published
2019

12. New Paradigms for Neural Monitoring in Thyroid Surgery

Author

Hui, Sun, CHE-WEI, Wu, Daqi, Zhang, Özer, Makay, Yishen, Zhao, Paolo, Carcofaro, HOON YUB KIM, Dionigi, Gianlorenzo, Pino, Antonella, Ettore, Caruso, Pontin, Alessandro, and Vincenzo, Pappalardo

Subjects
Recurrent Laryngeal Nerve, Monitoring, Intraoperative, Recurrent Laryngeal Nerve Injuries, Thyroid Gland, Thyroidectomy, Humans
Abstract

Intraoperative neuromonitoring (IONM) in thyroid gland surgery provides real-time feedback to the endocrine surgeon regarding the electrophysiological consequences of surgical manipulation of the laryngeal nerves. The goal of monitoring modalities is to detect surgical or physiological insults to the recurrent laryngeal nerve (RLN) while they are still reversible or, in cases where prevention is not an option, to minimize the damage done to these structures during thyroidectomy. In recent decades, monitoring of the RLN has become a fundamental part of endocrine surgery. IONM is a feasible procedure in both open and endoscopic, robotic thyroidectomy. Experts in IONM have organized a working group of general, endocrine, head and neck ENT surgeons and endocrinologists (International Neural Monitoring Study Group; INMSG) to develop standards for practicing this technique in endoscopic and robotic thyroidectomy. This paper presents recent clinical and research experience with intraoperative neural monitoring for thyroid gland surgery.

Published
2019

13. Division for Endocrine and Minimally Invasive Surgery Department of Human Pathology in Adulthood and Childhood 'G. Barresi', University of Messina

Author

Caruso, Ettore, Pino, Antonella, Pontin, Alessandro, and Dionisi, Gianlorenzo

Subjects
Thyroid diseases, stage thyroidectomy, Intraoperative neuromonitoring (IONM), lcsh:Biology (General), fungi, lcsh:R, lcsh:Medicine, lcsh:QH301-705.5
Abstract

The visual identification of the nerve is still today the standard technique in thyroid surgery. Although the systematic use of the intraoperative neuromonitoring (IONM) of the NLR has not demonstrated a statistically significant reduction in NLR lesions yet, IONM has been conclusive in the case of complex anatomy (re-operation, voluminous goiter, thyroid carcinoma) and in functional integrity of the NLR. The application of the IONM allowed to reconsider the two-phase thyroidectomy procedure in order to prevent bilateral lesions to the NLR. This method makes it possible to evaluate the possibility of proceeding safely to the completion of total thyroidectomy after resection of the dominant lobe and to decide, if necessary, to delay the resection of the second lobe at a later time, as in the case of injury or dysfunction of the NLR after lobectomy. The systematic application of IONM may lead the surgeon to modify the operative strategy in the presence of LOS from the NLR ensuring an almost zero incidence of bilateral paralysis of the NLR.It is necessary to define specific application guidelines, for the management of problems related to employment as in tumor pathology., Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche, Vol 106, No 2 (2018)

Published
2018

19. Stage Thyroidectomy:An Historical Perspective

Author

Caruso, Ettore, Pino, Antonella, Pontin, Alessandro, and Dionigi, Gianlorenzo

Subjects
Thyroid diseases, Stage thyroidectomy, Intraoperative neuromonitoring (IONM)
Published
2018

26. Patient and Surgeon Candidacy for Transoral Endoscopic Thyroid Surgery.

Author

Fama, Fausto, Daqi Zhang, Pontin, Alessandro, Makay, Özer, Tufano, Ralph P., Hoon Yub Kim, Hui Sun, and Dionigi, Gianlorenzo

Subjects
ENDOSCOPIC surgery, STERNOCLEIDOMASTOID muscle, DERMATOLOGIC surgery, BENIGN tumors, SURGEONS, INSUFFLATION, THYROIDECTOMY
Abstract

The transoral thyroidectomy (TT) is a feasible novel surgical procedure that does not need visible incisions, a truly cutaneous scar-free surgery. Inclusion criteria are (a) patients who have a ultrasonographically (US) estimated thyroid diameter not larger than 10 cm, (b) US estimated gland volume =45 mL, (c) nodule size =50 mm, (d) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter, (e) follicular neoplasm, and (f) papillary microcarcinoma without evidence of metastasis. The procedure is carried out through a three-port technique placed at the oral vestibule; one 10-mm port for a 30° endoscope and two additional 5-mm ports for dissecting and coagulating instruments. CO2 insufflation pressure is set at 6 mmHg. An anterior cervical subplatysmal space is created from the oral vestibule down to the sternal notch, laterally to the sternocleidomastoid muscle medial edges. TT is done fully endoscopically using conventional endoscopic instruments. [ABSTRACT FROM AUTHOR]

Published
2019
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33. Limitations of Continuous Neural Monitoring in Thyroid Surgery.

Author

Caruso E, Pino A, Pontin A, Pinto G, Damiano C, Catalfamo A, Famà F, and Dionigi G

Abstract

Continuous intraoperative neuromonitoring is currently the gold standard technique available to prevent recurrent laryngeal nerve injuries. It significantly reduces the complication rate compared with intermittent intraoperative neuromonitoring, and represents significant progress in thyroid surgery, particularly in cases of more difficult dissections. There are, however, some technological and interpretative limits related to the lack of standardization of continuous intraoperative neuromonitoring and the prolonged length of time employed in the surgical positioning of the probe, despite various proposed approaches to the vagal nerve. Nonetheless, this method can be considered a safe and modern approach to thyroid surgery that reduces post-surgical complications and provides useful information., Competing Interests: Conflict of Interest: None declared., (Copyright: © 2019 by The Medical Bulletin of Sisli Etfal Hospital.)

Published
2019
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34. New Paradigms for Neural Monitoring in Thyroid Surgery.

Author

Sun H, Wu CW, Zhang D, Makay Ö, Zhao Y, Carcofaro P, Kim HY, Dionigi G, Pino A, Caruso E, Pontin A, and Pappalardo V

Subjects
Humans, Recurrent Laryngeal Nerve surgery, Recurrent Laryngeal Nerve Injuries etiology, Thyroidectomy methods, Monitoring, Intraoperative methods, Recurrent Laryngeal Nerve Injuries prevention & control, Thyroid Gland surgery, Thyroidectomy adverse effects
Abstract

Intraoperative neuromonitoring (IONM) in thyroid gland surgery provides real-time feedback to the endocrine surgeon regarding the electrophysiological consequences of surgical manipulation of the laryngeal nerves. The goal of monitoring modalities is to detect surgical or physiological insults to the recurrent laryngeal nerve (RLN) while they are still reversible or, in cases where prevention is not an option, to minimize the damage done to these structures during thyroidectomy. In recent decades, monitoring of the RLN has become a fundamental part of endocrine surgery. IONM is a feasible procedure in both open and endoscopic, robotic thyroidectomy. Experts in IONM have organized a working group of general, endocrine, head and neck ENT surgeons and endocrinologists (International Neural Monitoring Study Group; INMSG) to develop standards for practicing this technique in endoscopic and robotic thyroidectomy. This paper presents recent clinical and research experience with intraoperative neural monitoring for thyroid gland surgery.

Published
2019

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