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

Author

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

Published
2022
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13. On site production of [18F]PSMA-1007 using different [18F]fluoride activities: practical, technical and economical impact

Author

Costantina Maisto, Anna Morisco, Roberta de Marino, Elisabetta Squame, Valentina Porfidia, Laura D’Ambrosio, Daria Di Martino, Paolo Gaballo, Michela Aurilio, Monica Buonanno, Aureliana Esposito, Marco Raddi, and Secondo Lastoria

Subjects
[18F]fluoride, Time of beam, [18F]PSMA-1007, Radiochemical yield (RCY), Radiochemical purity (RCP), Stability, Medical physics. Medical radiology. Nuclear medicine, R895-920, Therapeutics. Pharmacology, RM1-950
Abstract

Abstract Background Prostate-specific membrane antigen is overexpressed in prostate cancer and it is considered a good target for positron emission tomography/computed tomography imaging of primary cancer and recurrent/metastatic disease, as well as for radioligand therapy. Different PSMA-analogues labeled with [68Ga]gallium have been investigated, showing excellent imaging properties; however, only small amounts can be produced for each radiolabeling. Recently, a [18F]fluoride labeled PSMA-inhibitor, [18F]PSMA-1007, has been introduced, and it has ensured large-scale productions, overcoming this limitation of [68Ga]PSMAs. In this study, PSMA-1007 has been labeled with low (A), medium (B) and high (C) starting activities of [18F]fluoride, in order to verify if radiochemical yield, radiochemical purity and stability of [18F]PSMA-1007 were affected. These parameters have been measured in sixty-five consecutive batches. In addition, the estimation of [18F]PSMA-1007 production costs is provided. Results The radiochemical yield for low and medium activities of [18F]fluoride was 52%, while for the high one it decreased to 40%. The radiochemical purity was 99% for all three activities. [18F]PSMA-1007 did not show radiolysis up to 8 h after the end of synthesis, confirming that the radiopharmaceutical is stable and suitable to perform diagnostic studies in humans for a long period of time after the end of radiolabeling. Furthermore, radiochemical stability was demonstrated in fetal bovine serum at 4 °C and 37 °C for 120′. Conclusions A starting activity of [18F]fluoride of 90 GBq (B) seems to be the best option enabling a final amount of about of 50 GBq of [18F]PSMA-1007, which is promising as it allows to: (a) perform a large number of scans, and/or (b) supply the radiopharmaceutical to any peripheral diagnostic centers in need.

Published
2021
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15. Midregional‐proAdrenomedullin as a prognostic tool in sepsis and septic shock: A systematic review and meta‐analysis.

Author

Valeriani, Emanuele, Falletta, Antonio, Pastori, Daniele, Porfidia, Angelo, Mastroianni, Claudio Maria, Di Bari, Silvia, Motta, Eleonora, Pignatelli, Pasquale, and Oliva, Alessandra

Subjects
SEPTIC shock, CHILD patients, HOSPITAL patients, SEPSIS, PROGNOSTIC tests
Abstract

Background: Midregional‐proAdrenomedullin (MR‐proADM) has been recently proposed as a tool in patients with sepsis and septic shock. Our aim was to evaluate the prognostic role of MR‐proADM in hospitalized patients with sepsis and septic shock. Methods: PRISMA guideline was followed. MEDLINE and EMBASE were searched up to June 2023. Primary outcome was mean difference in MR‐proADM among survivors and nonsurvivors, secondary outcome mean difference in MR‐proADM according to infection severity and type. Risk of bias was evaluated using Newcastle–Ottawa scale for observational studies and Cochrane tool for randomized trials. Pooled mean differences (MD) with corresponding 95% confidence intervals (CIs) were calculated in a random‐effects model. Results: Twenty‐four studies included 6730 adult patients (1208 nonsurvivors and 5522 survivors) and three studies included 195 paediatric patients (30 nonsurvivors and 165 survivors). A total of 10, 4 and 13 studies included, respectively, patients with sepsis (3602 patients), septic shock (386 patients) and a mixed population (2937 patients). Twenty‐one studies included patients with different source of infection, three with pneumonia and one with a catheter‐related infection. Most studies (n = 12) had a follow‐up of 28 days. In adult cohort, pooled mean difference between nonsurvivors and survivors of MR‐proADM was 2.55 mmol/L (95% CI: 1.95–3.15) with higher values in patients with septic shock (4.25 mmol/L; 95% CI, 2.23–6.26 mmol/L) than in patients with sepsis (1.77 mmol/L; 95% CI: 1.11–2.44 mmol/L). In paediatric cohort, pooled mean difference was 3.11 mmol/L (95% CI: −0.02‐6.24 mmol/L). Conclusions: Higher values of MR‐proADM are detectable in nonsurvivors adult and paediatric‐hospitalized patients with sepsis or septic shock. [ABSTRACT FROM AUTHOR]

Published
2024
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17. A Single Center Retrospective Cohort Study Comparing Different Anticoagulants for the Treatment of Catheter-Related Thrombosis of the Upper Extremities in Women With Gynecologic and Breast Cancer

Author

Angelo Porfidia, Giulia Cammà, Nicola Coletta, Margherita Bigossi, Igor Giarretta, Andrea Lupascu, Giuseppe Scaletta, Enrica Porceddu, Paolo Tondi, Giovanni Scambia, Gabriella Ferrandina, and Roberto Pola

Subjects
central venous catheter (CVC), catheter-related thrombosis (CRT), gynecologic cancer, women, breast cancer, venous thromboembolism (VTE), Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

BackgroundCatheter-related thrombosis (CRT) of the upper extremities is a frequent complication among cancer patients that carry a central venous catheter (CVC) and may lead to pulmonary embolism (PE) and loss of CVC function. Despite its clinical impact, no anticoagulant treatment scheme has been rigorously evaluated in these patients. In addition, there is no proven evidence that direct oral anticoagulants (DOACs) are efficacious and safe in this setting because cancer patients with CRT of the upper extremities were not included in the clinical trials that led to the approval of DOACs for the treatment of cancer-associated venous thromboembolism (VTE).MethodsWe performed a single center retrospective cohort study on women with gynecologic or breast cancer treated with either low-molecular-weight heparin, fondaparinux, or DOACs for CRT of the upper extremities. Only patients who received anticoagulation at the proper therapeutic dose and for at least 3 months were included in the analysis. Effectiveness was evaluated in terms of preservation of line function, residual thrombosis, and recurrence of VTE (including PE). Safety was evaluated in terms of death, major bleeding (MB), and clinically relevant non-major bleeding (CRNMB).ResultsWe identified 74 women who fulfilled the criteria to be included in the analysis. Of these, 31 (41.9%) had been treated with fondaparinux, 21 (28.4%) with enoxaparin, and 22 (29.7%) with the DOAC edoxaban. We found no differences between patients treated with the three different therapeutic approaches, in terms of preservation of line function, incidence of residual thrombosis, and VTE recurrence (including PE). Safety was similar as well, with no MBs recorded in any treatment group.ConclusionThese results, although retrospective and based on a relatively small sample size, indicate that, in women with gynecologic or breast cancer, CRT of the upper extremities may be treated with similar effectiveness and safety with fondaparinux, enoxaparin, and edoxaban. Further studies are needed to substantiate these findings.

Published
2022
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18. Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

Author

Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di Martino, M, Pisanu, A, Gerardi, C, Gourgiotis, S, Riboni, C, Giordano, A, Ferrario, L, Agnoletti, V, Kruger, Y, Mole, D, Agresta, F, Prieto Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Villalabeitia, I, Quispe-Cruz, D, Orantia, A, Waledziak, M, de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Couto Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief, G, Salah Alzhraa, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Synekidou, E, Dakis, K, Alexandridou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, Germani, P, Mastronardi, M, Bogoni, S, Palmisano, S, De Manzini, N, Marino, M, Martines, G, Trigiante, G, Lagouvardou, E, Anania, G, Bombardini, C, Oppici, D, Pilia, T, Murzi, V, Gessa, E, Bracale, U, Di Nuzzo, M, Peltrini, R, Salvetti, F, Vigano, J, Sganga, G, Bianchi, V, Fransvea, P, Fontana, T, Sarro, G, Dinuzzi, V, Scaravilli, L, Papa, M, Jovine, E, Ciabatti, G, Mastrangelo, L, Rottoli, M, Ricci, C, Russo, I, Aiolfi, A, Bona, D, Lombardo, F, Cianci, P, Sederino, M, Bini, R, Chiara, O, Cantafio, S, Coretti, G, Licitra, E, Savino, G, Grimaldi, S, Porfidia, R, Moggia, E, Garino, M, Marafante, C, Pesce, A, Fabbri, N, Feo, C, Marra, E, Troian, M, Drigo, D, Nagliati, C, Muratore, A, Danna, R, Murgese, A, Crespi, M, Guerci, C, Frontali, A, Ferrari, L, Favi, F, Picariello, E, Rampini, A, D'Acapito, F, Ercolani, G, Solaini, L, Palmieri, F, Cali, M, Ferrara, F, Muttillo, I, Muttillo, E, Picardi, B, Galleano, R, Badran, A, Ghazouani, O, Cervellera, M, Campanella, G, Papa, G, Di Bella, A, Perrone, G, Petracca, G, Prioriello, C, Giuffrida, M, Cozzani, F, Rossini, M, Inama, M, Butturini, G, Moretto, G, Morelli, L, Candio, G, Guadagni, S, Cicuttin, E, Cremonini, C, Tartaglia, D, Genovese, V, Cillara, N, Cannavera, A, Deserra, A, Picciariello, A, Papagni, V, Vincenti, L, Bagaglini, G, Sica, G, Lapolla, P, Brachini, G, Bono, D, Nicotera, A, Zago, M, Sammartano, F, Benuzzi, L, Stella, M, Rossi, S, Cerioli, A, Puccioni, C, Olmi, S, Rubicondo, C, Uccelli, M, Guida, A, Lepiane, P, Sasia, D, Giraudo, G, Salomone, S, Belloni, E, Cossa, A, Lancellotti, F, Caronna, R, Chirletti, P, Saullo, P, Troiano, R, Mucilli, F, Barone, M, Ippoliti, M, Grande, M, Sensi, B, Siragusa, L, Santini, A, Di Carlo, I, Veroux, M, Gioco, R, Veroux, G, Curro, G, Ammendola, M, Komaei, I, Navarra, G, Tonini, V, Sartarelli, L, Ceresoli, M, Perrone, S, Roccamatisi, L, Millo, P, Brachet Contul, R, Ponte, E, Zuin, M, Portale, G, Tonello, A, Fratini, G, Bianchini, M, Perotti, B, Doria, E, Lunghi, E, Visconti, D, Al-Shami, K, Awadi, S, Buwaitel, M, Naffa', M, Samhouri, A, Sawalha, H, Ani, M, Fathil, I, Huei, J, Beristain-Hernandez, J, Garcia-Meza, A, Sepulveda-Rdriguez, R, Hernandez, E, Pinzon, C, Condoy, J, Garcia, F, Sadik, M, Kadir, B, Devi, J, Seerani, N, Zainab, Sohail-Asghar, M, Afzal, A, Akbar, A, Lohse, H, Cabrera, Z, Seto, G, Chiuyari, J, Ordemar, J, Rodriguez, M, Orantia-Carlos, A, Quitoy, M, Kwiatkowski, A, Mawlichanow, M, Rocha, M, Soares, C, Stoian, A, Draghici, A, Grigorean, V, Radulescu, R, Costea, R, Zarnescu, E, Kurtenkov, M, Gendrikson, G, Alla-Angelina, V, Arina, T, Kaldarov, A, Gachabayov, M, Abdullaev, A, Milentijevic, M, Karamarkovic, M, Panyko, A, Radonak, J, Soltes, M, Moran, L, Garcia, H, Vega, P, Estevez, S, Ausania, F, Farguell, J, Gonzalez-Abos, C, Sanchez-Cabus, S, Martin, B, Molina, V, Oms, L, Ilzarbe, L, Feijoo, E, Perra, E, Rojas-Bonet, N, Penalba-Palmi, R, Perez-Bru, S, Tur-Martinez, J, Alvarez-Torrado, A, Domingo-Gonzalez, M, Tejedor-Tejada, J, del Alamo, Y, Mendoza-Moreno, F, Garcia-Moreno-Nisa, F, Matias-Garcia, B, Duran, M, Calleja-Lozano, R, de Villar, J, Sanchez-Guillen, L, Caravaca, I, Triguero-Canovas, D, Aparicio, A, Melendez, B, Palacios, A, Landaluce-Olavarria, A, De Francisco, M, Estraviz-Mateos, B, Alconchel, F, Nicolas-Lopez, T, Ramirez, P, Munoz-Cruzado, V, Ciuro, F, del Pozo, E, Pizarro, S, Cabrera, V, Bayo, J, Hamid, H, Roesel, R, Cristaudi, A, Abbas, K, Ali, I, Tlili, A, Bayhan, H, Turkoglu, M, Uzunoglu, M, Azamat, I, Omarov, N, Uymaz, D, Altintoprak, F, Akin, E, First, N, Das, K, Ozer, N, Seker, A, Kara, Y, Bozkurt, M, Kocatas, A, Atici, S, Akalin, M, Calik, B, Colak, E, Altinel, Y, Meric, S, Aktimur, Y, Hudson, V, Duval, J, Khan, M, Saad, A, Kaur, M, Bradley, A, Fox, K, Tomasi, I, Beasley, D, Prasanti, A, Kotecha, P, Ebied, H, Paul, M, Sheth, H, Gerogiannis, I, Gaber, M, Sheikh, Z, Seth, S, Kunitsyna, M, Leo, C, Bellato, V, Zafar, N, Elserafy, A, Bond-smith, G, Tebala, G, Mathur, P, Abid, I, Chidumije, N, Sandhar, P, Ullah, S, Lezama, T, Anwaar, M, Magee, C, Ahmed, S, Davies, B, Apollos, J, Mccormack, K, Choudhary, H, Doulias, T, Morrison, T, Palepa, A, Cal, F, Sanchez, L, Dominguez, F, Al-Raimi, I, Alshargabi, H, Meead, A, Chooklin, S, Chuklin, S, Bilyak, A, Podda M., Pellino G., Di Saverio S., Coccolini F., Pacella D., Cioffi S. P. B., Virdis F., Balla A., Ielpo B., Pata F., Poillucci G., Ortenzi M., Damaskos D., De Simone B., Sartelli M., Leppaniemi A., Jayant K., Catena F., Giuliani A., Di Martino M., Pisanu A., Gerardi C., Gourgiotis S., Riboni C., Giordano A., Ferrario L., Agnoletti V., Kruger Y., Mole D., Agresta F., Prieto Calvo M., Wilson M., Soggiu F., Hamdan A., Gomes C. A., Fraga G., Ioannidis A., Demetrashvili Z., Sahani S., Bains L., Khamees A., Ababneh H., Aljaiuossi O., Pimentel S., Mohamad I. S., Yusoff A. R., Zarnescu N. O., Calu V., Litvin A., Lesko D., Elmehrath A., Elshami M., de Santibanes M., Gundara J., Alawadhi K., Lui R., Julianov A., Ralon S., Garzali I. -U., Machain G. M., Villalabeitia I., Quispe-Cruz D. A., Orantia A. C. C., Waledziak M., de Sa T. C., Ali S. M., Kovacevic B., Noel C., Abdalah H. M., Kchaou A., Isik A., Ansaloni L., Biffl W., Guerrieri M., Sartori A., Abradelo M., Nigri G., Di Lorenzo N., Mingoli A., Chiarugi M., Di Menno Stavron J., Mazza O., Valenzuela J. I., Pachajoa D. A. P., Alvarez F. A., Liano J. E., Tefay J., Alshaikh A., Hasan L., Couto Gomes F., Calderan T. R. A., Hirano E. S., Dardanov D., Saroglu A., Atanasov B., Belev N., Kovachev N., Chan S. M., Lok H. -T., Salcedo D., Robayo D., Trivino M. A., Manak J., de Araujo J., Sethi A., Awad A., Elbadawy M., Farid A., Hanafy A., Nafea A., Sherief G., Salah Alzhraa A., Abdelsalam W., Emile S., Elfallal A., Elfeki H., Elghadban H., Shoma A., Shetiwy M., Elbahnasawy M., Mohamed S., Hamed E. F., Khalil U. A., Chouillard E., Gumbs A., Police A., Mabilia A., Khutsishvili K., Tvaladze A., Ioannidis O., Anestiadou E., Loutzidou L., Konstantinidis K., Konstantinidou S., Manatakis D., Acheimastos V., Tasis N., Michalopoulos N., Kokoropoulos P., Papadoliopoulou M., Sotiropoulou M., Kapiris S., Metaxas P., Tsouknidas I., Kefili D., Petrakis G., Synekidou E., Dakis K., Alexandridou E., Papadopoulos A., Chouliaras C., Mouzakis O., Mulita F., Maroulis I., Vailas M., Triantafyllou T., Theodorou D., Lostoridis E., Nagorni E. -A., Tourountzi P., Baili E., Charalabopoulos A., Liakakos T., Schizas D., Kozadinos A., Syllaios A., Machairas N., Kykalos S., Stamopoulos P., Delis S., Farazi-Chongouki C., Kalaitzakis E., Giannarakis M., Lasithiotakis K., Petra G., Gupta A., Medappil N., Muthukrishnan V., Kamar J., Lal P., Agarwal R., Magnoli M., Aonzo P., Serventi A., Di Lascio P., Pinto M., Bergamini C., Bottari A., Fortuna L., Martellucci J., Cicako A., Miglietta C., Morino M., Delogu D., Picchetto A., Assenza M., D'Ambrosio G., Argenio G., Armellino M. F., Ioia G., Occhionorelli S., Andreotti D., Domenico L., Luppi D., Casadei M., Di Donato L., Manoochehri F., Marchese T. R. L., Sergi W., Manca R., Murgia R., Piras E., Conti L., Gianazza S., Rizzi A., Segalini E., Monti M., Iiritano E., Mariani N. M., De Nicola E., Scifo G., Pignata G., Andreuccetti J., Fleres F., Clarizia G., Spolini A., Biloslavo A., Germani P., Mastronardi M., Bogoni S., Palmisano S., De Manzini N., Marino M. V., Martines G., Trigiante G., Lagouvardou E., Anania G., Bombardini C., Oppici D., Pilia T., Murzi V., Gessa E., Bracale U., Di Nuzzo M. M., Peltrini R., Salvetti F., Vigano J., Sganga G., Bianchi V., Fransvea P., Fontana T., Sarro G., Dinuzzi V. P., Scaravilli L., Papa M. V., Jovine E., Ciabatti G., Mastrangelo L., Rottoli M., Ricci C., Russo I. S., Aiolfi A., Bona D., Lombardo F., Cianci P., Sederino M., Bini R., Chiara O., Cioffi S., Cantafio S., Coretti G., Licitra E., Savino G., Grimaldi S., Porfidia R., Moggia E., Garino M., Marafante C., Pesce A., Fabbri N., Feo C. V., Marra E., Troian M., Drigo D., Nagliati C., Muratore A., Danna R., Murgese A., Crespi M., Guerci C., Frontali A., Ferrari L., Favi F., Picariello E., Rampini A., D'Acapito F., Ercolani G., Solaini L., Palmieri F., Cali M., Ferrara F., Muttillo I. A., Muttillo E. M., Picardi B., Galleano R., Badran A., Ghazouani O., Cervellera M., Campanella G., Papa G., Di Bella A., Perrone G., Petracca G. L., Prioriello C., Giuffrida M., Cozzani F., Rossini M., Inama M., Butturini G., Moretto G., Morelli L., Candio G., Guadagni S., Cicuttin E., Cremonini C., Tartaglia D., Genovese V., Cillara N., Cannavera A., Deserra A., Picciariello A., Papagni V., Vincenti L., Bagaglini G., Sica G., Lapolla P., Brachini G., Bono D., Nicotera A., Zago M., Sammartano F., Benuzzi L., Stella M., Rossi S., Cerioli A., Puccioni C., Olmi S., Rubicondo C., Uccelli M., Guida A., Lepiane P., Sasia D., Giraudo G., Salomone S., Belloni E., Cossa A., Lancellotti F., Caronna R., Chirletti P., Saullo P., Troiano R., Mucilli F., Barone M., Ippoliti M., Grande M., Sensi B., Siragusa L., Santini A., Di Carlo I., Veroux M., Gioco R., Veroux G., Curro G., Ammendola M., Komaei I., Navarra G., Tonini V., Sartarelli L., Ceresoli M., Perrone S., Roccamatisi L., Millo P., Brachet Contul R., Ponte E., Zuin M., Portale G., Tonello A. S., Fratini G., Bianchini M., Perotti B., Doria E., Lunghi E. G., Visconti D., Al-Shami K., Awadi S., Buwaitel M. M. K., Naffa' M. F. N., Samhouri A., Sawalha H., Ani M. F. C., Fathil I. N. A., Huei J., Beristain-Hernandez J. -L., Garcia-Meza A., Sepulveda-Rdriguez R., Hernandez E. E. L., Pinzon C. L. A., Condoy J. N., Garcia F. C. B., Sadik M., Kadir B., Devi J., Seerani N., Sohail-Asghar M., Afzal A., Akbar A., Lohse H. S., Cabrera Z. S. L., Seto G. S. Y., Chiuyari J. R., Ordemar J., Rodriguez M., Orantia-Carlos A. C. C., Quitoy M. A., Kwiatkowski A., Mawlichanow M., Rocha M., Soares C., Stoian A. R., Draghici A. D., Grigorean V. T., Radulescu R. B., Costea R. V., Zarnescu E. C., Kurtenkov M., Gendrikson G., Alla-Angelina V., Arina T., Kaldarov A., Gachabayov M., Abdullaev A., Milentijevic M., Karamarkovic M., Panyko A., Radonak J., Soltes M., Moran L. A., Garcia H. C., Vega P. S., Estevez S., Ausania F., Farguell J., Gonzalez-Abos C., Sanchez-Cabus S., Martin B., Molina V., Oms L., Ilzarbe L., Feijoo E. P., Perra E. S., Rojas-Bonet N., Penalba-Palmi R., Perez-Bru S., Tur-Martinez J., Alvarez-Torrado A., Domingo-Gonzalez M., Tejedor-Tejada J., del Alamo Y. G., Mendoza-Moreno F., Garcia-Moreno-Nisa F., Matias-Garcia B., Duran M., Calleja-Lozano R., de Villar J. M. P., Sanchez-Guillen L., Caravaca I., Triguero-Canovas D., Aparicio A. C. M., Melendez B. D., Palacios A. M., Landaluce-Olavarria A., De Francisco M., Estraviz-Mateos B., Alconchel F., Nicolas-Lopez T., Ramirez P., Munoz-Cruzado V. D., Ciuro F. P., del Pozo E. P., Pizarro S. O., Cabrera V. H., Bayo J. M., Hamid H. K. S., Roesel R., Cristaudi A., Abbas K., Ali I., Tlili A., Bayhan H., Turkoglu M. A., Uzunoglu M. Y., Azamat I. F., Omarov N., Uymaz D. S., Altintoprak F., Akin E., First N., Das K., Ozer N., Seker A., Kara Y., Bozkurt M. A., Kocatas A., Atici S. D., Akalin M., Calik B., Colak E., Altinel Y., Meric S., Aktimur Y. E., Hudson V., Duval J. -L., Khan M., Saad A., Kaur M., Bradley A., Fox K., Tomasi I., Beasley D., Prasanti A. K., Kotecha P., Ebied H., Paul M., Sheth H., Gerogiannis I., Gaber M., Sheikh Z., Seth S., Kunitsyna M., Leo C. A., Bellato V., Zafar N., Elserafy A., Bond-smith G., Tebala G., Mathur P., Abid I., Chidumije N., Sandhar P., Ullah S. O. Z., Lezama T., Anwaar M. H., Magee C., Ahmed S., Davies B., Apollos J., McCormack K., Choudhary H., Doulias T., Morrison T., Palepa A., Cal F. B., Sanchez L., Dominguez F., Al-Raimi I., Alshargabi H., Meead A., Chooklin S., Chuklin S., Bilyak A., Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di Martino, M, Pisanu, A, Gerardi, C, Gourgiotis, S, Riboni, C, Giordano, A, Ferrario, L, Agnoletti, V, Kruger, Y, Mole, D, Agresta, F, Prieto Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Villalabeitia, I, Quispe-Cruz, D, Orantia, A, Waledziak, M, de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Couto Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief, G, Salah Alzhraa, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Synekidou, E, Dakis, K, Alexandridou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, 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I., Pachajoa D. A. P., Alvarez F. A., Liano J. E., Tefay J., Alshaikh A., Hasan L., Couto Gomes F., Calderan T. R. A., Hirano E. S., Dardanov D., Saroglu A., Atanasov B., Belev N., Kovachev N., Chan S. M., Lok H. -T., Salcedo D., Robayo D., Trivino M. A., Manak J., de Araujo J., Sethi A., Awad A., Elbadawy M., Farid A., Hanafy A., Nafea A., Sherief G., Salah Alzhraa A., Abdelsalam W., Emile S., Elfallal A., Elfeki H., Elghadban H., Shoma A., Shetiwy M., Elbahnasawy M., Mohamed S., Hamed E. F., Khalil U. A., Chouillard E., Gumbs A., Police A., Mabilia A., Khutsishvili K., Tvaladze A., Ioannidis O., Anestiadou E., Loutzidou L., Konstantinidis K., Konstantinidou S., Manatakis D., Acheimastos V., Tasis N., Michalopoulos N., Kokoropoulos P., Papadoliopoulou M., Sotiropoulou M., Kapiris S., Metaxas P., Tsouknidas I., Kefili D., Petrakis G., Synekidou E., Dakis K., Alexandridou E., Papadopoulos A., Chouliaras C., Mouzakis O., Mulita F., Maroulis I., Vailas M., Triantafyllou T., Theodorou D., Lostoridis E., Nagorni E. -A., Tourountzi P., Baili E., Charalabopoulos A., Liakakos T., Schizas D., Kozadinos A., Syllaios A., Machairas N., Kykalos S., Stamopoulos P., Delis S., Farazi-Chongouki C., Kalaitzakis E., Giannarakis M., Lasithiotakis K., Petra G., Gupta A., Medappil N., Muthukrishnan V., Kamar J., Lal P., Agarwal R., Magnoli M., Aonzo P., Serventi A., Di Lascio P., Pinto M., Bergamini C., Bottari A., Fortuna L., Martellucci J., Cicako A., Miglietta C., Morino M., Delogu D., Picchetto A., Assenza M., D'Ambrosio G., Argenio G., Armellino M. F., Ioia G., Occhionorelli S., Andreotti D., Domenico L., Luppi D., Casadei M., Di Donato L., Manoochehri F., Marchese T. R. L., Sergi W., Manca R., Murgia R., Piras E., Conti L., Gianazza S., Rizzi A., Segalini E., Monti M., Iiritano E., Mariani N. M., De Nicola E., Scifo G., Pignata G., Andreuccetti J., Fleres F., Clarizia G., Spolini A., Biloslavo A., Germani P., Mastronardi M., Bogoni S., Palmisano S., De Manzini N., Marino M. V., Martines G., Trigiante G., Lagouvardou E., Anania G., Bombardini C., Oppici D., Pilia T., Murzi V., Gessa E., Bracale U., Di Nuzzo M. M., Peltrini R., Salvetti F., Vigano J., Sganga G., Bianchi V., Fransvea P., Fontana T., Sarro G., Dinuzzi V. P., Scaravilli L., Papa M. V., Jovine E., Ciabatti G., Mastrangelo L., Rottoli M., Ricci C., Russo I. S., Aiolfi A., Bona D., Lombardo F., Cianci P., Sederino M., Bini R., Chiara O., Cioffi S., Cantafio S., Coretti G., Licitra E., Savino G., Grimaldi S., Porfidia R., Moggia E., Garino M., Marafante C., Pesce A., Fabbri N., Feo C. V., Marra E., Troian M., Drigo D., Nagliati C., Muratore A., Danna R., Murgese A., Crespi M., Guerci C., Frontali A., Ferrari L., Favi F., Picariello E., Rampini A., D'Acapito F., Ercolani G., Solaini L., Palmieri F., Cali M., Ferrara F., Muttillo I. A., Muttillo E. M., Picardi B., Galleano R., Badran A., Ghazouani O., Cervellera M., Campanella G., Papa G., Di Bella A., Perrone G., Petracca G. L., Prioriello C., Giuffrida M., Cozzani F., Rossini M., Inama M., Butturini G., Moretto G., Morelli L., Candio G., Guadagni S., Cicuttin E., Cremonini C., Tartaglia D., Genovese V., Cillara N., Cannavera A., Deserra A., Picciariello A., Papagni V., Vincenti L., Bagaglini G., Sica G., Lapolla P., Brachini G., Bono D., Nicotera A., Zago M., Sammartano F., Benuzzi L., Stella M., Rossi S., Cerioli A., Puccioni C., Olmi S., Rubicondo C., Uccelli M., Guida A., Lepiane P., Sasia D., Giraudo G., Salomone S., Belloni E., Cossa A., Lancellotti F., Caronna R., Chirletti P., Saullo P., Troiano R., Mucilli F., Barone M., Ippoliti M., Grande M., Sensi B., Siragusa L., Santini A., Di Carlo I., Veroux M., Gioco R., Veroux G., Curro G., Ammendola M., Komaei I., Navarra G., Tonini V., Sartarelli L., Ceresoli M., Perrone S., Roccamatisi L., Millo P., Brachet Contul R., Ponte E., Zuin M., Portale G., Tonello A. S., Fratini G., Bianchini M., Perotti B., Doria E., Lunghi E. 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S., Rojas-Bonet N., Penalba-Palmi R., Perez-Bru S., Tur-Martinez J., Alvarez-Torrado A., Domingo-Gonzalez M., Tejedor-Tejada J., del Alamo Y. G., Mendoza-Moreno F., Garcia-Moreno-Nisa F., Matias-Garcia B., Duran M., Calleja-Lozano R., de Villar J. M. P., Sanchez-Guillen L., Caravaca I., Triguero-Canovas D., Aparicio A. C. M., Melendez B. D., Palacios A. M., Landaluce-Olavarria A., De Francisco M., Estraviz-Mateos B., Alconchel F., Nicolas-Lopez T., Ramirez P., Munoz-Cruzado V. D., Ciuro F. P., del Pozo E. P., Pizarro S. O., Cabrera V. H., Bayo J. M., Hamid H. K. S., Roesel R., Cristaudi A., Abbas K., Ali I., Tlili A., Bayhan H., Turkoglu M. A., Uzunoglu M. Y., Azamat I. F., Omarov N., Uymaz D. S., Altintoprak F., Akin E., First N., Das K., Ozer N., Seker A., Kara Y., Bozkurt M. A., Kocatas A., Atici S. D., Akalin M., Calik B., Colak E., Altinel Y., Meric S., Aktimur Y. E., Hudson V., Duval J. -L., Khan M., Saad A., Kaur M., Bradley A., Fox K., Tomasi I., Beasley D., Prasanti A. K., Kotecha P., Ebied H., Paul M., Sheth H., Gerogiannis I., Gaber M., Sheikh Z., Seth S., Kunitsyna M., Leo C. A., Bellato V., Zafar N., Elserafy A., Bond-smith G., Tebala G., Mathur P., Abid I., Chidumije N., Sandhar P., Ullah S. O. Z., Lezama T., Anwaar M. H., Magee C., Ahmed S., Davies B., Apollos J., McCormack K., Choudhary H., Doulias T., Morrison T., Palepa A., Cal F. B., Sanchez L., Dominguez F., Al-Raimi I., Alshargabi H., Meead A., Chooklin S., Chuklin S., and Bilyak A.

Abstract

The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912–7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible.

Published
2023

19. Low-Dose Rivaroxaban to Prevent Recurrences of Venous Thromboembolism in Cancer: A Real-Life Experience with a Focus on Female Patients

Author

Santini, Paolo, Mosoni, Carolina, D'Errico, Alessandro, Porceddu, E., Lupascu, Andrea, Valeriani, E., Tondi, Paolo, Pola, Roberto, Porfidia, Angelo, Santini P., Mosoni C., D'Errico A., Lupascu A., Tondi P. (ORCID:0000-0003-1654-2448), Pola R. (ORCID:0000-0001-5224-2931), Porfidia A. (ORCID:0000-0003-4915-2892), Santini, Paolo, Mosoni, Carolina, D'Errico, Alessandro, Porceddu, E., Lupascu, Andrea, Valeriani, E., Tondi, Paolo, Pola, Roberto, Porfidia, Angelo, Santini P., Mosoni C., D'Errico A., Lupascu A., Tondi P. (ORCID:0000-0003-1654-2448), Pola R. (ORCID:0000-0001-5224-2931), and Porfidia A. (ORCID:0000-0003-4915-2892)

Abstract

Background: The way in which to prevent recurrent venous thromboembolism (VTE) is an unmet clinical need in cancer patients. International guidelines only provide conditional recommendations and do not specify which anticoagulant and dose should be used. In the last 2 years, we have been using low-dose rivaroxaban to prevent VTE recurrences in cancer patients. The results of this real-life experience are presented in this study. Methods: All patients had cancer and had previously completed a cycle of at least six months of full-dose anticoagulation for the treatment of a VTE index event, before receiving a prescription of low-dose rivaroxaban (10 mg once daily) for secondary prevention of VTE. Effectiveness and safety of this therapeutic regimen were evaluated in terms of VTE recurrences, major bleedings (MB), and clinically relevant non-major bleedings (CRNMB). Results: The analysis included 106 cancer patients. Their median age was 60 years (IQR 50–69). Metastatic cancer was present in 87 patients (82.1%). Six patients (5.7%) had brain metastases. Over a median follow-up time of 333 days (IQR 156–484), the incidence of VTE recurrences was 3.8% (95%CI 1.0–9.4), with a recurrence rate of 4.0 per 100 person-years (95%CI 1.1–10.2). We observed no MB (0.0%) and three CRNMB (2.8%) (95%CI 0.6–8.1). Conclusions: Low-dose rivaroxaban is potentially effective and safe in cancer patients that require prevention of recurrent VTE. Large-scale studies are needed to confirm these findings.

Published
2023

21. Pulmonary Embolism in COVID-19 Patients: Which Diagnostic Algorithm Should We Use?

Author

Angelo Porfidia, Carolina Mosoni, Rosa Talerico, Enrica Porceddu, Andrea Lupascu, Paolo Tondi, Francesco Landi, and Roberto Pola

Subjects
COVID-19, pulmonary embolism, computed tomography pulmonary angiography, diagnosis, algorithm, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Introduction: Although pulmonary embolism (PE) is a frequent complication of the clinical course of COVID-19, there is a lack of explicit indications regarding the best algorithm for diagnosing PE in these patients. In particular, it is not clear how to identify subjects who should undergo computed tomography pulmonary angiography (CTPA), rather than simply X-ray and/or high resolution computed tomography (HRCT) of the chest.Methods: We retrospectively analyzed COVID-19 patients who presented to the Emergency Department (ED) of our University hospital with acute respiratory failure, or that developed acute respiratory failure during hospital stay, to determine how many of them had a theoretical indication to undergo CTPA for suspected PE according to current guidelines. Next, we looked for differences between patients who underwent CTPA and those who only underwent X-ray and/or HRCT of the chest. Finally, we determined whether patients with a confirmed diagnosis of PE had specific characteristics that made them different from those with a CTPA negative for PE.Results: Out of 93 subjects with COVID-19 and acute respiratory failure, 73 (78.4%) had an indication to undergo CTPA according to the revised Geneva and Wells scores and the PERC rule-out criteria, and 54 (58%) according to the YEARS algorithm. However, in contrast with these indications, only 28 patients (30.1%) underwent CTPA. Of note, they were not clinically different from those who underwent X-ray and/or HRCT of the chest. Among the 28 subjects who underwent CTPA, there were 10 cases of PE (35.7%). They were not clinically different from those with CTPA negative for PE.Conclusions: COVID-19 patients with acute respiratory failure undergo CTPA, X-ray of the chest, or HRCT without an established criterion. Nonetheless, when CTPA is performed, the diagnosis of PE is anything but rare. Validated tools for identifying COVID-19 patients who require CTPA for suspected PE are urgently needed.

Published
2021
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22. Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

Author

Podda, Mauro, Pellino, Gianluca, Di Saverio, Salomone, Coccolini, Federico, Pacella, Daniela, Cioffi, Stefano Piero Bernardo, Virdis, Francesco, Balla, Andrea, Ielpo, Benedetto, Pata, Francesco, Poillucci, Gaetano, Ortenzi, Monica, Damaskos, Dimitrios, De Simone, Belinda, Sartelli, Massimo, Leppaniemi, Ari, Jayant, Kumar, Catena, Fausto, Giuliani, Antonio, Di Martino, Marcello, Pisanu, Adolfo, Chiara Gerardi, Stavros Gourgiotis, Cristiana Riboni, Alessio Giordano, Luca Ferrario, Vanni Agnoletti, Yoram Kruger, Damian Mole, Ferdinando Agresta, Mikel Prieto Calvo, Michael Wilson, Fiammetta Soggiu, Alaa Hamdan, Carlos Augusto Gomes, Gustavo Fraga, Argyrios Ioannidis, Zaza Demetrashvili, Saaz Sahani, Lovenish Bains, Almu'atasim Khamees, Hazim Ababneh, Osama Aljaiuossi, Samuel Pimentel, Ikhwan Sani Mohamad, Ahmad Ramzi Yusoff, Narcis Octavian Zarnescu, Valentin Calu, Andrey Litvin, Dusan Lesko, Ahmed Elmehrath, Mohamedraed Elshami, Martin de Santibañes, Justin Gundara, Kamel Alawadhi, Rashid Lui, Alexander Julianov, Sergio Ralon, Ibrahim-Umar Garzali, Gustavo M Machain, Ibabe Villalabeitia, Darwin Artidoro Quispe-Cruz, Abigail Cheska C Orantia, Maciej Walędziak, Tiago Correia de Sá, Syed Muhammad Ali, Bojan Kovacevic, Colin Noel, Haidar M Abdalah, Ali Kchaou, Arda Isik, Luca Ansaloni, Walter Biffl, Mario Guerrieri, Alberto Sartori, Manuel Abradelo, Giuseppe Nigri, Nicola Di Lorenzo, Andrea Mingoli, Massimo Chiarugi, Juliana Di Menno Stavron, Oscar Mazza, José Ignacio Valenzuela, Diana Alejandra Pantoja Pachajoa, Fernando Andrés Alvarez, Julian Ezequiel Liaño, Joan Tefay, Abdulrahman Alshaikh, Layla Hasan, Felipe Couto Gomes, Thiago R A Calderan, Elcio S Hirano, Dragomir Dardanov, Azize Saroglu, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, Shannon Melissa Chan, Hon-Ting Lok, Diego Salcedo, Diana Robayo, María Alejandra Triviño, Jan Manak, Jorann de Araujo, Ananya Sethi, Ahmed Awad, Merihan Elbadawy, Ahmed Farid, Asmaa Hanafy, Ahmed Nafea, Ghozy Sherief, Abbas Salah Alzhraa, Wafaa Abdelsalam, Sameh Emile, Ahmed Elfallal, Hossam Elfeki, Hosam Elghadban, Ashraf Shoma, Mohamed Shetiwy, Mohamed Elbahnasawy, Salem Mohamed, Emad Fawzi Hamed, Usama Ahmed Khalil, Elie Chouillard, Andrew Gumbs, Andrea Police, Andrea Mabilia, Kakhi Khutsishvili, Anano Tvaladze, Orestis Ioannidis, Elissavet Anestiadou, Lydia Loutzidou, Konstantinis Konstantinidis, Sofia Konstantinidou, Dimitrios Manatakis, Vasileios Acheimastos, Nikolaos Tasis, Nikolaos Michalopoulos, Panagiotis Kokoropoulos, Maria Papadoliopoulou, Maria Sotiropoulou, Stylianos Kapiris, Panagiotis Metaxas, Ioannis Tsouknidas, Despoina Kefili, George Petrakis, Eirini Synekidou, Konstantinos Dakis, Eirini Alexandridou, Aristeidis Papadopoulos, Christos Chouliaras, Odysseas Mouzakis, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Tania Triantafyllou, Dimitrios Theodorou, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Paraskevi Tourountzi, Efstratia Baili, Alexandros Charalabopoulos, Theodore Liakakos, Dimitrios Schizas, Alexandros Kozadinos, Athanasios Syllaios, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Spiros Delis, Christos Farazi-Chongouki, Evangelos Kalaitzakis, Miltiadis Giannarakis, Konstantinos Lasithiotakis, Giorgia Petra, Amit Gupta, Noushif Medappil, Vijayanand Muthukrishnan, Jubin Kamar, Pawan Lal, Rajendra Agarwal, Matteo Magnoli, Paolo Aonzo, Alberto Serventi, Pierpaolo Di Lascio, Margherita Pinto, Carlo Bergamini, Andrea Bottari, Laura Fortuna, Jacopo Martellucci, Atea Cicako, Claudio Miglietta, Mario Morino, Daniele Delogu, Andrea Picchetto, Marco Assenza, Giancarlo D'Ambrosio, Giulio Argenio, Mariano Fortunato Armellino, Giovanna Ioia, Savino Occhionorelli, Dario Andreotti, Lacavalla Domenico, Davide Luppi, Massimiliano Casadei, Luca Di Donato, Farshad Manoochehri, Tiziana Rita Lucia Marchese, William Sergi, Roberto Manca, Raimondo Murgia, Enrico Piras, Lorenzo Conti, Simone Gianazza, Andrea Rizzi, Edoardo Segalini, Marco Monti, Elena Iiritano, Nicolò Maria Mariani, Enrico De Nicola, Giovanna Scifo, Giusto Pignata, Jacopo Andreuccetti, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Alan Biloslavo, Paola Germani, Manuela Mastronardi, Selene Bogoni, Silvia Palmisano, Nicolo' De Manzini, Marco Vito Marino, Gennaro Martines, Giuseppe Trigiante, Elpiniki Lagouvardou, Gabriele Anania, Cristina Bombardini, Dario Oppici, Tiziana Pilia, Valentina Murzi, Emanuela Gessa, Umberto Bracale, Maria Michela Di Nuzzo, Roberto Peltrini, Francesco Salvetti, Jacopo Viganò, Gabriele Sganga, Valentina Bianchi, Pietro Fransvea, Tommaso Fontana, Giuliano Sarro, Vincenza Paola Dinuzzi, Luca Scaravilli, Mario Virgilio Papa, Elio Jovine, Giulia Ciabatti, Laura Mastrangelo, Matteo Rottoli, Claudio Ricci, Iris Shari Russo, Alberto Aiolfi, Davide Bona, Francesca Lombardo, Pasquale Cianci, Mariagrazia Sederino, Roberto Bini, Osvaldo Chiara, Stefano Cioffi, Stefano Cantafio, Guido Coretti, Edelweiss Licitra, Grazia Savino, Sergio Grimaldi, Raffaele Porfidia, Elisabetta Moggia, Mauro Garino, Chiara Marafante, Antonio Pesce, Nicolò Fabbri, Carlo Vittorio Feo, Ester Marra, Marina Troian, Davide Drigo, Carlo Nagliati, Andrea Muratore, Riccardo Danna, Alessandra Murgese, Michele Crespi, Claudio Guerci, Alice Frontali, Luca Ferrari, Francesco Favi, Erika Picariello, Alessia Rampini, Fabrizio D'Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Palmieri, Matteo Calì, Francesco Ferrara, Irnerio Angelo Muttillo, Edoardo Maria Muttillo, Biagio Picardi, Raffaele Galleano, Ali Badran, Omar Ghazouani, Maurizio Cervellera, Gaetano Campanella, Gennaro Papa, Annamaria Di Bella, Gennaro Perrone, Gabriele Luciano Petracca, Concetta Prioriello, Mario Giuffrida, Federico Cozzani, Matteo Rossini, Marco Inama, Giovanni Butturini, Gianluigi Moretto, Luca Morelli, Giulio Candio, Simone Guadagni, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Valerio Genovese, Nicola Cillara, Alessandro Cannavera, Antonello Deserra, Arcangelo Picciariello, Vincenzo Papagni, Leonardo Vincenti, Giulia Bagaglini, Giuseppe Sica, Pierfrancesco Lapolla, Gioia Brachini, Dario Bono, Antonella Nicotera, Marcello Zago, Fabrizio Sammartano, Laura Benuzzi, Marco Stella, Stefano Rossi, Alessandra Cerioli, Caterina Puccioni, Stefano Olmi, Carolina Rubicondo, Matteo Uccelli, Anna Guida, Pasquale Lepiane, Diego Sasia, Giorgio Giraudo, Sara Salomone, Elena Belloni, Alessandra Cossa, Francesco Lancellotti, Roberto Caronna, Piero Chirletti, Paolina Saullo, Raffaele Troiano, Felice Mucilli, Mirko Barone, Massimo Ippoliti, Michele Grande, Bruno Sensi, Leandro Siragusa, Andrea Santini, Isidoro Di Carlo, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Giuseppe Currò, Michele Ammendola, Iman Komaei, Giuseppe Navarra, Valeria Tonini, Lodovico Sartarelli, Marco Ceresoli, Stefano Perrone, Linda Roccamatisi, Paolo Millo, Riccardo Brachet Contul, Elisa Ponte, Matteo Zuin, Giuseppe Portale, Alice Sabrina Tonello, Geri Fratini, Matteo Bianchini, Bruno Perotti, Emanuele Doria, Elia Giuseppe Lunghi, Diego Visconti, Khayry Al-Shami, Sajeda Awadi, Mohammad Musallam Khalil Buwaitel, Mo'taz Fawzat Naief Naffa', Ahmad Samhouri, Hatem Sawalha, Mohd Firdaus Che Ani, Ida Nadiah Ahmed Fathil, Jih Huei, Jose-Luis Beristain-Hernandez, Alejandro Garcia-Meza, Rafael Sepulveda-Rdriguez, Edgard Efren Lozada Hernández, Camilo Levi Acuña Pinzón, Jefferson Nieves Condoy, Francisco C Becerra García, Mohammad Sadik, Bushra Kadir, Jalpa Devi, Nandlal Seerani, Zainab, Mohammad Sohail-Asghar, Ameer Afzal, Ali Akbar, Helmut Segovia Lohse, Herald Segovia Lohse, Zamiara Solange Leon Cabrera, Gaby Susana Yamamoto Seto, José Ríos Chiuyari, Jorge Ordemar, Martha Rodríguez, Abigail Cheska C Orantia-Carlos, Margie Antionette Quitoy, Andrzej Kwiatkowski, Maciej Mawlichanów, Mónica Rocha, Carlos Soares, Alexandru Rares Stoian, Andreea Diana Draghici, Valentin Titus Grigorean, Raluca Bievel Radulescu, Radu Virgil Costea, Eugenia Claudia Zarnescu, Mikhail Kurtenkov, George Gendrikson, Volovich Alla-Angelina, Tsurbanova Arina, Ayrat Kaldarov, Mahir Gachabayov, Abakar Abdullaev, Milica Milentijevic, Milovan Karamarkovic, Arpád Panyko, Jozef Radonak, Marek Soltes, Laura Álvarez Morán, Haydée Calvo García, Pilar Suárez Vega, Sergio Estevez, Fabio Ausania, Jordi Farguell, Carolina González-Abós, Santiago Sánchez-Cabús, Belén Martín, Víctor Molina, Luis Oms, Lucas Ilzarbe, Eva Pont Feijóo, Elena Sofia Perra, Noel Rojas-Bonet, Rafael Penalba-Palmí, Susana Pérez-Bru, Jaume Tur-Martínez, Andrea Álvarez-Torrado, Marta Domingo-Gonzalez, Javier Tejedor-Tejada, Yaiza García Del Alamo, Fernando Mendoza-Moreno, Francisca García-Moreno-Nisa, Belén Matías-García, Manuel Durán, Rafael Calleja-Lozano, José Manuel Perez de Villar, Luis Sánchez-Guillén, Iban Caravaca, Daniel Triguero-Cánovas, Antonio Carlos Maya Aparicio, Blas Durán Meléndez, Andrea Masiá Palacios, Aitor Landaluce-Olavarria, Mario De Francisco, Begoña Estraviz-Mateos, Felipe Alconchel, Tatiana Nicolás-López, Pablo Ramírez, Virginia Duran Muñoz-Cruzado, Felipe Parej Ciuró, Eduardo Perea Del Pozo, Sergio Olivares Pizarro, Vicente Herrera Cabrera, Jose Muros Bayo, Hytham K S Hamid, Raffaello Roesel, Alessandra Cristaudi, Kinan Abbas, Iyad Ali, Ahmed Tlili, Hüseyin Bayhan, Mehmet Akif Türkoğlu, Mustafa Yener Uzunoglu, Ibrahim Fethi Azamat, Nail Omarov, Derya Salim Uymaz, Fatih Altintoprak, Emrah Akin, Necattin First, Koray Das, Nazmi Ozer, Ahmet Seker, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Semra Demirli Atici, Murat Akalin, Bulent Calik, Elif Colak, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Victoria Hudson, Jean-Luc Duval, Mansoor Khan, Ahmed Saad, Mandeep Kaur, Alison Bradley, Katherine Fox, Ivan Tomasi, Daniel Beasley, Alekhya Kotta Prasanti, Pinky Kotecha, Husam Ebied, Michaela Paul, Hemant Sheth, Ioannis Gerogiannis, Mohannad Gaber, Zara Sheikh, Shatadru Seth, Maria Kunitsyna, Cosimo Alex Leo, Vittoria Bellato, Noman Zafar, Amr Elserafy, Giles Bond-Smith, Giovanni Tebala, Pawan Mathur, Izza Abid, Nnaemeka Chidumije, Pardip Sandhar, Syed Osama Zohaib Ullah, Tamara Lezama, Muhammad Hassan Anwaar, Conor Magee, Salma Ahmed, Brooke Davies, Jeyakumar Apollos, Kieran McCormack, Hasham Choudhary, Triantafyllos Doulias, Tamsin Morrison, Anna Palepa, Fernando Bonilla Cal, Lianet Sánchez, Fabiana Domínguez, Ibrahim Al-Raimi, Haneen Alshargabi, Abdullah Meead, Serge Chooklin, Serhii Chuklin, Andriy Bilyak, Institut Català de la Salut, [Podda M] Emergency Surgery Unit, Department of Surgical Science, Policlinico Universitario 'D. Casula', Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy. [Pellino G] Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy. Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Di Saverio S] Department of Surgery, 'Madonna del Soccorso' Hospital, San Benedetto del Tronto, Italy. [Coccolini F] General, Emergency and Trauma Surgery Unit, Pisa University Hospital, Pisa, Italy. [Pacella D] Department of Public Health, University of Naples Federico II, Naples, Italy. [Cioffi SPB] Trauma and Acute Care Surgery Unit, 'Niguarda Ca Granda' Hospital, Milan, Italy, Vall d'Hebron Barcelona Hospital Campus, Podda, Mauro, Pellino, Gianluca, Di Saverio, Salomone, Coccolini, Federico, Pacella, Daniela, Cioffi, Stefano Piero Bernardo, Virdis, Francesco, Balla, Andrea, Ielpo, Benedetto, Pata, Francesco, Poillucci, Gaetano, Ortenzi, Monica, Damaskos, Dimitrio, De Simone, Belinda, Sartelli, Massimo, Leppaniemi, Ari, Jayant, Kumar, Catena, Fausto, Giuliani, Antonio, Di Martino, Marcello, Pisanu, Adolfo, Chiara Gerardi, Stavros Gourgiotis, Cristiana Riboni, Alessio Giordano, Luca Ferrario, Vanni Agnoletti, Yoram Kruger, Damian Mole, Ferdinando Agresta, Mikel Prieto Calvo, Michael Wilson, Fiammetta Soggiu, Alaa Hamdan, Carlos Augusto Gomes, Gustavo Fraga, Argyrios Ioannidis, Zaza Demetrashvili, Saaz Sahani, Lovenish Bains, Almu'atasim Khamees, Hazim Ababneh, Osama Aljaiuossi, Samuel Pimentel, Ikhwan Sani Mohamad, Ahmad Ramzi Yusoff, Narcis Octavian Zarnescu, Valentin Calu, Andrey Litvin, Dusan Lesko, Ahmed Elmehrath, Mohamedraed Elshami, Martin de Santibañes, Justin Gundara, Kamel Alawadhi, Rashid Lui, Alexander Julianov, Sergio Ralon, Ibrahim-Umar Garzali, Gustavo M Machain, Ibabe Villalabeitia, Darwin Artidoro Quispe-Cruz, Abigail Cheska C Orantia, Maciej Walędziak, Tiago Correia de Sá, Syed Muhammad Ali, Bojan Kovacevic, Colin Noel, Haidar M Abdalah, Ali Kchaou, Arda Isik, Luca Ansaloni, Walter Biffl, Mario Guerrieri, Alberto Sartori, Manuel Abradelo, Giuseppe Nigri, Nicola Di Lorenzo, Andrea Mingoli, Massimo Chiarugi, Juliana Di Menno Stavron, Oscar Mazza, José Ignacio Valenzuela, Diana Alejandra Pantoja Pachajoa, Fernando Andrés Alvarez, Julian Ezequiel Liaño, Joan Tefay, Abdulrahman Alshaikh, Layla Hasan, Felipe Couto Gomes, Thiago R A Calderan, Elcio S Hirano, Dragomir Dardanov, Alexander Julianov, Azize Saroglu, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, Shannon Melissa Chan, Hon-Ting Lok, Diego Salcedo, Diana Robayo, María Alejandra Triviño, Jan Manak, Saaz Sahani, Jorann de Araujo, Ananya Sethi, Ahmed Awad, Merihan Elbadawy, Ahmed Farid, Asmaa Hanafy, Ahmed Nafea, Ghozy Sherief, Abbas Salah Alzhraa, Wafaa Abdelsalam, Sameh Emile, Ahmed Elfallal, Hossam Elfeki, Hosam Elghadban, Ashraf Shoma, Mohamed Shetiwy, Mohamed Elbahnasawy, Salem Mohamed, Emad Fawzi Hamed, Usama Ahmed Khalil, Elie Chouillard, Andrew Gumbs, Andrea Police, Andrea Mabilia, Kakhi Khutsishvili, Anano Tvaladze, Orestis Ioannidis, Elissavet Anestiadou, Lydia Loutzidou, Konstantinis Konstantinidis, Sofia Konstantinidou, Dimitrios Manatakis, Vasileios Acheimastos, Nikolaos Tasis, Nikolaos Michalopoulos, Panagiotis Kokoropoulos, Maria Papadoliopoulou, Maria Sotiropoulou, Stylianos Kapiris, Panagiotis Metaxas, Ioannis Tsouknidas, Despoina Kefili, George Petrakis, Eirini Synekidou, Konstantinos Dakis, Eirini Alexandridou, Aristeidis Papadopoulos, Christos Chouliaras, Odysseas Mouzakis, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Tania Triantafyllou, Dimitrios Theodorou, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Paraskevi Tourountzi, Efstratia Baili, Alexandros Charalabopoulos, Theodore Liakakos, Dimitrios Schizas, Alexandros Kozadinos, Athanasios Syllaios, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Spiros Delis, Christos Farazi-Chongouki, Evangelos Kalaitzakis, Miltiadis Giannarakis, Konstantinos Lasithiotakis, Giorgia Petra, Evangelos Kalaitzakis, Amit Gupta, Noushif Medappil, Vijayanand Muthukrishnan, Jubin Kamar, Pawan Lal, Rajendra Agarwal, Matteo Magnoli, Paolo Aonzo, Alberto Serventi, Pierpaolo Di Lascio, Margherita Pinto, Carlo Bergamini, Andrea Bottari, Laura Fortuna, Jacopo Martellucci, Atea Cicako, Claudio Miglietta, Mario Morino, Daniele Delogu, Andrea Picchetto, Marco Assenza, Giancarlo D'Ambrosio, Giulio Argenio, Mariano Fortunato Armellino, Giovanna Ioia, Savino Occhionorelli, Dario Andreotti, Lacavalla Domenico, Davide Luppi, Massimiliano Casadei, Luca Di Donato, Farshad Manoochehri, Tiziana Rita Lucia Marchese, William Sergi, Roberto Manca, Raimondo Murgia, Enrico Piras, Lorenzo Conti, Simone Gianazza, Andrea Rizzi, Edoardo Segalini, Marco Monti, Elena Iiritano, Nicolò Maria Mariani, Enrico De Nicola, Giovanna Scifo, Giusto Pignata, Jacopo Andreuccetti, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Alan Biloslavo, Paola Germani, Manuela Mastronardi, Selene Bogoni, Silvia Palmisano, Nicolo' De Manzini, Marco Vito Marino, Gennaro Martines, Giuseppe Trigiante, Elpiniki Lagouvardou, Gabriele Anania, Cristina Bombardini, Dario Oppici, Tiziana Pilia, Valentina Murzi, Emanuela Gessa, Umberto Bracale, Maria Michela Di Nuzzo, Roberto Peltrini, Francesco Salvetti, Jacopo Viganò, Gabriele Sganga, Valentina Bianchi, Pietro Fransvea, Tommaso Fontana, Giuliano Sarro, Vincenza Paola Dinuzzi, Luca Scaravilli, Mario Virgilio Papa, Elio Jovine, Giulia Ciabatti, Laura Mastrangelo, Matteo Rottoli, Claudio Ricci, Iris Shari Russo, Alberto Aiolfi, Davide Bona, Francesca Lombardo, Pasquale Cianci, Mariagrazia Sederino, Roberto Bini, Osvaldo Chiara, Stefano Cioffi, Stefano Cantafio, Guido Coretti, Edelweiss Licitra, Grazia Savino, Sergio Grimaldi, Raffaele Porfidia, Elisabetta Moggia, Mauro Garino, Chiara Marafante, Antonio Pesce, Nicolò Fabbri, Carlo Vittorio Feo, Ester Marra, Marina Troian, Davide Drigo, Carlo Nagliati, Andrea Muratore, Riccardo Danna, Alessandra Murgese, Michele Crespi, Claudio Guerci, Alice Frontali, Luca Ferrari, Claudio Guerci, Francesco Favi, Erika Picariello, Alessia Rampini, Fabrizio D'Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Palmieri, Matteo Calì, Francesco Ferrara, Irnerio Angelo Muttillo, Edoardo Maria Muttillo, Biagio Picardi, Raffaele Galleano, Ali Badran, Omar Ghazouani, Maurizio Cervellera, Gaetano Campanella, Gennaro Papa, Annamaria Di Bella, Gennaro Perrone, Gabriele Luciano Petracca, Concetta Prioriello, Mario Giuffrida, Federico Cozzani, Matteo Rossini, Marco Inama, Giovanni Butturini, Gianluigi Moretto, Luca Morelli, Giulio Candio, Simone Guadagni, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Valerio Genovese, Nicola Cillara, Alessandro Cannavera, Antonello Deserra, Arcangelo Picciariello, Vincenzo Papagni, Leonardo Vincenti, Giulia Bagaglini, Giuseppe Sica, Pierfrancesco Lapolla, Gioia Brachini, Dario Bono, Antonella Nicotera, Marcello Zago, Fabrizio Sammartano, Laura Benuzzi, Marco Stella, Stefano Rossi, Alessandra Cerioli, Caterina Puccioni, Stefano Olmi, Carolina Rubicondo, Matteo Uccelli, Anna Guida, Pasquale Lepiane, Diego Sasia, Giorgio Giraudo, Sara Salomone, Elena Belloni, Alessandra Cossa, Francesco Lancellotti, Roberto Caronna, Piero Chirletti, Paolina Saullo, Raffaele Troiano, Felice Mucilli, Mirko Barone, Massimo Ippoliti, Michele Grande, Bruno Sensi, Leandro Siragusa, Andrea Santini, Isidoro Di Carlo, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Giuseppe Currò, Michele Ammendola, Iman Komaei, Giuseppe Navarra, Valeria Tonini, Lodovico Sartarelli, Marco Ceresoli, Stefano Perrone, Linda Roccamatisi, Paolo Millo, Riccardo Brachet Contul, Elisa Ponte, Matteo Zuin, Giuseppe Portale, Alice Sabrina Tonello, Geri Fratini, Matteo Bianchini, Bruno Perotti, Emanuele Doria, Elia Giuseppe Lunghi, Diego Visconti, Khayry Al-Shami, Sajeda Awadi, Mohammad Musallam Khalil Buwaitel, Mo'taz Fawzat Naief Naffa', Ahmad Samhouri, Hatem Sawalha, Mohd Firdaus Che Ani, Ida Nadiah Ahmed Fathil, Jih Huei, Ikhwan Sani Mohamad, Jose-Luis Beristain-Hernandez, Alejandro Garcia-Meza, Rafael Sepulveda-Rdriguez, Edgard Efren Lozada Hernández, Camilo Levi Acuña Pinzón, Jefferson Nieves Condoy, Francisco C Becerra García, Mohammad Sadik, Bushra Kadir, Jalpa Devi, Nandlal Seerani, Zainab, Mohammad Sohail-Asghar, Ameer Afzal, Ali Akbar, Helmut Segovia Lohse, Herald Segovia Lohse, Zamiara Solange Leon Cabrera, Gaby Susana Yamamoto Seto, José Ríos Chiuyari, Jorge Ordemar, Martha Rodríguez, Abigail Cheska C Orantia-Carlos, Margie Antionette Quitoy, Andrzej Kwiatkowski, Maciej Mawlichanów, Mónica Rocha, Carlos Soares, Alexandru Rares Stoian, Andreea Diana Draghici, Valentin Titus Grigorean, Raluca Bievel Radulescu, Narcis Octavian Zarnescu, Radu Virgil Costea, Eugenia Claudia Zarnescu, Mikhail Kurtenkov, George Gendrikson, Volovich Alla-Angelina, Tsurbanova Arina, Ayrat Kaldarov, Ayrat Kaldarov, Mahir Gachabayov, Abakar Abdullaev, Milica Milentijevic, Milovan Karamarkovic, Arpád Panyko, Jozef Radonak, Marek Soltes, Laura Álvarez Morán, Haydée Calvo García, Pilar Suárez Vega, Sergio Estevez, Fabio Ausania, Jordi Farguell, Carolina González-Abós, Santiago Sánchez-Cabús, Belén Martín, Víctor Molina, Luis Oms, Lucas Ilzarbe, Eva Pont Feijóo, Elena Sofia Perra, Noel Rojas-Bonet, Rafael Penalba-Palmí, Susana Pérez-Bru, Jaume Tur-Martínez, Andrea Álvarez-Torrado, Marta Domingo-Gonzalez, Javier Tejedor-Tejada, Yaiza García Del Alamo, Fernando Mendoza-Moreno, Francisca García-Moreno-Nisa, Belén Matías-García, Manuel Durán, Rafael Calleja-Lozano, José Manuel Perez de Villar, Luis Sánchez-Guillén, Iban Caravaca, Daniel Triguero-Cánovas, Antonio Carlos Maya Aparicio, Blas Durán Meléndez, Andrea Masiá Palacios, Aitor Landaluce-Olavarria, Mario De Francisco, Begoña Estraviz-Mateos, Felipe Alconchel, Tatiana Nicolás-López, Pablo Ramírez, Virginia Duran Muñoz-Cruzado, Felipe Parej Ciuró, Eduardo Perea Del Pozo, Sergio Olivares Pizarro, Vicente Herrera Cabrera, Jose Muros Bayo, Hytham K S Hamid, Raffaello Roesel, Alessandra Cristaudi, Kinan Abbas, Iyad Ali, Ahmed Tlili, Hüseyin Bayhan, Mehmet Akif Türkoğlu, Mustafa Yener Uzunoglu, Ibrahim Fethi Azamat, Nail Omarov, Derya Salim Uymaz, Fatih Altintoprak, Emrah Akin, Necattin First, Koray Das, Nazmi Ozer, Ahmet Seker, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Semra Demirli Atici, Murat Akalin, Bulent Calik, Elif Colak, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Victoria Hudson, Jean-Luc Duval, Mansoor Khan, Ahmed Saad, Mandeep Kaur, Alison Bradley, Katherine Fox, Ivan Tomasi, Daniel Beasley, Alekhya Kotta Prasanti, Pinky Kotecha, Husam Ebied, Michaela Paul, Hemant Sheth, Ioannis Gerogiannis, Mohannad Gaber, Zara Sheikh, Shatadru Seth, Maria Kunitsyna, Cosimo Alex Leo, Vittoria Bellato, Noman Zafar, Amr Elserafy, Giles Bond-Smith, Giovanni Tebala, Pawan Mathur, Izza Abid, Nnaemeka Chidumije, Pardip Sandhar, Syed Osama Zohaib Ullah, Tamara Lezama, Muhammad Hassan Anwaar, Conor Magee, Salma Ahmed, Brooke Davies, Jeyakumar Apollos, Kieran McCormack, Hasham Choudhary, Triantafyllos Doulias, Tamsin Morrison, Anna Palepa, Fernando Bonilla Cal, Lianet Sánchez, Fabiana Domínguez, Ibrahim Al-Raimi, Haneen Alshargabi, Abdullah Meead, Serge Chooklin, Serhii Chuklin, Andriy Bilyak, HUS Abdominal Center, II kirurgian klinikka, Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di Martino, M, Pisanu, A, Gerardi, C, Gourgiotis, S, Riboni, C, Giordano, A, Ferrario, L, Agnoletti, V, Kruger, Y, Mole, D, Agresta, F, Prieto Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Villalabeitia, I, Quispe-Cruz, D, Orantia, A, Waledziak, M, de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Couto Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief, G, Salah Alzhraa, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Synekidou, E, Dakis, K, Alexandridou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, Germani, P, Mastronardi, M, Bogoni, S, Palmisano, S, De Manzini, N, Marino, M, Martines, G, Trigiante, G, Lagouvardou, E, Anania, G, Bombardini, C, Oppici, D, Pilia, T, Murzi, V, Gessa, E, Bracale, U, Di Nuzzo, M, Peltrini, R, Salvetti, F, Vigano, J, Sganga, G, Bianchi, V, Fransvea, P, Fontana, T, Sarro, G, Dinuzzi, V, Scaravilli, L, Papa, M, Jovine, E, Ciabatti, G, Mastrangelo, L, Rottoli, M, Ricci, C, Russo, I, Aiolfi, A, Bona, D, Lombardo, F, Cianci, P, Sederino, M, Bini, R, Chiara, O, Cantafio, S, Coretti, G, Licitra, E, Savino, G, Grimaldi, S, Porfidia, R, Moggia, E, Garino, M, Marafante, C, Pesce, A, Fabbri, N, Feo, C, Marra, E, Troian, M, Drigo, D, Nagliati, C, Muratore, A, Danna, R, Murgese, A, Crespi, M, Guerci, C, Frontali, A, Ferrari, L, Favi, F, Picariello, E, Rampini, A, D'Acapito, F, Ercolani, G, Solaini, L, Palmieri, F, Cali, M, Ferrara, F, Muttillo, I, Muttillo, E, Picardi, B, Galleano, R, Badran, A, Ghazouani, O, Cervellera, M, Campanella, G, Papa, G, Di Bella, A, Perrone, G, Petracca, G, Prioriello, C, Giuffrida, M, Cozzani, F, Rossini, M, Inama, M, Butturini, G, Moretto, G, Morelli, L, Candio, G, Guadagni, S, Cicuttin, E, Cremonini, C, Tartaglia, D, Genovese, V, Cillara, N, Cannavera, A, Deserra, A, Picciariello, A, Papagni, V, Vincenti, L, Bagaglini, G, Sica, G, Lapolla, P, Brachini, G, Bono, D, Nicotera, A, Zago, M, Sammartano, F, Benuzzi, L, Stella, M, Rossi, S, Cerioli, A, Puccioni, C, Olmi, S, Rubicondo, C, Uccelli, M, Guida, A, Lepiane, P, Sasia, D, Giraudo, G, Salomone, S, Belloni, E, Cossa, A, Lancellotti, F, Caronna, R, Chirletti, P, Saullo, P, Troiano, R, Mucilli, F, Barone, M, Ippoliti, M, Grande, M, Sensi, B, Siragusa, L, Santini, A, Di Carlo, I, Veroux, M, Gioco, R, Veroux, G, Curro, G, Ammendola, M, Komaei, I, Navarra, G, Tonini, V, Sartarelli, L, Ceresoli, M, Perrone, S, Roccamatisi, L, Millo, P, Brachet Contul, R, Ponte, E, Zuin, M, Portale, G, Tonello, A, Fratini, G, Bianchini, M, Perotti, B, Doria, E, Lunghi, E, Visconti, D, Al-Shami, K, Awadi, S, Buwaitel, M, Naffa', M, Samhouri, A, Sawalha, H, Ani, M, Fathil, I, Huei, J, Beristain-Hernandez, J, Garcia-Meza, A, Sepulveda-Rdriguez, R, Hernandez, E, Pinzon, C, Condoy, J, Garcia, F, Sadik, M, Kadir, B, Devi, J, Seerani, N, Zainab, Sohail-Asghar, M, Afzal, A, Akbar, A, Lohse, H, Cabrera, Z, Seto, G, Chiuyari, J, Ordemar, J, Rodriguez, M, Orantia-Carlos, A, Quitoy, M, Kwiatkowski, A, Mawlichanow, M, Rocha, M, Soares, C, Stoian, A, Draghici, A, Grigorean, V, Radulescu, R, Costea, R, Zarnescu, E, Kurtenkov, M, Gendrikson, G, Alla-Angelina, V, Arina, T, Kaldarov, A, Gachabayov, M, Abdullaev, A, Milentijevic, M, Karamarkovic, M, Panyko, A, Radonak, J, Soltes, M, Moran, L, Garcia, H, Vega, P, Estevez, S, Ausania, F, Farguell, J, Gonzalez-Abos, C, Sanchez-Cabus, S, Martin, B, Molina, V, Oms, L, Ilzarbe, L, Feijoo, E, Perra, E, Rojas-Bonet, N, Penalba-Palmi, R, Perez-Bru, S, Tur-Martinez, J, Alvarez-Torrado, A, Domingo-Gonzalez, M, Tejedor-Tejada, J, del Alamo, Y, Mendoza-Moreno, F, Garcia-Moreno-Nisa, F, Matias-Garcia, B, Duran, M, Calleja-Lozano, R, de Villar, J, Sanchez-Guillen, L, Caravaca, I, Triguero-Canovas, D, Aparicio, A, Melendez, B, Palacios, A, Landaluce-Olavarria, A, De Francisco, M, Estraviz-Mateos, B, Alconchel, F, Nicolas-Lopez, T, Ramirez, P, Munoz-Cruzado, V, Ciuro, F, del Pozo, E, Pizarro, S, Cabrera, V, Bayo, J, Hamid, H, Roesel, R, Cristaudi, A, Abbas, K, Ali, I, Tlili, A, Bayhan, H, Turkoglu, M, Uzunoglu, M, Azamat, I, Omarov, N, Uymaz, D, Altintoprak, F, Akin, E, First, N, Das, K, Ozer, N, Seker, A, Kara, Y, Bozkurt, M, Kocatas, A, Atici, S, Akalin, M, Calik, B, Colak, E, Altinel, Y, Meric, S, Aktimur, Y, Hudson, V, Duval, J, Khan, M, Saad, A, Kaur, M, Bradley, A, Fox, K, Tomasi, I, Beasley, D, Prasanti, A, Kotecha, P, Ebied, H, Paul, M, Sheth, H, Gerogiannis, I, Gaber, M, Sheikh, Z, Seth, S, Kunitsyna, M, Leo, C, Bellato, V, Zafar, N, Elserafy, A, Bond-smith, G, Tebala, G, Mathur, P, Abid, I, Chidumije, N, Sandhar, P, Ullah, S, Lezama, T, Anwaar, M, Magee, C, Ahmed, S, Davies, B, Apollos, J, Mccormack, K, Choudhary, H, Doulias, T, Morrison, T, Palepa, A, Cal, F, Sanchez, L, Dominguez, F, Al-Raimi, I, Alshargabi, H, Meead, A, Chooklin, S, Chuklin, S, Bilyak, A, MANCTRA-1 Collaborative, Group, Palmisano, Silvia, and de Manzini, Nicolo'

Subjects
Infected pancreatic necrosi, Digestive System Diseases::Pancreatic Diseases::Pancreatitis::Pancreatitis, Acute Necrotizing [DISEASES], Infected pancreatic necrosis, Pàncrees - Infecció, 3126 Surgery, anesthesiology, intensive care, radiology, enfermedades del sistema digestivo::enfermedades pancreáticas::pancreatitis::pancreatitis aguda necrotizante [ENFERMEDADES], técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Acute pancreatitis, infecciones bacterianas y micosis::infección::infecciones intraabdominales [ENFERMEDADES], Pancreatitis, International study, Organ failure, Surgery, Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Mortality, Acute pancreatiti, Pàncrees - Necrosi, Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [DISEASES]
Abstract

The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990). Graphical abstract

Published
2023

25. Safety of antithrombotic therapy in subjects with hereditary hemorrhagic telangiectasia: prospective data from a multidisciplinary working group

Author

Eleonora Gaetani, Fabiana Agostini, Angelo Porfidia, Igor Giarretta, Daniela Feliciani, Luigi Di Martino, Annalisa Tortora, Antonio Gasbarrini, Roberto Pola, and on behalf of the Multidisciplinary Gemelli Group for HHT

Subjects
Medicine
Abstract

Abstract Subjects with the rare autosomal dominant disease Hereditary Hemorrhagic Telangiectasia (HHT) may develop medical conditions that require antithrombotic therapy (AT). However, safety of AT is uncertain in these patients and the only data currently available derive from retrospective analyses of registries and/or databases. At the HHT Centre of the ‘Fondazione Policlinico Universitario A. Gemelli IRCCS’ (Rome, Italy), a prospective study is currently ongoing to evaluate the safety of AT in subjects affected by HHT. The study is enrolling subjects with a definite diagnosis of HHT who receive an AT prescription by one of the physicians of the HHT Centre. The primary outcome is the number of hemorrhagic events, distinguished in major, clinically relevant non-major (CRNM), and minor bleedings, according to the criteria of the International Society on Thrombosis and Hemostasis (ISTH). Another primary outcome is worsening of epistaxis upon initiation of AT, assessed using the internationally accepted Epistaxis Severity Score (ESS). Additional outcomes are changes in hemoglobin levels and changes in the need of blood transfusion after initiation of AT. Here, we present the results of an interim analysis, conducted on the 12 HHT subjects that have been enrolled so far. After a mean follow-up of 6.5 ± 0.8 months, no major bleedings, no CRNM bleedings, and no minor bleedings different from epistaxis were recorded. Worsening of epistaxis upon initiation of AT was documented only in one patient, but did not require discontinuation of AT. There were no significant changes in the mean ESS measured before and after initiation of AT. There were no significant changes in hemoglobin levels and need for blood transfusion after initiation of AT. Although preliminary, these are the first prospective data on the safety of AT in HHT patients. Our interim analysis suggests that, when prescribed by experienced physicians in a multidisciplinary setting, AT is well tolerated by HHT patients. More patients and a longer follow-up are needed to confirm these findings.

Published
2019
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27. Analysis of Pros and Cons in Using [68Ga]Ga-PSMA-11 and [18F]PSMA-1007: Production, Costs, and PET/CT Applications in Patients with Prostate Cancer

Author

Costantina Maisto, Michela Aurilio, Anna Morisco, Roberta de Marino, Monica Josefa Buonanno Recchimuzzo, Luciano Carideo, Laura D’Ambrosio, Francesca Di Gennaro, Aureliana Esposito, Paolo Gaballo, Valentina Pirozzi Palmese, Valentina Porfidia, Marco Raddi, Alfredo Rossi, Elisabetta Squame, and Secondo Lastoria

Subjects
PCa, [68Ga]Ga-PSMA-11, [18F]PSMA-1007, PSMA, [68Ge]/[68Ga] generator, cyclotron RCY, Organic chemistry, QD241-441
Abstract

The aim of this work is to compare [68Ga]Ga-PSMA-11 and [18F]PSMA-1007 PET/CT as imaging agents in patients with prostate cancer (PCa). Comparisons were made by evaluating times and costs of the radiolabeling process, imaging features including pharmacokinetics, and impact on patient management. The analysis of advantages and drawbacks of both radioligands might help to make a better choice based on firm data. For [68Ga]Ga-PSMA-11, the radiochemical yield (RCY) using a low starting activity (L, average activity of 596.55 ± 37.97 MBq) was of 80.98 ± 0.05%, while using a high one (H, average activity of 1436.27 ± 68.68 MBq), the RCY was 71.48 ± 0.04%. Thus, increased starting activities of [68Ga]-chloride negatively influenced the RCY. A similar scenario occurred for [18F]PSMA-1007. The rate of detection of PCa lesions by Positron Emission Tomography/Computed Tomography (PET/CT) was similar for both radioligands, while their distribution in normal organs significantly differed. Furthermore, similar patterns of biodistribution were found among [18F]PSMA-1007, [68Ga]Ga-PSMA-11, and [177Lu]Lu-PSMA-617, the most used agent for RLT. Moreover, the analysis of economical aspects for each single batch of production corrected for the number of allowed PET/CT examinations suggested major advantages of [18F]PSMA-1007 compared with [68Ga]Ga-PSMA-11. Data from this study should support the proper choice in the selection of the PSMA PET radioligand to use on the basis of the cases to study.

Published
2022
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28. Antithrombotic treatment for retinal vein occlusion: a systematic review and meta-analysis

Author

Emanuele Valeriani, Francesco Paciullo, Angelo Porfidia, Pasquale Pignatelli, Matteo Candeloro, Marcello Di Nisio, Marco Paolo Donadini, Claudio Maria Mastroianni, Roberto Pola, Paolo Gresele, and Walter Ageno

Subjects
anticoagulants, aspirin, retinal vein occlusion, Hematology, anticoagulants, aspirin, low-molecular-weight heparin, retinal vein occlusion, thrombosis, low-molecular-weight heparin, thrombosis
Published
2023
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29. Risk of intracranial bleeding in patients with primary brain cancer receiving therapeutic anticoagulation for venous thromboembolism: A meta‐analysis

Author

Angelo Porfidia, Marzia Giordano, Carmelo L. Sturiale, Sonia D’Arrigo, Marco P. Donadini, Alessandro Olivi, Walter Ageno, and Roberto Pola

Subjects
anticoagulation, brain cancer, intracranial hemorrhage, meta‐analysis, venous thromboembolism, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Introduction Venous thromboembolism (VTE) is common in glioma patients. Also, spontaneous intracerebral hemorrhage (ICH) is frequently observed in subjects with primary brain tumors. Thus, the management of anticoagulant therapy for VTE is challenging and controversial in these patients. We performed a meta‐analysis to clarify the risk of ICH in glioma patients treated with anticoagulant therapy for VTE compared to glioma patients without VTE. Materials and Methods A systematic search of the literature was conducted using PubMed, Scopus, and EMBASE databases between January 1980 and January 2019 without language restrictions. Summary statistics for ICH were obtained by calculating the odds ratio (OR) using a random effects model, and heterogeneity across studies was estimated by the I2 statistic. The Newcastle–Ottawa Scale was used to evaluate the quality of studies. Results A total of 368 studies were initially identified. Of these, 346 were excluded after title review. The remaining 22 studies were reviewed in detail. According to the PICO criteria, 15 studies were excluded. Finally, 7 studies were included in the meta‐analysis. The OR for ICH in glioma patients receiving therapeutic anticoagulation for VTE versus those who did not receive anticoagulation was 3.66 (95% confidence interval [CI], 1.84–7.29; I2 = 31%). Conclusions This meta‐analysis demonstrates that anticoagulation for VTE increases the risk of ICH in subjects with malignant brain tumors. Future studies are warranted to fully understand the best medical treatment of VTE in glioma patients.

Published
2020
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32. No evidence of increased rate of thrombotic recurrences in patients with history of venous thromboembolism after vaccination for COVID-19

Author

Porfidia, Angelo, Esposto, Giorgio, Manzo, Cecilia, Santini, Paolo, Pola, Roberto, Porfidia A. (ORCID:0000-0003-4915-2892), Esposto G., Manzo C. (ORCID:0000-0002-0111-8663), Santini P., Pola R. (ORCID:0000-0001-5224-2931), Porfidia, Angelo, Esposto, Giorgio, Manzo, Cecilia, Santini, Paolo, Pola, Roberto, Porfidia A. (ORCID:0000-0003-4915-2892), Esposto G., Manzo C. (ORCID:0000-0002-0111-8663), Santini P., and Pola R. (ORCID:0000-0001-5224-2931)

Abstract

N/A

Published
2022

33. A Single Center Retrospective Cohort Study Comparing Different Anticoagulants for the Treatment of Catheter-Related Thrombosis of the Upper Extremities in Women With Gynecologic and Breast Cancer

Author

Porfidia, Angelo, Cammà, Giulia, Coletta, Nicola, Bigossi, Margherita, Giarretta, Igor, Lupascu, Andrea, Scaletta, Giuseppe, Porceddu, Enrica, Tondi, Paolo, Scambia, Giovanni, Ferrandina, Maria Gabriella, Pola, Roberto, Porfidia, Angelo (ORCID:0000-0003-4915-2892), Giarretta, Igor (ORCID:0000-0001-5380-0843), Tondi, Paolo (ORCID:0000-0003-1654-2448), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Ferrandina, Gabriella (ORCID:0000-0003-4672-4197), Pola, Roberto (ORCID:0000-0001-5224-2931), Porfidia, Angelo, Cammà, Giulia, Coletta, Nicola, Bigossi, Margherita, Giarretta, Igor, Lupascu, Andrea, Scaletta, Giuseppe, Porceddu, Enrica, Tondi, Paolo, Scambia, Giovanni, Ferrandina, Maria Gabriella, Pola, Roberto, Porfidia, Angelo (ORCID:0000-0003-4915-2892), Giarretta, Igor (ORCID:0000-0001-5380-0843), Tondi, Paolo (ORCID:0000-0003-1654-2448), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Ferrandina, Gabriella (ORCID:0000-0003-4672-4197), and Pola, Roberto (ORCID:0000-0001-5224-2931)

Abstract

BackgroundCatheter-related thrombosis (CRT) of the upper extremities is a frequent complication among cancer patients that carry a central venous catheter (CVC) and may lead to pulmonary embolism (PE) and loss of CVC function. Despite its clinical impact, no anticoagulant treatment scheme has been rigorously evaluated in these patients. In addition, there is no proven evidence that direct oral anticoagulants (DOACs) are efficacious and safe in this setting because cancer patients with CRT of the upper extremities were not included in the clinical trials that led to the approval of DOACs for the treatment of cancer-associated venous thromboembolism (VTE). MethodsWe performed a single center retrospective cohort study on women with gynecologic or breast cancer treated with either low-molecular-weight heparin, fondaparinux, or DOACs for CRT of the upper extremities. Only patients who received anticoagulation at the proper therapeutic dose and for at least 3 months were included in the analysis. Effectiveness was evaluated in terms of preservation of line function, residual thrombosis, and recurrence of VTE (including PE). Safety was evaluated in terms of death, major bleeding (MB), and clinically relevant non-major bleeding (CRNMB). ResultsWe identified 74 women who fulfilled the criteria to be included in the analysis. Of these, 31 (41.9%) had been treated with fondaparinux, 21 (28.4%) with enoxaparin, and 22 (29.7%) with the DOAC edoxaban. We found no differences between patients treated with the three different therapeutic approaches, in terms of preservation of line function, incidence of residual thrombosis, and VTE recurrence (including PE). Safety was similar as well, with no MBs recorded in any treatment group. ConclusionThese results, although retrospective and based on a relatively small sample size, indicate that, in women with gynecologic or breast cancer, CRT of the upper extremities may be treated with similar effectiveness and safety with fondaparinux, e

Published
2022

34. Distribution of Cerebrovascular Phenotypes According to Variants of the ENG and ACVRL1 Genes in Subjects with Hereditary Hemorrhagic Telangiectasia

Author

Gaetani, Eleonora, Peppucci, Elisabetta, Agostini, Fabiana, Di Martino, Luigi, Lucci Cordisco, Emanuela, Sturiale, Carmelo Lucio, Puca, Alfredo, Porfidia, Angelo, Alexandre, Andrea, Pedicelli, Alessandro, Pola, Roberto, Eleonora Gaetani (ORCID:0000-0002-7808-1491), Luigi Di Martino, Emanuela Lucci Cordisco (ORCID:0000-0002-6279-7604), Carmelo L. Sturiale (ORCID:0000-0002-4080-2492), Alfredo Puca (ORCID:0000-0001-6096-1776), Angelo Porfidia (ORCID:0000-0003-4915-2892), Andrea Alexandre, Alessandro Pedicelli (ORCID:0000-0002-2558-8838), Roberto Pola (ORCID:0000-0001-5224-2931), Gaetani, Eleonora, Peppucci, Elisabetta, Agostini, Fabiana, Di Martino, Luigi, Lucci Cordisco, Emanuela, Sturiale, Carmelo Lucio, Puca, Alfredo, Porfidia, Angelo, Alexandre, Andrea, Pedicelli, Alessandro, Pola, Roberto, Eleonora Gaetani (ORCID:0000-0002-7808-1491), Luigi Di Martino, Emanuela Lucci Cordisco (ORCID:0000-0002-6279-7604), Carmelo L. Sturiale (ORCID:0000-0002-4080-2492), Alfredo Puca (ORCID:0000-0001-6096-1776), Angelo Porfidia (ORCID:0000-0003-4915-2892), Andrea Alexandre, Alessandro Pedicelli (ORCID:0000-0002-2558-8838), and Roberto Pola (ORCID:0000-0001-5224-2931)

Abstract

Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder caused, in more than 80% of cases, by mutations of either the endoglin (ENG) or the activin A receptorlike type 1 (ACVRL1) gene. Several hundred variants have been identified in these HHT-causing genes, including deletions, missense and nonsense mutations, splice defects, duplications, and insertions. In this study, we have analyzed retrospectively collected images of magnetic resonance angiographies (MRA) of the brain of HHT patients, followed at the HHT Center of our University Hospital, and looked for the distribution of cerebrovascular phenotypes according to specific gene variants. We found that cerebrovascular malformations were heterogeneous among HHT patients, with phenotypes that ranged from classical arteriovenous malformations (AVM) to intracranial aneurysms (IA), developmental venous anomalies (DVA), and cavernous angiomas (CA). There was also wide heterogeneity among the variants of the ENG and ACVRL1 genes, which included known pathogenic variants, variants of unknown significance, variants pending classification, and variants which had not been previously reported. The percentage of patients with cerebrovascular malformations was significantly higher among subjects with ENG variants than ACVRL1 variants (25.0% vs. 13.1%, p < 0.05). The prevalence of neurovascular anomalies was different among subjects with different gene variants, with an incidence that ranged from 3.3% among subjects with the c.1231C > T, c.200G > A, or c.1120C > T missense mutations of the ACVRL1 gene, to 75.0% among subjects with the c.1435C > T missense mutation of the ACVRL1 gene. Further studies and larger sample sizes are required to confirm these findings.

Published
2022

35. Anticoagulant treatment for upper extremity deep vein thrombosis: A systematic review and meta-analysis

Author

Valeriani, E., Di Nisio, M., Porceddu, E., Agostini, F., Pola, R., Spoto, S., Donadini, M. P., Ageno, W., Porfidia, A., Agostini F., Pola R. (ORCID:0000-0001-5224-2931), Porfidia A. (ORCID:0000-0003-4915-2892), Valeriani, E., Di Nisio, M., Porceddu, E., Agostini, F., Pola, R., Spoto, S., Donadini, M. P., Ageno, W., Porfidia, A., Agostini F., Pola R. (ORCID:0000-0001-5224-2931), and Porfidia A. (ORCID:0000-0003-4915-2892)

Abstract

Background: Data on anticoagulant treatment for upper extremity deep vein thrombosis (UEDVT) are largely derived from studies on usual site venous thromboembolism (VTE). Objectives: The objective of this meta-analysis was to evaluate the efficacy and safety of anticoagulant therapy for UEDVT. Patients/Methods: A systematic search of MEDLINE and EMBASE was conducted for studies including patients with UEDVT. Primary outcomes were recurrent VTE and major bleeding. Secondary outcomes included clinically-relevant non-major bleeding and all-cause mortality. Summary estimates with 95% confidence intervals (CIs) were calculated by random-effect meta-analysis. Results: A total of 1473 patients from 11 prospective and nine retrospective studies were included. Sixty percent of patients had an indwelling catheter and 56.1% had cancer. Anticoagulant treatment consisted of direct oral anticoagulants, low molecular weight heparin followed by vitamin K antagonists, and low molecular weight heparin alone in 45.1%, 35.0%, and 19.9% of patients, respectively. During a median follow-up of 13 months, recurrent VTE occurred in 3% of patients (95% CI: 2–4; 21/1334 patients), major bleeding in 3% (95% CI: 2%–5%; 29/1235 patients), clinically-relevant non-major bleeding in 4% (95% CI: 3–6; 40/1075 patients), and all-cause mortality in 9% (95% CI: 5–15; 108/1084 patients). Rates of these outcomes were not significantly different between patients with or without cancer, patients with or without an indwelling catheter, and among those receiving different anticoagulant treatments. Conclusions: In patients with UEDVT, anticoagulant treatment is associated with a low risk of recurrent VTE and a nonnegligible risk of major bleeding.

Published
2022

37. Differences in Clinical Presentation, Rate of Pulmonary Embolism, and Risk Factors Among Patients With Deep Vein Thrombosis in Unusual Sites

Author

Angelo Porfidia MD, Enrica Porceddu MD, Daniela Feliciani MD, Marzia Giordano MD, Fabiana Agostini MD, Giulia Ciocci MD, Giulia Cammà MD, Igor Giarretta MD, Eleonora Gaetani MD, Paolo Tondi MD, and Roberto Pola MD, PhD

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Unusual site deep vein thrombosis (USDVT) is an uncommon form of venous thromboembolism with heterogeneous signs and symptoms, unknown rate of pulmonary embolism (PE), and poorly defined risk factors. We conducted a retrospective analysis of 107 consecutive cases of USDVTs, discharged from our University Hospital over a period of 2 years. Patients were classified based on the site of thrombosis and distinguished between patients with cerebral vein thrombosis, jugular vein thrombosis, thrombosis of the deep veins of the upper extremities, and abdominal vein thrombosis. We found statistically significant differences between groups in terms of age ( P < .0001) and gender distribution ( P < .05). We also found that the rate of symptomatic patients was significantly different between groups ( P < .0001). Another interesting finding was the significant difference between groups in terms of rate of PE ( P < .01). Finally, we found statistically significant differences between groups in terms of risk factors for thrombosis, in particular cancer ( P < .01). Unprovoked cases were differently distributed among groups ( P < .0001). This study highlights differences between patients with USDVT, which depend on the site of thrombosis, and provides data which might be useful in clinical practice.

Published
2019
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39. Emergency hernia repair in the elderly: multivariate analysis of morbidity and mortality from an Italian registry

Author

Ceresoli, M, Carissimi, F, Nigro, A, Fransvea, P, Lepre, L, Braga, M, Costa, G, Agresta, F., Alemanno, G., Anania, G., Antropoli, M., Argenio, G., Atzeni, J., Avenia, N., Azzinnaro, A., Baldazzi, G., Balducci, G., Barbera, G., Bellanova, G., Bergamini, C., Bersigotti, L., Bianchi, Pp., Bombardini, C., Borzellino, G., Bozzo, S., Brachini, G., Buonanno, Gm., Canini, T., Cardella, S., Carrara, G., Cassini, D., Castriconi, M., Ceccarelli, G., Celi, D., Ceresoli, M., Chiappetta, M., Chiarugi, M., Cillara, N., Cimino, F., Cobuccio, L., Cocorullo, G., Colangelo, E., Costa, G., Crucitti, A., Dallacaneva, P., De Luca, M., de Manzoni Garberini, A., De Nisco, C., De Prizio, M., De Sol, A., Dibella, A., Falcioni, T., Falco, N., Farina, C., Finotti, E., Fontana, T., Francioni, G., Fransvea, P., Frezza, B., Garbarino, G., Garulli, G., Genna, M., Giannessi, S., Gioffrè, A., Giordano, A., Gozzo, D., Grimaldi, S., Gulotta, G., Iacopini, V., Iarussi, T., Laracca, G., Laterza, E., Leonardi, A., Lepre, L., Lorenzon, L., Luridiana, G., Malagnino, A., Mar, G., Marini, P., Marzaioli, R., Massa, G., Mecarelli, V., Mercantini, P., Mingoli, A., Nigri, G., Occhionorelli, S., Paderno, N., Palini, Gm., Paradies, D., Paroli, M., Perrone, F., Petrucciani, N., Petruzzelli, L., Pezzolla, A., Piazza, D., Piazza, V., Piccoli, M., Pisanu, A., Podda, M., Poillucci, G., Porfidia, R., Rossi, G., Ruscelli, P., Spagnoli, A., Sulis, R., Tartaglia, D., Tranà, C., Travaglino, A., Tomaiuolo, P., Valeri, A., Vasquez, G., Zago, M., E. Zanoni., Ceresoli M., Carissimi F., Nigro A., Fransvea P., Lepre L., Braga M., Costa G., Agresta F., Alemanno G., Anania G., Antropoli M., Argenio G., Atzeni J., Avenia N., Azzinnaro A., Baldazzi G., Balducci G., Barbera G., Bellanova G., Bergamini C., Bersigotti L., Bianchi P.P., Bombardini C., Borzellino G., Bozzo S., Brachini G., Buonanno G.M., Canini T., Cardella S., Carrara G., Cassini D., Castriconi M., Ceccarelli G., Celi D., Chiappetta M., Chiarugi M., Cillara N., Cimino F., Cobuccio L., Cocorullo G., Colangelo E., Crucitti A., DallaCaneva P., Luca M., de Manzoni Garberini A., De Nisco C., De Prizio M., De Sol A., Dibella A., Falcioni T., Falco N., Farina C., Finotti E., Fontana T., Francioni G., Frezza B., Garbarino G., Garulli G., Genna M., Giannessi S., Gioffre A., Giordano A., Gozzo D., Grimaldi S., Gulotta G., Iacopini V., Iarussi T., Laracca G., Laterza E., Leonardi A., Lorenzon L., Luridiana G., Malagnino A., Mar G., Marini P., Marzaioli R., Massa G., Mecarelli V., Mercantini P., Mingoli A., Nigri G., Occhionorelli S., Paderno N., Palini G.M., Paradies D., Paroli M., Perrone F., Petrucciani N., Petruzzelli L., Pezzolla A., Piazza D., Piazza V., Piccoli M., Pisanu A., Podda M., Poillucci G., Porfidia R., Rossi G., Ruscelli P., Spagnoli A., Sulis R., Tartaglia D., Trana C., Travaglino A., Tomaiuolo P., Valeri A., Vasquez G., Zago M., Zanoni E., Ceresoli, M, Carissimi, F, Nigro, A, Fransvea, P, Lepre, L, Braga, M, Costa, G, Agresta, F, Alemanno, G, Anania, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Baldazzi, G, Balducci, G, Barbera, G, Bellanova, G, Bergamini, C, Bersigotti, L, Bianchi, P, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Buonanno, G, Canini, T, Cardella, S, Carrara, G, Cassini, D, Castriconi, M, Ceccarelli, G, Celi, D, Chiappetta, M, Chiarugi, M, Cillara, N, Cimino, F, Cobuccio, L, Cocorullo, G, Colangelo, E, Crucitti, A, Dallacaneva, P, Luca, M, de Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, Dibella, A, Falcioni, T, Falco, N, Farina, C, Finotti, E, Fontana, T, Francioni, G, Frezza, B, Garbarino, G, Garulli, G, Genna, M, Giannessi, S, Gioffre, A, Giordano, A, Gozzo, D, Grimaldi, S, Gulotta, G, Iacopini, V, Iarussi, T, Laracca, G, Laterza, E, Leonardi, A, Lorenzon, L, Luridiana, G, Malagnino, A, Mar, G, Marini, P, Marzaioli, R, Massa, G, Mecarelli, V, Mercantini, P, Mingoli, A, Nigri, G, Occhionorelli, S, Paderno, N, Palini, G, Paradies, D, Paroli, M, Perrone, F, Petrucciani, N, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Piccoli, M, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Rossi, G, Ruscelli, P, Spagnoli, A, Sulis, R, Tartaglia, D, Trana, C, Travaglino, A, Tomaiuolo, P, Valeri, A, Vasquez, G, Zago, M, and Zanoni, E

Subjects
medicine.medical_specialty, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, NO, Postoperative complications, Elderly, Laparotomy, medicine, Hernia, Incarcerated hernia, business.industry, Explorative laparotomy, Groin hernia · Incarcerated hernia · Elderly · Postoperative complications · Emergency surgery · Charlson’s comorbidity index, medicine.disease, Hernia repair, Comorbidity, Surgery, Groin hernia, Inguinal hernia, Charlson’s comorbidity index, Emergency surgery, business, Watchful waiting, Abdominal surgery
Abstract

Purpose The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. Methods This is a prospective observational study carried out between January 2017 and June 2018 in elderly patients who underwent emergency surgery for complicated hernia in 38 Italian hospitals. Pre-operative, surgical and postoperative data were recorded for each patient. ASA score, Charlson’s comorbidity index, P-POSSUM and CR-POSSUM were assessed. Results 259 patients were recruited, mean age was 80 years. A direct repair without mesh was performed in 62 (23.9%) patients. Explorative laparotomy was performed in 56 (21.6%) patients and bowel resection was necessary in 44 (17%). Mortality occurred in seven (2.8%) patients. Fifty-five (21.2%) patients developed complications, 12 of whom had a major one. At univariate and multivariate analyses, Charlson’s comorbidity index ≥ 6, altered mental status, and need for laparotomy were associated with major complications and mortality Conclusion Emergency surgery for complicated hernia is burdened by high morbidity and mortality in elderly patients. Preoperative comorbidity played a pivotal role in predicting complications and mortality and therefore Charlson’s comorbidity index could be adopted to select patients for elective operation

Published
2022

42. Anticoagulant treatment for upper extremity deep vein thrombosis: A systematic review and meta‐analysis

Author

Marcello Di Nisio, Marco P. Donadini, Angelo Porfidia, Emanuele Valeriani, Walter Ageno, Silvia Spoto, Enrica Porceddu, Fabiana Agostini, and Roberto Pola

Subjects
medicine.medical_specialty, medicine.drug_class, Low molecular weight heparin, Upper Extremity Deep Vein Thrombosis, Internal medicine, medicine, Humans, direct-acting oral anticoagulant, Prospective Studies, Retrospective Studies, business.industry, low molecular weight heparin, Settore MED/09 - MEDICINA INTERNA, Anticoagulant, Anticoagulants, Cancer, Retrospective cohort study, Venous Thromboembolism, Hematology, Heparin, Heparin, Low-Molecular-Weight, medicine.disease, Confidence interval, anticoagulants, upper extremity deep vein thrombosis, venous thromboembolism, Meta-analysis, business, medicine.drug
Abstract

Background Data on anticoagulant treatment for upper extremity deep vein thrombosis (UEDVT) are largely derived from studies on usual site venous thromboembolism (VTE). Objectives The objective of this meta-analysis was to evaluate the efficacy and safety of anticoagulant therapy for UEDVT. Patients/methods A systematic search of MEDLINE and EMBASE was conducted for studies including patients with UEDVT. Primary outcomes were recurrent VTE and major bleeding. Secondary outcomes included clinically-relevant non-major bleeding and all-cause mortality. Summary estimates with 95% confidence intervals (CIs) were calculated by random-effect meta-analysis. Results A total of 1473 patients from 11 prospective and 9 retrospective studies were included. Sixty percent of patients had an indwelling catheter and 56.1% had cancer. Anticoagulant treatment consisted of direct oral anticoagulants, low-molecular-weight heparin followed by vitamin K antagonists, and low-molecular-weight heparin alone in 45.1%, 35.0%, and 19.9% of patients, respectively. During a median follow-up of 13 months, recurrent VTE occurred in 3% of patients (95% CI, 2% to 4%; 21/1334 patients), major bleeding in 3% (95% CI, 2% to 5%; 29/1235 patients), clinically-relevant non-major bleeding in 4% (95% CI, 3% to 6%; 40/1075 patients), and all-cause mortality in 9% (95% CI, 5% to 15%; 108/1084 patients). Rates of these outcomes were not significantly different between patients with or without cancer, patients with or without an indwelling catheter, and among those receiving different anticoagulant treatments. Conclusions In patients with UEDVT, anticoagulant treatment is associated with a low risk of recurrent VTE and a non-negligible risk of major bleeding.

Published
2022
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43. Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach

Author

Costa, Gianluca, Fransvea, Pietro, Lepre, Luca, Liotta, Gianluca, Mazzoni, Gianluca, Biloslavo, Alan, Bianchi, Valentina, Occhionorelli, Savino, Costa, Alessandro, Sganga, Gabriele, FACS on behalf of the IGo-GIPS study group (Agresta, F, Alemanno, G, Altieri, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Badessi, G, Baldazzi, G, Bergamini, C, Biloslavo, A, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Brisinda, G, Buonanno, Gm, Canini, T, Capolupo, Gt, Carannante, F, Cardella, S, Caricato, M, Carrara, G, Cascone, Ca, Cassini, D, Castriconi, M, Catarci, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cimino, F, Cirocchi, R, Cobuccio, L, Coccolini, C, Cocorullo, G, Colangelo, E, Colozzi, S, Cortese, F, Costa, A, Costa, G, Cozza, V, Crucitti, A, Cucinotta, E, D’Alessio, R, Dalla Caneva, P, De Manzini, N, de Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, De Stefano, M, Dibella, A, Di Cosimi, C, Di Grezia, M, Falcioni, T, Falco, N, Farina, C, Fico, V, Finotti, E, Fontana, T, Francioni, G, Fransvea, P, Frezza, B, Garbarino, Gm, Garulli, G, Genna, M, Giannessi, S, Gioffrè, A, Giordano, A, Gozzo, D, Grimaldi, S, Iacopini, V, Iarussi, T, Kurihara, H, La Greca, A, Laracca, Gg, Laterza, E, La Vaccara, V, Leonardi, A, Lepre, L, Liotta, G, Luridiana, G, Magalini, S, Malagnino, A, Mar, G, Mariani, D, Marini, P, Marzaioli, R, Macianà, G, Mazzoni, G, Mecarelli, V, Mercantini, P, Mingoli, A, Mirco, P, Montuori, M, Nigro, C, Occhionorelli, S, Paderno, N, Palini, Gm, Paradies, D, Paroli, M, Perrone, F, Pepe, G, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Pignata, G, Pinotti, E, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Puccioni, C, Rocca, A, Rondelli, F, Rossi, G, Sacchi, M, Sapienza, P, Sganga, G, Spagnoli, A, Spinoglio, G, Sulis, R, Tartaglia, D, Tranà, C, Travaglino, A, Tomaiuolo, P, Tomassini, F, Tropeano, G, Valeri, A, Zago, M, and Zanoni, E. ).

Subjects
Surgical treatment, Laparoscopic approach, Perforated peptic ulcer
Published
2023

46. On site production of [18F]PSMA-1007 using different [18F]fluoride activities: practical, technical and economical impact

Author

Secondo Lastoria, Daria Di Martino, Roberta de Marino, Elisabetta Squame, Aureliana Esposito, Paolo Gaballo, Anna Morisco, Valentina Porfidia, Marco Raddi, Monica Buonanno, Michela Aurilio, L. D'Ambrosio, and Costantina Maisto

Subjects
Radiochemical yield (RCY), R895-920, Time of beam, RM1-950, urologic and male genital diseases, Analytical Chemistry, chemistry.chemical_compound, Medical physics. Medical radiology. Nuclear medicine, [18F]fluoride, Long period, Radioligand, medicine, Pharmacology (medical), Radiology, Nuclear Medicine and imaging, [18F]PSMA-1007, Membrane antigen, Pharmacology, medicine.diagnostic_test, Chemistry, Radiochemistry, Primary cancer, Positron emission tomography, Yield (chemistry), Radiochemical purity (RCP), Therapeutics. Pharmacology, 18f fluoride, Fluoride, Stability, Research Article
Abstract

Background Prostate-specific membrane antigen is overexpressed in prostate cancer and it is considered a good target for positron emission tomography/computed tomography imaging of primary cancer and recurrent/metastatic disease, as well as for radioligand therapy. Different PSMA-analogues labeled with [68Ga]gallium have been investigated, showing excellent imaging properties; however, only small amounts can be produced for each radiolabeling. Recently, a [18F]fluoride labeled PSMA-inhibitor, [18F]PSMA-1007, has been introduced, and it has ensured large-scale productions, overcoming this limitation of [68Ga]PSMAs. In this study, PSMA-1007 has been labeled with low (A), medium (B) and high (C) starting activities of [18F]fluoride, in order to verify if radiochemical yield, radiochemical purity and stability of [18F]PSMA-1007 were affected. These parameters have been measured in sixty-five consecutive batches. In addition, the estimation of [18F]PSMA-1007 production costs is provided. Results The radiochemical yield for low and medium activities of [18F]fluoride was 52%, while for the high one it decreased to 40%. The radiochemical purity was 99% for all three activities. [18F]PSMA-1007 did not show radiolysis up to 8 h after the end of synthesis, confirming that the radiopharmaceutical is stable and suitable to perform diagnostic studies in humans for a long period of time after the end of radiolabeling. Furthermore, radiochemical stability was demonstrated in fetal bovine serum at 4 °C and 37 °C for 120′. Conclusions A starting activity of [18F]fluoride of 90 GBq (B) seems to be the best option enabling a final amount of about of 50 GBq of [18F]PSMA-1007, which is promising as it allows to: (a) perform a large number of scans, and/or (b) supply the radiopharmaceutical to any peripheral diagnostic centers in need.

Published
2021

47. No evidence of increased rate of thrombotic recurrences in patients with history of venous thromboembolism after vaccination for COVID-19

Author

Angelo Porfidia, Giorgio Esposto, Chiara Manzo, Paolo Santini, and Roberto Pola

Subjects
Cerebral venous sinus thrombosis, Vaccination, Settore MED/09 - MEDICINA INTERNA, Anticoagulants, COVID-19, Letter to the Editors-in-Chief, COVID-19 vaccines, COVID-19, coronavirus, Thrombosis, Venous Thromboembolism, Hematology, CVST, cerebral venous sinus thrombosis, Recurrence, Humans, VITT, vaccine-induced immune thrombocytopenia, COVID
Abstract

Introduction Cerebral venous sinus thrombosis (CVST) after coronavirus (COVID-19) vaccination has been reported. There are no data about thrombosis risk in prior CVST patients. The objective of the study was to describe short-term serious adverse events to COVID-19 vaccines in patients with history of CVST. Material and methods We present an observational prospective study of patients with known CVST who received COVID-19 vaccination. Serious event rates within 30 days after second dose vaccination (except one dose for Janssen) were evaluated, including recurrences, hospital admission and death. Results The 62 vaccinated patients received: BNT162b2 (Pfizer-BioNTech) in 43 patients (69.4%), mRNA-1273 (Moderna) in 7 patients (11.3%), AZD1222 (ChAdOx1) in 7 patients (11.3%) and Ad26.COV2.S (Janssen) in 5 patients (8.1%). There were no thrombotic recurrences within 30 days of vaccination (95% confidence interval, 0.0–5.8). There was one death (1.6%), not attributable to the vaccine. Conclusions COVID-19 vaccines are safe for previous CVST patients.

Published
2022
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48. Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study

Author

Poillucci, Gaetano, Podda, Mauro, Pisanu, Adolfo, Mortola, Lorenzo, Dalla Caneva, Patrizia, Massa, Giulia, Costa, Gianluca, Savastano, Riccardo, Cillara, Nicola, Collaborative Study Group endorsed by SICUT ACOI SICG SICE and Italian Chapter of WSES, Agresta, F, Alemanno, G, Anania, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Baldazzi, G, Balducci, G, Barbera, G, Bellanova, G, Bergamini, C, Bersigotti, L, Bianchi, Pp, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Buonanno, Gm, Canini, T, Cardella, S, Carrara, G, Cassini, D, Castriconi, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cillara, N, Cimino, F, Cobuccio, L, Cocorullo, G, Colangelo, E, Costa, G, Crucitti, A, Dalla Caneva, P, De Luca, M, De Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, Dibella, A, Falcioni, T, Falco, N, Farina, C, Finotti, E, Fontana, T, Francioni, G, Fransvea, P, Frezza, B, Garulli, G, Genna, M, Giannessi, S, Gioffrè, A, Giordano, A, Gozzo, D, Grimaldi, S, Gulotta, G, Iacopini, V, Iarussi, T, Laterza, E, Leonardi, A, Lepre, L, Lorenzon, L, Luridiana, G, Malagnino, A, Mar, G, Marini, P, Marzaioli, R, Massa, G, Mecarelli, V, Mingoli, A, Nigri, G, Occhionorelli, S, Paderno, N, Palini, Gm, Paradies, D, Paroli, M, Perrone, F, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Piccoli, M, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Rossi, G, Ruscelli, P, Spagnoli, A, Sulis, R, Tartaglia, D, Tranà, C, Travaglino, A, Tomaiuolo, P, Valeri, A, Vasquez, G, Zago, M, Zanoni, E., Poillucci G., Podda M., Pisanu A., Mortola L., Dalla Caneva P., Massa G., Costa G., Savastano R., Cillara N., Agresta F., Alemanno G., Anania G., Antropoli M., Argenio G., Atzeni J., Avenia N., Azzinnaro A., Baldazzi G., Balducci G., Barbera G., Bellanova G., Bergamini C., Bersigotti L., Bianchi P.P., Bombardini C., Borzellino G., Bozzo S., Brachini G., Buonanno G.M., Canini T., Cardella S., Carrara G., Cassini D., Castriconi M., Ceccarelli G., Celi D., Ceresoli M., Chiarugi M., Cimino F., Cobuccio L., Cocorullo G., Colangelo E., Crucitti A., De Luca M., De Manzoni Garberini A., De Nisco C., De Prizio M., De Sol A., Dibella A., Falcioni T., Falco N., Farina C., Finotti E., Fontana T., Francioni G., Fransvea P., Frezza B., Garulli G., Genna M., Giannessi S., Gioffre A., Giordano A., Gozzo D., Grimaldi S., Gulotta G., Iacopini V., Iarussi T., Laterza E., Leonardi A., Lepre L., Lorenzon L., Luridiana G., Malagnino A., Mar G., Marini P., Marzaioli R., Mecarelli V., Mingoli A., Nigri G., Occhionorelli S., Paderno N., Palini G.M., Paradies D., Paroli M., Perrone F., Petruzzelli L., Pezzolla A., Piazza D., Piazza V., Piccoli M., Porfidia R., Rossi G., Ruscelli P., Spagnoli A., Sulis R., Tartaglia D., Trana C., Travaglino A., Tomaiuolo P., Valeri A., Vasquez G., Zago M., Zanoni E., Poillucci, G, Podda, M, Pisanu, A, Mortola, L, Dalla Caneva, P, Massa, G, Costa, G, Savastano, R, Cillara, N, Agresta, F, Alemanno, G, Anania, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Baldazzi, G, Balducci, G, Barbera, G, Bellanova, G, Bergamini, C, Bersigotti, L, Bianchi, P, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Buonanno, G, Canini, T, Cardella, S, Carrara, G, Cassini, D, Castriconi, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cimino, F, Cobuccio, L, Cocorullo, G, Colangelo, E, Crucitti, A, De Luca, M, De Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, Dibella, A, Falcioni, T, Falco, N, Farina, C, Finotti, E, Fontana, T, Francioni, G, Fransvea, P, Frezza, B, Garulli, G, Genna, M, Giannessi, S, Gioffre, A, Giordano, A, Gozzo, D, Grimaldi, S, Gulotta, G, Iacopini, V, Iarussi, T, Laterza, E, Leonardi, A, Lepre, L, Lorenzon, L, Luridiana, G, Malagnino, A, Mar, G, Marini, P, Marzaioli, R, Mecarelli, V, Mingoli, A, Nigri, G, Occhionorelli, S, Paderno, N, Palini, G, Paradies, D, Paroli, M, Perrone, F, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Piccoli, M, Porfidia, R, Rossi, G, Ruscelli, P, Spagnoli, A, Sulis, R, Tartaglia, D, Trana, C, Travaglino, A, Tomaiuolo, P, Valeri, A, Vasquez, G, Zago, M, and Zanoni, E

Subjects
medicine.medical_specialty, Multivariate analysis, Sports medicine, Settore MED/18 - CHIRURGIA GENERALE, Critical Care and Intensive Care Medicine, Acute appendicitis, Appendectomy, Elderly, Frail patients, Postoperative complications, NO, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Acute appendicitis, Appendectomy, Elderly, Frail patients, Postoperative complications, Internal medicine, medicine, Humans, Frail patient, Orthopedics and Sports Medicine, In patient, Prospective Studies, Prospective cohort study, Aged, Retrospective Studies, 030222 orthopedics, Creatinine, business.industry, Postoperative complication, 030208 emergency & critical care medicine, Perioperative, Length of Stay, Appendicitis, chemistry, Emergency Medicine, Laparoscopy, Surgery, Acute appendiciti, Morbidity, Risk assessment, business
Abstract

Background: A limited number of studies investigating perioperative risk factors associated with emergency appendectomy in elderly patients have been published to date. Whether older age may be associated with poorer outcomes following appendectomy is still a matter of debate. The primary aim of this study was to determine the predictors of postoperative morbidity following appendectomy in patients aged ≥ 65years. Methods: Data regarding all elderly patients who underwent emergency appendectomy from January 2017 to June 2018 admitted 36 Italian surgical departments were prospectively collected and analyzed. Baseline demographics and perioperative variables were evaluated. Uni- and multivariate analyses adjusted for differences between groups were carried out to determine possible predictors of adverse outcomes after appendectomy. Results: Between January 2017 and June 2018, 135 patients aged ≥ 65years with a diagnosis of AA met the study inclusion criteria. Twenty-six patients (19.3%) were diagnosed with some type of postoperative complication. Decreasing the preoperative hemoglobin level showed a statistically significant association with postoperative complications (OR 0.77, CI 0.61–0.97, P = 0.03). Preoperative creatinine level (P = 0.02, OR 2.04, CI 1.12–3.72), and open appendectomy (P = 0.03, OR 2.67, CI 1.11–6.38) were significantly associated with postoperative morbidity. After adjustment, the only independent predictor of postoperative morbidity was preoperative creatinine level (P = 0.04, OR 2.01, CI 1.05–3.89). Conclusions: In elderly patients with AA, perioperative risk assessment in the emergency setting must be as accurate as possible to identify modifiable risk factors that can be addressed before surgery, such as preoperative hemoglobin and creatinine levels.

Published
2019
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49. coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit

Author

Mauro Podda, Daniela Pacella, Gianluca Pellino, Federico Coccolini, Alessio Giordano, Salomone Di Saverio, Francesco Pata, Benedetto Ielpo, Francesco Virdis, Dimitrios Damaskos, Belinda De Simone, Ferdinando Agresta, Massimo Sartelli, Ari Leppaniemi, Cristiana Riboni, Vanni Agnoletti, Damian Mole, Yoram Kluger, Fausto Catena, Adolfo Pisanu, Chiara Gerardi, Salomone di Saverio, Dimitris Damaskos, Stavros Gourgiotis, Gaetano Poillucci, Kumar Jayant, Luca Ferrario, Mikel Prieto Calvo, Michael Wilson, Fiammetta Soggiu, Alaa Hamdan, Carlos Augusto Gomes, Gustavo Fraga, Argyrios Ioannidis, Zaza Demetrashvili, Saaz Sahani, Lovenish Bains, Almu'atasim Khamees, Hazim Ababneh, Osama Aljaiuossi, Samuel Pimentel, Ikhwan Sani Mohamad, Ahmad Ramzi Yusoff, Narcis Octavian Zarnescu, Valentin Calu, Andrey Litvin, Dusan Lesko, Ahmed Elmehrath, Mohamedraed Elshami, Martin de Santibañes, Justin Gundara, Kamel Alawadhi, Rashid Lui, Alexander Julianov, Sergio Ralon, Ibrahim-Umar Garzali, Gustavo M. Machain, Darwin Artidoro Quispe-Cruz, Abigail Cheska C. Orantia, Maciej Walędziak, Tiago Correia de Sá, Syed Muhammad Ali, Bojan Kovacevic, Colin Noel, Haidar M. Abdalah, Ali Kchaou, Arda Isik, Luca Ansaloni, Walter Biffl, Mario Guerrieri, Alberto Sartori, Manuel Abradelo, Giuseppe Nigri, Nicola Di Lorenzo, Andrea Mingoli, Massimo Chiarugi, Juliana Di Menno Stavron, Oscar Mazza, José Ignacio Valenzuela, Diana Alejandra Pantoja Pachajoa, Fernando Andrés Alvarez, Julian Ezequiel Liaño, Joan Tefay, Abdulrahman Alshaikh, Layla Hasan, Felipe Couto Gomes, Gustavo P. Fraga, Thiago R.A. Calderan, Elcio S. Hirano, Dragomir Dardanov, Azize Saroglu, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, Shannon Melissa Chan, Hon-Ting Lok, Diego Salcedo, Diana Robayo, María Alejandra Triviño, Jan Manak, Jorann de Araujo, Ananya Sethi, Ahmed Awad, Merihan Elbadawy, Ahmed Farid, Asmaa Hanafy, Ahmed Nafea, null Sherief-Ghozy, Alzhraa Salah – Abbas, Wafaa Abdelsalam, Sameh Emile, Ahmed Elfallal, Hossam Elfeki, Hosam Elghadban, Ashraf Shoma, Mohamed Shetiwy, Mohamed Elbahnasawy, Salem- Mohamed, Emad Fawzi Hamed, Usama Ahmed Khalil, Elie Chouillard, Andrew Gumbs, Andréa Police, Andrea Mabilia, Kakhi Khutsishvili, Anano Tvaladze, Orestis Ioannidis, Elissavet Anestiadou, Lydia Loutzidou, Konstantinis Konstantinidis, Sofia Konstantinidou, Dimitrios Manatakis, Vasileios Acheimastos, Nikolaos Tasis, Nikolaos Michalopoulos, Panagiotis Kokoropoulos, Maria Papadoliopoulou, Maria Sotiropoulou, Stylianos Kapiris, Panagiotis Metaxas, Ioannis Tsouknidas, Despoina Kefili, George Petrakis, Konstantinos Dakis, Eirini Alexandridou, Eirini Synekidou, Kostas Dakis, Aristeidis Papadopoulos, Christos Chouliaras, Odysseas Mouzakis, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Tania Triantafyllou, Dimitrios Theodorou, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Paraskevi Tourountzi, Efstratia Baili, Alexandros Charalabopoulos, Theodore Liakakos, Dimitrios Schizas, Alexandros Kozadinos, Athanasios Syllaios, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, Spiros Delis, Christos Farazi-Chongouki, Evangelos Kalaitzakis, Miltiadis Giannarakis, Konstantinos Lasithiotakis, Giorgia Petra, Amit Gupta, Noushif Medappil, Vijayanand Muthukrishnan, Jubin Kamar, Pawan Lal, Rajendra Agarwal, Matteo Magnoli, Paolo Aonzo, Alberto Serventi, Antonio Giuliani, Pierpaolo Di Lascio, Margherita Pinto, Carlo Bergamini, Andrea Bottari, Laura Fortuna, Jacopo Martellucci, Atea Cicako, Claudio Miglietta, Mario Morino, Daniele Delogu, Andrea Picchetto, Marco Assenza, Giancarlo D'Ambrosio, Giulio Argenio, Mariano Fortunato Armellino, Giovanna Ioia, Savino Occhionorelli, Dario Andreotti, Lacavalla Domenico, Davide Luppi, Massimiliano Casadei, Luca Di Donato, Farshad Manoochehri, Tiziana Rita Lucia Marchese, William Sergi, Roberto Manca, Raimondo Murgia, Enrico Piras, Lorenzo Conti, Simone Gianazza, Andrea Rizzi, Edoardo Segalini, Marco Monti, Elena Iiritano, Nicolò Maria Mariani, Enrico De Nicola, Giovanna Scifo, Giusto Pignata, Jacopo Andreuccetti, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Alan Biloslavo, Paola Germani, Manuela Mastronardi, Selene Bogoni, Silvia Palmisano, Nicolo’ De Manzini, Marco Vito Marino, Gennaro Martines, Giuseppe Trigiante, Elpiniki Lagouvardou, Gabriele Anania, Cristina Bombardini, Dario Oppici, Tiziana Pilia, Valentina Murzi, Emanuela Gessa, Umberto Bracale, Maria Michela Di Nuzzo, Roberto Peltrini, Francesco Salvetti, Jacopo Viganò, Gabriele Sganga, Valentina Bianchi, Pietro Fransvea, Tommaso Fontana, Giuliano Sarro, Vincenza Paola Dinuzzi, Luca Scaravilli, Mario Virgilio Papa, Elio Jovine, Giulia Ciabatti, Laura Mastrangelo, Matteo Rottoli, Claudio Ricci, Iris Shari Russo, Alberto Aiolfi, Davide Bona, Francesca Lombardo, Pasquale Cianci, Roberto Bini, Osvaldo Chiara, Stefano Cioffi, Stefano Cantafio, Guido Coretti, Edelweiss Licitra, Grazia Savino, Sergio Grimaldi, Raffaele Porfidia, Elisabetta Moggia, Mauro Garino, Chiara Marafante, Antonio Pesce, Nicolò Fabbri, Carlo Vittorio Feo, Ester Marra, Marina Troian, Davide Drigo, Carlo Nagliati, Muratore Andrea, Riccardo Danna, Alessandra Murgese, Michele Crespi, Claudio Guerci, Alice Frontali, Luca Ferrari, Francesco Favi, Erika Picariello, Alessia Rampini, Fabrizio D'Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Palmieri, Matteo Calì, Francesco Ferrara, Irnerio Angelo Muttillo, Edoardo Maria Muttillo, Biagio Picardi, Raffaele Galleano, Ali Badran, Omar Ghazouani, Maurizio Cervellera, Gaetano Campanella, Gennaro Papa, Annamaria Di Bella, Gennaro Perrone, Gabriele Luciano Petracca, Concetta Prioriello, Mario Giuffrida, Federico Cozzani, Matteo Rossini, Marco Inama, Giovanni Butturini, Gianluigi Moretto, Luca Morelli, Giulio Di Candio, Simone Guadagni, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Valerio Genovese, Nicola Cillara, Alessandro Cannavera, Antonello Deserra, Arcangelo Picciariello, Vincenzo Papagni, Leonardo Vincenti, Giulia Bagaglini, Giuseppe Sica, Pierfrancesco Lapolla, Gioia Brachini, Dario Bono, Antonella Nicotera, Marcello Zago, Fabrizio Sammartano, Laura Benuzzi, Marco Stella, Stefano Rossi, Alessandra Cerioli, Caterina Puccioni, Stefano Olmi, Carolina Rubicondo, Matteo Uccelli, Andrea Balla, Anna Guida, Pasquale Lepiane, Diego Sasia, Giorgio Giraudo, Sara Salomone, Elena Belloni, Alessandra Cossa, Francesco Lancellotti, Roberto Caronna, Piero Chirletti, Paolina Saullo, Raffaele Troiano, Felice Mucilli, Mirko Barone, Massimo Ippoliti, Michele Grande, Bruno Sensi, Leandro Siragusa, Monica Ortenzi, Andrea Santini, Isidoro Di Carlo, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Giuseppe Currò, Michele Ammendola, Iman Komaei, Giuseppe Navarra, Valeria Tonini, Lodovico Sartarelli, Samuele Vaccari, Marco Ceresoli, Stefano Perrone, Linda Roccamatisi, Paolo Millo, Riccardo Brachet Contul, Elisa Ponte, Matteo Zuin, Giuseppe Portale, Alice Sabrina Tonello, Geri Fratini, Matteo Bianchini, Bruno Perotti, Emanuele Doria, Elia Giuseppe Lunghi, Diego Visconti, Khayry Al-Shami, Sajeda Awadi, Mohammad Musallam Khalil Buwaitel, Mo'taz Fawzat Naief Naffa', Ahmad Samhouri, Hatem Sawalha, Mohd Firdaus Che Ani, Ida Nadiah Ahmed Fathil, Jih Huei, Andee Dzulkarnaen Zakaria, Mohammad Zawawi Ya'acob, Jose-Luis Beristain-Hernandez, Alejandro Garcia-Meza, Rafael Sepulveda-Rdriguez, Edgard Efren Lozada Hernández, Camilo Levi Acuña Pinzón, Jefferson Nieves Condoy, Francisco C. Becerra García, Mohammad Sadik, null Jalpa, Bushra kadir, Jalpa Devi, Nandlal Seerani, null Zainab, Mohammad Sohail- Asghar, Ameer Afzal, Ali Akbar, Helmut Segovia Lohse, Herald Segovia Lohse, Zamiara Solange Leon Cabrera, Gaby Susana Yamamoto Seto, José Ríos Chiuyari, Jorge Ordemar, Martha Rodríguez, Abigail Cheska C. Orantia-Carlos, Margie Antionette Quitoy, Andrzej Kwiatkowski, Maciej Mawlichanów, Mónica Rocha, Carlos Soares, Alexandru Rares Stoian, Andreea Diana Draghici, Valentin Titus Grigorean, Raluca Bievel Radulescu, Radu Virgil Costea, Eugenia Claudia Zarnescu, Mikhail Kurtenkov, George Gendrikson, Volovich Alla-Angelina, Tsurbanova Arina, Ayrat Kaldarov, Mahir Gachabayov, Abakar Abdullaev, Milica Milentijevic, Milovan Karamarkovic, Arpád Panyko, Jozef Radonak, Marek Soltes, Laura Álvarez Morán, Haydée Calvo García, Pilar Suárez Vega, Sergio Estevez, Fabio Ausania, Jordi Farguell, Carolina González-Abós, Santiago Sánchez-Cabús, Belén Martín, Víctor Molina, Luis Oms, Lucas Ilzarbe, Eva Pont Feijóo, Elena Sofia Perra, Noel Rojas-Bonet, Rafael Penalba-Palmí, Susana Pérez-Bru, Jaume Tur-Martínez, Andrea Álvarez-Torrado, Marta Domingo-Gonzalez, Javier Tejedor-Tejada, Marcello Di Martino, Yaiza García del Alamo, Fernando Mendoza-Moreno, Francisca García-Moreno-Nisa, Belén Matías-García, Manuel Durán, Rafael Calleja-Lozano, José Manuel Perez de Villar, Luis Sánchez-Guillén, Iban Caravaca, Daniel Triguero-Cánovas, Antonio Carlos Maya Aparicio, Blas Durán Meléndez, Andrea Masiá Palacios, Aitor Landaluce-olavarria, Mario De Francisco, Begoña Estraviz-Mateos, Felipe Alconchel, Tatiana Nicolás-López, Pablo Ramírez, Virginia Duran Muñoz-Cruzado, Felipe Pareja Ciuró, Eduardo Perea del Pozo, Sergio Olivares Pizarro, Vicente Herrera Cabrera, Jose Muros Bayo, Hytham K.S. Hamid, Raffaello Roesel, Alessandra Cristaudi, Kinan Abbas, Iyad Ali, Ahmed Tlili, Hüseyin Bayhan, Mehmet Akif Türkoğlu, Mustafa Yener Uzunoglu, Ibrahim Fethi Azamat, Nail Omarov, Derya Salim Uymaz, Fatih Altintoprak, Emrah Akin, Necattin First, Koray Das, Nazmi Ozer, Ahmet Seker, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Semra Demirli Atici, Murat Akalin, Bulent Calik, Elif Colak, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Victoria Hudson, Jean-Luc Duval, Mansoor Khan, Ahmed Saad, Mandeep Kaur, Alison Bradley, Katherine Fox, Ivan Tomasi, Daniel Beasley, Alekhya Kotta Prasanti, Pinky Kotecha, Husam Ebied, Michaela Paul, Hemant Sheth, Ioannis Gerogiannis, Mohannad Gaber, Zara Sheikh, Shatadru Seth, Maria Kunitsyna, Cosimo Alex Leo, Vittoria Bellato, Noman - Zafar, Amr Elserafy, Giles Bond-smith, Giovanni Tebala, Pawan Mathur, Izza Abid, Nnaemeka Chidumije, Pardip Sandhar, Syed Osama Zohaib Ullah, Tamara Lezama, Muhammad Hassan Anwaar, Conor Magee, Salma Ahmed, Brooke Davies, Jeyakumar Apollos, Kieran McCormack, Hasham Choudhary, Triantafyllos Doulias, Tamsin Morrison, Anna Palepa, Fernando Bonilla Cal, Lianet Sánchez, Fabiana Domínguez, Ibrahim Al-Raimi, Haneen Alshargabi, Abdullah Meead, Podda, Mauro, Pacella, Daniela, Pellino, Gianluca, Coccolini, Federico, Giordano, Alessio, Di Saverio, Salomone, Pata, Francesco, Ielpo, Benedetto, Virdis, Francesco, Damaskos, Dimitrio, De Simone, Belinda, Agresta, Ferdinando, Sartelli, Massimo, Leppaniemi, Ari, Riboni, Cristiana, Agnoletti, Vanni, Mole, Damian, Kluger, Yoram, Catena, Fausto, Pisanu, Adolfo, de Manzini, Nicolo', Palmisano, Silvia, Podda, M, Pacella, D, Pellino, G, Coccolini, F, Giordano, A, Di Saverio, S, Pata, F, Ielpo, B, Virdis, F, Damaskos, D, De Simone, B, Agresta, F, Sartelli, M, Leppaniemi, A, Riboni, C, Agnoletti, V, Mole, D, Kluger, Y, Catena, F, Pisanu, A, Gerardi, C, Gourgiotis, S, Poillucci, G, Jayant, K, Ferrario, L, Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Quispe-Cruz, D, Orantia, A, Waledziak, M, Correia de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pantoja Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Augusto Gomes, C, Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief-Ghozy, Salah - Abbas, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Dakis, K, Alexandridou, E, Synekidou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Giuliani, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, 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Subjects
Acute pancreatitis, Biliary pancreatitis, Global surgery, Guidelines compliance, International audit, Hepatology, Endocrinology, Diabetes and Metabolism, Gastroenterology, Settore MED/18, Hospitalization, Enteral Nutrition, Pancreatitis, Acute Disease, Humans, Biliary pancreatiti, Cholecystectomy, Acute pancreatiti, Human
Abstract

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

Published
2022

50. Prevalence of pulmonary embolism on hospital admission in COVID-19 patients: Is there a role for pre-test probability scores and home treatment?

Author

Porfidia, Angelo, Pola, Enrico, Pola, Roberto, Porfidia A. (ORCID:0000-0003-4915-2892), Pola E. (ORCID:0000-0001-5350-3910), Pola R. (ORCID:0000-0001-5224-2931), Porfidia, Angelo, Pola, Enrico, Pola, Roberto, Porfidia A. (ORCID:0000-0003-4915-2892), Pola E. (ORCID:0000-0001-5350-3910), and Pola R. (ORCID:0000-0001-5224-2931)

Abstract

NA

Published
2021

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