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1. Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis

Author

Anania G., Agresta F., Artioli E., Rubino S., Resta G., Vettoretto N., Petz W. L., Bergamini C., Arezzo A., Valpiani G., Morotti C., Silecchia G., Adamo V., Agrusa A., Alemanno G., Allaix M. E., Alo A., Altamura A., Ambrosi A., Antoniutti M., Apa D., Arcuri G., Baiocchi G. L., Balani A., Baldazzi G., Basti M., Benvenuto C., Berti S., Boni L., Borghi F., Botteri E., Brachet Contul R., Brescia A., Budassi A., Cafagna L., Calgaro M., Calo P. G., Campagnacci R., Canova G., Canu G. L., Caracino V., Carcoforo P., Carlini M., Casali L., Cassetti D., Cassinotti E., Catarci M., Cesari M., Checcacci P., Ciano P., Clementi M., Cocorullo G., Colombo F., Concone G., Contine A., Coppola M., Coratti A., Corcione F., Corleone P., Covotta L., Cuccurullo D., Cumbo P., D'ambrosio G., De Angelis F., De Luca M., De Manzini N., De Nisco C., De Palma G. D., De Paolis P., Degiuli M., Delogu D., Delrio P., Deserra A., Donini A., Elmore U., Ercolani G., Erdas E., Fabris L., Ferrari G., Feo G., Fidanza F., Foschi D., Galleano R., Garulli G., Gatti F., Gattolin A., Gelati S., Gelmini R., Ghazouani O., Gioffre A., Gobbi S., Grammatico V., Guariniello A., Giannessi S., Guerrieri M., Guerriero L., Gullotta G., Impellizzeri H., Izzo M., Jovine E., Lezoche G., Lirusso C., Lombardi R., Longoni M., Lucchi A., Luzzi A. P., Marini P., Marrosu A. G., Martino A., Mazza R., Mazzoccato S., Medas F., Meloni A., Milone M., Minciotti E., Monari F., Moretto G., Muttillo I. A., Navarra G., Neri S., Oldani A., Olmi S., Opocher E., Osenda E., Ottonello R., Panebianco V., Pavanello M., Pecchini F., Pellegrino L., Pennisi D., Perrotta N., Pertile D., Petri R., Picchetto A., Piccoli M., Pirrera B., Pisani Ceretti A., Pisano M., Podda M., Portolani N., Presenti L., Puzziello A., Razzi S., Rega D., Restini E., Ricci G., Rigamonti M., Rivolta U., Robustelli V., Romairone E., Rosati R., Rosso E., Roviello F., Sala S., Santarelli M., Sarro G., Sartori A., Scabini S., Scognamillo F., Sechi R., Solaini L., Soliani G., Soliani P., Soligo E., Sorrentino M., Spinoglio G., Stratta E., Taddei A., Talamo G., Targa S., Tartaglia N., Testa S., Ubiali P., Valeri A., Vasta F., Verzelli A., Vicentini R., Viola G., Violi V., Zago M., Zampino L., Anania, G., Agresta, F., Artioli, E., Rubino, S., Resta, G., Vettoretto, N., Petz, W. L., Bergamini, C., Arezzo, A., Valpiani, G., Morotti, C., Silecchia, G., Adamo, V., Agrusa, A., Alemanno, G., Allaix, M. E., Alo, A., Altamura, A., Ambrosi, A., Antoniutti, M., Apa, D., Arcuri, G., Baiocchi, G. L., Balani, A., Baldazzi, G., Basti, M., Benvenuto, C., Berti, S., Boni, L., Borghi, F., Botteri, E., Brachet Contul, R., Brescia, A., Budassi, A., Cafagna, L., Calgaro, M., Calo, P. G., Campagnacci, R., Canova, G., Canu, G. L., Caracino, V., Carcoforo, P., Carlini, M., Casali, L., Cassetti, D., Cassinotti, E., Catarci, M., Cesari, M., Checcacci, P., Ciano, P., Clementi, M., Cocorullo, G., Colombo, F., Concone, G., Contine, A., Coppola, M., Coratti, A., Corcione, F., Corleone, P., Covotta, L., Cuccurullo, D., Cumbo, P., D'Ambrosio, G., De Angelis, F., De Luca, M., De Manzini, N., De Nisco, C., De Palma, G. D., De Paolis, P., Degiuli, M., Delogu, D., Delrio, P., Deserra, A., Donini, A., Elmore, U., Ercolani, G., Erdas, E., Fabris, L., Ferrari, G., Feo, G., Fidanza, F., Foschi, D., Galleano, R., Garulli, G., Gatti, F., Gattolin, A., Gelati, S., Gelmini, R., Ghazouani, O., Gioffre, A., Gobbi, S., Grammatico, V., Guariniello, A., Giannessi, S., Guerrieri, M., Guerriero, L., Gullotta, G., Impellizzeri, H., Izzo, M., Jovine, E., Lezoche, G., Lirusso, C., Lombardi, R., Longoni, M., Lucchi, A., Luzzi, A. P., Marini, P., Marrosu, A. G., Martino, A., Mazza, R., Mazzoccato, S., Medas, F., Meloni, A., Milone, M., Minciotti, E., Monari, F., Moretto, G., Muttillo, I. A., Navarra, G., Neri, S., Oldani, A., Olmi, S., Opocher, E., Osenda, E., Ottonello, R., Panebianco, V., Pavanello, M., Pecchini, F., Pellegrino, L., Pennisi, D., Perrotta, N., Pertile, D., Petri, R., Picchetto, A., Piccoli, M., Pirrera, B., Pisani Ceretti, A., Pisano, M., Podda, M., Portolani, N., Presenti, L., Puzziello, A., Razzi, S., Rega, D., Restini, E., Ricci, G., Rigamonti, M., Rivolta, U., Robustelli, V., Romairone, E., Rosati, R., Rosso, E., Roviello, F., Sala, S., Santarelli, M., Sarro, G., Sartori, A., Scabini, S., Scognamillo, F., Sechi, R., Solaini, L., Soliani, G., Soliani, P., Soligo, E., Sorrentino, M., Spinoglio, G., Stratta, E., Taddei, A., Talamo, G., Targa, S., Tartaglia, N., Testa, S., Ubiali, P., Valeri, A., Vasta, F., Verzelli, A., Vicentini, R., Viola, G., Violi, V., Zago, M., Zampino, L., Anania G., Agresta F., Artioli E., Rubino S., Resta G., Vettoretto N., Petz W.L., Bergamini C., Arezzo A., Valpiani G., Morotti C., Silecchia G, and Adamo V, Agrusa A, Alemanno G, Allaix ME, Alò A, Altamura A, Ambrosi A, Antoniutti M, Apa D, Arcuri G, Baiocchi GL, Balani A, Baldazzi G, Basti M, Benvenuto C, Berti S, Boni L, Borghi F, Botteri E, Brachet Contul R, Brescia A, Budassi A, Cafagna L, Calgaro M, Calò PG, Campagnacci R, Canova G, Canu GL, Caracino V, Carcoforo P, Carlini M, Casali L, Cassetti D, Cassinotti E, Catarci M, Cesari M, Checcacci P, Ciano P, Clementi M, Cocorullo G, Colombo F, Concone G, Contine A, Coppola M, Coratti A, Corcione F, Corleone P, Covotta L, Cuccurullo D, Cumbo P, D'Ambrosio G, De Angelis F, De Luca M, De Manzini N, De Nisco C, De Palma GD, De Paolis P, Degiuli M, Delogu D, Delrio P, Deserra A, Donini A, Elmore U, Ercolani G, Erdas E, Fabris L, Ferrari G, Feo C, Fidanza F, Foschi D, Galleano R, Garulli G, Gatti F, Gattolin A, Gelati S, Gelmini R, Ghazouani O, Gioffrè A, Gobbi S, Grammatico V, Guariniello A, Giannessi S, Guerrieri M, Guerriero L, Guerriero G, Impellizzeri H, Izzo M, Jovine E, Lezoche G, Lirusso C, Lombardi R, Longoni M, Lucchi A, Luzzi AP, Marini P, Marrosu AG, Martino A, Mazza R, Mazzoccato S, Medas F, Meloni A, Milone M, Minciotti E, Monari F, Moretto G, Muttillo IA, Navarra G, Neri S, Oldani A, Olmi S, Opocher E, Osenda E, Ottonello R, Panebianco V, Pavanello M, Pecchini F, Pellegrino L, Pennisi D, Perrotta N, Pertile D, Petri R, Picchetto A, Piccoli M, Pirrera B, Pisani Ceretti A, Pisano M, Podda M, Portolani N, Presenti L, Puzziello A, Razzi S, Rega D, Restini E, Ricci G, Rigamonti M, Rivolta U, Robustelli V, Romairone E, Rosati R, Rosso E, Roviello F, Sala S, Santarelli M, Sarro G, Sartori A, Scabini S, Scognamillo F, Sechi R, Solaini L, Soliani G, Soliani P, Soligo E, Sorrentino M, Spinoglio G, Stratta E, Taddei A, Talamo G, Targa S, Tartaglia N, Testa S, Ubiali P, Valeri A, Vasta F, Verzelli A, Vicentini R, Viola G, Violi V, Zago M, Zampino L.

Subjects
Male, medicine.medical_specialty, Anastomosis, Colon, Intracorporeal anastomosis, Outcomes, Laparoscopic colectomy, Article, Intracorporeal anastomosi, Ileo-colic anastomosis, Laparoscopy, Postoperative complications, Right hemicolectomy, Aged, Anastomosis, Surgical, Colectomy, Colonic Neoplasms, Female, Humans, Prospective Studies, Treatment Outcome, Economica, Surgical, medicine, LS7_1, LS7_4, Right hemicolectomy, Ileo-colic anastomosis, Laparoscopy, Postoperative complications, Intracorporeal anastomosis, Outcomes, Outcome, LS7_9, medicine.diagnostic_test, business.industry, General surgery, Right hemicolectomy · Ileo-colic anastomosis · Laparoscopy · Postoperative complications · Intracorporeal anastomosis · Outcomes, Correction, Postoperative complication, Ileo-colic anastomosi, Prospective trial, Surgery, Side to side anastomosis, business, Laparoscopic right hemicolectomy
Abstract

Background While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration Clinical trial (Identifier: NCT03934151).

Published
2020

2. Correction to: Mesoglycan for pain control after open excisional HAEMOrrhoidectomy (MeHAEMO): an observational multicentre study on behalf of the Italian Society of Colorectal Surgery (SICCR) (BMC Surgery, (2020), 20, 1, (251), 10.1186/s12893-020-00914-5)

Author

Gallo G., Di Saverio S., Clerico G., Sturiale A., Manigrasso M., Luc A. R., Trompetto M., Sammarco G., Ferrari F., Carpino A., Sena G., Vescio G., Stratta E., Tonello P., Cornaglia S., Greco V., Talarico C., Tutino R., Falco N., Venturelli P., Cocorullo G., Pietroletti R., Rizza V., Milito G., Campanelli M., Lisi G., Brachitta S., Cavallaro V., Pecorella G., Turri B., Sasia D., Giuffrida M. C., Milone M., Palma G. D., Bianco V., Moggia E., Talamo G., Oggianu A., Pili M., Palumbo A., Fazio M., Aiello D., Bianco F., Bondurri A., La Torre M., Mancini S., Perinotti R., Serventi A., Fiorino M., Gallo G., Di Saverio S., Clerico G., Sturiale A., Manigrasso M., Luc A.R., Trompetto M., Sammarco G., Ferrari F., Carpino A., Sena G., Vescio G., Stratta E., Tonello P., Cornaglia S., Greco V., Talarico C., Tutino R., Falco N., Venturelli P., Cocorullo G., Pietroletti R., Rizza V., Milito G., Campanelli M., Lisi G., Brachitta S., Cavallaro V., Pecorella G., Turri B., Sasia D., Giuffrida M.C., Milone M., Palma G.D., Bianco V., Moggia E., Talamo G., Oggianu A., Pili M., Palumbo A., Fazio M., Aiello D., Bianco F., Bondurri A., La Torre M., Mancini S., Perinotti R., Serventi A., Fiorino M., Gallo, G., Di Saverio, S., Clerico, G., Sturiale, A., Manigrasso, M., Luc, A. R., Trompetto, M., Sammarco, G., Ferrari, F., Carpino, A., Sena, G., Vescio, G., Stratta, E., Tonello, P., Cornaglia, S., Greco, V., Talarico, C., Tutino, R., Falco, N., Venturelli, P., Cocorullo, G., Pietroletti, R., Rizza, V., Milito, G., Campanelli, M., Lisi, G., Brachitta, S., Cavallaro, V., Pecorella, G., Turri, B., Sasia, D., Giuffrida, M. C., Milone, M., Palma, G. D., Bianco, V., Moggia, E., Talamo, G., Oggianu, A., Pili, M., Palumbo, A., Fazio, M., Aiello, D., Bianco, F., Bondurri, A., La Torre, M., Mancini, S., Perinotti, R., Serventi, A., and Fiorino, M.

Subjects
Emtree
Abstract

An amendment to this paper has been published and can be accessed via the original article.

Published
2020

3. Mesoglycan for pain control after open excisional HAEMOrrhoidectomy (MeHAEMO): an observational multicentre study on behalf of the Italian Society of Colorectal Surgery (SICCR)

Author

Gallo, G., Di Saverio, S., Clerico, G., Sturiale, A., Manigrasso, M., Luc, A. R., Trompetto, M., Sammarco, G., Ferrari, F., Carpino, A., Sena, G., Vescio, G., Stratta, E., Tonello, P., Cornaglia, S., Greco, V., Talarico, C., Tutino, R., Falco, N., Venturelli, P., Cocorullo, G., Pietroletti, R., Rizza, V., Milito, G., Campanelli, M., Lisi, G., Brachitta, S., Cavallaro, V., Pecorella, G., Turri, B., Sasia, D., Giuffrida, M. C., Milone, M., Palma, G., Bianco, V., Moggia, E., Talamo, G., Oggianu, A., Pili, M., Palumbo, A., Fazio, M., Aiello, D., Bianco, F., Bondurri, A., Torre, M., Macini, S., Perinotti, R., Serventi, A., Fiorino, M., Gallo, G., Di Saverio, S., Clerico, G., Sturiale, A., Manigrasso, M., Luc, A. R., Trompetto, M., Sammarco, G., Ferrari, F., Carpino, A., Sena, G., Vescio, G., Stratta, E., Tonello, P., Cornaglia, S., Greco, V., Talarico, C., Tutino, R., Falco, N., Venturelli, P., Cocorullo, G., Pietroletti, R., Rizza, V., Milito, G., Campanelli, M., Lisi, G., Brachitta, S., Cavallaro, V., Pecorella, G., Turri, B., Sasia, D., Giuffrida, M. C., Milone, M., Palma, G., Bianco, V., Moggia, E., Talamo, G., Oggianu, A., Pili, M., Palumbo, A., Fazio, M., Aiello, D., Bianco, F., Bondurri, A., Torre, M., Macini, S., Perinotti, R., Serventi, A., and Fiorino, M.

Subjects
Male, medicine.medical_treatment, haemorrhoidal disease, post-operative pain, open excisional haemorrhoidectomy, mesoglycan, thrombosis, mucocutaneous bridges, Open excisional haemorrhoidectomy, Haemorrhoidal disease, Mesoglycan, Mucocutaneous bridges, Post-operative pain, Thrombosis, Mucocutaneous bridge, Retrospective Studie, 80 and over, Glycosaminoglycans, Aged, 80 and over, Pain, Postoperative, Fibrinolytic Agent, General Medicine, Middle Aged, Colorectal surgery, Treatment Outcome, Thrombosi, Female, Human, Research Article, Adult, Hemorrhoidectomy, medicine.medical_specialty, lcsh:Surgery, Pain, Hemorrhoids, Young Adult, Pain control, Fibrinolytic Agents, medicine, Humans, Postoperative, Aged, Retrospective Studies, business.industry, Gold standard, Correction, Diathermy, lcsh:RD1-811, medicine.disease, Surgery, Glycosaminoglycan, Defecation, Observational study, business, Hemorrhoid
Abstract

Background Excisional haemorrhoidectomy is the gold standard technique in patients with III and IV degree haemorrhoidal disease (HD). However, it is associated with a significant rate of post-operative pain. The aim of our study was to evaluate the efficacy of mesoglycan in the post-operative period of patients who underwent open excisional diathermy haemorrhoidectomy (OEH). Methods This was a retrospective multicentre observational study. Three hundred ninety-eight patients from sixteen colorectal referral centres who underwent OEH for III and IV HD were enrolled. All patients were followed-up on the first post-operative day (T1) and after 1 week (T2), 3 weeks (T3) and 6 weeks (T4). BMI, habits, SF-12 questionnaire, VAS at rest (VASs), after defecation (VASd), and after anorectal digital examination (VASe), bleeding and thrombosis, time to surgical wound healing and autonomy were evaluated. Results In the mesoglycan group, post-operative thrombosis was significantly reduced at T2 (p Conclusions The use of mesoglycan led to a significant reduction in post-operative thrombosis and pain with consequent early resumption of autonomy. Trial registration NCT04481698—Mesoglycan for Pain Control After Open Excisional HAEMOrrhoidectomy (MeHAEMO) https://clinicaltrials.gov/ct2/show/NCT04481698?term=Mesoglycan+for+Pain+Control+After+Open+Excisional+HAEMOrrhoidectomy+%28MeHAEMO%29&draw=2&rank=1

Published
2020

7. GOSAFE - Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery: early analysis on 977 patients

Author

Montroni, I, Rostoft, S, Spinelli, A, Van Leeuwen, BL, Ercolani, G, Saur, NM, Jaklitsch, MT, Somasundar, PS, Carino, ND, Ghignone, F, Foca, F, Zingaretti, C, Audisio, RA, Ugolini, G, Garutti, A, Taffurelli, G, Zattoni, D, Tramelli, P, Sermonesi, G, Di Candido, F, Carvello, M, Sacchi, M, De Lucia, F, Foppa, C, Plas, M, Van der Wal-Huisman, H, Tauceri, F, Perenze, B, Di Pietrantonio, D, Mirarchi, M, Fejka, M, Bleier, JIS, Frain, L, Fox, SW, Cardin, K, De Leon, LE, Baltatzis, M, Chan, AKC, Siriwardena, AK, Vertogen, B, Nanni, O, Garulli, G, Alagna, V, Pirrera, B, Lucchi, A, Monari, F, Conti, L, Capelli, P, Romboli, A, Palmieri, G, Banchini, F, Marano, L, Spaziani, A, Castagnoli, G, Bartoli, A, Trompetto, M, Gallo, G, Luc, AR, Clerico, G, Sammarco, G, De Luca, R, Barile, G, Simone, M, Costanzi, A, Mari, G, Maggioni, D, Pellegrino, R, Riggio, V, Kenig, J, Szabat, K, Scabini, S, Pertile, D, Stratta, E, Massobrio, A, Soriero, D, Nesbakken, A, Lonn, M, Backe, IF, Ferrari, G, Mazzola, M, Alampi, BDA, Achilli, P, Sfondrini, S, Ioannidis, O, Loutzidou, L, Galanos-Demiris, K, Pellino, G, Balducci, G, Frezza, B, Lucarini, A, Santos, C, Cooper, L, Siam, B, Levy, Y, Brenner, B, Kashtan, H, Belgrano, V, De Cian, F, Palermo, B, Eggenhoffner, R, Albertelli, M, Sanchez-Guillen, L, Arroyo, A, Lopez-Rodriguez, F, Lario, S, Lillo, C, Wexner, SD, SIOG Surgical Task Force, and ESSO GOSAFE Study Grp

Subjects
MULTICENTER, CANCER
Abstract

Objective: Older patients with cancer value functional outcomes as much as survival, but surgical studies lack functional recovery (FR) data. The value of a standardized frailty assessment has been confirmed, yet it's infrequently utilized due to time restrictions into everyday practice. The multicenter GOSAFE study was designed to (1) evaluate the trajectory of patients' quality of life (QoL) after cancer surgery (2) assess baseline frailty indicators in unselected patients (3) clarify the most relevant tools in predicting FR and clinical outcomes. This is a report of the study design and baseline patient evaluations. Materials & Methods: GOSAFE prospectively collected a baseline multidimensional evaluation before major elective surgery in patients (70 years) from 26 international units. Short-/mid-/Iong-term surgical outcomes were recorded with QoL and FR data. Results: 1003 patients were enrolled in a 26-month span. Complete baseline data were available for 977(97.4%). Median age was 78 years (range 70-94); 52.8% males. 968(99%) lived at home, 51.6% without caregiver. 54.4% had 3 medications, 5.9% none. Patients were dependent (ADL < 5) in 7.9% of the cases. Frailty was either detected by G8 = 2(37.4%), TUG > 20 s (5.2%) or ASAIII-IV (48.8%). Major comorbidities (CACI > 6) were detected in 36%; 20.9% of patients had cognitive impairment according to Mini-Cog. Conclusion: The GOSAFE showed that frailty is frequent in older patients undergoing cancer surgery. QoL and FR, for the first time, are going to be primary outcomes of a real-life observational study. The crucial role of frailty assessment is going to be addressed in the ability to predict postoperative outcomes and to correlate with QoL and FR. (C) 2019 Elsevier Ltd. All rights reserved.

Published
2020

8. Crohn's disease and postoperative recurrence. The role of anastomotic configurations and the kono-s anastomosis

Author

Fornaro, R, Caristo, G, Stratta, E, Oliva, A, Giovinazzo, D, Mascherini, M, and Frascio, M.

Subjects
Crohn's disease, Crohn Disease, Anastomosis, Recurrence, Anastomosis, Surgical, Postoperative Recurrences, Humans, Anastomosis, Crohn's disease, Postoperative Recurrences
Abstract

The observation that in more than 90% of Crohn's disease patients the postoperative recurrences are located in the pre-anastomotic tract leads us to suppose that the anastomosis would play a role in the appearance of recurrences.To focus the role of different anastomotic configurations in the incidence of recurrences, the Authors have conducted a review of the literature of the last two decades and have revised critically their experience.The rate of recurrences seem to be lower in patients in whom the anastomotic configuration is such as to present a wide lumen; it seems that they are lower after stapled side-to-side anastomosis. The Kono-S anastomosis, recently introduced technique, seems to offer better results.The role of the various types of anastomosis remains uncertain. Further large-scale controlled trials with long term follow-up are needed.Anastomosis, Crohn's disease, Postoperative Recurrences.L’osservazione che in oltre il 90% dei pazienti affetti da malattia di Crohn le recidive postoperatorie si trovano nel tratto pre-anastomotico ci porta a supporre che il tipo di anastomosi svolga un ruolo nella comparsa delle recidive. Per analizzare il ruolo delle diverse configurazioni anastomotiche nell’incidenza delle recidive, gli Autori hanno condotto una revisione della letteratura degli ultimi due decenni e hanno fatto una revisione critica della loro personale esperienza. Da questa analisi sembra risultare che il tasso di recidive sia inferiore nei pazienti nei quali la configurazione anastomotica è tale da presentare un ampio lume e quando si tratta di anastomosi laterolaterali fatte con suturatrice meccanica. L’anastomosi Kono-S, illustrata nell’iconografia è una tecnica introdotta di recente, e sembra offrire risultati migliori. In conclusione il ruolo dei vari tipi di anastomosi rimane incerto, e sono necessari ulteriori studi controllati su larga scala con follow-up a lungo termine ponendo attenzione in particolare ad tipo di anastomosi adottato.

Published
2019

9. Thrombotic complications in Inflammatory Bowel Diseases

Author

Fornaro, R., Caristo, G., Stratta, E., Caratto, M., Caratto, E., Giovinazzo, D., Maira, L. D., MARCO CASACCIA, and Frascio, M.

Subjects
Thrombotic complications - inflammatory bowel diseases, Crohn Disease, Fibrinolytic Agents, Anticoagulants, Humans, Colitis, Ulcerative, Thrombolytic Therapy, Venous Thromboembolism, Inflammatory Bowel Diseases
Abstract

Inflammatory bowel disease (IBD), Crohn's Disease (CD) and Ulcerative Colitis (UC) are associated with an increased risk of arterial and venous thromboembolism. A 2 to 3 time fold increased risk of developing thromboembolic complications was reported for IBD patients compared to general population. A systematic literature search was conducted using PubMed, Medline, Scopus, Cochrane database. The key words were: "Inflammatory Bowell Disease", "Crohn's Disease and Thrombosis", "Ulcerative Colitis and Thrombosis", "Thrombosis" and "Inflammatory Bowel Diseases and Thrombosis". Full articles and abstracts were included. Studies such as case reports, letters and commentaries were excluded from the analysis if appropriate data could not be extracted. Although no randomized controlled trials (RCTs) have been established to evaluate the efficacy of thromboprophylaxis in patients with IBD due to the incidence of VTE and PE in such patients, it is highly recommended the adoption of thromboprophylactic measures. Available prophylaxis and treatment options include pharmacological anticoagulant therapy (LMWH-Low Molecular Weight Heparin, Fondaparinux and UH-Unfractionated Heparin) and mechanical prophylaxis. In case of acute VTE patient must be treated with fibrinolytic agents and in selected non-responsive cases vascular surgery. IBD patients have an increased risk of VTE complications. Prophylaxis for VTE should be recommended in all patients who do not show contraindications to treatment.

Published
2019

10. Requirements for experimental data and associated uncertainties in order to validate multi-physics simulation tools: case of the experiments in the cabri reactor

Author

Hudelot, J.-P., Clamens, O., Lecerf, J., Labit, J.-M., Stratta, E., CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), The authors would like to acknowledge IRSN (Institut de Radioprotection et de Sûreté Nucléaire)for its financial, technical and scientific support and contribution to the CABRI experiments, CADARACHE, Bibliothèque, and CEA-Direction de l'Energie Nucléaire (CEA-DEN)

Subjects
[PHYS.NUCL] Physics [physics]/Nuclear Theory [nucl-th], multiphysics, [PHYS.NUCL]Physics [physics]/Nuclear Theory [nucl-th], [PHYS.NEXP] Physics [physics]/Nuclear Experiment [nucl-ex], Cabri, experiments, [PHYS.NEXP]Physics [physics]/Nuclear Experiment [nucl-ex], uncertainties
Abstract

International audience; This paper focuses on the opportunity given by the CABRI experiments tocontribute to the validation of High-Fidelity multi-physics computational tools; itdoes not address the safety demonstration for the CABRI reactor that is based on arobust and conservative approach that does not need the use of high-fidelity multiphysicsmodelling and simulation tools. The paper first presents a general approachand recommendations to be used to meet the requirements for experimental dataand associated uncertainties in order to validate multi-physics modelling andsimulation tools. After a short presentation of the CABRI facility, it then providesa review and critical analyses of the multi-physics available experimental data forCABRI. Finally, it addresses the adequacy and completeness of the CABRIexperimental datasets for the validation of multiphysics computational tools, aswell as promising perspectives in terms of instrumentations that could fill in thegaps in terms of information in the future experiments.

Published
2018

13. Copernic, a new tool based on simplified calculation methods for innovative lwrs conceptual design studies

Author

Morin, F., Gautier, G.-M., Bizeau, O., Cathalau, S., Stratta, E., Belliard, M., amplexor, amplexor, CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)

Subjects
[PHYS.NUCL] Physics [physics]/Nuclear Theory [nucl-th], [PHYS.NUCL]Physics [physics]/Nuclear Theory [nucl-th], [PHYS.NEXP] Physics [physics]/Nuclear Experiment [nucl-ex], [PHYS.NEXP]Physics [physics]/Nuclear Experiment [nucl-ex]
Abstract

International audience; This paper describes the COPERNIC tool used for the safety and operation assessment of innovative nuclear systems. COPERNIC is fast and easy-to-use thus it makes it possible to perform parametric studies on a given concept or comparative studies between various concepts. Over the last past months, it has been improved in order to allow simulations of passive (and some active) system behavior during LOCA transients in order to pre-design these system. Each individual system is implemented in COPERNIC as a transfer function that has been calibrated versus thermal-hydraulic CATHARE-2 models.

Published
2017

14. THERMAL-HYDRAULIC STUDY OF PASSIVE SAFETY SYSTEMS BASED ON THE HYDRAULIC DIODE PRINCIPLE FOR THE MANAGEMENT OF LARGE-BREAK LOSS OF COOLANT ACCIDENTS

Author

Stratta, E., Belliard, Michel, Belliard, Michel, and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)

Subjects
In-vessel flow limiter, Advanced accumulator, Passive safety systems, [SPI.MECA.MEFL] Engineering Sciences [physics]/Mechanics [physics.med-ph]/Fluids mechanics [physics.class-ph], Large-break LOCA, [SPI.MECA.MEFL]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Fluids mechanics [physics.class-ph]
Abstract

International audience; In the context of improvement studies for pressurized water reactors (PWR) in the post-Fukushima accident situation, passive safety systems have been identified as an interesting strategy for design-basis and severe accidents management. CATHARE code thermal-hydraulic studies, performed to evaluate the impact of two specific passive elements of safety systems during large-break loss-of-coolant-accidents (LB LOCA), are here presented. The two systems, namely the in-vessel flow limiter and the advanced accumulator, are based on the hydraulic diode principle: a singular pressure drop is added to the flow path by an induced fluid vortex, thus decreasing the mass flow. The in-vessel flow limiter is made up of some fins deflecting the fluid only in case of reversed flow, thus limiting the liquid mass exiting the primary circuit through the break. The advanced accumulator modifies its injection flow by switching the orientation of the injection pipe. After the reactor refill (high-rate injection phase), the flow regulation prevents the waste of the accumulator water: the lower the flow, the more lasting the injection. Parametric studies on the pressure-drop coefficient have been performed to evaluate each system's impact. The flow limiter coefficients validity domain has been verified by CFD studies (GENEPI code). Analyses on the maximum cladding temperature, the primary-circuit mass inventory and the core reflooding-front level have shown a benefit mainly depending on the pressure-drop coefficient value. The two systems' combined effect shows a great gain on the three mentioned parameters, even suggesting the possibility of reducing the active safety injection, thus reducing possible failures and investment costs.

Published
2017

15. Colon-rectal follow-up program: a monocentric experience

Author

Stratta, E., primary, Murialdo, R., additional, Sparavigna, M., additional, Scabini, S., additional, Romairone, E., additional, Zoppoli, G., additional, Tixi, L., additional, Ghiglione, A., additional, Harusha, E., additional, and Ballestrero, A., additional

Published
2017
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18. Mutations in CUL7, OBSL1 and CCDC8 in 3-M syndrome lead to disordered growth factor signalling

Author

Hanson, D, primary, Murray, P G, additional, Coulson, T, additional, Sud, A, additional, Omokanye, A, additional, Stratta, E, additional, Sakhinia, F, additional, Bonshek, C, additional, Wilson, L C, additional, Wakeling, E, additional, Temtamy, S A, additional, Aglan, M, additional, Rosser, E M, additional, Mansour, S, additional, Carcavilla, A, additional, Nampoothiri, S, additional, Khan, W I, additional, Banerjee, I, additional, Chandler, K E, additional, Black, G C M, additional, and Clayton, P E, additional

Published
2012
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19. GOSAFE - Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery: early analysis on 977 patients

Author

Barbara Frezza, Giampaolo Castagnoli, Genoveffa Balducci, Valentina Riggio, G. Ugolini, Antonio Arroyo, Gianluca Garulli, Caterina Foppa, Kristin Cardin, Matthijs Plas, Gaetano Gallo, Francesca De Lucia, Francisco López-Rodríguez, Sandra Lario, Franco De Cian, Flavia Foca, Alberto Realis Luc, Paola Tramelli, Roberta Pellegrino, Giacomo Sermonesi, Stefano Sfondrini, Federico Ghignone, Orestis Ioannidis, Nicole M. Saur, Michael David Fejka, Basilio Pirrera, Bruno Alampi, Siri Rostoft, Sam Fox, Chiara Zingaretti, Ingeborg Flåten Backe, Alessandro Spaziani, Barbara Perenze, Minas Baltatzis, Riccardo A. Audisio, Claudia Santos, Luigi Marano, Mariann Lønn, Stefano Scabini, Andrea Massobrio, Patrizio Capelli, Isacco Montroni, Luis E. De León, Cristina Lillo, Alessio Lucarini, Valerio Belgrano, Antonino Spinelli, Daniela Di Pietrantonio, Nicola de Liguori Carino, Davide Pertile, Luigi Conti, Andrea Romboli, Giuseppe Sammarco, Hanoch Kashtan, Baha Siam, Michael T. Jaklitsch, Arild Nesbakken, Michele De Simone, Oriana Nanni, Filippo Banchini, Ajith K. Siriwardena, Giorgio Ercolani, Pietro Achilli, Davide Zattoni, Bernadette Vertogen, Steven D. Wexner, Laura Frain, Konstantinos Galanos-Demiris, Dario Maggioni, Baruch Brenner, Gerardo Palmieri, Giovanni Taffurelli, Barbara L. van Leeuwen, Manuela Albertelli, Gianluca Pellino, Anthony Chan, Alberto Bartoli, Emanuela Stratta, Mario Trompetto, Anna Garutti, Francesca Tauceri, Michele Mazzola, Beatrice Palermo, G. Clerico, Jakub Kenig, Yochai Levy, Graziana Barile, Vincenzo Alagna, Giulio Mari, Roberto Eggenhöffner, Joshua I. S. Bleier, Giovanni Ferrari, Andrea Costanzi, Michele Carvello, Francesca Di Candido, Francesco Monari, Ponnandai Somasundar, Kinga Szabat, Matteo Sacchi, Luis Sánchez-Guillén, Lydia Loutzidou, Lisa Cooper, Hanneke van der Wal-Huisman, Mariateresa Mirarchi, Domenico Soriero, Raffaele De Luca, Andrea Lucchi, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Clinical Cognitive Neuropsychiatry Research Program (CCNP), Montroni I., Rostoft S., Spinelli A., Van Leeuwen B.L., Ercolani G., Saur N.M., Jacklitsh M.T., Somasundar P.S., de Liguori Carino N., Ghignone F., Foca F., Zingaretti C., Audisio R.A., Ugolini G., Garutti A., Taffurelli G., Zattoni D., Tramelli P., Sermonesi G., Di Candido F., Carvello M., Sacchi M., De Lucia F., Foppa C., Plas M., Van der Wal-Huisman H., Tauceri F., Perenze B., Di Pietrantonio D., Mirarchi M., Fejka M., Bleier J.I.S., Frain L., Fox S.W., Cardin K., De Leon L.E., Baltatzis M., Chan A.K.C., Siriwardena A.K., Vertogen B., Nanni O., Garulli G., Alagna V., Pirrera B., Lucchi A., Monari F., Conti L., Capelli P., Romboli A., Palmieri G., Banchini F., Marano L., Spaziani A., Castagnoli G., Bartoli A., Trompetto M., Gallo G., Luc A.R., Clerico G., Sammarco G., De Luca R., Barile G., Simone M., Costanzi A., Mari G., Maggioni M., Pellegrino R., Riggio V., Kenig J., Szabat K., Scabini S., Pertile D., Stratta E., Massobrio A., Soriero D., Nesbakken A., Lonn M., Backe I.F., Ferrari G., Mazzola M., Alampi B.D.A., Achilli P., Sfondrini S., Ioannidis O., Loutzidou L., Galanos-Demiris K., Pellino G., Balducci G., Frezza B., Lucarini A., Santos C., Cooper L., Siam B., Levy Y., Brenner B., Kashtan H., Belgrano V., De Cian F., Palermo B., Eggenhoffner R., Albertelli M., Sanchez-Guillen L., Arroyo A., Lopez-Rodriguez F., Lario S., Lillo C., Wexner S.D., Montroni, I., Rostoft, S., Spinelli, A., Van Leeuwen, B. L., Ercolani, G., Saur, N. M., Jacklitsh, M. T., Somasundar, P. S., de Liguori Carino, N., Ghignone, F., Foca, F., Zingaretti, C., Audisio, R. A., Ugolini, G., Garutti, A., Taffurelli, G., Zattoni, D., Tramelli, P., Sermonesi, G., Di Candido, F., Carvello, M., Sacchi, M., De Lucia, F., Foppa, C., Plas, M., Van der Wal-Huisman, H., Tauceri, F., Perenze, B., Di Pietrantonio, D., Mirarchi, M., Fejka, M., Bleier, J. I. S., Frain, L., Fox, S. W., Cardin, K., De Leon, L. E., Baltatzis, M., Chan, A. K. C., Siriwardena, A. K., Vertogen, B., Nanni, O., Garulli, G., Alagna, V., Pirrera, B., Lucchi, A., Monari, F., Conti, L., Capelli, P., Romboli, A., Palmieri, G., Banchini, F., Marano, L., Spaziani, A., Castagnoli, G., Bartoli, A., Trompetto, M., Gallo, G., Luc, A. R., Clerico, G., Sammarco, G., De Luca, R., Barile, G., Simone, M., Costanzi, A., Mari, G., Maggioni, M., Pellegrino, R., Riggio, V., Kenig, J., Szabat, K., Scabini, S., Pertile, D., Stratta, E., Massobrio, A., Soriero, D., Nesbakken, A., Lonn, M., Backe, I. F., Ferrari, G., Mazzola, M., Alampi, B. D. A., Achilli, P., Sfondrini, S., Ioannidis, O., Loutzidou, L., Galanos-Demiris, K., Pellino, G., Balducci, G., Frezza, B., Lucarini, A., Santos, C., Cooper, L., Siam, B., Levy, Y., Brenner, B., Kashtan, H., Belgrano, V., De Cian, F., Palermo, B., Eggenhoffner, R., Albertelli, M., Sanchez-Guillen, L., Arroyo, A., Lopez-Rodriguez, F., Lario, S., Lillo, C., and Wexner, S. D.

Subjects
Geriatric Oncology, Surgical Assessment, Functional Recovery, Pre&postoperative testing, Surgery morbidity, Surgery mortality, Male, medicine.medical_specialty, Surgery morbidity, MEDLINE, MULTICENTER, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Pre&postoperative testing, Quality of life, aged, aged, 80 and over, female, geriatric assessment, humans, male, neoplasms, postoperative complications, prospective studies, quality of life, Functional Recovery, Internal medicine, Neoplasms, medicine, 80 and over, Humans, 030212 general & internal medicine, Prospective Studies, Elective surgery, Geriatric Assessment, cancer, geriatric, outcome, Aged, Aged, 80 and over, business.industry, Surgical Assessment, Cancer, Functional recovery, medicine.disease, CANCER, Geriatric Oncology, Surgery mortality, Oncology, Geriatric oncology, 030220 oncology & carcinogenesis, Quality of Life, Observational study, Female, Geriatrics and Gerontology, business, Early analysis
Abstract

Objective: Older patients with cancer value functional outcomes as much as survival, but surgical studies lack functional recovery (FR) data. The value of a standardized frailty assessment has been confirmed, yet it's infrequently utilized due to time restrictions into everyday practice. The multicenter GOSAFE study was designed to (1) evaluate the trajectory of patients' quality of life (QoL) after cancer surgery (2) assess baseline frailty indicators in unselected patients (3) clarify the most relevant tools in predicting FR and clinical outcomes. This is a report of the study design and baseline patient evaluations. Materials & Methods: GOSAFE prospectively collected a baseline multidimensional evaluation before major elective surgery in patients (≥70 years) from 26 international units. Short−/mid−/long-term surgical outcomes were recorded with QoL and FR data. Results: 1003 patients were enrolled in a 26-month span. Complete baseline data were available for 977(97.4%). Median age was 78 years (range 70–94); 52.8% males. 968(99%) lived at home, 51.6% without caregiver. 54.4% had ≥ 3 medications, 5.9% none. Patients were dependent (ADL < 5) in 7.9% of the cases. Frailty was either detected by G8 ≤ 14(68.4%), fTRST ≥ 2(37.4%), TUG > 20 s (5.2%) or ASAIII-IV (48.8%). Major comorbidities (CACI > 6) were detected in 36%; 20.9% of patients had cognitive impairment according to Mini-Cog. Conclusion: The GOSAFE showed that frailty is frequent in older patients undergoing cancer surgery. QoL and FR, for the first time, are going to be primary outcomes of a real-life observational study. The crucial role of frailty assessment is going to be addressed in the ability to predict postoperative outcomes and to correlate with QoL and FR.

Published
2019

20. Effects of selexipag and its active metabolite in contrasting the profibrotic myofibroblast activity in cultured scleroderma skin fibroblasts

Author

Nicola Giordano, Renata Brizzolara, Carmen Pizzorni, Sabrina Paolino, Maurizio Cutolo, Paola Montagna, Stefano Soldano, Aurora Parodi, Barbara Ruaro, Vanessa Smith, Pier Paolo Tavilla, Emanuela Stratta, Claudio Corallo, Stefano Scabini, A.C. Trombetta, Alberto Sulli, Cutolo, M, Ruaro, B, Montagna, P, Brizzolara, R, Stratta, E, Trombetta, Ac, Scabini, S, Tavilla, Pp, Parodi, A, Corallo, C, Giordano, N, Paolino, S, Pizzorni, C, Sulli, A, Smith, V, and Soldano, S

Subjects
0301 basic medicine, lcsh:Diseases of the musculoskeletal system, Fibrosi, medicine.medical_treatment, Gene Expression, Skin fibroblast, Prostacyclin receptor agonist, Acetates, Selexipag, PATHWAY, Extracellular matrix, Systemic sclerosi, chemistry.chemical_compound, 0302 clinical medicine, Prostacyclin receptor agonists, Skin fibroblasts, Fibrosis, Systemic sclerosis, Connective tissue diseases, Acetamides, Medicine and Health Sciences, Myofibroblasts, Cells, Cultured, RAT PULMONARY-ARTERY, Skin, RAYNAUDS-PHENOMENON SECONDARY, biology, Chemistry, Middle Aged, medicine.anatomical_structure, Pyrazines, Phosphorylation, Systemic sclerosis, Female, Prostacyclin receptor agonists, Skin fibroblasts, Fibrosis, Connective tissue diseases, Myofibroblast, Research Article, GROWTH-FACTOR, 03 medical and health sciences, ENDOTHELIN-1, medicine, Humans, S100 Calcium-Binding Protein A4, Fibroblast, Protein kinase B, Aged, 030203 arthritis & rheumatology, Scleroderma, Systemic, HYPERTENSION, Growth factor, SYSTEMIC-SCLEROSIS, ORAL ILOPROST, Muscle, Smooth, Fibroblasts, Molecular biology, Actins, Fibronectin, 030104 developmental biology, biology.protein, lcsh:RC925-935
Abstract

Background: Myofibroblasts contribute to fibrosis through the overproduction of extracellular matrix (ECM) proteins, primarily type I collagen (COL-1) and fibronectin (FN), a process which is mediated in systemic sclerosis (SSc) by the activation of fibrogenic intracellular signaling transduction molecules, including extracellular signal-regulated kinases 1 and 2 (Erk1/2) and protein kinase B (Akt). Selexipag is a prostacyclin receptor agonist synthesized for the treatment of pulmonary arterial hypertension. The study investigated the possibility for selexipag and its active metabolite (ACT-333679) to downregulate the profibrotic activity in primary cultures of SSc fibroblasts/myofibroblasts and the fibrogenic signaling molecules involved. Methods: Fibroblasts from skin biopsies obtained with Ethics Committee (EC) approval from patients with SSc, after giving signed informed consent, were cultured until the 3rd culture passage and then either maintained in normal growth medium (untreated cells) or independently treated with different concentrations of selexipag (from 30 mu M to 0.3 mu M) or ACT-333679 (from 10 mu M to 0.1 mu M) for 48 h. Protein and gene expressions of a-smooth muscle actin (alpha-SMA), fibroblast specific protein-1 (S100A4), COL-1, and FN were investigated by western blotting and quantitative real-time PCR. Erk1/2 and Akt phosphorylation was investigated in untreated and ACT-333679-treated cells by western botting. Results: Selexipag and ACT-333679 significantly reduced protein synthesis and gene expression of a-SMA, S100A4, and COL-1 in cultured SSc fibroblasts/myofibroblasts compared to untreated cells, whereas FN was significantly downregulated at the protein level. Interestingly, ACT-333679 significantly reduced the phosphorylation of Erk1/2 and Akt in cultured SSc fibroblasts/myofibroblasts. Conclusions: Selexipag and mainly its active metabolite ACT-333679 were found for the first time to potentially interfere with the profibrotic activity of cultured SSc fibroblasts/myofibroblasts at least in vitro, possibly through the downregulation of fibrogenic Erk1/2 and Akt signaling molecules.

Published
2018
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21. Correction to: Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospectivetrial on 1225 cases comparing intra corporeal versus extra corporeal ileo‑colic side‑to‑side anastomosis (Surgical Endoscopy, (2019), 10.1007/s00464-019-07255-2)

Author

M. Sorrentino, A. Alo, G. L. Canu, F. Monari, A. G. Marrosu, E. Soligo, Wanda Petz, A. Gattolin, R. Vicentini, S. Razzi, M. Zago, S. Neri, A. Pisani Ceretti, D. Apa, F. Gatti, A. Donini, F. Medas, D. Cassetti, S. Rubino, R. Lombardi, G. D. DePalma, Alberto Arezzo, G. Soliani, P. Checcacci, G. Concone, Emanuele Botteri, F. Scognamillo, Ferdinando Agresta, Pierluigi Marini, S. Gelati, Luigi Boni, A. Coratti, Andrea Picchetto, G. Guerriero, M. Calgaro, Francesca Pecchini, A. Contine, Andrea Valeri, N. DeManzini, M. Clementi, A. Balani, F. Fidanza, R. Galleano, Carlo Bergamini, A. Brescia, G. Arcuri, Elio Jovine, E. Rosso, A. Oldani, E. Artioli, Nereo Vettoretto, Giuseppe Navarra, G. Sarro, E. Restini, Chiara Morotti, S. Giannessi, F. DeAngelis, M. Degiuli, G. Talamo, G. Alemanno, L. Cafagna, P. Cumbo, V. Violi, S. Targa, Irnerio Angelo Muttillo, A. Martino, M. DeLuca, Elisa Cassinotti, Alessandro Puzziello, S. Sala, Riccardo Rosati, E. Erdas, R. Petri, A. Deserra, A. Gioffre, G. Viola, E. Stratta, Mario Guerrieri, E. Minciotti, Mauro Podda, Giuseppe Spinoglio, F. Borghi, Micaela Piccoli, C. DeNisco, P. Carcoforo, D. Delogu, Giuseppe Resta, P. Corleone, D. Pennisi, Gianfranco Silecchia, E. Opocher, A. Taddei, A. Budassi, Paolo Delrio, A. Meloni, Marco E. Allaix, A. Ambrosi, H. Impellizzeri, N. Portolani, L. Guerriero, G. Ercolani, A. Guariniello, M. Antoniutti, M. Cesari, A. P. Luzzi, M. Izzo, M. Longoni, R. Mazza, C. Benvenuto, S. Gobbi, P. G. Calo, C. Feo, Antonino Agrusa, L. Covotta, L. Presenti, V. Adamo, Gian Luca Baiocchi, E. Osenda, R. Ottonello, Giancarlo D'Ambrosio, F. Roviello, V. Grammatico, G. Moretto, L. Zampino, Valerio Caracino, Giovanni Ferrari, D. Rega, V. Robustelli, Diego Cuccurullo, F. Vasta, Ugo Elmore, R. Campagnacci, Gianfranco Cocorullo, O. Ghazouani, G. Ricci, S. Berti, F. Colombo, Alberto Sartori, S. Scabini, S. Mazzoccato, B. Pirrera, A. Altamura, N. Tartaglia, E. Romairone, G. Baldazzi, Marco Catarci, G. Garulli, Lorenzo Casali, S. Testa, R. Brachet Contul, M. Basti, U. Rivolta, D. Pertile, M. Pavanello, M. Pisano, Marco Milone, A. Verzelli, P. Ubiali, L. Solaini, M. Coppola, G Anania, Massimo Carlini, F. Corcione, P. DePaolis, P. Ciano, M. Santarelli, V. Panebianco, Nicola Perrotta, R. Sechi, M. Rigamonti, G. Lezoche, L. Fabris, C. Lirusso, D. Foschi, G. Canova, P. Soliani, Roberta Gelmini, Stefano Olmi, A. Lucchi, Giorgia Valpiani, L. Pellegrino, Anania, G., Agresta, F., Artioli, E., Rubino, S., Resta, G., Vettoretto, N., Petz, W. L., Bergamini, C., Arezzo, A., Valpiani, G., Morotti, C., Silecchia, G., Adamo, V., Agrusa, A., Alemanno, G., Allaix, M. E., Alo, A., Altamura, A., Ambrosi, A., Antoniutti, M., Apa, D., Arcuri, G., Baiocchi, G. L., Balani, A., Baldazzi, G., Basti, M., Benvenuto, C., Berti, S., Boni, L., Borghi, F., Botteri, E., Brachet Contul, R., Brescia, A., Budassi, A., Cafagna, L., Calgaro, M., Calo, P. G., Campagnacci, R., Canova, G., Canu, G. L., Caracino, V., Carcoforo, P., Carlini, M., Casali, L., Cassetti, D., Cassinotti, E., Catarci, M., Cesari, M., Checcacci, P., Ciano, P., Clementi, M., Cocorullo, G., Colombo, F., Concone, G., Contine, A., Coppola, M., Coratti, A., Corcione, F., Corleone, P., Covotta, L., Cuccurullo, D., Cumbo, P., D'Ambrosio, G., Deangelis, F., Deluca, M., Demanzini, N., Denisco, C., Depalma, G. D., Depaolis, P., Degiuli, M., Delogu, D., Delrio, P., Deserra, A., Donini, A., Elmore, U., Ercolani, G., Erdas, E., Fabris, L., Ferrari, G., Feo, C., Fidanza, F., Foschi, D., Galleano, R., Garulli, G., Gatti, F., Gattolin, A., Gelati, S., Gelmini, R., Ghazouani, O., Gioffre, A., Gobbi, S., Grammatico, V., Guariniello, A., Giannessi, S., Guerrieri, M., Guerriero, L., Guerriero, G., Impellizzeri, H., Izzo, M., Jovine, E., Lezoche, G., Lirusso, C., Lombardi, R., Longoni, M., Lucchi, A., Luzzi, A. P., Marini, P., Marrosu, A. G., Martino, A., Mazza, R., Mazzoccato, S., Medas, F., Meloni, A., Milone, M., Minciotti, E., Monari, F., Moretto, G., Muttillo, I. A., Navarra, G., Neri, S., Oldani, A., Olmi, S., Opocher, E., Osenda, E., Ottonello, R., Panebianco, V., Pavanello, M., Pecchini, F., Pellegrino, L., Pennisi, D., Perrotta, N., Pertile, D., Petri, R., Picchetto, A., Piccoli, M., Pirrera, B., Pisani Ceretti, A., Pisano, M., Podda, M., Portolani, N., Presenti, L., Puzziello, A., Razzi, S., Rega, D., Restini, E., Ricci, G., Rigamonti, M., Rivolta, U., Robustelli, V., Romairone, E., Rosati, R., Rosso, E., Roviello, F., Sala, S., Santarelli, M., Sarro, G., Sartori, A., Scabini, S., Scognamillo, F., Sechi, R., Solaini, L., Soliani, G., Soliani, P., Soligo, E., Sorrentino, M., Spinoglio, G., Stratta, E., Taddei, A., Talamo, G., Targa, S., Tartaglia, N., Testa, S., Ubiali, P., Valeri, A., Vasta, F., Verzelli, A., Vicentini, R., Viola, G., Violi, V., Zago, M., and Zampino, L.

Subjects
medicine.medical_specialty, colon cancer right hemcolectomy, business.industry, medicine, Surgery, business, Side to side anastomosis, Surgical endoscopy, Laparoscopic right hemicolectomy, NO, LS7_4
Abstract

Due to an error in production the members of SICE CoDIG (Colon Dx Italian Group) listed in the Acknowledgments were not tagged correctly as authors in the XML of this article. This listing is presented again here:.

Published
2019

22. Effects of CTLA4-Ig treatment on circulating fibrocytes and skin fibroblasts from the same systemic sclerosis patients: an in vitro assay

Author

Carmen Pizzorni, Stefano Soldano, Vanessa Smith, Sabrina Paolino, Barbara Ruaro, Maurizio Cutolo, Paola Montagna, Renata Brizzolara, Stefano Scabini, A.C. Trombetta, Alberto Sulli, Emanuela Stratta, Paola Contini, Cutolo, M, Soldano, S, Montagna, P, Trombetta, Ac, Contini, P, Ruaro, B, Sulli, A, Scabini, S, Stratta, E, Paolino, S, Pizzorni, C, Smith, V, and Brizzolara, R

Subjects
Male, MYOFIBROBLAST, 0301 basic medicine, Pathology, lcsh:Diseases of the musculoskeletal system, Skin fibroblast, ABATACEPT, CXCR4, DISEASE, Systemic sclerosi, Fibrocytes, Skin fibroblasts, CTLA4-Ig, Systemic sclerosis, Connective tissue disease, 0302 clinical medicine, Fibrosis, SCLERODERMA, Fibrocyte, Medicine and Health Sciences, FIBROSIS, Medicine, Cells, Cultured, Skin, integumentary system, Stem Cells, Fibrocytes, Skin fibroblasts, CTLA4-Ig, Systemic sclerosis, Connective tissue disease, Middle Aged, Blot, Antirheumatic Agents, Female, Research Article, EXPRESSION, medicine.medical_specialty, CD14, Bone Marrow Cells, chemical and pharmacologic phenomena, CD11a, In Vitro Techniques, Abatacept, 03 medical and health sciences, INFLAMMATION, Humans, Progenitor cell, Aged, 030203 arthritis & rheumatology, CD86, Scleroderma, Systemic, business.industry, Fibroblasts, medicine.disease, RHEUMATOID-ARTHRITIS, 030104 developmental biology, T-CELLS, lcsh:RC925-935, business
Abstract

Background Systemic sclerosis (SSc) is characterized by vasculopathy and progressive fibrosis. CTLA4-Ig (abatacept) is able to interact with the cell surface costimulatory molecule CD86 and downregulate the target cell. The aim of this study was to evaluate the in-vitro effects of CTLA4-Ig treatment on circulating fibrocytes and skin fibroblasts isolated from the same SSc patient. Methods Circulating fibrocytes and skin fibroblasts were obtained from eight SSc patients with “limited” cutaneous involvement and from four healthy subjects (HSs). Samples were analyzed by fluorescence-activated cell sorter analysis (FACS) at baseline (T0) and after 8 days of culture (T8) for CD45, collagen type I (COL I), CXCR4, CD14, CD86, and HLA-DRII expression. Circulating fibrocytes were treated for 3 h and skin fibroblasts for 24/48 h with CTLA4-Ig (10, 50, 100, 500 μg/ml). Quantitative real-time polymerase chain reaction (qRT-PCR) was performed for CD86, COL I, FN, TGFβ, αSMA, S100A4, CXCR2, CXCR4, CD11a, and Western blotting was performed for COL I and FN. Results Using qRT-PCR, the T8-cultured SSc circulating fibrocytes which had not been treated with CTLA4-Ig showed higher gene expression for CD86, αSMA, S100A4, TGFβ, and COL I compared with HS circulating fibrocytes. Interestingly, αSMA/COL I gene expression was significantly lower only in the SSc circulating fibrocytes treated with CTLA4-Ig for 3 h (p

Published
2018
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23. Evaluation of a Lung Ultrasound Score in Hospitalized Adult Patients with COVID-19 in Barcelona, Spain.

Author

Lightowler MS, Sander JV, García de Casasola Sánchez G, Mateos González M, Güerri-Fernández R, Lorenzo Navarro MD, Nackers F, Stratta E, Lanusse C, and Huerga H

Abstract

Background/Objectives : During the COVID-19 pandemic and the burden on hospital resources, the rapid categorization of high-risk COVID-19 patients became essential, and lung ultrasound (LUS) emerged as an alternative to chest computed tomography, offering speed, non-ionizing, repeatable, and bedside assessments. Various LUS score systems have been used, yet there is no consensus on an optimal severity cut-off. We assessed the performance of a 12-zone LUS score to identify adult COVID-19 patients with severe lung involvement using oxygen saturation (SpO 2 )/fractional inspired oxygen (FiO 2 ) ratio as a reference standard to define the best cut-off for predicting adverse outcomes. Methods : We conducted a single-centre prospective study (August 2020-April 2021) at Hospital del Mar, Barcelona, Spain. Upon admission to the general ward or intensive care unit (ICU), clinicians performed LUS in adult patients with confirmed COVID-19 pneumonia. Severe lung involvement was defined as a SpO 2 /FiO 2 ratio <315. The LUS score ranged from 0 to 36 based on the aeration patterns. Results : 248 patients were included. The admission LUS score showed moderate performance in identifying a SpO 2 /FiO 2 ratio <315 (area under the ROC curve: 0.71; 95%CI 0.64-0.77). After adjustment for COVID-19 risk factors, an admission LUS score ≥17 was associated with an increased risk of in-hospital death (OR 5.31; 95%CI: 1.38-20.4), ICU admission (OR 3.50; 95%CI: 1.37-8.94) and need for IMV (OR 3.31; 95%CI: 1.19-9.13). Conclusions : Although the admission LUS score had limited performance in identifying severe lung involvement, a cut-off ≥17 score was associated with an increased risk of adverse outcomes. and could play a role in the rapid categorization of COVID-19 pneumonia patients, anticipating the need for advanced care.

Published
2024
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24. Point-of-care ultrasound for tuberculosis diagnosis in children: a Médecins Sans Frontières cross-sectional study in Guinea-Bissau.

Author

Moretó-Planas L, Sagrado MJ, Mahajan R, Gallo J, Biague E, Gonçalves R, Nuozzi P, Rocaspana M, Fonseca JV, Medina C, Camará M, Nadimpalli A, Alonso B, Llosa AE, Heuvelings L, Burza S, Molina I, Ruby LC, Stratta E, and Bélard S

Subjects
Humans, Child, Female, Infant, Male, Cross-Sectional Studies, Point-of-Care Systems, Guinea-Bissau, Ultrasonography methods, HIV Infections complications, HIV Infections epidemiology, Tuberculosis diagnosis, Malnutrition diagnostic imaging, Malnutrition complications
Abstract

Objective: Description of tuberculosis (TB)-focused point-of-care ultrasound (POCUS) findings for children with presumptive TB., Design: Cross-sectional study (July 2019 to April 2020)., Setting: Simão Mendes hospital in Bissau, a setting with high TB, HIV, and malnutrition burdens., Participants: Patients aged between 6 months and 15 years with presumptive TB., Interventions: Participants underwent clinical, laboratory and unblinded clinician-performed POCUS assessments, to assess subpleural nodules (SUNs), lung consolidation, pleural and pericardial effusion, abdominal lymphadenopathy, focal splenic and hepatic lesions and ascites. Presence of any sign prompted a POCUS positive result. Ultrasound images and clips were evaluated by expert reviewers and, in case of discordance, by a second reviewer. Children were categorised as confirmed TB (microbiological diagnosis), unconfirmed TB (clinical diagnosis) or unlikely TB. Ultrasound findings were analysed per TB category and risk factor: HIV co-infection, malnutrition and age., Results: A total of 139 children were enrolled, with 62 (45%) women and 55 (40%) aged <5 years; 83 (60%) and 59 (42%) were severely malnourished (SAM) and HIV-infected, respectively. TB confirmation occurred in 27 (19%); 62 (45%) had unconfirmed TB and 50 (36%) had unlikely TB. Children with TB were more likely to have POCUS-positive results (93%) compared with children with unlikely TB (34%). Common POCUS signs in patients with TB were: lung consolidation (57%), SUNs (55%) and pleural effusion (30%), and focal splenic lesions (28%). In children with confirmed TB, POCUS sensitivity was 85% (95% CI) (67.5% to 94.1%). In those with unlikely TB, specificity was 66% (95% CI 52.2% to 77.6%). Unlike HIV infection and age, SAM was associated with a higher POCUS-positivity. Cohen's kappa coefficient for concordance between field and expert reviewers ranged from 0.6 to 0.9., Conclusions: We found a high prevalence of POCUS signs in children with TB compared with children with unlikely TB. POCUS-positivity was dependent on nutritional status but not on HIV status or age. TB-focused POCUS could potentially play a supportive role in the diagnosis of TB in children., Trial Registration Number: NCT05364593., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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25. Conservative Treatment of Hemorrhoidal Disease.

Author

Stratta E, Gallo G, and Trompetto M

Subjects
Conservative Treatment, Humans, Hemorrhoids diagnosis, Hemorrhoids therapy
Abstract

Background: Hemorrhoids are vascular cushions underlying the distal rectal mucosa and contributing to approximately 15-20% of the resting anal pressure with a complete closure of the anal canal. They can become pathological (hemorrhoidal disease, HD) being the most common cause of painless rectal bleeding during defecation with or without prolapsing anal tissue. The treatment of HD must be tailored to both the severity of disease and patient's expectation., Methods: A narrative review of all the most relevant papers present on the three major databases (PUBMED, EMBASE and WEB OF SCIENCE) regarding conservative treatment was conducted., Results: Conservative treatment is effective in managing the majority of patients complaining of early stages of the disease. Dietary and lifestyle modifications are the first therapeutic step necessary to achieve a regular defecation with soft stool whereas oral phlebotonic drugs can help to control symptoms. The use of topical medications, particularly during the acute phase or in the post-operative period can also be beneficial for all patients complaining of HD., Conclusion: Despite a large number of available products in the market and the high incidence of HD, very few randomized controlled trials have been carried out and most of the studies are uncontrolled case series. Larger and better designed studies are necessary to establish the real benefit of all types of drugs for the treatment of early stages of HD., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Published
2021
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26. Sonographic findings in visceral leishmaniasis - A narrative review.

Author

Bélard S, Stratta E, Zhao A, Ritmeijer K, Moretó-Planas L, Fentress M, Nadimpalli A, Grobusch MP, Heller T, and Heuvelings CC

Subjects
Cross-Sectional Studies, Humans, Prospective Studies, Retrospective Studies, Ultrasonography, Leishmaniasis, Visceral diagnostic imaging
Abstract

Background: Visceral leishmaniasis (VL) is predominantly a neglected tropical parasitic disease but may also be acquired by travellers. We aimed at summarizing knowledge on sonographic presentation of VL to better understand sonographic features of VL., Methods: PubMed was searched for studies and case reports presenting original data on sonographic findings of VL, published before August 13th, 2019. Demographic, clinical, and sonographic data were extracted and summarized in a qualitative approach., Results: A total of 36 publications were included in this review; 27 of these were case reports and the remainder were prospective or retrospective studies. No study reported systematic cross-sectional comparative imaging. Overall, publications reported on 512 patients with VL of whom 12 were reported HIV-infected. Spleno- and hepatomegaly were the most frequently reported findings. Further relevant and repeatedly reported findings were splenic and hepatic lesions, abdominal lymphadenopathy, pleural and pericardial effusion and ascites. Reported focal splenic lesions were heterogeneous in size, shape, and echogenicity. Several publications reported gradual diminution and resolution of sonographic findings with VL treatment., Conclusion: Available literature on sonographic findings of VL is limited. Available reports indicate that spleno- and hepatomegaly, free fluid, abdominal lymphadenopathy, and focal splenic lesions may be common sonographic features in patients with VL. Because of the apparent overlap of sonographic features of VL, extrapulmonary tuberculosis and other conditions, interpretation of sonographic findings needs to be made with particular caution., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Published
2021
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27. Elective surgery for ulcerative colitis, ileo-rectal anastomosis or restorative proctocolectomy An Update.

Author

Fornaro R, Casaccia M, Caristo G, Batistotti P, Di Maira L, Atzori G, Oliva A, Stratta E, Razzore A, Caratto M, Caratto E, Giovinazzo D, and Frascio M

Subjects
Adenocarcinoma epidemiology, Adenocarcinoma etiology, Anal Canal surgery, Anastomosis, Surgical methods, Anastomotic Leak epidemiology, Anastomotic Leak etiology, Cell Transformation, Neoplastic, Fecal Incontinence etiology, Female, Humans, Infertility, Female etiology, Intestinal Mucosa injuries, Intestinal Mucosa pathology, Meta-Analysis as Topic, Patient Selection, Postoperative Complications epidemiology, Postoperative Complications etiology, Pulmonary Embolism epidemiology, Pulmonary Embolism etiology, Rectal Neoplasms epidemiology, Rectal Neoplasms etiology, Risk Factors, Urination Disorders etiology, Colitis, Ulcerative surgery, Elective Surgical Procedures adverse effects, Ileum surgery, Proctocolectomy, Restorative adverse effects, Rectum surgery
Abstract

Background: Despite advances in the medical management of Ulcerative Colitis (UC), surgery is required in about a third of patients., Aims and Methods: A review of the literature of the last 20 years was conducted in order to analyze the results of Ileo-Rectal Anastomosis (IRA) and of Ileal Pouch-Anal Anastomosis (IPAA) in the treatment of mild-to-moderate UC. Postoperative complications, functional results and the risk of cancer were analyzed in each of the two groups of patients., Results: In IRA group postoperative morbidity is low, varying from 8 to 28%. The risk of urinary and sexual dysfunction are rare and fertility rates are higher, compared to IPAA. The cumulative probability of success (working IRA) is 84% at 5 years and 51-69% at 10 years. The postoperative morbidity of IPAA is higher; dehiscence and pelvic sepsis were observed respectively in 9.5% and in 5.5%. A sexual dysfunction is present in 3.4%. In 18.8% occurs pouchitis. The risk of failure of the pouch is 6.8% and increased to 8.5% after 5 years. The risk of cancer is higher after IRA than after IPAA, with a cumulative risk at 20 years of 6-14% and 4.2% respectively., Discussion: The choice between IPAA or IRA is based upon patient's preference and clinical criteria (malignancy or sphincter injury). IPAA, intervention of choice, is burdened by a higher rate of complications, such as anastomotic leak with pelvic sepsis and subsequent functional pouch failure, pouchitis, infertility in young women, lesions of the pelvic nerves and portal vein thrombosis. There have been reports of cancer not only in the anal transitional zone, but also in the same pouch, either after mucosectomy that after stapled anastomosis. IRA is less invasive than IPAA and postoperative complications are lower. Does not require dissection of the pelvic and presents no risk of injury of the nerves of the urogenital sphere. The long-term results of the IRA are generally satisfactory and most of the patients stated that after the intervention improve both the health status and quality of life., Conclusion: Today IPAA is the gold standard. The IRA is indicated in selected patients where they meet the following requirements: normal sphincter tone, absence of severe perineal disease, rectum does not actively involved by the disease, absence of dysplasia or cancer. It is also indicated in patients who refuse an ileostomy and it can be proposed as a possible interim procedure in young women, because it does not need a pelvic dissection and because the risk of infertility is minimal or absent when compared to IPAA. Because the risk of cancer is higher, patients undergoing IRA must be adequately informed about the risk, as well as recurrent proctitis, also of cancer, and must fully understand the need for surveillance and accept at least annual endoscopy with rectal biopsies; if these conditions are not met, patients should not be candidates for IRA., Key Words: IPAA, IRA, Surgical treatment, Ulcerative Colitis.

Published
2019

28. Thrombotic complications in inflammatory bowel diseases.

Author

Fornaro R, Caristo G, Stratta E, Caratto M, Caratto E, Giovinazzo D, Di Maira L, Casaccia M, and Frascio M

Subjects
Anticoagulants therapeutic use, Colitis, Ulcerative complications, Crohn Disease complications, Fibrinolytic Agents therapeutic use, Humans, Venous Thromboembolism prevention & control, Inflammatory Bowel Diseases complications, Thrombolytic Therapy methods, Venous Thromboembolism etiology
Abstract

Inflammatory bowel disease (IBD), Crohn's Disease (CD) and Ulcerative Colitis (UC) are associated with an increased risk of arterial and venous thromboembolism. A 2 to 3 time fold increased risk of developing thromboembolic complications was reported for IBD patients compared to general population. A systematic literature search was conducted using PubMed, Medline, Scopus, Cochrane database. The key words were: "Inflammatory Bowell Disease", "Crohn's Disease and Thrombosis", "Ulcerative Colitis and Thrombosis", "Thrombosis" and "Inflammatory Bowel Diseases and Thrombosis". Full articles and abstracts were included. Studies such as case reports, letters and commentaries were excluded from the analysis if appropriate data could not be extracted. Although no randomized controlled trials (RCTs) have been established to evaluate the efficacy of thromboprophylaxis in patients with IBD due to the incidence of VTE and PE in such patients, it is highly recommended the adoption of thromboprophylactic measures. Available prophylaxis and treatment options include pharmacological anticoagulant therapy (LMWH-Low Molecular Weight Heparin, Fondaparinux and UH-Unfractionated Heparin) and mechanical prophylaxis. In case of acute VTE patient must be treated with fibrinolytic agents and in selected non-responsive cases vascular surgery. IBD patients have an increased risk of VTE complications. Prophylaxis for VTE should be recommended in all patients who do not show contraindications to treatment.

Published
2019

29. Type 2 diabetes affects bone cells precursors and bone turnover.

Author

Sassi F, Buondonno I, Luppi C, Spertino E, Stratta E, Di Stefano M, Ravazzoli M, Isaia G, Trento M, Passera P, Porta M, Isaia GC, and D'Amelio P

Subjects
Aged, Biomarkers blood, Case-Control Studies, Female, Humans, Intercellular Signaling Peptides and Proteins blood, Male, RANK Ligand blood, Bone Remodeling physiology, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 diagnosis, Osteoblasts metabolism, Osteoclasts metabolism
Abstract

Background: Here we study the effect of type 2 diabetes (T2DM) on bone cell precursors, turnover and cytokines involved in the control of bone cell formation and activity., Methods: We enrolled in the study 21 T2DM women and 21 non diabetic controls matched for age and body mass index (BMI). In each subject we measured bone cell precursors, Receptor Activator of Nuclear Factor κB (RANKL), Osteoprotegerin (OPG), Sclerostin (SCL) and Dickoppf-1 (DKK-1) as cytokines involved in the control of osteoblast and osteoclast formation and activity, bone density (BMD) and quality trough trabecular bone score (TBS) and bone turnover. T2DM patients and controls were compared for the analyzed variables by one way ANOVA for Gaussian ones and by Mann-Whitney or Kruskal-Wallis test for non-Gaussian variables., Results: RANKL was decreased and DKK-1 increased in T2DM. Accordingly, patients with T2DM have lower bone turnover compared to controls. BMD and TBS were not significantly different from healthy controls. Bone precursor cells were more immature in T2DM. However the number of osteoclast precursors was increased and that of osteoblasts decreased., Conclusions: Patients with T2DM have more immature bone cells precursors, with increased number of osteoclasts and decreased osteoblasts, confirming low bone turnover and reduced cytokines such as RANKL and DKK-1. BMD and TBS are not significantly altered in T2DM although, in contrast with other studies, this may be due to the match of patients and controls for BMI rather than age.

Published
2018
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30. National Survey of Medical Spanish Curriculum in U.S. Medical Schools.

Author

Morales R, Rodriguez L, Singh A, Stratta E, Mendoza L, Valerio MA, and Vela M

Subjects
Humans, United States, Curriculum trends, Hispanic or Latino ethnology, Multilingualism, Physician-Patient Relations, Schools, Medical trends, Students, Medical, Surveys and Questionnaires
Abstract

Background: Patients with limited English proficiency (LEP) may be at risk for medical errors and worse health outcomes. Language concordance between patient and provider has been shown to improve health outcomes for Spanish-speaking patients. Nearly 40 % of Hispanics, a growing population in the United States, are categorized as having limited English proficiency. Many medical schools have incorporated a medical Spanish curriculum to prepare students for clinical encounters with LEP patients., Objective: To describe the current state of medical Spanish curricula at United States medical schools., Methods: The Latino Medical Student Association distributed an e-mail survey comprising 39 items to deans from each U.S. medical school from July 2012 through July 2014. This study was IRB-exempt., Results: Eighty-three percent (110/132) of the U.S. medical schools completed the survey. Sixty-six percent (73/110) of these schools reported offering a medical Spanish curriculum. In addition, of schools with no curriculum, 32 % (12/37) planned to incorporate the curriculum within the next two years. Most existing curricula were elective, not eligible for course credit, and taught by faculty or students. Teaching modalities included didactic instruction, role play, and immersion activities. Schools with the curriculum reported that the diverse patient populations in their respective service areas and/or student interest drove course development. Barriers to implementing the curriculum included lack of time in students' schedules, overly heterogeneous student language skill levels, and a lack of financial resources. Few schools reported the use of validated instruments to measure language proficiency after completion of the curriculum., Conclusions: Growing LEP patient populations and medical student interest have driven the implementation of medical Spanish curricula at U.S. medical schools, and more schools have plans to incorporate this curriculum in the near future. Studies are needed to reveal best practices for developing and evaluating the curriculum.

Published
2015
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