53 results on '"Tommaso, Pollini"'
Search Results
2. The Landmark Series: Intraductal Papillary Mucinous Neoplasms of the Pancreas—From Prevalence to Early Cancer Detection
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Tommaso, Pollini, Paul, Wong, and Ajay V, Maker
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Oncology and Carcinogenesis ,Pancreatic Intraductal Neoplasms ,Adenocarcinoma ,Cystic ,Pancreatic Cancer ,Rare Diseases ,Clinical Research ,Neoplasms ,Prevalence ,Humans ,Mucinous ,Prospective Studies ,Oncology & Carcinogenesis ,Pancreas ,Early Detection of Cancer ,Retrospective Studies ,Cancer ,and Serous ,Prevention ,Carcinoma ,Pancreatic Hormones ,Pancreatic Neoplasms ,Oncology ,Pancreatic Ductal ,Surgery ,Patient Safety ,Digestive Diseases - Abstract
Modern series report a prevalence of pancreatic cysts in the general population of up to 50% in prospective studies. Of these, about half will be pancreatic cystic neoplasms (PCNs) that have varying degrees of malignant potential. Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are the most common PCNs and are known predecessors of pancreatic adenocarcinoma. Critically, they are one of the only radiographically identifiable precursors of pancreatic cancer and thus provide an opportunity for early cancer detection and surgical resection with curative intent. The combination of high prevalence and potential for malignant degeneration underscore the relevance of discussing the best management of IPMNs and improving the existing standard of care. Landmark data on IPMN prevalence, guidelines, surveillance, biomarkers, and immune landscape are highlighted.
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- 2023
3. It is not necessary to resect all mucinous cystic neoplasms of the pancreas: current guidelines do not reflect the actual risk of malignancy
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Tommaso Pollini, Giovanni Marchegiani, Antonio Facciorusso, Alberto Balduzzi, Marco Biancotto, Claudio Bassi, Ajay V. Maker, and Roberto Salvia
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Hepatology ,Gastroenterology - Published
- 2023
4. The use of a mobile application to disseminate guidelines on cystic neoplasms of the pancreas - A snapshot study of 1000 case-simulations
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Stefano Andrianello, Roberto Salvia, M. Biancotto, A. Caravati, Giovanni Marchegiani, Claudio Bassi, Marco Zampese, Tommaso Pollini, and A. Balduzzi
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Pregnenolone Carbonitrile ,medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,Guideline ,Simulation system ,Mobile Applications ,Pancreatic Neoplasms ,Clinical Practice ,Pancreatic cystic neoplasm ,Humans ,Snapshot (computer storage) ,Medicine ,Medical physics ,business ,Pancreas ,Dissemination - Abstract
Background No data exist on the actual application of pancreatic cystic neoplasm (PCN) guidelines in clinical practice. Aim Disseminate knowledge on existing PCN guidelines and determine which guidelines are prospectively chosen by iCyst app users for different case scenarios. Methods iCyst is a digital tool providing access to the three main existing guidelines (European, IAP, and AGA). Through a case simulation system, for one year, the app prospectively registered users’ guideline choices. Results During the study period, 276 users downloaded iCyst and entered 1020 completed simulations. Most users were European (88%) and were either surgeons (69%) or gastroenterologists (29%). Six different representative scenarios were identified. Overall, the European guidelines were the most commonly preferred (52%). In 16% of cases, the users did not choose any of the available guidelines. Conclusion Digital apps can be used to disseminate guidelines in clinical practice. Guideline dissemination might serve as the basis for future research lines on specific clinical scenarios that iCyst identifies as critical.
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- 2021
5. Systematic review and meta-analysis of observational studies on BD-IPMNS progression to malignancy
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A. Balduzzi, Roberto Salvia, Tommaso Pollini, E. Stigliani, A. Burelli, M. Biancotto, Claudio Bassi, A. Caravati, and Giovanni Marchegiani
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Oncology ,medicine.medical_specialty ,Mural Nodule ,endocrine system diseases ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Carcinoma in situ ,Gastroenterology ,medicine.disease ,Malignancy ,03 medical and health sciences ,0302 clinical medicine ,Dysplasia ,030220 oncology & carcinogenesis ,Concomitant ,Pancreatic cancer ,Meta-analysis ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,Pancreatic cysts ,business - Abstract
The vast majority of presumed branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) of the pancreas are referred to a surveillance program due to the relatively low risk of malignancy. We aim to evaluate all available data from observational studies focused on the risks of BD-IPMN progression and malignancy to provide vital insights into its management in clinical practice.A comprehensive search was conducted at PubMed, Cochrane, Web of Science and Embase for observational studies published before January 1st, 2020. The progression of BD-IPMN was defined as the development of worrisome features (WFs) or high-risk stigmata (HRS) during surveillance. Overall malignancy was defined as all malignancies, such as malignant IPMN, concomitant pancreatic ductal adenocarcinoma (PDAC) and other malignancies, including BD-IPMN with high-grade sec. Baltimore consensus 2015 or BD-IPMN with high-grade dysplasia (carcinoma in situ) sec. WHO 2010. A meta-analysis was performed to investigate the presence of a mural nodule as a possible predictor of malignancy.Twenty-four studies were included, with a total of 8941 patients with a presumed BD-IPMN. The progression rate was 20.2%, and 11.8% underwent surgery, 29.5% of whom showed malignancy at the final pathology. Of those, 78% had malignant IPMNs, and 22% had concomitant pancreatic cancer. Overall, 0.5% had distant metastasis. The meta-analysis showed that the risk of malignancy in the presence of a mural nodule5 mm had a RR of 5.457 (95% CI 1.404-21.353), while a nonenhancing mural nodule or an enhancing mural nodule 5 mm had a RR of 5.286 (95% CI 1.805-15.481) of harboring malignancy.Most presumed BD-IPMNs entering surveillance do not become malignant. Of those submitted to surgery, concomitant PDAC adds to the overall risk of detecting malignancy.
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- 2021
6. Hypofractionated Stereotactic Body Radiation Therapy With Simultaneous Integrated Boost and Simultaneous Integrated Protection in Pancreatic Ductal Adenocarcinoma
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Tommaso Pollini, G. Rossi, Salvatore Paiella, E. Zivelonghi, Tommaso Giuliani, Claudio Bassi, N. Simoni, L. Addari, C. Cavedon, Roberto Salvia, R. Micera, S. Guariglia, Giuseppe Malleo, Renzo Mazzarotto, and Michele Milella
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Male ,Organs at Risk ,Simultaneous integrated boost ,medicine.medical_specialty ,Pancreatic ductal adenocarcinoma ,medicine.medical_treatment ,Adenocarcinoma ,Radiosurgery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Pancreatectomy ,0302 clinical medicine ,Unresected ,pancreatic adenocarcinoma ,Clinical endpoint ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Adverse effect ,radiotherapy ,SBRT ,business.industry ,Induction chemotherapy ,Middle Aged ,Neoadjuvant Therapy ,Radiation therapy ,Outcome and Process Assessment, Health Care ,Locally advanced pancreatic adenocarcinoma ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,Female ,Dose Fractionation, Radiation ,Radiology ,business ,Carcinoma, Pancreatic Ductal - Abstract
To evaluate the safety and feasibility of stereotactic body radiation therapy (SBRT) with simultaneous integrated boost (SIB) and simultaneous integrated protection (SIP) in borderline resectable and locally advanced pancreatic ductal adenocarcinoma.Patients receiving SBRT following induction chemotherapy from January 2017 to December 2018 were included in this observational analysis. SBRT was delivered in five consecutive daily fractions by administering 30 Gy to the planning target volume while simultaneously delivering a 50 Gy SIB to the tumour-vessel interface. SIP was created by lowering the dose to 25 Gy on the overlap area between the planning target volume and the planning organ at risk volume. The primary end point was acute and late gastrointestinal grade ≥3 toxicity. Secondary end points were freedom from local progression, overall survival and progression-free survival (PFS).Fifty-nine consecutive patients (27 borderline resectable and 32 locally advanced) were included. Fifty-eight patients (98.3%) completed the SBRT planned treatment and 35 patients (59.4%) received surgical resection following SBRT. No acute or late grade ≥3 SBRT-related adverse events were observed. The median follow-up time was 15.1 months in the overall cohort and 18.1 months in censored patients. One- and 2-year freedom from local progression rates were 85% and 80% versus 79.7% and 60.6% in resected and unresected patients, respectively (P = 0.33). The median overall survival and PFS were 30.2 months and 19 months from diagnosis and 19.1 months and 10.7 months from SBRT in the entire cohort. Resected patients had improved 2-year overall survival rates (72.5% versus 49%, P = 0.012) and median PFS (13 months versus 5 months; P 0.001) relative to unresected patients. There was no survival difference between borderline resectable and locally advanced patients.SBRT with SIB/SIP had an excellent toxicity profile and could be administered safely on pancreatic ductal adenocarcinoma patients, even in a total neoadjuvant setting.
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- 2021
7. Prognostic Impact of Preoperative Nutritional Risk in Patients Who Undergo Surgery for Pancreatic Adenocarcinoma
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Davide Melisi, Marta Sandini, Alessandra Auriemma, Massimo Lanza, Giuseppe Malleo, Deborah Bonamini, Luca Gianotti, Sara Pilotto, Ilaria Trestini, Roberto Salvia, Salvatore Paiella, Giovanni Elio, Chiara Bovo, C. Soldà, Claudio Bassi, Isabella Sperduti, Daniela Tregnago, Alice Avancini, Tommaso Pollini, Michele Milella, Erica Secchettin, Clelia Bonaiuto, Trestini, I, Paiella, S, Sandini, M, Sperduti, I, Elio, G, Pollini, T, Melisi, D, Auriemma, A, Solda, C, Bonaiuto, C, Tregnago, D, Avancini, A, Secchettin, E, Bonamini, D, Lanza, M, Pilotto, S, Malleo, G, Salvia, R, Bovo, C, Gianotti, L, Bassi, C, and Milella, M
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medicine.medical_specialty ,Multivariate analysis ,FOLFIRINOX ,overall survival ,medicine.medical_treatment ,pancreatic cancer ,Nutritional Status ,Adenocarcinoma ,Surgical oncology ,Pancreatic cancer ,preoperative nutritional evaluation ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Radical surgery ,prognostic impact ,Neoadjuvant therapy ,risk ,Retrospective Studies ,Chemotherapy ,business.industry ,Pancreatic Tumors ,surgery ,Prognosis ,medicine.disease ,Surgery ,Pancreatic Neoplasms ,Italy ,Oncology ,business - Abstract
Background: Nutritional derangements are common hallmarks of pancreatic cancer (PC). Their early detection and management are usually overlooked in routine practice. This study aimed to explore preoperative nutritional status and its prognostic value in patients undergoing surgery for PC. Methods: Data from 73 patients who underwent surgery for PC from November 2015 to January 2018 at the General and Pancreatic Surgery Unit, The Pancreas Institute, University Hospital of Verona Hospital, Verona, Italy, were retrospectively evaluated. The Nutritional Risk Screening (NRS)-2002 was used to evaluate the preoperative nutritional risk. Body composition was assessed using bioimpedance vectorial analysis (BIVA) on the day prior to surgery. The effect of clinical, pathological, and nutritional characteristics on overall survival (OS) was investigated using a Cox and logistic regression model. Kaplan–Meier curves were compared using the log-rank test. Results: Most patients (80.8%) were at preoperative risk of malnutrition (NRS-2002 ≥ 3) despite a mean BMI of 24.1kg/m2(± 4.3). Twenty-four patients (32.9%) received neoadjuvant therapy prior to surgery. Preoperative NRS-2002 was significantly higher in this subset of patients (p = 0.026), with a significant difference by chemotherapy regimens (in favor of FOLFIRINOX, p = 0.035). In a multivariate analysis, the only independent prognostic factor for OS was the NRS-2002 score (HR 5.24, p = 0.013). Particularly, the likelihood of 2-year survival was higher in NRS < 3 (p = 0.009). Conclusions: Our analysis confirms that preoperative malnutrition has a detrimental impact on OS in PC patients undergoing radical surgery for PC. Careful preoperative nutritional evaluation of PC patients should be mandatory, especially in those who are candidates for neoadjuvant therapy.
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- 2020
8. Branch Duct Intraductal Papillary Mucinous Neoplasms: Recommendations for Follow-Up and Surgery
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A. Balduzzi, Giuseppe Malleo, Stefano Andrianello, Giovanni Marchegiani, A. Caravati, Roberto Salvia, M. Biancotto, and Tommaso Pollini
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medicine.medical_specialty ,Pancreatic ductal adenocarcinoma ,Pancreatic Intraductal Neoplasms ,Aftercare ,pancreatic ductal adenocarcinoma ,worrisome features ,Intraductal papillary mucinous neoplasm ,branch duct intraductal papillary mucinous neoplasms ,high-grade dysplasia ,high-risk stigmata ,invasive carcinoma ,Branch Duct ,medicine ,Humans ,Invasive carcinoma ,business.industry ,High grade dysplasia ,medicine.disease ,Pancreatic Neoplasms ,Pancreatic cystic neoplasm ,Practice Guidelines as Topic ,Surgery ,Radiology ,Pancreatic cysts ,business ,Precancerous Conditions - Abstract
Background and Aims: Pancreatic cysts are increasingly diagnosed, mainly during abdominal imaging performed for other reasons. Between pancreatic cystic neoplasm, intraductal papillary mucinous neoplasms are the most common pre-malignant entities. Intraductal papillary mucinous neoplasms involving side branches overall harbor a low risk of malignancy, and in the recent past, a progressively more conservative approach has been consolidated. Purpose of this report is to summarize the evidence supporting the current practice for the management of branch duct intraductal papillary mucinous neoplasm and to offer a useful practical guide from first observation to post-operative follow-up. Materials and Methods: Review of the most important scientific literature on intraductal papillary mucinous neoplasms was made. In this review article, we also report the experience of a high volume center in managing Pancreatic cystic neoplasms. Results: The correct management during surveillance still is a matter of debate, since many guidelines have been published suggesting different clinical approaches. Recently, follow-up discontinuation has also been proposed in selected cases. Conclusion: Despite significant improvements made by the increase of evidence, selecting surgical candidates because of an increased risk of malignant progression remains an unsolved issue and a hot topic for pancreatologists.
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- 2020
9. The tumour immune microenvironment and microbiome of pancreatic intraductal papillary mucinous neoplasms
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Tommaso Pollini, Volcan Adsay, Gabriele Capurso, Marco Dal Molin, Irene Esposito, Ralph Hruban, Claudio Luchini, Laura Maggino, Hanno Matthaei, Giovanni Marchegiani, Aldo Scarpa, Laura D Wood, Claudio Bassi, Roberto Salvia, Mari Mino-Kenudson, and Ajay V Maker
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Hepatology ,Microbiota ,Carcinoma ,Gastroenterology ,Pancreatic Ducts ,Adenocarcinoma ,Mucinous ,Pancreatic Ductal ,Humans ,Pancreatic Neoplasms ,Tumor Microenvironment ,Adenocarcinoma, Mucinous ,Carcinoma, Pancreatic Ductal ,Article ,Pancreatic Cancer ,Rare Diseases ,Clinical Research ,2.1 Biological and endogenous factors ,Aetiology ,Digestive Diseases ,Cancer - Abstract
Pancreatic intraductal papillary mucinous neoplasms (IPMNs) have gained substantial attention because they represent one of the only radiographically identifiable precursors of invasive pancreatic ductal adenocarcinoma. Although most of these neoplasms have low-grade dysplasia and will remain indolent, a subset of IPMNs will progress to invasive cancer. The role of the immune system in the progression of IPMNs is unclear, but understanding its role could reveal the mechanism of neoplastic progression and targets for immunotherapy to inhibit progression or treat invasive disease. The available evidence supports a shift in the immune composition of IPMNs during neoplastic progression. Although low-grade lesions contain a high proportion of effector T cells, high-grade IPMNs, and IPMNs with an associated invasive carcinoma lose the T-cell infiltrate and are characterised by a predominance of immunosuppressive elements. Several possible therapeutic strategies emerge from this analysis that are unique to IPMNs and its microbiome.
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- 2022
10. It is not necessary to resect all Mucinous Cystic Neoplasms of the Pancreas: Current guidelines do not reflect the actual risk of malignancy A Systematic review and Meta-Analysis
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Tommaso Pollini, G. Marchegiani, A. Facciorusso, A. Balduzzi, M. Biancotto, C. Bassi, A. Maker, and R. Salvia
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Hepatology ,Endocrinology, Diabetes and Metabolism ,Gastroenterology - Published
- 2022
11. Progression vs Cyst Stability of Branch-Duct Intraductal Papillary Mucinous Neoplasms After Observation and Surgery
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Hongbeom Kim, M. Biancotto, Stefano Andrianello, Wooil Kwon, Michael P. Kim, Brian K. P. Goh, Giorgia Tomasoni, Giampaolo Perri, Matthew H.G. Katz, Youngmin Han, Tommaso Pollini, Benedict Kinny-Köster, Jin-Young Jang, Roberto Salvia, Neda Amini, Ammar A. Javed, Christopher L. Wolfgang, Giovanni Marchegiani, Claudio Bassi, and Jin He
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Male ,medicine.medical_specialty ,Pancreatic Intraductal Neoplasms ,030230 surgery ,Preoperative care ,Article ,Pancreaticoduodenectomy ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Pancreatectomy ,Interquartile range ,Internal medicine ,medicine ,Humans ,Cyst ,Neoplasm Invasiveness ,Watchful Waiting ,Aged ,Original Investigation ,Cross-Over Studies ,business.industry ,Cancer ,Retrospective cohort study ,Odds ratio ,Middle Aged ,medicine.disease ,Pancreatic Neoplasms ,Dysplasia ,030220 oncology & carcinogenesis ,Concomitant ,Surgery ,Female ,business ,Carcinoma, Pancreatic Ductal - Abstract
IMPORTANCE: The progression of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas to malignant disease is still poorly understood. Observational and surgical series have failed to provide comprehensive information. OBJECTIVE: To identify dynamic variables associated with the development of malignant neoplasms by combining pathological features with data from preoperative repeated observations. DESIGN, SETTING, AND PARTICIPANTS: The Crossover Observational Multicentric Study included a retrospective cohort of patients with branch-duct IPMNs (BD IPMNs) enrolled in a surveillance program from January 1, 2000, to December 31, 2019. Patients were enrolled from 5 referral centers: the Pancreas Institute, Verona, Italy; Seoul National University Hospital, Seoul, South Korea; Singapore General Hospital, Singapore; Johns Hopkins School of Medicine, Baltimore, Maryland; and University of Texas MD Anderson Cancer Center, Houston. Patients underwent a minimum of 12 months of preoperative surveillance (median, 37 [interquartile range (IQR), 20-68] months). MAIN OUTCOMES AND MEASURES: Dynamic variables associated with malignant disease were explored to estimate the presence of high-grade dysplasia (HGD) and invasive cancer at final pathological examination. RESULTS: A total of 292 patients were included in the analysis (137 women [46.9%] and 155 men [53.1%]; median age, 64 [IQR, 56-71] years). During surveillance, 27 patients (9.2%) developed a worrisome feature after 5 years, and 46 of 276 (16.7%) developed high-risk stigmata (HRS). At final pathological evaluation, 107 patients (36.6%) had HGD or invasive cancer, and 16 (5.5%) had IPMNs with concomitant pancreatic ductal adenocarcinoma. Rates of HGD and invasive cancer at pathological evaluation significantly differed between those without worrisome features and those developing HRS from a previous worrisome feature (9 [27.3%] vs 13 [61.9%]; P
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- 2021
12. Guidelines on Pancreatic Cystic Neoplasms: Major Inconsistencies With Available Evidence and Clinical Practice— Results From an International Survey
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Marchegiani, Giovanni, primary, Salvia, Roberto, additional, Stefano, Andrianello, additional, Alberto, Balduzzi, additional, Tommaso, Pollini, additional, Andrea, Caravati, additional, Laura, Maggino, additional, Costanza, Zingaretti Caterina, additional, Claudio, Bassi, additional, Mohammed, Abu Hilal, additional, Mustapha, Adham, additional, Volkan, Adsay, additional, Peter, Allen, additional, Paolo, Arcidiacono, additional, Traian, Barbu Sorin, additional, Olca, Basturk, additional, Marc, Besselink, additional, William, Brugge, additional, Marco, Bruno, additional, Markus, Büchler, additional, Djuna, Cahen, additional, Gabriele, Capurso, additional, Barbara, Centeno, additional, Kevin, Conlon, additional, Stefano, Crippa, additional, Mirko, D'Onofrio, additional, Marco, Dal Molin, additional, Koushik, Das, additional, Marco, Del Chiaro, additional, Christos, Dervenis, additional, Juan Enrique, Domínguez-Muñoz, additional, Irene, Esposito, additional, Massimo, Falconi, additional, Carlos, Fernandez-del Castillo, additional, Helmut, Friess, additional, Isabella, Frigerio, additional, Luca, Frulloni, additional, Toru, Furukawa, additional, Armando, Gabbrielli, additional, Sebastien, Gaujoux, additional, Paula, Ghaneh, additional, P, Gho Brian K., additional, Antanas, Gulbinas, additional, Thilo, Hackert, additional, Ralph, Hruban, additional, Jin-Young, Jang, additional, Whe, Kim Sun, additional, Wataru, Kimura, additional, Günther, Kloeppel, additional, Min, Lee Jeong, additional, Marie, Lennon Anne, additional, Ajay, Maker, additional, Riccardo, Manfredi, additional, Hanno, Matthaei, additional, Mari, Mino-Kenudson, additional, Luis, Montagnini Andre, additional, Takao, Ohtsuka, additional, Dejan, Radenkovic, additional, Dushyant, Sahani, additional, Klaus, Sahora, additional, Alain, Sauvanet, additional, Aldo, Scarpa, additional, Max, Schmidt Christian, additional, Richard, Schulick, additional, Shailesh, Shrikhande, additional, Ajith, Siriwardena, additional, Martin, Smith, additional, Masao, Tanaka, additional, Swaroop, Vege Santhi, additional, Caroline, Verbeke, additional, Charles, Vollmer, additional, Jens, Werner, additional, Christopher, Wolfgang, additional, Laura, Wood, additional, Giuseppe, Zamboni, additional, and Nicholas, Zyromski, additional
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- 2021
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13. The faith of non-surveilled pancreatic cysts: a bicentric retrospective study
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Jakob Mühlbacher, N. Surci, Giovanni Marchegiani, Gerd Jomrich, Claudio Bassi, Roberto Salvia, Dietmar Tamandl, Klaus Sahora, P. Richwien, Stefano Andrianello, Tommaso Pollini, and Martin Schindl
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Adenoma ,Male ,medicine.medical_specialty ,Population ,Pancreatic Intraductal Neoplasms ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Pancreatic cancer ,Internal medicine ,medicine ,Humans ,education ,Watchful Waiting ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,Incidental Findings ,Intraductal papillary mucinous neoplasm ,business.industry ,Mortality rate ,Incidence (epidemiology) ,Incidence ,Carcinoma ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Pancreatic Neoplasms ,Oncology ,Cohort ,Disease Progression ,030211 gastroenterology & hepatology ,Surgery ,Female ,Pancreatic cysts ,Pancreatic Cyst ,business ,Neoplasms, Cystic, Mucinous, and Serous ,Carcinoma, Pancreatic Ductal - Abstract
Background Incidental discovery of pancreatic cystic neoplasms (PCLs) is a common and steadily increasing occurrence. The aim of this study was to investigate a cohort of patients presenting with incidentally detected PCLs which were not included in a surveillance protocol, and to compare their risk of malignant evolution with that of systematically surveilled lesions. Materials and methods A population of PCLs which did not receive surveillance over a period >10 years (population A) was selected at the Medical University of Vienna. A group of “low risk” branch duct intraductal papillary mucinous neoplasm ≤15 mm in size upon diagnosis undergoing a regular follow-up of at least 5 years at the University of Verona was selected as control (population B). The incidence of pancreatic cancer (PC), cumulative risk of PC and disease-specific survival were compared. Results Overall, 376 patients with non-surveilled PCLs were included in study group A and compared to 299 patients in group B. This comparison resulted in similar incidence rates of PC (1.6% vs 1.7%, p = 0.938), a strong similarity in terms of disease-specific mortality rates (1.3% vs 0.3%, p = 0.171) and the 5- and 10-year cumulative risk of PC (≅ 1% and 2%, p = 0.589) and DSS (≅ 100% and 98%, p = 0.050). Conclusion The “price to pay” for a negligence-based policy in the population of non-surveilled PCLs was reasonable, and the incidence of PC was comparable to that reported for a population of low-risk cysts enrolled to a standardized surveillance protocol.
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- 2021
14. Verona Evidence-Based Meeting (EBM) 2020 on Intraductal Papillary Mucinous Neoplasms (IPMNs) of the Pancreas: Meeting Report
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Roberto, Salvia, Marchegiani, Giovanni, Alberto, Balduzzi, Tommaso, Pollini, Andrea, Caravati, Laura, Maggino, Caterina Costanza Zingaretti, Bassi, Claudio, Mohammed Abu Hilal, Mustapha, Adham, Volkan, Adsay, Peter, Allen, Paolo, Arcidiacono, Sorin Traian Barbu, Olca, Basturk, Marc, Besselink, Marco, Bruno, Markus, Büchler, Djuna, Cahen, Gabriele, Capurso, Barbara, Centeno, Kevin, Conlon, Stefano, Crippa, Mirko, D'Onofrio, Marco Dal Molin, Koushik, Das, Marco Del Chiaro, Christos, Dervenis, Juan Enrique Domínguez-Muñoz, Afghani, Elham, Irene, Esposito, Massimo, Falconi, Carlos Fernandez-Del Castillo, Helmut, Friess, Isabella, Frigerio, Luca, Frulloni, Toru, Furukawa, Armando, Gabbrielli, Sebastien, Gaujoux, Paula, Ghaneh, Brian K, P Gho, Antanas, Gulbinas, Thilo, Hackert, Ralph, Hruban, Jin-Young, Jang, Wataru, Kimura, Günther, Kloeppel, Jeong Min Lee, Anne Marie Lennon, Ajay, V Maker, Riccardo, Manfredi, Hanno, Matthaei, Mari, Mino-Kenudson, Andre Luis Montagnini, Takao, Ohtsuka, Dejan, Radenkovic, Dushyant, Sahani, Klaus, Sahora, Alain, Sauvanet, Scarpa, Aldo, Christian Max Schmidt, Richard, Schulick, Shailesh, Shrikhande, Ajith, K Siriwardena, Martin, Smith, Masao, Tanaka, Swaroop Vege Santhi, Caroline, Verbeke, Charles, Vollmer, Jens, Werner, Christopher, Wolfgang, Laura, Wood, Giuseppe, Zamboni, and Nicholas, Zyromsk.
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Evidence-based medicine ,Intraductal papillary mucinous neoplasm ,Verona EBM 2020 on IPMN Consortium ,Verona evidence-based meeting - Published
- 2021
15. Actual malignancy risk of either operated or non-operated presumed mucinous cystic neoplasms of the pancreas under surveillance
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Claudio Luchini, L Gozzini, Claudio Bassi, Giovanni Marchegiani, F Cassalia, A. Caravati, Claudio Doglioni, Stefano Andrianello, G Belfiori, Stefano Crippa, Roberto Salvia, Tommaso Pollini, and Massimo Falconi
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Adult ,Male ,medicine.medical_specialty ,CLINICOPATHOLOGICAL CHARACTERISTICS, PROGRESSION, PREVALENCE, MANAGEMENT, MUTATIONS, LESIONS, FEATURES ,FEATURES ,Pancreatic mucinous cystic neoplasm ,PROGRESSION ,Malignancy ,Cystadenocarcinoma, Mucinous ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Pancreatectomy ,Risk Factors ,CLINICOPATHOLOGICAL CHARACTERISTICS ,PREVALENCE ,MANAGEMENT ,MUTATIONS ,LESIONS ,medicine ,Humans ,Pancreas ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Incidence ,Cancer ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Pancreatic Neoplasms ,medicine.anatomical_structure ,Italy ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,Surgery ,Female ,Radiology ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Background Despite the low malignant potential of pancreatic mucinous cystic neoplasms (MCNs), surgery is still performed. The aim of this pragmatic study was to assess the outcome of surgery and surveillance for patients presenting with a presumed MCN at the first evaluation. Methods Data for patients with a presumed MCN observed from 2000 to 2016 at the Verona Pancreas Institute and San Raffaele Hospital were extracted from prospective databases. The endpoints were risk of malignancy at pathology and rate of misdiagnosis for the surgical series, expressed as an odds ratio (OR) with 95 per cent confidence interval, and disease-specific survival (DSS) for the surveillance cohort investigated by the Kaplan–Meier method. Results A total of 424 patients were identified. In the surgical series (229 patients), the rate of misdiagnosis was 19.2 per cent. The rate of malignant MCNs was 10.9 per cent (25 patients). The overall rate of malignancy, including misdiagnoses, was 11.3 per cent (26 patients). Predictors of malignancy were mural nodules (OR 27.75, 95 per cent c.i. 4.44–173.61; P Conclusion Presumed MCNs with mural nodules, enhancing walls or cysts of 50 mm or larger should be considered for upfront surgical resection owing to the high risk of malignancy. In the absence of these features, the incidence of malignancy is negligible, favouring surveillance in selected patients given the low risk of malignancy and the high rate of misdiagnosis.
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- 2021
16. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study
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Dmitri, Nepogodiev, Joana Ff Simoes, Elizabeth, Li, Maria, Picciochi, James, C Glasbey, Glauco, Baiocchi, Ruth, Blanco-Colino, Daoud, Chaudhry, Ehab, Alameer, Kariem, El-Boghdadly, Funmilola, Wuraola, Dhruva, Ghosh, Rohan, R Gujjuri, Ewen, M Harrison, Herman, Lule, Haytham, Kaafarani, Mohammad, Khosravi, Irmgard, Kronberger, Sezai, Leventoğlu, Harvinder, Mann, Kenneth, A Mclean, Mengistu Gebreyohanes Mengesha, Maria Marta Modolo, Faustin, Ntirenganya, Lisa, Norman, Oumaima, Outani, Riinu, Pius, Peter, Pockney, Ahmad Uzair Qureshi, April Camilla Roslani, Sohei, Satoi, Catherine, Shaw, Aneel, Bhangu, Omar, M Omar, Waheed-Ul-Rahman, Ahmed, Leah, Argus, Alasdair, Ball, Edward, P Bywater, Amanpreet, Brar, Brett, E Dawson, Irani, Duran, Muhammed, Elhadi, Conor, S Jones, Sivesh, K Kamarajah, James, M Keatley, Samuel, Lawday, Ella, J Marson, Riinu, Ots, Irène, Santos, Elliott, H Taylor, Isobel, M Trout, Chris, Varghese, Mary, L Venn, William, Xu, Irida, Dajti, Arben, Gjata, Salah Eddine 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Khamees, Ahmad, Alkhatib, Raikhan, Bolatbekova, Mukhtar, Kulimbet, Talgat, Nurgozhin, Timur, Saliev, Baurzhan, Zhussupov, Ydyrys, Almabayev, Dilyara, Kaidarova, Khalil, Tamoos, Ahmed, Aqeelah, Alsnosy Abdullah Khalefa Mohammed, Faraj Al Maadany, Ghadah, Alkadeeki, Milad, Gahwagi, Wafa, Aldressi, Mohamed, Amnaina, Arowa Hassan Abdulrahman Alansari, Akram, Alkaseek, Ghozlan, Yagoub, Anass Ben Amer, Marwa, Salem, Ayman, Almugaddami, Dania, Burgan, Mohammed, Abdelkabir, Khayriyah, Alshareef, Rayet Al Islam Ben Jouira, Ayman, Meelad, Ahmad, Bouhuwaish, Sumayya Essayah Dwaga, Houda, Khalifa, Bushray, Almiqlash, Taha, Suliaman, Mohammed, Alawami, Fras, Elhajdawe, Hajir, Aboazamazem, Ibrahim, Ellojli, Ahmed, Msherghi, Ismail Ali Saleh, Mohammed, Alayan, Marcel Didier Ndayishyigikiye, Akutu, Munyika, Philipp, Plarre, David, W Borowski, Cameron, Wells, Rebecca, Teague, Brodie, Elliott, David, Kieser, Omar, Mohyieldin, Nick, Mcintosh, Cheyaanthan, Haran, Jasmin, King, Jeong, Ha, Matthew James McGuinness, Opeoluwa, Adesanya, Julius, Olaogun, Akinola, Akinmade, Kefas, Bwala, Peter, Agbonrofo, Akinwale, Afolabi, Usang, Usang, Sebastian, Ekenze, Samson, Olori, Taiwo Akeem Lawal, Abiodun, Okunlola, Stephen, Kache, Danjuma, Sale, Lofty-John, Anyanwu, Chukwuma, Okereke, Musliu Adetola Tolani, Venko, Filipce, Lazar, Todorovic, Sotir, Stavridis, John George Massoud, Sareyah, Alsibai, Rizwan, Sultan, Humera Naz Altaf, Abu Bakar Hafeez Bhatti, Shahzad Hussain Waqar, Aliya, Aziz, Asad Ali Kerawala, Lajpat, Rai, Mariyah, Anwer, Aiman, Tariq, Bushra, Ayub, Sami Ullah Niazi, Muhammad Yasir Naseem, Muhammad Zeeshan Sarwar, Muhammad Imran Khokhar, Imdad Ahmad Zahid, Haroon Javaid Majid, Nabila, Talat, Muhammad, Asif, Muhammad Hamid Chaudhary, Umer, Farooq, Siddique, Ahmad, Waleed, Mabood, Syed Imran Bukhari, Muhammad, Tariq, Eesha, Yaqoob, Saad, Javed, Muhammad Usman Malik, Hassan Nawaz Yaqoob, Glenda Marina Falcon Pacheco, Robinson Mas Melendez, Arazzelly Del Pilar Paucar Urbina, Jose Rios 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Amanda Lira Dos Santos Leite, Laercio, Pol-Fachin, Tainá Santos Bezerra, Alcimar Lavareda Dos Santos Junior Alcimar, Robson, Amorim, Maria Eduarda Bellotti Leão, João José Corrêa Bergamasco, Cintia Cardoso Pinheiro, Rubem Alves Da Silva Neto, Elaine Francisca De Araújo, Lilian, Guimaraes, Tatiana, Liborio-Kimura, Isabelle Melo da Camara, Victor Ripardo Siqueira, Juan, Rodriguez, Jeancarllo, Silva, Rubem Alves Silva Junior, Cláudio, Cardoso, Andre, Guimaraes, Wislene Sarajane Moreira Alves, Agna Soares Da Silva Menezes, Marcelo, Araujo, Kattiucy, Brito, Josie Marcelle Lira Albuquerque, Jairo Alberto Dussan-Sarria, Andressa, Souza, Andre Ricardo Stüker, Tiago, Bresciani, Luciana Cadore Stefani, Leandro Totti Cavazzola, Tainá, Costa, Matheus, Dasqueve, Gustavo De Bacco Marangon, Otávio Ritter Silveira Martins, Josy, Rodrigues, Guilherme Roloff Cardoso, Brasil Silva Neto, Tilaê, Soares, Aline, Zanella, Lucas Torelly Filippi, Enilde Eloena Guerra, Ricardo Pedrini Cruz, Antonio Nocchi Kalil, Gustavo, Laporte, Moacyr, Salem, Murilo de Lima Brazan, Caio Antonio de Campos Prado, Elaine Christine Dantas Moises, Hilda Satie Suto, Alice Gadotti Yasuda, Ana Carolina Tagliatti Zani, Roberto Cardoso Cardoso Dos Santos, Geraldo, Duarte, Edwaldo Edner Joviliano, Carolina Lourenço Gomes Dos Santos, Silvana Maria Quintana, Edwin, Tamashiro, Fabiana Cardoso Pereira Valera, Marília Veccechi Bijos Zaccaro, Isis, Andreotti, Leonardo, Lima, Wilson Salgado Jr, Alonço da Cunha Viana Júnior, Lana, Moutinho, Cora Pichler de Oliveira, Isabela Trindade Martins, Isabela Vieira Toledo, Marco Antonio Correa Guimaraes-Filho, Rodrigo, Arrivabeno, Claudio Bovolenta Murta, Danniel Frade Said, Jose Pontes Junior, Felipe Guimarães Pugliesi, Paulo, Gregorio, Alessandro, Mariani, Fabio, Minamoto, Juliana Lourenço da Silva, Bruno, Muller, Caio, Zanon, Vladimir, C Carvalho, Ana Lucia Munhoz Lima, Priscila, R Oliveira, Jorge Dos Santos Silva, Mariana Faccini Teixeira, Marco, Kulcsar, Leandro, Matos, Kamilla Schmitz Nunes, Joel Abdala Junior, Emne, Abdallah, Genival Barbosa Carvalho, Igor Correia de Farias, Cassia da Silva, Fabio Fernando Eloi Pinto, Luciana, Facure, André, Godoy, Bruna, Kupper, Fernanda, Leite, Matheus de Melo Lôbo, Henrique, Mantoan, Narimã, Marques, Tomas, Marques, João Paulo Medici, Silvio Melo Torres, Katheryne Merlos Garcia, Rafael Ribeiro Meduna, Ana Carolina Scintini Herbst, Silvana Soares Dos Santos, Bruna Tirapelli Gonçalves, Marcelo, Antonini, Carolina, Brienze, José Francisco Farah, Rodrigo, Gonçalves, Vinicius, Machado, Luis Roberto Nadal, Danilo Nadal Rodrigues, Adrieli, Pansani, Maria Luiza Rocha, Marcelo, Simonsen, Daniela, Tsuchiya, Rafaela, Vasques, Jorge, Amorim, Ana Alyra Carvalho, Rebeca, Correia, Brena Costa Dos Santos, Henrique Jorge Guedes Neto, Luis, Nakano, Mariana, Pereda, Vladimir, Vasconcelos, Jamile Barakat Awada, Guilherme, Gava, Tiago Riuji Ijichi, Nam Jin Kim, Rafael, Nunes, Fabio, Pinto, Thiago Henrique Sigoli Pereira, Gustavo Jardim Volpe, Arthur, Gatti, Caroline, Nardi, Ramon, Oliva, Layze Braz de Oliveira, Herica Emilia Félix de Carvalho, Ivonizete Pires Ribeiro, Gabriel Renan Soares Rodrigues, Álvaro Francisco Lopes de Sousa, Michel, Chebel, Paulo Henrique de Sousa Fernandes, Marcelo Augusto Faria Freitas, Juliano Rodrigues da Cunha, Zeenia, Ather, Dobromir, Dimitrov, Emil, Filipov, Elitsa, Gyokova, Ivelina, Ilieva, Tsvetomir, Ivanov, Martin, Karamanliev, Vasil, Neykov, Boyko, Atanasov, Nikolay, Belev, Paolina, Kamenova, Kaloyan, Tonev, Tsanko, Yotsov, Evguenia, Hristova, Kolyo, Spassov, Tsanko, Tsankov, Dragomir, Dardanov, Petar, Gribnev, Manol, Sokolov, James, Brown, John, Tanyi, Heather, Hurdle, Anthony, Maclean, Michael, Sander, Salim Al Riyami, Krittika, Bali, David, Bigam, Khaled, Dajani, Mehran, Anvari, Rafik, Bolis, David, Choi, Susan, Ellis, Michael, Gupta, Wael, Hanna, Dennis, Hong, Cynthia, Horner, Lea, Luketic, Peter, Moisiuk, Yaron, Shargall, Hilda, Alfaro, Nawar, Alkhamesi, Laura, Allen, Muriel, Brackstone, Eunice, Chan, Davy, Cheng, Jason, Chui, Nelson, Gonzalez, Brent, Lanting, S Danielle MacNeil, Robert, Mayer, Jacob, Mcgee, Mahesh, Nagappa, Nicholas, Power, Agya, Prempeh, Mehdi, Qiabi, Hassan, Razvi, Emil, Schemitsch, Herman, Sehmbi, Ushma, Shah, Yamini, Subramani, Edward, Vasarhelyi, Kelly, Vogt, Homer, Yang, Ali Ghorbani Abdehgah, Saba, Balvardi, Liane, Feldman, Julio Flavio Fiore Jr, Melissa, Hanson, Brent, Hopkins, Pepa, Kaneva, Lawrence, Lee, Julia, Leonard, Jad, Abou-Khalil, Andre, Martel, James, Stevenson, Susan, Lee, Richard, Merchant, Samuel, Avoine, Laurence, Belanger, Mathieu, Belanger, Etienne, Belzile, Anne-Sophie, Blais, Sofia, Boucher-Kovalik, Cindy, Boulanger-Gobeil, Etienne, Cardinal, Pierre-Olivier, Champagne, Jonathan, Cloutier, Simon, Corriveau-Durand, Mathieu, Cote, Maxime, Cote, Mathilde, Côté, Valérie, Courval, Suzanne, Demers, Christine, Desbiens, Mehdi El Ouazzani, Karine, Girard, Ève-Marie, Girard, Karo, Gosselin, Helene, Khuong, Nathalie, 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Philemon, Leung, Andrew, Lindberg, Juan Mata Gutierrez, Kelly, Mayson, Adam, Meneghetti, Drew, Phillips, John, Street, Carolina Carvajal Calderón, Daniel Alejandro Donoso Pizarro, Esteban, Fernández, Ángela, Molero, Nastassja, Mutarello, Jorge Núñez Lucic, Katherine Ochoa Gaete, Catalina Ruiz Lopez, Rina, Sepúlveda, Camila, Ulloa, Mauricio, Barreda, Matias, Dallaserra, Matías Günther Wood, Mauricio Sandoval Tobar, Francisco, Garcia-Huidobro, Jimena, Dona, Carolina Soto Diez, Daniel, Igor, Javier, Mena, José Tomás Reyes, Catalina Arredondo Soto, Jose, Campos, Javier, Gonzalez, Barbara, Rivera, Jaime, Altamirano-Villarroel, David, Cohn, Luis Marin de Amesti, Pedro, Recabal, Camilo, Sandoval, Bruno Catoia Fonseca, Monica, Contador, Andres, Hodali, Camila, Pincheira, Andrea Ramos Mantilla, Claudio Salas Garrido, Janina, Torres, Marco, Valenzuela, Zehua, Chen, Jiankun, Hu, Jin, Tao, Kun, Yang, Yuexin, Zhang, Yuan, Chen, Wang, Cunchuan, Wah, Yang, Xueli, Bai, Tingbo, Liang, Tao, Ma, Ning, Pu, Hanlin, Yin, Camilo, Caicedo, Diego Felipe Tellez Beltran, Alejandro, Escobar, Carolina Perez Granados, Lisbeth Alexandra Urueña Pinzon, Carlos, Bonilla, Diana, Santana, Oscar, Serrano, Andrea, Garcia, Fernando Giron Luque, Nasly, G Patino-Jaramillo, Laura Giselle Contreras Baquero, Nestor Augusto Muñoz Botero, Jhoana Andrea Murillo Castellanos, Andrea Juliana Vega Calvera, Lina, M Acosta Buitrago, Maria Paz Bohórquez-Tarazona, Paulo Andrés Cabrera Rivera, J Felipe Casas, Valeria Cormane Alfaro, Julian, Corso, Bayron, Guerra, Albert Franz Guerrero-Becerra, Akram Kadamani Abiyomaa, Felix Ramon Montes, Manuel Santiago Mosquera Paz, Camilo Andrés Polanía Sandoval, Natalia, Quintana, Carlos Fernando Roman Ortega, Carlos, Santacruz, Manuela, Téllez, Camilo Alejandro Velandia Sánchez, Fernando, Arias-Amézquita, Luis Felipe Cabrera Vargas, Natalia Cortes Murgueitio, Elkin, Escorcia, Kemel Ahmed Ghotme Ghotme, Jorge Luis Gomez-Mayorga, Alvaro Felipe Guerrero Vergel, Gabriel, Herrera-Almario, Eduardo, Londono-Schimmer, Juan, A Mejia, Guillermo, Monsalve, Camilo, Rodriguez, Juan Nicolas Rodriguez Niño, Luis Martín Rodríguez Ortegón, Daniel, Sanabria, Andres, Alvarez, Arnulfo, Andrade, Javier, Ardila-Montealegre, David, Baquero, Edgar Mauricio Barrios Vidales, María Alejandra Caicedo Giraldo, María Camila Carvajal, Maria, Castillo, Maria Carolina Castillo Florez, María Angelica Cendales, Danny Conde Monroy, Henry, Cortes, Mario, Daniel, Jairo De la Peña, Elena Leonor Delgado-Nieto, Hernando, Espitia, Carlos Figueroa Avendaño, Edgar Oswaldo Hernandez Burgos, Andres, Isaza-Restrepo, German, Londono, Margarita Maria Maldonado, Andrea, Montenegro, Juan Carlos Navarro, Jorge, Navarro-Alean, Katherine Parra Abaunza, Eliana, Pulido, Erika, M Ramírez Amaya, Carlos Eduardo Rey Chaves, Natalia Andrea Rivera Rincón, William Mauricio Riveros Castillo, Lizeth Rodriguez Sanchez, Wilson, Rubiano, Maria, Russi, Juan Carlos Sabogal Olarte, Javier Mauricio Salgado Tovar, Maria Juliana Sanchez, David Mauricio Solano Varela, Paula Torres Gomez, Marcial, Trillos, Ana María Vargas Patiño, Felipe, Vargas-Barato, Juan Pablo Villate Leon, María Alejandra Wagner Useche, Jesus, Acosta, Adriana, Almeciga, Luis Becerra Mendez, Rafael Jose Beltran, Ana, Bonilla, Miguel, Buitrago, Marino, Cabrera, Pedro Hernando Calderon Quiroz, Diego, Camacho-Nieto, Carlos Andrés Carvajal Fierro, Sergio Cervera Bonilla, Sandra, Diaz, Helena, Facundo, Jorge, Forero, Mauricio Garcia Mora, Karena Victoria Garcia Tirado, German Fabian Godoy Perez, Felipe, Gonzalez, Oscar, Guevara, Jairo Alonso Hernandez, David Ricardo Herrera Mora, Juan David Lalinde, Carlos, Lehmann, Eduardo Leon Llanos, Byron Eduardo Lopez De Mesa Lopez, Ivan, Mariño, Monica, Medina, Raúl Eduardo Pinilla Morales, Angela, Puerto, Andrea, Quintero-Ortíz, Juliana Rendón Hernández, Elio Fabio Sánchez Cortés, Alvaro Eduardo Sánchez Hernández, Raul, Suarez, Oscar, Suescun, Marco, Vanegas, Rodolfo, Varela, Jorge Luis Velez Bernal, David, Viveros-Carreño, Daniela Camargo Gómez, Angelica, Fletcher, Abel, Merchan, Euler Javier Burbano Luna, Indira, Cujiño, Mauricio Velasquez Galvis, Lina Maria Vergara Galliadi, Orlando Abonia Gonzalez Abonia Gonzalez, Maria Fernanda Acuna Saravia, Roberto, Arroyave, Jose Maria Barreto Angulo, Francisco Javier Bonilla-Escobar, Uriel, Cardona, Ivan Castañeda Giacometto, José Luis Castillo, Diego Fernando Castillo-Cobaleda, Diego Jose Caycedo Garcia, Brenda Marcela Coll Tello, Juan Carlos Dueñas-Ramirez, Oscar Andres Escobar Vidarte, Luis, Figueroa, Herney, Garcia-Perdomo, Alden, Gomez, Laura, Gomez, Alejandro, Gomez, Ana María Grande-Gil, David, Guarin, Natalia, Guzman, Enrique Herrera Castañeda, Marisol, Hinaoui, Anuar Armando Idrobo Escobar, Christian Kammerer Kammerer, Sergio, Leon, Carlos Antonio Llanos Lucero, Angie, López, Alexander Maximiliano Martinez-Blanco, Antonio José Montoya Casella, Ricardo Andres Niño Corredor, Sebastian, Ordoñez, Diego Alfredo Palta Uribe, 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Alvarez, Cesar David Galindo Regino, Angela Maria Giraldo Velasquez, Carlos Enrique Melo Moreno, Jorman, H Tejada, Jesus Hernan Tovar, German Alirio Tovar, Edison Alexander Benavides Hernández, Claudia Milena Orozco-Chamorro, Gustavo Adolfo Angel, Christian Ali Buesaquillo, Victor David Olave Montaño, Andrés, Sánchez-Gómez, Daniela Patricia Escalante Ureche, Jairo Martinez Garrido, Eben-Ezer, Genda, Fabrice, Eboma, Kristina, Bitunjac, Karlo, Grulović, Marijana, Vučković, Goran, Šantak, Emanuel, Borovic, Ana Bosak Versic, Damir, Hasandić, Natasa Poldan Grabar, Suzana Srsen Medancic, Lucija, Brkic, Sara, Cokarić, Petra Pavic Palac, Zeljka, Samac, Josipa, Tomić, Marija, Vrdoljak, Ivan, Bacic, Bernarda, Bakmaz, Nikolina Bratošević Vučičić, Domagoj, Brzic, Samir, Canovic, Emilio, Dijan, Maja Grgec Dragicevic, Robert, Karlo, Suzana, Konjevoda, Petra, Kovačević, Ivan, Kovačić, Frane, Markulić, Luka, Matak, Domagoj, Morović, Gordan, Perišić, Andrea, Simic, Neven, Skitarelić, Matea, Veršić, 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Ioanna, Pozotou, Olga, Stavrinidou, Anneza, Yiallourou, Lukáš, Burda, Michal, Dosoudil, Lubomir, Martinek, Wladyslaw, B Gawel, Milan, Lerch, Matúš, Peteja, Jan, Žatecký, Toman, Daniel, Martin, Formánek, Veronika, Javurkova, Markéta, Kepičová, Nicole, Macečková, Petr, Matousek, Ondrej, Simetka, Petr, Vavra, Karol, Zelenik, Jan, Černý, Sami, Khan, Robert, Lischke, Martin, Přibyl, Temoore, Younus, Yenuksha, Amarasena, Karel, Klíma, Setareh, Pirmorad, Zuzana, Hotová, Aleš, Mladěnka, Nulvin, Bozo, Julie Lykke Harbjerg, Louise, Hviid, Helle, Ø Kristensen, Mira, Mekhael, Mette Fugleberg Nielsen, Laerke, Paulsen, Saija, Sinimäki, Louise Zinck Mogensen, Peter, Bonde, Anders Lyng Ebbehøj, Anne-Sophie, Fenger, Aleksander Fjeld Haugstvedt, Christine Hangaard Hansen, Maria Lovisa Jönsson, Lars, N Jorgensen, Peter-Martin, Krarup, Anne-Louise, Lihn, Christian, Meyhoff, Helena, Otte, Anas Ould Si Amar, Henrik, Palm, Nis, Schlesinger, Henry, Smith, Ida, Tryggedsson, Anne Reiss Axelsen, Jens Kristian Baelum, Mark Bremholm Ellebaek, Signe Bremholm Ellebaek, Anders, Hogh, Maria, Acosta, Yancy, Acosta, Pedro, Baez, Luis Alfredo Betances, Luis Rodolfo Bonilla, Daniel, Cabreja, Wilton Cabrera Cruz, María Mabel Collado Expósito, Aldo, Crespo, Octavio, Cruz-Pineda, Claudio Samuel D'óleo García, Pedro, Díaz, Remberto, Escoto, Jatnna, Figueroa, Luis, Garcia, U Garcia-Dubus Rodriguez, Humberto, Gomez, Adrian, Grullon, Fatherin, Guerrero, Lillian, Guzman, Thelma Rocío Jiménez Mosquea, Engels, Lazala, Ariela, Lopez, Leeany Maletta Francisco, Jhomayri, Mercado, Herisardy, Munoz, Jeffrey, Paulino, Maricely Ambar Perez Fernandez, Rudeily, Reyes, Lilia Rosa Reyes Guilamo, Ruben, Rivas, Claudia Alejandra Rivas Torres, Ada, Rodríguez, Madelin Tamar Rosario Villa, Eleazar, Santana, Joel, Soto, Nassin, Tactuk, Cristina Kristel Tonos Sardiñas, Raul, Ubinas, Jose, Victoria, Aaron, Villegas, Ricardo, Acra-Tolari, Larissa, Beltran, Luis Fernand Betances, Alejandro, Blaubach, Denisse Idalia Campos Mejía, Nathalia, Capellan, María Fernanda Cedeño Bruzual, Saray Cordero Spencer, Gabriella Cuevas Lantigua, Luis De Jesus, Gabriela, Díaz, Pedro Pablo Díaz Vásquez, Karla, Disla, Jesús Antonio Echavarría Uceta, Paola Irina Eusebio Jimenez, Damaris, Fernandez, Marlin Fernandez Camilo, Jiomar Manuel Figueroa Germosen, Maruel, Fortunato, Leyla Gabriel Fernández, Alicia German Dihmes, Héctor, Herrera, Elizabeth Leon Cuevas, Jose Alejandro Mata, Mirian Mateo De La Cruz, Dolores Mejia De la Cruz, Marcos, Mirambeaux, Fabio Ortiz De La Cruz, Henry, Paulino, Gabriela, Pelletier, Merycarla, Pichardo, Rodriguez Pumarol Próspero Enrique, Julio, Rivas, Ann Stephany Sanchez Marmolejos, Roman Santana Santana, Irina Suero Almanzar, María Magdalena Vásquez Sánchez, Nicolás, Campuzano, José Ricardo Negrete Ocampo, Maria, Armas, Alvaro Santiago LeMarie Guerra, Gustavo León Vizcaya, Omar Ahmed Abdelwahab, Ahmed, O Elmehrath, Mohammed Ezzat Mostafa, Gamal, Amira, Ibrahim, Sallam, Mohamed, Sherief, Ahmed, 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Maher, Hosain, Ahmed, Hossam, Hamza Hussein Aly Salama Aly, Mohamed, Ibrahim, Abdelrahman, Ibrahim, Nourhan, Ibrahim, Noha Mohamed Salah Ibrahim Moussa Hamouda, Monica, Iskander, Islam, Khalifa, Mostafa, Kotb, Nada, Mahmoud, Alaa Mahmoud Abo Shabana, Nora, Mamdouh, Maram, Metwalli, Khaled, Metwally, Mahmoud, Moghazy, Moustafa, Mohamed, Mohamed, Mourad, Esraa, Moustafa, Kamilia, Mubarek, Nour Eldin Nader, Ahmed, Nasser, Samaa, Omar, Mostafa Shehata Qatora, Mohamed, Ragab, Marawan, Ragal, Dina, Ramadan, Rana, Ramadan, Sara, Ramadan, John, Romany, Ahmed, Sabry, Yasmeen, Said, Sara, Salamah, Ahmed Mostafa Saleh, Mona Saleh Mesbah Mohamed Elkaffas, Alaa, Salem, Hashem, Salim, Ahmed, Samih, Ahmed Samir Abdelaal, Ahmed, Shaheen, Yassmeen Sharafeldin Mohammed, Abdelrahman, Shehata, Mohamed, Shemeis, Karim, Shenit, Mennatallah, Sheta, Asmaa, Soffar, Yousef, Tanas, Ahmed, Tarek, Nermin, Yehia, Omar Khaled Mohamed Eid, Ammar Yasser Abdulfattah, Ahmed, Elsaghir, Mohamed Fouad Elganainy, Omar Ibrahim Elsayed, Omar, Elmandouh, Omar, Hamam, Mostafa Ahmed Shehata, Areej, A Abdelaziz, Ahmed, M Abbas, Wael Abd El-Ghani, Hossam Aldein, S Abd Elazeem, Mustafa Abd Elsayed, Ahmed Yassien Abd-Elkariem, Shimaa, Abdalla, Mahmoud, Abdel-Aleem, Khaled, Abdelazeem, Mahmoud, Abdelfattah, Mohammed, Abdelhafez, Mohamed, M Abdelkarem, Ali, Abdelraouf, Lamess, Abdullaha, Hossam, Abubeih, Moaiad Eldin Ahmed, Nagm Eldin Abu Elnga Ahmed, Ahmed, Ahmed, Sarah Ahmed Saad, Sherif, Alaa, Ali, Alhussaini, Abdelrahman Ahmed Abdelrahman Ali, Ibrahim, Ali, Wagdi, Ali, Mohamed Ali Mohamed, Mohamed, Ashraf, Muhammad, Bassiouni, Mohamed, G El-Adawy, Mohammad, El-Sharkawi, Hussein, Elkhayat, Khaled, Elmaghraby, Shady, Elsdfy, Mohamed, Elsharkawy, Almoutaz, Eltayeb, Mohamed Esmat Mohamed, Esraa, Essam, Mahmoud, Fahd, Osama, Farouk, Rabea, Gadelkareem, Ahmed, Ghoneim, Mohammed Hamada Takrouney, Ahmed, Hamdan, Abd El-Rahman Hamed, Ahmad, Hasan, Mohamed Abdelghafor Hassanin, Islam, Hawal, Kerollos, Henes, Mohamed Omar Herdan, Helal, F Hetta, Omar, Ibrahem, Mostafa, Ibrahim, Islam, H Ibrahim, Mahmoud, Kamel, Mohamed, Khallaf, Shrouk, M Elghazaly, Abobakr, Mahfouz, Osman, Mahmoud, Wesam, Mahran, Doha, Mahrous, Abadeer, Marsis, Ayman, Mohamed, Aliae Mohamed Hussein, Amr Mohamed Sayed, Mahmoud, M Mohammed, Ahmed, Mokhtar, Fatma, A Monib, Ahmed, Nageeb, Mariam Albatoul Nageh, Mohammed, Nageh, Nehal Gamal Omar, Abdelrahman, Ragab, Abdelrahman, Ramadan, Abdallah Rashad Temerik, Aya, Sabry, Hadeer, Safwat, Omar, Salah, Ahmed Elhussiny Salah Mahmoud, Ahmed, Saleh, Mahmoud, Sallam, Ahmed, Samir, Reem, Sayad, Esraa, Sayed, Ahmed, S Sedik, Mohammed, Shahine, Antonios, Soliman, Wael, Soliman, Mohamed Gamal Taher, Randa, Wanees, Ebrahim Ahmed Yousof, Ahmed, Youssef, Omar Zein Elabedeen, Ahmed Emad Sayed Hassan, Shrouk Abdel Fattah, Ahmed, Abostate, Samar, Ali, Saad Ali Saad Salama, Mohamed, Allam, Ahmed, Alsadek, Ebrahim, Arafa, Ahmed, Barakat, Mohammed El Sherpiny, Gehad, Elbehairy, Mahmoud, Eleisawy, 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David, Walawah, Makafui, Yigah, Safia, Yussif, Nuna, Jiagge, Emmanuel, Nachelleh, Jane, Acquaye, Kwabena, Agbedinu, Fareeda, Agyei, Akosua, Agyemang-Prempeh, Kwabena, Amo-Antwi, Michael, Amoah, George, Amoah, Yaw, A Amoako, Daniel Gyawu Aning, Frank, Ankobea-Kokroe, Dominic Annor Mintah, David, Anyitey-Kokor, Adu, Appiah-Kubi, Joshua, Arthur, Vincent, Ativor, Isaac, Barnor, Yasmine, Braimah, Regina, Darko-Asante, Anthony, Davor, Mohammed Duah Issahalq, Mawutor, Dzogbefia, Tano, Emile, Papa, Fiifi-Yankson, Valerie, Gaveh, Senyo, Gudugbe, Solomon, Gyabaah, Frank Enoch Gyamfi, Adam, Gyedu, Derrick, Gyimah, Bernard, Hammond, Boakye-Yiadom, Jonathan, Yorke, Joseph, Thomas Okpoti Konney, Anna, Konney, Kwasi, Kusi, Ishmael, Kyei, Agbenya, Lovi, Nuhu, Naabo, Boateng, Nimako, Beauty, Nyadu, Obed Ofori Nyarko, Ben Blay Ofosu-Barko, Philip Peprah Oppong, Anita, Osabutey, Martha, Poku, Robert, Sagoe, Abiboye, Yifieyeh, George, Ansong, Adam, Abass, Alhassan, Abdul-Mumin, Theophilus, Adjeso, John Abanga Alatiiga, Munira, Amadu, Nathaniel, Annan, German Azahares Leal, Mohammed, Bukari, Alexis, Buunaaim, Ernest, Cheyuo, Latif Daboo Salifu, Michael, Damah, Malcolm, Dery, Edem Kojo Dzantor, Odoniel Guerra Garcia, Yabasin Iddrisu Baba, Adamu, Issaka, Abdul-Jalilu Mohammed Muntaka, James, Murphy, Yaa Nyarko Agyeman, Wisdom Opoku Amankwaa, Imoro, Osman, Samuel, Pie, Anwar Sadat Seidu, Mohammed, Sheriff, Ana Maria Simono Charadan, Abraham, Titigah, Mundashiru, Yahaya, Musah, Yakubu, Edwin Mwintiereh Ta-Ang Yenli, Ioannis, Grypiotis, Nikolaos, Kiriakopoulos, Georgios, Koliopoulos, Vasilis, Kyvelos, Georgia, Micha, Triada, Papadopoulou, Dimitrios, Balalis, Evangelos, Fradelos, Dimitrios, Korkolis, Nicholas, Alexakis, Kyveli, Angelou, Dimitrios, Haidopoulos, Anastasia, Prodromidou, Alexandros, Rodolakis, Nikolaos, Thomakos, Dimitris, Psychogios, Pantelis, Antonakis, Konstantinos, Bramis, Leonidas, Chardalias, Ioannis, Contis, Nikos, Dafnios, Dionysios, Dellaportas, Papalouka, Dimitra, 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Liolis, Elias, Ioannis, Maroulis, Francesk, Mulita, Kerasia-Maria, Plachouri, Michail, Vailas, Charalampos, Doitsidis, Eva, Filo, Ioanna, Gkalonaki, Eleni, Kogia, Konstantina, Kontopoulou, Magdalini, Mitroudi, Christina, Panteli, Ioannis, Patoulias, Olga Ioulia Semkoglou, Dimitrios, Sfoungaris, Ioannis, Valioulis, Ioannis, Astreidis, Panagiotis, Christidis, Orestis, Ioannidis, Lydia, Loutzidou, Antonis, Mantevas, Konstantinos, Paraskevopoulos, Dimitris, Tatsis, Apostolos, Athanasiadis, Themistoklis, Dagklis, Ioannis, Kalogiannidis, Georgios, Kapetanios, Apostolos, Mamopoulos, Chrysoula, Margioula-Siarkou, Stamatios, Petousis, Ioannis, Tsakiridis, Christos, Anthoulakis, Chrysanthos, Christou, Antonios, Fantakis, Eirini, Iordanidou, Christos, Kaselas, Sousana, Panagiotidou, Vasileios, Papadopoulos, Kyriakos, Papavasiliou, Athanasios, Piachas, Ioannis, Siasios, Ioannis, Spyridakis, Theodoros, Theodoridis, Andreas, Tooulias, Eleftherios, Tsiridis, Maria, Tsopozidi, María, Alemán, Estuardo, Brolo, Ana Lucia Lemus, Jennifer, Greenberg, Krisna Mishel Morales Chew, José Rodrigo Oliva, María Alejandra De León Lima, Ismar Lopez Muralles, Felipe, Solares, Gaby, Ajcip, Claudia, Anton, Jose, Cojulun, Mario-Andrés, Flores, Noriega, José, Carlos Adolfo Marroquín Paiz, Steffanía, Morales, Ramiro, Najera, Eduardo Quiñónez Lorenzana, Pablo, Rivera, Lesly, Rodas, Victor, Santos, Dianne, Sosa, Natalia, Ybarra, José David Pérez Cajti, Carlos, Régil, Walter, A Osorio, Rember Rosales Arriola, Luis-Fernando, Talé-Rosales, Danilo, Herrera, Servio Tulio Torres Rodríguez, Sergio Alejandro Villeda, Joshua, Anicetti, Andrea Michelle Lowey Medina, Javier, Ardebol, Kathia, Barillas, Francis De Leon, Salvador, Recinos, Miguel-Angel, Marroquin-Alpirez, Yessica, Yax, Sophie, Hon, Yuk Ho Liu, Alex Qinyang Liu, Shirley, Liu, Hei Tung Natalie Chiu, Chi Man Tom Chow, Victor, Hau, Ho Wai Ip, Brian, Mak, Chung Ying Mok, Dennis, Ng, Yin Yu Eva Siu, Kiu Fung Wong, Jingya Jane Pu, Yu-Xiong, Su, Kit Ying Au-Yeung, David Yuen Chung Chan, Albert, Chan, Shannon Melissa Chan, Tsz Ching Chang, Tor Wo Chiu, Wang Kei Chiu, Zhexi, He, Man Fung Ho, Kevin Ki Wai Ho, Jacky Yan Kit Ho, Janet Wui Cheung Kung, Cheuk Ho Lam, Rainbow W, H Lau, Samuel Ka Kin Ling, Hon Ting Lok, Tony Wing Chung Mak, Chi-Fai, Ng, Simon, Ng, Kelvin Kwok-Chai Ng, Calvin S, H Ng, Michael Tim Yun Ong, Teresa, Tan, Sui Fan Tang, Jeremy Yuen-Chun Teoh, Anthony, Teoh, Bess Siu Yan Tsui, George Kwok Chu Wong, Randolph, Wong, Kwok Chuen Wong, Chi Hang Yee, Zsuzsanna, Antal, Attila, Kalman, Peter, Voros, Kiarash, Bahrehmand, Timea, Echim, Zoltan, Novak, Tamás, Sztipits, Laszló Ádám Bihari, László, Hidi, Laszlo, Piros, Balazs, Rózsa, Peter, Sotonyi, Lilla, Szatai, György, Herczeg, Bálint, Pordány, Fanni, Tornyi, Kristof, Dede, Tamás, Egyed, György, Saftics, Judit, Kulcsicka-Gut, Zsófia, Sipos, Dezso, Toth, Bhavin, Patel, Hardil, Majmudar, Saptak, Mankad, Sohilkhan, Pathan, Sharathkumarkl, L, Lokesh, Sasatti, Subramanyam, Mahankali, Santhosh Kumar Sampengere Annayappa, Tulika, Agrawal, Premkumar, Anandan, Aditya, Baindur, Manjunath, Bd, Savitha, C, S Anitha, G, Sandeep, Harigond, K Tejeswini, K, Venkatesh, Kesarla, Mallikarjuna, Manangi, B Hareesh, P, Jyothi K, R Ranjan, Athish, Shetty, Santhosh Shivashankar Chikkanayakanahalli, Tanvi, Sunil, Shreya, Syamala, Kavya, Tharanath, Aditya, Atal, Niranjana, Rajagopal, S Srinath, B, Vinod, Nk, L Thirumanikandan, P, Nitu, Mishra, Sushruta, Shrivastava, Rekha, Wadhwani, Reyaz, Ahmad, Zainab Ahmad Haq, Prateek, Behera, Ritika, Dhurwe, Rehan, Haq, Vaibhav, Jain, Anuj, Jain, Sunaina, Karna, Kameshwarachari, Pushpalatha, Sumit, Raj, John Ashutosh Santoshi, Pooja, Singh, Virendra, Verma, Vaishali, Waindeskar, Moorat Singh Yadav, Zaheda, Aziz, Koyel, Chakraborty, Preetam, Chappity, Gurudip, Das, Debajyoti, Datta, Saubhagya Kumar Jena, Madhabananda, Kar, Susanta, Khuntia, Pankaj, Kumar, Ravi, Kumar, Aswathi, Kv, Abhijeet, Mishra, Swastik, Mishra, Yash, Mittal, Dillip, Muduly, 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Somil, Jaiswal, Yashpal, Jaware, Navneet, Kala, Ruchi, Karnatak, Apjit, Kaur, Vijay, Kumar, Manoj, Kumar, Ambrish, Kumar, Upander, Kumar, Amit Kumar Shrivastava, Seema, Mehrotra, Brijesh, Mishra, Anand, Mishra, Namrata, Bal Krishna Ojha, Ahmad, Ozair, Uma Shanker Pal, Amita, Pandey, Nancy, Raja, Pooja, Ramakant, Ashutosh, Roy, Rekha, Sachan, Satyanarayan, Sankhwar, Pushp, Sankhwar, Divya, Sarin, Ayushi, Shukla, Sushil, Singh, Mohit, Singh, Kul Ranjan Singh, Renu, Singh, Uma, Singh, Urmila, Singh, Vandana, Solanki, Abhinav Arun Sonkar, Chhitij, Srivastava, Parijat, Suryawanshi, Vivek, Tewarson, Rajat, Verma, Manju Lata Verma, Awdhesh, Yadav, Gyan, Chand, K M, M Vishvak Chanthar, Dileep, Hoysal, Anjali, Mishra, Nitin, Batra, Arun, Bhatti, Rupali, Chopra, Shakina, David, Tapasya, Dhar, Uma Kant Dutt, Rohini, Dutta, Sumir, Gandhi, Parvez David Haque, B Paul Sudhakar John, Sreejith Kannummal Veetil, Gurvinder, Kaur, Navneet, Kumar, Anil, Luther, Anupam, Mahajan, Amit, Mahajan, Kavita, Mandrelle, Shefin, Mathews, Vishal, Michael, Partho, Mukherjee, Pinki, Pargal, Rajesh, Paul, Anupam, Phillip, Rachel, Phillips, Abhishek, Samuel, Noel, Singh, Inderjot, Singh, Abhijit, Singh, Sarvpreet Singh Grewal, Anusha, Singhania, Selven, Thirumalai, Ashish, Varghese, Joshua, Wesley, Josy, Thomas, Pradeep, Zechariah, Mariam Anjum Ifthikar, Rohan Thomas Mathew, Rohan, Shetty, M Vijayakumar Vijaykumar, Bm Zeeshan Hameed, Sufyan, Ibrahim, Gayathri, Jyothish, Sunil, Krishna, Stanley, Mathew, Arjun Suresh Kumar, Narinder, Singh, Piyush Kumar Sinha, Rachith, Sridhar, Sunny, Agarwal, Srikant, Balasubramaniam, Swati, Chhatrapati, Charulata, Deshpande, Ashni, Dharia, Sarita, Fernandes, Suraj, Gandhi, Mangesh, Gore, Abhilash, Jayakumar, Rameshwar, Mhamane, Anand, Nirgude, Sandesh, Parab, Manish, Patil, Amit, Peswani, Anjana, Sahu, Sarika, Samel, Fagun, Shah, Dipti, Haridas, Vijay, Shetty, Bejoy, Abraham, Varun, Agarwal, Quazi, Ahmad, Ashishkumar, Asari, Mohammad Ismail Attar, Nagaraja Sekhar Ayyalasomayajula, Sutej, Bachawat, Shivani, Bachhav, Vivek, Badhe, Sanjiv, Badhwar, Shubhabrata, Banerjee, Vikas, Basa, Vipul, Bothara, Somnath, Chattopadhyay, Sohin, Chaudhari, Rahul, Chavan, Priyank, Chawathe, Shailja, Dadhich, Anuj, Dalal, Avinash, Date, Mandar, Deshpande, Preetham, Dev, Niren, Dongre, Anirudha, Doshi, Maya, Gade, Shreyash, Gajjar, Mohan, Gawande, Amol, Ghalme, Bhavisha, Ghugare, Ishita, Gupta, Manoj, Jain, Divakar, Jain, Saumya Sekhar Jenasamant, Vaishali, Joshi, Vinay, Joshi, Neha, Kalwadia, Nandkishore, Kapadia, Hari Bipin Radhakrishnan Kattana, Tirathram, Kaushik, Akshat, Kayal, Shama, Kovale, Yogesh, Kulkarni, Abhaya, Kumar, Kranthi, Kumar, Kashmira, Kumawat, Vidyadhar, Lad, Namrata, Maskara, Rajesh, Mistry, Smruti Ranjan Mohanty, Kanchan, Motwani, Manoj, Mulchandani, Mandar, Nadkarni, Sanjay, Pandey, Mrunal, Parab, Dinshaw, Pardiwala, Amrita, Patkar, Neha, Pawar, Abhijit, Pawar, Abhinav, Pednekar, Vishal, Peshattiwar, Harshwardhan, Pokharkar, Ojas, Potdar, 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Reddy Voppuru, Anushri, Soni, Gira, Soni, Junaid, Alam, Dinesh, Bagaria, Minu, Bajpai, Akshay Kumar Bisoi, Arvind, Chaturvedi, Sandeep, Chauhan, Narendra, Choudhary, Rajendra Singh Chouhan, Sunil, Chumber, Kamran, Farooque, Vasubabu, Gudala, Amit, Gupta, Mohit, Joshi, Apoorva, Kabra, Shashank Sharad Kale, Abhinav, Kumar, Subodh, Kumar, Dhruv, Mahajan, Rajesh, Malhotra, P Ramesh Menon, Biplap, Misra, Samarth, Mittal, Rajinder, Parshad, Pratyusha, Priyadarshini, Sushma, Sagar, Pradeep Brijkishor Sharma, Vijay, Sharma, Vivek, Trikha, Mayank, Tyagi, Kuldeep, Bansal, Kalyan, Varma, Anurag, Mishra, Rajdeep, Singh, Rohit, Bhardwaj, Abhishek, Mittal, Sabarirajan, Ponnusamy, Gyan Ranjan Singh, Isha, Tuli, Pramod, Bhor, Sanjay, Dhar, Sachin, Kale, Manisha, Aggarwal, Himani, Gupta, Gurleen, Kaur, Ajinkya, Deshpande, Anup, Gadekar, Tanmay, Jaysingani, Taufiq, Panjwani, Rakesh, Patil, Narendra, Vaidya, Sunil Kumar Vishwakarma, Utkarsha, Wayal, Debnarayan, Dutta, Rajnish, Arora, Mohit, Dhingra, Pankaj Kumar Garg, Farhanul, Huda, Pankaj, Kandwal, Ravi, Kant, Rajkumar Kottayasamy Seenivasagam, Navin, Kumar, Shashank, Kumar, Lokavarapu Manoj Joshua, Radheyshyam, Mittal, Dharma Ram Poonia, Deepak, Rajput, Saravanan, Sadhasivam, Sudhir, Singh, Vivek, Singh, Kshitija, Chandanwale, Melissa, Philip, Vaibhav, Thorat, Yousuf, Choudhury, Devishmita, Das, Mautushi, Das, Subhadra, Goala, Farhana Yasmin Laskar, Parbin, Laskar, Kapil, Malik, Poulome, Mukherjee, Abhishek, Sarkar, S Thoibisana Singha, M Nongalei Singha, Damayanti, Singha, Gowtham, Srungavarapu, Ritesh, Tapkire, Siempui, Tling, Syed Muzamil Ishaq Andrabi, Gowhar Aziz Bhat, Nisar, Chowdri, Robindera, Kour, Fazl, Parray, Raahil, Shah, Zamir Ahmad Shah, Rauf, Wani, Soujanya, Adamala, Ravikanth, Gowder, Siddhi, Hegde, S Mashitha, M, Shreya, Sreeram, Sushil, Ankadavar, Darshan, Bafna, Bharat, Dhanani, Nikhil, Ingle, Piyush, Jadhao, Sinu, Joseph, Swapnil, Kapote, Shirin, Karkada, Parag, Lad, Rajan, Lohia, Suyog, Madje, Venkateshwaran, Narasiman, Meer, Chisthi, Gejoe, George, Harihara, Jothi, Dilber, Pareed, Godwin David, C Mathew, Livingston, Abel, Mansi, Agrawal, Rabindranath, B, Manish, Baldia, Ravi Kishore Barla, Manisha, Beck, Santosh, Benjamin, Jeremy, Bliss, Lisa, Cherian, Sreekar, Devarakonda, Geley, Ete, Arun Jacob Philip George, Amish, Gohil, Deeptiman, James, Mark Ranjan Jesudason, Lallu, Joseph, Treasa, Joseph, Kathir, Joyson, Gomathi, Karnan, Albert, Kota, Pushplata, Kumari, Anitha, Loganathan, Vasanth Mark Samuel, John, Mathew, Senthil, K Nathan, Joby Elizabeth Ninan, Ajay, Philip, R Priyadarshini Priyadarshini, Suganya, S, Habie, Samuel, Gilbert, Samuel, Daniel, Selvaraj, Srujan, Sharma, Suraj, Surendran, D Hariharan, T, Santhosh Kumar Thangaraj, Vinotha, Thomas, Varghese, Thomas, John, K Thomas, S Harish, Y, Manobhiram, Boggavarapu, Murali Krishna Voonna, Marilaeta Cindryani Lolobali, Christopher, Ryalino, Tjokorda Gde Agung Senapathi, Mahadewa, Tjokorda, I Made Gede Widnyana, Dita, Aditianingsih, Aino, Auerkari, Susilo, Chandra, Fachreza Aryo Damara, Mohammad Adya Firmansha Dilmy, Achmad Kemal Harzif, Sidharta Kusuma Manggala, Dedy, Pratama, Affan, Priyambodo, Andi Ade Ramlan, Ratna Farida Soenarto, Adhrie, Sugiarto, Ilham Utama Surya, Tamara, Tango, Aida Rosita Tantri, Raihanita, Zahra, Dedy, Fachrian, Andi, Hasyim, Ade, Susanti, Teddy, Saputra, Erwin, Syarifuddin, Andi Asadul Islam, Hendra, Pajan, Ahmad Hannan Amrullah, Khoirul, Anam, Thirza, Hadipranata, Julius Albert Sugianto, Aidyl, Fitrisyah, Mayang Indah Lestari, Nur Rachmat Lubis, Rizal, Zainal, Zulkifli, Zulkifli, Erick Gamaliel Amba, Warren, Lie, Andika Adiputra Thehumury, Tedy, Apriawan, Yunus Kuntawi Aji, Roidah Taqiyya Zahra Wathoni, Sumadi Lukman Anwar, Teguh, Aryandono, Wirsma Arif Harahap, Juni, Kurniawaty, Djayanti, Sari, Artanto, Wahyono, Yunita, Widyastuti, Akhmad Yun Jufan, Parisa, Arjmand, Mohammad, Etezadpour, Babak, Ganjeifar, Masoumeh, Hosseinpoor, Hassan, Mehrad-Majd, Mohsen, Rajati, Reza, Assadi, Ehsan, Noori, Parisa, Rajaei, Samira, Hajisadeghi, Mohammad, Mehdizadeh, Mina, Soltani, Narges, Alizadeh, Gholamreza Azarnia Azar Nia, Hamid, Heidari, Seyedmohamad Hosseini Zavareh Hosseini Zavareh, Ali Moazami Pour Moazami Pour, Farokh, Savaddar, Mostafa, Vahedian, Hoora, Amouzegar, Mojdeh, Bahadorzadeh, Seyedeh Homa Hemmasi, Ahmad, Kachoie, Ali Karimi Karimi, Sepideh, Miraj, Monireh, Mirzaie, Hossein Mokarami Mokarami, Amrollah, Salimi, Roghayyeh, Ahangari, Ali, Ahmadvand, Ali, Bashiri, Morteza, Borhani, Mohammad, Haidari, Mohammad Taghi Imani Khosroshahi, Shahrokh Jahan Bini, Mohsen, Koosha, Mohammad Kazem Moslemi, Ali, Naghibi, Shahrzad, Tehrani, Zahra, Yazdi, Seyyed Hassan Adeli, Majid, Alborzi, Hamed, Bagheri, Mohsen, Eshraghi, Hassan Fatemi Manesh, Mohammad, Ghomeisi, Seyed Fakhreddin Hejazi, Saeed, Madani, Nima Najafian Motahaver, Samieh, Norouzi, Mahdi Pezeshki Modarres, Ali, Shafiee, Jamshid, Vafaeimanesh, Hossein, Yusefi, Elahe, Hosseini, Pourya, Medhati, 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Marshall, Darya, Musa, Zeeshan, Ahmad, Emmet, Andrews, Bruno Chan Chin, Mark, Corrigan, Amy Edwards Murphy, Niamh, Foley, Padraig, Gardiner, Daniel, Hechtl, Michelle, Hsiao, Mohd Yasser Kayyal, Shane, Killeen, Maria, Lyons, Cathy, Burke, Matt, Hewitt, Marwa, Mohamed, Syeda Farah Nazir, Mei Yee Ng, Nor Azlia Abdul Wahab, Cathy, Monteith, Oladayo, Oduola, Lylas, Aljohmani, Timothy, Nugent, Paula, Corr, Lauren, Crone, Johnathon, Harris, Arnold, Hill, David, Kearney, Robert Anthony Keenan, Deirdre, Nolan, James, Ryan, Mark Philip Hehir, Carmen, Regan, Michael, Geary, Fergal, Malone, Claire, Mccarthy, Donal, B O'Connor, Shane, Considine, Emma, Donohoe, Caroline, Herron, John, Larkin, Thomas Hugh Lynch, Barry, Maguire, Rustom, Manecksha, Andrea Mc Carthy, Katharina, Nagassima, Erica, O'Sullivan, Pat, Rohan, Ryan, Roopnarinesingh, Salloum, Salloum, Thomas, Aherne, Mary, Barry, Gareth John Bowen, Ellen, Boyle, Joseph, Dowdall, Ann, Hanly, Ahmed, Hassanin, Helen, Heneghan, Conor, Hurson, Orlaith, Kelly, Rory, Kennelly, Aoife, Kiernan, Sean, T Martin, Nawar, Masarani, Damian, Mccartan, Enda, W McDermott, Ben, Murphy, Kin Cheung Ng, Nwabundo, Njeze, Aine, O'Neill, Ruth, S Prichard, Ned, Quirke, Ian Sean Reynolds, Des, Winter, Rowan, Casey, Mutaz, Elamin, Amy, Gillis, Dara, Kavanagh, Michael, Kelly, Áine, Mcnamee, Paul, Neary, Patrick, Owens, Akshaya, Ravi, Paul, Ridgway, Paul, Carroll, Chris, Collins, Amenah, Dhannoon, Amy, Fowler, Aisling, Hogan, Aoife, Lowery, Peter, Mcanena, Charlie, Timon, Stewart, Walsh, Wisam, Al-Ramli, Imran, Azeem, Muhammad Usaama Bahadoor, Zsolt, Bodnar, Hassan, Elmusharaf, Faisal Saeed Hassan, Adam, Hingum, Huilun, Huan, Seamus, Jennings, Mohamed Hamed Khalid, Mariya, Kuteva, Syed Nadeem Mujtaba, Shanell, Peeriyah, Hina, Rehman, Muhammad Assam Sarwar, Tony, Shaju, Ian, Stephens, Michael, Sugrue, Joseph, Thomas, Manvydas, Varzgalis, Saqib, Zeeshan, Alisha, Jaffer, Larne, Jones-Whiting, Colin, Peirce, Sean, Johnston, Seantee, Lim, Alwaleed, 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Massimiliano, Gennaro, Lorenzo, Giannini, Marcello, Guaglio, Marco, Guzzo, Andrea, Leva, Alberto, Macchi, Elena, Manzo, Fabio, Martinelli, Ilaria, Mattavelli, Vincenzo Maria Mazzaferro, Francesco, Raspagliesi, Luigi, Rolli, Laura, Sala, Roberto, Salvioni, Mario, Santinami, Silvia, Segattini, Luca, Sorrentino, Carlotta, Zaborra, Alexandre, Anesi, Gianmaria Casoni Pattacini, Mattia Di Bartolomeo, Francesca, Pecchini, Arrigo, Pellacani, Micaela, Piccoli, Federico, Fusini, Andrea, Gattolin, Marco, Migliore, Roberto, Rimonda, Diego, Sasia, Elisabetta, Travaglio, Federica, Brunetti, Marco, Cereda, Marco, Ceresoli, Luca, Cigagna, Cristina, Dell'Oro, Alessandro, Fogliati, Robert, Fruscio, Tommaso, Grassi, Maini Marzia Isabella, Luca Carlo Nespoli, Massimo, Oldani, Sara, Ornaghi, Nicolò, Tamini, Carmine, Antropoli, Antonio, Castaldi, Alessio, Palumbo, Gaia, Altieri, Umberto, Bracale, Francesco, Corcione, Marcello De Luca, Giovanni Domenico De Palma, Maria Michela Di Nuzzo, Ruggero, Lionetti, 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Matteo, Filardo, Marika Sharmayne Milani, Franco, Ragni, Andrea de Manzoni Garberini, Edoardo, Baldini, Diana, Carpaneto, Michele, Cauteruccio, Corrado, Ciatti, Luigi, Conti, Serena, Gattoni, Pietro, Maniscalco, Gerardo, Palmieri, Calogero Puma Pagliarello, Giuseppe, Caristo, Raffaele, Galleano, Michele, Malerba, Marcello, Calabrò, Francesca, Farnesi, Elia Giuseppe Lunghi, Andrea, Muratore, Nicoletta Sveva Pipitone Federico, Joel Reuben Abel, Lorenzo, Andreani, Darienzo, Antonio, Vittorio, Aprile, Riccardo, Balestri, Giacomo, Benettini, Stefano, Berrettini, Luca, Bruschini, Massimo, Chiarugi, Federico, Coccolini, Simone, Colangeli, Camilla, Cremonini, Lodovica Cristofani Mencacci, Iacopo, Dallan, Silvia De Santi, Gregorio Di Franco, Lorena Di Girolami, Giacomo, Fiacchini, Niccolò, Furbetta, Stylianos, Korasidis, Marco, Lucchi, Andrea, Morandi, Luca, Morelli, Serena, Musetti, Carlo Maria Neri, Matteo, Palmeri, Miriana, Picariello, Francesco, Porcelli, Marco, Puccini, Nicolo, Roffi, Erica, Statuti, Dario, Tartaglia, Alberto, Tonelli, Matteo, Vianini, Gianluca, Baronio, Mauro, Montuori, Enrico, Pinotti, Stefano Maria Massimiliano Basso, Federica, Maffeis, Paolo, Ubiali, Lorenzo, Aguzzoli, Saverio, Coiro, Giuseppe, Falco, Vincenzo Dario Mandato, Valentina, Mastrofilippo, Simone, Mele, Caterina, Baldi, Carlo, Corbellini, Gianluca Matteo Sampietro, Massimo, Dugo, Mauro, Garino, Chiara, Marafante, Antonio, Masciandaro, Elisabetta, Moggia, Alessandra, Murgese, Felice Eugenio Agro, Gabriella Teresa Capolupo, Filippo, Carannante, Marco, Caricato, Vincenzo, Denaro, Erica, Mazzotta, Rocco, Papalia, Giuseppe, Pascarella, Alessandro, Strumia, Biagio, Zampogna, Matteo, Cinquepalmi, Marco, Colasanti, Celeste Del Basso, Federica, Falaschi, Nicola, Guglielmo, Roberto Luca Meniconi, Alessandra, Pecoraro, Sofia, Usai, Giacomo, Crescentini, Antonella, Larcinese, Emanuele, Picone, Giovanni, Sinibaldi, Annamaria, Agnes, Salvatore, Agnes, Sergio, Alfieri, Francesco, Belia, Valentina, Bianchi, Giuseppe, Bianco, Alberto, Biondi, Paola, Campennì, Valerio, Cozza, Sabatino, D'Archi, Domenico, D'Ugo, Veronica De Simone, Marta Di Grezia, Sofia Di Lorenzo, Federica, Ferracci, Valeria, Fico, Gianluca, Franceschini, Pietro, Fransvea, Giulio, Gasparini, Luca, Gordini, Antonio La Greca, Francesco, Litta, Celestino Pio Lombardi, Angelo Alessandro Marra, Angelo, Parello, Marco Maria Pascale, Romeo, Patini, Gilda, Pepe, Roberto, Persiani, Caterina, Puccioni, Carlo, Ratto, Fausto, Rosa, Gianmarco, Saponaro, Lorenzo, Scardina, Tedesco, Silvia, Giuseppe, Tropeano, Maria, Benevolo, Daniele, Bugada, Flaminia, Campo, Maria Gabriella Dona, Valentina, Manciocco, Paolo, Marchesi, Riccardo, Mastroianni, Francesco, Mazzola, Silvia, Moretto, Raul, Pellini, Gerardo, Petruzzi, Barbara, Pichi, Giuseppe, Simone, Gabriele, Tuderti, Jacopo, Zocchi, Luigi Marino Cosentino, Andrea, Sagnotta, Roberta, Angelico, Vittoria, Bellato, Michela, Campanelli, Marzia, Franceschilli, Michele, Grande, Giorgio, Lisi, Tommaso Maria Manzia, Lorenzo, Petagna, Bruno, Sensi, Giuseppe, Sica, Leandro, Siragusa, Giuseppe, Tisone, Marco, Assenza, Barbara, Binda, Massimo, Biondi, Gioia, Brachini, Placido, Bruzzaniti, Mauro, Casagrande, Flavia, Ciccarone, Pierfranco Maria Cicerchia, Bruno, Cirillo, Daniele, Crocetti, Giancarlo, D'Ambrosio, Vito, D'Andrea, Francesca De Felice, Giorgio De Toma, Carlo Della Rocca, Giulia, Duranti, Pietro, Familiari, Enrico, Fiori, Giovanni Battista Fonsi, Alessandro, Frati, Stefania La Rocca, Filippo La Torre, Pierfrancesco, Lapolla, Giovanni, Marruzzo, Simona, Meneghini, Andrea, Mingoli, Andrea, Picchetto, Antonella, Polimeni, Diego, Ribuffo, Maurizio, Salvati, Antonio, Santoro, Paolo, Sapienza, Luigi, Simonelli, Valentino, Valentini, Martina, Zambon, Giuseppa, Zancana, Emma, Zuppi, Simone, D'Annunzio, Cosimo De Nunzio, Silvia, Fiorelli, Mohsen, Ibrahim, Chiara, Loffredo, Domenico, Massullo, Cecilia, Menna, Rocco, Monica, Massimiliano, Pelli, Erino Angelo Rendina, Leonardo, Teodonio, Andrea, Tubaro, Giulio, Argenio, Giulio, Accarino, Accarino, Giancarlo, Antonio Nicola Giordano, Luca, Cardinali, Elisa, Sebastiani, Grazia, Travaglini, Erika, Andreatta, Emanuele Luigi Giuseppe Asti, Daniele, Bernardi, Luigi, Bonavina, Caterina, Froiio, Andrea, Lovece, Chiara, Copelli, Alfonso, Manfuso, Pasquale Di Maio, Marco, Giudice, Oreste, Iocca, Rosario, Cennamo, Tommaso, Cornali, Francesco Di Marzo, Cristian, Altana, Francesco, Bussu, Giampiero, Capobianco, Anna Giacomina Carta, Sandro, Ciccarello, Maria Laura Cossu, Pietrina, Cottu, Giacomo De Riu, Salvatore, Dessole, Francesco, Dessole, Salvatora, Dettori, Carlo, Doria, Alessandro, Fancellu, Claudio, F Feo, Giorgio Carlo Ginesu, Giuliana, Giuliani, Marco Giuseppe Iannuccelli, Massimo, Madonia, Roberto, Mancino, Olindo, Massarelli, Gianfranco, Meloni, Fabio, Milia, Andrea, Mulliri, Teresa, Perra, Marco, Petrillo, Antonio, Piras, Franco, Piredda, Francesco, Pisanu, Alberto, Porcu, Davide, Rizzo, Angelino, Sanna, Antonio Mario Scanu, Fabrizio, Scognamillo, Damiano, Soma, Anna Rita Tanca, Alessandro, Tedde, Matteo, Tedde, Luigi Angelo Vaira, Andrea Bartalini Cinughi de Pazzi, Osvaldo Carpineto Samorani, Daniele, Fusario, Luigi, Marano, Gaia, Oldrà, Anna Lisa Pesce, Stefania Angela Piccioni, Luca, Resca, Vincenzo, Ricchiuti, Franco, Roviello, Vinno, Savelli, Alberto, Abrate, Pierpaolo, Bordoni, Lorenzo, Bosio, Guglielmo, Clarizia, Francesco, Fleres, Marco, Franzini, Antonio, Fratto, Pierluigi, Giumelli, Alessandro, Grechi, Alessandro, Longhini, Fabrizio, Lorusso, Elisa, Scarnecchia, Federica, Scolari, Alessandro, Spolini, Vincenzo, Maiuri, Matteo, Papandrea, Arturo, Roncone, Lorenzo, Conti, Andrea, Rizzi, Marco, Rovagnati, Alberto, Brolese, Tommaso, Cai, Francesco Antonio Ciarleglio, Francesca, Dalprà, Gianni, Malossini, Liliana, Mereu, Irene, Tamanini, Saverio, Tateo, Giovanni, Viel, Enrico, Battistella, Paolo Boscolo Rizzo, Cristoforo, Fabbris, Marco, Massani, Giacomo, Spinato, Roberta, Tutino, Ugo, Grossi, Alessandro, Iacomino, Simone, Novello, Maurizio, Romano, Serena, Rossi, Giulio, Santoro, Giacomo, Zanus, Sokol, Trungu, Giada, Aizza, Gabriele, Bellio, Selene, Bogoni, Marina, Bortul, Biagio, Casagranda, Sara, Cortinovis, Nicolò de Manzini, Davide, Drigo, Paola, Germani, Manuela, Mastronardi, Lucia, Paiano, Silvia, Palmisano, Pier Luigi Filosso, Francesco, Guerrera, Matteo, Marro, Mauro, Rinaldi, Enrico, Ruffini, Stefano, Salizzoni, Laura, Bardelli, Mattia, Berselli, Giacomo, Borroni, Eugenio, Cocozza, Matteo, Desio, Bottazzoli, Elisa, Giuseppe, Ietto, Valentina, Iori, Domenico, Iovino, Lorenzo, Livraghi, Valentina, Marchionini, Stefano, Megna, Emma Amal Nahal, Mara, Palumbo, Valeria, Quintodei, Alessandra, Zullo, Lucrezia, D'Alimonte, Giovanni, Pirozzolo, Chiara, Vignotto, Tommaso, Campagnaro, Andrea, Caravati, Simone, Conci, Carlotta De Cristofaro, Gabriele, Gecchele, Tommaso, Giuliani, Jacopo, Graziosi, Alfredo, Guglielmi, Salvatore, Paiella, Corrado, 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Rakotoarisoa, Maharo, Ramifehiarivo, Solonirina Harinarindra Ranaivoson, Hajamihamina Marina Parfaite Randriantsoa, Narindra Njarasoa Mihaja Razafimanjato, Jeannie Ba Razafindrahita, Solofoarimanana, Solofoarimanana, Guillaume Odilon Tsiambanizafy, Rakotonaivo Mamisoa Judicaël, Corinne Eulalie Solo, Tojomamy Herinjaka Ralaizafindraibe, Fanonjomahasoa Safiry Andofenohasina, Hanta, Rasataharifetra, Vanona Barijaona Razafindraibe, Angelin Sablon Herinirina, Andre, Das, Thanga, Ganapathy, Yohesuwary, Gunarasa, Kalyani, Mariapan, Maathichsudhaar, Muniandy, Mohd Firdauss Osman, Mohd Azem Fathi Mohammad Azmi, Jien Yen Soh, Wan Zainira Wan Zain, Andee Dzulkarnaen Zakaria, Zaidi, Zakaria, Kheng Hooi Chan, Firdaus, Hayati, Syamim, Johan, Jin Jiun Mah, Ratha Krishnan Sriram, Sentilnathan, Subramaniam, Nur Shahirah Binti Muhammad Shahimi, Khairul Hazim Hamdan, Mohd Razali Ibrahim, Guhan, Muthkumaran, Ju Ann Tan, Mohana Raj Thanapal, Dayang Anita Abdul Aziz, Mae-Lynn, Bastion, Mohd Hairul Nizam Harun, Farrah-Hani, Imran, Norshamsiah Md Din, Ayesha Mohd Zain, Mushawiahti, Mustapha, Syed, Nabil, Ainal Adlin Naffi, Abd Jabar Nazimi, Roszalina, Ramli, Bee Hong Soon, Pavin, Bal, Joo Qing Cheng, Mohd Rusdi Draman, Ahmad Nazran Fadzli, Sakina, Ghauth, Weipin, Hung, Suniza, Jamaris, Peng Soon Koh, Sivakumar, Krishnasamy, Yeong Sing Lee, Yew Toong Liew, Jeffery Zk Lim, Raymond Chung Siang Lim, Hiong Chin Lim, Siti Farhan Moh Pauzi, Shireen Anne Nah, Ashvin Krishna Nair, Doris Sin Wen Ng, Yuki Julius Ng We Yong, Kamarajan, Ramayah, Rahmah, Saaid, Anand, Sanmugam, Mee Hoong See, Kanesh Kumaran Seevalingam, Neha, Sethi, Srihari, Singaravel, Syeda Nureena Syed Jafer Hussain Zaidi, Chu Yik Tang, Li Ying Teoh, Kian Boon Wong, Ruben, Xavier, Ahmad Shuib Yahaya, Norhafiza, Ab, Rahman, Islah Munjih Ab, Rashid, Mohd Fahmi Abd Aziz, Mohd Norhisham Azmi Abdul Rahman, Nasser Muhammad Amjad, Shahidah Che Alhadi, Faisal, Elagili, Mohd Nazli Kamarulzaman, Azmi Md Nor, Ahmad Faidzal Othman, Mohd Yusof Sainal, Mat Salleh Sarif, Richelle, Chua, Aini Fahriza Ibrahim, Abdul Rauf Bin Ahmad, Yii Ling Lau, Ka Yee Liew, Kandasami, Palayan, Hui Yu Wong, Jasiah, Zakaria, Nor Azimah Abd Aziz, Norazila Abdul Rahim, Noorneza Abdul Rahman, Bahiyah, Abdullah, Mohamed Faizal Bin Sikkandar, Fatin, Firman, Nik Mohd Hazleigh, Intan Kartika Kamarudin, Shahril, Khalid, Mohd Fairudz Mohd Miswan, Akmal Zulayla Mohd Zahid, Norasyikin, Mustafa, Kadhim, Obaid, Mohd Yusoff Bin Yahaya Yahaya, Ahmad Ramzi Yusoff, Predrag, Andrejevic, Jeremy Borg Myatt, Svetlana, Brincat, Clifford, Caruana, Kurt Lee Chircop, Francesca, Chircop, Daniel Mario Chircop, Charles, Cini, Viktoria, Czok, Melanie, Farrugia, Gabriella, Grima, Fatimah Mj Hassan Almukhariq, Esther, Muscat, Darryl, Pisani, Mohsin Hassan Khan Roshan, Nicholas, Schembri, Mohamed, Shoukry, Neville, Spiteri, Gilbert, Tanti, Ziad Aboharp Hasan, Alberto Bazan Soto, Cedillo Rodrìguez Jonathan Rubén, Gustavo Esteban Lugo Zamudio, David Gerardo Miranda Gómez, José Alfredo Pérez Meave, Victor Pinto Angulo, Antonio Rojas Aguilar, Erik Efrain Sosa Duran, Alejandro Vàzquez Perez, Diego, Arroyo, Jose, Corona-Cruz, Hector, Martinez-Said, Heriberto, Medina-Franco, Manuel, Mendez, Teresa Moreno, Y Suárez Ma, Dolores Orta Díaz, Martha Patricia Pérez de León Vázquez, Angélica Azucena Soto Carvajal, Fidel Soto Hernández, Juan Ignacio Stenner, Adriana Valenzuela López, Mauricio Rene Hernandez, Rey Jesus Romero, Aldo Bernal Hernandez, Ana Olivia Cortes-Flores, Carlos Jose Zuloaga Fernandez Del Valle, Carlos Andres Colunga Tinajero, Jaime, Orozco-Perez, Laura Gabriela Peña Balboa, Guillermo, Yanowsky-Reyes, Víctor Hugo Alcalá Torres, Francisco José Barbosa Camacho, Irma Valeria Brancaccio Perez, Miguel Angel Calderon-Llamas, Aldo Camacho Gomez, Edgar-Joaquin, Cortes-Torres, Esteban, Cueva-Martinez, Oscar Durán Anguiano, Isaac Esparza Estrada, Roberto, Fierro-Rizo, Paola Flores Becerril, Clotilde Fuentes Orozco, Miguel García Castillo, Alejandro Gonzalez Ojeda, Ana Sofia Gonzalez Rubio, Erick Alonso González-García de Rojas, Luis Humberto Govea-Camacho, Jose Aldo Guzman Barba, Juan Carlos Ibarrola Peña, César Íñiguez Martínez, Francisco Javier Llamas-Macias, Ruben Eduardo Morán Galaviz, Cesar, Nuño-Escobar, Oscar-Everardo, Olvera-Flores, Jaqueline, Osuna-Rubio, Jose Victor Pérez-Navarro, Rodrigo, Prieto-Aldape, Luis Ricardo Ramirez Gonzalez, Marco Vinicio Ramírez Sánchez, Emilio, Reyes, Olaya Moramay Romero-Limón, Carlos Beas Ruiz-Velasco, José Antonio Sánchez Martínez, Guillermo, Sanchez-Villaseñor, Ismael, Sedano-Portillo, Gabriela Ambriz Gonzalez, Pedro Berrones Moreno Berrones Moreno, Ana Beatriz Calderon Alvarado, José de Jesús Cárdenas Barón, Araceli, Hernández, Francisco Javier León Frutos, Edgard Efren Lozada Hernandez, Eduardo Morales Valencia, Karla Daniela Pérez, Francina, Bolanos-Morales, Julio, Herrera-Zamora, Patricio, Santillan-Doherty, David Omar Arriaga Zavala, Salvador Francisco Campos Campos, Lizette, Carmona, 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Alexander, Borgstein, Suzanne, Gisbertz, Sarah, Mikdad, Mark van Berge Henegouwen, Roel, Bakx, Marc, Besselink, Daniel Hl Lemmers, Anne-Jasmin, Roelofs, Paul van Amstel, Claire van Helsdingen, Ludi, Smeele, Niels, Harlaar, Frederik, Jonker, Sjirk van der Burg, Justin, Y van Oostendorp, Saranda, Ombashi, Tim van der Voort, Martijn van Geldorp, Lisanne, Posma-Bouman, Hans Donald de Boer, Annette, Olieman, Henriette, Smid-Nanninga, Jean-Paul P, M De Vries, Rianne, Hogenbirk, Tyche, Derksen, Josephine, Franken, Steven, Oosterling, Peter, Nolte, Jelle van der List, Ian, Alwayn, Okker, Bijlstra, Andries, Braat, Ruth, Bulder, Michèle de Kok, Robin, Faber, Ben, Goudsmit, Jaap, Hamming, Sven, Mieog, Alexander, Vahrmeijer, Fenna E, M van de Leemkolk, Joost van der Vorst, Jan van Schaik, Merel, Verhagen, Kim, Albers, Larsa, Gawria, Harry Van Goor, Michiel, Warle, Tessa, M van Ginhoven, Charlotte, Viëtor, Evert-Jan, Boerma, Lara, Lallitsch, Donald, Schweitzer, Wouter, Leclercq, Julie, Sijmons, 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Asensio, Luis Asensio Gomez, Diego, Carrion, Nuria, Chavarrias, Alvaro de Arriba, Jose Antonio Gazo Martínez Gazo, Alberto Gegúndez Simón, Juan Gómez Rivas, Natalia Gonzalez Alcolea, Carolina, Gonzalez-Gomez, Sara Gortázar de Las Casas, María Alexandra Heras Garceau, Alicia Hernández Gutierrez, Luis, Lassaletta, Fuad Samir Lopez Fernández, Marta, Mancheño, Blanca, Mateos-Serrano, Isabel Pascual Miguelañez, Maria Fernanda Pedrero Escalas, Julio, Peñarrocha, Yolanda, Perez, Maria Isabel Prieto-Nieto, Teresa Rivera Schmitz, Laura, Rodrigáñez, Ines, Rubio-Perez, Isabel Sanchez Cuadrado, José Ignacio Sánchez Méndez, Jorge Fernando Tone, Carlos Toribio Vazquez, Aitor, Urbieta, Diego Córdova García, Francisca Garcia-Moreno Nisa, Laura, Jiménez, Inmaculada, Lasa, Belen, Matías-García, Fernando, Mendoza-Moreno, Marina Pérez González, Ana Sánchez Gollarte, Alejandro Sanchez Pellejero, Cristina Vera Mansilla, Rafael, Barberá, Lourdes, Montes-Jovellar, Sara Fra Fernández, Nicolas Moreno Mata, Barbara, Algar-Yañez, Gutiérrez, Bérénice, Olga De La Varga-Martínez, Paula, Fernandez-Valdes-Bango, Sandra Maria Gadin-Lopez, José María Martínez-Gómiz, Elena, Nieto-Moreno, Ana, Nieto-Moreno, Montserrat Ocampos Hernandez, Maria Laura Pelegrina-Lopez, Alicia Ruiz Escobar, Elena, Sáez-Ruiz, Beatriz, Vazquez-Rivero, Antonio, Lara, Belén Vielva Del Campo, Fernando Alcaide Matas, Simbad, Costas-Ochoa, José María García Pérez, Elizabeth, Marmol, Paula Troncoso Pereira, Maria Del Pilar Concejo Cutoli, Juan Ramón Gómez López, Juan Carlos Martín Del Olmo, Paloma Guillamot Ruano, Javier Páramo Zunzunegui, Antonio Albarracín Marín Blázquez, Alfonso, Aliaga-Sanchez, Marta María Arroyo Domingo, Miriam Artés Artés, Ana Isabel Avellaneda Camarena, Aida, Blaya, Emny Rochell Bobadilla Romero, Pedro Vicente Fernández-Fernández, Lorena Galindo Iñiguez, Víctor Javier García Porcel, Clara Giménez Francés, Antonio Javier Gomez Poveda, Rebeca Gonzalez Celdran, Francisco Miguel González Valverde, Laura Guillamon Vivancos, Elena, Gurrea-Almela, Alejandra Jara Maquilón, Jose David Jimenez Parra, Abd Al Aziz Lanagrán Torres, Raquel Lax Perez, Carmen Maria Lopez Lopez, Francisco, Machado, Alfonso Marco Garrido, Florencio Manuel Marin Martinez, Victoria Martínez Muñoz, Esther, Medina, Olimpia, Molina, José Manuel Muñoz Camarena, Julian, Onate, Pedro Antonio Parra Baños, Emilio Peña Ros, Enrique, Rubio, Marina Sánchez Robles, Carlos Sanchez Rodriguez, María Valero Soriano, María Teresa Yepes García, Felipe, Alconchel, Andrés Balaguer Román, Valentín, Cayuela, Ana, Conesa, Ana Delegido García, Pedro José Gil Vázquez, Paula Gómez Valles, Francisco, Gómez-Bosch, Vicente, J León-Muñoz, Francisco, Martínez, Alvaro, Navarro-Barrios, Tatiana, Nicolás-López, Pablo Ramirez Romero, Emiliano, Cano-Trigueros, María Concepcion Alonso González, Leticia Gómez Viana, Ana Pastor Zapata, Elisa Contreras Saiz, Tamara Díaz Vico, Maria, Fernandez-Hevia, Luis Joaquín García Flórez, Raquel, Rodríguez-Uria, Sandra, Sanz, Lorena, Solar-Garcia, Aida Suárez Sánchez, Jaume, Gelonch, Dietmar, Reinaldo, Miriam Abdulkarim Polo, Asier, Aguirre, Marta Alomar Bofill, Santiago, Baena, Ashish, Bartakke, Carmen Cabeza Oliver, Marta Castro Suárez, José Andrés Cifuentes Rodenas, Olga Claramonte Bellmunt, Ant Onia Crespí Mir, Anabel De La Llave Serralvo, Mar, Escales, Isabel Rosa Fernández Burgos, Pablo Gandia Gonzalez, Juan Lliteras Jorge, María Cristina Martínez Canto, Javier, Mata, Andreu, Morell, Naila, Pagès, Sara Pérez Palao, Cristian Plaza Valiente, Catalina Ramon Barcelo, Carmen Reyero Fernández, Albert Reyes Claret, Leticia Rodriguez Vaquero, Maialen Saez de Vicuña Salinas, Pilar Santos Cidon, Concepcion, Segura, Aina, Serra, Maria Serra Guivernau, Maria Soler Pedrola, Marta, Tasende, Marta Torrent Lluch, María Inmaculada Valldeperas Hernández, Rosa-Maria, Yañez-Lpez, Andrea, Craus-Miguel, Laura Fernández Vega, Natalia Pujol Cano, Juan José Segura-Sampedro, Laura Colet Oliver, Ivan Dot Pascuet, Mireia, Duart, Isabel Tello Galindo, Eduardo Arrea Salto, Jaume Cámara Cabrera, Marta Camats Terré, Juan Gabriel Castro Ríos, Marta de la Rosa-Estadella, Anna, Fernandez-Colorado, Anna, Gasulla-Rodriguez, Antonio, Gimenez-Gaibar, Elena, Gonzalez, Yeray Maldonado Sotoca, Matilde, Molina-Corbacho, Montserrat Monfort Mira, Josep, Rodoreda, Marta Santos Espí, Arnau Verdaguer Figuerola, Elisa Angela Diego-Alonso, Jaime, López-Sánchez, Luis, Muñoz-Bellvis, Jacobo, Trebol, Borja, Aguinagalde, Cristina Gabriela Alzate Arsuaga, Ainhoa Andres Imaz, Iñigo, Arana, Coro Aranzabal Urrutia, Mikel, Armendariz, Lorena, Arrabal, Iñigo, Augusto, Adolfo, Beguiristain, Laura, Busto, Ainhoa, Cuevas, Itziar De Ariño, Alejandro, Elúa, Leticia, Fernandez, Arantza, Fernandez-Monge, Lander, Gallego, Alba, Garcia, Amaia Garcia Dominguez, Gregorio, Garmendia, Carmen, Grañén, Pelayo Hevia Rodríguez, Maria, Iraola, José Miguel Izquierdo, Aintzane, Lizarazu, Jon Ander Lizarbe, Claudia Cristina Lopes Moreira, Iker, López, Ruth Marquina González, Tania, Pastor, Adrián Recio Ayesa, Ana Paula Riverola Aso, Carballo, Rodríguez, Araceli, Rodrìguez, Maria Inmaculada Ruiz Montesinos, Patricia, Torres, Jose, Undabeitia, Ainara, Villafruela, Maria Barrionuevo Ramos, David, Blanco, Marta, Calderón, Eva Corral Rubio, Angel, Cuadrado-García, Daniela, Cubek, Ignacio, Fariña, Maria Fernandez LLorente, Natalia Flores Amador, Mariana García Virosta, Luis Garcia-Sancho Tellez, Adelina Gonzalez Martinez, María, Hernandez, Rubén Herreros Ruiz-Valdepeñas, Carmen Jimenez Sanchez, Eduardo Llamazares Cobo, María, López, Javier, López-Martin, Teresa Martínez Marivela, Luis Miguel Martinez Parra, Paloma Maté Mate, Paloma, Medrano, Manuel Moriche Carretero, Sara Núñez O'Sullivan, Manuel Ortega Oria de Rueda, María Begoña Pastor Nieto, Clara, Pérez, Antonio, L Picardo, Remedios Revilla Amores, Carmen Rodríguez Haro, Jose Alberto Rojo López, Fatima Sanchez Cabezudo Noguera, Cristina, Sanz, Daniel Serralta de Colsa, Cristina Valor Garcia, Marta Velasco Martinez, Iván Andújar Lara, Aranzazu, Calero-Lillo, Enrique, López-Ruiz, Alberto Díaz García, Alejandro Menéndez Moreno, Luis Eduardo Pérez-Sánchez, Ángela, Pascual, Miguel Adeba García, Marta Alonso Fernández, Javier Alvarez Gama, Roberto, Ballestero, Loreto Berjon De La Vega, Paola Calleja Hermosa, Mariana, Carrillo-Rivas, Alfonso, Casado, Andrea, Cerveró, Bonifacio Cimadevilla Calvo, Patricia Corriols Noval, Paloma de la Dehesa Cueto-Felgueroso, Miren Jasone Diez Zapirain, José Estevez Tesouro, José Antonio Fernández-Dívar Sánchez, Lucia Garcia Alcalde, Juan García Cardo, Tito García Moreno, Daniel, García-López, Belen Garcia-Montesinos Perea, Miren Gonzalez Benito, Rocio, Gonzalez-Aguado, Miguel Ángel Gordo Vega Gordo-Vega, Jose, Gutierrez-Banos, Jaime Jimeno Fraile, Yolanda Jubete Castañeda, Patricia Lopez Gomez, Antonia Jesús López López, David Mato Mañas, Carmelo, Morales-Angulo, Dieter, Morales-Garcia, Sara, Naranjo, Jose Luis Rabago, Jose Manuel Rabanal, Rocio Revuelta Zorrilla, Adriana Reyes Echeverría, Juan Carlos Rodríguez-Sanjuán, Juan Ramón Sanz, Isabel Simal Badiola, Guillermo, Tejón, Enrique Toledo Martínez, Raquel Varea Malo, Begoña, Fadrique, Tania, Funes, Elena González Revilla, Isaias, Alarcón, Daniel Aparicio Sánchez, Pablo Beltran Miranda, Carmen, Cepeda-Franco, María Josefa Cuevas López, Sandra, Dios-Barbeito, Virginia María Durán Muñoz-Cruzado, Carlos Gonzalez De Pedro, Rosa, M Jimenez-Rodriguez, Francisco, Manresa-Manresa, Gabriel, Marin, Cristobalina, Martin-Garcia, Sara, Martínez-Núñez, Juan Manuel Martos Martinez, Lucas, Mengíbar, Felipe Pareja Ciuro, Eduardo Perea Del Pozo, Veronica Pino Diaz, José, Pintor-Tortolero, Claudia, Quintero-Pérez, Maria Luisa Reyes Diaz, Mercedes Rubio Manzanares Dorado, Alejandro Sanchez Arteaga, Ana, Senent-Boza, Luis, Tallon-Aguilar, Jose, Tinoco-Gonzalez, Luis-Cristobal, Capitan-Morales, Juan Cintas Catena, Javier, Valdes-Hernandez, María Del Campo Lavilla, Alina López De Fernández, Miriam Abellan Lucas, Alba Diaz Padillo, Maria Gómez Romero, Linda Grace Puerto Tamayo, El Mostafa El Yaqine Er Raoudi, Melody García Domínguez, María Ángeles Gascón Domínguez, Marta González Pérez, Alba Hernáez Arzoz, Joana San Anton, Cristian, Ruminot, Hander Guillermo Acosta Diaz, Daniella, Laguado, Kristina, Aghababyan, Alba, Jr, Enrique, Artigues, Rocío, Belda, Miguel, Beltran, Jose Ignacio Blanes, Elena Campos Carot, Miriam, Cantos, Laura, Costa, Carolina Ferrer Gomez, José María Gallego Sánchez, Oscar, Gil-Albarova, Juan, Gilabert-Estellés, Emilio Lopez Alcina, Isabel López Sánchez, Severiano Marin Bertolin, Carolina, Martinez-Perez, Antonio Melero Abellán, Claudia Mulas Fernández, Beatriz, Novoa, Ruth, Nuñez, Pablo Renovell Ferrer, Guijarro-Jorge, Ricardo, Carolina Soledad Romero Garcia, Miguel Sanfeliu Giner, Silvia, M West, Enrique, Zapater, Ignacio, Miranda, Ana, Monís, Alejandro Roselló Añón, María José Sangüesa, Jorge Sanz Romera, Marcos, Adrianzén, Maria Barrios Carvajal, Mireia, Bauzá, Ana Benítez Riesco, Jose Antonio Carbonell Lopez, María-Carmen, Fernández-Moreno, Ricardo Gadea Mateo, Francisco, Garcia, Maris Luisa García-Pérez, Luisa Paola Garzon, Ana, Izquierdo, Maria Lapeña Rodríguez, Carlos, León-Espinoza, Fernando, Lopez, Rosa Martí Fernández, Sara Martínez Castro, Berta Monleón López, Isabel Mora Oliver, David, Moro-Valdezate, Ernesto Muñoz Sornosa, Sara Palomares Casasús, Leticia Pérez Santiago, Mara Albert Fort, Reyes, Balanzá, Lorena Bermell Marco, Carla Carratalá Pérez, Claudia Pilar Clemente Tomas, Marta, Córcoles, Jose Ángel Diez Ares, Carlos Domingo Del Pozo, Nuria Estellés Vidagany, Gonzalo, Garrigos, Mar Gimeno Gimeno Vicente, Blanca Alastrue Giner, Segundo, Gomez-Abril, Paloma, Gonzalez, Paula Gonzálvez Guardiola, Guillermo Sebastian Martínez Fernández, Charo Martínez García, Lucía, Martínez-Costa, Luz María Moratalla Charcos, Sergio Navarro Martínez, Carmen, Payá-Llorente, Álvaro Pérez Rubio, Nuria, Peris, Eduardo Picazo Pineda, Jordi Planelles Gómez, Francisco Ripoll Vidal, Andrea, Roca, Enrique, Salmerón-González, Raquel Segura Roselló, Ramon Trullenque Juan, Cristina Verdejo Gimeno, Jose Miguel Zaragozá García, Gema Zomeño Bravo, Marcos Bruna Esteban, Hanna, Cholewa, Milton de Jesus, Matteo, Frasson, Luis Oliver García, Héctor, J Aguado, Antonio Jose Alonso Villalba, Francisco, Ardura, Carmen Elena Badillo Bercebal, María Bedate Núnez, Alvarez-Ramos Begoña Aranzazu, Juan Beltrán de Heredia, Hugo, Bermejo, Juan Berrocal Cuadrado, Maria Bragado González, Juan, Bustamante-Munguira, Raul Calvo Gonzalez, Yolanda, Carrascal, Ana Belén Casas Marcos, María Carmen Cervera, Sergio Chávez Valladares, Ángel Cilleruelo Ramos, Susana, Cortes, Jesús, Crespo-Sanjuán, María, Cuaresma, Luis Antonio Cuellar Martin, Carlos Ferreras García, Alvaro, Fuentes-Martín, Abel, Ganso, Elena García García, Luis, Garcia-Florez, Virginia, Garcia-Virto, Juan, Gatón, Julio Alberto Gobernado Tejedor, Tania Gómez Sanz, Jose Ignacio González Martín, María Begoña Gregorio Crespo, Ana Herranz Arriero, Jose, Herreros, Marta Ibáñez Nieto, César, Infante, Carlos, Jezieniecki, Moises, Juarez, Gregorio de Jesus Labrador Hernandez, Ana Patricia Legido Morán, Ricardo León Fernández, Alejandro, Leon-Andrino, Almudena, Llorente, Maria Lopez Pais, Mauricio Loucel Bellino, Sergio, Martin, Miguel Angel Martin-Ferrero, Gonzalo Martinez Municio, Elvira Mateos Alvarez, José María Matilla, Luis María Merino Peñacoba, Mario, Montes-Manrique, Fernando Natal Álvarez, David, C Noriega, Henar Nuñez Del Barrio, Francisco Javier Ortiz de Solórzano Aurusa, Lucía, Pañeda, Victoria Pascual Escudero, Miguel Pascual Samaniego, Adela, Pereda, Marta Pérez Febles, Laura, Pesquera, Maria, Plata, Emma Puertas Ruiz, Mario, Rodriguez-Lopez, Alejandro Romero de Diego, Ana, Ruano, María Ruiz Soriano, Cristina Sánchez Torralvo, Silvia Santiago Maniega, Bárbara, Segura-Méndez, Clarisa Simon Perez, José, Soro-García, Paula Suárez Mansilla Suárez-Mansilla, Jeancarlos Trujillo Díaz, Mª Esther Valsero Herguedas, Andrea Vazquez Fernandez, Eduardo Velasco García, Ana, Zabalza, Álvaro Zamora Horcajada, Fernando Acebes García, Enrique Asensio Díaz, Martín, Bailón, Alejandro David Bueno Cañones, Alvaro Centeno Velasco, Ekta Choolani Bhojwani, Fernando Labarga Rodríguez, Sara, Mambrilla, Pablo, Marcos-Santos, Toledano, Miguel, David Pacheco Sánchez, Baltasar, Pérez-Saborido, Pilar, Pinto, Katherine, Plua, Javier Sanchez Gonzalez, Vicente, Simo, Rosalía Velasco López, Sandra Veleda Belanche, Fabiola Eugenia Michel Campos, Iciar Muñoz Lindez, Maria, Balluerca, Maite, Camuera, Pablo, Helguera, Imanol, Herrero, Patricia Paunero Vazquez, María, Sánchez-Rubio, Isami, Soeda, María Dolores Arribas Del Amo, Vicente Manuel Borrego Estella, Estefania, Casas, Néstor Castán Villanueva, Daniel Delfau Lafuente, Elena Delgado Blanco, María, Domingo, Ismael Gil Romea, Azucena, Gonzalo, Emilio Lagunas Lostao, Noelia Lete Aguirre, Yaiza Martinez Lahoz, Jesús Víctor Pérez-Tierra Ruiz, Maria Del Mar Soriano, Isabel Valero Lázaro, Esmeralda Carnicer Escusol, Guillermo Pola Bandres, Juan Luis Blas Laina, Beatriz, Cros, Patricio Andrés Freile Pazmiño, David, Garcia-Aguilera, Ana Mejía Casado, Ana, Nogués, Issa Talal El-Abur, Carlos, Yánez, Isabel Gascon Ferrer, Carlos, Gracia-Roche, Ursula María Jariod Ferrer, María Victoria Simón Sanz, Tomas, Uson, Waseem, Ahamed, Sumudu, Jayasinghe, Eranda, Karunadasa, Prathibha, Nelihela, Sujeewa Priyantha Bandara Thalgaspitiya, Dickson, Wickramarathna, Nagenthiram, Harivallavan, Pirashanthan, Nagarasa, Eranga, Perera, Kanapathipillai, Piratheep, Vithranage Srimantha Dewsiri Rodrigo, Meera, Thayalan, Rajendram, Thayaparren, Arulprashanth, Arulanantham, Kanishka De Silva, Gagana, Ganga, Anuja Nadeeshan Kumarasinghe, Mahanada, Udukala, Koculen, Vimaleswaran, Prashanthan, Yogarajah, Ravindri, Jayasinghe, Probhodana, Ranaweera, Mohamed, Rishard, Dharmabandhu, N Samarasekera, Sanjeewa, Seneviratne, Sivasuriya, Sivaganesh, Chamal, Fernando, Nishantha, Mendis, Balasingam, Balagobi, Balasupramaniam, Sathesan, Lanka, Dasanayake, Malitha, Patabendige, Wickramasooriya, Dj, Kugarajh, Ganeshapillai, Sathyamoorthy, Prasanna, Dileepa, Ediriweera, Sumudu, Kumarage, Asanka, Jayawardane, Athula, Kaluarachchi, Pituwala Liyanage Adithya Sirisena, Abubakr, Abubakr, Hozifa, Mohamed, Ismail, Mustafa, Mogahid, Sharfeldein, Samir, Ismail, Reem, Musa, Monira, Sarih, Mussab, Abaker, Eman Adam Abdalla, Mohamad, Abdelbagi, Alsafe, Adlan, Ahmed, Alnaeem, Safa, Atyah, Yasir, Awad, Rsheeda, Dawelbait, Mohamed El Hag, Ibrahim, Elbashir, Sami, Eldirdiri, Samwal, Eldirdiri, Mohammed Eltahier Abdalla Omer, Lana Abdalgadir Ahmed Mohamed, Hiba Hassan Rehmtallah Ahmed, Mohammed Balla Yousif Balla, Abdulmoiz, Aljafari, Abdulmalek, Aljafari, Elsagad, Mohamed, Abdulkader, Mohammad, Abdulkader, Shaar, Mohamed Nafea Shaar, Maab Hussein Yousif Elhafiz, Mohammed Husien Yosif Elhafiz, Abubakr Ali Mohammed Alhassan Humidan, Almigdad, Ali, Hisham, Eljack, Mohamedyasin, Elrashid, Manhal, Ahmed, Albrra, Alhag, Douaa, Ali, Mohammed Ahmed Babikir, Imad, Bakheit, Hytham K, S Hamid, Sami, Mohamed, Walid, Shaban, Nidhal, Siddig, Mohamed, Suliman, Rihab Yasir Abdelmagid, Abubaker, Yassin, Omer, Abbas, Eltahir, Abdelrahim, Muhammed, Ahmed, Mohamed, Elobaid, Adil, Hashim, Ali, Mohamed, Omer, Mohamed, Khalid, Osman, Abdallah, Yousif, Safaa, Abdulaal, Marwa, Elsadig, Mohammed, Hussain, Malaz Amir Ataalmanan, Doha Amir AtaAlmanan, Tebyan Amir AtaAlmanan, Alaa, Elgaili, Maria, Mohamed, Usra, Omara, Alkhansa, Osman, Amna, Osman, Safaa, Saad, Abdelkareem, Ahmed, Ali Adil Ali Karar, Aya, Alhassan, Mohanad, Alsidig, Mohamed, Eljack, Mohammed Ibrahim Mohammed Ali, Awad Kamal Awad Osman, Liena, Mohamed, Samah Ibrahim Omer Mohamed Osman Mohamed Osman, Altayeb, Mohammed, Ayman, Mohammed, Khadija, Muhmmed, Eltahir, Musa, Egbal Sahal Abdelmajed, Khalid Z M, Y Hamid, Omnia M, M Yousif, Mahmoud, Saleh, Osman, Bashir, Yassein, Elhussein, Omar, Madani, Eva, Angenete, Jennifer, Park, Lars, Gillberg, Monir, Jawad, Linas, Pieteris, Yousif, Saeed, Sergej, Safonov, Martin, Spångfors, Henrik, Andersson, Hans, Bahlmann, Karin Björnström Karlsson, Michelle, Chew, Lara, Daham, Lina De Geer, Helen, Didriksson, Gunilla, Gagnö, Carina, Jonsson, Anna, Oscarsson, Pamela, Buchwald, Mathilde, Delorme, Marie-Louise, Lydrup, Shahin, Mohseni, Arvid, Pourlotfi, Souheil, Reda, Kajsa, Anderin, Nina, Blomme, Josefin, Segelman, Malin, Simlund, Anders, Thorell, Fredrik, Wogensen, Daniel, Danielsson, Peter, Elbe, Rebecka, Hultgren, Boel, Hynning, Fredrik, Klevebro, Karin, Lind, Ebba, K Lindqvist, Carl, Montan, Ernesto, Sparrelid, Clara Svenberg Lind, Jeremy, Wales, Andreas, Älgå, Martin, Nordberg, Emil, Pieniowski, Ioannis, Gkekas, Niklas, Löfgren, Karolina, Niska, Robert, Zürner, Silvio, Däster, Otto, Kollmar, Savas, Soysal, Stephanie, Taha-Mehlitz, Athanasios, Tampakis, Dominik Valentin Flury, Marie, Heyne-Pietschmann, Gregor Jan Kocher, Ana, M Calinescu, Barbara, Wildhaber, Markus, Gass, Jürg, Metzger, Andreas, Scheiwiller, Lukas, Briner, Oliver, Dwidar, Steven, Grandjean, Pietro, Ricciardi, Alexandra, Calmels, Christodoulou, Michel, Morena, Antonilli, Dimitrios, Christoforidis, Alessandra, Cristaudi, Jacopo, Galafassi, Maria Luisa Gasparri, Francesco, Mongelli, Martino, Munini, Andrea, Papadia, Sotirios Georgios Popeskou, Alex, Alfieri, Thomas, Bächler, Matteo, Giardini, Christian, Gingert, Laura, Guglielmetti, Inna, Meyer, Tobias, Müller, Daniel, Schöni, Folco, Solimene, Frank, Weidner, Marco, Bueter, Daniel, Gero, Amelie, Müller, Carmen, Portenkirchner, Andreas, Thalheimer, Jeannette, Widmer, Ahmad, Hmaideh, Alaa, Kour, Saleem, Swaes, Omar, Alannaz, Ramez, Aljasem, Ezeddin, Dabbagh, M Wafa Hamoud Alhussein, Amr, Hamza, Mazen, Mohammad, Abd El-Fattah Mouhandes, Mohamad, Shareeda, Mohammad Nour Shashaa, Mousa, Sifat, Sheraa, Tahhan, Rahaf, Toutounji, Mohamed, Abdulrahman, Albaraa, Abdulsalam, Ziad Al Jarad, Hala, Alayyoubi, Dina, Alfarra, Ahmad, Alhamid, Mahmoud, Alnasser, Mulham, Gharib, Ruwaid, Gharib, Obaida, Kabel, Osama, Kherallah, Abdulqader, Klaho, Mohamed Shukri Najjar, Ahmad, Razouk, Joud, Shiekhoni, Wael, Alkhaleel, Amira, Almosa, Mohammad, Aloulou, Maen, Alzaeem, Khaled, Arnaout, Muhamad Zakaria Brimo Alsaman, Mohamad, Estanbouli, Hanadi, Hawa, Ahmad Nbrass Kabawi, Ghina, Maarawi, Yehia, Mashhadany, Sana Shaikh Torab, Waleed, Abd, Tayma Abd Alghafour, Hani, Abdalnour, Nazeeh Al Aktaa, Marwan Al Aliwy, M Maher Al Arje, Tasneem Al Najjar, Ahmad, Al-Mouakeh, Ahmad, Aldakhil, Aos, Alhamid, Hasan, Alhasan, Mohamad Shadi Alkarrash, Jumaa, Alkhamis, Sara, Alshekh, Ahmad Yamen Arnaout, Oula, Azizeh, Mohammed, Dalaleh, Aghyad, Danial, Zain, Douba, Raghad, Ghadri, Mohammad Maen Ghannam, Anas, Ghawi, Luma Haj Kassem, M Yasser Halwani, Shahed, Hamadieh, Mohammad, Hanino, Ala Aldeen Hasan, Haya, Jawish, Nasr Ullah Kabbani, Saadullah, Kabbany, Mohamad, Kadi, Lama, Kadoura, Ahmad Amir Kayali, Ammar, Kayyali, Aya, Kelzia, Amana, Kezze, Abdullah, Khalaf, Maymona, Khayata, Mohammad Nour Kitaz, Mohammad, Kour, Raghad, Makki, Ruqaya, Masri, Joseph, Masri, Noor, Masri, Muhammad, Mazketly, Shiar, Mustafa, Ezzeldin, Nashed, Yaman Qoudra Danial, Hasan, Raslan, Rima, Salem, Mohammed Asaad Salem, Thabet Sayed Bakir, Manaf, Sharabaji, Majd Sheikh Alganameh, Duaa Sheikh Kadro, Joudy, Shurbatji, Mohammad Noor Sultan, Dana, Sultan, Hala, Swied, Bakri Tarras Jarkas, Tayf, Toutounji, Fadi, Ward, Rama, Zazo, Aya, Zazo, Zainab, Zeino, Mohamed, Alaktaa, Wael, Alsado, Hala, Fares, Nouran, Hawa, Hamza, Ibrahim, Abdulmonem, Kawas, Mourad, Niazi, Bayan, Toutounji, Mohammad, Abdow, Mohamad, Ahmad, Tareq, Ahmad, Rawan Al Azhar, Hiba Al Hage Diab, Rahaf Al Mulke, Mohammad, Al-Jadaan, Ahmad, Alhussein, Zahra, Alnajem, Omar, Alneser, Bayan, Alsaid, Elias, Azar, Lubna, Bakr, Ammar, Hamza, Yara, Houdifa, Sami, Jomaa, Samer, Kefo, Hiba, Mardini, Alaa, Mohammad, Fadi, Rayya, Fatima, Razzouk, Mohannad, Saleh, Anwar, Shamandi, Ammar Youzkatli Alkhatib, Omar Abdul Salam, Dany, Ajami, Mohammad, Alhamid, Ahmad, Alkhaledi, Danny, Hadidi, Massa, Jabra, Mamdouh, Kallas, Antoine, Laktine, Joelle, Naem, Naya, Naoum, Ghena Mohammed Fawaz Ashour, Ahmad, Alhouri, Deema, Fallouh, Ahmad, N Mohammad, Ahmad, Rmman, Ali, Slitin, Christine, Tanos, Ibrahim, Wakim, Hanaa, Zahrawi, Majd, Abouassi, Layth, Abouassi, Ayham, Aboutrab, Basel, Ahmad, Ahmad Mustafa Ahmad, Aya, Ahmad, Afaf, Ahmad, Mohamad, Alabras, Mohammad, Albasheer, Ola, Alkasser, Mhd Khaled Alkasser, Ali, Alkhdor, Marah, Azkoul, Mohammad Karam Chaaban, Haya, Deeb, Basel, Jazieh, Basel, Kouz, Youssef, Kozah, Raied, Mohamad, Ammar, Mohammad, Mhd Zied Nasri, Mohammed Mouaz Shebani, Mohammed, Shwin, Alaa, Sommaq, Amal, Youssef, Tala Al Asadi, Suhad, Alkhateb, Rasha Khalil Alsayyad, Roula, Altom, Mhd Amin Alzabibi, Batoul, Bakkar, Hlma, Ismail, Salma Khadem Alsrouji, Sara, Melhem, Mohamad, Sankari, Mosa, Shibani, Noura, Shujaa, Ibrahim, 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Giuseppe Salamone, Francesca Toia, Massimiliano Tripoli, Nepogodiev, D, Rosati, R, Surgery, Medicine and Pharmacy academic/administration, Basic (bio-) Medical Sciences, Surgical clinical sciences, Faculty of Medicine and Pharmacy, Gastroenterology, Medical Oncology, Clinical sciences, Breda, João, ARD - Amsterdam Reproduction and Development, Paediatric Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Endocrinology, metabolism and nutrition, Graduate School, Tytgat Institute for Liver and Intestinal Research, Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria Bisulli, Barbara Bonfanti, Safia Boussedra, Jury Brandolini, Crescenzo Cacciapuoti, Stefano Cardelli, Riccardo Casadei, Matteo Cescon, Alessandro Cipolli, Riccardo Cipriani, Alfredo Conti, Luca Contu, Francesco Costa, Niccolo’ Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero Dolci, Giulia Dondi, Matteo Droghetti, Sergio Nicola Forti Parri, Elena Garelli, Chiara Gelati, Giuliana Germinario, Federico A. Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, leonardo solaini, giorgio ercolani, Fruscio, R, Ornaghi, S, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Žundienė, Laura, Dulskas, Audrius, Kuliavas, Justas, Čekauskas, Albertas, Kielaitė-Gulla, Aistė, Poškus, Tomas, Strupas, Kęstutis, Želvys, Arūnas, COVIDSurg Collaborative, GlobalSurg Collaborative, Department of Surgery, HUS Abdominal Center, Simoes, Jff, Li, E, Picciochi, M, Glasbey, Jc, Baiocchi, G, Blanco-Colino, R, Chaudhry, D, Alameer, E, El-Boghdadly, K, Wuraola, F, Ghosh, D, Gujjuri, Rr, Harrison, Em, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mann, H, Mclean, Ka, Mengistu, Gm, Modolo, Mm, Ntirenganya, F, Norman, L, Outani, O, Pius, R, Pockney, P, Qureshi, Au, Roslani, Ac, Satoi, S, Shaw, C, Bhangu, A, Omar, Om, Ahmed, Wur, Argus, L, Ball, A, Bywater, Ep, Brar, A, Dawson, Be, Duran, I, Elhadi, M, Jones, C, Kamarajah, Sk, Keatley, Jm, Lawday, S, Marson, Ej, Ots, R, Santos, I, Taylor, Eh, Trout, Im, Varghese, C, Venn, Ml, Xu, W, Dajti, I, Gjata, A, Kacimi, Seo, Boccalatte, L, Cox, D, Townend, P, Aigner, F, Kronberger, Ie, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Gomes, Gma, Buarque, Il, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, Wh, Ren, Dl, Calvache, Ja, Rivera, Cjp, Hadzibegovic, Ad, Kopjar, T, Mihanovic, J, Jimenez, Pma, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, Daa, Dhufera, H, Hailu, S, Mengesha, Mg, Kauppila, Jh, Arnaud, Ap, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, Mw, Acquah, Dk, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, Ml, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Milan, Pb, Khosravi, Mh, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Abou Chaar, Mk, Ayasra, F, Fakhradiyev, I, Hamdun, Ih, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, Lh, Sanchez, Iid, Gonzalez, D, Martinez, L, Martinez, Mj, Nayen, A, and Ramos-De la Medina, A
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Male ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,MULTICENTER ,infectious diseases ,0302 clinical medicine ,030202 anesthesiology ,Anesthesiology ,Cirugía ,80 and over ,Prospective Studies ,Young adult ,Child ,Lung ,Aged, 80 and over ,COVID-19 ,delay ,SARS-CoV-2 ,surgery ,timing ,SARS‐CoV‐2 infection ,Operative ,Child, Preschool ,Pneumonia & Influenza ,Infection ,Cohort study ,Human ,medicine.medical_specialty ,Clinical Sciences ,Sars-cov-2 ,GlobalSurg Collaborative ,Settore MED/28 - MALATTIE ODONTOSTOMATOLOGICHE ,03 medical and health sciences ,Clinical Research ,Biodefense ,Correspondence ,Humans ,PULMONARY COMPLICATIONS ,CRIANÇAS EM IDADE PRÉ-ESCOLAR ,Aged ,Science & Technology ,Cirurgia ,Prevention ,Infant ,Odds ratio ,Pneumonia ,Prospective Studie ,Clinical research ,Surgery ,Human medicine ,610 Medizin und Gesundheit ,1109 Neurosciences ,Internationality ,Settore MED/29 - CHIRURGIA MAXILLOFACCIALE ,Settore MED/18 - CHIRURGIA GENERALE ,Adolescent ,Adult ,Cohort Studies ,Female ,Middle Aged ,Surgical Procedures, Operative ,Time ,Young Adult ,Practice Guidelines as Topic ,gastroenterology ,Medicine and Health Sciences ,030212 general & internal medicine ,Prospective cohort study ,Mortality rate ,Covid19 ,Infectious Diseases ,Patient Safety ,medicine.symptom ,6.4 Surgery ,Life Sciences & Biomedicine ,610 Medicine & health ,COVID-19, SARS-CoV-2, delay, surgery, timing ,Asymptomatic ,NO ,COVIDSurg Collaborative ,Vaccine Related ,All institutes and research themes of the Radboud University Medical Center ,medicine ,Mortalitat ,ddc:610 ,Mortality ,Preschool ,LS7_4 ,Surgical Procedures ,business.industry ,Neurosciences ,Evaluation of treatments and therapeutic interventions ,1103 Clinical Sciences ,3126 Surgery, anesthesiology, intensive care, radiology ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,Anesthesiology and Pain Medicine ,Emerging Infectious Diseases ,Good Health and Well Being ,Mortalidad ,Cohort Studie ,business - Abstract
Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. ispartof: ANAESTHESIA vol:76 issue:6 pages:748-758 ispartof: location:England status: published
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- 2021
17. Serous Cystic Neoplasms of the Pancreas Management in the Real-world: Still Operating on a Benign Entity
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Stefano Andrianello, M. Biancotto, Claudio Bassi, Giuseppe Malleo, Giovanni Marchegiani, Giulia Bernardi, A. Caravati, Roberto Salvia, and Tommaso Pollini
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medicine.medical_specialty ,Presumptive diagnosis ,Resection ,03 medical and health sciences ,pancreatic cysts ,0302 clinical medicine ,Serous cystic neoplasms ,medicine ,Humans ,Pancreas ,Pancreatic duct ,business.industry ,Jaundice ,Serous cystic neoplasms, pancreatic cysts, pancreas ,medicine.disease ,Surgery ,Pancreatic Neoplasms ,Serous fluid ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,pancreas ,medicine.symptom ,Pancreatic cysts ,business - Abstract
OBJECTIVE Our aim is to provide a real-life picture of serous cystic neoplasms (SCNs) management once a presumptive diagnosis is made. SUMMARY BACKGROUND DATA SCNs of the pancreas are invariably benign entities. While consensus about their management is lacking, surgical resection still plays a role. METHODS Presumed SCNs evaluated from 1990 to 2018 were included. Indications for surgery, predictors of resection, rate and predictors of misdiagnosis in the surgical cohort and time trends of management strategies were the main outcomes. RESULTS A total of 672 presumed SCNs were included. Presence of symptoms (37%) and large size (34.1%) were the most frequent indications for surgery. Symptoms (60.4 vs 19.0%, p < 0.001), size (45 vs 30 mm, p < 0.001), solid components (19.7 vs 6.2%, p < 0.001), thick walls (14.4 vs 5.6%, p = 0.001) and main pancreatic duct dilation (13.4 vs 5.6%, p = 0.004) were associated with upfront resection (n = 134, 19.9%). Upfront resection decreased over time and 15.4% of patients eventually crossed over to surgery. Increase in size (6,9 vs 1,3 mm/year), development of symptoms (25.3 vs 3.4%, p < 0.001), solid component (6.0 vs 1.4%, p = 0.010) or jaundice (3.6 vs 0.7%, p = 0.028) were associated with crossing over to surgery. Major morbidity and mortality occurred in 17.1% and 1.7% of patients, respectively. Misdiagnosis occurred mostly in case of macrocystic/unilocular lesions of the body-tail. CONCLUSIONS In the real-life scenario, SCNs still represent an indication for surgery particularly once large and symptomatic. During surveillance, resection occurs mostly in younger individuals for body/tail lesions. Evidence-based consensus on appropriate indications for surgery is urgently needed.
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- 2020
18. The management of intraductal papillary mucinous neoplasms of the pancreas
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Giovanni Marchegiani, Stefano Andrianello, Giampaolo Perri, A. Caravati, Roberto Salvia, Giuseppe Malleo, Tommaso Pollini, and Salvatore Paiella
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medicine.medical_specialty ,endocrine system diseases ,business.industry ,IPMN ,medicine.medical_treatment ,Mortality rate ,Pancreatic Intraductal Neoplasms ,Main duct ,Resection ,Branch Duct ,High morbidity ,medicine.anatomical_structure ,Radiological weapon ,medicine ,Humans ,Surgery ,Radiology ,Watchful Waiting ,Pancreas ,business ,Watchful waiting - Abstract
Intraductal papillary mucinous neoplasms (IPMN) of the pancreas are one of the most common preneoplastic entities among pancreatic cystic neoplasms (PCN). Their incidence is increasing due to an extensive use of cross-sectional imaging, but management still remains controversial. Among IPMNs, the main duct (MD-IPMN) and mixed (MT-IPMN) types harbor a high risk of malignant degeneration requiring resection in most of cases. The branch duct type (BD-IPMN), on the other side, can be safely surveilled as surgical resection is limited to selected cases deemed at high risk of malignant progression according to specific clinical and radiological features. An accurate diagnosis and a correct assessment of malignant potential are often hard to achieve, and clinical management still relies on the experience of the gastroenterologist/surgeon that is called to choose between a major pancreatic resection burdened by high morbidity and mortality rates and a life-long surveillance. The purpose of this report is to summarize the available evidence supporting the current practice for the management of IPMN and to offer a useful practical guide from first observation to postoperative follow-up.
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- 2019
19. Screening/surveillance programs for pancreatic cancer in familial high-risk individuals: A systematic review and proportion meta-analysis of screening results
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Salvatore Paiella, Davide Melisi, Stefano Andrianello, Roberto Salvia, Luca Casetti, Mirko D'Onofrio, Laura Maggino, Giuseppe Malleo, Deborah Bonamini, Alessandro Esposito, Giulia De Marchi, Claudio Bassi, Luca Landoni, Massimiliano Tuveri, Tommaso Pollini, Riccardo De Robertis, Matteo De Pastena, Aldo Scarpa, Erica Secchettin, Giovanni Marchegiani, and Teresa Lucia Pan
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Risk ,Pediatrics ,medicine.medical_specialty ,surveillance program ,Endocrinology, Diabetes and Metabolism ,pancreatic cancer ,MEDLINE ,familial pancreatic cancer ,Cochrane Library ,screening program ,03 medical and health sciences ,0302 clinical medicine ,Pancreatic cancer ,medicine ,Humans ,Early Detection of Cancer ,Hepatology ,Intraductal papillary mucinous neoplasm ,business.industry ,Gastroenterology ,medicine.disease ,Random effects model ,diagnostic yield ,Pancreatic Neoplasms ,Treatment Outcome ,Dysplasia ,030220 oncology & carcinogenesis ,Meta-analysis ,Cohort ,030211 gastroenterology & hepatology ,business - Abstract
Background/Objectives Screening/surveillance programs for pancreatic cancer (PC) in familial high-risk individuals (FPC-HRI) have been widely reported, but their merits remain unclear. The data reported so far are heterogeneous—especially in terms of screening yield. We performed a systematic review and meta-analysis of currently available data coming from screening/surveillance programs to evaluate the proportion of screening goal achievement (SGA), overall surgery and unnecessary surgery. Methods We searched MEDLINE, Embase, PubMed and the Cochrane Library database from January 2000 to December 2016to identify studies reporting results of screening/surveillance programs including cohorts of FPC-HRI. The main outcome measures were weighted proportion of SGA, overall surgery, and unnecessary surgery among the FPC-HRI cohort, using a random effects model. SGA was defined as any diagnosis of resectable PC, PanIN3, or high-grade dysplasia intraductal papillary mucinous neoplasm (HGD-IPMN). Unnecessary surgery was defined as any other final pathology. Results In a meta-analysis of 16 studies reporting on 1551 FPC-HRI cases, 30 subjects (1.82%), received a diagnosis of PC, PanIN3 or HGD-IPMNs. The pooled proportion of SGA was 1.4%(95% CI 0.8–2, p Conclusions The weighted proportion of SGA of screening/surveillance programs published thus far is excellent. However, the probability of receiving surgery during the screening/surveillance program is non-negligible, and unnecessary surgery is a potential negative outcome.
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- 2018
20. Surgery following observation of branch-duct ipmn reveals dynamic predictors of malignancy: significance of cyst stability vs progression. Results of the 'cros' multicentric study
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M. Kim, Claudio Bassi, Brian K. P. Goh, Matthew H.G. Katz, C.L. Wolfgang, Benedict Kinny-Köster, Roberto Salvia, Giampaolo Perri, Giovanni Marchegiani, Jin He, Stefano Andrianello, Tommaso Pollini, Neda Amini, Jin-Young Jang, and Ammar A. Javed
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Branch Duct ,medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Cyst ,medicine.disease ,business ,Malignancy ,Surgery - Published
- 2021
21. A novel microfluidic-based assay to determine high-risk pancreatic cysts for surgery utilizing pancreatic cyst fluid: an international multicenter study
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L. Kone, C. Fernandez-del Castillo, Roberto Salvia, Jordan M. Winter, K. Roggin, M. Yip-Schnieder, Claudio Bassi, Christian M. Schmidt, M.W. Büchler, Charles J. Yeo, Ajay V. Maker, G. Chlipala, Tommaso Pollini, T. Hackert, and William R. Brugge
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Pathology ,medicine.medical_specialty ,Hepatology ,Multicenter study ,business.industry ,Gastroenterology ,medicine ,Pancreatic cysts ,medicine.disease ,business ,Pancreatic cyst fluid - Published
- 2021
22. iCyst: 1 year, 1000 and more simulations through an app
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Stefano Andrianello, Roberto Salvia, M. Biancotto, Tommaso Pollini, Erica Secchettin, Giovanni Marchegiani, Deborah Bonamini, Claudio Bassi, A. Balduzzi, Helmut Friess, and A. Caravati
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medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,Medicine ,Medical physics ,business - Published
- 2021
23. Are Cystic Pancreatic Neuroendocrine Tumors an Indolent Entity Results from a Single-Center Surgical Series
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Riccardo De Robertis, Giovanni Marchegiani, Harmony Impellizzeri, Luca Landoni, Claudio Bassi, Anna Malpaga, Sara Cingarlini, G. Montagnini, Paola Capelli, Tommaso Pollini, Marco Miotto, Chiara Nessi, Mirko D'Onofrio, Letizia Boninsegna, Salvatore Paiella, Aldo Scarpa, Roberto Salvia, Giovanni Butturini, and Ilaria Posenato
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Adult ,Male ,medicine.medical_specialty ,Cystic pancreatic neuroendocrine tumors ,Endocrinology, Diabetes and Metabolism ,Population ,Neuroendocrine tumors ,Single Center ,Postoperative outcome ,Young Adult ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Solid pancreatic neuroendocrine tumors ,Single-center surgical series ,Clinical features ,medicine ,Humans ,Lack of knowledge ,Diagnostic Errors ,education ,Pathological ,Aged ,Aged, 80 and over ,education.field_of_study ,Endocrine and Autonomic Systems ,business.industry ,Middle Aged ,medicine.disease ,Tumor Burden ,Well differentiated ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,030220 oncology & carcinogenesis ,Cohort ,Female ,030211 gastroenterology & hepatology ,Radiology ,Neoplasm Recurrence, Local ,Pancreatic Cyst ,business ,Follow-Up Studies - Abstract
Introduction: Cystic pancreatic neuroendocrine tumors (CPanNETs) represent an uncommon variant of pancreatic neuroendocrine tumors (PanNETs). Due to their rarity, there is a lack of knowledge with regard to clinical features and postoperative outcome. Methods: The prospectively maintained surgical database of a high-volume institution was queried, and 46 resected CPanNETs were detected from 1988 to 2015. Clinical, demographic, and pathological features and survival outcomes of CPanNETs were described and matched with a population of 92 solid PanNETs (SPanNETs) for comparison. Results: CPanNETs accounted for 7.8% of the overall number of resected PanNETs (46/587). CPanNETs were mostly sporadic (n = 42, 91%) and nonfunctioning (39%). Two functioning CPanNETs were detected (4.3%), and they were 2 gastrinomas. The median tumor diameter was 30 mm (range 10-120). All tumors were well differentiated, with 38 (82.6%) G1 and 8 (17.4%) G2 tumors. Overall, no CPanNET showed a Ki-67 >5%. A correct preoperative diagnosis of a CPanNET was made in half of the cases. After a median follow-up of >70 months, the 5- and 10-year overall survival of resected CPanNETs was 93.8 and 62.5%, respectively, compared to 92.7 and 84.6% for SPanNETs (p > 0.05). The 5- and 10-year disease-free survival rates were 94.5 and 88.2% for CPanNETs and 81.8 and 78.9% for SPanNETs, respectively (p > 0.05). Conclusion: In the setting of a surgical cohort, CPanNETs are rare, nonfunctional, and well-differentiated neoplasms. After surgical resection, they share the excellent outcome of their well-differentiated solid counterparts for both survival and recurrence.
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- 2017
24. Serous cystadenoma of the pancreas: a benign entity still representing indication for surgery in the real life
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Giovanni Marchegiani, Claudio Bassi, Giuseppe Malleo, G. Bernardi, M. Biancotto, Stefano Andrianello, Tommaso Pollini, A. Caravati, and Roberto Salvia
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medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,medicine ,Radiology ,Serous Cystadenoma ,business ,Pancreas - Published
- 2020
25. 'Trivial' cysts redefine the risk of cancer development in presumed branch-duct ipmn of the pancreas: a potential target for follow-up discontinuation?
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A. Caravati, Giovanni Marchegiani, Stefano Andrianello, Erica Secchettin, Claudio Bassi, M. Biancotto, Tommaso Pollini, Roberto Salvia, Giuseppe Malleo, and Deborah Bonamini
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Branch Duct ,medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Gastroenterology ,Medicine ,Radiology ,Cancer development ,business ,Pancreas ,Discontinuation - Published
- 2020
26. Epidemiology, clinical features and diagnostic work-up of cystic neoplasms of the pancreas: Interim analysis of the prospective PANCY survey
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Silvia Giovanelli, Matteo Tacelli, Romano Sassatelli, Renato Cannizzaro, Luigi Veneroni, Bastianello Germanà, E.D. Mandelli, Cosimo Sperti, Andrea Galli, Fabio Monica, Carlo Fabbri, Luca Frulloni, Saverio Alicante, Riccardo Casadei, C. Vattiato, Massimo Falconi, Luca Barresi, Germana de Nucci, Domenico Stillittano, Mauro Frego, Giovanna Del Vecchio Blanco, Claudio Ricci, Filippo Antonini, A. Pezzullo, Gabriele Capurso, Silvia Carrara, Vincenzo Giorgio Mirante, Giulia De Marchi, Lucia Moletta, Paolo Cecinato, Mariano Quartini, Rita Conigliaro, Massimo Graffeo, Milena Di Leo, Elisabetta Buscarini, Gioia Pozza, Deborah Bonamini, Giampiero Macarri, Tommaso Pollini, Giovanni Marchegiani, Raffaele Pezzilli, Giulio Belfiori, Alberto Fantin, Giampiero Manes, and Stefano Crippa
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Endoscopic ultrasound ,Male ,Epidemiology ,Endosonography ,Settore MED/12 ,0302 clinical medicine ,Surveys and Questionnaires ,Prospective Studies ,Prospective cohort study ,Aged, 80 and over ,medicine.diagnostic_test ,Cystadenoma, Serous ,Gastroenterology ,Middle Aged ,Magnetic Resonance Imaging ,Neuroendocrine Tumors ,medicine.anatomical_structure ,Italy ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,030211 gastroenterology & hepatology ,Female ,Radiology ,Pancreas ,Adult ,medicine.medical_specialty ,Adolescent ,Cystic neoplasm ,Adenocarcinoma ,Multidetector computed tomography ,03 medical and health sciences ,Young Adult ,Cystadenoma, Mucinous ,medicine ,Humans ,Mucinous cystadenoma ,Aged ,Hepatology ,Intraductal papillary mucinous neoplasm ,business.industry ,Pancreatic cyst ,Serous Cystadenoma ,medicine.disease ,Cystic Neoplasm ,Pancreatic Neoplasms ,Biomarkers ,Cytology ,Magnetic resonance imaging ,Cystadenoma ,business - Abstract
Introduction A prospective survey to evaluate the diagnostic workup of cystic pancreatic neoplasms (CPNs) according to the Italian guidelines. Methods An online data sheet was built. Results Fifteen of the 1385 patients (1.1%) had non cystic neoplastic lesions. Forty percent (518/1295) had at least one 1st degree relative affected by a solid tumor of the digestive and extra-digestive organs. Symptoms/signs associated with the cystic lesion were present in 24.5% of the patients. The cysts were localized in the head of the pancreas in 38.5% of patients. Of the 2370 examinations (1.7 examinations per patient) which were carried out for the diagnosis, magnetic resonance imaging was performed as a single test in 48.4% of patients and in combination with endoscopic ultrasound in 27% of the cases. Of the 1370 patients having CPNs, 89.9% had an intraductal papillary mucinous neoplasm (IPMN) (70.1% a branch duct IPMN, 6.2% a mixed type IPMN and 4.6% a main duct IPMN), 12.7% had a serous cystadenoma, 2.8% a mucinous cystadenoma, 1.5% a non-functioning cystic neuroendocrine neoplasm, 0.7% a solid-pseudopapillary cystic neoplasm, 0.3% a cystic adenocarcinoma, and 1.2% an undetermined cystic neoplasm. Seventy-eight (5.7%) patients were operated upon after the initial work-up. Conclusions This prospective study offers a reliable real-life picture of the diagnostic work-up CPN.
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- 2019
27. 'Trivial' Cysts Redefine the Risk of Cancer in Presumed Branch-Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas: A Potential Target for Follow-Up Discontinuation?
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M. Biancotto, Stefano Andrianello, Erica Secchettin, Claudio Bassi, Giovanni Marchegiani, Giuseppe Malleo, Deborah Bonamini, Tommaso Pollini, Roberto Salvia, and A. Caravati
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Male ,medicine.medical_specialty ,endocrine system diseases ,Pancreatic Intraductal Neoplasms ,Aftercare ,Risk Assessment ,Endosonography ,Branch Duct ,03 medical and health sciences ,0302 clinical medicine ,Pancreatectomy ,Postoperative Complications ,Carcinoma ,follow-up ,Medicine ,Humans ,Watchful Waiting ,Aged ,Retrospective Studies ,Hepatology ,business.industry ,Incidence ,IPMN ,Disease progression ,Gastroenterology ,Follow up studies ,Pancreatic Ducts ,pancreatic cyst ,Cancer ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Discontinuation ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Disease Progression ,030211 gastroenterology & hepatology ,Female ,Radiology ,business ,Pancreas ,Neoplasms, Cystic, Mucinous, and Serous ,Carcinoma, Pancreatic Ductal ,Follow-Up Studies ,IPMN, pancreatic cyst, follow-up - Abstract
The management of small and incidental branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) still is of concern. The aim is assessing the safety of a surveillance protocol through the evaluation of their progression to malignancy.All presumed BD-IPMNs observed from 2000 to 2016 were included. Only patients presenting without worrisome features (WFs) and high-risk stigmata (HRS) at diagnosis were included. Development of WF, HRS, pancreatic cancer (PC), and survival were analyzed. BD-IPMNs were defined as trivial in the continuing absence of WF/HRS after 5 years of surveillance. The age-specific standardized incidence ratio of PC in the general population was used for comparison.A total of 1,036 BD-IPMNs without WF/HRS at diagnosis were included, 4.2% developed WF or HRS, and 1.1% developed PC after a median of 62 months. The median cyst growth rate was 0 mm/yr. A growth rate ≥2.5 mm/yr and the development of WF resulted independent predictors of PC. The standardized incidence ratio of PC for trivial BD-IPMN (n = 378) was 22.45 (95% confidence interval 8.19-48.86), but considering only patients aged65 years (n = 198), it decreased to 3.84 (95% confidence interval 0.77-11.20).Surveillance of the vast majority of presumed BD-IPMNs is safe, as the risk of PC is comparable to postoperative mortality of pancreatic surgery. A growth rate ≥2.5 mm/yr is the main predictor of PC, reinforcing the role of repeated observations. A trivial BD-IPMN in patients aged65 years might not increase the risk of developing PC compared with general population, identifying potential targets for follow-up discontinuation.
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- 2019
28. The Evolution of Surgical Strategies for Pancreatic Neuroendocrine Tumors (Pan-NENs): Time-trend and Outcome Analysis From 587 Consecutive Resections at a High-volume Institution
- Author
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Harmony Impellizzeri, Maria Vittoria Davì, Alessandro Esposito, Giuseppe Malleo, Massimo Falconi, Antonio Amodio, Massimiliano Tuveri, Sara Cingarlini, Giovanni Butturini, Luca Casetti, Lorenzo Crepaz, Giovanni Marchegiani, Claudio Bassi, Mirko D'Onofrio, Chiara Nessi, Marco Miotto, Tommaso Pollini, Anna Malpaga, Roberto Salvia, Aldo Scarpa, Riccardo De Robertis, Caterina Costanza Zingaretti, Luca Landoni, Letizia Boninsegna, Salvatore Paiella, Paola Capelli, Landoni, L., Marchegiani, G., Pollini, T., Cingarlini, S., D'Onofrio, M., Capelli, P., De Robertis, R., Davi, M. V., Amodio, A., Impellizzeri, H., Malpaga, A., Miotto, M., Boninsegna, L., Crepaz, L., Nessi, C., Zingaretti, C. C., Paiella, S., Esposito, A., Casetti, L., Malleo, G., Tuveri, M., Butturini, G., Salvia, R., Scarpa, A., Falconi, M., and Bassi, C.
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Outcome analysis ,030230 surgery ,Neuroendocrine tumors ,Pan-NEN ,surgery ,03 medical and health sciences ,Pancreatectomy ,0302 clinical medicine ,Text mining ,Nodal status ,medicine ,Humans ,cancer ,neuroendocrine ,pancreas ,Surgical approach ,Tumor size ,business.industry ,Cancer ,Middle Aged ,medicine.disease ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,cancer, neuroendocrine, pancreas, Pan-NEN, surgery ,Female ,Radiology ,Pancreas ,business ,Hospitals, High-Volume - Abstract
Objective The objective of the present analysis is 2-fold: first, to define the evolution of time trends on the surgical approach to pancreatic neuroendocrine neoplasms (Pan-NENs); second, to perform a complete analysis of the predictors of oncologic outcome. Background Reflecting their rarity and heterogeneity, Pan-NENs represent a clinical dilemma. In particular, there is a scarcity of data regarding their long-term follow-up after surgical resection. Methods From the Institutional Pan-NEN database, 587 resected cases from 1990 to 2015 were extracted. The time span was arbitrarily divided into 3 discrete clusters enabling a balanced comparison between patient groups. Analyses for predictors of recurrence and survival were performed, together with conditional survival analyses. Results Among the 587 resected Pan-NENs, 75% were nonfunctioning tumors, and 5% were syndrome-associated tumors. The mean age was 54 years (±14 years), and 51% of the patients were female. The median tumor size was 20 mm (range 4 to 140), 62% were G1, 32% were G2, and 4% were G3 tumors. Time trends analysis revealed that the number of resected Pan-NENs constantly increased, while the size (from 25 to 20 mm) and G1 proportion (from 65% to 49%) decreased during the study period. After a mean follow-up of 75 months, recurrence analysis revealed that nonfunctioning tumors, tumor grade, N1 status, and vascular invasion were all independent predictors of recurrence. Regardless of size, G1 nonfunctioning tumors with no nodal involvement and vascular invasion had a negligible risk of recurrence at 5 years. Conclusions Pan-NENs have been increasingly diagnosed and resected during the last 3 decades, revealing reliable predictors of outcome. Functioning and nodal status, tumor grade, and vascular invasion accurately predict survival and recurrence with resulting implications for patient follow-up.
- Published
- 2019
29. Guidelines on pancreatic cystic neoplasms: major inconsistencies with available evidence and clinical practice
- Author
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Helmut Friess, Claudio Bassi, A. Balduzzi, A. Caravati, Roberto Salvia, M. Biancotto, Tommaso Pollini, Erica Secchettin, M. Giovanni, Stefano Andrianello, and Deborah Bonamini
- Subjects
Clinical Practice ,medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,medicine ,Intensive care medicine ,business - Published
- 2021
30. Systematic review and meta-analysis of observational studies on BD-IPMN progression to malignancy
- Author
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Roberto Salvia, Tommaso Pollini, M. Biancotto, Giovanni Marchegiani, A. Caravati, Claudio Bassi, Stefano Andrianello, and A. Balduzzi
- Subjects
Oncology ,medicine.medical_specialty ,Hepatology ,business.industry ,Meta-analysis ,Internal medicine ,Gastroenterology ,medicine ,Observational study ,business ,Malignancy ,medicine.disease - Published
- 2021
31. 1560P Sarcopenia and sarcopenic obesity in pancreatic ductal adenocarcinoma (PDAC) patients undergoing surgery after neoadjuvant therapy (NAT): Prevalence and clinical implications
- Author
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Alice Avancini, Claudio Bassi, Tommaso Pollini, Daniela Tregnago, Mirko D'Onofrio, C.F. del Castillo, M. Milella, Davide Melisi, C. Soldà, Luca Gianotti, Ilaria Trestini, Roberto Salvia, Isabella Sperduti, Salvatore Paiella, Sara Pilotto, Giuseppe Malleo, Thomas Hank, Alessandra Auriemma, and M. Sandini
- Subjects
Oncology ,medicine.medical_specialty ,Pancreatic ductal adenocarcinoma ,business.industry ,medicine.medical_treatment ,Hematology ,medicine.disease ,Internal medicine ,Sarcopenia ,medicine ,Sarcopenic obesity ,business ,Neoadjuvant therapy - Published
- 2020
32. CORRELATION BETWEEN BODY COMPOSITION, INFLAMMATION AND SURVIVAL IN PANCREATIC CANCER TREATED WITH NEOADJUVANT THERAPY
- Author
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Marta Sandini, Alessandra Auriemma, Claudio Bassi, Thomas Hank, C. Fernandez-del Castillo, Mirko D'Onofrio, Daniela Tregnago, Luca Gianotti, Giuseppe Malleo, C. Soldà, Michele Milella, Ilaria Trestini, Alice Avancini, Tommaso Pollini, Davide Melisi, Isabella Sperduti, Sara Pilotto, and Salvatore Paiella
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,Proportional hazards model ,FOLFIRINOX ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Adipose tissue ,Inflammation ,medicine.disease ,Gastroenterology ,Pancreatic cancer ,Internal medicine ,medicine ,Population study ,NAD+ kinase ,medicine.symptom ,business ,Neoadjuvant therapy - Abstract
To evaluate the association between body composition (BC) and systemic inflammatory response (SIR) following neoadjuvant treatment (NAD), and to explore their impact on long-term outcome in pancreatic ductal adenocarcinoma (PDAC) pts. Non-consecutive PDAC pts undergoing surgical exploration after NAD with available CT-scans (both at diagnosis and preoperatively) at two academic medical institutions from 2013 to 2015 were evaluated. BC was assessed by analyzing L3 CT-scan images before and after NAD. Neutrophil-lymphocyte ratio (NLR) was as a marker for SIR. Data were correlated with OS using Cox model. Kaplan-Meier curves were compared with Log-Rank test. The study population consisted of 108 pts (males: 56.5%), with a median follow-up of 16 months. 91 pts (89.8%) received FOLFIRINOX. BC changed significantly during NAD: total and visceral adipose tissue decreased (p Our data provide evidence that BC impacts on long-term outcome in PDAC pts submitted to NAD. In addition, our results suggest a strict correlation between host SIR and changes in BC during and after NAD.
- Published
- 2020
33. Central pancreatectomy for benign or low-grade malignant pancreatic lesions - A single-center retrospective analysis of 116 cases
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Roberto Salvia, Deborah Bonamini, Tommaso Pollini, Alessandro Esposito, Massimiliano Tuveri, Luca Landoni, Tommaso Giuliani, Federico Faustini, Salvatore Paiella, Matteo De Pastena, and Claudio Bassi
- Subjects
Male ,medicine.medical_specialty ,Central pancreatectomy ,medicine.medical_treatment ,Pancreatic resection ,Population ,Middle pancreatectomy ,Pancreatic fistula ,Pancreatic neuroendocrine tumor ,030230 surgery ,Anastomosis ,Single Center ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Pancreatectomy ,Postoperative Complications ,Stomach Neoplasms ,Internal medicine ,Intestinal Neoplasms ,medicine ,Humans ,education ,Retrospective Studies ,education.field_of_study ,pancreatic neuroendocrine tumors ,business.industry ,Incidence (epidemiology) ,Mortality rate ,General Medicine ,Middle Aged ,medicine.disease ,middle pancreatectomy ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,medicine.anatomical_structure ,Treatment Outcome ,Oncology ,Italy ,030220 oncology & carcinogenesis ,Surgery ,Female ,Neoplasm Grading ,Neoplasm Recurrence, Local ,Pancreas ,business - Abstract
Background Central pancreatectomy (CP) is a parenchyma-sparing surgery for benign or low-grade malignant pancreatic tumors. This study aimed to evaluate the safety of the procedure and to analyze the long-term pancreatic function. The age-specific incidence ratio (IR) was calculated based on the incidence of diabetes mellitus in the general Italian population of Italy. Materials and methods Patients submitted to CP from January 1990 to December 2017 at the Department of General and Pancreatic Surgery of the Pancreas Institute of Verona, Italy, were evaluated. Results The final population was composed of 116 patients. There was a clear prevalence of females (74.1%), the mean age was 48 ± 15 years and the main indication for surgery was a pancreatic neuroendocrine tumor (45.7%). A pancreojejunal anastomosis was performed more frequently than a pancreogastric anastomosis (78.4% vs 11.6%). The mean length of stay was 20 ± 33 days. The overall abdominal complications rate was 62%. The frequency of clinically relevant postoperative pancreatic fistula (grades B and C) was 26.7%. The mortality rate was 0%. The rate of R1-resection was 0.8%, as was the recurrence rate. After a mean follow-up of 12.8 years ±6.5, 6 patients developed new-onset diabetes (NODM, 7.5%), and the IR was 1.36 (95%CI 0.49–2.96). Conclusions CP is associated with high rates of abdominal complications, however, considering the amount of the normal pancreas that was spared, it might be indicated for selected benign or low-malignancy pancreatic tumors. CP patients have the same incidence of diabetes than the general population.
- Published
- 2018
34. The Actual Prevalence of Symptoms in Pancreatic Cystic Neoplasms: A Prospective Propensity Matched Cohort Analysis
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Giuseppe Malleo, Claudio Bassi, Chiara Miatello, Stefano Andrianello, Erica Secchettin, Giovanni Marchegiani, Roberto Salvia, Mirko D'Onofrio, Giorgia Tedesco, and Tommaso Pollini
- Subjects
Adult ,Male ,medicine.medical_specialty ,Abdominal pain ,Pancreatic disease ,Adolescent ,Population ,Pancreatic Intraductal Neoplasms ,Pain ,Cystic neoplasms pancreas ,Pancreatic cancer ,Symptoms ,Malignancy ,Asymptomatic ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,Surveys and Questionnaires ,medicine ,Prevalence ,Humans ,Prospective Studies ,education ,Propensity Score ,Pancreas ,Aged ,Aged, 80 and over ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Abdominal Pain ,Pancreatic Neoplasms ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Case-Control Studies ,030211 gastroenterology & hepatology ,Surgery ,Female ,medicine.symptom ,business - Abstract
Background: The prevalence of symptoms in pancreatic cystic neoplasms (PCNs) is mainly based on retrospective surgical series. The aim of this study is to describe the actual prevalence of symptoms in PCNs under surveillance. Methods: Patients with PCNs under surveillance observed from 2015 to 2017 were submitted to magnetic resonance imaging (MRI) and a specific interview. An identical survey was carried out on a control population matched for age, sex, and comorbidities in which any pancreatic disease was excluded by MRI. Results: Two groups of 184 individuals were compared. Patients with PCNs have a similar prevalence of abdominal pain when compared to controls (35.2 vs. 28.8, p = 0.2). PCNs in the distal pancreas experienced a significantly increased prevalence of abdominal pain (42.3 vs. 28.8%, p = 0.04), whereas size and presumed connection with the ductal system did not affect the prevalence of abdominal pain. PCNs associated with abdominal pain did not differ in terms of clinical and radiological features from asymptomatic ones. Conclusion: Patients with PCNs under surveillance have a similar prevalence of abdominal pain when compared to a matched population of controls. Abdominal pain might not correlate with radiological signs of malignancy.
- Published
- 2018
35. Systematic review, meta-analysis, and a high-volume center experience supporting the new role of mural nodules proposed by the updated 2017 international guidelines on IPMN of the pancreas
- Author
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Giuseppe Malleo, Claudio Bassi, Tommaso Pollini, Armando Gabbrielli, Chiara Dal Borgo, Alex Borin, Stefano Andrianello, Mirko D'Onofrio, Giampaolo Perri, Giovanni Marchegiani, Giorgia Romanò, Roberto Salvia, and Aldo Scarpa
- Subjects
medicine.medical_specialty ,Multivariate analysis ,endocrine system diseases ,Malignancy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Carcinoma ,Humans ,Neoplasm Invasiveness ,pancreas ,Mural nodules (MNs) ,business.industry ,intraductal papillary mucinous neoplasms (IPMN) ,medicine.disease ,Adenocarcinoma, Mucinous ,Pancreatic Neoplasms ,medicine.anatomical_structure ,Dysplasia ,Strictly standardized mean difference ,030220 oncology & carcinogenesis ,Meta-analysis ,Practice Guidelines as Topic ,pancreas, intraductal papillary mucinous neoplasms (IPMN), Mural nodules (MNs) ,Adenocarcinoma ,030211 gastroenterology & hepatology ,Surgery ,Radiology ,business ,Pancreas ,Hospitals, High-Volume ,Carcinoma, Pancreatic Ductal - Abstract
Background Mural nodules (MNs) have a predominant role in the 2016 revision of the international guidelines on intraductal papillary mucinous neoplasms (IPMN) of the pancreas. The aim of this study was to evaluate MNs as predictors of invasive cancer (iCa) or high-grade dysplasia (HGD) in IPMNs and to investigate the role of MN size in risk prediction. Methods A PRISMA-compliant systematic review of the literature and meta-analysis on selected studies were conducted. The random effect model was adopted, and the pooled SMD (standardized mean difference) obtained. The surgical series of IPMNs at a single high-volume institution was reviewed. Results This review included 70 studies and 2297 resected IPMNs. MNs have a positive predictive value for malignancy of 62.2%. The meta-analysis suggested that MN size has a considerable effect on predicting IPMNs with both iCa or HGD with a mean SMD of 0.79. All studies included in the meta-analysis used contrast-enhanced endosonography (CE-EUS) to assess MNs. Due to the heterogeneity of the proposed thresholds, no reliable MN size cut-off was identified. Of 317 IPMNs resected at our institution, 102 (32.1%) had a preoperative diagnosis of MN. Multivariate analysis showed that MN is the only independent predictor of iCa and HGD for all types of IPMNs. Conclusion MNs are reliable predictors of iCa and HGD in IPMNs as proposed by the 2016 IAP guidelines. CE-EUS seems to be the best tool for characterizing size and has the best accuracy for predicting malignancy. Further studies should determine potential MN dimensional cut-offs.
- Published
- 2018
36. Prognostic value of mural nodules and their size in IPMN of the pancreas: high-volume center experience, systematic review and meta-analysis
- Author
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Claudio Bassi, Tommaso Pollini, C. Dal Borgo, Giovanni Marchegiani, Giorgia Romanò, Stefano Andrianello, Alex Borin, Roberto Salvia, Giuseppe Malleo, Mirko D'Onofrio, and Giampaolo Perri
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Meta-analysis ,High volume center ,Gastroenterology ,Medicine ,Mural ,Radiology ,business ,Pancreas ,Value (mathematics) - Published
- 2019
37. Natural History of Intraductal Papillary Mucinous Neoplasm of the Pancreas Reappraisal of the Indolent Precursor of Pancreatic Cancer
- Author
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M. Biancotto, Claudio Bassi, Giuseppe Malleo, Giovanni Marchegiani, Tommaso Pollini, A. Caravati, Roberto Salvia, and Stefano Andrianello
- Subjects
Natural history ,Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,Intraductal papillary mucinous neoplasm ,business.industry ,Pancreatic cancer ,medicine ,Surgery ,Pancreas ,medicine.disease ,business - Published
- 2018
38. The natural history of intraductal papillary mucinous neoplasms of the pancreas: Reappraisal of the indolent precursor of pancreatic cancer
- Author
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M. Biancotto, Giovanni Marchegiani, Roberto Salvia, Giuseppe Malleo, Claudio Bassi, Tommaso Pollini, A. Caravati, and Stefano Andrianello
- Subjects
Pathology ,medicine.medical_specialty ,Intraductal papillary mucinous neoplasm ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,030204 cardiovascular system & hematology ,medicine.disease ,Natural history ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Pancreatic cancer ,medicine ,business ,Pancreas - Published
- 2018
39. The role of age in pancreatic intraductal papillary neoplasms: same survival but different implications for the management
- Author
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A. Caravati, Giovanni Marchegiani, Claudio Bassi, Erica Secchettin, Giampaolo Perri, Stefano Andrianello, Tommaso Pollini, Roberto Salvia, and Giuseppe Malleo
- Subjects
Pathology ,medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Papillary Neoplasm ,Gastroenterology ,Medicine ,business - Published
- 2018
40. Biliary fistula after pancreaticoduodenectomy: data from 1618 consecutive pancreaticoduodenectomies
- Author
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Tommaso Pollini, Stefano Andrianello, Giuseppe Malleo, Deborah Bonamini, Luca Landoni, Roberto Salvia, Claudio Bassi, and Giovanni Marchegiani
- Subjects
Male ,medicine.medical_specialty ,Biliary Fistula ,Time Factors ,Databases, Factual ,medicine.medical_treatment ,Pancreaticoduodenectomy ,Biliary fistula ,pancreaticoduodenectomy ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Medicine ,Humans ,Prospective Studies ,Risk factor ,Prospective cohort study ,Aged ,Hepatology ,Common bile duct ,business.industry ,Incidence (epidemiology) ,Incidence ,Gastroenterology ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Italy ,Pancreatic fistula ,030220 oncology & carcinogenesis ,Concomitant ,Drainage ,030211 gastroenterology & hepatology ,Female ,business ,Hospitals, High-Volume - Abstract
Biliary fistula (BF) occurs in 3-8% of patients following pancreaticoduodenectomy (PD). It usually pursues a benign course, but rarely may represent a life-threatening event.Data from 1618 PDs were collected prospectively. BF was defined as the presence of bile stained fluid from drains by post-operative day 3 and confirmed by sinogram in the majority of cases. Three classifications were validated.BF occurred in 58 (3.6%) patients. In 22 cases was associated with pancreatic fistula (POPF). POPF, PPH, operative time and a smaller common bile duct (CBD) were significantly associated with BF. Only CBD diameter (HR 0.55, CI 95% 0.44-0.7, p 0.01) was an independent predictor of BF. Patients with smaller CBDs developing concomitant BF and POPF carried the highest mortality rate (34.8%, n = 8/22). All the existing classifications resulted in discrete categories of BFs when considering hospital stay and total cost as dependent variables.Biliary fistula is rare, but it can be life threatening when associated with POPF. As the sole independent risk factor is the CBD diameter, surgical technique is crucial. Regardless of the existing classification systems, further studies must assess the additive burden of BF when a concomitant POPF is present.
- Published
- 2016
41. Neoadjuvant therapy followed by resection versus upfront resection for pancreatic cancer: the actual spectrum and clinical burden of postoperative complications
- Author
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Marta Sandini, Claudio Bassi, Giuseppe Malleo, Stefano Andrianello, Giovanni Marchegiani, Clizia Gasparini, Roberto Salvia, Tommaso Pollini, and Chiara Nessi
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastroenterology ,medicine.disease ,Resection ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Pancreatic cancer ,medicine ,030211 gastroenterology & hepatology ,Radiology ,business ,Neoadjuvant therapy - Published
- 2017
42. The prognostic value of Mural Nodules and their size in IPMN of the Pancreas: High-volume center experience, systematic review and meta-analysis
- Author
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Giorgia Romanò, Armando Gabbrielli, Chiara Dal Borgo, Tommaso Pollini, Giuseppe Malleo, Giampaolo Perri, Giovanni Marchegiani, Alex Borin, Claudio Bassi, Mirko D'Onofrio, Stefano Andrianello, Aldo Scarpa, and Roberto Salvia
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,Mural ,medicine.anatomical_structure ,Meta-analysis ,High volume center ,Medicine ,Radiology ,business ,Pancreas ,Value (mathematics) - Published
- 2017
43. The role of age in the management of IPMNs of the pancreas: same risk of cancer-related death but different implications for the management
- Author
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Tommaso Pollini, Claudio Bassi, Roberto Salvia, Giovanni Marchegiani, Stefano Andrianello, Giampaolo Perri, and Giuseppe Malleo
- Subjects
Oncology ,medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Cancer ,medicine.disease ,Pancreas ,business - Published
- 2018
44. Incidence and Risk Factor of New-Onset Diabetes After Distal Pancreatectomy
- Author
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Roberto Salvia, Tommaso Pollini, Stefano Andrianello, Alvaro Andres Duarte Garces, Sara Nobile, Claudio Bassi, Giovanni Marchegiani, Roberta Piccolo, Giuseppe Malleo, and Matteo De Pastena
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Incidence (epidemiology) ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,New onset diabetes ,030220 oncology & carcinogenesis ,Internal medicine ,Medicine ,030211 gastroenterology & hepatology ,Risk factor ,business ,Distal pancreatectomy - Published
- 2018
45. The evolution of surgical strategies for pancreatic neuroendocrine tumors
- Author
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Marchegiani, Giovanni, primary, Landoni, Luca, additional, Tommaso, Pollini, additional, Malpaga, Anna, additional, Cingarlini, Sara, additional, Salvia, Roberto, additional, and Bassi, Claudio, additional
- Published
- 2017
- Full Text
- View/download PDF
46. Screening programs for pancreatic cancer in familial high-risk individuals: A systematic review and meta-analysis of the prevalence of goals of screening achievement, overall and unnecessary surgery
- Author
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Claudio Bassi, Giulia De Marchi, Tommaso Pollini, Roberto Salvia, Salvatore Paiella, and Matteo De Pastena
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Unnecessary Surgery ,Gastroenterology ,medicine.disease ,Meta-analysis ,Pancreatic cancer ,Screening programs ,Physical therapy ,Medicine ,business ,Intensive care medicine - Published
- 2017
47. A Single Institution's 27-Year Surgical Experience with Pancreatic Neuroendocrine Tumors: Time Trends, Comparison of Current Staging Systems and Outcome Analysis
- Author
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Isacco Damoli, Salvatore Paiella, Beatrice Bianchi, Chiara Nessi, Luca Landoni, Tommaso Baroni, Tommaso Pollini, Harmony Impellizzeri, Roberto Salvia, Marco Miotto, Caterina Costanza Zingaretti, Lorenzo Crepaz, Anna Malpaga, and Giovanni Marchegiani
- Subjects
medicine.medical_specialty ,Hepatology ,Time trends ,business.industry ,General surgery ,Gastroenterology ,Outcome analysis ,Neuroendocrine tumors ,medicine.disease ,Surgery ,not available ,medicine ,Single institution ,business - Published
- 2017
48. Pancreaticoduodenectomy in patients ≥ 75 years of age: Are there any differences with other age ranges in oncological and surgical outcomes? Results from a tertiary referral center
- Author
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Tommaso Pollini, Laura Maggino, Debora Ciprani, Alessandro Esposito, Luca Casetti, Massimiliano Tuveri, Giovanni Marchegiani, Giovanni Zancan, Roberto Salvia, Claudio Bassi, Luca Landoni, Giulia De Marchi, Matteo De Pastena, Salvatore Paiella, Deborah Bonamini, Erica Secchettin, Enrico Marrano, and Giuseppe Malleo
- Subjects
Male ,medicine.medical_treatment ,Blood Loss, Surgical ,Kaplan-Meier Estimate ,Pancreatic surgery ,Tertiary Care Centers ,Elderly ,Postoperative Complications ,0302 clinical medicine ,Periampullary cancer ,Medicine ,Prospective Studies ,Aged, 80 and over ,Age Factors ,Gastroenterology ,General Medicine ,Middle Aged ,Pancreaticoduodenectomy ,people.cause_of_death ,3. Good health ,Survival Rate ,Treatment Outcome ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Adult ,Reoperation ,medicine.medical_specialty ,Operative Time ,Young Adult ,03 medical and health sciences ,Pancreatic cancer ,Retrospective Cohort Study ,Humans ,In patient ,Aged ,Retrospective Studies ,business.industry ,Patient Selection ,General surgery ,medicine.disease ,Surgery ,Pancreatic Neoplasms ,Referral center ,business ,people ,Follow-Up Studies - Abstract
AIM To compare surgical and oncological outcomes after pancreaticoduodenectomy (PD) in patients ≥ 75 years of age with two younger cohorts of patients. METHODS The prospectively maintained Institutional database of pancreatic resection was queried for patients aged ≥ 75 years (late elderly, LE) submitted to PD for any disease from January 2010 to June 2015. We compared clinical, demographic and pathological features and survival outcomes of LE patients with 2 exact matched cohorts of younger patients [≥ 40 to 64 years of age (adults, A) and ≥ 65 to 74 years of age (young elderly, YE)] submitted to PD, according to selected variables. RESULTS The final LE population, as well as the control groups, were made of 96 subjects. Up to 71% of patients was operated on for a periampullary malignancy and pancreatic cancer (PDAC) accounted for 79% of them. Intraoperative data (estimated blood loss and duration of surgery) did not differ among the groups. The overall complication rate was 65.6%, 61.5% and 58.3% for LE, YE and A patients, respectively, P = NS). Reoperation and cardiovascular complications were significantly more frequent in LE than in YE and A groups (P = 0.003 and P = 0.019, respectively). When considering either all malignancies and PDAC only, the three groups did not differ in survival. Considering all benign diseases, the estimated mean survival was 58 and 78 mo for ≥ and < 75 years of age (YE + A groups), respectively (P = 0.012). CONCLUSION Age is not a contraindication for PD. A careful selection of LE patients allows to obtain good surgical and oncological results.
- Published
- 2017
49. Does the size of mural nodule matter to predict malignancy in BD-IPMN? A systematic review of the literature and single high-volume center experience
- Author
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Alex Borin, Alessandra Pulvirenti, Chiara Dal Borgo, A. Caravati, Erica Secchettin, Laura Maggino, Giampaolo Perri, Tommaso Pollini, Roberto Salvia, Giuseppe Malleo, Deborah Bonamini, Claudio Bassi, and Giovanni Marchegiani
- Subjects
Mural Nodule ,medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,High volume center ,Gastroenterology ,Medicine ,Radiology ,business ,Malignancy ,medicine.disease ,Nuclear medicine - Published
- 2016
50. Undetermined cystic lesions of the distal pancreas: When resection is not warranted regardless of the diagnosis
- Author
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Keith D. Lillemoe, Cristina R. Ferrone, Carlos Fernandez-del Castillo, Giuseppe Malleo, Tommaso Pollini, Roberto Salvia, Andrea Zanconato, Claudio Bassi, and Giovanni Marchegiani
- Subjects
Cystic lesion ,medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,Medicine ,Radiology ,business ,Pancreas ,Resection - Published
- 2016
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