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4. Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study

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Pata, F, Di Martino, M, Podda, M, Di Saverio, S, Ielpo, B, Pellino, G, Julio, A, Alshamrani, A, Alturkistani, A, Alghamdi, A, Almalki, A, Orengia, A, Kuvvetli, A, Pisanu, A, Smith, A, Trevino Figueroa, A, Nacion, A, Alhazmi, A, Bouhuwaish, A, Khalid, A, Alsufyani, A, Rubio, A, Bavikatte, A, Kumar, A, Jamiri, A, de San Ildefonso Pereira, A, Porcu, A, Sartori, A, Rocca, A, Sretenovic, A, Anselmo, A, De Luca, A, Charalabopoulos, A, Tzivanakis, A, Bandin, A, Najar, A, Frontali, A, Faisal, A, Roldan, A, Hamid, A, Andre, A, Minaya-Bravo, A, Das, A, Bondurri, A, Costanzi, A, Lucchi, A, Mihailescu, A, Police, A, Zuchini, A, Romano, A, Iossa, A, Chessa, A, Tromba, A, Castaldi, A, Brillantino, A, Ferronetti, A, Giuliani, A, Ramos-De la Medina, A, Tarasconi, A, Picciariello, A, Ioannidis, A, Leppaniemi, A, Rashid, A, Mitul, A, Mehraj, A, Laharwal, A, Iqbal, A, Liarakos, A, Marinis, A, de Andres-Asenjo, B, Matias-Garcia, B, De Simone, B, Creavin, B, Stubbs, B, Goh, B, Jovanovic, B, Sensi, B, Gazia, C, Cerdan, C, Diaz, C, Chacon, C, Yanez, C, Faro, C, Reinke, C, Dominguez, C, Paranjape, C, Thomas, C, Fung, C, De Lucia, C, Jennifer, C, Ovalle-Chao, C, Guerci, C, Kenington, C, Gica, C, Folliero, C, Varela, C, Popowich, D, Delogu, D, Zigiotto, D, Vinci, D, D'Antonio, D, Merlini, D, Moro-Valdezate, D, Keller, D, Nicolaescu, D, Sasia, D, Rodas, E, Linardoutsos, D, Russello, D, Najar-Castaneda, P, Stavrou, H, Rosso, E, Saladino, E, Ricciardi, E, Smith-Singares, E, Baili, E, Douka, E, Guaitoli, E, Francone, E, Vaterlini, E, Pierobon, E, Morales, E, Ros, E, Benzoni, E, Erdas, E, Pinotti, E, Colas-Ruiz, E, Laterza, E, Foianini, E, Cardamone, E, Licardie, E, Marino, F, Alsofyani, F, Qahtani, F, Khan, F, Maraska, F, Saliu, F, Madrid, F, Rosa, F, Luvisetto, F, Alconchel, F, Pareja-Ciuro, F, Neves, F, Agresta, F, Cordera, F, Pardo, F, Mendoza-Moreno, F, Munoz-Flores, F, Silvestri, F, Tropeano, F, Pecchini, F, Serio, F, Colombo, F, Di Marzo, F, Ferrara, F, Lancellotti, F, Litta, F, Martini, F, Roscio, F, Blanco-Antona, F, Barcenas, F, Schlottmann, F, Herrera-Almario, G, van Ramshorst, G, Gallo, G, Luglio, G, Kampouroglou, G, Papadopoulos, G, Arredondo, G, Calini, G, Formisano, G, Galiffa, G, Palini, G, Colucci, G, Pagano, G, Vanni, G, Pattacini, G, Gravante, G, Lisi, G, Bellanova, G, De Nobili, G, Necchi, G, Sinibaldi, G, Bacchiocchi, G, Bagaglini, G, Maggi, G, Izzo, G, Argenio, G, Brisinda, G, Esposito, G, Frazzetta, G, De Luca, G, Nigri, G, Sica, G, Martin-Martin, G, Ugon, G, Martinez-Mier, G, Machain Vega, G, Nari, G, Nikaj, H, Neri, I, San Roman, I, Fidoshev, I, Martinez, I, Negoi, I, Ortega, I, Vicente Rodriguez, I, Cornejo, I, Mora-Guzman, I, al-Najami, I, Romic, I, Balciscueta, I, Olivier, J, Lammel-Lindemann, J, Dziakova, J, Salinas, J, Jovanovic, J, Reyes, J, Salas, J, Diaz-Elizondo, J, Parreira, J, Bellido, J, Salamea, J, Martin del Olmo, J, Ordonez, J, Junaid, S, Davies, J, Sahnan, K, Bekele, K, Voon, K, Siragusa, L, Petagna, L, Ferrario, L, Giordano, L, Nespoli, L, Pio, L, Moletta, L, Curella, L, Taglietti, L, Bonavina, L, Conti, L, Perez-Sanchez, L, Cabrera Vargas, L, Sanchez-Guillen, L, Tallon-Aguilar, L, Khan, M, Spampinato, M, Viola, M, Malet, M, Angrisani, M, Calussi, M, Catarci, M, Giordano, M, Materazzo, M, Milone, M, Pellicciaro, M, Marino, M, Moreno Villamizar, M, Lolli, M, Bellini, M, Lemma, M, Chiarello, M, Montes-Manrique, M, Rodriguez-Lopez, M, Serradilla-Martin, M, Peter, M, Paniagua-Garcia-Senorans, M, Rutegard, M, Salo, M, Silveri, M, Veroux, M, Nardi, M, Rottoli, M, Tolonen, M, Pedraza Ciro, M, Zuluaga, M, Iacobone, M, Montuori, M, Ali, M, Garcia Dominguez, M, Paola, M, Piccoli, M, Campanelli, M, De Rosa, M, Manigrasso, M, Maruccia, M, Torre, M, Zuolo, M, Pera, M, Weerasekera, M, Prieto, M, Thway, M, Shaat, M, Azfar, M, Shalaby, M, Raza, M, Younis, M, Elhadi, M, Althomali, M, Al Amri, N, Dudi-Venkata, N, Alselaim, N, Smart, N, Trelles, N, Falco, N, Petrucciani, N, Antonacci, N, Cillara, N, Gica, N, Pecorelli, N, Tamini, N, Machairas, N, Feituri, N, Ortega Torrecilla, N, Avila Mercado, O, Alaamer, O, Irkorucu, O, Alsherif, O, Buonomi, O, Valles-Guerra, O, Ioannidis, O, Hernandez Palmas, O, Sanz Guadarrama, O, Bozbiyik, O, Rodrigues, P, Milito, P, Panaccio, P, Dorovinis, P, Prieto, P, Baroffio, P, Marsanic, P, Ajawin, P, Koh, P, Anoldo, P, Major, P, Alharthi, Q, Lui, R, Caruso, R, Brady, R, Rattan, R, Singhal, R, Angelico, R, Isernia, R, Tutino, R, Peltrini, R, Tejos, R, Fajardo, R, Elia, R, Morales-Conde, S, Benli, S, Fuentes, S, de las Casas, S, de Guzman Aragon, S, Vertaldi, S, Awad, S, Gentilli, S, Weckmann Lujan, S, Tayar, S, Althobaiti, S, Di Giovanni, S, Ghedan, S, Perez-Bertolez, S, Chiappetta, S, Delis, S, Scaringi, S, Cetinkunar, S, Kykalos, S, Muhammad Ali, S, Krivan, S, Fung, T, Delko, T, Nicolas Lopez, T, De Campos, T, Calderon Duque, T, Perra, T, Liakakos, T, Daskalakis, T, Koeter, T, Zalla, T, Gonzalez, T, Campagnaro, T, Oumar, T, Grossi, U, Sosa, V, Testa, V, Tomajer, V, Andriola, V, Tonini, V, Celentano, V, Voglino, V, Katta, V, Garcia Orozco, V, Turrado-Rodriguez, V, Visag-Castillo, V, Graham, V, Rachkov, V, Papagni, V, Vigorita, V, Jimenez Carneros, V, Bellato, V, Bechstein, W, Altinel, Y, Balciscueta, Z, Pata F., Di Martino M., Podda M., Di Saverio S., Ielpo B., Pellino G., Julio A., Alshamrani A., Alturkistani A., Alghamdi A., Almalki A., Orengia A., Kuvvetli A., Pisanu A., Smith A., Trevino Figueroa A. M., Nacion A. J., Alhazmi A., Bouhuwaish A., Khalid A., Alsufyani A., Rubio A. V., Bavikatte A., Kumar A., Jamiri A. -R., de San Ildefonso Pereira A., Porcu A., Sartori A., Rocca A., Sretenovic A., Anselmo A., De Luca A., Charalabopoulos A., Tzivanakis A., Bandin A., Najar A., Frontali A., Faisal A., Roldan A. M., Hamid A., Andre A., Minaya-Bravo A., Das A., Bondurri A., Costanzi A., Lucchi A., Mihailescu A., Police A., Zuchini A. M., Romano A., Iossa A., Chessa A., Tromba A., Castaldi A., Brillantino A., Ferronetti A., Giuliani A., Ramos-De la Medina A., Tarasconi A., Picciariello A., Ioannidis A., Leppaniemi A., Rashid A., Mitul A. R., Mehraj A., laharwal A., Iqbal A., Liarakos A., Marinis A., de Andres-Asenjo B., Matias-Garcia B., De Simone B., Creavin B., Stubbs B., Goh B., Jovanovic B., Sensi B., Gazia C., Cerdan C., Diaz C. J. G., Chacon C. P., Yanez C., Faro C. L., Reinke C., Dominguez C., Paranjape C., Thomas C., Fung C. C., De Lucia C., Jennifer C. H. F., Ovalle-Chao C., Guerci C., Kenington C., Gica C., Folliero C., Varela C., Popowich D., Delogu D., Zigiotto D., Vinci D., D'Antonio D., Merlini D. A., Merlini D., Moro-Valdezate D., Keller D., Nicolaescu D. C., Sasia D., Rodas E., Linardoutsos D., Russello D., Najar-Castaneda P. A., Stavrou H. G., Rosso E., Saladino E., Ricciardi E., Smith-Singares E., Baili E., Douka E., Guaitoli E., Francone E., Vaterlini E. M., Pierobon E. S., Morales E., Ros E. P., Benzoni E., Erdas E., Pinotti E., Colas-Ruiz E., Laterza E., Foianini E., Cardamone E., Licardie E., Marino F., Alsofyani F., Qahtani F., Khan F., Maraska F., Saliu F., Madrid F., Rosa F., Luvisetto F., Alconchel F., Pareja-Ciuro F., Neves F., Agresta F., Cordera F., Pardo F., Mendoza-Moreno F., Munoz-Flores F., Silvestri F. M., Tropeano F. P., Pecchini F., Serio F., Colombo F., Di Marzo F., Ferrara F., Lancellotti F., Litta F., Martini F., Roscio F., Blanco-Antona F., Barcenas F. J. Q., Schlottmann F., Herrera-Almario G., van Ramshorst G., Gallo G., Luglio G., Kampouroglou G., Papadopoulos G., Arredondo G., Calini G., Formisano G., Galiffa G., Palini G. M., Colucci G., Pagano G., Vanni G., Pattacini G. C., Gravante G., Lisi G., Bellanova G., De Nobili G., Necchi G. S., Sinibaldi G., Bacchiocchi G., Bagaglini G., Maggi G., Izzo G., Argenio G., Brisinda G., Esposito G., Frazzetta G., De Luca G. M., Nigri G., Sica G., Martin-Martin G., Ugon G. A., Martinez-Mier G., Machain Vega G. M., Nari G., Nikaj H., Neri I., San Roman I. A., Fidoshev I., Martinez I., Negoi I., Ortega I., Vicente Rodriguez I., Cornejo I., Mora-Guzman I., al-Najami I., Romic I., Balciscueta I., Olivier J., Lammel-Lindemann J., Dziakova J., Salinas J., Jovanovic J. P., Reyes J. A. S., Salas J., Diaz-Elizondo J. A., Parreira J. G., Bellido J., Salamea J., Martin del Olmo J. C., Ordonez J. M., Junaid S., Davies J., Sahnan K., Bekele K., Voon K., Siragusa L., Petagna L., Ferrario L., Giordano L., Nespoli L., Pio L., Moletta L., Curella L., Taglietti L., Bonavina L., Conti L., Perez-Sanchez L. E., Cabrera Vargas L. F., Sanchez-Guillen L., Tallon-Aguilar L., Khan M., Spampinato M. G., Viola M., Malet M. V., Angrisani M., Calussi M., Catarci M., Giordano M., Materazzo M., Milone M., Pellicciaro M., Marino M. V., Moreno Villamizar M. D., Lolli M. G., Bellini M. I., Lemma M., Chiarello M. M., Montes-Manrique M., Rodriguez-Lopez M., Serradilla-Martin M., Peter M., Paniagua-Garcia-Senorans M., Rutegard M., Salo M., Silveri M., Veroux M., Nardi M., Rottoli M., Tolonen M., Pedraza Ciro M., Zuluaga M., Iacobone M., Montuori M., Ali M., Garcia Dominguez M., Paola M. M., Piccoli M., Campanelli M., De Rosa M., Manigrasso M., Maruccia M., Torre M., Zuolo M., Pera M., Weerasekera M., Prieto M., Thway M. M., Shaat M., Azfar M., Shalaby M., Raza M. A., Younis M. U., Elhadi M., AlThomali M., Al Amri N., Dudi-Venkata N., Alselaim N., Smart N., Trelles N., Falco N., Petrucciani N., Antonacci N., Cillara N., Gica N., Pecorelli N., Tamini N., Machairas N., Feituri N., Ortega Torrecilla N., Avila Mercado O., AlAamer O., Irkorucu O., Alsherif O., Buonomi O. C., Valles-Guerra O., Ioannidis O., Hernandez Palmas O. I., Sanz Guadarrama O., Bozbiyik O., Rodrigues P., Milito P., Panaccio P., Dorovinis P., Prieto P., Baroffio P., Marsanic P., Ajawin P., Koh P. S., Anoldo P., Major P., Alharthi Q., Lui R., Caruso R., Brady R., Rattan R., Singhal R., Angelico R., Isernia R. M., Tutino R., Peltrini R., Tejos R., Fajardo R., Elia R., Morales-Conde S., Benli S., Fuentes S., de las Casas S. G., de Guzman Aragon S. O., Vertaldi S., Awad S., Gentilli S., Weckmann Lujan S. A., Tayar S., Althobaiti S., Di Giovanni S., Ghedan S., Perez-Bertolez S., Chiappetta S., Delis S., Scaringi S., Cetinkunar S., Kykalos S., Muhammad Ali S., Krivan S., Fung T. L. D., Delko T., Nicolas Lopez T., De Campos T., Calderon Duque T., Perra T., Liakakos T., Daskalakis T., Koeter T., Zalla T., Gonzalez T. E., Campagnaro T., Oumar T. A., Grossi U., Sosa V., Testa V., Tomajer V., Andriola V., Tonini V., Celentano V., Voglino V., Katta V. R., Garcia Orozco V. H., Turrado-Rodriguez V., Visag-Castillo V., Graham V., Rachkov V., Papagni V., Vigorita V., Jimenez Carneros V., Bellato V., Bechstein W., Altinel Y., Balciscueta Z., Pata, F, Di Martino, M, Podda, M, Di Saverio, S, Ielpo, B, Pellino, G, Julio, A, Alshamrani, A, Alturkistani, A, Alghamdi, A, Almalki, A, Orengia, A, Kuvvetli, A, Pisanu, A, Smith, A, Trevino Figueroa, A, Nacion, A, Alhazmi, A, Bouhuwaish, A, Khalid, A, Alsufyani, A, Rubio, A, Bavikatte, A, Kumar, A, Jamiri, A, de San Ildefonso Pereira, A, Porcu, A, Sartori, A, Rocca, A, Sretenovic, A, Anselmo, A, De Luca, A, Charalabopoulos, A, Tzivanakis, A, Bandin, A, Najar, A, Frontali, A, Faisal, A, Roldan, A, Hamid, A, Andre, A, Minaya-Bravo, A, Das, A, Bondurri, A, Costanzi, A, Lucchi, A, Mihailescu, A, Police, A, Zuchini, A, Romano, A, Iossa, A, Chessa, A, Tromba, A, Castaldi, A, Brillantino, A, Ferronetti, A, Giuliani, A, Ramos-De la Medina, A, Tarasconi, A, Picciariello, A, Ioannidis, A, Leppaniemi, A, Rashid, A, Mitul, A, Mehraj, A, Laharwal, A, Iqbal, A, Liarakos, A, Marinis, A, de Andres-Asenjo, B, Matias-Garcia, B, De Simone, B, Creavin, B, Stubbs, B, Goh, B, Jovanovic, B, Sensi, B, Gazia, C, Cerdan, C, Diaz, C, Chacon, C, Yanez, C, Faro, C, Reinke, C, Dominguez, C, Paranjape, C, Thomas, C, Fung, C, De Lucia, C, Jennifer, C, Ovalle-Chao, C, Guerci, C, Kenington, C, Gica, C, Folliero, C, Varela, C, Popowich, D, Delogu, D, Zigiotto, D, Vinci, D, D'Antonio, D, Merlini, D, Moro-Valdezate, D, Keller, D, Nicolaescu, D, Sasia, D, Rodas, E, Linardoutsos, D, Russello, D, Najar-Castaneda, P, Stavrou, H, Rosso, E, Saladino, E, Ricciardi, E, Smith-Singares, E, Baili, E, Douka, E, Guaitoli, E, Francone, E, Vaterlini, E, Pierobon, E, Morales, E, Ros, E, Benzoni, E, Erdas, E, Pinotti, E, Colas-Ruiz, E, Laterza, E, Foianini, E, Cardamone, E, Licardie, E, Marino, F, Alsofyani, F, Qahtani, F, Khan, F, Maraska, F, Saliu, F, Madrid, F, Rosa, F, Luvisetto, F, Alconchel, F, Pareja-Ciuro, F, Neves, F, Agresta, F, Cordera, F, Pardo, F, Mendoza-Moreno, F, Munoz-Flores, F, Silvestri, F, Tropeano, F, Pecchini, F, Serio, F, Colombo, F, Di Marzo, F, Ferrara, F, Lancellotti, F, Litta, F, Martini, F, Roscio, F, Blanco-Antona, F, Barcenas, F, Schlottmann, F, Herrera-Almario, G, van Ramshorst, G, Gallo, G, Luglio, G, Kampouroglou, G, Papadopoulos, G, Arredondo, G, Calini, G, Formisano, G, Galiffa, G, Palini, G, Colucci, G, Pagano, G, Vanni, G, Pattacini, G, Gravante, G, Lisi, G, Bellanova, G, De Nobili, G, Necchi, G, Sinibaldi, G, Bacchiocchi, G, Bagaglini, G, Maggi, G, Izzo, G, Argenio, G, Brisinda, G, Esposito, G, Frazzetta, G, De Luca, G, Nigri, G, Sica, G, Martin-Martin, G, Ugon, G, Martinez-Mier, G, Machain Vega, G, Nari, G, Nikaj, H, Neri, I, San Roman, I, Fidoshev, I, Martinez, I, Negoi, I, Ortega, I, Vicente Rodriguez, I, Cornejo, I, Mora-Guzman, I, al-Najami, I, Romic, I, Balciscueta, I, Olivier, J, Lammel-Lindemann, J, Dziakova, J, Salinas, J, Jovanovic, J, Reyes, J, Salas, J, Diaz-Elizondo, J, Parreira, J, Bellido, J, Salamea, J, Martin del Olmo, J, Ordonez, J, Junaid, S, Davies, J, Sahnan, K, Bekele, K, Voon, K, Siragusa, L, Petagna, L, Ferrario, L, Giordano, L, Nespoli, L, Pio, L, Moletta, L, Curella, L, Taglietti, L, Bonavina, L, Conti, L, Perez-Sanchez, L, Cabrera Vargas, L, Sanchez-Guillen, L, Tallon-Aguilar, L, Khan, M, Spampinato, M, Viola, M, Malet, M, Angrisani, M, Calussi, M, Catarci, M, Giordano, M, Materazzo, M, Milone, M, Pellicciaro, M, Marino, M, Moreno Villamizar, M, Lolli, M, Bellini, M, Lemma, M, Chiarello, M, Montes-Manrique, M, Rodriguez-Lopez, M, Serradilla-Martin, M, Peter, M, Paniagua-Garcia-Senorans, M, Rutegard, M, Salo, M, Silveri, M, Veroux, M, Nardi, M, Rottoli, M, Tolonen, M, Pedraza Ciro, M, Zuluaga, M, Iacobone, M, Montuori, M, Ali, M, Garcia Dominguez, M, Paola, M, Piccoli, M, Campanelli, M, De Rosa, M, Manigrasso, M, Maruccia, M, Torre, M, Zuolo, M, Pera, M, Weerasekera, M, Prieto, M, Thway, M, Shaat, M, Azfar, M, Shalaby, M, Raza, M, Younis, M, Elhadi, M, Althomali, M, Al Amri, N, Dudi-Venkata, N, Alselaim, N, Smart, N, Trelles, N, Falco, N, Petrucciani, N, Antonacci, N, Cillara, N, Gica, N, Pecorelli, N, Tamini, N, Machairas, N, Feituri, N, Ortega Torrecilla, N, Avila Mercado, O, Alaamer, O, Irkorucu, O, Alsherif, O, Buonomi, O, Valles-Guerra, O, Ioannidis, O, Hernandez Palmas, O, Sanz Guadarrama, O, Bozbiyik, O, Rodrigues, P, Milito, P, Panaccio, P, Dorovinis, P, Prieto, P, Baroffio, P, Marsanic, P, Ajawin, P, Koh, P, Anoldo, P, Major, P, Alharthi, Q, Lui, R, Caruso, R, Brady, R, Rattan, R, Singhal, R, Angelico, R, Isernia, R, Tutino, R, Peltrini, R, Tejos, R, Fajardo, R, Elia, R, Morales-Conde, S, Benli, S, Fuentes, S, de las Casas, S, de Guzman Aragon, S, Vertaldi, S, Awad, S, Gentilli, S, Weckmann Lujan, S, Tayar, S, Althobaiti, S, Di Giovanni, S, Ghedan, S, Perez-Bertolez, S, Chiappetta, S, Delis, S, Scaringi, S, Cetinkunar, S, Kykalos, S, Muhammad Ali, S, Krivan, S, Fung, T, Delko, T, Nicolas Lopez, T, De Campos, T, Calderon Duque, T, Perra, T, Liakakos, T, Daskalakis, T, Koeter, T, Zalla, T, Gonzalez, T, Campagnaro, T, Oumar, T, Grossi, U, Sosa, V, Testa, V, Tomajer, V, Andriola, V, Tonini, V, Celentano, V, Voglino, V, Katta, V, Garcia Orozco, V, Turrado-Rodriguez, V, Visag-Castillo, V, Graham, V, Rachkov, V, Papagni, V, Vigorita, V, Jimenez Carneros, V, Bellato, V, Bechstein, W, Altinel, Y, Balciscueta, Z, Pata F., Di Martino M., Podda M., Di Saverio S., Ielpo B., Pellino G., Julio A., Alshamrani A., Alturkistani A., Alghamdi A., Almalki A., Orengia A., Kuvvetli A., Pisanu A., Smith A., Trevino Figueroa A. M., Nacion A. J., Alhazmi A., Bouhuwaish A., Khalid A., Alsufyani A., Rubio A. V., Bavikatte A., Kumar A., Jamiri A. -R., de San Ildefonso Pereira A., Porcu A., Sartori A., Rocca A., Sretenovic A., Anselmo A., De Luca A., Charalabopoulos A., Tzivanakis A., Bandin A., Najar A., Frontali A., Faisal A., Roldan A. M., Hamid A., Andre A., Minaya-Bravo A., Das A., Bondurri A., Costanzi A., Lucchi A., Mihailescu A., Police A., Zuchini A. M., Romano A., Iossa A., Chessa A., Tromba A., Castaldi A., Brillantino A., Ferronetti A., Giuliani A., Ramos-De la Medina A., Tarasconi A., Picciariello A., Ioannidis A., Leppaniemi A., Rashid A., Mitul A. R., Mehraj A., laharwal A., Iqbal A., Liarakos A., Marinis A., de Andres-Asenjo B., Matias-Garcia B., De Simone B., Creavin B., Stubbs B., Goh B., Jovanovic B., Sensi B., Gazia C., Cerdan C., Diaz C. J. G., Chacon C. P., Yanez C., Faro C. L., Reinke C., Dominguez C., Paranjape C., Thomas C., Fung C. C., De Lucia C., Jennifer C. H. F., Ovalle-Chao C., Guerci C., Kenington C., Gica C., Folliero C., Varela C., Popowich D., Delogu D., Zigiotto D., Vinci D., D'Antonio D., Merlini D. A., Merlini D., Moro-Valdezate D., Keller D., Nicolaescu D. C., Sasia D., Rodas E., Linardoutsos D., Russello D., Najar-Castaneda P. A., Stavrou H. G., Rosso E., Saladino E., Ricciardi E., Smith-Singares E., Baili E., Douka E., Guaitoli E., Francone E., Vaterlini E. M., Pierobon E. S., Morales E., Ros E. P., Benzoni E., Erdas E., Pinotti E., Colas-Ruiz E., Laterza E., Foianini E., Cardamone E., Licardie E., Marino F., Alsofyani F., Qahtani F., Khan F., Maraska F., Saliu F., Madrid F., Rosa F., Luvisetto F., Alconchel F., Pareja-Ciuro F., Neves F., Agresta F., Cordera F., Pardo F., Mendoza-Moreno F., Munoz-Flores F., Silvestri F. M., Tropeano F. P., Pecchini F., Serio F., Colombo F., Di Marzo F., Ferrara F., Lancellotti F., Litta F., Martini F., Roscio F., Blanco-Antona F., Barcenas F. J. Q., Schlottmann F., Herrera-Almario G., van Ramshorst G., Gallo G., Luglio G., Kampouroglou G., Papadopoulos G., Arredondo G., Calini G., Formisano G., Galiffa G., Palini G. M., Colucci G., Pagano G., Vanni G., Pattacini G. C., Gravante G., Lisi G., Bellanova G., De Nobili G., Necchi G. S., Sinibaldi G., Bacchiocchi G., Bagaglini G., Maggi G., Izzo G., Argenio G., Brisinda G., Esposito G., Frazzetta G., De Luca G. M., Nigri G., Sica G., Martin-Martin G., Ugon G. A., Martinez-Mier G., Machain Vega G. M., Nari G., Nikaj H., Neri I., San Roman I. A., Fidoshev I., Martinez I., Negoi I., Ortega I., Vicente Rodriguez I., Cornejo I., Mora-Guzman I., al-Najami I., Romic I., Balciscueta I., Olivier J., Lammel-Lindemann J., Dziakova J., Salinas J., Jovanovic J. P., Reyes J. A. S., Salas J., Diaz-Elizondo J. A., Parreira J. G., Bellido J., Salamea J., Martin del Olmo J. C., Ordonez J. M., Junaid S., Davies J., Sahnan K., Bekele K., Voon K., Siragusa L., Petagna L., Ferrario L., Giordano L., Nespoli L., Pio L., Moletta L., Curella L., Taglietti L., Bonavina L., Conti L., Perez-Sanchez L. E., Cabrera Vargas L. F., Sanchez-Guillen L., Tallon-Aguilar L., Khan M., Spampinato M. G., Viola M., Malet M. V., Angrisani M., Calussi M., Catarci M., Giordano M., Materazzo M., Milone M., Pellicciaro M., Marino M. V., Moreno Villamizar M. D., Lolli M. G., Bellini M. I., Lemma M., Chiarello M. M., Montes-Manrique M., Rodriguez-Lopez M., Serradilla-Martin M., Peter M., Paniagua-Garcia-Senorans M., Rutegard M., Salo M., Silveri M., Veroux M., Nardi M., Rottoli M., Tolonen M., Pedraza Ciro M., Zuluaga M., Iacobone M., Montuori M., Ali M., Garcia Dominguez M., Paola M. M., Piccoli M., Campanelli M., De Rosa M., Manigrasso M., Maruccia M., Torre M., Zuolo M., Pera M., Weerasekera M., Prieto M., Thway M. M., Shaat M., Azfar M., Shalaby M., Raza M. A., Younis M. U., Elhadi M., AlThomali M., Al Amri N., Dudi-Venkata N., Alselaim N., Smart N., Trelles N., Falco N., Petrucciani N., Antonacci N., Cillara N., Gica N., Pecorelli N., Tamini N., Machairas N., Feituri N., Ortega Torrecilla N., Avila Mercado O., AlAamer O., Irkorucu O., Alsherif O., Buonomi O. C., Valles-Guerra O., Ioannidis O., Hernandez Palmas O. I., Sanz Guadarrama O., Bozbiyik O., Rodrigues P., Milito P., Panaccio P., Dorovinis P., Prieto P., Baroffio P., Marsanic P., Ajawin P., Koh P. S., Anoldo P., Major P., Alharthi Q., Lui R., Caruso R., Brady R., Rattan R., Singhal R., Angelico R., Isernia R. M., Tutino R., Peltrini R., Tejos R., Fajardo R., Elia R., Morales-Conde S., Benli S., Fuentes S., de las Casas S. G., de Guzman Aragon S. O., Vertaldi S., Awad S., Gentilli S., Weckmann Lujan S. A., Tayar S., Althobaiti S., Di Giovanni S., Ghedan S., Perez-Bertolez S., Chiappetta S., Delis S., Scaringi S., Cetinkunar S., Kykalos S., Muhammad Ali S., Krivan S., Fung T. L. D., Delko T., Nicolas Lopez T., De Campos T., Calderon Duque T., Perra T., Liakakos T., Daskalakis T., Koeter T., Zalla T., Gonzalez T. E., Campagnaro T., Oumar T. A., Grossi U., Sosa V., Testa V., Tomajer V., Andriola V., Tonini V., Celentano V., Voglino V., Katta V. R., Garcia Orozco V. H., Turrado-Rodriguez V., Visag-Castillo V., Graham V., Rachkov V., Papagni V., Vigorita V., Jimenez Carneros V., Bellato V., Bechstein W., Altinel Y., and Balciscueta Z.

Abstract

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide.

Published
2022

5. Correction: Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study (World Journal of Surgery, (2022), 46, 9, (2021-2035), 10.1007/s00268-022-06649-z)

Author

Pata F., Pata, F, Di Martino, M, Podda, M, Di Saverio, S, Ielpo, B, Pellino, G, Julio, A, Alshamrani, A, Alturkistani, A, Alghamdi, A, Almalki, A, Orengia, A, Kuvvetli, A, Pisanu, A, Smith, A, Trevino Figueroa, A, Nacion, A, Alhazmi, A, Bouhuwaish, A, Khalid, A, Alsufyani, A, Rubio, A, Bavikatte, A, Kumar, A, Jamiri, A, de San Ildefonso Pereira, A, Porcu, A, Sartori, A, Rocca, A, Sretenovic, A, Anselmo, A, De Luca, A, Charalabopoulos, A, Tzivanakis, A, Bandin, A, Najar, A, Frontali, A, Faisal, A, Roldan, A, Hamid, A, Andre, A, Minaya-Bravo, A, Das, A, Bondurri, A, Costanzi, A, Lucchi, A, Mihailescu, A, Police, A, Zuchini, A, Romano, A, Iossa, A, Chessa, A, Tromba, A, Castaldi, A, Brillantino, A, Ferronetti, A, Giuliani, A, Ramos-De la Medina, A, Tarasconi, A, Picciariello, A, Ioannidis, A, Leppaniemi, A, Rashid, A, Mitul, A, Mehraj, A, Laharwal, A, Iqbal, A, Liarakos, A, Marinis, A, de Andres-Asenjo, B, Matias-Garcia, B, De Simone, B, Creavin, B, Stubbs, B, Goh, B, Jovanovic, B, Sensi, B, Gazia, C, Cerdan, C, Diaz, C, Chacon, C, Yanez, C, Faro, C, Reinke, C, Dominguez, C, Paranjape, C, Thomas, C, Fung, C, De Lucia, C, Jennifer, C, Ovalle-Chao, C, Guerci, C, Kenington, C, Gica, C, Folliero, C, Varela, C, Popowich, D, Delogu, D, Zigiotto, D, Vinci, D, D'Antonio, D, Merlini, D, Moro-Valdezate, D, Keller, D, Nicolaescu, D, Sasia, D, Rodas, E, Linardoutsos, D, Russello, D, Najar-Castaneda, P, Stavrou, H, Rosso, E, Saladino, E, Ricciardi, E, Smith-Singares, E, Baili, E, Douka, E, Guaitoli, E, Francone, E, Vaterlini, E, Pierobon, E, Morales, E, Ros, E, Benzoni, E, Erdas, E, Pinotti, E, Colas-Ruiz, E, Laterza, E, Foianini, E, Cardamone, E, Licardie, E, Marino, F, Alsofyani, F, Qahtani, F, Khan, F, Maraska, F, Saliu, F, Madrid, F, Rosa, F, Luvisetto, F, Alconchel, F, Pareja-Ciuro, F, Neves, F, Agresta, F, Cordera, F, Pardo, F, Mendoza-Moreno, F, Munoz-Flores, F, Silvestri, F, Tropeano, F, Pecchini, F, Serio, F, Colombo, F, Di Marzo, F, Ferrara, F, Lancellotti, F, Litta, F, Martini, F, Roscio, F, Blanco-Antona, F, Barcenas, F, Schlottmann, F, Herrera-Almario, G, van Ramshorst, G, Gallo, G, Luglio, G, Kampouroglou, G, Papadopoulos, G, Arredondo, G, Calini, G, Formisano, G, Galiffa, G, Palini, G, Colucci, G, Pagano, G, Vanni, G, Pattacini, G, Gravante, G, Lisi, G, Bellanova, G, De Nobili, G, Necchi, G, Sinibaldi, G, Bacchiocchi, G, Bagaglini, G, Maggi, G, Izzo, G, Argenio, G, Brisinda, G, Esposito, G, Frazzetta, G, De Luca, G, Nigri, G, Sica, G, Martin-Martin, G, Ugon, G, Martinez-Mier, G, Machain Vega, G, Nari, G, Nikaj, H, Neri, I, San Roman, I, Fidoshev, I, Martinez, I, Negoi, I, Ortega, I, Vicente Rodriguez, I, Cornejo, I, Mora-Guzman, I, al-Najami, I, Romic, I, Balciscueta, I, Olivier, J, Lammel-Lindemann, J, Dziakova, J, Salinas, J, Jovanovic, J, Reyes, J, Salas, J, Diaz-Elizondo, J, Parreira, J, Bellido, J, Salamea, J, Martin del Olmo, J, Ordonez, J, Junaid, S, Davies, J, Sahnan, K, Bekele, K, Voon, K, Siragusa, L, Petagna, L, Ferrario, L, Giordano, L, Nespoli, L, Pio, L, Moletta, L, Curella, L, Taglietti, L, Bonavina, L, Conti, L, Perez-Sanchez, L, Cabrera Vargas, L, Sanchez-Guillen, L, Tallon-Aguilar, L, Khan, M, Spampinato, M, Viola, M, Malet, M, Angrisani, M, Calussi, M, Catarci, M, Giordano, M, Materazzo, M, Milone, M, Pellicciaro, M, Marino, M, Moreno Villamizar, M, Lolli, M, Bellini, M, Lemma, M, Chiarello, M, Montes-Manrique, M, Rodriguez-Lopez, M, Serradilla-Martin, M, Peter, M, Paniagua-Garcia-Senorans, M, Rutegard, M, Salo, M, Silveri, M, Veroux, M, Nardi, M, Rottoli, M, Tolonen, M, Pedraza Ciro, M, Zuluaga, M, Iacobone, M, Montuori, M, Ali, M, Garcia Dominguez, M, Paola, M, Piccoli, M, Campanelli, M, De Rosa, M, Manigrasso, M, Maruccia, M, Torre, M, Zuolo, M, Pera, M, Weerasekera, M, Prieto, M, Thway, M, Shaat, M, Azfar, M, Shalaby, M, Raza, M, Younis, M, Elhadi, M, Althomali, M, Al Amri, N, Dudi-Venkata, N, Alselaim, N, Smart, N, Trelles, N, Falco, N, Petrucciani, N, Antonacci, N, Cillara, N, Gica, N, Pecorelli, N, Tamini, N, Machairas, N, Feituri, N, Ortega Torrecilla, N, Avila Mercado, O, Alaamer, O, Irkorucu, O, Alsherif, O, Buonomo, O, Valles-Guerra, O, Ioannidis, O, Hernandez Palmas, O, Sanz Guadarrama, O, Bozbiyik, O, Rodrigues, P, Milito, P, Panaccio, P, Dorovinis, P, Prieto, P, Baroffio, P, Marsanic, P, Ajawin, P, Koh, P, Anoldo, P, Major, P, Alharthi, Q, Lui, R, Caruso, R, Brady, R, Rattan, R, Singhal, R, Angelico, R, Isernia, R, Tutino, R, Peltrini, R, Tejos, R, Fajardo, R, Elia, R, Morales-Conde, S, Benli, S, Fuentes, S, de las Casas, S, de Guzman Aragon, S, Vertaldi, S, Awad, S, Gentilli, S, Weckmann Lujan, S, Tayar, S, Althobaiti, S, Di Giovanni, S, Ghedan, S, Perez-Bertolez, S, Chiappetta, S, Delis, S, Scaringi, S, Cetinkunar, S, Kykalos, S, Muhammad Ali, S, Krivan, S, Fung, T, Delko, T, Nicolas Lopez, T, De Campos, T, Calderon Duque, T, Perra, T, Liakakos, T, Daskalakis, T, Koeter, T, Zalla, T, Gonzalez, T, Campagnaro, T, Oumar, T, Grossi, U, Sosa, V, Testa, V, Tomajer, V, Andriola, V, Tonini, V, Celentano, V, Voglino, V, Katta, V, Garcia Orozco, V, Turrado-Rodriguez, V, Visag-Castillo, V, Graham, V, Rachkov, V, Papagni, V, Vigorita, V, Jimenez Carneros, V, Bellato, V, Bechstein, W, Altinel, Y, Balciscueta, Z, Pata F., Di Martino M., Podda M., Di Saverio S., Ielpo B., Pellino G., Julio A., Alshamrani A., Alturkistani A., Alghamdi A., Almalki A., Orengia A., Kuvvetli A., Pisanu A., Smith A., Trevino Figueroa A. M., Nacion A. J., Alhazmi A., Bouhuwaish A., Khalid A., Alsufyani A., Rubio A. V., Bavikatte A., Kumar A., Jamiri A. -R., de San Ildefonso Pereira A., Porcu A., Sartori A., Rocca A., Sretenovic A., Anselmo A., De Luca A., Charalabopoulos A., Tzivanakis A., Bandin A., Najar A., Frontali A., Faisal A., Roldan A. M., Hamid A., Andre A., Minaya-Bravo A., Das A., Bondurri A., Costanzi A., Lucchi A., Mihailescu A., Police A., Zuchini A. M., Romano A., Iossa A., Chessa A., Tromba A., Castaldi A., Brillantino A., Ferronetti A., Giuliani A., Ramos-De la Medina A., Tarasconi A., Picciariello A., Ioannidis A., Leppaniemi A., Rashid A., Mitul A. R., Mehraj A., laharwal A., Iqbal A., Liarakos A., Marinis A., de Andres-Asenjo B., Matias-Garcia B., De Simone B., Creavin B., Stubbs B., Goh B., Jovanovic B., Sensi B., Gazia C., Cerdan C., Diaz C. J. G., Chacon C. P., Yanez C., Faro C. L., Reinke C., Dominguez C., Paranjape C., Thomas C., Fung C. C., De Lucia C., Jennifer C. H. F., Ovalle-Chao C., Guerci C., Kenington C., Gica C., Folliero C., Varela C., Popowich D., Delogu D., Zigiotto D., Vinci D., D'Antonio D., Merlini D. A., Merlini D., Moro-Valdezate D., Keller D., Nicolaescu D. C., Sasia D., Rodas E., Linardoutsos D., Russello D., Najar-Castaneda P. A., Stavrou H. G., Rosso E., Saladino E., Ricciardi E., Smith-Singares E., Baili E., Douka E., Guaitoli E., Francone E., Vaterlini E. M., Pierobon E. S., Morales E., Ros E. P., Benzoni E., Erdas E., Pinotti E., Colas-Ruiz E., Laterza E., Foianini E., Cardamone E., Licardie E., Marino F., Alsofyani F., Qahtani F., Khan F., Maraska F., Saliu F., Madrid F., Rosa F., Luvisetto F., Alconchel F., Pareja-Ciuro F., Neves F., Agresta F., Cordera F., Pardo F., Mendoza-Moreno F., Munoz-Flores F., Silvestri F. M., Tropeano F. P., Pecchini F., Serio F., Colombo F., Di Marzo F., Ferrara F., Lancellotti F., Litta F., Martini F., Roscio F., Blanco-Antona F., Barcenas F. J. Q., Schlottmann F., Herrera-Almario G., van Ramshorst G., Gallo G., Luglio G., Kampouroglou G., Papadopoulos G., Arredondo G., Calini G., Formisano G., Galiffa G., Palini G. M., Colucci G., Pagano G., Vanni G., Pattacini G. C., Gravante G., Lisi G., Bellanova G., De Nobili G., Necchi G. S., Sinibaldi G., Bacchiocchi G., Bagaglini G., Maggi G., Izzo G., Argenio G., Brisinda G., Esposito G., Frazzetta G., De Luca G. M., Nigri G., Sica G., Martin-Martin G., Ugon G. A., Martinez-Mier G., Machain Vega G. M., Nari G., Nikaj H., Neri I., San Roman I. A., Fidoshev I., Martinez I., Negoi I., Ortega I., Vicente Rodriguez I., Cornejo I., Mora-Guzman I., al-Najami I., Romic I., Balciscueta I., Olivier J., Lammel-Lindemann J., Dziakova J., Salinas J., Jovanovic J. P., Reyes J. A. S., Salas J., Diaz-Elizondo J. A., Parreira J. G., Bellido J., Salamea J., Martin del Olmo J. C., Ordonez J. M., Junaid S., Davies J., Sahnan K., Bekele K., Voon K., Siragusa L., Petagna L., Ferrario L., Giordano L., Nespoli L., Pio L., Moletta L., Curella L., Taglietti L., Bonavina L., Conti L., Perez-Sanchez L. E., Cabrera Vargas L. F., Sanchez-Guillen L., Tallon-Aguilar L., Khan M., Spampinato M. G., Viola M., Malet M. V., Angrisani M., Calussi M., Catarci M., Giordano M., Materazzo M., Milone M., Pellicciaro M., Marino M. V., Moreno Villamizar M. D., Lolli M. G., Bellini M. I., Lemma M., Chiarello M. M., Montes-Manrique M., Rodriguez-Lopez M., Serradilla-Martin M., Peter M., Paniagua-Garcia-Senorans M., Rutegard M., Salo M., Silveri M., Veroux M., Nardi M., Rottoli M., Tolonen M., Pedraza Ciro M., Zuluaga M., Iacobone M., Montuori M., Ali M., Garcia Dominguez M., Paola M. M., Piccoli M., Campanelli M., De Rosa M., Manigrasso M., Maruccia M., Torre M., Zuolo M., Pera M., Weerasekera M., Prieto M., Thway M. M., Shaat M., Azfar M., Shalaby M., Raza M. A., Younis M. U., Elhadi M., AlThomali M., Al Amri N., Dudi-Venkata N., Alselaim N., Smart N., Trelles N., Falco N., Petrucciani N., Antonacci N., Cillara N., Gica N., Pecorelli N., Tamini N., Machairas N., Feituri N., Ortega Torrecilla N., Avila Mercado O., AlAamer O., Irkorucu O., Alsherif O., Buonomo O. C., Valles-Guerra O., Ioannidis O., Hernandez Palmas O. I., Sanz Guadarrama O., Bozbiyik O., Rodrigues P., Milito P., Panaccio P., Dorovinis P., Prieto P., Baroffio P., Marsanic P., Ajawin P., Koh P. S., Anoldo P., Major P., Alharthi Q., Lui R., Caruso R., Brady R., Rattan R., Singhal R., Angelico R., Isernia R. M., Tutino R., Peltrini R., Tejos R., Fajardo R., Elia R., Morales-Conde S., Benli S., Fuentes S., de las Casas S. G., de Guzman Aragon S. O., Vertaldi S., Awad S., Gentilli S., Weckmann Lujan S. A., Tayar S., Althobaiti S., Di Giovanni S., Ghedan S., Perez-Bertolez S., Chiappetta S., Delis S., Scaringi S., Cetinkunar S., Kykalos S., Muhammad Ali S., Krivan S., Fung T. L. D., Delko T., Nicolas Lopez T., De Campos T., Calderon Duque T., Perra T., Liakakos T., Daskalakis T., Koeter T., Zalla T., Gonzalez T. E., Campagnaro T., Oumar T. A., Grossi U., Sosa V., Testa V., Tomajer V., Andriola V., Tonini V., Celentano V., Voglino V., Katta V. R., Garcia Orozco V. H., Turrado-Rodriguez V., Visag-Castillo V., Graham V., Rachkov V., Papagni V., Vigorita V., Jimenez Carneros V., Bellato V., Bechstein W., Altinel Y., Balciscueta Z., Pata F., Pata, F, Di Martino, M, Podda, M, Di Saverio, S, Ielpo, B, Pellino, G, Julio, A, Alshamrani, A, Alturkistani, A, Alghamdi, A, Almalki, A, Orengia, A, Kuvvetli, A, Pisanu, A, Smith, A, Trevino Figueroa, A, Nacion, A, Alhazmi, A, Bouhuwaish, A, Khalid, A, Alsufyani, A, Rubio, A, Bavikatte, A, Kumar, A, Jamiri, A, de San Ildefonso Pereira, A, Porcu, A, Sartori, A, Rocca, A, Sretenovic, A, Anselmo, A, De Luca, A, Charalabopoulos, A, Tzivanakis, A, Bandin, A, Najar, A, Frontali, A, Faisal, A, Roldan, A, Hamid, A, Andre, A, Minaya-Bravo, A, Das, A, Bondurri, A, Costanzi, A, Lucchi, A, Mihailescu, A, Police, A, Zuchini, A, Romano, A, Iossa, A, Chessa, A, Tromba, A, Castaldi, A, Brillantino, A, Ferronetti, A, Giuliani, A, Ramos-De la Medina, A, Tarasconi, A, Picciariello, A, Ioannidis, A, Leppaniemi, A, Rashid, A, Mitul, A, Mehraj, A, Laharwal, A, Iqbal, A, Liarakos, A, Marinis, A, de Andres-Asenjo, B, Matias-Garcia, B, De Simone, B, Creavin, B, Stubbs, B, Goh, B, Jovanovic, B, Sensi, B, Gazia, C, Cerdan, C, Diaz, C, Chacon, C, Yanez, C, Faro, C, Reinke, C, Dominguez, C, Paranjape, C, Thomas, C, Fung, C, De Lucia, C, Jennifer, C, Ovalle-Chao, C, Guerci, C, Kenington, C, Gica, C, Folliero, C, Varela, C, Popowich, D, Delogu, D, Zigiotto, D, Vinci, D, D'Antonio, D, Merlini, D, Moro-Valdezate, D, Keller, D, Nicolaescu, D, Sasia, D, Rodas, E, Linardoutsos, D, Russello, D, Najar-Castaneda, P, Stavrou, H, Rosso, E, Saladino, E, Ricciardi, E, Smith-Singares, E, Baili, E, Douka, E, Guaitoli, E, Francone, E, Vaterlini, E, Pierobon, E, Morales, E, Ros, E, Benzoni, E, Erdas, E, Pinotti, E, Colas-Ruiz, E, Laterza, E, Foianini, E, Cardamone, E, Licardie, E, Marino, F, Alsofyani, F, Qahtani, F, Khan, F, Maraska, F, Saliu, F, Madrid, F, Rosa, F, Luvisetto, F, Alconchel, F, Pareja-Ciuro, F, Neves, F, Agresta, F, Cordera, F, Pardo, F, Mendoza-Moreno, F, Munoz-Flores, F, Silvestri, F, Tropeano, F, Pecchini, F, Serio, F, Colombo, F, Di Marzo, F, Ferrara, F, Lancellotti, F, Litta, F, Martini, F, Roscio, F, Blanco-Antona, F, Barcenas, F, Schlottmann, F, Herrera-Almario, G, van Ramshorst, G, Gallo, G, Luglio, G, Kampouroglou, G, Papadopoulos, G, Arredondo, G, Calini, G, Formisano, G, Galiffa, G, Palini, G, Colucci, G, Pagano, G, Vanni, G, Pattacini, G, Gravante, G, Lisi, G, Bellanova, G, De Nobili, G, Necchi, G, Sinibaldi, G, Bacchiocchi, G, Bagaglini, G, Maggi, G, Izzo, G, Argenio, G, Brisinda, G, Esposito, G, Frazzetta, G, De Luca, G, Nigri, G, Sica, G, Martin-Martin, G, Ugon, G, Martinez-Mier, G, Machain Vega, G, Nari, G, Nikaj, H, Neri, I, San Roman, I, Fidoshev, I, Martinez, I, Negoi, I, Ortega, I, Vicente Rodriguez, I, Cornejo, I, Mora-Guzman, I, al-Najami, I, Romic, I, Balciscueta, I, Olivier, J, Lammel-Lindemann, J, Dziakova, J, Salinas, J, Jovanovic, J, Reyes, J, Salas, J, Diaz-Elizondo, J, Parreira, J, Bellido, J, Salamea, J, Martin del Olmo, J, Ordonez, J, Junaid, S, Davies, J, Sahnan, K, Bekele, K, Voon, K, Siragusa, L, Petagna, L, Ferrario, L, Giordano, L, Nespoli, L, Pio, L, Moletta, L, Curella, L, Taglietti, L, Bonavina, L, Conti, L, Perez-Sanchez, L, Cabrera Vargas, L, Sanchez-Guillen, L, Tallon-Aguilar, L, Khan, M, Spampinato, M, Viola, M, Malet, M, Angrisani, M, Calussi, M, Catarci, M, Giordano, M, Materazzo, M, Milone, M, Pellicciaro, M, Marino, M, Moreno Villamizar, M, Lolli, M, Bellini, M, Lemma, M, Chiarello, M, Montes-Manrique, M, Rodriguez-Lopez, M, Serradilla-Martin, M, Peter, M, Paniagua-Garcia-Senorans, M, Rutegard, M, Salo, M, Silveri, M, Veroux, M, Nardi, M, Rottoli, M, Tolonen, M, Pedraza Ciro, M, Zuluaga, M, Iacobone, M, Montuori, M, Ali, M, Garcia Dominguez, M, Paola, M, Piccoli, M, Campanelli, M, De Rosa, M, Manigrasso, M, Maruccia, M, Torre, M, Zuolo, M, Pera, M, Weerasekera, M, Prieto, M, Thway, M, Shaat, M, Azfar, M, Shalaby, M, Raza, M, Younis, M, Elhadi, M, Althomali, M, Al Amri, N, Dudi-Venkata, N, Alselaim, N, Smart, N, Trelles, N, Falco, N, Petrucciani, N, Antonacci, N, Cillara, N, Gica, N, Pecorelli, N, Tamini, N, Machairas, N, Feituri, N, Ortega Torrecilla, N, Avila Mercado, O, Alaamer, O, Irkorucu, O, Alsherif, O, Buonomo, O, Valles-Guerra, O, Ioannidis, O, Hernandez Palmas, O, Sanz Guadarrama, O, Bozbiyik, O, Rodrigues, P, Milito, P, Panaccio, P, Dorovinis, P, Prieto, P, Baroffio, P, Marsanic, P, Ajawin, P, Koh, P, Anoldo, P, Major, P, Alharthi, Q, Lui, R, Caruso, R, Brady, R, Rattan, R, Singhal, R, Angelico, R, Isernia, R, Tutino, R, Peltrini, R, Tejos, R, Fajardo, R, Elia, R, Morales-Conde, S, Benli, S, Fuentes, S, de las Casas, S, de Guzman Aragon, S, Vertaldi, S, Awad, S, Gentilli, S, Weckmann Lujan, S, Tayar, S, Althobaiti, S, Di Giovanni, S, Ghedan, S, Perez-Bertolez, S, Chiappetta, S, Delis, S, Scaringi, S, Cetinkunar, S, Kykalos, S, Muhammad Ali, S, Krivan, S, Fung, T, Delko, T, Nicolas Lopez, T, De Campos, T, Calderon Duque, T, Perra, T, Liakakos, T, Daskalakis, T, Koeter, T, Zalla, T, Gonzalez, T, Campagnaro, T, Oumar, T, Grossi, U, Sosa, V, Testa, V, Tomajer, V, Andriola, V, Tonini, V, Celentano, V, Voglino, V, Katta, V, Garcia Orozco, V, Turrado-Rodriguez, V, Visag-Castillo, V, Graham, V, Rachkov, V, Papagni, V, Vigorita, V, Jimenez Carneros, V, Bellato, V, Bechstein, W, Altinel, Y, Balciscueta, Z, Pata F., Di Martino M., Podda M., Di Saverio S., Ielpo B., Pellino G., Julio A., Alshamrani A., Alturkistani A., Alghamdi A., Almalki A., Orengia A., Kuvvetli A., Pisanu A., Smith A., Trevino Figueroa A. M., Nacion A. J., Alhazmi A., Bouhuwaish A., Khalid A., Alsufyani A., Rubio A. V., Bavikatte A., Kumar A., Jamiri A. -R., de San Ildefonso Pereira A., Porcu A., Sartori A., Rocca A., Sretenovic A., Anselmo A., De Luca A., Charalabopoulos A., Tzivanakis A., Bandin A., Najar A., Frontali A., Faisal A., Roldan A. M., Hamid A., Andre A., Minaya-Bravo A., Das A., Bondurri A., Costanzi A., Lucchi A., Mihailescu A., Police A., Zuchini A. M., Romano A., Iossa A., Chessa A., Tromba A., Castaldi A., Brillantino A., Ferronetti A., Giuliani A., Ramos-De la Medina A., Tarasconi A., Picciariello A., Ioannidis A., Leppaniemi A., Rashid A., Mitul A. R., Mehraj A., laharwal A., Iqbal A., Liarakos A., Marinis A., de Andres-Asenjo B., Matias-Garcia B., De Simone B., Creavin B., Stubbs B., Goh B., Jovanovic B., Sensi B., Gazia C., Cerdan C., Diaz C. J. G., Chacon C. P., Yanez C., Faro C. L., Reinke C., Dominguez C., Paranjape C., Thomas C., Fung C. C., De Lucia C., Jennifer C. H. F., Ovalle-Chao C., Guerci C., Kenington C., Gica C., Folliero C., Varela C., Popowich D., Delogu D., Zigiotto D., Vinci D., D'Antonio D., Merlini D. A., Merlini D., Moro-Valdezate D., Keller D., Nicolaescu D. C., Sasia D., Rodas E., Linardoutsos D., Russello D., Najar-Castaneda P. A., Stavrou H. G., Rosso E., Saladino E., Ricciardi E., Smith-Singares E., Baili E., Douka E., Guaitoli E., Francone E., Vaterlini E. M., Pierobon E. S., Morales E., Ros E. P., Benzoni E., Erdas E., Pinotti E., Colas-Ruiz E., Laterza E., Foianini E., Cardamone E., Licardie E., Marino F., Alsofyani F., Qahtani F., Khan F., Maraska F., Saliu F., Madrid F., Rosa F., Luvisetto F., Alconchel F., Pareja-Ciuro F., Neves F., Agresta F., Cordera F., Pardo F., Mendoza-Moreno F., Munoz-Flores F., Silvestri F. M., Tropeano F. P., Pecchini F., Serio F., Colombo F., Di Marzo F., Ferrara F., Lancellotti F., Litta F., Martini F., Roscio F., Blanco-Antona F., Barcenas F. J. Q., Schlottmann F., Herrera-Almario G., van Ramshorst G., Gallo G., Luglio G., Kampouroglou G., Papadopoulos G., Arredondo G., Calini G., Formisano G., Galiffa G., Palini G. M., Colucci G., Pagano G., Vanni G., Pattacini G. C., Gravante G., Lisi G., Bellanova G., De Nobili G., Necchi G. S., Sinibaldi G., Bacchiocchi G., Bagaglini G., Maggi G., Izzo G., Argenio G., Brisinda G., Esposito G., Frazzetta G., De Luca G. M., Nigri G., Sica G., Martin-Martin G., Ugon G. A., Martinez-Mier G., Machain Vega G. M., Nari G., Nikaj H., Neri I., San Roman I. A., Fidoshev I., Martinez I., Negoi I., Ortega I., Vicente Rodriguez I., Cornejo I., Mora-Guzman I., al-Najami I., Romic I., Balciscueta I., Olivier J., Lammel-Lindemann J., Dziakova J., Salinas J., Jovanovic J. P., Reyes J. A. S., Salas J., Diaz-Elizondo J. A., Parreira J. G., Bellido J., Salamea J., Martin del Olmo J. C., Ordonez J. M., Junaid S., Davies J., Sahnan K., Bekele K., Voon K., Siragusa L., Petagna L., Ferrario L., Giordano L., Nespoli L., Pio L., Moletta L., Curella L., Taglietti L., Bonavina L., Conti L., Perez-Sanchez L. E., Cabrera Vargas L. F., Sanchez-Guillen L., Tallon-Aguilar L., Khan M., Spampinato M. G., Viola M., Malet M. V., Angrisani M., Calussi M., Catarci M., Giordano M., Materazzo M., Milone M., Pellicciaro M., Marino M. V., Moreno Villamizar M. D., Lolli M. G., Bellini M. I., Lemma M., Chiarello M. M., Montes-Manrique M., Rodriguez-Lopez M., Serradilla-Martin M., Peter M., Paniagua-Garcia-Senorans M., Rutegard M., Salo M., Silveri M., Veroux M., Nardi M., Rottoli M., Tolonen M., Pedraza Ciro M., Zuluaga M., Iacobone M., Montuori M., Ali M., Garcia Dominguez M., Paola M. M., Piccoli M., Campanelli M., De Rosa M., Manigrasso M., Maruccia M., Torre M., Zuolo M., Pera M., Weerasekera M., Prieto M., Thway M. M., Shaat M., Azfar M., Shalaby M., Raza M. A., Younis M. U., Elhadi M., AlThomali M., Al Amri N., Dudi-Venkata N., Alselaim N., Smart N., Trelles N., Falco N., Petrucciani N., Antonacci N., Cillara N., Gica N., Pecorelli N., Tamini N., Machairas N., Feituri N., Ortega Torrecilla N., Avila Mercado O., AlAamer O., Irkorucu O., Alsherif O., Buonomo O. C., Valles-Guerra O., Ioannidis O., Hernandez Palmas O. I., Sanz Guadarrama O., Bozbiyik O., Rodrigues P., Milito P., Panaccio P., Dorovinis P., Prieto P., Baroffio P., Marsanic P., Ajawin P., Koh P. S., Anoldo P., Major P., Alharthi Q., Lui R., Caruso R., Brady R., Rattan R., Singhal R., Angelico R., Isernia R. M., Tutino R., Peltrini R., Tejos R., Fajardo R., Elia R., Morales-Conde S., Benli S., Fuentes S., de las Casas S. G., de Guzman Aragon S. O., Vertaldi S., Awad S., Gentilli S., Weckmann Lujan S. A., Tayar S., Althobaiti S., Di Giovanni S., Ghedan S., Perez-Bertolez S., Chiappetta S., Delis S., Scaringi S., Cetinkunar S., Kykalos S., Muhammad Ali S., Krivan S., Fung T. L. D., Delko T., Nicolas Lopez T., De Campos T., Calderon Duque T., Perra T., Liakakos T., Daskalakis T., Koeter T., Zalla T., Gonzalez T. E., Campagnaro T., Oumar T. A., Grossi U., Sosa V., Testa V., Tomajer V., Andriola V., Tonini V., Celentano V., Voglino V., Katta V. R., Garcia Orozco V. H., Turrado-Rodriguez V., Visag-Castillo V., Graham V., Rachkov V., Papagni V., Vigorita V., Jimenez Carneros V., Bellato V., Bechstein W., Altinel Y., and Balciscueta Z.

Abstract

In the original online version of this article Oreste Claudio Buonomo’s family name was misspelled. The original article was corrected.

Published
2022

10. Ayurvedic herbal extracts suppress Candidal biofilms in vitro.

Author

Wijesinghe, G. K., Jayarathna, T. A., Dilhari, K. A. A., Gunasekara, C., Fernando, N., Kottegoda, N., Samaranayake, L. P., and Weerasekera, M. M.

Subjects
PLANT extracts, AYURVEDIC medicine, INHIBITORY Concentration 50, SCANNING electron microscopy, CANDIDA, BIOFILMS
Abstract

Plant derivatives have been used for centuries to treat various health disorders of the human including microbial infections. A vast majority of these infections are initiated and perpetuated by biofilms. This study investigated the biofilm suppressant effect of phytomedicinal preparations used widely in traditional Ayurvedic medicine. Triphala, a mixture of Terminalia bellirica, Terminalia chebula and Emblica officinalis and Mimusops elengi bark extract. Inhibitory effect of extracts was first investigated against the planktonic C. albicans and C. tropicalis using well diffusion method. Minimum biofilm inhibitory concentration for in-vitro biofilms was determined by MTT assay. The biofilm suppressant effect was determined by measuring biofilm viability at different time intervals, post-exposure to the two herbal extracts, using MTT. Scanning electron microscopy was performed to assess the post-exposure biofilm architecture. Triphala inhibited both species of the planktonic yeasts and only the biofilm phase of C. tropicalis. Further, biofilm inhibition was seen in the co-cultured mixed species C. albicans and C. tropicalis biofilms with Triphala treatment. Triphala did not have any inhibitory effect on C. albicans. M. elengi had no inhibitory effect on biofilms of either Candida species. Scanning electron microscopy (SEM) revealed increased cell density of C. albicans in the biofilm. However, Triphala treatment had an inhibitory effect against C. tropicalis biofilms. SEM imaging revealed altered cell morphology of C. tropicalis cells in the biofilm after exposure to Triphala. In conclusion Triphala, but not M. elengi, extracts exhibit selective and differential biofilm inhibitory activity against Candida species. C. albicans biofilms are more resistant to the anti-biofilm activity of Triphala. [ABSTRACT FROM AUTHOR]

Published
2022
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11. Screening and quantitative analysis of antibiotic resistance genes in hospital and aquaculture effluent in Sri Lanka as an emerging environmental contaminant.

Author

Liyanage, G. Y., Weerasekera, M. M., and Manage, P. M.

Subjects
DRUG resistance in bacteria, POINT sources (Pollution), ANTIBIOTIC residues, AQUACULTURE, GENES, QUANTITATIVE research
Abstract

Hospital and aquaculture wastewaters play an important role in the evolution and spread of antibiotic resistance genes. In the present study, nine Antibiotic Resistance Genes (ARGs) were screened, which belong to two common groups of antibiotics: penicillin -- OPR D, bla TEM, bla OXA, amp a, and amp b, and tetracycline -- tet A, tet M, tet B, and tet S. The highest number of positive hospital wastewater sample locations were for bla TEM (51%) gene, followed in descending order by amp a (15%), bla OXA (14%), OPR D (5%) and amp b (1%). The highest number of positive sample locations for tet (M) genes was detected in aquaculture sampling sites (82%), followed by tet (A), tet (S), and tet (B) were 53%, 35%, and 18% respectively. A significant positive correlation (p = 0.001) between the concentrations of penicillin (0.001-0.006 µg/mL) and bla TEM gene (7.56 x 105-9.8 x 105 copies/mL) was found. The average concentrations of the OPR D and amp a was in the range 1.2 x 10²-1.56 x 10² copies/ mL, 1.2 x 105-6.56 x 105 copies/mL in hospital wastewater, whereas tet M and tet A in aquaculture effluent water was in the range 1.1 x 105-9.23 x 105 copies/mL and 1.3 x 104-4.56 x 104 copies/mL, respectively. The penicillin group (AMX, AMP, CLOX) in hospital wastewater effluent and tetracycline (TET, OTC) in aquaculture wastewater effluent were found to be important point sources of antibiotic pollution in their respective environments. [ABSTRACT FROM AUTHOR]

Published
2022
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27. Determination of Antimicrobial Potential of Five Herbs used in Ayurveda Practices against Candida albicans, Candida parapsilosis and Methicillin Resistant Staphylococcus aureus.

Author

Gunasekara, T. D. C. P., Radhika, N. D. M., Ragunathan, K. K., Gunathilaka, D. P. P., Weerasekera, M. M., Hewageegana, H. G. S. P., Arawwawala, L. A. D. M., and Fernando, S. S. N.

Subjects
ANTI-infective agents, AYURVEDIC medicine, TRADITIONAL medicine, CANDIDA albicans, METHICILLIN-resistant staphylococcus aureus
Abstract

Background: Medicinal plants are an important source of novel antimicrobial agents. Ayurvedic treatment involves the use of a variety of medicinal plants that merit investigation. Aims: To investigate the antimicrobial activity of bark of Pongamia pinnata (L.) Pierre, stem of Rubia cordifolia Linn, leaves of Jasminum officinale Linn, stem of Berberis ceylanica C.K. Schneid. and fruit of Garcina zeylanica Roxb. Subjects and Methods: Aqueous and ethanolic extracts of dried bark of Pongamia pinnata (Magul karanda), dried stem of Rubia cordifolia Linn (Welmadata), tender leaves of Jasminum officinale Linn (Jasmine) and dried stem of Berberis ceylanica (Dāruharidrā) were prepared according to standard protocols and tested for antimicrobial activity against five clinical isolates and one standard strain each of Candida albicans (ATCC 10231), Candida parapsilosis (ATCC 22019) and six Methicillin Resistant Staphylococcus aureus (MRSA) clinical isolates using the well diffusion method. Experiments were done in triplicates using well diffusion method. The plant extracts which gave a zone of inhibition in the well diffusion assay were further tested for Minimum Inhibitory Concentrations (MIC). Results: Aqueous and ethanolic extracts of Berberis ceylanica and ethanolic extract of Rubia cordifolia had antimicrobial activity against Candida albicans and Candida parapsilosis. Aqueous and ethanolic extracts of Garcinia zeylanica, and the ethanolic extracts of Jasminum officinale, Rubia cordifolia and Pongamia pinnata had antimicrobial activity against MRSA. Conclusions: Berberis ceylanica and Rubia crodifolia had antimicrobial activity against Candida species while Garcinia zeylanica, Jasminum officinale, Rubia crodifolia and Pongamia pinnata had antimicrobial activity against MRSA. [ABSTRACT FROM AUTHOR]

Published
2017
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32. Proportion of lower limb fungal foot infections in patients with type 2 diabetes at a tertiary care hospital in Sri Lanka.

Author

Wijesuriya, T. M., Weerasekera, M. M., Kottahachchi, J., Ranasinghe, K. N. P., Dissanayake, M. S. S., Prathapan, S., Gunasekara, T. D. C. P., Nagahawatte, A., Guruge, L. D., Bulugahapitiya, U., and Fernando, S. S. N.

Subjects
*MYCOSES, *PEOPLE with diabetes, *FOOT diseases, *FOOT infections, *ASPERGILLUS niger
Abstract

Background: Superficial fungal foot infection (SFFI) in diabetic patients increases the risk of developing diabetic foot syndrome. Sixteen percent of urban population is suffering from diabetes in Sri Lanka. As the diabetes patients are more prone to get fungal foot infections, early intervention is advisable owing to the progressive nature of the infection. There is no data on the prevalence of SFFIs in diabetic patients in Sri Lanka. Objective: To determine the etiological agents causing SFFI in patients with type 2 diabetes. Materials and Methods: Three hundred eighty five diabetic patients were included. Nail clippings and swabs were collected from the infected sites using the standard protocol. Laboratory identification was done and pathogens were identified to the species level by morphophysiological methods. Results: Clinically 295 patients showed SFFI, of which 255 (86%) were mycologically confirmed for infection. Out of 236 direct microscopy (KOH) positives, 227 (96%) were culture positive. Two hundred and fifty one patients (98%) with SFFI had diabetes for more than 10 years. Of the patients with SFFIs 92% had >100 mg/dl FBS and 81% had >140 mg/dl PPBS levels and 80% had both elevated FBS and PPBS. Non-dermatophyte fungal species were the commonest pathogens followed by yeast and dermatophytes. Conclusion: Aspergillus niger was the commonest pathogen followed by Candida albicans. SFFIs were seen significantly with the increasing age, gender, duration of diabetes and with less controlled glycaemic level. [ABSTRACT FROM AUTHOR]

Published
2014
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33. Synthesis and structural characterization of copper nanoparticles doped activated carbon derived from coconut coir for drinking water purification

Author

Madhusha, C., Jayasundara, T., Munaweera, I., Perera, C., Wijesinghe, G., Weerasekera, M., Sandaruwan, C., Meiyazhagan, A., Robles Hernandez, F.C., Ajayan, P.M., and Kottegoda, N.

Abstract

Modifying and functionalizing activated carbon using metal nanoparticles have received great scientific attention in recent decades as a method to improve its inherent properties. The synergistic effects between the dopant and the activated carbon could lead to advanced properties in the hybrid material compared to individual counterparts. In this study, copper-doped activated carbon from coconut coir (Cu-ACC) is synthesized by an in-situreduction method. The successful doping of zerovalent copper nanoparticles (Cu np) into the activated carbon matrix was confirmed using several characterization techniques. Peaks related to zerovalent Cu np in the X-ray diffractogram confirmed the successful formation of zerovalent Cu np. The dopant-matrix interactions were confirmed through peak shifts in the Fourier Transform Infrared Spectroscopy and D and G band changes in the Raman spectrum of Cu-ACC. The Cu 2p band in XPS of the Cu-ACC showed a sharp doublet at 932.7 eV, confirming the presence of metallic Cu. As indicated in the TEM/SEM images, Cu np demonstrated a spherical morphology with an average diameter of 5 nm. It was further observed that the Cu-ACC nanohybrid material could remove fluoride (63%) and hardness (69%) in synthetic water. Cu-ACC further demonstrates an enhanced antimicrobial activity against three commonly found water pathogens; E. coli, S. typhi, and S. flexneri.The material is expected to be used in next-generation domestic water filters formulated as single-use sachet bags.

Published
2022
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34. Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study

Author

Pata, Francesco, Di Martino, Marcello, Podda, Mauro, Di Saverio, Salomone, Ielpo, Benedetto, Pellino, Gianluca, Julio, Abba, Alshamrani, Abdullah, Alturkistani, Abdullah, Alghamdi, Abdulrahman, Almalki, Abdulrahman, Orengia, Adam, Kuvvetli, Adnan, Pisanu, Adolfo, Smith, Adrian, Treviño Figueroa, Adriana Michelle, Nacion, Aeris Jane, Alhazmi, Ahmad, Bouhuwaish, Ahmad, Khalid, Ahmad, Alsufyani, Ahmed, Rubio, Ainhoa Valle, Bavikatte, Akshay, Kumar, Akshay, Jamiri, Al-Radjid, de San Ildefonso Pereira, Alberto, Porcu, Alberto, Sartori, Alberto, Rocca, Aldo, Sretenovic, Aleksandar, Anselmo, Alessandro, De Luca, Alessandro, Charalabopoulos, Alexandros, Tzivanakis, Alexios, Bandin, Alfonso, Nájar, Alfonso, Frontali, Alice, Faisal, Alsulaimani, Roldan, Amaia Martínez, Hamid, Amal, André, Ana, Minaya-Bravo, Ana, Das, Andre, Bondurri, Andrea, Costanzi, Andrea, Lucchi, Andrea, Mihailescu, Andrei, Police, Andrea, Zuchini, Andres Mendoza, Romano, Angela, Iossa, Angelo, Chessa, Antonella, Tromba, Antonella, Castaldi, Antonio, Brillantino, Antonio, Ferronetti, Antonio, Giuliani, Antonio, Ramos-De la Medina, Antonio, Tarasconi, Antonio, Picciariello, Arcangelo, Ioannidis, Argyrios, Leppäniemi, Ari, Rashid, Arshad, Mitul, Ashrarur Rahman, Mehraj, Asif, Laharwal, Asim, Iqbal, Atif, Liarakos, Athanasios, Marinis, Athanasios, de Andrés-Asenjo, Beatriz, Matías-García, Belén, De Simone, Belinda, Creavin, Ben, Stubbs, Ben, Goh, Brian, Jovanovic, Branislav, Sensi, Bruno, Gazia, Carlo, Cerdán, Carlos, Díaz, Carlos Javier Gómez, Chacón, Carlos Petrola, Yánez, Carlos, Faro, Carmelo Lo, Reinke, Caroline, Dominguez, Casandra, Paranjape, Charudutt, Thomas, Charlotte, Fung, Chia Chi, De Lucia, Chiara, Jennifer, Chiu Hiu Fung, Ovalle-Chao, Christian, Guerci, Claudio, Kenington, Cleo, Gica, Corina, Folliero, Cristina, Varela, Cristopher, Popowich, Daniel, Delogu, Daniele, Zigiotto, Daniele, Vinci, Danilo, D’Antonio, Dario, Merlini, David Alessio, Merlini, David, Moro-Valdezate, David, Keller, Deborah, Nicolaescu, Diana Cristiana, Sasia, Diego, Rodas, Edgar, Linardoutsos, Dimitrios, Russello, Domenico, Nájar-Castañeda, Pedro Alfonso, Stavrou, Habil Gregor, Rosso, Edoardo, Saladino, Edoardo, Ricciardi, Edoardo, Smith-Singares, Eduardo, Baili, Efstratia, Douka, Eleftheria, Guaitoli, Eleonora, Francone, Elisa, Vaterlini, Elisa Maria, Pierobon, Elisa Sefora, Morales, Emilio, Ros, Emilio Peña, Benzoni, Enrico, Erdas, Enrico, Pinotti, Enrico, Colás-Ruiz, Enrique, Laterza, Ernesto, Foianini, Esteban, Cardamone, Eugenia, Licardie, Eugenio, Marino, Fabio, Alsofyani, Fahad, Qahtani, Fahad, Khan, Farhan, Maraska, Fatlum, Saliu, Fatmir, Madrid, Fausto, Rosa, Fausto, Luvisetto, Federico, Alconchel, Felipe, Pareja-Ciuro, Felipe, Neves, Fernanda, Agresta, Ferdinando, Cordera, Fernando, Pardo, Fernando, Mendoza-Moreno, Fernando, Munoz-Flores, Fernando, Silvestri, Francesca Maria, Tropeano, Francesca Paola, Pecchini, Francesca, Serio, Francesca, Colombo, Francesco, Di Marzo, Francesco, Ferrara, Francesco, Lancellotti, Francesco, Litta, Francesco, Martini, Francesco, Roscio, Francesco, Blanco-Antona, Francisco, Barcenas, Francisco Javier Quezada, Schlottmann, Francisco, Herrera-Almario, Gabriel, van Ramshorst, Gabrielle, Gallo, Gaetano, Luglio, Gaetano, Kampouroglou, Georgios, Papadopoulos, Georgios, Arredondo, Gerardo, Calini, Giacomo, Formisano, Giampaolo, Galiffa, Giampaolo, Palini, Gian Marco, Colucci, Gianluca, Pagano, Gianluca, Vanni, Gianluca, Pattacini, Gianmaria Casoni, Gravante, Gianpiero, Lisi, Giorgio, Bellanova, Giovanni, De Nobili, Giovanni, Necchi, Giovanni Sammy, Sinibaldi, Giovanni, Bacchiocchi, Giulia, Bagaglini, Giulia, Maggi, Giulia, Izzo, Giuliano, Argenio, Giulio, Brisinda, Giuseppe, Esposito, Giuseppe, Frazzetta, Giuseppe, De Luca, Giuseppe Massimiliano, Nigri, Giuseppe, Sica, Giuseppe, Martin-Martin, Gonzalo, Ugon, Gustavo Armand, Martinez-Mier, Gustavo, Machain Vega, Gustavo Miguel, Nari, Gustavo, Nikaj, Herald, Neri, Ignacio, San Roman, Igor Alberdi, Fidoshev, Iliya, Martínez, Iñaki, Negoi, Ionut, Ortega, Irene, Vicente Rodríguez, Irune, Cornejo, Isabel, Mora-Guzmán, Ismael, al-Najami, Issam, Romic, Ivan, Balciscueta, Izaskun, Olivier, James, Lammel-Lindemann, Jan, Dziakova, Jana, Salinas, Javier, Jovanovic, Jelena Pejanovic, Reyes, Jeryl Anne Silvia, Salas, Joanne, Diaz-Elizondo, Jose Antonio, Parreira, Jose Gustavo, Bellido, Juan, Salamea, Juan, Martín del Olmo, Juan Carlos, Ordoñez, Juliana María, Junaid, Sofi, Davies, Justin, Sahnan, Kapil, Bekele, Kebebe, Voon, Kelvin, Siragusa, Leandro, Petagna, Lorenzo, Ferrario, Luca, Giordano, Luca, Nespoli, Luca, Pio, Luca, Moletta, Lucia, Curella, Luciano, Taglietti, Lucio, Bonavina, Luigi, Conti, Luigi, Pérez-Sánchez, Luis Eduardo, Cabrera Vargas, Luis Felipe, Sánchez-Guillén, Luis, Tallon-Aguilar, Luis, Khan, Mansoor, Spampinato, Marcello Giuseppe, Viola, Marcelo, Malet, Marcelo Viola, Angrisani, Marco, Calussi, Marco, Catarci, Marco, Giordano, Marco, Materazzo, Marco, Milone, Marco, Pellicciaro, Marco, Marino, Marco Vito, Moreno Villamizar, María Daniela, Lolli, Maria Giulia, Bellini, Maria Irene, Lemma, Maria, Chiarello, Maria Michela, Montes-Manrique, Mario, Rodriguez-Lopez, Mario, Serradilla-Martín, Mario, Peter, Mark, Paniagua-García-Señoráns, Marta, Rutegård, Martin, Salö, Martin, Silveri, Massimiliano, Veroux, Massimiliano, Nardi, Matteo, Rottoli, Matteo, Tolonen, Matti, Pedraza Ciro, Mauricio, Zuluaga, Mauricio, Iacobone, Maurizio, Montuori, Mauro, Ali, Mazin, García Domínguez, Melody, Paola, Menna Maria, Piccoli, Micaela, Campanelli, Michela, De Rosa, Michele, Manigrasso, Michele, Maruccia, Michele, Torre, Michele, Zuolo, Michele, Pera, Miguel, Weerasekera, Mihiri, Prieto, Mikel, Thway, Min Myat, Shaat, Mohamed, Azfar, Mohammad, Shalaby, Mostafa, Raza, Muhammad Asif, Younis, Muhammad Umar, Elhadi, Muhammed, Ali, Mujahid, Althomali, Musab, Al Amri, Nadiah, Dudi-Venkata, Nagendra, Alselaim, Nahar, Smart, Neil, Trelles, Nelson, Falco, Nicolò, Petrucciani, Niccolo, Antonacci, Nicola, Cillara, Nicola, Gica, Nicolae, Pecorelli, Nicolò, Tamini, Nicolò, Machairas, Nikolaos, Feituri, Nura, Ortega Torrecilla, Nuria, Avila Mercado, Octavio, Alaamer, Ohood, Irkorucu, Oktay, Alsherif, Omar, Buonomi, Oreste Claudio, Valles-Guerra, Orestes, Ioannidis, Orestis, Hernández Palmas, Oscar Isaac, Sanz Guadarrama, Oscar, Bozbiyik, Osman, Rodrigues, Pablo, Milito, Pamela, Panaccio, Paolo, Dorovinis, Panagiotis, Prieto, Paola, Baroffio, Paolo, Marsanic, Patrizia, Ajawin, Pawel, Koh, Peng Soon, Anoldo, Pietro, Major, Piotr, Alharthi, Qasem, Lui, Rashid, Caruso, Riccardo, Brady, Richard, Rattan, Rishi, Singhal, Rishi, Angelico, Roberta, Isernia, Roberta Maria, Tutino, Roberta, Peltrini, Roberto, Tejos, Rodrigo, Fajardo, Roosevelt, Elia, Rossella, Morales-Conde, Salvador, Benli, Sami, Fuentes, Sara, de las Casas, Sara Gortázar, de Guzmán Aragón, Sara Ortiz, Vertaldi, Sara, Awad, Selmy, Gentilli, Sergio, Weckmann Lujan, Sergio Alberto, Tayar, Serkan, Althobaiti, Shabab, Di Giovanni, Silvia, Ghedan, Soliman, Pérez-Bertólez, Sonia, Chiappetta, Sonja, Delis, Spiros, Scaringi, Stefano, Çetinkünar, Süleyman, Kykalos, Stylianos, Muhammad Ali, Syed, Krivan, Sylvia, Fung, Tak Lit Derek, Delko, Tarik, Nicolás López, Tatiana, De Campos, Tercio, Calderón Duque, Teresa, Perra, Teresa, Liakakos, Theodore, Daskalakis, Theodoros, Koëter, Tijmen, Zalla, Tiku, González, Tomás Elosua, Campagnaro, Tommaso, Oumar, Toure Alpha, Grossi, Ugo, Sosa, Valentina, Testa, Valentina, Tomajer, Valentina, Andriola, Valeria, Tonini, Valeria, Celentano, Valerio, Voglino, Valerio, Katta, Venkateswara Rao, García Orozco, Víctor Hugo, Turrado-Rodriguez, Victor, Visag-Castillo, Victor, Graham, Victoria, Rachkov, Viktor, Papagni, Vincenzo, Vigorita, Vincenzo, Jiménez Carneros, Virginia, Bellato, Vittoria, Bechstein, Wolf, Altinel, Yuksel, Balciscueta, Zutoia, Pata, Francesco, Di Martino, Marcello, Podda, Mauro, Di Saverio, Salomone, Ielpo, Benedetto, Pellino, Gianluca, Luglio, Gaetano, Pata, F, Di Martino, M, Podda, M, Di Saverio, S, Ielpo, B, Pellino, G, Julio, A, Alshamrani, A, Alturkistani, A, Alghamdi, A, Almalki, A, Orengia, A, Kuvvetli, A, Pisanu, A, Smith, A, Trevino Figueroa, A, Nacion, A, Alhazmi, A, Bouhuwaish, A, Khalid, A, Alsufyani, A, Rubio, A, Bavikatte, A, Kumar, A, Jamiri, A, de San Ildefonso Pereira, A, Porcu, A, Sartori, A, Rocca, A, Sretenovic, A, Anselmo, A, De Luca, A, Charalabopoulos, A, Tzivanakis, A, Bandin, A, Najar, A, Frontali, A, Faisal, A, Roldan, A, Hamid, A, Andre, A, Minaya-Bravo, A, Das, A, Bondurri, A, Costanzi, A, Lucchi, A, Mihailescu, A, Police, A, Zuchini, A, Romano, A, Iossa, A, Chessa, A, Tromba, A, Castaldi, A, Brillantino, A, Ferronetti, A, Giuliani, A, Ramos-De la Medina, A, Tarasconi, A, Picciariello, A, Ioannidis, A, Leppaniemi, A, Rashid, A, Mitul, A, Mehraj, A, Laharwal, A, Iqbal, A, Liarakos, A, Marinis, A, de Andres-Asenjo, B, Matias-Garcia, B, De Simone, B, Creavin, B, Stubbs, B, Goh, B, Jovanovic, B, Sensi, B, Gazia, C, Cerdan, C, Diaz, C, Chacon, C, Yanez, C, Faro, C, Reinke, C, Dominguez, C, Paranjape, C, Thomas, C, Fung, C, De Lucia, C, Jennifer, C, Ovalle-Chao, C, Guerci, C, Kenington, C, Gica, C, Folliero, C, Varela, C, Popowich, D, Delogu, D, Zigiotto, D, Vinci, D, D'Antonio, D, Merlini, D, Moro-Valdezate, D, Keller, D, Nicolaescu, D, Sasia, D, Rodas, E, Linardoutsos, D, Russello, D, Najar-Castaneda, P, Stavrou, H, Rosso, E, Saladino, E, Ricciardi, E, Smith-Singares, E, Baili, E, Douka, E, Guaitoli, E, Francone, E, Vaterlini, E, Pierobon, E, Morales, E, Ros, E, Benzoni, E, Erdas, E, Pinotti, E, Colas-Ruiz, E, Laterza, E, Foianini, E, Cardamone, E, Licardie, E, Marino, F, Alsofyani, F, Qahtani, F, Khan, F, Maraska, F, Saliu, F, Madrid, F, Rosa, F, Luvisetto, F, Alconchel, F, Pareja-Ciuro, F, Neves, F, Agresta, F, Cordera, F, Pardo, F, Mendoza-Moreno, F, Munoz-Flores, F, Silvestri, F, Tropeano, F, Pecchini, F, Serio, F, Colombo, F, Di Marzo, F, Ferrara, F, Lancellotti, F, Litta, F, Martini, F, Roscio, F, Blanco-Antona, F, Barcenas, F, Schlottmann, F, Herrera-Almario, G, van Ramshorst, G, Gallo, G, Luglio, G, Kampouroglou, G, Papadopoulos, G, Arredondo, G, Calini, G, Formisano, G, Galiffa, G, Palini, G, Colucci, G, Pagano, G, Vanni, G, Pattacini, G, Gravante, G, Lisi, G, Bellanova, G, De Nobili, G, Necchi, G, Sinibaldi, G, Bacchiocchi, G, Bagaglini, G, Maggi, G, Izzo, G, Argenio, G, Brisinda, G, Esposito, G, Frazzetta, G, De Luca, G, Nigri, G, Sica, G, Martin-Martin, G, Ugon, G, Martinez-Mier, G, Machain Vega, G, Nari, G, Nikaj, H, Neri, I, San Roman, I, Fidoshev, I, Martinez, I, Negoi, I, Ortega, I, Vicente Rodriguez, I, Cornejo, I, Mora-Guzman, I, al-Najami, I, Romic, I, Balciscueta, I, Olivier, J, Lammel-Lindemann, J, Dziakova, J, Salinas, J, Jovanovic, J, Reyes, J, Salas, J, Diaz-Elizondo, J, Parreira, J, Bellido, J, Salamea, J, Martin del Olmo, J, Ordonez, J, Junaid, S, Davies, J, Sahnan, K, Bekele, K, Voon, K, Siragusa, L, Petagna, L, Ferrario, L, Giordano, L, Nespoli, L, Pio, L, Moletta, L, Curella, L, Taglietti, L, Bonavina, L, Conti, L, Perez-Sanchez, L, Cabrera Vargas, L, Sanchez-Guillen, L, Tallon-Aguilar, L, Khan, M, Spampinato, M, Viola, M, Malet, M, Angrisani, M, Calussi, M, Catarci, M, Giordano, M, Materazzo, M, Milone, M, Pellicciaro, M, Marino, M, Moreno Villamizar, M, Lolli, M, Bellini, M, Lemma, M, Chiarello, M, Montes-Manrique, M, Rodriguez-Lopez, M, Serradilla-Martin, M, Peter, M, Paniagua-Garcia-Senorans, M, Rutegard, M, Salo, M, Silveri, M, Veroux, M, Nardi, M, Rottoli, M, Tolonen, M, Pedraza Ciro, M, Zuluaga, M, Iacobone, M, Montuori, M, Ali, M, Garcia Dominguez, M, Paola, M, Piccoli, M, Campanelli, M, De Rosa, M, Manigrasso, M, Maruccia, M, Torre, M, Zuolo, M, Pera, M, Weerasekera, M, Prieto, M, Thway, M, Shaat, M, Azfar, M, Shalaby, M, Raza, M, Younis, M, Elhadi, M, Althomali, M, Al Amri, N, Dudi-Venkata, N, Alselaim, N, Smart, N, Trelles, N, Falco, N, Petrucciani, N, Antonacci, N, Cillara, N, Gica, N, Pecorelli, N, Tamini, N, Machairas, N, Feituri, N, Ortega Torrecilla, N, Avila Mercado, O, Alaamer, O, Irkorucu, O, Alsherif, O, Buonomi, O, Valles-Guerra, O, Ioannidis, O, Hernandez Palmas, O, Sanz Guadarrama, O, Bozbiyik, O, Rodrigues, P, Milito, P, Panaccio, P, Dorovinis, P, Prieto, P, Baroffio, P, Marsanic, P, Ajawin, P, Koh, P, Anoldo, P, Major, P, Alharthi, Q, Lui, R, Caruso, R, Brady, R, Rattan, R, Singhal, R, Angelico, R, Isernia, R, Tutino, R, Peltrini, R, Tejos, R, Fajardo, R, Elia, R, Morales-Conde, S, Benli, S, Fuentes, S, de las Casas, S, de Guzman Aragon, S, Vertaldi, S, Awad, S, Gentilli, S, Weckmann Lujan, S, Tayar, S, Althobaiti, S, Di Giovanni, S, Ghedan, S, Perez-Bertolez, S, Chiappetta, S, Delis, S, Scaringi, S, Cetinkunar, S, Kykalos, S, Muhammad Ali, S, Krivan, S, Fung, T, Delko, T, Nicolas Lopez, T, De Campos, T, Calderon Duque, T, Perra, T, Liakakos, T, Daskalakis, T, Koeter, T, Zalla, T, Gonzalez, T, Campagnaro, T, Oumar, T, Grossi, U, Sosa, V, Testa, V, Tomajer, V, Andriola, V, Tonini, V, Celentano, V, Voglino, V, Katta, V, Garcia Orozco, V, Turrado-Rodriguez, V, Visag-Castillo, V, Graham, V, Rachkov, V, Papagni, V, Vigorita, V, Jimenez Carneros, V, Bellato, V, Bechstein, W, Altinel, Y, Balciscueta, Z, Institut Català de la Salut, [Pata F] General Surgery Unit, UOC di Chirurgia, Nicola Giannettasio Hospital, CS, Italy. La Sapienza University, Rome, Italy. [Di Martino M] Division of Hepatobiliary and Liver Transplantation Surgery, A.O.R.N. Cardarelli, Naples, Italy. [Podda M] Department of Surgical Science, University of Cagliari, Cagliari, Italy. [Di Saverio S] Department of Surgery, Madonna del Soccorso General Hospital, San Benedetto del Tronto, Italy. [Ielpo B] Hepatobiliary division, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain. [Pellino G] Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania ‘‘Luigi Vanvitelli’’, Policlinico CS, Naples, Italy. Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], covid-19, surgery, coronavirus, sars-cov-2, appendicectomy, laparoscopy, nom, management, Enquestes, Apendicectomia, COVID-19 (Malaltia), surgery, Surgical Procedures, Operative::Digestive System Surgical Procedures::Appendectomy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Apendicitis, Pandèmia de COVID-19, 2020, Appendectomy, Humans, Appendiciti, Pandemics, Cirurgia, Pandemic, SARS-CoV-2, COVID-19, Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Digestive System Diseases::Gastrointestinal Diseases::Appendicitis [DISEASES], Otros calificadores::Otros calificadores::/cirugía [Otros calificadores], técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Appendicitis, Apendicitis - Cirurgia, Other subheadings::Other subheadings::/surgery [Other subheadings], Settore MED/18, Settore MED/18 - Chirurgia Generale, Acute Disease, enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedades del sistema digestivo::enfermedades gastrointestinales::apendicitis [ENFERMEDADES], intervenciones quirúrgicas::procedimientos quirúrgicos del sistema digestivo::apendicectomía [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Human
Abstract

Background In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide.

Published
2022

35. Mpox Outbreak in Previously Non-Endemic Countries: A Review on Impact on Asia.

Author

Wickramasinghe M, Weerasekera M, and Perera N

Abstract

Mpox (human mpox) is an opportunistic viral zoonosis that bears a strong resemblance to smallpox. The virus is divided into 2 distinct clades, clade I and clade II, which were originally confined to the moist forest regions of Africa. However, due to air travel and the exotic pet trade, these clades have spread globally. As immunity from smallpox vaccination declined, Mpox emerged as the most significant viral infection affecting humans within the Orthopoxvirus genus. While sporadic cases occurred worldwide, the largest Mpox outbreak outside Africa took place in 2022, prompting the WHO to declare a global public health emergency. Asia plays a pivotal role in both hosting and contributing to the spread of Mpox, driven by socio-economic factors such as high population density, widespread illegal wildlife trade, and a continuous rise in air travel. The increasing number of Mpox cases in Asia poses a significant challenge to healthcare systems, especially during times of global economic crisis. Strengthening diagnostic capabilities and infrastructure, while sustainably utilizing available resources to target high-risk populations, will be essential in addressing the Mpox threat in the region., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Published
2024
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36. Biofilms and microbiome profiles in chronic wounds: links to antibiotic use and wound severity in a Sri Lankan cohort.

Author

Dilhari A, Campbell PM, Munasinghe A, Brown H, Kaluarachchi TDJ, Gunasekara C, Pathirage S, Fernando N, Weerasekara D, Humphreys GJ, McBain AJ, and Weerasekera M

Subjects
Humans, Sri Lanka, Middle Aged, Male, Female, Aged, Cohort Studies, Adult, Bacteria isolation & purification, Bacteria genetics, Bacteria classification, Bacteria drug effects, Chronic Disease, Biofilms drug effects, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents pharmacology, Microbiota drug effects, Wound Infection microbiology, Wound Infection drug therapy
Abstract

Aims: We have characterized the microbiome of infected chronic diabetic wounds (CDWs), exploring associations with antibiotic use and wound severity in a Sri Lankan cohort., Methods and Results: Fifty CDW patients were enrolled, 38 of whom received antibiotics. Tissue biopsies were analysed by microbiome profiling, and wounds were graded using the University of Texas Wound Grading System. Biofilm presence was assessed in 20 wounds. The microbiome was largely dominated by Enterobacteriaceae, Pseudomonadaceae, Streptococcaceae, and Corynebacteriaceae. Proteobacteria levels were significantly higher in antibiotic-treated wounds (P = .019), with increased Pseudomonas abundance. Wounds were categorized as grade 1 (10), grade 2 (29), and grade 3 (11). Alpha diversity varied by wound grade (P = .015), with grade 2 wounds showing the highest diversity and grade 3 the lowest. All 20 tested wounds were biofilm-positive, and community composition varied more in antibiotic-treated wounds (P = .004)., Conclusions: CDW microbiomes were dominated by Enterobacteriaceae and Pseudomonadaceae, with elevated Proteobacteria in antibiotic-treated wounds. Alpha diversity correlated with wound severity, peaking in grade 2 wounds. The high prevalence of biofilms in wounds underscores the need for management of CDWs that address microbial complexity., (© The Author(s) 2024. Published by Oxford University Press on behalf of Applied Microbiology International.)

Published
2024
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37. Ilmenite-Grafted Graphene Oxide as an Antimicrobial Coating for Fruit Peels.

Author

Kodithuwakku P, Jayasundara D, Munaweera I, Jayasinghe R, Thoradeniya T, Bogahawatta A, Manuda KRJ, Weerasekera M, and Kottegoda N

Abstract

Postharvest loss is a significant global challenge that needs to be urgently addressed to sustain food systems. This study describes a simple microwave-assisted green synthesis method in developing a nanohybrid material combining natural ilmenite (FeTiO 3 ) and graphene oxide (GO) as a promising antimicrobial fruit peel coating to reduce postharvest loss. The natural ilmenite was calcined in an inert environment and was mixed with GO in a microwave reactor to obtain the nanohybrid. The nanohybrid was then incorporated into an alginate biopolymer to form the fruit coating. Microscopic images revealed successful grafting of FeTiO 3 nanoparticles onto the GO sheets. Spectroscopic measurements of Raman, X-ray photoemission, and infrared provided insights into the interactions between the two matrices. The optical band gap calculated from Tauc's relation using UV-vis data showed a significant reduction in the band gap of the hybrid compared to that of natural ilmenite. The antimicrobial activity was assessed using Escherichia coli , which showed a substantial decrease in colony counts. Bananas coated with the nanohybrid showed a doubling in the shelf life compared with uncoated fruits. Consistent with this, the electronic nose (E-nose) measurements and freshness indicator tests revealed less deterioration of the physicochemical properties of the coated bananas. Overall, the results show promising applications for the ilmenite-grafted GO nanohybrid as a food coating capable of minimizing food spoilage due to microbial activity., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Published
2024
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38. Unravelling Streptococcus agalactiae: Serotype distribution, virulence factors, obstetrics history and clinical presentation correlations in tertiary care hospitals of the western province of Sri Lanka.

Author

Dilrukshi N, Kottahachchi J, Dissanayake T, Weerasekera M, Sampath A, and Fernando N

Subjects
Humans, Female, Sri Lanka epidemiology, Pregnancy, Adult, Pregnancy Complications, Infectious microbiology, Streptococcus agalactiae genetics, Streptococcus agalactiae pathogenicity, Streptococcus agalactiae classification, Streptococcus agalactiae isolation & purification, Virulence Factors genetics, Serogroup, Streptococcal Infections microbiology, Streptococcal Infections epidemiology, Tertiary Care Centers
Abstract

Purpose: This study investigated to detect serotypes and virulence genes of Group B Streptococcus (GBS) isolated from pregnant women., Methods: Forty-five samples of GBS isolates from January to August 2019 at antenatal clinics of 4 teaching hospitals in Western Province, Sri Lanka were included. Isolated GBS were carried to identify 9 serotypes by multiplex PCR. Different virulence determinants, including bac, rib and scp(B) have been detected by PCR., Results: Among GBS-positive culture isolates most abundant serotype detected was type III 12/45 (26.7%) while serotype VII, VIII and IX were not seen. Furthermore, serotype Ia (15.6%); II (20%); V (17.8%); VI (15.6%); Ib (2.2%) and IV (2.2%) were identified. Among 5 rectal isolates, 1 isolate was serotype Ia, 2 isolates were serotype II and 2 isolates were serotype III. Forty (40/45) isolates expressed scpB gene (88.8%). Presence of rib gene was confirmed in 17.8%, bac in 13.3% isolates. ScpB, rib and bac were identified in 4.4% isolates, 8.9% isolates were scpB, rib positive and bac negative, 8.9% isolates were scpB, bac positive and rib negative. These three-virulence genes did not express in 8.9% isolates. ScpB gene was found once in serotype Ib and IV and all serotype VI expressed scpB gene. Rib gene was more common among serotype II and it was not found in serotype Ib, IV and VI. Bac gene was more common in serotype V and it was not found in serotype Ia, Ib and IV. There was not significant association between serotypes and virulence gene (p > 0.05)., Conclusion: Serotype III is the most abundant serotype. In formulation of vaccine against GBS for Sri Lanka, serotype III should be targeted. Prevalence of vaccine candidate virulence protein such as β antigens of the C protein (bac) and surface protein Rib (rib) genes were low in this study., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jananie Kottahachchi reports financial support and equipment, drugs, or supplies were provided by University of Sri Jayewardenepura Faculty of Medical Sciences. Niluka Dilrukshi reports a relationship with University of Sri Jayewardenepura Faculty of Medical Sciences that includes: non-financial support. No., (Copyright © 2024 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Published
2024
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39. Aromatase (CYP19) gene as a biomarker for detection of naphthalene and phenanthrene in Colombo to Mirissa coastal water in Sri Lanka.

Author

Mallikarachchi KEP, Bandara KRV, Weerasekera MM, Nugara RN, Undugoda LJS, and Manage PM

Subjects
Aromatase genetics, Sri Lanka, Naphthalenes analysis, Biomarkers, Water analysis, Water Pollutants, Chemical analysis, Polycyclic Aromatic Hydrocarbons analysis, Phenanthrenes analysis
Abstract

Naphthalene (NAP) and phenanthrene (PHE) are prevalent Polycyclic Aromatic Hydrocarbons (PAHs) in the environment. High-Performance Liquid Chromatography (HPLC) analysis was performed on marine water samples (n = 57) collected from 19 locations. Molecular screening of the aromatase (CYP19) gene expression was examined using quantitative Reverse Transcriptase PCR (qRT-PCR). The findings of the study showed a significant range of naphthalene concentrations along the coastline, spanning from 1.70 to 15.05 mg/L, where phenanthrene concentrations varied from undetectable to a maximum of 5.36 mg/L. The relative expression of the CYP19 gene ranged from 0.5 to 13.9 in the sampling sites. The ANOVA analysis showed a significant positive correlation (p < 0.05) between the concentrations of PAHs and CYP19 gene expression. The study concluded that the CYP19 gene could be useful in detecting contaminants such as naphthalene and phenanthrene in water. This study may help develop effective strategies to detect and mitigate PAH pollution in coastal areas., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Published
2024
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40. Metal doped silica nanohybrids with extensive bacterial coverage for antibacterial applications exhibit synergistic activity.

Author

Yapa PN, Munaweera I, Sandaruwan C, Weerasinghe L, and Weerasekera MM

Subjects
Bacteria, Silver pharmacology, Silicon Dioxide pharmacology, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents chemistry, Silanes
Abstract

Nanotechnology has triumphantly overcome several barriers that have formed in modern life. Bacterial infections are a critical public health issue. They emphasized the failure of conventional treatments, high mortality and morbidity rates, antibiotic resistance, and other factors leading to the development of novel and affordable antibacterial medications. In this study, three types of metals (Ag, Cu, and Co) were doped separately into a silanol network in silica nanoparticles. The synthesized monometallic nanohybrids were combined in equal proportions to formulate bi and trimetallic nanohybrids. They were characterized structurally and morphologically. Fourier transform infrared (FTIR) and Raman spectroscopy studies were used to investigate the formation of the bonds and the pertinent peak positions. X-ray diffractograms (XRD) validated the crystalline structures of the metal nanohybrids. X-ray photoelectron spectroscopic study (XPS) confirmed the successful addition of metals to the silanol network. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) images were used to characterize the morphology of nanohybrids and demonstrate their dimensions are on the nanoscale. The fraction of each metal doped in the silanol network was determined using energy dispersive spectroscopy (EDS) and atomic absorption spectrometry (AAS). To assess activity and confirm antibacterial synergy, the antibacterial activity of all synthesized nanohybrids was examined. The minimum inhibitory concentration-MIC (Ranged from 12.25 to 1560.00 μg/mL), minimum bactericidal concentration-MBC (Ranged from 197.00 to 3125.00 μg/mL), IC 50 values (Ranged from 30.56 to 1683.00 μg/mL-) and fractional inhibitory concentration index (FICI) were determined and compared. Well diffusion assay was conducted against both ATCC cultures and clinical samples of gram-positive bacteria; Staphylococcus aureus (ATCC 25923), Streptococcus pneumoniae (ATCC 49619), MRSA (ATCC 33591) and gram-negative bacteria; Escherichia coli (ATCC 25922), Klebsiella pneumoniae (ATCC BAA 1706) and Pseudomonas aeruginosa (ATCC 27853). The highest synergistic radical scavenging performance of trimetallic nanohybrid (90.67 ± 0.095 %) was established by the DPPH (2,2 diphenyl-1-picrylhydrazil) experiment. Finally, when compared to monometallic nanohybrids, it was demonstrated that the synthesized multimetallic nanohybrids have a substantial potential as an emerging and cost-effective antibacterial agent., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Published
2024
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41. Risk Assessment of Alcohol Consumption for Oral Cancer: A Case-Control Study in Patients Attending the National Cancer Institute (Apeksha Hospital, Maharagama) of Sri Lanka.

Author

Edirisinghe ST, Devmini T, Pathmaperuma S, Weerasekera M, De Silva K, Liyanage I, Niluka M, Madushika K, Deegodagamage S, Wijesundara C, Rich A, De Silva H, Hussaini H, De Silva DK, and Yasawardena S

Subjects
United States, Humans, Sri Lanka epidemiology, Case-Control Studies, National Cancer Institute (U.S.), Smoking, Alcohol Drinking adverse effects, Alcohol Drinking epidemiology, Risk Factors, Risk Assessment, Squamous Cell Carcinoma of Head and Neck, Mouth Neoplasms etiology, Mouth Neoplasms complications, Carcinoma, Squamous Cell pathology, Head and Neck Neoplasms
Abstract

Background: Oral squamous cell cancer (OSCC) is one of the commonest cancers in Sri Lanka., Objectives: This study aimed to determine the use of alcohol, its duration and consuming pattern in relation to the risk of developing OSCC in patients attending the National Cancer Institute of Sri Lanka., Methods: A case-control study was carried out on 105 patients with a histologically confirmed primary OSCC and 210 age-sex matched controls. Information on alcohol consumption was obtained via an interviewer-administered questionnaire., Results: Participants who had consumed alcohol at some point in their life had a 3.8-fold risk of developing OSCC (p=0.000). Current consumers had a higher risk compared to who have consumed previously. Former consumers had a lower risk of developing OSCC compared to current consumers. Individuals who had consumed alcohol for more than 20 years had a greater risk [Odds ratio (OR)=4.69] of developing OSCC compared to those who had consumed alcohol for less than ten years (OR=3.25). Those who consumed the locally-made illicit liquor (Kasippu) had the greatest risk (OR=8.45; p<0.05) of developing OSCC when considering the type of alcohol consumed., Conclusions: Alcohol consumption is a risk factor for OSCC. The OSCC risk increased with longer duration of alcohol use, the consumption of locally-made illicit liquor and current consumers of alcohol.

Published
2023
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42. Biofilm formation and antibiotic resistance among Coagulase Negative Staphylococcus species isolated from central venous catheters of intensive care unit patients.

Author

Medis S, Dissanayake T, Kottahachchi J, Namali D, Gunasekara S, Wijesinghe G, Dilrukshi N, and Weerasekera M

Subjects
Humans, Coagulase, Gentian Violet, Staphylococcus, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Drug Resistance, Microbial, Intensive Care Units, Cloxacillin, Biofilms, Central Venous Catheters adverse effects, Catheter-Related Infections microbiology
Abstract

Purpose: This study was conducted to determine the biofilm formation of coagulase negative Staphylococcus species (CoNS) isolated from patients with catheter related blood stream infection (CRBSI) and colonized central venous catheters (CVC) and their antibiotic susceptibility patterns and in situ biofilm formation of CVC tips., Methods: Eighty-two CoNS isolated from intensive care unit (ICU) patients with CRBSI (n ​= ​8) or colonized CVC (n ​= ​74) were included. Species identification and antibiotic susceptibility test were done. All isolates were screened for biofilm formation using crystal violet and 3-(4,5-dimethylthiazole-2-yl)-2-5-diphenyl-2H-tetrazolium bromide (MTT) assays and categorized as strong or moderate biofilm formers. CVC tips were subjected to crystal violet stain and scanning electron microscopy (SEM) to detect in-situ biofilm formation., Results: Staphylococcus haemolyticus (n ​= ​34; 41%) was the commonest to cause both CRBSI and CVC colonization. All 82 CoNS produced biofilms. Among them 77 (93.90%) were strong biofilm formers including all from CRBSI patients and 05 (6.10%) were moderate biofilm formers as detected by both methods. SEM showed bacteria adhered to surfaces of CVC tips with microbial-aggregates embedded in extracellular matrix. Mean crystal violet absorbance of CVC from CRBSI patients (0.6628) was significantly higher than colonized CVC (mean value 0.5592) (p ​= ​0.030). S. haemolyticus showed higher resistance to cloxacillin compared to other CoNS (p ​= ​0.039)., Conclusion: Majority of CoNS isolated were strong biofilm formers. In-situ biofilm formation on CVC tips were significantly evident in CRBSI patients compared to CVC colonized patients. S. haemolyticus is the commonest to cause both CRBSI and CVC colonization and shows significantly higher cloxacillin resistance rate., Competing Interests: Declaration of competing interest None., (Copyright © 2022 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Published
2023
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43. Vascular Endothelial Growth Factor A (VEGF-A) and Vascular Endothelial Growth Factor Receptor 2 (VEGFR-2) as Potential Biomarkers for Oral Squamous Cell Carcinoma: A Sri Lankan Study.

Author

Edirisinghe ST, Weerasekera M, De Silva DK, Devmini MT, Pathmaperuma S, Wijesinghe GK, Nisansala T, Maddumage A, Huzaini H, Rich AM, De Silva H, Trudy M, Goonasinghe R, De Silva K, and Yasawardena S

Subjects
Humans, Vascular Endothelial Growth Factor A genetics, Vascular Endothelial Growth Factor A metabolism, Vascular Endothelial Growth Factor Receptor-2 genetics, Squamous Cell Carcinoma of Head and Neck, Sri Lanka, Biomarkers, Vascular Endothelial Growth Factors, Neovascularization, Pathologic metabolism, Vascular Endothelial Growth Factor Receptor-1, Vascular Endothelial Growth Factor Receptor-3 metabolism, Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell genetics, Carcinoma, Squamous Cell blood supply, Mouth Neoplasms metabolism, Head and Neck Neoplasms
Abstract

Background: The incidence of oral squamous cell carcinoma (OSCC) is very high in South Asia and Vascular endothelial growth factor (VEGF) is one of the key factors essential for cancer growth. The importance of VEGF-A and VEGF Receptor 2(VEGFR-2) in oral cancer pathophysiology is yet to be decided. Vascular Endothelial Growth Factor A (VEGF-A) is the main factor concerned in angiogenesis in tumors, but its role in Oral Squamous Cell Carcinoma (OSCC) is still debatable. Our study aimed to determine the role of VEGF-A and VEGFR-2 in OSCC., Methods: Blood from 30 patients with primary OSCC and 1:1 age-sex-matched controls was subjected to qPCR and ELISA to detect VEGF-A gene expression and serum level. Tumors of the 30 patients were investigated for VEGF Receptor-2 (VEGFR-2) expression and were analyzed using Image J software version 1.52 for DAB percentage (DAB-P) area and optical density (OD)., Results: VEGF-A relative gene expression among patients was 2.43-fold higher compared to the healthy control group. Well-differentiated had a 1.98-fold increment, while poorly differentiated had a 3.58-fold increment. Serum VEGF-A was significantly elevated among the patients compared to controls (458.7 vs 253.2, p=0.0225). Poorly differentiated had a higher serum VEGF concentration (1262.0±354.7pg/ml) compared with other two. Mean VEGFR-2 DAB-P level in OSCC was 42.41±5.61(p=0.15). Well-differentiated had a DAB-P of 41.20±5.32 while poorly differentiated had DAB-P 46.21±3.78. The mean OD in OSCC was 0.54±0.16. VEGFR-2 OD in well and poorly differentiated OSCC were 0.48±0.12 and 0.68±0.17, respectively., Conclusions: VEGF-A gene expression, serum levels, and tissue VEGFR-2 levels correlated linearly with the stage and grade of the tumor. This study justifies the value of VEGF-A as a potential biomarker in OSCC in early detection of OSCC. More studies are needed to accept the use of VEGF-A.

Published
2023
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44. Distribution of mecA and qacA/B genes among coagulase negative staphylococci isolated from central venous catheters of intensive care unit patients.

Author

Medis S, Dissanayake T, Weerasekera M, Namali D, Gunasekara S, and Kottahachchi J

Subjects
Anti-Bacterial Agents pharmacology, Bacterial Proteins analysis, Bacterial Proteins genetics, Clindamycin, Cloxacillin, Coagulase genetics, Erythromycin, Humans, Intensive Care Units, Microbial Sensitivity Tests, Staphylococcus genetics, Anti-Infective Agents, Local, Central Venous Catheters, Staphylococcal Infections epidemiology
Abstract

Purpose: This study was designed to detect the prevalence of antibiotic and antiseptic resistance genes, mecA and qacA/B in coagulase negative Staphylococcus (CoNS) species isolated from intensive care unit patients with catheter related blood stream infections (CRBSI) or colonized central venous catheters (CVC)., Methods: Consecutive CoNS isolates from ICU patients with CRBSI or colonized central venous catheters were speciated and antibiotic susceptibilities were determined. The mecA and qacA/B genes were detected by polymerase chain reaction., Results: Eighty-two CoNS isolates from ICU patients with CRBSI (n ​= ​8) or colonized CVC (n ​= ​74) were included. The mecA gene was detected in 62 CoNS isolates (76%). The commonest species isolated was S. haemolyticus (n ​= ​34; 41%) and 30 of these possessed mecA which was significantly higher compared to other CoNS species (p ​= ​0.036). The qacA/B gene was detected in 13 (16%) isolates. Eleven (13%) CoNS had both genes. A significant association was seen with the presence of mecA and resistance to cloxacillin (p ​&lt; ​0.001) and erythromycin (p ​= ​0.046). Presence of qacA/B (p ​= ​0.007) or both mecA and qacA/B (p ​= ​0.014) was associated with a higher resistance to clindamycin., Conclusion: A considerably high prevalence of mecA and qacA/B genes as well as co-existence of both genes is noted among the CoNS isolated from ICU patients. This indicates the need of taking prompt actions in hospital acquired infection prevention including continuous surveillance., Competing Interests: Conflict of interest None., (Copyright © 2022 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Published
2022
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45. The Risk of Oral Cancer among Different Categories of Exposure to Tobacco Smoking in Sri Lanka

Author

Edirisinghe ST, Weerasekera M, De Silva DK, Liyanage I, Niluka M, Madushika K, Deegodagamage S, Wijesundara C, Rich AM, De Silva H, Hussaini HM, De Silva K, and Yasawardene S

Subjects
Areca adverse effects, Humans, Risk Factors, Squamous Cell Carcinoma of Head and Neck, Sri Lanka epidemiology, Tobacco Smoking adverse effects, Tobacco Smoking epidemiology, Tobacco Products, Carcinoma, Squamous Cell epidemiology, Carcinoma, Squamous Cell etiology, Head and Neck Neoplasms, Mouth Neoplasms epidemiology, Mouth Neoplasms etiology, Mouth Neoplasms pathology
Abstract

Background: The global incidence of oral squamous cell carcinoma (OSCC) is on the rise with no improvement seen in survival rates. Tobacco consumption varies depending on geographic location, ethnicity and culture. The present case-controlled study aimed to determine the relative risk of OSCC for different tobacco consumption patterns in a selected Sri Lankan population. Methods: One hundred and five patients with histopathologically confirmed OSCC attending the National Cancer Institute (Apeksha Hospital) of Sri Lanka and 210 age and gender-matched controls from the community responded to an interviewer-administered questionnaire regarding their smoking and betel-quid chewing (with/ without smokeless tobacco) habits were included in the study. The odds ratios (OR) and 95% confidence intervals (CI) were calculated. p<0.05 was considered as statistically significant. Results: The overall risk of OSCC increased 2.93-fold for smokers. Those smoking two packets of cigarettes or more per day (OR=5.56; 95% CI-2.822- 10.984; p=0.000) had more than double the risk of OSCC than those smoking 1-2 packets per day. Smoking for more than 20 years had a 3.4-fold risk of OSCC. Consumption of betel quid containing tobacco (smokeless tobacco) had a 4.26-fold higher risk for OSCC (OR=4.26; 95% CI-2.21-8.21; p=0.000), and the risk increased when all four ingredients (betel leaf, slaked lime, areca nut, and tobacco) were consumed together (OR=4.26; 95% CI-2.34-7.74; p=0.000). The combined effect from concurrent smoking and betel chewing emerged as the highest risk for OSCC (OR=15.34) which significantly exceeded the risks evident for the two habits practised in isolation from each other. Conclusions: Use of smokeless tobacco, consumption of all four ingredients together, duration of smoking, the number of cigarettes smoked per day and combined consumption of betel quid and smoking are significant risk factors in the development of OSCC among Sri Lankans.

Published
2022
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46. Possible clinical implications and future directions of managing bacterial biofilms in cutaneous leishmaniasis wounds.

Author

Kaluarachchi TDJ, Campbell PM, Wickremasinghe R, Ranasinghe S, Yasewardene S, De Silva H, McBain AJ, and Weerasekera M

Abstract

Cutaneous leishmaniasis (CL) lesions are chronic and result in disfiguring scars. The microbiological aspects of these wounds have not been systematically investigated. We have recently reported that 61.5% of CL wounds in a Sri Lankan cohort harboured bacterial biofilms, mainly composed of bacilli, Enterobacteriaceae, and Pseudomonas, which could delay wound healing. We have additionally reported that biofilms were significantly associated patients over 40 years of age, discharge, pain and/or itching of the wound, and high pus cell counts. Using this as background knowledge and other relevant literature, we highlight the importance of investigating the role of biofilms in CL wound healing, clinical indicators, cost-effective laboratory tests involving less invasive sampling techniques for diagnosing biofilms and potential therapeutic options for biofilm-containing CL wounds, such as adjunctive application of wound debridement and antimicrobial treatment along with anti-parasitic drugs., (© 2022. The Author(s).)

Published
2022
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47. The genotypes and virulence attributes of C. albicans isolates from oral leukoplakia.

Author

Weerasekera MM, Wijesinghe GK, Sampath A, Dilhari A, Madhumal T, Dilrukshi R, Willaddara R, Karunathilaka S, Gunasekara C, Fernando N, and Samaranayake L

Subjects
Genotype, Humans, Leukoplakia, Oral, Virulence genetics, Candida, Candida albicans genetics
Abstract

Background: There is a debate as to whether some types of oral leucoplakias (OL) are caused by Candida species, and whether they contribute to the malignant transformation, associated with a minority of such lesions. As no detailed population analysis of yeast isolates from OL is available, we evaluated the virulence attributes, and genotypes of 35 C. albicans from OL, and compared their genotypes with 18 oral isolates from healthy individuals., Material and Methods: The virulence traits evaluated were esterase, phospholipase, proteinase, haemolysin and coagulase production, and phenotypic switching activity, and yeast adherence and biofilm formation. DNA from OL and control yeasts were evaluated for A, B or C genotype status., Results: Phospholipase, proteinase, and coagulase activity and biofilm formation was observed in 80%, 66%, 97 % and 77 % of the isolates, respectively. Phenotypic switching was detected in 8.6%, while heamolytic, and esterase activity and adherence were noted in all isolates., Conclusions: The genotype A was predominant amongst both the OL and control groups. Due to the small sample size of our study a larger investigation to define the role of candidal virulent attributes in the pathogenicity of OL is warranted, and the current data should serve as a basis until then.

Published
2021
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48. Contributing role of TNF, IL-10, sTNFR1 and TNF gene polymorphisms in disease severity of leptospirosis.

Author

Nisansala T, Weerasekera M, Ranasinghe N, Marasinghe C, Gamage C, Fernando N, and Gunasekara C

Subjects
Adult, Cytokines blood, Female, Humans, Interleukin-10 immunology, Leptospirosis immunology, Male, Middle Aged, Receptors, Tumor Necrosis Factor, Type I immunology, Severity of Illness Index, Sri Lanka epidemiology, Tumor Necrosis Factor-alpha immunology, Interleukin-10 blood, Leptospirosis blood, Leptospirosis genetics, Polymorphism, Genetic, Receptors, Tumor Necrosis Factor, Type I blood, Tumor Necrosis Factor-alpha blood, Tumor Necrosis Factor-alpha genetics
Abstract

The immune response is hypothesized as an important factor in the disease outcome of leptospirosis. Exaggerated immune response may promote tissue damage that lead to severe disease outcome. In this study TNF, IL-10, sTNFR1 levels were measured among sixty-two hospitalized leptospirosis confirmed patients in Sri Lanka. Thirty-one serum samples from healthy individuals were obtained as controls. PCR-RFLP method was used to identify TNF gene polymorphisms and to determine their association with TNF expression and disease severity in leptospirosis. TNF (p = 0.0022) and IL-10 (p < 0.0001) were found to be significantly elevated in leptospirosis patients, while sTNFR1 (p < 0.0001) was significantly suppressed. TNF was not significantly elevated in patients with complications while the anti-inflammatory cytokine IL-10 was significantly elevated among patients with complications (p = 0.0011) and with mortality (p = 0.0088). The ratio of IL-10 to TNF was higher among patients with complications (p = 0.0008) and in fatal cases (p = 0.0179). No association between TNF gene polymorphisms and TNF expression was detected due to the low frequency of heterozygous and mutated genes present in this study population. Thus the findings of the study show that elevated levels of IL-10 in the acute phase of disease could lead to severe outcomes and a high IL-10/TNF ratio is observed in patients with complications due to leptospirosis., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2021
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49. Diagnostic salivary biomarkers in oral cancer and oral potentially malignant disorders and their relationships to risk factors - A systematic review.

Author

Piyarathne NS, Rasnayake RMSGK, Angammana R, Chandrasekera P, Ramachandra S, Weerasekera M, Yasawardene S, Abu-Eid R, Jayasinghe JAP, and Gupta E

Subjects
Biomarkers, Tumor analysis, Humans, Risk Factors, Saliva, Carcinoma, Squamous Cell diagnosis, Head and Neck Neoplasms, Mouth Neoplasms diagnosis, Mouth Neoplasms etiology
Abstract

Introduction: Oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) are a significant health burden globally. Smoking, alcohol, and betel quid are the main risk factors. Lack of screening methods has been highlighted as a significant challenge in management. Salivary biomarkers are proposed as noninvasive diagnostic tools. The aim of this systematic review was to study salivary biomarkers reported in OSCC and OPMD. Specific objectives were to select a salivary biomarker panel suitable for early detection of OSCC and OPMD and to assess relationships between salivary biomarkers and risk factors., Methods: Electronic literature search was conducted in academic databases (Scopus, Medline, Embase and Web of Science) without any restrictions. Following calibration, two blinded reviewers screened the studies and extracted data. A risk of bias assessment was conducted using Newcastle Ottawa scale. 295 studies were included with descriptive data analysis., Expert Opinion: A salivary biomarker panel including Interleukin (IL) 1β, IL6, and IL8 was selected for OSCC and OPMD. Reported relationships between salivary biomarkers and risk factors are discussed and research gaps are highlighted. Future research should be directed to assess potential salivary biomarkers and their relationships to risk factors in order to understand the biomarker's role in disease initiation.

Published
2021
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50. Diagnosing human cutaneous leishmaniasis using fluorescence in situ hybridization.

Author

Jayasena Kaluarachchi T, Wickremasinghe R, Weerasekera M, Yasawardene S, McBain AJ, Yapa B, De Silva H, Menike C, Jayathilake S, Munasinghe A, Wickremasinghe R, and Ranasinghe S

Subjects
Humans, In Situ Hybridization, Fluorescence, Nucleic Acid Amplification Techniques, Polymerase Chain Reaction, Sensitivity and Specificity, Leishmaniasis, Cutaneous diagnosis
Abstract

Cutaneous leishmaniasis (CL) is endemic in Sri Lanka. Giemsa-stained slit-skin-smears (SSS-Giemsa) and histology are routinely used in diagnosis with a sensitivity of 40-70%. PCR currently has limited accessibility. Therefore, we assessed the sensitivity and specificity of a previously described fluorescence in situ hybridization assay, on skin smears and biopsy samples to overcome the limitations encountered with routine diagnostic methods.Samples from a total of 123 suspected CL patients were collected and subjected to SSS-Giemsa, fluorescence in situ hybridization (FISH) on slit skin smears (SSS-FISH), formalin-fixed-paraffin-embedded-tissues stained with Hematoxylin & Eosin staining (FFPE-H&E) and FISH on formalin-fixed-paraffin-embedded-tissues (FFPE-FISH). Negative controls of 61 patient samples were collected from a CL non-endemic area and subjected to the same procedures. The gold standard PCR was used as a comparator. For FISH, two previously described cyanine 3 tagged Leihsmania genus-specific probes were used.Compared to PCR, SSS-Giemsa, SSS-FISH, FFPE-H&E, and FFPE-FISH had sensitivities of 76.5%, 79.1%, 50.4% and 80.9%, respectively. Routine diagnostic tests (SSS-Giemsa and FFPE-H&E) had a specificity of 100%. SSS-FISH and FFPE-FISH had specificities of 96.7% and 93.4%, respectively. FFPE-FISH had a statistically significant higher diagnostic performance than FFPE-H&E (p < 0.001). The relative performance of SSS-Giemsa, SSS-FISH and FFPE-FISH was similar (p > 0.05 for all comparisons).We conclude that FFPE-FISH is a more accurate diagnostic tool than FFPE-H&E. SSS-FISH did not have an additional advantage over SSS-Giemsa in diagnosis. However, SSS-FISH could be recommended as a minimally invasive method in studies assessing wound healing where immunological probes are used.

Published
2021
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