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1. The Effect of Fascial Closure With Triclosan-Coated Sutures on the Incidence of Abdominal Wall Dehiscence: An Individual Participant Data Meta-Analysis

Author: Allard S. Timmer, Niels Wolfhagen, Frank Pianka, Phillip Knebel, Christoph Justinger, Christos Stravodimos, Kosuke Ichida, Toshiki Rikiyama, József Baracs, András Vereczkei, Luca Gianotti, Marta Sandini, Jaime Ruiz-Tovar, Artur Marc-Hernández, Toru Nakamura, Marcel G. W. Dijkgraaf, Marja A. Boermeester, and Stijn W. de Jonge
Subjects: wound closure, fascial closure, fascial dehiscence, coated sutures, triclosan-coated sutures, Specialties of internal medicine, RC581-951
Abstract: IntroductionWound closure with triclosan-coated sutures (TCS) appears to reduce the risk of surgical site infection (SSI). Because there is a strong association between postoperative SSI and the development of acute abdominal wall dehiscence (AWD) after laparotomy, we hypothesized that the use of TCS for wound closure after laparotomy may also reduce the risk of AWD.MethodsThe MEDLINE, Embase, and CENTRAL databases were searched from their inception to 01 November 2022. Randomized trials that compared the use of TCS with identical but uncoated sutures for fascial closure were eligible if they could provide individual participant data (IPD) on AWD. From these trials, we only included in the analysis those subjects who underwent open abdominal surgery. The primary outcome was the incidence of AWD within 30 days postoperatively, requiring emergency reoperation. The certainty of evidence was assessed using the GRADE methodology (PROSPERO: CRD42019121173.ResultsWe identified twelve eligible trials. Eight studies shared IPD. The incidence of AWD within 30 days after surgery was 27/1,565 (1.7%) in the TCS group vs. 40/1,430 (2.8%) in the control group (Relative Risk: 0.70 [95% confidence interval (CI) 0.44–1.11, I2 = 0%, τ2 = 0.00]). The certainty of evidence was moderate after downgrading for imprecision. The incidence of incisional SSI was 163/1,576 (10.3%) vs. 198/1,439 (13.8%), RR 0.80 (95% CI 0.67–0.97).ConclusionWe found no conclusive evidence to support the use of triclosan-coated sutures for the prevention of acute abdominal wall dehiscence after laparotomy. In these selected studies, a significant reduction in incisional SSI was observed.
Published: 2024
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2. Intraoperative pyloric drainage is unnecessary during esophagectomies: a meta-analysis and systematic review of randomized controlled trials

Author: Armand Csontos, Dávid Németh, Lajos Szakó, Gergő Berke, Dóra Lili Sindler, Dávid Berki, Csenge Papp, Péter Hegyi, András Vereczkei, and András Papp
Subjects: esophageal cancer, esophagectomy, esophageal surgery, pyloroplasty, minimal invasive, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Pathology, RB1-214
Abstract: Objective: The topic of this meta-analysis is the comparison of gastric conduit esophageal reconstructions with or without pyloroplasty.Background: Surgical procedures, especially minimal invasive esophagectomy (MIE) can be a curative treatment in the early stages of esophageal cancer. Previously, intraoperative pyloroplasty was routinely performed, but nowadays it became debated again in the light of minimally invasive esophagectomy.Methods: A comprehensive search was performed in multiple databases to identify randomized controlled trials investigating the topic. Two independent authors performed the selection based on predefined criteria. Statistical analysis was performed to assess any significant difference, then the bias and quality of the data were estimated.Results: Nine relevant RCTs consisting of 529 patients with esophageal cancer were identified. No significance was found in mortality [odds ratio (OR): 0.85; p = 0.642], anastomosis leakage (OR: 0.57; p = 0.254), respiratory morbidity (OR: 0.51; p = 0.214) and vomiting (OR: 0.74; p = 0.520), however the results about gastric emptying time (GET) were controversial (weighted mean difference (WMD): −67.71; p = 0.009, OR: 2.75; p = 0.072). Significant heterogeneity was not detected except for GET. Trial sequential analyses (TSA) show that a certain conclusion would require more data except in the binary variables of GET.Conclusion: We conclude that the pyloric drainage procedure is not routinely necessary, but further well-designed studies would be needed, especially in Europe.
Published: 2024
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3. The development of one-day surgical care in Hungary between 2010 and 2019

Author: Róbert Pónusz, Dóra Endrei, Dalma Kovács, Evelin Pónusz, Bence Kis Kelemen, Diána Elmer, Noémi Németh, András Vereczkei, and Imre Boncz
Subjects: Health policy reform, Diagnosis-related groups, Financing, Case mix index, Hungary, Public aspects of medicine, RA1-1270
Abstract: Abstract Background The constant increase in the utilization of one-day surgical care could be identified since more than a decade in most of European countries. Initially, according to the international rankings, the exploitation of one-day surgery in Hungary was not really significant. In 2010, the Hungarian policy makers intended to increase one-day surgical care as a priority strategy. The aim of our study was to analyze the evolution of the Hungarian one-day surgical care during the last decade in DRG- based performance financing system in Hungary. Methods The dataset of the research was provided by the National Health Insurance Fund Administration of Hungary. The most important indicators related to the one-day surgical care were compared to inpatient care (market share, number of cases, and DRG cost-weights). To discover the impact of one-day surgical care to the utilization of inpatient treatment, the number of hospitalized days was also analyzed. Results Between 2010 and 2019, the market share of one-day surgical cases increased from 42, to 80%. Simultaneously the constant increase of one-day surgical cases, the number of hospitalized days were decreased in inpatient care by 17%. The value of Case Mix Index has also increased, approximately by 140%, which could confirm that more complex interventions are being conducted in one-day surgical care as well. Conclusions Due to the comprehensive health policy strategy related to the dissemination of one-day surgical care in Hungary, several important performance indicators were improved between 2010 and 2019. Given that Hungary belongs to the low- and middle-income countries, the results of the study could be considerable even in an international comparison.
Published: 2022
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4. Use of blood products during the first months of COVID-19 pandemic period: A single center report

Author: Sándor Pál, Barbara Réger, Hussain Alizadeh, Árpád Szomor, András Vereczkei, Tamás Kiss, Attila Miseta, Margit Solymár, and Zsuzsanna Faust
Subjects: COVID-19 and blood product usage, Blood components, Restrictive transfusion policy, Patient blood management, Pre-transfusion hemoglobin, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: The novel coronavirus (SARS-CoV-2) outbreak exerted a serious effect on healthcare. Between 1st of January and May 31, 2020 due to the special regulations in Hungary, the number of reported COVID-19 infections were relatively low (3876 cases). The inpatient and outpatient care and the blood supply were significantly affected by the implemented regulations. The aim of this study was to evaluate the use of blood products amid the first five months of the pandemic situation. This investigation has observed a significant reduction of hospitalizations (37.35%). Analyzing individually the included units, pre-transfusion hemoglobin concentrations of transfused patients presented slight modifications, which were not statistically significant. The special regulations resulted major changes in the frequency of diagnoses at admissions in case of the Department of Surgery, while in case of the other specialities (Division of Hematology and Department of Anesthesiology and Intensive Therapy), there were no major changes compared to pre-pandemic period. Considering each department separately, transfused red blood cell concentrates (RBC) per patient, and the proportion of transfused patients did not change significantly. However, the combination of these modifications resulted in the significant decrease in RBC transfusions (p
Published: 2023
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5. Effect of triclosan-coated sutures for abdominal wound closure on the incidence of abdominal wound dehiscence: a protocol for an individual participant data meta-analysis

Author: Phillip Knebel, Marja A Boermeester, András Vereczkei, Marcel G W Dijkgraaf, Stijn W de Jonge, Niels Wolfhagen, Jaime Ruiz-Tovar, Toru Nakamura, Kosuke Ichida, Toshiki Rikiyama, Allard S Timmer, Frank Pianka, Christoph Justinger, Christos Stravodimos, József Baracs, Luca Gianotti, and Artur M Hernández
Subjects: Medicine
Published: 2022
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6. Prognostic role of HPV infection in esophageal squamous cell carcinoma

Author: Laura Bognár, Ivett Hegedűs, Szabolcs Bellyei, Éva Pozsgai, László Zoltán, Katalin Gombos, Örs Péter Horváth, András Vereczkei, and András Papp
Subjects: Human papillomavirus, Esophageal squamous cell carcinoma, Neoadjuvant therapy, Heat shock protein, Growth hormone-releasing hormone receptor, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background The aims of this study were to evaluate whether HPV infection has a prognostic role in patients with esophageal squamous cell carcinoma who underwent oncological treatment and also to compare the heat shock proteins (Hsp) 90, 27 and 16.2 and growth hormone-releasing hormone receptor (GHRH-R) expression patterns of the pre-treatment tumor biopsies with the HPV status and with the oncological response. Methods Pre-treatment tumor biopsies of 74 patients with locally advanced esophageal squamous cell carcinoma were processed retrospectively. The presence of HPV was detected by chromogenic in situ hybridization. Hsp and GHRH-R expressions were determined using immunohistochemistry. Following neoadjuvant or definitive radiochemotherapy, the patients were restaged according to the Response Evaluation Criteria in Solid Tumors. The correlation between the HPV status, response to treatment and Hsp and GHRH-R expressions were evaluated. Results Fourteen (19%) patients were HPV-positive. These patients were more likely to respond poorly to multimodal therapy (71.4% were non-responders vs. 28.6% responders) and had shorter survival compared to HPV-negative patients (mean survival of 8 months vs. 11 months), although the difference was not significant. A significantly higher number of HPV-positive patients expressed Hsp 90 and 16.2 at high levels (93 and 79%, respectively) than at low levels (Chi-Square p = 0.019 and p = 0.031). Higher levels of Hsp expressions were associated with poorer response to therapy and worse overall survival. No correlation was found between GHRH-R expression and the HPV status, nor between GHRH-R expression and the treatment response of the examined samples. Conclusions We found that HPV infection was associated with poor response to oncological treatment and decreased overall survival, and therefore proved to be a negative prognostic factor in patients with esophageal squamous cell carcinoma. There was a linear correlation between levels of Hsp 90 and 16.2 expression and HPV positivity.
Published: 2018
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7. Endoscopic sphincterotoMy for delayIng choLecystectomy in mild acute biliarY pancreatitis (EMILY study): protocol of a multicentre randomised clinical trial

Author: Péter Hegyi, Andrea Szentesi, Miklós Sahin-Tóth, Katalin Márta, Áron Vincze, Imola Nemeth, Levente Pál Kucserik, György Lázár, László Czakó, Zsolt Szentkereszty, Mária Papp, Károly Palatka, Ferenc Izbéki, Áron Altorjay, Imola Török, Sorin Barbu, Marcel Tantau, András Vereczkei, Lajos Bogár, Márton Dénes, Noémi Zádori, Judit Antal, Markus M Lerch, John Neoptolemos, Ole H Petersen, and Dezső Kelemen
Subjects: Medicine
Abstract: Introduction According to the literature, early cholecystectomy is necessary to avoid complications related to gallstones after an initial episode of acute biliary pancreatitis (ABP). A randomised, controlled multicentre trial (the PONCHO trial) revealed that in the case of gallstone-induced pancreatitis, early cholecystectomy was safe in patients with mild gallstone pancreatitis and reduced the risk of recurrent gallstone-related complications, as compared with interval cholecystectomy. We hypothesise that carrying out a sphincterotomy (ES) allows us to delay cholecystectomy, thus making it logistically easier to perform and potentially increasing the efficacy and safety of the procedure.Methods/Design EMILY is a prospective, randomised, controlled multicentre trial. All patients with mild ABP, who underwent ES during the index admission or in the medical history will be informed to take part in EMILY study. The patients will be randomised into two groups: (1) early cholecystectomy (within 6 days after discharge) and (2) patients with delayed (interval) cholecystectomy (between 45 and 60 days after discharge). During a 12-month period, 93 patients will be enrolled from participating clinics. The primary endpoint is a composite endpoint of mortality and recurrent acute biliary events (that is, recurrent ABP, acute cholecystitis, uncomplicated biliary colic and cholangitis). The secondary endpoints are organ failure, biliary leakage, technical difficulty of the cholecystectomy, surgical and other complications.Ethics and dissemination The trial has been registered internationally ISRCTN 10667869, and approved by the relevant organisation, the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (EKU/2018/12176–5).Trial registration number ISCRTN10667869; Pre-results.
Published: 2019
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8. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

Author: Cristian Mesina, Oussama Baraket, Arda Isik, Iyiade Olaoye, Tadeja Pintar, Wagih Ghnnam, Andreas Hecker, Ionut Negoi, Andrey Litvin, A R K Adesunkanmi, Julival Ribeiro, Stijn W. de Jonge, Norio Sato, Carlos Augusto Gomes, Manos Pikoulis, Federico Coccolini, Yeong Yeh Lee, Frederick A. Moore, Gustavo M. Machain, Francesco Cortese, Elif Colak, Luca Ansaloni, Daniela Corsi, Enrico Cicuttin, Fikri M. Abu-Zidan, Fausto Catena, Andrew W. Kirkpatrick, Raul Coimbra, I. A. Kryvoruchko, Chiara Gurioli, Paola Fugazzola, Gabriele Sganga, András Vereczkei, Sanjay Marwah, Kenji Inaba, Agron Dogjani, Antonio Tarasconi, Elisabetta Cerutti, Rao R. Ivatury, Ibrahima Sall, Michael Sugrue, Francesco M. Labricciosa, Marco Ceresoli, Renol M. Koshy, Jae Il Kim, Goran Augustin, Mauro Podda, Therese M. Duane, Katia Iskandar, Osvaldo Chiara, Dimitris Damaskos, Timothy Craig Hardcastle, Yunfeng Cui, Vishal G Shelat, Joel Noutakdie Tochie, Andrew B. Peitzman, Sameer Dhingra, Miklosh Bala, Ashraf Abbas, Samir Delibegovic, Leonardo Pagani, George Gkiokas, Claudio Casella, Mahir Gachabayov, Gabriel Rodrigues, Stefano Di Bella, Vladimir Khokha, Kemal Rasa, Nicola de’ Angelis, Ernest E. Moore, Robert G. Sawyer, Ronald V. Maier, Yoram Kluger, Ines Rubio-Perez, Victor Y. Kong, Gennaro Perrone, Francesco Di Marzo, Jan Ulrych, Gian Luca Baiocchi, Matti Tolonen, Athanasios Marinis, Cristina Marmorale, G. Tomadze, Peter K. Kim, Belinda De Simone, Aleksandar Karamarkovic, Ian Stephens, Mouaqit Ouadii, Massimo Sartelli, Davide Luppi, Boyko Atanasov, Helmut Alfredo Segovia Lohse, Ervis Agastra, Syed Mohammad Umar Kabir, Massimo Chiarugi, Carlos A. Ordoñez, Giuseppe Pipitone, Bruno Viaggi, Joseph M. Galante, Suman Baral, Ewen A. Griffiths, Mushira Enani, Marja A. Boermeester, Zaza Demetrashvili, Ari Leppäniemi, Torsten Herzog, Walter L. Biffl, Salomone Di Saverio, Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Agastra, Ervi, Abu-Zidan, Fikri M, Abbas, Ashraf El Sayed, Ansaloni, Luca, Adesunkanmi, Abdulrashid Kayode, Atanasov, Boyko, Augustin, Goran, Bala, Miklosh, Baraket, Oussama, Baral, Suman, Biffl, Walter L, Boermeester, Marja A, Ceresoli, Marco, Cerutti, Elisabetta, Chiara, Osvaldo, Cicuttin, Enrico, Chiarugi, Massimo, Coimbra, Raul, Colak, Elif, Corsi, Daniela, Cortese, Francesco, Cui, Yunfeng, Damaskos, Dimitri, De' Angelis, Nicola, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, de Jonge, Stijn W, Dhingra, Sameer, Di Bella, Stefano, Di Marzo, Francesco, Di Saverio, Salomone, Dogjani, Agron, Duane, Therese M, Enani, Mushira Abdulaziz, Fugazzola, Paola, Galante, Joseph M, Gachabayov, Mahir, Ghnnam, Wagih, Gkiokas, George, Gomes, Carlos Augusto, Griffiths, Ewen A, Hardcastle, Timothy C, Hecker, Andrea, Herzog, Torsten, Kabir, Syed Mohammad Umar, Karamarkovic, Aleksandar, Khokha, Vladimir, Kim, Peter K, Kim, Jae Il, Kirkpatrick, Andrew W, Kong, Victor, Koshy, Renol M, Kryvoruchko, Igor A, Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao, Labricciosa, Francesco M, Lee, Yeong Yeh, Leppäniemi, Ari, Litvin, Andrey, Luppi, Davide, Machain, Gustavo M, Maier, Ronald V, Marinis, Athanasio, Marmorale, Cristina, Marwah, Sanjay, Mesina, Cristian, Moore, Ernest E, Moore, Frederick A, Negoi, Ionut, Olaoye, Iyiade, Ordoñez, Carlos A, Ouadii, Mouaqit, Peitzman, Andrew B, Perrone, Gennaro, Pikoulis, Mano, Pintar, Tadeja, Pipitone, Giuseppe, Podda, Mauro, Raşa, Kemal, Ribeiro, Julival, Rodrigues, Gabriel, Rubio-Perez, Ine, Sall, Ibrahima, Sato, Norio, Sawyer, Robert G, Segovia Lohse, Helmut, Sganga, Gabriele, Shelat, Vishal G, Stephens, Ian, Sugrue, Michael, Tarasconi, Antonio, Tochie, Joel Noutakdie, Tolonen, Matti, Tomadze, Gia, Ulrych, Jan, Vereczkei, Andra, Viaggi, Bruno, Gurioli, Chiara, Casella, Claudio, Pagani, Leonardo, Baiocchi, Gian Luca, Catena, Fausto, Sartelli, M, Coccolini, F, Kluger, Y, Agastra, E, Abu-Zidan, F, Abbas, A, Ansaloni, L, Adesunkanmi, A, Atanasov, B, Augustin, G, Bala, M, Baraket, O, Baral, S, Biffl, W, Boermeester, M, Ceresoli, M, Cerutti, E, Chiara, O, Cicuttin, E, Chiarugi, M, Coimbra, R, Colak, E, Corsi, D, Cortese, F, Cui, Y, Damaskos, D, de' Angelis, N, Delibegovic, S, Demetrashvili, Z, De Simone, B, de Jonge, S, Dhingra, S, Di Bella, S, Di Marzo, F, Di Saverio, S, Dogjani, A, Duane, T, Enani, M, Fugazzola, P, Galante, J, Gachabayov, M, Ghnnam, W, Gkiokas, G, Gomes, C, Griffiths, E, Hardcastle, T, Hecker, A, Herzog, T, Kabir, S, Karamarkovic, A, Khokha, V, Kim, P, Kim, J, Kirkpatrick, A, Kong, V, Koshy, R, Kryvoruchko, I, Inaba, K, Isik, A, Iskandar, K, Ivatury, R, Labricciosa, F, Lee, Y, Leppaniemi, A, Litvin, A, Luppi, D, Machain, G, Maier, R, Marinis, A, Marmorale, C, Marwah, S, Mesina, C, Moore, E, Moore, F, Negoi, I, Olaoye, I, Ordonez, C, Ouadii, M, Peitzman, A, Perrone, G, Pikoulis, M, Pintar, T, Pipitone, G, Podda, M, Rasa, K, Ribeiro, J, Rodrigues, G, Rubio-Perez, I, Sall, I, Sato, N, Sawyer, R, Segovia Lohse, H, Sganga, G, Shelat, V, Stephens, I, Sugrue, M, Tarasconi, A, Tochie, J, Tolonen, M, Tomadze, G, Ulrych, J, Vereczkei, A, Viaggi, B, Gurioli, C, Casella, C, Pagani, L, Baiocchi, G, Catena, F, HUS Abdominal Center, II kirurgian klinikka, and University of Helsinki
Subjects: Review, DAMAGE CONTROL LAPAROTOMY, Intra-abdominal infections, Peritonitis, Sepsis, Anti-Bacterial Agents, Critical Pathways, Humans, Treatment Outcome, Anti-Infective Agents, Intraabdominal Infections, 0302 clinical medicine, PERFORATED DIVERTICULITIS, Medicine, LAPAROSCOPIC CHOLECYSTECTOMY, Surgical approach, Iais, biology, Peritoniti, Anti-Infective Agents / therapeutic use, Medical emergencies. Critical care. Intensive care. First aid, 3. Good health, SURGICAL-TREATMENT, 030220 oncology & carcinogenesis, embryonic structures, Emergency Medicine, 030211 gastroenterology & hepatology, KLEBSIELLA-PNEUMONIAE, medicine.medical_specialty, RD1-811, Sepsi, MEDLINE, ANTIBIOTIC-THERAPY, 03 medical and health sciences, Intra-abdominal infection, Emergency surgery, Effective treatment, COMPUTED-TOMOGRAPHY, Intensive care medicine, Anti-Bacterial Agents / therapeutic use, Task force, business.industry, RC86-88.9, Abdominal Infection, SEPTIC SHOCK, Intraabdominal Infections / surgery, 3126 Surgery, anesthesiology, intensive care, radiology, biology.organism_classification, Review article, PRIMARY RESECTION, ACUTE COLONIC DIVERTICULITIS, Surgery, business, Intraabdominal Infections / drug therapy
Abstract: Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.
Published: 2021

9. Early occurrence of pseudocysts in acute pancreatitis – a multicenter international cohort analysis of 2275 cases

Author: Áron Vincze, László Gajdán, Péter Hegyi, Imola Török, Péter Jenő Hegyi, Artautas Mickevicius, Nándor Faluhelyi, Márk Félix Juhász, Benedek Tinusz, József Hamvas, Alexandra Mikó, Dóra Mosztbacher, Klementina Ocskay, Mária Papp, Tamás Takács, Szilárd Váncsa, András Vereczkei, Andrea Szentesi, Bálint Erőss, Lajos Szakó, Márta Varga, László Czakó, Orsolya Farkas, Alex Váradi, Attila Miseta, Veronika Dunás-Varga, Nóra Vörhendi, Ferenc Izbéki, A. Párniczky, Noémi Gede, and Krisztina Fehér
Subjects: medicine.medical_specialty, Abdominal pain, Pancreatic pseudocyst, Endocrinology, Diabetes and Metabolism, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Internal medicine, medicine, Hepatology, business.industry, medicine.disease, digestive system diseases, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Etiology, Acute pancreatitis, Pancreatitis, 030211 gastroenterology & hepatology, medicine.symptom, Pancreas, business, Cohort study, acute pancreatitis, pancreas, pancreatic fluid collection, pancreatic local complication, pancreatic pseudocyst
Abstract: Background: Pseudocysts being the most frequent local complications of acute pancreatitis (AP) have substantial effect on the disease course, hospitalization and quality of life of the patient. Our study aimed to understand the effects of pre-existing (OLD-P) and newly developed (NEW-P) pseudocysts on AP. Methods: Data were extracted from the Acute Pancreatitis Registry organized by the Hungarian Pancreatic Study Group (HPSG). 2275 of 2461 patients had uploaded information concerning pancreatic morphology assessed by imaging technique. Patients were divided into “no pseudocyst” (NO-P) group, “old pseudocyst” (OLD-P) group, or “newly developed pseudocyst” (NEW-P) groups. Results: The median time of new pseudocyst development was nine days from hospital admission and eleven days from the beginning of the abdominal pain. More NEW-P cases were severe (15.9% vs 4.7% in the NO-P group p < 0.001), with longer length of hospitalization (LoH) (median: 14 days versus 8 days, p < 0.001), and were associated with several changed laboratory parameters. OLD-P was associated with male gender (72.2% vs. 56.1%, p = 0.0014), alcoholic etiology (35.2% vs. 19.8% in the NO-P group), longer hospitalization (median: 10 days, p < 0.001), a previous episode of AP (p < 0.001), pre-existing diagnosis of chronic pancreatitis (CP) (p < 0.001), current smoking (p < 0.001), and increased alcohol consumption (unit/week) (p = 0.014). Conclusion: Most of the new pseudocysts develop within two weeks. Newly developing pseudocysts are associated with a more severe disease course and increased length of hospitalization. Pre-existing pseudocysts are associated with higher alcohol consumption and smoking. Because CP is more frequently associated with a pre-existing pseudocyst, these patients need closer attention after AP.
Published: 2021

10. COVID-19 pandemic: implications on the surgical treatment of gastrointestinal and hepatopancreatobiliary tumours in Europe

Author: Nevermann, N F, Hillebrandt, K H, Knitter, S, Ritschl, P V, Krenzien, F, Benzing, C, Bahra, M, Biebl, M, Sauer, I M, Öllinger, R, Schöning, W, Schmelzle, M, Pratschke, J, Abu Hilal, Mohammad, Aldrighetti, Luca, Andersson, Roland, András, Vereczkei, Andreou, Andreas, Arer, İlker Murat, Atıcı, Ali Emre, Szijártó, Attila, Ayav, Ahmet, Aydın, Hüseyin Onur, Bartsch, Detlev, Belli, Andrea, Bertrand, Claude, Bockhorn, Maximilian, Bolli, Martin, Brekalo, Zdrinko, Bruns, Christiane, Ciria, Ruben, Coker, Ahmet, Croner, Roland, dHoore, Andre, Demartines, Nicolas, Demir, Ekin, Dibra, Arvin, Dilek, Osman Nuri, Dogrul, Ahmet, Efanov, Mikhail, Ekmekcigil, Ela, Ergün, Sefa, Farsi, Marco, Fichtner-Feigl, Stefan, Fretland, Åsmund, Friess, Helmut, Beets, Geerard, Gloor, Beat, Gockel, Ines, Gökakın, Ali Kağan, Gomez i Gavara, Concepción, Gretschel, Stephan, Hackl, Christina, Hecker, Andreas, Heinrich, Stefan, Huber, Tobias, Ibis, Cem, Izbicki, Jakob R, Kahlert, Christoph, Kamphues, Carsten, Kapan, Selin, Kazemier, Geert, Kleeff, Joerg, Klink, Christian, Knoefel, Wolfram, Kosieradzki, Maciej, Kube, Rainer, Löb, Stefan, Maagaard Andersen, Lars, Matthaei, Hanno, Mittler, Jens, Morgul, Mehmet Haluk, Moszkowicz, David, Musanovic, Nermin, Nickel, Felix, Nilsson, Magnus, Öfner, Dietmar, Oruğ, Taner, Pascher, Andreas, Pessaux, Patrick, Radionov, Michail, Raraty, Michael, Reissfelder, Christoph, Rhaiem, Rami, Rotellar, Fernando, Ryska, Miroslav, López-Ben, Santiago, Saribeyoglu, Kaya, Schafmayer, Clemens, Schmelzle, Moritz, Schmidt, Thomas, Schneider, Martin, Schoenberg, Markus, Schöning, Wenzel, Seehofer, Daniel, Sönmez, Recep Erçin, Soubrane, Olivier, Stange, Daniel, Strücker, Benjamin, Tursunovic, Amir, Tüzüner, Acar, Vondran, Florian, Weber, Georg, Wellner, Ulrich, Yazici, Pinar, Yeğen, Cumhur, Yol, Sinan, Institut de Recherche sur les Maladies Virales et Hépatiques (IVH), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), COVID‐19 Surgical Oncology Collaboration Group, Nevermann, N. F., Hillebrandt, K. H., Knitter, S., Ritschl, P. V., Krenzien, F., Benzing, C., Bahra, M., Biebl, M., Sauer, I. M., Ollinger, R., Schoning, W., Schmelzle, M., Pratschke, J., Abu Hilal, M., Aldrighetti, L., Andersson, R., Andras, V., Andreou, A., Arer, I. M., Atici, A. E., Szijarto, A., Ayav, A., Aydin, H. O., Bartsch, D., Belli, A., Bertrand, C., Bockhorn, M., Bolli, M., Brekalo, Z., Bruns, C., Ciria, R., Coker, A., Croner, R., D'Hoore, A., Demartines, N., Demir, E., Dibra, A., Dilek, O. N., Dogrul, A., Efanov, M., Ekmekcigil, E., Ergun, S., Farsi, M., Fichtner-Feigl, S., Fretland, A., Friess, H., Beets, G., Gloor, B., Gockel, I., Gokakin, A. K., Gomez i Gavara, C., Gretschel, S., Hackl, C., Hecker, A., Heinrich, S., Huber, T., Ibis, C., Izbicki, J. R., Kahlert, C., Kamphues, C., Kapan, S., Kazemier, G., Kleeff, J., Klink, C., Knoefel, W., Kosieradzki, M., Kube, R., Lob, S., Maagaard Andersen, L., Matthaei, H., Mittler, J., Morgul, M. H., Moszkowicz, D., Musanovic, N., Nickel, F., Nilsson, M., Ofner, D., Orug, T., Pascher, A., Pessaux, P., Radionov, M., Raraty, M., Reissfelder, C., Rhaiem, R., Rotellar, F., Ryska, M., Lopez-Ben, S., Saribeyoglu, K., Schafmayer, C., Schmidt, T., Schneider, M., Schoenberg, M., Seehofer, D., Sonmez, R. E., Soubrane, O., Stange, D., Strucker, B., Tursunovic, A., Tuzuner, A., Vondran, F., Weber, G., Wellner, U., Yazici, P., Yegen, C., Yol, S., UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service de chirurgie
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, MEDLINE, Surveys and Questionnaires, Correspondence, Pandemic, Humans, Medicine, General, Surgical treatment, Intensive care medicine, Referral and Consultation, Pandemics, Gastrointestinal Neoplasms, SARS-CoV-2, business.industry, Liver Neoplasms, COVID-19, Liver Transplantation, Europe, Pancreatic Neoplasms, Biliary Tract Neoplasms, Surgical Oncology, Italy, Surgical Procedures, Operative, Surgery, Coronavirus Infections, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Published: 2020
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11. Knowledge, awareness, and attitude towards infection prevention and management among surgeons : identifying the surgeon champion

Author: Goran Augustin, Helmut Segovia-Lohse, Boris Sakakushev, Samir Delibegovic, George Gkiokas, Guntars Pupelis, Yoram Kluger, Xavier Guirao, Arda Isik, Therese M. Duane, Michael McFarlane, Ines Rubio-Perez, Victor Y. Kong, Wagih Ghnnam, Dimitris Damaskos, Boyko Atanasov, Federico Coccolini, Fausto Catena, Timothy Craig Hardcastle, András Vereczkei, Miran Rems, Francesco M. Labricciosa, Andreas Hecker, Ernest E. Moore, Alain Chichom-Mefire, Cristian Mesina, Massimo Sartelli, Robert G. Sawyer, A R K Adesunkanmi, Vladimir Khokha, Kamal M.F. Itani, Gian Luca Baiocchi, Jakub Kenig, Aleksandar Karamarkovic, Belinda De Simone, Ionut Negoi, Boonying Siribumrungwong, Jan Ulrych, Addison K. May, Fikri M. Abu-Zidan, Peep Talving, Carlos Augusto Gomes, Gustavo M. Machain, Francesco Cortese, Sanjay Marwah, Donald E. Fry, Iyiade Olaoye, Tadeja Pintar, Marja A. Boermeester, Zaza Demetrashvili, Miguel Caínzos, Ari Leppäniemi, Lena M. Napolitano, Kemal Rasa, Eftychios Lostoridis, Miklosh Bala, Andrey Litvin, Luca Ansaloni, II kirurgian klinikka, Department of Surgery, Clinicum, HUS Abdominal Center, APH - Methodology, AII - Infectious diseases, Surgery, and AGEM - Digestive immunity
Subjects: Male, Health Knowledge, Attitudes, Practice, 030230 surgery, GUIDELINES, 0302 clinical medicine, Antibiotic therapy, Infection, Prevention, Surgeon, Adult, Female, Humans, Infection Control, Middle Aged, Surgeons, Surgical Wound Infection, United States, Antimicrobial stewardship, Medicine, Infection control, 030212 general & internal medicine, Practice, Knowledge awareness, Health Knowledge, Behavior change, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Opinion leadership, Champion, 3. Good health, TIME, Emergency Medicine, Best practice, lcsh:Surgery, SOCIETY, AMERICAN-COLLEGE, 03 medical and health sciences, Nursing, Surgical department, SURGICAL SITE INFECTION, Surgery, ANTIMICROBIAL STEWARDSHIP PROGRAM, business.industry, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, Attitudes, Commentary, UPDATE, business
Abstract: Despite evidence supporting the effectiveness of best practices of infection prevention and management, many surgeons worldwide fail to implement them. Evidence-based practices tend to be underused in routine practice. Surgeons with knowledge in surgical infections should provide feedback to prescribers and integrate best practices among surgeons and implement changes within their team. Identifying a local opinion leader to serve as a champion within the surgical department may be important. The "surgeon champion" can integrate best clinical practices of infection prevention and management, drive behavior change in their colleagues, and interact with both infection control teams in promoting antimicrobial stewardship.
Published: 2018

12. Diffuse colon polyposis unexpected, total regression due to combined treatment on liver metastasis

Author: Zsanett Biró, András Vereczkei, Örs Péter Horváth, and András Papp
Subjects: medicine.medical_specialty, medicine.medical_treatment, Immunology, Colonoscopy, lcsh:Medicine, Applied Microbiology and Biotechnology, Microbiology, Metastasis, FOLFOX, Genetics, medicine, Carcinoma, Molecular Biology, Chemotherapy, medicine.diagnostic_test, business.industry, lcsh:R, Cell Biology, medicine.disease, Surgery, Colon polyps, Precancerous condition, FOLFIRI, Molecular Medicine, Radiology, business, medicine.drug
Abstract: The diffuse colonic polyposis regards as a precancerous condition, thus both in tumorous and in premalignant condition the only therapy is the total colectomy. In our case on a 62-year-old male begun medical checkup due to weakness, slimming and haematochezia. The blood test revealed that the patients CA 19-9 levels were significantly elevated. The colonoscopy found multiple polyposis in the whole large bowel, furthermore a sigma carcinoma with stenosis. During the surgery multiple and bilobar colorectal liver metastasis were verified, which were proposed with CT scan. Because of the obstruction, we made a palliative sigma resection. Then adjuvant FOLFIRI therapy started. After 6 period chemotherapy performed abdominal CT scan showed the progression in the liver process. Therefore second-line Erbitux + FOLFIRI chemotherapy started. After 11 cycles performed restaging CT scan showed significant regression of the liver metastasis. During the control colonoscopy the previously showed multiple polyposis of the large bowel were not detected, the polyps unexpectedly vanished. Because of the significant regression of the liver metastasis suggested the lobectomy, but the oncoteam decided to continue chemotherapy sequence. After 1 year in the course of oncology care performed PET-CT scan showed progression in the liver metastasis particularly in the right lobe. The oncologyst started third-line Avastin + FOLFOX chemotherapy, but the patient died 3 years after the diagnosis. In our opinion, the regression of the diffuse colonic polyposis of the patient was due to the biological therapy. The submitted case is a literary rarity, because there is no relevant data in the literature that describes the positive effect of the chemotherapy for colon polyps.
Published: 2017

13. The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author: Federico Coccolini, Leonel Lagunes, André Ricardo Araujo da Silva, Massimo Sartelli, Sara Al-Dahir, Young R. Lee, Mario Tumbarello, Faryal Khamis, Natalia Santos, Jean Carlet, Fausto Catena, Agron Dogjani, Jan Ulrych, Isidro Martinez Casas, András Vereczkei, Salomone Di Saverio, Sydney Malama, Harry van Goor, Garima Kapoor, Hong Bin Kim, Norio Sato, Gustavo M. Machain, Chinmay Gandhi, Iryna Kozlovska, Ramiro Manzano-Nunez, Katia Iskandar, Fikri M. Abu-Zidan, Sujith J Chandy, Rosio Isabel Guerra Gronerth, Therese M. Duane, Lena M. Napolitano, Carlos A. Ordoñez, Yonghong Xiao, Michael McFarlane, Cristian Mesina, Sanjay Marwah, Goran Augustin, Tatjana Goranovic, Bruno M. Pereira, Ivan Kerschaever, Timothy Craig Hardcastle, Marcelo A. Beltrán, Stephen Y. Liang, Julio C. Haidamus Monteiro, Vishalkumar G Shelat, Kuo Ching Yuan, Sandro Scarpelini, Narayan Dutt Pant, Martha Quiodettis, Carlos Alves, Mutasim M. Elmangory, Céline Pulcini, Addison K. May, Guntars Pupelis, Selman Uranues, Pamela Barbadoro, Sandro Rizoli, Ernest E. Moore, Rifat Latifi, Ashish Khanna, Hossein Samadi Kafil, Richard R. Watkins, Boonying Siribumrungwong, Abdelkarim H. Omari, Agnes Wechsler-Fördös, Lewis J. Kaplan, Nusrat Shafiq, Jason A. Roberts, Warren Lowman, Laurent Dortet, Stephen M. Brecher, Luca Ansaloni, Rodolfo Soto, Tanya L. Zakrison, Sameer Dhingra, Jacobus Preller, Eleftherios Mylonakis, Wagih Ghnnam, Asri Che Jusoh, Pierluigi Viale, Costi D. Sifri, Miklosh Bala, José Gustavo Parreira, Alfredo Ponce-de-León, Jae G. Lee, Jakub Kenig, Kjetil Søreide, Halil Alis, Lilian M. Abbo, Mahir Gachabayov, Marco Catani, Ronald Kiguba, Jean-Ralph Zahar, Wietse P. Zuidema, Robert G. Sawyer, Loredana Scoccia, Nuno Pereira, Vladimir Khokha, Ionut Negoi, Aneel Bhangu, Michał Pędziwiatr, Helen Giamarellou, Garyphallia Poulakou, Shyam Kumar Mishra, Francesco Di Marzo, Jeffrey M. Tessier, Boris Sakakushev, Milica D. Nestorovic, Hamilton Petry de Souza, Tarcisio Reis, Yousheng Li, Dominik Mertz, Andreas Hecker, Ngo Tat Trung, Anand Kumar, Belefquih Bouchra, Leonardo Pagani, James M. Sanders, AA Munyika, Brian S. Zuckerbraun, Souha S. Kanj, Arda Isik, Luigia Scudeller, Adrien Hodonou, Philip S. Barie, Marc Maegele, Jill R. Cherry-Bukowiec, Peep Talving, Orestis Ioannidis, Miran Rems, Oliver A. Cornely, Harumi Gomi, Ewen A. Griffiths, Mushira Enani, Zaza Demetrashvili, Gereltuya Dorj, Piotr Major, Miguel Caínzos, Ari Leppäniemi, Jesús Rodríguez-Baño, Wen Chien Ko, Ziad A. Memish, Osvaldo Chiara, Elif Colak, José Artur Paiva, A R K Adesunkanmi, Timothy M. Rawson, Georgios Gkiokas, Paula Ferrada, Francesco M. Labricciosa, Alain Chichom-Mefire, Jan J. De Waele, Yunfeng Cui, Adrián Camacho-Ortiz, J. Esteban Foianini, Majdi N. Al-Hasan, Belinda De Simone, David P. Nicolau, Kaoru Koike, Athanasios Marinis, Florian M.E. Wagenlehner, Aleksandar Karamarkovic, Adrian Brink, Emilio Maseda, II kirurgian klinikka, Department of Surgery, Clinicum, HUS Abdominal Center, Surgery, Other Research, Università degli Studi di Macerata = University of Macerata (UNIMC), Università Politecnica delle Marche [Ancona] (UNIVPM), Central Hospital [Bolzano, Italy], Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Milpark Hospital (Milpark Hospital), Milpark Hospital, University of Cape Town, World Alliance against Antibiotics Resistance, Cleveland Clinic, Regional Hospital, Limbe, Rimini Infermi Hospital, Maggiore Hospital, Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], University of Bologna, Northeastern Ohio Medical University (NEOMED), Foundation IRCCS Policlinico San Matteo, University of Miami Leonard M. Miller School of Medicine (UMMSM), United Arab Emirates University (UAEU), Obafemi Awolowo University (OAU), Xavier University of Louisiana, University of South Carolina School of Medicine, Columbia, South Carolina, Training Hospital Istanbul, Hospital de São João [Porto], Centro de Investigação em Estudos da Criança (CIEC), Universidade do Minho, University Hospital Center Zagreb, Hadassah Hebrew University Medical Center [Jerusalem], Weill Cornell Medicine [New York], Universidad de La Serena (USERENA), Queens Elizabeth Hospital [Birmingham], Université Internationale de Casablanca (UIC), VA Boston Healthcare System, Boston University School of Medicine (BUSM), Boston University [Boston] (BU), Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of psychiatry-King‘s College London, University Hospital of Cologne [Cologne], 4th Department of Internal Medicine, University of Athens Medical School [Athens], Center for Visual Information Technology [Hyderabad] (CVIT), International Institute of Information Technology, Hyderabad [Hyderabad] (IIIT-H), Chonnam National University [Gwangju], Shanghai Jiaotong University, University of Houston, Centro Hospitalar Universitário São João - Faculty of Medicine - University of Porto - Grupo de Infecção e Sepsis, Porto, Unité de biostatistiques, CHU Clermont-Ferrand, ATTIKON University General Hospital, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Duke University Marine Laboratory, University Hospital Virgen Macarena, Service de bactériologie, virologie, parasitologie et hygiène, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sartelli, M, Labricciosa, FM, Barbadoro, P, Pagani, L, Dorj, G, Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlo, Araujo da Silva, André R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltrán, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Caínzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, Therese M., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Esteban Foianini, J., Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgio, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andrea, Hodonou, Adrien M., Ioannidis, Oresti, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppäniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasio, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, Shyam K., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherio, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, José-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, Bruno M., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobu, Pulcini, Céline, Pupelis, Guntar, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodríguez-Baño, Jesú, Sakakushev, Bori, Sanders, Jame, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Søreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andra, Wagenlehner, Florian, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Fördös, Agne, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, and Zuidema, Wietse P.
Subjects: 0301 basic medicine, Cross-sectional study, Psychological intervention, Antibiotics, Antimicrobial stewardship, Infections, Surgery, Anti-Infective Agents, Antimicrobial Stewardship, Cross-Sectional Studies, Global Health, Humans, Intraabdominal Infections, Postoperative Complications, Surveys and Questionnaires, GUIDELINES, HEALTH-CARE EPIDEMIOLOGY, 0302 clinical medicine, Global health, Medicine and Health Sciences, PROGRAM, Infection control, Medicine, 030212 general & internal medicine, Response rate (survey), DISEASES SOCIETY, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 3. Good health, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], CIRURGIA, Emergency Medicine, Infection, Life Sciences & Biomedicine, medicine.medical_specialty, 030106 microbiology, lcsh:Surgery, MEDLINE, 03 medical and health sciences, Antibiotic resistance, AMERICA, Science & Technology, business.industry, Antibiotic, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, HOSPITALS, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: Contains fulltext : 177987.pdf (Publisher’s version ) (Open Access) BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.
Published: 2017

14. Erratum to: Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Author: Kuo Ching Yuan, Sujith J Chandy, Katia Iskandar, Michael McFarlane, Nathalie Guessennd, M. Bala, Timothy M. Rawson, Francesco M. Labricciosa, Sandro Rizoli, Stephen M. Brecher, Alain Chichom-Mefire, Richard Ofori-Asenso, Rao R. Ivatury, Miguel Sanchez-Garcia, Ngo Tat Trung, Carlos Augusto Gomes, Angel Dillip, Yunfeng Cui, Yousheng Li, Antonio Corcione, Tonny Loho, F. Corcione, Vishalkumar G Shelat, Federico Coccolini, Helen Giamarellou, W. R. Heizmann, Richard R. Watkins, Zaza Demetrashvili, Asma Althani, Iain J. Abbott, Andreas Hecker, Addison K. May, Adrián Camacho-Ortiz, Wagih Ghnnam, Sydney Malama, Kenneth Y.Y. Kok, Jonathan Tilsed, Shamshul Ansari, Garima Kapoor, Young R. Lee, B. Sakakushev, A R K Adesunkanmi, Fausto Catena, Kjetil Søreide, Andrew W. Kirkpatrick, Rifat Latifi, Daniel Curcio, Marc Leone, Norio Sato, Arda Isik, Robert G. Sawyer, Gereltuya Dorj, Mouaqit Ouadii, F. A. Moore, Miran Rems, Jason A. Roberts, Ravinder S. Vohra, Fikri M. Abu-Zidan, András Vereczkei, Zsolt J. Balogh, Georgios Gkiokas, Sara Al-Dahir, Walter L. Biffl, Raul Coimbra, Sonja Hansen, Mainul Haque, Kenji Inaba, Ferdinando Agresta, Jean-Ralph Zahar, Miguel Caínzos, Ari Leppäniemi, Pierre-François Laterre, S. Di Saverio, Jean-François Timsit, Vladimir Khokha, Gabriele Sganga, Luca Ansaloni, Brian J. Wright, Jean Louis Vincent, Agron Dogjani, Jan Ulrych, Reinhold Kafka-Ritsch, Paula Ferrada, Sanjay Marwah, Rashid Ansumana, Swati Dhingra, Lewis J. Kaplan, Warren Lowman, Aneel Bhangu, Matthew C Knox, Ionut Negoi, Yonghong Xiao, Gabriel Trueba, H. A. Segovia Lohse, Claudio Rocha, Waldemar Uhl, Joseph R Fitchett, Gustavo Pereira Fraga, Michael P. Doyle, Jae G. Lee, Goran Augustin, Valery N. Egiev, G. A. Pereira Júnior, Jakub Kenig, Ashwani Kumar, Abdelkarim H. Omari, Peter K. Kim, Oussema Baraket, Suk-Kyung Hong, Stephen Y. Liang, Ernest E. Moore, Torsten Herzog, Mutasim M. Elmangory, Victor Y. Kong, Hervé Dupont, John E. Mazuski, H. van Goor, Pierluigi Viale, Kelly A. Cairns, Guntars Pupelis, Martin G. Kees, Philippe Montravers, Christian Eckmann, R. V. Maier, Yoram Kluger, Marja A. Boermeester, Carl Erik Nord, Ronald Kiguba, Etienne Ruppé, Harumi Gomi, Hany E. Marei, Ewen A. Griffiths, J. J. De Waele, Mushira Enani, Ignacio Martin-Loeches, Boonying Siribumrungwong, B. De Simone, Rodolfo Soto, Caroline Colijn, Samir Delibegovic, Stephanie Goldberg, Marcelo A. Beltrán, Rita Maria Melotti, Matteo Bassetti, Adrien Hodonou, Marc Maegele, Sanoop K. Zachariah, Jill R. Cherry-Bukowiec, Dominik Mertz, Claudio Viscoli, Diego Piazza, Massimo Sartelli, O.R. Buyne, Manuel Guzman-Blanco, Majdi N. Al-Hasan, Peep Talving, Michael Bernhard, Imtiaz Wani, Renato Bessa Melo, I. Di Carlo, Tanya L. Zakrison, Dieter G. Weber, Soumitra R. Eachempati, Carlos A. Ordoñez, Amos Massele, Kaoru Koike, Aleksandar Karamarkovic, Adrian Brink, Brad Spellberg, Maurizio Labbate, David P. Nicolau, Jose J. Diaz, A. Che Jusoh, and Engineering & Physical Science Research Council (EPSRC)
Subjects: medicine.medical_specialty, International Cooperation, lcsh:Surgery, Peritonitis, Microbial Sensitivity Tests, Tigecycline, 030230 surgery, medicine.disease_cause, Emerging and Re-emerging Infectious Diseases, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Anti-Infective Agents, medicine, Humans, Agora, Intensive care medicine, computer.programming_language, Science & Technology, business.industry, Abdominal Infection, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Drug Resistance, Microbial, 030208 emergency & critical care medicine, lcsh:RD1-811, lcsh:RC86-88.9, Prognosis, medicine.disease, Antimicrobial, Methicillin-resistant Staphylococcus aureus, Spelling, 3. Good health, Emergency Medicine, Intraabdominal Infections, Surgery, Artificial intelligence, Erratum, business, computer, Life Sciences & Biomedicine, medicine.drug
Abstract: Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
Published: 2017

15. IROA: International Register of Open Abdomen, preliminary results

Author: Arda Isik, Luca Ansaloni, Tugan Tezcaner, Fausto Catena, Rao R. Ivatury, Federico Coccolini, András Vereczkei, Giulia Montori, Guillermo Perez Chagerben, Francesco Salvetti, Fernando Hernández, Sergei Shlyapnikov, Torsten Kaussen, Mahir Gachabayov, Kuo-Ching Yuan, Boris Sakakushev, Francesco Trotta, Martha Quiodettis, Paola Fugazzola, Zaza Demetrashvili, Rafael L. Curado, Stefano Rausei, Christian Galatioto, Marco Ceresoli, Athanasios Marinis, Ionut Negoi, Desmond Khor, Dimitrios Damaskos, Yovcho Yovtchev, Sefa Ozyazici, Giovanni Bellanova, Aleix Martínez-Pérez, Massimo Chiarugi, Monica Zese, Gianluca Costa, Giuseppe Novelli, Michael Sugrue, Davide Corbella, Miguel Leon Arellano, Gustavo Pereira Fraga, Ohad Guetta, Stefano Costa, Bruno M. Pereira, Demetrios Demetriades, Asri Che Jusoh, Savino Occhionorelli, Orestis Ioannidis, Daniele Dondossola, Wagih Ghannam, Miklosh Bala, Wellington Fernandes, Kenji Inaba, Vinicius Cordeiro Fonseca, Agron Dogjani, Sandeep Singh, Stefano Maccatrozzo, Massimo Sartelli, Mirco Nacoti, Coccolini, F, Montori, G, Ceresoli, M, Catena, F, Ivatury, R, Sugrue, M, Sartelli, M, Fugazzola, P, Corbella, D, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Maccatrozzo, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Yovtchev, Y, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, and Ansaloni, L
Subjects: Male, Internationality, Fistula, Kaplan-Meier Estimate, 030230 surgery, Barker, Cohort Studies, 0302 clinical medicine, Ischemia, Abdomen, Epidemiology, Prospective Studies, Registries, Bogotà bag, Commercial, Compartment, IROA, Negative pressure, Non-commercial, Open abdomen, Peritonitis, Register, Skin, Trauma, Vascular emergencies, Witmann, Child, Digestive System Surgical Procedures, Peritoniti, Abdominal Wound Closure Techniques, Middle Aged, Bogota bag, Vascular emergencie, Child, Preschool, 030220 oncology & carcinogenesis, Emergency Medicine, Female, Erratum, Cohort study, Adult, medicine.medical_specialty, NO, 03 medical and health sciences, Emergency surgery, medicine, Humans, Aged, Adult patients, business.industry, medicine.disease, Surgery, Wounds and Injuries, Pancreatitis, business
Abstract: Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers (R)) through a dedicated website: www.clinicalregisters.org. Results: Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39 +/- 18.37; 56% male; Mean BMI: 36 +/- 5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%), Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(+/- 4.83) days; Mean number of dressing changes: 0.88(+/- 0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p
Published: 2017

16. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

Author: Jort D. Deelder, Hasan H. Eker, Florin Iordache, Mark Tenhagen, Filip Muysoms, Victor Turrado, Marjolein Ankersmit, Annelieke M. K. Harmsen, Ramon Vilallonga, Michael Rhodes, Simone Arolfo, Peter M. N. Y. H. Go, Benjamin Babic, András Vereczkei, Rick S. van den Helder, Gabor S. A. Abis, Ramon R. Gorter, Luigi Boni, Jaap Bonjer, F. Borja DeLacy, Stavros A. Antoniou, Charlotte L. Deijen, Marguerite A. W. Gorter-Stam, M. Papoulas, Marlieke Bruntink, Barbara Defoort, Amish Acharya, M. Mahir Ozmen, Jennifer Straatman, Johannes C.F. Ket, Dieuwertje A. van Dam, Paediatric Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Reproduction & Development, Surgery, and ICaR - Ischemia and repair
Subjects: Appendectomy, Appendicitis, Complicated appendicitis, Laparoscopic appendectomy, Uncomplicated appendicitis, Surgery, medicine.medical_specialty, Time Factors, education, 030230 surgery, Laparoscopy/methods, 03 medical and health sciences, 0302 clinical medicine, Medical, medicine, Humans, ddc:610, Appendicitis/diagnostic imaging, Tomography, Appendectomy/methods, Societies, Medical, Ultrasonography, Surgical research, business.industry, Consensus Statement, Guideline, Antibiotic Prophylaxis, Magnetic Resonance Imaging, X-Ray Computed, Europe, Tomography x ray computed, 030220 oncology & carcinogenesis, Family medicine, Acute appendicitis, Acute Disease, Laparoscopy, Societies, Consensus development, business, Tomography, X-Ray Computed, Web survey
Abstract: Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis. Electronic supplementary material The online version of this article (doi:10.1007/s00464-016-5245-7) contains supplementary material, which is available to authorized users.
Published: 2016

17. Antimicrobials : a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Author: Richard R. Watkins, Adrien Hodonou, Brad Spellberg, Fausto Catena, Marc Maegele, Sanoop K. Zachariah, András Vereczkei, Katia Iskandar, Jill R. Cherry-Bukowiec, Jean-Ralph Zahar, Shamshul Ansari, Luca Ansaloni, Addison K. May, Aneel Bhangu, Rao R. Ivatury, Sujith J Chandy, Joseph R Fitchett, Gustavo Pereira Fraga, Peep Talving, Tonny Loho, Amos Massele, Kaoru Koike, Marcelo A. Beltrán, Salomone Di Saverio, Zaza Demetrashvili, Isidoro Di Carlo, Rifat Latifi, Christian Eckmann, Miran Rems, Adrián Camacho-Ortiz, Dieter G. Weber, Majdi N. Al-Hasan, Manuel Guzman-Blanco, Soumitra R. Eachempati, Ravinder S. Vohra, Kjetil Søreide, Etienne Ruppé, Matteo Bassetti, Arda Isik, Andrew W. Kirkpatrick, Hany E. Marei, Gereltuya Dorj, Belinda De Simone, Aleksandar Karamarkovic, Adrian Brink, Jason A. Roberts, Caroline Colijn, Francesco M. Labricciosa, Mainul Haque, Frederick A. Moore, Michael Bernhard, Miguel Caínzos, Ari Leppäniemi, Sara Al-Dahir, Sonja Hansen, Maurizio Labbate, Boonying Siribumrungwong, Hervé Dupont, Rita Maria Melotti, Helen Giamarellou, Vishal G Shelat, Martin G. Kees, Rodolfo Soto, F. Corcione, Michael McFarlane, Kenji Inaba, Samir Delibegovic, Kuo Ching Yuan, David P. Nicolau, Gerson Alves Pereira Júnior, Jose J. Diaz, Dominik Mertz, Claudio Viscoli, Lewis J. Kaplan, George Gkiokas, Torsten Herzog, Alain Chichom-Mefire, Agron Dogjani, Jan Ulrych, Jan J. De Waele, Jean-François Timsit, Warren Lowman, Yunfeng Cui, Asmaa Althani, Yousheng Li, Diego Piazza, Staphanie R. Goldberg, Yoram Kluger, Carlos A. Ordoñez, Carl Erik Nord, Waldemar Uhl, O.R. Buyne, Imtiaz Wani, Wolfgang R. Heizmann, Valery N. Egiev, Timothy M. Rawson, Abdel K. Omari, Renato Bessa Melo, A R K Adesunkanmi, Miguel Sanchez-Garcia, Pierre-François Laterre, Vladimir Khokha, Harumi Gomi, Massimo Sartelli, Boris Sakakhushev, Ewen A. Griffiths, Ngo Tat Trung, Young R. Lee, Tanya L. Zakrison, Mushira Enani, Ignacio Martin-Loeches, Gabriele Sganga, Ionut Negoi, Carlos Augusto Gomes, Jakub Kenig, Ronald V. Maier, Norio Sato, Gabriel Trueba, Kelly A. Cairns, Claudio Rocha, Anand Kumar, Andreas Hecker, Fikri M. Abu-Zidan, Marja A. Boermeester, Michael P. Doyle, Peter K. Kim, Federico Coccolini, Paula Ferrada, Sandro Rizoli, Stephen M. Brecher, Robert G. Sawyer, Victory Kong, Jean Louis Vincent, Goran Augustin, Suk-Kyung Hong, Stephen Y. Liang, Helmut Alfredo Segovia Lohse, Walter L. Biffl, Reinhold Kafka-Ritsch, Jae Gil Lee, Ernest E. Moore, Sameer Dhingra, Miklosh Bala, Sydney Malama, Kenneth Y.Y. Kok, Oussama Baraket, Harry van Goor, Garima Kapoor, Philippe Montravers, Iain J. Abbott, Wagih Ghnnam, Angel Dillip, Raul Coimbra, Sanjay Marwah, Mouaqit Ouadii, Zsolt J. Balogh, Nathalie Guessennd, Richard Ofori-Asenso, Jonathan Tilsed, Antonio Corcione, Daniel Curcio, Marc Leone, Guntars Pupelis, Yonghong Xiao, Ferdinando Agresta, Mutasim M. Elmangory, Brian J. Wright, John E. Mazuski, Asri Che Jusoh, Perluigi Viale, Ronald Kiguba, Rashid Ansumana, Matthew C Knox, CHU Amiens-Picardie, 6th Department of Internal Medicine, Diagnostic and Therapeutic Center of Athens 'Hygeia', Department of Anesthesiology and Intensive Care, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Hartford Hospital, Department of Laboratory Medicine, Karolinska Institutet [Stockholm], Equipe mobile d'infectiologie, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service Microbiologie-Hygiène Hospitalière, Infectious Diseases, Università degli studi di Genova = University of Genoa (UniGe), Service d'anesthésie - réanimation chirurgicale [CHU Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université libre de Bruxelles (ULB), Sartelli, Massimo, Weber, Dieter G., Ruppé, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean-Loui, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltrán, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry-Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho-Ortiz, Adrian, Chandy, Sujith J., Che Jusoh, Asri, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, José J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Hervé, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzmán-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andrea, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre-Françoi, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amo, Mcfarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Júnior, Gerson Alve, Piazza, Diego, Pupelis, Guntar, Rawson, Timothy Mile, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Bori, Sanchez-Garcia, Miguel, Sato, Norio, Segovia Lohse, Helmut A., Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean-Francoi, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andra, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean-Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, Viale, Perluigi, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), University of Genoa (UNIGE), Sartelli, M, Weber, DG, Ruppe, E, Bassetti, M, Dorj, G, Kok, Kenneth Y.Y., and Viale, Pierluigi
Subjects: Anti-Infective Agent, 0301 basic medicine, INTENSIVE-CARE-UNIT, International Cooperation, Settore MED/18 - CHIRURGIA GENERALE, Drug Resistance, morbidity, Review, Drug resistance, Tigecycline, CLOSTRIDIUM-DIFFICILE INFECTION, VANCOMYCIN-RESISTANT ENTEROCOCCI, Microbial, SPECTRUM-BETA-LACTAMASE, 0302 clinical medicine, Anti-Infective Agents, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine and Health Sciences, Agora, 030212 general & internal medicine, wb_330, computer.programming_language, Iais, biology, Microbial Sensitivity Test, Antimicrobials, Drug Resistance, Microbial, Antimicrobials, (AGORA), Prognosis, Antimicrobial, 3. Good health, CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE, antibiotic-resistance, Intra-abdominal infections (IAI), Surgery, Emergency Medicine, CLINICAL-PRACTICE GUIDELINES, 7c0bbdab, BLOOD-STREAM INFECTIONS, CRITICALLY-ILL PATIENTS, Human, medicine.drug, medicine.medical_specialty, Prognosi, 030106 microbiology, Microbial Sensitivity Tests, wa_110, qw_45, Emerging and Re-emerging Infectious Diseases, 03 medical and health sciences, wi_140, Antibiotic resistance, Intraabdominal Infection, medicine, Humans, intra-abdominal infections, GRAM-NEGATIVE BACTERIA, Intensive care medicine, Chirurgie, VENTILATOR-ASSOCIATED PNEUMONIA, business.industry, Médecine pathologie humaine, Intraabdominal Infections, biology.organism_classification, Review article, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], business, computer
Abstract: Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs., 0, SCOPUS: ar.j, info:eu-repo/semantics/published
Published: 2016

18. Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS Study)

Author: Elif Colak, Iyiade Olaoye, Raghuveer Mn, Tugan Tezcaner, David W da Costa, Varut Lohsiriwat, Vinod V. Prabhu, Tadeja Pintar, Fausto Catena, Raul Coimbra, Daniel Rios-Cruz, Zaza Demetrashvili, Dimitrios Anyfantakis, Isidoro Di Carlo, John Agboola, Konstantinos Pouggouras, Charalampos Spyropoulos, AA Munyika, Sanjay Marwah, Stefano Rausei, Giovanni Bellanova, Francesco Pata, András Vereczkei, Piotr Major, Nereo Vettoretto, Ari Leppäniemi, Ramakrishnapillai Padmakumar, Geanina Loredana Curca, Oussama Baraket, Marco Catani, Massimo Sartelli, Miguel Leon, Konstantinos Bouliaris, Maria Luisa Sánchez de Molina, Eftychios Lostoridis, Gianfranco Cocorullo, Bandar Alharthi, Ionut Negoi, Zygimantas Kuliesius, Sanjay Gupta, Maurice Zida, Terry Curry, Savas Bayrak, Frederic Branger, Pedro Leão, Teresa Giménez Maurel, Saleh Abdel Kader, Cristian Mesina, Marcelo A. Beltrán, Eudaldo López-Tomassetti Fernandez, Carlos A. Ordoñez, Martin Hutan, Jakub Kenig, Avidyl Krasniqi, Sumita A Jain, Tonguç Utku Yılmaz, Miran Rems, Dmitry Smirnov, Gabrielle H. van Ramshorst, Robin Kaushik, Renato Bessa Melo, Mario Paulo Faro, Ouadii Mouaqit, Asri Che Jusoh, Adamu Amhed, Abdelkarim H. Omari, Jaan Tepp, Ali Guner, Miklosh Bala, Charampolos Seretis, Alain Chichom-Mefire, Nadezda Drozdova, Matej Skrovina, Saila Kauhanen, Aurélien Venara, Aintzane Lizarazu Pérez, Kuo-Ching Yuan, Adesina Ajibade, Silvia Figueiredo Costa, Yoshimitsu Izawa, Mahir Gachabayov, Michael McFarlane, Ricardo Alessandro Teixeira Gonsaga, Ashok Kshirsagar, Jae Gil Lee, Gustavo Pereira Fraga, Koray Das, Jan Ulrych, Tamer El Zalabany, Luca Ansaloni, Victor Y. Kong, Matti Tolonen, Jorge Pereira, Nick Michalopoulos, Georgios Gkiokas, Arda Isik, Orestis Ioannidis, Aleix Martínez-Pérez, Seckin Akkucuk, Giovanni Sinibaldi, Gabriela Elisa Nita, Jae Il Kim, Yunfeng Cui, Federico Coccolini, Ewen A. Griffiths, Roberto Bini, Salomone Di Saverio, Mushira Enani, Boris Sakakushev, Mustafa Yener Uzunoglu, Asrhaf Abbas, Fikri M. Abu-Zidan, David van Dellen, Sandra Gutierrez, Samir Delibegovic, Ioannis Nikolopoulos, Daniele Brunelli, Vishal G Shelat, Ferdinando Agresta, Gerson Alves Pereira Júnior, Goran Augustin, Mantas Jokubauskas, Zeynep Özkan, Sanoop K. Zachariah, Nutu Vlad, Romeo Lages Simões, Konstantinos Lasithiotakis, Giorgio Vasquez, Matthew Boal, Daniele Marrelli, Sanjay Kumar Yadav, Paola Rodriguez Ossa, Vladimir Khokha, Carlos Augusto Gomes, Justas Zilinskas, Gianluca Guercioni, Renol M. Koshy, Gian Luca Baiocchi, Athanasios Marinis, Aleksandar Karamarkovic, Radu Moldovanu, Andrey V. Borodach, Myftar Torba, II kirurgian klinikka, Clinicum, [et al.], Universidade do Minho, Sartelli, M., Abu Zidan, F., Catena, F., Griffiths, E., Di Saverio, S., Coimbra, R., Ordoñez, C., Leppaniemi, A., Fraga, G., Coccolini, F., Agresta, F., Abbas, A., Abdel Kader, S., Agboola, J., Amhed, A., Ajibade, A., Akkucuk, S., Alharthi, B., Anyfantakis, D., Augustin, G., Baiocchi, G., Bala, M., Baraket, O., Bayrak, S., Bellanova, G., Beltràn, M., Bini, R., Boal, M., Borodach, A., Bouliaris, K., Branger, F., Brunelli, D., Catani, M., Che Jusoh, A., Chichom Mefire, A., Cocorullo, G., Colak, E., Costa, D., Costa, S., Cui, Y., Curca, G., Curry, T., Das, K., Delibegovic, S., Demetrashvili, Z., Di Carlo, I., Drozdova, N., El Zalabany, T., Enani, M., Faro, M., Gachabayov, M., Giménez Maurel, T., Gkiokas, G., Gomes, C., Gonsaga, R., Guercioni, G., Guner, A., Gupta, S., Gutierrez, S., Hutan, M., Ioannidis, O., Isik, A., Izawa, Y., Jain, S., Jokubauskas, M., Karamarkovic, A., Kauhanen, S., Kaushik, R., Kenig, J., Khokha, V., Kim, J., Kong, V., Koshy, R., Krasniqi, A., Kshirsagar, A., Kuliesius, Z., Lasithiotakis, K., Leão, P., Lee, J., Leon, M., Lizarazu Pérez, A., Lohsiriwat, V., López Tomassetti Fernandez, E., Lostoridis, E., Mn, R., Major, P., Marinis, A., Marrelli, D., Martinez Perez, A., Marwah, S., Mcfarlane, M., Melo, R., Mesina, C., Michalopoulos, N., Moldovanu, R., Mouaqit, O., Munyika, A., Negoi, I., Nikolopoulos, I., Nita, G., Olaoye, I., Omari, A., Ossa, P., Ozkan, Z., Padmakumar, R., Pata, F., Pereira Junior, G., Pereira, J., Pintar, T., Pouggouras, K., Prabhu, V., Rausei, S., Rems, M., Rios Cruz, D., Sakakushev, B., Sánchez de Molina, M., Seretis, C., Shelat, V., Simões, R., Sinibaldi, G., Skrovina, M., Smirnov, D., Spyropoulos, C., Tepp, J., Tezcaner, T., Tolonen, M., Torba, M., Ulrych, J., Uzunoglu, M., van Dellen, D., van Ramshorst, G., Vasquez, G., Venara, A., Vereczkei, A., Vettoretto, N., Vlad, N., Yadav, S., Yilmaz, T., Yuan, K., Zachariah, S., Zida, M., Zilinskas, J., and Ansaloni, L.
Subjects: medicine.medical_specialty, Infections, Intra-abdominal, Sepsis, Septic shock, Ciências da Saúde [Ciências Médicas], Surgery, Emergency Medicine, Ciências Médicas::Ciências da Saúde, Sepsi, medicine.medical_treatment, macromolecular substances, 030230 surgery, GUIDELINES, Likelihood ratios in diagnostic testing, PERITONITIS, 03 medical and health sciences, PROGNOSTIC-FACTORS, 0302 clinical medicine, Internal medicine, Medicine and Health Sciences, MANAGEMENT, medicine, Intra-abdominal Sepsis, Univariate analysis, Science & Technology, COLONIC PERFORATION, Receiver operating characteristic, business.industry, Abdominal Infection, Immunosuppression, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Infections, Intra-abdominal Sepsis, Observational study, Infection, business, SYSTEM, Research Article
Abstract: BACKGROUND: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. ----- METHODS: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. ----- RESULTS: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p
Published: 2015

19. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author: Massimo Sartelli, Francesco M. Labricciosa, Federico Coccolini, Raul Coimbra, Fikri M. Abu-Zidan, Luca Ansaloni, Majdi N. Al-Hasan, Shamshul Ansari, Philip S. Barie, Miguel Angel Caínzos, Marco Ceresoli, Massimo Chiarugi, Jeffrey A. Claridge, Enrico Cicuttin, Evan Patchen Dellinger, Donald E. Fry, Xavier Guirao, Timothy Craig Hardcastle, Andreas Hecker, Ari K. Leppäniemi, Andrey Litvin, Sanjay Marwah, Emilio Maseda, John E. Mazuski, Ziad Ahmed Memish, Andrew W. Kirkpatrick, Leonardo Pagani, Mauro Podda, Huseyin Kemal Rasa, Boris E. Sakakushev, Robert G. Sawyer, Fabio Tumietto, Yonghong Xiao, Wedad Faraj Aboubreeg, Harissou Adamou, Lali Akhmeteli, Emrah Akin, Maria Grazia Alberio, Felipe Alconchel, Ibrahim Amadou Magagi, Ana Belén Araúz, Giulio Argenio, Boyko C. Atanasov, Semra Demirli Atici, Selmy Sabry Awad, Efstratia Baili, Lovenish Bains, Miklosh Bala, Oussama Baraket, Suman Baral, Vladislav A. Belskii, Moussa Benboubker, Offir Ben-Ishay, Pierpaolo Bordoni, Abdalia Boumédiène, Giuseppe Brisinda, Laura Cavazzuti, Sujith J. Chandy, Maria Michela Chiarello, Nicola Cillara, Guglielmo Clarizia, Maria-Elena Cocuz, Iuliu Gabriel Cocuz, Luigi Conti, Raffaella Coppola, Yunfeng Cui, Jacek Czepiel, Fabrizio D’Acapito, Dimitrios Damaskos, Koray Das, Belinda De Simone, Samir Delibegovic, Zaza Demetrashvili, Dzemail S. Detanac, Sameer Dhingra, Stefano Di Bella, Evgeni N. Dimitrov, Agron Dogjani, Mario D’Oria, Irina Magdalena Dumitru, Mutasim M. Elmangory, Octavian Enciu, Massimo Fantoni, Daniela Filipescu, Francesco Fleres, Domitilla Foghetti, Pietro Fransvea, Mahir Gachabayov, Rita Galeiras, Gianni Gattuso, Wagih M. Ghannam, Valeria Ghisetti, Giorgio Giraudo, Kebebe Bekele Gonfa, Emre Gonullu, Yousif Tag Elsir Y. Hamad, Matthias Hecker, Arda Isik, Nizar Ismail, Azzain Ismail, Sumita Agarwal Jain, Souha S. Kanj, Garima Kapoor, Ilias Karaiskos, Alfie J. Kavalakat, Jakub Kenig, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Jae Il Kim, Yoshiro Kobe, Kenneth Yuh Yen Kok, Bojan M. Kovacevic, Igor Andreevich Kryvoruchko, Akira Kuriyama, Aitor Landaluce-Olavarria, Konstantinos Lasithiotakis, Varut Lohsiriwat, Eftychios Lostoridis, Davide Luppi, Gustavo Miguel Machain Vega, Marc Maegele, Athanasios Marinis, Gennaro Martines, Aleix Martínez-Pérez, Damien Massalou, Cristian Mesina, Gökhan Metan, María Guadalupe Miranda-Novales, Shyam Kumar Mishra, Mohaned Ibrahim Hussein Mohamed, Ali Yasen Y. Mohamedahmed, Ismael Mora-Guzmán, Francesk Mulita, Ana-Maria Musina, Pradeep H. Navsaria, Ionut Negoi, Gabriela Elisa Nita, Donal B. O’Connor, Carlos Alberto Ordoñez, Desiré Pantalone, Arpád Panyko, Aristeidis Papadopoulos, Nikolaos Pararas, Francesco Pata, Tapan Patel, Gianluca Pellino, Teresa Perra, Gennaro Perrone, Antonio Pesce, Tadeja Pintar, Georgi Ivanov Popivanov, Alberto Porcu, Martha Alexa Quiodettis, Razrim Rahim, Ashrarur Rahman Mitul, Martin Reichert, Miran Rems, Glendee Yolande Reynolds Campbell, Nuno Rocha-Pereira, Gabriel Rodrigues, Gustavo Eduardo Roncancio Villamil, Stefano Rossi, Ibrahima Sall, Hossein Samadi Kafil, Diego Sasia, Jeremiah Seni, Charalampos Seretis, Mario Serradilla-Martín, Vishal G. Shelat, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Boun Kim Tan, Antonio Tarasconi, Dario Tartaglia, Elena Adelina Toma, Gia Tomadze, Adriana Toro, Marcos Roberto Tovani-Palone, Harry van Goor, Alin Vasilescu, Andras Vereczkei, Massimiliano Veroux, Sergio Alberto Weckmann, Lukas Werner Widmer, AliIbrahim Yahya, Sanoop K. Zachariah, Andee Dzulkarnaen Zakaria, Nadezhda Zubareva, Wietse P. Zuidema, Isidoro Di Carlo, Francesco Cortese, Gian Luca Baiocchi, Ronald V. Maier, and Fausto Catena
Subjects: Cross-sectional survey, Antimicrobial stewardship, Antibiotic prescribing, Antibiotic resistance, Infection prevention and control, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.
Published: 2022
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20. Novel Noninvasive Paraclinical Study Method for Investigation of Liver Diseases

Author: Nina Gyorfi, Adrian Robert Gal, Andras Fincsur, Karoly Kalmar-Nagy, Kitti Mintal, Edina Hormay, Attila Miseta, Tamas Tornoczky, Anita Katalin Nemeth, Peter Bogner, Tamas Kiss, Zsuzsanna Helyes, Zoltan Sari, Mihaly Klincsik, Vladimir Tadic, Laszlo Lenard, Andras Vereczkei, Zoltan Karadi, Zoltan Vizvari, and Attila Toth
Subjects: NAFLD, hepatic steatosis, bioelectrical impedance spectroscopy, noninvasive measurement, low-frequency measurement, validation, Biology (General), QH301-705.5
Abstract: Based on a prior university patent, the authors developed a novel type of bioimpedance-based test method to noninvasively detect nonalcoholic fatty liver disease (NAFLD). The development of a new potential NAFLD diagnostic procedure may help to understand the underlying mechanisms between NAFLD and severe liver diseases with a painless and easy-to-use paraclinical examination method, including the additional function to detect even the earlier stages of liver disease. The aim of this study is to present new results and the experiences gathered in relation to NAFLD progress during animal model and human clinical trials.
Published: 2023
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21. A pandemic recap: lessons we have learned

Author: Federico Coccolini, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Bruno Viaggi, Akira Kuriyama, Edoardo Picetti, Chad Ball, Fikri Abu-Zidan, Marco Ceresoli, Bruno Turri, Sumita Jain, Carlo Palombo, Xavier Guirao, Gabriel Rodrigues, Mahir Gachabayov, Fernando Machado, Lostoridis Eftychios, Souha S. Kanj, Isidoro Di Carlo, Salomone Di Saverio, Vladimir Khokha, Andrew Kirkpatrick, Damien Massalou, Francesco Forfori, Francesco Corradi, Samir Delibegovic, Gustavo M. Machain Vega, Massimo Fantoni, Demetrios Demetriades, Garima Kapoor, Yoram Kluger, Shamshul Ansari, Ron Maier, Ari Leppaniemi, Timothy Hardcastle, Andras Vereczkei, Evika Karamagioli, Emmanouil Pikoulis, Mauro Pistello, Boris E. Sakakushev, Pradeep H. Navsaria, Rita Galeiras, Ali I. Yahya, Aleksei V. Osipov, Evgeni Dimitrov, Krstina Doklestić, Michele Pisano, Paolo Malacarne, Paolo Carcoforo, Maria Grazia Sibilla, Igor A. Kryvoruchko, Luigi Bonavina, Jae Il Kim, Vishal G. Shelat, Jacek Czepiel, Emilio Maseda, Sanjay Marwah, Mircea Chirica, Giandomenico Biancofiore, Mauro Podda, Lorenzo Cobianchi, Luca Ansaloni, Paola Fugazzola, Charalampos Seretis, Carlos Augusto Gomez, Fabio Tumietto, Manu Malbrain, Martin Reichert, Goran Augustin, Bruno Amato, Alessandro Puzziello, Andreas Hecker, Angelo Gemignani, Arda Isik, Alessandro Cucchetti, Mirco Nacoti, Doron Kopelman, Cristian Mesina, Wagih Ghannam, Offir Ben-Ishay, Sameer Dhingra, Raul Coimbra, Ernest E. Moore, Yunfeng Cui, Martha A. Quiodettis, Miklosh Bala, Mario Testini, Jose Diaz, Massimo Girardis, Walter L. Biffl, Matthias Hecker, Ibrahima Sall, Ugo Boggi, Gabriele Materazzi, Lorenzo Ghiadoni, Junichi Matsumoto, Wietse P. Zuidema, Rao Ivatury, Mushira A. Enani, Andrey Litvin, Majdi N. Al-Hasan, Zaza Demetrashvili, Oussama Baraket, Carlos A. Ordoñez, Ionut Negoi, Ronald Kiguba, Ziad A. Memish, Mutasim M. Elmangory, Matti Tolonen, Korey Das, Julival Ribeiro, Donal B. O’Connor, Boun Kim Tan, Harry Van Goor, Suman Baral, Belinda De Simone, Davide Corbella, Pietro Brambillasca, Michelangelo Scaglione, Fulvio Basolo, Nicola De’Angelis, Cino Bendinelli, Dieter Weber, Leonardo Pagani, Cinzia Monti, Gianluca Baiocchi, Massimo Chiarugi, Fausto Catena, and Massimo Sartelli
Subjects: Pandemia, International, Thoughts, Reflection, Ethics, Biology, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.
Published: 2021
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22. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

Author: Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Oussama Baraket, Suman Baral, Walter L. Biffl, Marja A. Boermeester, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Elif Colak, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola de’ Angelis, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Stijn W. de Jonge, Sameer Dhingra, Stefano Di Bella, Francesco Di Marzo, Salomone Di Saverio, Agron Dogjani, Therese M. Duane, Mushira Abdulaziz Enani, Paola Fugazzola, Joseph M. Galante, Mahir Gachabayov, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Syed Mohammad Umar Kabir, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Igor A. Kryvoruchko, Kenji Inaba, Arda Isik, Katia Iskandar, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Gustavo M. Machain, Ronald V. Maier, Athanasios Marinis, Cristina Marmorale, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Manos Pikoulis, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Helmut Segovia Lohse, Gabriele Sganga, Vishal G. Shelat, Ian Stephens, Michael Sugrue, Antonio Tarasconi, Joel Noutakdie Tochie, Matti Tolonen, Gia Tomadze, Jan Ulrych, Andras Vereczkei, Bruno Viaggi, Chiara Gurioli, Claudio Casella, Leonardo Pagani, Gian Luca Baiocchi, and Fausto Catena
Subjects: Intra-abdominal infections, Peritonitis, Sepsis, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.
Published: 2021
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23. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

Author: Salvador Navarro, Giorgio Giraudo, Harry van Goor, Sergio Aloia, Saila Kauhanen, Luca Ansaloni, Miran Rems, Cyrille Huchon, Rodolfo Scibé, Stefano Rausei, Ihor Herych, Damien Massalou, Ferdinando Agresta, Gianluca Guercioni, Fausto Catena, Cristian Mesina, Olivier Pittet, Ionut Negoi, Konstantinos Bouliaris, Cristian Tranà, Elia Poiasina, András Vereczkei, Marco Catani, Jorge Pereira, Mario Dente, Vladimir Khokha, Zoran Krivokapic, Alessandro Ferrero, Daniele Marrelli, Federico Coccolini, Pietro Coletta, Athanasios Marinis, Radu Moldovanu, Dmitry Smirnov, Dimitrios Giakoustidis, Daniel Lazzareschi, Jelena Petrović, Matej Skrovina, Samipetteri Laine, Fabio Cesare Campanile, Ludwig Ney, Martin Hutan, P. Pletinckx, Michele Cucchi, Adam Dziki, Korhan Taviloğlu, Günter Weiss, Mirjami Uotila-Nieminen, Salomone Di Saverio, Pierluigi Viale, Davide Corbella, Avdyl Krasniqi, Dragoljub Zivanovic, Elio Jovine, Piotr Major, Nikola Vladov, Ari Leppäniemi, Nurkan Törer, Sergio Colizza, Carlo De Werra, Charalampos Seretis, Orestis Ioannidis, Nereo Vettoretto, Jaan Tepp, Eliane Angst, Konstantinos Lasithiotakis, Jakub Kenig, Massimo Sartelli, Goran Augustin, Giorgio Vasquez, Helen Tzerbinis, Tadeja Pintar, Miguel Leon, Renato Bessa Melo, Halil Alis, Rafael Díaz-Nieto, Roberto Bini, Boris Sakakushev, David van Dellen, Samir Delibegovic, [Sartelli,M, Lazzareschi,DV, Scibè,R] Department of Surgery, Macerata Hospital, Macerata, Italy. [Catena,F, Cucchi,M] Emergency Surgery, Maggiore Parma Hospital, Parma, Italy. [Ansaloni,L, Coccolini,F, Poiasina,E] Department of General Surgery, Ospedali Riuniti, Bergamo, Italy. [Leppaniemi,A] Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland. [Taviloglu,K] Department of Surgery, Sisli Florence Nigtingale Hospital, Istanbul, Turkey. [van Goor,H] Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands. [Viale,P] Department of Internal Medicine Geriatrics and Nephrologic Diseases, Clinic of Infectious Diseases, St Orsola-Malpighi University Hospital, Bologna, Italy. [Corbela,D] Department of Anestesiology, Ospedali Riuniti, Bergamo, Italy. [de Werra,C, Aloia,S] General, Oncological, Geriatrical Surgery and advanced Technology, University Federico II, Naples, Italy. [Marrelli,D] Department of Human Pathology and Oncology, Policlinico le Scotte, University Hospital, Siena, Italy. [Colizza,S] Department of Surgery, Fatebenefratelli Isola Tiberina hospital, Rome, Italy. [Alis,H] Department of General Surgery, Bakirkoy Training Research Hospital, Istanbul, Turkey. [Torer,N] Department of General Surgery, Baskent University Faculty of Medicine, Adana, Turkey. [Navarro,S] Department of Surgery, Parc Tauli University Hospital, Barcelona, Spain. [Sakakushev,B] First General Surgery Clinic, University Hospital St. George/Chair of Surgical Propedeutics, Medical Faculty, Medical University Plovdiv, Plovdic, Bulgaria. [Massalou,D] Department of Emergency Surgery, University Hospital of Nice, University of Nice Sophia-Antipolis, Sophia-Antipolis, France. [Augustin,G] Department of Surgery, University Hospital Center, Zagreb, Croatia. [Catani,M] Emergency Department, Umberto I Hospital, 'La Sapienza' University of Rome, Rome, Italy. [Kauhanen,S] Department of Gastroenterological surgery Turku, University Central Hospital, Turku, Finland. [Pletinckx,P] Department of Surgery, AZ Maria Middelares, Ghent, Belgium. [Kenig,J] 3rd Department of Generał Surgery, Narutowicz Hospital, Krakow, Połand. [Di Saverio,S, Jovine,E] Department of Surgery, Maggiore Hospital, Bologna, Italy. [Guercioni,G] Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy. [Skrovina,M] Department of Surgery Hospital and Oncological Centre Novy Jicin, Novy Jicin, Czech republic. [Díaz-Nieto,R] Department of General and Digestive Surgery, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Ferrero,A] Department of Surgery, Mauriziano Hospital, Torino, Italy. [Rausei,S] Department of Surgery (Chief Renzo Dionigi), University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. [Laine,S] Department GI-surgery, Kuopio University Hospital, Kuopio, Finland. [Major,P] 2nd Department of Surgery, Jagiellonian University, Krakow, Poland. [Angst,E] Department of Visceral Surgery and Medicine, Inselspital Bern, University of Bern, Bern, Switzerland. [Pittet,O] Department of Visceral Surgery Centre Hospitalier Universitaire Vaudois, CHUV, Lausanne, Switzerland. [Herych,I] Department of General Surgery, Lviv Emergency Hospital, Lviv, Ukraine. [Agresta,F] Department of General Surgery, Ospedale Civile, Adria (RO), Italy. [Vettoretto,N] General and Vascular Surgery, M.Mellini Hospital, Chiari, Italy. [Tepp,J] First General Surgery, North Estonia Regional Hospital, Tallinn, Estonia. [Weiss,G] Intensive Care Klinikum, Magdeburg gGmbH, Magdeburg, Germany. [Vasquez,G] Department of Emergency Surgery Azienda Ospedaliero-Universitaria S.Anna, Ferrara, Italy. [Vladov,N] Department of Hepato-biliary and Pancreatic surgery and Transplantology, Military Medical Hospital, Sofia, Bulgaria. [Tranà,C] Department of Surgery, Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy. [Delivegovic,S] Department of surgery, University Clinic Center Tuzla, Tuzla, Bosnia and Herzegovina. [Dziki,A] Department of General and Colorectal Surgery, University Hospital, Central Veterans Hospital, Lodz, Poland. [Giraudo,G] Surgical Department Santa Croce e Carle hospital, Cuneo, Italy. [Pereira,J] Department of Surgery, São Teotónio Hospital, Viseu, Portugal. [Tzerbinis,H] Department of HPB and Liver Transplant Surgery, Royal Free Hospital, London, United Kingdom. [van Dellen,D] Department of Surgery, Manchester Royal Infirmare, Manchester, UK. [Hutan,M] IInd Surgical department of Medical faculty Comenius University, University Hospital Bratislava, st. Cyril and Methodius Hospital, Bratislava, Slovakia. [Vereczkei,A] Department of Surgery, Medical School University of Pécs, Pécs, Hungary. [Krasniqi,A] Department of Abdominal Surgery, University Clinical Centre of Kosovo, Prishtina, Kosovo. [Seretis,Ch] 2nd Department of Surgery, General Army Hospital of Athens, Athens, Greece. [Mesina,C] Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Roumanie. [Rems,M] Surgical Department, General hospital Jesenice, Jesenice, Slovenia. [Campanile,FC] Department of surgery, Andosilla Hospital, Civita Castellana, Italy. [Coletta,P] Department of Surgery, Jesi Hospital, Jesi, Italy. [Uotila-Nieminen,M] Department of Gastrointestinal Surgery, North Carelian Central Hospital, Joensuu, Finland. [Dente,M] Oncologic, Digestive and Emergency Surgery, Bocage Hospital, Dijon, France. [Bouliaris,K] Surgical Department General Hospital of Larissa, Larissa, Greece. [Lasithiotakis,K] Department of General Surgery, University Hospital of Heraklion, Heraklion, Greece. [KhoKha,V] Surgical Department, Mozyr, Belarus. [Zivanovic,D] Department of Pediatric surgery, Paediatric surgery and orthopaedic Clinic, Nis, Serbia. [Smirnov,D] General Surgery, Clinical Hospital at Chelyabinsk Station OJSC 'Russian Railroads', Chelyabinsk City, Russian Federation. [Marinis,A] First Department of Surgery, Tzanion General Hospital, Piraeus, Greece. [Negoi,I] Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania. [Ney,L] Deparment of Surgery, Downtown Campus, University Hospital of Munich, Munich, Germany. [Bini,R] General and emergency surgery, SG Bosco Hospital, Torino, Italy. [León,M] Department of General Surgery, Hospital La Paz, Madrid, Spain. [Huchon,C] Department of Gynecology and Obstetrics, CHI Poissy-St-Germain-En-Laye, France and University Versailles Saint-Quentin, Versailles, France. [Moldovanu,R] Chirurgie Viscerale, Digestive et Oncologique Hospital Prive, Arras les Bonnettes, Arras, France. [de Melo,RB] Department of General Surgery, Hospital São João Porto, Porto, Portugal. [Giakoustidis,D] Division of Transplantation, Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece. [Ioannidis,O] 1st Surgical Department, General Regional Hospital 'George Papanikolaou', Thessaloniki, Greece. [Pintar,T] Department of Abdominal Surgery, umc Ljubljana, Ljubljana, Slovenia. [Krivokapic,Z, Petrovic,J] First Surgical clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade 8, Belgrade, Serbia., and II kirurgian klinikka
Subjects: Infecciones Intraabdominales, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Digestive System Surgical Procedures [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial [Medical Subject Headings], 030230 surgery, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drainage [Medical Subject Headings], Abceso Abdominal, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Reoperation [Medical Subject Headings], 0302 clinical medicine, Epidemiology, Farmacoresistencia Microbiana, Medicine, Diseases::Bacterial Infections and Mycoses::Infection::Sepsis [Medical Subject Headings], PRIMARY ANASTOMOSIS, Publication Characteristics::Study Characteristics::Multicenter Study [Medical Subject Headings], Adulto, Mortality rate, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Diverticulitis, 3. Good health, Humanos, Procedimientos Quirúrgicos del Sistema Digestivo, 030220 oncology & carcinogenesis, Emergency Medicine, Diseases::Digestive System Diseases::Peritoneal Diseases::Peritonitis [Medical Subject Headings], Reoperación, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness [Medical Subject Headings], Research Article, medicine.medical_specialty, Perforation (oil well), education, Infección Hospitalaria, lcsh:Surgery, APPENDECTOMY, Enfermedad Crítica, Diseases::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess [Medical Subject Headings], Sepsis, 03 medical and health sciences, Internal medicine, HARTMANNS PROCEDURE, MANAGEMENT, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Estudio Multicéntrico, Diseases::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [Medical Subject Headings], business.industry, Septic shock, Abdominal Infection, lcsh:RD1-811, lcsh:RC86-88.9, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, PRIMARY RESECTION, Emergency medicine, Observational study, Surgery, business, DIVERTICULITIS
Abstract: The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012). Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152). According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.
Published: 2012

24. Design and Development of a Flexible 3D-Printed Endoscopic Grasping Instrument

Author: Boban Sudarevic, Joel Troya, Karl-Hermann Fuchs, Alexander Hann, Andras Vereczkei, and Alexander Meining
Subjects: endoscopy, endoscopic intervention, 3D printing, endoscopic instruments, minimally invasive surgery, rapid prototyping, Technology, Engineering (General). Civil engineering (General), TA1-2040, Biology (General), QH301-705.5, Physics, QC1-999, Chemistry, QD1-999
Abstract: (1) Background: Interventional endoscopic procedures are growing more popular, requiring innovative instruments and novel techniques. Three-dimensional printing has demonstrated great potential for the rapid development of prototypes that can be used for the early assessment of various concepts. In this work, we present the development of a flexible endoscopic instrument and explore its potential benefits. (2) Methods: The properties of the instrument, such as its maneuverability, flexibility, and bending force, were evaluated in a series of bench tests. Additionally, the effectiveness of the instrument was evaluated in an ex vivo porcine model by medical experts, who graded its properties and performance. Furthermore, the time necessary to complete various interventional endoscopic tasks was recorded. (3) Results: The instrument achieved bending angles of ±216° while achieving a bending force of 7.85 (±0.53) Newtons. The time needed to reach the operating region was 120 s median, while it took 70 s median to insert an object in a cavity. Furthermore, it took 220 s median to insert the instrument and remove an object from the cavity. (4) Conclusions: This study presents the development of a flexible endoscopic instrument using three-dimensional printing technology and its evaluation. The instrument demonstrated high bending angles and forces, and superior properties compared to the current state of the art. Furthermore, it was able to complete various interventional endoscopic tasks in minimal time, thus potentially leading to the improved safety and effectiveness of interventional endoscopic procedures in the future.
Published: 2023
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25. Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study

Author: Massimo Sartelli, Fikri M. Abu-Zidan, Francesco M. Labricciosa, Yoram Kluger, Federico Coccolini, Luca Ansaloni, Ari Leppäniemi, Andrew W. Kirkpatrick, Matti Tolonen, Cristian Tranà, Jean-Marc Regimbeau, Timothy Hardcastle, Renol M. Koshy, Ashraf Abbas, Ulaş Aday, A. R. K. Adesunkanmi, Adesina Ajibade, Lali Akhmeteli, Emrah Akın, Nezih Akkapulu, Alhenouf Alotaibi, Fatih Altintoprak, Dimitrios Anyfantakis, Boyko Atanasov, Goran Augustin, Constança Azevedo, Miklosh Bala, Dimitrios Balalis, Oussama Baraket, Suman Baral, Or Barkai, Marcelo Beltran, Roberto Bini, Konstantinos Bouliaris, Ana B. Caballero, Valentin Calu, Marco Catani, Marco Ceresoli, Vasileios Charalampakis, Asri Che Jusoh, Massimo Chiarugi, Nicola Cillara, Raquel Cobos Cuesta, Luigi Cobuccio, Gianfranco Cocorullo, Elif Colak, Luigi Conti, Yunfeng Cui, Belinda De Simone, Samir Delibegovic, Zaza Demetrashvili, Demetrios Demetriades, Ana Dimova, Agron Dogjani, Mushira Enani, Federica Farina, Francesco Ferrara, Domitilla Foghetti, Tommaso Fontana, Gustavo P. Fraga, Mahir Gachabayov, Grelpois Gérard, Wagih Ghnnam, Teresa Giménez Maurel, Georgios Gkiokas, Carlos A. Gomes, Ali Guner, Sanjay Gupta, Andreas Hecker, Elcio S. Hirano, Adrien Hodonou, Martin Hutan, Igor Ilaschuk, Orestis Ioannidis, Arda Isik, Georgy Ivakhov, Sumita Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Robin Kaushik, Jakub Kenig, Vladimir Khokha, Denis Khokha, Jae Il Kim, Victor Kong, Dimitris Korkolis, Vitor F. Kruger, Ashok Kshirsagar, Romeo Lages Simões, Andrea Lanaia, Konstantinos Lasithiotakis, Pedro Leão, Miguel León Arellano, Holger Listle, Andrey Litvin, Aintzane Lizarazu Pérez, Eudaldo Lopez-Tomassetti Fernandez, Eftychios Lostoridis, Davide Luppi, Gustavo M. Machain V, Piotr Major, Dimitrios Manatakis, Marianne Marchini Reitz, Athanasios Marinis, Daniele Marrelli, Aleix Martínez-Pérez, Sanjay Marwah, Michael McFarlane, Mirza Mesic, Cristian Mesina, Nickos Michalopoulos, Evangelos Misiakos, Felipe Gonçalves Moreira, Ouadii Mouaqit, Ali Muhtaroglu, Noel Naidoo, Ionut Negoi, Zane Nikitina, Ioannis Nikolopoulos, Gabriela-Elisa Nita, Savino Occhionorelli, Iyiade Olaoye, Carlos A. Ordoñez, Zeynep Ozkan, Ajay Pal, Gian M. Palini, Kyriaki Papageorgiou, Dimitris Papagoras, Francesco Pata, Michał Pędziwiatr, Jorge Pereira, Gerson A. Pereira Junior, Gennaro Perrone, Tadeja Pintar, Magdalena Pisarska, Oleksandr Plehutsa, Mauro Podda, Gaetano Poillucci, Martha Quiodettis, Tuba Rahim, Daniel Rios-Cruz, Gabriel Rodrigues, Dmytry Rozov, Boris Sakakushev, Ibrahima Sall, Alexander Sazhin, Miguel Semião, Taanya Sharda, Vishal Shelat, Giovanni Sinibaldi, Dmitrijs Skicko, Matej Skrovina, Dimitrios Stamatiou, Marco Stella, Marcin Strzałka, Ruslan Sydorchuk, Ricardo A. Teixeira Gonsaga, Joel Noutakdie Tochie, Gia Tomadze, Lara Ugoletti, Jan Ulrych, Toomas Ümarik, Mustafa Y. Uzunoglu, Alin Vasilescu, Osborne Vaz, Andras Vereczkei, Nutu Vlad, Maciej Walędziak, Ali I. Yahya, Omer Yalkin, Tonguç U. Yilmaz, Ali Ekrem Ünal, Kuo-Ching Yuan, Sanoop K. Zachariah, Justas Žilinskas, Maurizio Zizzo, Vittoria Pattonieri, Gian Luca Baiocchi, and Fausto Catena
Subjects: Acute peritonitis, Source control, Early warning score, Emergency surgery, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Methods This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28–66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4–10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0–1, 22.7% for those who had scores of 2–3, 46.8% for those who had scores of 4–5, and 86.7% for those who have scores of 7–8. Conclusions The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
Published: 2019
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26. Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Author: Massimo Sartelli, Gian L. Baiocchi, Salomone Di Saverio, Francesco Ferrara, Francesco M. Labricciosa, Luca Ansaloni, Federico Coccolini, Deepak Vijayan, Ashraf Abbas, Hariscine K. Abongwa, John Agboola, Adamu Ahmed, Lali Akhmeteli, Nezih Akkapulu, Seckin Akkucuk, Fatih Altintoprak, Aurelia L. Andreiev, Dimitrios Anyfantakis, Boiko Atanasov, Miklosh Bala, Dimitrios Balalis, Oussama Baraket, Giovanni Bellanova, Marcelo Beltran, Renato Bessa Melo, Roberto Bini, Konstantinos Bouliaris, Daniele Brunelli, Adrian Castillo, Marco Catani, Asri Che Jusoh, Alain Chichom-Mefire, Gianfranco Cocorullo, Raul Coimbra, Elif Colak, Silvia Costa, Koray Das, Samir Delibegovic, Zaza Demetrashvili, Isidoro Di Carlo, Nadezda Kiseleva, Tamer El Zalabany, Mario Faro, Margarida Ferreira, Gustavo P. Fraga, Mahir Gachabayov, Wagih M. Ghnnam, Teresa Giménez Maurel, Georgios Gkiokas, Carlos A. Gomes, Ewen Griffiths, Ali Guner, Sanjay Gupta, Andreas Hecker, Elcio S. Hirano, Adrien Hodonou, Martin Hutan, Orestis Ioannidis, Arda Isik, Georgy Ivakhov, Sumita Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Saila Kauhanen, Robin Kaushik, Alfie Kavalakat, Jakub Kenig, Vladimir Khokha, Desmond Khor, Dennis Kim, Jae I. Kim, Victor Kong, Konstantinos Lasithiotakis, Pedro Leão, Miguel Leon, Andrey Litvin, Varut Lohsiriwat, Eudaldo López-Tomassetti Fernandez, Eftychios Lostoridis, James Maciel, Piotr Major, Ana Dimova, Dimitrios Manatakis, Athanasio Marinis, Aleix Martinez-Perez, Sanjay Marwah, Michael McFarlane, Cristian Mesina, Michał Pędziwiatr, Nickos Michalopoulos, Evangelos Misiakos, Ali Mohamedahmed, Radu Moldovanu, Giulia Montori, Raghuveer Mysore Narayana, Ionut Negoi, Ioannis Nikolopoulos, Giuseppe Novelli, Viktors Novikovs, Iyiade Olaoye, Abdelkarim Omari, Carlos A. Ordoñez, Mouaqit Ouadii, Zeynep Ozkan, Ajay Pal, Gian M. Palini, Lars I. Partecke, Francesco Pata, Gerson A. Pereira Júnior, Tadeja Pintar, Magdalena Pisarska, Cesar F. Ploneda-Valencia, Konstantinos Pouggouras, Vinod Prabhu, Padmakumar Ramakrishnapillai, Jean-Marc Regimbeau, Marianne Reitz, Daniel Rios-Cruz, Sten Saar, Boris Sakakushev, Charalampos Seretis, Alexander Sazhin, Vishal Shelat, Matej Skrovina, Dmitry Smirnov, Charalampos Spyropoulos, Marcin Strzałka, Peep Talving, Ricardo A. Teixeira Gonsaga, George Theobald, Gia Tomadze, Myftar Torba, Cristian Tranà, Jan Ulrych, Mustafa Y. Uzunoğlu, Alin Vasilescu, Savino Occhionorelli, Aurélien Venara, Andras Vereczkei, Nereo Vettoretto, Nutu Vlad, Maciej Walędziak, Tonguç U. Yilmaz, Kuo-Ching Yuan, Cui Yunfeng, Justas Zilinskas, Gérard Grelpois, and Fausto Catena
Subjects: Acute appendicitis, Diagnosis, Management, Surgery, Antibiotics, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016–September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.
Published: 2018
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27. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship—results from an international cross-sectional survey

Author: Massimo Sartelli, Francesco M. Labricciosa, Pamela Barbadoro, Leonardo Pagani, Luca Ansaloni, Adrian J. Brink, Jean Carlet, Ashish Khanna, Alain Chichom-Mefire, Federico Coccolini, Salomone Di Saverio, Addison K. May, Pierluigi Viale, Richard R. Watkins, Luigia Scudeller, Lilian M. Abbo, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Sara Al-Dahir, Majdi N. Al-Hasan, Halil Alis, Carlos Alves, André R. Araujo da Silva, Goran Augustin, Miklosh Bala, Philip S. Barie, Marcelo A. Beltrán, Aneel Bhangu, Belefquih Bouchra, Stephen M. Brecher, Miguel A. Caínzos, Adrian Camacho-Ortiz, Marco Catani, Sujith J. Chandy, Asri Che Jusoh, Jill R. Cherry-Bukowiec, Osvaldo Chiara, Elif Colak, Oliver A. Cornely, Yunfeng Cui, Zaza Demetrashvili, Belinda De Simone, Jan J. De Waele, Sameer Dhingra, Francesco Di Marzo, Agron Dogjani, Gereltuya Dorj, Laurent Dortet, Therese M. Duane, Mutasim M. Elmangory, Mushira A. Enani, Paula Ferrada, J. Esteban Foianini, Mahir Gachabayov, Chinmay Gandhi, Wagih Mommtaz Ghnnam, Helen Giamarellou, Georgios Gkiokas, Harumi Gomi, Tatjana Goranovic, Ewen A. Griffiths, Rosio I. Guerra Gronerth, Julio C. Haidamus Monteiro, Timothy C. Hardcastle, Andreas Hecker, Adrien M. Hodonou, Orestis Ioannidis, Arda Isik, Katia A. Iskandar, Hossein S. Kafil, Souha S. Kanj, Lewis J. Kaplan, Garima Kapoor, Aleksandar R. Karamarkovic, Jakub Kenig, Ivan Kerschaever, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Hong B. Kim, Wen-Chien Ko, Kaoru Koike, Iryna Kozlovska, Anand Kumar, Leonel Lagunes, Rifat Latifi, Jae G. Lee, Young R. Lee, Ari Leppäniemi, Yousheng Li, Stephen Y. Liang, Warren Lowman, Gustavo M. Machain, Marc Maegele, Piotr Major, Sydney Malama, Ramiro Manzano-Nunez, Athanasios Marinis, Isidro Martinez Casas, Sanjay Marwah, Emilio Maseda, Michael E. McFarlane, Ziad Memish, Dominik Mertz, Cristian Mesina, Shyam K. Mishra, Ernest E. Moore, Akutu Munyika, Eleftherios Mylonakis, Lena Napolitano, Ionut Negoi, Milica D. Nestorovic, David P. Nicolau, Abdelkarim H. Omari, Carlos A. Ordonez, José-Artur Paiva, Narayan D. Pant, Jose G. Parreira, Michal Pędziwiatr, Bruno M. Pereira, Alfredo Ponce-de-Leon, Garyphallia Poulakou, Jacobus Preller, Céline Pulcini, Guntars Pupelis, Martha Quiodettis, Timothy M. Rawson, Tarcisio Reis, Miran Rems, Sandro Rizoli, Jason Roberts, Nuno Rocha Pereira, Jesús Rodríguez-Baño, Boris Sakakushev, James Sanders, Natalia Santos, Norio Sato, Robert G. Sawyer, Sandro Scarpelini, Loredana Scoccia, Nusrat Shafiq, Vishalkumar Shelat, Costi D. Sifri, Boonying Siribumrungwong, Kjetil Søreide, Rodolfo Soto, Hamilton P. de Souza, Peep Talving, Ngo Tat Trung, Jeffrey M. Tessier, Mario Tumbarello, Jan Ulrych, Selman Uranues, Harry Van Goor, Andras Vereczkei, Florian Wagenlehner, Yonghong Xiao, Kuo-Ching Yuan, Agnes Wechsler-Fördös, Jean-Ralph Zahar, Tanya L. Zakrison, Brian Zuckerbraun, Wietse P. Zuidema, and Fausto Catena
Subjects: Antibiotics, Infections, Surgery, Antimicrobial stewardship, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p
Published: 2017
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28. Erratum to: IROA: International Register of Open Abdomen, preliminary results

Author: Giuseppe Novelli, Fernando Hernández, Giovanni Bellanova, Massimo Chiarugi, Luca Ansaloni, Mahir Gachabayov, Asri Che Jusoh, Boris Sakakushev, Mirco Nacoti, Savino Occhionorelli, Francesco Salvetti, Giulia Montori, Gustavo Pereira Fraga, Zaza Demetrashvili, Guillermo Perez Chagerben, Gianluca Costa, Wagih Ghannam, Athanasios Marinis, Monica Zese, Davide Corbella, Rao R. Ivatury, Sefa Ozyazici, Federico Coccolini, Michael Sugrue, Vinicius Cordeiro Fonseca, Kuo-Ching Yuan, Wellington Fernandes, Orestis Ioannidis, Paola Fugazzola, Stefano Costa, Miklosh Bala, Ionut Negoi, Desmond Khor, Daniele Dondossola, Bruno M. Pereira, Yovcho Yovtchev, Rafael L. Curado, Arda Isik, Sandeep Singh, Sergei Shlyapnikov, Stefano Rausei, Dimitrios Damaskos, Stefano Maccatrozzo, Aleix Martínez-Pérez, Miguel Leon Arellano, Massimo Sartelli, Ohad Guetta, Christian Galatioto, Demetrios Demetriades, Marco Ceresoli, Kenji Inaba, Agron Dogjani, Tugan Tezcaner, Fausto Catena, András Vereczkei, Torsten Kaussen, Francesco Trotta, and Martha Quiodettis
Subjects: MEDLINE, Peritonitis, 030230 surgery, Trauma, Barker, 03 medical and health sciences, 0302 clinical medicine, Ischemia, Medicine, Open abdomen, Skin, Compartment, business.industry, Commercial, Published Erratum, Bogotà bag, Vascular emergencies, Register, medicine.disease, Negative pressure, IROA, Register (music), Non-commercial, Emergency Medicine, Surgery, Medical emergency, business, Research Article, Witmann
Abstract: Background No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org. Results Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male; Mean BMI: 36±5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%),Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(±4.83) days; Mean number of dressing changes: 0.88(±0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p
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29. A proposal for a CT driven classification of left colon acute diverticulitis

Author: Salomone Di Saverio, Fausto Catena, Zaza Demetrashvili, Fikri M. Abu-Zidan, Damien Massalou, Carlos Augusto Gomes, Federico Coccolini, Miran Rems, Charalampos Spyropoulos, András Vereczkei, Jae Il Kim, Offir Ben-Ishay, Goran Augustin, Yunfeng Cui, Rodolfo Soto, Darija Soldatenkova, Massimo Sartelli, Gerson Alves Pereira, Imtiaz Wani, Renato Bessa Melo, Norio Sato, Matej Skrovina, Jakub Kenig, Victor Y. Kong, Carlos A. Ordoñez, Daniel Rios-Cruz, Abdelkarim H. Omari, Sanoop K. Zachariah, Marco Catani, Dmitry Smirnov, Jaan Tepp, Koray Das, Zurabs Kecbaja, Ferdinando Agresta, Michael McFarlane, Ewen A. Griffiths, Frederick A. Moore, Roberto Bini, Boris Sakakushev, Emanuele Caproli, Miklosh Bala, Diego Piazza, Georgios Gkiokas, Isidoro Di Carlo, Varut Lohsiriwat, Mahir Gachabayov, Raul Coimbra, Ioannis Nikolopoulos, Sanjay Marwah, Helmut Alfredo Segovia Lohse, Jan Ulrych, Tadaja Pintar, Mario Paulo Faro, Ionut Negoi, Gian Luca Baiocchi, Athanasios Marinis, Aleksandar Karamarkovic, Ashraf Abbas, Konstantinos Bouliaris, Giovanni Bellanova, Cristian Tranà, F. Corcione, David Costa Navarro, Arda Isik, Kenneth Y.Y. Kok, Vishal G Shelat, Luca Ansaloni, Gabriele Anania, and Elif Colak
Subjects: medicine.medical_specialty, Acute diverticulitis, medicine.diagnostic_test, business.industry, Computed tomography, Review, Diverticulitis, medicine.disease, Surgery, NO, Left colon, medicine, Emergency Medicine, Radiology, Day to day, Ct imaging, business, Radiation treatment planning
Abstract: Computed tomography (CT) imaging is the most appropriate diagnostic tool to confirm suspected left colonic diverticulitis. However, the utility of CT imaging goes beyond accurate diagnosis of diverticulitis; the grade of severity on CT imaging may drive treatment planning of patients presenting with acute diverticulitis. The appropriate management of left colon acute diverticulitis remains still debated because of the vast spectrum of clinical presentations and different approaches to treatment proposed. The authors present a new simple classification system based on both CT scan results driving decisions making management of acute diverticulitis that may be universally accepted for day to day practice.
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29 results on '"András Vereczkei"'

1. The Effect of Fascial Closure With Triclosan-Coated Sutures on the Incidence of Abdominal Wall Dehiscence: An Individual Participant Data Meta-Analysis

2. Intraoperative pyloric drainage is unnecessary during esophagectomies: a meta-analysis and systematic review of randomized controlled trials

3. The development of one-day surgical care in Hungary between 2010 and 2019

4. Use of blood products during the first months of COVID-19 pandemic period: A single center report

5. Effect of triclosan-coated sutures for abdominal wound closure on the incidence of abdominal wound dehiscence: a protocol for an individual participant data meta-analysis

6. Prognostic role of HPV infection in esophageal squamous cell carcinoma

7. Endoscopic sphincterotoMy for delayIng choLecystectomy in mild acute biliarY pancreatitis (EMILY study): protocol of a multicentre randomised clinical trial

8. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

9. Early occurrence of pseudocysts in acute pancreatitis – a multicenter international cohort analysis of 2275 cases

10. COVID-19 pandemic: implications on the surgical treatment of gastrointestinal and hepatopancreatobiliary tumours in Europe

11. Knowledge, awareness, and attitude towards infection prevention and management among surgeons : identifying the surgeon champion

12. Diffuse colon polyposis unexpected, total regression due to combined treatment on liver metastasis

13. The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey

14. Erratum to: Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

15. IROA: International Register of Open Abdomen, preliminary results

16. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

17. Antimicrobials : a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

18. Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS Study)

19. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

20. Novel Noninvasive Paraclinical Study Method for Investigation of Liver Diseases

21. A pandemic recap: lessons we have learned

22. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

23. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

24. Design and Development of a Flexible 3D-Printed Endoscopic Grasping Instrument

25. Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study

26. Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

27. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship—results from an international cross-sectional survey

28. Erratum to: IROA: International Register of Open Abdomen, preliminary results

29. A proposal for a CT driven classification of left colon acute diverticulitis

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29 results on '"András Vereczkei"'

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