Author: "Umberto Bracale" / Topic: business - Searchworks@Jio Institute Digital Library Search Results

159 results on '"Umberto Bracale"'

1. Sequential Minimally Invasive Treatment of Concomitant Abdominal Aortic Aneurysm and Colorectal Cancer: A Single-Center Experience

Author: Carlo De Werra, Umberto Bracale, Maria Michela Di Nuzzo, Luca del Guercio, Raffaele Serra, Maurizio Sodo, Rosa Maria Terracciano, Marco Panagrosso, Roberto Peltrini, Francesco Corcione, Bracale, Umberto, Di Nuzzo, Maria Michela, Bracale, Umberto Marcello, Del Guercio, Luca, Panagrosso, Marco, Serra, Raffaele, Terracciano, Rosa Maria, De Werra, Carlo, Corcione, Francesco, Peltrini, Roberto, and Sodo, Maurizio
Subjects: Male, Laparoscopic surgery, medicine.medical_specialty, Time Factors, Percutaneous, medicine.medical_treatment, Endovascular aneurysm repair, Blood Vessel Prosthesis Implantation, Postoperative Complications, Aneurysm, medicine.artery, medicine, Humans, Colectomy, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Abdominal aortic aneurysm, Endovascular aneurysm repair, Colorectal cancer, Laparoscopic surgery, Endovascular Procedures, General Medicine, Perioperative, Length of Stay, medicine.disease, Common iliac artery, Abdominal aortic aneurysm, Surgery, Treatment Outcome, Concomitant, Female, Laparoscopy, Colorectal Neoplasms, Cardiology and Cardiovascular Medicine, business, Aortic Aneurysm, Abdominal
Abstract: Background The surgical management of concomitant occurrence of abdominal aortic aneurysm (AAA) and colorectal cancer (CRC) is still controversial. Conversely, benefits from a minimally invasive approach are well known concerning the treatment of both AAA and CRC. The aim of this study is to assess safety and feasibility of a sequential 2-staged minimally invasive during the same recovery by endovascular aneurysm repair (EVAR) technique and laparoscopic colorectal resection. Methods From January 2008 to December 2020, all patients with concomitant AAA and CRC were consecutively treated by EVAR and laparoscopic colorectal resection. Perioperative data were retrospectively collected in order to evaluate short- and long-term outcomes following the sequential 2-staged procedures. Results A total of 24 patients were included. The localization of the aneurysm was infrarenal abdominal aortic in 23 cases and in one case of common iliac artery. EVAR procedure has always been performed first. In 18 patients, a percutaneous access has been used while in 6 patients a surgical access has been adopted. Twelve patients had cancer in the left colon, 9 in the right colon, and 3 patients had rectal cancer. No conversions or intraoperative complications had occurred during laparoscopic surgery. The major complications rate after EVAR and CRC surgery was 8.3% and 12.5%, respectively. The mean interval between EVAR and CRC treatment was 7.8 ± 1 and the mean length of stay was 15.4 ± 3.6. No deaths occurred during hospitalization and between the procedures. Overall mortality was 20.8% with a mean follow-up of 39.41 ± 19.2 months. Conclusion Elective sequential 2-staged minimally invasive treatment is a safe and feasible approach with acceptable morbidity and mortality rates and it should be adopted in current clinical practice to manage concomitant AAA and CRC.
Published: 2022

2. Risk of appendiceal neoplasm after interval appendectomy for complicated appendicitis: A systematic review and meta-analysis

Author: Ruggero Lionetti, Michele D'Ambra, Francesco Corcione, Umberto Bracale, Roberta Green, Marcello De Luca, Alberto Cuocolo, Roberto Peltrini, Valeria Cantoni, Carolina Bartolini, Peltrini, Roberto, Cantoni, Valeria, Green, Roberta, Lionetti, Ruggero, D'Ambra, Michele, Bartolini, Carolina, De Luca, Marcello, Bracale, Umberto, Cuocolo, Alberto, and Corcione, Francesco
Subjects: medicine.medical_specialty, Adenoma, Complicated appendiciti, Adenocarcinoma, law.invention, Randomized controlled trial, Appendiceal neoplasm, law, Internal medicine, medicine, Appendectomy, Humans, Neoplasm, Appendicular inflammatory ma, Interval appendectomy, Randomized Controlled Trials as Topic, Retrospective Studies, business.industry, Complicated appendicitis, Appendicitis, medicine.disease, Mucinous Neoplasm, Appendiceal Neoplasms, Meta-analysis, Surgery, business
Abstract: Background Non-operative management is often the treatment of choice in cases of complicated appendicitis and routine interval appendectomy is not usually recommended. Actually, recent studies show an alarming number of appendiceal neoplasms following interval appendectomy. The aim of this study is to evaluate the prevalence of appendiceal neoplasms and their histological types after interval appendectomy for complicated appendicitis in adults. Methods A comprehensive literature search of the PubMed, Scopus and Web of Science databases was conducted according to the PRISMA statement. Studies reporting appendiceal neoplasm rates after interval appendectomy and histopathological characteristics were included. The most recent World Health Organization (WHO) classification of malignant tumours was considered. A pooled prevalence analysis for both prevalence and pathology was performed. Results A total of eight studies was included: seven retrospective series and one randomized controlled trial. The pooled prevalence of neoplasms after interval appendectomy was 11% (95% CI 7-15; I2 = 37.5%, p = 0.13). Appendiceal mucinous neoplasms occurred in 43% (95% CI 19-68), adenocarcinoma in 29% (95% CI 6-51), appendiceal neuroendocrine neoplasm in 21% (95% CI 6-36), globet cell carcinoma in 13% (95% CI -2-28), adenoma or serrated lesions in 20% (95% CI -0-41) of cases. Conclusion The risk of appendiceal neoplasm in patients treated with interval appendectomy for complicated appendicitis is 11%; mucinous neoplasm is the most common histopathological type. Further studies should investigate this association in order to clarify the biological pathway and clinical implications.
Published: 2021

3. Efficacy and Safety of Jotec E-Ventus BX Stent Graft for Iliac Branch Device Procedure: A Retrospective Clinical Study

Author: Giancarlo Accarino, Anna Petrone, Giuseppe Filiberto Serraino, Pasquale Mastroroberto, Michele Andreucci, Giovanni Fornino, Raffaele Serra, Umberto Bracale, Davide Turchino, Nicola Ielapi, Luca del Guercio, Maurizio Sodo, Giulio Accarino, Michele Provenzano, Bracale, Umberto Marcello, Turchino, Davide, Accarino, Giancarlo, Petrone, Anna, Del Guercio, Luca, Sodo, Maurizio, Fornino, Giovanni, Accarino, Giulio, Ielapi, Nicola, Serraino, Giuseppe Filiberto, Mastroroberto, Pasquale, Provenzano, Michele, Andreucci, Michele, and Serra, Raffaele
Subjects: Male, endovascular treatment, medicine.medical_specialty, Time Factors, Endoleak, medicine.medical_treatment, Prosthesis Design, Endovascular aneurysm repair, aorto-iliac aneurysm, endoleaks, iliac branch device, prognosis, Retrospective data, Blood Vessel Prosthesis Implantation, Occlusion, medicine, Clinical endpoint, Humans, Vascular Patency, Aged, Retrospective Studies, business.industry, Endovascular Procedures, Graft Occlusion, Vascular, Stent, General Medicine, Middle Aged, Vascular surgery, Aortic Aneurysm, Blood Vessel Prosthesis, Surgery, Cross-Sectional Studies, Treatment Outcome, Italy, Iliac Aneurysm, Cohort, cardiovascular system, Female, Stents, Cardiology and Cardiovascular Medicine, business
Abstract: Background The endovascular aneurysm repair (EVAR) is a successful treatment for aorto-iliac aneurysms. The success of EVAR is enhanced by the use of devices that maintain the patency of targeted arteries namely the iliac branch device (IBD) With this study we aimed to evaluate the association between the use of Jotec E-ventus during EVAR with IBD and prognosis in patients with aorto-iliac aneurysms. Methods This is a retrospective, multicentric study enrolling patients referred to our Vascular Surgery Units from January 2015 to January 2020. All patients underwent EVAR with IBD using Jotec E-ventus as bridging stent. Primary endpoint was the development of types I and III endoleaks. Secondary endpoint was the onset of device occlusion with loss of vascular patency. Results We studied 32 patients (mean age 71.7±4.5y). Of these, 25 patients were treated with standard EVAR procedure whereas 7 were treated with isolated IBD due to extension of disease involving iliac bifurcation. Median follow-up lasted 15[IQR11-27] months. During follow-up, incidence rates for endoleaks and occlusion were 3.98(95%CI 0.48-14.41) and 1.99(95%CI 0.05-11.12) per 100 pts/year. Conclusions Jotec E-ventus during EVAR is associated with a low rate of severe complications in a small cohort of patients with aorto-iliac aneurysms.
Published: 2021

4. Workplace Violence towards Healthcare Workers: An Italian Cross-Sectional Survey

Author: Vito Cerabona, Michele Provenzano, Gianluca Buffone, Egidio Bevacqua, Franco Arturi, Nicola Giannotta, Michele Andreucci, Raffaele Serra, Umberto Bracale, Sabrina Mellace, Nicola Ielapi, Davide Costa, Ielapi, Nicola, Andreucci, Michele, Bracale, Umberto Marcello, Costa, Davide, Bevacqua, Egidio, Giannotta, Nicola, Mellace, Sabrina, Buffone, Gianluca, Cerabona, Vito, Arturi, Franco, Provenzano, Michele, and Serra, Raffaele
Subjects: medicine.medical_specialty, Workplace violence, business.industry, Cross-sectional study, Aggression, healthcare workers, Communication, RT1-120, Nursing, nurses, Work experience, Test (assessment), healthcare worker, Family medicine, Health care, workplace violence, Medicine, Population study, Observational study, medicine.symptom, business, General Nursing
Abstract: Background. Workplace violence (WPV) is a major healthcare problem with important consequences in healthcare areas and may impact negatively not only healthcare workers but also the quality and safety of patient care. Objectives: This an observational online web-based survey using Google® Modules, specifically aiming to investigate the phenomenon of WPV in Italian healthcare services. Methods. Data collection for this study lasted one month, with the questionnaire available from 1 May 2021 to 31 May 2021. Continuous variables were considered as either mean ± standard deviation (SD) or median and interquartile range (IQR) based on their distribution. Comparison between groups was assessed by unpaired t-test or Mann–Whitney U test according to variable distribution. Categorical variables were analyzed using the chi-squared test. Results. The study population consisted of 203 healthcare workers, represented by nurses (61.6%), medical doctors (16.8%), patient care assistants (4.9%), and others (16.7%). Female gender was associated with a 2.6 times higher risk for the presence of aggression (p = 0.034), and nurse as a job with about 4 times increased risk for the presence of aggression (p = 0.006). The risk for aggression increased by 5% for each year of work experience. Conclusions. WPV is still matter of concern in Italian healthcare services. A strong organizational effort is demanded from healthcare institutions in order prevent internal and external violence in healthcare settings.
Published: 2021

5. Insomnia Prevalence among Italian Night-Shift Nurses

Author: Michele Provenzano, Gianluca Buffone, Sabrina Mellace, Umberto Bracale, Michele Andreucci, Andrea Bitonti, Egidio Bevacqua, Raffaele Serra, Nicola Ielapi, Davide Costa, Stefano Candido, Ielapi, Nicola, Andreucci, Michele, Bracale, Umberto Marcello, Costa, Davide, Bevacqua, Egidio, Bitonti, Andrea, Mellace, Sabrina, Buffone, Gianluca, Candido, Stefano, Provenzano, Michele, and Serra, Raffaele
Subjects: night shift, insomnia, Population, prevalence, RT1-120, Affect (psychology), nursing, italy, Article, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Interquartile range, Insomnia, medicine, 030212 general & internal medicine, education, General Nursing, education.field_of_study, business.industry, Test (assessment), Italy, Observational study, Analysis of variance, medicine.symptom, business, 030217 neurology & neurosurgery, Demography
Abstract: Background. Insomnia is one of the major health problems related with a decrease in quality of life (QOL) and also in poor functioning in night-shift nurses, that also may negatively affect patients’ care. The aim of this study is to evaluate the prevalence of insomnia in night shift nurses. This observational online web-based survey using Google®® modules specifically aimed to investigate the prevalence and risk factors for insomnia among Italian nurses. Methods. Data collection for this study lasted one month, with the questionnaire available from 1 March 2021 to 1 April 2021. Continuous variables were considered as either mean ± standard deviation (SD) or median and interquartile range (IQR) based on their distribution. Comparison among insomnia categories was assessed by one-way ANOVA or Kruskal–Wallis test according to variable distribution. Categorical variables were analyzed using chi-square test. Results. A total of 2355 responses were included in the final analysis, with 917 from the Northern zone, 815 from the Western zone, and 623 from the Southern zone of Italy. The prevalence of insomnia in the overall population was 65.4% (1524 out 2355 nurses suffered from insomnia). Conclusions. Nursing is a high-pressure profession, with heavy duties and high professional risks. We found an important prevalence of insomnia in night shift nurses, and we hope it may help to solicit further studies aimed to identify the risk factors for this working disorder among nurses.
Published: 2021

6. Extended totally extraperitoneal Rives–Stoppa (eTEP-RS) technique for ventral hernia: initial experience of The Wall Hernia Group and a surgical technique update

Author: Giusto Pignata, Enrico Lauro, Alberto Di Leo, Jacopo Andreuccetti, Alberto Sartori, Silvia Sanna, Umberto Bracale, and Lorenzo Crepaz
Subjects: medicine.medical_specialty, Incisional hernia, medicine.medical_treatment, 030230 surgery, Asymptomatic, Prosthesis, 03 medical and health sciences, 0302 clinical medicine, Recurrence, medicine, Humans, Incisional Hernia, Hernia, Herniorrhaphy, Ventral hernia repair, business.industry, Length of Stay, Surgical Mesh, medicine.disease, Hernia, Ventral, Surgery, 030220 oncology & carcinogenesis, Seroma, Ventral hernia, Invasive surgery, medicine.symptom, business
Abstract: The enhanced-view extended totally extraperitoneal (eTEP) approach for ventral hernia repair is a novel surgical technique. We present the results from the initial experience with eTEP repair Rives–Stoppa (eTEP-RS) at two Italian centers, and we provide an update on this approach. Between December 2018 and July 2020, 19 patients suffering from ventral hernia were treated with the eTEP-RS. Patients’ characteristics, operative details, and complications were analyzed. The median follow-up time was 16 (range 6–24) months. Thirteen (68.4%) patients with ventral incisional hernias and 6 (31.6%) with primary ventral hernia underwent an eTEP-RS procedure. The average defect area was 21 cm2 and the prosthesis’s average size was 380 cm2. We registered complications in two cases (10.5%); 1 patient had an asymptomatic seroma (Clavien–Dindo grade 1), and another had intestinal obstruction on the 10th postoperative day (Clavien–Dindo grade 3B). The mean hospital stay was 3.9 (range: 2–6) days. There was no hernia recurrence. The eTEP-RS is a feasible and safe approach in ventral hernia repair with minimally invasive surgery. Further studies are needed to define patients’ selection and to know long-term outcomes.
Published: 2021

7. Prevention of incisional hernia at the site of stoma closure with different reinforcing mesh types: a systematic review and meta-analysis

Author: Simone Castiglioni, Maria Michela Di Nuzzo, Umberto Bracale, Francesco Corcione, Gaia Altieri, Roberto Peltrini, Nicola Imperatore, Michele D'Ambra, Luciano Grimaldi, Ruggero Lionetti, Peltrini, Roberto, Imperatore, Nicola, Altieri, Gaia, Castiglioni, Simone, DI NUZZO, MARIA MICHELA, Grimaldi, Luciano, D'Ambra, Michele, Lionetti, Ruggero, Bracale, Umberto, and Corcione, Francesco
Subjects: medicine.medical_specialty, Synthetic mesh, Incisional hernia, medicine.medical_treatment, Stoma reversal, Review, Lower risk, Prosthesis, Biologic mesh, Stoma, Ileostomy, medicine, Humans, Incisional Hernia, Herniorrhaphy, business.industry, Prevention, Colostomy, Surgical Stomas, Prostheses and Implants, Surgical Mesh, medicine.disease, Surgery, Seroma, business, Abdominal surgery
Abstract: Purpose To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses used. Methods A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Cochrane databases was conducted to identify comparative studies until September 2020. A meta-analysis of postoperative outcomes and a network meta-analysis for a multiple comparison of the prostheses with each other were performed. Results Seven studies were included in the analysis (78.4% ileostomy and 21.6% colostomy) with a total of 1716 patients with (n = 684) or without (n = 1032) mesh. Mesh placement was associated with lower risk of SSIH (7.8%vs18.1%, OR0.266,95% CI 0.123–0.577, p p p = 0.66), seroma formation (4.4% vs 7.1%, OR 1.052, 95% CI 0.64–1.73, p = 0.84), anastomotic leakage (3.7% vs 2.7%, OR 1.598, 95% CI 0.846–3.019, p = 0.149) and length of stay (SMD − 0.579,95% CI − 1.261 to 0.102, p = 0.096) between mesh and no mesh groups. Use of prosthesis was associated with a significant lower need for a reoperation than no mesh group (8.1% vs 12.1%, OR 0.332, 95% CI 0.119–0.930, p = 0.036). Incidence of seroma is lower with biologic than polypropylene meshes but they showed a trend towards poor results compared with polypropylene or biosynthetic meshes. Conclusion Despite longer operative time, mesh prophylactic reinforcement at the site of stoma seems a safe and effective procedure with lower incidence of SSIH, need for reoperation and comparable short-term outcomes than standard closure technique. A significant superiority of a specific mesh type was not identified.
Published: 2021

8. Long splenic flexure carcinoma requiring laparoscopic extended left hemicolectomy with CME and transverse-rectal anastomosis: technique for a modified partial Deloyers in 5 steps to achieve enough reach and preserving middle colic vessels

Author: Salomone Di Saverio, Nicola de Angelis, Carlos Pastor Idoate, Weronyka Stupalkowska, Giuseppe Nigri, Umberto Bracale, Patricia Tejedor, Pierpaolo Sileri, Roberto Cirocchi, Giovanni D. Tebala, Kostantinos Stasinos, Francesco Di Marzo, Belinda De Simone, Antonio Giuliani, J Wheeler, Efstratios Kouroumpas, Apollo - University of Cambridge Repository, Di Saverio, S., Stasinos, K., Stupalkowska, W., Bracale, U., Sileri, P., Giuliani, A., Nigri, G., Kouroumpas, E., Wheeler, J. M. D., Tebala, G. D., Di Marzo, F., De Simone, B., Idoate, C. P., De Angelis, N., Cirocchi, R., and Tejedor, P.
Subjects: medicine.medical_specialty, Embryology, Colic, anastomosis, Adenocarcinoma, Inferior mesenteric artery, Hepatic Flexure, Descending colon, Left extended colectomy, surgical, medicine.artery, medicine, Ascending colon, Humans, Mesentery, Deloyers procedure, Colectomy, Aged, Splenic flexure, colon, business.industry, Splenic flexure carcinoma, Anastomosis, Surgical, Transverse colon, colonic derotation, complete mesocolic excision, deloyers procedure, embryology, left extended colectomy, splenic flexure carcinoma, aged, anastomosis, surgical, colectomy, female, humans, adenocarcinoma, colic, colon, transverse, colonic neoplasms, laparoscopy, digestive system diseases, Surgery, transverse, medicine.anatomical_structure, Colonic derotation, Colonic Neoplasms, Inferior mesenteric vein, Female, Laparoscopy, business, Complete mesocolic excision, Colon, Transverse
Abstract: Funder: Università degli Studi dell'Insubria, INTRODUCTION: This How-I-Do-It article presents a modified Deloyers procedure by mean of the case of a 67-year-old female with adenocarcinoma extending for a long segment and involving the splenic flexure and proximal descending colon who underwent a laparoscopic left extended hemicolectomy (LELC) with derotation of the right colon and primary colorectal anastomosis. BACKGROUND: While laparoscopic extended right colectomy is a well-established procedure, LELC is rarely used (mainly for distal transverse or proximal descending colon carcinomas extending to the area of the splenic flexure). LELC presents several technical challenges which are demonstrated in this How-I-Do-It article. TECHNIQUE AND METHODS: Firstly, the steps needed to mobilize the left colon and procure a safe approach to the splenic flexure are described, especially when a tumor is closely related to it. This is achieved by mobilization and resection of the descending colon, while maintaining a complete mesocolic excision to the level of the duodenojejunal ligament for the inferior mesenteric vein and flush to the aorta for the inferior mesenteric artery. Subsequently, we depict the adjuvant steps required to enable a primary anastomosis by trying to mobilize the transverse colon and release as much of the mesocolic attachments at the splenic flexure area. Finally, we present the rare instance when a laparoscopic derotation of the ascending colon is required to provide a tension-free anastomosis. The resection is completed by delivery of the fully derotated ascending colon and hepatic flexure through a suprapubic mini-Pfannenstiel incision. The primary colorectal anastomosis is subsequently fashioned in a tension-free way and provides for a quick postoperative recovery of the patient. RESULTS: This modified Deloyers procedure preserves the middle colic since the fully mobilized mesocolon allows for a tension-free anastomosis while maintaining better blood supply to the mobilized stump. Also, by eliminating the need for a mesenteric window and the transposition of the caecum, we allow the small bowel to rest over the anastomosis and the mobilized transverse colon and reduce the possibility of an internal herniation of the small bowel into the mesentery. CONCLUSIONS: Laparoscopic derotation of the right colon and a partial, modified Deloyers procedure preserving the middle colic vessels are feasible techniques in experienced hands to provide primary anastomosis after LELC with improved functional outcome. Nevertheless, it is important to consider anatomical aspects of the left hemicolectomy along with oncological considerations, to provide both a safe oncological resection along with good postoperative bowel function.
Published: 2022
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9. The 'complete common mesentery' and the agenesis of Toldt’s and Fredet’s fasciae

Author: Francesco Corcione, Roberto Peltrini, Umberto Bracale, Chiara Caricato, Maria Michela Di Nuzzo, Peltrini, R., Di Nuzzo, M. M., Caricato, C., Bracale, U., and Corcione, F.
Subjects: business.industry, Agenesis, MEDLINE, Common mesentery, Medicine, Radiology, Nuclear Medicine and imaging, Surgery, Anatomy, business, medicine.disease, Pathology and Forensic Medicine
Published: 2021

10. Vascular Nursing and Vascular Surgery

Author: Raffaele Serra, Martina Catana, Nicola Ielapi, Noemi Licastro, Umberto Bracale, Ielapi, N., Licastro, N., Catana, M., Bracale, U. M., and Serra, R.
Subjects: medicine.medical_specialty, cardiovascular nursing, MEDLINE, Vascular access, vascular nursing, vascular surgery, 030204 cardiovascular system & hematology, Nurse's Role, Perioperative Care, 030218 nuclear medicine & medical imaging, Vascular Nursing, 03 medical and health sciences, Wound care, Postoperative Complications, 0302 clinical medicine, Risk Factors, Humans, Medicine, Vascular Diseases, Physician's Role, Intensive care medicine, Patient Care Team, Delivery of Health Care, Integrated, business.industry, Vascular disease, General Medicine, Vascular surgery, medicine.disease, Frailty assessment, Treatment Outcome, Perioperative care, Surgery, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures
Abstract: Background Patients requiring vascular surgery have turned in older subjects with several comorbidities with frailty problems and increased vulnerability. Treating this kind of patients has become an important challenge both for vascular surgeons and for dedicated nurses, as these patients are more susceptible to postoperative complications and during discharge. The aim of this review is to analyze the role of vascular nurse in vascular surgery activities. Methods For this study, Medline, ScienceDirect, and Scopus databases were searched. The following keywords were used: nursing and vascular surgery, nursing and vascular disease, nursing and vascular procedure, and care and vascular patient. Results From the search strategy, the following areas were identified as relevant and analyzed in detail: vascular disease related to vascular surgery, the definition of vascular nursing, the role of vascular nursing in implementing clinical pathways in vascular surgery procedures, nursing postoperative care in vascular surgery, frailty assessment in vascular patient, nursing in phlebology and wound care, and the management of vascular access. Conclusions Vascular nursing is a discipline that is able to provide comprehensive and optimal care, better postoperative outcomes, and coordinated, standardized, and cost-effective clinical pathways for patients managed in the area of vascular surgery.
Published: 2020

11. Case report of a large cephalic vein aneurysm inducing heart failure in a renal transplant patient with radio-cephalic fistula for haemodialysis

Author: Umberto Bracale, Ettore Dinoto, Antonio Peluso, Alessia Viscardi, Luca del Guercio, Marco Panagrosso, Panagrosso, M., Bracale, U. M., del Guercio, L., Viscardi, A., Peluso, A., and Dinoto, E.
Subjects: medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, Fistula, Arteriovenous fistula, Case Report, Heart failure, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, medicine, cardiovascular diseases, Vein, Kidney transplantation, Cephalic vein, business.industry, Renal transplantation, medicine.disease, Surgery, Transplantation, medicine.anatomical_structure, 030220 oncology & carcinogenesis, cardiovascular system, 030211 gastroenterology & hepatology, business, Kidney disease, Surgical repair
Abstract: Highlights • The venous aneurysm is one of the most common complications of autologous AVF. • The vein aneurysm should be treat by surgical resection and anastomotic ligature. • AVF shouldn’t be ligated from 1-year kidney transplantation except in some cases. • Surgical ligation to prevent complications could be considered an option., Introduction The autologous arteriovenous fistula (AVF) is considered the best vascular access for haemodialysis in patients with chronic kidney disease but in time can lead to several complications. Presentation of a case Herein we describe a case of a large cephalic vein aneurysm causing heart failure in a renal transplant patient being treated with radio-cephalic AVF for haemodialysis. The patient was judged to be at very high risk for potential catastrophic rupture of the aneurysm and his cardiac function was deteriorating so a surgical resection was offered. Under general anesthesia, a longitudinal incision was performed on the volar side of the forearm and the anastomotic junction was ligated. The cephalic vein aneurysm was isolated and a total resection of the vein, up to the joint of the elbow, was carried out. A specimen was also submitted for histological and immunohistochemical analysis. Discussion At present no clear indications pertaining to the need to close an AVF after kidney transplantation exist. Some authors recommend a closing of the fistula in patients with stable renal function to prevent the onset of complications, while others advise never to close the asymptomatic fistula in order to preserve vascular access for haemodialysis in case of graft failure. Conclusion Based on our clinical experience, we suggest not ligating vascular access during the first year following transplantation with the exception of patients needing emergent closure. Otherwise, surgical closure to prevent the onset of complications could be considered a viable option in the following subset of patients: those who are 3 or more years from transplantation with good and stable renal function, those with a significant growth of venous aneurysms or have a high AVF flow rate or are young patients.
Published: 2020

12. Managing Peripheral Artery Disease in Diabetic Patients: A Questionnaire Survey from Vascular Centers of the Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS)

Author: G Bajardi, Francesco Setacci, Emad Hussein, Giancarlo Bracale, Olivier Goëau-Brissonnière, Ben R. Saleem, E Dinoto, Liborio Ferrante, Jamal J. Hoballah, Gianmarco de Donato, Maurizio Taurino, Bruno Gossetti, F Pecoraro, Bianca Pane, Anna Giribono, Raffaele Pulli, Vincenzo De Luca, Tarek Sraieb, Carlo Setacci, Andrea Stella, Umberto Bracale, Matteo Tozzi, Raffaele Pio Ammollo, Mohamed N. Bouayed, Patrizio Castelli, Maddalena Illario, Bracale U.M., Ammollo R.P., Hussein E.A., Hoballah J.J., Goeau-Brissonniere O., Taurino M., Setacci C., Pecoraro F., Bracale G., Giribono A.M., Ferrante L., de Donato G., Dinoto E., Bajardi G., Illario M., Bouayed M.N., Saleem B.R., Pulli R., Gossetti B., Pane B., Castelli P., Tozzi M., Sraieb T., Setacci F., Stella A., De Luca V., Bracale, Umberto Marcello, Ammollo, Raffaele Pio, Hussein, Emad A, Hoballah, Jamal J, Goeau-Brissonniere, Olivier, Taurino, Maurizio, Setacci, Carlo, Pecoraro, Felice, and Bracale, Giancarlo
Subjects: medicine.medical_treatment, Psychological intervention, 030204 cardiovascular system & hematology, vascular surgery, Settore MED/22 - Chirurgia Vascolare, 030218 nuclear medicine & medical imaging, Wound care, 0302 clinical medicine, Ischemia, Practice Patterns, Physicians', Response rate (survey), Practice Patterns, Nurses', diabetes, Mediterranean Region, Endovascular Procedures, vascular medicine, General Medicine, Treatment Outcome, Cardiology and Cardiovascular Medicine, Vascular Surgical Procedures, diabetic foot, management, Specialization, Reoperation, medicine.medical_specialty, Revascularization, Nurse's Role, Amputation, Surgical, 03 medical and health sciences, peripheral arterial disease, Mediterranean Sea, medicine, Humans, Training, Healthcare Disparities, Endovascular Surgery, Vascular Surgery, Physician's Role, Patient Care Team, Wound Healing, business.industry, General surgery, Vascular surgery, medicine.disease, Diabetic foot, Amputation, Health Care Surveys, Orthopedic surgery, Surgery, business, wound care
Abstract: Background The Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS) was founded on October 1, 2018, to enhance cooperation among vascular professionals within Mediterranean countries. Due to its prominent social and economic impact on national health systems, diabetic arteriopathy has been selected as the very first topic to be investigated by the federation. Methods MeFAVS members were asked to reply to a questionnaire on the management of diabetic ischemic foot. Results were collected and analyzed statistically. The questionnaire consisted of 15 multiple choice answers regarding diabetic foot (DF) diagnosis and treatment. The questionnaire was submitted to 21 centers on April 20, 2019. Results Response rate was 62%. The survey revealed that vascular surgeons, diabetologists, and wound care nurses made-up the core of the diabetic teams present in 76.9%, 69.3%, and 92.3% of the centers, respectively. Diabetic teams were most often led by vascular surgeons (53.8%) and diabetologists (42.2%), but only in 7.9% of cases by nurses. Duplex ultrasonography and computed tomographic angiography were the most commonly available tools used to assess diabetic peripheral arterial disease (PAD). Surgical wound care was undertaken by vascular surgeons in the majority of cases, and only in 46.2% of the cases to orthopedic or plastic surgeons, while nonsurgical wound care was handled by specialized nurses (76.6%) and diabetologists (53.8%). First-line revascularization was preferred over conservative treatment (61.5% vs 53.8%) and endovascular strategy (45.3%) over open (33.7%) or hybrid (21.0%) surgery. Vascular surgeons and interventional radiologists were found to be the most common performers of endovascular revascularization (92.3% and 53.8%, respectively). Amputations had an overall rate of 16.6% (range 4–30%) and a mean reintervention rate of 22.5%, and were usually performed by vascular surgeons for both minor and major interventions (84.6%) followed by orthopedic surgeons (15.4% minor and 30.8% major). The availability of a DF clinic (84.6%) and endovascular (53.8%) and open surgery (46.2%) capabilities were considered fundamental to reduce amputation rates. Conclusions Especially since the introduction and spreading of new endovascular techniques for the treatment of DF, it is a common consensus amongst vascular surgeons that a standardized approach to the discipline is necessary in order to improve outcomes such as amputation-free survival and mortality and it is with this perspective and purpose that transnational cooperation amongst vascular professionals and residents in training are aiming for greater proficiency in endovascular and open surgery.
Published: 2020

13. Does a 3D laparoscopic approach improve surgical outcome of mininvasive right colectomy? A retrospective case–control study

Author: Diego Cuccurullo, Vania Silvestri, Giovanni Merola, Emanuele Pontecorvi, Felice Pirozzi, Umberto Bracale, Antonio Sciuto, Francesco Corcione, Antonia Rizzuto, and Giusto Pignata
Subjects: Male, medicine.medical_specialty, Operative Time, 03 medical and health sciences, Imaging, Three-Dimensional, 0302 clinical medicine, 3d vision, Humans, Medicine, Laparoscopy, Colectomy, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Anastomosis, Surgical, Significant difference, Case-control study, Middle Aged, Surgery, Treatment Outcome, Surgery, Computer-Assisted, Multicenter study, Case-Control Studies, 030220 oncology & carcinogenesis, Right Colectomy, Operative time, Female, 030211 gastroenterology & hepatology, business, Right hemicolectomy
Abstract: Laparoscopy has gained wide acceptance due its benefits for patients. However, advanced laparoscopic procedures are still challenging. One critical issue is lack of stereoscopic vision. Despite its diffusion, the totally laparoscopic approach for right hemicolectomy (TLRC) is still debated due to its difficulty, particularly for fashioning of the ileocolic anastomosis. The aim of this multicenter study is to investigate whether 3D vision offers any advantages on surgical performance over 2D vision during TLRC. All data of consecutive patients who underwent elective TLRC for cancer at three Italian surgical centers with either 2D or 3D technology from January 2013 to December 2018 were retrieved from a computer-maintained database. A case-matched analysis using the Mantel-Haenszel method was performed. After matching, a total of 106 patients were analyzed with 53 patients in each group. Mean operative time was significantly longer for 2D-TLRC than for 3D-TLRC (153.2 ± 52.4 vs. 131 ± 51 min, p = 0.029) and a statistically significant difference in anastomosing time (p = 0.032, 19.2 ± 5.9 min vs. 21.7 ± 6.2 min for 3D and 2D group, respectively) was also recorded. No difference in the median number of harvested nodes (23 ± 11 vs. 21 ± 7 for 3D and 2D group, respectively; p = 0.48) was found. Neither intraoperative complications nor conversions occurred in the two groups. In conclusion, 3D vision appears to improve the performance of a TLRC by reducing operative time and making intracorporeal anastomosis easier. Prospective randomized studies are required to determine the real beneficial effects.
Published: 2020

14. Single staged hybrid approach for multilevel aortic-iliac-femoral-popliteal disease

Author: Guido Bajardi, Umberto Bracale, Felice Pecoraro, Ettore Dinoto, Marco Panagrosso, Andrea Cutrupi, Dinoto, Ettore, Pecoraro, Felice, Cutrupi, Andrea, Bracale, Umberto M., Panagrosso, Marco, Bajardi, Guido, Dinoto E., Pecoraro F., Cutrupi A., Bracale U.M., Panagrosso M., and Bajardi G.
Subjects: medicine.medical_specialty, Arterial disease, medicine.medical_treatment, Disease, Revascularization, Renal artery stenosis, Settore MED/22 - Chirurgia Vascolare, 03 medical and health sciences, 0302 clinical medicine, Intensive care, medicine.artery, Case report, Peripheral arterial disease, medicine, Renal artery, Endovascular, business.industry, Blood flow, Hybrid approach, medicine.disease, Surgery, Hybrid procedure, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business
Abstract: Highlights • Multilevel peripheral arterial disease in diabetic patients is cause of amputation. • Herein we report a case of critic limb ischemia addressed by hybrid procedure. • Hybrid procedure outcomes seem to be as good as with open revascularization. • Hybrid procedure show less morbidity and shorter intensive care and hospital stay., Introduction Multilevel peripheral arterial disease (MPAD) is the main cause of critic limb ischemia (CLI). Vascular interventions are required to increase distal blood flow and reduce the risk of lower limb amputation. Presentation of case We report a case of complex hybrid revascularization in a patient presenting a Rutherford V MPAD involving the infrarenal aorta, iliac, femoral and popliteal segments. The simultaneous hybrid intervention consisted of an endovascular aortic stent-graft placement and a surgical above-the-knee prosthetic femoro-popliteal bypass. In the same operation a renal stenting was performed due to a significant renal artery stenosis associated to a systemic hypertension non-responder to medical management. Discussion Hybrid interventions can be performed simultaneously or staged with benefit given by the complementary role of endovascular and surgical treatments allowing the correction of eventually inadequate results of both approaches. Reports of simultaneous hybrid treatments are limited but, despite the complexity of such procedures, primary success rate is reported high. Also in the reported case, a complex simultaneous treatment in a patient presenting MPAD in association to a significant and symptomatic renal artery disease was feasible in the same operation. Conclusion Hybrid procedure are safe with high degree of efficacy in terms of revascularization procedure, reduced morbidity and shorter intensive care and hospital stay. In our experience, the use of hybrid procedure is technically feasible and allowed the treatment of MPAD with a good outcomes.
Published: 2020

15. Clinical and Pathological Correlations in Chronic Venous Disease

Author: Giuseppina Torcia, Michele Andreucci, Pasquale Mastroroberto, Giuseppe Filiberto Serraino, S Ciranni, Caterina Chilà, Umberto Bracale, Michele Provenzano, Egidio Bevacqua, Nicola Ielapi, Chiara Mignogna, Maria Renne, Maria Donata Di Taranto, Raffaele Serra, Serra, Raffaele, Marcello Bracale, Umberto, Chilà, Caterina, Renne, Maria, Mignogna, Chiara, Ielapi, Nicola, Ciranni, Salvatore, Torcia, Giuseppina, Bevacqua, Egidio, Taranto, Maria Donata Di, Mastroroberto, Pasquale, Serraino, Giuseppe Filiberto, Provenzano, Michele, and Andreucci, Michele
Subjects: Adult, Male, Vascular Endothelial Growth Factor A, medicine.medical_specialty, extracellular matrix, Disease, MMP9, Gastroenterology, Varicose Veins, PGP 9.5, fibronectin, Internal medicine, mental disorders, Varicose veins, medicine, Humans, Prospective Studies, Stage (cooking), Vein, Pathological, varicose, MMP, business.industry, varicose vein, General Medicine, veins, VEGF, Fibronectins, Phenotype, medicine.anatomical_structure, Matrix Metalloproteinase 9, Chronic Disease, Cohort, Immunohistochemistry, Female, Surgery, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Ubiquitin Thiolesterase, Biomarkers
Abstract: Background Chronic Venous Disease (CVD) has a high prevalence in the western world. Varicose veins (VVs) are the main signs of this disease that is characterized by important pathological vessel wall changes. The aim of this study is to correlate the main histopathological abnormalities with related clinical issues of CVD. Methods A cohort of patients with VVs scheduled for open surgical treatment namely stab avulsion of VVs was recruited. Subsequently, venous tissue from stab avulsion was collected in order to evaluate the following biomarkers: Vascular-Endothelial Growth Factor (VEGF), Protein Gene Product 9.5 (PGP 9.5), Fibronectin (FN), and Matrix Metalloproteinase-9 (MMP-9). The Clinical-Etiology-Anatomy-Pathophysiology (CEAP) criteria were used to classify CVD. Results Fourteen tissue fragments were processed for histological and immunohistochemical studies. Of these, 43% were from CEAP C2 patients, 36% from CEAP C3 patients, and 21% from CEAP C4 patients. CEAP Class C2 had few to moderate structures positive to VEGF; occasional structures positive to Fibronectin, numerous structures positive to MMP9, few to moderate structures positive to PGP 9.5. CEAP Class C3 had moderate structures positive to VEGF; few to moderate structures positive to Fibronectin; many structures positive to MMP9; few to moderate structures positive to PGP 9.5. CEAP Class C4 had numerous structures positive to VEGF; numerous structures positive to Fibronectin; abundant structures positive to MMP-9; few structures positive to PGP 9.5. Conclusions In this study, positive VEGF, FN, and MMP-9 structures were found with increasing trends in relation to the disease staging. VEGF and FN are associated with a progressive increase from C2 to C4. The MMP-9 marker has an important positivity even at early stage of the disease, being higher in CEAP C4 patients. PGP 9.5 decreases in CEAP C4 patients and this is concordant to decreased vein wall innervation.
Published: 2022

16. Laparoscopic gastrectomy for stage II and III advanced gastric cancer: long‑term follow‑up data from a Western multicenter retrospective study

Author: Felice Pirozzi, Vania Silvestri, Emanuele Pontecorvi, Roberto Peltrini, Giovanni Ferrari, Giovanni Merola, Diego Cuccurullo, Dragan Gunjic, Elisa Cassinotti, Antonio Sciuto, Paolo De Martini, Umberto Bracale, Giusto Pignata, Pasquale Dolce, Milos Bjelovic, Luigi Boni, Monica Gualtierotti, Stefano Olmi, Jacopo Andreuccetti, Francesco Corcione, Matteo Uccelli, Bracale, U., Merola, G., Pignata, G., Andreuccetti, J., Dolce, P., Boni, L., Cassinotti, E., Olmi, S., Uccelli, M., Gualtierotti, M., Ferrari, G., De Martini, P., Bjelovic, M., Gunjic, D., Silvestri, V., Pontecorvi, E., Peltrini, R., Pirozzi, F., Cuccurullo, D., Sciuto, A., and Corcione, F.
Subjects: Male, medicine.medical_specialty, Advanced gastric cancer, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Testicular Neoplasms, Gastrectomy, Stomach Neoplasms, Internal medicine, Humans, Medicine, Laparoscopy, Retrospective Studies, medicine.diagnostic_test, business.industry, Stomach, Mortality rate, Retrospective cohort study, Hepatology, medicine.disease, Early Gastric Cancer, Surgery, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Laparoscopic gastrectomy, Lymph Node Excision, 030211 gastroenterology & hepatology, business, Follow-Up Studies, Abdominal surgery
Abstract: Introduction There has been an increasing interest for the laparoscopic treatment of early gastric cancer, especially among Eastern surgeons. However, the oncological effectiveness of Laparoscopic Gastrectomy (LG) for Advanced Gastric Cancer (AGC) remains a subject of debate, especially in Western countries where limited reports have been published. The aim of this paper is to retrospectively analyze short- and long-term results of LG for AGC in a real-life Western practice. Materials and methods All consecutive cases of LG with D2 lymphadenectomy for AGC performed from January 2005 to December 2019 at seven different surgical departments were analyzed retrospectively. The primary outcome was diseases-free survival (DFS). Secondary outcomes were overall survival (OS), number of retrieved lymph nodes, postoperative morbidity and conversion rate. Results A total of 366 patients with stage II and III AGC underwent either total or subtotal LG. The mean number of harvested lymph nodes was 25 ± 14. The mean hospital stay was 13 ± 10 days and overall postoperative morbidity rate 27.32%, with severe complications (grade ≥ III) accounting for 9.29%. The median follow-up was 36 ± 16 months during which 90 deaths occurred, all due to disease progression. The DFS and OS probability was equal to 0.85 (95% CI 0.81–0.89) and 0.94 (95% CI 0.92–0.97) at 1 year, 0.62 (95% CI 0.55–0.69) and 0.63 (95% CI 0.56–0.71) at 5 years, respectively. Conclusion Our study has led us to conclude that LG for AGC is feasible and safe in the general practice of Western institutions when performed by trained surgeons.
Published: 2022

17. Smoke Evacuation During Laparoscopic Surgery: A Problem Beyond the COVID-19 Period. A Quantitative Analysis of CO2 Environmental Dispersion Using Different Devices

Author: Giovanni Merola, Elisa Cassinotti, Emanuele Pontecorvi, Vania Silvestri, Umberto Bracale, Luigi Boni, Maria Triassi, Paolo Montuori, Francesco Corcione, Immacolata Russo, Bracale, U., Silvestri, V., Pontecorvi, E., Russo, I., Triassi, M., Cassinotti, E., Merola, G., Montuori, P., Boni, L., and Corcione, F.
Subjects: Insufflation, Laparoscopic surgery, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, SARS-COV-2, smoke evacuation device, Operating theater, Pneumoperitoneum, Smoke, medicine, Statistical dispersion, Laparoscopy, medicine.diagnostic_test, Pandemic, business.industry, COVID-19, Carbon Dioxide, medicine.disease, laparoscopic surgery, CO, Anesthesia, Surgery, business, Pneumoperitoneum, Artificial, Human
Abstract: Background. The COVID-19 pandemic leads to several debates regarding the possible risk for healthcare professionals during surgery. SAGES and EAES raised the issue of the transmission of infection through the surgical smoke during laparoscopy. They recommended the use of smoke evacuation devices (SEDs) with CO2 filtering systems. The aim of the present study is to compare the efficacy of different SEDs evaluating the CO2 environmental dispersion in the operating theater. Methods. We prospectively evaluated the data of 4 group of patients on which we used different SEDs or standard trocars: AIRSEAL system (S1 group), a homemade device (S2 group), an AIRSEAL system + homemade device (S3 group), and with standard trocars and without SED (S4 group). Quantitative analysis of CO2 environmental dispersion was carried out associated to the following data in order to evaluate the pneumoperitoneum variations: a preset insufflation pressure, real intraoperative pneumoperitoneum pressure, operative time, total volume of insufflated CO2, and flow rate index. Results. 16 patients were prospectively enrolled. The [CO2] mean value was 711 ppm, 641 ppm, 593 ppm, and 761 ppm in S1, S2, S3, and S4 groups, respectively. The comparison between data of all groups showed statistically significant differences in the measured ambient CO2 concentration. Conclusion. All tested SEDs seem to be useful to reduce the CO2 environmental dispersion respect to the use of standard trocars. The association of AIRSEAL system and a homemade device seems to be the best solution combining an adequate smoke evacuation and a stable pneumoperitoneum during laparoscopic surgery.
Published: 2022

18. Endovascular Treatment versus Medical Therapy for Hypertensive Patients with Renal Artery Stenosis: An Updated Systematic Review

Author: Umberto Bracale, Maria Donata Di Taranto, Leandro Pecchia, Davide Piaggio, Maurizio Sodo, Piaggio, Davide, Bracale, Umberto, Pecchia, Leandro, Di Taranto, Maria Donata, Sodo, Maurizio, and Bracale, Umberto Marcello
Subjects: Arterial hypertension, medicine.medical_specialty, Medical therapy, medicine.medical_treatment, MEDLINE, Blood Pressure, 030204 cardiovascular system & hematology, Renal Artery Obstruction, Renal artery stenosis, Balloon, 030218 nuclear medicine & medical imaging, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Angioplasty, medicine, Humans, Endovascular treatment, Renal artery stenosi, Antihypertensive Agents, Vascular Patency, business.industry, General Medicine, medicine.disease, Surgery, Hypertension, Renovascular, Treatment Outcome, Meta-analysis, Systematic review, Stents, Cardiology and Cardiovascular Medicine, business, Angioplasty, Balloon
Abstract: The benefit of balloon angioplasty, with or without stenting, for the treatment of patients with renal artery stenosis remains controversial. A number of randomized controlled trials have attempted to determine its efficacy but the matter remains unclear. A 2014 Cochrane Review, which combined data from eight trials, showed homogeneity amongst the trials with no significant benefit shown. This systematic review replicates the same research methods and meta-analysis while expanding it to include papers between 2014 and 2018. One of the trials included in the previous review published results in the interim. Additionally, two ongoing trials identified in the 2014 review are yet to publish any result. Meta-analysis of the reports showed no heterogeneity between trials and no significant improvement shown by balloon angioplasty, with or without stenting, versus medical therapy. Further studies are recommended in order to assess the benefits of balloon angioplasty for patients with more severe renal artery stenosis.
Published: 2019

19. Position Paper on Young Vascular Surgeons Training of the Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS): State of the Art and Perspectives

Author: Carlo Setacci, Umberto Bracale, Mohamed N. Bouayed, Raffaele Serra, Antonio Peluso, Guido Bajardi, Vincenzo De Luca, Timothy Resch, Anna Petrone, Maurizio Taurino, Laurent Chiche, Eric L.G. Verhoeven, Mauro Gargiulo, Patrizio Castelli, Nikolaos Saratzis, Felice Pecoraro, Raffaele Pio Ammollo, Marianna Maisto, Marco Panagrosso, Giovanni Pratesi, Ben R. Saleem, Andrea Stella, Raffaele Pulli, Bianca Pane, Ivan Cvjetko, Clark J. Zeebregts, Maddalena Illario, Emad Hussein, Giancarlo Bracale, Olivier Goëau-Brissonnière, Luca del Guercio, José Fernandes e Fernandes, Ettore Dinoto, Vincent Riambau, Francesco Setacci, Jamal J. Hoballah, Man, Biomaterials and Microbes (MBM), Bracale, Umberto Marcello, Ammollo, Raffaele Pio, Hussein, Emad A, Hoballah, Jamal J, Taurino, Maurizio, Saleem, Ben R, Setacci, Carlo, Pecoraro, Felice, Serra, Raffaele, Bracale, Giancarlo, Panagrosso, Marco, Peluso, Antonio, Petrone, Anna, Maisto, Marianna, Guercio, Luca Del, Dinoto, Ettore, Bajardi, Guido, Bouayed, Mohamed N, Zeebregts, Clark J, Pulli, Raffaele, Pane, Bianca, Pratesi, Giovanni, Castelli, Patrizio, Setacci, Francesco, Gargiulo, Mauro, Stella, Andrea, Illario, Maddalena, De Luca, Vincenzo, Verhoeven, Eric L G, Riambau, Vincent, Saratzis, Nikolao, Cvjetko, Ivan, Resch, Timothy, Fernandes, José Fernandes E, Chiche, Laurent, and Goeau-Brissonniere, Olivier
Subjects: medicine.medical_specialty, Arterial disease, media_common.quotation_subject, Vascular Surgery, Settore MED/22 - Chirurgia Vascolare, Training (civil), Peripheral Arterial Disease, State (polity), medicine, Mediterranean Sea, Humans, Training, Economic impact analysis, Vascular surgery specialty, media_common, National health, Surgeons, business.industry, Mediterranean Region, Internship and Residency, General Medicine, Vascular surgery, endovascular surgery, Mediterranean sea, training, vascular surgery, Education, Medical, Graduate, Family medicine, Endovascular Surgery, Position paper, Surgery, Clinical Competence, Curriculum, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures, Diabetic Angiopathies, Learning Curve, Program Evaluation, Specialization
Abstract: The Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS) was founded in 2018, with the aim to promote cooperation among vascular professionals within Mediterranean countries. Due to its prominent social and economic impact on national health systems, diabetic peripheral artery was selected as the very first topic to be investigated by the federation. In this second paper, different experiences from delegates of participating countries were shared to define common strategies to harmonize, standardize, and optimize education and training in the Vascular Surgery specialty.
Published: 2021

20. Hypoxia-Inducible Factor Stabilizers in End Stage Kidney Disease: 'Can the Promise Be Kept?'

Author: Yuri Battaglia, Michele Andreucci, Davide Bolignano, Ashour Michael, Giuseppina Crugliano, Giuseppe Coppolino, Michele Provenzano, Nicola Ielapi, Teresa Faga, Antonio Pisani, Raffaele Serra, Umberto Bracale, Crugliano, Giuseppina, Serra, Raffaele, Ielapi, Nicola, Battaglia, Yuri, Coppolino, Giuseppe, Bolignano, Davide, Bracale, Umberto Marcello, Pisani, Antonio, Faga, Teresa, Michael, Ashour, Provenzano, Michele, and Andreucci, Michele
Subjects: renal failure, medicine.medical_treatment, Review, Gastroenterology, Kidney Failure, renal disease, hemic and lymphatic diseases, Renal Insufficiency, Chronic, Biology (General), Spectroscopy, Anemia, Iron-Deficiency, treatment, General Medicine, Iron deficiency, anemia, Computer Science Applications, Chemistry, Hypoxia-inducible factors, erythropoietin, Glomerular Filtration Rate, medicine.drug, medicine.medical_specialty, Anemia, QH301-705.5, Iron, Renal function, Chronic kidney disease, Erythropoietin, ESAs, Renal disease, Renal failure, Treatment, Catalysis, Inorganic Chemistry, Internal medicine, medicine, Humans, Renal Insufficiency, Chronic, Physical and Theoretical Chemistry, Molecular Biology, QD1-999, Dialysis, business.industry, Organic Chemistry, Prolyl-Hydroxylase Inhibitors, Iron-Deficiency, medicine.disease, Hematinics, Kidney Failure, Chronic, Hemoglobin, business, chronic kidney disease, Kidney disease
Abstract: Anemia is a common complication of chronic kidney disease (CKD). The prevalence of anemia in CKD strongly increases as the estimated Glomerular Filtration Rate (eGFR) decreases. The pathophysiology of anemia in CKD is complex. The main causes are erythropoietin (EPO) deficiency and functional iron deficiency (FID). The administration of injectable preparations of recombinant erythropoiesis-stimulating agents (ESAs), especially epoetin and darbepoetin, coupled with oral or intravenous(iv) iron supplementation, is the current treatment for anemia in CKD for both dialysis and non-dialysis patients. This approach reduces patients’ dependence on transfusion, ensuring the achievement of optimal hemoglobin target levels. However, there is still no evidence that treating anemia with ESAs can significantly reduce the risk of cardiovascular events. Meanwhile, iv iron supplementation causes an increased risk of allergic reactions, gastrointestinal side effects, infection, and cardiovascular events. Currently, there are no studies defining the best strategy for using ESAs to minimize possible risks. One class of agents under evaluation, known as prolyl hydroxylase inhibitors (PHIs), acts to stabilize hypoxia-inducible factor (HIF) by inhibiting prolyl hydroxylase (PH) enzymes. Several randomized controlled trials showed that HIF-PHIs are almost comparable to ESAs. In the era of personalized medicine, it is possible to envisage and investigate specific contexts of the application of HIF stabilizers based on the individual risk profile and mechanism of action.
Published: 2021

21. Laparoscopic splenic artery aneurysmectomy with ICG guided partial splenectomy: alternative approach

Author: Francesco Corcione, Emanuele Pontecorvi, Vania Silvestri, Umberto Bracale, Marcello Filotico, Federica Lauria, and Andrea Coppola
Subjects: Male, medicine.medical_specialty, Spleen, Splenic artery, chemistry.chemical_compound, Aneurysm, Postoperative Complications, medicine.artery, medicine, Humans, Immunodeficiency, Thrombocytosis, business.industry, Middle Aged, medicine.disease, Surgery, Partial splenectomy, medicine.anatomical_structure, chemistry, Splenectomy, Laparoscopy, Pancreas, business, Indocyanine green, Splenic Artery
Abstract: We herein report the case of a voluminous splenic artery aneurysm (SAA) diagnosed in a 48 year-old Caucasian male patient. After endovascular treatment failure, considering the volumetric aneurysm increase and recurrent symptoms, a laparoscopic splenic artery aneurysmectomy with partial splenectomy guided by indocyanine green fluorescence (ICG) was performed. This conservative strategy leads to save a spleen volume of about 10 cm3 to avoid postsplenectomy thrombocytosis and infections, potential immunodeficiency and overwhelming postsplenectomy infection syndrome (OPSS) and to preserve pancreatic vascularization preventing distal pancreas injuries.
Published: 2021

22. Risk of anastomotic bleeding after left colectomy with preservation of inferior mesenteric artery for diverticular disease: preliminary results

Author: Michele D'Ambra, Pasquale Dolce, Roberto Peltrini, Umberto Bracale, Vania Silvestri, Gaia Altieri, Francesco Corcione, Maria Michela Di Nuzzo, Ruggero Lionetti, Bracale, Umberto, Peltrini, Roberto, DI Nuzzo, Maria M, Altieri, Gaia, Silvestri, Vania, Dolce, Pasquale, D'Ambra, Michele, Lionetti, Ruggero, and Corcione, Francesco
Subjects: Diverticular Diseases, medicine.medical_specialty, Staple line reinforcement, business.industry, Diverticular Disease, Left colectomy, Anastomotic Leak, Mesenteric Artery, Inferior, Colorectal anastomosis, Perioperative, Inferior mesenteric artery, Surgery, Anastomotic leakage, Retrospective Studie, medicine.artery, medicine, Diverticular disease, Humans, Anastomotic bleeding, business, Colectomy, Retrospective Studies, Human
Abstract: Background The inferior mesenteric artery (IMA) preservation in elective laparoscopic left colectomy for diverticular disease may reduce the risk of anastomotic leakage. However, an increased risk of bleeding is assumed. The purpose of this study is to investigate the risk of colorectal anastomosis bleeding, when IMA is resected or preserved during left colectomy. Methods A retrospective review of a prospectively collected database was performed. All patients who underwent elective left colectomy, from December 2018 to September 2020, were included. Patients' data and clinical information were collected and analyzed. Patients were categorized in two group: IMA resected (IMAR) and IMA preserving (IMA-P) left colectomy. Perioperative outcomes between the two groups were compared. Results Sixty-three consecutive patients who underwent left colectomy over a period of three years were enrolled: 42 in IMA-R group and 22 in the IMA-P group. There were no significant differences in demographic and intraoperative characteristics between the two groups, except for patients' age and primary disease. Six patients (9.37%) developed anastomotic bleeding during recovery, more frequently in the IMA-P than IMA-R group, although the difference is not statistically significative (13.6% and 7.3%; p=0.406). All bleedings were self-limited and only one needed red blood cells transfusion. Using the bioabsorbable staple line reinforcement (BSLR) has proved to be advantageous in preventing anastomotic bleeding in the IMA-P group. Conclusions IMA preserving left colectomy seems to be associated with a higher risk of mostly selflimited anastomotic bleeding during recovery. BSLR seems to be effective in this group of patients.
Published: 2021

23. Management of intraoperative and postoperative complications during laparoscopic colorectal procedures

Author: Umberto Bracale and Francesco Corcione
Subjects: Postoperative Complications, business.industry, Humans, Medicine, Laparoscopy, Surgery, Colorectal Neoplasms, business
Published: 2021

24. Impact of neoadjuvant therapy followed by laparoscopic radical gastrectomy with D2 lymph node dissection in Western population: A multi-institutional propensity score-matched study

Author: Stefano Olmi, Roberto Peltrini, Antonio Sciuto, Jacopo Andreuccetti, Monica Gualtierotti, Milos Bjelovic, Felice Pirozzi, Dragan Gunjic, Elisa Cassinotti, Paolo De Martini, Pasquale Dolce, Giusto Pignata, Umberto Bracale, Giovanni Ferrari, Luigi Boni, Diego Cuccurullo, Francesco Corcione, Matteo Uccelli, Bracale, U., Corcione, F., Pignata, G., Andreuccetti, J., Dolce, P., Boni, L., Cassinotti, E., Olmi, S., Uccelli, M., Gualtierotti, M., Ferrari, G., De Martini, P., Bjelovic, M., Gunjic, D., Cuccurullo, D., Sciuto, A., Pirozzi, F., and Peltrini, R.
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Population, postoparative complications, Gastrectomy, Stomach Neoplasms, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Postoperative Period, education, Lymph node, Neoadjuvant therapy, Aged, Retrospective Studies, education.field_of_study, oncological outcomes, oncological outcome, business.industry, gastric cancer, laparoscopic gastrectomy, Postoperative complication, Cancer, General Medicine, Length of Stay, Middle Aged, medicine.disease, Prognosis, Combined Modality Therapy, Neoadjuvant Therapy, Surgery, Survival Rate, Dissection, medicine.anatomical_structure, Oncology, Propensity score matching, Cohort, Female, Laparoscopy, business, Follow-Up Studies
Abstract: Background and Objectives: In the setting of a minimally invasive approach, we aimed to compare short and long-term postoperative outcomes of patients treated with neoadjuvant therapy (NAT) + surgery or upfront surgery in Western population. Methods: All consecutive patients from six Italian and one Serbian center with locally advanced gastric cancer who had undergone laparoscopic gastrectomy with D2 lymph node dissection were selected between 2005 and 2019. After propensity score-matching, postoperative morbidity and oncologic outcomes were investigated. Results: After matching, 97 patients were allocated in each cohort with a mean age of 69.4 and 70.5 years. The two groups showed no difference in operative details except for a higher conversion rate in the NAT group (p = 0.038). The overall postoperative complications rate significantly differed between NAT + surgery (38.1%) and US (21.6%) group (p = 0.019). NAT was found to be related to a higher risk of postoperative morbidity in patients older than 60 years old (p = 0.013) but not in patients younger (p = 0.620). Conversely, no difference in overall survival (p = 0.41) and disease-free-survival (p = 0.34) was found between groups. Conclusions: NAT appears to be related to a higher postoperative complication rate and equivalent oncological outcomes when compared with surgery alone. However, poor short-term outcomes are more evident in patients over 60 years old receiving NAT.
Published: 2021

25. The role of direct peritoneal resuscitation in the treatment of hemorrhagic shock after trauma and in emergency acute care surgery: a systematic review

Author: Marcelo Augusto Fontenelle Ribeiro-Junior, Cássia Tiemi Kawase Costa, Samara de Souza Augusto, Paola Rezende Néder, Yasmin Garcia Batista Elia, Rishi, Rattan, Andressa Daniel Maurício, Giuliani, Antonio, Gallo, Gaetano, Mauro, Podda, Umberto, Bracale, Tiziana, Principi, Pata, Francesco, and Salomone Di Saverio
Subjects: Resuscitation, open abdomen, shock, Shock, Hemorrhagic, Critical Care and Intensive Care Medicine, Microcirculation, visceral ischemia, Rats, Sprague-Dawley, Edema, medicine, Animals, Humans, Orthopedics and Sports Medicine, primary fascial closure, Septic shock, business.industry, direct peritoneal resuscitation, Hypoxia (medical), medicine.disease, inflammation, haemorrhage, Rats, Blood pressure, medicine.anatomical_structure, Anesthesia, Shock (circulatory), Emergency Medicine, Abdomen, Fluid Therapy, Surgery, medicine.symptom, business
Abstract: Direct peritoneal resuscitation (DPR) has been used to help preserve microcirculation by reversing vasoconstriction and hypoperfusion associated with the pathophysiological process of shock, which can occur despite appropriate intravenous resuscitation. This approach depends on infusing a hyperosmolar solution intraperitoneally via a percutaneous catheter with the tip ending near the pelvis or the root of the mesentery. The abdomen is usually left open with a negative pressure abdominal dressing to continuously evacuate the infused dialysate. Hypertonicity of the solution triggers visceral vasodilation to help maintain blood flow, even during shock, and is also associated with reduced local inflammatory cytokines and other mediators, preservation of endothelial cell function, and mitigation of organ edema and necrosis. It also has a direct effect on liver perfusion and edema, more rapidly corrects electrolyte abnormalities compared to intravenous resuscitation alone, and may requireless intravenous fluid to stabilize blood pressure, all of which shortens the time required to close patients’ abdomen. An online query using the search term “direct peritoneal resuscitation” was carried out in PubMed, MEDLINE and SciELO, limited to publications indexed from January 2014 to June 2020. Of the 20 articles returned, full text was able to be obtained for 19. A manual review of included articles’ references was resulted in the addition of 1 article, for a total of 20 included articles. The 20 articles were comprised of 15 animal studies, 4 clinical studies,and 1 expert opinion. The benefits include both local and possibly systemic effects on perfusion, hypoxia, acidosis, and inflammation, and are associated with improved outcomes and reduced complications. DPR shows promise in patients with hemorrhagic shock, septic shock, and other conditions resulting in an open abdomen after damage control laparotomy.
Published: 2021

26. 'One Health' Approach for Health Innovation and Active Aging in Campania (Italy)

Author: Cristina Ponsiglione, Giovanni Tramontano, Giovanni Annuzzi, Maddalena Illario, Rosa Zampetti, Anna Marro, Jean Bousquet, Giannamaria Vallefuoco, Regina Roller-Wirnsberger, Guido Iaccarino, Gaetano Cafiero, Alberto Lombardi, Aurelio Crudeli, Giancarlo Bracale, Maria Triassi, Mariarosa A. B. Melone, Mario Losasso, Donatella Tramontano, Umberto Bracale, Maurizio Taglialatela, Maria Luisa Chiusano, Luigi Riccio, Vincenzo De Luca, Carmine Vecchione, Ugo Trama, Francesco Cacciatore, Pietro Buono, De Luca, V., Tramontano, G., Riccio, L., Trama, U., Buono, P., Losasso, M., Bracale, U. M., Annuzzi, G., Zampetti, R., Cacciatore, F., Vallefuoco, G., Lombardi, A., Marro, A., Melone, M. A. B., Ponsiglione, C., Chiusano, M. L., Bracale, G., Cafiero, G., Crudeli, A., Vecchione, C., Taglialatela, M., Tramontano, D., Iaccarino, G., Triassi, M., Roller-Wirnsberger, R., Bousquet, J., Illario, M., De Luca, Vincenzo, Tramontano, Giovanni, Riccio, Luigi, Trama, Ugo, Buono, Pietro, Losasso, Mario, Marcello Bracale, Umberto, Annuzzi, Giovanni, Zampetti, Rosa, Cacciatore, Francesco, Vallefuoco, Giannamaria, Lombardi, Alberto, Marro, Anna, Melone, Mariarosa Anna Beatrice, Ponsiglione, Cristina, Luisa Chiusano, Maria, Bracale, Giancarlo, Cafiero, Gaetano, Crudeli, Aurelio, Vecchione, Carmine, Taglialatela, Maurizio, Tramontano, Donatella, Iaccarino, Guido, Triassi, Maria, Roller-Wirnsberger, Regina, and Bousquet and Maddalena Illario, Jean
Subjects: Aging, Economic growth, Population, digital health, Review, information and communication technologies, silver economy, Healthy Aging, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), active and healthy aging, Health care, health innovation, Humans, 030212 general & internal medicine, education, Ecosystem, health care economics and organizations, Health policy, Aged, education.field_of_study, information and communication technologie, business.industry, future health and health care, Public Health, Environmental and Occupational Health, health policy, Digital health, One Health, Italy, 030228 respiratory system, General partnership, Sustainability, Quality of Life, Public Health, Business, Public aspects of medicine, RA1-1270, Human
Abstract: This article describes how innovations are exploited in Campania (Italy) to improve health outcomes, quality of life, and sustainability of social and healthcare services. Campania's strategy for digitalization of health and care and for healthy aging is based on a person-centered, life-course, “One Health” approach, where demographic change is considered capable of stimulating a growth dynamic linked to the opportunities of combining the “Silver Economy” with local assets and the specific health needs of the population. The end-users (citizens, patients, and professionals) contribute to the co-creation of products and services, being involved in the identification of unmet needs and test-bed activity. The Campania Reference Site of the European Innovation Partnership on Active and Healthy Aging is a flexible regional ecosystem to address the challenge of an aging population with a life-course approach. The good practices, developed in the context of research and innovation projects and innovative procurements by local stakeholders and collaborations with international networks, have been allowing the transfer of innovative solutions, knowledge, and skills to the stakeholders of such a multi-sectoral ecosystem for health.
Published: 2021

27. Clinics and pathology of Krukenberg tumor: a systematic review and meta-analysis

Author: Michele D'Ambra, Maria D'Armiento, Marcello De Luca, Luigi Insabato, Francesco Corcione, Umberto Bracale, Ruggero Lionetti, Alberto Coppellotti, Fulvio Zullo, Roberto Peltrini, Antonio Travaglino, Antonio Raffone, Lionetti, Ruggero, DE LUCA, Marcello, Raffone, Antonio, Travaglino, Antonio, Coppellotti, Alberto, Peltrini, Roberto, Bracale, Umberto, D'Ambra, Michele, Insabato, Luigi, Zullo, Fulvio, D'Armiento, Maria, and Corcione, Francesco
Subjects: Ovarian Neoplasms, medicine.medical_specialty, business.industry, Stomach, Obstetrics and Gynecology, medicine.disease, Krukenberg tumor, Asymptomatic, Gastroenterology, Primary tumor, Appendix, Krukenberg Tumor, medicine.anatomical_structure, Internal medicine, Meta-analysis, Ascites, medicine, Humans, Female, medicine.symptom, business, Pathological
Abstract: Background Krukenberg tumor (KT) is defined as a secondary neoplasm of the ovary. While ovarian metastases account for about 30% of ovarian tumors, KTs are rare, accounting for about 1-2% of the total. The rarity of KT is at least in part responsible for the lack of a precise clinic-pathological characterization of these tumors. Clinically, KT may have a subtle clinical presentation, with few symptomatic manifestations and nonspecific clinical signs, even though in Literature there is disagreement about the clinical presentation of these patients; such difficulties in the diagnostic framework often leads to a delayed diagnosis with serious consequences on the patient outcome. Objectives We aimed to provide a clinico-pathological characterization of Krukenberg Tumor (KT) through a systematic review and meta-analysis. Methods Electronic databases were searched for all studies assessing clinicopathological features of KT series. Pooled prevalence of each clinical or pathological factor was calculated according to the random-effect model. Results Forty-eight studies with 3025 KT patients were included; 39.7% of patients were ≥50 and 39.8% were postmenopausal. The most common primary tumor sites were stomach (42.5%), colon-rectum (26.1%), breast (9.3%), and appendix (5%); 48.7% of KTs were synchronous with the primary tumor, 64.3% were bilateral, 40.5% had a diameter ≥10 cm; 55.3% showed extraovarian extent and 49% showed peritoneal involvement. The most common presenting symptoms were ascites (51.7%), palpable mass (31.3%), pain (29.3%), abdominal distention (28.7%), irregular bleeding (9.1%), asymptomatic (11.2%); 27.5% of patients showed increased serum level of CA125, while 29.4% showed increased CEA levels. Cytokeratin-7 was positive in 34.5% of cases and cytokeratin-20 in 34.3%. Conclusions KT shows a highly variable presentation. Understanding the prevalence of clinico-pathological factors may be helpful to improve the diagnosis and management of KT.
Published: 2021

28. Novel biomarkers in cardiovascular surgery

Author: Federica Jiritano, Giuseppe Filiberto Serraino, Noemi Licastro, Umberto Bracale, Raffaele Serra, Nicola Ielapi, Pasquale Mastroroberto, Antonia Rizzuto, Michele Provenzano, Michele Andreucci, Serra, Raffaele, Jiritano, Federica, Bracale, Umberto M, Ielapi, Nicola, Licastro, Noemi, Provenzano, Michele, Andreucci, Michele, Rizzuto, Antonia, Mastroroberto, Pasquale, and Serraino, Giuseppe F
Subjects: medicine.medical_specialty, Clinical Biochemistry, MEDLINE, heart, Disease, 030204 cardiovascular system & hematology, surgery, 03 medical and health sciences, Health problems, 0302 clinical medicine, Risk Factors, Drug Discovery, Health care, medicine, Humans, Intensive care medicine, Surgical treatment, business.industry, cardiovascular, Patient Selection, Biochemistry (medical), arterie, veins, arteries, biomarkers, Prognosis, Cardiovascular Diseases, 030220 oncology & carcinogenesis, biomarker, business, Biomarkers
Abstract: Cardiovascular disease includes health problems related to the heart, arteries and veins and is a significant healthcare problem worldwide. Cardiovascular disease may be acute or chronic and relapses are frequent. Biomarkers involved in this field may help clinicians and surgeons in diagnosis and adequate decision making. Relevant articles searched in the following databases Medline, Scopus, ScienceDirect, were retrieved and analysed. Several biomarkers have been identified and we analyzed those of most importance from a clinical and surgical point of view. Biomarkers can better identify high-risk individuals, facilitate follow-up process, provide information regarding prognosis and better tailor the most appropriate surgical treatment.
Published: 2021

29. Transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis

Author: Simone Castiglioni, Umberto Bracale, Francesco Corcione, Maurizio Sodo, Roberto Peltrini, E. Botteri, Nicola Imperatore, Cesare Stabilini, D. Neola, Giuseppe Cavallaro, Bracale, U, Corcione, F, Neola, D, Castiglioni, S, Cavallaro, G, Stabilini, C, Botteri, E, Sodo, M, Imperatore, N, and Peltrini, R
Subjects: medicine.medical_specialty, business.industry, Ventral hernia repair, MEDLINE, Robotic TAR, Retrospective cohort study, Review, Lower risk, Transversus abdominis release, Hernia, Ventral, Surgery, Tar (tobacco residue), Robotic Surgical Procedures, Meta-analysis, Medicine, Humans, Surgical Wound Infection, Transversus abdominis, business, Herniorrhaphy, Abdominal surgery, Abdominal Muscles, Retrospective Studies
Abstract: Purpose To compare early postoperative outcomes after transversus abdominis release (TAR) for ventral hernia repair with open (oTAR) and robotic (rTAR) approach. Methods A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Web of Science databases was conducted to identify comparative studies until October 2020. A meta-analysis of postoperative short-term outcomes was performed including complications rate, operative time, length of stay, surgical site infection (SSI), surgical site occurrence (SSO), SSO requiring intervention (SSOPI), systemic complications, readmission, and reoperation rates as measure outcomes. Results Six retrospective studies were included in the analysis with a total of 831 patients who underwent rTAR (n = 237) and oTAR (n = 594). Robotic TAR was associated with lower risk of complications rate (9.3 vs 20.7%, OR 0.358, 95% CI 0.218–0.589, p p = 0.02), lower risk of developing systemic complications (6.3 vs 26.5%, OR 0.208, 95% CI 0.100–0.433, p p p Conclusion Robotic TAR improves recovery by adding the benefits of minimally invasive procedures when compared to open surgery. Although postoperative complications appear to decrease with a robotic approach, further studies are needed to support the real long-term and cost-effective advantages.
Published: 2021

30. Effects of the first and second wave of the COVID-19 pandemic on patients with colorectal cancer: what has really changed in the outcomes?

Author: M M Di Nuzzo, Francesco Corcione, Michele D'Ambra, Roberto Peltrini, Nicola Imperatore, Umberto Bracale, Peltrini, R., Imperatore, N., Di Nuzzo, M. M., D'Ambra, M., Bracale, U., and Corcione, F.
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Delayed Diagnosis, AcademicSubjects/MED00910, Coronavirus disease 2019 (COVID-19), Colorectal cancer, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Colorectal Neoplasm, Health Services Accessibility, Internal medicine, Pandemic, Research Letter, medicine, Humans, Antigens, Tumor-Associated, Carbohydrate, Pandemics, Colectomy, business.industry, Delayed Diagnosi, COVID-19, medicine.disease, Carcinoembryonic Antigen, Italy, Lymph Node Excision, Surgery, AcademicSubjects/MED00010, Colorectal Neoplasms, business, Human
Published: 2021

31. Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients

Author: Marco Caricato, Gabriella Teresa Capolupo, Roberto Peltrini, Filippo Carannante, Nicola Imperatore, Francesco Corcione, Diego Cuccurullo, Umberto Bracale, Peltrini, R., Imperatore, N., Carannante, F., Cuccurullo, D., Capolupo, G. T., Bracale, U., Caricato, M., and Corcione, F.
Subjects: Laparoscopic surgery, Male, medicine.medical_specialty, Short-term outcomes, Multivariate analysis, Colorectal cancer, medicine.medical_treatment, Affect (psychology), Cohort Studies, Postoperative complications, Elderly, Retrospective Studie, medicine, Humans, Rectal cancer, Laparoscopy, Retrospective Studies, Aged, medicine.diagnostic_test, business.industry, Rectal Neoplasms, Mortality rate, Rectum, Perioperative, Middle Aged, medicine.disease, Surgery, Postoperative complication, Short-term outcome, Treatment Outcome, Original Article, Cohort Studie, business, Cohort study, Human
Abstract: Postoperative complications and mortality rates after rectal cancer surgery are higher in elderly than in non-elderly patients. The aim of this study is to evaluate whether, like in open surgery, age and comorbidities affect postoperative outcomes limiting the benefits of a laparoscopic approach. Between April 2011 and July 2020, data of 287 patients with rectal cancer submitted to laparoscopic rectal resection from different institutions were collected in an electronic database and were categorized into two groups: p p = 0.02) compared with 210 non-elderly patients. There were no significative differences between groups in terms of overall postoperative complications (p = 0.3), number of patients with complications (p = 0.2), length of stay (p = 0.2) and death during hospitalization (p = 0.9). The only independent variables correlated with postoperative morbidity were male gender (OR 2.56; 95% CI 1.53–3.68, p p
Published: 2021

32. Laparoscopic-guided Ropivacaine trocar-site infiltration can improve post-operative pain control after laparoscopic adrenalectomy

Author: Luigi Petramala, Angelo Iossa, Daniele Crocetti, Claudio Letizia, Giorgio De Toma, Giuseppe Cavallaro, Enrico Fiori, Umberto Bracale, Sergio Gazzanelli, Andrea Polistena, and Olga Iorio
Subjects: general surgery, Visual analogue scale, medicine.medical_treatment, Analgesic, evidence-based medicine/surgery, Transversus Abdominis Plane Block, Medicine, Humans, Ropivacaine, Anesthetics, Local, Laparoscopy, Abdominal Muscles, Retrospective Studies, Pain, Postoperative, Analgesics, medicine.diagnostic_test, business.industry, Adrenalectomy, Endocrine surgery, Surgical Instruments, Anesthesia, Morphine, Surgery, business, medicine.drug
Abstract: Background There is no consensus on pain control in patients undergoing laparoscopy; nowadays, conventional therapy may be improved by transversus abdominis plane block. The aim of this evaluation is to investigate the role of laparoscopic-assisted trocar-site ropivacaine infiltration during adrenalectomy in pain control Methods This is a retrospective evaluation of a prospectively maintained database including patients undergoing adrenalectomy. Patients were divided into 2 groups: Group A patients received laparoscopic-assisted trocar-site infiltration of 7.5 mg/mL ropivacaine and Group B patients did not receive any infiltration. All patients received a 24-hour infusion of 20 mg morphine; pain was checked at 6, 24, and 48 hours after surgery by Visual Analogue Scale (VAS) score. A rescue analgesia by was given if VAS score was > 4 or on patient request. Results No differences in operative time, complications, and post-operative stay and no complications related to trocar-site infiltration were found. 6-hour and 48-hour VAS scores were not found to be significantly different between groups, even if a slight decrease in VAS score in Group A was reported. Group A showed significant reduction in VAS score at 24 hours (2.44 +/− .41 vs 3.01 +/− .78, P < .005) and in the number of patients requiring further analgesic drugs administration (40.6% vs 57.8%, P < .005) Conclusions Laparoscopic-guided trocar-site ropivacaine infiltration can be considered safe and effective in the management of post-operative pain and in the reduction of analgesic need in patients undergoing laparoscopic adrenalectomy. The retrospective nature of the study and the lack of a consistent series of patients require further evaluations.
Published: 2021

33. Targeting Nanostrategies for Imaging of Atherosclerosis

Author: Agnese Grassia, Giuliana Fortunato, Enza Torino, Tommaso Claudio Diomaiuti, Umberto Bracale, Francesca De Sarno, Paolo Bevilacqua, Eugenia Romano, Liberatore Tramontano, Maria Donata Di Taranto, Valentina Mollo, Angela Costagliola di Polidoro, Costagliola di Polidoro, Angela, Grassia, Agnese, De Sarno, Francesca, Bevilacqua, Paolo, Mollo, Valentina, Romano, Eugenia, Di Taranto, Maria Donata, Fortunato, Giuliana, Bracale, Umberto Marcello, Tramontano, Liberatore, Diomaiuti, Tommaso Claudio, and Torino, Enza
Subjects: Gadolinium DTPA, Pathology, medicine.medical_specialty, Article Subject, imaging, hydrodenticity, cardiovascular disease, nanoparticles, nanotechnology, nanomedicine, atherosclerosis, bioengineering, Cardiovascular research, Contrast Media, Context (language use), 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Medical technology, High spatial resolution, Medicine, Humans, Radiology, Nuclear Medicine and imaging, R855-855.5, Hyaluronic Acid, Stroke, 030304 developmental biology, 0303 health sciences, medicine.diagnostic_test, Atherosclerotic cardiovascular disease, business.industry, Clinical events, Macrophages, Magnetic resonance imaging, medicine.disease, Atherosclerosis, Magnetic Resonance Imaging, Plaque, Atherosclerotic, Angiography, Microscopy, Electron, Scanning, Nanoparticles, business, Research Article
Abstract: Despite the progress in cardiovascular research, atherosclerosis still represents the main cause of death worldwide. Clinically, the diagnosis of Atherosclerotic Cardiovascular Disease (ASCVD) relies on imaging methodologies including X-ray angiography and computed tomography (CT), which however still fails in the identification of patients at high risk of plaque rupture, the main cause of severe clinical events as stroke and heart attack. Magnetic resonance imaging, which is characterized by very high spatial resolution, could provide a better characterization of atherosclerotic plaque (AP) anatomy and composition, aiding in the identification of “vulnerable” plaques. In this context, hydrogel matrices, which have been demonstrated able to boost relaxometric properties of Gd-based contrast agents (CAs) by the effect of Hydrodenticity, represent a valuable tool towards the precision imaging of ASCVD improving the performance of this class of CAs while reducing systemic toxicity. In particular, hydrogel nanoparticles encapsulating Gd-DTPA can further contribute to providing CA-specific accumulation in the AP by nanoparticle surface decoration triggering an active targeting of the AP with the overall effect of allowing an earlier and more accurate diagnosis. In this work, we tested crosslinked Hyaluronic Acid Nanoparticles (cHANPs) in the complex environment of human atherosclerotic plaque. In addition, the surface of cHANPs was decorated with the antibody anti-CD36 (Ab36-cHANPs) for the active targeting of AP-associated macrophages. Results demonstrate that the Hydrodenticity of cHANPs and Ab36-cHANPs is preserved in this complex system and, preliminarily, that interaction of these probes with the AP is present.
Published: 2021

34. Intraoperative use of indocyanine green fluorescence imaging in rectal cancer surgery: The state of the art

Author: Maurizio Sodo, Ruggero Lionetti, Gaetano Luglio, Felice Mucilli, Roberto Peltrini, Michele D'Ambra, Salomone Di Saverio, Maria Michela Di Nuzzo, Simone Castiglioni, Francesco Corcione, Mauro Podda, Umberto Bracale, Peltrini, R., Podda, M., Castiglioni, S., Di Nuzzo, M. M., D'Ambra, M., Lionetti, R., Sodo, M., Luglio, G., Mucilli, F., Di Saverio, S., Bracale, U., and Corcione, F.
Subjects: Indocyanine Green, Fluorescence-lifetime imaging microscopy, medicine.medical_specialty, genetic structures, Colorectal cancer, Near infrared, Anastomotic Leak, Review, Fluorescence imaging, chemistry.chemical_compound, Medicine, Humans, Anastomotic leakage, Rectal cancer, Lymph node, Lymphatic chain, business.industry, Rectal Neoplasms, Optical Imaging, Gastroenterology, Rectum, General Medicine, medicine.disease, Total mesorectal excision, eye diseases, Dissection, medicine.anatomical_structure, chemistry, Radiology, business, Indocyanine green, Abdominal surgery, Human
Abstract: Indocyanine green (ICG) fluorescence imaging is widely used in abdominal surgery. The implementation of minimally invasive rectal surgery using new methods like robotics or a transanal approach required improvement of optical systems. In that setting, ICG fluorescence optimizes intraoperative vision of anatomical structures by improving blood and lymphatic flow. The purpose of this review was to summarize all potential applications of this upcoming technology in rectal cancer surgery. Each type of use has been separately addressed and the evidence was investigated. During rectal resection, ICG fluorescence angiography is mainly used to evaluate the perfusion of the colonic stump in order to reduce the risk of anastomotic leaks. In addition, ICG fluorescence imaging allows easy visualization of organs such as the ureter or urethra to protect them from injury. This intraoperative technology is a valuable tool for conducting lymph node dissection along the iliac lymphatic chain or to better identifying the rectal dissection planes when a transanal approach is performed. This is an overview of the applications of ICG fluorescence imaging in current surgical practice and a synthesis of the results obtained from the literature. Although further studies are need to investigate the real clinical benefits, these findings may enhance use of ICG fluorescence in current clinical practice and stimulate future research on new applications.
Published: 2021

35. The Impact of Chronic Kidney Disease on Peripheral Artery Disease and Peripheral Revascularization

Author: Michele Provenzano, Egidio Bevacqua, Teresa Faga, Maria Donata Di Taranto, Umberto Bracale, Raffaele Serra, Michele Andreucci, Ashour Michael, Luca del Guercio, Pasquale Mastroroberto, Giuseppe Fliberto Serraino, Maurizio Sodo, Nicola Ielapi, Federica Jiritano, Serra, Raffaele, Bracale, Umberto Marcello, Ielapi, Nicola, Del Guercio, Luca, Di Taranto, Maria Donata, Sodo, Maurizio, Michael, Ashour, Faga, Teresa, Bevacqua, Egidio, Jiritano, Federica, Serraino, Giuseppe Fliberto, Mastroroberto, Pasquale, Provenzano, Michele, and Andreucci, Michele
Subjects: medicine.medical_specialty, medicine.medical_treatment, Renal function, Disease, Review, Revascularization, urologic and male genital diseases, peripheral artery disease, albuminuria, chronic kidney disease, CKD, peripheral artery disease, PAD, ESKD, amputations, albuminuria, Internal medicine, Epidemiology, medicine, CKD, ESKD, business.industry, Incidence (epidemiology), General Medicine, Perioperative, chronic kidney disease, PAD, amputations, medicine.disease, female genital diseases and pregnancy complications, Cardiology, Albuminuria, medicine.symptom, business, Kidney disease
Abstract: Chronic kidney disease (CKD) is a clinical condition characterized by high morbidity and mortality. Globally, CKD is also increasing in prevalence and incidence. The two principal kidney measures namely estimated glomerular filtration rate (eGFR) and albuminuria have been found to be predictors of renal and cardiovascular (CV) endpoints including peripheral artery disease (PAD). The prevalence of PAD was increased in CKD patients and, particularly, in patients with more severe CKD stages. Despite the fact that revascularization strategies are suitable in CKD patients in similar fashion to non-CKD patients, few CKD patients underwent these procedures. In fact, if it is true that revascularization improves prognosis in PAD patients irrespective of baseline eGFR, it was also demonstrated that CKD patients, who underwent revascularization, were at higher risk for amputations, mortality, re-intervention and perioperative complications. With the present review article, we have examined the association between CKD, PAD and peripheral revascularization highlighting data about epidemiology, pathophysiologic mechanisms, and results from previous observational and intervention studies. We have also examined the future perspectives and challenges of research around the association between CKD and PAD.
Published: 2021

36. Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as Biomarkers for Cardiovascular Surgery Procedures: A Literature Review

Author: Stefano de Franciscis, Michele Andreucci, Umberto Bracale, Federica Jiritano, Michele Provenzano, Noemi Licastro, Nicola Ielapi, Pasquale Mastroroberto, Giuseppe Filiberto Serraino, Raffaele Serra, Serra, Raffaele, Ielapi, Nicola, Licastro, Noemi, Provenzano, Michele, Andreucci, Michele, Bracale, Umberto Marcello, Jiritano, Federica, de Franciscis, Stefano, Mastroroberto, Pasquale, and Serraino, Giuseppe Filiberto
Subjects: Oncology, medicine.medical_specialty, Percutaneous, Neutrophils, precision medicine, PLR, Disease, vascular surgery, NLR, surgery, Internal medicine, medicine, Humans, Lymphocyte Count, Lymphocytes, Neutrophil to lymphocyte ratio, Adverse effect, Neutrophil-to-lymphocyte ratio, Pharmacology, endovascular, business.industry, Platelet Count, Mortality rate, neutrophil-to-lymphocyte ratio, nlr, platelet-to-lymphocyte ratio, plr, cardiac surgery, outcome, General Medicine, Perioperative, Vascular surgery, Prognosis, Cardiac surgery, business, Biomarkers
Abstract: Background: Neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have been studied so far as prognostic factors of cardiovascular diseases. Their role interplayed with endothelial inflammation, has emerged as optimal predictors for major cardiovascular disease events and as prognostic factors for post-procedural outcomes. Methods: A review of the current literature was undertaken to investigate the relationship between NLR and PLR with percutaneous, cardiac surgery, and vascular surgery procedures. Results: Our findings show that perioperative NLR and PLR levels are significantly correlated with patient morbidity and mortality rates. Conclusions: These biomarkers have several attractive characteristics, as they are inexpensive and quickly available, and they can contribute to the early identification of patients at high risk for periprocedural adverse events.
Published: 2021

37. Laparoscopic segmental resection for tumours of the Angle of Treitz: a challenging but feasible surgical option. Results from a retrospective case-series analysis

Author: Ruggero Lionetti, Roberto Peltrini, Filippo Carannante, Antonio Sciuto, Emanuele Pontecorvi, Umberto Bracale, Andrea Coppola, Diego Cuccurullo, Francesco Corcione, Vania Silvestri, Felice Pirozzi, Michele D'Ambra, Bracale, U., Pontecorvi, E., Silvestri, V., Cuccurullo, D., D'Ambra, M., Lionetti, R., Coppola, A., Carannante, F., Pirozzi, F., Peltrini, R., Sciuto, A., and Corcione, F.
Subjects: Male, Endoscopy, Gastrointestinal, Retrospective Studie, Gastrointestinal Stromal Tumor, Medicine, Overall survival, Laparoscopy, Prospective cohort study, Gastrointestinal Neoplasms, Aged, 80 and over, GiST, medicine.diagnostic_test, Angle of Treitz, Sarcoma, Middle Aged, Survival Rate, Jejunum, Treatment Outcome, Gastrointestinal Neoplasm, Original Article, Female, Segmental resection, Duodenal cancer, GIST, Colon, Transverse, Human, Adult, medicine.medical_specialty, Gastrointestinal Stromal Tumors, Duodenum, Operative Time, Adenocarcinoma, Rare Diseases, Rare Disease, Humans, Neoplasm Invasiveness, Retrospective Studies, Aged, Neoplasm Invasivene, business.industry, Duodenal segmental resection, Transverse colon, medicine.disease, Surgery, Feasibility Studie, Feasibility Studies, business, Rare disease
Abstract: Tumours of the small intestine are rare and account for about 5% of gastrointestinal tract neoplasms. The angle of Treitz (AT) could be defined as the intestinal loop comprised between the third duodenal portion and the first 10 cm of jejunum. A gold standard surgical treatment for AT neoplasm has not yet been well defined. This paper is focused on a very rare disease and at the best of our knowledge this is the largest case series in the literature about the Laparoscopic Segmental Resection (LSR) of AT tumours. Using a prospectively collected database, all data of consecutive patients, from January 2007 to May 2019, who underwent LSR for AT tumours at two different institutions were analysed. Patients’ demographics, intra and post-operative data, 30-day mortality and overall survival were collected. A total of 16 patients were retrieved from our database. The mean operative time was 206,5 ± 79 min. Conversion to open surgery was needed in two cases due to tumor size and, respectively, invasion of the transverse colon which required a multivisceral resection. The mean distal and proximal resection margins were 7.4 ± 2.2 and 3.9 ± 1.2 cm. The median number of harvested nodes was 9 ± 3. Pathological diagnosis was GIST in 11 cases, adenocarcinoma in 4 and sarcoma in 1 case. In conclusion, in experienced hands, LSR appears to be a safe and effective treatment option for tumours of the AT. Prospective studies are needed to confirm these findings. Electronic supplementary material The online version of this article (10.1007/s13304-020-00910-7) contains supplementary material, which is available to authorized users.
Published: 2021

38. The use of the Amplatzer Vascular Plug in the prevention of endoleaks during abdominal endovascular aneurysm repair: A systematic literature review on current applications

Author: David Pakeliani, Michele Provenzano, Umberto Bracale, Luca del Guercio, Michele Andreucci, Anna Petrone, Liborio Ferrante, Raffaele Serra, Davide Turchino, Nicola Ielapi, Bracale, Umberto M, Petrone, Anna, Provenzano, Michele, Ielapi, Nicola, Ferrante, Liborio, Turchino, Davide, del Guercio, Luca, Pakeliani, David, Andreucci, Michele, and Serra, Raffaele
Subjects: Male, medicine.medical_specialty, Endoleak, medicine.medical_treatment, Endovascular surgery, Vascular plug, embolization, 030204 cardiovascular system & hematology, abdominal aortic aneurysm, endovascular aneurysm repair, endoleak, Endovascular aneurysm repair, Vascular occlusion, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Blood Vessel Prosthesis Implantation, 0302 clinical medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Embolization, Retrospective Studies, business.industry, Endovascular Procedures, General Medicine, medicine.disease, Embolization, Therapeutic, Abdominal aortic aneurysm, Surgery, Systematic review, Treatment Outcome, Iliac Aneurysm, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Aortic Aneurysm, Abdominal
Abstract: Objectives The Amplatzer Vascular Plug (AVP) is a vascular occlusion device designed to provide optimal embolization in several fields of the endovascular surgery. A full literature review was conducted to analyze AVPs in comparison with coils for the prevention of endoleaks during endovascular abdominal aortic aneurysm repair. Methods A systematic review was designed under PRISMA statement guidelines for systematic reviews and meta-analyses. The results were updated with a subsequent electronic search using Medline and Scopus databases up to December 2019. Results Eighteen articles making this comparison were found. In 79.7% of the cases, the target vessel was the internal iliac artery; in 1.6%, the common iliac artery; and in 16.7%, the inferior mesenteric artery. Risk of complications (buttock claudication, groin hematoma, endoleaks, and erectile dysfunction) after AVP was low. A cost comparison revealed that the mean cost for coils was around US$2262, while the average cost for the AVP was US$310. Conclusions The AVP is an effective and safe device for occluding peripheral vessels, proved to have lower complications rates. Compared with coil embolization, the AVP technique is potentially associated with lower procedural costs.
Published: 2021

39. Laparoscopic repair of internal hernia with late presentation and primary closure of the mesocolic defect – a video vignette

Author: Roberto Peltrini, Francesco Corcione, Mariangela Ilardi, Nello Pirozzi, Umberto Bracale, Peltrini, R., Pirozzi, N., Ilardi, M., Bracale, U., and Corcione, F.
Subjects: Internal hernia, medicine.medical_specialty, Potential risk, business.industry, Incidence (epidemiology), General surgery, Gastroenterology, Postoperative complication, digestive system diseases, Colorectal surgery, Hernia, Abdominal, Late presentation, 03 medical and health sciences, 0302 clinical medicine, Vignette, Internal Hernia, 030220 oncology & carcinogenesis, Medicine, Humans, 030211 gastroenterology & hepatology, Laparoscopy, business, Herniorrhaphy, Colorectal resection, Human
Abstract: Although the incidence of internal hernia after colorectal resection is low, most surgeons are aware of the potential risk of this postoperative complication [1]. Internal herniae are reported to be associated with left-sided resections in two third of the cases due to the shifting of the small bowel behind the neo-left colon [2]. They occur, in the majority of cases , in the early postoperative period with a high morbidity and a not inconsiderable mortality. Early recognition is mandatory in order to avoid the deterioration of a patient's condition and to allow a minimally invasive approach. However, the management of internal hernia following colorectal surgery is controversial and no recommendations have been established for their prevention.
Published: 2021

40. Incarcerated Inguinal and Crural Hernias

Author: Umberto Bracale, Emanuele Pontecorvi, Andrea Bianchin, Vania Silvestri, Alberto Sartori, Francesco Corcione, and Jacopo Andreuccetti
Subjects: medicine.medical_specialty, Surgical approach, Groin, medicine.diagnostic_test, business.industry, General surgery, medicine.disease, digestive system diseases, stomatognathic diseases, Inguinal hernia, surgical procedures, operative, medicine.anatomical_structure, medicine, Hernia, Inguinal hernioplasty, Laparoscopy, business, Laparoscopic treatment
Abstract: The chance of developing an inguinal hernia during one’s lifetime is relatively high and the rates are 27–43% for men and 3–6% for women. Inguinal hernioplasty is most frequently performed operation in wealthy countries. Laparoscopic approach for groin hernia has shown excellent results, and from the anesthesiological point of view, laparoscopy represents a safe technique. The risk of imprisonment for inguinal hernia is 11–24%, however, there is no evidence supporting an optimal surgical approach for patients with incarcerated or strangulated groin hernia. The aim of this study is to investigate indications, risks, and benefits of laparoscopic treatment of incarcerated groin hernia in elderly and frail patients.
Published: 2021

41. Surgical stress and metabolic response after totally laparoscopic right colectomy

Author: Gregory Alexander Raciti, Giovanni Domenico De Palma, Giuseppe De Simone, Sara Vertaldi, Francesco Beguinot, Claudia Miele, Antonella Desiderio, Nunzio Velotti, Fatima Domenica Elisa De Palma, Umberto Bracale, Michele Manigrasso, Marco Milone, Giuseppe Servillo, Michele D'Ambra, Giuseppe Perruolo, Milone, M., Desiderio, A., Velotti, N., Manigrasso, M., Vertaldi, S., Bracale, U., D'Ambra, M., Servillo, G., De Simone, G., De Palma, F. D. E., Perruolo, G., Raciti, G. A., Miele, C., Beguinot, F., De Palma, G. D., 'Federico II' University of Naples Medical School, Institute of Experimental Endocrinology and Oncology (IEOS), Consiglio Nazionale delle Ricerche (CNR), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)
Subjects: Male, medicine.medical_specialty, Surgical stress, Colorectal cancer, medicine.medical_treatment, Science, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Anastomosis, [SDV.IMM.II]Life Sciences [q-bio]/Immunology/Innate immunity, Article, Extracorporeal, Proinflammatory cytokine, 03 medical and health sciences, 0302 clinical medicine, Medical research, Humans, Medicine, Colectomy, Aged, Inflammation, Multidisciplinary, Molecular medicine, Tumor Necrosis Factor-alpha, business.industry, Interleukins, Insulin, Anastomosis, Surgical, Cancer, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, 3. Good health, C-Reactive Protein, Oncology, [SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology, 030220 oncology & carcinogenesis, Colonic Neoplasms, Right Colectomy, Female, Laparoscopy, 030211 gastroenterology & hepatology, business, Biomarkers
Abstract: No clear consensus on the need to perform an intracorporeal anastomosis (IA) after laparoscopic right colectomy is currently available. One of the potential benefits of intracorporeal anastomosis may be a reduction in surgical stress. Herein, we evaluated the surgical stress response and the metabolic response in patients who underwent right colonic resection for colon cancer. Fifty-nine patients who underwent laparoscopic resection for right colon cancer were randomized to receive an intracorporeal or an extracorporeal anastomosis (EA). Data including demographics (age, sex, BMI and ASA score), pathological (AJCC tumour stage and tumour localization) and surgical results were recorded. Moreover, to determine the levels of the inflammatory response, mediators, such as C-reactive protein (CRP), tumour necrosis factor (TNF), interleukin 1β (IL-1β), IL-6, IL-10, and IL-13, were evaluated. Similarly, cortisol and insulin levels were evaluated as hormonal responses to surgical stress. We found that the proinflammatory mediator IL-6, CRP, TNF and IL-1β levels, were significantly reduced in IA compared to EA. Concurrently, an improved profile of the anti-inflammatory cytokines IL-10 and IL-13 was observed in the IA group. Relative to the hormone response to surgical stress, cortisol was increased in patients who underwent EA, while insulin was reduced in the EA group. Based on these results, surgical stress and metabolic response to IA justify advocating the adoption of a totally laparoscopic approach when performing a right colectomy for cancer.This trial is registered on ClinicalTrials.gov (ID: NCT03422588).
Published: 2021

42. The Shaggy Aorta Syndrome. An updated review

Author: Giuseppe Filiberto Serraino, Nicola Ielapi, Umberto Bracale, Armando Pingitore, Pasquale Mastroroberto, Michele Andreucci, Noemi Licastro, Raffaele Serra, Stefano de Franciscis, Federica Jiritano, Michele Provenzano, Serra, R., Bracale, U. M., Jiritano, F., Ielapi, N., Licastro, N., Provenzano, M., Andreucci, M., Pingitore, A., de Franciscis, S., Mastroroberto, P., and Serraino, G. F.
Subjects: Aortic valve, Adult, Male, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Clinical Decision-Making, Embolism, trans-catheter aortic valve implantation, Aortic Diseases, 030204 cardiovascular system & hematology, Severity of Illness Index, 030218 nuclear medicine & medical imaging, endovascular aneurysm repair, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, medicine.artery, medicine, Humans, Embolization, Spinal cord injury, Aged, Aged, 80 and over, Aorta, tavi, aortic embolization, business.industry, Cerebral infarction, General Medicine, Syndrome, evar, Middle Aged, medicine.disease, Atherosclerosis, Prognosis, Surgery, shaggy aorta, medicine.anatomical_structure, Inclusion and exclusion criteria, cardiovascular system, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Background Shaggy aorta (SA) depicts the severe aortic surface degeneration, extremely friable and likely to cause spontaneous peripheral and visceral embolization or during catheterization, aortic manipulation, surgery or minimally invasive procedures. This study aims to provide the most accurate and up-to-date information on this disease. Methods Potentially eligible studies to be included were identified by searching the following databases: CENTRAL Library, ClinicalTrials.gov , MEDLINE, CINAHL, using a combination of subject headings and text words to identify relevant studies: (Shaggy aorta) OR (aortic embolization) OR (aortic embolism) OR (aortic thrombus) OR (aortic plaque). From a total of 29111 abstracts, and after applying inclusion and exclusion criteria, we considered 60 studies for inclusion in this review. Results Appropriate measurement and assessment of the aortic wall are pivotal in the modern era, in particular when percutaneous procedures are performed, as SA has been identified as an independent risk factor for spinal cord injury, mesenteric embolization, and cerebral infarction after endovascular aortic repair. Furthermore, SA increases the rate of cerebral complications during trans-catheter aortic valve implantation (TAVI). Conclusions In conclusion, prompt diagnosis of SA syndrome and appropriate guidelines on the management of this conditions may help physicians to better assess the patient risk and to minimize the dreadful related complications
Published: 2021

43. Use of the ORBEYETM Exoscope in General Surgery: The Advent of Video-Assisted Open Surgery

Author: Umberto Bracale, Ruggero Lionetti, Francesco Corcione, Giovanni Merola, Michele D'Ambra, Roberto Peltrini, Nello Pirozzi, Vania Silvestri, Emanuele Pontecorvi, Corcione, F., Silvestri, V., Merola, G., Dambra, M., Lionetti, R., Pirozzi, N., Peltrini, R., Pontecorvi, E., and Bracale, U.
Subjects: medicine.medical_specialty, general surgery, Microsurgery, medicine.medical_treatment, Magnification, Neurosurgical Procedure, 03 medical and health sciences, 0302 clinical medicine, Medicine, Video assisted, exoscope, Microscopy, training, business.industry, General surgery, Open surgery, Gold standard, medicine.disease, Esophagectomy, Inguinal hernia, Dissection, ORBEYE, 030220 oncology & carcinogenesis, Surgery, Neurosurgery, Asthenopia, business, 030217 neurology & neurosurgery, Human
Abstract: Background. Microsurgery has quickly become the “gold standard” approach for vascular surgical steps during neurosurgery. However, despite its advantages, the microscope has not been widely adopted in general surgery. A new 3D‐surgical exoscope, the ORBEYETM, has been developed and introduced to some surgical specialties. Herein, we present our preliminary experience with the ORBEYETM exoscope as applied to a number of general surgical procedures. Method. Throughout February 2020, 7 patients had undergone varying surgical procedures at our institute utilizing the ORBEYETM in some of specific procedural steps where the surgeons felt that the surgery would benefit from more enhanced magnification. Upon completion, all the surgeons who had taken part in the procedure were asked if they had experienced any nausea, dizziness, or eyestrain during its use. Results. The ORBEYETM was employed in a number of surgical steps for the following procedures: throughout an inguinal hernia repair, during a duodeno-cephalo-pancreatectomy, for a subtotal gastrectomy, during para-aortic mass dissection, and during Ivor Lewis procedure. None of the surgeons involved in the procedures reported experiencing any nausea, dizziness nor eyestrain, nor any other physical discomforts. Conclusion. To the best of our knowledge, ours is the very first report on the employment of the ORBEYE exoscope during general surgery. Our experience assures us that this highly ergonomic technology with its high-resolution 4K 3D optical system allows the surgeon to perform safe and precise surgery in several dedicated steps in which adequate magnification is required with no adverse effects to the surgeon or the surgical procedure itself.
Published: 2021

44. Management of Deep Femoral Artery Pseudoaneurysm in a COVID-19 patient

Author: Antonio Peluso, Umberto Bracale, Pietro Venetucci, Antonio Catelli, Peluso, Antonio, Venetucci, Pietro, Catelli, Antonio, and Bracale, Umberto Marcello
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), General Medicine, medicine.disease, Surgery, Pseudoaneurysm, Text mining, Correspondence, Deep Femoral Artery, Medicine, business, Cardiology and Cardiovascular Medicine
Published: 2021

45. Covered versus Bare-metal Kissing Stents for the Reconstruction of the Aortic Bifurcation in the ILIACS registry

Author: Michele Antonello, Chiara Mascoli, Franco Grego, Giovanni Pratesi, Raffaello Bellosta, Matteo Pegorer, Roberta Suita, Alessia Sonetto, Umberto Bracale, Aaron Fargion, Patrizio Castelli, Sergio Zacà, Narayana Pipitò, Davide Turchino, Andrea Cumino, Sara Speziali, Michelangelo Ferri, Mauro Gargiulo, Carlo Pratesi, Davide Marinazzo, Filippo Piacentino, Francesco Squizzato, Federico Fontana, Raffaele Pulli, Graziana Derone, Domenico Angiletta, Gabriele Piffaretti, Michele Piazza, Gianluca Citoni, Arnaldo Ippoliti, Filippo Benedetto, Francesco, Squizzato, Michele, Piazza, Raffaele, Pulli, Aaron, Fargion, Gabriele, Piffaretti, Carlo, Pratesi, Franco, Grego, Michele, Antonello, Fontana, Federico, Piacentino, Filippo, Castelli, Patrizio, Speziali, Sara, Angiletta, Domenico, Marinazzo, Davide, Zacà, Sergio, Bellosta, Raffaello, Pegorer, Matteo, Ippoliti, Arnaldo, Pratesi, Giovanni, Citoni, Gianluca, Benedetto, Filippo, Pipitò, Narayana, Derone, Graziana, Ferri, Michelangelo, Cumino, Andrea, Suita, Roberta, Gargiulo, Mauro, Mascoli, Chiara, Sonetto, Alessia, Bracale, UMBERTO MARCELLO, Turchino, Davide, Squizzato F., Piazza M., Pulli R., Fargion A., Piffaretti G., Pratesi C., Grego F., Antonello M., Fontana F., Piacentino F., Castelli P., Speziali S., Angiletta D., Marinazzo D., Zaca S., Bellosta R., Pegorer M., Ippoliti A., Pratesi G., Citoni G., Benedetto F., Pipito N., Derone G., Ferri M., Cumino A., Suita R., Gargiulo M., Mascoli C., Sonetto A., Bracale U.M., and Turchino D.
Subjects: Biocompatible, Male, Registrie, Arterial Occlusive Disease, Aortic bifurcation, Endovascular procedures, Iliac artery, Peripheral artery disease, Registries, Stents, Time Factors, Constriction, Pathologic, Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Aortic Diseases, Arterial Occlusive Diseases, Female, Humans, Italy, Limb Salvage, Middle Aged, Polytetrafluoroethylene, Prosthesis Design, Retrospective Studies, Treatment Outcome, Vascular Patency, Coated Materials, Biocompatible, Iliac Artery, Self Expandable Metallic Stents, Retrospective Studie, 80 and over, Stent, Medicine, Bare metal, Constriction, surgical procedures, operative, medicine.anatomical_structure, Endovascular procedure, Cohort, medicine.symptom, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Time Factor, Covered stent, Pathologic, business.industry, Proportional hazards model, Angioplasty, Coated Materials, Critical limb ischemia, Aortic Disease, Surgery, Settore MED/22, Multicenter study, Propensity score matching, business, Balloon
Abstract: Objective: We compared the early and mid-term outcomes of polytetrafluoroethylene covered stents (CSs) vs bare metal stents (BMSs) used in the kissing conformation for the reconstruction of the aortic bifurcation in aortoiliac obstructive disease. Methods: A multicenter cohort registry (2015-2019) collected data from 1306 patients who had undergone endovascular treatment of aortoiliac arterial obstructive disease. Only patients who had received bilateral iliac kissing stents for TransAtlantic Inter-Society Consensus (TASC) class C and D lesions were included in the present analysis. The 30-day outcomes, mid-term primary patency, and limb salvage rates were compared between the CSs and BMSs in matched patient cohorts after propensity score matching. The follow-up results were analyzed using Kaplan-Meier curves. Cox proportional hazards models were used to identify the predictors of primary patency. Results: A total of 336 patients were treated with kissing stents, 201 with CSs (60%) and 135 with BMSs (40%). In the unmatched cohort, patients receiving CSs were more likely to have critical limb ischemia (41% vs 30%; P = .038), complex iliac lesions, such as TASC D (90% vs 56%; P < .01), and iliac occlusions (59% vs 44%; P < .01). After propensity score matching, 220 patients were selected (110 with CSs and 110 with BMSs), without differences in the clinical presentation (critical limb ischemia, 41% vs 33%; P = .167), or anatomic complexity (TASC D, 66% vs 60%, P = .21; iliac occlusion, 48% vs 49%, P = .89). The 30-day mortality was 0%. The early medical (unmatched, 5% vs 4%, P = 1.00; matched, 5% vs 4%, P = .75) and surgical (unmatched, 5% vs 5%, P = 1.00; matched, 5% vs 3%, P = .72) complication rates were similar between the CSs and BMSs. However, the CSs resulted in a lower risk of intraoperative iliac rupture (0% vs 3.5%; P = .013) and greater ankle-brachial index improvement (0.43 ± 0.22 vs 0.36 ± 0.24; P = .02). At 36 months, the overall primary patency (92% ± 7% vs 92% ± 8%; P = .38), secondary patency (98% ± 3% vs 98% ± 4%; P = .50), and limb salvage (93% ± 9% vs 97% ± 5%; P = .20) rates were similar. In cases of moderate to severe iliac calcification, the CSs showed better results in the matched cohort (100% vs 89% ± 9%; P = .048). On multivariate analysis, CS use (hazard ratio [HR], 1.67; P = .45) did not significantly affect primary patency, but older age (HR, 0.93; P = .03) and kissing stent diameter ≥8 mm (HR, 0.25; P = .03) were significantly associated. Conclusion: In the present multicenter study, the use of kissing stents for the treatment of the aortic bifurcation provided good early and mid-term results. CSs were preferred for more complex lesions, were protective from iliac rupture, and allowed for greater ankle-brachial index improvement. The 3-year patency rates were similar between the CSs and BMSs. However, CSs showed improved results in the case of moderate to severe calcification.
Published: 2021

46. A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy

Author: Ilaria Ficarelli, Luigi Salemme, Rosario Mancusi, Eugenio Stabile, Loris Flora, Raffaele Pio Ammollo, Emilio Soreca, Daniela Viola, Paolo Sangiuolo, Enrico Cappello, Giovanni Esposito, Giovanni Cioffi, Raffaella Niola, Gennaro Vigliotti, Danilo Barbarisi, Angelo Cioppa, Umberto Bracale, Eugenio Laurenzano, Mario De Laurentis, Alfonsina M Corbisiero, Eugenio Martelli, Giancarlo Accarino, Carlo Ruotolo, Claudio Molino, Giampaolo Amabile, Gianpaolo Santini, Alessandro Luongo, Antonio D'angelo, Bruno Villari, Giuseppe Sarti, Adolfo Crinisio, Gianluca Cangiano, Pietro Landino, Claudia De Gregorio, Fernando Petrosino, Raffaele Piccolo, Davide Razzano, Michele Franzese, Stabile, E., Piccolo, R., Franzese, M., Accarino, G., Bracale, U. M., Cappello, E., Cioffi, G., Cioppa, A., Crinisio, A., Flora, L., Landino, P., Martelli, E., Mancusi, R., Niola, R., Petrosino, F., Razzano, D., Ruotolo, C., Salemme, L., Sangiuolo, P., Santini, G., Soreca, E., Vigliotti, G., Villari, B., Amabile, G., Ammollo, R. P., Barbarisi, D., Corbisiero, A. M., D'Angelo, A., Cangiano, G., De Gregorio, C., De Laurentis, M., Laurenzano, E., Ficarelli, I., Luongo, A., Molino, C., Sarti, G., Viola, D., and Esposito, G.
Subjects: medicine.medical_specialty, Cross-sectional study, medicine.medical_treatment, Ischemia, cross-sectional studies, ischemia, 030204 cardiovascular system & hematology, Rate ratio, Revascularization, COVID-19, chronic limb-threatening ischemia (CLTI), peripheral artery disease (PAD), adult, aged, aged, 80 and over, chronic disease, extremities, female, hospitalization, humans, italy, male, middle aged, peripheral arterial disease, retrospective studies, risk factors, SARS-CoV-2, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 80 and over, 030212 general & internal medicine, Peripheral artery disease (PAD), Aged, 80 and over, business.industry, Outbreak, Original Articles, medicine.disease, Amputation, Population study, Cardiology and Cardiovascular Medicine, business
Abstract: The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown ( n = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 ± 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32–0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; p < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions.
Published: 2021

47. Interval appendicectomy for complicated appendicitis: do not let your guard down!

Author: Umberto Bracale, Francesco Corcione, Mauro Podda, Roberto Peltrini, S. Di Saverio, Peltrini, R., Podda, M., Di Saverio, S., Bracale, U., and Corcione, F.
Subjects: medicine.medical_specialty, Guard (information security), business.industry, General surgery, Interval appendicectomy, Complicated appendicitis, medicine.disease, Appendicitis, Medicine, Appendectomy, Humans, Surgery, Laparoscopy, business
Published: 2021

48. Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Author: Benedetto, Ielpo, Mauro, Podda, Gianluca, Pellino, Pata, Francesco, Gianpiero, Gravante, Salomone Di Saverio, Gallo, Gaetano, Rashid, Lui, Adam, Orengia, Aditya, Chowdary, Aditya, Kulkarni, Adnan, Kuvvetli, Adolfo, Navarro, Adolfo, Pisanu, Adrian, Smith, Adriana Cavero Ibiricu, Aeris Jane, D Nacion, Ahmad, Alsaleh, Ahmad, Alhazmi, Ahmad, Elmabri, Ajaz, Wani, Ahmet, Rencuzogullari, Aingeru Sarriugarte Lasarte, Ainhoa Valle Rubio, Akshay, Bavikatte, Akshay, Kumar, Al-Radjid, Jamiri, Alain Michel Alvarado Padilla, Alban, Cacurri, Alberto de San Ildefonso, Alberto, Porcu, Alberto, Sartori, Aldo, Rocca, Alejandro Paz Yáñez, Alejandro, Becaria, Alejandro, Solís-Peña, Aleksandar, Sretenović, Alex, Urbistondo, Alfonso, Bandin, Alfonso, Najar, Alessandro De Luca, Alex, Boddy, Alexandros, Charalabopoulos, Alexios, Tzivanakis, Alfonso, Amendola, Alfredo Ramirez-Gutierrez de Velasco, Ali Cihat Yildirim, Alice, Frontali, Alpha Oumar Toure, Alvaro, García-Granero, Amaia Martínez Roldan, Amaia Sanz Larrainzar, Amila Sanjiva Ratnayake, Ana María Gonzalez-Ganso, Ana, M Minaya-Bravo, Andre, Das, Andrea, Bondurri, Andrea, Costanzi, Andrea, Lucchi, Andrea, Mazzari, Andrea, Musig, Andrea, Peloso, Andrea, Piano, Andrea, Police, Andrei, Mihailescu, Andrés, Pouy, Angela, Romano, Iossa, Angelo, Anna Carmen Leonetti, Anna, Guariniello, Anna, Isaac, Anna Pia Delli Bovi, Antonella, Chessa, Antonella, Tromba, Antonio Álvarez Martínez, Antonio, Brillantino, Antonio, Caira, Antonio, Castaldi, Antonio, Ferronetti, Antonio, Giuliani, Antonio, Prestera, Antonio Ramos-De la Medina, Antonio, Tarasconi, Antonino, Tornambè, Arcangelo, Picciariello, Argyrios, Ioannidis, Ari, Leppäniemi, Arshad, Khan, Arshad, Rashid, Arteaga Luis Eduardo Pérez-Sánchez, Ashok, Mittal, Ashrarur Rahman Mitul, Asif, Mehraj, Asim, Laharwal, Asnel, Dorismé, Athanasios, Marinis, Atif, Iqbal, Augusto, Moncada, Bartolomeo, Braccio, Basim, Alkhafaji, Beatriz de Andrés Asenjo, Beatriz, Martin-Perez, Belinda Sánchez Pérez, Ben, Creavin, Benedetto, Calì, Beniamino, Pascotto, Benjamin, Stubbs, Benjamin Zavala Retes, Branislav, Jovanovic, Brian Kp Goh, Bruno, Sensi, Carlo, Biddau, Carlo, Gazia, Carlo, Vallicelli, Carlos Alberto Fagundes, Carlos Cerdán Santacruz, Carlos, Chirico, Carlos Javier Gómez, Carlos, Petrola, Carlos Sánchez Rodriguez, Carlos Yánez Benítez, Carmelisa, Dammaro, Carmelo Lo Faro, Caroline, Reinke, Casandra Dominguez Paez, Catalina, Oliva, Charudutt, Paranjape, Charlotte, Thomas, Chi Fung Chia, Chi Kwan Kong, Chiara De Lucia, Christian Ovalle Chao, Claudio, Arcudi, Claudio, Guerci, Clement, Chia, Cristiano, Parise, Cristina, Folliero, Cristopher, Varela, Dalya, M Ferguson, Daniel, Camacho, Daniel, Popowich, Daniel Souza Lima, Daniela, Rega, Daniele, Delogu, Daniele, Zigiotto, Danilo, Vinci, Dario, D'Antonio, Dario, Parini, David Alessio Merlini, David DE Zimmerman, David, Moro-Valdezate, Davide, Pertile, Deborah Maria Giusti, Deborah, S Keller, Delko, Tarik, Denis, Kalivaçi, Dennis, Mazingi, Diana Gabriela Maldonado-Pintado, Diego, Sasia, Dimitrios, Linardoutsos, Dixon, Osilli, Domenico, Murrone, Domenico, Russello, Edgar, Rodas, Edisson Alberto Acuña Roa, Edoardo, Ricciardi, Edoardo, Rosso, Edoardo, Saladino, Eduardo, Flores-Villalba, Eduardo Ruiz Ajs, Eduardo, Smith-Singares, Efstratia, Baili, Efstratios, Kouroumpas, Eirini, Bourmpouteli, Eleftheria, Douka, Elena, Martin-Perez, Eleonora, Guaitoli, Elgun, Samadov, Elisa, Francone, Elisa, Vaterlini, Emilio, Morales, Emilio, Peña, Enhao, Zhao, Eneko Del Pozo Andres, Enrico, Benzoni, Enrico, Erdas, Enrico, Pinotti, Enrique, Colás-Ruiz, Erman, Aytac, Ernesto, Laterza, Ervis, Agastra, Esteban, Foianini, Esteban, Moscoso, Estefania, Laviano, Ester, Marra, Eugenia, Cardamone, Eugenio, Licardie, Eustratia, Mpaili, Eva, Pinna, Evaristo, Varo, Fabian Martín Navarro, Fabio, Marino, Fabio, Medas, Fabio, Romano, Fatlum, Maraska, Fatmir, Saliu, Fausto, Madrid, Fausto, Rosa, Federica, Mastella, Federico, Gheza, Federico, Luvisetto, Felipe, Alconchel, Felipe Monge Vieira, Felipe, Pareja, Ferdinando, Agresta, Fernanda, Luna, Fernando, Bonilla, Fernando, Cordera, Fernando, Burdió, Fernando, Mendoza-Moreno, Fernando Muñoz Flores, Fernando Pardo Aranda, Fiona, Taylor, Flavia, L Ramos, Flavio, Fernandes, Francesca Paola Tropeano, Francesco, Balestra, Francesco, Bianco, Francesco, Ceci, Francesco, Colombo, Francesco Di Marzo, Francesco, Ferrara, Francesco, Lancellotti, Francesco, Lazzarin, Francesco, Litta, Francesco, Martini, Francesco, Pizza, Francesco, Roscio, Francesco, Virdis, Francisco Blanco Antona, Francisco Cervantes Ramírez, Francisco Miguel Fernandez, Francisco Oliver Llinares, Francisco, Quezada, Francisco, Schlottmann, Gabriel, Herrera-Almario, Gabriel, Massaferro, Gabriele, Bislenghi, Gabrielle van Ramshorst, Gaetano, Gallo, Gaetano, Luglio, Georgios, Bointas, Georgios, Kampouroglou, Georgios, Papadopoulos, Gerardo Arredondo Manrique, Giacomo, Calini, Giacomo, Nastri, Giampaolo, Formisano, Giampaolo, Galiffa, Gian Marco Palini, Gianluca, Colucci, Gianluca, Pagano, Gianluca, Vanni, Gianmaria Casoni Pattacini, Gilda De Paola, Giorgio, Lisi, Giovanna, Partida, Giovanni, Bellanova, Giovanni De Nobili, Giovanni Sammy Necchi, Giovanni, Sinibaldi, Giovanni, Tebala, Giulia, Bagaglini, Giuliano, Izzo, Giulio, Argenio, Giuseppe, Brisinda, Giuseppe, Candilio, Giuseppe Di Grezia, Giuseppe, Esposito, Giuseppe, Faillace, Giuseppe, Frazzetta, Giuseppe La Gumina, Giuseppe, Nigri, Giuseppe, Romeo, Gloria Chocarro Amatriaín, Gloria, Ortega, Gonzalo, Martin-Martin, Gregor, A Stavrou, Gunadi, Gustavo Armand Ugon, Gustavo, Machain, Gustavo, Marcucci, Gustavo, Martínez-Mier, Gustavo Miguel Machain, Gustavo, Nari, Haydée, Calvo, Hamada, Fathy, Hamilto, Hazem, Ahmed, Hazem, Faraj, Hector, Nava, Hector Ordas Macias, Herald, Nikaj, Heriberto, Solano, Huma Ahmed Khan, Humberto Sánchez Alarcón, Husam, Ebied, Iacopo, Giani, Ibabe Villalabeitia Ateca, Ignacio, Neri, Igor Alberdi San Roman, 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Maria Ordoñez, Julieta, Gutierrez, Julio, Abba, Junaid Ahmad Sofi, Kashaf, Sherafgan, Kapil, Sahnan, Katsuhiko, Yanaga, Kevin, Beatson, Laharwal, Asim, Laura, Alvarez, Leandro, Siragusa, Lee, Farber, Lester, Ong, Liarakos, Athanasios, Lorena, García-Bruña, Luca De Martino, Luca, Ferrario, Luca, Giordano, Luca, Gordini, Luca, Pio, Luca, Ponchietti, Lucia, Moletta, Luciano, Curella, Luciano, Poggi, Lucio, Taglietti, Luigi, Bonavina, Luigi, Conti, Luigi, Goffredi, Luis Angel Garcia Ruiz, Luis, Barrionuevo, Luis Enrique Fregoso, Luis, F Cabrera, Luis, G Rodriguez, Luis, Grande, Luis Gregorio Osoria, Luis Javier Kantun Gonzalez, Luis, Sánchez-Guillén, Luis, Tallon-Aguilar, Luis, Tresierra, Luisa, Giavarini, Mahmoud, Hasabelnabi, Maja, Odovic, Mamoru, Uemura, Mansoor, Khan, Manuel, Artiles-Armas, Mara, David, Marcello Di Martino, Marcello Giuseppe Spampinato, Marcelo A, F Ribeiro, Marcelo, Viola, Marco, Angrisani, Marco, Calussi, Marco, Cannistrà, Marco, Catarci, Marco, Cereda, Marco, Conte, Marco, Giordano, Marco, Pellicciaro, Marco Vito Marino, Maria, E Vaterlini, María, F Jiménez, María Giulia Lolli, Bellini, MARIA IRENE, Maria, Lemma, Maria Michela Chiarello, Maria, Nicola, Mario, Arrigo, Mario Caneda Mejia, Mario Montes Manrique, Mario, Rodriguez-Lopez, Mario, Serradilla-Martín, Mario Zambrano Lara, Marisa, Martínez, Mark, Bagnall, Mark, Peter, Marta Cañón Lara, Marta Jimenez Gomez, Marta, Paniagua-Garcia-Señorans, Marta Perez Gonzalez, Martin, Rutegård, Martin, Salö, Marzia, Franceschilli, Massimiliano, Silveri, Massimiliano, Veroux, Massimo, Pezzulo, Matteo, Nardi, Matteo, Rottoli, Matti, Tolonen, Mauricio Pedraza Ciro, Mauricio, Zuluagua, Maurizio, Cannavò, Maurizio, Cervellera, Maurizio, Iacobone, Mauro, Montuori, Melody García Domínguez, Meltem, Bingol-Kologlu, Mian, Tahir, Michael, Lim, Michael Sj Wilson, Michael, Wilson, Michela, Campanelli, Michele, Bisaccia, Michele De Rosa, Michele, Maruccia, Michele, Paterno, Michele, Pisano, Michele, Torre, Michele, Treviño, Michele, Zuolo, Miguel, A Hernandez Bartolome, Miguel, Farina, Miguel, Pera, Miguel Prieto Calvo, Milagros, Sotelo, Min Myat Thway, Mohamed, Hassan, Mohamed Salah Eldin Hassan, Mohammad, Azfar, Mohammad, Bouhuwaish, Mohammad, Taha, Mohammad, Zaieem, Mohammed, Korkoman, Montserrat, Guraieb, Mostafa, Shalaby, Muhammad Asif Raza, Muhammad Umar Younis, Muhammed, Elhadi, Mujahid Zulfiqar Ali, Nadeem, Quazi, Nagendra, N Dudi-Venkata, Nahar, Alselaim, Natasha, Loria, Nathalie Villan Ramírez, Nay Win Than, Neil, Smart, Nelson, Trelles, Nicanor, Pinto, Niccolò, Allievi, Niccolo, Petrucciani, Nicola, Antonacci, Nicola, Cillara, Nicolae, Gica, Nicolaescu Diana Cristiana, Nicolás, Nicolás, Nicolò, Falco, Nicolò, Pecorelli, Nicolò, Tamini, Nikolaos Andreas Dallas, Nikolaos, Machairas, Noelia, Brito, Nura Ahmed Fieturi, Nuria, Ortega, Octavio, Avilamercado, Oktay, Irkorucu, Omar, Alsherif, Orestes, Valles, Orestis, Ioannidis, Oscar Hernández Palmas, Oscar Isaac Hernandez Palmas, Oscar Sanz 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Angelico, Roberta Maria Isernia, Roberta, Tutino, Roberto, Faccincani, Roberto, Peltrini, Rocío, Carrera-Ceron, Rodrigo, Tejos, Rohit, Kashyap, Roosevelt, Fajardo, Rosa, Lozito, Royer Madariaga Pareja, Sabrina, Garbarino, Salvador, Morales-Conde, Sami, Benli, Sami, Mansour, Samir, Flores, Samuel Limon Suarez, Santiago Lopez Ben, Sara, Fuentes, Sara, Napetti, Sara Ortiz de Guzmán, Selmy, Awad, Sergio, A Weckmann Luján, Sergio, Gentilli, Sergio, Grimaldi, Sergio Olivares Pizarro, Serkan, Tayar, Shakeeb, Nabi, Shannon, M Chan, Sheikh, Junaid, Sidney, Rojas, Silvana, Monetti, Silvia, García, Silvia, Salvans, Silvia, Tenconi, Simon, Shaw, Simone, Santoni, Sofia Andrea Parra, Sofía, Cárdenas, Sonia, Pérez-Bertólez, Sonja, Chiappetta, Sophie, Dessureault, Spiros, Delis, Stefano Amore Bonapasta, Stefano, Rausei, Stefano, Scaringi, Sundeep, Keswani, Syed Muhammad Ali, Süleyman, Cetinkunar, Tak Lit Derek Fung, Tariq, Rawashdeh, Tatiana Nicolás López, Tercio De Campos, Teresa Calderon Duque, Teresa, Perra, Theodore, Liakakos, Theodoros, Daskalakis, Theodoros, Liakakos, Thomas, Barnes, Tijmen, Koëter, Tiku, Zalla, Tomás, E González, Tomás, Elosua, Tommaso, Campagnaro, Tommy, Brown, Topi, Luoto, Touré Alpha Oumar, Ugo, Giustizieri, Ugo, Grossi, Umberto, Bracale, Uriel, Rivas, Valentina, Sosa, Valentina, Testa, Valeria, Andriola, Valerio, Balassone, Valerio, Celentano, Valerio, Progno, Varun, Raju, Vanessa, Carroni, Venera, Cavallaro, Venkateswara Rao Katta, Veronica De Simone, Vicent Primo Romaguera, Victor Hugo García Orozco, Victor, Luraschi, Victor, Rachkov, Victor, Turrado-L, Victor, Visag-Castillo, Victoria, Dowling, Victoria, Graham, Vincenzo, Papagni, Vincenzo, Vigorita, Vinicius Cordeiro Fonseca, Virginia Jimenez Carneros, Vittoria, Bellato, Walyson, Gonçalves, William, F Powers, William, Grigg, Wolf, O Bechstein, Yu Bing Lim, Yuksel, Altinel, Zoran, Golubović, Zutoia, Balciscueta, Ielpo B., Podda M., Pellino G., Pata F., Caruso R., Gravante G., Di Saverio S., Gallo G., Lui R., Orengia A., Chowdary A., Kulkarni A., Kuvvetli A., Navarro A., Pisanu A., Smith A., Ibiricu A.C., Nacion A.J.D., Alsaleh A., Alhazmi A., Elmabri A., Wani A., Rencuzogullari A., Lasarte A.S., Rubio A.V., Bavikatte A., Kumar A., Jamiri A.-R., Padilla A.M.A., Cacurri A., de San Ildefonso A., Porcu A., Sartori A., Rocca A., Yanez A.P., Becaria A., Solis-Pena A., Sretenovic A., Urbistondo A., Bandin A., Najar A., De Luca A., Boddy A., Charalabopoulos A., Tzivanakis A., Amendola A., de Velasco A.R.-G., Yildirim A.C., Frontali A., Toure A.O., Garcia-Granero A., Roldan A.M., Larrainzar A.S., Ratnayake A.S., Gonzalez-Ganso A.M., Minaya-Bravo A.M., Das A., Bondurri A., Costanzi A., Lucchi A., Mazzari A., Musig A., Peloso A., Piano A., Police A., Mihailescu A., Pouy A., Romano A., Iossa A., Leonetti A.C., Guariniello A., Isaac A., Bovi A.P.D., Chessa A., Tromba A., Martinez A.A., Brillantino A., Caira A., Castaldi A., Ferronetti A., Giuliani A., Prestera A., la Medina A.R.-D., Tarasconi A., Tornambe A., Picciariello A., Ioannidis A., Leppaniemi A., Khan A., Rashid A., Perez-Sanchez A.L.E., Mittal A., Mitul A.R., Mehraj A., Laharwal A., Dorisme A., Marinis A., Iqbal A., Moncada A., Braccio B., Alkhafaji B., de Andres Asenjo B., Martin-Perez B., Perez B.S., Creavin B., Cali B., Pascotto B., Stubbs B., Retes B.Z., Jovanovic B., Goh B.K.P., Sensi B., Biddau C., Gazia C., Vallicelli C., Fagundes C.A., Santacruz C.C., Chirico C., Diaz C.J.G., Petrola C., Rodriguez C.S., Benitez C.Y., Dammaro C., Faro C.L., Reinke C., Paez C.D., Oliva C., Paranjape C., Thomas C., Chia C.F., Kong C.K., De Lucia C., Chao C.O., Arcudi C., Guerci C., Chia C., Parise C., Folliero C., Varela C., Ferguson D.M., Camacho D., Popowich D., Lima D.S., Rega D., Delogu D., Zigiotto D., Vinci D., D'Antonio D., Parini D., Merlini D.A., Zimmerman D.D.E., Moro-Valdezate D., Pertile D., Giusti D.M., Keller D.S., Tarik D., Kalivaci D., Mazingi D., Maldonado-Pintado D.G., Sasia D., Linardoutsos D., Osilli D., Murrone D., Russello D., Rodas E., Roa E.A.A., Ricciardi E., Rosso E., Saladino E., Flores-Villalba E., Ajs E.R., Smith-Singares E., Baili E., Kouroumpas E., Bourmpouteli E., Douka E., Martin-Perez E., Guaitoli E., Samadov E., Francone E., Vaterlini E., Morales E., Pena E., Zhao E., Andres E.D.P., Benzoni E., Erdas E., Pinotti E., Colas-Ruiz E., Aytac E., Laterza E., Agastra E., Foianini E., Moscoso E., Laviano E., Marra E., Cardamone E., Licardie E., Mpaili E., Pinna E., Varo E., Navarro F.M., Marino F., Medas F., Romano F., Maraska F., Saliu F., Madrid F., Rosa F., Mastella F., Gheza F., Luvisetto F., Alconchel F., Vieira F.M., Pareja F., Agresta F., Luna F., Bonilla F., Cordera F., Burdio F., Mendoza-Moreno F., Flores F.M., Aranda F.P., Taylor F., Ramos F.L., Fernandes F., Tropeano F.P., Balestra F., Bianco F., Ceci F., Colombo F., Di Marzo F., Ferrara F., Lancellotti F., Lazzarin F., Litta F., Martini F., Pizza F., Roscio F., Virdis F., Antona F.B., Ramirez F.C., Fernandez F.M., Llinares F.O., Quezada F., Schlottmann F., Herrera-Almario G., Massaferro G., Bislenghi G., van Ramshorst G., Luglio G., Bointas G., Kampouroglou G., Papadopoulos G., Manrique G.A., Calini G., Nastri G., Formisano G., Galiffa G., Palini G.M., Colucci G., Pagano G., Vanni G., Pattacini G.C., De Paola G., Lisi G., Partida G., Bellanova G., De Nobili G., Necchi G.S., Sinibaldi G., Tebala G., Bagaglini G., Izzo G., Argenio G., Brisinda G., Candilio G., Di Grezia G., Esposito G., Faillace G., Frazzetta G., La Gumina G., Nigri G., Romeo G., Amatriain G.C., Ortega G., Martin-Martin G., Stavrou G.A., Gunadi, Ugon G.A., Machain G., Marcucci G., Martinez-Mier G., Machain G.M., Nari G., Calvo H., Fathy H., Hamilto, Ahmed H., Faraj H., Nava H., Macias H.O., Nikaj H., Solano H., Khan H.A., Alarcon H.S., Ebied H., Giani I., Ateca I.V., Neri I., Roman I.A.S., Fidoshev I., Rodriguez I.M., Negoi I., Ortega I., Bernescu I., Russo I.S., Rodriguez I.V., Palomares I., Baltazar I., Torrejimeno I.J., Jurado I.M.C., Reccia I., Hussain I., Toledo I.B., Mora-Guzman I., Dogaru I., Romic I., Balciscueta I., Kenington J.C., Sagolsem J., Jang J.Y., Olivier J., Lammel-Lindemann J., Dziakova J., Villavicencio J.I.R., Salinas J., Parreira J.P.J.G., Jovanovic, Perez J.R., Reyes J.A.S., Luque J.A.M., Mak J., Rodriguez J.S., Kok J.H.H., Krook J., Diaz-Elizondo J.A., Castell J., Garcia-Flores J.E., Navalon J.M.J., Rodrigues J.M.S., Pereira J., Gomez J.T.C., Luque J.B., del Olmo J.C.M., Salamea J.C., Olivier J.F.C., Laina J.L.B., Ordonez J.M., Gutierrez J., Abba J., Sofi J.A., Sherafgan K., Sahnan K., Yanaga K., Beatson K., Asim L., Alvarez L., Siragusa L., Farber L., Ong L., Athanasios L., Garcia-Bruna L., De Martino L., Ferrario L., Giordano L., Gordini L., Pio L., Ponchietti L., Moletta L., Curella L., Poggi L., Taglietti L., Bonavina L., Conti L., Goffredi L., Ruiz L.A.G., Barrionuevo L., Fregoso L.E., Cabrera L.F., Rodriguez L.G., Grande L., Osoria L.G., Gonzalez L.J.K., Sanchez-Guillen L., Tallon-Aguilar L., Tresierra L., Giavarini L., Hasabelnabi M., Odovic M., Uemura M., Khan M., Artiles-Armas M., David M., Di Martino M., Spampinato M.G., Ribeiro M.A.F., Viola M., Angrisani M., Calussi M., Cannistra M., Catarci M., Cereda M., Conte M., Giordano M., Pellicciaro M., Marino M.V., Vaterlini M.E., Jimenez M.F., Lolli M.G., Bellini M.I., Lemma M., Chiarello M.M., Nicola M., Arrigo M., Mejia M.C., Manrique M.M., Rodriguez-Lopez M., Serradilla-Martin M., Lara M.Z., Martinez M., Bagnall M., Peter M., Lara M.C., Gomez M.J., Paniagua-Garcia-Senorans M., Gonzalez M.P., Rutegard M., Salo M., Franceschilli M., Silveri M., Veroux M., Pezzulo M., Nardi M., Rottoli M., Tolonen M., Ciro M.P., Zuluagua M., Cannavo M., Cervellera M., Iacobone M., Montuori M., Dominguez M.G., Bingol-Kologlu M., Tahir M., Lim M., Wilson M.S., Wilson M., Campanelli M., Bisaccia M., De Rosa M., Maruccia M., Paterno M., Pisano M., Torre M., Trevino M., Zuolo M., Hernandez Bartolome M.A., Farina M., Pera M., Calvo M.P., Sotelo M., Thway M.M., Hassan M., Hassan M.S.E., Azfar M., Bouhuwaish M., Taha M., Zaieem M., Korkoman M., Guraieb M., Shalaby M., Raza M.A., Younis M.U., Elhadi M., Ali M.Z., Quazi N., Dudi-Venkata N.N., Alselaim N., Loria N., Ramirez N.V., Than N.W., Smart N., Trelles N., Pinto N., Allievi N., Petrucciani N., Antonacci N., Cillara N., Gica N., Cristiana N.D., Krystek N., Falco N., Pecorelli N., Tamini N., Dallas N.A., Machairas N., Brito N., Fieturi N.A., Ortega N., Mercado O.A., Irkorucu O., Alsherif O., Valles O., Ioannidis O., Palmas O.H., Palmas O.I.H., Guadarrama O.S., Bozbiyik O., Omelanczuk P., Ottolino P., Rodrigues P., Ruiz P., Campenni P., Chiarade P., Olivares P.P., Baroffio P., Panaccio P., Wintringer P., Di Fronzo P., Talento P., Favoriti P., Sendino P., Marsanic P., Mifsut P., Andrade P., Ajawin P., Abadia-Barno P., Castaneda P.A.N., Arevalos P.O.S., Bellver P.P., Koh P.S., Souza P., Major P., Bali R.S., Khattar R.M., Melo R.B., Ebrahiminia R., Azar R., Murga R.L., Pirolo R., Brady R., Davies R.J., Dholakia R., Rattan R., Singhal R., Lim R., Angelico R., Isernia R.M., Tutino R., Faccincani R., Peltrini R., Carrera-Ceron R., Tejos R., Kashyap R., Fajardo R., Lozito R., Pareja R.M., Garbarino S., Morales-Conde S., Benli S., Mansour S., Flores S., Suarez S.L., Ben S.L., Fuentes S., Napetti S., de Guzman S.O., Awad S., Weckmann Lujan S.A., Gentilli S., Grimaldi S., Pizarro S.O., Tayar S., Nabi S., Chan S.M., Junaid S., Rojas S., Monetti S., Garcia S., Salvans S., Tenconi S., Shaw S., Santoni S., Parra S.A., Cardenas S., Perez-Bertolez S., Chiappetta S., Dessureault S., Delis S., Bonapasta S.A., Rausei S., Scaringi S., Keswani S., Ali S.M., Cetinkunar S., Fung T.L.D., Rawashdeh T., Lopez T.N., De Campos T., Duque T.C., Perra T., Liakakos T., Daskalakis T., Barnes T., Koeter T., Zalla T., Gonzalez T.E., Elosua T., Campagnaro T., Brown T., Luoto T., Oumar T.A., Giustizieri U., Grossi U., Bracale U., Rivas U., Sosa V., Testa V., Andriola V., Tonini V., Balassone V., Celentano V., Progno V., Raju V., Carroni V., Cavallaro V., Katta V.R., De Simone V., Romaguera V.P., Orozco V.H.G., Luraschi V., Rachkov V., Turrado-L V., Visag-Castillo V., Dowling V., Graham V., Papagni V., Vigorita V., Fonseca V.C., Carneros V.J., Bellato V., Goncalves W., Powers W.F., Grigg W., Bechstein W.O., Lim Y.B., Altinel Y., Golubovic Z., Balciscueta Z., Ielpo, B., Podda, M., Pellino, G., Pata, F., Caruso, R., Gravante, G., Di Saverio, S., Gallo, G., Lui, R., Orengia, A., Chowdary, A., Kulkarni, A., Kuvvetli, A., Navarro, A., Pisanu, A., Smith, A., Ibiricu, A. 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Subjects: medicine.medical_specialty, Anti-Bacterial Agents, Appendectomy, Appendicitis, COVID-19 Testing, Hospital Administration, Humans, Pandemics, Personal Protective Equipment, Practice Patterns, Physicians', Surveys and Questionnaires, Attitude of Health Personnel, COVID-19, Surgeons, Coronavirus disease 2019 (COVID-19), Settore MED/18 - CHIRURGIA GENERALE, COVID-19 pandemic. Acute appendicitis, MEDLINE, Practice Patterns, 030230 surgery, Health administration, 03 medical and health sciences, 0302 clinical medicine, Anti-Bacterial Agent, Pandemic, medicine, Surveys and Questionnaire, Appendiciti, General, Laparoscopy, Personal protective equipment, Physicians', medicine.diagnostic_test, business.industry, General surgery, Original Articles, medicine.disease, Anti-bacterial agents, appendectomy, appendicitis, COVID-19 testing, hospital administration, humans, pandemics, personal protective equipment, practice patterns physicians', surveys and questionnaires, attitude of health personnel, surgeons, appendicitis - COVI-19 - ACIE study - management, Acute appendicitis, Original Article, Surgery, Covid-19, business, Human
Abstract: Background Surgical strategies are being adapted to face the COVID‐19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X‐ray plus molecular testing (PCR) being the commonest (19·8 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6·6 and 2·4 per cent respectively before, but 23·7 and 5·3 per cent, during the pandemic (both P, The COVID‐19 pandemic required reorganization of surgical services, affecting patients with common surgical diseases including acute appendicitis. No evidence is available on the topic. This study found global variation in screening policies, use of personal protective equipment and intraoperative directives. There has been increased adoption of non‐operative management and open appendicectomy. Hands off
Published: 2021

49. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Author: Dmitri, Nepogodiev, Joana Ff Simoes, Elizabeth, Li, Maria, Picciochi, James, C Glasbey, Glauco, Baiocchi, Ruth, Blanco-Colino, Daoud, Chaudhry, Ehab, Alameer, Kariem, El-Boghdadly, Funmilola, Wuraola, Dhruva, Ghosh, Rohan, R Gujjuri, Ewen, M Harrison, Herman, Lule, Haytham, Kaafarani, Mohammad, Khosravi, Irmgard, Kronberger, Sezai, Leventoğlu, Harvinder, Mann, Kenneth, A Mclean, Mengistu Gebreyohanes Mengesha, Maria Marta Modolo, Faustin, Ntirenganya, Lisa, Norman, Oumaima, Outani, Riinu, Pius, Peter, Pockney, Ahmad Uzair Qureshi, April Camilla Roslani, Sohei, Satoi, Catherine, Shaw, Aneel, Bhangu, Omar, M Omar, Waheed-Ul-Rahman, Ahmed, Leah, Argus, Alasdair, Ball, Edward, P Bywater, Amanpreet, Brar, Brett, E Dawson, Irani, Duran, Muhammed, Elhadi, Conor, S Jones, Sivesh, K Kamarajah, James, M Keatley, Samuel, Lawday, Ella, J Marson, Riinu, Ots, Irène, Santos, Elliott, H Taylor, Isobel, M Trout, Chris, Varghese, Mary, L Venn, William, Xu, Irida, Dajti, Arben, Gjata, Salah Eddine Oussama Kacimi, Luis, Boccalatte, Daniel, Cox, Philip, Townend, Felix, Aigner, Irmgard Elisabeth Kronberger, Elgun, Samadov, Amer, Alderazi, Kamral, Hossain, Greg, Padmore, Gabrielle van Ramshorst, Ismaïl, Lawani, Anis, Cerovac, Samir, Delibegovic, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Muhammad, Gohar, Mihail, Slavchev, Chukwuemeka, Nwegbu, Arnav, Agarwal, Janet, Martin, Joshua, Ng-Kamstra, Maricarmen, Olivos, Wenhui, Lou, Dong-Lin, Ren, Jose Andres Calvache, Carlos, J Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos, Gouvas, Jaroslav, Klat, René, Novysedlák, Nicolas, Amisi, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango-Naranjo, Sameh, Emile, Danilo Alfonso Arévalo Sandoval, Hailu, Dhufera, Samuel, Hailu, Mengistu, G Mengesha, Joonas, H Kauppila, Alexis, P Arnaud, Zaza, Demetrashvili, Markus, Albertsmeier, Hans, Lederhuber, Markus, W Löffler, Daniel Kwesi Acquah, Bernard, Ofori, 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Mohammed Shadrul Alam, Akm Khairul Basher, Shahnoor, Islam, M Nazmul Islam, S, Sabbir, Karim, Muntasir, Faisel, Sadia, Khan, Iftekhar Ibne Mannan, Nawshin, Nazia, Malissa, Bentham, Sasha, Corbin, Alex, Doyle, Asha, Eastmond, Amelia, Haynes, Margaret, O'Shea, Emil, Phillips, Keisha, Walkes, Evgeniy, L Artyushkov, Mark, L Kaplan, Vladislav, Straltsov, Yauheniya, Litvina, Alexei, Lyzikov, Victor, E Tihmanovich, Mafalda, Borges, Tim, Brits, Nicolas De Hous, Stefan De Wachter, Tomas, Menovsky, Xavier, Mortiers, Dorien, Vermeulen, Nils, Vleminckx, Dirk, Ysebaert, Julie, Bontinck, Danny, Bulthé, Ricky, Rasschaert, Anne-Sophie Van Haver, Koen Van Belle, Laurence, Verstraeten, Manon, Vounckx, Sébastien, D'Ulisse, Yasmine De Bruyne, Badih El Nakadi, Tessely, Heloise, Matteo, Luisetto, Sotirios, Marinakis, Maxime, Maton, Claire, Viste, Elke Van Daele, Mathieu, Vandeputte, Marc, Duinslaeger, Daniel, Jacobs-Tulleneers-Thevissen, Yanina, Jansen, Ward, Janssens, Rastislav, Kunda, Nouredin, Messaoudi, Michael, Ruyssers, Ellen Van Eetvelde, Marian, Vanhoeij, Jef Van den Eynde, Raf Van den Eynde, Ahmed, M Chaoui, Marcellin, Akpla, Souliath, Lawani, Hermann, Agossou, Hulrich Aouagbe Behanzin, Covalic, Bokossa, Hubert, Dewanon, Hugues, Yome, Alassan, Boukari, Oswald, Gbehade, Labissi Francois Amossou, Francis, Dossou, Tatjana, Barišić, Miran, Boras, Zdrinko, Brekalo, Ivana Čuljak Blagojević, Ana, Damjanović, Vedran, Dragisic, Ana Dugandžić Šimić, Filip, Gunaric, Martin, Kajic, Darko, Knežević, Tanja, Krešić, Valentina, Lasić, Ludvig, Letica, Vlatka, Martinovic, Iva, Mikulic, Josip, Miskovic, Hrvoje, Pehar, Pejana, Rastović, Irena, Sesar, Violeta, Šetka-Čuljak, Martina, Soljic, Dejan, Tiric, Vajdana, Tomić, Anja, Vasilj, Igor, Hudic, Renato Aguera Oliver, Felipe Azenha Lamonica, Jorge De Medeiros, Henrique Donizetti Bianchi Florindo, Rodolfo Jose Favaretto Filho, Fernanda Costa Pereira, Rodrigo, Rodrigues, Antonio Antunes Rodrigues Junior, Fernanda Ruiz de Andrade, Maisa, Salvetti, 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Volpe, Arthur, Gatti, Caroline, Nardi, Ramon, Oliva, Layze Braz de Oliveira, Herica Emilia Félix de Carvalho, Ivonizete Pires Ribeiro, Gabriel Renan Soares Rodrigues, Álvaro Francisco Lopes de Sousa, Michel, Chebel, Paulo Henrique de Sousa Fernandes, Marcelo Augusto Faria Freitas, Juliano Rodrigues da Cunha, Zeenia, Ather, Dobromir, Dimitrov, Emil, Filipov, Elitsa, Gyokova, Ivelina, Ilieva, Tsvetomir, Ivanov, Martin, Karamanliev, Vasil, Neykov, Boyko, Atanasov, Nikolay, Belev, Paolina, Kamenova, Kaloyan, Tonev, Tsanko, Yotsov, Evguenia, Hristova, Kolyo, Spassov, Tsanko, Tsankov, Dragomir, Dardanov, Petar, Gribnev, Manol, Sokolov, James, Brown, John, Tanyi, Heather, Hurdle, Anthony, Maclean, Michael, Sander, Salim Al Riyami, Krittika, Bali, David, Bigam, Khaled, Dajani, Mehran, Anvari, Rafik, Bolis, David, Choi, Susan, Ellis, Michael, Gupta, Wael, Hanna, Dennis, Hong, Cynthia, Horner, Lea, Luketic, Peter, Moisiuk, Yaron, Shargall, Hilda, Alfaro, Nawar, Alkhamesi, Laura, Allen, Muriel, Brackstone, Eunice, Chan, Davy, Cheng, Jason, Chui, Nelson, Gonzalez, Brent, Lanting, S Danielle MacNeil, Robert, Mayer, Jacob, Mcgee, Mahesh, Nagappa, Nicholas, Power, Agya, Prempeh, Mehdi, Qiabi, Hassan, Razvi, Emil, Schemitsch, Herman, Sehmbi, Ushma, Shah, Yamini, Subramani, Edward, Vasarhelyi, Kelly, Vogt, Homer, Yang, Ali Ghorbani Abdehgah, Saba, Balvardi, Liane, Feldman, Julio Flavio Fiore Jr, Melissa, Hanson, Brent, Hopkins, Pepa, Kaneva, Lawrence, Lee, Julia, Leonard, Jad, Abou-Khalil, Andre, Martel, James, Stevenson, Susan, Lee, Richard, Merchant, Samuel, Avoine, Laurence, Belanger, Mathieu, Belanger, Etienne, Belzile, Anne-Sophie, Blais, Sofia, Boucher-Kovalik, Cindy, Boulanger-Gobeil, Etienne, Cardinal, Pierre-Olivier, Champagne, Jonathan, Cloutier, Simon, Corriveau-Durand, Mathieu, Cote, Maxime, Cote, Mathilde, Côté, Valérie, Courval, Suzanne, Demers, Christine, Desbiens, Mehdi El Ouazzani, Karine, Girard, Ève-Marie, Girard, Karo, Gosselin, Helene, Khuong, Nathalie, 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Juliana Sanchez, David Mauricio Solano Varela, Paula Torres Gomez, Marcial, Trillos, Ana María Vargas Patiño, Felipe, Vargas-Barato, Juan Pablo Villate Leon, María Alejandra Wagner Useche, Jesus, Acosta, Adriana, Almeciga, Luis Becerra Mendez, Rafael Jose Beltran, Ana, Bonilla, Miguel, Buitrago, Marino, Cabrera, Pedro Hernando Calderon Quiroz, Diego, Camacho-Nieto, Carlos Andrés Carvajal Fierro, Sergio Cervera Bonilla, Sandra, Diaz, Helena, Facundo, Jorge, Forero, Mauricio Garcia Mora, Karena Victoria Garcia Tirado, German Fabian Godoy Perez, Felipe, Gonzalez, Oscar, Guevara, Jairo Alonso Hernandez, David Ricardo Herrera Mora, Juan David Lalinde, Carlos, Lehmann, Eduardo Leon Llanos, Byron Eduardo Lopez De Mesa Lopez, Ivan, Mariño, Monica, Medina, Raúl Eduardo Pinilla Morales, Angela, Puerto, Andrea, Quintero-Ortíz, Juliana Rendón Hernández, Elio Fabio Sánchez Cortés, Alvaro Eduardo Sánchez Hernández, Raul, Suarez, Oscar, Suescun, Marco, Vanegas, Rodolfo, Varela, Jorge Luis Velez 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Andrea Carolina Perea Serna, July, Ríos, Gabriel, Ríos-Samper, Juan David Rivera Garcia, Juan Camilo Salcedo Moreno, John, Sandoval, Guillermo Alberto Sarmiento Ramirez, Paola Andrea Tabares Romero, Ricardo, Urzola, Iliana Maria Valdes-Duque, Miguel, Velasquez, Lina Maria Villegas, James, Zapata-Copete, José Omar Zorrilla Lara, Mauricio Zuluaga Zuluaga, Alejandra Echeverri Moreno, Juan Sebastian Figueroa, Adolfo Enrique Gómez Ortiz, Maria Fernanda Gonzalez Mosos, Alejandro, González-Orozco, Juan Jose Jaramillo Roncancio, María Camila Leyva Martínez, Monica, Mosos, Juan Sebastian Ramirez, Henry Andrés Rodríguez, Juan David Saavedra Henao, María Alejandra Torrado Varón, Leidy Natalia Idarraga Ramírez, Lorena, Ocampo, Monica Cardona Marin, Ana Maria Marin Gonzalez, David Alejandro Mejia, Luis Emiro Vanegas, Yicel Alvarez Martinez, Sandra Aruachan Vesga, Dayana Vanessa Baron Fuentes, Alejandra Caballero Salas, Gustavo Antonio Martinez Estrada, Kelly Viloria Campo, Juan Antonio Corralez Alvarez, Cesar David Galindo Regino, Angela Maria Giraldo Velasquez, Carlos Enrique Melo Moreno, Jorman, H Tejada, Jesus Hernan Tovar, German Alirio Tovar, Edison Alexander Benavides Hernández, Claudia Milena Orozco-Chamorro, Gustavo Adolfo Angel, Christian Ali Buesaquillo, Victor David Olave Montaño, Andrés, Sánchez-Gómez, Daniela Patricia Escalante Ureche, Jairo Martinez Garrido, Eben-Ezer, Genda, Fabrice, Eboma, Kristina, Bitunjac, Karlo, Grulović, Marijana, Vučković, Goran, Šantak, Emanuel, Borovic, Ana Bosak Versic, Damir, Hasandić, Natasa Poldan Grabar, Suzana Srsen Medancic, Lucija, Brkic, Sara, Cokarić, Petra Pavic Palac, Zeljka, Samac, Josipa, Tomić, Marija, Vrdoljak, Ivan, Bacic, Bernarda, Bakmaz, Nikolina Bratošević Vučičić, Domagoj, Brzic, Samir, Canovic, Emilio, Dijan, Maja Grgec Dragicevic, Robert, Karlo, Suzana, Konjevoda, Petra, Kovačević, Ivan, Kovačić, Frane, Markulić, Luka, Matak, Domagoj, Morović, Gordan, Perišić, Andrea, Simic, Neven, Skitarelić, Matea, Veršić, 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Ioanna, Pozotou, Olga, Stavrinidou, Anneza, Yiallourou, Lukáš, Burda, Michal, Dosoudil, Lubomir, Martinek, Wladyslaw, B Gawel, Milan, Lerch, Matúš, Peteja, Jan, Žatecký, Toman, Daniel, Martin, Formánek, Veronika, Javurkova, Markéta, Kepičová, Nicole, Macečková, Petr, Matousek, Ondrej, Simetka, Petr, Vavra, Karol, Zelenik, Jan, Černý, Sami, Khan, Robert, Lischke, Martin, Přibyl, Temoore, Younus, Yenuksha, Amarasena, Karel, Klíma, Setareh, Pirmorad, Zuzana, Hotová, Aleš, Mladěnka, Nulvin, Bozo, Julie Lykke Harbjerg, Louise, Hviid, Helle, Ø Kristensen, Mira, Mekhael, Mette Fugleberg Nielsen, Laerke, Paulsen, Saija, Sinimäki, Louise Zinck Mogensen, Peter, Bonde, Anders Lyng Ebbehøj, Anne-Sophie, Fenger, Aleksander Fjeld Haugstvedt, Christine Hangaard Hansen, Maria Lovisa Jönsson, Lars, N Jorgensen, Peter-Martin, Krarup, Anne-Louise, Lihn, Christian, Meyhoff, Helena, Otte, Anas Ould Si Amar, Henrik, Palm, Nis, Schlesinger, Henry, Smith, Ida, Tryggedsson, Anne Reiss Axelsen, Jens Kristian Baelum, Mark Bremholm Ellebaek, Signe Bremholm Ellebaek, Anders, Hogh, Maria, Acosta, Yancy, Acosta, Pedro, Baez, Luis Alfredo Betances, Luis Rodolfo Bonilla, Daniel, Cabreja, Wilton Cabrera Cruz, María Mabel Collado Expósito, Aldo, Crespo, Octavio, Cruz-Pineda, Claudio Samuel D'óleo García, Pedro, Díaz, Remberto, Escoto, Jatnna, Figueroa, Luis, Garcia, U Garcia-Dubus Rodriguez, Humberto, Gomez, Adrian, Grullon, Fatherin, Guerrero, Lillian, Guzman, Thelma Rocío Jiménez Mosquea, Engels, Lazala, Ariela, Lopez, Leeany Maletta Francisco, Jhomayri, Mercado, Herisardy, Munoz, Jeffrey, Paulino, Maricely Ambar Perez Fernandez, Rudeily, Reyes, Lilia Rosa Reyes Guilamo, Ruben, Rivas, Claudia Alejandra Rivas Torres, Ada, Rodríguez, Madelin Tamar Rosario Villa, Eleazar, Santana, Joel, Soto, Nassin, Tactuk, Cristina Kristel Tonos Sardiñas, Raul, Ubinas, Jose, Victoria, Aaron, Villegas, Ricardo, Acra-Tolari, Larissa, Beltran, Luis Fernand Betances, Alejandro, Blaubach, Denisse Idalia Campos Mejía, Nathalia, Capellan, María Fernanda Cedeño Bruzual, Saray Cordero Spencer, Gabriella Cuevas Lantigua, Luis De Jesus, Gabriela, Díaz, Pedro Pablo Díaz Vásquez, Karla, Disla, Jesús Antonio Echavarría Uceta, Paola Irina Eusebio Jimenez, Damaris, Fernandez, Marlin Fernandez Camilo, Jiomar Manuel Figueroa Germosen, Maruel, Fortunato, Leyla Gabriel Fernández, Alicia German Dihmes, Héctor, Herrera, Elizabeth Leon Cuevas, Jose Alejandro Mata, Mirian Mateo De La Cruz, Dolores Mejia De la Cruz, Marcos, Mirambeaux, Fabio Ortiz De La Cruz, Henry, Paulino, Gabriela, Pelletier, Merycarla, Pichardo, Rodriguez Pumarol Próspero Enrique, Julio, Rivas, Ann Stephany Sanchez Marmolejos, Roman Santana Santana, Irina Suero Almanzar, María Magdalena Vásquez Sánchez, Nicolás, Campuzano, José Ricardo Negrete Ocampo, Maria, Armas, Alvaro Santiago LeMarie Guerra, Gustavo León Vizcaya, Omar Ahmed Abdelwahab, Ahmed, O Elmehrath, Mohammed Ezzat Mostafa, Gamal, Amira, Ibrahim, Sallam, Mohamed, Sherief, Ahmed, 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Maher, Hosain, Ahmed, Hossam, Hamza Hussein Aly Salama Aly, Mohamed, Ibrahim, Abdelrahman, Ibrahim, Nourhan, Ibrahim, Noha Mohamed Salah Ibrahim Moussa Hamouda, Monica, Iskander, Islam, Khalifa, Mostafa, Kotb, Nada, Mahmoud, Alaa Mahmoud Abo Shabana, Nora, Mamdouh, Maram, Metwalli, Khaled, Metwally, Mahmoud, Moghazy, Moustafa, Mohamed, Mohamed, Mourad, Esraa, Moustafa, Kamilia, Mubarek, Nour Eldin Nader, Ahmed, Nasser, Samaa, Omar, Mostafa Shehata Qatora, Mohamed, Ragab, Marawan, Ragal, Dina, Ramadan, Rana, Ramadan, Sara, Ramadan, John, Romany, Ahmed, Sabry, Yasmeen, Said, Sara, Salamah, Ahmed Mostafa Saleh, Mona Saleh Mesbah Mohamed Elkaffas, Alaa, Salem, Hashem, Salim, Ahmed, Samih, Ahmed Samir Abdelaal, Ahmed, Shaheen, Yassmeen Sharafeldin Mohammed, Abdelrahman, Shehata, Mohamed, Shemeis, Karim, Shenit, Mennatallah, Sheta, Asmaa, Soffar, Yousef, Tanas, Ahmed, Tarek, Nermin, Yehia, Omar Khaled Mohamed Eid, Ammar Yasser Abdulfattah, Ahmed, Elsaghir, Mohamed Fouad Elganainy, Omar Ibrahim Elsayed, Omar, Elmandouh, Omar, Hamam, Mostafa Ahmed Shehata, Areej, A Abdelaziz, Ahmed, M Abbas, Wael Abd El-Ghani, Hossam Aldein, S Abd Elazeem, Mustafa Abd Elsayed, Ahmed Yassien Abd-Elkariem, Shimaa, Abdalla, Mahmoud, Abdel-Aleem, Khaled, Abdelazeem, Mahmoud, Abdelfattah, Mohammed, Abdelhafez, Mohamed, M Abdelkarem, Ali, Abdelraouf, Lamess, Abdullaha, Hossam, Abubeih, Moaiad Eldin Ahmed, Nagm Eldin Abu Elnga Ahmed, Ahmed, Ahmed, Sarah Ahmed Saad, Sherif, Alaa, Ali, Alhussaini, Abdelrahman Ahmed Abdelrahman Ali, Ibrahim, Ali, Wagdi, Ali, Mohamed Ali Mohamed, Mohamed, Ashraf, Muhammad, Bassiouni, Mohamed, G El-Adawy, Mohammad, El-Sharkawi, Hussein, Elkhayat, Khaled, Elmaghraby, Shady, Elsdfy, Mohamed, Elsharkawy, Almoutaz, Eltayeb, Mohamed Esmat Mohamed, Esraa, Essam, Mahmoud, Fahd, Osama, Farouk, Rabea, Gadelkareem, Ahmed, Ghoneim, Mohammed Hamada Takrouney, Ahmed, Hamdan, Abd El-Rahman Hamed, Ahmad, Hasan, Mohamed Abdelghafor Hassanin, Islam, Hawal, Kerollos, Henes, Mohamed Omar Herdan, Helal, F Hetta, Omar, Ibrahem, Mostafa, Ibrahim, Islam, H Ibrahim, Mahmoud, Kamel, Mohamed, Khallaf, Shrouk, M Elghazaly, Abobakr, Mahfouz, Osman, Mahmoud, Wesam, Mahran, Doha, Mahrous, Abadeer, Marsis, Ayman, Mohamed, Aliae Mohamed Hussein, Amr Mohamed Sayed, Mahmoud, M Mohammed, Ahmed, Mokhtar, Fatma, A Monib, Ahmed, Nageeb, Mariam Albatoul Nageh, Mohammed, Nageh, Nehal Gamal Omar, Abdelrahman, Ragab, Abdelrahman, Ramadan, Abdallah Rashad Temerik, Aya, Sabry, Hadeer, Safwat, Omar, Salah, Ahmed Elhussiny Salah Mahmoud, Ahmed, Saleh, Mahmoud, Sallam, Ahmed, Samir, Reem, Sayad, Esraa, Sayed, Ahmed, S Sedik, Mohammed, Shahine, Antonios, Soliman, Wael, Soliman, Mohamed Gamal Taher, Randa, Wanees, Ebrahim Ahmed Yousof, Ahmed, Youssef, Omar Zein Elabedeen, Ahmed Emad Sayed Hassan, Shrouk Abdel Fattah, Ahmed, Abostate, Samar, Ali, Saad Ali Saad Salama, Mohamed, Allam, Ahmed, Alsadek, Ebrahim, Arafa, Ahmed, Barakat, Mohammed El Sherpiny, Gehad, Elbehairy, Mahmoud, Eleisawy, 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Massimiliano, Gennaro, Lorenzo, Giannini, Marcello, Guaglio, Marco, Guzzo, Andrea, Leva, Alberto, Macchi, Elena, Manzo, Fabio, Martinelli, Ilaria, Mattavelli, Vincenzo Maria Mazzaferro, Francesco, Raspagliesi, Luigi, Rolli, Laura, Sala, Roberto, Salvioni, Mario, Santinami, Silvia, Segattini, Luca, Sorrentino, Carlotta, Zaborra, Alexandre, Anesi, Gianmaria Casoni Pattacini, Mattia Di Bartolomeo, Francesca, Pecchini, Arrigo, Pellacani, Micaela, Piccoli, Federico, Fusini, Andrea, Gattolin, Marco, Migliore, Roberto, Rimonda, Diego, Sasia, Elisabetta, Travaglio, Federica, Brunetti, Marco, Cereda, Marco, Ceresoli, Luca, Cigagna, Cristina, Dell'Oro, Alessandro, Fogliati, Robert, Fruscio, Tommaso, Grassi, Maini Marzia Isabella, Luca Carlo Nespoli, Massimo, Oldani, Sara, Ornaghi, Nicolò, Tamini, Carmine, Antropoli, Antonio, Castaldi, Alessio, Palumbo, Gaia, Altieri, Umberto, Bracale, Francesco, Corcione, Marcello De Luca, Giovanni Domenico De Palma, Maria Michela Di Nuzzo, Ruggero, Lionetti, Dalila Loredana Lo Bue, Gaetano, Luglio, Gianluca, Pagano, Roberto, Peltrini, Nello, Pirozzi, Francesca Paola Tropeano, Alessia, Aversano, Andrea, Belli, Maria, D'Amico, Paolo, Delrio, Francesco, Izzo, Renato, Patrone, Daniela, Rega, Pietro, Maida, Ester, Marra, Gianpaolo, Marte, Andrea, Tufo, Francesco, Bianco, Antonio, Cappiello, Simona, Gili, Paola, Incollingo, Alessandra, Novi, Giulia, Bagaglini, Claudio, Iovino, Francesco Menegon Tasselli, Maria Paola Menna, Francesco Maria Romano, Settimio, Rossi, Guido, Sciaudone, Francesco, Selvaggi, Lucio, Selvaggi, Francesca, Simonelli, Guido, Coretti, Mario, Pannullo, Adolfo, Renzi, Francesca, Ascari, Giuliano, Barugola, Giacomo, Ruffo, Paolo, Baroffio, Paolo, Bellora, Laura Enrica Benedetti, Cristina, Cerri, Giordana, D'Aloisio, Maurizio, Ferrari, Elisa, Francone, Sergio, Gentilli, Herald, Nikaj, Antonella, Chessa, Alessandro, Fiorini, Luca, Campagnaro, Franco, Chioffi, Pietro, Ciccarino, Roberto, Colasanti, Francesco de Falco, Fotios, 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Matteo, Filardo, Marika Sharmayne Milani, Franco, Ragni, Andrea de Manzoni Garberini, Edoardo, Baldini, Diana, Carpaneto, Michele, Cauteruccio, Corrado, Ciatti, Luigi, Conti, Serena, Gattoni, Pietro, Maniscalco, Gerardo, Palmieri, Calogero Puma Pagliarello, Giuseppe, Caristo, Raffaele, Galleano, Michele, Malerba, Marcello, Calabrò, Francesca, Farnesi, Elia Giuseppe Lunghi, Andrea, Muratore, Nicoletta Sveva Pipitone Federico, Joel Reuben Abel, Lorenzo, Andreani, Darienzo, Antonio, Vittorio, Aprile, Riccardo, Balestri, Giacomo, Benettini, Stefano, Berrettini, Luca, Bruschini, Massimo, Chiarugi, Federico, Coccolini, Simone, Colangeli, Camilla, Cremonini, Lodovica Cristofani Mencacci, Iacopo, Dallan, Silvia De Santi, Gregorio Di Franco, Lorena Di Girolami, Giacomo, Fiacchini, Niccolò, Furbetta, Stylianos, Korasidis, Marco, Lucchi, Andrea, Morandi, Luca, Morelli, Serena, Musetti, Carlo Maria Neri, Matteo, Palmeri, Miriana, Picariello, Francesco, Porcelli, Marco, Puccini, Nicolo, Roffi, Erica, Statuti, Dario, Tartaglia, Alberto, Tonelli, Matteo, Vianini, Gianluca, Baronio, Mauro, Montuori, Enrico, Pinotti, Stefano Maria Massimiliano Basso, Federica, Maffeis, Paolo, Ubiali, Lorenzo, Aguzzoli, Saverio, Coiro, Giuseppe, Falco, Vincenzo Dario Mandato, Valentina, Mastrofilippo, Simone, Mele, Caterina, Baldi, Carlo, Corbellini, Gianluca Matteo Sampietro, Massimo, Dugo, Mauro, Garino, Chiara, Marafante, Antonio, Masciandaro, Elisabetta, Moggia, Alessandra, Murgese, Felice Eugenio Agro, Gabriella Teresa Capolupo, Filippo, Carannante, Marco, Caricato, Vincenzo, Denaro, Erica, Mazzotta, Rocco, Papalia, Giuseppe, Pascarella, Alessandro, Strumia, Biagio, Zampogna, Matteo, Cinquepalmi, Marco, Colasanti, Celeste Del Basso, Federica, Falaschi, Nicola, Guglielmo, Roberto Luca Meniconi, Alessandra, Pecoraro, Sofia, Usai, Giacomo, Crescentini, Antonella, Larcinese, Emanuele, Picone, Giovanni, Sinibaldi, Annamaria, Agnes, Salvatore, Agnes, Sergio, Alfieri, Francesco, Belia, Valentina, Bianchi, Giuseppe, Bianco, Alberto, Biondi, Paola, Campennì, Valerio, Cozza, Sabatino, D'Archi, Domenico, D'Ugo, Veronica De Simone, Marta Di Grezia, Sofia Di Lorenzo, Federica, Ferracci, Valeria, Fico, Gianluca, Franceschini, Pietro, Fransvea, Giulio, Gasparini, Luca, Gordini, Antonio La Greca, Francesco, Litta, Celestino Pio Lombardi, Angelo Alessandro Marra, Angelo, Parello, Marco Maria Pascale, Romeo, Patini, Gilda, Pepe, Roberto, Persiani, Caterina, Puccioni, Carlo, Ratto, Fausto, Rosa, Gianmarco, Saponaro, Lorenzo, Scardina, Tedesco, Silvia, Giuseppe, Tropeano, Maria, Benevolo, Daniele, Bugada, Flaminia, Campo, Maria Gabriella Dona, Valentina, Manciocco, Paolo, Marchesi, Riccardo, Mastroianni, Francesco, Mazzola, Silvia, Moretto, Raul, Pellini, Gerardo, Petruzzi, Barbara, Pichi, Giuseppe, Simone, Gabriele, Tuderti, Jacopo, Zocchi, Luigi Marino Cosentino, Andrea, Sagnotta, Roberta, Angelico, Vittoria, Bellato, Michela, Campanelli, Marzia, Franceschilli, Michele, Grande, Giorgio, Lisi, Tommaso Maria Manzia, Lorenzo, Petagna, Bruno, Sensi, Giuseppe, Sica, Leandro, Siragusa, Giuseppe, Tisone, Marco, Assenza, Barbara, Binda, Massimo, Biondi, Gioia, Brachini, Placido, Bruzzaniti, Mauro, Casagrande, Flavia, Ciccarone, Pierfranco Maria Cicerchia, Bruno, Cirillo, Daniele, Crocetti, Giancarlo, D'Ambrosio, Vito, D'Andrea, Francesca De Felice, Giorgio De Toma, Carlo Della Rocca, Giulia, Duranti, Pietro, Familiari, Enrico, Fiori, Giovanni Battista Fonsi, Alessandro, Frati, Stefania La Rocca, Filippo La Torre, Pierfrancesco, Lapolla, Giovanni, Marruzzo, Simona, Meneghini, Andrea, Mingoli, Andrea, Picchetto, Antonella, Polimeni, Diego, Ribuffo, Maurizio, Salvati, Antonio, Santoro, Paolo, Sapienza, Luigi, Simonelli, Valentino, Valentini, Martina, Zambon, Giuseppa, Zancana, Emma, Zuppi, Simone, D'Annunzio, Cosimo De Nunzio, Silvia, Fiorelli, Mohsen, Ibrahim, Chiara, Loffredo, Domenico, Massullo, Cecilia, Menna, Rocco, Monica, Massimiliano, Pelli, Erino Angelo Rendina, Leonardo, Teodonio, Andrea, Tubaro, Giulio, Argenio, Giulio, Accarino, Accarino, Giancarlo, Antonio Nicola Giordano, Luca, Cardinali, Elisa, Sebastiani, Grazia, Travaglini, Erika, Andreatta, Emanuele Luigi Giuseppe Asti, Daniele, Bernardi, Luigi, Bonavina, Caterina, Froiio, Andrea, Lovece, Chiara, Copelli, Alfonso, Manfuso, Pasquale Di Maio, Marco, Giudice, Oreste, Iocca, Rosario, Cennamo, Tommaso, Cornali, Francesco Di Marzo, Cristian, Altana, Francesco, Bussu, Giampiero, Capobianco, Anna Giacomina Carta, Sandro, Ciccarello, Maria Laura Cossu, Pietrina, Cottu, Giacomo De Riu, Salvatore, Dessole, Francesco, Dessole, Salvatora, Dettori, Carlo, Doria, Alessandro, Fancellu, Claudio, F Feo, Giorgio Carlo Ginesu, Giuliana, Giuliani, Marco Giuseppe Iannuccelli, Massimo, Madonia, Roberto, Mancino, Olindo, Massarelli, Gianfranco, Meloni, Fabio, Milia, Andrea, Mulliri, Teresa, Perra, Marco, Petrillo, Antonio, Piras, Franco, Piredda, Francesco, Pisanu, Alberto, Porcu, Davide, Rizzo, Angelino, Sanna, Antonio Mario Scanu, Fabrizio, Scognamillo, Damiano, Soma, Anna Rita Tanca, Alessandro, Tedde, Matteo, Tedde, Luigi Angelo Vaira, Andrea Bartalini Cinughi de Pazzi, Osvaldo Carpineto Samorani, Daniele, Fusario, Luigi, Marano, Gaia, Oldrà, Anna Lisa Pesce, Stefania Angela Piccioni, Luca, Resca, Vincenzo, Ricchiuti, Franco, Roviello, Vinno, Savelli, Alberto, Abrate, Pierpaolo, Bordoni, Lorenzo, Bosio, Guglielmo, Clarizia, Francesco, Fleres, Marco, Franzini, Antonio, Fratto, Pierluigi, Giumelli, Alessandro, Grechi, Alessandro, Longhini, Fabrizio, Lorusso, Elisa, Scarnecchia, Federica, Scolari, Alessandro, Spolini, Vincenzo, Maiuri, Matteo, Papandrea, Arturo, Roncone, Lorenzo, Conti, Andrea, Rizzi, Marco, Rovagnati, Alberto, Brolese, Tommaso, Cai, Francesco Antonio Ciarleglio, Francesca, Dalprà, Gianni, Malossini, Liliana, Mereu, Irene, Tamanini, Saverio, Tateo, Giovanni, Viel, Enrico, Battistella, Paolo Boscolo Rizzo, Cristoforo, Fabbris, Marco, Massani, Giacomo, Spinato, Roberta, Tutino, Ugo, Grossi, Alessandro, Iacomino, Simone, Novello, Maurizio, Romano, Serena, Rossi, Giulio, Santoro, Giacomo, Zanus, Sokol, Trungu, Giada, Aizza, Gabriele, Bellio, Selene, Bogoni, Marina, Bortul, Biagio, Casagranda, Sara, Cortinovis, Nicolò de Manzini, Davide, Drigo, Paola, Germani, Manuela, Mastronardi, Lucia, Paiano, Silvia, Palmisano, Pier Luigi Filosso, Francesco, Guerrera, Matteo, Marro, Mauro, Rinaldi, Enrico, Ruffini, Stefano, Salizzoni, Laura, Bardelli, Mattia, Berselli, Giacomo, Borroni, Eugenio, Cocozza, Matteo, Desio, Bottazzoli, Elisa, Giuseppe, Ietto, Valentina, Iori, Domenico, Iovino, Lorenzo, Livraghi, Valentina, Marchionini, Stefano, Megna, Emma Amal Nahal, Mara, Palumbo, Valeria, Quintodei, Alessandra, Zullo, Lucrezia, D'Alimonte, Giovanni, Pirozzolo, Chiara, Vignotto, Tommaso, Campagnaro, Andrea, Caravati, Simone, Conci, Carlotta De Cristofaro, Gabriele, Gecchele, Tommaso, Giuliani, Jacopo, Graziosi, Alfredo, Guglielmi, Salvatore, Paiella, Corrado, Pedrazzani, Tommaso, Pollini, Simone, Rattizzato, Andrea, Ruzzenente, Roberto, Salvia, Giulia, Turri, Matilde, Bacchion, Giovanni, Butturini, Andrea, Casaril, Alessandro, Giardino, Harmony, Impellizzeri, Marco, Inama, Frigerio, Isabella, Gianluigi, Moretto, Marco De Zuanni, Enrica, Deiana, Mario, Guglielmo, Alessandro, Broglia, Claudia, Casarini, Caterina Costanza Zingaretti, Marta, Bonaldi, Giovanni, Cesana, Francesco, Mastriale, Stefano, Olmi, Matteo Uccelli Yasuyuki Fukami, Takuya, Saito, Tsuyoshi, Sano, Naoki, Hirai, Kazuyoshi, Hirota, Tetsuya, Kushikata, Tasuku, Oyama, Junichi, Saito, Katsuhiko, Ishibashi, Mizue, Kamiyama, Kyongsuk, Son, Kentaroh, Tarao, Takayuki, Yamada, Toshiya, Shiga, Chisaki, Aze, Yoshihiko, Deguchi, Hirotoshi, Hasegawa, Tatsuki, Hoshino, Yasushi, Innami, Hiroyuki, Inoue, Shingo, Ito, Takeshi, Nomura, Tomomi, Ogihara, Reina, Okada, Takashi, Ouchi, Yuri, Sekiya, Keikoku, Tachibana, Emi, Takano, Masae, Yamamoto, Shuko, Matsuda, Yuka, Matsuki, Kenji, Shigemi, Teruyuki, Hiraki, Yui, Inoue, Shosaburo, Jotaki, Tatsuro, Abe, Masatoshi, Eto, Junichi, Inokuchi, Eiji, Kashiwagi, Fumio, Kinoshita, Satoshi, Kobayashi, Ken, Lee, Takashi, Matsumoto, Keisuke, Monji, Hidekazu, Naganuma, Masaki, Shiota, Ario, Takeuchi, Shinju, Obara, Saori, Takatsuki, Saori, Tanaka, Koji, Iida, Kota, Kagawa, Shuichiro, Neshige, Tomohiro, Chaki, Naoyuki, Hirata, Satoshi, Kazuma, Motonobu, Kimizuka, Sho, Kumita, Noriaki, Nishihara, Sato, Satoshi, Atsushi, Sawada, Shunsuke, Tachibana, Michiaki, Yamakage, Yuta, Nakamura, Kozo, Sato, Tomoya, Irie, Tomoko, Irisawa, Eiki, Kanemaru, Yuko, Koga, Yoshihiko, Chiba, Jun, Makino, Shinnosuke, Ohama, Shinichiro, Okada, Kano, Teruaki, Tatsuya, Kida, Tomohide, Takei, Kazuhiro, Hanazaki, Hiroyuki, Kitagawa, Tsutomu, Namikawa, Toshiyuki, Mizota, Chikashi, Takeda, Shintaro, Yagi, Hiroshi, Imai, Makoto, Ishitobi, Manabu, Kato, Kouhei, Nishikawa, Takeshi, Sasaki, Hiroshi, Yonekura, Akihiro, Kanaya, Daisuke, Irimada, Haruka, Ishikawa, Kaiho, Yu, Mitsuru, Ida, Masahiko, Kawaguchi, Kenji, Kawamura, Munehiro, Ogawa, Hiroshi, Okada, Shunji, Endo, Yoshinori, Fujiwara, Masaharu, Higashida, Hisako, Kubota, Toshimasa, Okada, Hironori, Tanaka, Tomio, Ueno, Kazuhiko, Yoshimatsu, Motohiro, Kikukawa, Akira, Kuriyama, Susumu, Matsushime, Hishikawa, Hidehiko, Haruaki, Hino, Yoji, Hisamatsu, Akio, Kamiya, Hidefumi, Kinoshita, Masato, Kita, Toshinori, Kobayashi, Taku, Michiura, Hirokazu, Miki, Tomohiro, Murakawa, Hidetaka, Okada, Tomohito, Saito, Ryoichi, Saito, Motohiko, Sugi, Genichiro, Sumi, Yamaki, So, Tomohisa, Yamamoto, Aya, Yoshida, Tatsuya, Kambara, Sayaka, Kanematsu, Okazaki, Satoshi, Takeshi, Hijikawa, Hiroaki, Kitade, Hidesuke, Yanagida, Tomoyuki, Fujita, Satsuki, Fukushima, Naoki, Tadokoro, Taku, Furukawa, Yusuke, Iizuka, Yuji, Otsuka, Masamitsu, Sanui, Ikumi, Sawada, Hideki, Iwahashi, Morikazu, Miyamoto, Masashi, Takano, Tsutomu, Mieda, Chihiro, Ando, Tetsuro, Isada, Taku, Ishizaki, Qaed Bani Amer, Sachi, Ishida, Yasuma, Kobayashi, Norifumi, Kuratani, Tomoe, Sakurai, Misa, Takada, Yutaka, Iba, Junji, Tsukagoshi, Akira, Yamada, Yuki, Amano, Kentaro, Fumoto, Shusaku, Noro, Ayataka, Fujimoto, Kyoichi, Tomoto, Yukiyasu, Okamura, Teiichi, Sugiura, Katshuhiko, Uesaka, Natsuki, Takemura, Kento, Kuroda, Megumi, Hayashi, Satoi, Kaneko, Izumi, Kawagoe, Tsukasa, Kochiyama, Yamaguchi, Ai, Nobutsugu, Abe, Tadao, Ando, Mieko, Chinzei, Kouichi, Hirano, Yoichi, Kobayashi, Ryota, Matsuki, Hironori, Matsumoto, Akira, Motoyasu, Harumasa, Nakazawa, Hikari, Noguchi, Kaio, Okamura, Motoaki, Ono, Hiroyuki, Seki, Eiji, Sunami, Atsushi, Tajima, Shinji, Tanigaki, Kohji, Uzawa, Hidenobu, Watanabe, Yukari, Furuhata, Satoshi, Toyama, Tokujiro, Uchida, Yutaka, Enomoto, Yuri, Furukawa, Yoko, Hasumi, Jinso, Hirota, Katsuyuki, Iida, Shingo, Ikeda, Tatsuhiko, Ikeda, Natsuko, Kawamata, Yosuke, Kawasaki, Minako, Koizumi, Yoshiharu, Kono, Shigeki, Kuzuhara, Junichi, Maeda, Mai, Moriyama, Shoichi, Nagamoto, Rinako, Nakanishi, Michio, Noda, Atsushi, Seichi, Shintaro, Takahashi, Kobayashi, Takashi, Misuzu, Takeda, Kenta, Tanakura, Katsuyuki, Terajima, Munechika, Tsuji, Chiharu, Ueshima, Naoya, Yamamoto, Mari, Yamamoto, Toshiya, Yokota, Yuki, Yoshioka, Sakoh, Yuri, Shintaro, Iwata, Akira, Kawai, Shuhei, Osaki, Masashi, Ishikawa, Masae, Iwasaki, Tomonori, Morita, Reina, Hirooka, Yoshinori, Nakata, Shigehito, Sawamura, Yusuke, Ishida, Aya, Kawachi, Takayuki, Kobayashi, Fumiaki, Nagashima, Naoki, Suzuki, Kohei, Ando, Noriko, Miyazawa, Yukio, Tanaka, Khatab, Abuissa, Alaa, Aljabali, Amal, Almasri, Mera, Alrabadi, Rana, Alshara, Yasmeen, Alzghoul, Ahmed, Alzughoul, Ali, Freihat, Emran, Jeitan, Qais, Owais, Aseel, Smadi, Mahmoud, Abukhadra, Huthifa, Abunawas, Abdallah Ahmed Mezel Al-Azzam, Ammar, Aladaileh, Ismail, Albadawi, Mohammad, Alhawatmeh, Mohannad Yaser Alkhaza'leh, Roaa Salem Jwaid Alneimat, Saba, Alwahedy, Abdel Rahman Mohannad Ahmad Alwardat, Slsabela, Dhoon, Khaled, El-Qawaqzeh, Tarteel, Hrerat, Enas, Jaradat, Teeba, Mubaydeen, Husam, Sarayrah, Mohammad Abdel Elah, A Tarawneh, Mohammad Yousef Karasneh, Amany, Zurgan, Mohammad, Alassaf, Sayel, H Alzraikat, Justin, Z Amarin, Ahmed, Hijjawi, Haya, H Suradi, Louay, Y Zaghlol, Ahmad, Abdalah, Ghaida, Abdallah, Ammar Abu Tarieh, Tareq, Abu-Libdeh, Faisal, Abualteen, Murad Al Abdallah, Zakaria Al Bdour, Seif Al Dahabrh, Farah, Al-Kasaji, Zaid Al-Sheikh Ali, Mohammad, Al-Thaher, Tareq, Alnajjar, Mohannad, Alqedrh, Mohammad, Alsaleh, Mohammad, Alzaatreh, Ghandi, Amayreh, Yazeed, Ayasra, Ahmad, Eid, Ibrahim, Ghayada, Khaled Moh'd Ahmed Hasanein, Anas, Hassouneh, Raid, Hijazeen, Majedah, Hmeidan, Ahmed, Khaled, Barihan, Khasawneh, Omar, Kifayeh, Yasser, Lafi, Jasem, Seba, Qusai, Semrin, Fda, Sma, Mohammad, Theab, Haitham, Tumeh, Muna Aba Zaid, Alaa, Abazeed, Bader, Abbad, Osaid, Abbadi, Nizar, Abu-Ishkerih, Malk, Al-Osta, Reham, Al-Zyadat, Bashar Omar Falah Alawneh, Majd, Alhattab, Mohd Mujahed Alkurdieh, Ziad, Awwad, Mohammad, Hammouri, Hamzeh, Hussein, 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Fade, Alawneh, Motasem, Al-Latayfeh, Abdel-Ellah, Al-Shudifat, Abd Almonem Shaikh Ahmad, Abdelkarim, Abdeljalil, Haneen, Abdelrahman, Abdulmalek, Abdulmalek, Lina, Abedalqader, Laith Abu Abed, Omar Al Smadi, Salameh, Alarood, Mohammad, Allouzi, Maha, Almansour, Sari, Almi'Ani, Abdulhakim, Alsaiad, Khaled, Alshaikh, Farah, Androus, Mirna, Awbakh, Belal, Azzam, Hammam Bany Yasin, Maher, Daoud, Lujain, Dawod, Omar, Dawod, Reem, Elmusa, Saba, Fadli, Farah, Hammad, Majd, Hunaiti, Mahmoud, Muhtaseb, Rawan, Owaimer, Zaki, Qulaghassi, Saleh, Romman, Rawand, Saket, Said, Sharawi, Alaa, Tawalbeh, Mohammed, Al-Howthi, Laila, Ababneh, Roba, Ababneh, Faris Jamal Abu Za'nouneh, Sajedah Al Dhoun, Ahmad Al Khassawneh, Ahmed Al Sharie, Ayah Ahmad Al Shraideh, Tawfik, Al-Dabaa, Salsabeel, Al-Jarrah, Hothaifa, Al-Jarrah, Hadeel, Al-Othman, Zuhair, Alaradi, Qutaiba, Alshannaq, Rima, Alsulaiman, Motasem, Alzaqh, Yazan, Alzu'Bi, Ziad, Audat, Mohammad, Bahhour, Saja, Bdour, Roa, Khatatbeh, Fares, Marji, Tagleb, Mazahreh, Dina, Nail, Amjad, Nuseir, Asmaa, Rabab'Ah, Taher, Sawadi, Ghina, Zidan, Dima Abu Muhfouz, Abdullah, Nael, Ahmad, Qasim, Amar, Al-Jarrah, Faisal, Rawagah, Dima, Y Abu Ismail, Wedad, Al-Dolat, Mai, Alzoubi, Malak, Alzoubi, Mu'Taz, Alzu'Bi, Ruba, Asha, Ali, Guboug, Hasan, Hussein, Shireen, Rawashdeh, Mohammad, Sanwar, Adnan, Ababneh, Basil, Abu-Eisheh, Haneen Ahmad Alhami, Saif Aldeen Al Dwairi, Hana' Al Shurman, Zakaria Al Yahya, Hussam, Al-Atiyah, Hasan, Al-Balas, Anas, Aljaiuossi, Shatha, Alqawasmi, Sadeel, Alqudah, Mahmoud, Alshourman, Abdulsalam Bani Hamad, Anas Bany Issa, Raed, Ennab, Sara, Hamdoni, Zaid, Hijazi, Ali, Khafaja, Mohamed, Mraiyan, Riyad, Obeidat, Dina, Olaywah, Mohamad, Qudah, Mhamdd, Talal, Askar, Aidarov, Aisulu, Sarmenova, Almat, Kodasbaev, Orazbek, Sakhov, Shynar, Tanabayeva, Sultan, Amrayev, Berik, Dzhumabekov, Maulen, Malgazhdarov, Kanat, Tezekbaev, Yerlan, Kukubassov, Alima, Satanova, Michael, Mwachiro, Robert, Parker, Ian, Simel, Shamshuddin, Mohammedali, Claude, Mwaria, Ralph, Obure, Sayed Shah Nur Hussein Shah, Chetan, Hirani, Muthoni, Kibunyi, Claire, Mailu, Victor, Mwangi, Roy, Ogenya, Lydia, Osea, Davies, Cheruiyot, Omar, Hirsi, Carolyne, Muiru, Samuel, Wanjara, Chang Woo Kim, Suk Hwan Lee, Ahmad, Almulla, Mustafa, Dashti, Omar, Elghany, Abdullah, Sultan, Husain, Al-Mahmeed, Jasim, Alabbad, Ibtisam, Albader, Shuaib, Aldalal, Mahdi, Baba, Fareed, Abdulsalam, Naser, Alhajri, Athari, Alwael, Brook, Ayele, Hatem, Marie, Ahmed, Zaitoun, Ahmad, M AlAli, Ahmed, Alkhamis, Ous, Alozairi, Sulaiman, Almazeedi, Salman, Alsabah, Mostafa, Abdelkarim, Asmaa Al Rashed, Saud Al Subaie, Tariq, Al-Shaiji, Abdullatif, Al-Terki, Omar, Alhunaidi, Ali, Aljewaied, Khaled, Alzamel, Ahmed, Farag, Hussein, Hayati, Salah, Termos, Sarah, Wood, Maha, Al-Gilani, Mutlaq, Al-Sihan, Haifa, Alotaibi, Dmitrijs, Lobovs, Andrejs, Pcolkins, Armands, Sivins, Ingus Arnolds Apse, Annija Evelīna Berga, Anna, Ivanova, Jevgenijs, Demicevs, Igors, Ivanovs, Aleksejs, Kaminskis, Janis, Opincans, Jānis, Pāvulāns, Agris, Rudzāts, Anna, Udre, Samer, Dbouk, Imadeddine, Farfour, Mohamad, Rakka, Ingrid, Antonios, Joe El Hage, Stephanie, Hage, Lea, Haiby, Hiba, Kahi, Anthony, Lichaa, Rita Milan Moussa, Michel, Salameh, Riad, Sarkis, Obey, Albaini, Tony, Haykal, Bassem, Safadi, Hussein, Abou-Abbass, Reem Al Makari, Zeina Al Zein, Mariam, Baidoun, Rania, Itani, Mustafa, Owiedat, Ali, H Abdel Sater, Michel, Akl, Nour, Badran, Sara El Mustapha, Fathallah, Fatouh, Youssef, Ghoussoub, Nader, Saad, Fatima, Serhan, Bassem, Souleiman, Walid, Alame, Peter, Ghiya, Firas, Ibrahim, Rasha, Abdallah, Mohamad, B Kassab, Samar, Karout, Aya Abdul Al, Hilal, Chaaban, Ghinwa, Fakih, Huzifa, Haj-Ibrahim, Rabih, Awad, Hadi El Assaad, Ahmed, Alfeqeeh, Hosam, Muftah, Taha, Abdulrahman, Naeimah, Ahseen, Hayat Omar Abunaaja, Abdulmuez, Abdulmalik, Abd El Jawad Al Gasi, Sara, Alsaeiti, Fatimah, Elkhafeefi, Nasre, Elrefai, Rofida, Ahmad, Tarek, Alhouni, Safya, Alkarky, 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Farah, Abojeila, Mohamed, Aliwa, Sana, Shagour, Ahmed, Altobal, Omar, Aljuroushi, Hadeel, Almadani, Hajer, Attia, Amal Sharif Eljali, Ayyah, Emran, Mabruka, Omar, Radhwan, Salim, Ashraf, Samer, Nayrouz Abdullah Abulshuwashi, Emadeddin T, M Ben Khalifa, Hdaya Abdalla, S Benabdalla, Hatem, Elnageh, Ali, Hammad, Duha Milad Abdullah, Marwa, Abusalem, Esraa Ben Esmael, Fatma, Benmasoud, Laila, Debri, Randa, Elmokhtar, Manal Ezeddin Kamel Sheta, Bushra Sayeh Mohamed Elhabashi, Balkees, Younis, Amna, Elmabrouk, Ahmed, Momen, Abdalrahem Essied Alzubi Alzoubi, Kusay, Ayad, Ameerah Mahdi Abraheem Hasan, Fawzie, Musrati, Malek, Abusannoga, Ans, Malek, Hatem, Ajaj, Eman, Abdulwahed, Mohammed, Aboubeirah, Aya, Alqurpaa, Entisar, Alshareea, Sarra, Aribi, Tomather, Aribi, Marwa, Biala, Reem, Ghamgh, Mohannned, Issa, Amani Hamid Lamari, Mohammed, Mufth, Omar Sudig Abboud, Muad Fathi Khalleefah Abu Hallalah, Saleh, Abumahara, Sarah, Aburima, Mohammed, Adrees, Abdurahman, Ahtash, Asmaa Al Shukri, Hind, Alameen, Rehab, Alarabi, Alarabi, Alarabi, Aisha, Alelwany, Abdulkarim, Alesmail, Noran, Algadi, Khuloud, Almaqrahi, Hadel, Alosta, Mohamed, Alsharedi, Rasha, Bashir, Mahmoud Ben Ghrema, Sari Bin Nour, Sofian, Elbarouni, Ahmed, Elhadi, Abdulmohimen, A Elkhadar, Esraa, Elkouba, Nabiha, Elmsherghi, Abdulmohimen, Gammoudi, Abdulraouf, Ghariba, Fatima Zayed Gjam, Arwa, Haidar, Hala, Helal, Mohammed, Huwaysh, Ahmed Khalid Alhadheeri, Eslam, Kriem, Halim, Osman, Mohamed Ali Ossman, Marwah, Shilfeet, Laila, Turshani, Nouran, Albishty, Abdulmueti, Alhadi, Salem, Ali, Manal Ahmed Altoumi, Sumayyah Ghayth Bahroun, Eman, Younes, Hana, Atarabulsi, Mohamed, Elshaibi, Abdullmujeeb, Othman, Hayat Ben Hasan, Najat Shaban Ben Hasan, Rabab Shaban Ben Hasan, Vidmantas, Barauskas, Edvinas, Dainius, Zilvinas, Dambrauskas, Albertas, Dauksa, Inga, Dekeryte, Rita, Gudaityte, Kristijonas, Jasaitis, Akvilė, Koženiauskaitė, Virgilijus, Krasauskas, Ausra, Lukosiute-Urboniene, Almantas, Maleckas, Romualdas, Riauka, Vygintas, Šlenfuktas, Saulius, Svagzdys, Kestutis, Urbonas, Tomas, Vanagas, Linas, Venclauskas, Donatas, Venskutonis, Justas, Zilinskas, Marijus, Ambrazevicius, Vilius, Syminas, Oleg, Aliosin, Agne, Cizauskaite, Vitalijus, Eismontas, Jonas, Jurgaitis, Vytenis, Mikutaitis, Donatas, Petrauskas, Narimantas Evaldas Samalavicius, Dainius, Simcikas, Algirdas, Slepavicius, Albinas, Tamosiunas, Vaidotas, Turskis, Bernardas, Vasiliauskas, Laura, Aniukstyte, Audrius, Dulskas, Gediminas, Januška, Justas, Kuliavas, Margarita, Montrimaite, Albertas, Cekauskas, Azuolas Algimantas Kaminskas, Sarunas, Kozenevskis, Tomas, Poskus, Kestutis, Strupas, Arunas, Zelvys, Georges, Decker, Audrey, Noël, Maheriandrianina Fanambinana Voahary Rajaonarivony, Randimbinirina Zakarimanana Lucas, Herimampionona, E Andriantsoa, Mamisoa, B Rasamoelina, Rakotonarivo Aina Andrianina Vatosoa, Liantsoa, Andriamanana, Casimir Fp Rahantasoa Finaritra, Aristide Romain Raherison, Tsirimalala, Rajaobelison, Haritiana, Rakotoarisoa, Maharo, Ramifehiarivo, Solonirina Harinarindra Ranaivoson, Hajamihamina Marina Parfaite Randriantsoa, Narindra Njarasoa Mihaja Razafimanjato, Jeannie Ba Razafindrahita, Solofoarimanana, Solofoarimanana, Guillaume Odilon Tsiambanizafy, Rakotonaivo Mamisoa Judicaël, Corinne Eulalie Solo, Tojomamy Herinjaka Ralaizafindraibe, Fanonjomahasoa Safiry Andofenohasina, Hanta, Rasataharifetra, Vanona Barijaona Razafindraibe, Angelin Sablon Herinirina, Andre, Das, Thanga, Ganapathy, Yohesuwary, Gunarasa, Kalyani, Mariapan, Maathichsudhaar, Muniandy, Mohd Firdauss Osman, Mohd Azem Fathi Mohammad Azmi, Jien Yen Soh, Wan Zainira Wan Zain, Andee Dzulkarnaen Zakaria, Zaidi, Zakaria, Kheng Hooi Chan, Firdaus, Hayati, Syamim, Johan, Jin Jiun Mah, Ratha Krishnan Sriram, Sentilnathan, Subramaniam, Nur Shahirah Binti Muhammad Shahimi, Khairul Hazim Hamdan, Mohd Razali Ibrahim, Guhan, Muthkumaran, Ju Ann Tan, Mohana Raj Thanapal, Dayang Anita Abdul Aziz, Mae-Lynn, Bastion, Mohd Hairul Nizam 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Jerneja, Vidmar, Adnan Sayid Abdo, Abdifatah Dahir Ali, Abdilaahi Ahmed Hayir, Sadiq, Ibrahim, Afnan, Nuh, Kadra, Omar, Ridwan, Saeed, Nikita, Blake, Cassandra, Ferreira, Corne, Nel, Colin, Noel, Marcel de Kock, Nathan, Kaplan, Emile, Kayombo, Paballo Clinton Khaeane, Asha, Malan, Wikus Wessel Mulder, Daylen, Rutledge, Cornel, Steyn, Gert, Steyn, Naser, Almgla, Mohamed, Daoub, Hammaad, Gamieldien, Thomas, Hilton, Nazmie, Kariem, Maahir, Kariem, Christo, Kloppers, Maritz, Laubscher, Wanga, Mtimkulu, Walid, Mugla, Daniel, Nel, Ferhana, Gool, Timothy, Hardcastle, Wasim, Mahomed, Nivashen, Pillay, Kayla, Rossini, Stephanie Van Straten, Annamart, Laubscher, Adelaide, Lee, Mohammed Yusuf Parker, Sinead, Quirke, Therese Du Preez, Adeline, Jacobs, Reinier, Swart, Modise Zacharia Koto, Neha, Kumar, Imraan, Sardiwalla, Mapuor, Areu, Juan Campos Garcia, Paula, Ferrara, Christoph José Klein Zampaña, Raquel, Lopez, Hernan, Sandoval, Guillermo, Carreño, German Mínguez Ruiz, Conrado Andrés Ros, Raquel Angulo Artal, Luis, Barbier, Guillermo, García-Operé, Marta, Jiménez-Jiménez, Héctor, Marín, Mikel, Oñate, Luis Antonio Pascua-Gómez, María Alexandra Pesántez Peralta, Ibabe Villalabeitia Ateca, Ladislao Cayetano Paniagua, Joan, Camí, Pablo, Collera, Martínez, David, Carlos Javier Gómez Díaz, Jordi Querolt Coll, M Dolors Rosines Cubells, Cristina Soto Montesinos, Guillermo, Triana, Marina, Xicola, Alfonso, Alias, Albert, Baduell, Mariano, Balaguer-Castro, María Pilar Camacho Carrasco, Marina Cámara Vallejo, Borja Campuzano Bitterling, Guillem, Claret, Francisco, J Cuesta-González, Alberto Di Somma, Joaquim Enseñat Nora, Neus, Fabregas, Ada Ferrer Fuertes, Abel, Ferrés, Cesar, Ginesta, Jose Juan Gonzalez Sanchez, Isabel, Gracia, Jhon Alexander Hoyos Castro, Montsant, Jornet-Gibert, Xavier, Morales, Alejandra, Mosteiro-Cadaval, Leire, Pedrosa, José Poblete Carrizo, Marina, Renau-Cerrillo, Luis Alberto Reyes Figueroa, Pedro Roldan Ramos, Jordi Rumià Arboix, Marta, Sabater-Martos, Josep, M Segur, Thomaz, E Topczewski, Jorge, Torales, Ramon, Torné, Pere, Torner, Ricard, Valero, Marian, Vives-Barquiel, Eulalia, Ballester, Alberto Basterra Rincon, Vitiello, Giulia, Belén Martin Arnau, Marta, Gil, Silvia, Martin, Monica, Serrano-Navidad, Mauricio Agüero Mariño, Núria Casanova Torrequebrada, Berta Fabregó Capdevila, Adrián López Campillo, Gemma, Mancebo, Ester, Miralpeix, Blanca, Montcusí, Marina, Munarriz, Ariadna, Salvadó, Josep, M Sole-Sedeno, Clara Téllez Marquès, Ana Centeno Álvarez, Ruth Lopez Gonzalez, Luisana Riba Combatti, Andrea Sanz Llorente, Miguel Bejarano Serrano, Blanca Capdevila Vilaró, Maria Coronas Soucheiron, Mario Cuesta Argos, Irene de Haro Jorge, Yaiza Galvañ Félix, Luis, García-Aparicio, Rebeca, Leal, Albert Malet Contreras, Irene, Martínez-Padilla, Clara, Massaguer, Ines Moraleda Gudayol, María Elena Muñoz Fernández, Paco, Parri, Cristina Pérez Costoya, Javier, Rojas-Ticona, Leopoldo Tapia Moral, Francisco, Vicario, Francesc Angles Crespo, David Bosch Garcia, Berta, Escudero, Carlos Garcia Cardona, Sergi, Bellmunt-Montoya, Javier de la Torre, Úrsula, Acosta, Iago Alvarez Saez, Eva Andreu Riobello, Fernando Ascanio Gosling, Jose, Bagan, Irene, Brana, Bartomeu, Caimari, Marta Cicuendez López Ocaña, Anna, Conesa, Alba de Pablo García-Cuenca, Natalija, Dediulia, Francesc, Duran-Valles, Jordi Giralt López de Sagredo, Maria Jose Gomez-Jurado, Ernesto, Guerra-Farfan, Juan Sebastian Guillén, María Guisasola Rabés, Viviana Andrea Hernández Angel, Maria Jurado Ruiz, Yuri, Loaiza, Manuel, Lopez, Susana, Manrique, Maria Dolores Mateo Arzo, Joan, Minguell-Monyart, Enric Miret Alomar, Sonia Monreal Clua, Víctor Morales Ariza, Clara Morales Comas, Judith, Murillo, Jose Maria Nieto Rodriguez, Elena Vilardell Ortiz, Jorge, Pamias, Montserrat Pascual Pascual Arellano, Remei Perera Sarri, Aleix Pons Bartroli, Nil, Prat, Alfredo Pueyo Ferrer, Rosa Pujol Pina, Jordi, Raurich-Leandro, Maria José Reche Padilla, Joaquín Rivero Déniz, Natalia, Rodriguez, Manuel Saez Barba, Vanessa Sanchez Torrents, Berta, Serrano, María Sol Siliato Robles, Christian Siso Raber, Iñigo, Soler, Maria Carmen Suescun López, Jordi Teixidor Serra, Cristina, Tello-Díaz, Marta Utrilla Pérez, Ramon, Vilallonga, Irene Vives Roselló, Vázquez García César, Mireia, Gili-Bueno, Carlos Gomez Roig, Gloria, González, Aamer, Malik, Maria Del Mar Martí-Ejarque, Mario Rafael Medina Hernández, Carolina, Pozo, Laura, Ruiz-Villa, Nuria, Sierra, Antonio, Valle, Susana, Velasquez, Mirentxu, Arrieta, Daniel, Escobar, Arkaitz, Lara, Alicia, Rojo, Idoia, Villamor, Javier Aitor Zabala Lopez-Maturana, Begoña, Estraviz, Laura Fernández Gómez Cruzado, Melania González de Miguel, David, Lecumberri, Victor Luis Gomez Corujo, Silvia, Bleda, Joaquin De Haro, Carlos, Martínez-Pinedo, David, Padilla-Valverde, Rafael Picón Rodríguez, Francisco Javier Redondo Calvo, Daniel, Sanchez-Pelaez, Alfonso Espinosa Ruiz, Eduardo, Rodriguez, Ignacio Alcalá Rueda, Gonzalo Díaz Tapia, Alvaro Sanchez Barrueco, Maria Dieguez López, Isabel López García, Pilar López-Toribio López, Marina, Bosch, Carolina Curtis Martínez, Alba Fernández Candela, Sandra Lario Pérez, Cristina Lillo García, Clara López de Lerma Martínez de Carneros, Francisco López Rodríguez-Arias, Inmaculada, Oller, Saray, Quinto, Luis, Sánchez-Guillén, Antonio Sanchís López, Álvaro, Soler-Silva, Daniel Triguero Cánovas, Victoria Garcia Peces, Estefania, Hernández-García, Guillermo, Plaza, Rafael Abad Alonso, Francisca Aranda Lozano, Marta Calvo Fernández, Eneko Del Pozo Andres, Josune Etxabe Gurrutxaga, Francisco Javier Fernández Pablos, Francisco Javier Ibáñez-Aguirre, Begoña Ochoa Villalabeitia, Natalia, Ortega, Amaia Sanz Larrainzar, Irune Vicente Rodriguez, Javier Jimenez Miramón, Jose, M Jover, Tamara, Llamero, Jose Luis Ramos Rodriguez, Ainhoa Valle Rubio, Maria Teresa Albiol, Codina, Antonio, Clara, Codony, Ramon Farres Coll, Cristina Farrés Pla, Nuria Gomez Romeu, Santiago, Lopez-Ben, Marcel, Pujadas, Berta, Tió, Francesc, Tuca, Elizabeth, Bárcena, Esther Brea Gómez, Antonio Francisco Guisado Calderón, Elisabeth Fernandez Castro, Montserrat Mairal Fraile, Oscar, Pastor, Cristina García Amador, Raquel Latorre Fragua, Marta, Allue, Pablo, Colsa, Teresa Gimenez Maurel, Raúl Latorre Tomey, Luis Francisco Martín Anoro, Luca, Ponchietti, Alejandra Utrilla Fornals, Carlo, Brugiotti, Carlos Jiménez Viñas, Fátima, Sena-Ruiz, Julio, Plata-Bello, Octavio, Arencibia, Daniel Gonzalez Garcia-Cano, Maria, Laseca, Antonio, Navarro-Sánchez, David Ortiz López, Maria, Pelloni, Sara, Berrocal, Elima Pilar Cagigal Ortega, Jorge, Calvera, Iria, Cervera, Patricia Díaz Peña, Silvia Verónica Domínguez Ovejas, Francisco, Donis, Patricia Fernández Bernabé, Gema, Fraga, Raúl Garcés García, Antonio, García, Elena Garcia De Castro, Antonio García Domínguez, Miguel Angel García García, Judit, Gonzalez, Carles Heredia Llinàs, Inés, Hernández, Norberto Herrera Merino, Carmen Lucero León Gámez, Ana Luis Siles, Maria Marqueta De Salas, Paula Martinez Pascual, Almudena Ortiz Simón, Laura, Osuna, Marta Perez Gonzalez, Antonio Ramos Bonilla, Lorena Rodríguez Gómez, Jose Luis Uquillas, Miguel Angel Alonso Prieto, Marta, Ballesteros-Pomar, Sara Busto Suarez, Mario, Castaño, Laura Castillo Pardo, Mario De Arriba Alonso, Fernando Diez Burón, Anna Farrés Rabanal, Diego Fernández-Samos Fernández, David, Garcia, Cristina García Pérez, Miguel García Sanz, Cesar, Gracia, Javier, Gualis, Gonzalo Gutiérrez Carrillo, Mateo, Hevia, Eva Higuera Miguélez, Gregorio, Laguna, Cristina Lombardia Gonzalez de Lera, Pablo López Martínez, Pasquale, Maiorano, Sergio Marcos Contreras, Elio Martín Gutiérrez, Marta, Molina, Irene, Perez, Teresa Renedo Villar, Luis Angel Suarez Gonzalez, Eva Alvarez Torres, Luz Bueno Rey, Zulay Adriana Calderon Barajas, Ana, M Castaño-Leon, Aida, Fernández, Pablo Garcia Pimentel, Luis, Jimenez-Roldan, Meta, Levstek, Rosalia Navarro Casado, Claudia Olea Vielba, Ana Maria Parada Rodriguez, Igor, Paredes, Patricia, Pascual-Cambero, Miguel Saiz Sánchez-Buitrago, Claudia Sarrais Polo, Victor Zarza Fernandez de Alegria, Mireya, Bonet, Alberto Encinas Vicente, Jose Miguel Villacampa Auba, Maria Dolores Burgueño, Patricia Serrano Méndez, Thomas, W Jorgensen, Mercedes, Martin, Mónica, Huecas, Felipe, Velasco, Verónica Alen Villamayor, Santiago Alonso Bartolomé, Miguel Alonso Juarranz, Luis Felipe Ávila-Ramírez, Javier Buendia Pérez, Barbara, Burgos-Blasco, Enrique Camarero Rodríguez, Paula Campelos Fernández, Claudia, Celotti, Marco Ciappara Paniagua, Ignacio, Cristobal, Alejandro Encinas Bascones, Elena, Fernandez-Martin, Inés Gil Prados, Jesus Gimeno Hernandez, Maria Alejandra Giraldo, Manuel Gomez Cervantes, Noemi Guemes Villahoz, Araceli Hernández Ramos, Maria Cruz Iglesias Moreno, Bibiana Lasses Martínez, Francisco Leyva Rodríguez, Leyre López Antoñanzas, Javier Martín Monterrubio, Jose Maria Martinez-de-la-Casa, Lourdes Montero Cruces, Jesús Moreno Sierra, Jose Maria Muguerza, Alexia Victoria Paluso Montero, Natalia Pérez Romero, Adriana, Poch, Jaime Rodríguez de Alarcón, Adriana Ruano Campos, Rebeca Ruiz Roman, Patricia Saez Carlin, Cristina Sánchez Del Pueblo, Lidia Sotillo Valenzuela, Armando, Galvan, Miguel Ángel García Ureña, Enrique, González, Manuel Medina Pedrique, Alvaro Robin Valle de Lersundi, Carlos San Miguel, Juan, Aragón-Chamizo, Monica, Ballon, Jose, M Barrio, Beatriz Castro Catalan, Laura Cebolla Rojas, Renan Carlo Colombari, Miguel Cuende Diez, Paula Dujovne Lindenbaum, Oscar, Gil-de-Sagredo, Silvia Kayser Mata, Pablo Lozano Lominchar, Yeniffer Tatiana Moreno Salazar, Angela, Moreno-Gutierrez, Melanie, Morote, Uxue, Murgoitio, Nikolas Palma Caucig, Lucía Polanco Pujol, Alejandro, Prosperi, María Belén Ramírez Senent, Diego Fernando Ruiz Chiriboga, Mercedes, Sanz, Maria, Tudela, María Adrien Lara, Raquel, Alarza, Isabel Alonso Sebastian, Mariano Artés Caselles, Laura, Calles-Sastre, Marcos Casas Sánchez, Aritz Equisoain Azcona, Lucía, Fuentes, Lucia Gil Cidoncha, Sofía Herrero Gámiz, Eva Iglesias Garcia, Jose Luis Lucena De La Poza, Mª Eugenia Marín Martínez, Pilar Martín Rodrigo, Joaquin Manuel Muñoz Rodríguez, Verónica, Polaino, Alberto Pueyo Rabanal, Xabier Remirez Arriaga, Xiana, Rial, Miguel Sánchez Suárez, Maria Eugenia Torguet Muñoz, Borja Bazán Inostroza, Lara Blanco Terés, Alba Correa Bonito, Angela de la Hoz, Gustavo, Eisenberg, Javier Garcia Septiem, Jose Maria Lopesino, Rocio, Maqueda, Elena, Martin-Perez, Jose Luis Muñoz de Nova, Julia Revuelta Ramírez, Ana Rodríguez Sánchez, Álvaro Valdés de Anca, Laura Colao García, David Díaz Pérez, Enrique Esteban Agustí, Pablo Galindo Jara, Ana Belén Gallardo, Cesar, Garcia, Maria Gutierrez Samaniego, Miguel Angel Hernandez Bartolome, Lorenzo, Rabadan, Barriga Sánchez Raquel, Beatriz, Diéguez, Miguel, Hernández-García, Carolina Alfonso Carrillo, María Belén Alonso Bartolomé, Estibaliz, Alvarez, Mario, Alvarez-Gallego, Paula, Aragón-Ramos, Pablo Cesar Arteaga Asensio, Luis Asensio Gomez, Diego, Carrion, Nuria, Chavarrias, Alvaro de Arriba, Jose Antonio Gazo Martínez Gazo, Alberto Gegúndez Simón, Juan Gómez Rivas, Natalia Gonzalez Alcolea, Carolina, Gonzalez-Gomez, Sara Gortázar de Las Casas, María Alexandra Heras Garceau, Alicia Hernández Gutierrez, Luis, Lassaletta, Fuad Samir Lopez Fernández, Marta, Mancheño, Blanca, Mateos-Serrano, Isabel Pascual Miguelañez, Maria Fernanda Pedrero Escalas, Julio, Peñarrocha, Yolanda, Perez, Maria Isabel Prieto-Nieto, Teresa Rivera Schmitz, Laura, Rodrigáñez, Ines, Rubio-Perez, Isabel Sanchez Cuadrado, José Ignacio Sánchez Méndez, Jorge Fernando Tone, Carlos Toribio Vazquez, Aitor, Urbieta, Diego Córdova García, Francisca Garcia-Moreno Nisa, Laura, Jiménez, Inmaculada, Lasa, Belen, Matías-García, Fernando, Mendoza-Moreno, Marina Pérez González, Ana Sánchez Gollarte, Alejandro Sanchez Pellejero, Cristina Vera Mansilla, Rafael, Barberá, Lourdes, Montes-Jovellar, Sara Fra Fernández, Nicolas Moreno Mata, Barbara, Algar-Yañez, Gutiérrez, Bérénice, Olga De La Varga-Martínez, Paula, Fernandez-Valdes-Bango, Sandra Maria Gadin-Lopez, José María Martínez-Gómiz, Elena, Nieto-Moreno, Ana, Nieto-Moreno, Montserrat Ocampos Hernandez, Maria Laura Pelegrina-Lopez, Alicia Ruiz Escobar, Elena, Sáez-Ruiz, Beatriz, Vazquez-Rivero, Antonio, Lara, Belén Vielva Del Campo, Fernando Alcaide Matas, Simbad, Costas-Ochoa, José María García Pérez, Elizabeth, Marmol, Paula Troncoso Pereira, Maria Del Pilar Concejo Cutoli, Juan Ramón Gómez López, Juan Carlos Martín Del Olmo, Paloma Guillamot Ruano, Javier Páramo Zunzunegui, Antonio Albarracín Marín Blázquez, Alfonso, Aliaga-Sanchez, Marta María Arroyo Domingo, Miriam Artés Artés, Ana Isabel Avellaneda Camarena, Aida, Blaya, Emny Rochell Bobadilla Romero, Pedro Vicente Fernández-Fernández, Lorena Galindo Iñiguez, Víctor Javier García Porcel, Clara Giménez Francés, Antonio Javier Gomez Poveda, Rebeca Gonzalez Celdran, Francisco Miguel González Valverde, Laura Guillamon Vivancos, Elena, Gurrea-Almela, Alejandra Jara Maquilón, Jose David Jimenez Parra, Abd Al Aziz Lanagrán Torres, Raquel Lax Perez, Carmen Maria Lopez Lopez, Francisco, Machado, Alfonso Marco Garrido, Florencio Manuel Marin Martinez, Victoria Martínez Muñoz, Esther, Medina, Olimpia, Molina, José Manuel Muñoz Camarena, Julian, Onate, Pedro Antonio Parra Baños, Emilio Peña Ros, Enrique, Rubio, Marina Sánchez Robles, Carlos Sanchez Rodriguez, María Valero Soriano, María Teresa Yepes García, Felipe, Alconchel, Andrés Balaguer Román, Valentín, Cayuela, Ana, Conesa, Ana Delegido García, Pedro José Gil Vázquez, Paula Gómez Valles, Francisco, Gómez-Bosch, Vicente, J León-Muñoz, Francisco, Martínez, Alvaro, Navarro-Barrios, Tatiana, Nicolás-López, Pablo Ramirez Romero, Emiliano, Cano-Trigueros, María Concepcion Alonso González, Leticia Gómez Viana, Ana Pastor Zapata, Elisa Contreras Saiz, Tamara Díaz Vico, Maria, Fernandez-Hevia, Luis Joaquín García Flórez, Raquel, Rodríguez-Uria, Sandra, Sanz, Lorena, Solar-Garcia, Aida Suárez Sánchez, Jaume, Gelonch, Dietmar, Reinaldo, Miriam Abdulkarim Polo, Asier, Aguirre, Marta Alomar Bofill, Santiago, Baena, Ashish, Bartakke, Carmen Cabeza Oliver, Marta Castro Suárez, José Andrés Cifuentes Rodenas, Olga Claramonte Bellmunt, Ant Onia Crespí Mir, Anabel De La Llave Serralvo, Mar, Escales, Isabel Rosa Fernández Burgos, Pablo Gandia Gonzalez, Juan Lliteras Jorge, María Cristina Martínez Canto, Javier, Mata, Andreu, Morell, Naila, Pagès, Sara Pérez Palao, Cristian Plaza Valiente, Catalina Ramon Barcelo, Carmen Reyero Fernández, Albert Reyes Claret, Leticia Rodriguez Vaquero, Maialen Saez de Vicuña Salinas, Pilar Santos Cidon, Concepcion, Segura, Aina, Serra, Maria Serra Guivernau, Maria Soler Pedrola, Marta, Tasende, Marta Torrent Lluch, María Inmaculada Valldeperas Hernández, Rosa-Maria, Yañez-Lpez, Andrea, Craus-Miguel, Laura Fernández Vega, Natalia Pujol Cano, Juan José Segura-Sampedro, Laura Colet Oliver, Ivan Dot Pascuet, Mireia, Duart, Isabel Tello Galindo, Eduardo Arrea Salto, Jaume Cámara Cabrera, Marta Camats Terré, Juan Gabriel Castro Ríos, Marta de la Rosa-Estadella, Anna, Fernandez-Colorado, Anna, Gasulla-Rodriguez, Antonio, Gimenez-Gaibar, Elena, Gonzalez, Yeray Maldonado Sotoca, Matilde, Molina-Corbacho, Montserrat Monfort Mira, Josep, Rodoreda, Marta Santos Espí, Arnau Verdaguer Figuerola, Elisa Angela Diego-Alonso, Jaime, López-Sánchez, Luis, Muñoz-Bellvis, Jacobo, Trebol, Borja, Aguinagalde, Cristina Gabriela Alzate Arsuaga, Ainhoa Andres Imaz, Iñigo, Arana, Coro Aranzabal Urrutia, Mikel, Armendariz, Lorena, Arrabal, Iñigo, Augusto, Adolfo, Beguiristain, Laura, Busto, Ainhoa, Cuevas, Itziar De Ariño, Alejandro, Elúa, Leticia, Fernandez, Arantza, Fernandez-Monge, Lander, Gallego, Alba, Garcia, Amaia Garcia Dominguez, Gregorio, Garmendia, Carmen, Grañén, Pelayo Hevia Rodríguez, Maria, Iraola, José Miguel Izquierdo, Aintzane, Lizarazu, Jon Ander Lizarbe, Claudia Cristina Lopes Moreira, Iker, López, Ruth Marquina González, Tania, Pastor, Adrián Recio Ayesa, Ana Paula Riverola Aso, Carballo, Rodríguez, Araceli, Rodrìguez, Maria Inmaculada Ruiz Montesinos, Patricia, Torres, Jose, Undabeitia, Ainara, Villafruela, Maria Barrionuevo Ramos, David, Blanco, Marta, Calderón, Eva Corral Rubio, Angel, Cuadrado-García, Daniela, Cubek, Ignacio, Fariña, Maria Fernandez LLorente, Natalia Flores Amador, Mariana García Virosta, Luis Garcia-Sancho Tellez, Adelina Gonzalez Martinez, María, Hernandez, Rubén Herreros Ruiz-Valdepeñas, Carmen Jimenez Sanchez, Eduardo Llamazares Cobo, María, López, Javier, López-Martin, Teresa Martínez Marivela, Luis Miguel Martinez Parra, Paloma Maté Mate, Paloma, Medrano, Manuel Moriche Carretero, Sara Núñez O'Sullivan, Manuel Ortega Oria de Rueda, María Begoña Pastor Nieto, Clara, Pérez, Antonio, L Picardo, Remedios Revilla Amores, Carmen Rodríguez Haro, Jose Alberto Rojo López, Fatima Sanchez Cabezudo Noguera, Cristina, Sanz, Daniel Serralta de Colsa, Cristina Valor Garcia, Marta Velasco Martinez, Iván Andújar Lara, Aranzazu, Calero-Lillo, Enrique, López-Ruiz, Alberto Díaz García, Alejandro Menéndez Moreno, Luis Eduardo Pérez-Sánchez, Ángela, Pascual, Miguel Adeba García, Marta Alonso Fernández, Javier Alvarez Gama, Roberto, Ballestero, Loreto Berjon De La Vega, Paola Calleja Hermosa, Mariana, Carrillo-Rivas, Alfonso, Casado, Andrea, Cerveró, Bonifacio Cimadevilla Calvo, Patricia Corriols Noval, Paloma de la Dehesa Cueto-Felgueroso, Miren Jasone Diez Zapirain, José Estevez Tesouro, José Antonio Fernández-Dívar Sánchez, Lucia Garcia Alcalde, Juan García Cardo, Tito García Moreno, Daniel, García-López, Belen Garcia-Montesinos Perea, Miren Gonzalez Benito, Rocio, Gonzalez-Aguado, Miguel Ángel Gordo Vega Gordo-Vega, Jose, Gutierrez-Banos, Jaime Jimeno Fraile, Yolanda Jubete Castañeda, Patricia Lopez Gomez, Antonia Jesús López López, David Mato Mañas, Carmelo, Morales-Angulo, Dieter, Morales-Garcia, Sara, Naranjo, Jose Luis Rabago, Jose Manuel Rabanal, Rocio Revuelta Zorrilla, Adriana Reyes Echeverría, Juan Carlos Rodríguez-Sanjuán, Juan Ramón Sanz, Isabel Simal Badiola, Guillermo, Tejón, Enrique Toledo Martínez, Raquel Varea Malo, Begoña, Fadrique, Tania, Funes, Elena González Revilla, Isaias, Alarcón, Daniel Aparicio Sánchez, Pablo Beltran Miranda, Carmen, Cepeda-Franco, María Josefa Cuevas López, Sandra, Dios-Barbeito, Virginia María Durán Muñoz-Cruzado, Carlos Gonzalez De Pedro, Rosa, M Jimenez-Rodriguez, Francisco, Manresa-Manresa, Gabriel, Marin, Cristobalina, Martin-Garcia, Sara, Martínez-Núñez, Juan Manuel Martos Martinez, Lucas, Mengíbar, Felipe Pareja Ciuro, Eduardo Perea Del Pozo, Veronica Pino Diaz, José, Pintor-Tortolero, Claudia, Quintero-Pérez, Maria Luisa Reyes Diaz, Mercedes Rubio Manzanares Dorado, Alejandro Sanchez Arteaga, Ana, Senent-Boza, Luis, Tallon-Aguilar, Jose, Tinoco-Gonzalez, Luis-Cristobal, Capitan-Morales, Juan Cintas Catena, Javier, Valdes-Hernandez, María Del Campo Lavilla, Alina López De Fernández, Miriam Abellan Lucas, Alba Diaz Padillo, Maria Gómez Romero, Linda Grace Puerto Tamayo, El Mostafa El Yaqine Er Raoudi, Melody García Domínguez, María Ángeles Gascón Domínguez, Marta González Pérez, Alba Hernáez Arzoz, Joana San Anton, Cristian, Ruminot, Hander Guillermo Acosta Diaz, Daniella, Laguado, Kristina, Aghababyan, Alba, Jr, Enrique, Artigues, Rocío, Belda, Miguel, Beltran, Jose Ignacio Blanes, Elena Campos Carot, Miriam, Cantos, Laura, Costa, Carolina Ferrer Gomez, José María Gallego Sánchez, Oscar, Gil-Albarova, Juan, Gilabert-Estellés, Emilio Lopez Alcina, Isabel López Sánchez, Severiano Marin Bertolin, Carolina, Martinez-Perez, Antonio Melero Abellán, Claudia Mulas Fernández, Beatriz, Novoa, Ruth, Nuñez, Pablo Renovell Ferrer, Guijarro-Jorge, Ricardo, Carolina Soledad Romero Garcia, Miguel Sanfeliu Giner, Silvia, M West, Enrique, Zapater, Ignacio, Miranda, Ana, Monís, Alejandro Roselló Añón, María José Sangüesa, Jorge Sanz Romera, Marcos, Adrianzén, Maria Barrios Carvajal, Mireia, Bauzá, Ana Benítez Riesco, Jose Antonio Carbonell Lopez, María-Carmen, Fernández-Moreno, Ricardo Gadea Mateo, Francisco, Garcia, Maris Luisa García-Pérez, Luisa Paola Garzon, Ana, Izquierdo, Maria Lapeña Rodríguez, Carlos, León-Espinoza, Fernando, Lopez, Rosa Martí Fernández, Sara Martínez Castro, Berta Monleón López, Isabel Mora Oliver, David, Moro-Valdezate, Ernesto Muñoz Sornosa, Sara Palomares Casasús, Leticia Pérez Santiago, Mara Albert Fort, Reyes, Balanzá, Lorena Bermell Marco, Carla Carratalá Pérez, Claudia Pilar Clemente Tomas, Marta, Córcoles, Jose Ángel Diez Ares, Carlos Domingo Del Pozo, Nuria Estellés Vidagany, Gonzalo, Garrigos, Mar Gimeno Gimeno Vicente, Blanca Alastrue Giner, Segundo, Gomez-Abril, Paloma, Gonzalez, Paula Gonzálvez Guardiola, Guillermo Sebastian Martínez Fernández, Charo Martínez García, Lucía, Martínez-Costa, Luz María Moratalla Charcos, Sergio Navarro Martínez, Carmen, Payá-Llorente, Álvaro Pérez Rubio, Nuria, Peris, Eduardo Picazo Pineda, Jordi Planelles Gómez, Francisco Ripoll Vidal, Andrea, Roca, Enrique, Salmerón-González, Raquel Segura Roselló, Ramon Trullenque Juan, Cristina Verdejo Gimeno, Jose Miguel Zaragozá García, Gema Zomeño Bravo, Marcos Bruna Esteban, Hanna, Cholewa, Milton de Jesus, Matteo, Frasson, Luis Oliver García, Héctor, J Aguado, Antonio Jose Alonso Villalba, Francisco, Ardura, Carmen Elena Badillo Bercebal, María Bedate Núnez, Alvarez-Ramos Begoña Aranzazu, Juan Beltrán de Heredia, Hugo, Bermejo, Juan Berrocal Cuadrado, Maria Bragado González, Juan, Bustamante-Munguira, Raul Calvo Gonzalez, Yolanda, Carrascal, Ana Belén Casas Marcos, María Carmen Cervera, Sergio Chávez Valladares, Ángel Cilleruelo Ramos, Susana, Cortes, Jesús, Crespo-Sanjuán, María, Cuaresma, Luis Antonio Cuellar Martin, Carlos Ferreras García, Alvaro, Fuentes-Martín, Abel, Ganso, Elena García García, Luis, Garcia-Florez, Virginia, Garcia-Virto, Juan, Gatón, Julio Alberto Gobernado Tejedor, Tania Gómez Sanz, Jose Ignacio González Martín, María Begoña Gregorio Crespo, Ana Herranz Arriero, Jose, Herreros, Marta Ibáñez Nieto, César, Infante, Carlos, Jezieniecki, Moises, Juarez, Gregorio de Jesus Labrador Hernandez, Ana Patricia Legido Morán, Ricardo León Fernández, Alejandro, Leon-Andrino, Almudena, Llorente, Maria Lopez Pais, Mauricio Loucel Bellino, Sergio, Martin, Miguel Angel Martin-Ferrero, Gonzalo Martinez Municio, Elvira Mateos Alvarez, José María Matilla, Luis María Merino Peñacoba, Mario, Montes-Manrique, Fernando Natal Álvarez, David, C Noriega, Henar Nuñez Del Barrio, Francisco Javier Ortiz de Solórzano Aurusa, Lucía, Pañeda, Victoria Pascual Escudero, Miguel Pascual Samaniego, Adela, Pereda, Marta Pérez Febles, Laura, Pesquera, Maria, Plata, Emma Puertas Ruiz, Mario, Rodriguez-Lopez, Alejandro Romero de Diego, Ana, Ruano, María Ruiz Soriano, Cristina Sánchez Torralvo, Silvia Santiago Maniega, Bárbara, Segura-Méndez, Clarisa Simon Perez, José, Soro-García, Paula Suárez Mansilla Suárez-Mansilla, Jeancarlos Trujillo Díaz, Mª Esther Valsero Herguedas, Andrea Vazquez Fernandez, Eduardo Velasco García, Ana, Zabalza, Álvaro Zamora Horcajada, Fernando Acebes García, Enrique Asensio Díaz, Martín, Bailón, Alejandro David Bueno Cañones, Alvaro Centeno Velasco, Ekta Choolani Bhojwani, Fernando Labarga Rodríguez, Sara, Mambrilla, Pablo, Marcos-Santos, Toledano, Miguel, David Pacheco Sánchez, Baltasar, Pérez-Saborido, Pilar, Pinto, Katherine, Plua, Javier Sanchez Gonzalez, Vicente, Simo, Rosalía Velasco López, Sandra Veleda Belanche, Fabiola Eugenia Michel Campos, Iciar Muñoz Lindez, Maria, Balluerca, Maite, Camuera, Pablo, Helguera, Imanol, Herrero, Patricia Paunero Vazquez, María, Sánchez-Rubio, Isami, Soeda, María Dolores Arribas Del Amo, Vicente Manuel Borrego Estella, Estefania, Casas, Néstor Castán Villanueva, Daniel Delfau Lafuente, Elena Delgado Blanco, María, Domingo, Ismael Gil Romea, Azucena, Gonzalo, Emilio Lagunas Lostao, Noelia Lete Aguirre, Yaiza Martinez Lahoz, Jesús Víctor Pérez-Tierra Ruiz, Maria Del Mar Soriano, Isabel Valero Lázaro, Esmeralda Carnicer Escusol, Guillermo Pola Bandres, Juan Luis Blas Laina, Beatriz, Cros, Patricio Andrés Freile Pazmiño, David, Garcia-Aguilera, Ana Mejía Casado, Ana, Nogués, Issa Talal El-Abur, Carlos, Yánez, Isabel Gascon Ferrer, Carlos, Gracia-Roche, Ursula María Jariod Ferrer, María Victoria Simón Sanz, Tomas, Uson, Waseem, Ahamed, Sumudu, Jayasinghe, Eranda, Karunadasa, Prathibha, Nelihela, Sujeewa Priyantha Bandara Thalgaspitiya, Dickson, Wickramarathna, Nagenthiram, Harivallavan, Pirashanthan, Nagarasa, Eranga, Perera, Kanapathipillai, Piratheep, Vithranage Srimantha Dewsiri Rodrigo, Meera, Thayalan, Rajendram, Thayaparren, Arulprashanth, Arulanantham, Kanishka De Silva, Gagana, Ganga, Anuja Nadeeshan Kumarasinghe, Mahanada, Udukala, Koculen, Vimaleswaran, Prashanthan, Yogarajah, Ravindri, Jayasinghe, Probhodana, Ranaweera, Mohamed, Rishard, Dharmabandhu, N Samarasekera, Sanjeewa, Seneviratne, Sivasuriya, Sivaganesh, Chamal, Fernando, Nishantha, Mendis, Balasingam, Balagobi, Balasupramaniam, Sathesan, Lanka, Dasanayake, Malitha, Patabendige, Wickramasooriya, Dj, Kugarajh, Ganeshapillai, Sathyamoorthy, Prasanna, Dileepa, Ediriweera, Sumudu, Kumarage, Asanka, Jayawardane, Athula, Kaluarachchi, Pituwala Liyanage Adithya Sirisena, Abubakr, Abubakr, Hozifa, Mohamed, Ismail, Mustafa, Mogahid, Sharfeldein, Samir, Ismail, Reem, Musa, Monira, Sarih, Mussab, Abaker, Eman Adam Abdalla, Mohamad, Abdelbagi, Alsafe, Adlan, Ahmed, Alnaeem, Safa, Atyah, Yasir, Awad, Rsheeda, Dawelbait, Mohamed El Hag, Ibrahim, Elbashir, Sami, Eldirdiri, Samwal, Eldirdiri, Mohammed Eltahier Abdalla Omer, Lana Abdalgadir Ahmed Mohamed, Hiba Hassan Rehmtallah Ahmed, Mohammed Balla Yousif Balla, Abdulmoiz, Aljafari, Abdulmalek, Aljafari, Elsagad, Mohamed, Abdulkader, Mohammad, Abdulkader, Shaar, Mohamed Nafea Shaar, Maab Hussein Yousif Elhafiz, Mohammed Husien Yosif Elhafiz, Abubakr Ali Mohammed Alhassan Humidan, Almigdad, Ali, Hisham, Eljack, Mohamedyasin, Elrashid, Manhal, Ahmed, Albrra, Alhag, Douaa, Ali, Mohammed Ahmed Babikir, Imad, Bakheit, Hytham K, S Hamid, Sami, Mohamed, Walid, Shaban, Nidhal, Siddig, Mohamed, Suliman, Rihab Yasir Abdelmagid, Abubaker, Yassin, Omer, Abbas, Eltahir, Abdelrahim, Muhammed, Ahmed, Mohamed, Elobaid, Adil, Hashim, Ali, Mohamed, Omer, Mohamed, Khalid, Osman, Abdallah, Yousif, Safaa, Abdulaal, Marwa, Elsadig, Mohammed, Hussain, Malaz Amir Ataalmanan, Doha Amir AtaAlmanan, Tebyan Amir AtaAlmanan, Alaa, Elgaili, Maria, Mohamed, Usra, Omara, Alkhansa, Osman, Amna, Osman, Safaa, Saad, Abdelkareem, Ahmed, Ali Adil Ali Karar, Aya, Alhassan, Mohanad, Alsidig, Mohamed, Eljack, Mohammed Ibrahim Mohammed Ali, Awad Kamal Awad Osman, Liena, Mohamed, Samah Ibrahim Omer Mohamed Osman Mohamed Osman, Altayeb, Mohammed, Ayman, Mohammed, Khadija, Muhmmed, Eltahir, Musa, Egbal Sahal Abdelmajed, Khalid Z M, Y Hamid, Omnia M, M Yousif, Mahmoud, Saleh, Osman, Bashir, Yassein, Elhussein, Omar, Madani, Eva, Angenete, Jennifer, Park, Lars, Gillberg, Monir, Jawad, Linas, Pieteris, Yousif, Saeed, Sergej, Safonov, Martin, Spångfors, Henrik, Andersson, Hans, Bahlmann, Karin Björnström Karlsson, Michelle, Chew, Lara, Daham, Lina De Geer, Helen, Didriksson, Gunilla, Gagnö, Carina, Jonsson, Anna, Oscarsson, Pamela, Buchwald, Mathilde, Delorme, Marie-Louise, Lydrup, Shahin, Mohseni, Arvid, Pourlotfi, Souheil, Reda, Kajsa, Anderin, Nina, Blomme, Josefin, Segelman, Malin, Simlund, Anders, Thorell, Fredrik, Wogensen, Daniel, Danielsson, Peter, Elbe, Rebecka, Hultgren, Boel, Hynning, Fredrik, Klevebro, Karin, Lind, Ebba, K Lindqvist, Carl, Montan, Ernesto, Sparrelid, Clara Svenberg Lind, Jeremy, Wales, Andreas, Älgå, Martin, Nordberg, Emil, Pieniowski, Ioannis, Gkekas, Niklas, Löfgren, Karolina, Niska, Robert, Zürner, Silvio, Däster, Otto, Kollmar, Savas, Soysal, Stephanie, Taha-Mehlitz, Athanasios, Tampakis, Dominik Valentin Flury, Marie, Heyne-Pietschmann, Gregor Jan Kocher, Ana, M Calinescu, Barbara, Wildhaber, Markus, Gass, Jürg, Metzger, Andreas, Scheiwiller, Lukas, Briner, Oliver, Dwidar, Steven, Grandjean, Pietro, Ricciardi, Alexandra, Calmels, Christodoulou, Michel, Morena, Antonilli, Dimitrios, Christoforidis, Alessandra, Cristaudi, Jacopo, Galafassi, Maria Luisa Gasparri, Francesco, Mongelli, Martino, Munini, Andrea, Papadia, Sotirios Georgios Popeskou, Alex, Alfieri, Thomas, Bächler, Matteo, Giardini, Christian, Gingert, Laura, Guglielmetti, Inna, Meyer, Tobias, Müller, Daniel, Schöni, Folco, Solimene, Frank, Weidner, Marco, Bueter, Daniel, Gero, Amelie, Müller, Carmen, Portenkirchner, Andreas, Thalheimer, Jeannette, Widmer, Ahmad, Hmaideh, Alaa, Kour, Saleem, Swaes, Omar, Alannaz, Ramez, Aljasem, Ezeddin, Dabbagh, M Wafa Hamoud Alhussein, Amr, Hamza, Mazen, Mohammad, Abd El-Fattah Mouhandes, Mohamad, Shareeda, Mohammad Nour Shashaa, Mousa, Sifat, Sheraa, Tahhan, Rahaf, Toutounji, Mohamed, Abdulrahman, Albaraa, Abdulsalam, Ziad Al Jarad, Hala, Alayyoubi, Dina, Alfarra, Ahmad, Alhamid, Mahmoud, Alnasser, Mulham, Gharib, Ruwaid, Gharib, Obaida, Kabel, Osama, Kherallah, Abdulqader, Klaho, Mohamed Shukri Najjar, Ahmad, Razouk, Joud, Shiekhoni, Wael, Alkhaleel, Amira, Almosa, Mohammad, Aloulou, Maen, Alzaeem, Khaled, Arnaout, Muhamad Zakaria Brimo Alsaman, Mohamad, Estanbouli, Hanadi, Hawa, Ahmad Nbrass Kabawi, Ghina, Maarawi, Yehia, Mashhadany, Sana Shaikh Torab, Waleed, Abd, Tayma Abd Alghafour, Hani, Abdalnour, Nazeeh Al Aktaa, Marwan Al Aliwy, M Maher Al Arje, Tasneem Al Najjar, Ahmad, Al-Mouakeh, Ahmad, Aldakhil, Aos, Alhamid, Hasan, Alhasan, Mohamad Shadi Alkarrash, Jumaa, Alkhamis, Sara, Alshekh, Ahmad Yamen Arnaout, Oula, Azizeh, Mohammed, Dalaleh, Aghyad, Danial, Zain, Douba, Raghad, Ghadri, Mohammad Maen Ghannam, Anas, Ghawi, Luma Haj Kassem, M Yasser Halwani, Shahed, Hamadieh, Mohammad, Hanino, Ala Aldeen Hasan, Haya, Jawish, Nasr Ullah Kabbani, Saadullah, Kabbany, Mohamad, Kadi, Lama, Kadoura, Ahmad Amir Kayali, Ammar, Kayyali, Aya, Kelzia, Amana, Kezze, Abdullah, Khalaf, Maymona, Khayata, Mohammad Nour Kitaz, Mohammad, Kour, Raghad, Makki, Ruqaya, Masri, Joseph, Masri, Noor, Masri, Muhammad, Mazketly, Shiar, Mustafa, Ezzeldin, Nashed, Yaman Qoudra Danial, Hasan, Raslan, Rima, Salem, Mohammed Asaad Salem, Thabet Sayed Bakir, Manaf, Sharabaji, Majd Sheikh Alganameh, Duaa Sheikh Kadro, Joudy, Shurbatji, Mohammad Noor Sultan, Dana, Sultan, Hala, Swied, Bakri Tarras Jarkas, Tayf, Toutounji, Fadi, Ward, Rama, Zazo, Aya, Zazo, Zainab, Zeino, Mohamed, Alaktaa, Wael, Alsado, Hala, Fares, Nouran, Hawa, Hamza, Ibrahim, Abdulmonem, Kawas, Mourad, Niazi, Bayan, Toutounji, Mohammad, Abdow, Mohamad, Ahmad, Tareq, Ahmad, Rawan Al Azhar, Hiba Al Hage Diab, Rahaf Al Mulke, Mohammad, Al-Jadaan, Ahmad, Alhussein, Zahra, Alnajem, Omar, Alneser, Bayan, Alsaid, Elias, Azar, Lubna, Bakr, Ammar, Hamza, Yara, Houdifa, Sami, Jomaa, Samer, Kefo, Hiba, Mardini, Alaa, Mohammad, Fadi, Rayya, Fatima, Razzouk, Mohannad, Saleh, Anwar, Shamandi, Ammar Youzkatli Alkhatib, Omar Abdul Salam, Dany, Ajami, Mohammad, Alhamid, Ahmad, Alkhaledi, Danny, Hadidi, Massa, Jabra, Mamdouh, Kallas, Antoine, Laktine, Joelle, Naem, Naya, Naoum, Ghena Mohammed Fawaz Ashour, Ahmad, Alhouri, Deema, Fallouh, Ahmad, N Mohammad, Ahmad, Rmman, Ali, Slitin, Christine, Tanos, Ibrahim, Wakim, Hanaa, Zahrawi, Majd, Abouassi, Layth, Abouassi, Ayham, Aboutrab, Basel, Ahmad, Ahmad Mustafa Ahmad, Aya, Ahmad, Afaf, Ahmad, Mohamad, Alabras, Mohammad, Albasheer, Ola, Alkasser, Mhd Khaled Alkasser, Ali, Alkhdor, Marah, Azkoul, Mohammad Karam Chaaban, Haya, Deeb, Basel, Jazieh, Basel, Kouz, Youssef, Kozah, Raied, Mohamad, Ammar, Mohammad, Mhd Zied Nasri, Mohammed Mouaz Shebani, Mohammed, Shwin, Alaa, Sommaq, Amal, Youssef, Tala Al Asadi, Suhad, Alkhateb, Rasha Khalil Alsayyad, Roula, Altom, Mhd Amin Alzabibi, Batoul, Bakkar, Hlma, Ismail, Salma Khadem Alsrouji, Sara, Melhem, Mohamad, Sankari, Mosa, Shibani, Noura, Shujaa, Ibrahim, 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Demirgan, Ahmet Guray Durmaz, Gulcin, Ercan, Candas, Ercetin, Hasim Furkan Gullu, Nadir Adnan Hacım, Serhat, Meriç, Kamil, Özdoğan, Merve, Tokocin, Mehmet Alim Turgut, Talar, Vartanoglu, Hakan, Yigitbas, Hüsnü, Aydın, Ece, Bahçeci, Mestan, Bilmez, Elif, Binboğa, Sinan, Binboga, Gokhan, Demirayak, Bengi, Demirayak, Keziban, Doğan, Ahmet Cem Dural, Murat, Ekin, Sina, Ferahman, Fatih, Guven, Mehmet, Karabulut, Sema, Karakaş, Selçuk, Köse, Ayşe Büşra Önder, Ismail Umut Onur, Nuri Alper Sahbaz, Levent, Yaşar, Ulviye, Yigit, Güneş Özlem Yıldız, Ümmühan Zeynep Bilgili, Bayram, Doğan, Cevper, Ersoz, Abdullah, Ilktac, Senad, Kalkan, Eyyüb Selim Ünlü, Halil, Alis, Süleyman, Büyükaşık, Burak, Kankaya, Oguzkagan, Batikan, Ensar, Çakır, Musa Murat Caliskan, Mahmut Emin Çiçek, Anil, Demir, Selim, Doğan, Emre, Erdoğan, Mert, Güler, Muhammed, Gürlük, Ufuk Oguz Idiz, Rozan, Kaya, Cebrail, Oğuz, Ömer Akay Ömer, Serkan Süleyman Özpak, Hüsnü, Şevik, Mert Mahsuni Sevinc, Cihad, Tatar, Oğuzhan, Tekin, 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Yanar, Ahmet, Akmercan, Gül, Çakmak, Tuncay, Kötan, Tunc, Lacin, Ayten, Saracoglu, M Umit Ugurlu, Tumay, Umuroglu, Tevfik Kıvılcım Uprak, Esra Yamansavci Şirzai, Bedrettin, Yıldızeli, Elif, Baran, Emre, Bozkurt, Sinan, Ömeroğlu, Mert, Tanal, Aydın Eray Tufan, Mehmet, Uludag, Gürkan, Yetkin, Murat, Kalın, Omer Faruk Ozkan, Hanife Şeyda Ülgür, Tayfun, Bisgin, Muhammet Berkay Sakaoglu, Selman, Sökmen, Deniz, Caglar, Candan, Cicek, Demre, Delipinar, Emre, Divarci, Egemen, Ozdemir, Hilmican, Ulman, Seda Dilek Yetut, Feyme, Zafer, Ismail, Sert, Burçin, Abud, Murat, Akalin, Cengiz, Aydin, Bulent, Calik, Emine Burcu Cigsar, Semra Demirli Atıcı, Ayberk, Dursun, Mustafa, Emiroglu, Hüseyin, Erdinç, Tayfun, Kaya, Gizem, Kilinc, Yasemin, Kirmizi, Merve Dilara Öney, Mustafa Onur Oztan, Semra, Salimoğlu, Cem, Tugmen, İbrahim, Uyar, Sertaç Ata Güler, Alican, Güreşin, Ozan Can Tatar, Nihat Zafer Utkan, Kemal, Arslan, Mustafa Bilal Hamarat, Ismail, Hasirci, Mehmet Serkan Ozkent, Mehmet Eşref Ulutaş, Burak, Yilmaz, Mertcan, Akçay, Yesim, Akdeniz, Emrah, Akin, Fatih, Altintoprak, Enes, Baş, Zulfu, Bayhan, Guner, Cakmak, Recayi, Çapoğlu, Fehmi, Çelebi, Hakan, Demir, Enis, Dikicier, Ugur Can Dulger, Necattin, Firat, Emre, Gönüllü, Ahmet Tarik Harmantepe, Muhammet Burak Kamburoğlu, Belma, Kocer, Ibrahim Furkan Küçük, Baris, Mantoglu, Ali, Muhtaroğlu, Kayhan, Ozdemir, Merve, Yigit, Zehra Alan Köylü, Engin, Aybar, Mert, Candan, Ahmet Burak Ciftci, Elif, Çolak, Huseyin, Eraslan, Gultekin Ozan Kucuk, Süleyman, Polat, Ahmet Can Sarı, Mustafa Safa Uyanik, Kürşat, Yemez, Çağrı, Büyükkasap, Kayahan, Eyuboglu, Ali, Guner, Murat Emre Reis, Nurullah, Damburacı, Omer, Karahan, Barış, Sevinç, Fatma Ayca Gultekin, Odongo, Samuel, Mohammed, Hirsi, Isakwa, Ibrahim, Isabirye, Isa, Daniel, Asiimwe, Mumbere, Bienfait, Isaac, Edyedu, Esther, Namutosi, Mutekanga, Nicholus, Ssekitooleko, Badru, Treasure, Ibingira, Ehanga Idi Marcel, Racheal, Kirabo, Ronald, Mbiine, Cephas, Nakanwagi, Christine, Namugenyi, Joseph, Ntege, Arnold, Ntege, Henry Othieno Misanga, Nantambi, Rose, John Baptist Ssenyondwa, Nimanya Stella Alice, Lois, Asiimwe, Clara Atieno Odhiambo, Francis, Basimbe, Brian, Bbosa, Walter Dreak Erabu, Bili, Hussein, Joel, Kiryabwire, Castro, Kisuule, Moses, Magezi, Lynette Mpagi Katassi, Dionizi, Muganga, Didace, Mugisa, Othiniel, Musana, Fredderick, Mutyaba, Twaha, Muwanga, Peter, Muwanguzi, Assumpta, Nabawanuka, Teddy, Nakirijja, Goretti, Nassali, Rosemary, Nassanga, Moses, Nassimu, Peter, Ssekweyama, Peter, Ssenyonjo, Kagga, Ssenyonjo, Eden Micheal Ssettabi, Linda, Turyabahika, Justine, Walusimbi, Daniel, Zaake, Benson, Oguttu, Denis, Oluka, Mujuni, Samson, Okello Simon Peter, Vladyslav, Hordoskyi, Andrii, Kurmanskyi, Sofiia, Zhurba, Maksym, Boruta, Andrey, Kebkalo, Volodimir, Tyselskiy, Andriy, Beznosenko, Olha, Bubliieva, Viktor, Cherniienko, Yevhenii, Kostiuchenko, Bogdan, Maksymenko, Alina, Minich, Sikachov, Sergei, Ihor, Yovenko, Khaled, Elsisy, Ahmed, Ibrahim, Ravi, Trehan, Vikram Somashekhar Basappanavar, Hisham, M Elsayed, Rajnish, Garg, Suresh Kailasam Sivamurthy, Sabina, Khan, Rubina, Lone, Ibrar, Majid, Abid, Qazi, Mohamed, Serour, Nayzak, Raoof, Gavin, Spence, Maryam, Babar, Sheela Anne George Varayannoor, Muna AbdulRazzaq Tahlak, Khalid, Alawadi, Amar, Alomar, Taiceer, Abdulwahab, Murad, Abdunabi, Amr El Yamany, Hossam Al Mahdy, Maitha, Alqemzi, Bilal, Elyafawi, Hamda, Khansaheb, Omar, Abdulateef, Hayder, Al-Masari, Amna Salam Al-Wandi, Sameh, S Alsafty, Shaimaa, Ibrahim, Nour, Abdel-Fattah, Ruari, Jardine, Priyanka, Kunte, Gianluca, Maresca, Stuart, Mcintosh, Lucy, Mcleod, Ahmed, Nassar, Ashrafun, Nessa, Laura, Osborne, Peter, Osei-Bonsu, William, Paine, Jelizaveta, Pereca, Rachel, Vaughan, Kanastana, Yasotharan, Megan, Kershaw, Angharad, King, Joanna, Krawczyk, Cheri, Price, Anushka, Sieunarine, Andrew, Temperton, Vimla, Victor, Sophie, Walker, Matthew, Williams, Thomas, Woodhouse, Andras, Farkas, Maria, Hobrok, Rhona, Kilpatrick, 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Malaz, Abbakar, Vanessa, Badas, Radu, Chirvasuta, Joe, Drybrough, Alexandra, Hamshere, Annabelle, Harrison, Rebecca, Ireson, Nelson, Kamali, Abigail, Lau, Sumant, Luhana, Luisa, Macdonald, Barbara, Ribeiro, Alistair, Savage, Tanisha, Sharma, Paul, Swift, Rachel, Taute, Stephanie, Alford, Chase, Elswick, J Quentin Clemens, John Michael DiBianco, Anna, Faris, Mark, Hemmila, Giulia, I Lane, Lena, Napolitano, Jane, J Wong, Shelly, Abramowicz, Dina, Amin, Steven, Roser, Daniel, Beswick, Elisa, Birnbaum, Khaled, Campa, Carolyn, Chabuz, Brandon, Chapman, Nicole, Christian, Marco Del Chiaro, Adam, Dyas, Anna, Gergen, Anne, Getz, Ana, Gleisner, Ryan, Griffin, Laura, Harmon, Scott, Hirsch, Victoria, Huynh, Juan Pablo Idrovo, Laura, Leonard, Helen, Madsen, Robert, Mcintyre, Robert, Meguid, Kenny, Rodriguez, Richard, Schulick, Christopher, Scott, Lauren, Steward, Camille, Stewart, Malcolm, Su, Sarah, Tevis, Daniel, Thieu, Shane, Urban, Catherine, Velopulos, Jon, Vogel, Thomas, Vogler, Kristen, 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Batko, Anthony, Colon, Sofia, Gabrilovich, Carma, Goldstein, Christina, Gory, Janmejay, Hingu, Brian, Leoce, Anh, Nguyen, Guergana, Panayotova, Ruchi, Ram, Deviney, Rattigan, Jerette, Schultz, Sara, Solar, John, Stein, Grace, Tsui, Elizabeth, Warnack, Apostolos, Gaitanidis, Leon, Naar, Robert, Sinyard, Sophia, Angelides, Laura, Fitzmaurice, Alexander, Himstead, Mehraneh, Jafari, Zeljka, Jutric, Kari, Kansal, Lydia, Kirillova, Isabella, Kuo, Kapila, Patel, Erika Linmey Tay Lasso, Maki, Yamamoto, Maleeha, Ahmad, Steven, Chang, Gary Alan Bass, Benjamin, Braslow, Daniel, Dempsey, Caoimhe, Duffy, Daniel, Holena, Jonathan, Imran, John, Keogh, Cara, Lorenzi, Niels, Martin, Mark, Seamon, Lauren, Huckaby, Katrina, Morgan, Caroline, Rieser, Lauren, Rosenblum, Cindy, Teng, J Michael DiMaio, Mohanad, Hamandi, Mary, Hoffman, Allison, T Lanfear, Michael, Connolly, Benjamin, Hall, Tareq, Kheirbek, Elizabeth, Renaud, Kevin, Behm, Judy, Boughey, Kristin Cardiel Nunez, Sean, Cleary, Mihai, Dumbrava, Travis, Grotz, James, Jakub, Rahul, Kanade, David, Larson, Sherief, Shawki, Dennis, Wigle, Haradeen, Dhillon, Avni, Suri, Leonardo Weber Graeff, Ahmed, Elshabrawy, Grace Ihsiu Todd, Mark, Davies, Yan, Qi, Walter, Biffl, Kathryn, Schaffer, Sarah, Averbach, Terry, Curry, Alexandra, Schwartz, Mary Kathryn Abel, Veronica, Andaya, Kristina, Benirschke, Katherine, Bigay, Marissa, Boeck, Lee-Lynn, Chen, Lee-May, Chen, Huey-Lan, Chern, Amanda, Compadre, Patricia, Conroy, Alexa, Glencer, Patrick, Ha, Barbara Cs Hamilton, Johannes, R Kratz, Rondall, Lane, Rex, H Lee, Brenda, Nunez-Garcia, Richard, O'Donnell, Doruk, Ozgediz, Paul, Park, Ankit, Sarin, Ipsit, Shah, Bonnie, Sheu, Madhulika, Varma, Katherine, Wai, Rosanna, Wustrack, Mary Jue Xu, Melissa, Zimel, Pedro, Escobar, Meredid Maldonado Santiago, Mohammad, Azam, Asad, Choudhry, Eric, Hammond, William, Marx, Jihad, Abbas, Somya, Al-Embideen, Carol, Angel, Bailea, Bobich, Raul, Bosio, Gregory, Georgiadis, Tahir, Jamil, Maria, Kenner, Meghan, Lark, Tamara, Maghathe, Sonia, Masih, Gabriel, Naimy, Kristin, O'Mara-Gardner, Emily, Rady, Roberta, Redfern, Jack, Sample, Joseph, Sferra, Kaitlyn, Sharp, Jessica, Shoemaker, Stephen, Stanek, John, Stengle, Hibba, Sumra, Jeffrey, M Sutton, Faris, Azar, Anne, Fischer, Jaymie, Henry, Lawrence, Lottenberg, Mario, Rueda, Sasha, Thiel, Adel, Bozorgzadeh, John, Kelly, Armando Salim Munoz Abraham, Erin, Scott, Camila, Haro, Andrés, Pouy, Gastón, Acuña, Sofia, Álvarez, Ana Carmen Carbajal, Fabiola, Castedo, Diego, Pereiranuñez, Helena, Sobrero, Josefina, Tarigo, Rafat, Al-Saban, Fatima, Al-Eryani, Siham Al Maqtari, Sahar, Al-Maqtari, Mahmmoud, Abdualqader, Majed, Aeed, Ghadeer Al Sanany, Anwaar Al Dhafif, Buthina Al Jarmozi, Saba, Al-Ameri, Awsan, Al-Dhaheri, Dhyia Alhuq Al-Surimi, Amira, Alakhdury, Sabreen, Alashmali, Zainab, Alattas, Manar, Alduba'Ai, Hamdan, Aldumaini, Wafa, Alhaddad, Abdelrahman, Alharazi, Nawal, Alhemyari, Adnan, Alhumaida, Maniee, Aljabri, Hassan, Almarashi, Zuhoor, Almohanady, Marwa, Alodine, Nooraldin, Alqasemi, Basma, Alqudaimi, Ansam Mohammed Ghaleb Alrobaiee, Mohammed, Alsabri, Radfan, Alsalal, Ramzi, Alsayadi, Musaed, Alsayadi, Reem, Alshaipani, Ebrahim, Alsharabi, Nora, Atiah, Hadeel, Bajjah, Muhib, Esmael, Asma, Ghallab, Rana, Ghannam, Adwa'A, Hamid, Lina, Hashem, Sara, Saif, Shaima, Sayad, Nawras, Shaban, Amatallah Hadi Shamsan, Sarah, Shream, Amal, Shukri, Shahd, Zeid, Nabila, Abdullah, Abdulrahman Faisal Al-Garadi, Ahmed, M Ali Al-Radhi, Norhan, Naji, Shaima'A, Nasser, Areej Taha Al Anaib, Ebrahim, Abdurab, Fadhl Al Muhtadi, Amer, Al-Hebbah, Ahmed, Al-Madhrahi, Shehab, Al-Mahdi, Sakhr Abdulhakeem Al-Maswari, Ayman, Al-Oqabi, Zakarya Abdullah Al-Zaazaai, Karim, Al-Zazay, Ali, Alafif, Asem, Albzzaz, Lina, Alqalisi, Mohammed, Alrezami, Haneen, Alshargabi, Mokhtar, Alshargabi, Hossam, Ghanem, Kareem, Saeed, Rasheed, Shalabi, Fareed, Showqi, Miriam, Maimbo, Catherine, Mkandawire, Mulaya, Mubambe, Theresa, Nkole, Vanessa, Savopoulos, Patricia, Shinondo, Chabwera, Shumba, Penias, Tembo, Shelton, Chivanga, Ngqabutho, Dube, Handsome, Dube, Daniel, Dzinotyiwei, Ronald, Makanda, Moses, Mangena, Partson, Maphosa, Derek, Matsika, Proud, Mawere, Nkosikhona, Moyo, Assel, Moyo, Arnold, Muguwu, Simbarashe, Mungazi, Garikai, Mwale, Gamuchirai, Ndabvonga, Mambote Crispin Olivier Ntoto, Hardlife, Ranganai, Ernesto Sánchez Castillo, Oltah, Tshuma, Grace, Gwini, Vimbai Moyana Muguto, Gilbert, Moyo, Trust, Mushawarima, Tinashe, Shoko, Rorisang, Jamela, Marvellous, Machiri, Eric, Shumba, Antony, Chengahomwe, Yemurai, Bikwa, Maxwell, Chimhina, Jeremy, Marume, Kudzayi, Munanzvi, Precious G, T Mutambanengwe, Federico, Ferrari, Marco, Fontanella, Franco, Odicino, Romano, Vito, Nepogodiev D, Emanuele Cammarata, Sofia Campanella, Daniela Canzonieri, Adriana Cordova, Federico De Michele, Ettore Dinoto, Mara Franza, Leo Licari, Daniele Matta, Domenico Mirabella, Felice Pecoraro, Roberto Pirrello, Pierfrancesco Pugliese, Fernando Rosatti, Giuseppe Salamone, Francesca Toia, Massimiliano Tripoli, Nepogodiev, D, Rosati, R, Surgery, Medicine and Pharmacy academic/administration, Basic (bio-) Medical Sciences, Surgical clinical sciences, Faculty of Medicine and Pharmacy, Gastroenterology, Medical Oncology, Clinical sciences, Breda, João, ARD - Amsterdam Reproduction and Development, Paediatric Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Endocrinology, metabolism and nutrition, Graduate School, Tytgat Institute for Liver and Intestinal Research, Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria Bisulli, Barbara Bonfanti, Safia Boussedra, Jury Brandolini, Crescenzo Cacciapuoti, Stefano Cardelli, Riccardo Casadei, Matteo Cescon, Alessandro Cipolli, Riccardo Cipriani, Alfredo Conti, Luca Contu, Francesco Costa, Niccolo’ Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero Dolci, Giulia Dondi, Matteo Droghetti, Sergio Nicola Forti Parri, Elena Garelli, Chiara Gelati, Giuliana Germinario, Federico A. Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, leonardo solaini, giorgio ercolani, Fruscio, R, Ornaghi, S, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Žundienė, Laura, Dulskas, Audrius, Kuliavas, Justas, Čekauskas, Albertas, Kielaitė-Gulla, Aistė, Poškus, Tomas, Strupas, Kęstutis, Želvys, Arūnas, COVIDSurg Collaborative, GlobalSurg Collaborative, Department of Surgery, HUS Abdominal Center, Simoes, Jff, Li, E, Picciochi, M, Glasbey, Jc, Baiocchi, G, Blanco-Colino, R, Chaudhry, D, Alameer, E, El-Boghdadly, K, Wuraola, F, Ghosh, D, Gujjuri, Rr, Harrison, Em, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mann, H, Mclean, Ka, Mengistu, Gm, Modolo, Mm, Ntirenganya, F, Norman, L, Outani, O, Pius, R, Pockney, P, Qureshi, Au, Roslani, Ac, Satoi, S, Shaw, C, Bhangu, A, Omar, Om, Ahmed, Wur, Argus, L, Ball, A, Bywater, Ep, Brar, A, Dawson, Be, Duran, I, Elhadi, M, Jones, C, Kamarajah, Sk, Keatley, Jm, Lawday, S, Marson, Ej, Ots, R, Santos, I, Taylor, Eh, Trout, Im, Varghese, C, Venn, Ml, Xu, W, Dajti, I, Gjata, A, Kacimi, Seo, Boccalatte, L, Cox, D, Townend, P, Aigner, F, Kronberger, Ie, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Gomes, Gma, Buarque, Il, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, Wh, Ren, Dl, Calvache, Ja, Rivera, Cjp, Hadzibegovic, Ad, Kopjar, T, Mihanovic, J, Jimenez, Pma, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, Daa, Dhufera, H, Hailu, S, Mengesha, Mg, Kauppila, Jh, Arnaud, Ap, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, Mw, Acquah, Dk, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, Ml, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Milan, Pb, Khosravi, Mh, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Abou Chaar, Mk, Ayasra, F, Fakhradiyev, I, Hamdun, Ih, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, Lh, Sanchez, Iid, Gonzalez, D, Martinez, L, Martinez, Mj, Nayen, A, and Ramos-De la Medina, A
Subjects: Male, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MULTICENTER, infectious diseases, 0302 clinical medicine, 030202 anesthesiology, Anesthesiology, Cirugía, 80 and over, Prospective Studies, Young adult, Child, Lung, Aged, 80 and over, COVID-19, delay, SARS-CoV-2, surgery, timing, SARS‐CoV‐2 infection, Operative, Child, Preschool, Pneumonia & Influenza, Infection, Cohort study, Human, medicine.medical_specialty, Clinical Sciences, Sars-cov-2, GlobalSurg Collaborative, Settore MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, 03 medical and health sciences, Clinical Research, Biodefense, Correspondence, Humans, PULMONARY COMPLICATIONS, CRIANÇAS EM IDADE PRÉ-ESCOLAR, Aged, Science & Technology, Cirurgia, Prevention, Infant, Odds ratio, Pneumonia, Prospective Studie, Clinical research, Surgery, Human medicine, 610 Medizin und Gesundheit, 1109 Neurosciences, Internationality, Settore MED/29 - CHIRURGIA MAXILLOFACCIALE, Settore MED/18 - CHIRURGIA GENERALE, Adolescent, Adult, Cohort Studies, Female, Middle Aged, Surgical Procedures, Operative, Time, Young Adult, Practice Guidelines as Topic, gastroenterology, Medicine and Health Sciences, 030212 general & internal medicine, Prospective cohort study, Mortality rate, Covid19, Infectious Diseases, Patient Safety, medicine.symptom, 6.4 Surgery, Life Sciences & Biomedicine, 610 Medicine & health, COVID-19, SARS-CoV-2, delay, surgery, timing, Asymptomatic, NO, COVIDSurg Collaborative, Vaccine Related, All institutes and research themes of the Radboud University Medical Center, medicine, Mortalitat, ddc:610, Mortality, Preschool, LS7_4, Surgical Procedures, business.industry, Neurosciences, Evaluation of treatments and therapeutic interventions, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Anesthesiology and Pain Medicine, Emerging Infectious Diseases, Good Health and Well Being, Mortalidad, Cohort Studie, business
Abstract: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. ispartof: ANAESTHESIA vol:76 issue:6 pages:748-758 ispartof: location:England status: published
Published: 2021

50. Aortic aneurysms, chronic kidney disease and metalloproteinases

Author: Giuseppe Filiberto Serraino, Pasquale Mastroroberto, Teresa Faga, Ashour Michael, Gemma Patella, Umberto Bracale, Michele Andreucci, Nicola Ielapi, Raffaele Serra, Michele Provenzano, Andreucci, M., Provenzano, M., Faga, T., Michael, A., Patella, G., Mastroroberto, P., Serraino, G. F., Bracale, U. M., Ielapi, N., and Serra, R.
Subjects: 0301 basic medicine, lcsh:QR1-502, Apoptosis, Review, 030204 cardiovascular system & hematology, Matrix metalloproteinase, Renal tubular injury, Biochemistry, lcsh:Microbiology, mps, proteinuria, egfr, aneurysm expansion, extracellular matrix, cardiovascular risk, end-stage kidney disease, renal tubular injury, Renin-Angiotensin System, 0302 clinical medicine, Fibrosis, MPs, ADAMTS, Proteolytic enzymes, End-stage kidney disease, Extracellular matrix, Prognosis, Aortic Aneurysm, Proteinuria, Matrix Metalloproteinase 8, Aneurysm expansion, Matrix Metalloproteinase 9, Disease Progression, Matrix Metalloproteinase 2, medicine.symptom, Glomerular Filtration Rate, Risk, Epithelial-Mesenchymal Transition, EGFR, Renal function, Inflammation, 03 medical and health sciences, medicine, Animals, Humans, Renal Insufficiency, Chronic, Molecular Biology, Cell Proliferation, Tissue Inhibitor of Metalloproteinase-1, business.industry, MP, medicine.disease, Cardiovascular risk, Aneurysm, 030104 developmental biology, Cancer research, Albuminuria, Metalloproteases, Kidney Failure, Chronic, business, Kidney disease
Abstract: Metalloproteinases (MPs) are proteolytic enzymes involved in extracellular matrix deposition, regulation of cellular signals of inflammation, proliferation, and apoptosis. Metalloproteinases are classified into three families: Matrix-MPs (MMPs), A-Disintegrin-and-Metalloprotease (ADAMs), and the A-Disintegrin-and-Metalloproteinase-with-Thrombospondin-1-like-Domains (ADAMTS). Previous studies showed that MPs are involved in the development of aortic aneurysms (AA) and, concomitantly, in the onset of chronic kidney disease (CKD). CKD has been, per se, associated with an increased risk for AA. The aim of this review is to examine the pathways that may associate MPs with CKD and AA. Several MMPs, such as MMP-2, -8, -9, and TIMP-1 have been shown to damage the AA wall and to have a toxic effect on renal tubular cells, leading to fibrosis. Similarly, ADAM10 and 17 have been shown to degrade collagen in the AA wall and to worsen kidney function via pro-inflammatory stimuli, the impairment of the Renin-Angiotensin-Aldosterone System, and the degradation of structural proteins. Moreover, MMP-2 and -9 inhibitors reduced aneurysm growth and albuminuria in experimental and human studies. It would be important, in the future, to expand research on MPs from both a prognostic, namely, to refine risk stratification in CKD patients, and a predictive perspective, likely to improve prognosis in response to targeted treatments.
Published: 2021

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