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1. Unraveling the Sea Slug Fauna from an Extremely Variable Environment, The ‘Passetto’ Rocky Tide Pools (North Adriatic Sea)

Author

Yann Toso, Francesco Martini, Agnese Riccardi, and Giulia Furfaro

Subjects
sea slug, Nudibranchia, checklist, Mediterranean Sea, biodiversity, Hydraulic engineering, TC1-978, Water supply for domestic and industrial purposes, TD201-500
Abstract

The Mediterranean Sea is known to be a hot spot for marine biodiversity, especially if considering the highly specialized Heterobranchia mollusks. In recent years, there has been increasing effort to fill some knowledge gaps existing on Mediterranean heterobranch diversity, but, to date, several potentially interesting habitats remain unexplored. In fact, most studies have been focused on sea slugs inhabiting coastal areas and lakes, but those living in extremely variable areas like Mediterranean rocky tide pools remain almost completely ignored even if it is reported worldwide that they can host a high sea slug diversity. In this context, the rocky tide pool system near the ‘Passetto’ urban beach (Ancona, Italy) in the North Adriatic Sea (Mediterranean Sea) represents a biodiversity hot spot, highlighting the importance of the conservation of this peculiar habitat. A preliminary quantitative survey on the associated Heterobranchia unveiled a thriving community residing in this limited and fragile habitat, and it inspired a more detailed investigation as performed in the present study. In order to reveal the presence of species that have gone unnoticed, an in-depth study was carried out between 2018 and 2022, which aimed to amplify the knowledge on this vulnerable environment and the fauna associated with this as yet poorly known habitat. Tide pooling activities corroborated by photographic analyses allowed the recording of 45 taxa in total and the addition of 25 species to the previously known list. Within those, (i) two species were potentially new to science, (ii) one was recorded in the Mediterranean Sea for the first time, (iii) two species were added to the Italian fauna, and (iv) one species constituted a new record for Sector 9 of the Italian Seas.

Published
2024
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2. Standardized protocol for reproductive phenology monitoring of fucalean algae of the genus Cystoseira s.l. with potential for restoration

Author

Fabio Rindi, Alba Vergés, Irene Zuchegna, Silvia Bianchelli, Sònia de Caralt, Cristina Galobart, Jorge Santamaría, Francesco Martini, Margalida Monserrat, Sotiris Orfanidis, Cèlia Sitjà, Soultana Tsioli, Jana Verdura, Luisa Mangialajo, Simonetta Fraschetti, Roberto Danovaro, and Emma Cebrian

Subjects
macroalgae, phenology, Cystoseira, Mediterranean, conservation, Science, General. Including nature conservation, geographical distribution, QH1-199.5
Abstract

Active marine restoration is strongly encouraged to prevent the loss of the valuable habitats formed by Cystoseira sensu lato species, since they enhance biodiversity and preserve ecosystem functions and services. Current restoration interventions are mainly based on recruitment enhancement methods by deploying bags with fertile receptacles in situ or by outplanting juveniles grown ex situ under laboratory conditions. These methods allow the recovery of endangered species avoiding the depletion of the donor populations. In all cases, a priori knowledge of the reproductive phenology and recruitment periods of the species to be restored is essential, since the success of restoration techniques relies on collecting fertile branches and the obtention and survival of recruits. For their collection, identified donor populations characterized by dense Cystoseira s.l. cover should be studied. Specifically, monitoring the reproductive phenology of populations is crucial to detect the period of the year in which they develop mature reproductive structures and to understand how it might be linked to environmental conditions. Then, these general patterns on the reproductive phenology of Cystoseira s.l. species are essential to determine the most suitable time and conditions to plan for the most effective restoration action. Here, we provide a cost-effective and friendly protocol that can be easily and widely implemented for all Cystoseira s.l. species. We pose that this protocol provides a standardized and useful methodology to understand the environmental factors driving the optimal periods for sampling fertile branches across the Mediterranean Sea, and thus it can be an essential tool to plan future restoration actions.

Published
2023
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3. The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author

Daniele Balducci, Michele Montori, Francesco Martini, Marco Valvano, Federico De Blasio, Maria Eva Argenziano, Giuseppe Tarantino, Antonio Benedetti, Emanuele Bendia, Marco Marzioni, and Luca Maroni

Subjects
radiofrequency ablation, cholangiocarcinoma, stenting, survival, meta-analysis, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Endoluminal biliary radiofrequency ablation (RFA) has been proposed as a palliative treatment for patients with malignant biliary obstruction (MBO) in order to improve stent patency and survival. However, the existing data on patients with inoperable extrahepatic cholangiocarcinoma (eCCA) are conflicting. We performed a meta-analysis of randomized trials comparing RFA plus stenting versus stenting alone in patients with inoperable eCCA. We searched for trials published in the PubMed/MEDLINE, Scopus, and Cochrane databases up to November 2023. Data extraction was conducted from published studies, and a quality assessment was carried out in accordance with the guidelines recommended by the Cochrane Collaboration. Hazard ratios (HRs) with 95% CI were estimated from the trials. The primary endpoints of interest were overall survival and stent patency. Out of 275 results, 5 randomized trials and 370 patients were included. While overall survival was not different between the groups (HR 0.62; 95% CI 0.36–1.07; p = 0.09; I2 = 80%;), the subgroup analysis of studies employing plastic stents showed a trend toward better survival in the RFA-treated group (HR 0.42; 95% CI 0.22–0.80; p = 0.009; I2 = 72%). Stent patency was improved in patients receiving RFA (HR 0.64; 95% CI 0.45–0.90; p = 0.01; I2 = 23%). Adverse events were not different between the groups (OR 1.21; 95% CI 0.69–2.12; p = 0.50; I2 = 0%). Despite the promising results, high heterogeneity and potential biases in the included studies suggest the need for further high-quality randomized trials to explore the potential cumulative effects of RFA on CCA treatment outcomes.

Published
2024
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4. Exploring the Molecular Aspects of Myeloproliferative Neoplasms Associated with Unusual Site Vein Thrombosis: Review of the Literature and Latest Insights

Author

Erika Morsia, Elena Torre, Francesco Martini, Sonia Morè, Antonella Poloni, Attilio Olivieri, and Serena Rupoli

Subjects
myeloproliferative neoplasms, splanchnic vein thrombosis, cerebral vein thrombosis, clonal hematopoiesis of indeterminate potential, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

Myeloproliferative neoplasms (MPNs) are the leading causes of unusual site thrombosis, affecting nearly 40% of individuals with conditions like Budd–Chiari syndrome or portal vein thrombosis. Diagnosing MPNs in these cases is challenging because common indicators, such as spleen enlargement and elevated blood cell counts, can be obscured by portal hypertension or bleeding issues. Recent advancements in diagnostic tools have enhanced the accuracy of MPN diagnosis and classification. While bone marrow biopsies remain significant diagnostic criteria, molecular markers now play a pivotal role in both diagnosis and prognosis assessment. Hence, it is essential to initiate the diagnostic process for splanchnic vein thrombosis with a JAK2 V617F mutation screening, but a comprehensive approach is necessary. A multidisciplinary strategy is vital to accurately determine the specific subtype of MPNs, recommend additional tests, and propose the most effective treatment plan. Establishing specialized care pathways for patients with splanchnic vein thrombosis and underlying MPNs is crucial to tailor management approaches that reduce the risk of hematological outcomes and hepatic complications.

Published
2024
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5. Macroalgal forest restoration: the effect of the foundation species

Author

Silvia Bianchelli, Simonetta Fraschetti, Francesco Martini, Marco Lo Martire, Ettore Nepote, Davide Ippoliti, Fabio Rindi, and Roberto Danovaro

Subjects
active restoration, Gongolaria barbata, indicators of success, associated biodiversity, meiofauna, macrofauna, Science, General. Including nature conservation, geographical distribution, QH1-199.5
Abstract

IntroductionActive restoration is the strategy needed to trigger or accelerate the recovery of degraded marine habitats, which provide the goods and services essential for preserving biodiversity and human wellbeing. Ecosystem engineers are generally the target species in the ecological restoration of marine ecosystems, and large-sized brown macroalgae (e.g., the Cystoseira complex) are a priority due to their crucial ecological importance and vulnerability in many regions of the Mediterranean Sea. MethodsHere, we present the results of a successful intervention of ecological restoration of Gongolaria barbata. Results and DiscussionOne year after the restoration intervention, we observed the recovery of the canopy in terms of ca. 15m2 with a significant increase in faunal abundance and biodiversity compared with reference areas. However, despite the high restored macroalgal growth rates, the assemblage structure was still significantly different from that of reference pristine areas. Despite the fast faunal colonization of a new 3D habitat linked to the successful re-introduction of the ecosystem engineers (i.e., macroalgae), the complete restoration of the properties of a habitat can be a much longer process. We conclude that, after 1 year, active restoration of macroalgal forests still results in a partial recovery of ecosystem functions (i.e., rehabilitation) rather than a full ecosystem restoration, thus stressing the need for long-term monitoring of restoration interventions.

Published
2023
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7. Combining passive and active restoration to rehabilitate a historically polluted marine site

Author

Silvia Bianchelli, Francesco Martini, Marco Lo Martire, Roberto Danovaro, and Cinzia Corinaldesi

Subjects
passive and active restoration, Gongolaria barbata, artificial barriers, indicators of success, associated biodiversity, meiofauna, Science, General. Including nature conservation, geographical distribution, QH1-199.5
Abstract

IntroductionPassive and active restoration approaches have been often considered as different alternatives to achieve the ecological restoration of a degraded site. This false dichotomy has been overcome in terrestrial ecosystems, for which a range of restoration approaches have often been applied within the same restoration project, creating a continuum of interventions. In the marine environment, the combined approach based on passive and active restoration is less studied.MethodsHere, we tested the possibility of actively restoring a macroalgal population in a historically polluted industrial site, subjected to decadal passive restoration (i.e., unassisted, or spontaneous recovery following cessation of industrial activity), in the Mediterranean Sea. Recently, it has been demonstrated that in the site under scrutiny, there is no longer any sign of the historical contamination or impact on benthic fauna therefore the environmental conditions are indistinguishable from surrounding non-impacted areas. We used artificial breakwater barriers already present in the site to restore a population of the brown algae Gongolaria barbata. The intervention was conducted by applying an in situ recruitment approach and a complementary action using cages to exclude the herbivores. The G. barbata recruits were transplanted on the artificial reefs and after they reached the maximum growth inside the cages, one cage was opened and another one was completely removed to also test the grazing pressure. The associated benthic assemblages were also analysed in terms of meio- and macrofaunal abundance, the richness of taxa, and taxonomic composition.Results and discussionOur results indicate that, at least over a relatively short period (i.e., 6 months), the use of the cages represents a useful tool to let the macroalgae grow enough to counterbalance the herbivory pressure. The associated fauna below the macroalgae was characterized by a different taxonomic composition when compared to controls (i.e., artificial reefs without the macroalgae), particularly when considered the rare taxa. In conclusion, the combination of passive and active restoration can be considered a useful approach to restore marine sites degraded by historical industrial activities.

Published
2023
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8. Seed viability testing for research and conservation of epiphytic and terrestrial orchids

Author

Namrata Pradhan, Xuli Fan, Francesco Martini, Huayang Chen, Hong Liu, Jiangyun Gao, and Uromi Manage Goodale

Subjects
Plant conservation, Seed banking, Seed viability test, Orchid seeds, Epiphytic orchids, Terrestrial orchids, Botany, QK1-989
Abstract

Abstract Background Seed viability testing is essential in plant conservation and research. Seed viability testing determines the success of ex-situ conservation efforts, such as seed banking but commonly testing protocols of orchids lack consistency and accuracy, therefore, there is a need to select an appropriate and reliable viability test, especially when conducting comparative studies. Here, we evaluated the suitability of three seed viability tests, Evans blue test (EB), Fluorescein diacetate test (FDA) and Tetrazolium test (TTC), with and without sterilization, on seeds of 20 orchid species, which included five epiphytes and fifteen terrestrials, using both fresh seeds and seeds stored at − 18 ºC for 6 to 8 years. Results We found that sterilization and lifeform of seeds affected seed viability across all tests but the storage time was not an influential factor. Sterilization negatively affected seed viability under EB and FDA test conditions but increased the detection of viable seeds in the TTC test in both epiphytic and terrestrial species. The EB test, when administered without sterilization provided the highest viability results. Being non-enzymatic unlike TTC and FDA tests, as expected, the EB test was the most reliable with similar results between sterilized and not sterilized seeds for most epiphytic and terrestrial species as well as when compared between groups. Conclusions The lifeform of the species and seed sterilization prior to testing are important influential factors in orchid seed viability testing. Since EB test was found to be reliable we recommend the EB test for seed viability assessment in orchids rather than the less reliable but commonly used TTC test, or the FDA test, which require more expensive and sophisticated instrumentation. Since storage time was not an influential factor in orchid seed viability testing, the recommendations of this study can be used for both fresh as well as long-term stored orchid seeds. This is helpful for research and especially for conservation measures such as seed banking. However, due to the species specificity of the bio-physiology of orchids, we call for comprehensive viability test assessment in the hyper diverse orchid family to be extended to a greater number of species to facilitate efficient conservation and research.

Published
2022
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9. Risk Stratification in Primary Biliary Cholangitis

Author

Francesco Martini, Daniele Balducci, Martina Mancinelli, Valerio Buzzanca, Elena Fracchia, Giuseppe Tarantino, Antonio Benedetti, Marco Marzioni, and Luca Maroni

Subjects
primary biliary cholangitis, risk stratification, precision medicine, Medicine
Abstract

Primary Biliary Cholangitis (PBC) is a chronic cholestatic liver disease with a heterogeneous presentation, symptomatology, disease progression, and response to therapy. The current risk stratification assessment, aimed at identifying patients with a higher risk of disease progression, encompasses an in-depth analysis of demographic data, clinical and laboratory findings, antibody profiles, and the evaluation of liver fibrosis using both invasive and noninvasive techniques. Treatment response scores after one year of therapy remain to date a major factor influencing the prognosis of PBC patients. While the initial therapeutic approach with ursodeoxycholic acid (UDCA) is universally applied, new second-line treatment options have recently emerged, with many others under investigation. Consequently, the prevailing one-size-fits-all approach is poised to be supplanted by tailored strategies, ensuring high-risk patients receive the most appropriate treatment regimen from diagnosis. This will require the development of a risk prediction model to assess, at the time of diagnosis, the course, outcome, and response to first and additional treatments of PBC patients. This manuscript provides a comprehensive overview of the current and emerging tools used for risk stratification in PBC and speculates on how these developments might shape the disease landscape in the near future.

Published
2023
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10. Intrinsic biotic factors and microsite conditions drive seedling survival in a species with masting reproduction

Author

Francesco Martini, Chaobo Zou, and Uromi Manage Goodale

Subjects
aspect, initial seedling height, maple, Mast seeding, plant population and community dynamics, seedling mortality, Ecology, QH540-549.5
Abstract

Abstract Seedling recruitment following a masting event, where more fruits are produced in synchrony and intermittently compared with other species, plays a crucial role in determining species diversity and community structure. Such seedling recruitment can be superabundant, but followed by high mortality shortly thereafter. Differences in biotic factors such as seedling characteristics, competition, and herbivory, and microsite‐specific abiotic factors could determine seedling fate in space and time. In a subtropical forest in south China, for 2 years using censuses conducted every 1–2 months, we monitored 40 seed traps and 120, 1 m2 quadrats in five 1‐ha plots located from 1,400 to 1,850 m asl for the masting maple species, Acer campbellii subsp. sinense (Pax) P.C.DeJong. We measured biotic—conspecific and heterospecific seedling density, species richness, herbivory, seedling height, and leaf number—and abiotic—canopy openness, slope, and aspect—factors to assess drivers of seedling survival and evaluated A. campbellii subsp. sinense presence in the soil seed bank (SSB). The masting seed dispersal peak and seedling emergence peak occurred between October 2017 and January 2018, and May 2018, respectively. Of 688 selected seedlings, mortality was 92.7% within one year. No seeds were observed in the SSB. Seedling height and leaf number positively affected seedling survival, while seed placement as measured by aspect also showed effects on survival. Conspecific and heterospecific density and herbivory did not show any clear effect. Higher probabilities of seedling survival were found in areas with larger canopy openness (≥12% canopy gap size) and in steeper microsites (≥35°). Synthesis. Masting is mainly studied as a population‐level phenomenon from the fruiting tree perspective. Our study of individual seedling fate revealed that intrinsic biotic factors and seed placement were key drivers of survival. Although biotic determinants such as competition from conspecifics or heterospecifics or herbivory did not determine survival, their ubiquitous presence may be an underlying equalizer in community dynamics where seedlings that overcome biotic pressures, if placed at the right microsite, are at better odds at being recruited to the next life history stages.

Published
2019
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11. Abiotic Drivers of Seedling Bank Diversity in Subtropical Forests of Southern China

Author

Francesco Martini, Chaobo Zou, Xiaoyang Song, and Uromi Manage Goodale

Subjects
community assembly, elevation, environmental filtering, plant diversity, seedling dynamics, soil nutrients, Evolution, QH359-425, Ecology, QH540-549.5
Abstract

Abiotic factors are important to shape plant community composition and diversity through processes described as environmental filtering. Most studies on plant diversity in forests focus on adult trees, while the abiotic drivers of forest seedling community characteristics are less understood. Here, we studied seedling banks’ composition, richness, diversity, and abundance, and investigated their relationships with microsite abiotic conditions along a wide elevational gradient. We sampled seedling communities in 312 1-m2 quadrats, distributed in 13 one-ha plots in four subtropical forests in south China, covering an elevation gradient of 1500 m, for 2 years. We measured light availability, slope, and 11 soil nutrients for each seedling quadrat. We used analysis of similarities and multivariate analysis of variance to compare the composition and abiotic drivers of the four forests’ seedling communities. We then used mixed models and structural equation modeling to test the direct and indirect effects of abiotic factors on seedling species richness, diversity, and abundance. The differences in seedling community composition among these forests were mostly explained by differences in elevations and soil nutrients. Seedling diversity as Shannon and Simpson diversity index decreased with increasing elevation and increased with increasing slope, but seedling abundance and species richness did not. Elevation had an indirect effect on Simpson’s diversity index through modulating the direct effects of soil properties. Our findings show that soil properties play a prominent role in favoring differentiation in species composition among the four forests we studied and provide additional evidence to decreasing species diversity with elevation. However, this was reflected in decreasing Shannon and Simpson indices rather than species richness, which is more commonly studied. Whether and to what extent future environmental changes in climate and soil acidification will alter future forest composition and diversity needs to be investigated.

Published
2021
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12. Cancer-Associated Fibroblasts in Cholangiocarcinoma: Current Knowledge and Possible Implications for Therapy

Author

Michele Montori, Chiara Scorzoni, Maria Eva Argenziano, Daniele Balducci, Federico De Blasio, Francesco Martini, Tiziana Buono, Antonio Benedetti, Marco Marzioni, and Luca Maroni

Subjects
CAF, cancer-associated fibroblast, cholangiocarcinoma, desmoplasia, α-SMA, stroma, Medicine
Abstract

Cholangiocarcinoma (CCA) is an aggressive neoplasia with an increasing incidence and mortality. It is characterized by a strong desmoplastic stroma surrounding cancer cells. Cancer-associated fibroblasts (CAFs) are the main cell type of CCA stroma and they have an important role in modulating cancer microenvironments. CAFs originate from multiple lines of cells and mainly consist of fibroblasts and alpha-smooth muscle actin (α-SMA) positive myofibroblast-like cells. The continuous cross-talking between CCA cells and desmoplastic stroma is permitted by CAF biochemical signals, which modulate a number of pathways. Stromal cell-derived factor-1 expression increases CAF recruitment to the tumor reactive stroma and influences apoptotic pathways. The Bcl-2 family protein enhances susceptibility to CAF apoptosis and PDGFRβ induces fibroblast migration and stimulates tumor lymphangiogenesis. Many factors related to CAFs may influence CCA prognosis. For instance, a better prognosis is associated with IL-33 expression and low stromal IL-6 (whose secretion is stimulated by microRNA). In contrast, a worst prognosis is given by the expression of PDGF-D, podoplanin, SDF-1, α-SMA high expression, and periostin. The maturity phenotype has a prognostic relevance too. New therapeutic strategies involving CAFs are currently under study. Promising results are obtained with anti-PlGF therapy, nintedanib (BIBF1120), navitoclax, IPI-926, resveratrol, and controlled hyperthermia.

Published
2022
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13. Elevation and micro environmental conditions directly and indirectly influence forests’ soil seed bank communities

Author

Chaobo Zou, Francesco Martini, Shang-Wen Xia, Diana Castillo-Diaz, and Uromi Manage Goodale

Subjects
Canopy openness, Diversity indices, Microenvironment, Rarity, Soil nutrients, Soil pH, Ecology, QH540-549.5
Abstract

The soil seed bank (SSB) plays an important role in determining future community composition and health of forests. The extent to which abiotic conditions alter the abundance and diversity of the future forest composition via modulating the regenerative capacity of the SSB and their relationship with each other is not fully understood. We studied how elevation and abiotic conditions (canopy openness, slope, aspect, soil pH, and a natural gradient of these soil nutrients: total nitrogen [N], total carbon [C], C:N ratio, available phosphorus [P], available potassium [K], calcium [Ca], iron [Fe], magnesium [Mg], manganese [Mn], and sulfur [S]) affect community characteristics, calculated as: (1) seedling abundance, (2) species richness, (3) Shannon-Weiner diversity index, (4) Simpson index, (5) Chao 2 richness estimator, (6) number of species represented by only one individual, and (7) number of species that occur only in one plot. We used soils sampled in 13 1-ha plots along an altitudinal gradient from 400 to 1850 m above sea level. We determined both direct and indirect causal relationships between abiotic factors and SSB community characteristics using linear mixed models and structural equation modeling. Increased elevation and canopy openness resulted in lower species richness and diversity as well as fewer rare species. However, greater canopy openness resulted in higher abundance. Abundance and richness of the SSB were lower in steeper slopes, but this negative effect appeared to be along an indirect pathway through soil pH and nutrients such as soil Mn and S. Soil P had a significant negative relationship with SSB characteristics for all indices evaluated here, except for SSB abundance, which was positively affected by increased soil pH. Our results highlight the role of abiotic factors in forest regeneration and resilience through their influence on the soil seed bank community. This study is one of the very first to provide data on the SSB along a wide elevational range in subtropical forests, and can be the basis to assess the regeneration potential and health of the study region.

Published
2021
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14. Perioperative complications of sleeve gastrectomy: Review of the literature

Author

Antonio Iannelli, Patrick Treacy, Lionel Sebastianelli, Luigi Schiavo, and Francesco Martini

Subjects
Bleeding, complications, leak, management, sleeve gastrectomy, Surgery, RD1-811, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Sleeve gastrectomy (SG) has known a spectacular rise worldwide during the last decade. The absence of digestive anastomosis simplifies the surgical technique, reducing anastomosis-related complications such as fistula, stricture and marginal ulcer. Furthermore, the respect for digestive continuity preserves the functions of pylorus, that regulates gastric emptying, and duodenum, where calcium, B vitamins and iron are absorbed. Despite the multiple advantages, SG also has specific complications such as bleeding, stenosis, portal thrombosis and leak. The staple line leak at the oesophagogastric junction is the most feared complication and its prevention remains difficult, as the involved mechanisms have been only partially elucidated. Its management is long and requires a multidisciplinary technical platform including Intensive Care Unit, digestive endoscopy and interventional radiology as well as a specialised surgeon. The aim of this review is to explain in detail the perioperative complications of SG, their prevention and treatment, referring to the most recent available literature.

Published
2019
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16. A THz Spectrometer Using Band Pass Filters

Author

Francesco Martini, Ennio Giovine, Fabio Chiarello, and Pasquale Carelli

Subjects
terahertz, spectrometer, metasurfaces, metallic mirrors, Physics, QC1-999, Nuclear and particle physics. Atomic energy. Radioactivity, QC770-798
Abstract

We describe a THz spectrometer operating between 1.2 and 10.5 THz, consisting of band pass filters made by metasurfaces. The source is made of a 10 W small black body. The detector is a high sensitivity room temperature pyroelectric sensor. Various techniques that are used to prepare samples are described. The spectra obtained are compared with those measured with a Fourier Transformer Infrared Spectrometer on the same samples. Our instrument, which uses commercial technologies available at the present time, can constitute an economical alternative to very expensive spectrometers. It has already been successfully used, obtaining precise spectroscopic measurements on many inorganic powders.

Published
2020
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17. Classification and mapping of the woody vegetation of Gonarezhou National Park, Zimbabwe

Author

Francesco Martini, Robert Cunliffe, Alessio Farcomeni, Michele de Sanctis, Giacomo d'Ammando, and Fabio Attorre

Subjects
Environmental modelling, Miombo woodland, Mopane woodland, Potential natural vegetation, Random Forests, Woody vegetation, General. Including nature conservation, geographical distribution, QH1-199.5
Abstract

Within the framework of the Great Limpopo Transfrontier Conservation Area (GLTFCA), the purpose of this study was to produce a classification of the woody vegetation of the Gonarezhou National Park, Zimbabwe, and a map of its potential distribution. Cover-abundance data of woody species were collected in 330 georeferenced relevés across the Park. These data were used to produce two matrices: the first one using the cover-abundance values as collected in five height layers and the second one based on merging the layers into a single cover value for each species. Automatic classifications were produced for both matrices to determine the optimal number of vegetation types. The two classification approaches both produced 14 types belonging to three macro-groups: mopane, miombo and alluvial woodlands. The results of the two classifications were compared looking at the constant, dominant and diagnostic species of each type. The classification based on separate layers was considered more effective and retained. A high-resolution map of the potential distribution of vegetation types for the whole study area was produced using Random Forest. In the model, the relationship between bioclimatic and topographic variables, known to be correlated to vegetation types, and the classified relevés was used. Identified vegetation types were compared with those of other national parks within the GLTFCA, and an evaluation of the main threats and pressures was conducted. Conservation implications: Vegetation classification and mapping are useful tools for multiple purposes including: surveying and monitoring plant and animal populations, communities and their habitats, and development of management and conservation strategies. Filling the knowledge gap for the Gonarezhou National Park provides a basis for standardised and homogeneous vegetation classification and mapping for the entire Great Limpopo Transfrontier Conservation Area.

Published
2016
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24. Remote assessments of human pressure on biodiversity may miss important human threats

Author

Christos Mammides, Francesco Martini, and Constantinos Kounnamas

Abstract

Monitoring human pressure on biodiversity within protected areas (PAs) remains a challenging task due to the vast number of PAs worldwide (> 250,000) and the fact that we lack basic information for most of them. Consequently, researchers are increasingly relying on remote sensing techniques to overcome this challenge. However, remote assessments of human pressure on biodiversity may miss crucial threats, such as hunting and invasive species, which are often best documented through in-situ field surveys. Here, we use a unique European Union dataset documenting human threats within 8,210 PAs through field surveys to assess the relationship between those threats and three commonly used indices of human pressure that are largely derived using remote-sensing methods—the Human Footprint and Human Modification indices and the LandScan Global Population Database. We find that the indices are not always related to the threats recorded within PAs through field surveys. The indices seem to best capture threats associated with urbanization, agriculture, and pollution but not necessarily others. Although remote assessments of human pressure on biodiversity are crucial for conservation, researchers and practitioners must be aware of their limitations and must complement such assessments with information collected in the field whenever possible.

Published
2022

25. Ten-year outcome of one-anastomosis gastric bypass with a biliopancreatic limb of 150 cm versus Roux-en-Y gastric bypass: a single-institution series of 940 patients

Author

Arnaud Liagre, Marine Benois, Michel Queralto, Hubert Boudrie, Olivier Van Haverbeke, Gildas Juglard, Francesco Martini, and Niccolo Petrucciani

Subjects
obesity, complications, bariatric surgery, Gastric Bypass, one-anastomosis gastric bypass, Body Mass Index, Obesity, Morbid, roux-en-y gastric bypass, Weight Loss, Humans, Surgery, long-term outcomes, Retrospective Studies
Abstract

Long-term outcomes of one-anastomosis gastric bypass (OAGB) need to be compared with those of Roux-en-Y gastric bypass (RYGB).The present study evaluates the long-term outcomes at 10-year follow-up of OAGB with a biliopancreatic limb of 150 cm versus RYGB.Private practice, France.Data of patients who underwent OAGB or RYGB as primary or secondary procedures between 2010 and 2011 at a referral center were collected prospectively and analyzed retrospectively.A total of 940 patients underwent OAGB (n = 405) or RYGB (n = 535). Operative time was significantly shorter in the OAGB group. Postoperative morbidity occurred in 17.2% of patients after RYGB versus 8.1% after OAGB (P ≤ .0001). Patients in the RYGB group had a significantly higher rate of kinking of the jejuno-jejunal anastomosis, stenosis of the gastrojejunal anastomosis, and dysphagia for early ulcers. At long term, no differences were found in the rate of severe malnutrition. Cumulated morbidity was significantly higher after RYGB, with higher incidence of internal hernia, anastomotic ulcer, blind-loop syndrome, and hypoglycemia. Conversion to RYGB and laparoscopic exploration for chronic pain were more frequent after OAGB. Surgery for weight regain was significantly more frequent after RYGB. Patients in the OAGB group had significantly lower weight, body mass index, and greater percentage excess, and total weight losses at 120 months. No significant differences were detected in co-morbidity outcomes.After 10 years, both RYGB and OAGB are effective procedures. However, OAGB is associated with shorter operative times and better results in short- and long-term morbidity and weight loss outcomes.

Published
2022

26. Perforated Ulcer of the Gastrojejunal Anastomosis and Concomitant Internal Hernia After One Anastomosis Gastric Bypass

Author

Arnaud Liagre, Francesco Martini, and Niccolo Petrucciani

Subjects
Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism, Surgery
Abstract

Purpose The management of concomitant complications after OAGB is challenging. We aim to show the surgical management of two concomitant complications after one anastomosis gastric bypass: internal hernia and anastomotic ulcer perforation. Materials and Methods We present the case of a 32-year-old woman with BMI of 51 kg/m2, who underwent OAGB. Three years later, she presented with intense and brutal epigastric pain. She was a heavy smoker. Her weight and BMI were 75 kg and 26 kg/m2, respectively. Clinical examination showed generalized peritonitis, computed tomography showed pneumoperitoneum, diffuse peritoneal effusion, and rotation of the superior mesenteric vessels indicative of an internal hernia. Results A generalized biliary peritonitis secondary to a perforated ulcer on the gastrojejunal anastomosis and internal hernia of the common loop into a large Petersen orifice were diagnosed. The internal hernia was reduced, and a perforation of the posterior surface of the gastrojejunal anastomosis was identified. Surgical treatment consisted in the placement of a Kehr’s drain into the perforation, closure of the Petersen orifice, and lavage-drainage of the peritoneal cavity. The postoperative course was uneventful, and she was discharged on postoperative day 12. The Kehr’s drain was removed 1 month after discharge. Conclusion The combination of two different complications after OAGB can make the pre- and intra-operative judgment difficult and hamper the therapeutic approach. The initial reduction of the internal hernia made it possible to reduce the pressure in the surgical assembly and facilitated the treatment of the anastomotic perforation.

Published
2023

28. Serological response after anti-SARS-CoV-2 BNT162b2 vaccine in IBD patients on biological therapy: a monocentric case-control study

Author

Michele MONTORI, Francesco MARTINI, Federico DE BLASIO, Tiziana BUONO, Claudia QUATRACCIONI, Paola GUARDATI, Manuela CALZOLARI, Chiara ROSSI, Emanuele BENDIA, Stefano MENZO, Carmine VALENZA, Rinaldo PELLICANO, Luca MARONI, and Antonio BENEDETTI

Subjects
Endocrinology, Diabetes and Metabolism, Gastroenterology, Internal Medicine
Abstract

Inflammatory Bowel Disease (IBD) patients on biological therapy are receiving vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). However, it is unclear if IBD therapy could influence the response to this vaccine. In a case-control study, we assessed the antibody profiling after anti-SARS-CoV-2 BNT162b2 vaccine in IBD patients on biological therapy.We analyzed seroprevalence and antibody titer, after 14 weeks from the first BNT162b2 vaccine dose, in IBD patients on biological therapy and Health Care Workers (HCWs). In IBD patients, medical history and disease data were recorded.Eighty-two subjects were enrolled in this study. Among them, 40 were IBD patients on biological therapy and 42 were HCWs. All subjects developed an IgG anti-Spike antibody titer above the cut-off. IBD patients on biological therapy developed a lower antibody titer than HCWs (P0.00001). No differences were reported in patients who received at least one dose of the vaccine within a period of 7 days from the last biological drug administration, compared to all other IBD patients. A difference was found between patients who were on concomitant immunosuppressive therapy and patients on sole biological therapy (P = 0.0287). Patients with presence of any sign of disease activity (clinical, endoscopic or laboratory) showed a higher development of antibody titer compared to those in complete disease remission (P = 0,0468).Our data indicate that in IBD patients, treatment with biological therapies do not affect the seroprevalence but leads to a lower antibody titer development after anti-SARS-CoV-2 BNT162b2 vaccine.

Published
2023

29. Esophageal and gastric malignancies after bariatric surgery: a retrospective global study

Author

Chetan Parmar, Roxanna Zakeri, Mohamed Abouelazayem, Thomas H. Shin, Ali Aminian, Tala Mahmoud, Barham K. Abu Dayyeh, Melissa Y. Wee, Laura Fischer, Freek Daams, Kamal Mahawar, Carlos Sosa Gallardo, Cataldo Agustin, Fernando Wright, Ignacio Fuente, Miguel Carbajo, Patricio Cal, Jacob Chisholm, Lilian Kow, Michael H.L. Tan, Philip Gan, Sivakumar Gananadha, Daniel M. Felsenreich, Gerhard Prager, Chris Matthys, Jacques M. Himpens, Marc A.M.R.M. Focquet, Almino Ramos, Manoel Galvano Nato, Thiago Vidal, Amin Andalib, Aya Siblini, Lorenzo Ferri, Lina Abdarabo, Yehonatan Nevo, Radu Pescarus, Wah Yang, Hosam Hamed, Arnaud Liagre, Damien Bergeat, De Montrichard Marie, Francesco Martini, François Regis, Laurent Genser, Mehdi Skalli, Marius Nedelcu, Milan Smejkal, Radwan Kassir, Regenet Nicolas, Christine Stier, Dan-Sebastian Nedelcut, Grigorios Christodoulidis, Amar Vennapusa, Mohammad Kermansaravi, Asnat Raziel, Nasser Sakran, Alberto Oldani, Cristian Eugeniu Boru, Fouzia Mécheri, Francesca Ciccarese, Giovanni Carlo Cesana, Mario Musella, Matteo Uccelli, Mirto Foletto, Pasquale Auricchio, Stefano Olmi, Yosuke Seki, Anne Kasteleijn, Gerhard Van 'T Hof, Jan A. Apers, Judith W.H. Hart, Justin S.L. Van De Sande, Marijn Takkenberg, Pierre B.G.M. Feskens, Rob Snoekx, Victor D. Plat, Jorunn Sandvik, Piotr Kalinowski, Celso Nabais, Ahmed Z. Al-Bahrani, Mohammad Al Zoubi, Carla Bettonica, Javier Osorio, Javier Tejedor-Tejada, Lourdes M. Sanz, Marta Cuadrado, Rajesh Gianchandani Moorjani, Fringeli Yannick, Michel Suter, Yves Borbély, Zehetner Joerg, Juan S. Barajas-Gamboa, Matthew Kroh, Aaron P. Kisiel, Anna Kamocka, Arul Immanuel, Bruno Sgromo, Bussa Gopinath, David Khoo, Samrat Mukherjee, Dimitrios Pournaras, Tim Underwood, Ewen A. Griffiths, Glenn V. Miller, Helen Jaretzke, Jan Dmitrewski, Martin S. Wadley, Ragad Al-Housni, Richard S. Gillies, Rishi Singhal, Shaun R. Preston, Steven John Robinson, William J. Hawkins, Marco Adamo, Mohamed El Kalaawy, James Gossage, Christopher B. Crawford, Veeravich Jaruvongvanich, Parmar, C., Zakeri, R., Abouelazayem, M., Shin, T. H., Aminian, A., Mahmoud, T., Abu Dayyeh, B. K., Wee, M. Y., Fischer, L., Daams, F., Mahawar, K., Gallardo, C. S., Agustin, C., Wright, F., Fuente, I., Carbajo, M., Cal, P., Chisholm, J., Kow, L., Tan, M. H. L., Gan, P., Gananadha, S., Felsenreich, D. M., Prager, G., Matthys, C., Himpens, J. M., Focquet, M. A. M. R. M., Ramos, A., Nato, M. G., Vidal, T., Andalib, A., Siblini, A., Ferri, L., Abdarabo, L., Nevo, Y., Pescarus, R., Yang, W., Hamed, H., Liagre, A., Bergeat, D., Marie, D. M., Martini, F., Regis, F., Genser, L., Skalli, M., Nedelcu, M., Smejkal, M., Kassir, R., Nicolas, R., Stier, C., Nedelcut, D. -S., Christodoulidis, G., Vennapusa, A., Kermansaravi, M., Raziel, A., Sakran, N., Oldani, A., Boru, C. E., Mecheri, F., Ciccarese, F., Cesana, G. C., Musella, M., Uccelli, M., Foletto, M., Auricchio, P., Olmi, S., Seki, Y., Kasteleijn, A., Van 'T Hof, G., Apers, J. A., Hart, J. W. H., Van De Sande, J. S. L., Takkenberg, M., Feskens, P. B. G. M., Snoekx, R., Plat, V. D., Sandvik, J., Kalinowski, P., Nabais, C., Al-Bahrani, A. Z., Al Zoubi, M., Bettonica, C., Osorio, J., Tejedor-Tejada, J., Sanz, L. M., Cuadrado, M., Moorjani, R. G., Yannick, F., Suter, M., Borbely, Y., Joerg, Z., Barajas-Gamboa, J. S., Kroh, M., Kisiel, A. P., Kamocka, A., Immanuel, A., Sgromo, B., Gopinath, B., Khoo, D., Mukherjee, S., Pournaras, D., Underwood, T., Griffiths, E. A., Miller, G. V., Jaretzke, H., Dmitrewski, J., Wadley, M. S., Al-Housni, R., Gillies, R. S., Singhal, R., Preston, S. R., Robinson, S. J., Hawkins, W. J., Adamo, M., El Kalaawy, M., Gossage, J., Crawford, C. B., Jaruvongvanich, V., Surgery, CCA - Cancer Treatment and quality of life, Amsterdam Gastroenterology Endocrinology Metabolism, and Plastic, Reconstructive and Hand Surgery

Subjects
Adult, obesity, Sleeve gastrectomy, medicine.medical_specialty, Palliative treatment, bariatric surgery, esophageal cancer, esophagogastric cancer, gtastric cancer, metabolic surgery, adult, female, gastrectomy, humans, middle aged, retrospective studies, treatment outcome, gastric bypass, morbid, stomach neoplasms, medicine.medical_treatment, Esophageal cancer, Esophagogastric cancer, Population, Gastric Bypass, Bariatric Surgery, Gastrectomy, Stomach Neoplasms, medicine, Humans, In patient, Adjustable gastric band, education, Retrospective Studies, Bariatric surgery, education.field_of_study, business.industry, Cancer, Middle Aged, medicine.disease, Obesity, Obesity, Morbid, Surgery, Treatment Outcome, Adenocarcinoma, Female, Metabolic surgery, Gastric cancer, business
Abstract

Background Bariatric surgery can influence the presentation, diagnosis, and management of gastrointestinal cancers. Oesophago-Gastric (OG) malignancies in patients who have had a prior bariatric procedure have not been fully characterised. Objective To characterise OG malignancies after bariatric procedures. Setting University Hospital, United Kingdom. Methods We performed a retrospective, multi-centre observational study of patients with OG malignancies after bariatric surgery to characterise this condition. Results This study includes 170 patients from 75 centres in 25 countries who underwent bariatric procedures between 1985 and 2020. At the time of the bariatric procedure, the mean age was 50.2 ± 10 years and the mean weight 128.8 ± 28.9 kg. Females comprised 57.3% (n=98) of the population. Most (n=64) patients underwent a Roux-en-Y Gastric Bypass (RYGB) followed by Adjustable Gastric Band (AGB) (n = 46) and Sleeve Gastrectomy (SG) (n = 43). Time to cancer diagnosis after bariatric surgery was 9.5 ± 7.4 years and mean weight at diagnosis was 87.4 ± 21.9 kg. The time lag was 5.9 ± 4.1 years after SG compared to 9.4 ± 7.1 years after RYGB and 10.5 ± 5.7 years after AGB. One-third of patients presented with metastatic disease. The majority of tumours were adenocarcinoma (82.9%). Approximately 1 in 5 patients underwent palliative treatment from the outset. Time from diagnosis to mortality was under one year for most patients who died over the intervening period. Conclusions The OGMOS (Oesophago-Gastric Malignancies after Obesity/ Bariatric Surgery) study presents the largest series to date of patients developing OG malignancies after bariatric surgery and attempts to characterise this condition.

Published
2022

30. Rail higher education in Europe: current situation analysis for future developments

Author

Arbra Bardhi, Borna Abramović, Marin Marinov, Reem Hadeed, Igor Dömény, Anna Dolinayova, Carlos Casanueva Perez, Martin Lehnert, Francesco Martini, Anne-Katrin Osdoba, Stefano Ricci, and Denis Šipuš

Subjects
railway, training, education, higher education, ERASMUS+, Europe
Abstract

The paper aims at describing the activities developed within the project ASTONRAIL (Advanced approaches and practices for rail training and education to innovate rail study programmes & improve rail higher education provision), funded by ERASMUS+ Programme. The project target is to provide a portfolio of new rail skills development strategies, approaches and professional practices in order to strengthen and modernize Europe’s current rail higher education system.

Published
2023

32. Revisional One Anastomosis Gastric Bypass with a 150-cm Biliopancreatic Limb After Failure of Adjustable Gastric Banding: Mid-Term Outcomes and Comparison Between One- and Two-Stage Approaches

Author

Olivier Van Haverbeke, Celine Hamid, Arnaud Liagre, Radwan Kassir, Tarek Debs, Francesco Martini, Hubert Boudrie, Marine Benois, Niccolò Petrucciani, Gildas Juglard, and Gianluca Costa

Subjects
Adult, Reoperation, One anastomosis gastric bypass, medicine.medical_specialty, Complications, Gastroplasty, Gastric banding, Original Contributions, Endocrinology, Diabetes and Metabolism, Revisional surgery, Gastric bypass, Population, Gastric Bypass, Anastomosis, Weight loss, adjustable gastric banding, bariatric surgery, complications, one anastomosis gastric bypass, revisional surgery, medicine, Humans, Stage (cooking), education, Retrospective Studies, Bariatric surgery, education.field_of_study, Nutrition and Dietetics, business.industry, Anastomosis, Surgical, Middle Aged, Adjustable gastric banding, Obesity, Morbid, Surgery, Treatment Outcome, Laparoscopy, medicine.symptom, business, Complication, Laparoscopic adjustable gastric banding
Abstract

Purpose Laparoscopic adjustable gastric banding (LAGB) was a common procedure worldwide but associated with a high rate of long-term failure. This study aims to evaluate the safety and effectiveness of conversion to one anastomosis gastric bypass (OAGB) after failed LAGB. Materials and Methods We undertook a retrospective analysis of a prospectively maintained database in a tertiary referral center for bariatric surgery. All cases of revisional OAGB with a biliopancreatic limb (BPL) of 150 cm after failed LAGB performed between 2010 and 2016 were analyzed. Results Overall, 215 patients underwent conversion from LAGB to OAGB. Indication for surgery was primary weight loss (WL) failure in 30.7% of cases and long-term complications in the remaining patients, with or without associated weight regain. At the time of OAGB, the mean age was 43.2 ± 10.5 years and the mean BMI was 42 ± 6.9. Overall postoperative morbidity was 13.5%. The postoperative abscess ± leak rate was 5.9% in the overall population. Two years after OAGB, 9.7% of patients were lost to follow-up, % excess weight loss (EWL) was 88.2 ± 23.9, and % total weight loss (TWL) was 38.7 ± 9.3. At 5 years, 16.6% of patients were lost to follow-up, %EWL was 82.4 ± 25, and %TWL was 36.1 ± 10. There was no statistical difference in complication rates or WL results between the one-stage and two-stage approaches. Conclusion OAGB with a 150-cm BPL represents a safe and effective option after failed LAGB. Both synchronous OAGB and two-step revisional OAGB guarantee satisfying results in terms of postoperative morbidity and WL outcomes. Graphical abstract (PLEASE CORRECT THE GRAPHICAL ABSTRACT !!! 215 PATIENTS INSTEAD OF 250

Published
2021

33. Internal Hernia After One Anastomosis Gastric Bypass (OAGB): Lessons Learned from a Retrospective Series of 3368 Consecutive Patients Undergoing OAGB with a Biliopancreatic Limb of 150 cm

Author

Olivier Van Haverbeke, Celine Hamid, Hubert Boudrie, Radwan Kassir, Francesco Martini, Gildas Juglard, Niccolò Petrucciani, and Arnaud Liagre

Subjects
Internal hernia, One anastomosis gastric bypass, medicine.medical_specialty, Complications, Original Contributions, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Gastric bypass, Gastric Bypass, Anastomosis, Humans, Medicine, Obesity, morbid, Retrospective Studies, Bariatric surgery, Nutrition and Dietetics, business.industry, Mortality rate, Incidence (epidemiology), Bowel resection, Obesity, Morbid, Surgery, bariatric surgery, complications, internal hernia, obesity, one anastomosis gastric bypass, humans, retrospective studies, gastric bypass, laparoscopy, Laparoscopy, business, Complication, Body mass index
Abstract

Background Internal hernia (IH) represents a relatively common and well-known complication after Roux-en-Y gastric bypass. IH after one anastomosis gastric bypass (OAGB) is less frequent and rarely reported in the literature. This study presents a series of IH after OAGB observed in a high-volume bariatric center. Methods Data of patients who underwent OAGB with an afferent limb of 150 cm between May 2010 and September 2019 were prospectively collected and retrospectively analyzed. Data of patients undergoing surgery for IH during follow-up were collected and analyzed. Results Ninety-six patients out of 3368 with a history of OAGB had intestinal incarceration in the Petersen’s orifice (2.8%). Specificity and sensitivity of computed tomography scans in the diagnosis of IH were 59% and 76%, respectively. The mean timeframe between OAGB and surgery for IH was 21.9±18.3 months. Mean body mass index at the time of IH surgery was 24.7 ± 3.6. Surgery was completed laparoscopically in 96.8% of cases. Nine patients (9.3%) had signs of bowel hypovascularization. In all patients, the herniated bowel was repositioned, and the Petersen’s orifice was closed, without the need for bowel resection. Mean hospital stay was 1.9 ± 4.8 days. The postoperative morbidity rate was 8.3%. Long-term IH relapse was observed in 14 patients; signs of bowel hypovascularization due to incarceration in a small orifice was observed in eight of these patients (57%). Conclusions Incidence of IH after OAGB is 2.8%. IH is associated with a low rate of bowel ischemia and the need for intestinal resection.

Published
2021

34. Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

Author

Francesco Martini, Tarek Debs, Hubert Boudrie, Yves Anduze, Radwan Kassir, Arnaud Liagre, Stefano Valabrega, Niccolò Petrucciani, and Olivier Van Haverbeke

Subjects
Single-anastomosis duodeno-ileal bypass, Reoperation, medicine.medical_specialty, Sleeve gastrectomy, Complications, Referral, Duodeno-ileal, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Original Contributions, Revisional surgery, Gastric Bypass, 030209 endocrinology & metabolism, anastomosis, Anastomosis, 03 medical and health sciences, 0302 clinical medicine, surgical, Weight loss, Gastrectomy, bariatric surgery, complications, obesity, revisional surgery, single-anastomosis duodeno-ileal bypass, sleeve gastrectomy, anastomosis, surgical, gastrectomy, humans, referral and consultation, reoperation, retrospective studies, treatment outcome, gastric bypass, morbid, medicine, Humans, Obesity, Referral and Consultation, Retrospective Studies, Bariatric surgery, Nutrition and Dietetics, Medical treatment, business.industry, Anastomosis, Surgical, Reflux, Postoperative complication, Surgery, Obesity, Morbid, Treatment Outcome, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract

Background The need for revisional procedures after sleeve gastrectomy (SG) for insufficient weight loss or weight regain, gastroesophageal reflux, or other complications is reported to be 18–36% in studies with 10-year follow-up. Single-anastomosis duodeno-ileal bypass (SADI) may be performed as a revisional procedure after SG. This study aims to evaluate the short- and mid-term outcomes of SADI after SG in a referral center for bariatric surgery. Materials and Methods Data of patients who underwent SADI between March 2015 and March 2020 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 106 patients underwent SADI after a previous SG. The timeframe between SG and SADI was 50 ± 31.3 months. Postoperative mortality was observed in two cases (1.8%) and morbidity in 15.1% of patients. At 24 months, %total weight loss was 37.6 ± 12.3 and %excess weight loss 76.9 ± 25.2 (64 patients). Three patients were treated for malnutrition during follow-up, two with medical treatment and one with SADI reversal. Conclusion SADI after SG provides effective weight loss results in the short-term, even if in the present series the postoperative complication rate was non-negligible. Further trials are needed to establish the more advantageous revisional bariatric procedure after failed SG.

Published
2021

36. OAGB After Sleeve: Gastric Recalibration Is Mandatory

Author

Arnaud Liagre and Francesco Martini

Subjects
Treatment Outcome, Nutrition and Dietetics, Gastrectomy, Endocrinology, Diabetes and Metabolism, Weight Loss, Stomach, Gastric Bypass, Humans, Surgery, Obesity, Morbid, Retrospective Studies
Published
2022

37. Near-field nano-spectroscopy of strong mode coupling in phonon-polaritonic crystals

Author

Xin Hu, Tsz Wing Lo, Andrea Mancini, Christopher R. Gubbin, Francesco Martini, Jian Zhang, Zhongmiao Gong, Alberto Politi, Simone De Liberato, Xuefeng Zhang, Dangyuan Lei, and Stefan A. Maier

Subjects
General Physics and Astronomy
Abstract

Strongly coupled phonon polaritons in patterned polar dielectric nano-resonators give rise to the formation of hybridized energy states with intriguing properties. However, direct observation of mode coupling in these periodic nanostructures is still challenging for momentum-matching-required far-field spectroscopies. Here, we explore the near-field response of strong coupling between propagating and localized polariton modes sustained in SiC phonon polaritonic crystals (PhPCs) to reveal the evolution of Rabi splittings with the change of lattice constant in the near-field perspective. The near-field nano-spectra of PhPCs show distinct Rabi splitting near the forbidden bands of ∼16 cm−1 in the band structures. In particular, an exotic three-polariton-coupling effect is observed with three splitting peaks in the nano-spectra induced by the interaction between local monopolar modes in nano-pillars and zone-folded phonon polaritons. Furthermore, sharp dips indicating weak near-field scatterings appear in nano-spectra at the intrinsic frequencies of the monopolar modes with strong local-field enhancement, which are estimated to be bright scattering peaks intuitively. These results would inspire the dispersion engineering and characterization of coupled phononic nano-resonators for diverse nanophotonic applications.

Published
2022

38. Fire simulation in railway tunnels: towards the design requirements for emergency exits

Author

Francesco Martini, Andrea Quattrini, and Stefano Ricci

Abstract

Emergency exits are one of the most critical elements during fire safety design in railway tunnels, allowing for a quick evacuation from the endangered area to the nearest safe location. At the present-state, there is lack of a comprehensive regulation framework for the design of the ventilation systems protecting the exits from smoke and other by-products during a tunnel fire and the design is normally case-tailored. With the ultimate goal of finding the most appropriate design requirements as the main parameters involved vary, this paper discusses the simulation of two scenarios identified as highly critical for a mixed traffic line: a 10 MW fire of a passenger couch and a 250 MW fire of a freight wagon. The method used is the Computational Fluid Dynamics (CFD) supported by the Fire Dynamics Simulator (FDS). The key requirement is the minimum airflow needed to keep the exits safe according to the variability of parameters, such as position of fire, wind, single or twin tunnel. The scenarios are a short cross-connection between single-track twin tunnels and a connection to a safe zone in a double-track single tunnel. In each case, temperature, pressure and smoke entering the compartment demonstrate to be relevant parameters affecting the results. The results of an extensive simulation campaign pave the ground for next developments aimed at setup a design handbook covering a large set of infrastructure and operation conditions represent a step ahead a recognized standards in railway tunnels design.

Published
2022

45. Endoscopic Kehr’s T-Tube placement to treat persistent large gastro-cutaneous fistula after one anastomosis gastric bypass: video demonstration

Author

Arnaud Liagre, Michel Queralto, Jean Marc Combis, Paulo Peireira, Jane N. Buchwald, Francesco Martini, and Niccolo Petrucciani

Subjects
Gastric Fistula, Nutrition and Dietetics, endoscopy, fistula, one anastomosis gastric bypass, t-tube, video, Cutaneous Fistula, Endocrinology, Diabetes and Metabolism, Gastric Bypass, Middle Aged, Obesity, Morbid, Humans, Female, Surgery
Abstract

Background We aim to show the endoscopic placement of a T-tube to treat a persistent large gastro-cutaneous fistula after OAGB. Methods We present the case of a 46-year-old woman with BMI of 48 kg/m2, who underwent OAGB and was re-operated on the 2nd postoperative day (POD) for leakage. Washing and drainage of the abdominal cavity was performed, and no fistulous orifice was identified. An upper gastrointestinal (GI) endoscopy was performed at POD 20 for the persistence of leakage of 150 ml/day by the drain and a gastric fistulous orifice of 2 cm was detected. Results At POD 22, under general anesthesia, upper GI endoscopy was performed and a T-tube was placed in the fistulous orifice with a “rendez-vous” technique (as demonstrated in the Video), placing the T branch in the digestive lumen pressed against the wall and the long part of the T exiting at the cutaneous orifice. The T-tube was clamped after 3 days and the patient could be gradually re-fed. The patient was discharged 8 days after the procedure, with perfect clinical tolerance and no complications. The ablation of the tube one was performed on POD 84. No relapse occurred during a follow-up of 48 months. Conclusion Persistent large gastro-cutaneous fistulas with an orifice bigger than 1 cm in diameter are difficult to manage. The endoscopic placement of a T-tube seems a useful option, which may facilitate the healing of the fistula. Further studies are needed to better define the role of this procedure.

Published
2022

46. Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols - An analysis from the GENEVA Study

Author

Rishi Singhal, Islam Omar, Brijesh Madhok, Christian Ludwig, Abd A. Tahrani, Kamal Mahawar, Michał Pędziwiatr, Piotr Major, Piotr Zarzycki, Athanasios Pantelis, Dimitris P. Lapatsanis, Georgios Stravodimos, Chris Matthys, Marc Focquet, Wouter Vleeschouwers, Antonio G. Spaventa, Carlos Zerrweck, Antonio Vitiello, Giovanna Berardi, Mario Musella, Alberto Sanchez-Meza, Felipe J. Cantu, Fernando Mora, Marco A. Cantu, Abhishek Katakwar, D. Nageshwar Reddy, Haitham Elmaleh, Mohammad Hassan, Abdelrahman Elghandour, Mohey Elbanna, Ahmed Osman, Athar Khan, Laurent Layani, Nalini Kiran, Andrey Velikorechin, Maria Solovyeva, Hamid Melali, Shahab Shahabi, Ashish Agrawal, Apoorv Shrivastava, Ankur Sharma, Bhavya Narwaria, Mahendra Narwaria, Asnat Raziel, Nasser Sakran, Sergio Susmallian, Levent Karagöz, Murat Akbaba, Salih Zeki Pişkin, Ahmet Ziya Balta, Zafer Senol, Emilio Manno, Michele Giuseppe Iovino, Mohamed Qassem, Sebastián Arana-Garza, Heitor P. Povoas, Marcos Leão Vilas-Boas, Alan Li, Basil J. Ammori, Hany Balamoun, Mohammed Salman, Amrit Manik Nasta, Ramen Goel, Hugo Sánchez-Aguilar, Miguel F. Herrera, Adel Abou-Mrad, Lucie Cloix, Guilherme Silva Mazzini, Leonardo Kristem, Andre Lazaro, Jose Campos, Joaquín Bernardo, Jesús González, Carlos Trindade, Octávio Viveiros, Rui Ribeiro, David Goitein, David Hazzan, Lior Segev, Tamar Beck, Hernán Reyes, Jerónimo Monterrubio, Paulina García, Marine Benois, Radwan Kassir, Alessandro Contine, Moustafa Elshafei, Sueleyman Aktas, Sylvia Weiner, Till Heidsieck, Luis Level, Silvia Pinango, Patricia Martinez Ortega, Rafael Moncada, Victor Valenti, Ivan Vlahović, Zdenko Boras, Arnaud Liagre, Francesco Martini, Gildas Juglard, Manish Motwani, Sukhvinder Singh Saggu, Hazem Al Momani, Luis Adolfo Aceves López, María Angelina Contreras Cortez, Rodrigo Aceves Zavala, Christine D'Haese, Ivo Kempeneers, Jacques Himpens, Andrea Lazzati, Luca Paolino, Sarah Bathaei, Abdulkadir Bedirli, Aydın Yavuz, Çağrı Büyükkasap, Safa Özaydın, Andrzej Kwiatkowski, Katarzyna Bartosiak, Maciej Walędziak, Antonella Santonicola, Luigi Angrisani, Paola Iovino, Rossella Palma, Angelo Iossa, Cristian Eugeniu Boru, Francesco De Angelis, Gianfranco Silecchia, Abdulzahra Hussain, Srivinasan Balchandra, Izaskun Balciscueta Coltell, Javier Lorenzo Pérez, Ashok Bohra, Altaf K. Awan, Paul C. Leeder, Sherif Awad, Waleed Al-Khyatt, Ashraf Shoma, Hosam Elghadban, Sameh Ghareeb, Bryan Mathews, Marina Kurian, Andreas Larentzakis, Gavriella Zoi Vrakopoulou, Konstantinos Albanopoulos, Ahemt Bozdag, Azmi Lale, Cuneyt Kirkil, Mursid Dincer, Ahmad Bashir, Ashraf Haddad, Leen Abu Hijleh, Bruno Zilberstein, Danilo Dallago de Marchi, Willy Petrini Souza, Carl Magnus Brodén, Hjörtur Gislason, Kamran Shah, Antonio Ambrosi, Giovanna Pavone, Nicola Tartaglia, S. Lakshmi Kumari Kona, K. Kalyan, Cesar Ernesto Guevara Perez, Miguel Alberto Forero Botero, Adrian Covic, Daniel Timofte, Madalina Maxim, Dashti Faraj, Larissa Tseng, Ronald Liem, Gürdal Ören, Evren Dilektasli, Ilker Yalcin, Hudhaifa AlMukhtar, Mohammed Al Hadad, Rasmi Mohan, Naresh Arora, Digvijaysingh Bedi, Claire Rives-Lange, Jean-Marc Chevallier, Tigran Poghosyan, Hugues Sebbag, Lamia Zinaï, Saadi Khaldi, Charles Mauchien, Davide Mazza, Georgiana Dinescu, Bernardo Rea, Fernando Pérez-Galaz, Luis Zavala, Anais Besa, Anna Curell, Jose M. Balibrea, Carlos Vaz, Luis Galindo, Nelson Silva, José Luis Estrada Caballero, Sergio Ortiz Sebastian, João Caetano Dallegrave Marchesini, Ricardo Arcanjo da Fonseca Pereira, Wagner Herbert Sobottka, Felipe Eduardo Fiolo, Matias Turchi, Antonio Claudio Jamel Coelho, Andre Luis Zacaron, André Barbosa, Reynaldo Quinino, Gabriel Menaldi, Nicolás Paleari, Pedro Martinez-Duartez, Gabriel Martínez de Aragon Ramírez de Esparza, Valentin Sierra Esteban, Antonio Torres, Jose Luis Garcia-Galocha, Miguel Josa, Jose Manuel Pacheco-Garcia, Maria Angeles Mayo-Ossorio, Pradeep Chowbey, Vandana Soni, Hercio Azevedo de Vasconcelos Cunha, Michel Victor Castilho, Rafael Meneguzzi Alves Ferreira, Thiago Alvim Barreiro, Alexandros Charalabopoulos, Elias Sdralis, Spyridon Davakis, Benoit Bomans, Giovanni Dapri, Koenraad Van Belle, Mazen Takieddine, Pol Vaneukem, Esma Seda Akalın Karaca, Fatih Can Karaca, Aziz Sumer, Caghan Peksen, Osman Anil Savas, Elias Chousleb, Fahad Elmokayed, Islam Fakhereldin, Hany Mohamed Aboshanab, Talal Swelium, Ahmad Gudal, Lamees Gamloo, Ayushka Ugale, Surendra Ugale, Clara Boeker, Christian Reetz, Ibrahim Ali Hakami, Julian Mall, Andreas Alexandrou, Efstratia Baili, Zsolt Bodnar, Almantas Maleckas, Rita Gudaityte, Cem Emir Guldogan, Emre Gundogdu, Mehmet Mahir Ozmen, Deepti Thakkar, Nandakishore Dukkipati, Poonam Shashank Shah, Shashank Subhashchandra Shah, Simran Shashank Shah, Md Tanveer Adil, Periyathambi Jambulingam, Ravikrishna Mamidanna, Douglas Whitelaw, Vigyan Jain, Deepa Kizhakke Veetil, Randeep Wadhawan, Max Torres, Tabata Tinoco, Wouter Leclercq, Marleen Romeijn, Kelly van de Pas, Ali K. Alkhazraji, Safwan A. Taha, Murat Ustun, Taner Yigit, Aatif Inam, Muhammad Burhanulhaq, Abdolreza Pazouki, Foolad Eghbali, Mohammad Kermansaravi, Amir Hosein Davarpanah Jazi, Mohsen Mahmoudieh, Neda Mogharehabed, Gregory Tsiotos, Konstantinos Stamou, Francisco J Barrera Rodriguez, Marco A. Rojas Navarro, Omar MOhamed Torres, Sergio Lopez Martinez, Elda Rocio Maltos Tamez, Gustavo A. Millan Cornejo, Jose Eduardo Garcia Flores, Diya Aldeen Mohammed, Mohamad Hayssam Elfawal, Asim Shabbir, Kim Guowei, Jimmy By So, Elif Tuğçe Kaplan, Mehmet Kaplan, Tuğba Kaplan, DangTuan Pham, Gurteshwar Rana, Mojdeh Kappus, Riddish Gadani, Manish Kahitan, Koshish Pokharel, Alan Osborne, Dimitri Pournaras, James Hewes, Errichetta Napolitano, Sonja Chiappetta, Vincenzo Bottino, Evelyn Dorado, Axel Schoettler, Daniel Gaertner, Katharina Fedtke, Francisco Aguilar-Espinosa, Saul Aceves-Lozano, Alessandro Balani, Carlo Nagliati, Damiano Pennisi, Andrea Rizzi, Francesco Frattini, Diego Foschi, Laura Benuzzi, Chirag Parikh, Harshil Shah, Enrico Pinotti, Mauro Montuori, Vincenzo Borrelli, Jerome Dargent, Catalin A Copaescu, Ionut Hutopila, Bogdan Smeu, Bart Witteman, Eric Hazebroek, Laura Deden, Laura Heusschen, Sietske Okkema, Theo Aufenacker, Willem den Hengst, Wouter Vening, Yonta van der Burgh, Ahmad Ghazal, Hamza Ibrahim, Mourad Niazi, Bilal Alkhaffaf, Mohammad Altarawni, Giovanni Carlo Cesana, Marco Anselmino, Matteo Uccelli, Stefano Olmi, Christine Stier, Tahsin Akmanlar, Thomas Sonnenberg, Uwe Schieferbein, Alejandro Marcolini, Diego Awruch, Marco Vicentin, Eduardo Lemos de Souza Bastos, Samuel Azenha Gregorio, Anmol Ahuja, Tarun Mittal, Roel Bolckmans, Tom Wiggins, Clément Baratte, Judith Aron Wisnewsky, Laurent Genser, Lynn Chong, Lillian Taylor, Salena Ward, Michael W. Hi, Helen Heneghan, Naomi Fearon, Andreas Plamper, Karl Rheinwalt, Justin Geoghegan, Kin Cheung Ng, Krzysztof Kaseja, Maciej Kotowski, Tarig A. Samarkandy, Adolfo Leyva-Alvizo, Lourdes Corzo-Culebro, Cunchuan Wang, Wah Yang, Zhiyong Dong, Manel Riera, Rajesh Jain, Hosam Hamed, Mohammed Said, Katia Zarzar, Manuel Garcia, Ahmet Gökhan Türkçapar, Ozan Şen, Edoardo Baldini, Luigi Conti, Cacio Wietzycoski, Eduardo Lopes, Tadeja Pintar, Jure Salobir, Cengiz Aydin, Semra Demirli Atici, Anıl Ergin, Huseyin Ciyiltepe, Mehmet Abdussamet Bozkurt, Mehmet Celal Kizilkaya, Nezihe Berrin Dodur Onalan, Mariana Nabila Binti Ahmad Zuber, Wei Jin Wong, Amador Garcia, Laura Vidal, Marc Beisani, Jorge Pasquier, Ramon Vilallonga, Sharad Sharma, Chetan Parmar, Lyndcie Lee, Pratik Sufi, Hüseyin Sinan, and Mehmet Saydam

Subjects
obesity, Endocrinology, Diabetes and Metabolism, bariatric surgery, resuming elective surgery, laparoscopy, body mass index, BMI, covid-19, metabolic surgery, obesity surgery, pandemic, Sars-Cov-2, female, gastrectomy, humans, male, pandemics, retrospective studies, treatment outcome, weight loss, gastric bypass, Resuming Elective surgery, Obesity, Morbid, Bariatric surgery, Nutrition and Dietetics, Pandemic, Manchester Cancer Research Centre, SARS-CoV-2, ResearchInstitutes_Networks_Beacons/mcrc, COVID-19, Obesity, Morbid, Obesity surgery, Metabolic surgery, Body Mass Index, Female, Gastrectomy, Humans, Male, Pandemics, Retrospective Studies, Treatment Outcome, Weight Loss, Bariatric Surgery, Gastric Bypass, Laparoscopy
Abstract

Background: It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach. Methods: We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI - Group I (BMI60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed. Results: This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 ± 24.4 Kgs and 43.03 ± 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively. The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass. Conclusion: The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection.

Published
2022

47. Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study (vol 46, pg 2021, 2022)

Author

Pata, Francesco, Di Martino, Marcello, Podda, Mauro, Di Saverio, Salomone, Ielpo, Benedetto, Pellino, ACIE Appy Study Collaborative Abba Julio, Gianluca., Abdullah, Alshamrani, Abdullah, Alturkistani, Abdulrahman, Alghamdi, Abdulrahman, Almalki, Adam, Orengia, Adnan, Kuvvetli, Adolfo, Pisanu, Adrian, Smith, Adriana Michelle Treviño Figueroa, Aeris Jane Nacion, Ahmad, Alhazmi, Ahmad, Bouhuwaish, Ahmad, Khalid, Ahmed, Alsufyani, Ainhoa Valle Rubio, Akshay, Bavikatte, Kumar, Akshay, Al-Radjid, Jamiri, Alberto de San Ildefonso Pereira, Alberto, Porcu, Alberto, Sartori, Aldo, Rocca, Aleksandar, Sretenovic, Anselmo, Alessandro, Alessandro De Luca, Alexandros, Charalabopoulos, Alexios, Tzivanakis, Alfonso, Bandin, Alfonso, Nájar, Alice, Frontali, Alsulaimani, Faisal, Amaia Martínez Roldan, Amal, Hamid, Ana, André, Ana, Minaya-Bravo, Andre, Das, Andrea, Bondurri, Andrea, Costanzi, Lucchi, Andrea, Andrei, Mihailescu, Police, Andrea, Andres Mendoza Zuchini, Angela, Romano, Iossa, Angelo, Antonella, Chessa, Antonella, Tromba, Antonio, Castaldi, Antonio, Brillantino, Antonio, Ferronetti, Giuliani, Antonio, Antonio Ramos-De la Medina, Antonio, Tarasconi, Arcangelo, Picciariello, Argyrios, Ioannidis, Ari, Leppäniemi, Arshad, Rashid, Ashrarur Rahman Mitul, Asif, Mehraj, Asim, Laharwal, Atif, Iqbal, Athanasios, Liarakos, Athanasios, Marinis, Beatriz de Andrés-Asenjo, Belén, Matías-García, DE SIMONE, Belinda, Ben, Creavin, Ben, Stubbs, Brian, Goh, Branislav, Jovanovic, Bruno, Sensi, Carlo, Gazia, Carlos, Cerdán, Carlos Javier Gómez Díaz, Carlos Petrola Chacón, Carlos, Yánez, Carmelo Lo Faro, Caroline, Reinke, Casandra, Dominguez, Charudutt, Paranjape, Charlotte, Thomas, Chia Chi Fung, DE LUCIA, Chiara, Chiu Hiu Fung Jennifer, Christian, Ovalle-Chao, Claudio, Guerci, Cleo, Kenington, Corina, Gica, Cristina, Folliero, Cristopher, Varela, Daniel, Popowich, Daniele, Delogu, Daniele, Zigiotto, Danilo, Vinci, Dario, D'Antonio, David Alessio Merlini, David, Merlini, David, Moro-Valdezate, Deborah, Keller, Diana Cristiana Nicolaescu, Diego, Sasia, Edgar, Rodas, Dimitrios, Linardoutsos, Domenico, Russello, Pedro Alfonso Nájar-Castañeda, Habil Gregor Stavrou, Edoardo, Rosso, Edoardo, Saladino, Edoardo, Ricciardi, Eduardo, Smith-Singares, Efstratia, Baili, Eleftheria, Douka, Guaitoli, Eleonora, Elisa, Francone, Elisa Maria Vaterlini, Elisa Sefora Pierobon, Emilio, Morales, Emilio Peña Ros, Enrico, Benzoni, Enrico, Erdas, Enrico, Pinotti, Enrique, Colás-Ruiz, Ernesto, Laterza, Esteban, Foianini, Eugenia, Cardamone, Eugenio, Licardie, Fabio, Marino, Fahad, Alsofyani, Fahad, Qahtani, Farhan, Khan, Fatlum, Maraska, Fatmir, Saliu, Fausto, Madrid, Fausto, Rosa, Federico, Luvisetto, Felipe, Alconchel, Felipe, Pareja-Ciuro, Fernanda, Neves, Ferdinando, Agresta, Fernando, Cordera, Fernando, Pardo, Fernando, Mendoza-Moreno, Fernando, Munoz-Flores, Francesca Maria Silvestri, Francesca Paola Tropeano, Francesca, Pecchini, Francesca, Serio, Francesco, Colombo, Francesco Di Marzo, Francesco, Ferrara, Francesco, Lancellotti, Francesco, Litta, Francesco, Martini, Francesco, Roscio, Francisco, Blanco-Antona, Francisco Javier Quezada Barcenas, Francisco, Schlottmann, Gabriel, Herrera-Almario, Gabrielle van Ramshorst, Gallo, Gaetano, Gaetano, Luglio, Georgios, Kampouroglou, Georgios, Papadopoulos, Gerardo, Arredondo, Giacomo, Calini, Giampaolo, Formisano, Galiffa, Giampaolo, Gian Marco Palini, Gianluca, Colucci, Gianluca, Pagano, Gianluca, Vanni, Gianmaria Casoni Pattacini, Gianpiero, Gravante, Giorgio, Lisi, Giovanni, Bellanova, Giovanni De Nobili, Giovanni Sammy Necchi, Sinibaldi, Giovanni, Giulia, Bacchiocchi, Giulia, Bagaglini, Maggi, Giulia, Giuliano, Izzo, Giulio, Argenio, Giuseppe, Brisinda, Giuseppe, Esposito, Giuseppe, Frazzetta, Giuseppe Massimiliano De Luca, Nigri, Giuseppe, Giuseppe, Sica, MARTIN DE MERCADO, Gonzalo, Gustavo Armand Ugon, Gustavo, Martinez-Mier, Gustavo Miguel Machain Vega, Gustavo, Nari, Herald, Nikaj, Ignacio, Neri, Igor Alberdi San Roman, Iliya, Fidoshev, Iñaki, Martínez, Ionut, Negoi, Irene, Ortega, Irune Vicente Rodríguez, Isabel, Cornejo, Ismael, Mora-Guzmán, Issam, Al-Najami, Ivan, Romic, Izaskun, Balciscueta, James, Olivier, Jan, Lammel-Lindemann, Jana, Dziakova, Javier, Salinas, Jelena Pejanovic Jovanovic, Jeryl Anne Silvia Reyes, Joanne, Salas, Jose Antonio Diaz-Elizondo, Jose Gustavo Parreira, Juan, Bellido, Juan, Salamea, Juan Carlos Martín Del Olmo, Juliana María Ordoñez, Sofi, Junaid, Justin, Davies, Kapil, Sahnan, Kebebe, Bekele, Kelvin, Voon, Leandro, Siragusa, Lorenzo, Petagna, Ferrario, Luca, Luca, Giordano, Luca, Nespoli, Luca, Pio, Lucia, Moletta, Luciano, Curella, Lucio, Taglietti, Luigi, Bonavina, Luigi, Conti, Luis Eduardo Pérez-Sánchez, Luis Felipe Cabrera Vargas, Luis, Sánchez-Guillén, Luis, Tallon-Aguilar, Mansoor, Khan, Marcello Giuseppe Spampinato, Marcelo, Viola, Marcelo Viola Malet, Angrisani, Marco, Marco, Calussi, Marco, Catarci, Marco, Giordano, Marco, Materazzo, Marco, Milone, Marco, Pellicciaro, Marco Vito Marino, María Daniela Moreno Villamizar, Lolli, MARIA GIULIA, Bellini, MARIA IRENE, Maria, Lemma, Maria Michela Chiarello, Mario, Montes-Manrique, Mario, Rodriguez-Lopez, Mario, Serradilla-Martín, Mark, Peter, Marta, Paniagua-García-Señoráns, Martin, Rutegård, Martin, Salö, Massimiliano, Silveri, Massimiliano, Veroux, Matteo, Nardi, Matteo, Rottoli, Matti, Tolonen, Mauricio Pedraza Ciro, Mauricio, Zuluaga, Maurizio, Iacobone, Mauro, Montuori, Mazin, Ali, Melody García Domínguez, Menna Maria Paola, Micaela, Piccoli, Michela, Campanelli, Michele De Rosa, Manigrasso, Michele, Maruccia, Michele, Michele, Torre, Michele, Zuolo, Miguel, Pera, Mihiri, Weerasekera, Mikel, Prieto, Min Myat Thway, Mohamed, Shaat, Mohammad, Azfar, Mostafa, Shalaby, Muhammad Asif Raza, Muhammad Umar Younis, Muhammed, Elhadi, Mujahid, Ali, Musab, Althomali, Nadiah Al Amri, Nagendra, Dudi-Venkata, Nahar, Alselaim, Neil, Smart, Nelson, Trelles, Nicolò, Falco, Petrucciani, Niccolo', Nicola, Antonacci, Nicola, Cillara, Nicolae, Gica, Nicolò, Pecorelli, Nicolò, Tamini, Nikolaos, Machairas, Nura, Feituri, Nuria Ortega Torrecilla, Octavio Avila Mercado, Ohood, Alaamer, Oktay, Irkorucu, Omar, Alsherif, Oreste Claudio Buonomo, Orestes, Valles-Guerra, Orestis, Ioannidis, Oscar Isaac Hernández Palmas, Oscar Sanz Guadarrama, Osman, Bozbiyik, Pablo, Rodrigues, Pamela, Milito, Paolo, Panaccio, Panagiotis, Dorovinis, Paola, Prieto, Paolo, Baroffio, Patrizia, Marsanic, Pawel, Ajawin, Peng Soon Koh, Pietro, Anoldo, Piotr, Major, Qasem, Alharthi, Rashid, Lui, Riccardo, Caruso, Richard, Brady, Rishi, Rattan, Rishi, Singhal, Roberta, Angelico, Roberta Maria Isernia, Roberta, Tutino, Roberto, Peltrini, Rodrigo, Tejos, Roosevelt, Fajardo, Rossella, Elia, Salvador, Morales-Conde, Sami, Benli, Sara, Fuentes, Sara Gortázar de Las Casas, Sara Ortiz de Guzmán Aragón, Sara, Vertaldi, Selmy, Awad, Sergio, Gentilli, Sergio Alberto Weckmann Lujan, Serkan, Tayar, Shabab, Althobaiti, DI GIOVANNI, Silvia, Soliman, Ghedan, Sonia, Pérez-Bertólez, Sonja, Chiappetta, Spiros, Delis, Stefano, Scaringi, Süleyman, Çetinkünar, Stylianos, Kykalos, Syed Muhammad Ali, Sylvia, Krivan, Tak Lit Derek Fung, Tarik, Delko, Tatiana Nicolás López, Tercio De Campos, Teresa Calderón Duque, Teresa, Perra, Theodore, Liakakos, Theodoros, Daskalakis, Tijmen, Koëter, Tiku, Zalla, Tomás Elosua González, Tommaso, Campagnaro, Toure Alpha Oumar, Ugo, Grossi, Valentina, Sosa, Valentina, Testa, Valentina, Tomajer, Valeria, Andriola, Valeria, Tonini, Valerio, Celentano, Voglino, Valerio, Venkateswara Rao Katta, Víctor Hugo García Orozco, Victor, Turrado-Rodriguez, Victor, Visag-Castillo, Victoria, Graham, Viktor, Rachkov, Vincenzo, Papagni, Vincenzo, Vigorita, Virginia Jiménez Carneros, Bellato, Vittoria, Wolf, Bechstein, Yuksel, Altinel, and Zutoia, Balciscueta

Subjects
appendicitis, COVID19
Published
2022

48. Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Author

Singhal, Rishi, Omar, Islam, Madhok, Brijesh, Rajeev, Yashasvi, Graham, Yitka, Tahrani, Abd A, Ludwig, Christian, Wiggins, Tom, Mahawar, Kamal, Michał, Pędziwiatr, Piotr, Major, Piotr, Zarzycki, Athanasios, Pantelis, Dimitris, P Lapatsanis, Georgios, Stravodimos, Chris, Matthys, Marc, Focquet, Wouter, Vleeschouwers, Antonio, G Spaventa, Carlos, Zerrweck, Antonio, Vitiello, Giovanna, Berardi, Mario, Musella, Alberto, Sanchez-Meza, Felipe, J Cantu Jr, Fernando, Mora, Marco, A Cantu, Abhishek, Katakwar, D Nageshwar Reddy, Haitham, Elmaleh, Mohammad, Hassan, Abdelrahman, Elghandour, Mohey, Elbanna, Ahmed, Osman, Athar, Khan, Laurent, Layani, Nalini, Kiran, Andrey, Velikorechin, Maria, Solovyeva, Hamid, Melali, Shahab, Shahabi, Ashish, Agrawal, Apoorv, Shrivastava, Ankur, Sharma, Bhavya, Narwaria, Mahendra, Narwaria, Asnat, Raziel, Nasser, Sakran, Sergio, Susmallian, Levent, Karagöz, Murat, Akbaba, Salih Zeki Pişkin, Ahmet Ziya Balta, Zafer, Senol, Emilio, Manno, Michele Giuseppe Iovino, Mohamed, Qassem, Sebastián, Arana-Garza, Heitor, P Povoas, Marcos Leão Vilas-Boas, Alan, Li, Basil, J Ammori, Hany, Balamoun, Mohammed, Salman, Amrit Manik Nasta, Ramen, Goel, Hugo, Sánchez-Aguilar, Miguel, F Herrera, Adel, Abou-Mrad, Lucie, Cloix, Guilherme Silva Mazzini, Leonardo, Kristem, Andre, Lazaro, Jose, Campos, Joaquín, Bernardo, Jesús, González, Carlos, Trindade, Octávio, Viveiros, Rui, Ribeiro, David, Goitein, David, Hazzan, Lior, Segev, Tamar, Beck, Hernán, Reyes, Jerónimo, Monterrubio, Paulina, García, Marine, Benois, Radwan, Kassir, Alessandro, Contine, Moustafa, Elshafei, Sueleyman, Aktas, Sylvia, Weiner, Till, Heidsieck, Luis, Level, Silvia, Pinango, Patricia Martinez Ortega, Rafael, Moncada, Victor, Valenti, Ivan, Vlahović, Zdenko, Boras, Arnaud, Liagre, Francesco, Martini, Gildas, Juglard, Manish, Motwani, Sukhvinder Singh Saggu, Hazem Al Momani, Luis Adolfo Aceves López, María Angelina Contreras Cortez, Rodrigo Aceves Zavala, Christine, D'Haese, Ivo, Kempeneers, Jacques, Himpens, Andrea, Lazzati, Luca, Paolino, Sarah, Bathaei, Abdulkadir, Bedirli, Aydın, Yavuz, Çağrı, Büyükkasap, Safa, Özaydın, Andrzej, Kwiatkowski, Katarzyna, Bartosiak, Maciej, Walędziak, Santonicola, Antonella, Luigi, Angrisani, Iovino, Paola, Rossella, Palma, Angelo, Iossa, Cristian Eugeniu Boru, Francesco De Angelis, Gianfranco, Silecchia, Abdulzahra, Hussain, Srivinasan, Balchandra, Izaskun Balciscueta Coltell, Javier Lorenzo Pérez, Ashok, Bohra, Altaf, K Awan, Brijesh, Madhok, Paul, C Leeder, Sherif, Awad, Waleed, Al-Khyatt, Ashraf, Shoma, Hosam, Elghadban, Sameh, Ghareeb, Bryan, Mathews, Marina, Kurian, Andreas, Larentzakis, Gavriella Zoi Vrakopoulou, Konstantinos, Albanopoulos, Ahemt, Bozdag, Azmi, Lale, Cuneyt, Kirkil, Mursid, Dincer, Ahmad, Bashir, Ashraf, Haddad, Leen Abu Hijleh, Bruno, Zilberstein, Danilo Dallago de Marchi, Willy Petrini Souza, Carl Magnus Brodén, Hjörtur, Gislason, Kamran, Shah, Antonio, Ambrosi, Giovanna, Pavone, Nicola, Tartaglia, S Lakshmi Kumari Kona, Kalyan, K, Cesar Ernesto Guevara Perez, Miguel Alberto Forero Botero, Adrian, Covic, Daniel, Timofte, Madalina, Maxim, Dashti, Faraj, Larissa, Tseng, Ronald, Liem, Gürdal, Ören, Evren, Dilektasli, Ilker, Yalcin, Hudhaifa, Almukhtar, Mohammed Al Hadad, Rasmi, Mohan, Naresh, Arora, Digvijaysingh, Bedi, Claire, Rives-Lange, Jean-Marc, Chevallier, Tigran, Poghosyan, Hugues, Sebbag, Lamia, Zinaï, Saadi, Khaldi, Charles, Mauchien, Davide, Mazza, Georgiana, Dinescu, Bernardo, Rea, Fernando, Pérez-Galaz, Luis, Zavala, Anais, Besa, Anna, Curell, Jose, M Balibrea, Carlos, Vaz, Luis, Galindo, Nelson, Silva, José Luis Estrada Caballero, Sergio Ortiz Sebastian, João Caetano Dallegrave Marchesini, Ricardo Arcanjo da Fonseca Pereira, Wagner Herbert Sobottka, Felipe Eduardo Fiolo, Matias, Turchi, Antonio Claudio Jamel Coelho, Andre Luis Zacaron, André, Barbosa, Reynaldo, Quinino, Gabriel, Menaldi, Nicolás, Paleari, Pedro, Martinez-Duartez, Gabriel Martínez de Aragon Ramírez de Esparza, Valentin Sierra Esteban, Antonio, Torres, Jose Luis Garcia-Galocha, Miguel, Josa, Jose Manuel Pacheco-Garcia, Maria Angeles Mayo-Ossorio, Pradeep, Chowbey, Vandana, Soni, Hercio Azevedo de Vasconcelos Cunha, Michel Victor Castilho, Rafael Meneguzzi Alves Ferreira, Thiago Alvim Barreiro, Alexandros, Charalabopoulos, Elias, Sdralis, Spyridon, Davakis, Benoit, Bomans, Giovanni, Dapri, Koenraad Van Belle, Mazentakieddine, Pol, Vaneukem, Esma Seda Akalın Karaca, Fatih Can Karaca, Aziz, Sumer, Caghan, Peksen, Osman Anil Savas, Elias, Chousleb, Fahad, Elmokayed, Islam, Fakhereldin, Hany Mohamed Aboshanab, Talal, Swelium, Ahmad, Gudal, Lamees, Gamloo, Ayushka, Ugale, Surendra, Ugale, Clara, Boeker, Christian, Reetz, Ibrahim Ali Hakami, Julian, Mall, Andreas, Alexandrou, Efstratia, Baili, Zsolt, Bodnar, Almantas, Maleckas, Rita, Gudaityte, Cem Emir Guldogan, Emre, Gundogdu, Mehmet Mahir Ozmen, Deepti, Thakkar, Nandakishore, Dukkipati, Poonam Shashank Shah, Shashank Subhashchandra Shah, Simran Shashank Shah, Md Tanveer Adil, Periyathambi, Jambulingam, Ravikrishna, Mamidanna, Douglas, Whitelaw, Vigyan, Jain, Deepa Kizhakke Veetil, Randeep, Wadhawan, Max, Torres, Tabata, Tinoco, Wouter, Leclercq, Marleen, Romeijn, Kelly van de Pas, Ali, K Alkhazraji, Safwan, A Taha, Murat, Ustun, Taner, Yigit, Aatif, Inam, Muhammad, Burhanulhaq, Abdolreza, Pazouki, Foolad, Eghbali, Mohammad, Kermansaravi, Amir Hosein Davarpanah Jazi, Mohsen, Mahmoudieh, Neda, Mogharehabed, Gregory, Tsiotos, Konstantinos, Stamou, Francisco, J Barrera Rodriguez, Marco, A Rojas Navarro, Omar MOhamed Torres, Sergio Lopez Martinez, Elda Rocio Maltos Tamez, Gustavo, A Millan Cornejo, Jose Eduardo Garcia Flores, Diya Aldeen Mohammed, Mohamad Hayssam Elfawal, Asim, Shabbir, Kim, Guowei, Jimmy By So, Elif Tuğçe Kaplan, Mehmet, Kaplan, Tuğba, Kaplan, Dangtuan, Pham, Gurteshwar, Rana, Mojdeh, Kappus, Riddish, Gadani, Manish, Kahitan, Koshish, Pokharel, Alan, Osborne, Dimitri, Pournaras, James, Hewes, Errichetta, Napolitano, Sonja, Chiappetta, Vincenzo, Bottino, Evelyn, Dorado, Axel, Schoettler, Daniel, Gaertner, Katharina, Fedtke, Francisco, Aguilar-Espinosa, Saul, Aceves-Lozano, Alessandro, Balani, Carlo, Nagliati, Damiano, Pennisi, Andrea, Rizzi, Francesco, Frattini, Diego, Foschi, Laura, Benuzzi, Chirag, Parikh, Harshil, Shah, Enrico, Pinotti, Mauro, Montuori, Vincenzo, Borrelli, Jerome, Dargent, Catalin, A Copaescu, Ionut, Hutopila, Bogdan, Smeu, Bart, Witteman, Eric, Hazebroek, Laura, Deden, Laura, Heusschen, Sietske, Okkema, Theo, Aufenacker, Willem den Hengst, Wouter, Vening, Yonta van der Burgh, Ahmad, Ghazal, Hamza, Ibrahim, Mourad, Niazi, Bilal, Alkhaffaf, Mohammad, Altarawni, Giovanni Carlo Cesana, Marco, Anselmino, Matteo, Uccelli, Stefano, Olmi, Christine, Stier, Tahsin, Akmanlar, Thomas, Sonnenberg, Uwe, Schieferbein, Alejandro, Marcolini, Diego, Awruch, Marco, Vicentin, Eduardo Lemos de Souza Bastos, Samuel Azenha Gregorio, Anmol, Ahuja, Tarun, Mittal, Roel, Bolckmans, Tom, Wiggins, Clément, Baratte, Judith Aron Wisnewsky, Laurent, Genser, Lynn, Chong, Lillian, Taylor, Salena, Ward, Michael, W Hi, Helen, Heneghan, Naomi, Fearon, Andreas, Plamper, Karl, Rheinwalt, Justin, Geoghegan, Kin Cheung Ng, Krzysztof, Kaseja, Maciej, Kotowski, Tarig, A Samarkandy, Adolfo, Leyva-Alvizo, Lourdes, Corzo-Culebro, Cunchuan, Wang, Wah, Yang, Zhiyong, Dong, Manel, Riera, Rajesh, Jain, Hosam, Hamed, Mohammed, Said, Katia, Zarzar, Manuel, Garcia, Ahmet Gökhan Türkçapar, Ozan, Şen, Edoardo, Baldini, Luigi, Conti, Cacio, Wietzycoski, Eduardo, Lopes, Tadeja, Pintar, Jure, Salobir, Cengiz, Aydin, Semra Demirli Atici, Anıl, Ergin, Huseyin, Ciyiltepe, Mehmet Abdussamet Bozkurt, Mehmet Celal Kizilkaya, Nezihe Berrin Dodur Onalan, Mariana Nabila Binti Ahmad Zuber, Wei Jin Wong, Amador, Garcia, Laura, Vidal, Marc, Beisani, Jorge, Pasquier, Ramon, Vilallonga, Sharad, Sharma, Chetan, Parmar, Lyndcie, Lee, Pratik, Sufi, Hüseyin, Sinan, and Mehmet, Saydam

Subjects
Nutrition and Dietetics, Manchester Cancer Research Centre, SARS-CoV-2, ResearchInstitutes_Networks_Beacons/mcrc, Endocrinology, Diabetes and Metabolism, obesity, older patients, resuming elective surgery, metabolic surgery, Resuming elective surgery, Bariatric Surgery, COVID-19, Metabolic surgery, Obesity, Older patients, Aged, Humans, Pandemics, Postoperative Complications, Prospective Studies, Obesity, Morbid, Surgery, Morbid
Abstract

Background Age ≥ 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort. Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups — patients ≥ 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality. Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 ± 2.5 years, 119.5 ± 24.5 kg, and 43 ± 7 in Group I and 39.8 ± 11.3 years, 117.7±20.4 kg, and 43.7 ± 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I (11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups. Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those ≥ 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups. Graphical abstract

Published
2022

49. Treatment of Persistent Large Gastrocutaneous Fistulas After Bariatric Surgery: Preliminary Experience with Endoscopic Kehr's T-Tube Placement

Author

Arnaud Liagre, Michel Queralto, Jonathan Levy, Jean Marc Combis, Paulo Peireira, Jane N. Buchwald, Gildas Juglard, Niccolò Petrucciani, and Francesco Martini

Subjects
Gastric Fistula, Male, Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism, bariatric surgery, endoscopy, kehr's t-tube, large gastrocutaneous fistula, leak, pigtail drain, Bariatric Surgery, Endoscopy, Obesity, Morbid, Drainage, Humans, Surgery, Female
Abstract

Purpose Post-bariatric surgery gastrocutaneous fistula is a chronic leak with an incidence of 1.7 to 4.0% and no standardized management. A large gastrocutaneous fistula (LGCF) is not indicated for treatment with pigtail drains. We aimed to evaluate results of a novel treatment using endoscopic Kehr’s T-tube placement. Methods Only patients with a postoperative LGCF duration of > 10 days and a flow rate of > 50 cc by external drainage after revisional surgery for sepsis were included. Endoscopic placement of Kehr’s T-tube was performed. Patients had been reoperated with wash and drainage for severe sepsis after initial bariatric surgery in which no fistula had been discovered. Patients not reoperated, or with a fistula requiring intraoperative Kehr’s T-tube placement, or a pigtail drain were excluded. Primary outcomes were endoscopic characteristics and results (LGCF closure rate, Kehr T-tube retention time, etc.). Results The study group included 12 women, 2 men; body mass index 43.1 ± 4.5 kg/m2. Interventions were SG (7), RYGB (2), OAGB (4), and SADI-S (1). Endoscopic assessment was carried out after a mean of 33.2 ± 44.3 days after the bariatric procedure. The mean fistula orifice diameter was 2.0 ± 0.9 cm. Kehr’s T-tube was positioned at a mean 51.5 ± 54.8 days after the bariatric procedure. T-tube tolerance was excellent. Mean additional days: hospitalization, 34.4 ± 27.0; T-tube retention, 86.4 ± 73.1; fistula healing, 139.9 ± 111.5, LGCF closure rate, 92.9%. Complications: 1 pulmonary embolism, 2 T-tube migrations,1 drain-path bleed, 1 skin abscess. No mortality. Conclusions Endoscopic Kehr’s T-tube placement was successful in closing persistent post-bariatric surgery LGCF in 92.9% of patients. Graphical abstract

Published
2021

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