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2. Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey
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Shalaby, M, Elsheikh, A, Hamed, H, Null, N, Elsheik, A, Sakr, A, Fouad, A, Kassem, A, Elfeki, H, Madbouly, K, Alzahrani, K, Marzouk, K, Ali, M, Helal, M, Elsorogy, M, Farid, M, Di Lorenzo, N, Sileri, P, Wexner, S, Khafagy, W, Adeyeye, A, El-Hussuna, A, Frontali, A, Saklani, A, Lelpo, B, Molena, D, Pandey, D, Karbovnichaya, E, Pata, F, Van Ramshor, G, Gallo, G, Spolverato, G, Pellino, G, Bagaglini, G, Rubio-Perez, I, Negoi, I, Frigerio, I, Juloski, J, Ninkovic, M, Franceschilli, M, Azer, M, Efetov, S, Ippoliti, S, Garoufalia, Z, Fazli, M, Dogjani, A, Cherfa, H, Omar, T, Minoldo, J, Alvarez Gallesio, J, Quesada, M, Bacher, A, Kropshofer, S, Ponholzer, F, Tesik, P, Gehwolf, P, Isci, S, Uranitsch, S, Berchtold, V, Samadov, E, Abualsel, A, Mitul, A, Islam, S, Vanlander, A, Van Praet, C, Van Daele, E, Vanommeslaeghe, H, Stijns, J, Abosi-Appeadu, K, Depuydt, M, Allaeys, M, Yves, V, Colleoni, R, Slavchev, M, Elbahrawy, A, Luc, J, Milford, K, Romic, I, Monti, A, Haydal, A, Klein, M, Ocklind, M, Hadi, S, Alqasaby, A, Elganash, A, Daibes, A, Elsaied, A, Elhattab, A, Lotfy, A, Alnashar, A, Elnour, A, Abdelhalim, A, Abdelhamid, A, Abdellatif, A, Abdelmohsen, A, Abdelrafee, A, Elhawary, A, Zidan, A, Eleshra, A, Elkafoury, A, Ezz, A, Abdelmomen, A, Elkased, A, Fawzy, A, Elkhouly, A, Hemidan, A, Abbas, A, Ismail, A, Attia, A, Farid, A, Elnakash, A, Negida, A, Soliman, A, Taki-Eldin, A, Albadry, A, Sanad, A, Elbatal, A, Elgazar, A, Saleh, A, Fahiem, A, Mohamed, A, Nageeb, A, Elmetwally, A, Alkhalegy, A, El-Wakeel, A, Shemes, A, Fadel, B, Lutfi, B, Ali, D, Abolnasr, K, Gamal, E, Abdallah, E, Ahmed, E, Salem, E, Hamed, E, Elshikh, E, Enad, F, Sarhan, F, Abouelnagah, G, Tagg, G, Atef, G, Shaker, G, Beshir, H, Zakaria, H, Barbary, H, Elgendy, H, Sharaf, H, Elnaghi, H, Elghadban, H, Elzayat, I, Fakhr, I, Sallam, I, Abdelmoneim, I, Elnemr, I, Zewar, K, Elalfy, K, Sabet, K, Mansour, K, Osman, K, Elgaly, M, Shams, M, Abozeid, M, Mohammed, M, Elkatt, M, Samaha, M, Mikhael, M, Khalil, M, Alhendawey, M, Elrefai, M, Gabr, M, Fayed, M, Abdelmaksoud, M, Salem, M, Mohamed Mohamed, M, Nabeeh, M, Elsayed, M, Abdelmonem, M, Eldemery, M, Elmesery, M, Fikry, M, Gharbia, M, Omar, M, Elmoghazy, M, Ghazala, M, Hamed, M, Metwally, M, Arnouse, M, Amen, M, Amary, M, Kandel, M, Abuzeid, M, Rabea, M, Sobh, M, Taman, M, Fathy, M, Moustafa, M, Zuhdy, M, Adel, M, Alaa, M, Alawady, M, Edassy, M, Eldesouki, M, Salim, M, Sanad, M, Khalaf, M, Henes, M, Abdelglil, M, Mohmmed, M, Abdelkhalik, M, Shetiwy, M, Elshazli, M, Hegazy, M, Ahmed, M, Abdelhalim, M, Shahein, M, Sofan, M, Hammad, M, Ahmad, M, Milad, N, Farouk, N, Eldesouky, O, Mohamed, O, Mahadel, O, Gaarour, O, Torky, R, Elhafez, R, Adly, R, Nageeb, R, Hamdi, S, Gamal, S, Emile, S, Regal, S, Abdelrasheed, S, Elzeftawy, S, Khashshan, S, Ashraf, T, Khafagy, T, Nabil, T, Abdelazim, T, Rizk, T, Amr, W, Yousef, Y, Youssef, Y, Castaldi, A, Fiore, A, Hasani, A, Mariani, A, Dagorno, C, Antonio, D, Izzo, G, Addari, G, Mangiameli, G, Rea, L, Pio, L, Paci, M, Andrea, P, De Fatico, G, Elvira, T, Schuldes, A, Rihan, E, Moeslein, G, Lederhuber, H, Botros, I, Jaman, I, Doerner, J, Elseberbihy, J, Sherbiny, K, Ghonim, M, Mikrish, A, Aziz, M, Hatm, M, Archid, R, Gendy, S, Ahmad, S, Charalabopoulos, A, Prodromidou, A, Ioannidis, A, Mpaili, E, Boukorou, G, Papadopoulos, G, Liakakos, T, Styliani, V, Agrawal, A, Jain, A, Rashid, A, Mehraj, A, Brahmachari, S, Lakshmi, H, Vishwakarma, K, Parida, L, Sharma, M, Zaieem, M, Makasarwala, M, Nittala, R, Kumar, S, Vikrantmr, S, Junaid, S, Khuller, S, More, V, Ahmed, A, Alomieri, A, Alhamdany, A, Del, M, Najm, G, Lateef, N, Mcnamara, D, Abdelmageed, M, Majeed, M, Troci, A, Porcu, A, Marano, A, Di Bartolomeo, A, Giani, A, Giardino, A, Canfora, A, Balla, A, Barberis, A, Belli, A, Borasi, A, Manetti, A, Mingoli, A, Morini, A, Maurizi, A, Marra, A, Epifani, A, Iossa, A, Parello, A, Guida, A, Maffioli, A, Scafa, A, Spinelli, A, Matarangolo, A, Picciariello, A, Pirozzi, B, Cirillo, B, Gazia, C, Ratto, C, 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R, Rimonda, R, Di Saverio, S, Di Carlo, S, Perra, T, Campagnaro, T, Testa, V, Andriola, V, Grappelli, V, Capizzi, V, Chiarella, V, Bellato, V, Yanaga, K, Farouk, M, Uraiqat, A, Almasri, M, Nabwana, A, Siboe, M, W, N, Njoroge, G, Ilkul, J, Obure, R, Palkhi, Y, Alkhayat, A, Ali, A, Malek, A, Abdelsayed, E, Zahra, T, Ayoub, L, Sleilati, F, Aoun, R, Algatanesh, N, Fieturi, N, Ng, J, Díaz, A, Duran, E, Guerrero, J, Jasso, M, Flores, M, Felix, M, Angulo, V, Mejdane, A, Aitali, A, Amal, B, Zentar, A, Bensaad, A, Yacir, E, Jawad, F, Rachid, M, Maliki-Alaoui, M, Ouadii, M, Mohammed, O, Thein, N, Koirala, D, Hilling, D, Pouwels, S, Okunlola, A, Adejumo, A, Akinmade, A, Shittu, A, Oluyomi, A, Abiodun, A, Lawal, B, Odion, C, Popoola, A, Jolayemi, E, Shomoye, E, Wuraola, F, Eke, G, Abiyere, H, Oluwasuyi, I, George, I, Njokanma, I, Aremu, I, Dare, J, Abdur-Rahman, L, Oludara, M, Mohammad, M, Adeoluwa, O, Situ, O, Agbonrofo, P, Kewulere, R, Aliyu, Y, Adebowale, Y, Galala, A, Rao, S, Waleed, A, Inam, A, Shaikh, A, Qureshi, A, Muhammad, A, Kerawala, A, Aslam, M, Mehr, A, Javed, A, Ahmad, F, Majid, H, Ahmed, H, Daudi, I, Akhtar, K, Niaz, K, Anwer, M, Amir, M, Hanif, M, Asif, M, Raza, M, Khokhar, M, Jameel, M, Nasir, M, Shafique, M, Ateeb, M, Nadeem, M, Shah, R, Waqar, S, Shah, S, Waseem, T, Ghafoor, T, Fatima, T, Bashir, U, Gonzales, E, Ruiz, L, Freitas, C, De Sousa, X, Al-Bahrani, A, Portela, C, Elgazar, E, Robles, E, Khan, I, Jarboa, L, Khawar, M, Echevarria, M, Bashah, M, Dawdi, S, Musthafa, S, Ali, S, Ciubotaru, C, Bonci, E, Muresan, M, Bogdan, S, Ioan, T, Zubayraeva, A, Derinov, A, Zakharenko, A, Novikova, A, Bashlachev, A, Kaldarov, A, Stanislav, B, Gorin, D, Puzenko, D, Kazachenko, E, Ashimov, E, Medkova, I, Ignatov, I, Sergeevich, K, Sidorova, L, Kiselev, M, Danilov, M, Aleksandr, O, Rodimov, S, Garmanovs, T, Kitsenko, Y, Valery, N, Japhet, N, Sibiany, A, Saadeldin, A, Abuosba, A, Alawadhi, A, Alharbi, A, Althumali, A, Alghuliga, A, Alotaibi, A, Abduraboh, A, Kateb, A, Sindy, A, Al Eisa, A, Almulhim, A, Aljawhari, A, Abozeid, A, Saad, A, Alqarni, A, Alwan, A, Alwusaibie, A, Bafaraj, A, Eldeeb, A, Tarabay, A, Alhedaithy, A, Almaghrabi, A, Abed, A, Abdullah, A, Semilan, A, Farag, M, Khudhayr, E, Hussain, M, Abbas, G, Alqudaihi, H, Abualnaja, Y, Shaheen, A, Mubarak, A, Ali, B, Alhazmi, B, Hijazi, B, Abdulrahman, C, Oyedepo, C, Alzamel, H, Tairab, E, Alsuwaimel, M, Hejazi, S, Alnoqaidan, E, Alhussien, F, Jallad, F, Khadwardi, F, Alghamdi, F, Haddad, F, Sauri, F, Alafghani, H, Alfalah, H, Gad, H, Aboelmagid, H, Ibrahim, H, Elzayady, H, Sharafeldin, H, Sembawa, H, Alabbas, H, Abbas, H, Elgamal, H, Alawfi, H, Al-Sadery, H, Abdelmotaleb, H, Al Hassn, I, Mudawi, I, Nekhala, I, Elsanhoury, K, Said, K, Albeshri, K, Albahooth, K, Mohammed, K, Asar, K, Osman, L, Alzamanan, M, Alnabarawi, M, Althobaiti, M, Al Naeb, M, Hassan, M, Abdelhamid, M, Alyami, M, Mirza, M, Sayouh, M, Alkhayat, M, Basendowah, M, Ghunaim, M, Alhussaini, M, Khoj, M, Sbaih, M, Saeed, M, Abdelaziz, N, Malibary, N, Abdo, N, Amer, N, Al Turki, N, Durayb, N, Yassin, N, Akeel, N, Larbi, N, Alsallum, O, Suliman, O, Elsherbiny, O, Abusalem, O, Albalawi, I, Abutalib, R, Alarabi, R, Khan, R, Alazzam, S, Alghamdi, S, Alsawat, S, Salim, S, Alshukr, S, Alzahrani, S, Golea, S, Alowairdhi, T, Salman, U, Abusiam, W, Abualkhair, W, Saber, W, Tashkandi, W, Alhazmi, W, Yassine, W, Alshabi, Y, Ibrahim, Y, Shahin, Y, Aljathlany, Y, Alnahas, Y, Alrashidi, Y, Wali, Z, Ndong, A, Ba, M, Faye, P, Arbutina, D, Milic, L, Cuk, V, Hussein, A, Mccaul, J, Bertels, L, Pohl, L, Arnold, M, Mbatani, N, Oosthuizen, P, Rayamajhi, S, Vosloo, S, Jooma, U, Landaluce-Olavarria, A, Vázquez-Melero, A, Marcos, A, Puerto Puerto, A, De La Hermosa, A, Senent-Boza, A, Ugarte-Sierra, B, Montalbán, B, Martin-Perez, B, Gomez, C, Colás-Ruiz, E, Santos, E, Senra, F, Mora-Guzmán, I, Dziakova, J, Díaz, J, Silva, J, Laina, J, Tallon-Aguilar, L, Di Martino, M, Chacón, M, Frasson, M, Calvo, M, Millan, M, Tejedoe, P, Pérez-Bertólez, S, Turrado-Rodríguez, V, Elsanosi, A, Abdalbakheet, D, Salim, O, Youssef, M, Barbon, C, Bouchrika, A, Maghrebi, H, Loukil, I, Yildiz, A, Dursun, A, Gulcu, B, Calik, B, Eral, B, Yeşilyurt, D, Yakar, F, Akin, F, Kilinc, G, Uslu, G, Tuncer, K, Koc, M, Leventoğlu, S, Sokmen, S, Atici, S, Kaya, T, Dere, Ü, Kırmızı, Y, Ssenono, K, Lule, H, Mbiine, R, Hamza, A, Peediyakkal, S, Varma, G, Mussa, H, Al-Masari, H, Shehata, M, Seiam, M, Nimir, N, Khare, R, Rashid, S, Kazim, S, Gondal, Z, Sherif, A, Ghanem, A, Helmy, A, Ibrahim, A, Elshaer, A, Marzouk, A, Tamburrini, A, Parente, A, Light, A, Diamantopoulou, A, Singh, B, Gurung, B, Frauenfelder, C, Leo, C, Raptis, D, Thakrar, D, Madhuri, T, Tsounaki, E, Garreffa, E, Soggiu, F, Stavrou, G, Ng, H, Tabasi, H, Nasef, H, Kostakis, I, Jeffery, J, Warusavitarne, J, Lund, J, Qurashi, K, Sahnan, K, Tong, K, Orecchia, L, Kaur, M, Zaidi, M, Ganau, M, Curtis, N, Bhatt, N, Machairas, N, Zafar, N, Toma, O, Sarmah, P, Bassuni, M, Davies, J, Shawer, S, Lewis, S, Subramanian, S, Nadeem, U, Njau, A, Tohamy, A, Pakula, A, Simioni, A, Jarvis, B, Skandalakis, G, Hesham, H, Isaiah, I, Villwock, J, Martin, L, Kress, M, Sebelik, M, Lathan, S, Towfigh, S, Holubar, S, Demeester, S, Alshehari, M, Ghabisha, S, Abdulatef, S, Al-Kubati, W, Obadiel, Y, Gots, A, Nakazwe, M, Chipaila, J, Mazingi, D, Shalaby, Mostafa, ElSheikh, Ahmed M., Hamed, Hosam, null, null, Elsheik, Ahmed, Sakr, Ahmad, Fouad, Amgad, Kassem, Amr, Elfeki, Hossam, Madbouly, Khaled, Alzahrani, Khalid H., Marzouk, Khalid, Ali, Mahmoud, Helal, Mohamed Alaa Abdelmoez, Elsorogy, Mohamed, Farid, Mohamed, Di Lorenzo, Nicola, Sileri, Pierpaolo, Wexner, Steven, Khafagy, Wael, Adeyeye, Ademola, El-Hussuna, Alaa, Frontali, Alice, Saklani, Avanish, Lelpo, Benedettao, Molena, Daniela, Pandey, Diwakar, Karbovnichaya, Elena, Pata, Francesco, Van Ramshor, Gabrielle H., Gallo, Gaetano, Spolverato, Gaya, Pellino, Gianluca, Bagaglini, Giulia, Rubio-Perez, Ines, Negoi, Ionut, Frigerio, Isabella, Juloski, Jovan, Ninkovic, Marijana, Franceschilli, Marzia, Azer, Mina, Efetov, Sergey, Ippoliti, Simona, Garoufalia, Zoe, Fazli, Mohammad Rafi, Dogjani, Agron, Cherfa, Harieche Abdennour Abderahim, Omar, Tilioua, Minoldo, Javier, Alvarez Gallesio, José Maria, Quesada, Matias, Bacher, Annica, Kropshofer, Stephan, Ponholzer, Florian, Tesik, Philip, Gehwolf, Philipp, Isci, Sevim, Uranitsch, Stefan, Berchtold, Valeria, Samadov, Elgun, Abualsel, Abdulmenem, Mitul, Ashrarur Rahman, Islam, S. M. Nazmul, Vanlander, Aude, Van Praet, Charles, Van Daele, Elke, Vanommeslaeghe, Hanne, Stijns, Jasper, Abosi-Appeadu, Kessewa, Depuydt, Martijn, Allaeys, Mathias, Yves, Van Nieuwenhove, Colleoni, Ramiro, Slavchev, Mihail, Elbahrawy, Aly, Luc, Jessica G. Y., Milford, Karen, Romic, Ivan, Monti, Alessio, Haydal, Ashraf, Klein, Mads Falk, Ocklind, Miranda E. K., Hadi, Sabah Anwar, Alqasaby, Abdallah, Elganash, Abdelazim, Daibes, Adel Goda Hussein, Elsaied, Adham, Elhattab, Ahmad, Lotfy, Ahmad, Alnashar, Ahmed, Elnour, Ahmed Abd Elbaset Elsayed Abu, Abdelhalim, Ahmed, Abdelhamid, Ahmed, Abdellatif, Ahmed, Abdelmohsen, Ahmed, Abdelrafee, Ahmed, Elhawary, Ahmed Adel, Zidan, Ahmed Azmy, Eleshra, Ahmed, Elkafoury, Ahmed, Ezz, Ahmed, Abdelmomen, Ahmed Ezzat Elghrieb, Elkased, Ahmed Farag, Fawzy, Ahmed, Elkhouly, Ahmed G., Hemidan, Ahmed Gamal Abouelfetouh Ibrahim, Abbas, Ahmed Hosam Eldin Hasan, Ismail, Ahmed Mahmoud Ahmed, Attia, Ahmed Mohamed, Farid, Ahmed Mohammed, Elnakash, Ahmed Mostafa, Negida, Ahmed, Soliman, Ahmed, Taki-Eldin, Ahmed, Albadry, Ali Almahdy Ali, Sanad, Aly, Elbatal, Amira Alsayed Abdelhai, Elgazar, Amr, Saleh, Amr, Fahiem, Andrew, Mohamed, Anwar Yahya A., Nageeb, Ashraf, Elmetwally, Ashraf S., Alkhalegy, Ayman, El-Wakeel, Ayman, Shemes, Ayman, Fadel, Bashir A., Lutfi, Basma Waseem, Ali, Doaa, Abolnasr, Khaled Samir, Gamal, Ehab, Abdallah, Emad, Ahmed, Emad Ali, Salem, Eman Abdalla Mohamed, Hamed, Esmael Ali, Elshikh, Essam, Enad, Farazdaq, Sarhan, Fetoh Alaaeldin Fetoh, Abouelnagah, Galal, Tagg, Gamal Hassan El, Atef, Gehad, Shaker, George Samir Habib, Beshir, Hatem, Zakaria, Hazem M., Barbary, Hesham, Elgendy, Hesham, Sharaf, Hesham, Elnaghi, Hisham, Elghadban, Hosam, Elzayat, Ibrahim, Fakhr, Ibrahim, Sallam, Ibrahim, Abdelmoneim, Ibrahim Tharwat Mohamed, Elnemr, Islam, Zewar, Karem Shahin Mohamed, Elalfy, Khaled, Sabet, Khaled, Mansour, Khaled Yousery Ibrahim, Osman, Khalid Abdalla Abdelgadir, Elgaly, Maher Elesawi Kamel, Shams, Maher, Abozeid, Mahmoud, Mohammed, Mahmoud M., Elkatt, Mahmoud Mohamed, Samaha, Mahmoud Yahia, Mikhael, Marolla Maher Eskander, Khalil, Medhat M. H. A., Alhendawey, Moaaz, Elrefai, Mohamad, Gabr, Mohamed A., Fayed, Mohamed Abdelaziz Mohamed Abdalla M, Abdelmaksoud, Mohamed, Salem, Mohamed Abouelmagd, Mohamed Mohamed, Mohamed Adel, Nabeeh, Mohamed Adel, Elsayed, Mohamed Ahmed Abdelhalim Ahmed, Abdelmonem, Mohamed Ahmed, Ali, Mohamed Anwar Abdel Razik, Eldemery, Mohamed, Elmesery, Mohamed, Fikry, Mohamed, Gharbia, Mohamed, Omar, Mohamed I., Elmoghazy, Mohamed Ibrahim, Ghazala, Mohamed Jomma, Hamed, Mohamed Korayem Fattouh, Metwally, Mohamed, Arnouse, Mohamed Mohamed Hamdy, Amen, Mohamed Mohsen, Amary, Mohamed Mokhtar, Kandel, Mohamed Mosaad, Abuzeid, Mohamed Mostafa, Rabea, Mohamed, Sobh, Mohamed Ramadan, Taman, Mohamed, Fathy, Mohammad, Moustafa, Mohammad Montaser Hassan, Zuhdy, Mohammad, Adel, Mohammed, Alaa, Mohammed, Alawady, Mohammed, Edassy, Mohammed El, Mohammed, Mohammed Mustafa Hassan, Eldesouki, Mohammed Nabil, Salim, Mohammed Said Mahmoud, Sanad, Mohammed, Khalaf, Mohsen George, Henes, Mohsen Michael, Abdelglil, Momen, Mohmmed, Mona Mhmoud, Abdelkhalik, Morsi Mohamed Morsi, Shetiwy, Mosab, Elshazli, Mostafa, Hegazy, Mostafa, Ahmed, Mostafa Mahmoud, Abdelhalim, Mostafa Mohammed, Shahein, Mostafa, Sofan, Mostafa, Hammad, Muhammed Alaa Moukhtar, Ahmad, Mustafa, Milad, Nader, Farouk, Nehal, Eldesouky, Omnia, Mohamed, Omnia Y., Mahadel, Osama Abdel Salam, Gaarour, Osama, Torky, Radwan Abdelsabour, Elhafez, Raheem El-Gohary Abd, Adly, Ramy Magdy, Nageeb, Ramy Mikhael, Hamdi, Salah, Gamal, Sameh, Emile, Sameh Hany, Regal, Samer, Abdelrasheed, Sayed, Elzeftawy, Shady Ahmed, Khashshan, Sohib Mohammed Mohammed, Ashraf, Tamer, Khafagy, Tamer, Nabil, Tamer, Abdelazim, Tarek, Rizk, Tarek Taher, Amr, Wesam, Yousef, Yousef Mohamed, Youssef, Youssef Abdel Aziz, Castaldi, Antonio, Fiore, Antonio, Hasani, Ariola, Mariani, Aurora, Dagorno, Claire, Antonio, D'Alessandro, Izzo, Giuliano, Addari, Giulio, Mangiameli, Giuseppe, Rea, Lo Dico, Pio, Luca, Paci, Marco, Andrea, Police, De Fatico, GSerena, Elvira, Tartaglia, Schuldes, Alejandro Daniel Lira, Rihan, Eslam, Moeslein, Gabriela, Lederhuber, Hans, Botros, Ibram, Jaman, Ismail, Doerner, Johannes, Elseberbihy, John Rezk Hanna, Sherbiny, Kareem El, Ghonim, Mostafa, Mikrish, Amir, Aziz, Mina, Hatm, Mohamed, Archid, Rami, Gendy, Samuel Elkess Morcos, Ahmad, Sufian, Charalabopoulos, Alexandros, Prodromidou, Anastasia, Ioannidis, Argyrios, Mpaili, Eustratia, Boukorou, Garyfallia, Papadopoulos, Georgios, Liakakos, Theodore, Styliani, Vasileiadou, Agrawal, Abhishek, Jain, Amita, Rashid, Arshad, Mehraj, Asif, Brahmachari, Swagata, Lakshmi, Harish Neelamraju, Vishwakarma, Kushagra, Parida, Lalit, Sharma, Meenakshi, Zaieem, Mohammad, Makasarwala, Murtaza, Nittala, Rigved, Kumar, Sanjeev, Vikrantmr, Sharma, Junaid, Sheikh, Khuller, Somyaa, More, Vinal, Ahmed, Abeer Abdul Hameed, Alomieri, Adil, Alhamdany, Arkan Shubber, Del, Muslim Ka, Najm, Ghadah, Lateef, Nawras Falah, Mcnamara, Deborah, Abdelmageed, Mohammed Elkassaby, Majeed, Mudassar, Troci, Albert, Porcu, Alberto, Marano, Alessandra, Di Bartolomeo, Alessandro, Giani, Alessandro, Giardino, Alessandro, Canfora, Alfonso, Balla, Andrea, Barberis, Andrea, Belli, Andrea, Borasi, Andrea, Manetti, Andrea, Mingoli, Andrea, Morini, Andrea, Maurizi, Angela, Marra, Angelo Alessandro, Epifani, Angelo Gabriele, Iossa, Angelo, Parello, Angelo, Guida, Anna, Maffioli, Anna, Scafa, Anthony Kevin, Spinelli, Antonino, Matarangolo, Antonio, Picciariello, Arcangelo, Pirozzi, Brunella, Cirillo, Bruno, Gazia, Carlo, Ratto, Carlo, Foppa, Caterina, Marafante, Chiara, Andrea, Chierici, Tanda, Cinzia, Guerci, Claudio, Don, Cristine, Zigiotto, Daniele, Coniglio, Denise, Sasia, Diego, Visconti, Diego, Altomare, Donato F., Guaitoli, Eleonora, Botteri, Emanuele, Pinotti, Enrico, Martinelli, Fabio, Uggeri, Fabio, Bàmbina, Fabrizio, Falaschi, Federica, Costanzo, Federico, La Torre, Filippo, Milana, Flavio, Abbatini, Francesca, De Lucia, Francesca, Tropeano, Francesca Paola, Colombo, Francesco, Ferrara, Francesco, 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Grace, Abiyere, Henry, Oluwasuyi, Ige, George, Ihediwa, Njokanma, Iloba Gabriel, Aremu, Isiaka, Dare, Julius Kolajo, Abdur-Rahman, Lukman, Ahmad, Misbahu Haruna, Oludara, Mobolaji Adewale, Mohammad, Mohammad Aminu, Adeoluwa, Ojajuni, Situ, Oladele, Agbonrofo, Peter, Kewulere, Raji Taofiq, Aliyu, Yakubu, Adebowale, Yusuf, Galala, Ahmed, Rao, Satish, Waleed, Aasma, Inam, Aatif, Shaikh, Abdul Razaque, Qureshi, Ahmad Uzair, Muhammad, Aneeqah Din, Ahmed, Arooj, Kerawala, Asad Ali, Aslam, Mohammad, Mehr, Asma, Javed, Ayesha, Ahmad, Farooq, Majid, Haroon Javaid, Ahmed, Hassan, Daudi, Irfan, Akhtar, Khalid, Niaz, Khurram, Anwer, Mariyah, Amir, Mohammed, Hanif, Muhammad Amir, Asif, Muhammad, Raza, Muhammad Asif, Khokhar, Muhammad Imran, Jameel, Muhammad Khurram, Nasir, Muhammad, Shafique, Muhammad Salman, Ateeb, Mujammad, Nadeem, Munawar, Shah, Rahmat Ullah, Waqar, Shahzad Hussain, Shah, Shahzad Alam, Waseem, Talat, Ghafoor, Tariq, Fatima, Tauseef, Bashir, Umar, Gonzales, Erick Ivan Huaman, Ruiz, Luis Angel Garcia, Freitas, Carla, De Sousa, Xavier, Al-Bahrani, Ahmed, Portela, Carlos Antonio Sanchez, Elgazar, Elsayed Aly, Robles, Eloy Morasen, Khan, Irfan Jan, Jarboa, Lutfi, Khawar, Mahwish, Echevarria, Miguel Jose Pinto, Bashah, Moataz M., Dawdi, Salahaldeen, Musthafa, Shameel, Ali, Syed Muhammad, Ciubotaru, Cezar, Bonci, Eduard-Alexandru, Muresan, Mihai-Stefan, Bogdan, Stoica, Ioan, Tanase, Zubayraeva, Albina, Derinov, Aleksandr, Zakharenko, Alexander, Novikova, Anastasia, Bashlachev, Andrey, Kaldarov, Ayrat, Stanislav, Berelavichus, Gorin, David, Puzenko, Dmitriy, Kazachenko, Ekaterina, Ashimov, Erkin, Medkova, Iuliia, Ignatov, Ivan, Sergeevich, Kochetkov Viktor, Sidorova, Lyudmila, Kiselev, Michail, Danilov, Michail, Aleksandr, Ogoreltsev, Rodimov, Sergey, Garmanovs, Tatiana, Kitsenko, Yury, Valery, Nekoval, Japhet, Ntezamizero, Sibiany, Abdulrahman, Saadeldin, Abdelhalim, Abuosba, Abdelrahman, Alawadhi, Abdulbari Mohammed, Alharbi, Abdulhamid, Althumali, Abdullah, Alghuliga, Abdullah, Alotaibi, Abdullah, Abduraboh, Abdullah Fayez, Kateb, Abdullah, Sindy, Abdullah, Al Eisa, Abdulmohsen, Alotaibi, Abdulrahman, Almulhim, Abdulrhman, Aljawhari, Adel Ali, Abozeid, Ahmad Mahmoud, Saad, Ahmad, Alqarni, Ahmed, Alwan, Ahmed, Alwusaibie, Ahmed, Bafaraj, Ahmed, Eldeeb, Ahmed, Tarabay, Ahmed, Mohammed, Mahfoudh, Alhedaithy, Alhanouf, Almaghrabi, Alhassan Hesham, Abed, Ali Ibrahim Eldawy, Abdullah, Alqahtani Ali, Semilan, Anmar, Farag, Mohamed, Khudhayr, Essa, Hussain, Marwah, Abbas, Ghanem, Alqudaihi, Heba, Abualnaja, Yousra, Shaheen, Abelnasser, Mubarak, Ashraf Abdelazeem Mohamed, Ali, Bandar Idrees A., Alhazmi, Barrag, Hijazi, Bilal Ahmed, Abdulrahman, Chadi, Oyedepo, Charles Olajide, Alzamel, Heythem, Tairab, Elsanousi Ibrahim Sabir, Alsuwaimel, Munir A., Hejazi, Soha, Alnoqaidan, Emad, Alhussien, Fade Ahmed, Jallad, Fadi Sami, Khadwardi, Faisal, Alghamdi, Faisal Saleh, Haddad, Feras, Sauri, Fozan, Alafghani, Haitham, Alfalah, Haitham, Gad, Hamada, 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Nouf, Larbi, Noureddine, Alsallum, Ofays, Suliman, Omar AAbu, Elsherbiny, Osama, Abusalem, Osama, Albalawi, Ibrahim Altedlawi, Abutalib, Raid Abdullah, Alarabi, Rayan, Khan, Roaa Ghazi, Alazzam, Saleh, Alghamdi, Saleh, Alsawat, Salem, Salim, Sami, Alshukr, Sarah, Alzahrani, Saud, Golea, Smain, Alowairdhi, Tumadher, Salman, Usama, Abusiam, Wael, Abualkhair, Wael, Saber, Wael, Tashkandi, Wail, Alhazmi, Waleed, Tashkandi, Waleed, Yassine, Wassim Abou, Alshabi, Yaser Ahmad, Ibrahim, Yaser, Shahin, Yasser, Ibrahim, Yassin, Aljathlany, Yousef, Alnahas, Yousef, Alrashidi, Yousef, Wali, Zubair, Ndong, Abdourahmane, Ba, Mamadou, Faye, Papa Mamadou, Arbutina, Dragana, Milic, Ljiljana, Cuk, Vladica, Hussein, Abdinafic Mohamud, Mccaul, Jeannie, Bertels, Laurie, Pohl, Linda, Arnold, Marion, Mbatani, Nomonde, Oosthuizen, Pj, Rayamajhi, Shreya, Vosloo, Susan, Jooma, Uzair, Landaluce-Olavarria, Aitor, Vázquez-Melero, Alba, Marcos, Alberto, Puerto Puerto, Alejandro, De La Hermosa, Alicia Ruiz, 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Tamburrini, A, Parente, A, Light, A, Diamantopoulou, A, Singh, B, Gurung, B, Frauenfelder, C, Leo, C, Raptis, D, Thakrar, D, Madhuri, T, Tsounaki, E, Garreffa, E, Soggiu, F, Stavrou, G, Ng, H, Tabasi, H, Nasef, H, Kostakis, I, Jeffery, J, Warusavitarne, J, Lund, J, Qurashi, K, Sahnan, K, Tong, K, Orecchia, L, Kaur, M, Zaidi, M, Ganau, M, Curtis, N, Bhatt, N, Machairas, N, Zafar, N, Toma, O, Sarmah, P, Bassuni, M, Davies, J, Shawer, S, Lewis, S, Subramanian, S, Nadeem, U, Njau, A, Tohamy, A, Pakula, A, Simioni, A, Jarvis, B, Skandalakis, G, Hesham, H, Isaiah, I, Villwock, J, Martin, L, Kress, M, Sebelik, M, Lathan, S, Towfigh, S, Holubar, S, Demeester, S, Alshehari, M, Ghabisha, S, Abdulatef, S, Al-Kubati, W, Obadiel, Y, Gots, A, Nakazwe, M, Chipaila, J, Mazingi, D, Shalaby, Mostafa, ElSheikh, Ahmed M., Hamed, Hosam, null, null, Elsheik, Ahmed, Sakr, Ahmad, Fouad, Amgad, Kassem, Amr, Elfeki, Hossam, Madbouly, Khaled, Alzahrani, Khalid H., Marzouk, Khalid, Ali, Mahmoud, Helal, Mohamed Alaa Abdelmoez, Elsorogy, Mohamed, Farid, Mohamed, Di Lorenzo, Nicola, Sileri, Pierpaolo, Wexner, Steven, Khafagy, Wael, Adeyeye, Ademola, El-Hussuna, Alaa, Frontali, Alice, Saklani, Avanish, Lelpo, Benedettao, Molena, Daniela, Pandey, Diwakar, Karbovnichaya, Elena, Pata, Francesco, Van Ramshor, Gabrielle H., Gallo, Gaetano, Spolverato, Gaya, Pellino, Gianluca, Bagaglini, Giulia, Rubio-Perez, Ines, Negoi, Ionut, Frigerio, Isabella, Juloski, Jovan, Ninkovic, Marijana, Franceschilli, Marzia, Azer, Mina, Efetov, Sergey, Ippoliti, Simona, Garoufalia, Zoe, Fazli, Mohammad Rafi, Dogjani, Agron, Cherfa, Harieche Abdennour Abderahim, Omar, Tilioua, Minoldo, Javier, Alvarez Gallesio, José Maria, Quesada, Matias, Bacher, Annica, Kropshofer, Stephan, Ponholzer, Florian, Tesik, Philip, Gehwolf, Philipp, Isci, Sevim, Uranitsch, Stefan, Berchtold, Valeria, Samadov, Elgun, Abualsel, Abdulmenem, Mitul, Ashrarur Rahman, Islam, S. M. Nazmul, Vanlander, Aude, Van Praet, Charles, Van Daele, Elke, Vanommeslaeghe, Hanne, Stijns, Jasper, Abosi-Appeadu, Kessewa, Depuydt, Martijn, Allaeys, Mathias, Yves, Van Nieuwenhove, Colleoni, Ramiro, Slavchev, Mihail, Elbahrawy, Aly, Luc, Jessica G. Y., Milford, Karen, Romic, Ivan, Monti, Alessio, Haydal, Ashraf, Klein, Mads Falk, Ocklind, Miranda E. K., Hadi, Sabah Anwar, Alqasaby, Abdallah, Elganash, Abdelazim, Daibes, Adel Goda Hussein, Elsaied, Adham, Elhattab, Ahmad, Lotfy, Ahmad, Alnashar, Ahmed, Elnour, Ahmed Abd Elbaset Elsayed Abu, Abdelhalim, Ahmed, Abdelhamid, Ahmed, Abdellatif, Ahmed, Abdelmohsen, Ahmed, Abdelrafee, Ahmed, Elhawary, Ahmed Adel, Zidan, Ahmed Azmy, Eleshra, Ahmed, Elkafoury, Ahmed, Ezz, Ahmed, Abdelmomen, Ahmed Ezzat Elghrieb, Elkased, Ahmed Farag, Fawzy, Ahmed, Elkhouly, Ahmed G., Hemidan, Ahmed Gamal Abouelfetouh Ibrahim, Abbas, Ahmed Hosam Eldin Hasan, Ismail, Ahmed Mahmoud Ahmed, Attia, Ahmed Mohamed, Farid, Ahmed Mohammed, Elnakash, Ahmed Mostafa, Negida, Ahmed, Soliman, Ahmed, Taki-Eldin, Ahmed, Albadry, Ali Almahdy Ali, Sanad, Aly, Elbatal, Amira Alsayed Abdelhai, Elgazar, Amr, Saleh, Amr, Fahiem, Andrew, Mohamed, Anwar Yahya A., Nageeb, Ashraf, Elmetwally, Ashraf S., Alkhalegy, Ayman, El-Wakeel, Ayman, Shemes, Ayman, Fadel, Bashir A., Lutfi, Basma Waseem, Ali, Doaa, Abolnasr, Khaled Samir, Gamal, Ehab, Abdallah, Emad, Ahmed, Emad Ali, Salem, Eman Abdalla Mohamed, Hamed, Esmael Ali, Elshikh, Essam, Enad, Farazdaq, Sarhan, Fetoh Alaaeldin Fetoh, Abouelnagah, Galal, Tagg, Gamal Hassan El, Atef, Gehad, Shaker, George Samir Habib, Beshir, Hatem, Zakaria, Hazem M., Barbary, Hesham, Elgendy, Hesham, Sharaf, Hesham, Elnaghi, Hisham, Elghadban, Hosam, Elzayat, Ibrahim, Fakhr, Ibrahim, Sallam, Ibrahim, Abdelmoneim, Ibrahim Tharwat Mohamed, Elnemr, Islam, Zewar, Karem Shahin Mohamed, Elalfy, Khaled, Sabet, Khaled, Mansour, Khaled Yousery Ibrahim, Osman, Khalid Abdalla Abdelgadir, Elgaly, Maher Elesawi Kamel, Shams, Maher, Abozeid, Mahmoud, Mohammed, Mahmoud M., Elkatt, Mahmoud Mohamed, Samaha, Mahmoud Yahia, Mikhael, Marolla Maher Eskander, Khalil, Medhat M. H. A., Alhendawey, Moaaz, Elrefai, Mohamad, Gabr, Mohamed A., Fayed, Mohamed Abdelaziz Mohamed Abdalla M, Abdelmaksoud, Mohamed, Salem, Mohamed Abouelmagd, Mohamed Mohamed, Mohamed Adel, Nabeeh, Mohamed Adel, Elsayed, Mohamed Ahmed Abdelhalim Ahmed, Abdelmonem, Mohamed Ahmed, Ali, Mohamed Anwar Abdel Razik, Eldemery, Mohamed, Elmesery, Mohamed, Fikry, Mohamed, Gharbia, Mohamed, Omar, Mohamed I., Elmoghazy, Mohamed Ibrahim, Ghazala, Mohamed Jomma, Hamed, Mohamed Korayem Fattouh, Metwally, Mohamed, Arnouse, Mohamed Mohamed Hamdy, Amen, Mohamed Mohsen, Amary, Mohamed Mokhtar, Kandel, Mohamed Mosaad, Abuzeid, Mohamed Mostafa, Rabea, Mohamed, Sobh, Mohamed Ramadan, Taman, Mohamed, Fathy, Mohammad, Moustafa, Mohammad Montaser Hassan, Zuhdy, Mohammad, Adel, Mohammed, Alaa, Mohammed, Alawady, Mohammed, Edassy, Mohammed El, Mohammed, Mohammed Mustafa Hassan, Eldesouki, Mohammed Nabil, Salim, Mohammed Said Mahmoud, Sanad, Mohammed, Khalaf, Mohsen George, Henes, Mohsen Michael, Abdelglil, Momen, Mohmmed, Mona Mhmoud, Abdelkhalik, Morsi Mohamed Morsi, Shetiwy, Mosab, Elshazli, Mostafa, Hegazy, Mostafa, Ahmed, Mostafa Mahmoud, Abdelhalim, Mostafa Mohammed, Shahein, Mostafa, Sofan, Mostafa, Hammad, Muhammed Alaa Moukhtar, Ahmad, Mustafa, Milad, Nader, Farouk, Nehal, Eldesouky, Omnia, Mohamed, Omnia Y., Mahadel, Osama Abdel Salam, Gaarour, Osama, Torky, Radwan Abdelsabour, Elhafez, Raheem El-Gohary Abd, Adly, Ramy Magdy, Nageeb, Ramy Mikhael, Hamdi, Salah, Gamal, Sameh, Emile, Sameh Hany, Regal, Samer, Abdelrasheed, Sayed, Elzeftawy, Shady Ahmed, Khashshan, Sohib Mohammed Mohammed, Ashraf, Tamer, Khafagy, Tamer, Nabil, Tamer, Abdelazim, Tarek, Rizk, Tarek Taher, Amr, Wesam, Yousef, Yousef Mohamed, Youssef, Youssef Abdel Aziz, Castaldi, Antonio, Fiore, Antonio, Hasani, Ariola, Mariani, Aurora, Dagorno, Claire, Antonio, D'Alessandro, Izzo, Giuliano, Addari, Giulio, Mangiameli, Giuseppe, Rea, Lo Dico, Pio, Luca, Paci, Marco, Andrea, Police, De Fatico, GSerena, Elvira, Tartaglia, Schuldes, Alejandro Daniel Lira, Rihan, Eslam, Moeslein, Gabriela, Lederhuber, Hans, Botros, Ibram, Jaman, Ismail, Doerner, Johannes, Elseberbihy, John Rezk Hanna, Sherbiny, Kareem El, Ghonim, Mostafa, Mikrish, Amir, Aziz, Mina, Hatm, Mohamed, Archid, Rami, Gendy, Samuel Elkess Morcos, Ahmad, Sufian, Charalabopoulos, Alexandros, Prodromidou, Anastasia, Ioannidis, Argyrios, Mpaili, Eustratia, Boukorou, Garyfallia, Papadopoulos, Georgios, Liakakos, Theodore, Styliani, Vasileiadou, Agrawal, Abhishek, Jain, Amita, Rashid, Arshad, Mehraj, Asif, Brahmachari, Swagata, Lakshmi, Harish Neelamraju, Vishwakarma, Kushagra, Parida, Lalit, Sharma, Meenakshi, Zaieem, Mohammad, Makasarwala, Murtaza, Nittala, Rigved, Kumar, Sanjeev, Vikrantmr, Sharma, Junaid, Sheikh, Khuller, Somyaa, More, Vinal, Ahmed, Abeer Abdul Hameed, Alomieri, Adil, Alhamdany, Arkan Shubber, Del, Muslim Ka, Najm, Ghadah, Lateef, Nawras Falah, Mcnamara, Deborah, Abdelmageed, Mohammed Elkassaby, Majeed, Mudassar, Troci, Albert, Porcu, Alberto, Marano, Alessandra, Di Bartolomeo, Alessandro, Giani, Alessandro, Giardino, Alessandro, Canfora, Alfonso, Balla, Andrea, Barberis, Andrea, Belli, Andrea, Borasi, Andrea, Manetti, Andrea, Mingoli, Andrea, Morini, Andrea, Maurizi, Angela, Marra, Angelo Alessandro, Epifani, Angelo Gabriele, Iossa, Angelo, Parello, Angelo, Guida, Anna, Maffioli, Anna, Scafa, Anthony Kevin, Spinelli, Antonino, Matarangolo, Antonio, Picciariello, Arcangelo, Pirozzi, Brunella, Cirillo, Bruno, Gazia, Carlo, Ratto, Carlo, Foppa, Caterina, Marafante, Chiara, Andrea, Chierici, Tanda, Cinzia, Guerci, Claudio, Don, Cristine, Zigiotto, Daniele, Coniglio, Denise, Sasia, Diego, Visconti, Diego, Altomare, Donato F., Guaitoli, Eleonora, Botteri, Emanuele, Pinotti, Enrico, Martinelli, Fabio, Uggeri, Fabio, Bàmbina, Fabrizio, Falaschi, Federica, Costanzo, Federico, La Torre, Filippo, Milana, Flavio, Abbatini, Francesca, De Lucia, Francesca, Tropeano, Francesca Paola, Colombo, Francesco, Ferrara, Francesco, Litta, Francesco, Carrano, Francesco Maria, Orlando, Francesco, Roscio, Francesco, Selvaggi, Francesco, Giarratano, Gabriella, Pagano, Gianluca, Lisi, Giorgio, Argenio, Giulio, Zancana, Giuseppa, Cavallaro, Giuseppe, Frazzetta, Giuseppe, Mariateresa, Grasso, Sciaudone, Guido, Vella, Ivan, Siragusa, Leandro, Santurro, Letizia, Ferri, Lorenzo, Petagna, Lorenzo, Ferrario, Luca, Pitoni, Ludovica, Pignatelli, Marcello Filograna, Angrisani, Marco, Giugliano, Marco, Inama, Marco, Marino, Marco V., Veltri, Marco, Giuffrida, Maria Carmela, Menna, Maria Paola, Valente, Marina, Rottoli, Matteo, Sacchi, Matteo, Uccelli, Matteo, Rho, Maurizio, Garino, Mauro, Montuori, Mauro, Campanelli, Michela, Zese, Monica, De Falco, Nadia, Cillara, Nicola, Mariani, Nicolò Maria, Tamini, Nicolò, Adorisio, Ottavio, Campennì, Paola, Venturelli, Paolina, Bernante, Paolo, Sapienza, Paolo, Cianci, Pasquale, Marsanic, Patrizia, Lapolla, Pierfrancesco, Tecchio, Piero, Familiari, Pietro, Fransvea, Pietro, Bruzzaniti, Placido, Hassan, Redan, Pirovano, Riccardo, Rimonda, Roberto, Di Saverio, Salomone, Di Carlo, Sara, Perra, Teresa, Campagnaro, Tommaso, Testa, Valentina, Andriola, Valeria, Grappelli, Virgilio Michael Ambrosi, Capizzi, Vita, Chiarella, Vito, Bellato, Vittoria, Yanaga, Katsuhiko, Farouk, Mohamed, Uraiqat, Ahmad, Almasri, Mahmoud, Nabwana, Ambrose, Siboe, Mark M. W., W, Njoroge P., Njoroge, Githu, Ilkul, Jh., Obure, Ralph Ombati, Palkhi, Yusuf, Alkhayat, Ali, Ali, Ali Sayed, Malek, Amgad Nashaat Abdel, Abdelsayed, Emad Fahim, Zahra, Tarek, Ayoub, Larissa, Sleilati, Fadi, Aoun, Rany, Algatanesh, Nassib, Fieturi, Nura Ahmed, Ng, Jen Siang, Díaz, Andrés Vega, Duran, Erik Efrain Sosa, Guerrero, José Eaazim Flores, Jasso, Manuel Meza, Flores, Manuel SSalas, Felix, Marcos José Serrato, Angulo, Victor Manuel Pinto, Mejdane, Abdelhadi, Aitali, Abdelmounaim, Amal, Benzakour, Zentar, Aziz, Bensaad, Ahmed, Yacir, El Alami, Jawad, Fassi Fihri Mohamed, Rachid, Mohamed Ghassane, Maliki-Alaoui, Mohamed, Ouadii, Mouaqit, Mohammed, Ouazni, Thein, Nyan, Koirala, Dinesh Prasad, Hilling, Denise, Pouwels, Sjaak, Okunlola, Abiodun Idowu, Adejumo, Adeyinka, Akinmade, Akinola, Shittu, Asimiyu Adekunle, Oluyomi, Ayodele Samuel, Abiodun, Azeez Lateef, Lawal, Bashir, Odion, Clement, Popoola, Ademola, Jolayemi, Edward, Shomoye, El-Zaki, Wuraola, Funmilola Olanike, Eke, Grace, Abiyere, Henry, Oluwasuyi, Ige, George, Ihediwa, Njokanma, Iloba Gabriel, Aremu, Isiaka, Dare, Julius Kolajo, Abdur-Rahman, Lukman, Ahmad, Misbahu Haruna, Oludara, Mobolaji Adewale, Mohammad, Mohammad Aminu, Adeoluwa, Ojajuni, Situ, Oladele, Agbonrofo, Peter, Kewulere, Raji Taofiq, Aliyu, Yakubu, Adebowale, Yusuf, Galala, Ahmed, Rao, Satish, Waleed, Aasma, Inam, Aatif, Shaikh, Abdul Razaque, Qureshi, Ahmad Uzair, Muhammad, Aneeqah Din, Ahmed, Arooj, Kerawala, Asad Ali, Aslam, Mohammad, Mehr, Asma, Javed, Ayesha, Ahmad, Farooq, Majid, Haroon Javaid, Ahmed, Hassan, Daudi, Irfan, Akhtar, Khalid, Niaz, Khurram, Anwer, Mariyah, Amir, Mohammed, Hanif, Muhammad Amir, Asif, Muhammad, Raza, Muhammad Asif, Khokhar, Muhammad Imran, Jameel, Muhammad Khurram, Nasir, Muhammad, Shafique, Muhammad Salman, Ateeb, Mujammad, Nadeem, Munawar, Shah, Rahmat Ullah, Waqar, Shahzad Hussain, Shah, Shahzad Alam, Waseem, Talat, Ghafoor, Tariq, Fatima, Tauseef, Bashir, Umar, Gonzales, Erick Ivan Huaman, Ruiz, Luis Angel Garcia, Freitas, Carla, De Sousa, Xavier, Al-Bahrani, Ahmed, Portela, Carlos Antonio Sanchez, Elgazar, Elsayed Aly, Robles, Eloy Morasen, Khan, Irfan Jan, Jarboa, Lutfi, Khawar, Mahwish, Echevarria, Miguel Jose Pinto, Bashah, Moataz M., Dawdi, Salahaldeen, Musthafa, Shameel, Ali, Syed Muhammad, Ciubotaru, Cezar, Bonci, Eduard-Alexandru, Muresan, Mihai-Stefan, Bogdan, Stoica, Ioan, Tanase, Zubayraeva, Albina, Derinov, Aleksandr, Zakharenko, Alexander, Novikova, Anastasia, Bashlachev, Andrey, Kaldarov, Ayrat, Stanislav, Berelavichus, Gorin, David, Puzenko, Dmitriy, Kazachenko, Ekaterina, Ashimov, Erkin, Medkova, Iuliia, Ignatov, Ivan, Sergeevich, Kochetkov Viktor, Sidorova, Lyudmila, Kiselev, Michail, Danilov, Michail, Aleksandr, Ogoreltsev, Rodimov, Sergey, Garmanovs, Tatiana, Kitsenko, Yury, Valery, Nekoval, Japhet, Ntezamizero, Sibiany, Abdulrahman, Saadeldin, Abdelhalim, Abuosba, Abdelrahman, Alawadhi, Abdulbari Mohammed, Alharbi, Abdulhamid, Althumali, Abdullah, Alghuliga, Abdullah, Alotaibi, Abdullah, Abduraboh, Abdullah Fayez, Kateb, Abdullah, Sindy, Abdullah, Al Eisa, Abdulmohsen, Alotaibi, Abdulrahman, Almulhim, Abdulrhman, Aljawhari, Adel Ali, Abozeid, Ahmad Mahmoud, Saad, Ahmad, Alqarni, Ahmed, Alwan, Ahmed, Alwusaibie, Ahmed, Bafaraj, Ahmed, Eldeeb, Ahmed, Tarabay, Ahmed, Mohammed, Mahfoudh, Alhedaithy, Alhanouf, Almaghrabi, Alhassan Hesham, Abed, Ali Ibrahim Eldawy, Abdullah, Alqahtani Ali, Semilan, Anmar, Farag, Mohamed, Khudhayr, Essa, Hussain, Marwah, Abbas, Ghanem, Alqudaihi, Heba, Abualnaja, Yousra, Shaheen, Abelnasser, Mubarak, Ashraf Abdelazeem Mohamed, Ali, Bandar Idrees A., Alhazmi, Barrag, Hijazi, Bilal Ahmed, Abdulrahman, Chadi, Oyedepo, Charles Olajide, Alzamel, Heythem, Tairab, Elsanousi Ibrahim Sabir, Alsuwaimel, Munir A., Hejazi, Soha, Alnoqaidan, Emad, Alhussien, Fade Ahmed, Jallad, Fadi Sami, Khadwardi, Faisal, Alghamdi, Faisal Saleh, Haddad, Feras, Sauri, Fozan, Alafghani, Haitham, Alfalah, Haitham, Gad, Hamada, Aboelmagid, Hamdy Haggag Ebrahim, Ibrahim, Hamed, Elzayady, Hany M., Sharafeldin, Hatem Abdelrahman Ahmed, Sembawa, Hatem A., Alabbas, Haytham, Abbas, Hazem, Elgamal, Hesham, Alawfi, Homoud, Al-Sadery, Humood, Abdelmotaleb, Hussien Ali, Al Hassn, Ibrahim, Mudawi, Ishag M., Nekhala, Islam, Elsanhoury, Kareem, Said, Khalid Babieker, Albeshri, Khalid A., Albahooth, Khalid, Mohammed, Khalid Fathelrahman Bakier, Asar, Khalid Mohammad Ibrahim, Osman, Luqman, Alzamanan, Mahdi, Alnabarawi, Mahmoud, Althobaiti, Majid, Elsayed, Mohamed Abdelmoneim, Al Naeb, Mohamed, Hassan, Mohamed Salah Eldin, Abdelhamid, Mohamed Sayed, Alyami, Mohammad, Mirza, Mohammad Amin, Sayouh, Mohammad, Alkhayat, Mohammed Amer, Basendowah, Mohammed, Ghunaim, Mohammed, Alhussaini, Mohammed Khalid, Khoj, Mohammed, Sbaih, Mohammed, Saeed, Muhammad Ahmad, Ali, Muhammad Zulfiqar, Abdelaziz, Nabil Yassin Tammam, Malibary, Nadim, Abdo, Nael, Amer, Nasser Mohammed, Al Turki, Neamat Ahmed Ali, Durayb, Norah, Yassin, Nouf, Akeel, Nouf, Larbi, Noureddine, Alsallum, Ofays, Suliman, Omar AAbu, Elsherbiny, Osama, Abusalem, Osama, Albalawi, Ibrahim Altedlawi, Abutalib, Raid Abdullah, Alarabi, Rayan, Khan, Roaa Ghazi, Alazzam, Saleh, Alghamdi, Saleh, Alsawat, Salem, Salim, Sami, Alshukr, Sarah, Alzahrani, Saud, Golea, Smain, Alowairdhi, Tumadher, Salman, Usama, Abusiam, Wael, Abualkhair, Wael, Saber, Wael, Tashkandi, Wail, Alhazmi, Waleed, Tashkandi, Waleed, Yassine, Wassim Abou, Alshabi, Yaser Ahmad, Ibrahim, Yaser, Shahin, Yasser, Ibrahim, Yassin, Aljathlany, Yousef, Alnahas, Yousef, Alrashidi, Yousef, Wali, Zubair, Ndong, Abdourahmane, Ba, Mamadou, Faye, Papa Mamadou, Arbutina, Dragana, Milic, Ljiljana, Cuk, Vladica, Hussein, Abdinafic Mohamud, Mccaul, Jeannie, Bertels, Laurie, Pohl, Linda, Arnold, Marion, Mbatani, Nomonde, Oosthuizen, Pj, Rayamajhi, Shreya, Vosloo, Susan, Jooma, Uzair, Landaluce-Olavarria, Aitor, Vázquez-Melero, Alba, Marcos, Alberto, Puerto Puerto, Alejandro, De La Hermosa, Alicia Ruiz, Senent-Boza, Ana, Ugarte-Sierra, Bakarne, Montalbán, Beatriz Cros, Martin-Perez, Beatriz, Gomez, Caroina Gonzalez, Colás-Ruiz, Enrique, Santos, Esther Garcia, Senra, Fatima, Mora-Guzmán, Ismael, Dziakova, Jana, Díaz, Jeancarlos J. Trujillo, Silva, Jesús, Laina, Juan Luis Blas, Tallon-Aguilar, Luis, Di Martino, Marcello, Chacón, Mario Franco, Frasson, Matteo, Calvo, Mikel Prieto, Millan, Monica, Tejedoe, Patricia, Pérez-Bertólez, Sonia, Turrado-Rodríguez, Víctor, Elsanosi, Abdelrhman Azhari Mohammed, Abdalbakheet, Duaa, Ahmed, Mohamed, Salim, Omer El Faroug H., Youssef, Mohamed, Barbon, Carlotta, Bouchrika, Amal, Maghrebi, Houcine, Loukil, Issam, Yildiz, Alp, Dursun, Ayberk, Gulcu, Baris, Calik, Bulent, Eral, Burak, Yeşilyurt, Değercan, Yakar, Fatih, Akin, Furkan Atakan, Kilinc, Gizem, Uslu, Gülberk, Tuncer, Korhan, Koc, Mehmet Ali, Leventoğlu, Sezai, Sokmen, Selman, Atici, Semra Demirli, Kaya, Tayfun, Dere, Ümit Akın, Kırmızı, Yasemin, Ssenono, Kavuma Daniel, Lule, Herman, Mbiine, Ronald, Hamza, Ahmed, Ali, Shabeer, Peediyakkal, Saidalavi Padinhare, Varma, Gopala Pillay, Mussa, Haidar Aal, Al-Masari, Hayder Makki, Shehata, Mina, Seiam, Moham, Aziz, Muhammad Akram Abdul, Nimir, Nessrein, Khare, Ritu, Rashid, Shahid, Kazim, Shuiab, Gondal, Zafar, Sherif, Ahmed Elshawadfy, Ghanem, Ahmed, Helmy, Ahmed Hazem I., Ibrahim, Ahmed, Elshaer, Ahmed Mohammed, Marzouk, Ahmed Msm, Tamburrini, Alessandro Paolo, Parente, Alessandro, Light, Alexander, Diamantopoulou, Angela, Singh, Baljit, Gurung, Binay, Frauenfelder, Claire, Leo, Cosimo Alex, Raptis, Dimitri, Thakrar, Dixa, Madhuri, Thumuluru Kavitha, Tsounaki, Efthymia, Garreffa, Emanuele, Soggiu, Fiammetta, Stavrou, George, Ng, Hwei Jene, Tabasi, Hani, Nasef, Hazem, Kostakis, Ioannis D., Jeffery, James, Warusavitarne, Janindra, Lund, Jon, Qurashi, Kamran, Sahnan, Kapil, Tong, Kin Seng, Orecchia, Luca, Kaur, Mandeep, Zaidi, Mariam, Ganau, Mario, Hassan, Mohamed Ali Gad, Curtis, Nathan, Bhatt, Nikita, Machairas, Nikolaos, Zafar, Noman, Toma, Omar, Sarmah, Panchali, Bassuni, Majid, Davies, Justin, Shawer, Sami, Shawer, Sherif, Lewis, Sophia, Subramanian, Sivaraman, Ahmad, Suhaib, Nadeem, Uqba, Njau, Aidan, Tohamy, Aley Eldin, Pakula, Andrea M., Simioni, Andrea, Jarvis, Bennie L., Skandalakis, Georgios P., Hesham, Hosai Todd, Isaiah, Isaac A., Villwock, Jennifer, Martin, Linda W., Kress, Melissa, Sebelik, Merry, Lathan, Sanaz, Towfigh, Shirin, Holubar, Stefan D., Demeester, Steve, Alshehari, Mohammed Mohammed Hasan, Ghabisha, Saif Ali, Abdulatef, Shehab Ahmed Ali, Al-Kubati, Waheeb, Obadiel, Yasser Abdurabo, Gots, Alexander, Nakazwe, Mildred, Chipaila, Jackson, and Mazingi, Dennis
- Abstract
BackgroundSARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice.MethodsThis is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure.ResultsNine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout.There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management.ResultsNine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout.There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits
- Published
- 2024
3. ‘PartBreCon’ study. A UK multicentre retrospective cohort study to assess outcomes following PARTial BREast reCONstruction with chest wall perforator flaps
- Author
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Agrawal, A., primary, Romics, L., additional, Thekkinkattil, D., additional, Soliman, M., additional, Kaushik, M., additional, Barmpounakis, P., additional, Mortimer, C., additional, Courtney, C.A., additional, Goyal, A., additional, Garreffa, E., additional, Carmichael, A., additional, Lane, R.A., additional, Rutherford, C., additional, Kim, B., additional, Achuthan, R., additional, Pitsinis, V., additional, Goh, S., additional, Ray, B., additional, Grover, K., additional, Vidya, R., additional, Murphy, J., additional, Dumitru, Dorin, additional, Bichoo, Raouef, additional, Singh, Nirbhaibir, additional, Tuffaha, Hussein, additional, Mallidis, Evangelos, additional, Valassiadou, Kalliope, additional, Kantola, Venla, additional, Prusty, Lydia, additional, Gvaramadze, Anzors, additional, Blackhall, Vivienne, additional, Mansell, James, additional, and Hamad, Ahmed, additional
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- 2023
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4. Does Neo-adjuvant chemotherapy response in the primary breast tumour correlate with axillary response in proven node positive ER positive HER2 negative disease?
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Borkar, N., primary, Provenzano, E., additional, Garreffa, E., additional, Benson, J., additional, Forouhi, P., additional, Hugh-Davies, L., additional, Wilson, C., additional, McAdam, K., additional, Russell, S., additional, and Agrawal, A., additional
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- 2020
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5. Should chemotherapy in neoadjuvant setting in node positive breast cancers be guided by biology over magnitude of tumour burden?
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Provenzano, E., primary, Garreffa, E., additional, Wignarajah, P., additional, Borkar, N., additional, Psychogiou, V., additional, Newton, A., additional, Benson, J., additional, Forouhi, P., additional, Hughes-Davies, L., additional, Wilson, C., additional, McAdam, K., additional, Russell, S., additional, and Agrawal, A., additional
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- 2020
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6. Definition of Tumor Bed Boost in Oncoplastic Breast Surgery: An Understanding and Approach
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Garreffa, E., primary, Hughes-Davies, L., additional, Coles, C.E., additional, Russell, S., additional, Lightowlers, S.V., additional, and Agrawal, A., additional
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- 2019
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7. 230 Poster - Should chemotherapy in neoadjuvant setting in node positive breast cancers be guided by biology over magnitude of tumour burden?
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Provenzano, E., Garreffa, E., Wignarajah, P., Borkar, N., Psychogiou, V., Newton, A., Benson, J., Forouhi, P., Hughes-Davies, L., Wilson, C., McAdam, K., Russell, S., and Agrawal, A.
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- 2020
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8. 253 Poster - Does Neo-adjuvant chemotherapy response in the primary breast tumour correlate with axillary response in proven node positive ER positive HER2 negative disease?
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Borkar, N., Provenzano, E., Garreffa, E., Benson, J., Forouhi, P., Hugh-Davies, L., Wilson, C., McAdam, K., Russell, S., and Agrawal, A.
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- 2020
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9. Global variations in the definition and management of multifocal and multicentric breast cancer: the MINIM international survey
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Yazan A. Masannat, Nicola Rocco, Emanuele Garreffa, Bahadir M. Gulluoglu, Ashutosh Kothari, Anna Maglia, Maurizio B. Nava, Omar S. Omar, Shelley Potter, Giuseppe Catanuto, Masannat Y. A., Rocco N., Garreffa E., GÜLLÜOĞLU M. B., Kothari A., Maglia A., Nava M. B., Omar O. S., Potter S., Catanuto G., Masannat, Y. A., Rocco, N., Garreffa, E., Gulluoglu, B. M., Kothari, A., Maglia, A., Nava, M. B., Omar, O. S., Potter, S., and Catanuto, G.
- Subjects
Klinik Tıp ,Sentinel Lymph Node Biopsy ,SURGERY ,CERRAHİ ,Carcinoma, Ductal, Breast ,Breast Neoplasms ,CLINICAL MEDICINE ,Sağlık Bilimleri ,Clinical Medicine (MED) ,multicentric ,Tıp ,breast cancer ,Surgery Medicine Sciences ,Cerrahi Tıp Bilimleri ,Health Sciences ,Humans ,Medicine ,survey ,Female ,Klinik Tıp (MED) ,Neoplasm Staging - Abstract
Multifocal and multicentric breast cancers (MFMCBCs) have traditionally been considered a contraindication to breast-conserving surgery (BCS) because of concerns about locoregional control.The most common definition of MFMCBC is anatomical, based on the presence of cancer foci either in a single breast quadrant (multifocal) or in more than one (multicentric). Other definitions are based on the distance between tumours, with multifocal tumours defined as being within 2 cm of each other (up to 5 cm in some articles), and multicentric tumours further away.The reported incidence of MFMCBC varies between 4 and 60 per cent, and has increased, possibly owing to improved imaging accuracy resulting in better detection rates. Similarly, BCS rates for MFMCBC have increased over time as a result of the introduction of advanced oncoplastic techniques that allow en bloc resection of all cancer foci while preserving (or even improving) breast cosmesis. These advances in oncoplastic breast surgery, together with the support of the St Gallen expert panel and emerging evidence of no significant difference in disease-free or overall survival between MFMCBC and unifocal cancers, have resulted in changing practice, with many surgeons considering BCS in selected patients. This topic is still, however, debated as other authors have questioned the oncological safety of BCS in this setting because of a lack of RCTs or high-quality prospective cohort studies.
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- 2022
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10. Use of tumour bed boost radiotherapy in volume replacement oncoplastic breast surgery: A systematic review.
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Garreffa E, Meattini I, Coles CE, and Agrawal A
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- Humans, Female, Mastectomy, Segmental, Radiotherapy, Adjuvant, Breast pathology, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Breast Neoplasms pathology
- Abstract
Tumour bed boost radiotherapy (RT) following breast conserving surgery reduces local recurrence in high-risk disease. There is recent debate over challenges to accurately localise tumour bed for RT boost delivery following volume replacement oncoplastic breast surgery (VR-OBS). This review evaluates the reporting of RT boost following VR-OBS in the literature published between January 2010 and December 2021. This review was in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). Nine studies met the inclusion criteria (n = 670 patients), and RT boost was used in eight studies. Boost was administered in total to 384 patients (62.5% of irradiated patients). Only two studies reported boost planned target volumes and only one compared these against surgical specimen volumes. RT boost was not reported in most published studies on VR-OBS. Future prospective research are strongly needed to evaluate long-term outcomes of VR-OBS following RT boost, especially on breast cosmesis and patients' satisfaction., Competing Interests: Declaration of Competing Interest None of the authors or collaborators declared any conflict of interest related to this project., (Crown Copyright © 2023. Published by Elsevier B.V. All rights reserved.)
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- 2023
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11. Should Acellular Dermal Matrices Be Used for Implant-based Breast Reconstruction after Mastectomy? Clinical Recommendation Based on the GRADE Approach.
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Cinquini M, Rocco N, Catanuto G, Garreffa E, Ferrando PM, Gonzalez-Lorenzo M, Maglia A, Montagna G, Villanucci A, Visintini Cividin V, and Nava MB
- Abstract
Acellular dermal matrices (ADMs) entered the market in the early 2000s and their use has increased thereafter. Several retrospective cohort studies and single surgeon series reported benefits with the use of ADMs. However, robust evidence supporting these advantages is lacking. There is the need to define the role for ADMs in implant-based breast reconstruction (IBBR) after mastectomy., Methods: A panel of world-renowned breast specialists was convened to evaluate evidence, express personal viewpoints, and establish recommendation for the use of ADMs for subpectoral one-/two-stage IBBR (compared with no ADM use) for adult women undergoing mastectomy for breast cancer treatment or risk reduction using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach., Results: Based on the voting outcome, the following recommendation emerged as a consensus statement: the panel members suggest subpectoral one- or two-stage IBBR either with ADMs or without ADMs for adult women undergoing mastectomy for breast cancer treatment or risk reduction (with very low certainty of evidence)., Conclusions: The systematic review has revealed a very low certainty of evidence for most of the important outcomes in ADM-assisted IBBR and the absence of standard tools for evaluating clinical outcomes. Forty-five percent of panel members expressed a conditional recommendation either in favor of or against the use of ADMs in subpectoral one- or two-stages IBBR for adult women undergoing mastectomy for breast cancer treatment or risk reduction. Future subgroup analyses could help identify relevant clinical and pathological factors to select patients for whom one technique could be preferable to another., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
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- 2023
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12. Global variations in the definition and management of multifocal and multicentric breast cancer: the MINIM international survey.
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Masannat YA, Rocco N, Garreffa E, Gulluoglu BM, Kothari A, Maglia A, Nava MB, Omar OS, Potter S, and Catanuto G
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- Female, Humans, Neoplasm Staging, Sentinel Lymph Node Biopsy, Breast Neoplasms diagnosis, Breast Neoplasms pathology, Breast Neoplasms therapy, Carcinoma, Ductal, Breast pathology
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- 2022
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13. Regional lymphadenopathy following COVID-19 vaccination: Literature review and considerations for patient management in breast cancer care.
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Garreffa E, Hamad A, O'Sullivan CC, Hazim AZ, York J, Puri S, Turnbull A, Robertson JF, and Goetz MP
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- Breast Neoplasms epidemiology, Breast Neoplasms therapy, COVID-19 Vaccines administration & dosage, Diagnosis, Differential, Diagnostic Errors, Female, Humans, Incidence, Lymphadenopathy chemically induced, Lymphadenopathy epidemiology, Predictive Value of Tests, Prognosis, Risk Assessment, Risk Factors, Time Factors, Breast Neoplasms diagnostic imaging, COVID-19 Vaccines adverse effects, Lymphadenopathy diagnostic imaging, Mammography, Positron Emission Tomography Computed Tomography, Vaccination adverse effects
- Abstract
Purpose: Over 1 billion doses of COVID-19 vaccines have been already administered across the United States, the United Kingdom and the European Union at the time of writing. Furthermore, 1.82 million booster doses have been administered in the US since 13th August, and similar booster programmes are currently planned or under consideration in the UK and the EU beginning in the autumn of 2021. Early reports showed an association between vaccine administration and the development of ipsilateral axillary and supraclavicular lymphadenopathy, which could interfere with the diagnosis, treatment and follow-up of breast cancer patients. In this paper, we review the available evidence on vaccine-related lymphadenopathy, and we discuss the clinical implications of the same on breast cancer diagnosis and management., Methods: A literature search was performed - PubMed, Ovid Medline, Scopus, CINHAL, Springer Nature, ScienceDirect, Academic Search Premier and the Directory of Open Access Journals were searched for articles reporting on regional palpable or image-detected lymphadenopathy following COVID-19 vaccination. Separately, we compiled a series of case studies from the University Hospitals of Derby and Burton, United Kingdom and the Mayo Clinic in Minnesota, United States of America, to illustrate the impact that regional lymphadenopathy post-COVID-19 vaccination can have on the diagnosis and management of patients being seen in diagnostic and therapeutic breast clinics., Results: From the literature search, 15 studies met the inclusion criteria (n = 2057 patients, 737 with lymphadenopathy). The incidence of lymphadenopathy ranged between 14.5% and 53% and persisted for >6 weeks in 29% of patients., Conclusions: Clinicians managing breast cancer patients should be aware that the COVID-19 vaccination may result in regional lymphadenopathy in a significant number of patients, which can result in unnecessary investigations, treatment and increased patient anxiety. An accurate COVID-19 vaccination history should be collected from all patients where regional lymphadenopathy is a clinical and/or an imaging finding and then combined with clinical judgement when managing individual cases., Competing Interests: Conflict of interest statement The authors declare that they have no conflict of interest., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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14. Outcomes of Volume Replacement Oncoplastic Breast-Conserving Surgery Using Chest Wall Perforator Flaps: Comparison with Volume Displacement Oncoplastic Surgery and Total Breast Reconstruction.
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Garreffa E and Agrawal A
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- Humans, Mastectomy, Mastectomy, Segmental, Mammaplasty, Perforator Flap, Thoracic Wall surgery
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- 2021
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15. Regional lymphadenopathy following COVID-19 vaccination: considerations for primary care management.
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Garreffa E, York J, Turnbull A, and Kendrick D
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- COVID-19 Vaccines, Humans, Primary Health Care, SARS-CoV-2, Vaccination, COVID-19, Lymphadenopathy
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- 2021
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16. Achieving margin clearance following oncoplastic breast surgery in comparison with simple wide local excision: a three-dimensional specimen assessment.
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Garreffa E, Kankam HKN, Bali R, Duckworth A, Jimenez Linan M, Mahler Araujo B, Moyle P, Wright P, Provenzano E, and Agrawal A
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- Breast diagnostic imaging, Breast surgery, Humans, Margins of Excision, Mastectomy, Breast Neoplasms surgery, Mastectomy, Segmental
- Abstract
Background: Pre-operative breast tumour radial dimensions often determine the choice between simple wide local excision (WLE) and oncoplastic breast surgery (OBS). We reviewed the three-dimensional interplay between tumour and surgical specimen dimensions in the two cohorts., Methods: Demographic, tumour and treatment data were collected for all patients undergoing OBS by a single surgeon and compared with a randomly selected cohort of WLE patients treated. The relationship between tumour and specimen medio-lateral, supero-inferior and antero-posterior dimensions were explored in both groups. Subgroup analyses were performed in the OBS cohort (parenchymal displacement versus replacement)., Results: We identified 60 OBS patients (63 breasts), comparing them with 60 WLE patients. Pre-operative tumour estimated size was significantly larger in the OBS cohort and concordant with macroscopic tumour radial dimensions and final microscopic tumour size. Surgical specimen weight was more than 3.5 times higher in the OBS group and its radial dimensions were almost double. No significant difference was observed for the antero-posterior dimensions. The rate of margin re-excisions and completion mastectomies were lower in the OBS cohort. WLE patients with positive margins had a lower tumour-to-specimen ratio, whereas, the requirement for further surgery in the OBS cohort was associated with larger tumour dimensions., Conclusion: Despite larger tumour dimensions, OBS is not inferior to WLE in providing clear surgical margins. Our analysis of the three-dimensional spatial relationship between cancer and surgical specimen, although not completely conclusive, can be helpful in the selection of the most appropriate surgical approach for every patient., (© 2020 Royal Australasian College of Surgeons.)
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- 2020
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17. "Medial Hemi-Mastopexy": An Innovation to Avoid Medial Pole Emptiness in Reduction Mammaplasty.
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Agrawal A and Garreffa E
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- Body Weight, Breast surgery, Female, Humans, Hypertrophy, Breast Neoplasms surgery, Mammaplasty
- Abstract
Introduction: Therapeutic mammaplasty is a well-established advanced oncoplastic technique for larger tumors in large breasts. However, the larger the breasts are, the greater is the lower outer parenchymal displacement due to weight resulting in relative emptiness in the medial/cleavage part. Therefore, the default practice of excising the medial wing parenchymal component of Wise pattern (WP) incision may either maintain or worsen such anatomy., Methods: We present a technical innovation to improve the standard WP technique: instead of excision, the medial wing of the WP incision is deepithelized, and parenchyma is preserved to retain or augment bulk., Results: Between July 2015 and December 2018, a total of 16 patients (26 breasts) underwent a medial hemi-mastopexy. This technique seems to be safe, with minimal complications even after radiotherapy., Conclusions: Although its use is limited in lower inner quadrant tumors, "medial hemi-mastopexy" can be safely applied to cancers located in all the other quadrants and potentially in the cosmetic setting as well. This case series is limited by the small numbers and short follow-up; however, the data show promising results.
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- 2020
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18. Definition of Tumor Bed Boost in Oncoplastic Breast Surgery: An Understanding and Approach.
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Garreffa E, Hughes-Davies L, Russell S, Lightowlers S, and Agrawal A
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- Breast pathology, Breast surgery, Breast Neoplasms diagnosis, Breast Neoplasms pathology, Cooperative Behavior, Dose-Response Relationship, Radiation, Female, Fiducial Markers, Humans, Perforator Flap transplantation, Radiation Oncologists, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted methods, Radiotherapy, Adjuvant methods, Retrospective Studies, Surgeons, Tumor Burden, Breast diagnostic imaging, Breast Neoplasms therapy, Mammaplasty methods, Mastectomy, Segmental adverse effects, Tomography, X-Ray Computed methods
- Abstract
Introduction: Definition of the tumor bed (TB) is currently guided by intraoperatively placed metal clips. However, this traditional planning method may not be sufficient for tumor cavity defect refilled with modern oncoplastic breast surgery. We explored the impact of a close cooperation between surgeon and oncologist on the accuracy of TB contouring after partial breast reconstruction with chest wall perforator flaps (CWPF)., Patients and Methods: A retrospective review of patients who received radiotherapy after CWPF was performed. TB and boost volume were defined by the surgeon, considering clips and the typical radiologic appearance of the flap, and by a radiation oncologist, and results were compared with the surgical specimen volume (SPV). The boost volume was marked as 5 mm penumbral ring thickness of native breast tissue wall around the replaced flap (nonbreast tissue)., Results: There were no significant differences between SPV and surgeon-defined TB values. Conversely, the radiation oncologist-defined values were significantly smaller than the actual SPV. If a ring-shaped TB boost was delivered, this would have allowed a potential reduction of irradiated tissue of 127.6%., Conclusion: TB definition solely by surgical clips may be prone to inaccuracy in case of volume replacement oncoplastic breast surgery. Our approach of combining the clips with the redefinition of the flap on computed tomographic scan may provide more accurate TB definition. Although an ideal ring-shaped boost might be difficult to reproduce in practice, it introduces a new paradigm: a lower radiation dose inside TB is tolerable, if not desirable, at least in CWPF., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2020
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19. Pectoral nerves blocks (PECS) and sedation: A way to avoid general anesthesia in breast surgery - A single institution early experience.
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Garreffa E, Cantagalli F, Mastrantuono A, Cammarota E, Torresini G, Sozio A, Minora S, and Brucchi M
- Subjects
- Adult, Aged, Aged, 80 and over, Anesthetics, Local therapeutic use, Axilla, Delirium epidemiology, Female, Humans, Levobupivacaine therapeutic use, Lymph Node Excision methods, Mepivacaine therapeutic use, Middle Aged, Pain Measurement, Pain, Postoperative physiopathology, Postoperative Complications epidemiology, Postoperative Nausea and Vomiting epidemiology, Sentinel Lymph Node Biopsy methods, Analgesics, Opioid therapeutic use, Anesthesia, General, Breast Neoplasms surgery, Conscious Sedation, Mastectomy methods, Nerve Block methods, Pain, Postoperative drug therapy, Thoracic Nerves
- Published
- 2020
- Full Text
- View/download PDF
20. Cost-effectiveness of pre-pectoral implant-based breast reconstruction: A pilot comparative analysis.
- Author
-
Garreffa E and Agrawal A
- Subjects
- Adult, Breast Implants economics, Breast Neoplasms surgery, Cohort Studies, Female, Humans, Length of Stay economics, Mammaplasty economics, Mastectomy methods, Middle Aged, Pilot Projects, Retrospective Studies, Risk Assessment, United Kingdom, Breast Implantation economics, Breast Implantation methods, Cost-Benefit Analysis, Hospital Costs, Mammaplasty methods, Pectoralis Muscles surgery
- Published
- 2019
- Full Text
- View/download PDF
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