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1. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

Author

Abbo, L., Abgueguen, P., Almirante, B., Azzini, A.M., Bani-Sadr, F., Bassetti, M., Ben-Ami, R., Beović, B., Béraud, G., Botelho-Nevers, E., Bou, G., Boutoille, D., Cabié, A., Cacopardo, B., Cascio, A., Cassir, N., Castelli, F., Cecala, M., Charmillon, A., Chirouze, C., Cisneros, J.M., Colmenero, J.D., Coppola, N., Corcione, S., Daikos, G.L., Dalla Gasperina, D., De la Calle Cabrera, C., Delobel, P., Di Caprio, D., Durante Mangoni, E., Dupon, M., Ettahar, N., Falagas, M.E., Falcone, M., Fariñas, M.C., Faure, E., Forestier, E., Foti, G., Gallagher, J., Gattuso, G., Gendrin, V., Gentile, I., Giacobbe, D.R., Gogos, C.A., Grandiere Perez, L., Hansmann, Y., Horcajada, J.P., Iacobello, C., Jacob, J.T., Justo, J.A., Kernéis, S., Komnos, A., Kotnik Kevorkijan, B., Lebeaux, D., Le Berre, R., Lechiche, C., Le Moxing, V., Lescure, F.X., Libanore, M., Martinot, M., Merino de Lucas, E., Mondain, V., Mondello, P., Montejo, M., Mootien, J., Muñoz, P., Nir-Paz, R., Pan, A., Paño-Pardo, J.R., Patel, G., Paul, M., Pérez Rodríguez, M.T., Piroth, L., Pogue, J., Potoski, B.A., Pourcher, V., Pyrpasopoulou, A., Rahav, G., Rizzi, M., Rodríguez-Baño, J., Salavert, M., Scheetz, M., Sims, M., Spahija, G., Stefani, S., Stefos, A., Tamma, P.D., Tattevin, P., Tedesco, A., Torre-Cisneros, J., Tripolitsioti, P., Tsiodras, S., Uomo, G., Verdon, R., Viale, P., Vitrat, V., Weinberger, M., Wiener-Well, Y., Papst, L., Pulcini, C., Durante-Mangoni, E., Kaye, K.S., and Raka, L.

Published
2018
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3. Acute cardiovascular events in patients with community acquired pneumonia: results from the observational prospective FADOI-ICECAP study

Author

Pieralli, F, Vannucchi, V, Nozzoli, C, Augello, G, Dentali, F, De Marzi, G, Uomo, G, Risaliti, F, Morbidoni, L, Mazzone, A, Santini, C, Tirotta, D, Corradi, F, Gerloni, R, Gnerre, P, Gussoni, G, Valerio, A, Campanini, M, Manfellotto, D, Fontanella, A, Attardo, T, Tavecchia, L, Gessi, V, Torrigiani, A, Corbo, L, Gallucci, F, Mastrobuoni, C, Giani, A, Teodora, C, Ricchiuti, E, Rosato, A, Giampaolo, L, Di Gregorio, S, Parodi, L, Pallini, F, Landini, G, Giuri, P, Prampolini, G, Arioli, D, Leone, M, Canale, C, Condemi, F, Lupica, R, Manzola, F, Masciana, R, Agnelli, G, Becattini, C, D'Agostini, E, Mosconi, M, Bogliari, G, Rossi, A, Iannantuoni, G, Bartolino, L, Montagnani, A, Verdiani, V, Gambacorta, M, Lenti, S, Francioni, S, Pierfranceschi, M, Cattabiani, C, Orlandini, F, Scuotri, L, La Regina, M, Corsini, F, Anastasio, L, Mumoli, N, Mazzi, V, Camaiti, A, Balbi, G, Ragazzo, F, Pengo, M, Pieralli F., Vannucchi V., Nozzoli C., Augello G., Dentali F., De Marzi G., Uomo G., Risaliti F., Morbidoni L., Mazzone A., Santini C., Tirotta D., Corradi F., Gerloni R., Gnerre P., Gussoni G., Valerio A., Campanini M., Manfellotto D., Fontanella A., Attardo T., Tavecchia L., Gessi V., Torrigiani A., Corbo L., Gallucci F., Mastrobuoni C., Giani A., Teodora C., Ricchiuti E., Rosato A., Giampaolo L., Di Gregorio S., Parodi L., Pallini F., Landini G., Giuri P., Prampolini G., Arioli D., Leone M. C., Canale C., Condemi F., Lupica R., Manzola F., Masciana R., Agnelli G., Becattini C., D'Agostini E., Mosconi M. G., Bogliari G., Rossi A., Iannantuoni G., Bartolino L., Montagnani A., Verdiani V., Gambacorta M., Lenti S., Francioni S., Pierfranceschi M. G., Cattabiani C., Orlandini F., Scuotri L., La Regina M., Corsini F., Anastasio L., Mumoli N., Mazzi V., Camaiti A., Balbi G., Ragazzo F., Pengo M., Pieralli, F, Vannucchi, V, Nozzoli, C, Augello, G, Dentali, F, De Marzi, G, Uomo, G, Risaliti, F, Morbidoni, L, Mazzone, A, Santini, C, Tirotta, D, Corradi, F, Gerloni, R, Gnerre, P, Gussoni, G, Valerio, A, Campanini, M, Manfellotto, D, Fontanella, A, Attardo, T, Tavecchia, L, Gessi, V, Torrigiani, A, Corbo, L, Gallucci, F, Mastrobuoni, C, Giani, A, Teodora, C, Ricchiuti, E, Rosato, A, Giampaolo, L, Di Gregorio, S, Parodi, L, Pallini, F, Landini, G, Giuri, P, Prampolini, G, Arioli, D, Leone, M, Canale, C, Condemi, F, Lupica, R, Manzola, F, Masciana, R, Agnelli, G, Becattini, C, D'Agostini, E, Mosconi, M, Bogliari, G, Rossi, A, Iannantuoni, G, Bartolino, L, Montagnani, A, Verdiani, V, Gambacorta, M, Lenti, S, Francioni, S, Pierfranceschi, M, Cattabiani, C, Orlandini, F, Scuotri, L, La Regina, M, Corsini, F, Anastasio, L, Mumoli, N, Mazzi, V, Camaiti, A, Balbi, G, Ragazzo, F, Pengo, M, Pieralli F., Vannucchi V., Nozzoli C., Augello G., Dentali F., De Marzi G., Uomo G., Risaliti F., Morbidoni L., Mazzone A., Santini C., Tirotta D., Corradi F., Gerloni R., Gnerre P., Gussoni G., Valerio A., Campanini M., Manfellotto D., Fontanella A., Attardo T., Tavecchia L., Gessi V., Torrigiani A., Corbo L., Gallucci F., Mastrobuoni C., Giani A., Teodora C., Ricchiuti E., Rosato A., Giampaolo L., Di Gregorio S., Parodi L., Pallini F., Landini G., Giuri P., Prampolini G., Arioli D., Leone M. C., Canale C., Condemi F., Lupica R., Manzola F., Masciana R., Agnelli G., Becattini C., D'Agostini E., Mosconi M. G., Bogliari G., Rossi A., Iannantuoni G., Bartolino L., Montagnani A., Verdiani V., Gambacorta M., Lenti S., Francioni S., Pierfranceschi M. G., Cattabiani C., Orlandini F., Scuotri L., La Regina M., Corsini F., Anastasio L., Mumoli N., Mazzi V., Camaiti A., Balbi G., Ragazzo F., and Pengo M.

Abstract

Background: The burden of cardiovascular (CV) complications in patients hospitalised for community-acquired pneumonia (CAP) is still uncertain. Available studies used different designs and different criteria to define CV complications. We assessed the cumulative incidence of acute of CV complications during hospitalisation for CAP in Internal Medicine Units (IMUs). Methods: This was a prospective study carried out in 26 IMUs, enrolling patients consecutively hospitalised for CAP. Defined CV complications were: newly diagnosed heart failure, acute coronary syndrome, new onset of supraventricular or ventricular arrhythmias, new onset hemorrhagic or ischemic stroke or transient ischemic attack. Outcome measures were: in-hospital and 30-day mortality, length of hospital stay and rate of 30-day re-hospitalisation. Results: A total of 1266 patients were enrolled, of these 23.8% experienced at least a CV event, the majority (15.5%) represented by newly diagnosed decompensated heart failure, and 75% occurring within 3 days. Female gender, a history of CV disease, and more severe pneumonia were predictors of CV events. In-hospital (12.2% vs 4.7%, p < 0.0001) and 30-day (16.3% vs 8.9%, p = 0.0001) mortality was higher in patients with CV events, as well as the re-hospitalisation rate (13.3% vs 9.3%, p = 0.002), and mean hospital stay was 11.4 ± 6.9 vs 9.5 ± 5.6 days (p < 0.0001). The occurrence of CV events during hospitalisation significantly increased the risk of 30-day mortality (HR 1.69, 95% CI 1.14–2.51; p = 0.009). Conclusion: Cardiovascular events are frequent in CAP, and their occurrence adversely affects outcome. A strict monitoring might be useful to intercept in-hospital CV complications for those patients with higher risk profile. Trial registration: NCT03798457 Registered 10 January 2019 - Retrospectively registered

Published
2021

6. Acute cardiovascular events in patients with community acquired pneumonia: results from the observational prospective FADOI-ICECAP study

Author

Pieralli, F., Vannucchi, V., Nozzoli, C., Augello, G., Dentali, F., De Marzi, G., Uomo, G., Risaliti, F., Morbidoni, L., Mazzone, A., Santini, C., Tirotta, D., Corradi, F., Gerloni, R., Gnerre, P., Gussoni, G., Valerio, A., Campanini, M., Manfellotto, D., Fontanella, A., Attardo, T., Tavecchia, L., Gessi, V., Torrigiani, A., Corbo, L., Gallucci, F., Mastrobuoni, C., Giani, A., Teodora, C., Ricchiuti, E., Rosato, A., Giampaolo, L., Di Gregorio, S., Parodi, L., Pallini, F., Landini, G., Giuri, P., Prampolini, G., Arioli, D., Leone, M. C., Canale, C., Condemi, F., Lupica, R., Manzola, F., Masciana, R., Agnelli, G., Becattini, C., D'Agostini, E., Mosconi, M. G., Bogliari, G., Rossi, A., Iannantuoni, G., Bartolino, L., Montagnani, A., Verdiani, V., Gambacorta, M., Lenti, S., Francioni, S., Pierfranceschi, M. G., Cattabiani, C., Orlandini, F., Scuotri, L., La Regina, M., Corsini, F., Anastasio, L., Mumoli, N., Mazzi, V., Camaiti, A., Balbi, G., Ragazzo, F., Pengo, M., Pieralli, F, Vannucchi, V, Nozzoli, C, Augello, G, Dentali, F, De Marzi, G, Uomo, G, Risaliti, F, Morbidoni, L, Mazzone, A, Santini, C, Tirotta, D, Corradi, F, Gerloni, R, Gnerre, P, Gussoni, G, Valerio, A, Campanini, M, Manfellotto, D, Fontanella, A, Attardo, T, Tavecchia, L, Gessi, V, Torrigiani, A, Corbo, L, Gallucci, F, Mastrobuoni, C, Giani, A, Teodora, C, Ricchiuti, E, Rosato, A, Giampaolo, L, Di Gregorio, S, Parodi, L, Pallini, F, Landini, G, Giuri, P, Prampolini, G, Arioli, D, Leone, M, Canale, C, Condemi, F, Lupica, R, Manzola, F, Masciana, R, Agnelli, G, Becattini, C, D'Agostini, E, Mosconi, M, Bogliari, G, Rossi, A, Iannantuoni, G, Bartolino, L, Montagnani, A, Verdiani, V, Gambacorta, M, Lenti, S, Francioni, S, Pierfranceschi, M, Cattabiani, C, Orlandini, F, Scuotri, L, La Regina, M, Corsini, F, Anastasio, L, Mumoli, N, Mazzi, V, Camaiti, A, Balbi, G, Ragazzo, F, and Pengo, M

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Community-acquired pneumonia, Myocardial Infarction, Disease, Cardiovascular event, 030204 cardiovascular system & hematology, lcsh:Infectious and parasitic diseases, Cardiovascular events, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Prevalence, Pneumonia, Bacterial, 80 and over, Humans, Cumulative incidence, lcsh:RC109-216, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, business.industry, Incidence, Bacterial, Correction, Pneumonia, Length of Stay, Middle Aged, medicine.disease, Hospitalization, Community-Acquired Infections, Infectious Diseases, Italy, Heart failure, Observational study, Female, business, Hospital Units, Research Article
Abstract

Background The burden of cardiovascular (CV) complications in patients hospitalised for community-acquired pneumonia (CAP) is still uncertain. Available studies used different designs and different criteria to define CV complications. We assessed the cumulative incidence of acute of CV complications during hospitalisation for CAP in Internal Medicine Units (IMUs). Methods This was a prospective study carried out in 26 IMUs, enrolling patients consecutively hospitalised for CAP. Defined CV complications were: newly diagnosed heart failure, acute coronary syndrome, new onset of supraventricular or ventricular arrhythmias, new onset hemorrhagic or ischemic stroke or transient ischemic attack. Outcome measures were: in-hospital and 30-day mortality, length of hospital stay and rate of 30-day re-hospitalisation. Results A total of 1266 patients were enrolled, of these 23.8% experienced at least a CV event, the majority (15.5%) represented by newly diagnosed decompensated heart failure, and 75% occurring within 3 days. Female gender, a history of CV disease, and more severe pneumonia were predictors of CV events. In-hospital (12.2% vs 4.7%, p p = 0.0001) mortality was higher in patients with CV events, as well as the re-hospitalisation rate (13.3% vs 9.3%, p = 0.002), and mean hospital stay was 11.4 ± 6.9 vs 9.5 ± 5.6 days (p p = 0.009). Conclusion Cardiovascular events are frequent in CAP, and their occurrence adversely affects outcome. A strict monitoring might be useful to intercept in-hospital CV complications for those patients with higher risk profile. Trial registration NCT03798457 Registered 10 January 2019 - Retrospectively registered

Published
2021

12. Results of prospective multicenter study on heart failure on Campania Internal Medicine wards: the FASHION study

Author

Gallucci F, Ronga I, Fontanella A, Uomo G, ABETE, PASQUALE, Ambrosca C, Avella F, Beneduce F, Boni R, Borgia M, Cannavale A, Caputo D, Caserta L, Caso P, Ciaramella F, Cositore G, Dalia C, De Donato MT, De Feo V, Esposito N, Fimiani B, Galderisi M, Giaquinto E, Giordano P, Grasso E, Guida L, Ilardi A, Maffettone A, Mastrobuoni C, Mayer MC, Rabitti PG, Ranucci R, Renis M, Schiavo A, Tassinario S, Zuccoli A., Gallucci, F, Ronga, I, Fontanella, A, Uomo, G, Abete, Pasquale, Ambrosca, C, Avella, F, Beneduce, F, Boni, R, Borgia, M, Cannavale, A, Caputo, D, Caserta, L, Caso, P, Ciaramella, F, Cositore, G, Dalia, C, De Donato, Mt, De Feo, V, Esposito, N, Fimiani, B, Galderisi, M, Giaquinto, E, Giordano, P, Grasso, E, Guida, L, Ilardi, A, Maffettone, A, Mastrobuoni, C, Mayer, Mc, Rabitti, Pg, Ranucci, R, Renis, M, Schiavo, A, Tassinario, S, and Zuccoli, A.

Subjects
medicine.medical_specialty, Pediatrics, aging, New York Heart Association Class, lcsh:Medicine, Heart failure, 030204 cardiovascular system & hematology, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Epidemiology, Health care, medicine, 030212 general & internal medicine, internal medicine wards, Ejection fraction, business.industry, lcsh:R, Atrial fibrillation, General Medicine, medicine.disease, gender difference, Etiology, epidemiology, business
Abstract

Heart failure (HF) is characterized by a high prevalence and hospitalization rate with considerable health and social impact; the knowledge of its epidemiological features remains the mainstay to assess adequacy of the health care needs. The aim of this study was to evaluate the prevalence of HF in Internal Medicine Units of the Campania region (Italy) and patients’ characteristics. We recruited all patients with HF admitted between April 1 and June 30, 2014, in 23 Units of Internal Medicine: 975 patients (19.5% of 5000 admissions), 518 women and 457 men, mean age 76.9±9.9 (range 34-100) with 741 (76%) older than 70 years. The mean age was higher in women than men; 35.8% of patients had atrial fibrillation, with higher prevalence in women than in men. Coronary artery disease represented the leading etiology while prevalence of non-ischemic heart failure was higher in women. New York Heart Association class was indicated in 926 patients. Left ventricular ejection fraction (LVEF) was measured in 503 patients; 18.4% of patients had a severely reduced LVEF40%. At least one hospital admission in the previous 12 months was registered in 39.6% of patients. One, two and more than two relevant comorbidities were present in 8.6%, 24.7% and 64.8% of patients, respectively. Arterial hypertension and coronary artery disease were more frequent in female. In conclusion, advanced age and clinical complexity were the main characteristics of HF patients hospitalized in the Internal Medicine Units in Campania. Gender differences also emerged from the analysis of demographic parameters and etiopathogenetic features. Some diagnostic and therapeutic aspects not in line with that recommended by the most recent HF international guidelines were registered.

Published
2017

13. Abstracts from the sixth meeting of the international association of pancreatology, November 2–4, 1994, Chicago, IL

Author

Burdick, Michael, Hollingsworth, Tony, Gansauge, S., Gansauge, F., Link, K. H., Schoenberg, M. H., Poch, B., Beger, H. G., Wagner, A. C. C., Steffen, H., Göke, B., Gaisano, H. Y., Sheu, L., Foskett, J. K., Trimble, W. S., Lee, Y. L., Kwon, H. Y., Park, H. S., Lee, S. M., Park, H. J., aguchi, S., Green, G. M., Mitamura, K., Komatsu, Y., Arai, I., Yamaura, H., Wang, OJ, Adrian, TE, Teyssen, S., Niebel, W., Niebergall, E., Singer, M. V., Umehara, K, Ohara, T, Kataoka, K, Okamura, H, Kato, M, Sakagami, J, Ohta, A, Murase, M, Hosoda, M, Yamane, Y, Kashima, K, Ibata, Y, Balthazar, Emil J., Banks, P. A., Garzof, S. G., Langevin, R. E., Silverman, S. G., Sica, G. T., Bassi, C., Benini, A., Muner, A., Falconi, M., Abbas, H., Pederzoli, P., Salvia, R., Minelli, E. Bertazzoni, Shaskar, S. Shanmuga, Shearer, M. G., Imrie, C. W., Brodmerkel, G. J., Reed, P. A., Carr-Locke, DL, Musa, A, Lichtenstein, DR, Dam, J Van, Banks, PA, Eisele, S., Schoenberg, M. H., Böchjer, M., Beger, H. G., Foitzik, Th., Fern’andez-del Castillo, C., Rattner, D. W., Ferraro, M. J., Warshaw, A. L., Foitzik, Th., Schmidt, J., Hotz, H., Warshaw, A. L., Buhr, H. J., Klar, E., Heinisch, A., Kadow, R., Bioss, U., Schölmerich, J., Zimgibl, H., Leser, H. -G., Manes, G., Rabitti, P. G., Laccetti, M., Cavallera, A., Paceili, L., Gagiione, G., Uomo, G., Marinqhini, A., Zinsmeister, A. R., Melton, L. J., DiMagno, E. P., Marotta, F., Chui, D. H., Barbi, G., Zhong, G. G., Marotta, F., Chui, D. H., Tajiri, H., Bellini, O., Zhong, G. G., Barbi, G., McKay, C, Baxter, J. N., Imrie, C. W., Mithöfer, K., Fern’andez-delCastillo, C., Frick, T. W., Lewandrowski, K., Rattner, D. W., Warshaw, A. L., Pezzilli, R., Billi, P., Miniero, R., Gullo, L., Barakat, B., Migliuli, M., Rau, B., Schad, M., Schoenberg, M., Beger, H. G., Richter, F., Matthias, R., Sakagami, J, Kataoka, K, Ohta, A, Umehara, K, Imoto, M, Murase, M, Hosoda, M, Yamane, Y, Kato, M, Kashima, K, Ashihara, T, Schofield, D, Sharer, NM, Heywood, KM, Waters, HM, Braganza, JM, Scott, P, Sharer, NM, Bilton, D, Deardon, D, Lee, S, Taylor, PM, McCloy, RF, Braganza, JM, Shen, J., Shao, H., Wu, Z. P., Jin, J. J., Shiel, N, Cassidy, O, Sharma, H, Braganza, J. M., Soöckmann, F., Ahrens, J., Leonhardt, U., Otto, J., Ritzel, U., Ramadori, G., Tian, Fuzhou, Hu, JZ, Huang, DR, Wang, XH, Lian, HW, Zhang, BY, Miao, JG, Li, Xu, Zhou, HT, Uomo, G., Rabitti, P. G., Laccetti, M., Manes, G., Esposico, P., Perrocti, F., Visconci, M., Vaccaro, M. I., Dagrosa, M. A., Mora, M. I., Sordelli, D. O., Vogt, W., MeOmann, H., Heinisch, A., Linseis, A., Holstege, A., Schölmerich, J., Leser, H. -G., Weiser, M. R., Gibbs, S. A. L., Hechcman, H. B., Moore, F. D., Worthington, H. V., Runt, L. P., HcCloy, R. F., KacLennan, I. A., Braqanza, J. M., Heath, D, Alexander, D, Wilson, C, Larvin, M, Imrie, CW, McMahon, MJ, Larvin, M, Ward, J, Robinson, PJ, Chalmers, AG, McMahon, MJ, Apte, M, Wilson, J, McCaughan, G, Korsten, M, Norton, I, Piroia, R, Bimmler, D., Frick, T. W., Scheele, G. A., Bockman, Dale E., Büchler, Markus, Beger, Hans G., Cavallini, G., Brunori, M. P., Rigo, L., Bovo, P., Filippini, M., Vaona, B., Di Francesco, V., Frulloni, L., Marcori, M., Farri, P. C., Laardini, M. T., Pederzoli, P., Chowdhury, Riaz, Ochi, Koji, Mizushima, Takaaki, Tsurumi, Tetsuya, Harada, Hideo, Laver, P., Hoist, J. J., Ohe, M. v. d., Goebell, H., Mi Zumoto, A., Sarr, M. G., DiMagno, E. P., Moore, R., Frey, C. F., Debas, H. T., Mulvihill, S. J., Onizuka, S., Kuroda, H., Kuroda, Y., Hongo, H., Matsuzaki, S., Ito, M., Sekine, L., Tsunoda, T., Pap, ’A., Hrisztov, V., Pap, ’A., Marosi, E., Simon, K., Tak’acs, T., Pederzoli, P., Falconi, M., Bassi, C., Bonora, A., Talamini, G., Saivia, R., Benini, L., Caldiron, E., Vesentini, S., Cavallini, G., Raijman, Isaac, Kortan, Paul, Haber, Gregory B., Ramesh, H, Varghese, CJ, Schofield, D, Kay, PM, Bottiglieri, T, Uden, S, Bilton, D, Braganza, JM, Gut, A, Segal, I, Snehalatha, C, Mohan, V, Braganza, JM, Silva, E., Ceneviva, R., Velludo, M. A. L., Silvan, E., Ruebner, B., Ceneviva, R., Velludo, M. A. L., Roselino, J. E. S., Foss, M. C., Talaraini, G., Falcaoi, M., Frmlltai, L, K Fraacesca, V., Maxwi, M., Vaosa, B., Baro, P., Baxu, C., Pedercoli, P., Cavalliai, G., Taiamini, G., Iacano, C., Faicsai, M., Frulloni, L., Rige, L., Castagnisi, A., Marcori, M., Angelini, G., Bassi, C., Bom, P., Vaoss, B., Vantini, I., Sen, G., Pederzali, P., Cavallini, G., Štimee, B, Bulajič, M, Milosavljevi’c, T, Krsti’c, R, Markovi’c, M, Korneti, V, Ugljcš’c, M, Abruzzesse, IL, Evans, DB, Larry, L, King, T, Raijman, I, Roubein, L, Frazier, M, lacono, C., Faca, E., Falezza, G., Bonora, E., Aurola PP, Serio, G., lacono, C., Nicoli, N., Mansueto, G. C., Zicari, M., Marchiori, L., Mangiante, G., Seno, G., Imarnura, M., Yamauchi, H., Inoue, M., Onda, M., UchlDa, E., Almqtq, T., Yamanaka, Y., Kqbayashi, T., Yokqyama, T., Aida, K., Sasajima, K., Tajiri, T., Egami, K., Yamashita, K., Naitq, Z., Asano, G., Lewandrowski, K. B., Kirby, R. E., Southern, J. F., Compton, C. C., Warshaw, A. L., Lip, J, Strömmer, L, Permert, J, Larsson, J, Adrian, TE, Loftus, E. V., Adkins, M. C., Olivares-Pakzad, B., Batts, K. P., Stephens, D. H., Farnell, M. B., Sarr, H. G., Thompson, G. B., van Heerden, J. A., Kelly, D. G., Miller, L. J., Pearson, R. K., Clain, J. E., Petersen, B. T., DiMagno, E. P., Matsumoto, Cancer S., Chowdhury, R., Mizushima, T., Ochi, K., Harada, H., Miki, H., Ozkan, Hnsan, Saisho, Hiromitsu, Yarnaguchi, Taketo, Ishihara, Takeshi, Kikuchi, Yasuharu, Tsuyuguchi, Toshio, Ohto, Masao, Pasqual, C., Sperti, C., Liesai, G., Guido, M., Pedrazzoli, S., Sperti, C., Pasquali, C., Khajeturian, E., Guolo, P., Pedrazzoli, S., Tadokoro, H., Watanabe, S., Moriyoshi, Y., Yoshida, K., Shiratori, K., Takeuchi, T., Uchida, E., Onda, M., Tajiri, T., Egami, K., Yamashita, K., Aida, K., Yamanaka, Y., Kobayashi, T., Aimoto, T., Yokoyama, T., Inoue, M., Naito, Z., Asano, G., Valentich, M. A., Monis, B., Barotto, N. N., and Herrera, P.

Published
1994
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16. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

Author

Papst, Lea, Beović, Bojana, Pulcini, Céline, Durante-Mangoni, Emanuele, Rodríguez-Baño, Jesús, Kaye, Keith S, Daikos, George L, Raka, Lul, Paul, Mical, Esgap, Esgbis, ESGIE and the CRGNB treatment survey study group collaborators: Abbo, L, Abgueguen, P, Almirante, B, Azzini, Am, Bani-Sadr, F, Bassetti, M, Ben-Ami, R, Beović, B, Béraud, G, Botelho-Nevers, E, Bou, G, Boutoille, D, Cabié, A, Cacopardo, B, Cascio, A, Cassir, N, Castelli, F, Cecala, M, Charmillon, A, Chirouze, C, Cisneros, Jm, Colmenero, Jd, Coppola, N, Corcione, S, Daikos, Gl, Dalla Gasperina, D, De la Calle Cabrera, C, Delobel, P, Di Caprio, D, Durante Mangoni, E, Dupon, M, Ettahar, N, Falagas, Me, Falcone, M, Fariñas, Mc, Faure, E, Forestier, E, Foti, G, Gallagher, J, Gattuso, G, Gendrin, V, Gentile, I, Giacobbe, Dr, Gogos, Ca, Grandiere Perez, L, Hansmann, Y, Horcajada, Jp, Iacobello, C, Jacob, Jt, Justo, Ja, Kernéis, S, Komnos, A, Kotnik Kevorkijan, B, Lebeaux, D, Le Berre, R, Lechiche, C, Le Moing, V, Lescure, Fx, Libanore, M, Martinot, M, Merino de Lucas, E, Mondain, V, Mondello, P, Montejo, M, Mootien, J, Muñoz, P, Nir-Paz, R, Pan, A, Paño-Pardo, Jr, Patel, G, Paul, M, Pérez Rodríguez MT, Piroth, L, Pogue, J, Potoski, Ba, Pourcher, V, Pyrpasopoulou, A, Rahav, G, Rizzi, M, Rodríguez-Baño, J, Salavert, M, Scheetz, M, Sims, M, Spahija, G, Stefani, S, Stefos, A, Tamma, Pd, Tattevin, P, Tedesco, A, Torre-Cisneros, J, Tripolitsioti, P, Tsiodras, S, Uomo, G, Verdon, R, Viale, P, Vitrat, V, Weinberger, M, Wiener-Well, Y, Papst L., Beovic B., Pulcini C., Durante-Mangoni E., Rodriguez-Bano J., Kaye K.S., Daikos G.L., Raka L., Paul M., Abbo L., Abgueguen P., Almirante B., Azzini A.M., Bani-Sadr F., Bassetti M., Ben-Ami R., Beraud G., Botelho-Nevers E., Bou G., Boutoille D., Cabie A., Cacopardo B., Cascio A., Cassir N., Castelli F., Cecala M., Charmillon A., Chirouze C., Cisneros J.M., Colmenero J.D., Coppola N., Corcione S., Dalla Gasperina D., De la Calle Cabrera C., Delobel P., Di Caprio D., Durante Mangoni E., Dupon M., Ettahar N., Falagas M.E., Falcone M., Farinas M.C., Faure E., Forestier E., Foti G., Gallagher J., Gattuso G., Gendrin V., Gentile I., Giacobbe D.R., Gogos C.A., Grandiere Perez L., Hansmann Y., Horcajada J.P., Iacobello C., Jacob J.T., Justo J.A., Kerneis S., Komnos A., Kotnik Kevorkijan B., Lebeaux D., Le Berre R., Lechiche C., Le Moxing V., Lescure F.X., Libanore M., Martinot M., Merino de Lucas E., Mondain V., Mondello P., Montejo M., Mootien J., Munoz P., Nir-Paz R., Pan A., Pano-Pardo J.R., Patel G., Perez Rodriguez M.T., Piroth L., Pogue J., Potoski B.A., Pourcher V., Pyrpasopoulou A., Rahav G., Rizzi M., Salavert M., Scheetz M., Sims M., Spahija G., Stefani S., Stefos A., Tamma P.D., Tattevin P., Tedesco A., Torre-Cisneros J., Tripolitsioti P., Tsiodras S., Uomo G., Verdon R., Viale P., Vitrat V., Weinberger M., Wiener-Well Y., University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Monaldi Hospital, Hospital Virgen Macarena, University of Michigan Medical School [Ann Arbor], University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, National and Kapodistrian University of Athens (NKUA), University Clinical Center of Kosova, Rambam Health Care Campus, Jackson Memorial Hospital, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Vall d'Hebron University Hospital [Barcelona], University of Verona (UNIVR), Centre Hospitalier Universitaire de Reims (CHU Reims), Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Tel Aviv Sourasky Medical Centre, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hospital Universitario, A Coruña, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU de la Martinique [Fort de France], ARNAS 'Garibaldi, S. Luigi-Currò, Ascoli-Tomaselli', Università degli studi di Palermo - University of Palermo, Assistance Publique-Hôpitaux de Marseille (AP-HM), ASST Spedali Civili of Brescia, ARNAS Civico Palermo, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hospital Universitario Virgen del Rocío [Sevilla], Hospital Regional Universitario de Málaga [Spain], Università degli studi della Campania 'Luigi Vanvitelli', University of Turin, University of Insubria, Varese, Hospital Clínic de Barcelona, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], AO San Sebastiano, CHU Bordeaux [Bordeaux], CH Valenciennes, Henry Dunant Hospital, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Hospital Marques de Valdecillas, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Métropole Savoie [Chambéry], Ospedale di Reggio Calabria, Children’s Hospital of Philadelphia (CHOP ), Carlo Poma Hospital Mantova (ASST Mantova ), CH Belfort-Montbéliard, University of Naples Federico II, AUO San Martino IST Ist Nazl Ric Canc, I-16132 Genoa, Italy, University of Patras [Patras], Centre Hospitalier Le Mans (CH Le Mans), CHU Strasbourg, IMIM-Hospital del Mar, Generalitat de Catalunya, Cannizzaro Hospital, Emory University School of Medicine, Emory University [Atlanta, GA], University of South Carolina [Columbia], AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), General Hospital of Larissa, University medical centre Maribor (UKC Maribor), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP-HP - Hôpital Bichat - Claude Bernard [Paris], University of Ferrara at St. Anna Hospital, CH Colmar, Hospital General Universitario de Alicante, CHU Nice [Cimiez], Hôpital Cimiez [Nice] (CHU), AOU Policlinico 'G. Martino', Messina, Italy, Hospital Universitario Cruces = Cruces University Hospital, Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Hospital General Universitario 'Gregorio Marañón' [Madrid], Hadassah Hebrew University Medical Center [Jerusalem], Azienda Istituti Ospitalieri di Cremona, Lozano Blesa Clinical Hospital [Zaragoza, Spain], Mount Sinai Hospital [Toronto, Canada] (MSH), Complejo Hospitalario de Vigo, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Detroit Medical Center, University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis] (UPMC), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hippokration General Hospital, Sheba Medical Centre, Ramat Gan, Israel, ASST Papa Giovanni XXIII [Bergamo, Italy], Hospital Universitario La Fe, Valencia, Northwestern Hospital Chicago, Beaumont Hospital, Lagjia e Universitetit, Rruga 1, nr.32, 10000 Prishtina, Kosovo, parent, Università degli studi di Catania [Catania], Larissa University Hospital, Johns Hopkins University School of Medicine [Baltimore], CHU Pontchaillou [Rennes], Ospedale Fracastoro San Bonifacio [Verona], Hospital Reina Sofia, Cordoba, Agioi Anargiroi Hospital, Attikon University Hospital, Ospedale Cardarelli, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), CH Annecy Genevois, Assah Harofeh Medical Centre, Zerifin, Israel, Shaare Zedek Medical Centre, Jerusalem, Israel, National Institutes of Health (US), Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), Red Española de Investigación en Patología Infecciosa, European Commission, Papst, Lea, Beović, Bojana, Pulcini, Céline, Durante-Mangoni, Emanuele, Rodríguez-Baño, Jesú, Kaye, Keith S, Daikos, George L, Raka, Lul, Paul, Mical, Papst, L., Beovic, B., Pulcini, C., Durante-Mangoni, E., Rodriguez-Bano, J., Kaye, K. S., Daikos, G. L., Raka, L., Paul, M., Abbo, L., Abgueguen, P., Almirante, B., Azzini, A. M., Bani-Sadr, F., Bassetti, M., Ben-Ami, R., Beraud, G., Botelho-Nevers, E., Bou, G., Boutoille, D., Cabie, A., Cacopardo, B., Cascio, A., Cassir, N., Castelli, F., Cecala, M., Charmillon, A., Chirouze, C., Cisneros, J. M., Colmenero, J. D., Coppola, N., Corcione, S., Dalla Gasperina, D., De la Calle Cabrera, C., Delobel, P., Di Caprio, D., Dupon, M., Ettahar, N., Falagas, M. E., Falcone, M., Farinas, M. C., Faure, E., Forestier, E., Foti, G., Gallagher, J., Gattuso, G., Gendrin, V., Gentile, I., Giacobbe, D. R., Gogos, C. A., Grandiere Perez, L., Hansmann, Y., Horcajada, J. P., Iacobello, C., Jacob, J. T., Justo, J. A., Kerneis, S., Komnos, A., Kotnik Kevorkijan, B., Lebeaux, D., Le Berre, R., Lechiche, C., Le Moxing, V., Lescure, F. X., Libanore, M., Martinot, M., Merino de Lucas, E., Mondain, V., Mondello, P., Montejo, M., Mootien, J., Munoz, P., Nir-Paz, R., Pan, A., Pano-Pardo, J. R., Patel, G., Perez Rodriguez, M. T., Piroth, L., Pogue, J., Potoski, B. A., Pourcher, V., Pyrpasopoulou, A., Rahav, G., Rizzi, M., Salavert, M., Scheetz, M., Sims, M., Spahija, G., Stefani, S., Stefos, A., Tamma, P. D., Tattevin, P., Tedesco, A., Torre-Cisneros, J., Tripolitsioti, P., Tsiodras, S., Uomo, G., Verdon, R., Viale, P., Vitrat, V., Weinberger, M., Wiener-Well, Y., Università degli studi di Verona = University of Verona (UNIVR), Assistance Publique - Hôpitaux de Marseille (APHM), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], and Università degli studi di Torino = University of Turin (UNITO)

Subjects
0301 basic medicine, Acinetobacter baumannii, Carbapenem, Antibiotics, Drug Resistance, Drug resistance, Tigecycline, Carbapenem-resistant Gram-negative bacilli, Combination therapy, Enterobacteriaceae, Polymyxin, Pseudomonas aeruginosa, Survey, 0302 clinical medicine, Surveys and Questionnaires, polycyclic compounds, 030212 general & internal medicine, Anti-Bacterial Agents, Carbapenems, Cross Infection, Cross-Sectional Studies, Drug Resistance, Bacterial, Gram-Negative Bacteria, Gram-Negative Bacterial Infections, Hospitals, Humans, Microbial Sensitivity Tests, Microbiology (medical), Infectious Diseases, biology, Microbial Sensitivity Test, Bacterial, antibiotic management, carbapenem-resistant Gram-negative bacteria, General Medicine, 3. Good health, medicine.drug, Human, medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Fosfomycin, carbapenem-resistant Gram-negative bacteria, 03 medical and health sciences, Hospital, Internal medicine, Anti-Bacterial Agent, medicine, Gram-Negative Bacterial Infection, Cross-Sectional Studie, business.industry, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, Infectious disease (medical specialty), Carbapenem-resistant gram-negative bacilli, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, antibiotic management, business, Rifampicin
Abstract

ESGAP, ESGBIS, ESGIE and the CRGNB treatment survey study group., [Objectives] To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria in hospitals., [Methods] Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the USA. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions., [Results] Between January and June 2017, 115 of 141 eligible hospitals participated (overall response rate 81.6%, country-specific rates 66.7%–100%). Most were tertiary-care (99/114, 86.8%), university-affiliated (110/115, 89.1%) hospitals and most representatives were infectious disease specialists (99/115, 86.1%). Combination therapy was prescribed in 114/115 (99.1%) hospitals at least occasionally. Respondents were more likely to consider combination therapy when treating bacteraemia, pneumonia and central nervous system infections and for Enterobacteriaceae, P. aeruginosa and A. baumannii similarly. Combination of a polymyxin with a carbapenem was used in most cases, whereas combinations of a polymyxin with tigecycline, an aminoglycoside, fosfomycin or rifampicin were also common. Monotherapy was used for treatment of complicated urinary tract infections, usually with an aminoglycoside or a polymyxin. The intended goal of combination therapy was to improve the effectiveness of the treatment and to prevent development of resistance. In general, respondents shared the misconception that combination therapy is supported by strong scientific evidence., [Conclusions] Combination therapy was the preferred treatment strategy for infections caused by carbapenem-resistant Gram-negative bacteria among hospital representatives, even though high-quality evidence for carbapenem-based combination therapy is lacking., EDM received funding by NIH for project HHSN272201000039C. JRB received funding for research from Plan Nacional de I + D + i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001)—co-financed by European Development Regional Fund A way to achieve Europe, Operative Programme Intelligent Growth 2014–2020.

Published
2018
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21. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

Author

Papst, L. Beovic, B. Pulcini, C. Durante-Mangoni, E. Rodríguez-Baño, J. Kaye, K.S. Daikos, G.L. Raka, L. Paul, M. Abbo, L. Abgueguen, P. Almirante, B. Azzini, A.M. Bani-Sadr, F. Bassetti, M. Ben-Ami, R. Béraud, G. Botelho-Nevers, E. Bou, G. Boutoille, D. Cabié, A. Cacopardo, B. Cascio, A. Cassir, N. Castelli, F. Cecala, M. Charmillon, A. Chirouze, C. Cisneros, J.M. Colmenero, J.D. Coppola, N. Corcione, S. Dalla Gasperina, D. De la Calle Cabrera, C. Delobel, P. Di Caprio, D. Dupon, M. Ettahar, N. Falagas, M.E. Falcone, M. Fariñas, M.C. Faure, E. Forestier, E. Foti, G. Gallagher, J. Gattuso, G. Gendrin, V. Gentile, I. Giacobbe, D.R. Gogos, C.A. Grandiere Perez, L. Hansmann, Y. Horcajada, J.P. Iacobello, C. Jacob, J.T. Justo, J.A. Kernéis, S. Komnos, A. Kotnik Kevorkijan, B. Lebeaux, D. Le Berre, R. Lechiche, C. Le Moxing, V. Lescure, F.X. Libanore, M. Martinot, M. Merino de Lucas, E. Mondain, V. Mondello, P. Montejo, M. Mootien, J. Muñoz, P. Nir-Paz, R. Pan, A. Paño-Pardo, J.R. Patel, G. Pérez Rodríguez, M.T. Piroth, L. Pogue, J. Potoski, B.A. Pourcher, V. Pyrpasopoulou, A. Rahav, G. Rizzi, M. Salavert, M. Scheetz, M. Sims, M. Spahija, G. Stefani, S. Stefos, A. Tamma, P.D. Tattevin, P. Tedesco, A. Torre-Cisneros, J. Tripolitsioti, P. Tsiodras, S. Uomo, G. Verdon, R. Viale, P. Vitrat, V. Weinberger, M. Wiener-Well, Y. ESGAP, ESGBIS, ESGIE the CRGNB treatment survey study group

Abstract

Objectives: To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria in hospitals. Methods: Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the USA. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions. Results: Between January and June 2017, 115 of 141 eligible hospitals participated (overall response rate 81.6%, country-specific rates 66.7%–100%). Most were tertiary-care (99/114, 86.8%), university-affiliated (110/115, 89.1%) hospitals and most representatives were infectious disease specialists (99/115, 86.1%). Combination therapy was prescribed in 114/115 (99.1%) hospitals at least occasionally. Respondents were more likely to consider combination therapy when treating bacteraemia, pneumonia and central nervous system infections and for Enterobacteriaceae, P. aeruginosa and A. baumannii similarly. Combination of a polymyxin with a carbapenem was used in most cases, whereas combinations of a polymyxin with tigecycline, an aminoglycoside, fosfomycin or rifampicin were also common. Monotherapy was used for treatment of complicated urinary tract infections, usually with an aminoglycoside or a polymyxin. The intended goal of combination therapy was to improve the effectiveness of the treatment and to prevent development of resistance. In general, respondents shared the misconception that combination therapy is supported by strong scientific evidence. Conclusions: Combination therapy was the preferred treatment strategy for infections caused by carbapenem-resistant Gram-negative bacteria among hospital representatives, even though high-quality evidence for carbapenem-based combination therapy is lacking. © 2018 European Society of Clinical Microbiology and Infectious Diseases

Published
2018

24. Comparison of Two Dosing Regimens of Gabexate in The Prophylaxis of Post-Ercp Pancreatitis

Author

Masci E, Cavallini G, Mariani A, Frulloni L, Curioni S, Tittobello A, Uomo G, Costamagna G, Zambelli S, Macarri G, Innocenti P, Dragonetti C, Gabexate in Digestive Endoscopy Italian Group, TESTONI , PIER ALBERTO, Masci, E, Cavallini, G, Mariani, A, Frulloni, L, Testoni, PIER ALBERTO, Curioni, S, Tittobello, A, Uomo, G, Costamagna, G, Zambelli, S, Macarri, G, Innocenti, P, Dragonetti, C, and Gabexate in Digestive Endoscopy Italian, Group

Subjects
Male, Pancreatic disease, medicine.medical_treatment, chemistry.chemical_compound, Endoscopic Retrograde, Reference Values, Gabexate, 80 and over, Prospective Studies, Infusions, Intravenous, Prospective cohort study, Saline, Pain Measurement, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Gastroenterology, Middle Aged, Cholangiopancreatography, Treatment Outcome, Italy, Anesthesia, Acute Disease, Chemoprophylaxis, Acute pancreatitis, Female, Drug, Intravenous, Adult, Infusions, medicine.medical_specialty, Adolescent, Biliary Tract Diseases, Placebo, Risk Assessment, Drug Administration Schedule, Dose-Response Relationship, Double-Blind Method, medicine, Humans, Aged, Dose-Response Relationship, Drug, Hepatology, business.industry, Pancreatic Diseases, medicine.disease, Surgery, Pancreatitis, chemistry, Follow-Up Studies, business
Abstract

Objectives A continuous 13-h infusion of gabexate starting 30–90 min before endoscopic cholangiopancreatography (ERCP) can reduce postprocedural pancreatitis, the onset of which is generally observed within the first 6 h after ERCP. This study was designed to verify whether a 6.5-h infusion of gabexate was as effective as a 13-h infusion, at the same concentration, for reducing the incidence of post-ERCP pancreatitis (primary endpoint) and pancreatic hyperenzymemia and pain (secondary endpoints). Methods A total of 434 patients (201 male and 233 female; mean age 63.9 yr, range 18–96 yr) scheduled for ERCP were prospectively recruited in 25 Italian centers. Patients were randomized double-blind to two treatment groups. All subjects enrolled were first treated with a 500-mg continuous intravenous infusion of gabexate, starting 30 min before the endoscopic maneuvers and continuing up to 6.5 h after it. Over the next 6.5 h, 214 patients (group I) continued the infusion of gabexate (for a total of 1 g over 13 h) and 220 patients (group II) were given placebo (saline solution). Results The overall incidence of acute pancreatitis was 1.8% (eight patients), which included 1.4% in group I (three of 214 patients) and 2.2% in group II (five of 220 patients). Serum amylase and lipase values over time, peak levels of the two enzymes, pancreatic pain, and need for analgesics did not significantly differ in the two groups. Conclusions These results suggest that a 6.5-h infusion of gabexate (for a total of 500 mg) is not less effective than a 13 h infusion, with evident savings.

Published
2003
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25. Italian consensus guidelines for chronic pancreatitis

Author

Frulloni, L, Falconi, M, Gabbrielli, A, Gaia, E, Graziani, R, Pezzilli, R, Uomo, G, Andriulli, A, Balzano, G, Benini, L, Calculli, L, Campra, D, Capurso, G, Cavestro, Gm, De Angelis, C, Ghezzo, L, Manfredi, R, Malesci, A, Mariani, A, Mutignani, M, Ventrucci, M, Zamboni, G, Amodio, A, Vantini, I, Bassi, C, Delle Fave, G, Capurso, Iv, Magarini, F, Albarello, L, Alfieri, S, Anti, M, Arcidiacono, P, Baiocchi, L, Berretti, D, Boraschi, P, Buscarini, E, Carroccio, A, Celebrano, Mr, Casadei, R, Chilovi, F, Conigliaro, R, Dall'Oglio, L, De Boni, M, De Pretis, G, Di Priolo, S, Di Sebastiano PL, Doglietto, Gb, Filauro, M, Frieri, G, Fuini, A, Loriga, P, Macarri, G, Manes, G, Massucco, P, Milani, S, Pasquali, Claudio, Pederzoli, P, Pietrangeli, M, Rocca, R, Russello, D, Siquini, W, Traina, M, Veneroni, L, Zilli, M, Italian Association for the Study of the Pancreas, Frulloni L, Falconi M, Gabbrielli A, Gaia E, Graziani R, Pezzilli R, Uomo G, Andriulli A, Balzano G, Benini L, Calculli L, Campra D, Capurso G, Cavestro GM, De Angelis C, Ghezzo L, Manfredi R, Malesci A, Mariani A, Mutignani M, Ventrucci M, Zamboni G, Amodio A, Vantini I, Italian Association for the Study of the Pancreas (AISP), Bassi C, Delle Fave G, Capurso IV, Magarini F, Albarello L, Alfieri S, Anti M, Arcidiacono P, Baiocchi L, Berretti D, Boraschi P, Buscarini E, Carroccio A, Celebrano MR, Casadei R, Chilovi F, Conigliaro R, Dall'Oglio L, De Boni M, De Pretis G, Di Priolo S, Di Sebastiano PL, Doglietto GB, Filauro M, Frieri G, Fuini A, Loriga P, Macarri G, Manes G, Massucco P, Milani S, Pasquali C, Pederzoli P, Pietrangeli M, Rocca R, Russello D, Siquini W, Traina M, Veneroni L, Zilli M, Zamboni G., Frulloni, L, Falconi, M, Gabbrielli, A, Gaia, E, Graziani, R, Pezzilli, R, Uomo, G, Andriulli, A, Balzano, G, Benini, L, Calculli, L, Campra, D, Capurso, G, Cavestro, Gm, De Angelis, C, Ghezzo, L, Manfredi, R, Malesci, A, Mariani, A, Mutignani, M, Ventrucci, M, Zamboni, G, Amodio, A, Vantini, I, Italian Association for the Study of the Pancreas, (AISP), Bassi, C, Delle Fave, G, Capurso, Iv, Magarini, F, Albarello, L, Alfieri, S, Anti, M, Arcidiacono, P, Baiocchi, L, Berretti, D, Boraschi, P, Carroccio, A, Celebrano, Mr, Casadei, R, Chilovi, F, Conigliaro, R, Dall'Oglio, L, De Boni, M, De Pretis, G, Di Priolo, S, Di Sebastiano, Pl, Doglietto, Gb, Filauro, M, Frieri, G, Fuini, A, Macarri, G, Manes, G, Massucco, P, Milani, S, Pasquali, C, Pederzoli, P, Pietrangeli, M, Rocca, R, Russello, D, Siquini, W, Traina, M, Veneroni, L, Zilli, M, and Zamboni, G.

Subjects
medicine.medical_specialty, complications, pancreatic supplements, diagnostic imaging, pancreatitis, MEDLINE, cholangiopancreatography, chronic, endoscopic retrograde, pain, quality of life, radiography, sphincterotomy, steatorrhea, surgery, therapy, ultrasonography, Appropriate use, guidelines, chronica pancreatitis, Pancreatitis, Chronic, Pancreatitis, chronic, Complications, Surgery, Medical imaging, Medicine, Humans, Pancreatic stones, Intensive care medicine, Surgical treatment, Hepatology, medicine.diagnostic_test, business.industry, Pancreatitis, Radiography, Therapy, Ultrasonography, Cholangiopancreatography, Sphincterotomy, Diagnostic imaging, Pain, Quality of life, Steatorrhea, Pancreatic supplements, Gastroenterology, medicine.disease, Endoscopy, Pancreatic pain, Italy, CHRONIC PANCREATITIS, Radiology, business
Abstract

This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. Keywords: Pancreatitis, chronic; Complications; Surgery; Radiography; Therapy; Ultrasonography; Cholangiopancreatography

Published
2010

27. Surgical treatment of pancreatic endocrine tumours in Italy: results of a prospective multicentre study of 262 cases

Author

Zerbi, A, Capitanio, V, Boninsegna, L, Pasquali, C, Rindi, G, Delle Fave, G, Del Chiaro, M, Casadei, R, Falconi, M, Di Carlo, V, Pederzoli, P, Pedrazzoli, S, Tomassetti, P, Garcea, D, Uomo, G, Colangelo, E, Mosca, F, Fronda, G, Bresadola, F, Cantore, M, Leone, B, Farinati, F, Toma, S, Luppi, G, Bene, A, Bajetta, E, Ruffini, L, Gebbia, V, Liguori, L, De Toma, G, Dogliotti, L, Massidda, B, Di Carlo V, Pederzoli P, Delle Fave G, Pedrazzoli S, Tomassetti P, Casadei R, Garcea D, Uomo G, Colangelo E, Mosca F, Fronda GR, Bresadola F, Cantore M, Leone BE, Farinati F, Toma SS, Luppi G, Bene A, Bajetta E, Ruffini L, Gebbia V, Liguori L, De Toma G, Dogliotti L, Massidda B, Zerbi, A, Capitanio, V, Boninsegna, L, Pasquali, C, Rindi, G, Delle Fave, G, Del Chiaro, M, Casadei, R, Falconi, M, Di Carlo, V, Pederzoli, P, Pedrazzoli, S, Tomassetti, P, Garcea, D, Uomo, G, Colangelo, E, Mosca, F, Fronda, G, Bresadola, F, Cantore, M, Leone, B, Farinati, F, Toma, S, Luppi, G, Bene, A, Bajetta, E, Ruffini, L, Gebbia, V, Liguori, L, De Toma, G, Dogliotti, L, Massidda, B, Di Carlo V, Pederzoli P, Delle Fave G, Pedrazzoli S, Tomassetti P, Casadei R, Garcea D, Uomo G, Colangelo E, Mosca F, Fronda GR, Bresadola F, Cantore M, Leone BE, Farinati F, Toma SS, Luppi G, Bene A, Bajetta E, Ruffini L, Gebbia V, Liguori L, De Toma G, Dogliotti L, and Massidda B

Abstract

Background: Information on the treatment of pancreatic endocrine tumours (PETs) comes mostly from small, retrospective, uncontrolled studies. Methods: Newly diagnosed, histologically proven PETs, observed from June 2004 to March 2007 in 24 Italian centres, were included in a specific dataset. Results: Three-hundred and ten patients (mean age 57.6 years, females 46.6%) were analysed. At the time of recruitment, 262 (84.5%) underwent surgery. The percentage of operated patients was 91.9% and 62.0% in surgical and non-surgical centres, respectively. A curative resection was carried out in 83.6% (n=219) of cases, a palliative resection (debulking) in 10.7% (n=28), an exploratory laparotomy in 4.6% (n=12), and a bypass procedure in 1.1% (n=3). Laparoscopy was performed in 8.0% (n=21) of cases. Resection consisted of a pancreatoduodenectomy in 46 cases (21.0%), a distal pancreatectomy in 95 (43.4%), an enucleation in 50 (22.8%), a middle pancreatectomy in 16 (7.3%) and a total pancreatectomy in 12 (5.5%). Liver resection was associated with pancreatic resection in 26 cases (9.9%). Post-operative mortality was 1.5% and morbidity 39.7%, respectively. A curative resection was performed more frequently in asymptomatic, small, non-metastatic, benign and at uncertain behaviour tumours, with low Ki67 values. Conclusions: This study strongly indicates the fact that surgical resection represents the cornerstone treatment of PETs

Published
2011

28. Clinicopathological features of pancreatic endocrine tumors: A prospective multicenter study in italy of 297 sporadic cases

Author

Zerbi, A, Falconi, M, Rindi, G, Delle Fave, G, Tomassetti Casadei, P, Pasquali, C, Di Carlo, V, Capitanio, V, Boninsegna, L, Pederzoli, P, Pedrazzoli, S, Garcea, D, Uomo, G, Colangelo, E, Mosca, F, Fronda, G, Bresadola, F, Cantore, M, Farinati, F, Leone, B, Toma, S, Luppi, G, Bene, A, Bajetta, E, Ruffini, L, Gebbia, V, Liguori, L, De Toma, G, Dogliotti, L, Massidda, B, Zerbi A, Falconi M, Rindi G, Delle Fave G, Tomassetti Casadei PR, Pasquali C, Di Carlo V, Capitanio V, Boninsegna L, Pederzoli P, Pedrazzoli S, Garcea D, Uomo G, Colangelo E, Mosca F, Fronda GR, Bresadola F, Cantore M, Farinati F, Leone BE, Toma SS, Luppi G, Bene A, Bajetta E, Ruffini L, Gebbia V, Liguori L, De Toma G, Dogliotti L, Massidda B., Zerbi, A, Falconi, M, Rindi, G, Delle Fave, G, Tomassetti Casadei, P, Pasquali, C, Di Carlo, V, Capitanio, V, Boninsegna, L, Pederzoli, P, Pedrazzoli, S, Garcea, D, Uomo, G, Colangelo, E, Mosca, F, Fronda, G, Bresadola, F, Cantore, M, Farinati, F, Leone, B, Toma, S, Luppi, G, Bene, A, Bajetta, E, Ruffini, L, Gebbia, V, Liguori, L, De Toma, G, Dogliotti, L, Massidda, B, Zerbi A, Falconi M, Rindi G, Delle Fave G, Tomassetti Casadei PR, Pasquali C, Di Carlo V, Capitanio V, Boninsegna L, Pederzoli P, Pedrazzoli S, Garcea D, Uomo G, Colangelo E, Mosca F, Fronda GR, Bresadola F, Cantore M, Farinati F, Leone BE, Toma SS, Luppi G, Bene A, Bajetta E, Ruffini L, Gebbia V, Liguori L, De Toma G, Dogliotti L, and Massidda B.

Abstract

Objectives: Information on pancreatic endocrine tumors (PETs) comes mostly from small, retrospective, uncontrolled studies conducted on highly selected patients. The aim of the study was to describe the clinical and pathological features of PETs in a prospective, multicenter study.Methods: Newly diagnosed, histologically proven, sporadic PETs observed from June 2004 to March 2007 in 24 Italian centers were included in a specific data set.Results: Two hundred ninety-seven patients (mean age 58.614.7 years, females 51.2%, males 48.8%) were analyzed. In 73 cases (24.6%), the tumor was functioning (F) (53 insulinomas, 15 gastrinomas, 5 other syndromes) and in 232 (75.4%) it was non-functioning (NF); in 115 cases (38.7%), the diagnosis was incidental. The median tumor size was 20 mm (range 2-150). NF-PETs were significantly more represented among carcinomas (P0.001). Nodal and liver metastases were detected in 84 (28.3%) and 85 (28.6%) cases, respectively. The presence of liver metastases was significantly higher in the NF-PETs than in the F-PETs (32.1% vs. 17.8%; P0.05), and in the symptomatic than in the asymptomatic patients (34.6% vs. 19.1%; P<0.005). At the time of recruitment, the majority of patients (251, 84.5%) had undergone surgery, with complete resection in 209 cases (83.3%).Conclusions: This study points out the high number of new cases of PETs observed in Italy, with a high prevalence of NF and incidentally discovered forms. The size of the tumor was smaller and the rate of metastasis was lower than usually reported, suggesting a trend toward an earlier diagnosis. © 2010 by the American College of Gastroenterology

Published
2010

29. Antioxidant treatment in hereditary pancreatitis. A pilot study on three young patients

Author

Uomo, G, Talamini, G, and Rabitti, PG

Subjects
Antioxidants -- Health aspects, Pancreatitis -- Diet therapy, Health, Diet therapy, Health aspects
Abstract

Antioxidant treatment in hereditary pancreatitis. A pilot study on three young patients. Uomo G, Talamini G, Rabitti PG. Dig Liver Dis 2001;33:58-62. BACKGROUND: Abdominal pain is the most challenging symptom [...]

Published
2001

30. Italian consensus guidelines for chronic pancreatitis

Author

Frulloni, L., Falconi, M., Gabbrielli, A., Gaia, E., Graziani, R., Pezzilli, R., Uomo, G., Andriulli, A., Balzano, G., Benini, L., Calculli, L., Campra, D., Capurso, G., Cavestro, G., De Angelis, C., Ghezzo, L., Manfredi, R., Malesci, A., Mariani, A., Mutignani, M., Ventrucci, M., Zamboni, G., Amodio, A., Vantini, I., Italian Association for the Study of the Pancreas, Bassi, C., Delle Fave, G., Capurso, I., Magarini, F., Albarello, L., Alfieri, S., Anti, M., Arcidiacono, P., Baiocchi, L., Berretti, D., Boraschi, P., Buscarini, E., Carroccio, A., Frulloni, L., Falconi, M., Gabbrielli, A., Gaia, E., Graziani, R., Pezzilli, R., Uomo, G., Andriulli, A., Balzano, G., Benini, L., Calculli, L., Campra, D., Capurso, G., Cavestro, G., De Angelis, C., Ghezzo, L., Manfredi, R., Malesci, A., Mariani, A., Mutignani, M., Ventrucci, M., Zamboni, G., Amodio, A., Vantini, I., Italian Association for the Study of the Pancreas, Bassi, C., Delle Fave, G., Capurso, I., Magarini, F., Albarello, L., Alfieri, S., Anti, M., Arcidiacono, P., Baiocchi, L., Berretti, D., Boraschi, P., Buscarini, E., and Carroccio, A.

Subjects
chronic pancreatitis, Settore MED/09 - Medicina Interna, Italian, consensus guideline, consensus guidelines
Published
2010

31. Clinicopathological features of pancreatic endocrine tumors: a prospective multicenter study in Italy of 297 sporadic cases

Author

Zerbi A, Falconi M, Rindi G, Delle Fave G, Tomassetti Casadei PR, Pasquali C, Di Carlo V, Capitanio V, Boninsegna L, Pederzoli P, Pedrazzoli S, Garcea D, Uomo G, Colangelo E, Mosca F, Fronda GR, Bresadola F, Cantore M, Farinati F, Leone BE, Toma SS, Luppi G, Bene A, Bajetta E, Ruffini L, Gebbia V, Liguori L, De Toma G, Dogliotti L, Massidda B., A., Zerbi, Falconi, Massimo, G., Rindi, G. D., Fave, P., Tomassetti, C., Pasquali, V., Capitanio, L., Boninsegna, V. D., Carlo, A. I. S. P., Network Study Group, Zerbi A, Falconi M, Rindi G, Delle Fave GF, Tomassetti P, Pasquali C, Capitanio V, Boninsegna L, Di Carlo V, and the members of the AISP-Network Study Group, Zerbi, A, Falconi, M, Rindi, G, Delle Fave, G, Tomassetti Casadei, P, Pasquali, C, Di Carlo, V, Capitanio, V, Boninsegna, L, Pederzoli, P, Pedrazzoli, S, Garcea, D, Uomo, G, Colangelo, E, Mosca, F, Fronda, G, Bresadola, F, Cantore, M, Farinati, F, Leone, B, Toma, S, Luppi, G, Bene, A, Bajetta, E, Ruffini, L, Gebbia, V, Liguori, L, De Toma, G, Dogliotti, L, and Massidda, B

Subjects
Adult, Male, medicine.medical_specialty, Pancreatic disease, Gastroenterology, Pancreatic tumor, Internal medicine, medicine, Carcinoma, Endocrine system, Humans, Prospective Studies, Prospective cohort study, Aged, Islet Cell, Female, Insulinoma, Italy, Middle Aged, Pancreatic Neoplasms, PANCREAS, Hepatology, business.industry, Pancreatic Neoplasm, medicine.disease, medicine.anatomical_structure, Multicenter study, Clinicopathological features, Carcinoma, Islet Cell, Pancreas, business, Human
Abstract

Objectives: Information on pancreatic endocrine tumors (PETs) comes mostly from small, retrospective, uncontrolled studies conducted on highly selected patients. The aim of the study was to describe the clinical and pathological features of PETs in a prospective, multicenter study.Methods: Newly diagnosed, histologically proven, sporadic PETs observed from June 2004 to March 2007 in 24 Italian centers were included in a specific data set.Results: Two hundred ninety-seven patients (mean age 58.614.7 years, females 51.2%, males 48.8%) were analyzed. In 73 cases (24.6%), the tumor was functioning (F) (53 insulinomas, 15 gastrinomas, 5 other syndromes) and in 232 (75.4%) it was non-functioning (NF); in 115 cases (38.7%), the diagnosis was incidental. The median tumor size was 20 mm (range 2-150). NF-PETs were significantly more represented among carcinomas (P0.001). Nodal and liver metastases were detected in 84 (28.3%) and 85 (28.6%) cases, respectively. The presence of liver metastases was significantly higher in the NF-PETs than in the F-PETs (32.1% vs. 17.8%; P0.05), and in the symptomatic than in the asymptomatic patients (34.6% vs. 19.1%; P

Published
2010

32. Pratical guidelines for acute pancreatitis

Author

PEZZILLI, RAFFAELE, CASADEI, RICCARDO, FANTINI, MARIA PIA, DALLOLIO, LAURA, FABBRI, GIULIANA, MORSELLI LABATE, ANTONIO MARIA, CALCULLI, LUCIA, A. Zerbi, V. Di Carlo, C. Bassi, G. F. Delle Fave, Bassi, C, Castoldi, L, Rabitti, P, Balzano, G, Gaia, E, Mutignani, M, Uomo, G, Brazzi, L, D'Alessandro, A, Frulloni, L, Scarpellini, P, Gabbrielli, A, Del Chiaro, M, Mariani, A, De Rai, P, Billi, P, Casadei, R, Nicoletti, R, R. Pezzilli, A. Zerbi, V. Di Carlo, C. Bassi, G.F. Delle Fave, Working Group of the Italian Association for the Study of the Pancreas on Acute Pancreatitis […, Fantini, M P, Dallolio, L, Fabbri, G, Morselli-Labate, A M, Bassi, C, Calculli, L, Castoldi, L, Rabitti, P, Balzano, G, Gaia, E, Mutignani, M, Uomo, G, Brazzi, L, D'Alessandro, A, Frulloni, L, Scarpellini, P, Gabbrielli, A, Del Chiaro, M, Mariani, A, De Rai, P, Billi, P, Casadei, R, Nicoletti, R, and …]

Subjects
medicine.medical_specialty, acute pancreatitis, diagnosis, diagnostic imaging, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, pancreatitis, Gastroenterology, Basal (phylogenetics), Severity assessment, Enteral Nutrition, Internal medicine, medicine, therapeutics, Humans, In patient, Cholecystectomy, guidelines, pancreas, APACHE, acute pancreatiti, therapy, Analgesics, Hepatology, business.industry, Pancreatitis, Acute Necrotizing, disease management, pancreatic necrosis, prognosis, Alanine Transaminase, Lipase, medicine.disease, Surgery, Buprenorphine, Parenteral nutrition, Acute Disease, Etiology, Pancreatitis, Acute pancreatitis, business, Tomography, X-Ray Computed, guideline, management
Abstract

INTRODUCTION: The following is a summary of the official guidelines of the Italian Association for the Study of the Pancreas regarding the medical, endoscopic and surgical management of acute pancreatitis. STATEMENTS: Clinical features together with elevation of the plasma concentrations of pancreatic enzymes are the cornerstones of diagnosis (recommendation A). Contrast-enhanced computed tomography (CT) provides good evidence for the presence of pancreatiti (recommendation C) and it should be carried out 48-72 h after the onset of symptoms in patients with predicted severe pancreatitis. Severity assessment is essential for the selection of the proper initial treatment in the management of acute pancreatitis (recommendation A) and should be done using the APACHE II score, serum C-reactive protein and CT assessment (recommendation C). The etiology of acute pancreatitis should be able to be determined in at least 80% of cases (recommendation B). An adequate volume of intravenous fluid should be administered promptly to correct the volume deficit and maintain basal fluid requirements (recommendation A); analgesia is crucial for the correct treatment of the disease (recommendation A). Enteral feeding is indicated in severe necrotizing pancreatitis and it is better than total parenteral nutrition (recommendation A). The use of prophylactic broad-spectrum antibiotics reduces infection rates in CT-proven necrotizing pancreatitis (recommendation A). Infected pancreatic necrosis in patients with clinical signs and symptoms of sepsis is an indication for intervention, including surgery and radiological drainage (recommendation B). CONCLUSIONS: The participants agreed to revise the guidelines every 3 years in order to re-evaluate each question on the management of acute pancreatitis patients according to the most recent literature.

Published
2010

34. International Multidisciplinary Classification of Acute Pancreatitis Severity: The 2013 Spanish Edition

Author

Maraví-Poma, E., Patchen Dellinger, E., Forsmark, C. E., Layer, P., Lévy, P., Shimosegawa, T., Siriwardena, A. K., Uomo, G., Whitcomb, D. C., Windsor, J. A., Petrov, M. S., Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Surgery, and Other departments

Subjects
macromolecular substances
Abstract

Objective: To develop a new classification of acute pancreatitis severity on the basis of a sound conceptual framework, comprehensive review of the published evidence, and worldwide consultation. Backgrounds: The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of specialist in pancreatic diseases, but are suboptimal because these definitions are based on the empiric description of events not associated with severity. Methods: A personal invitation to contribute to the development of a new classification of acute pancreatitis severity was sent to all surgeons, gastroenterologists, internists, intensivists and radiologists currently active in the field of clinical acute pancreatitis. The invitation was not limited to members of certain associations or residents of certain countries. A global web-based survey was conducted, and a dedicated international symposium was organized to bring contributors from different disciplines together and discuss the concept and definitions. Results: The new classification of severity is based on the actual local and systemic determinants of severity, rather than on the description of events that are non-causally associated with severity. The local determinant relates to whether there is (peri) pancreatic necrosis or not, and if present, whether it is sterile or infected. The systemic determinant relates to whether there is organ failure or not, and if present, whether it is transient or persistent. The presence of one determinant can modify the effect of another, whereby the presence of both infected (peri) pancreatic necrosis and persistent organ failure has a greater impact upon severity than either determinant alone. The derivation of a classification based on the above principles results in four categories of severity: mild, moderate, severe, and critical. Conclusions: This classification is the result of a consultative process among specialists in pancreatic diseases from 49 countries spanning North America, South America, Europe, Asia, Oceania and Africa. It provides a set of concise up to date definitions of all the main entities pertinent to classifying the severity of acute pancreatitis in clinical practice and research. This ensures that the determinant-based classification can be used in a uniform manner throughout the world. (C) 2013 Elsevier Espana, S.L. and SEMICYUC. All rights reserved

Published
2014

35. Plasma calprotectin assay in patients with acute pancreatitis

Author

CARROCCIO, Antonio, DI PRIMA, Lidia, NOTO, Davide, MANISCALCO, Rocco Picciotto, Uomo, G., Rocco, P., Forte, G., Rabitti, P., Carroccio, A., Uomo, G., DI PRIMA, L., Rocco, P., Forte, G., Noto, D., Rabitti, P., and Maniscalco, R.

Subjects
Calprotectin, Settore MED/09 - Medicina Interna, acute pancreatitis
Published
2003

36. Gabexate for the Prevention of Pancreatic Damage Related to Endoscopic Retrograde Cholangiopancreatography

Author

Cavallini, G, Tittobello, A, Frulloni, L, Masci, E, Mariani, A, Difrancesco, V, Angelini, Gp, Casarini, Mb, Bedogni, G, Conigliaro, R, Bonardi, L, Khajekini, Mta, Cipolletta, L, Bianco, Ma, Costamagna, G, Perri, V, Dobrilla, G, Depretis, G, Familiari, Luigi, Giacobbe, Giuseppa, Fratton, A, Carone, N, Loriga, P, Muscas, A, Mazzeo, F, Gaeta, L, Miglioli, M, Pezzilli, R, Morelli, A, Santucci, L, Naccarato, R, Delfavero, G, Orlandi, F, Macarri, Gp, Russo, A, Virgilio, C, Uomo, G, and Manes, G.

Subjects
medicine.medical_specialty, Serine Proteinase Inhibitors, Pancreatic disease, Randomization, Gabexate, Cholangiopancreatography, Double-Blind Method, Female, Gabexate, Humans, Lipase, Pancreatitis, Serine Proteinase Inhibitors, Placebo, Gastroenterology, chemistry.chemical_compound, Double-Blind Method, Internal medicine, medicine, Humans, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, business.industry, Lipase, General Medicine, medicine.disease, Pancreatitis, chemistry, Acute pancreatitis, Female, business, Complication
Abstract

Background Endoscopic retrograde cholangiopancreatography (ERCP) is associated with elevated levels of pancreatic enzymes and pancreatitis. Gabexate, a protease inhibitor, has been used to prevent pancreatic damage related to ERCP. Methods We conducted a multicenter, double-blind comparison of gabexate (1 g given by intravenous infusion starting 30 to 90 minutes before endoscopy and continuing for 12 hours afterward) with placebo (mannitol and sodium chloride, administered in the same fashion). A total of 435 adults scheduled to undergo ERCP and, when indicated, endoscopic sphincterotomy underwent randomization; 17 were excluded from the final analysis for various reasons. The remaining 418 patients (mean age, 60.4 years) — 208 in the gabexate group and 210 in the placebo group — were analyzed. Acute pancreatitis was considered to be present if serum amylase or lipase levels (or both) were five times greater than the upper limits of normal in association with the onset of pancreatic pain. Results After th...

Published
1996
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37. [Determinant-based classification of acute pancreatitis severity. International multidisciplinary classification of acute pancreatitis severity: the 2013 German edition]

Author

Layer, P., Dellinger, E.P., Forsmark, C.E., Levy, P., Maravi-Poma, E., Shimosegawa, T., Siriwardena, A.K., Uomo, G., Whitcomb, D.C., Windsor, J.A., Petrov, M.S., and Geenen, E.J.M. van

Subjects
macromolecular substances, Molecular gastro-enterology and hepatology [IGMD 2]
Abstract

Item does not contain fulltext OBJECTIVE: The aim of this study was to develop a new international classification of acute pancreatitis severity on the basis of a sound conceptual framework, comprehensive review of published evidence, and worldwide consultation. BACKGROUND: The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of pancreatologists but suboptimal because these definitions are based on empiric descriptions of occurrences that are merely associated with severity. METHODS: A personal invitation to contribute to the development of a new international classification of acute pancreatitis severity was sent to all surgeons, gastroenterologists, internists, intensive medicine specialists, and radiologists who are currently active in clinical research on acute pancreatitis. The invitation was not limited to members of certain associations or residents of certain countries. A global Web-based survey was conducted and a dedicated international symposium was organised to bring contributors from different disciplines together and discuss the concept and definitions. RESULT: The new international classification is based on the actual local and systemic determinants of severity, rather than descriptions of events that are correlated with severity. The local determinant relates to whether there is (peri)pancreatic necrosis or not, and if present, whether it is sterile or infected. The systemic determinant relates to whether there is organ failure or not, and if present, whether it is transient or persistent. The presence of one determinant can modify the effect of another such that the presence of both infected (peri)pancreatic necrosis and persistent organ failure have a greater effect on severity than either determinant alone. The derivation of a classification based on the above principles results in 4 categories of severity - mild, moderate, severe, and critical. CONCLUSIONS: This classification is the result of a consultative process amongst pancreatologists from 49 countries spanning North America, South America, Europe, Asia, Oceania, and Africa. It provides a set of concise up-to-date definitions of all the main entities pertinent to classifying the severity of acute pancreatitis in clinical practice and research. This ensures that the determinant-based classification can be used in a uniform manner throughout the world.

Published
2013

38. Current Considerations for the Treatment of Severe Chronic Pain : The Potential for Tapentadol

Author

Pergolizzi, J., Alegre, C., Blake, D., Alén, J.C., Caporali, R., Casser, H.R., Correa-Illanes, G., Fernandes, P., Galilea, E., Jany, R., Jones, A., Mejjad, O., Morovic-Vergles, Jadranka, Oteo Álvaro, A., Radrigán Araya, F.J., Simões, M.E., and Uomo, G.

Subjects
treatment, chronic pain, tapentadol
Abstract

Studies suggest that around 20% of adults in Europe experience chronic pain, which not only has a considerable impact on their quality of life but also imposes a substantial economic burden on society. More than one-third of these people feel that their pain is inadequately managed. A range of analgesic drugs is currently available, but recent guidelines recommend that NSAIDs and COX-2 inhibitors should be prescribed cautiously. Although the short-term efficacy of opioids is good, adverse events are common and doses are frequently limited by tolerability problems. There is a perceived need for improved pharmacological treatment options. Currently, many treatment decisions are based solely on pain intensity. However, chronic pain is multifactorial and this apaproach ignores the fact that different causative mechanisms may be involved. The presence of more than one causative mechanism means that chronic pain can seldom be controlled by a single agent. Therefore, combining drugs with different analgesic actions increases the probability of interrupting the pain signal, but is often associated with an increased risk of drug/drug interactions, low compliance and increased side effects. Tapentadol combines μ-opioid receptor agonism and noradrenaline reuptake inhibition in a single molecule, with both mechanisms contributing to its analgesic effects. Preclinical testing has shown that μ-opioid agonism is primarily responsible for analgesia in acute pain, whereas noradrenaline reuptake inhibition is more important in chronic pain. In clinical trials in patients with chronic pain, the efficacy of tapentadol was similar to that of oxycodone, but it produced significantly fewer gastrointestinal side-effects and treatment discontinuations. Pain relief remained stable throughout a 1-year safety study. Thus, tapentadol could possibly overcome some of the limitations of currently available analgesics for the treatment of chronic pain.

Published
2012

41. Surgical management of acute pancreatitis in Italy: lessons from a prospective multicentre study

Author

DE RAI, P, Zerbi, A, Castoldi, L, Bassi, C, Frulloni, L, Uomo, G, Gabbrielli, A, Pezzilli, R, Cavallini, G, DI CARLO, V, PROINF AISP PROGETTO INFORMATIZZATO PANCREATITE ACUTA, ASSOCIAZIONE ITALIANA PER LO STUDIO DEL PANCREAS COMPUTERIZED PROJECT ON ACUTE PANCREATITIS, COLLABORATORS AGUGIARO S, ITALIAN ASSOCIATION FOR THE STUDY OF THE PANCREAS STUDY G. R. O. U. P., Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, Dd, Bassi, Nicolo', Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, Gm, Esposito, C, Cordovana, A, Cavina, E, Seccia, M, Lippolis, P, Musco, B, Barletta, M, Chilovi, E, DE GUELFI, A, Chirletti, P, Caronna, R, Scozzafava, S, Cardi, M, Cirino, E, Buffone, A, Colangelo, E, Caracino, V, Cortese, F, Casentini, A, Costamagna, G, Trincali, A, Curzio, M, Clivio, S, Segato, S, D'Alessandro, A, Ambrosiani, V, D'Ambrosio, B, Chiodo, C, Dicillo, M, Reale, L, Grandolfo, A, Fabbrucci, P, Bruscino, A, Mugnaini, P, Ferrarese, S, Ugenti, I, Forte, Gb, Rocco, P, Franzãˆ, A, Bertelãˆ, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, Pc, Sbrana, F, Balestracci, T, Giulini, Sm, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Calandro, L, Mazzitelli, L, Costarella, Sm, Egidio, A, Teggia, Pm, Stefano, E, Cassini, P, Modica, G, Lupo, F, Giraci, G, Mosca, F, DEL CHIARO, M, Mosella, G, Benassai, G, Nanni, M, D'Aristotile, A, Negro, P, Pirazzoli, A, Rabitti, Pg, Romano, C, Gerardi, G, Troianello, B, Russello, D, DI STEFANO, A, Avelli, S, Salval, N, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, Pa, Masci, E, Mariani, A, Torelli, E, Garcea, Mr, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, and Cipolla, A.

Published
2010

42. Surgical management of acute pancreatitis in Italy: lessons from a prospective multicentre study. HPB (Oxford), 2010; 12(9): 597-604

Author

De Rai, P., Zerbi, A., Castoldi, L., Bassi, Claudio, Frulloni, Luca, Uomo, G., Gabbrielli, Armando, Pezzilli, R., Cavallini, Giorgio, and Di Carlo, V.

Subjects
Male, Time Factors, acute pancreatitis, Biliary Tract Diseases, surgery, biliary, Jejunostomy, Practice Patterns, Risk Assessment, Severity of Illness Index, Laparoscopic, Pancreatectomy, Endoscopic Retrograde, Risk Factors, Aged, Chi-Square Distribution, Cholangiopancreatography, Endoscopic Retrograde, Cholecystectomy, Laparoscopic, Female, Guideline Adherence, Humans, Italy, Pancreatitis, Pancreatitis, Acute Necrotizing, Pancreatitis, Alcoholic, Practice Guidelines as Topic, Prospective Studies, Treatment Outcome, Cholecystectomy, Practice Patterns, Physicians', Physicians', Alcoholic, Cholangiopancreatography, Acute Necrotizing
Published
2010

45. A prospective multicentre survey on the treatment of acute pancreatitis in Italy

Author

Pezzilli, R, Uomo, G., Gabbrielli, A., Zerbi, A., Frulloni, L., De Rai, P., Castoldi, L., Cavallini, G., Di Carlo, V., Agugiaro, S., Turri, L., Bartoli, A., Barberini, F., Cavazoni, G., Bartolo, F., Della Papa, D., Bassi, C., Bassi, N., Massani, M., Benedetti, A., Macarri, G., Piergallini, L., Briani, G., Bartolasi, L., Brugnano, L., Buonanno, G. M., Esposito, C., Cardovana, A., Cavina, E., Seccia, M., Lipollis, P., Musco, B., Barletta, M., Chilovi, E., De Guelmi, A., Chirletti, Piero, Caronna, Roberto, Scozzafava, S., Cardi, Maurizio, Cirino, E., Buffone, A., Colangelo, E., Caracino, V., Cortese, F., Cosentini, A., Costamagna, G., Tringali, A., Curzio, M., Clivio, S., Segato, S., D'Alessandro, A., Ambrosini, V., D'Amborsio, B., Chiodo, C., Dicillo, M., Reale, L., Grandolfo, A., Fabbrucci, P., Bruscino, A., Mugnaini, P., Ferrarese, S., Ugenti, I., Forte, G. B., Rocco, P., Franzè, A., Bertelè, A., Sereni, G., Friedman, D., Mariani, L. M., Murelli, F., Gai, V., Antro, C., Garcea, D., Gardini, A., Lucci, E., Giulianotti, P. C., Sbrana, F., Balestracci, T., Giulini, S. M., Pellizzari, A., Ronconi, M., Cimaschi, S., Grassini, M., Lacitignola, S., Caliandro, L., Mazzitelli, R., Costarella, S. M., Egidio, A., Mello Teggia, P., Stefano, E., Cassini, P., Modica, G., Lupo, F., Giraci, G., Mosca, F., Del Chiaro, M., Mosella, G., Benassai, G., Nanni, M., D'Aristotile, A., Negro, P., Pirazzoli, A., Rabitti, P. G., Romano, C., Gerardi, G., Troianello, B., Russello, D., Di Stefano, A., Avelli, S., Salvai, M., Bellini, N., Scalon, P., Staudacher, C., Parolini, D., Strazzabosco, M., Signorelli, S., Tedeschi, U., Testoni, P. A., Masci, E., Mariani, A., Torelli, E., Garcea, M. R., Lombardi, V., Cecconi, L., Valeri, A., Presenti, L., Alessio, F., Ventrucci, M., Virzi, S., and Cipolla, A.

Subjects
Adult, Male, medicine.medical_specialty, ERCP, Pancreatitis, Pancreatitis acute necrotising, Aged, Aged, 80 and over, Analgesics, Anti-Bacterial Agents, Digestive System Surgical Procedures, Female, Histamine Antagonists, Humans, Italy, Middle Aged, Prospective Studies, Severity of Illness Index, Treatment Outcome, Medicine (all), Hepatology, Gastroenterology, Therapeutic approach, Internal medicine, Severity of illness, 80 and over, Medicine, Prospective cohort study, business.industry, medicine.disease, Surgery, medicine.anatomical_structure, Acute pancreatitis, Tramadol, business, Pancreas, medicine.drug
Abstract

The Italian Association for the Study of the Pancreas released a diagnostic and therapeutic algorithm for acute pancreatitis in 1999.This study focused on the analysis of the therapeutic approach for the treatment of acute pancreatitis in Italy.One thousand, one hundred and seventy-three patients were recruited: 1006 patients (85.8%) had mild acute pancreatitis (MAP) and 167 (14.2%) had the severe acute pancreatitis (SAP); 161 patients showed pancreatic necrosis at computed tomography; 121 patients (10.3%) had sequelae and 36 (3.1%) died.Non-steroidal anti-inflammatory drugs and tramadol were used more frequently in patients with the MAP whereas opioids and the association schedules were used more frequently in patients with the SAP (P0.001). Gabexate mesilate was utilised in 831 out of 1173 patients (70.8%); in particular, gabexate mesilate was used in 70.6% patients with MAP and in 73.1% of those with SAP (P=0.521). The duration of the drug administration was significantly shorter in those having MAP than in those having the SAP (P0.001). The antibiotics most frequently used for the prophylaxis against infection from pancreatic necrosis (43.1%) were carbapenems. Only a small number of patients received enteral nutrition (4.7%). Endoscopic retrograde cholangiopancreatography was carried out in 344 of the 1173 patients (29.3%). Surgery was performed in 48 with SAP (19 had elective biliary surgery and 29 had pancreatic surgery).The results of this survey indicate a lack of compliance with the guidelines which regard the indications mainly for interventional endoscopy and surgery.

Published
2007

47. COMPARISON OF TWO DOSING REGIMENS OF GABEXATE IN THE PROPHYLAXIS OF POST-ERCP PANCREATITIS

Author

Masci, E, Cavallini, G, Mariani, A, Frulloni, L, Testoni, Pa, Curioni, S, Tittobello, A, Uomo, G, Costamagna, G, Zambelli, S, Macarri, G, Innocenti, P, Dragonetti, C, Angelini, Gp, Bonardi, L, Ayoubi, M, Caputi, O, Casetti, T, Tampieri, I, Cestari, R, Salerni, B, DE GRAZIA, F, DE PRETIS, G, Zilli, M, Zoratti, L, DEL PIANO, M, Occhipinti, P, D'Imperio, N, Billi, P, Pezzilli, R, Casadei, A, Familiari, Luigi, Benedetti, A, Giardini, M, Forte, Gb, Rocco, P, Leo, P, Ficano, L, Sciume', C, Loriga, P, Bergamini, S, Muscas, A, Mosca, S, Nicosia, F, Caldini, F, Norberto, L, D'Amico, D, Perri, V, Gabrielli, A, Pugliese, V, Russo, A, Bonanno, G, Viceconte, G, and Piglionica, D.

Published
2003

49. Long term outcome of acute pancreatitis in Italy: Results of a multicentre study

Author

Castoldi, L, De Rai, P, Zerbi, A, Frulloni, L, Uomo, G, Gabbrielli, A, Bassi, C, Pezzilli, R, Agugiaro, S, Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, D, Bassi, N, Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, G, Esposito, C, Cordovana, A, Cavina, E, Seccia, M, Musco, B, Barletta, M, Chilovi, E, De Guelfi, A, Chirletti, P, Caronna, R, Scozzafava, S, Cardi, M, Cirino, E, Buffone, A, Colangelo, E, Caracino, V, Cortese, F, Casentini, A, Costamagna, G, Trincali, A, Curzio, M, Clivio, S, Segato, S, D'Alessandro, A, Ambrosiani, V, D'Ambrosio, B, Chiodo, C, Dicillo, M, Reale, L, Grandolfo, A, Fabbrucci, P, Bruscino, A, Mugnaini, P, Ferrarese, S, Ugenti, I, Forte, G, Rocco, P, Franzè, A, Bertelè, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, P, Sbrana, F, Balestracci, T, Giulini, S, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Martina, C, Mazzitelli, L, Costarella, S, Reggio, E, Mello Teggia P., N, Stefano, E, Cassini, P, Modica, G, Lupo, F, Giraci, G, Mosca, F, Del Chiaro, M, Mosella, G, Benassai, G, Nanni, M, D'Aristotile, A, Negro, P, Pirazzoli, A, Rabitti, P, Romano, C, Gerardi, G, Troianello, B, Ruscello, D, Di Stefano, A, Avelli, S, Salval, N, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, P, Masci, E, Mariani, A, Torelli, E, Garcea, M, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, Cipolla, A, FERRARESE, SAMUELE, Mello Teggia P. , n, Cipolla, A., STRAZZABOSCO, MARIO, Castoldi, L, De Rai, P, Zerbi, A, Frulloni, L, Uomo, G, Gabbrielli, A, Bassi, C, Pezzilli, R, Agugiaro, S, Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, D, Bassi, N, Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, G, Esposito, C, Cordovana, A, Cavina, E, Seccia, M, Musco, B, Barletta, M, Chilovi, E, De Guelfi, A, Chirletti, P, Caronna, R, Scozzafava, S, Cardi, M, Cirino, E, Buffone, A, Colangelo, E, Caracino, V, Cortese, F, Casentini, A, Costamagna, G, Trincali, A, Curzio, M, Clivio, S, Segato, S, D'Alessandro, A, Ambrosiani, V, D'Ambrosio, B, Chiodo, C, Dicillo, M, Reale, L, Grandolfo, A, Fabbrucci, P, Bruscino, A, Mugnaini, P, Ferrarese, S, Ugenti, I, Forte, G, Rocco, P, Franzè, A, Bertelè, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, P, Sbrana, F, Balestracci, T, Giulini, S, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Martina, C, Mazzitelli, L, Costarella, S, Reggio, E, Mello Teggia P., N, Stefano, E, Cassini, P, Modica, G, Lupo, F, Giraci, G, Mosca, F, Del Chiaro, M, Mosella, G, Benassai, G, Nanni, M, D'Aristotile, A, Negro, P, Pirazzoli, A, Rabitti, P, Romano, C, Gerardi, G, Troianello, B, Ruscello, D, Di Stefano, A, Avelli, S, Salval, N, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, P, Masci, E, Mariani, A, Torelli, E, Garcea, M, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, Cipolla, A, FERRARESE, SAMUELE, Mello Teggia P. , n, Cipolla, A., and STRAZZABOSCO, MARIO

Abstract

Background: In Italy, no long-term studies regarding the natural history of acute pancreatitis have been carried out. Aim: To report the results of a follow-up on a large series of patients hospitalised for pancreatitis. Methods: Data of 631 patients admitted to 35 Italian hospitals were retrospectively evaluated 51.7 ± 8.4 months after discharge. Results: The average recovery time after mild or severe pancreatitis was 28.2 and 53.4 days respectively. Fourteen sequelae were not resolved and 9 cases required late surgical intervention. Eighty patients (12.7%) had a second hospital admission. Of the patients with mild biliary pancreatitis, 67.9% underwent a cholecystectomy. The overall incidence of relapse was 12.7%. Mortality was 9.8% and no death was related to pancreatitis. Three patients died from carcinoma of the pancreas. Conclusion: Reported recovery time after an attack of pancreatitis was longer than expected in the mild forms. The treatment of sequelae was delayed beyond one year after discharge. The incidence of relapse of biliary pancreatitis in patients not undergoing a cholecystectomy was low, due to endoscopic treatment. Mortality from pancreatic-related causes is low, but there is an association with malignant pancreatic or ampullary tumours not diagnosed during the acute phase of the illness. © 2013 Editrice Gastroenterologica Italiana S.r.l

Published
2013

50. Determinant-Based Classification of Acute Pancreatitis Severity: An International Multidisciplinary Consultation

Author

Dellinger, E.P., Forsmark, C.E., Layer, P., Levy, P., Maravi-Poma, E., Petrov, M.S., Shimosegawa, T., Siriwardena, A.K., Uomo, G., Whitcomb, D.C., Windsor, J.A., Geenen, E.J.M. van, et al., Dellinger, E.P., Forsmark, C.E., Layer, P., Levy, P., Maravi-Poma, E., Petrov, M.S., Shimosegawa, T., Siriwardena, A.K., Uomo, G., Whitcomb, D.C., Windsor, J.A., Geenen, E.J.M. van, and et al.

Abstract

Item does not contain fulltext, OBJECTIVE:: To develop a new international classification of acute pancreatitis severity on the basis of a sound conceptual framework, comprehensive review of published evidence, and worldwide consultation. BACKGROUND:: The Atlanta definitions of acute pancreatitis severity are ingrained in the lexicon of pancreatologists but suboptimal because these definitions are based on empiric description of occurrences that are merely associated with severity. METHODS:: A personal invitation to contribute to the development of a new international classification of acute pancreatitis severity was sent to all surgeons, gastroenterologists, internists, intensivists, and radiologists who are currently active in clinical research on acute pancreatitis. The invitation was not limited to members of certain associations or residents of certain countries. A global Web-based survey was conducted and a dedicated international symposium was organized to bring contributors from different disciplines together and discuss the concept and definitions. RESULT:: The new international classification is based on the actual local and systemic determinants of severity, rather than description of events that are correlated with severity. The local determinant relates to whether there is (peri)pancreatic necrosis or not, and if present, whether it is sterile or infected. The systemic determinant relates to whether there is organ failure or not, and if present, whether it is transient or persistent. The presence of one determinant can modify the effect of another such that the presence of both infected (peri)pancreatic necrosis and persistent organ failure have a greater effect on severity than either determinant alone. The derivation of a classification based on the above principles results in 4 categories of severity-mild, moderate, severe, and critical. CONCLUSIONS:: This classification is the result of a consultative process amongst pancreatologists from 49 countries spanning North America, South

Published
2012

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