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1. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

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Phelps, Nowell H, Singleton, Rosie K, Zhou, Bin, Heap, Rachel A, Mishra, Anu, Bennett, James E, Paciorek, Christopher J, Lhoste, Victor PF, Carrillo-Larco, Rodrigo M, Stevens, Gretchen A, Rodriguez-Martinez, Andrea, Bixby, Honor, Bentham, James, Di Cesare, Mariachiara, Danaei, Goodarz, Rayner, Archie W, Barradas-Pires, Ana, Cowan, Melanie J, Savin, Stefan, Riley, Leanne M, Aguilar-Salinas, Carlos A, Baker, Jennifer L, Barkat, Amina, Bhutta, Zulfiqar A, Branca, Francesco, Caixeta, Roberta B, Cuschieri, Sarah, Farzadfar, Farshad, Ganapathy, Shubash, Ikeda, Nayu, Iotova, Violeta, Kengne, Andre P, Khang, Young-Ho, Laxmaiah, Avula, Lin, Hsien-Ho, Ma, Jun, Mbanya, Jean Claude N, Miranda, J Jaime, Pradeepa, Rajendra, Rodríguez-Artalejo, Fernando, Sorić, Maroje, Turley, Maria, Wang, Limin, Webster-Kerr, Karen, Aarestrup, Julie, Abarca-Gómez, Leandra, Abbasi-Kangevari, Mohsen, Abdeen, Ziad A, Abdrakhmanova, Shynar, Abdul Ghaffar, Suhaila, Abdul Rahim, Hanan F, Abdurrahmonova, Zulfiya, Abu-Rmeileh, Niveen M, Abubakar Garba, Jamila, Acosta-Cazares, Benjamin, Adam, Ishag, Adamczyk, Marzena, Adams, Robert J, Adu-Afarwuah, Seth, Aekplakorn, Wichai, Afsana, Kaosar, Afzal, Shoaib, Agbor, Valirie N, Agdeppa, Imelda A, Aghazadeh-Attari, Javad, Ågren, Åsa, Aguenaou, Hassan, Agyemang, Charles, Ahmad, Mohamad Hasnan, Ahmad, Noor Ani, Ahmadi, Ali, Ahmadi, Naser, Ahmadi, Nastaran, Ahmed, Imran, Ahmed, Soheir H, Ahrens, Wolfgang, Aitmurzaeva, Gulmira, Ajlouni, Kamel, Al-Hazzaa, Hazzaa M, Al-Hinai, Halima, Al-Lahou, Badreya, Al-Lawati, Jawad A, Al-Raddadi, Rajaa, Al Asfoor, Deena, Al Hourani, Huda M, Al Qaoud, Nawal M, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Aldwairji, Maryam A, Alexius, Sylvia, Ali, Mohamed M, Alieva, Anna V, Alkandari, Abdullah, Alkerwi, Ala'a, Alkhatib, Buthaina M, Allin, Kristine, Alomary, Shaker A, Alomirah, Husam F, Alshangiti, Arwa M, Alvarez-Pedrerol, Mar, Aly, Eman, Amarapurkar, Deepak N, Amiano Etxezarreta, Pilar, Amoah, John, Amougou, Norbert, Amouyel, Philippe, Andersen, Lars Bo, Anderssen, Sigmund A, Androutsos, Odysseas, Ängquist, Lars, Anjana, Ranjit Mohan, Ansari-Moghaddam, Alireza, Anufrieva, Elena, Aounallah-Skhiri, Hajer, Araújo, Joana, Ariansen, Inger, Aris, Tahir, Arku, Raphael E, Arlappa, Nimmathota, Aryal, Krishna K, Assefa, Nega, Aspelund, Thor, Assah, Felix K, Assembekov, Batyrbek, Assunção, Maria Cecília F, Aung, May Soe, Aurélio de Valois, Correia Júnior Marco, Auvinen, Juha, Avdičová, Mária, Avi, Shina, Azad, Kishwar, Azevedo, Ana, Azimi-Nezhad, Mohsen, Azizi, Fereidoun, Babu, Bontha V, Bacopoulou, Flora, Bæksgaard Jørgensen, Maja, Baharudin, Azli, Bahijri, Suhad, Bajramovic, Izet, Bakacs, Marta, Balakrishna, Nagalla, Balanova, Yulia, Bamoshmoosh, Mohamed, Banach, Maciej, Banegas, José R, Baran, Joanna, Baran, Rafał, Barbagallo, Carlo M, Barbosa Filho, Valter, Barceló, Alberto, Baretić, Maja, Barnoya, Joaquin, Barrera, Lena, Barreto, Marta, Barros, Aluisio JD, Barros, Mauro Virgílio Gomes, Bartosiewicz, Anna, Basit, Abdul, Bastos, Joao Luiz, Bata, Iqbal, Batieha, Anwar M, Batista, Aline P, Batista, Rosangela L, Battakova, Zhamilya, Baur, Louise A, Bayauli, Pascal M, Beaglehole, Robert, Bel-Serrat, Silvia, Belavendra, Antonisamy, Ben Romdhane, Habiba, Benedek, Theodora, Benedics, Judith, Benet, Mikhail, Benitez Rolandi, Gilda Estela, Benzeval, Michaela, Bere, Elling, Berger, Nicolas, Bergh, Ingunn Holden, Berhane, Yemane, Berkinbayev, Salim, Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Berrios Carrasola, Ximena, Bettiol, Heloísa, Beutel, Manfred E, Beybey, Augustin F, Bezerra, Jorge, Bhagyalaxmi, Aroor, Bharadwaj, Sumit, Bhargava, Santosh K, Bi, Hongsheng, Bi, Yufang, Bia, Daniel, Biasch, Katia, Bika Lele, Elysée Claude, Bikbov, Mukharram M, Bista, Bihungum, Bjelica, Dusko J, Bjerregaard, Anne A, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B, Björkelund, Cecilia, Bloch, Katia V, Blokstra, Anneke, Blychfeld Magnazu, Moran, Bo, Simona, Bobak, Martin, Boddy, Lynne M, Boehm, Bernhard O, Boer, Jolanda MA, Boggia, Jose G, Bogova, Elena, Boissonnet, Carlos P, Bojesen, Stig E, Bonaccio, Marialaura, Bongard, Vanina, Bonilla-Vargas, Alice, Bopp, Matthias, Borghs, Herman, Botomba, Steve, Bourne, Rupert RA, Bovet, Pascal, Boymatova, Khadichamo, Braeckevelt, Lien, Braeckman, Lutgart, Bragt, Marjolijn CE, Braithwaite, Tasanee, Brajkovich, Imperia, Breckenkamp, Juergen, Breda, João, Brenner, Hermann, Brewster, Lizzy M, Brian, Garry R, Briceño, Yajaira, Brinduse, Lacramioara, Bringolf-Isler, Bettina, Brito, Miguel, Brophy, Sinead, Brug, Johannes, Bruno, Graziella, Bugge, Anna, Buoncristiano, Marta, Burazeri, Genc, Burns, Con, Cabrera de León, Antonio, Cacciottolo, Joseph, Cai, Hui, Cama, Tilema, Cameron, Christine, Camolas, José, Can, Günay, Cândido, Ana Paula c, Cañete, Felicia, Capanzana, Mario V, Čapková, Naděžda, Capuano, Eduardo, Capuano, Rocco, Capuano, Vincenzo, Cardol, Marloes, Cardoso, Viviane C, Carlsson, Axel C, Carmuega, Esteban, Carvalho, Joana, Casajús, José A, Casanueva, Felipe F, Casas, Maribel, Celikcan, Ertugrul, Censi, Laura, Cervantes-Loaiza, Marvin, Cesar, Juraci A, Chamnan, Parinya, Chamukuttan, Snehalatha, Chan, Angelique, Chan, Queenie, Charchar, Fadi J, Charles, Marie-Aline, Chaturvedi, Himanshu K, Chaturvedi, Nish, Che Abdul Rahim, Norsyamlina, Chee, Miao Li, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Long-Sheng, Chen, Shuohua, Chen, Zhengming, Cheng, Ching-Yu, Cheng, Yiling J, Cheraghian, Bahman, Chetrit, Angela, Chikova-Iscener, Ekaterina, Chinapaw, Mai JM, Chinnock, Anne, Chiolero, Arnaud, Chiou, Shu-Ti, Chirita-Emandi, Adela, Chirlaque, María-Dolores, Cho, Belong, Christensen, Kaare, Christofaro, Diego G, Chudek, Jerzy, Cifkova, Renata, Cilia, Michelle, Cinteza, Eliza, Cirillo, Massimo, Claessens, Frank, Clare, Philip, Clarke, Janine, Clays, Els, Cohen, Emmanuel, Cojocaru, Cosmin R, Colorado-Yohar, Sandra, Compañ-Gabucio, Laura-María, Concin, Hans, Confortin, Susana C, Cooper, Cyrus, Coppinger, Tara C, Corpeleijn, Eva, Cortés, Lilia Yadira, Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L, Crampin, Amelia C, Cross, Amanda J, Crujeiras, Ana B, Cruz, Juan J, Csányi, Tamás, Csilla, Semánová, Cucu, Alexandra M, Cui, Liufu, Cureau, Felipe V, Czenczek-Lewandowska, Ewelina, D'Arrigo, Graziella, d'Orsi, Eleonora, da Silva, Alanna G, Dacica, Liliana, Dahm, Christina C, Dallongeville, Jean, Damasceno, Albertino, Damsgaard, Camilla T, Dankner, Rachel, Dantoft, Thomas M, Dasgupta, Parasmani, Dastgiri, Saeed, Dauchet, Luc, Davletov, Kairat, de Assis Guedes de Vasconcelos, Francisco, de Assis, Maria Alice Altenburg, De Backer, Guy, De Bacquer, Dirk, De Bacquer, Jaco, de Bont, Jeroen, De Curtis, Amalia, de Fragas Hinnig, Patrícia, de Gaetano, Giovanni, De Henauw, Stefaan, De Miguel-Etayo, Pilar, De Neve, Jan-Walter, Duarte de Oliveira, Paula, De Ridder, David, De Ridder, Karin, de Rooij, Susanne R, de Sá, Ana Carolina MGN, De Smedt, Delphine, Deepa, Mohan, Deev, Alexander D, DeGennaro, Vincent Jr, Delisle, Hélène, Delpeuch, Francis, Demarest, Stefaan, Dennison, Elaine, Dereń, Katarzyna, Deschamps, Valérie, Devrishov, Ruslan D, Dhimal, Meghnath, Di Castelnuovo, Augusto, Dias-da-Costa, Juvenal Soares, Díaz-Sánchez, María Elena, Diaz, Alejandro, Díaz Fernández, Pedro, Díez Ripollés, María Pilar, Dika, Zivka, Djalalinia, Shirin, Djordjic, Visnja, Do, Ha TP, Dobson, Annette J, Dominguez, Liria, Donati, Maria Benedetta, Donfrancesco, Chiara, Dong, Guanghui, Dong, Yanhui, Donoso, Silvana P, Döring, Angela, Dorobantu, Maria, Dorosty, Ahmad Reza, Dörr, Marcus, Doua, Kouamelan, Dragano, Nico, Drygas, Wojciech, Du, Shufa, Duan, Jia Li, Duante, Charmaine A, Duboz, Priscilla, Duleva, Vesselka L, Dulskiene, Virginija, Dumith, Samuel C, Dushpanova, Anar, Dwyer, Terence, Dyussupova, Azhar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Ebrahimi, Narges, Echeverría, Guadalupe, Eddie, Ricky, Eftekhar, Ebrahim, Efthymiou, Vasiliki, Egbagbe, Eruke E, Eggertsen, Robert, Eghtesad, Sareh, Eiben, Gabriele, Ekelund, Ulf, El-Khateeb, Mohammad, El Ammari, Laila, El Ati, Jalila, Eldemire-Shearer, Denise, Elliott, Paul, Enang, Ofem, Endevelt, Ronit, Engle-Stone, Reina, Erasmus, Rajiv T, Erem, Cihangir, Ergor, Gul, Eriksen, Louise, Eriksson, Johan G, Escobedo-de la Peña, Jorge, Eslami, Saeid, Esmaeili, Ali, Evans, Alun, Evans, Roger G, Faeh, David, Fagherazzi, Guy, Fakhradiyev, Ildar, Fakhretdinova, Albina A, Fall, Caroline H, Faramarzi, Elnaz, Farjam, Mojtaba, Farrugia Sant'Angelo, Victoria, Farzi, Yosef, Fattahi, Mohammad Reza, Fawwad, Asher, Fawzi, Wafaie W, Felix-Redondo, Francisco J, Ferguson, Trevor S, Fernandes, Romulo A, Fernández-Bergés, Daniel, Ferrante, Daniel, Ferrao, Thomas, Ferrari, Gerson, Ferrari, Marika, Ferrario, Marco M, Ferreccio, Catterina, Ferreira, Haroldo S, Ferrer, Eldridge, Ferrieres, Jean, Figueiró, Thamara Hubler, Fijalkowska, Anna, Fink, Günther, Fisberg, Mauro, Fischer, Krista, Foo, Leng Huat, Forsner, Maria, Fottrell, Edward F, Fouad, Heba M, Francis, Damian K, Franco, Maria do Carmo, Fras, Zlatko, Fraser, Brooklyn, Frontera, Guillermo, Fuchs, Flavio D, Fuchs, Sandra C, Fujiati, Isti I, Fujita, Yuki, Fumihiko, Matsuda, Furdela, Viktoriya, Furusawa, Takuro, Gabriela, Stefan Adela, Gaciong, Zbigniew, Gafencu, Mihai, Galán Cuesta, Manuel, Galbarczyk, Andrzej, Galcheva, Sonya V, Galenkamp, Henrike, Galeone, Daniela, Galfo, Myriam, Galvano, Fabio, Gao, Jingli, Gao, Pei, Garcia-de-la-Hera, Manoli, García Mérida, María José, García Solano, Marta, Gareta, Dickman, Garnett, Sarah P, Gaspoz, Jean-Michel, Gasull, Magda, Gaya, Adroaldo Cesar Araujo, Gaya, Anelise Reis, Gazzinelli, Andrea, Gehring, Ulrike, Geiger, Harald, Geleijnse, Johanna M, George, Ronnie, Gerdts, Eva, Ghaderi, Ebrahim, Ghamari, Seyyed-Hadi, Ghanbari, Ali, Ghasemi, Erfan, Gheorghe-Fronea, Oana-Florentina, Gialluisi, Alessandro, Giampaoli, Simona, Gianfagna, Francesco, Gieger, Christian, Gill, Tiffany K, Giovannelli, Jonathan, Gironella, Glen, Giwercman, Aleksander, Gkiouras, Konstantinos, Glushkova, Natalya, Godara, Ramesh, Godos, Justyna, Gogen, Sibel, Goldberg, Marcel, Goltzman, David, Gómez, Georgina, Gómez Gómez, Jesús Humberto, Gomez, Luis F, Gómez, Santiago F, Gomula, Aleksandra, Gonçalves Cordeiro da Silva, Bruna, Gonçalves, Helen, Gonçalves, Mauer, González-Alvarez, Ana D, Gonzalez-Chica, David A, González-Gil, Esther M, Gonzalez-Gross, Marcela, González-Leon, Margot, González-Rivas, Juan P, González-Villalpando, Clicerio, González-Villalpando, María-Elena, Gonzalez, Angel R, Gottrand, Frederic, Graça, Antonio Pedro, Grafnetter, Dušan, Grajda, Aneta, Grammatikopoulou, Maria G, Gregg, Edward W, Gregor, Ronald D, Gregório, Maria João, Grøholt, Else Karin, Grøntved, Anders, Grosso, Giuseppe, Gruden, Gabriella, Gu, Dongfeng, Guajardo, Viviana, Gualdi-Russo, Emanuela, Guallar-Castillón, Pilar, Gualtieri, Andrea, Gudmundsson, Elias F, Gudnason, Vilmundur, Guerchet, Maëlenn, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L, Gujral, Unjali P, Gulliford, Martin C, Gunnlaugsdottir, Johanna, Gunter, Marc J, Guo, Xiu-Hua, Guo, Yin, Gupta, Prakash C, Gupta, Rajeev, Gureje, Oye, Gurinović, Mirjana A, Gutiérrez González, Enrique, Gutierrez, Laura, Gutzwiller, Felix, Gwee, Xinyi, Ha, Seongjun, Hadaegh, Farzad, Hadjigeorgiou, Charalambos A, Haghshenas, Rosa, Hakimi, Hamid, Halkjær, Jytte, Hambleton, Ian R, Hamzeh, Behrooz, Hanekom, Willem A, Hange, Dominique, Hanif, Abu AM, Hantunen, Sari, Hao, Jie, Hardman, Carla Menêses, Hardy, Louise, Hari Kumar, Rachakulla, Harmer Lassen, Tina, Harooni, Javad, Hashemi-Shahri, Seyed Mohammad, Hassapidou, Maria, Hata, Jun, Haugsgjerd, Teresa, Hayes, Alison J, He, Jiang, He, Yuan, He, Yuna, Heidinger-Felső, Regina, Heier, Margit, Heinen, Mirjam, Hejgaard, Tatjana, Hendriks, Marleen Elisabeth, Henrique, Rafael dos Santos, Henriques, Ana, Hernandez Cadena, Leticia, Herrala, Sauli, Herrera-Cuenca, Marianella, Herrera, Victor M, Herter-Aeberli, Isabelle, Herzig, Karl-Heinz, Heshmat, Ramin, Heude, Barbara, Hill, Allan G, Ho, Sai Yin, Ho, Suzanne C, Hobbs, Michael, Höfelmann, Doroteia A, Holdsworth, Michelle, Homayounfar, Reza, Homs, Clara, Hoogendijk, Emiel, Hopman, Wilma M, Horimoto, Andrea RVR, Hormiga, Claudia M, Horta, Bernardo L, Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yonghua, Huerta, José María, Huhtaniemi, Ilpo Tapani, Huiart, Laetitia, Huidumac Petrescu, Constanta, Husseini, Abdullatif, Huu, Chinh Nguyen, Huybrechts, Inge, Hwalla, Nahla, Hyska, Jolanda, Iacoviello, Licia, Iakupova, Ellina M, Ibarluzea, Jesús, Ibrahim, Mohsen M, Ibrahim Wong, Norazizah, Igland, Jannicke, Ijoma, Chinwuba, Ikram, M Arfan, Iñiguez, Carmen, Irazola, Vilma E, Ishida, Takafumi, Isiguzo, Godsent C, Islam, Muhammad, Islam, Sheikh Mohammed Shariful, Islek, Duygu, Ittermann, Till, Ivanova-Pandourska, Ivaila Y, Iwasaki, Masanori, Jääskeläinen, Tuija, Jackson, Rod T, Jacobs, Jeremy M, Jadoul, Michel, Jafar, Tazeen, Jallow, Bakary, James, Kenneth, Jamil, Kazi M, Jamrozik, Konrad, Jan, Nataša, Jansson, Anna, Janszky, Imre, Janus, Edward, Jarani, Juel, Jarnig, Gerald, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelaković, Ana, Jelaković, Bojan, Jennings, Garry, Jiang, Chao Qiang, Jimenez, Ramon O, Jöckel, Karl-Heinz, Joffres, Michel, Jokelainen, Jari J, Jonas, Jost B, Jonnagaddala, Jitendra, Jøran Kjerpeseth, Lars, Jørgensen, Torben, Joshi, Pradeep, Joshi, Rohina, Josipović, Josipa, Joukar, Farahnaz, Jóźwiak, Jacek J, Judge, Debra S, Juolevi, Anne, Jurak, Gregor, Jurca Simina, Iulia, Juresa, Vesna, Kaaks, Rudolf, Kaducu, Felix O, Kadvan, Agnes L, Kafatos, Anthony, Kaj, Mónika, Kajantie, Eero O, Kakutia, Natia, Kállayová, Daniela, Kalmatayeva, Zhanna, Kalter-Leibovici, Ofra, Kameli, Yves, Kanala, Kodanda R, Kannan, Srinivasan, Kapantais, Efthymios, Karaglani, Eva, Karakosta, Argyro, Kårhus, Line L, Karki, Khem B, Karlsson, Omat, Kassi Anicet, Adoubi, Katchunga, Philippe B, Katibeh, Marzieh, Katz, Joanne, Katzmarzyk, Peter T, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli M, Kaze, François F, Kazembe, Benson M, Ke, Calvin, Keil, Ulrich, Keinan Boker, Lital, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kelleher, Cecily, Kemper, Han CG, Keramati, Maryam, Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khaledifar, Arsalan, Khalili, Davood, Kheiri, Bahareh, Kheradmand, Motahareh, Khosravi, Alireza, Khouw, Ilse MSL, Kiechl-Kohlendorfer, Ursula, Kiechl, Sophia J, Kiechl, Stefan, Killewo, Japhet, Kim, Hyeon Chang, Kim, Jeongseon, Kindblom, Jenny M, Kingston, Andrew, Klakk, Heidi, Klanarong, Suntara, Klanova, Jana, Klimek, Magdalena, Klimont, Jeannette, Klumbiene, Jurate, Knoflach, Michael, Kobel, Susanne, Koirala, Bhawesh, Kolle, Elin, Kolo, Sanda M, Kolsteren, Patrick, König, Jürgen, Korpelainen, Raija, Korrovits, Paul, Korzycka, Magdalena, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Koussoh Simone, Malik, Kovács, Éva, Kovacs, Viktoria Anna, Kovalskys, Irina, Kowlessur, Sudhir, Koziel, Slawomir, Kratenova, Jana, Kratzer, Wolfgang, Kriaucioniene, Vilma, Kriemler, Susi, Kristensen, Peter Lund, Krizan, Helena, Kroker-Lobos, Maria F, Krokstad, Steinar, Kromhout, Daan, Kruger, Herculina S, Kruger, Ruan, Kryst, Łukasz, Kubinova, Ruzena, Kuciene, Renata, Kujala, Urho M, Kujundzic, Enisa, Kulaga, Zbigniew, Kulimbet, Mukhtar, Kulothungan, Vaitheeswaran, Kumar, R Krishna, Kumari, Meena, Kunešová, Marie, Kurjata, Pawel, Kusuma, Yadlapalli S, Kutsenko, Vladimir, Kuulasmaa, Kari, Kyobutungi, Catherine, La, Quang Ngoc, Laamiri, Fatima Zahra, Laatikainen, Tiina, Labadarios, Demetre, Lachat, Carl, Lackner, Karl J, Lai, Daphne, Laid, Youcef, Lall, Lachmie, Lam, Tai Hing, Landaeta Jimenez, Maritza, Landais, Edwige, Lankila, Tiina, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Larissa, Simo Pone, Lateva, Mina P, Latt, Tint Swe, Laurenzi, Martino, Lauria, Laura, Lazo-Porras, Maria, Le Coroller, Gwenaëlle, Le Nguyen Bao, Khanh, Le Port, Agnès, Le, Tuyen D, Lee, Jeannette, Lee, Jeonghee, Lee, Paul H, Lehtimäki, Terho, Lemogoum, Daniel, Leong, Elvynna, Leskošek, Branimir, Leszczak, Justyna, Leth-Møller, Katja B, Leung, Gabriel M, Levitt, Naomi S, Li, Yanping, Liivak, Merike, Lilly, Christa L, Lim, Charlie, Lim, Wei-Yen, Lima-Costa, M Fernanda, Lin, Xu, Lind, Lars, Lingam, Vijaya, Linkohr, Birgit, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Liu, Jing, Liu, Lijuan, Liu, Liping, Liu, Xiaotian, Lo, Wei-Cheng, Loit, Helle-Mai, Long, Khuong Quynh, Longo Abril, Guadalupe, Lopes, Luis, Lopes, Marcus SS, Lopes, Oscar, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A, Lozano, José Eugenio, Lukrafka, Janice L, Luksiene, Dalia, Lundqvist, Annamari, Lunet, Nuno, Lunogelo, Charles, Lustigová, Michala, Łuszczki, Edyta, M'Buyamba-Kabangu, Jean-René, Ma, Guansheng, Ma, Xu, Machado-Coelho, George LL, Machado-Rodrigues, Aristides M, Macia, Enguerran, Macieira, Luisa M, Madar, Ahmed A, Madraisau, Sherilynn, Madsen, Anja L, Maestre, Gladys E, Maggi, Stefania, Magliano, Dianna J, Magnacca, Sara, Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Mäki, Päivi, Malekpour, Mohammad-Reza, Malekzadeh, Fatemeh, Malekzadeh, Reza, Malhotra, Rahul, Mallikharjuna Rao, Kodavanti, Malta, Deborah C, Malyutina, Sofia K, Maniego, Lynell V, Manios, Yannis, Mann, Jim I, Mannix, Masimango Imani, Mansour-Ghanaei, Fariborz, Manyanga, Taru, Manzato, Enzo, Mapatano, Mala Ali, Marcil, Anie, Margozzini, Paula, Maria-Magdalena, Rosu, Mariño, Joany, Markaki, Anastasia, Markey, Oonagh, Markidou Ioannidou, Eliza, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martin-Prevel, Yves, Martin, Rosemarie, Martorell, Reynaldo, Martos, Eva, Maruf, Fatai A, Maruszczak, Katharina, Marventano, Stefano, Masala, Giovanna, Mascarenhas, Luis P, Masinaei, Masoud, Masoodi, Shariq R, Mathiesen, Ellisiv B, Mathur, Prashant, Matijasevich, Alicia, Matłosz, Piotr, Matsha, Tandi E, Matsudo, Victor, Matteo, Giletta, Maulik, Pallab K, Mavrogianni, Christina, Mazur, Artur, McFarlane, Shelly R, McGarvey, Stephen T, McKee, Martin, McLean, Rachael M, McLean, Scott B, McNairy, Margaret L, McNulty, Breige A, Mediene Benchekor, Sounnia, Medzioniene, Jurate, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisfjord, Jørgen, Meisinger, Christa, Melgarejo, Jesus D, Melkumova, Marina, Mello, Júlio, Méndez, Fabián, Mendivil, Carlos O, Menezes, Ana Maria B, Menon, Geetha R, Mensink, Gert BM, Menzano, Maria Teresa, Meshram, Indrapal I, Meto, Diane T, Meyer, Haakon E, Mi, Jie, Michaelsen, Kim F, Michels, Nathalie, Mikkel, Kairit, Miłkowska, Karolina, Miller, Jody C, Milushkina, Olga, Minderico, Cláudia S, Mini, GK, Miquel, Juan Francisco, Mirjalili, Mohammad Reza, Mirkopoulou, Daphne, Mirrakhimov, Erkin, Mišigoj-Duraković, Marjeta, Mistretta, Antonio, Mocanu, Veronica, Modesti, Pietro A, Moghaddam, Sahar Saeedi, Mohamed, Shukri F, Mohammad, 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2024
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2. Perfusion Assessment in Left-Sided/Low Anterior Resection (PILLAR III): A Randomized, Controlled, Parallel, Multicenter Study Assessing Perfusion Outcomes With PINPOINT Near-Infrared Fluorescence Imaging in Low Anterior Resection.

Author

Jafari, Mehraneh D, Pigazzi, Alessio, McLemore, Elisabeth C, Mutch, Matthew G, Haas, Eric, Rasheid, Sowsan H, Wait, Alyssa D, Paquette, Ian M, Bardakcioglu, Ovunc, Safar, Bashar, Landmann, Ron G, Varma, Madhulika G, Maron, David J, Martz, Joseph, Bauer, Joel J, George, Virgilio V, Fleshman, James W, Steele, Scott R, and Stamos, Michael J

Subjects
Colon, Rectum, Humans, Rectal Neoplasms, Indocyanine Green, Fluoroscopy, Intraoperative Care, Anastomosis, Surgical, Middle Aged, Female, Male, Anastomotic Leak, Optical Imaging, Anastomotic leak, Angiography, Colorectal anastomosis, Indocyanine green, Perfusion, Clinical Research, Prevention, Clinical Trials and Supportive Activities, Clinical Sciences, Surgery
Abstract

BackgroundIndocyanine green fluoroscopy has been shown to improve anastomotic leak rates in early phase trials.ObjectiveWe hypothesized that the use of fluoroscopy to ensure anastomotic perfusion may decrease anastomotic leak after low anterior resection.DesignWe performed a 1:1 randomized controlled parallel study. Recruitment of 450 to 1000 patients was planned over 2 years.SettingsThis was a multicenter trial.PatientsIncluded patients were those undergoing resection defined as anastomosis within 10 cm of the anal verge.InterventionPatients underwent standard evaluation of tissue perfusion versus standard in conjunction with perfusion evaluation using indocyanine green fluoroscopy.Main outcome measuresPrimary outcome was anastomotic leak, with secondary outcomes of perfusion assessment and the rate of postoperative abscess requiring intervention.ResultsThis study was concluded early because of decreasing accrual rates. A total of 25 centers recruited 347 patients, of whom 178 were randomly assigned to perfusion and 169 to standard. The groups had comparable tumor-specific and patient-specific demographics. Neoadjuvant chemoradiation was performed in 63.5% of perfusion and 65.7% of standard (p > 0.05). Mean level of anastomosis was 5.2 ± 3.1 cm in perfusion compared with 5.2 ± 3.3 cm in standard (p > 0.05). Sufficient visualization of perfusion was reported in 95.4% of patients in the perfusion group. Postoperative abscess requiring surgical management was reported in 5.7% of perfusion and 4.2% of standard (p = 0.75). Anastomotic leak was reported in 9.0% of perfusion compared with 9.6% of standard (p = 0.37). On multivariate regression analysis, there was no difference in anastomotic leak rates between perfusion and standard (OR = 0.845 (95% CI, 0.375-1.905); p = 0.34).LimitationsThe predetermined sample size to adequately reduce the risk of type II error was not achieved.ConclusionsSuccessful visualization of perfusion can be achieved with indocyanine green fluoroscopy. However, no difference in anastomotic leak rates was observed between patients who underwent perfusion assessment versus standard surgical technique. In experienced hands, the addition of routine indocyanine green fluoroscopy to standard practice adds no evident clinical benefit. See Video Abstract at http://links.lww.com/DCR/B560.Valoracin de la irrigacin de lado izquierdo/reseccin anterior baja pilar iii un estudio aleatorizado, controlado, paralelo y multicntrico que evala los resultados de la irrigacin con pinpoint imgenes de fluorescencia cercana al infrarrojo en la reseccin anterior bajaANTECEDENTES:Se ha demostrado que la fluoroscopia con verde de indocianina mejora las tasas de fuga anastomótica en ensayos en fases iniciales.OBJETIVO:Nuestra hipótesis es que la utilización de fluoroscopia para asegurar la irrigación anastomótica puede disminuir la fuga anastomótica luego de una resección anterior baja.DISEÑO:Realizamos un estudio paralelo, controlado, aleatorizado 1:1. Se planificó el reclutamiento de 450-1000 pacientes durante 2 años.AMBITO:Multicéntrico.PACIENTES:Pacientes sometidos a resección definida como una anastomosis dentro de los 10cm del margen anal.INTERVENCIÓN:Pacientes que se sometieron a la evaluación estándar de la irrigación tisular contra la estándar en conjunto con la valoración de la irrigación mediante fluoroscopia con verde indocianina.PRINCIPALES VARIABLES EVALUADAS:El principal resultado fue la fuga anastomótica, y los resultados secundarios fueron la evaluación de la perfusión y la tasa de absceso posoperatorio que requirió intervención.RESULTADOS:Este estudio se cerró anticipadamente debido a la disminución de las tasas de acumulación. Un total de 25 centros reclutaron a 347 pacientes, de los cuales 178 fueron, de manera aleatoria, asignados a perfusión y 169 a estándar. Los grupos tenían datos demográficos específicos del tumor y del paciente similares. Recibieron quimio-radioterapia neoadyuvante el 63,5% de la perfusión y el 65,7% del estándar (p> 0,05). La anastomosis estuvo en un nivel promedio de 5,2 + 3,1 cm en perfusión en comparación con 5,2 + 3,3 cm en estándar (p> 0,05). Se reportó una visualización suficiente de la perfusión en el 95,4% de los pacientes del grupo de perfusión. El absceso posoperatorio que requirió tratamiento quirúrgico fue de 5,7% de los perfusion y en el 4,2% del estándar (p = 0,75). Se informó fuga anastomótica en el 9,0% de la perfusión en comparación con el 9,6% del estándar (p = 0,37). En el análisis de regresión multivariante, no hubo diferencias en las tasas de fuga anastomótica entre la perfusión y el estándar (OR 0,845; IC del 95% (0,375; 1,905); p = 0,34).LIMITACIONES:No se logró el tamaño de muestra predeterminado para reducir satisfactoriamente el riesgo de error tipo II.CONCLUSIÓN:Se puede obtener una visualización adecuada de la perfusión con ICG-F. Sin embargo, no se observaron diferencias en las tasas de fuga anastomótica entre los pacientes que se sometieron a evaluación de la perfusión versus la técnica quirúrgica estándar. En manos expertas, agregar ICG-F a la rutina de la práctica estándar no agrega ningún beneficio clínico evidente. Consulte Video Resumen en http://links.lww.com/DCR/B560. (Traducción-Dr Juan Antonio Villanueva-Herrero).

Published
2021

5. Preoperative small bowel dilation is associated with ileus after right colectomy

Author

Alexander Booth, Matthew Di Leo, Mark Kovacs, Pinckney Johnstone Maxwell, IV, Colleen Donahue, Virgilio V George, and Thomas Curran

Subjects
Colorectal surgery, Ileus, Enhanced recovery, Perioperative management, Perioperative nutrition, Surgery, RD1-811
Abstract

Background: The relationship between preoperative bowel dysfunction and postoperative ileus has not been explored clinically. We hypothesized chronic partial obstruction, based on preoperative small bowel diameter, is associated with ileus after colon surgery. Methods: This was a retrospective case-control study of patients undergoing right colectomy or ileocolic resection with primary anastomosis. Patients who developed ileus were compared to those who did not. Results: Postoperative ileus occurred in 22 of 69 patients (32%). Preoperative small bowel dilation with maximum diameter >3 cm was present in 13 patients (19%) with 7 developing ileus (54%; p=0.06). In a multivariable model, small bowel dilation >3 cm (OR 4.6; 95% CI: 1.3-16.6) and preoperative weight loss >10 pounds (OR 9.8; 95% CI: 1.6-57.9) were independently associated with ileus. Conclusions: Colorectal surgery patients with preoperative bowel dilation have an increased risk of postoperative ileus. This knowledge can better inform patient expectations for recovery and help guide perioperative nutritional management, particularly with patient selection for parenteral nutrition.

Published
2022
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7. Physicochemical, Textural, and Protein Digestibility Properties of Extruded Meat Analogs Prepared from Rice Bran Protein Concentrate and Black Soybean (Glycine max L. cv. Tudela).

Author

Balonga, Bernadeth P., Garcia, Virgilio V., Completo, Gladys Cherisse J., and Flores, Floirendo P.

Subjects
*RICE bran, *SOYBEAN, *AMINO acid analysis, *MEAT alternatives, *PROTEINS, *MEAT
Abstract

Soybean is one of the most utilized raw materials in developing plant-based meat alternatives mainly because of its high protein content at a low cost. However, in terms of protein quality, it lacks sulfur-containing amino acids (cysteine and methionine), which limits its use as a complete protein source for substituting meat. Protein from rice bran contains a significant amount of cysteine and methionine; hence, this study aimed to develop meat analogs from black soybean (cv. Tudela) flour (S), rice bran protein concentrate (RP), and their blend (SRP) through singlescrew extrusion using a two-way factorial in a completely randomized design. Single-screw extrusion is the cost-effective alternative to the widely used twin-screw extrusion. Results from the analyses on physicochemical [proximate composition, color values, pH, nitrogen solubility index (NSI), and amino acid analysis] and functional [water absorption capacity (WAC) and oil absorption capacity (OAC)] properties of the developed products revealed that at p < 0.05, products from S and RP blend have functionality with potential for a wider range of food applications than when S and RP are extruded separately. Amino acid analysis also revealed that combining RP with S increased the amount of sulfur-containing amino acids by 130.17%. Protein digestibility of products was as follows: S at 88.50%, SRP at 81.81%, and RP at 73.86%, respectively; with oil modification of the feed formulations to 20%, the protein digestibility significantly improved to as follows: S at 96.62%, SRP at 85.89%, and RP at 93.83% at p < 0.05. Extruded S and SRP have texture profiles comparable to chicken and extruded RP to pork. Results from this study may provide base data for the formulation of plant-based meat alternatives with improved protein quality and meat-like texture. [ABSTRACT FROM AUTHOR]

Published
2023
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8. Abdominal Surgical Procedures in Adult Patients With Cystic Fibrosis: What Are the Risks?

Author

Melissa A, Hite, Wolfgang B, Gaertner, Bryan, Garcia, Patrick A, Flume, Pinckney J, Maxwell, Virgilio V, George, and Thomas, Curran

Subjects
Adult, Postoperative Complications, Adolescent, Cystic Fibrosis, Gastroenterology, Humans, General Medicine, Length of Stay, Fibrosis, Colectomy, Retrospective Studies
Abstract

With advances in medical care, patients with cystic fibrosis are more commonly living into adulthood, yet there are limited data describing the need for GI surgery and its outcomes in adult cystic fibrosis patients.We aim to use a national administrative database to evaluate trends in abdominal GI surgery and associated postoperative outcomes among adult cystic fibrosis patients.This was a national retrospective cohort study.A national all-payor administrative database from 2000 to 2014 was used.Patients included adults (age ≥18 years) with cystic fibrosis undergoing abdominal GI surgery.The primary outcome was trend over time in number of surgical admissions. Secondary outcomes included morbidity and mortality by procedure type.We identified 3075 admissions for abdominal surgery, of which 28% were elective. Major GI surgical procedures increased over the study period ( p0.01), whereas appendectomy and cholecystectomy did not demonstrate a clear trend ( p = 0.90). The most common procedure performed was cholecystectomy ( n = 1280; 42%). The most common major surgery was segmental colectomy ( n = 535; 18%). Obstruction was the most common surgical indication ( n = 780; 26%). For major surgery, in-hospital mortality was 6%, morbidity was 37%, and mean length of stay was 15.9 days (SE 1.2).The study is limited by a lack of granular physiological and clinical data within the administrative data source.Major surgical admissions for adult patients with cystic fibrosis are increasing, with the majority being nonelective. Major surgery is associated with significant morbidity, mortality, and prolonged length of hospital stay. These findings may inform perioperative risk for adult patients with cystic fibrosis in need of GI surgery. See Video Abstract at http://links.lww.com/DCR/B850 .ANTECEDENTES:Con los avances en la medicina, los pacientes con fibrosis quística viven más comúnmente hasta la edad adulta, pero hay datos escasos que describan la necesidad de cirugía gastrointestinal y sus resultados en pacientes adultos con fibrosis quística.OBJETIVO:Nuestro objetivo es utilizar una base de datos administrativa nacional para evaluar las tendencias en la cirugía gastrointestinal abdominal y los resultados posoperatorios asociados entre los pacientes adultos con fibrosis quística.DISEÑO:Estudio de cohorte retrospectivo nacional.AJUSTE:Base de datos administrativa nacional de todas las instituciones pagadoras desde 2000 a 2014.PACIENTES:Todos los pacientes adultos (edad18) con fibrosis quística sometidos a cirugía gastrointestinal abdominal.PRINCIPALES MEDIDAS DE RESULTADO:El resultado primario fue la tendencia a lo largo del tiempo en el número de ingresos quirúrgicos. Los resultados secundarios incluyeron morbilidad y mortalidad por tipo de procedimiento.RESULTADOS:Identificamos 3.075 ingresos por cirugía abdominal de los cuales el 28% fueron electivos. Los procedimientos quirúrgicos gastrointestinales mayores aumentaron durante el período de estudio (p0,01) mientras que la apendicectomía y la colecistectomía no demostraron una tendencia clara (p = 0,90). El procedimiento realizado con mayor frecuencia fue la colecistectomía (n = 1.280; 42%). La cirugía mayor más común fue la colectomía segmentaria (n = 535; 18%). La obstrucción fue la indicación quirúrgica más común (n = 780; 26%). Para la cirugía mayor, la mortalidad hospitalaria fue del 6%, la morbilidad del 37% y la estadía media de 15,9 días (EE 1,2).LIMITACIONES:El estudio está limitado por la falta de datos clínicos y fisiológicos granulares dentro de la fuente de datos administrativos.CONCLUSIONES:Los ingresos quirúrgicos mayores de pacientes adultos con fibrosis quística están aumentando y la mayoría no son electivos. La cirugía mayor se asocia con una morbilidad y mortalidad significativas y una estancia hospitalaria prolongada. Estos hallazgos pueden informar el riesgo perioperatorio para pacientes adultos con fibrosis quística que necesitan cirugía gastrointestinal. Consulte Video Resumen en http://links.lww.com/DCR/B850 . (Traducción-Dr. Felipe Bellolio ).

Published
2022

10. Disease-free Survival and Local Recurrence for Laparoscopic Resection Compared With Open Resection of Stage II to III Rectal Cancer: Follow-up Results of the ACOSOG Z6051 Randomized Controlled Trial

Author

Fleshman, James, Branda, Megan E., Sargent, Daniel J., Boller, Anne Marie, George, Virgilio V., Abbas, Maher A., Peters, Walter R., Jr, Maun, Dipen C., Chang, George J., Herline, Alan, Fichera, Alessandro, Mutch, Matthew G., Wexner, Steven D., Whiteford, Mark H., Marks, John, Birnbaum, Elisa, Margolin, David A., Larson, David W., Marcello, Peter W., Posner, Mitchell C., Read, Thomas E., Monson, John R. T., Wren, Sherry M., Pisters, Peter W. T., and Nelson, Heidi

Published
2019
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13. Selective typescreen for elective colectomy based on a transfusion risk score may generate substantial cost savings

Author

Alexander T, Booth, Shelby, Allen, Vlad V, Simianu, Christine C, Jensen, Marc L, Schermerhorn, Virgilio V, George, and Thomas, Curran

Subjects
Cost Savings, Elective Surgical Procedures, Risk Factors, Humans, Blood Transfusion, Colectomy, Retrospective Studies
Abstract

Preoperative type and screen are currently recommended for all patients undergoing colectomy. We aimed to identify risk factors for transfusion and define a low-risk cohort of patients undergoing colectomy in whom type and screen may be safely avoided.We identified all patients undergoing elective colectomy in the National Surgical Quality Improvement Project-Targeted Colectomy files from 2012 to 2016. Patients transfused preoperatively and those undergoing other concurrent major abdominal procedures were excluded. We compared patients who received blood transfusion on the day of surgery to those who did not. Half of the cohort was randomly selected for development of a points-based model predicting blood transfusion on the day of surgery. This model was then validated using the remaining patients.Of 61,964 patients undergoing colectomy, 3128 (5%) patients were transfused with 1290 (2.1%) occurring on the day of surgery. Preoperative anemia was the strongest predictor of blood transfusion on the day of surgery. Among patients with hematocrit 35%, day of surgery transfusion risk was 0.8%; 99% of patients with hematocrit 35% had a score 20 or less. Selective type and screen for patients with score ≤ 20 or hematocrit 35% would avoid type and screen in 91% and 81% of patients, respectively.Transfusion following elective colectomy is rare and can be accurately predicted by preoperative patient characteristics. Selective type and screen based on these parameters have the potential to prevent operative delays and lower cost.

Published
2021

16. Gentamicin-collagen sponge for infection prophylaxis in colorectal surgery

Author

Bennett-Guerrero, Elliott, Pappas, Theodore N., Koltun, Walter A., Fleshman, James W., Min Lin, Garg, Jyotsana, Mark, Daniel B., Marcet, Jorge E., Remzi, Feza H., George, Virgilio V., Newland, Kerstin, and Corey, G.R.

Subjects
Collagen -- Evaluation, Colorectal surgery -- Complications and side effects, Gentamicin -- Evaluation, Surgical wound infections -- Drug therapy, Drug therapy, Combination
Abstract

The study attempts to evaluate the efficacy of gentamicin-collagen sponge as a form of treatment for infection prophylaxis in colorectal surgery. The results indicate that gentamicin-collagen sponge is ineffective in such cases and also results in significantly more surgical-site infections.

Published
2010

17. Contributors

Author

Abdul-Hussein, Mustafa, Abhyankar, Sunil, Adam, Rodney D., Adams, Paul C., Adesanya, T.M. Ayodele, Agudelo Higuita, Nelson Iván, Ahmed, Omar G., Akst, Lee, Anderson, Kelley P., Andre, Paul, Anstead, Gregory M., Aring, Ann M., Armstrong, Cheryl A., Arshi, Arash, Avalos, Danny, Azar, Cecilio M., Azarbal, Amir, Baeseman, Zachary, Bailey, Justin, Bajaj, Mandeep, Bakhutashvili, Vladimer, Balagué, Federico, Banti, Matthew Michael, Barth, Bradley, Basello, Gina M., Bassaly, Renee, Bassily-Marcus, Adel, Baughn, Julie, Belakovskiy, Aleksandr, Ben-Ami, Ronen, Bencheqroun, Hassan, Bernstein, David I., Bernstein, Jonathan A., Beyer, Caroline, Biggerstaff, Kristin Schmid, Birt, Mitchell, Blum, William, Bolotin, Diana, Bonnema, Rachel A., Borenstein, David, Bossart, Christopher, Bowman, Deidra, Bragg, Dee Ann, Bragg, Scott, Brice, Sylvia L., Briggs, Allyson M., Brill, John, Brown, Rachel, Buckley, Peter F., Burns, Sarah, Byrd, Kenneth P., Cadavid, Diego, Caraccio, Thomas R., Carek, Peter J., Carrion, Andres F., Cass, Amanda S., Castell, Donald O., Catinella, Anthony P., Cayley, William E., Jr., Cerquozzi, Sonia, Cervera, Alvaro, Cetani, Filomena, Chamberlain, Rachel, Chan, Lawrence, Chan, Miriam, Chandramohan, Divya, Chang, Zenas, Chen, Jimmy, Chen, Lin Yee, Chihara, Shingo, Chitlur, Meera, Chohan, Saima, Christensen, Jacob, Chyu, Kuang-Yuh, Cigarroa, Joaquin E., Cleland, Paul, Cline, Matthew, Coates, Laura C., Colenbrander, August, Commins, Ryan, Conageski, Christine, Conly, John, Contini, Carlo, Cooper, Ashley, Cooper, Stacy, Cormier, Allison, Cunha, Burke A., Cunha, Cheston B., Curran, Thomas, Curry, Amy, Daines, Cori L., Damas, Oriana M., Damitz, Beth A., Datta, Nandini, Dattilo, Natalie C., Davaro, Raul, David, Kevin A., de Leon, André, de Leon, Tate, DeCastro, Alexei O., DeGeorge, Katharine C., DeLoughery, Thomas G., Deodhar, Atul, Desai, Urmi, Dessinioti, Clio, Diamond, Michael P., Dion, Christopher, Do, Catherine, Dobbs, Thomas, Donahue, Colleen A., Donnan, Geoffrey A., Dorsch, John N., Dougan, Michael, Douglas, Chad, Dowlatshahi, Dar, Dowler, Shannon, Drevets, Douglas, Dudley, Samuel C., Jr., Duggan, Peter R., Eagle, Kim A., Eck, Leigh M., El Atrouni, Wissam, Elston, Dirk M., Embil, John M., Epstein, Scott K., Evans, Susan, Evens, Andrew M., Fagan, J. Barry, Fairweather, Mark, Falk, Marni J., Faris, Anna, Faugno, Anthony J., III, Faust, Hilary, Fayssoux, Kinder, Feldman, Dorianne, Ferguson, Ian, Fife, Terry. D., Finley, David J., Firnhaber, Jonathon, Fisher, Lynn, Fisher, William E., Fleseriu, Maria, Fletcher, Donald, Foster, Jeffrey Michael, Frank, Jennifer, Freeman, Ellen W., Frenz, David A., Gaba, Ruchi, Gaines, Melissa, Garcia, Mark, Ghany, Marc G., George, Virgilio V., Ghazi, Muhammad Ahmad, Gibney, Geoffrey, Gilbert, Donald L., Gilchrist, Karissa, Gillaspie, Erin A., Gilotra, Tarvinder, Gladwin, Mark T., Gluckman, Stephen J., Goddard, Andrew W., Goerl, Kyle, Gold, Mark S., Goldstein, Amy, González-Fernández, Marlis, Goodwin, Gregory, Gosmanov, Aidar R., Gradoni, Luigi, Graham, Timothy P., Grant-Kels, Jane M., Grdinovac, Kristine, Greenberg, Leslie, Greene, William, Greensher, Joseph, Gregory, David, Greiwe, Justin, Hague, Melissa, Halder, Rebat, Hall, Alan M., Harris, Kari R., Harrison, Taylor B., Hartman, Adam L., Hayes, Erin, Haynes, James W., Heidelbaugh, Joel J., Hinshaw, Molly A., Hockenberry, Brandon, Hohl, Raymond J., Holguin, Therese, Holstein, Sarah A., Holyoak, Michael, Homan, Gretchen, Hommema, Kevin, Hommema, Laurie A.M., Horn, Leora, Hossani-Madani, Ahmad Reza, House, Steven A., Houssayni, Sarah, Hueston, William J., Huettemann, Richard, Huffstetler, Alison, Hunter, Anthony, Ibidapo-Obe, Oyetokunbo, Ing, Alice M., Irwin, Gretchen, Isaac, Daniel, Jackson, Alan C., Jackson-Tarlton, Caitlin, Jacobson, Kurt M., Jaller, Jose A., James, W. Ennis, Jeang, Lauren, Jha, Abhishek, Jia, Xiaoming, Johnson, Casey R., Johnson, Lisa M., Jolissaint, Joshua S., Judson, Marc A., Kadhiravan, Tamilarasu, Kalia, Rachna, Kamprath, Sagar, Kanter, Jessica Rachel, Karnad, Dilip R., Karnchanasorn, Rudruidee, Katsambas, Andreas, Katz, Ben, Katzman, Rebecca, Kaunitz, Andrew M., Keegan, B. Mark, Kellerman, Rick D., Kellermann, Scott, Kelly, Christina M., Khaki, Sheevaun, Kim, Arthur Y., Kim, Haejin, Kirsner, Robert S., Kiwalkar, Sonam, Knoefel, Janice, Kolb, Amanda, Kolla, Bhanu Prakash, Korley, Frederick, Kovalsky, Adrienne N., Krause, Megan, Kraut, Eric H., Krishnamurti, Lakshmanan, Krishnan, Kumar, Kuhlmann, Zachary, Kulkarni, Roshni, Kumar, Seema, Kwaan, Mary R., Kyle, Robert A., Lampton, Lucius M., Lange, Richard A., Langlois, Fabienne, Lau, Christine, Lawrence-Hylland, Susan, Lazaroff, Jake, Lee, Lydia U., Leikin, Jerrold B., Leikin, Scott, Leung, Alexander K.C., Levy-Clarke, Grace, LeWinter, Martin M., Lewis, Jennifer, Li, Ming, Liebenstein, Tyler, Lin, Albert P., Linder, Jeffrey A., Lock, James, Long, M. Chantel, Loo-Gross, Colleen, Lubsen, Julia R., Lun, Ronda, Mahvi, David (Sasha), Maiorella, RosaMarie, Malhotra, Uma, Manlove, Emily, Manson, JoAnn E., Mansukhani, Meghna, Marcocci, Claudio, Margo, Curtis E., Marker, Jason E., Martin, Paul, Mathis, Samuel E., Matson, Kristine, Matza, Mark A., Maxwell, Pinckney J., IV, May, Danica, Mazepa, Gregory Marshall, McClain, Molly, McGrew, Christopher, McGuigan, Christopher Charles, Mehta, Meetal, Meiselman, Mick S., Mercado, Moises, Merrell, Ryan, Meyers, Steven L., Michael, William, Miller, Brian J., Millington, Timothy M., Mirza, Moben, Mofenson, Howard C., Mogensen, Kris M., Moritz, Michael L., Mortada, Rami, Mortaji, Parisa, Moss, Heather E., Moul, Judd W., Muller, Martha, Murinova, Natalia E., Murphy, Michael, Muthusubramanian, Arjun, Nagji, Alykhan S., Naranjo, Laura, Nasim, Rabab, Nazari, Matthew A., Nazeef, Moniba, Neelakantan, Viswanathan K., Neff, Don, Neil, Tara, Nelson, William G., Neschis, David G., Nester, Theresa, Nguyen, Tam T., Nicol, Andrea L., Nieves-Arriba, Lucybeth, North, Crystal, Novac, Andrei, Novelli, Enrico M., Nye, Lauren, Obi, Andrea T., Okeson, Jeffrey P., Oliveira, Carlos R., Ong, Peck Y., Oram, Daniel S., Ortiz, David D., Ozgonenel, Bulent, Pacak, Karel, Padin-Rosado, Jose A., Padungkiatsagul, Tanyatuth, Paladine, Heather L., Pandolfino, John E., Patel, Deval, Patton, Simon, Penna, Gerson O., Penna, Maria Lucia, Perkins, Allen, Peterson, Leah, Petroianu, Georg A., Petronic-Rosic, Vesna M., Phan, Hanna, Pietroni, Mark, Plotnikoff, Gregory A., Pollart, Susan M., Poon, Jennifer, Porter, Andrew S.T., Powell, Charles, Pusateri, Margaret, Quinn, James M., Rahko, Peter S., Rajkumar, S. Vincent, Rajpara, Anand, Ramakrishnan, Kalyanakrishnan, Ramirez, Julio A., Rana, Jatin, Rank, Matthew A., Raoult, Didier, Rapose, Alwyn, Rau, Rachel E., Ravindran, Anita, Regehr, Jared, Reid, Ian R., Rennert-May, Elissa, Rew, Karl, Rezapour, Mona, Rhyne, Amanda, Riese, Martha, Robbins, David C., Robert, Sophie, Robertson, Amy D., Robinson, Malcolm, Roche, William P., Rohrberg, Tessa, Rose, Candice, Rose, Peter G., Ross, Stephen, Roth, Alan R., Ruha, Anne-Michelle, Rundell, Kristen, Said, Adnan, Sairenji, Tomoko, Samson, Susan L., Sanchez, Carlos E., Sangodkar, Sandeep, Santana, Arelis, Sarode, Ravindra, Schatz, Michael, Schevchuck, Alex, Schiller, Lawrence R., Schrager, Sarina, Schuller, Dan, Seashore, Justin, Seery, Amy, Seifert, Steven A., Semel, Jeffery D., Shaffi, Saeed Kamran, Shah, Beejal, Shah, Meera, Shah, Prediman Krishan, Shah, Shenil, Shammo, Jamile M., Shapiro, Eugene D., Sharara, Ala I., Sharma, Sonal, Sheehan, John P., Sherman, Kamille S., Shevy, Laura Elyse, Shew, Sable, Sierpina, Victor S., Sievers, Karlynn, Silk, Hugh, Simon, Lisa, Sinclair, Aaron D., Siraj, Dawd S., Smith, Jeannina, Smith, Zachary L., Soder, Rupal, Sojka, John, Somers, William J., Song, Mihae, Sosa, Nestor, Sowder, Timothy, Speer, Linda, St. Louis, Erik Kent, Stephens, Todd, Stiles, Melissa, Stratakis, Constantine, Stulberg, Daniel, Suárez, José D., Takashima, Masayoshi, Takyar, Varun, Talhari, Carolina, Tang, Jie, Tate, Jessica, Templeton, Kim, Teng, Joyce M.C., Thomson, Joanna, Tillett, William, Timbadia, Paresh J., Tobin, Kenneth, Tsaltas, Theodore T., Unizony, Sebastian H., Unruh, Mark, Uppendahl, Locke, Vallurupalli, Anusha, Van Buren, George, II, van Duin, David, Van Durme, Daniel J., Varlamov, Elena V., Veglia, Megan, Vélez, Christopher, Vercellotti, Gregory, Vincent, Kyle, Vinh, Donald C., Vyas, Jatin Mahesh, Wagner, Tamara, Wakefield, Thomas W., Wald, Arnold, Wald, Ellen R., Walker, Robin A., Wang, Ernest, Wang, Jennifer, Watanabe, Koji, Weber, Ruth, Wehler, Cheryl, Wei, Alice C., Weida, Jane A., Weissman, David N., Welliver, Robert C., Sr., Wester, Rebecca M., Wexler, Randell, Wilamowska, Katarzyna, Williams, Kimberly, Williams, Tracy L., Winterhoff, Boris, Wipperman, Jennifer, Wirtz, Mark W., Wittler, Robert, Wood, Gary S., Worswick, Scott, Wu, Dominic J., Wu, Steve W., Wyre, Hadley, Yakubov, Steven, Yang, Xinghong, Yang, Yul W., Yew, Kenneth S., Yi, Yooni, Yiannias, James A., Young, Natawadee, and Zea Vera, Alonso G.

Published
2023
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22. A Prospective, Multicenter, Randomized, Controlled Study of Non-cross-linked Porcine Acellular Dermal Matrix Fascial Sublay for Parastomal Reinforcement in Patients Undergoing Surgery for Permanent Abdominal Wall Ostomies

Author

David E. Beck, James W. Fleshman, Steven D. Wexner, Joel J. Bauer, Virgilio V. George, and Neil Hyman

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Gastroenterology, Colostomy, General Medicine, medicine.disease, digestive system, Parastomal hernia, digestive system diseases, Surgery, law.invention, Abdominal wall, Ileostomy, surgical procedures, operative, medicine.anatomical_structure, Stoma (medicine), Randomized controlled trial, law, medicine, Hernia, business, Prospective cohort study
Abstract

BACKGROUND:A large proportion of patients with a colostomy or an ileostomy develop parastomal hernias. The placement of a reinforcing material at the stoma site may reduce parastomal hernia incidence.OBJECTIVE:We aimed to assess the safety and efficacy of stoma reinforcement with sublay placement of

Published
2014

23. Implementation of Clinical Video Telemedicine (CVT) within a VA Medical Center Is Cost Effective and Well Received by Veterans

Author

Alyssa D. Fajardo, John Wennergren, Virgilio V. George, and Imtiaz A. Munshi

Subjects
Government, Telemedicine, business.industry, Specialty, Telehealth, medicine.disease, humanities, Patient satisfaction, Health care, Medicine, Medical emergency, business, human activities, health care economics and organizations, Reimbursement, Simulation, Mile
Abstract

Background: The Veterans Administration (VA) has been using telehealth to enhance Veteran access to high quality VA care for over a decade. Clinical video telehealth (CVT) is one such telehealth tool that allows Veterans the opportunity to be evaluated by specialists at the Indianapolis VA while they actually remain in their community (in their local healthcare setting). Such tools are reported to improve satisfaction by avoiding the need to make the long, stressful, and often costly trips to the Medical Center. Our goal is to describe the results of CVT implementation at the Indianapolis VA. Methods: A retrospective review of the data from 2011-2014 related to the use of CVT at the Indianapolis VA was undertaken. The data collected during this time period included: the number of CVT visits per year by specialty, the number of miles in travel avoided per visit, and patient satisfaction survey data, which are obtained after each CVT visit. Results: A total of 14,708 Veterans have enrolled in our CVT telehealth program since 2011. There were 23,267 visits in 2013. 486,170 miles related to travel were avoided (calculating the number of miles avoided in travel from home to a local satellite site as compared to having to travel from home to the Indianapolis VA). At the current Government reimbursement rate of $0.42/mile, this is expressed in a cost avoidance of $209,053. In total, since 2011, the telehealth CVT program has saved the Government $331,132, a total of 770,075 miles saved in travel for our Veterans. In addition, the CVT program has been very well received by our Veterans with an overall satisfaction score of 96%. Conclusion: Our results indicate that the implementation of CVT is cost effective and is well received by Veterans. Telehealth modalities such as CVT are viable options that enhance Veteran satisfaction by decreasing the time and the costs related to travel while continuing to offer high quality health care.

Published
2014

24. Cycle derivatives of the generalized fan and the generalized wheel

Author

Virgilio V. Britos, Romulo C. Guerrero, and Rosalio G. Artes

Subjects
Combinatorics, Discrete mathematics, Applied Mathematics, Wheel graph, Bound graph, Graph, Mathematics
Abstract

The cycle derivative of a graph G, denoted by G 0 , is a graph obtained from G by treating the prime cycles (also called chordless cycles or induced cycles) of G as vertices of G 0 and two vertices x and y in G 0 are adjacent if and only if the corresponding cycles C(x) and C(y) have a common edge in G. This study establishes the cycle derivatives of the generalized fan and the generalized wheel. Also the sizes of the cycle derivatives of these graphs are determined.

Published
2014

25. Cecum Schwannoma: Uncommon Colonic Mass and New Surgical Approach Using Single Site Laparoscopy

Author

Imtiaz A. Munshi, Virgilio V. George, Bryan Holcomb, Matthew A. Ziegler, Luis Velazco, Alyssa D. Fajardo, and Bruce W. Robb

Subjects
Gastrointestinal bleeding, Abdominal pain, medicine.medical_specialty, Constipation, business.industry, General Medicine, Schwannoma, medicine.disease, Descending colon, Surgery, Cecum, medicine.anatomical_structure, Intussusception (medical disorder), Medicine, Ascending colon, medicine.symptom, business
Abstract

Introduction: Schwannomas (SNs) are rare tumors derived from Schwann cells. They can occur almost anywhere, but the most common location is cranial nerve VIII where they present as acoustic neuromas. SNs rarely may be located in the GI tract. Case reports of stomach, small intestine, descending colon, and rectal SN exist. An extremely rare site is the ascending colon. Here, we present a case of a 45-year-old man with a diagnosed SN of the ascending colon that was treated successfully via single site laparoscopic right hemicolectomy. Discussion: SNs have been reported to have a wide range of clinical manifestations including intermittent gastrointestinal bleeding, intestinal obstruction, constipation, intussusception, and abdominal pain. The diagnosis is made by histopathological examination demonstrating KIT (CD117) and CD34 stained negative samples and S-100 protein is stained positive. Surgical resection is the mainstay of therapy.

Published
2014

26. Long-axis rotational volvulus in an ileal J-pouch anal anastomosis: A preventable rare complication

Author

Alyssa D. Fajardo and Virgilio V. George

Subjects
medicine.medical_specialty, business.industry, Proctocolectomy, medicine.medical_treatment, General Medicine, Anastomosis, medicine.disease, Ulcerative colitis, digestive system diseases, Volvulus, Surgery, stomatognathic diseases, stomatognathic system, Acute abdomen, parasitic diseases, Medicine, Pouch, medicine.symptom, business, Complication, Barium enema
Abstract

Puropose: This study was designed to report a very rare long-term complication of ileal-Jpouch anal anastomosis: An 180 degree longaxial rotational volvulus causing J pouch obstruction. Methods: An Ovid and Medline search using the following keywords was performed: J pouch ileoanal anastomosis, J-pouch ileoanal anastomosis complications, J-pouch volvulus, J-pouch complications, restorative proctocolectomy complications, and restorative proctocolectomy volvulus. One J-pouch ileoanal anastomosis 180° volvulus report was found [1]. Result: We describe a long-axis 180° rotational volvulus complication of a J-pouch ileoanal anastomosis. The J pouch was performed three years prior after the laparoscopic total proctocolectomy for chronic ulcerative colitis. Pouch excision and new ileoanal J-pouch surgery were then performed along with pexy using alloderm mesh placement with excellent outcomes. Conclusion: Long-axis 180° rotational volvulus is a rare complication of a J-pouch ileoanal anastomosis. Pouch dysfunction after a long-axis rotational volvulus is an uncommon cause of acute abdomen. Lack of adhesions and pouch size are risk factors for the pouch torsion. Prompt diagnosis and treatment are essential for the pouch salvage. Simple abdominal x-ray, barium enema and CT scan represent important tools for diagnosis. Salvage surgery should be performed even if detorsion and decompression of the affected bowel are achieved. Surgery has excellent outcomes if performed after the prompt diagnosis. Pouch pexy should be done to prevent recurrent volvulus.

Published
2014

27. Evaluation of the Single-Port Laparoscopic Right Hemicolectomy Learning Curve

Author

Andrea Jester, Joshua A. Waters, Bruce W. Robb, Virgilio V. George, Don J. Selzer, and Michael J. Guzman

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Colorectal surgery, Surgery, Port (medical), Learning curve, Cohort, Medicine, Stage (cooking), business, Laparoscopy, Laparoscopic right hemicolectomy, Colectomy
Abstract

Background: The use of single-port laparoscopy has gained popularity within recent years. Part of the appeal in learning this approach is that it draws heavily from concepts mastered through conventional laparoscopy. Various studies have shown the efficacy and feasibility of the single-port laparoscopic approach, but there are few that examine the learning curve in adopting this new technique. Objective: Our goal was to better define the learning curve in performing a single-port laparoscopic right hemicolectomy. Design: A review of prospectively gathered operative data was performed to analyze the results of single-port laparoscopic right hemicolectomies performed within our institution by experienced laparoscopic surgeons. The first 100 cases were divided into quintiles. Comparisons were made among the cohorts regarding patient demographics, operative time, length of stay, conversions, and complications. Results: There was no difference among quintiles with regard to age, sex, BMI, or ASA class. Operative time, conversions, length of stay, and number of complications did not significantly vary among each group of patients. There was a significant difference in estimated blood loss and length of stay between the fifth cohort and the others due to one patient’s poor outcome. Conclusions: The single-port laparoscopic right hemicolectomy learning curve for surgeons already skilled in laparoscopy is short. There are few differences in various outcome measures among groups at any stage in the learning curve. The skills utilized to perform conventional laparoscopic colorectal surgery readily translate to the single-port approach and result in proficiency from nearly the start.

Published
2013

29. Partial Purification and Characterization of Polyphenol Oxidase Isozymes in Banana Bud

Author

Kazuko Oba, Ikuzo Uritani, Angelina M. Alvarez, Virgilio V. Garcia, and Norio Iwatsuki

Subjects
Gel electrophoresis, chemistry.chemical_classification, Chromatography, Chemistry, Organic Chemistry, Substrate (chemistry), General Medicine, Applied Microbiology and Biotechnology, Biochemistry, Polyphenol oxidase, Isozyme, Analytical Chemistry, Enzyme, Butyl-Toyopearl 650, Molecular Biology, Polyacrylamide gel electrophoresis, Incubation, Biotechnology
Abstract

Polyphenol oxidase was extracted from banana buds in the presences of Triton X-100, isoascorbate, and Polyclar AT, and two isozymes I and II have been separated and partially purified by chromatographies on Butyl Toyopearl 650 and DEAE-cellulose. I and II had different mobility in polyacrylamide gel electrophoresis with optimum pHs of 6.8 and 5.5, respectively. Both enzymes showed the apparent Km values of 0.5 mM for dopamine with substrate inhibitions at its higher concentrations. I and II were inhibited competitively by NaCI with the Ki values of 140 mM and 40 mM, respectively. I and II have a high heat stability, and 88 and 95% of the initial activities were retained after 1-hr incubation at 70°C, respectively.

Published
2016

30. Single-Port Laparoscopic Right Hemicolectomy: A Safe Alternative to Conventional Laparoscopy

Author

Virgilio V. George, Joshua A. Waters, Michael J. Guzman, Bruce W. Robb, Alyssa D. Fajardo, Eric A. Wiebke, and Don J. Selzer

Subjects
Adult, Male, Laparoscopic surgery, medicine.medical_specialty, medicine.medical_treatment, Colonic Diseases, Port (medical), medicine, Humans, Hemicolectomy, Laparoscopy, Colectomy, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, General surgery, Gastroenterology, Cosmesis, General Medicine, Middle Aged, Colorectal surgery, Surgery, Endoscopy, Treatment Outcome, Right Colectomy, Female, business
Abstract

Single-port laparoscopic surgery has evolved from an effort to minimize tissue trauma, limit morbidity, and maximize cosmesis. Limited data exist comparing single-port with conventional laparoscopy for right colectomy. Our aim is to compare single-port with laparoscopic colectomy with regard to safety and feasibility. We assert that this approach can be adopted in a safe and efficacious manner while using standard laparoscopic instrumentation.This is a retrospective analysis of prospectively gathered data regarding 16 single-port and 27 conventional laparoscopic right hemicolectomies performed by a single surgeon between January 2008 and February 2009. Demographics, operative outcomes, and morbidity were included and analyzed using either Student t test or Fisher exact probability test.Single-port and conventional laparoscopic groups were similar with regard to age, gender, body mass index, prior abdominal surgery, and co-morbidity. Seventy-five percent and 70% of the operations were performed for malignancy in the single-port and the conventional laparoscopy group, respectively (P = .69). Operative duration was 106 minutes in the single-port group vs 100 minutes in the conventional group (P = .64). Blood loss was 54 mL and 90 mL, respectively (P = .07). No conversions or additions of ports occurred. Hospital stay was 5.3 days in the single-port group vs 6 days in the conventional group (P = .53). Margins were negative in both groups. Mean lymph node number was 18 and 16 nodes (P = .92). There was one death in the conventional group (P = .44). Morbidity including wound infection was 18.8% and 14.9%, respectively (P = .73).These findings support single-port right colectomy as a safe and efficacious approach to right colon resections in patients eligible for laparoscopy with minimal additional equipment or learning curve for experienced laparoscopic colorectal surgeons. The single port was undertaken without an increase in morbidity or mortality. There was no increase in operative time with use of the single-port approach. Finally, adequate lymph node harvest and margin clearance was maintained.

Published
2010

31. Safety and Short-term Outcomes of a Single-Port Laparoscopic Approach to Colorectal Surgery

Author

M. Francesca Monn, Alyssa D. Fajardo, Rachel M. Danforth, Leigh J Spera, and Virgilio V. George

Subjects
Male, medicine.medical_specialty, Patient safety, Colonic Diseases, Port (medical), medicine, Humans, Colectomy right, Laparoscopy, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, General surgery, Retrospective cohort study, Equipment Design, Middle Aged, Colorectal surgery, Laparoscopes, Surgery, Term (time), Outcome and Process Assessment, Health Care, Rectal Diseases, Female, Patient Safety, business, Colorectal Surgery
Published
2015

32. A SMYD3 small-molecule Inhibitor impairing cancer cell growth

Author

Peserico A, Germani A, Sanese P, Aj, Barbosa, di Virgilio V, Fittipaldi R, EDOARDO FABINI, Bertucci C, Varchi G, Mp, Moyer, Caretti G, del Rio A, Simone C, Peserico, Alessia, Germani, Aldo, Sanese, Paola, Barbosa, Armenio Jorge, Di Virgilio, Valeria, Fittipaldi, Raffaella, Fabini, Edoardo, Bertucci, Carlo, Varchi, Greta, Moyer, Mary Pat, Caretti, Giuseppina, Del Rio, Alberto, and Simone, Cristiano

Subjects
Transcriptional Activation, Physiology, Clinical Biochemistry, animals, cell Line, tumor, cell movement, cell proliferation, cell transformation, neoplastic, gene expression regulation, neoplastic, histone-lysine N-methyltransferase, humans, liver neoplasms, mice, RNA interference, transcriptional activation, up-regulation, physiology, clinical biochemistry, cell biology, Cell Transformation, Article, Cell Line, Mice, Animals, Cell Line, Tumor, Cell Movement, Cell Proliferation, Cell Transformation, Neoplastic, Gene Expression Regulation, Neoplastic, Histone-Lysine N-Methyltransferase, Humans, Liver Neoplasms, RNA Interference, Up-Regulation, Neoplastic, Tumor, Animal, Medicine (all), Cell Biology, Gene Expression Regulation, Liver Neoplasm, Human
Abstract

SMYD3 is a histone lysine methyltransferase that plays an important role in transcriptional activation as a member of an RNA polymerase complex, and its oncogenic role has been described in different cancer types. We studied the expression and activity of SMYD3 in a preclinical model of colorectal cancer (CRC) and found that it is strongly upregulated throughout tumorigenesis both at the mRNA and protein level. Our results also showed that RNAi-mediated SMYD3 ablation impairs CRC cell proliferation indicating that SMYD3 is required for proper cancer cell growth. These data, together with the importance of lysine methyltransferases as a target for drug discovery, prompted us to carry out a virtual screening to identify new SMYD3 inhibitors by testing several candidate small molecules. Here we report that one of these compounds (BCI-121) induces a significant reduction in SMYD3 activity both in vitro and in CRC cells, as suggested by the analysis of global H3K4me2/3 and H4K5me levels. Of note, the extent of cell growth inhibition by BCI-121 was similar to that observed upon SMYD3 genetic ablation. Most of the results described above were obtained in CRC; however, when we extended our observations to tumor cell lines of different origin, we found that SMYD3 inhibitors are also effective in other cancer types, such as lung, pancreatic, prostate, and ovarian. These results represent the proof of principle that SMYD3 is a druggable target and suggest that new compounds capable of inhibiting its activity may prove useful as novel therapeutic agents in cancer treatment.

Published
2015

33. Transanal endoscopic microsurgery: the first attempt in treatment of rectal amyloidoma

Author

Virgilio V. George and Richa Sharma

Subjects
Male, Natural Orifice Endoscopic Surgery, medicine.medical_specialty, Microsurgery, medicine.medical_treatment, Biopsy, Rectum, Anal Canal, Case Report, Lesion, Medicine, Humans, Aged, Amyloidoma, medicine.diagnostic_test, business.industry, Amyloidosis, Gastroenterology, General Medicine, Anal canal, medicine.disease, Surgery, medicine.anatomical_structure, Rectal Diseases, Treatment Outcome, medicine.symptom, business, Tomography, X-Ray Computed
Abstract

Localized amyloidosis is characterized by amyloid protein deposition restricted to one organ or tissue without systemic involvement. Gastrointestinal manifestations of localized amyloidoma are unusual, which makes amyloidoma restricted to the rectum a very rare diagnosis requiring a high index of suspicion. We present a rare account for rectal amyloidoma with an unusual presentation of obstructive symptoms and its treatment using a sophisticated surgical modality, transanal endoscopic microsurgery (TEM), which resulted in complete excision of the lesion without hospitalization and complications. The successful treatment for this rectal amyloidoma using TEM emphasizes the need to broaden its application in the treatment of various rectal lesions while preserving organ function and decreasing recurrence.

Published
2014

35. Factors associated with the timing of diagnosis of venous thromboembolism: results from the MASTER registry

Author

Ageno, W, Agnelli, G, Imberti, D, Moia, M, Palareti, G, Pistelli, R, Rossi, R, Vitale, J, Bellisi, M, Bianchi, M, Verso, M, Brancaccio, V, Ciampa, A, Cimminiello, C, Dragani, A, Grifoni, S, Impaglatelli, M, Margheriti, R, Iovane, G, Musumeci, A, Pini, M, Pittaluga, PA, Prisco, V, Rupoli, S, Scannapieco, G, Signorelli, S, Silingardi, M, Virgilio, V., SIRAGUSA, Sergio, Ageno, W, Agnelli, G, Imberti, D, Moia, M, Palareti, G, Pistelli, R, Rossi, R, Vitale, J, Bellisi, M, Bianchi, M, Verso, M, Brancaccio, V, Ciampa, A, Cimminiello, C, Dragani, A, Grifoni, S, Impaglatelli, M, Margheriti, R, Iovane, G, Musumeci, A, Pini, M, Pittaluga, PA, Prisco, V, Rupoli, S, Scannapieco, G, Signorelli, S, Silingardi, M, Siragusa, S, and Virgilio, V

Subjects
venous thrombosis, timing, diagnosis, Settore MED/15 - Malattie Del Sangue
Abstract

INTRODUCTION: Signs and symptoms of venous thromboembolism (VTE) are non-specific and thus can make diagnosis difficult, even for an experienced clinician. We aimed to evaluate the timing of diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) in Italian hospitals and to identify individual and clinical predictors of timely or delayed diagnosis. MATERIAL AND METHODS: MASTER is a multicenter prospective registry of patients with acute DVT and PE. Information on clinical presentation and diagnostic methods, temporary and permanent risk factors, were captured by an electronic data network at the time of the index event. RESULTS: Data on 2047 patients (1024 males), 1505 with DVT and 542 with PE, were analysed. Delayed diagnosis (i.e. more than 10 days from onset of symptoms) was observed in 340 (22.6%) patients with DVT and in 88 (16.2%) with PE, respectively. In DVT patients, factors associated with earlier diagnosis were the presence of multiple signs or symptoms (p=0.014), the presence of pain (p=0.049), and previous venous thrombosis (p=0.016). Neither the presence of other known risk factors nor ongoing prophylaxis influenced the timing of diagnosis. In PE patients, only multiple signs or symptoms at presentation (p=0.014) and the presence of transient risk factors (p=0.001) were significantly associated with earlier diagnosis. CONCLUSIONS: Substantial delays occur when diagnosing both DVT and PE. The severity of presentation, but not patient risk profile are associated with earlier diagnosis, even in patients with signs or symptoms of PE.

Published
2008

44. V874 INCISIONLESS DUAL DIVERSIONS CREATION OF UROSTOMY AND COLOSTOMY USING THE DA VINCI ROBOT

Author

Nick W. Liu, Michael C. Risk, Thomas A. Gardner, Virgilio V. George, and Bruce W. Robb

Subjects
medicine.medical_specialty, Surgical approach, business.industry, Urology, General surgery, medicine.medical_treatment, Urinary diversion, Colostomy, Ileal ureter, Surgery, Robotic systems, Urostomy, medicine, Robot, Robotic surgery, business
Abstract

Introduction and Objective: With the introduction of the Da Vinci robotic system (Intuitive Surgical Inc.), many urological reconstructive procedures have been performed through this minim...

Published
2012

45. Single-port laparoscopic right hemicolectomy: the first 100 resections

Author

Dipen C. Maun, Joshua A. Waters, Blake J. Johansen, Virgilio V. George, Andrea Jester, Brian M. Rapp, Don J. Selzer, Bruce W. Robb, Michael J. Guzman, and Ben M Tsai Md

Subjects
Adult, Male, medicine.medical_specialty, Colorectal cancer, Adenocarcinoma, Postoperative Complications, medicine, Carcinoma, Humans, Laparoscopy, Colectomy, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, General surgery, Gastroenterology, Retrospective cohort study, General Medicine, Length of Stay, Middle Aged, medicine.disease, Inflammatory Bowel Diseases, Colorectal surgery, Treatment Outcome, Colonic Neoplasms, Feasibility Studies, Median body, Female, Outcomes research, business, Abdominal surgery
Abstract

Background Single-port laparoscopy remains a novel technique in the field of colorectal surgery. Several small series have examined its safety for colon resection. Objective Our aim was to analyze our entire experience and short-term outcomes with single-port laparoscopic right hemicolectomy since its introduction at our institution. We assert that this approach is feasible and safe for the wide array of patients and indications encountered by a colorectal surgeon. Design This is a retrospective analysis of prospectively gathered data for all patients who underwent single-port laparoscopic right hemicolectomy with the use of standard laparoscopic instrumentation, for malignant or benign disease, between July 2009 and November 2010 in a high-volume, academic, colorectal surgery practice. Main outcome measures Demographic, clinical, operative, and pathologic factors were reviewed and analyzed. All conversions to conventional laparoscopic or open operations were considered in this analysis. Results One hundred patients underwent single-port laparoscopic right hemicolectomy during the study period. Mean age was 63 years, and 61% of the patients were men. Forty-three percent had undergone previous abdominal surgery, and the median body mass index was 26 (range, 18-46). Median ASA classification was 3 (range, 1-4). Five percent of the operations were performed urgently, and 56% were performed for carcinoma, of which half were T3 or T4 tumor stage. Median operative duration was 105 (range, 64-270) minutes. Mean and median blood loss was 106 and 50 mL. Two percent required conversion to multiport laparoscopy, and 4% converted to the open approach. Median postoperative stay was 4 (range, 2-48) days. Median lymph node number was 18 (range, 11-42). There was one mortality in this series. Morbidity, including wound infection, was 13%. Conclusions This represents the largest experience with single-port laparoscopic right hemicolectomy to date. This technique was used with acceptable morbidity and mortality and without compromise of conventional oncologic parameters by colorectal surgeons experienced in minimally invasive technique. These findings support the use of a single-port approach for patients requiring right hemicolectomy.

Published
2012

46. Production of Linamarase in Aspergillus oryzae Using Cassava Cortex

Author

Dulce M. Flores, Fujiharu Yanagida, T. Hasegaw, Yukimichi Koizumi, and Virgilio V. Garcia

Subjects
Linamarase, biology, Inoculation, food and beverages, Fungi imperfecti, biology.organism_classification, Linamarin, Spore, chemistry.chemical_compound, medicine.anatomical_structure, Aspergillus oryzae, chemistry, Biochemistry, Cortex (anatomy), biology.protein, medicine, Inducer, Food science
Abstract

Cassava cortex was successfully used in the induction of linamarase in Aspergillus oryzae in place of linamarin which is an expensive inducer. Induction by cassava cortex was attributed to its linamarin content. However, besides linamarin, some other components in the cortex may have enhanced induction or stabilized the enzyme induced thus resulting in increased linamarase production. Statistical evaluation showed the significant influence (p

Published
1994

47. Gentamicin-collagen sponge for infection prophylaxis in colorectal surgery

Author

Elliott, Bennett-Guerrero, Theodore N, Pappas, Walter A, Koltun, James W, Fleshman, Min, Lin, Jyotsna, Garg, Daniel B, Mark, Jorge E, Marcet, Feza H, Remzi, Virgilio V, George, Kerstin, Newland, G R, Corey, and Hongqiu, Yang

Subjects
Male, Surgical Sponges, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Antibiotics, Kaplan-Meier Estimate, Absorbable Implants, medicine, Humans, Surgical Wound Infection, Treatment Failure, Antibiotic prophylaxis, Colectomy, Antibacterial agent, Aged, Intention-to-treat analysis, business.industry, Rectum, General Medicine, Antibiotic Prophylaxis, Middle Aged, Colorectal surgery, Surgery, Anti-Bacterial Agents, Intention to Treat Analysis, Clinical trial, Chemoprophylaxis, Female, Collagen, Gentamicins, business, Colorectal Neoplasms
Abstract

Despite the routine use of prophylactic systemic antibiotics, surgical-site infection continues to be associated with significant morbidity and cost after colorectal surgery. The gentamicin-collagen sponge, an implantable topical antibiotic agent, is approved for surgical implantation in 54 countries. Since 1985, more than 1 million patients have been treated with the sponges.In a phase 3 trial, we randomly assigned 602 patients undergoing open or laparoscopically assisted colorectal surgery at 39 U.S. sites to undergo either the insertion of two gentamicin-collagen sponges above the fascia at the time of surgical closure (the sponge group) or no intervention (the control group). All patients received standard care, including prophylactic systemic antibiotics. The primary end point was surgical-site infection occurring within 60 days after surgery, as adjudicated by a clinical-events classification committee that was unaware of the study-group assignments.The incidence of surgical-site infection was higher in the sponge group (90 of 300 patients [30.0%]) than in the control group (63 of 302 patients [20.9%], P=0.01). Superficial surgical-site infection occurred in 20.3% of patients in the sponge group and 13.6% of patients in the control group (P=0.03), and deep surgical-site infection in 8.3% and 6.0% (P=0.26), respectively. Patients in the sponge group were more likely to visit an emergency room or surgeon's office owing to a wound-related sign or symptom (19.7%, vs. 11.0% in the control group; P=0.004) and to be rehospitalized for surgical-site infection (7.0% vs. 4.3%, P=0.15). The frequency of adverse events did not differ significantly between the two groups.Our large, multicenter trial shows that the gentamicin-collagen sponge is not effective at preventing surgical-site infection in patients who undergo colorectal surgery; paradoxically, it appears to result in significantly more surgical-site infections. (Funded by Innocoll Technologies; ClinicalTrials.gov number, NCT00600925.)

Published
2010

49. Some Properties of Proteins in Taro Corms and Cassava Roots

Author

Shuko Naito, Yoshiko Kojima, Miho Sasaki, Virgilio V. Garcia, Ikuzo Uritani, Wakako Takeuchi, and Kazuko Nagata

Subjects
Gel electrophoresis, chemistry.chemical_classification, biology, Molecular mass, Corm, Xanthosoma sagittifolium, biology.organism_classification, Araceae, Colocasia esculenta, Horticulture, chemistry, Botany, Storage protein, Colocasia
Abstract

The proteins in the crystalline part (lower part) of crystalline naro (a kind of physiologically-deteriorated taro), occurring in the childcorms of Colocasia esculenta cv. Ishikawa-wase, amounted to about 10 to 30% of those in the non-crystalline part (upper part). The decrease in protein content was greater in the storage proteins than in the other soluble proteins, bated on the zymograms and densitograms of sodium dodecyl sulfatepolyacrylamide gel electrophoresis (SDS-PAGE). The corms of C. esculenta cv. Calamba in the Philippines looked very similar to cv. Ishikawa-wase in size end outer form, and some of them showed the symptom of crystalline taro. Further, the zymogram of cv. Calamba was the same as that of cv. Ishikawa-wase, and the molecular weights (MWs) of the two storage proteins were also the same, than is, 11-13 and 23-26 kD. The protein content in the corms of Xanthosoma sagittifolium cv. San Fernando was 2 to 3 times higher than that in the Colocasia corms described above. Three kinds of storage-like proteins were present and had MWs of about 11, 13 and 23 kD. The latter two were presumed to be the same as those in the Colocasia corms. The SDS-PAGE zymograms and densitograms of the proteins from diseased cv. Calamba corms were diffefent from those of healthy corms, in that a decrease in the storage proteins and a simultaneous increase in the other soluble proteins were observed in the diseased tissue. Cassava roots seemed to have four kinds of storage-like proteins with MWS of about 23, 30, 37 and 53 kD. When either physiological of microbial deterioration occurred in cassava roots, changes in the metabolism of proteins involving a decrease in the storage-like pfoteins were observed in the tissue, based on the SDS-PAGE zymograms and densitograms.

Published
1992

50. Partial Purification and Characterization of Linamarase from Aspergillus oryzae

Author

Dulce M. Flores, Tadao Hasegawa, Mineo Kojima, Virgilio V. Garcia, and Fujiharu Yanagida

Subjects
chemistry.chemical_classification, Linamarase, Chromatography, biology, Isoelectric focusing, Fungi imperfecti, biology.organism_classification, Linamarin, chemistry.chemical_compound, Enzyme, Biochemistry, Aspergillus oryzae, chemistry, Sephadex, Hydrolase, biology.protein
Abstract

Linamarase produced by Aspergillus oryzae SAl was purified 193-fold by ammonium sulfate fractionation, Sephadex G-25, DEAE-cellulose and Ultrogel AcA 44 chromatographies. The enzyme has Km values of 2.l2mM and 0.53mM with respect to linamarin and ρ-nitrophenyl-β-glucoside, respectively. The molecular size of the enzyme was found to be 100000 daltons by Ultrogel AcA 44. The enzyme had optimum activity at pH5.5, and it was found to be very stable at 40-50°C for 50 minutes. It was competitively inhibited by gluconoδ-lactone with a Ki of 0.1mM. Isoelectric focusing showed the presence of three active forms of isomers at pI values of 8.85, 7.30 and 6.55.

Published
1992

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