Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study.

Purpose: Postoperative pain is a major concern for patients undergoing ultrasound scalpel-assisted hemorrhoidectomy, potentially exacerbated by delayed wound healing. This study aimed to evaluate the impact of an intimate cleansing gel containing chlorhexidine, hyaluronic acid, and other anti-inflammatory agents (Antroclean Fisioderm) on postoperative pain, itching, and wound healing in patients who had undergone this procedure.

Methods: This multicenter observational case-control study involved a cohort of consecutive adult patients who underwent hemorrhoidectomy using an ultrasound device.

The Diagnosis of Wilkie's Syndrome Associated with Nutcracker Syndrome: A Case Report and Literature Review.

Superior mesenteric artery (SMA) syndrome or Wilkie's syndrome is a vascular compression disorder that causes the abnormal compression of the third portion of the duodenum by the SMA. It has a low incidence rate, which is higher in young women, and is rarely associated with the Nutcracker phenomenon: a condition of the compression of the left renal vein between the SMA and the aorta, which manifests as pain in the left flank and pelvis. Here, we report on the case of a 54-year-old woman with a history of repeated episodes of abdominal pain caused by the Nutcracker syndrome and Wilkie's syndrome.

The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease.

The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached.

The Use of Artificial Intelligence Approaches for Performance Improvement of Low-Cost Integrated Navigation Systems.

In this paper, the authors investigate the possibility of applying artificial intelligence algorithms to the outputs of a low-cost Kalman filter-based navigation solution in order to achieve performance similar to that of high-end MEMS inertial sensors. To further improve the results of the prototype and simultaneously lighten filter requirements, different AI models are compared in this paper to determine their performance in terms of complexity and accuracy. By overcoming some known limitations (e.

The Classification Algorithms Applied to the Inpatient Stay for Lower Limb Surgery.

The revolutions of recent years in health care have involved several areas ranging from patient treatment to resource management. Therefore, several strategies have been put in place to increase patient value while trying to reduce spending. Several indicators have arisen to evaluate the performance of healthcare processes.

Effect of Clinical and Demographic Variables on the Hospital Stay of Patients Undergoing Total Knee Arthroplasty.

The knee is the joint most affected by osteoarthritis and in its severe form can significantly affect people's physical and functional abilities. The increased demand for surgery leads to greater attention by health care management to be able to keep costs down. A major expense item for this procedure is Length of Stay (LOS).

A Regressive Model to Study the Hospitalization for Laparoscopic Appendectomy: A Multicenter Study.

Appendicitis is a most common abdominal condition worldwide, and appendectomy especially laparoscopic appendectomy is among the most commonly performed general surgeries. In this study, data were collected from patients who underwent laparoscopic appendectomy surgery at the Evangelical Hospital "Betania" in Naples, Italy. Linear multiple regression was used to obtain a simple predictor that can also assess which of the independent variables considered to be a risk factor.

Innovative Fusion Strategy for MEMS Redundant-IMU Exploiting Custom 3D Components.

In recent years, the overall performances of inertial Micro-Electro Mechanical Sensors (MEMSs) exhibited substantial improvements to values very close or similar to so-called tactical-grade sensors. However, due to their high costs, numerous researchers are currently focusing on the performance enhancement of cheap consumer-grade MEMS inertial sensors for all those applications (as an example, small unmanned aerial vehicles, UAVs), where cost effectiveness is a relevant request; the use of redundancy proves to be a feasible method for this purpose. In this regard, the authors propose, hereinafter, a suitable strategy aimed at fusing raw measurements provided by multiple inertial sensors mounted on a 3D-printed structure.

Usefulness of damage control approach in patients with limited acute mesenteric ischemia: a prospective study of 85 patients.

To evaluate the efficacy of the damage control approach by two-step surgical procedure in not critical patients (without sepsis or septic shock) with peritonitis from limited acute mesenteric ischemia. From April 2013 to April 2020, 85 patients [49 (57.7%) women and 36 (42.

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

Background: There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates.

Assessment of surgeon communication skills from the patient perspective: A national evaluation using the Communication Assessment Tool.

Objective: The Communication Assessment Tool (CAT) has previously been translated and adapted to the Italian context. This national study aimed to validate the CAT and evaluate communication skills of practicing surgeons from the patient perspective.

Methods: CAT consists of 14 items associated with a 5-point scale (5 = excellent); results are reported as the percent of ''excellent'' scores.

The Italian Consensus on minimally invasive simultaneous resections for synchronous liver metastasis and primary colorectal cancer: A Delphi methodology.

At the time of diagnosis synchronous colorectal cancer, liver metastases (SCRLM) account for 15-25% of patients. If primary tumour and synchronous liver metastases are resectable, good results may be achieved performing surgical treatment incorporated into the chemotherapy regimen. So far, the possibility of simultaneous minimally invasive (MI) surgery for SCRLM has not been extensively investigated.

Safety and effectiveness of minimal sphincterotomy in the treatment of female patients with chronic anal fissure.

To evaluate the outcome of a left lateral internal sphincterotomy extended for 20% of total sphincter length in female patients with chronic anal fissure, high anal resting pressure and normal preoperative anal continence. Between January 2014 and January 2018 all the female patients with chronic anal fissure showing failure of medical therapy, perfect anal continence (Cleveland Clinic Florida incontinence score = 0) and high anal resting pressure underwent a lateral internal sphincterotomy extended for 1/5 of total lateral sphincter length, basing on the preoperative measurements by three-dimensional endoanal ultrasound. Postoperative follow-up included clinical assessment at 3, 6 and 12 months associated with manometric and ultrasonographic evaluation at 6 months.

COVID-19 and the role of chronic inflammation in patients with obesity.

Coronavirus disease 2019 (COVID-19) and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a particular risk to people living with preexisting conditions that impair immune response or amplify pro-inflammatory response. Low-grade chronic systemic inflammation, common in people with obesity, is associated with the development of atherosclerosis, type 2 diabetes, and hypertension, well known comorbidities that adversely affect the outcomes of patients with COVID-19. Risk stratification based on the Edmonton Obesity Staging System (EOSS), which classifies obesity based on the presence of medical, mental, and/or functional complications rather than on body mass index (BMI), has been shown to be a better predictor of all-cause mortality and it may well be that EOSS stages may better describe the risk of hyperinflammation in patients with COVID-19 infection.

Predictive Factors of Intestinal Necrosis in Acute Mesenteric Ischemia.

Objectives: Acute mesenteric ischemia (AMI) is a gastrointestinal and vascular emergency in which the detection of patients requiring intestinal resection is mandatory.

Methods: Registered data of 55 consecutive patients admitted to our center between January 2010 and December 2016 that underwent an explorative laparotomy for a suspected diagnosis of irreversible transmural intestinal necrosis (ITIN) were analyzed. Demographic, clinical, laboratory and CT findings were statistically analyzed in order to search predictive factors of ITIN and their correlation to its clinical spectre.

The role of C-reactive protein after surgery for obesity and metabolic disorders.

Background: C-reactive protein (CRP) rise might be different in patients with obesity due to chronic inflammation.

Objectives: The aim was to analyze postoperative CRP rise and its role as an early prognostic marker of infectious complications.

Setting: Center of maximum care in Germany.

Efficacy and safety of ultrasound-guided placement of central venous port systems via the right internal jugular vein in elderly oncologic patients: our single-center experience and protocol.

Background: Ultrasound-guidance has become the routine method for internal jugular vein (IJV) catheterization reducing dramatically failure and complication rates for central venous port (CVP) placement.

Aims: The aim of this study was to determine the safety and efficacy of ultrasound-guided IJV CVP placement in elderly oncologic patients.

Methods: Between January 2013 and December 2015, 101 elderly oncological patients underwent right IJV CVP placement under ultrasound-guidance.

Light Augmentation Device: A New Surgical Tool for Improved Laparoscopic Visibility and Transillumination: Proof-of-Concept Study.

The light augmentation device (LAD) is a new disposable tool designed to improve observation by transillumination in laparoscopic surgery. It can be introduced into the abdomen through an 11-12 mm port as a supplementary light source. The miniaturized design allows the surgeon to pick up the device with an endograsper and to place it under direct vision where needed.

Early outcomes of colon laparoscopic resection in the elderly patients compared with the younger.

Background: The aim of this study was to define any benefits in terms of early outcome for laparoscopic colectomy in patients over 75 years old (OP) compared with the outcomes of a younger populations (YP).

Methods: Forty elderly patients undergoing laparoscopic colectomy for colorectal cancer between 2007-2011 were studied, the patients are divided for gender, age, year of surgery, site of cancer, and comorbidity on admission and compared with 40 younger patients.

Results And Discussion: Mean (standard deviation) age was 81.