Effect of in-hospital delay on acute appendicitis severity: does time really matter?

Appendicitis is one of the most common abdominal emergencies. Evidence is controversial in determining if the in-hospital time delay to surgery can worsen the clinical presentation of appendicitis. This study aimed to clarify if in-hospital surgical delay significantly affected the proportion of complicated appendicitis in a large prospective cohort of patients treated with appendectomy for acute appendicitis.

Complication of Gastric Cancer Surgery: A Single Centre Experience.

Background/aim: Gastric cancer surgery is still characterised by high morbidity and mortality. However, in 2018 an online platform, GASTRODATA has been proposed in Europe to standardize the recording of gastric surgery complications. The aim of the study was to present a single center experience regarding incidence and grading of acute postoperative complications in a population of patients treated surgically for gastric cancer on the basis of the gastrodata online platform.

Standards of fracture care in polytrauma: results of a Europe-wide survey by the ESTES polytrauma section.

Introduction: Fixation of major fractures plays a pivotal role in the surgical treatment of polytrauma patients. In addition to ongoing discussions regarding the optimal timing in level I trauma centers, it appears that the respective trauma systems impact the implementation of both, damage control and safe definitive surgery strategies. This study aimed to assess current standards of polytrauma treatment in a Europe-wide survey.

The uncharted severity of complications after appendectomy for acute appendicitis in children: results from 348 consecutive patients.

Appendectomy is the most frequently performed emergent procedure in paediatric patients. However, there is a wide heterogeneity in outcome definitions and, conversely, a lack of information about complications' severity. This study aims to analyse the outcome of children operated for acute appendicitis, with reference to complications' severity grading.

Impact of lockdown on emergency general surgery during first 2020 COVID-19 outbreak.

Purpose: To evaluate and analyze the impact of lockdown strategy due to coronavirus disease 2019 (COVID-19) on emergency general surgery (EGS) in the Milan area at the beginning of pandemic outbreak.

Methods: A survey was distributed to 14 different hospitals of the Milan area to analyze the variation of EGS procedures. Each hospital reported the number of EGS procedures in the same time frame comparing 2019 and 2020.

Three-dimensional evaluation of dental decompensation and mandibular symphysis remodeling on orthodontic-surgical treatment of Class III malocclusion.

Introduction: The purposes of this research were to identify the buccolingual inclinations of the mandibular teeth and the mandibular symphysis remodeling that result from the orthodontic decompensation movement.

Methods: The sample consisted of 30 adults with Class III dentofacial deformity, who had presurgical orthodontic treatment. Three-dimensional images were generated by cone-beam computed tomography scans at 2 different times (initial and before orthognathic surgery).

Micro-osteoperforation effectiveness on tooth movement rate and impact on oral health related quality of life.

Objectives: To investigate the effect of micro-osteoperforation (MOP) on the rate of tooth movement (RTM), space closure duration, and oral health-related quality of life (OHRQoL) during completion of anterior retraction in patients undergoing combined orthodontic-surgical treatment after premolar extraction and decompensation with sliding mechanics.

Materials And Methods: Twenty-four participants with indications for premolar extractions were randomly allocated to treatment with conventional sliding mechanics (control group; CG) or with to treatment in which three MOPs were performed every activation (experimental group; EG). Dental impressions were taken monthly until space closure was completed and dental casts were converted to three-dimensional models.

Indications and interventions of damage control orthopedic surgeries: an expert opinion survey.

Objectives: The objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO.

Background: The indications to perform temporary surgery in musculoskeletal injuries may vary during the hospitalization and have not been defined. We performed a literature review and an expert opinion survey about the indications for damage control orthopaedics (DCO).

Minimally Invasive Approach for Diagnosing TMJ Osteoarthritis.

This study's objectives were to test correlations among groups of biomarkers that are associated with condylar morphology and to apply artificial intelligence to test shape analysis features in a neural network (NN) to stage condylar morphology in temporomandibular joint osteoarthritis (TMJOA). Seventeen TMJOA patients (39.9 ± 11.

Morbidity after negative appendectomy: a single-centre experience on 627 cases.

Introduction: Acute appendicitis is one of the most common causes of abdominal pain in emergency departments worldwide. Despite the improvement in radiological and clinical investigations, negative appendectomy remains a debated topic as well as the optimal strategy for use in cases demonstrating a nonpathological appendix during a procedure for suspected appendicitis. The aim of the present study was thus to analyse clinical outcomes of histologically NA to better elucidate the burden associated with a potentially avoidable procedure.

Uselessness of microbiological samples in acute appendicitis with frank pus: to collect or not to collect?

Introduction: Current use of antimicrobial therapy is prophylactic, empirical and broad spectrum. But, the age-old practice of obtaining cultures still remain. The aim of this study was to evaluate bacterial etiology and adequacy of antibiotic prophylaxis in patients diagnosed with acute appendicitis to help determine the utility of intraoperative cultures in guiding clinical decision-making.

Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA).

Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question.

Material And Methods: A prospective analysis of adult patients enrolled in the IROA.

Federating Heterogeneous Datasets to Enhance Data Sharing and Experiment Reproducibility.

Recent studies have demonstrated the difficulties to replicate scientific findings and/or experiments published in past. The effects seen in the replicated experiments were smaller than previously reported. Some of the explanations for these findings include the complexity of the experimental design and the pressure on researches to report positive findings.

Evaluation of the Impact of a New Synthetic Vitamin E-Bonded Membrane on the Hypo-Responsiveness to the Erythropoietin Therapy in Hemodialysis Patients: A Multicenter Study.

Background: Oxidative stress has been related to hypo-response to erythropoiesis-stimulating agents (ESAs) in hemodialysis (HD) patients. The aim of this study was to verify whether vitamin E (ViE) on a synthetic polysulfone dialyzer can improve ESA responsiveness.

Methods: This controlled, multicenter study involved 93 HD patients on stable ESA therapy, who were randomized to either ViE-coated polysulfone dialyzer or to a low-flux synthetic dialyzer.

International consensus conference on open abdomen in trauma.

Background: A part of damage-control laparotomy is to leave the fascial edges and the skin open to avoid abdominal compartment syndrome and allow further explorations. This condition, known as open abdomen (OA), although effective, is associated with severe complications. Our aim was to develop evidence-based recommendations to define indications for OA, techniques for temporary abdominal closure, management of enteric fistulas, and methods of definitive wall closure.

The open abdomen, indications, management and definitive closure.

The indications for Open Abdomen (OA) are generally all those situations in which is ongoing the development an intra-abdominal hypertension condition (IAH), in order to prevent the development of abdominal compartmental syndrome (ACS). In fact all those involved in care of a critically ill patient should in the first instance think how to prevent IAH and ACS. In case of ACS goal directed therapy to achieve early opening and early closure is the key: paradigm of closure shifts to combination of therapies including negative pressure wound therapy and dynamic closure, in order to reduce complications and avoid incisional hernia.

Existential crises in two religious patients: Vicissitudes of faith and the emergence of the true self.

The authors present two clinical cases involving an existential crisis which led the patients to lose what had been the foundation in their lives, their faith. Although the therapeutic settings differ--the first patient had a few psychotherapy sessions following a psychotic episode with a mystical background, while the second was in the final stage of analytic treatment - the authors highlight how in both clinical cases a loss of faith becomes a total and urgent crisis of the Self. The fracture which ensues seems to generate an intense engagement of the body which, paradoxically during a loss of faith, induces an experience of ecstasy of the kind that has traditionally been reported.

Post-dilution hemodiafiltration with a heparin-grafted polyacrylonitrile membrane.

The aim of this multicenter, prospective study was to explore the possibility of carrying out routine sessions of post-dilution hemodiafiltration with a polyacrylonitrile membrane grafted with heparin (HeprAN) and reduced anticoagulation. Forty-four patients from eight centers were included in the study and treated by means of post-dilution on-line hemodiafiltration with automatic control of TMP, according to three different modalities tested consecutively: phase 1, polyethersulfone filter primed with heparinized saline and anticoagulated with continuous infusion of unfractionated heparin 1000/h; phase 2, HeprAN membrane filter primed with saline without heparin. Anticoagulation: a 1000-unit bolus of unfractionated heparin at the start of session followed by a second one at the end of the second dialysis hour; phase 3, same filter and priming procedure as in phase 2; anticoagulation with nadroparin calcium at the beginning of treatment.

Dental and alveolar arch forms in a Caucasian population compared with commercially available archwires.

Introduction: The aim of this study was to identify an arch form, comprising dentition and alveolus, representative of the Caucasian population, and to compare it with the shape of the main archwires on the market.

Materials And Methods: The study sample comprised 35 pairs of dental casts, taken from the arches of 35 Southern Europeans with ideal natural occlusion. After the dental casts were scanned, the reference points of the dental arches (FA points) and alveolar bone (WALA ridges) were identified with 3D software.

Transversal changes in dental arches from non-extraction treatment with self ligating brackets.

Objective: The present study aimed at analyzing, with the use of dental casts, the transverse changes of the upper and lower dental arches, after non-extraction orthodontic treatment, with self-ligating brackets.

Methods: The sample comprised 29 patients, all presenting Class I malocclusion with upper and lower crowding of at least 4 mm and treated only with a fixed appliance, without stripping, extraction or distalization. The dental casts were obtained before and after leveling with 0.

Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver.

Background: An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial.

Methods: Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel Ag Hydrofiber dressing or a common dressing.

Structural and functional alterations of subcutaneous small resistance arteries in severe human obesity.

Obese persons are at increased cardiovascular risk and exhibit increased arterial stiffness and impaired endothelial function of large- and medium-size arteries. We hypothesized that normotensive subjects suffering from severe obesity would also present remodeling and endothelial dysfunction of small resistance arteries. A total of 16 lean (age: 49.

[Duodenal perforation post-ERCP: diagnostically and therapeutic management].

Objective: Author's experience with periduodenal perforation after ERCP and there systematic approach is presented.

Methods: A retrospective study of 6 instances of duodenal perforation related to endoscopic retrograde cholangiopancreatography. The study follows these parameters: type of perforations, clinical presentation, diagnostic methods, time to diagnosis, methods of management, surgical procedures, length of stay, mortality and morbidity.