Enhanced perioperative care in emergency general surgery: the WSES position paper.

Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients' outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available.

Biliary Sepsis Due to Recurrent Acute Calculus Cholecystitis (ACC) in a High Surgical-Risk Elderly Patient: An Unexpected Complication.

Acute calculus cholecystitis (ACC) is increasing in frequency within an ageing population, in which biliary tract infection, including cholecystitis and cholangitis, is the second most common cause of sepsis, with higher morbidity and mortality rates. Patient's critical conditions, such as septic shock or anaesthesiology contraindication, may be reasons to avoid laparoscopic cholecystectomy-the first-line treatment of ACC-preferring gallbladder drainage. It can aid in patient's stabilization with also the benefit of identifying the causative organism to establish a targeted antibiotic therapy, especially in patients at high risk for antimicrobial resistance such as healthcare-associated infection.

Urgent and emergency surgery for secondary peritonitis during the COVID-19 outbreak: an unseen burden of a healthcare crisis.

The COVID-19 pandemic has raised concerns about the negative impact of the fear of contagion on people's willingness to seek medical care and the subsequent effects on patients' prognosis. To date, not much is known about the outcomes of acute surgical diseases in this scenario. The aim of this multicenter observational study is to explore the effects of COVID-19 outbreak on the outcomes of patients who underwent surgery for peritonitis.

Crude oil and S500 diesel removal from seawater by polyurethane composites reinforced with palm fiber residues.

In this work, we prepared PU-composites with Australian palm residues (PR) in different contents (5, 10, 15, and 20 wt%) and granulometry (28 and 35 mesh) to improve the oil (crude oil and S500 Diesel) sorption capacity. The foams were characterized by life cycle assessment (LCA), scanning electron microscopy, oil sorption, desorption, and Langmuir, Freundlich, and Temkin sorption isotherms. LCA indicated that higher PR contents decreased the foam environmental impacts than the classical residue handling, indicating that 20 wt% PR is the better environmental option, independent of the residues granulometry.

Comprehensive insight into surfactant modified-PBAT physico-chemical and biodegradability properties.

This work aimed to prepare surfactant modified-PBAT (poly(butylene adipate-co-terephthalate)) sheets with superior properties to increase the PBAT applicability and be a possible solution for plastic disposal environmental problems. Three different surfactant contents (0, 1, 5, and 10 wt%) were investigated, and their effects on PBAT chemical structure, mechanical and morphological properties, wettability, and water absorption were investigated. Modified-PBAT samples showed high hydrogen bond coefficients (0.

Morphological, optical, and elemental analysis of dental enamel after debonding laminate veneer with Er,Cr:YSGG laser: A pilot study.

Laminate veneer removal is becoming a routine procedure at the dental clinic and the use of laser can facilitate its removal. This work aimed to evaluate the morphological, elemental, and optical changes in the remaining enamel after veneer removal using Er,Cr:YSGG laser. Forty-four enamel slabs were prepared and randomly distributed into nine experimental groups, for bonding using lithium disilicate laminates with three different luting agents (Variolink Veneer, RelyX U200, and RelyX Veneer).

Signet Ring Cell Carcinoma of the Ampulla of Vater With Focal Neuroendocrine Differentiation of the Amphicrine Type: Report of a Case With Long-Term Survival.

Carcinoma of the ampulla of Vater is an uncommon neoplasm and represents 0.5% of all gastrointestinal malignancies, being less common than carcinoma of the pancreas and bile ducts. The most common ampullary tumor is the adenocarcinoma with tubular growth pattern.

Characterization of malignant gastrointestinal stromal tumors-a single center experience.

Background: The recurrence rate, related to the unpredictable behavior of gastrointestinal stromal tumors (GISTs), continues to be a major topic of investigation, since no actual risk evaluation scales have proven to be exceedingly effective in predicting prognosis. We therefore focus in this study on investigating the predictive variables of disease recurrence.

Methods: Between September 2004 and January 2011, 34 patients, 18 males and 16 females with a median age of 62 (range, 27-87) years, underwent operations for primary, localized and advanced GISTs.

WSES classification and guidelines for liver trauma.

The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of the patient.

Estimation of the prevalence of asymptomatic pancreatic cysts in the population of San Marino.

Background: There has been a dramatic increase in the number of pancreatic cystic lesions observed in the past two decades but data regarding the prevalence of cysts in the general population are lacking.

Methods: All the individuals who undergo CT at the San Marino State Hospital are residents of the Republic of San Marino; their demographic distribution is available and precise. CT scans carried out over 1 year at the State Hospital were reviewed for asymptomatic pancreatic cysts.

Surgery for isolated liver metastases from pancreatic cancer.

The resection of liver metastases from pancreatic ductal adenocarcinoma has been discouraged because it is commonly thought that it does not improve survival. However, the role of potential prognostic factors is unclear, and universally accepted strategies have not been proposed. Between 2003 and 2014, 15 patients with isolated synchronous or metachronous metastases from pancreatic cancer underwent liver resection in our department.

Effectiveness of the diode laser in the treatment of ligature-induced periodontitis in rats: a histopathological, histometric, and immunohistochemical study.

The aim of this study was to evaluate the effects of the use of a high-power gallium-aluminum-arsenide diode laser (GaAlAs; 808 nm, 1 W, 20 s, 20 Hz, 10 J) alone or as adjunctive therapy to scaling and root planing in the treatment of induced periodontitis in rats. Periodontitis was induced by placing a ligature around the mandibular first molar of 60 rats. After 7 days, the ligature was removed and the animals were divided into four groups as follows: C (control), no periodontal treatment; SRP, scaling and root planing (SRP); DL, diode laser (DL) irradiation treatment; and SRP/DL, both SRP and DL irradiation treatment.

Tensegrity model hypothesis: may this paradigm be useful to explain hepatic and pancreatic carcinogenesis in patients with persistent hepatitis B or hepatitis C virus infection?

Context: Hepatitis B (HBV) and hepatitis C virus (HCV) possess well-known oncogenic properties and may promote carcinogenesis in liver. However antigens and replicative sequences of HBV/HCV have been also detected in different extra-hepatic tissues, including the pancreas. Although epidemiological studies and meta-analyses have recently suggested that HBV/HCV may be also risk factors for pancreatic cancer and several researches have investigated the possible mechanisms and intra-/extra-cellular paths involved in pancreatic and hepatic carcinogenesis, to date, these complex processes remain largely unexplained.

Next generation sequencing improves the accuracy of KRAS mutation analysis in endoscopic ultrasound fine needle aspiration pancreatic lesions.

The use of endoscopic ultrasonography has allowed for improved detection and pathologic analysis of fine needle aspirate material for pancreatic lesion diagnosis. The molecular analysis of KRAS has further improved the clinical sensitivity of preoperative analysis. For this reason, the use of highly analytical sensitive and specific molecular tests in the analysis of material from fine needle aspirate specimens has become of great importance.

A case of lung metastasis in myxoinflammatory fibroblastic sarcoma: analytical review of one hundred and thirty eight cases.

Purpose: Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare soft tissue tumour first identified at the end of the 1990s. This study presents our experience and literature reviews focusing on risk of recurrence.

Methods: Rizzoli Orthopaedic Institute database and literature were searched for patients with MIFS observed from 1997 to 2012.

Preoperative diagnosis of a solid pseudopapillary tumour of the pancreas by Endoscopic Ultrasound Fine Needle Biopsy: A retrospective case series.

Background: A solid pseudopapillary tumour of the pancreas (SPTP) is a rare neoplasm.

Aim: We herein present five cases of SPTP diagnosed using endoscopic ultrasound (EUS) guided fine-needle biopsy (FNB) using a needle with side fenestration (ProCore-needle).

Methods: From January 2011 to June 2012 in five patients with SPTP tissue acquisition was carried out with a 19-gauge (4 patients) or a 22-gauge (one patient) needle.

Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy.

Background: The relationship between hospital volumes and short-term patients' outcomes of colon cancer (CC) surgery is not well established in the literature. Moreover, evidence about short-term outcomes of urgent compared with elective CC procedures is scanty. The aims of this study are 1) to determine whether caseloads and other hospital characteristics are associated with short-term outcomes of CC surgery; 2) to compare the outcomes of urgent and elective CC surgery.

Association between hepatitis B or hepatitis C virus infection and risk of pancreatic adenocarcinoma development: a systematic review and meta-analysis.

Background: Pancreatic adenocarcinoma (PAC) is an aggressive cancer with a poor prognosis. To date, PAC causes are still largely unknown. Antigens and replicative sequences of oncogenic hepatitis B (HBV) and hepatitis C (HCV) virus were detected in different extra-hepatic tissues, including pancreas.