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Perrone G, Giuffrida M, Abu-Zidan F, Kruger VF, Livrini M, Petracca GL, Rossi G, Tarasconi A, Tian BWCA, Bonati E, Mentz R, Mazzini FN, Campana JP, Gasser E, Kafka-Ritsch R, Felsenreich DM, Dawoud C, Riss S, Gomes CA, Gomes FC, Gonzaga RAT, Canton CAB, Pereira BM, Fraga GP, Zem LG, Cordeiro-Fonseca V, de Mesquita Tauil R, Atanasov B, Belev N, Kovachev N, Meléndez LJJ, Dimova A, Dimov S, Zelić Z, Augustin G, Bogdanić B, Morić T, Chouillard E, Bajul M, De Simone B, Panis Y, Esposito F, Notarnicola M, Lauka L, Fabbri A, Hentati H, Fnaiech I, Aurélien V, Bougard M, Roulet M, Demetrashvili Z, Pipia I, Merabishvili G, Bouliaris K, Koukoulis G, Doudakmanis C, Xenaki S, Chrysos E, Kokkinakis S, Vassiliu P, Michalopoulos N, Margaris I, Kechagias A, Avgerinos K, Katunin J, Lostoridis E, Nagorni EA, Pujante A, Mulita F, Maroulis I, Vailas M, Marinis A, Siannis I, Bourbouteli E, Manatakis DK, Tasis N, Acheimastos V, Maria S, Stylianos K, Kuzeridis H, Korkolis D, Fradelos E, Kavalieratos G, Petropoulou T, Polydorou A, Papacostantinou I, Triantafyllou T, Kimpizi D, Theodorou D, Toutouzas K, Chamzin A, Frountzas M, Schizas D, Karavokyros I, Syllaios A, Charalabopoulos A, Boura M, Baili E, Ioannidis O, Loutzidou L, Anestiadou E, Tsouknidas I, Petrakis G, Polenta E, Bains L, Gupta R, Singh SK, Khanduri A, Bala M, Kedar A, Pisano M, Podda M, Pisanu A, Martines G, Trigiante G, Lantone G, Agrusa A, Di Buono G, Buscemi S, Veroux M, Gioco R, Veroux G, Oragano L, Zonta S, Lovisetto F, Feo CV, Pesce A, Fabbri N, Lantone G, Marino F, Perrone F, Vincenti L, Papagni V, Picciariello A, Rossi S, Picardi B, Del Monte SR, Visconti D, Osella G, Petruzzelli L, Pignata G, Andreuccetti J, D'Alessio R, Buonfantino M, Guaitoli E, Spinelli S, Sampietro GM, Corbellini C, Lorusso L, Frontali A, Pezzoli I, Bonomi A, Chierici A, Cotsoglou C, Manca G, Delvecchio A, Musa N, Casati M, Letizia L, Abate E, Ercolani G, D'Acapito F, Solaini L, Guercioni G, Cicconi S, Sasia D, Borghi F, Giraudo G, Sena G, Castaldo P, Cardamone E, Portale G, Zuin M, Spolverato Y, Esposito M, Isernia RM, Di Salvo M, Manunza R, Esposito G, Agus M, Asti ELG, Bernardi DT, Tonucci TP, Luppi D, Casadei M, Bonilauri S, Pezzolla A, Panebianco A, Laforgia R, De Luca M, Zese M, Parini D, Jovine E, De Sario G, Lombardi R, Aprea G, Palomba G, Capuano M, Argenio G, Orio G, Armellino MF, Troian M, Guerra M, Nagliati C, Biloslavo A, Germani P, Aizza G, Monsellato I, Chahrour AC, Anania G, Bombardini C, Bagolini F, Sganga G, Fransvea P, Bianchi V, Boati P, Ferrara F, Palmieri F, Cianci P, Gattulli D, Restini E, Cillara N, Cannavera A, Nita GE, Sarnari J, Roscio F, Clerici F, Scandroglio I, Berti S, Cadeo A, Filippelli A, Conti L, Grassi C, Cattaneo GM, Pighin M, Papis D, Gambino G, Bertino V, Schifano D, Prando D, Fogato L, Cavallo F, Ansaloni L, Picheo R, Pontarolo N, Depalma N, Spampinato M, D'Ugo S, Lepre L, Capponi MG, Campa RD, Sarro G, Dinuzzi VP, Olmi S, Uccelli M, Ferrari D, Inama M, Moretto G, Fontana M, Favi F, Picariello E, Rampini A, Barberis A, Azzinnaro A, Oliva A, Totaro L, Benzoni I, Ranieri V, Capolupo GT, Carannante F, Caricato M, Ronconi M, Casiraghi S, Casole G, Pantalone D, Alemanno G, Scheiterle M, Ceresoli M, Cereda M, Fumagalli C, Zanzi F, Bolzon S, Guerra E, Lecchi F, Cellerino P, Ardito A, Scaramuzzo R, Balla A, Lepiane P, Tartaglia N, Ambrosi A, Pavone G, Palini GM, Veneroni S, Garulli G, Ricci C, Torre B, Russo IS, Rottoli M, Tanzanu M, Belvedere A, Milone M, Manigrasso M, De Palma GD, Piccoli M, Pattacini GC, Magnone S, Bertoli P, Pisano M, Massucco P, Palisi M, Luzzi AP, Fleres F, Clarizia G, Spolini A, Kobe Y, Toma T, Shimamura F, Parker R, Ranketi S, Mitei M, Svagzdys S, Pauzas H, Zilinskas J, Poskus T, Kryzauskas M, Jakubauskas M, Zakaria AD, Zakaria Z, Wong MPK, Jusoh AC, Zakaria MN, Cruz DR, Elizalde ABR, Reynaud AB, Hernandez EEL, Monroy JMVP, Hinojosa-Ugarte D, Quiodettis M, Du Bois ME, Latorraca J, Major P, Pędziwiatr M, Pisarska-Adamczyk M, Walędziak M, Kwiatkowski A, Czyżykowski Ł, da Costa SD, Pereira B, Ferreira ARO, Almeida F, Rocha R, Carneiro C, Perez DP, Carvas J, Rocha C, Ferreira C, Marques R, Fernandes U, Leao P, Goulart A, Pereira RG, Patrocínio SDD, de Mendonça NGG, Manso MIC, Morais HMC, Cardoso PS, Calu V, Miron A, Toma EA, Gachabayov M, Abdullaev A, Litvin A, Nechay T, Tyagunov A, Yuldashev A, Bradley A, Wilson M, Panyko A, Látečková Z, Lacko V, Lesko D, Soltes M, Radonak J, Turrado-Rodriguez V, Termes-Serra R, Morales-Sevillano X, Lapolla P, Mingoli A, Brachini G, Degiuli M, Sofia S, Reddavid R, de Manzoni Garberini A, Buffone A, Del Pozo EP, Aparicio-Sánchez D, Dos Barbeito S, Estaire-Gómez M, Vitón-Herrero R, de Los Ángeles Gil Olarte-Marquez M, Gil-Martínez J, Alconchel F, Nicolás-López T, Rahy-Martin AC, Pelloni M, Bañolas-Suarez R, Mendoza-Moreno F, Nisa FGM, Díez-Alonso M, Rodas MEV, Agundez MC, Andrés MIP, Moreira CCL, Perez AL, Ponce IA, González-Castillo AM, Membrilla-Fernández E, Salvans S, Serradilla-Martín M, Pardo PS, Rivera-Alonso D, Dziakova J, Huguet JM, Valle NP, Ruiz EC, Valcárcel CR, Moreno CR, Salazar YTM, García JJR, Micó SS, López JR, Farré SP, Gomez MS, Petit NM, Titos-García A, Aranda-Narváez JM, Romacho-López L, Sánchez-Guillén L, Aranaz-Ostariz V, Bosch-Ramírez M, Martínez-Pérez A, Martínez-López E, Sebastián-Tomás JC, Jimenez-Riera G, Jimenez-Vega J, Cuellar JAN, Campos-Serra A, Muñoz-Campaña A, Gràcia-Roman R, Alegre JM, Pinto FL, O'Sullivan SN, Antona FB, Jiménez BM, López-Sánchez J, Carmona ZG, Fernández RT, Sierra IB, de León LRG, Moreno VP, Iglesias E, Cumplido PL, Bravo AA, Simó IR, Domínguez CL, Caamaño AG, Lozano RC, Martínez MD, Torres ÁN, de Quiros JTMB, Pellino G, Cloquell MM, Moller EG, Jalal-Eldin S, Abdoun AK, Hamid HKS, Lohsiriwat V, Mongkhonsupphawan A, Baraket O, Ayed K, Abbassi I, Ali AB, Ammar H, Kchaou A, Tlili A, Zribi I, Colak E, Polat S, Koylu ZA, Guner A, Usta MA, Reis ME, Mantoglu B, Gonullu E, Akin E, Altintoprak F, Bayhan Z, Firat N, Isik A, Memis U, Bayrak M, Altıntaş Y, Kara Y, Bozkurt MA, Kocataş A, Das K, Seker A, Ozer N, Atici SD, Tuncer K, Kaya T, Ozkan Z, Ilhan O, Agackiran I, Uzunoglu MY, Demirbas E, Altinel Y, Meric S, Hacım NA, Uymaz DS, Omarov N, Balık E, Tebala GD, Khalil H, Rana M, Khan M, Florence C, Swaminathan C, Leo CA, Liasis L, Watfah J, Trostchansky I, Delgado E, Pontillo M, Latifi R, Coimbra R, Edwards S, Lopez A, Velmahos G, Dorken A, Gebran A, Palmer A, Oury J, Bardes JM, Seng SS, Coffua LS, Ratnasekera A, Egodage T, Echeverria-Rosario K, Armento I, Napolitano LM, Sangji NF, Hemmila M, Quick JA, Austin TR, Hyman TS, Curtiss W, McClure A, Cairl N, Biffl WL, Truong HP, Schaffer K, Reames S, Banchini F, Capelli P, Coccolini F, Sartelli M, Bravi F, Vallicelli C, Agnoletti V, Baiocchi GL, Catena F. Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago. World J Emerg Surg 2024; 19:14. [PMID: 38627831 PMCID: PMC11020610 DOI: 10.1186/s13017-024-00543-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. METHODS This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. RESULTS 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. CONCLUSIONS After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception.
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Affiliation(s)
- Gennaro Perrone
- Department of Emergency Surgery, Maggiore Hospital, Parma, Italy
| | - Mario Giuffrida
- General Surgery Unit, Maggiore Hospital, Parma, Italy.
- Department of General Surgery, Ospedale Guglielmo da Saliceto, 29100, Piacenza, Italy.
| | - Fikri Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Vitor F Kruger
- Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Marco Livrini
- Department of Emergency Surgery, Maggiore Hospital, Parma, Italy
| | | | - Giorgio Rossi
- Department of Emergency Surgery, Maggiore Hospital, Parma, Italy
| | - Antonio Tarasconi
- General Surgery Department, UO Chirurgia Generale, ASST Cremona, Cremona, Italy
| | - Brian W C A Tian
- Department of General Surgery, Singapore General Hospital, Singapore, Singapore
| | - Elena Bonati
- General Surgery Unit, Maggiore Hospital, Parma, Italy
| | - Ricardo Mentz
- General Surgery Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Federico N Mazzini
- General Surgery Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Juan P Campana
- General Surgery Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Elisabeth Gasser
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Reinhold Kafka-Ritsch
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniel M Felsenreich
- Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Christopher Dawoud
- Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Riss
- Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Carlos Augusto Gomes
- Faculdade de Medicina, SUPREMA, Hospital Universitario Terezinha de Jesus de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Felipe Couto Gomes
- Faculdade de Medicina, SUPREMA, Hospital Universitario Terezinha de Jesus de Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | - Cassio Alfred Brattig Canton
- Medical Course, Department of Surgery - Emergency Surgery and Trauma Sector, Padre Albino University Center, Catanduva, Brazil
| | | | - Gustavo P Fraga
- Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Leticia Gonçalves Zem
- Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | | | | | - Boyko Atanasov
- UMHAT Eurohospital-Plovdiv/Medical University Plovdiv, Plovdiv, Bulgaria
| | - Nikolay Belev
- UMHAT Eurohospital-Plovdiv/Medical University Plovdiv, Plovdiv, Bulgaria
| | - Nikola Kovachev
- UMHAT Eurohospital-Plovdiv/Medical University Plovdiv, Plovdiv, Bulgaria
| | - L Juan José Meléndez
- Trauma and Acute Care Surgeon Hospital Rafael Angel Calderón Guardia, San José, Costa Rica
| | - Ana Dimova
- General Hospital Zabok and Croatian War Veteran Hospital Bracak, Zabok, Croatia
| | - Stefan Dimov
- General Hospital Zabok and Croatian War Veteran Hospital Bracak, Zabok, Croatia
| | - Zdravko Zelić
- General Hospital Zabok and Croatian War Veteran Hospital Bracak, Zabok, Croatia
| | - Goran Augustin
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Branko Bogdanić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Trpimir Morić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Elie Chouillard
- Department of General and Bariatric Surgery, American Hospital in Paris, Paris, France
| | - Melinda Bajul
- Emergency and General Minimally Invasive Surgery, Poissy and St Germain Hospital, Poissy, France
| | - Belinda De Simone
- Department of Emergency and General Minimally Invasive Surgery, Academic Hospital of Villeneuve St Georges, Villeneuve-Saint-Georges, France
| | - Yves Panis
- Colorectal Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly/Seine, France
| | - Francesco Esposito
- Department of Colorectal Surgery, Pôle Des Maladies de L'Appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | | | | | | | | | | | - Venara Aurélien
- Department of Visceral Surgery CHU Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France
| | - Marie Bougard
- Department of Visceral Surgery CHU Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France
| | - Maxime Roulet
- Department of Visceral Surgery CHU Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France
| | | | - Irakli Pipia
- N.Kipshidze Central University Hospital, Tbilisi, Georgia
| | | | | | | | | | - Sofia Xenaki
- Department of General Surgery - University Hospital of Heraklion Crete, Crete, Greece
| | - Emmanuel Chrysos
- Department of General Surgery - University Hospital of Heraklion Crete, Crete, Greece
| | - Stamatios Kokkinakis
- Department of General Surgery - University Hospital of Heraklion Crete, Crete, Greece
| | | | | | - Ioannis Margaris
- 4th Surgical Department "Attikon" University Hospital, Chaidari, Greece
| | | | | | - Jevgeni Katunin
- Department of Digestive Surgery, Athens Bioclinic Hospital, Athens, Greece
| | | | | | | | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Ioannis Maroulis
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Michail Vailas
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Athanasios Marinis
- Third Department of Surgery, Tzaneio General Hospital, Piraeus, GR, Greece
| | - Ioannis Siannis
- Third Department of Surgery, Tzaneio General Hospital, Piraeus, GR, Greece
| | - Eirini Bourbouteli
- Third Department of Surgery, Tzaneio General Hospital, Piraeus, GR, Greece
| | | | - Nikolaos Tasis
- 2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
| | | | | | | | | | - Dimitrios Korkolis
- Surgical Oncology Department of Agios Savvas Anticancer Hospital of Athens, Athens, Greece
| | - Evangelos Fradelos
- Surgical Oncology Department of Agios Savvas Anticancer Hospital of Athens, Athens, Greece
| | - George Kavalieratos
- Surgical Oncology Department of Agios Savvas Anticancer Hospital of Athens, Athens, Greece
| | | | | | | | - Tania Triantafyllou
- Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | - Despina Kimpizi
- Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | - Dimitrios Theodorou
- Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | | | - Alexandros Chamzin
- 1st Propaedeutic Department of Surgery, Hippocratio Hospital of Athens, Athens, Greece
| | - Maximos Frountzas
- 1st Propaedeutic Department of Surgery, Hippocratio Hospital of Athens, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Ioannis Karavokyros
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Athanasios Syllaios
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | - Maria Boura
- National and Kapodistrian University of Athens, Athens, Greece
| | - Efstratia Baili
- National and Kapodistrian University of Athens, Athens, Greece
| | - Orestis Ioannidis
- 4th Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital "George Papanikolaou", Thessaloniki, Greece
| | - Lydia Loutzidou
- 4th Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital "George Papanikolaou", Thessaloniki, Greece
| | - Elissavet Anestiadou
- 4th Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital "George Papanikolaou", Thessaloniki, Greece
| | - Ioannis Tsouknidas
- 2n, Department of Surgery, General Hospital of Chania "St George", Chania, Greece
| | - Georgios Petrakis
- 2n, Department of Surgery, General Hospital of Chania "St George", Chania, Greece
| | - Eleni Polenta
- 2n, Department of Surgery, General Hospital of Chania "St George", Chania, Greece
| | - Lovenish Bains
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
| | - Rahul Gupta
- Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India
| | - Sudhir K Singh
- Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India
| | - Archana Khanduri
- Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India
| | - Miklosh Bala
- General Surgery and Trauma Unit Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Asaf Kedar
- General Surgery and Trauma Unit Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Marcello Pisano
- Chirurgia d'Urgenza Policlinico Universitario di MonserratoAzienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Mauro Podda
- Chirurgia d'Urgenza Policlinico Universitario di MonserratoAzienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Adolfo Pisanu
- Chirurgia d'Urgenza Policlinico Universitario di MonserratoAzienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Gennaro Martines
- Chirurgia "M.Rubino" Azienda Ospedaliero Universitaria Policlinico Bari, Bari, Italy
| | - Giuseppe Trigiante
- Chirurgia "M.Rubino" Azienda Ospedaliero Universitaria Policlinico Bari, Bari, Italy
| | - Giuliano Lantone
- Chirurgia "M.Rubino" Azienda Ospedaliero Universitaria Policlinico Bari, Bari, Italy
| | - Antonino Agrusa
- Unit of General and Emergency Surgery, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University Hospital Policlinico "P. Giaccone, University of Palermo - Palermo, Palermo, Italy
| | - Giuseppe Di Buono
- Unit of General and Emergency Surgery, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University Hospital Policlinico "P. Giaccone, University of Palermo - Palermo, Palermo, Italy
| | - Salvatore Buscemi
- Unit of General and Emergency Surgery, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University Hospital Policlinico "P. Giaccone, University of Palermo - Palermo, Palermo, Italy
| | - Massimiliano Veroux
- General Surgery Unit and Organ Transplant Unit, University Hospital of Catania, Catania, Italy
| | - Rossella Gioco
- General Surgery Unit and Organ Transplant Unit, University Hospital of Catania, Catania, Italy
| | - Gastone Veroux
- General Surgery Unit and Organ Transplant Unit, University Hospital of Catania, Catania, Italy
| | - Luigi Oragano
- SOC Chirurgia Generale - ASL VCO (Piemonte), Verbania, Italy
| | - Sandro Zonta
- SOC Chirurgia Generale - ASL VCO (Piemonte), Verbania, Italy
| | | | - Carlo V Feo
- Unità Operativa Chirurgia Generale ProvincialeAzienda USL di Ferrara, Ferrara, Italy
| | - Antonio Pesce
- Unità Operativa Chirurgia Generale ProvincialeAzienda USL di Ferrara, Ferrara, Italy
| | - Nicolò Fabbri
- Unità Operativa Chirurgia Generale ProvincialeAzienda USL di Ferrara, Ferrara, Italy
| | - Giulio Lantone
- Surgery Unit, National Institute of Gastroenterology 'S. de Bellis', Research Hospital, Castellana Grotte, BA, Italy
| | - Fabio Marino
- Surgery Unit, National Institute of Gastroenterology 'S. de Bellis', Research Hospital, Castellana Grotte, BA, Italy
| | - Fabrizio Perrone
- Surgery Unit, National Institute of Gastroenterology 'S. de Bellis', Research Hospital, Castellana Grotte, BA, Italy
| | - Leonardo Vincenti
- Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari - Dept of Emergency and Organ Transplantation, Bari, Italy
| | - Vincenzo Papagni
- Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari - Dept of Emergency and Organ Transplantation, Bari, Italy
| | - Arcangelo Picciariello
- Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari - Dept of Emergency and Organ Transplantation, Bari, Italy
| | - Stefano Rossi
- Department of General and Emergency Surgery, San Filippo Neri Hospital, Rome, Italy
| | - Biagio Picardi
- Department of General and Emergency Surgery, San Filippo Neri Hospital, Rome, Italy
| | | | - Diego Visconti
- Chirurgia Generale d'Urgenza e PS - AOU Città della Salute e della Scienza di Torino, Presidio San Giovanni Battista - Molinette, Turin, Italy
| | - Giulia Osella
- Chirurgia Generale d'Urgenza e PS - AOU Città della Salute e della Scienza di Torino, Presidio San Giovanni Battista - Molinette, Turin, Italy
| | - Luca Petruzzelli
- Chirurgia Generale d'Urgenza e PS - AOU Città della Salute e della Scienza di Torino, Presidio San Giovanni Battista - Molinette, Turin, Italy
| | - Giusto Pignata
- Chirurgia Generale 2 ASST Spedali Civili di Brescia, Brescia, Italy
| | | | | | | | | | - Stefano Spinelli
- Chirurgia Generale PO Valle d'Itria ASL TA, Martina Franca, Italy
| | | | - Carlo Corbellini
- Unità Operativa di Chirurgia Generale Ospedale di Rho - ASST Rhodense, Milan, Italy
| | - Leonardo Lorusso
- Unità Operativa di Chirurgia Generale Ospedale di Rho - ASST Rhodense, Milan, Italy
| | - Alice Frontali
- General Surgery Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, AAST Fatebenefratelli Sacco, Milan, Italy
- General Surgery Unit, University of Milan, ASST Vimercate, Via Santi Cosma e Damiano 16, 20871, Vimercate, Italy
| | - Isabella Pezzoli
- General Surgery Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, AAST Fatebenefratelli Sacco, Milan, Italy
| | - Alessandro Bonomi
- General Surgery Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, AAST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Chierici
- General Surgery Unit, University of Milan, ASST Vimercate, Via Santi Cosma e Damiano 16, 20871, Vimercate, Italy
| | - Christian Cotsoglou
- General Surgery Unit, University of Milan, ASST Vimercate, Via Santi Cosma e Damiano 16, 20871, Vimercate, Italy
| | - Giuseppe Manca
- Unità Operativa Complessa di Chirurgia Generale, Presidio Ospedaliero "A. Perrino", Brindisi, Italy
| | - Antonella Delvecchio
- Unità Operativa Complessa di Chirurgia Generale, Presidio Ospedaliero "A. Perrino", Brindisi, Italy
| | - Nicola Musa
- Unità Operativa Complessa di Chirurgia Generale, Presidio Ospedaliero "A. Perrino", Brindisi, Italy
| | | | - Laface Letizia
- Ospedale Vittorio Emanuele III Carate Brianza, Carate Brianza, Italy
| | - Emmanuele Abate
- Ospedale Vittorio Emanuele III Carate Brianza, Carate Brianza, Italy
| | - Giorgio Ercolani
- UOC Chirurgia Generale e Terapie Oncologiche Avanzate Ospedale Morgagni-Pierantoni AUSLRomagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Fabrizio D'Acapito
- UOC Chirurgia Generale e Terapie Oncologiche Avanzate Ospedale Morgagni-Pierantoni AUSLRomagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Leonardo Solaini
- UOC Chirurgia Generale e Terapie Oncologiche Avanzate Ospedale Morgagni-Pierantoni AUSLRomagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Gianluca Guercioni
- UOC ChirurgiaOspedale Provinciale "C. E G. Mazzoni" Ascoli Piceno, Area Vasta 5, Regione Marche, Italy
| | - Simone Cicconi
- UOC ChirurgiaOspedale Provinciale "C. E G. Mazzoni" Ascoli Piceno, Area Vasta 5, Regione Marche, Italy
| | - Diego Sasia
- Santa Croce and Carle Hospital, Cuneo, Italy
| | | | | | - Giuseppe Sena
- Dipartimento di Specialità Chirurgiche, Azienda Ospedaliera "Pugliese-Ciaccio" di Catanzaro, Catanzaro, Italy
| | - Pasquale Castaldo
- Dipartimento di Specialità Chirurgiche, Azienda Ospedaliera "Pugliese-Ciaccio" di Catanzaro, Catanzaro, Italy
| | - Eugenia Cardamone
- Dipartimento di Specialità Chirurgiche, Azienda Ospedaliera "Pugliese-Ciaccio" di Catanzaro, Catanzaro, Italy
| | - Giuseppe Portale
- Department of General Surgery, ULSS 6 Euganea, CittadellaPadua, Italy
| | - Matteo Zuin
- Department of General Surgery, ULSS 6 Euganea, CittadellaPadua, Italy
| | - Ylenia Spolverato
- Department of General Surgery, ULSS 6 Euganea, CittadellaPadua, Italy
| | | | | | | | - Romina Manunza
- Chirurgia d'Urgenza ospedale Brotzu - ARNAS, Palermo, Italy
| | | | - Marcello Agus
- Chirurgia d'Urgenza ospedale Brotzu - ARNAS, Palermo, Italy
| | | | | | | | - Davide Luppi
- Dipartimento di Chirurgia Generale 2 e D'Urgenza dell'Arcispedale Santa Maria Nuova - Ausl RE IRCCS, Reggio Emilia, Italy
| | - Massimiliano Casadei
- Dipartimento di Chirurgia Generale 2 e D'Urgenza dell'Arcispedale Santa Maria Nuova - Ausl RE IRCCS, Reggio Emilia, Italy
| | - Stefano Bonilauri
- Dipartimento di Chirurgia Generale 2 e D'Urgenza dell'Arcispedale Santa Maria Nuova - Ausl RE IRCCS, Reggio Emilia, Italy
| | - Angela Pezzolla
- U.O. di Chirurgia Videolaparoscopica della AOU Policlinico di Bari, Bari, Italy
| | | | - Rita Laforgia
- U.O. di Chirurgia Videolaparoscopica della AOU Policlinico di Bari, Bari, Italy
| | - Maurizio De Luca
- Department of General Surgery, Santa Maria della Misericordia Hospital, AULSS5 Polesana - Rovigo, Rovigo, Italy
| | - Monica Zese
- Department of General Surgery, Santa Maria della Misericordia Hospital, AULSS5 Polesana - Rovigo, Rovigo, Italy
| | - Dario Parini
- Department of General Surgery, Santa Maria della Misericordia Hospital, AULSS5 Polesana - Rovigo, Rovigo, Italy
| | - Elio Jovine
- Chirurgia A e d'Urgenza IRCCS Ospedale Maggiore Bologna Largo, Bartolo Nigrisoli 2, 40133, Bologna, Italy
| | - Giuseppina De Sario
- Chirurgia A e d'Urgenza IRCCS Ospedale Maggiore Bologna Largo, Bartolo Nigrisoli 2, 40133, Bologna, Italy
| | - Raffaele Lombardi
- Chirurgia A e d'Urgenza IRCCS Ospedale Maggiore Bologna Largo, Bartolo Nigrisoli 2, 40133, Bologna, Italy
| | - Giovanni Aprea
- UOC Chirurgia Endoscopica - AOU Federico II Di Napoli, Naples, Italy
| | - Giuseppe Palomba
- UOC Chirurgia Endoscopica - AOU Federico II Di Napoli, Naples, Italy
| | - Marianna Capuano
- UOC Chirurgia Endoscopica - AOU Federico II Di Napoli, Naples, Italy
| | - Giulio Argenio
- UOC Chirurgia d'Urgenza AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Gianluca Orio
- UOC Chirurgia d'Urgenza AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | | | - Marina Troian
- SC Chirurgia Generale, ASUGI - Ospedale San Giovanni di Dio, Gorizia, Italy
| | - Martina Guerra
- SC Chirurgia Generale, ASUGI - Ospedale San Giovanni di Dio, Gorizia, Italy
| | - Carlo Nagliati
- SC Chirurgia Generale, ASUGI - Ospedale San Giovanni di Dio, Gorizia, Italy
| | - Alan Biloslavo
- Clinica Chirurgica, Cattinara University Hospital, ASUGI Trieste, Trieste, Italy
| | - Paola Germani
- Clinica Chirurgica, Cattinara University Hospital, ASUGI Trieste, Trieste, Italy
| | - Giada Aizza
- Clinica Chirurgica, Cattinara University Hospital, ASUGI Trieste, Trieste, Italy
| | - Igor Monsellato
- SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | | | | | | | | | - Gabriele Sganga
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Pietro Fransvea
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valentina Bianchi
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Boati
- Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Francesco Ferrara
- Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Francesco Palmieri
- Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Pasquale Cianci
- Department of Surgery and Traumatology-General Surgery Unit, "Lorenzo Bonomo Hospital"-ASL BAT, Andria, Italy
| | - Domenico Gattulli
- Department of Surgery and Traumatology-General Surgery Unit, "Lorenzo Bonomo Hospital"-ASL BAT, Andria, Italy
| | - Enrico Restini
- Department of Surgery and Traumatology-General Surgery Unit, "Lorenzo Bonomo Hospital"-ASL BAT, Andria, Italy
| | - Nicola Cillara
- Chirurgia Generale PO Santissima Trinità - ASL Cagliari, Cagliari, Italy
| | | | - Gabriela Elisa Nita
- Chirurgia GeneraleOspedale Sant'Anna di AUSL di Reggio Emilia, Reggio Emilia, Italy
| | - Jlenia Sarnari
- Chirurgia GeneraleOspedale Sant'Anna di AUSL di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Roscio
- Division of General Surgery, ASST Valle Olona, Busto Arsizio, Italy
| | - Federico Clerici
- Division of General Surgery, ASST Valle Olona, Busto Arsizio, Italy
| | - Ildo Scandroglio
- Division of General Surgery, ASST Valle Olona, Busto Arsizio, Italy
| | - Stefano Berti
- S.C. Chirurgia Generale, S. Andrea Hospital - ASL 5, La Spezia, Italy
| | - Alessandro Cadeo
- S.C. Chirurgia Generale, S. Andrea Hospital - ASL 5, La Spezia, Italy
| | - Alice Filippelli
- S.C. Chirurgia Generale, S. Andrea Hospital - ASL 5, La Spezia, Italy
| | - Luigi Conti
- Acute Care Surgery Unit, Ospedale G. Da Saliceto, Piacenza, Italy
| | - Carmine Grassi
- Acute Care Surgery Unit, Ospedale G. Da Saliceto, Piacenza, Italy
| | | | - Marina Pighin
- Chirurgia Generale dell'Ospedale Sant'Anna di San Fermo della Battaglia, San Fermo Della Battaglia, Italy
| | - Davide Papis
- Chirurgia Generale dell'Ospedale Sant'Anna di San Fermo della Battaglia, San Fermo Della Battaglia, Italy
| | | | | | | | - Daniela Prando
- Uoc Chirurgia Ospedale Santa Maria degli Angeli Adria, Adria, Italy
| | - Luisella Fogato
- Uoc Chirurgia Ospedale Santa Maria degli Angeli Adria, Adria, Italy
| | - Fabio Cavallo
- Uoc Chirurgia Ospedale Santa Maria degli Angeli Adria, Adria, Italy
| | - Luca Ansaloni
- U.O.C. Chirurgia Generale 1 IRCCS Policlinico San Matteo Pavia, University of Pavia, Pavia, Italy
| | - Roberto Picheo
- U.O.C. Chirurgia Generale 1 IRCCS Policlinico San Matteo Pavia, University of Pavia, Pavia, Italy
| | - Nicholas Pontarolo
- U.O.C. Chirurgia Generale 1 IRCCS Policlinico San Matteo Pavia, University of Pavia, Pavia, Italy
| | - Norma Depalma
- Department of General and Emergency Surgery - "Vito Fazzi" Hospital, Lecce, Italy
| | - Marcello Spampinato
- Department of General and Emergency Surgery - "Vito Fazzi" Hospital, Lecce, Italy
| | - Stefano D'Ugo
- Department of General and Emergency Surgery - "Vito Fazzi" Hospital, Lecce, Italy
| | - Luca Lepre
- General and Emergency Surgery Unit, Emergency Dept, Ospedale Santo Spirito in Sassia, 00193, Rome, Italy
| | - Michela Giulii Capponi
- General and Emergency Surgery Unit, Emergency Dept, Ospedale Santo Spirito in Sassia, 00193, Rome, Italy
| | - Rossella Domenica Campa
- General and Emergency Surgery Unit, Emergency Dept, Ospedale Santo Spirito in Sassia, 00193, Rome, Italy
| | - Giuliano Sarro
- G.Fornaroli" Hospital, Magenta ASST Ovest Milanese, Milan, Italy
- Istituto Clinico San Gaudenzio - Novara, Novara, Italy
| | | | | | | | | | - Marco Inama
- Unità di Chirurgia GeneraleOspedale Pederzoli, Peschiera del Garda, VR, Italy
| | - Gianluigi Moretto
- Unità di Chirurgia GeneraleOspedale Pederzoli, Peschiera del Garda, VR, Italy
| | - Michele Fontana
- Unità di Chirurgia GeneraleOspedale Pederzoli, Peschiera del Garda, VR, Italy
| | - Francesco Favi
- Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | | | - Alessia Rampini
- Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | - Andrea Barberis
- S.C. Chirurgia Generale ed Epatobiliopancreatica, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | - Antonio Azzinnaro
- S.C. Chirurgia Generale ed Epatobiliopancreatica, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | - Alba Oliva
- S.C. Chirurgia Generale ed Epatobiliopancreatica, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | | | | | | | - Gabriella Teresa Capolupo
- Colorectal Surgery Unit, Fondazione Policlinico Campus Bio-Medico, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Filippo Carannante
- Colorectal Surgery Unit, Fondazione Policlinico Campus Bio-Medico, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Marco Caricato
- Colorectal Surgery Unit, Fondazione Policlinico Campus Bio-Medico, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Maurizio Ronconi
- S.C. Chirurgia Generale Ospedale Di Gardone Val Trompia - ASST Spedali Civili, Brescia, Italy
| | - Silvia Casiraghi
- S.C. Chirurgia Generale Ospedale Di Gardone Val Trompia - ASST Spedali Civili, Brescia, Italy
| | - Giovanni Casole
- S.C. Chirurgia Generale Ospedale Di Gardone Val Trompia - ASST Spedali Civili, Brescia, Italy
| | - Desire Pantalone
- Unit of Critical Care Surgery and Trauma-Trauma Team University Hospital Careggi, Florence, Italy
| | - Giovanni Alemanno
- Unit of Critical Care Surgery and Trauma-Trauma Team University Hospital Careggi, Florence, Italy
| | - Maximilian Scheiterle
- Unit of Critical Care Surgery and Trauma-Trauma Team University Hospital Careggi, Florence, Italy
| | | | | | | | - Federico Zanzi
- Ospedale Santa Maria delle Croci Ravenna Reparto di Chirurgia d'Urgenza, Ravenna, Italy
| | - Stefano Bolzon
- Ospedale Santa Maria delle Croci Ravenna Reparto di Chirurgia d'Urgenza, Ravenna, Italy
| | - Enrico Guerra
- Ospedale Santa Maria delle Croci Ravenna Reparto di Chirurgia d'Urgenza, Ravenna, Italy
| | - Francesca Lecchi
- UOC Chirurgia GeneraleOspedale Fatebenefratelli e Oftalmico, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Paola Cellerino
- UOC Chirurgia GeneraleOspedale Fatebenefratelli e Oftalmico, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonella Ardito
- UOC Chirurgia GeneraleOspedale Fatebenefratelli e Oftalmico, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Rosa Scaramuzzo
- General Surgery Unit, San Paolo Hospital, Civitavecchia, Italy
| | - Andrea Balla
- General Surgery Unit, San Paolo Hospital, Civitavecchia, Italy
| | | | - Nicola Tartaglia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonio Ambrosi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giovanna Pavone
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | | | | | - Claudio Ricci
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Beatrice Torre
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Iris Shari Russo
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Matteo Rottoli
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Marta Tanzanu
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Angela Belvedere
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Marco Milone
- University of Naples "Federico II", Naples, Italy
| | | | | | - Micaela Piccoli
- General Surgery,Emergencies and New Technologies, Baggiovara Civil Hospital Modena, Baggiovara, Italy
| | | | - Stefano Magnone
- General Surgery, Ospedale Papa Giovanni XXIII, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Paolo Bertoli
- General Surgery, Ospedale Papa Giovanni XXIII, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Michele Pisano
- General Surgery, Ospedale Papa Giovanni XXIII, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Paolo Massucco
- Chirurgia Generale e OncologicaOsp. Mauriziano - Torino, Turin, Italy
| | - Marco Palisi
- Chirurgia Generale e OncologicaOsp. Mauriziano - Torino, Turin, Italy
| | | | - Francesco Fleres
- General Surgery Unit - ASST Valtellina e Alto Lario, Sondrio Hospital - Sondrio, Sondrio, Italy
| | - Guglielmo Clarizia
- General Surgery Unit - ASST Valtellina e Alto Lario, Sondrio Hospital - Sondrio, Sondrio, Italy
| | - Alessandro Spolini
- General Surgery Unit - ASST Valtellina e Alto Lario, Sondrio Hospital - Sondrio, Sondrio, Italy
| | | | | | | | | | | | | | - Saulius Svagzdys
- Department of Surgery Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Henrikas Pauzas
- Department of Surgery Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Justas Zilinskas
- Department of Surgery Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tomas Poskus
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Marius Kryzauskas
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Matas Jakubauskas
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Andee Dzulkarnaen Zakaria
- Department of Surgery, School of Medical Sciences and Hospital, Universiti Sains Malaysia, Gelugor, Malaysia
| | - Zaidi Zakaria
- Department of Surgery, School of Medical Sciences and Hospital, Universiti Sains Malaysia, Gelugor, Malaysia
| | - Michael Pak-Kai Wong
- Department of Surgery, School of Medical Sciences and Hospital, Universiti Sains Malaysia, Gelugor, Malaysia
| | - Asri Che Jusoh
- Department of General Surgery, Hospital Sultan Ismail Petra, Kuala Krai, Kelantan, Malaysia
| | | | - Daniel Rios Cruz
- Departamento de Cirugía Gastrointestinal y Enfermedades Digestivas "DR DANIEL RIOS CRUZ". Hospital Center Vista Hermosa, Cuernavaca Morelos, México
| | - Aurea Barbara Rodriguez Elizalde
- Departamento de Cirugía Gastrointestinal y Enfermedades Digestivas "DR DANIEL RIOS CRUZ". Hospital Center Vista Hermosa, Cuernavaca Morelos, México
| | - Alejandro Bañon Reynaud
- Departamento de Cirugía Gastrointestinal y Enfermedades Digestivas "DR DANIEL RIOS CRUZ". Hospital Center Vista Hermosa, Cuernavaca Morelos, México
| | | | | | | | | | | | | | - Piotr Major
- Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Michał Pędziwiatr
- Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | | | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Andrzej Kwiatkowski
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Łukasz Czyżykowski
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | | | - Bela Pereira
- Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | | | - Filipe Almeida
- Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Ricardo Rocha
- Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Carla Carneiro
- Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Diego Pita Perez
- Unidade Local de Saúde do Nordeste, EPE; Serviço de Cirurgia Geral, Bragança, Portugal
| | - João Carvas
- Unidade Local de Saúde do Nordeste, EPE; Serviço de Cirurgia Geral, Bragança, Portugal
| | - Catarina Rocha
- Unidade Local de Saúde do Nordeste, EPE; Serviço de Cirurgia Geral, Bragança, Portugal
| | | | | | | | - Pedro Leao
- General Surgery Grupo Trofa Saúde, Porto, Portugal
| | | | - Rita Gonçalves Pereira
- General Surgery Department, Centro Hospitalar Barreiro Montijo, E.P.E., Barreiro, Portugal
| | | | | | | | | | | | - Valentin Calu
- Carol Davila University of Medicine and Pharmacy Bucharest and Elias University Emergency Hospital Bucharest, Bucharest, Romania
| | - Adrian Miron
- Carol Davila University of Medicine and Pharmacy Bucharest and Elias University Emergency Hospital Bucharest, Bucharest, Romania
| | - Elena Adelina Toma
- Carol Davila University of Medicine and Pharmacy Bucharest and Elias University Emergency Hospital Bucharest, Bucharest, Romania
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | - Abakar Abdullaev
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | - Andrey Litvin
- Department of Surgical Diseases No. 3, Gomel State Medical University, University Clinic, Gomel, Belarus
| | - Taras Nechay
- Pirogov Medical University Research Institute of Clinical Surgery, Moscow, Russia
| | - Alexander Tyagunov
- Pirogov Medical University Research Institute of Clinical Surgery, Moscow, Russia
| | - Anvar Yuldashev
- Pirogov Medical University Research Institute of Clinical Surgery, Moscow, Russia
| | | | | | - Arpád Panyko
- 4t, Department of Surgery, University Hospital Bratislava, Bratislava, Slovakia
| | - Zuzana Látečková
- 4t, Department of Surgery, University Hospital Bratislava, Bratislava, Slovakia
| | - Vladimír Lacko
- 4t, Department of Surgery, University Hospital Bratislava, Bratislava, Slovakia
| | - Dusan Lesko
- 1s, Department of Surgery, UPJS and UNLP Kosice, Kosice, Slovak Republic
| | - Marek Soltes
- 1s, Department of Surgery, UPJS and UNLP Kosice, Kosice, Slovak Republic
| | - Jozef Radonak
- 1s, Department of Surgery, UPJS and UNLP Kosice, Kosice, Slovak Republic
| | - Victor Turrado-Rodriguez
- Gastrointestinal Surgery Department, Hospital Clinic de Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Roser Termes-Serra
- Gastrointestinal Surgery Department, Hospital Clinic de Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Xavier Morales-Sevillano
- Gastrointestinal Surgery Department, Hospital Clinic de Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Pierfrancesco Lapolla
- Policlinico Umberto I University Hospital - Sapienza University of Rome, Rome, Italy
| | - Andrea Mingoli
- Policlinico Umberto I University Hospital - Sapienza University of Rome, Rome, Italy
| | - Gioia Brachini
- Policlinico Umberto I University Hospital - Sapienza University of Rome, Rome, Italy
| | - Maurizio Degiuli
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, 10043, Orbassano (Turin), Italy
| | - Silvia Sofia
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, 10043, Orbassano (Turin), Italy
| | - Rossella Reddavid
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, 10043, Orbassano (Turin), Italy
| | | | | | | | | | | | - Mercedes Estaire-Gómez
- General and Colorectal Surgeon, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Rebeca Vitón-Herrero
- General and Colorectal Surgeon, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | - José Gil-Martínez
- General and Digestive Surgery. Virgen de la Arrixaca University Hospital (IMIB-Arrixaca), Murcia, Spain
| | - Felipe Alconchel
- General and Digestive Surgery. Virgen de la Arrixaca University Hospital (IMIB-Arrixaca), Murcia, Spain
| | - Tatiana Nicolás-López
- General and Digestive Surgery. Virgen de la Arrixaca University Hospital (IMIB-Arrixaca), Murcia, Spain
| | - Aida Cristina Rahy-Martin
- Emergency Surgery Unit, University Hospital of Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
| | - María Pelloni
- Emergency Surgery Unit, University Hospital of Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
| | - Raquel Bañolas-Suarez
- Emergency Surgery Unit, University Hospital of Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
| | | | | | - Manuel Díez-Alonso
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | | | | | | | | | | | | | | | - Silvia Salvans
- Emergency Surgery Unit, Department of General Surgery, Hospital del Mar, Barcelona, Spain
| | | | - Pablo Sancho Pardo
- Department of Surgery, Miguel Servet University Hospital, Saragossa, Spain
| | | | - Jana Dziakova
- Hospital Clínico San Carlos in Madrid, Madrid, Spain
| | | | | | | | | | | | | | - Juan Jesús Rubio García
- Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Silvia Sevila Micó
- Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Joaquín Ruiz López
- Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | | | | | | | - Alberto Titos-García
- Trauma and Emergency Surgery Unit General, Digestive and Transplantation Department, University Regional Hospital Málaga, Málaga, Spain
| | - Jose Manuel Aranda-Narváez
- Trauma and Emergency Surgery Unit General, Digestive and Transplantation Department, University Regional Hospital Málaga, Málaga, Spain
| | - Laura Romacho-López
- Trauma and Emergency Surgery Unit General, Digestive and Transplantation Department, University Regional Hospital Málaga, Málaga, Spain
| | - Luis Sánchez-Guillén
- Colorectal and Gastrointestinal Department Hospital General Universitario de Elche Universidad Miguel Hernández, Elche, Alicante, Spain
| | - Veronica Aranaz-Ostariz
- Colorectal and Gastrointestinal Department Hospital General Universitario de Elche Universidad Miguel Hernández, Elche, Alicante, Spain
| | - Marina Bosch-Ramírez
- Colorectal and Gastrointestinal Department Hospital General Universitario de Elche Universidad Miguel Hernández, Elche, Alicante, Spain
| | - Aleix Martínez-Pérez
- Department of General and Digestive Surgery. Hospital, Universitario Doctor Peset, Valencia, Spain
| | - Elías Martínez-López
- Department of General and Digestive Surgery. Hospital, Universitario Doctor Peset, Valencia, Spain
| | | | - Granada Jimenez-Riera
- Hepatobiliar and Pancreatic Surgery Unit General and Digestive Surgery University Hospital Virgen de Valme, Seville, Spain
| | - Javier Jimenez-Vega
- Hepatobiliar and Pancreatic Surgery Unit General and Digestive Surgery University Hospital Virgen de Valme, Seville, Spain
| | - Jose Aurelio Navas Cuellar
- Hepatobiliar and Pancreatic Surgery Unit General and Digestive Surgery University Hospital Virgen de Valme, Seville, Spain
| | | | - Anna Muñoz-Campaña
- Emergency Surgery Unit at Hospital Universitari Parc Tauli, Sabadell, Spain
| | | | - Javier Martínez Alegre
- General and Colorectal Surgeon, Hospital Universitario Infanta Sofia Madrid, Madrid, Spain
| | - Francisca Lima Pinto
- General and Colorectal Surgeon, Hospital Universitario Infanta Sofia Madrid, Madrid, Spain
| | - Sara Nuñez O'Sullivan
- General and Colorectal Surgeon, Hospital Universitario Infanta Sofia Madrid, Madrid, Spain
| | | | | | - Jaime López-Sánchez
- General Surgery Service of the University Hospital of Salamanca, Salamanca, Spain
| | | | | | | | | | | | - Eva Iglesias
- Hospital Universtario Puerta de Hierro, Madrid, Spain
| | | | | | - Ignacio Rey Simó
- HPB and Transplantation Unit, Head of Emergency Surgery Unit, Seville, Spain
| | | | | | - Rafael Calleja Lozano
- General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain
| | - Manuel Durán Martínez
- General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain
| | - Álvaro Naranjo Torres
- General and Digestive Surgery Department, Reina Sofía University Hospital, Cordoba, Spain
| | | | - Gianluca Pellino
- Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | | | - Ahmed K Abdoun
- Department of Sugery, Almoalem Medical City, Khartoum, Sudan
| | | | - Varut Lohsiriwat
- Colorectal Surgery Unit, Department of Surgery and Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Aitsariya Mongkhonsupphawan
- Colorectal Surgery Unit, Department of Surgery and Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Oussama Baraket
- Department of General Surgery Bizerte Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Karim Ayed
- Department of General Surgery Bizerte Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Imed Abbassi
- Department of General Surgery Bizerte Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ali Ben Ali
- Department of Gastrointestinal Surgery, Sahloul Hospital, Sousse, Tunis, Tunisia
| | - Houssem Ammar
- Department of Gastrointestinal Surgery, Sahloul Hospital, Sousse, Tunis, Tunisia
| | | | | | | | - Elif Colak
- Samsun Training and Research Hospital Colak, Samsun, Turkey
| | - Suleyman Polat
- Samsun Training and Research Hospital Colak, Samsun, Turkey
| | | | - Ali Guner
- Department of General Surgery, Division of Upper GI Surgery and Institute of Medical Science, Department of Biostatistics and Medical Informatics, Trabzon, Turkey
| | - Mehmet Arif Usta
- Department of General Surgery, Division of Upper GI Surgery and Institute of Medical Science, Department of Biostatistics and Medical Informatics, Trabzon, Turkey
| | - Murat Emre Reis
- Department of General Surgery, Division of Upper GI Surgery and Institute of Medical Science, Department of Biostatistics and Medical Informatics, Trabzon, Turkey
| | - Baris Mantoglu
- Department of General Surgery, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Emre Gonullu
- Department of General Surgery, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Emrah Akin
- Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Fatih Altintoprak
- Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Zulfu Bayhan
- Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Necattin Firat
- Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Arda Isik
- General Surgery Clinic, School of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Ufuk Memis
- General Surgery Clinic, School of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | | | | | - Yasin Kara
- General Surgery Clinic, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Abdussamet Bozkurt
- General Surgery Clinic, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Ali Kocataş
- General Surgery Clinic, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Koray Das
- University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
| | - Ahmet Seker
- University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
| | - Nazmi Ozer
- University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
| | - Semra Demirli Atici
- Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, İzmir, Turkey
| | - Korhan Tuncer
- Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, İzmir, Turkey
| | - Tayfun Kaya
- Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, İzmir, Turkey
| | - Zeynep Ozkan
- Department of General Surgery Elazig, Elazig Health Practice and Research Center, Elazig, Turkey
| | - Onur Ilhan
- Department of General Surgery Elazig, Elazig Health Practice and Research Center, Elazig, Turkey
| | - Ibrahim Agackiran
- Department of General Surgery Elazig, Elazig Health Practice and Research Center, Elazig, Turkey
| | | | - Eren Demirbas
- Department of General Surgery, Bursa Kestel State Hospital, Kestel, Turkey
| | - Yuksel Altinel
- Department of General Surgery, Bagcilar Training and Research Hospital University of Health Science, Istanbul, Turkey
| | - Serhat Meric
- Department of General Surgery, Bagcilar Training and Research Hospital University of Health Science, Istanbul, Turkey
| | - Nadir Adnan Hacım
- Department of General Surgery, Bagcilar Training and Research Hospital University of Health Science, Istanbul, Turkey
| | - Derya Salim Uymaz
- Department of General Surgery, Koç University Hospital, Istanbul, Turkey
| | - Nail Omarov
- Department of General Surgery, Koç University Hospital, Istanbul, Turkey
| | - Emre Balık
- Department of General Surgery, Koç University Hospital, Istanbul, Turkey
| | - Giovanni D Tebala
- John Radcliffe Hospital Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Hany Khalil
- John Radcliffe Hospital Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Mridul Rana
- John Radcliffe Hospital Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Mansoor Khan
- Brighton and Sussex University Hospitals, Brighton, UK
| | | | | | - Cosimo Alex Leo
- Northwick Park and St Mark's Hospital - London North West NHS Trust, Harrow, UK
| | - Lampros Liasis
- Northwick Park and St Mark's Hospital - London North West NHS Trust, Harrow, UK
| | - Josef Watfah
- Northwick Park and St Mark's Hospital - London North West NHS Trust, Harrow, UK
| | | | - Edward Delgado
- Hospital de ClínicasClínica Quirúrgica ¨F¨, Montevideo, Uruguay
| | | | - Rifat Latifi
- Department of Surgery, School of Medicine, Westchester Medical Center, New York Medical College, Valhalla, USA
| | - Raul Coimbra
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, Moreno Valley, CA, USA
| | - Sara Edwards
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, Moreno Valley, CA, USA
| | - Ana Lopez
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, Moreno Valley, CA, USA
| | - George Velmahos
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ander Dorken
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Anthony Gebran
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Amanda Palmer
- Division of Trauma, Acute Care Surgery and Surgical Critical Care, Department of Surgery, West Virginia University, Morgantown, USA
| | - Jeffrey Oury
- Division of Trauma, Acute Care Surgery and Surgical Critical Care, Department of Surgery, West Virginia University, Morgantown, USA
| | - James M Bardes
- Division of Trauma, Acute Care Surgery and Surgical Critical Care, Department of Surgery, West Virginia University, Morgantown, USA
| | | | | | | | | | | | | | | | | | | | - Jacob A Quick
- Department of Surgery, University of Missouri, Columbia, USA
| | - Tyler R Austin
- Department of Surgery, University of Missouri, Columbia, USA
| | | | | | | | | | | | | | | | | | - Filippo Banchini
- Department of General Surgery, Ospedale Guglielmo da Saliceto, 29100, Piacenza, Italy
| | - Patrizio Capelli
- Department of General Surgery, Ospedale Guglielmo da Saliceto, 29100, Piacenza, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | | | - Francesca Bravi
- Healthcare Administration, Santa Maria Delle Croci Hospital, AUSL Romagna, Ravenna, Italy
| | | | - Vanni Agnoletti
- Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | - Gian Luca Baiocchi
- General Surgery, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fausto Catena
- Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
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Polat S, Karaburgu S, Unluhizarci K, Dundar M, Ozkul Y, Arslan YK, Karaca Z, Kelestimur F. Unexpectedly high mutation rate of cyp11b1 compared to cyp21a2 in randomly-selected turkish women: a large screening study. J Endocrinol Invest 2023; 46:2367-2377. [PMID: 37055708 DOI: 10.1007/s40618-023-02093-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/06/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders resulting from enzyme deficiencies associated with steroidogenesis. The clinical presentation of non-classic CAH (NCAH) in females is often indistinguishable from other hyperandrogenic disorders like polycystic ovary syndrome (PCOS). The data on the prevalence of NCAH in unselected women in the literature is scanty. The research aimed to evaluate the prevalence of NCAH, carrier frequencies, and the correlation between clinical symptoms and genotype in Turkish women. METHODS The study group comprised two hundred and seventy randomly-selected unrelated asymptomatic women of reproductive age (18-45). Subjects were recruited from female blood donors. All volunteers underwent clinical examination and hormone measurements. The protein-encoding exons and exon-intron boundaries of the CYP21A2, CYP11B1, HSD3β2 and CYP21A2 promoter were sequenced by direct DNA sequencing. RESULTS After genotyping, seven (2.2%) individuals were diagnosed with NCAH. The heterozygous carrier frequencies of CYP21A2, CYP21A2 promoter, CYP11B1, and HSD3β2 genes with 34, 34, 41, and 1 pathologic mutation were determined at 12.6%, 12.6%, 15.2%, and 0.37% of volunteers, respectively. Gene-conversion (GC) frequencies between CYP21A2/CYP21A1P and CYP11B1/CYP11B2 were determined as 10.4% and 14.8%, respectively. CONCLUSION Despite GC-derived higher mutation frequency determined in the CYP11B1 gene, the reason for the low frequency of NCAH due to 11OHD compared to 21OHD might be that gene-conversion arises with active CYP11B2 rather than an inactive pseudogene. HSD3β1 exhibits high homology with HSD3β2 located on the same chromosome; remarkably, it demonstrates low heterozygosity and no GC, most probably the outcome of a tissue-specific expression pattern.
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Affiliation(s)
- S Polat
- Department of Medical Genetics, Medical Faculty, Erzincan Binali Yıldırım University, Basbaglar Mah., 24100, Erzincan, Merkez, Turkey.
| | - S Karaburgu
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - K Unluhizarci
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - M Dundar
- Department of Medical Genetics, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Y Ozkul
- Department of Medical Genetics, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Y K Arslan
- Department of Biostatistics, Medical Faculty, Çukurova University, Adana, Turkey
| | - Z Karaca
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - F Kelestimur
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
- Department of Endocrinology, Medical Faculty, Yeditepe University, Istanbul, Turkey
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Teke K, Avci IE, Cinar NB, Baynal EA, Bosnali E, Polat S, Yilmaz H, Kara O, Dillioglugil O. Immune-inflammatory-nutritional status predicts oncologic outcomes after radical cystectomy for urothelial carcinoma of bladder. Actas Urol Esp 2023; 47:430-440. [PMID: 36731820 DOI: 10.1016/j.acuroe.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To perform the first investigation of the role of immune-inflammatory-nutritional status (INS) on oncological outcomes in patients undergoing open radical cystectomy (ORC) for urothelial carcinoma (UC). MATERIALS AND METHODS The records of consecutive patients who underwent ORC for non-metastatic bladder cancer between 2009 and 2020 were retrospectively analyzed. Neoadjuvant chemotherapy, non-urothelial tumor biology, and absence of oncological follow-up were exclusion criteria. Systemic immune-inflammatory index (SII) and Prognostic Nutritional Index (PNI) values were calculated and optimal cut-off values for these were used to designate four subgroups: "high SII-high PNI", "low SII-high PNI", "low SII-low PNI", and "high SII-low PNI". The Low SII-high PNI INS group had best overall survival (OS) rate while the remainder were included in non-favorable INS group. Survival curves were constructed, and a multivariate Cox regression model was used for OS and recurrence-free survival (RFS). RESULTS After exclusions, the final cohort size was 173 patients. The mean age was 64.31 ± 8.35 and median follow-up was 21 (IQR: 9-58) months. Optimal cut-off values for SII and PNI were 1216 and 47, respectively. The favorable INS group (low SII-high PNI, n = 89) had the best OS rate (62.9%). Multivariate Cox regression analysis indicated that non-favorable INS (n = 84) was a worse independent prognostic factor for OS (HR: 1.509, 95%CI: 1.104-3.145, p = 0.001) and RFS (HR: 1.285; 95%CI: 1.009-1.636, p = 0.042). CONCLUSION Preoperative assessment of INS may be a useful prognostic panel for OS and RFS in patients who had ORC for UC.
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Affiliation(s)
- K Teke
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - I E Avci
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey.
| | - N B Cinar
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - E A Baynal
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - E Bosnali
- Department of Urology, Derince Education and Research Hospital, Kocaeli, Turkey
| | - S Polat
- Department of Urology, Amasya University, Amasya, Turkey
| | - H Yilmaz
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - O Kara
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - O Dillioglugil
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
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Polat S, Danaciolgu YO, Yarimoglu S, Soytas M, Erdogan A, Teke K, Degirmenci T, Tasci AI. External validation of the current scoring systems and derivation of a novel scoring system to predict stone free rates after retrograde intrarenal surgery in patients with cumulative stone diameter of 2-4 cm. Actas Urol Esp 2023; 47:211-220. [PMID: 36333221 DOI: 10.1016/j.acuroe.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/28/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Our primary aim is to perform the external validation of the current scoring systems in predicting stone-free status (SFS) after retrograde intrarenal surgery (RIRS) for renal stones 2-4 cm and develop a novel scoring system by re-examining possible predictive factors related to SFS. METHODS Patients who underwent RIRS due to renal stones with a cumulative stone diameter of 2-4 cm between January 2017 and March 2021 were retrospectively screened. Residual stones ≤2 mm were defined as clinically insignificant, and these cases were considered to have SFS. Possible predictive factors related to SFS were examined using the multivariate logistic regression analysis. A nomogram and a scoring system were developed using independent predictive variables. The prediction ability of the previous and the new scoring system were evaluated with the ROC analysis. RESULTS The existing scoring systems were found to be insufficient in predicting SFS (AUC < 0.660 for all). The independent predictors of SFS were identified as stone surface area (OR: 0.991, p < 0.001), stone density (OR: 0.998, p < 0.001), number of stones (OR: 0.365, p = 0.033), and stone localization (p = 0.037). Using these predictive markers, a new scoring system with a score ranging between 4 and 15 was developed. The AUC value for this scoring system was 0.802 (0.734-0.870). CONCLUSION The RUSS, S-ReSC and R.I.R.S. scoring systems and Ito's nomogram failed to predict SFS in stones >2 cm. The SFS predictive ability of our new scoring system was higher in >2 cm stones compared to the other scoring systems.
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Affiliation(s)
- S Polat
- Amasya University, Faculty of Medicine, Urology Department, Amasya, Turkey.
| | - Y O Danaciolgu
- UHC Istanbul Bakırkoy Sadi Konuk Training and Research Hospital, Urology Department, Estambul, Turkey
| | - S Yarimoglu
- UHC İzmir Bozyaka Training and Research Hospital, Urology Department, Bozyaka, Turkey
| | - M Soytas
- Istanbul Medipol University, Urology Department, Estambul, Turkey
| | - A Erdogan
- UHC Istanbul Umraniye Training and Research Hospital, Urology Department, Estambul, Turkey
| | - K Teke
- Kocaeli University, Faculty of Medicine, Urology Department, Kocaeli, Turkey
| | - T Degirmenci
- UHC İzmir Bozyaka Training and Research Hospital, Urology Department, Bozyaka, Turkey
| | - A I Tasci
- UHC Istanbul Bakırkoy Sadi Konuk Training and Research Hospital, Urology Department, Estambul, Turkey
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Polat S, Karkin K, Gürlen G, Aydamirov M. Can anxiety and depression serve as primary factors associated with erectile dysfunction after coronavirus disease? Eur Rev Med Pharmacol Sci 2023; 27:2314-2319. [PMID: 37013749 DOI: 10.26355/eurrev_202303_31765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE We investigated the association between anxiety and depression and erectile dysfunction (ED) in patients who developed ED after coronavirus disease 2019 (COVID-19). PATIENTS AND METHODS This study included 228 men who were hospitalized in pandemic wards between July 2021 and January 2022 with positive reverse transcription-polymerase chain reaction test results for the severe acute respiratory syndrome coronavirus 2 RNA. All patients responded to a Turkish version of the International Index of Erectile Function (IIEF) questionnaire to determine erectile status. Patients were administered the Turkish version of the Beck Depression Inventory (BDI) and Generalized Anxiety Disorder 7-item scale (GAD-7) questionnaires the day after hospitalization and also during the 1st month after diagnosis of COVID-19 to compare the COVID-19 situation with the previous situation. RESULTS Patients' mean age was 49.66 ± 13.3 years. The mean pre-COVID-19 erectile function score of 28.65 ± 1.33 decreased to a mean post-COVID-19 score of 26.58 ± 4.23, which indicates a statistically significant difference (p=0.03). Post-COVID-19 ED occurred in 46 (20.1%) patients; 10 (4.3%) patients had mild, 23 (10.0%) had mild-to-moderate, 5 (2.1%) had moderate, and 8 (3.5%) patients had severe ED. The mean pre-COVID-19 BDI score (which indicates depression) of 1.79 ± 2.45 increased to a mean post-COVID-19 score of 2.42 ± 2.89 (p<0.01). Additionally, the mean pre-COVID-19 GAD-7 score of 4.79 ± 1.83 increased to a mean post-COVID-19 score of 6.79 ± 2.52, which indicates a statistically significant difference (p<0.01). We observed a negative correlation between the increase in BDI and GAD-7 scores and the decrease in IIEF scores (r=0.426, p<.001, r=0.568, p<.001, respectively). CONCLUSIONS Our study highlights that COVID-19 can cause ED and that disease-induced anxiety and depression serve as primary contributors to ED.
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Affiliation(s)
- S Polat
- Health Sciences University, Adana City Training and Research Hospital Psychiatry Clinic Adana, Turkey.
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Teke K, Erkut Avci I, Burak Cinar N, Abdullah Baynal E, Bosnali E, Polat S, Yilmaz H, Kara O, Dillioglugil O. El estado inmunológico-inflamatorio-nutricional predice los resultados oncológicos tras la cistectomía radical por carcinoma urotelial de vejiga. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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De Simone B, Abu-Zidan FM, Chouillard E, Di Saverio S, Sartelli M, Podda M, Gomes CA, Moore EE, Moug SJ, Ansaloni L, Kluger Y, Coccolini F, Landaluce-Olavarria A, Estraviz-Mateos B, Uriguen-Etxeberria A, Giordano A, Luna AP, Amín LAH, Hernández AMP, Shabana A, Dzulkarnaen ZA, Othman MA, Sani MI, Balla A, Scaramuzzo R, Lepiane P, Bottari A, Staderini F, Cianchi F, Cavallaro A, Zanghì A, Cappellani A, Campagnacci R, Maurizi A, Martinotti M, Ruggieri A, Jusoh AC, Rahman KA, Zulkifli ASM, Petronio B, Matías-García B, Quiroga-Valcárcel A, Mendoza-Moreno F, Atanasov B, Campanile FC, Vecchioni I, Cardinali L, Travaglini G, Sebastiani E, Chooklin S, Chuklin S, Cianci P, Restini E, Capuzzolo S, Currò G, Filippo R, Rispoli M, Aparicio-Sánchez D, Muñóz-Cruzado VD, Barbeito SD, Delibegovic S, Kesetovic A, Sasia D, Borghi F, Giraudo G, Visconti D, Doria E, Santarelli M, Luppi D, Bonilauri S, Grossi U, Zanus G, Sartori A, Piatto G, De Luca M, Vita D, Conti L, Capelli P, Cattaneo GM, Marinis A, Vederaki SA, Bayrak M, Altıntas Y, Uzunoglu MY, Demirbas IE, Altinel Y, Meric S, Aktimur YE, Uymaz DS, Omarov N, Azamat I, Lostoridis E, Nagorni EA, Pujante A, Anania G, Bombardini C, Bagolini F, Gonullu E, Mantoglu B, Capoglu R, Cappato S, Muzio E, Colak E, Polat S, Koylu ZA, Altintoprak F, Bayhan Z, Akin E, Andolfi E, Rezart S, Kim JI, Jung SW, Shin YC, Enciu O, Toma EA, Medas F, Canu GL, Cappellacci F, D’Acapito F, Ercolani G, Solaini L, Roscio F, Clerici F, Gelmini R, Serra F, Rossi EG, Fleres F, Clarizia G, Spolini A, Ferrara F, Nita G, Sarnari J, Gachabayov M, Abdullaev A, Poillucci G, Palini GM, Veneroni S, Garulli G, Piccoli M, Pattacini GC, Pecchini F, Argenio G, Armellino MF, Brisinda G, Tedesco S, Fransvea P, Ietto G, Franchi C, Carcano G, Martines G, Trigiante G, Negro G, Vega GM, González AR, Ojeda L, Piccolo G, Bondurri A, Maffioli A, Guerci C, Sin BH, Zuhdi Z, Azman A, Mousa H, al Bahri S, Augustin G, Romic I, Moric T, Nikolopoulos I, Andreuccetti J, Pignata G, D’Alessio R, Kenig J, Skorus U, Fraga GP, Hirano ES, de Lima Bertuol JV, Isik A, Kurnaz E, Asghar MS, Afzal A, Akbar A, Nikolouzakis TK, Lasithiotakis K, Chrysos E, Das K, Özer N, Seker A, Ibrahim M, Hamid HKS, Babiker A, Bouliaris K, Koukoulis G, Kolla CC, Lucchi A, Agostinelli L, Taddei A, Fortuna L, Agostini C, Licari L, Viola S, Callari C, Laface L, Abate E, Casati M, Anastasi A, Canonico G, Gabellini L, Tosi L, Guariniello A, Zanzi F, Bains L, Sydorchuk L, Iftoda O, Sydorchuk A, Malerba M, Costanzo F, Galleano R, Monteleone M, Costanzi A, Riva C, Walędziak M, Kwiatkowski A, Czyżykowski Ł, Major P, Strzałka M, Matyja M, Natkaniec M, Valenti MR, Di Vita MDP, Sotiropoulou M, Kapiris S, Massalou D, Veroux M, Volpicelli A, Gioco R, Uccelli M, Bonaldi M, Olmi S, Nardi M, Livadoti G, Mesina C, Dumitrescu TV, Ciorbagiu MC, Ammendola M, Ammerata G, Romano R, Slavchev M, Misiakos EP, Pikoulis E, Papaconstantinou D, Elbahnasawy M, Abdel-elsalam S, Felsenreich DM, Jedamzik J, Michalopoulos NV, Sidiropoulos TA, Papadoliopoulou M, Cillara N, Deserra A, Cannavera A, Negoi I, Schizas D, Syllaios A, Vagios I, Gourgiotis S, Dai N, Gurung R, Norrey M, Pesce A, Feo CV, Fabbri N, Machairas N, Dorovinis P, Keramida MD, Mulita F, Verras GI, Vailas M, Yalkin O, Iflazoglu N, Yigit D, Baraket O, Ayed K, Ghalloussi MH, Patias P, Ntokos G, Rahim R, Bala M, Kedar A, Sawyer RG, Trinh A, Miller K, Sydorchuk R, Knut R, Plehutsa O, Liman RK, Ozkan Z, Kader SA, Gupta S, Gureh M, Saeidi S, Aliakbarian M, Dalili A, Shoko T, Kojima M, Nakamoto R, Atici SD, Tuncer GK, Kaya T, Delis SG, Rossi S, Picardi B, del Monte SR, Triantafyllou T, Theodorou D, Pintar T, Salobir J, Manatakis DK, Tasis N, Acheimastos V, Ioannidis O, Loutzidou L, Symeonidis S, de Sá TC, Rocha M, Guagni T, Pantalone D, Maltinti G, Khokha V, Abdel-elsalam W, Ghoneim B, López-Ruiz JA, Kara Y, Zainudin S, Hayati F, Azizan N, Khei VTP, Yi RCX, Sellappan H, Demetrashvili Z, Lekiashvili N, Tvaladze A, Froiio C, Bernardi D, Bonavina L, Gil-Olarte A, Grassia S, Romero-Vargas E, Bianco F, Gumbs AA, Dogjani A, Agresta F, Litvin A, Balogh ZJ, Gendrikson G, Martino C, Damaskos D, Pararas N, Kirkpatrick A, Kurtenkov M, Gomes FC, Pisanu A, Nardello O, Gambarini F, Aref H, Angelis ND, Agnoletti V, Biondi A, Vacante M, Griggio G, Tutino R, Massani M, Bisetto G, Occhionorelli S, Andreotti D, Lacavalla D, Biffl WL, Catena F. The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis? World J Emerg Surg 2022; 17:61. [PMID: 36527038 PMCID: PMC9755784 DOI: 10.1186/s13017-022-00466-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. METHODS Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. RESULTS A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. CONCLUSIONS The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands.
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Affiliation(s)
- Belinda De Simone
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Fikri M. Abu-Zidan
- grid.43519.3a0000 0001 2193 6666The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates., United Arab Emirates University, Al-Ain, UAE
| | - Elie Chouillard
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Salomone Di Saverio
- Department of General Surgery, Santa Maria del Soccorso Hospital, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Massimo Sartelli
- Department of General Surgery, Macerata Hospital, Macerata, Italy
| | - Mauro Podda
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Carlos Augusto Gomes
- Faculdade de Ciência Médicas e da Saúde de Juiz de Fora, Hospital Universitario Terezinha de Jesus (SUPREMA), Juiz de Fora, Brazil
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XErnest E. Moore Shock Trauma Center at Denver Health, Denver, CO USA
| | - Susan J. Moug
- grid.8756.c0000 0001 2193 314XDepartment of Surgery, Royal Alexandra Hospital, Paisley and Golden Jubilee National Hospital, University of Glasgow, Glasgow, Scotland
| | - Luca Ansaloni
- grid.18887.3e0000000417581884Department of General Surgery, University Hospital of Pavia, Pavia, Italy
| | - Yoram Kluger
- Department of General Surgery, The Rambam Academic Hospital, Haifa, Israel
| | - Federico Coccolini
- grid.144189.10000 0004 1756 8209Department of General and Emergency Surgery, University Hospital of Pisa, Pisa, Italy
| | | | | | | | - Alessio Giordano
- General Surgery Unit ASL Toscana Centro, Santo Stefano Hospital, Prato, Italy
| | | | | | | | - Amanda Shabana
- grid.8348.70000 0001 2306 7492Emergency Surgery Department, John Radcliffe Hospital, Oxford, UK
| | - Zakaria Andee Dzulkarnaen
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Muhammad Asyraf Othman
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Mohamad Ikhwan Sani
- grid.11875.3a0000 0001 2294 3534Department of Surgery, School of Medical Sciences and Hospital USM, Universiti Sains Malaysia, Kubang Kerian, Kelantan Malaysia
| | - Andrea Balla
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Rosa Scaramuzzo
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Pasquale Lepiane
- UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, 00053 Civitavecchia, Rome, Italy
| | - Andrea Bottari
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Fabio Staderini
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Fabio Cianchi
- grid.24704.350000 0004 1759 9494SOD Chirurgia dell’Apparato Digerente, AOU Careggi, Florence, Italy
| | - Andrea Cavallaro
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | - Antonio Zanghì
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | - Alessandro Cappellani
- grid.8158.40000 0004 1757 1969Department of Surgery, University of Catania, Policlinico “G. Rodolico - San Marco” Hospital, Catania, Italy
| | | | - Angela Maurizi
- U.O.C. of General Surgery, “Carlo Urbani” Hospital, Jesi, AN Italy
| | | | | | - Asri Che Jusoh
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Karim Abdul Rahman
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Anis Suraya M. Zulkifli
- Department of General Surgery, Hospital Sultan Ismail Petra, 18000 Kuala Krai, Kelantan Malaysia
| | - Barbara Petronio
- Chirurgia Generale e Mininvasiva, San Polo Monfalcone, Monfalcone, GO Italy
| | - Belén Matías-García
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Ana Quiroga-Valcárcel
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Fernando Mendoza-Moreno
- grid.411336.20000 0004 1765 5855Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Boyko Atanasov
- grid.35371.330000 0001 0726 0380RIMU, Medical University of Plovdiv, UMHAT Eurohospital, Plovdiv, Bulgaria
| | | | - Ilaria Vecchioni
- Ospedale San Giovanni Decollato Andosilla – ASL, Civita Castellana, Viterbo, VT Italy
| | - Luca Cardinali
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | - Grazia Travaglini
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | - Elisa Sebastiani
- UOC Chirurgia Generale, Ospedale “Madonna del Soccorso”, San Benedetto del Tronto, AP Italy
| | | | | | - Pasquale Cianci
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Enrico Restini
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Sabino Capuzzolo
- grid.416083.80000 0004 1768 5712Lorenzo Bonomo Hospital, ASL BAT, Andria, Puglia Italy
| | - Giuseppe Currò
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Rosalinda Filippo
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Michele Rispoli
- grid.411489.10000 0001 2168 2547Generall Surgery Unit, Science of Health Department, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Daniel Aparicio-Sánchez
- grid.411109.c0000 0000 9542 1158Emergency Surgery Unit, Hospital Virgen del Rocío, Seville, Spain
| | | | - Sandra Dios Barbeito
- grid.411109.c0000 0000 9542 1158Emergency Surgery Unit, Hospital Virgen del Rocío, Seville, Spain
| | - Samir Delibegovic
- grid.412410.20000 0001 0682 9061Clinic for Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Amar Kesetovic
- grid.412410.20000 0001 0682 9061Clinic for Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Diego Sasia
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Felice Borghi
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Giorgio Giraudo
- grid.413179.90000 0004 0486 1959Santa Croce and Carle Hospital, Cuneo, Italy
| | - Diego Visconti
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Emanuele Doria
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Mauro Santarelli
- Chirurgia Generale d’Urgenza e PS - AOU Cittá della Salute e della Scienza, Turin, Italy
| | - Davide Luppi
- General and Emergency Surgery, ASMN IRCCS REGGIO EMILIA, Reggio Emilia, Italy
| | - Stefano Bonilauri
- General and Emergency Surgery, ASMN IRCCS REGGIO EMILIA, Reggio Emilia, Italy
| | - Ugo Grossi
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Giacomo Zanus
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Alberto Sartori
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Giacomo Piatto
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Maurizio De Luca
- U.O. Chirurgia Generale e d’Urgenza Ospedale San Valentino, Montebelluna, Treviso, Italy
| | - Domenico Vita
- grid.5608.b0000 0004 1757 3470Surgery Unit 2, Regional Hospital Treviso, DISCOG, University of Padua, Treviso, Italy
| | - Luigi Conti
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Patrizio Capelli
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Gaetano Maria Cattaneo
- grid.476050.0Department of Surgery, G. Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | - Athanasios Marinis
- grid.414012.20000 0004 0622 6596Styliani-Aikaterini Vederaki, Third Department of Surgery, “Tzaneio” General Hospital, Piraeus, Greece
| | - Styliani-Aikaterini Vederaki
- grid.414012.20000 0004 0622 6596Styliani-Aikaterini Vederaki, Third Department of Surgery, “Tzaneio” General Hospital, Piraeus, Greece
| | - Mehmet Bayrak
- Mehmet Bayrak, Clinic for Surgery, Private Ortadogu Hospital, Adana, Turkey
| | | | | | | | - Yuksel Altinel
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Serhat Meric
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Yunus Emre Aktimur
- grid.488643.50000 0004 5894 3909Department of General Surgery, Bagcilar Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Derya Salim Uymaz
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Nail Omarov
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Ibrahim Azamat
- grid.15876.3d0000000106887552General Surgery Department, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Eftychios Lostoridis
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Eleni-Aikaterini Nagorni
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Antonio Pujante
- grid.513828.50000 0004 0623 027X1St Department of Surgery, Kavala General Hospital, Kavala, Greece
| | - Gabriele Anania
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Cristina Bombardini
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Francesco Bagolini
- grid.416315.4UO Chirurgia 1, Dipartimento Chirurgico, Arcispedale Sant’Anna, Azienda Ospedaliero-Universitaria’di Ferrara, Ferrara, Italy
| | - Emre Gonullu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Baris Mantoglu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Recayi Capoglu
- grid.459902.30000 0004 0386 5536Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Stefano Cappato
- Department of General Surgery ASL 4, Lavagna Hospital, Genoa, Italy
| | - Elena Muzio
- Department of General Surgery ASL 4, Lavagna Hospital, Genoa, Italy
| | - Elif Colak
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Suleyman Polat
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Zehra Alan Koylu
- grid.510471.60000 0004 7684 9991Samsun Training and Research Hospital, University of Samsun, Samsun, Turkey
| | - Fatih Altintoprak
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Zülfü Bayhan
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Emrah Akin
- grid.49746.380000 0001 0682 3030Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan, Turkey
| | - Enrico Andolfi
- grid.416351.40000 0004 1789 6237General and Emergency Surgery Unit, San Donato Hospital, Arezzo, Italy
| | - Sulce Rezart
- grid.416351.40000 0004 1789 6237General and Emergency Surgery Unit, San Donato Hospital, Arezzo, Italy
| | - Jae Il Kim
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Sung Won Jung
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Yong Chan Shin
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Octavian Enciu
- grid.8194.40000 0000 9828 7548Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Elena Adelina Toma
- grid.8194.40000 0000 9828 7548Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Fabio Medas
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Gian Luigi Canu
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Federico Cappellacci
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Fabrizio D’Acapito
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | - Giorgio Ercolani
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | - Leonardo Solaini
- grid.415079.e0000 0004 1759 989XGeneral and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini 34, 47121 Forlì, Italy
| | | | | | - Roberta Gelmini
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Francesco Serra
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Elena Giulia Rossi
- grid.7548.e0000000121697570Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia School of Medicine AOU Policlinico Di Modena, Modena, Italy
| | - Francesco Fleres
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Guglielmo Clarizia
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Alessandro Spolini
- UOC General Surgery, Hospital Civil of Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Francesco Ferrara
- grid.414126.40000 0004 1760 1507Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Gabriela Nita
- grid.458453.b0000 0004 1756 7652AUSL Reggio Emilia, Ospedale Sant’Anna, Castelnuovo ne Monti, Reggio Emilia, Italy
| | - Jlenia Sarnari
- grid.458453.b0000 0004 1756 7652AUSL Reggio Emilia, Ospedale Sant’Anna, Castelnuovo ne Monti, Reggio Emilia, Italy
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | - Abakar Abdullaev
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | | | - Gian Marco Palini
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Simone Veneroni
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Gianluca Garulli
- grid.414614.2Chirurgia generale e d’urgenza, Ospedale Infermi di Rimini, AUSL Romagna, Rimini, Italy
| | - Micaela Piccoli
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Gianmaria Casoni Pattacini
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Francesca Pecchini
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Giulio Argenio
- UOC Chirurgia d’Urgenza, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | - Giuseppe Brisinda
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Silvia Tedesco
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Pietro Fransvea
- grid.414603.4Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Giuseppe Ietto
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Caterina Franchi
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Giulio Carcano
- grid.18147.3b0000000121724807General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, Varese, Italy
| | - Gennaro Martines
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Giuseppe Trigiante
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Giulia Negro
- General Surgery Unit, Azienda Ospedaliero Universitaria Policlinico Bari - Italy, Bari, Italy
| | - Gustavo Machain Vega
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Agustín Rodríguez González
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Leonardo Ojeda
- grid.412213.70000 0001 2289 5077Department of Surgery, Hospital de Clinicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Gaetano Piccolo
- grid.4708.b0000 0004 1757 2822Unit of HepatoBilioPancreatic and Digestive Surgery, Department of Health Sciences, San Paolo Hospital, University of Milan, Via Di Rudinì 8, 20142 Milan, Italy
| | - Andrea Bondurri
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Anna Maffioli
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Claudio Guerci
- grid.4708.b0000 0004 1757 2822Department of General Surgery, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Boo Han Sin
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Zamri Zuhdi
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Azlanudin Azman
- HPB Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Hussam Mousa
- grid.43519.3a0000 0001 2193 6666College of Medicine, Tawam Hospital, UAE University, Al-Ain, UAE
| | - Shadi al Bahri
- grid.43519.3a0000 0001 2193 6666College of Medicine, Tawam Hospital, UAE University, Al-Ain, UAE
| | - Goran Augustin
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | - Ivan Romic
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | - Trpimir Moric
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre, Zagreb, Croatia
| | | | - Jacopo Andreuccetti
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giusto Pignata
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Rossella D’Alessio
- grid.412725.72nd Department of General Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Jakub Kenig
- grid.5522.00000 0001 2162 9631Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland
| | - Urszula Skorus
- grid.5522.00000 0001 2162 9631Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland
| | - Gustavo Pereira Fraga
- grid.411087.b0000 0001 0723 2494Division of Trauma Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil
| | - Elcio Shiyoiti Hirano
- grid.411087.b0000 0001 0723 2494Division of Trauma Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil
| | | | - Arda Isik
- grid.412176.70000 0001 1498 7262School of Medicine, Erzincan University, Erzincan, Turkey
| | - Eray Kurnaz
- grid.412176.70000 0001 1498 7262School of Medicine, Erzincan University, Erzincan, Turkey
| | | | - Ameer Afzal
- grid.412129.d0000 0004 0608 7688King Edward Medical University, Lahore, Pakistan
| | - Ali Akbar
- grid.412129.d0000 0004 0608 7688King Edward Medical University, Lahore, Pakistan
| | | | - Konstantinos Lasithiotakis
- grid.412481.a0000 0004 0576 5678Department of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Crete, Greece
| | - Emmanuel Chrysos
- grid.412481.a0000 0004 0576 5678Department of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Crete, Greece
| | - Koray Das
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Nazmi Özer
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Ahmet Seker
- Department of General Surgery, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | | | | | | | - Konstantinos Bouliaris
- Surgical Department, Koutlimbaneio and Triantafylleio General Hospital of Larissa, Larisa, Greece
| | - George Koukoulis
- Surgical Department, Koutlimbaneio and Triantafylleio General Hospital of Larissa, Larisa, Greece
| | | | - Andrea Lucchi
- U.O. Chirurgia Generale Ospedale “Ceccarini” Riccione, Riccione, Italy
| | - Laura Agostinelli
- U.O. Chirurgia Generale Ospedale “Ceccarini” Riccione, Riccione, Italy
| | - Antonio Taddei
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Laura Fortuna
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Carlotta Agostini
- grid.24704.350000 0004 1759 9494Hepatobiliary Surgery, Department of Clinical and Experimental Medicine, University of Florence, AOU Careggi, Florence, Italy
| | - Leo Licari
- grid.10776.370000 0004 1762 5517Department of Surgical, Oncological and Oral Sciences (DICHIRONS), Policlinico P. Giaccone, University of Palermo, Via Liborio Giuffré 5, 90127 Palermo, Italy
| | - Simona Viola
- grid.10776.370000 0004 1762 5517University of Palermo, Palermo, Italy
| | - Cosimo Callari
- Department of Surgery, Buccheri La Ferla Hospital, Via Messina Marine, 197, 90123 Palermo, Italy
| | - Letizia Laface
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | - Emmanuele Abate
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | - Massimiliano Casati
- Department of General Surgery, Vittorio Emanuele III Hospital, Carate Brianza - ASST Brianza, Carate Brianza, Italy
| | | | | | - Linda Gabellini
- Chirurgia Generale, Ospedale San Giovanni Di Dio, Florence, Italy
| | - Lorenzo Tosi
- grid.6292.f0000 0004 1757 1758Residency Program in General Surgery, University of Bologna, Bologna, Italy
| | - Anna Guariniello
- grid.415207.50000 0004 1760 3756Section of Emergency Surgery, Department of Surgery, S.Maria delle Croci Hospital Ravenna, Ravenna, Italy
| | - Federico Zanzi
- grid.415207.50000 0004 1760 3756Section of Emergency Surgery, Department of Surgery, S.Maria delle Croci Hospital Ravenna, Ravenna, Italy
| | - Lovenish Bains
- grid.414698.60000 0004 1767 743XDepartment of Surgery, Maulana Azad Medical College and Nayak Hospital, New Delhi, 110002 India
| | - Larysa Sydorchuk
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Oksana Iftoda
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Andrii Sydorchuk
- grid.445372.30000 0004 4906 2392Bukovinian State Medical University, Chernivtsi, Ukraine
| | | | | | | | - Michela Monteleone
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Andrea Costanzi
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Carlo Riva
- Andrea Costanzi, Carlo Riva, O.U. of General Surgery, San Leopoldo Mandic Hospital, Merate, ASST, Lecco, Italy
| | - Maciej Walędziak
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Andrzej Kwiatkowski
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Łukasz Czyżykowski
- grid.415641.30000 0004 0620 0839Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Piotr Major
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Strzałka
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej Matyja
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Michal Natkaniec
- grid.5522.00000 0001 2162 9631Department of General and Emergency Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Maria Rosaria Valenti
- U.O. General Surgery, Azienda Ospedaliera Universitaria “Policlinico - San Marco”, Catania, Italy
| | | | - Maria Sotiropoulou
- grid.414655.70000 0004 4670 43293Rd Surgical Department, Evangelismos General Hospital, Athens, Greece
| | - Stylianos Kapiris
- grid.414655.70000 0004 4670 43293Rd Surgical Department, Evangelismos General Hospital, Athens, Greece
| | - Damien Massalou
- grid.410528.a0000 0001 2322 4179Department of Emergency Surgery, Centre Hospitalier Universitaire de Nice (CHU de Nice), Université Côte d’Azur, Nice, France
| | | | | | - Rossella Gioco
- General Surgery, Azienda Policlinico San Marco, Catania, Italy
| | - Matteo Uccelli
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Marta Bonaldi
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Stefano Olmi
- General and Oncological Surgery Department, San Marco Hospital GSD, Zingonia, BG Italy
| | - Matteo Nardi
- San Giovanni Calibita Hospital- Fondazione Fatebenefratelli, Rome, Italy
| | - Giada Livadoti
- San Giovanni Calibita Hospital- Fondazione Fatebenefratelli, Rome, Italy
| | - Cristian Mesina
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Theodor Viorel Dumitrescu
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Mihai Calin Ciorbagiu
- grid.452359.c0000 0004 4690 999XDepartment of Surgery, Emergency County Hospital of Craiova, Craiova, Romania
| | - Michele Ammendola
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Giorgio Ammerata
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Roberto Romano
- grid.411489.10000 0001 2168 2547Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University “Magna Graecia” Medical School, Viale Europa, 88100 Germaneto, Catanzaro Italy
| | - Mihail Slavchev
- Department of General Surgery, University Hospital Eurohospital, Plovdiv, Bulgaria
| | - Evangelos P. Misiakos
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Pikoulis
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Papaconstantinou
- grid.5216.00000 0001 2155 08003Rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mohamed Elbahnasawy
- grid.412258.80000 0000 9477 7793Emergency Medicine and Traumatology Department, Tanta University Faculty of Medicine, Tanta, Egypt
| | - Sherief Abdel-elsalam
- grid.412258.80000 0000 9477 7793Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Daniel M. Felsenreich
- grid.22937.3d0000 0000 9259 8492Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Julia Jedamzik
- grid.22937.3d0000 0000 9259 8492Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Nikolaos V. Michalopoulos
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros A. Sidiropoulos
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Papadoliopoulou
- grid.5216.00000 0001 2155 08004Rd Department of Surgery Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nicola Cillara
- grid.459832.1Surgery Department, Santissima Trinità Hospital, Cagliari, Italy
| | - Antonello Deserra
- grid.459832.1Surgery Department, Santissima Trinità Hospital, Cagliari, Italy
| | | | - Ionuţ Negoi
- grid.8194.40000 0000 9828 7548General Surgery Department, Carol Davila University of Medicine and Pharmacy, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Dimitrios Schizas
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Athanasios Syllaios
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Ilias Vagios
- grid.411565.20000 0004 0621 2848First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Stavros Gourgiotis
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Nick Dai
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Rekha Gurung
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Marcus Norrey
- grid.5335.00000000121885934Addenbrooke’s Hospital, Cambridge University, Cambridge, UK
| | - Antonio Pesce
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Carlo Vittorio Feo
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Nicolo’ Fabbri
- grid.8484.00000 0004 1757 2064Department of Surgery, Delta Hospital, Azienda USL of Ferrara, University of Ferrara, Ferrara, Italy
| | - Nikolaos Machairas
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Panagiotis Dorovinis
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Myrto D. Keramida
- grid.5216.00000 0001 2155 08002Nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, General Hospital Laiko, Athens, Greece
| | - Francesk Mulita
- grid.412458.eDepartment of Surgery, General University Hospital of Patras, Patras, Greece
| | | | - Michail Vailas
- grid.412458.eDepartment of Surgery, General University Hospital of Patras, Patras, Greece
| | - Omer Yalkin
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Nidal Iflazoglu
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Direnc Yigit
- Department of Surgical Oncology and Gastroenterological Surgery, Bursa City Hospital, Bursa, Turkey
| | - Oussama Baraket
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Karim Ayed
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Mohamed hedi Ghalloussi
- grid.265234.40000 0001 2177 9066Department of General Surgery, Habib Bougatfa Hospital, University Tunis El Manar, Bizerte, Tunisia
| | - Parmenion Patias
- grid.414012.20000 0004 0622 65962nd Department of Surgery, General Hospital of Athens “G.Gennimatas”, Athens, Greece
| | - Georgios Ntokos
- grid.414012.20000 0004 0622 65962nd Department of Surgery, General Hospital of Athens “G.Gennimatas”, Athens, Greece
| | - Razrim Rahim
- grid.462995.50000 0001 2218 9236Department of Surgery, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Miklosh Bala
- grid.9619.70000 0004 1937 0538Department of General Surgery and Trauma, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Asaf Kedar
- grid.9619.70000 0004 1937 0538Department of General Surgery and Trauma, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Robert G. Sawyer
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | - Anna Trinh
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | - Kelsey Miller
- grid.268187.20000 0001 0672 1122Western Michigan University School of Medicine, Kalamazoo, USA
| | | | - Ruslan Knut
- Regional Emergency Hospital, Chernivtsi, Ukraine
| | | | | | - Zeynep Ozkan
- General Surgery Clinic, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | - Saleh Abdel Kader
- Egypt and NMC Specialty Hospital Al Ain, Ain Shams University, Al-Ain, UAE
| | - Sanjay Gupta
- grid.413220.60000 0004 1767 2831Government Medical College and Hospital, Chandigarh, India
| | - Monika Gureh
- grid.413220.60000 0004 1767 2831Government Medical College and Hospital, Chandigarh, India
| | - Sara Saeidi
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Aliakbarian
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Dalili
- grid.411583.a0000 0001 2198 6209Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tomohisa Shoko
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Mitsuaki Kojima
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Raira Nakamoto
- grid.410818.40000 0001 0720 6587Department of Emergency and Critical Care Medicine, Department of Acute Care Surgery Center, Adachi Medical Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Semra Demirli Atici
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gizem Kilinc Tuncer
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Tayfun Kaya
- grid.414882.30000 0004 0643 0132Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | | | - Stefano Rossi
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Biagio Picardi
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Simone Rossi del Monte
- grid.416357.2Department of General and Emergency Surgery, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Tania Triantafyllou
- grid.5216.00000 0001 2155 0800Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | - Dimitrios Theodorou
- grid.5216.00000 0001 2155 0800Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece
| | - Tadeja Pintar
- grid.29524.380000 0004 0571 7705Department of Abdominal Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Jure Salobir
- grid.29524.380000 0004 0571 7705Department of Abdominal Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Dimitrios K. Manatakis
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Nikolaos Tasis
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Vasileios Acheimastos
- grid.414025.60000 0004 0638 8093Vasileios Acheimastos, Athens Naval and Veterans Hospital, Athens, Greece
| | - Orestis Ioannidis
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Lydia Loutzidou
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Savvas Symeonidis
- grid.414012.20000 0004 0622 65964Th Department of Surgery, Medical School Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece
| | - Tiago Correia de Sá
- grid.466592.aGeneral Surgery Department, Centro Hospitalar Do Tâmega e Sousa Penafiel, Penafiel, Portugal
| | - Mónica Rocha
- grid.466592.aGeneral Surgery Department, Centro Hospitalar Do Tâmega e Sousa Penafiel, Penafiel, Portugal
| | - Tommaso Guagni
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | - Desiré Pantalone
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | - Gherardo Maltinti
- grid.24704.350000 0004 1759 9494Department of general surgery, Careggi University Hospital, Florence, Italy
| | | | - Wafaa Abdel-elsalam
- grid.411978.20000 0004 0578 3577Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Basma Ghoneim
- grid.411978.20000 0004 0578 3577Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - José Antonio López-Ruiz
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Yasin Kara
- grid.414850.c0000 0004 0642 8921General Surgery Clinic Health Sciences University Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Syaza Zainudin
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Firdaus Hayati
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Nornazirah Azizan
- grid.265727.30000 0001 0417 0814Faculty of Medicine and Health Sciences, Queen Elisabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Victoria Tan Phooi Khei
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Rebecca Choy Xin Yi
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Harivinthan Sellappan
- grid.265727.30000 0001 0417 0814Department of Surgery, Queen Elizabeth Hospital, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | | | | | - Ana Tvaladze
- N.Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Caterina Froiio
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Daniele Bernardi
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Luigi Bonavina
- grid.4708.b0000 0004 1757 2822IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Angeles Gil-Olarte
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Sebastiano Grassia
- General Surgery Unit, S. Leonardo Hospital, Castellammare Di Stabia, Naples, Italy
| | - Estela Romero-Vargas
- grid.411375.50000 0004 1768 164XAngeles Gil-Olarte, Estela Romero-Vargas, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Francesco Bianco
- General Surgery Unit, S. Leonardo Hospital, Castellammare Di Stabia, Naples, Italy
| | - Andrew A. Gumbs
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Agron Dogjani
- Department of General Surgery, University Hospital of Tirana, Tirana, Albania
| | - Ferdinando Agresta
- Department of General Surgery, AULSS2 Trevigiana del Veneto, Ospedale di Vittorio Veneto, Vittorio Veneto, TV Italy
| | - Andrey Litvin
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Zsolt J. Balogh
- grid.414724.00000 0004 0577 6676Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW Australia
| | - George Gendrikson
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Costanza Martino
- Anesthesia and Intensive Care Unit, Umberto I Hospital, AUSL Romagna, Lugo, Italy
| | - Dimitrios Damaskos
- grid.4305.20000 0004 1936 7988Department of General and Emergency Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK
| | - Nikolaos Pararas
- grid.411335.10000 0004 1758 7207Department of General Surgery, Dr. Sulaiman Al Habib Hospital, Alfaisal University, Riyadh, Saudi Arabia
| | - Andrew Kirkpatrick
- grid.414959.40000 0004 0469 2139General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Mikhail Kurtenkov
- grid.410686.d0000 0001 1018 9204Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kalingrad, Russia
| | - Felipe Couto Gomes
- Faculdade de Ciência Médicas e da Saúde de Juiz de Fora, Hospital Universitario Terezinha de Jesus (SUPREMA), Juiz de Fora, Brazil
| | - Adolfo Pisanu
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Oreste Nardello
- grid.7763.50000 0004 1755 3242Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | | | - Hager Aref
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals, Poissy, France
| | - Nicola de’ Angelis
- grid.412116.10000 0004 1799 3934Unit of Digestive and HPB Surgery, CARE Department, Henri Mondor Hospital and University Paris-Est, Creteil, France
| | - Vanni Agnoletti
- grid.414682.d0000 0004 1758 8744Department of General and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | - Antonio Biondi
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Vacante
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Giulia Griggio
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Roberta Tutino
- grid.10776.370000 0004 1762 5517Chirurgia 1; Dipartimento di Discipline Chirurgiche , Oncologiche e Stomatologiche (DI.CHIR.ON.S), Ospedale “Ca’Foncell”; Univerità degli studi di Palermo, Treviso; Palermo, Italy
| | - Marco Massani
- grid.10776.370000 0004 1762 5517Chirurgia 1; Dipartimento di Discipline Chirurgiche , Oncologiche e Stomatologiche (DI.CHIR.ON.S), Ospedale “Ca’Foncell”; Univerità degli studi di Palermo, Treviso; Palermo, Italy
| | - Giovanni Bisetto
- grid.5608.b0000 0004 1757 3470Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologica (DI.SC.O.G.), Chirurgia 1-Ospedale “Ca Foncello”- Treviso, Università degli Studi di Padova, Padua, Italy
| | - Savino Occhionorelli
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Dario Andreotti
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Domenico Lacavalla
- grid.8484.00000 0004 1757 2064Department of General Surgery, Arcispedale Sant’Anna-University of Ferrara, Ferrara, Italy
| | - Walter L. Biffl
- grid.415401.5Department of Emergency and Trauma Surgery, Scripps Clinic Medical Group, La Jolla, CA USA
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744Department of General and Trauma Surgery, Bufalini Hospital, Cesena, Italy
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8
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Guclu G, Polat S, Kelebek H, Capanoglu E, Selli S. Elucidation of the impact of four different drying methods on the phenolics, volatiles, and color properties of the peels of four types of citrus fruits. J Sci Food Agric 2022; 102:6036-6046. [PMID: 35462413 DOI: 10.1002/jsfa.11956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/05/2022] [Accepted: 04/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Citrus fruit peels are considered to be process waste in the fruit juice industry but they are a valuable raw material due to their volatile and bioactive components. Drying is one of the most common methods to preserve this material. In this study, four drying processes were applied to the peels of four kinds of citrus fruits. The drying processes were convective drying (CD), microwave drying (MD), conductive hydro drying (CHD), and freeze drying (FD). The citrus fruits used were orange, bitter orange, grapefruit, and lemon. RESULTS The influence of dehydration on the aroma and phenolic composition, microstructure, and color properties were studied in detail. It was determined that drying increased the amount of both phenolics and volatiles in the dried samples. The MD and FD methods better preserved the color and phenolics of the samples, and the MD and CD processes increased the amount of aroma substances. CONCLUSION The MD method would be more suitable for drying citrus peels due to its shorter duration and its positive effects on the phenolic and aroma components. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Gamze Guclu
- Department of Food Engineering, Faculty of Agriculture, Cukurova University, Adana, Turkey
| | - Suleyman Polat
- Department of Food Engineering, Faculty of Agriculture, Cukurova University, Adana, Turkey
| | - Hasim Kelebek
- Department of Food Engineering, Faculty of Engineering, Adana Alparslan Turkes Science and Technology University, Adana, Turkey
| | - Esra Capanoglu
- Faculty of Chemical and Metallurgical Engineering, Food Engineering Department, Istanbul Technical University, Istanbul, Turkey
| | - Serkan Selli
- Department of Food Engineering, Faculty of Agriculture, Cukurova University, Adana, Turkey
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9
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Polat S, Danacioglu Y, Yarimoglu S, Soytas M, Erdogan A, Teke K, Degirmenci T, Tasci A. Validación externa de los sistemas de puntuación actuales y desarrollo de un nuevo sistema de puntuación para la predicción de la tasa libre de cálculos tras la cirugía intrarrenal retrógrada en pacientes con un diámetro acumulado del cálculo de 2-4 cm. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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10
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Unal Turhan E, Polat S, Erginkaya Z, Konuray G. Investigation of synergistic antibacterial effect of organic acids and ultrasound against pathogen biofilms on lettuce. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.101643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Polat S, Guclu G, Kelebek H, Keskin M, Selli S. Comparative elucidation of colour, volatile and phenolic profiles of black carrot (Daucus carota L.) pomace and powders prepared by five different drying methods. Food Chem 2022; 369:130941. [PMID: 34479009 DOI: 10.1016/j.foodchem.2021.130941] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 02/07/2023]
Abstract
Black carrot pomace is a juice industry by-product that can be easily spoiled due to its high moisture content and usually considered as waste; however, it is a valuable product with high amount of bioactive compounds that can be recovered for further application in several industrial fields. Drying is an effective method for the preservation of this product. Thus, the influence of five drying methods (FD: freeze drying, MWD: microwave drying, CD: convective drying, VCD: vacuum/convective drying, CHD: conductive hydro drying) on colour, phenolics and volatiles of pomace were investigated. Findings revealed that drying process decreased the amount of anthocyanins, colourless phenolics and volatile compounds. CHD resulted in similar colour quality and yielded a better preservation of colour and phenolics while FD provided dried sample with an aroma quality similar to fresh sample. The shorter duration of the CHD makes it a better choice.
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Affiliation(s)
- Suleyman Polat
- Department of Food Engineering, Faculty of Agriculture, Cukurova University, 01330 Adana, Turkey
| | - Gamze Guclu
- Department of Food Engineering, Faculty of Agriculture, Cukurova University, 01330 Adana, Turkey
| | - Hasim Kelebek
- Department of Food Engineering, Faculty of Engineering, Adana Alparslan Turkes Science and Technology University, 01250 Adana, Turkey
| | - Muharrem Keskin
- Department of Biosystems Engineering, Faculty of Agriculture, Hatay Mustafa Kemal University, 31040 Antakya, Hatay, Turkey
| | - Serkan Selli
- Department of Food Engineering, Faculty of Agriculture, Cukurova University, 01330 Adana, Turkey; Department of Nutrition and Dietetics, Faculty of Health Sciences, Cukurova University, 01330 Adana, Turkey.
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12
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Ciftci A, Ocak S, Polat S. Lockdown effect on emergency surgical consults during the covid-19 outbreak: Experience of a pandemic hospital. Med-Science 2022. [DOI: 10.5455/medscience.2022.03.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The covid-19 pandemic has significantly impacted many lives and health care systems around the world. Many countries have imposed lockdowns and extraordinary restriction measures including curfews to control the disease. This study aimed to evaluate the lockdown effect on surgical emergencies during this outbreak. Patients admitted to the emergency department (ED) and referred to general surgery (GS) was retrospectively analyzed during the first lockdown period (April 1-May 31,2020) and before the covid-19 pandemic, corresponding time last year (April 1-May 31,2019). Patient admission rates to ED and general surgery outpatient clinics, patient characteristics, reasons for consultation, hospitalization rates, surgical intervention requirements, and reasons for urgent surgery were compared. A significant reduction was observed in the number of patients admitted to ED, and general surgery consultation is required in the covid-19 lockdown period (72% and 32% decrease respectively). There was no difference in hospitalization and surgical intervention rates between the groups (p=0.158 and p=0.871 respectively). The number of patients referred to general surgery with a diagnosis of perianal disorders was significantly higher in the lockdown group. Covid-19 lockdown and restrictions have dramatically decreased general surgery patients' admissions to emergencies. This situation suggests that some patients with serious diseases may not apply to the emergency departments and so may delay their treatments. Establishing pandemic hospitals and directing uninfected patients to centers other than pandemic hospitals can reduce these delays. We hope, this study findings will be guiding health authorities in making rearrangements in hospitals during subsequent waves and lockdowns in this pandemic and other new pandemic in the future.
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13
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Polat S. Color quality, ascorbic acid, total carotenoid, and volatile compounds of dried orange slices as influenced by packaging methods and storage conditions. J FOOD PROCESS PRES 2021. [DOI: 10.1111/jfpp.15898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Suleyman Polat
- Department of Food Engineering Faculty of Agriculture Cukurova University Adana Turkey
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14
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Polat S, Karaburgu S, Unluhizarci K, Dündar M, Özkul Y, Arslan YK, Karaca Z, Kelestimur F. The role of androgen receptor CAG repeat polymorphism in androgen excess disorder and idiopathic hirsutism. J Endocrinol Invest 2020; 43:1271-1281. [PMID: 32166698 DOI: 10.1007/s40618-020-01215-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/04/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The study aimed to investigate whether repeat number in the androgen receptor (AR) gene has any contribution to phenotypes of the disease of androgen excess (polycystic ovary syndrome (PCOS), idiopathic hyperandrogenemia (IHA) and idiopathic hirsutism (IH) in a cohort of Turkish women. METHODS Three hundred and fifty-four voluntary premenopausal women (172 healthy controls and 182 patients with androgen excess disorders and idiopathic hirsutism) 18-45 years of age seen at an outpatient endocrine clinic at Erciyes University Hospital between January 2013 and December 2014 were included. All volunteers have undergone physical examination and biochemical evaluation. The polymorphic (CAG)n repeat of the human AR was determined by fragment analyses. RESULTS Detailed clinical analyses of the patients ended up with 137 PCOS, 24 IHA, and 21 IH. Pairwise comparisons revealed the CAG repeat number differences between the PCOS and controls (p = 0.005) and IH and controls (p = 0.020). Women with CAG repeat length ≤ 17 had a significantly increased twofold risk for PCOS than those women with > 17 CAG repeats OR: 2.0 (95% CI 1.2-3.3, p = 0.005). Women with CAG repeat length ≤ 17 had a significantly increased threefold risk for IH than those women with > 17 CAG repeats OR: 2.9 (95% CI 1.2-7.3, p = 0.020). When correlation analysis was performed, a weak negative correlation was detected between the short allele and FGS score (r = - 0.131, p = 0.013) and a positive relationship between total testosterone and longer allele in the IHA group (r = 0.425, p = 0.039). Median repeat length of the shorter allele between oligomenorrhea and woman with normal menstrual cycle was found to be statistically significant (p = 0.017). CONCLUSION This study indicated that the risk of PCOS and IH is associated with the inheritance of ARs with shorter CAG repeats.
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Affiliation(s)
- S Polat
- Department of Medical Genetics, Medical Faculty, Erzincan University, Basbaglar Mah, 24100, Erzincan, Merkez, Turkey.
| | - S Karaburgu
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - K Unluhizarci
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - M Dündar
- Department of Medical Genetics, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Y Özkul
- Department of Medical Genetics, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Y K Arslan
- Department of Biostatistics, Medical Faculty, Erzincan University, Erzincan, Turkey
| | - Z Karaca
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - F Kelestimur
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
- Department of Endocrinology, Medical Faculty, Yeditepe University, İstanbul, Turkey
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15
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Sefik E, Eker A, Gunlusoy B, Celik S, Bozkurt IH, Basmaci I, Polat S, Degirmenci T, Ceylan Y. The effect of alpha blocker treatment prior to prostate biopsy on voiding functions, pain scores and health-related quality-of-life outcomes: A prospective randomized trial. Prog Urol 2020; 30:198-204. [PMID: 31983605 DOI: 10.1016/j.purol.2019.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/06/2019] [Accepted: 12/30/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the effect of alpha-blocker treatment prior to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) on voiding functions, pain scores and health-related quality-of-life outcomes. MATERIALS AND METHODS From January 2018 to April 2019, a total of 112 patients underwent TRUS-Bx due to elevated prostate-specific antigen (PSA) or abnormal digital rectal examination findings. Patients were divided into 2 groups depending on whether they received pharmacological treatment before biopsy. Group 1 consisted of patients with no alpha-blocker treatment prior to biopsy and Group 2 consisted of patients who received Tamsulosin for one week before biopsy continuing for one week after biopsy. Voiding function was evaluated three times using the validated International Prostate Symptom Score (IPSS) and uroflowmetry (maximal flow rate (Qmax) and residual volume (PVR)). The Turkish version of the Medical Outcomes Study Short Form 36-item Questionnaire (SF-36) was used to assess health-related quality of life. Pain scores were rated according to the Visual Analogue Scale (VAS) just after the biopsy procedure. RESULTS Mean IPSS and Qmax on the post-biopsy 7 day were significantly in favor of Group 2 (P<0.001, P=0.004). Although post-biopsy day 7 PVR was similar between the groups, Δ1 PVR was significantly in favor of Group 2 (P=0.004). Mean VAS score was 2.7±2.3 for the Tamsulosin group and 4.2±2.2 for the control group (P=0.001). There was no significant difference between two groups according to baseline and postoperative 1st month SF-36 scores. CONCLUSION Alpha-blocker therapy prior to TRUS-Bx is effective in preventing voiding dysfunction and biopsy-related pain in patients undergoing TRUS-Bx. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- E Sefik
- Health Sciences University, Bozyaka Training and Research Hospital, Department of Urology.
| | - A Eker
- Health Sciences University, Bozyaka Training and Research Hospital, Department of Urology
| | - B Gunlusoy
- Health Sciences University, Bozyaka Training and Research Hospital, Department of Urology
| | - S Celik
- Health Sciences University, Bozyaka Training and Research Hospital, Department of Urology
| | - I H Bozkurt
- Health Sciences University, Bozyaka Training and Research Hospital, Department of Urology
| | - I Basmaci
- Health Sciences University, Bozyaka Training and Research Hospital, Department of Urology
| | - S Polat
- Amasya University, Faculty of Medicine, Department of Urology
| | - T Degirmenci
- Health Sciences University, Bozyaka Training and Research Hospital, Department of Urology
| | - Y Ceylan
- Health Sciences University, Bozyaka Training and Research Hospital, Department of Urology
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16
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Polat S, Karaburgu S, Ünlühizarcı K, Dündar M, Özkul Y, Arslan YK, Karaca Z, Kelestimur F. Comprehensive genotyping of Turkish women with hirsutism. J Endocrinol Invest 2019; 42:1077-1087. [PMID: 30811025 DOI: 10.1007/s40618-019-01028-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Hirsutism is a medical sign rather than a disease affects 5-8% of women of reproductive age. Hirsutism is associated with hyperandrogenemia in most patients excluding those with idiopathic hirsutism (IH). The most common cause of hirsutism is polycystic ovary syndrome (PCOS) followed by IH and idiopathic hyperandrogenemia (IHA); however, the clinical presentation of non-classical congenital adrenal hyperplasia (NCAH) in females is often indistinguishable from other hyperandrogenic disorders with common clinical signs such as hirsutism. OBJECTIVE The primary aim of the study is to examine the physical properties of the three genes and to make a detailed comparison of the mutations with the clinical data to contribute the etiology of hirsutism. SUBJECTS AND METHODS 122 women admitted to the Endocrinology Clinic at Erciyes University Hospital with hirsutism were enrolled in the study between 2013-2014. All the participants were clinically evaluated. Protein-encoding exons, exon-intron boundaries of CYP21A2 (including proximal promoter), CYP11B1 and HSD3B2 genes were analyzed via state-of-the-art genetic studies. RESULTS DNA sequencing analyses revealed two homozygous and three compound heterozygous 21-hydroxylase deficient (21OHD) NCAH patients. Additionally, three novel CYP21A2 mutations (A89V, M187I and G491S) and two novel CYP11B1 mutations (V188I and G87A) were determined. The frequencies of heterozygous mutations in CYP21A2 (including promoter), CYP11B1 and HSD3B2 genes were determined as 26.5% (15% coding region, 11.5% promoter), 11.5% and 0%, respectively. CONCLUSION 21OHD-NCAH prevalence was determined to be ~4%. Unexpectedly, high heterozygous mutation rates were observed in CYP11B1 gene and CYP21A2 promoter region. CYP11B1 and HSD3B2 deficiencies were not prevalent in Turkish women with hirsutism despite the existence of higher heterozygous mutation rate in CYP11B1.
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Affiliation(s)
- S Polat
- Department of Medical Genetics, Medical Faculty, Erzincan University, Erzincan, Turkey.
| | - S Karaburgu
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - K Ünlühizarcı
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - M Dündar
- Department of Medical Genetics, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Y Özkul
- Department of Medical Genetics, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Y K Arslan
- Department of Biostatistics, Medical Faculty, Erzincan University, Erzincan, Turkey
| | - Z Karaca
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - F Kelestimur
- Department of Endocrinology, Medical Faculty, Erciyes University, Kayseri, Turkey
- Department of Endocrinology, Medical Faculty, Yeditepe University, Istanbul, Turkey
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17
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Amanpour A, Vandamme J, Polat S, Kelebek H, Van Durme J, Selli S. Non-thermal plasma effects on the lipoxygenase enzyme activity, aroma and phenolic profiles of olive oil. INNOV FOOD SCI EMERG 2019. [DOI: 10.1016/j.ifset.2019.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Oz Gergin O, Bayram A, Gergin İS, Aksu R, Yay A, Balcıoglu E, Polat S, Coşkun G, Soyer Sarıca Z, Yıldız K. Comparison of myotoxic effects of levobupivacaine, bupivacaine and ropivacaine: apoptotic activity and acute effect on pro-inflammatory cytokines. Biotech Histochem 2019; 94:252-260. [DOI: 10.1080/10520295.2018.1548711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- O. Oz Gergin
- Faculty of Medicine, Department of Anesthesia, Erciyes University, Kayseri, Turkey
| | - A. Bayram
- Medical Faculty, Erciyes University, Kayseri, Turkey
| | - İ. S. Gergin
- Department of Neurosurgery, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - R. Aksu
- Medical Faculty, Erciyes University, Kayseri, Turkey
| | - A. Yay
- Medical Faculty, Erciyes University, Kayseri, Turkey
| | - E. Balcıoglu
- Medical Faculty, Erciyes University, Kayseri, Turkey
| | - S. Polat
- Medical Faculty, Cukurova University, Adana, Turkey
| | - G. Coşkun
- Medical Faculty, Cukurova University, Adana, Turkey
| | - Z. Soyer Sarıca
- Hakan Çetinsaya Experimantal Animal Center, Erciyes University, Kayseri, Turkey
| | - K. Yıldız
- Medical Faculty, Erciyes University, Kayseri, Turkey
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19
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Polat S, Sayan P. Characterization and Kinetics of Calcium Sulfate Dihydrate Crystallization in the Presence of Trimesic Acid. ASIA-PAC J CHEM ENG 2017. [DOI: 10.1002/apj.2081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S. Polat
- Department of Chemical Engineering, Faculty of Engineering; Marmara University; 34722 İstanbul Turkey
| | - P. Sayan
- Department of Chemical Engineering, Faculty of Engineering; Marmara University; 34722 İstanbul Turkey
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Erguder T, Ozcebe H, Bilir N, Keskinkılıç B, Polat S, Çulha G, Taştı E, Erşahin Y, Özmen M, San R, Morton J, Palipudi KM, Asma S. Adult tobacco smoking in Turkey: policy implications and trends from the Global Adult Tobacco Survey. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv171.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Akyildiz ZI, Polat S, Yurekli BS, Kocabas GU, Tuluce K, Tuluce SY, Kocabas U, Bozkaya G, Yuksel A, Nazli C. Epicardial fat, body mass index, and triglyceride are independent contributors of serum fibroblast growth factor 21 level in obese premenopausal women. J Endocrinol Invest 2015; 38:361-6. [PMID: 25312836 DOI: 10.1007/s40618-014-0185-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/29/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The hormone fibroblast growth factor 21 (FGF-21) regulates carbohydrate and lipid homeostasis. FGF-21 represents an attractive novel therapy for obesity since administration of FGF-21 has been shown to improve metabolic abnormalities in obese animal models. We investigated FGF-21 and its relationship with epicardial fat thickness (EFT), metabolic parameters, and inflammatory markers in premenopausal obese women compared to controls with similar Systematic Coronary Risk Evaluation (SCORE) project risk profiles. METHODS Forty-five obese premenopausal women with body mass index (BMI) ≥30 kg/m(2) and 41 control premenopausal women with BMI <25 kg/m(2) with similar SCORE project risk profiles were included in this case-control study. EFT was evaluated by two-dimensional transthoracic echocardiography. Serum FGF-21 was measured with an ELISA kit. RESULTS FGF-21 and EFT were significantly higher in obese women compared to controls (p < 0.001). Multiple stepwise linear regression analysis showed that EFT, BMI, and triglycerides (TG) independently contributed to FGF-21 (R(2) = 0.757, p < 0.001). However, homeostasis model assessment of insulin resistance (HOMA-IR), visceral ectopic fat, and inflammatory markers were not found as a direct contributor to serum FGF-21 level (p > 0.05). CONCLUSIONS EFT, BMI, and TG may play an important role in predicting serum FGF-21 level which may be a potential therapeutic target in cardiometabolic disorders in the future.
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Affiliation(s)
- Z I Akyildiz
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey.
| | - S Polat
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - B S Yurekli
- Department of Endocrinology and Metabolism, Ege University Faculty of Medicine, Izmir, Turkey
| | - G U Kocabas
- Department of Endocrinology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - K Tuluce
- Department of Cardiology, Izmir Karsiyaka State Hospital, Izmir, Turkey
| | - S Y Tuluce
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
| | - U Kocabas
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
| | - G Bozkaya
- Department of Biochemistry, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - A Yuksel
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - C Nazli
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
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Cebe MA, Polat S, Cebe F, Tuncdemir MT, Isman E. Bonding performance of two newly developed self-adhering materials between zirconium and dentin. Niger J Clin Pract 2015; 18:221-6. [DOI: 10.4103/1119-3077.151046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tunca Z, Kıvırcık Akdede B, Özerdem A, Alkın T, Polat S, Ceylan D, Bayın M, Cengizçetin Kocuk N, Şimşek S, Resmi H, Akan P. Diverse glial cell line-derived neurotrophic factor (GDNF) support between mania and schizophrenia: a comparative study in four major psychiatric disorders. Eur Psychiatry 2014; 30:198-204. [PMID: 25543333 DOI: 10.1016/j.eurpsy.2014.11.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/14/2014] [Accepted: 11/14/2014] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) have essential roles in synaptic plasticity which is involved in pathogenesis and treatment of psychiatric disorders. However, it is not clear whether they act simultaneously during illness states in major psychiatric disorders. METHODS BDNF and GDNF serum levels were measured concomitantly by enzyme-linked immunosorbent assay (ELISA) method in 171 patients diagnosed with schizophrenia (n=33), bipolar disorder-manic episode (n=39), bipolar/unipolar depression (n=64, 24/40) and obsessive-compulsive disorder (n=35) according to DSM-IV, and 78 healthy volunteers. SCID-I and SCID non-patient version were used for clinical evaluation of the patients and healthy volunteers, respectively. Correlations between the two trophic factor levels, and illness severity scores, duration of illness and medication dosages were studied across different illnesses. RESULTS While patients had equally lower BDNF levels in all diagnoses, GDNF levels were significantly higher in mania and lower in schizophrenia compared to healthy controls. BDNF levels were negatively correlated to illness severity scores in affective episodes (mania and depression). Longer duration of illness (>5 years) had an impact on lower GDNF levels in schizophrenia. BDNF levels and antipsychotic drug dosages in schizophrenia, and GDNF levels and antidepressant drug dosages in obsessive-compulsive disorder were positively correlated. CONCLUSION Our data confirmed the evidence of equally deficient neuronal support by BDNF in all major psychiatric illnesses, but suggested a diverse glial functioning between schizophrenia and mania.
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Affiliation(s)
- Z Tunca
- Dokuz Eylul University, Medical School, Izmir, Turkey.
| | | | - A Özerdem
- Dokuz Eylul University, Medical School, Izmir, Turkey
| | - T Alkın
- Dokuz Eylul University, Medical School, Izmir, Turkey
| | | | | | | | | | | | - H Resmi
- Dokuz Eylul University, Medical School, Izmir, Turkey
| | - P Akan
- Dokuz Eylul University, Medical School, Izmir, Turkey
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Dogruk Kacar S, Ozuguz P, Bagcioglu E, Coskun KS, Uzel Tas H, Polat S, Karaca S. The frequency of body dysmorphic disorder in dermatology and cosmetic dermatology clinics: a study from Turkey. Clin Exp Dermatol 2014; 39:433-8. [PMID: 24758305 DOI: 10.1111/ced.12304] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is a distressing and impairing preoccupation with a slight or imagined defect in appearance. There are few reports on the prevalence of BDD in the Turkish population. AIM To investigate the frequency of BDD in dermatology settings, and to compare the results from cosmetic dermatology with those from general dermatology settings. METHODS This cross-sectional study recruited 400 patients from cosmetic dermatology (CD) (n = 200) and general dermatology (GD) clinics (n = 200). A mini-survey was used to collect demographic and clinical characteristics, and the dermatology version of a brief self-report BDD screening questionnaire was administered. A five-point Likert scale was used for objective scoring of the stated concern, which was performed by dermatologists, and patients who scored ≥ 3 were excluded from the study. RESULTS In total, 318 patients (151 in the CD group and 167 in the GD group) completed the study, and of these, 20 were diagnosed with BDD. The CD group had a higher rate of BDD (8.6%) than the GD group (4.2%) but this was not significant (P = 0.082). The major concern focused on body and weight (40.0%), followed by acne (25.0%). CONCLUSIONS The number of cosmetic procedures in dermatology practices is increasing Therefore, it is becoming more important to recognize patients with BDD. Although the rates of BDD found in the present study are in agreement with the literature data, population-based differences still exist between this study and previous studies.
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Affiliation(s)
- S Dogruk Kacar
- Department of Dermatology, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
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25
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Ozyilmaz E, Gunasti S, Kuyuku Y, Polat S, Gumurdulu D, Kuleci S, Hanta I, Kocabas A. Hermansky Pudlak Syndrome and Pulmonary Alveolar Proteinosis at the same patient: first case report in the world literature. Sarcoidosis Vasc Diffuse Lung Dis 2013; 30:217-220. [PMID: 24284295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 05/31/2013] [Indexed: 06/02/2023]
Abstract
Hermansky-Pudlak Syndrome (HPS) is a rare autosomal recessive disorder presenting with oculocutaneous albinism, bleeding diathesis and lysosomal accumulation of ceroid lipofuscin which leads to interstitial fibrosis in lung. Pulmonary fibrosis which is usually associated with HPS-1 and HPS-4 subtypes usually manifests in the third/fourth decades of life representing with giant lamellar bodies of alveolar type-II-cells and their apparent degeneration causes restrictive lung disease. Pulmonary manifestation of this syndrome may lead to premature death. Pulmonary Alveolar Proteinosis(PAP) is another rare disease characterized by alveolar deposition of surfactant phospholipids and proteins secondary to defective clearance by alveolar macrophages. PAP may occur as autoimmune diseases and/or secondary to toxic inhalation, systemic infections or hematological disorders. None of the cases were reported secondary to HPS according to the best our knowledge. As well, pulmonary involvement of HPS was never reported as PAP. We report the first case of PAP in a patient with HPS.
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Affiliation(s)
- E Ozyilmaz
- Cukurova University Faculty of Medicine Department of Pulmonary Disease Balcali.
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26
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Polat S, Koerner-Rettberg C, Heesen I, Ballmann M. 261 Effect of different treatment regimens of CFRD on clinical status: A register study. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60402-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dogan M, Dogan DO, Duger C, Polat S, Muderris S. Recurrent rhinolithiasis: a case report with review of the literature. W INDIAN MED J 2012; 61:760-763. [PMID: 23620978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Rhinolith is an uncommon nasal mass and a rare entity encountered in clinical practice. The typical symptoms of rhinolith are unilateral nasal obstruction, foul smelling purulent nasal discharge and epistaxis, crusting, swelling of nose or face, anosmia, epiphora and headache. In this report, we present a case of recurrent rhinolith manifesting as an incidental finding on dental radiographs. A 26-year old male patient with a history of long standing halitosis had an operation for rhinolith seven years previously. Rhinolith in the right nasal cavity was diagnosed on rigid endoscopic examination. Rhinolith was removed by using a rigid nasal endoscope under local anaesthesia. To our knowledge, recurrence of rhinolith has not been described previously in the literature.
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Affiliation(s)
- M Dogan
- Department of Otolaryngology Head and Neck Surgery, Numune Hospital, 58010 Sivas, Turkey
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28
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Polat S, Camurdan AD, Aksakal N, Agladioglu S, Beyazova U, Sahin F, Atak A, Er A. Evaluation of perinatal and intrafamilial hepatitis B prevention programmes in a well child clinic: 9-year follow-up study in Turkey. Trans R Soc Trop Med Hyg 2011; 105:220-5. [PMID: 21367440 DOI: 10.1016/j.trstmh.2010.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 12/03/2010] [Accepted: 12/03/2010] [Indexed: 11/19/2022] Open
Abstract
Evaluating the performance of well child clinics on adherence to recommended perinatal hepatitis B prevention programmes as well as assessing the outcome of infants living with hepatitis B surface antigen (HBsAg)-positive parents is important. A retrospective study was performed of 336 babies who had at least one HBsAg-positive parent and were followed-up in the well child clinic of Gazi University Hospital (Ankara, Turkey) between 2001 and 2009. Rates of passive immunisation in 109 babies with HBsAg-positive mothers and initiation of hepatitis B vaccination of all 336 babies with HBsAg-positive parents were 98.8% and 100% respectively. Ninety-two babies (27.4%) were lost to follow-up before completing primary immunisation. The recommended perinatal hepatitis B prevention programme was performed successfully in 194 of the 306 infants who were old enough for post-vaccination serotesting (63.4%). One baby became HBsAg-positive, and 88.1% of babies were seroprotected. Hepatitis B surface antibody (anti-HBs) levels were found to be increased if the HBsAg-positive parent was the father. There was a negative correlation between serotesting time and anti-HBs titres. The study infants had a total of 187 siblings and 123 (65.8%) were serotested after completing primary immunisation with 108 found to be seropositive. Although the vaccination rate in the perinatal hepatitis B prevention programme is satisfactory, post-vaccination serotesting and evaluation of infants and their siblings are still deficient.
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Affiliation(s)
- S Polat
- Mersin University School of Medicine, Department of Social Pediatrics, Zeytinlibahce, Mersin, 33079, Turkey.
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29
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Isa-Kara M, Sari F, Emre-Coskun M, Kustarci A, Burak-Polat H, Ozdemir H, Polat S. Stabilization of autotransplanted teeth using thermoplastic retainers. Med Oral Patol Oral Cir Bucal 2011; 16:e369-75. [DOI: 10.4317/medoral.16.e369] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Accepted: 08/21/2010] [Indexed: 11/05/2022] Open
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30
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Akbas E, Polat S, Karakas-Celik S, Altintas ZM, Yildirim M, Yilgor E. A severely mental and motor retarded boy with monosomy 9pter-->p22 trisomy 10q26-->qter due to paternal reciprocal translocation 46,XY,t(9;10)(p23;q26). Genet Couns 2011; 22:417-423. [PMID: 22303803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report on a twenty-two months old male patient with hypotonia, mental and motor retardation and trigonocephaly. Standard GTG banding chromosomal analysis (from metaphyses of a periferal blood lymphocyte culture) showed 46,XY, der(9) monosomy 9pter-->p22, trisomy 10q26--> qter karyotype. This unbalanced translocation resulted from the father's t(9,10) (p22;p26) karyotype. Deletions of the terminal part of 9p and partial trisomy of chromosome 10q are rare chromosomal disorders. To our knowledge, this is the first case report in the literature of a deletion of 9pter-->p22.3 and a duplication of 10q26-->qter. We assume that the clinical anomalies are due to der(9) monosomy 9pter-->p22, trisomy 10q-->26qter.
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Affiliation(s)
- E Akbas
- Mersin University, Faculty of Medicine, Department of Medical Biology and Genetics, Mersin, Turkey.
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Akbas E, Soylemez F, Hallioglu O, Polat S, Turkoz G. Analysis of the SRY gene in a girl with 45,X/46,XY genotype. Genet Couns 2009; 20:249-254. [PMID: 19852431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Analysis of the SRY gene in a girl with 45,X/46,XY genotype: We present a Turner syndrome patient with a 45, X/46, XY mosaicism. A seven-year-old patient was admitted to our laboratory for evaluation of Turner Syndrome. On physical examination, short stature, a webbed neck, a broad chest with widely spaced nipples, syndactyly on toes, horse shoe kidney and typical findings of aortic coarctation were present. The chromosome karyotype of the patient was 45 X/46 XY. Molecular analysis of the blood lymphocytes confirmed the presence of the SRY gene of the patient. We report here the clinical and cytogenetic findings in a patient with an unusual sex chromosome mosaicism.
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Affiliation(s)
- E Akbas
- University of Mersin, Faculty of Medicine, Department of Medical Biology and Genetics, Mersin, Turkey
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Abstract
AbstractObjective:The aim of this retrospective analysis was to evaluate the diagnosis of vertigo, dizziness and imbalance in elderly patients in two tertiary neurotology clinics.Design and setting:Six hundred and seventy-seven patients aged over 65 years were assessed by the same senior author, and 601 patients were enrolled in the study.Results:The most frequent diagnoses were benign paroxysmal positional vertigo (42.43 per cent), idiopathic vestibulopathy (20.29 per cent), migraine vestibulopathy (13.15 per cent), Ménière's disease (12.47 per cent) and acute vestibular attack (6.49 per cent).Conclusion and significance:This retrospective study showed that 93.5 per cent of the elderly patients studied had been diagnosed with peripheral vertigo. The majority of patients had been classified as having benign paroxysmal positional vertigo, idiopathic vestibulopathy or migraine vestibulopathy.
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Affiliation(s)
- A Uneri
- Balance Center, Department of Otorhinolaryngology, Acibadem Kozyatagi Oncology and Neurology Hospital, Istanbul, Turkey.
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Abstract
The aim of this study is to analyse the intra and extracoronal scattering of laser light. Twelve vital teeth from 12 volunteer individuals (aged 22-29 years) were used. The camera removing the charge coupled device's infrared cut filter was used for imaging the laser Doppler flowmetry light during pulpal blood flow measurement. When the obtained photos were analysed, it was seen that the laser beam caused the tooth to shine like a lamp and it also illuminated the tissues inside the mouth (tongue, lips, adjacent teeth, etc.). As a result, it was shown that when the necessary cautions were not taken, the laser could scatter all around the tissues surrounding the tooth. Because of the conductive characteristic of the fibre and the optical characteristics of the tooth, we think that the beam is inevitably scattered onto the tissues outside the pulp and together with the isolation of the gingiva, crown should be isolated, as well.
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Affiliation(s)
- S Polat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cumhuriyet University, 58140 Sivas, Turkey.
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Abstract
Lipiodol is a lipid based contrast medium and is very useful in sialography. It gives very fine images and clearly shows the details of the gland. It is viscous and has a relatively high iodine content. However, lipiodol UF drops sometimes remain in the salivary gland and in the adjacent tissues for a long time and may cause irritation. We report a case where lipiodol UF leaked from Stensen's duct and was not resorbed after a period of 70 months.
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Affiliation(s)
- D Ozdemir
- Department of Prosthodontics, Cumhuriyet University, Faculty of Dentistry, 58140, Sivas, Turkey
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Gürelik M, Karadağ O, Polat S, Ozüm U, Aslan A, Gürelik B, Göksel HM. The effects of the electrical stimulation of the nasal mucosa on cortical cerebral blood flow in rabbits. Neurosci Lett 2004; 365:210-3. [PMID: 15246550 DOI: 10.1016/j.neulet.2004.04.079] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2004] [Revised: 04/19/2004] [Accepted: 04/30/2004] [Indexed: 11/24/2022]
Abstract
The cerebral vessels have sympathetic, parasympathetic, and sensory innervations. A sensory innervation of the cerebral vessels originating in the trigeminal ganglion has been described in a number of species by several investigations. It has been shown that the electrical stimulation of the trigeminal ganglion causes an increase of cerebral blood flow (CBF). The aim of our present study is to stimulate the trigeminal ganglion with an extracranial and non-invasive method. A stimulating electrode was put in the nasal mucosa via right nares of rabbits and trigeminal ganglion was stimulated orthodromically via nasociliary nerve (NCN). Variations in the cortical CBF were evaluated by laser Doppler flowmetry. In experiment group, CBF increased together with the beginning of electrical stimulation. The flow values were remained high as long as the stimulation. In post-stimulation period, the CBF was decreased gradually and returned to the baseline values at 120s. This study demonstrated that the electrical stimulation of the NCN branch of the trigeminal nerve increases the cortical CBF under physiological conditions.
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Affiliation(s)
- M Gürelik
- Department of Neurosurgery, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey.
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Ozbilgin MK, Polat S, Mete UO, Tap O, Kaya M. Antigen-presenting cells in the hypertrophic pharyngeal tonsils: a histochemical, immunuhistochemical and ultrastructural study. J Investig Allergol Clin Immunol 2004; 14:320-8. [PMID: 15736718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
The antigen presenting cells (APCs) with special interest to dendritic cells (DC), were investigated in 28 hypertrophic and 10 control pharyngeal tonsils of children by histochemistry, immunohistochemistry and electron microscopy. In this study, we are trying to clarify the function and classification of APC in pharyngeal tonsils using morphologic criteria, Human Leukocyte Antigen Monoclonal Antibody (HLA-DR MoAb), which is specific for APCs, and acid phosphatase (APh) reacting with both phagosomes and lysosomes. The surface epithelium of the patient group examined by light microscopy, heavy infiltration of lymphocytes, degenerated columnar cells and a few HLA-DR MoAb (+) columnar cells was observed. Additionally, a significant number of APCs which were Langerhans cells (LCs), interdigitating dendritic cell (IDC), follicular dendritic cell (FDC) and macrophages were stained with both HLA-DR MoAb and APh in the epithelial, interfollicular-subepithelial and follicular areas. Ultrastructural examinations revealed that lymphocytes, macrophages, LC and M cells were found among the surface columnar epithelial cells of the patient group. The interactions between M cells and LC suggested that M cells probably passed antigens from surface to LC. In the interfollicular-subepithelial areas of the hypertrophic pharyngeal tonsil, IDCs were in close contact with lymphocytes, macrophages and plasma cells. Seven types of FDCs (FDC-1 - FDC-7) were recognised according to their ultrastructural appearances. Differentiated FDCs (FDC-4) were also in close contact with each active subtype of FDCs in follicular areas besides lymphocytes. These findings supported the idea that although the pharyngeal tonsils contained several types of active APCs, only DC were in close contact with immunocompetent cells and the other APC's. Therefore, these morphologic appearances of DC could be a sign of function to initiate the immune response of the pharyngeal tonsil.
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Babar E, Ozgünen T, Melik E, Polat S, Akman H. Effects of ketamine on different types of anxiety/fear and related memory in rats with lesions of the median raphe nucleus. Eur J Pharmacol 2001; 431:315-20. [PMID: 11730724 DOI: 10.1016/s0014-2999(01)01340-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the present study was to determine the involvement of the median raphe serotonergic system in the effects of ketamine on anxiety behaviours and related memory. The effects of ketamine pretreatment (3 and 10 mg/kg, i.p.) on three types of fear-motivated behaviours, unconditioned one-way escape, conditioned avoidance and freezing were tested. Experiments were performed with the inhibitory avoidance apparatus in rats with ibotenic acid lesions of the median raphe nucleus. It was found that 10 mg/kg ketamine had an anxiogenic-like effect on one-way escape type of fear and anxiolytic-like effect on conditioned freezing-related fear; these effects were unaffected by median raphe lesions. Both ketamine doses impaired freezing-related fear memory. Ketamine (10 mg/kg) also produced an anxiolytic-like effect on avoidance type of fear and impaired avoidance memory. The median raphe lesions attenuated the anxiolytic action of the drug on the avoidance type of fear and prevented ketamine-induced avoidance memory impairment. These results suggest that the anxiolytic-like effect of ketamine on avoidance-type fear is mediated through the median raphe serotonergic system.
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Affiliation(s)
- E Babar
- Division of Neurophysiology, Department of Physiology, Medical Faculty, University of Cukurova, 01330 Barcali, Adana, Turkey.
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Tuna M, Polat S, Erman T, Ildan F, Göçer AI, Tuna N, Tamer L, Kaya M, Cetinalp E. Effect of anti-rat interleukin-6 antibody after spinal cord injury in the rat: inducible nitric oxide synthase expression, sodium- and potassium-activated, magnesium-dependent adenosine-5'-triphosphatase and superoxide dismutase activation, and ultrastructural changes. J Neurosurg 2001; 95:64-73. [PMID: 11453434 DOI: 10.3171/spi.2001.95.1.0064] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The inflammatory cells that accumulate at the damaged site after spinal cord injury (SCI) may secrete interleukin-6 (IL-6), a mediator known to induce the expression of inducible nitric oxide synthase (iNOS). Any increased production of NO by iNOS activity would aggravate the primary neurological damage in SCI. If this mechanism does occur, the direct or indirect effects of IL-6 antagonists on iNOS activity should modulate this secondary injury. In this study, the authors produced spinal cord damage in rats and applied anti-rat IL-6 antibody to neutralize IL-6 bioactivity and to reduce iNOS. They determined the spinal cord tissue activities of Na+-K+/Mg++ adenosine-5'-triphosphatase (ATPase) and superoxide dismutase, evaluated iNOS immunoreactivity, and examined ultrastructural findings to assess the results of this treatment. METHODS Seventy rats were randomly allocated to four groups. Group I (10 rats) were killed to provide normal spinal cord tissue for testing. In Group II 20 rats underwent six-level laminectomy for the effects of total laminectomy alone to be determined. In Group III 20 rats underwent six-level T2-7 laminectomy and SCI was produced by extradural compression of the exposed cord. The same procedures were performed in the 20 Group IV rats, but these rats also received one (2 microg) intraperitoneal injection of anti-rat IL-6 antibody immediately after the injury and a second dose 24 hours posttrauma. Half of the rats from each of Groups II through IV were killed at 2 hours and the other half at 48 hours posttrauma. The exposed cord segments were immediately removed and processed for analysis. CONCLUSIONS The results showed that neutralizing IL-6 bioactivity with anti-rat IL-6 antibody significantly attenuates iNOS activity and reduces secondary structural changes in damaged rat spinal cord tissue.
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Affiliation(s)
- M Tuna
- Department of Neurosurgery, Cukurova University, School of Medicine, Adana, Turkey.
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Göçer AI, Ildan F, Tuna M, Polat S, Tamer L, Erman T, Kaya M. Effects of trapidil on ATPase, lipid peroxidation, and correlation with ultrastructure in experimental spinal cord injury. Neurosurg Rev 2001; 24:136-42. [PMID: 11485236 DOI: 10.1007/pl00012398] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study was performed to investigate the effect of trapidil on ischemic damage of cells after spinal cord injury. The injury was produced by extradural clip compression of the exposed spinal cord in rats according to Rivlin and Tator. The ten rats in group 1 were used to determine normal findings without any surgery or medication. On the 15 rats in group 2, only six-level laminectomy was performed to determine the influence of the total laminectomy on the biochemical factors measured and the, light and ultrastructural findings. The 15 rats each in groups 3 and 4 were used as trauma and trapidil (40 mg/kg) treatment groups, respectively. The injury actually produced a significant decrease in Na+-K+/Mg+2 ATPase activity of the injured segments as early as 10 min after trauma. Trapidil attenuated Na+-K+/Mg+2 ATPase inactivation in the traumatized rats for 120 min after treatment (P<0.05) and significantly reduced the malone dialdehyde content below that in the traumatized group at all determined times (P<0.05). Light and electron microscopic findings supported the biochemical results.
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Affiliation(s)
- A I Göçer
- Department of Neurosurgery, Cukurova University School of Medicine, Balcali/Adana, Turkey.
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Oral R, Can D, Kaplan S, Polat S, Ates N, Cetin G, Miral S, Hanci H, Ersahin Y, Tepeli N, Bulguc AG, Tiras B. Child abuse in Turkey: an experience in overcoming denial and a description of 50 cases. Child Abuse Negl 2001; 25:279-290. [PMID: 11330925 DOI: 10.1016/s0145-2134(00)00241-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To share the experiences of the first clinical multidisciplinary child abuse and neglect (CAN) team in Turkey with international child abuse community. METHODS The authors established the first Turkish CAN follow-up team at Dr. Behcet Uz Children's Hospital. Following a training program in five teaching hospitals in Izmir, the authors kept a record of every case diagnosed with CAN from these hospitals between 1996 and 1998. The demographic, epidemiologic, and medical features of this case series are summarized. RESULTS Fifty cases were diagnosed and followed-up. Seventy-six percent of patients were reported from Dr. Behcet Uz Children's Hospital. Age and sex distribution was 9.2 +/- 6.7 years and 46% male, 54% female, respectively. The offenders were only father in 38%, only mother in 28%, and multiple in 34%. More than three CAN risk factors were present in 94%. Of the children reported 44% survived, 14% died, and 42% were lost to follow-up. Sixteen percent were free of reabuse, and 42% survived with handicaps. CONCLUSIONS Child abuse and neglect is a reality in Turkey. The team's work increased pediatricians' awareness of CAN. Reporting these cases to Social Affairs Bureau was established for the first time in Turkey. Physicians in Turkey need training to diagnose and properly report CAN. The implemen tation of a national CAN prevention program is an urgent need for Turkey.
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Affiliation(s)
- R Oral
- Department of Pediatrics, Dr. Behcet Uz Teaching Hospital for Children, Izmir, Turkey
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41
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Ildan F, Göçer AI, Tuna M, Polat S, Kaya M, Isbir T, Cetinalp E. The effects of the pre-treatment of intravenous nimodipine on Na(+)-K+/Mg+2 ATPase, Ca+2/Mg+2 ATPase, lipid peroxidation and early ultrastructural findings following middle cerebral artery occlusion in the rat. Neurol Res 2001; 23:96-104. [PMID: 11210440 DOI: 10.1179/016164101101198208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Excessive calcium influx has been implicated in the pathophysiology of ischemic cerebral damage. The effects of nimodipine, a calcium antagonist, on the Na(+)-K+/MG+2 ATPase activity, Ca+2/Mg+2 ATPase, lipid peroxidation, and early ultrastructural findings were examined at the acute stage of ischemia in the rat brain. Ischemia was produced by permanent unilateral occlusion of the middle cerebral artery. In Group I, the rats which had no ischemia and not received medication were used for determining Na(+)-K+/Mg+2 ATPase, Ca+2/Mg+2 ATPase, the extent of lipid peroxidation by measuring the malondialdehyde content and normal ultrastructural findings. In Group II, the rats which had only subtemporal craniectomy without occlusion and received saline solution were used for determining the effect of the surgical procedure on the biochemical indices and ultrastructural findings. In Group III, the rats received saline solution following the occlusion in the same amount of nimodipine and in the same duration as used in Group IV. In Group IV, nimodipine pre-treatment 15 min before occlusion (microgram kg-1 min-1 over a 10 min period) was applied i.v. Na(+)-K+/Mg+2 ATPase and Ca+2/Mg+2 ATPase activities decreased significantly and promptly as early as 10 min and remained at a lower level than the contralateral hemisphere in the same group and at the normal level in Group I. Nimodipine pre-treatment immediately attenuated the inactivation of Na(+)-K+/Mg+2 ATPase (p < 0.05) but there was no change on Ca+2/Mg+2 ATPase activity (p < 0.05). Malondialdehyde content increased significantly in Group III following ischemia as early as 30 min. Nimodipine pre-treatment decreased the malondialdehyde level in Group IV (p < 0.05). This study supports the possibility that nimodipine pre-treatment effects the membrane stabilizing properties via inhibiting the lipid peroxidation and subsequently restoring some membrane bound and lipid dependent enzymes' activity such as Na(+)-K+/Mg+2 ATPase and the ultrastructural findings.
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Affiliation(s)
- F Ildan
- Department of Neurosurgery, Cukurova University School of Medicine, Balcali-Adana/ 01330, Turkey.
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Asar M, Kayişli UA, Izgüt-Uysal VN, Oner G, Kaya M, Polat S. Cadmium-induced changes in epithelial cells of the rat stomach. Biol Trace Elem Res 2000; 77:65-81. [PMID: 11097472 DOI: 10.1385/bter:77:1:65] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2000] [Accepted: 02/09/2000] [Indexed: 11/11/2022]
Abstract
The aim of this study was to determine the changes in the function and fine structure of the gastric mucosa following exposure to high cadmium (Cd) for 30 d in rats. In the present study, control animals were fed with normal food and tap water and the remaining animals received Cd (15 ppm CdCl2) in drinking water for the same period. Receiving Cd for 30 d increased the mean blood (p < 0.01) and mucosa (p < 0.001) Cd levels, while decreased mucus thickness, mucin content (p < 0.01) significantly. Basal acid output fell significantly (p < 0.01). Light and electron microscopic examination revealed the following: (1) Cd decreases the mean number of surface mucous, isthmic-neck, parietal cells (p < 0.05) and chief cells (p < 0.001) per unit from the control value and (2) in some cells of zymogenic unit, the Cd-induced alterations were characterized with dilated Golgi cisternae, focal enlarged endoplasmic reticulum, broken tubulovesicles, degenerated mitochondria, dense nuclei, as well as lysosomal structures. We concluded that Cd augments the elimination rate of zymogenic unit's cells by increasing the alteration rate, and the reduced basal acid output, mucin content, and mucus thickness can be explained easily with the loss of zymogenic unit's cell population.
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Affiliation(s)
- M Asar
- Department of Histology and Embryology Faculty of Medicine, University of Akdeniz, Antalya, Turkey
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Polat S, Ozdemir N, Soylu M, Mete U, Unlügenç Z, Kaya M. Ultrastructural effects of topical beta-adrenergic antagonists and an alpha-adrenergic agonist on the rabbit cornea. Ophthalmologica 2000; 213:183-8. [PMID: 10202292 DOI: 10.1159/000027416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the present study the effects of beta-adrenergic antagonist and alpha-adrenergic agonist drugs on rabbit corneas were evaluated in vivo by using transmission electron microscopy. Twenty-four New Zealand albino rabbits were divided into six groups according to the drug applied. The rabbits to which only balanced salt solution (BSS) or BSS and benzalkonium chloride (BAC) were applied were taken as the control groups. The other four groups consisted of the rabbits to which Timoptic 0.5%, Betagan 0.5%, Betoptic 0.5% and Iopidine 1% were applied, respectively. All of drugs were instilled topically twice daily for 6 weeks. In the BSS group, all layers of the cornea were ultrastructurally normal. In the BSS and BAC group slight epithelial and endothelial changes were found. However, in the other groups, loss of microvilli, increase in glycogen particles, nuclear indentation, widening of the intercellular spaces and cytoplasmic vacuolization in epithelium were observed. No significant abnormality was found in the basal lamina, stroma and Descemet's membrane. Slight ultrastructural changes were noted in the endothelium such as vacuolization due to dilatation of the endoplasmic reticulum cisternae and focal cytoplasmic lytic areas. The results of this study indicate that various ultrastructural changes occur in groups treated with antiglaucomatous drug and that topical treatment with timolol and apraclonidine for 6 weeks is more toxic to the rabbit cornea than levobunolol and betaxolol.
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Affiliation(s)
- S Polat
- Department of Histology and Embryology, University of Cukurova Medical Faculty, Adana, Turkey
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Abstract
The aim of this study was to determine the cadmium (Cd)-induced functional and structural changes in gastric parietal cells of male rats exposed to high Cd for 30 d. In the present study, control animals were fed with normal food and tap water; the remaining animals received Cd (15 ppm CdCl2) in drinking water for the same period. Receiving Cd for 30 d increased the mean blood Cd level, the mean tissue Cd content, and the mean blood pressure (p < 0.01, p < 0.001, p < 0.01, respectively). The basal acid output fell; however, the increases in stimulated acid output were not statistically significant. Light and electron microscopic examination revealed respectively that (1) Cd decreases the mean parietal cell number per unit from the control value of 23.46 +/- 3.84 to 19.46 +/- 2.12 (p < 0.05) and it affected preferentially the cells located at the distal half of the zymogenic unit and (2) in parietal cells, the Cd-induced alterations were characterized with swollen canalicular profiles, broken-down tubulovesicles, or degenerated mitochondria. We concluded that Cd augments the elimination rate of parietal cells by increasing the alteration rate and reduced basal acid output can be explained easily with the loss of parietal cell population.
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Affiliation(s)
- M Asar
- Department of Histology and Embryology, University of Akdeniz, Antalya, Turkey
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Tuna M, Göçer AI, Polat S, Bağdatoğlu H, Zorludemir S, Ozel S, Tamer L, Kaya M, Haciyakupoğlu S. The effect of collagen, interleukin-1 alpha and glicosaminoglycan on the neovascularization of central nervous system. Neurol Res 1998; 20:513-25. [PMID: 9713842 DOI: 10.1080/01616412.1998.11740557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Neovascularization, the development of a new microvasculature, has an important role in physiological and pathological processes. The vascular changes in the brain can be easily detected because the proliferation of endothelial cells in its vascular structure is quite small, and so constitutes a good model for neovascularization studies. In the present investigation, to induce intracerebral neovascularization, we implanted collagen, Interleukin-1 alpha (IL-1 alpha) and glicosaminoglycan into the brain of pigs, in order to test the hypothesis that IL-1 alpha, collagen and glicosaminoglycan play a pivotal role in the process of neovascularization. Both pure collagen and collagen combined with IL-1 alpha induced neovascularization according to light-electron microscopic findings and values of enzymes' activities. In particular, collagen combined with IL-1 alpha synergically affected the increase of neovascularization. However, glicosaminoglycan did not affect it significantly. Although the results of this study provided us with some interesting data indicating the beneficial effects of collagen combined with IL-1 alpha on neovascularization, further studies should be done to study the short term effect of these biochemical substances.
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Affiliation(s)
- M Tuna
- Department of Neurosurgery, University of Cukurova, School of Medicine, Adana, Turkey
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Göçer AI, Polat S, Ozel S, Tuna M, Kaya M, Cetinalp E, Haciyakupoglu S. The effect of trapidil on the reactive astrocytic proliferation following spinal cord trauma in rats: light and electron microscopic findings. Neurol Res 1998; 20:365-73. [PMID: 9618703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Platelet-derived growth factor (PDGF) released from platelets is one of the mitogens in serum, which plays a major role upon the cell biology, namely enhancing cell division and controlling of the maturation, especially upon the glial cell growth and its differentiation. Trapidil, which is an anti-PDGF agent, inhibits the effect of PDGF, especially the proliferative effects on the glial and tumoral cells in vitro. Previous studies suggested that the astrocytic proliferation stimulated by PDGF was inhibited by trapidil via the selective antagonism. Trapidil was not found to have a considerable effect on the prevention of nonpermissive astrocytes in this study. It should be theorized that trapidil, administered immediately even after the trauma, could not reach the injury site in effective measure because of secondary events such as edema and impairment of blood circulation. This suggestion should be another subject for studies concerning trapidil which is administered prior to the trauma.
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Affiliation(s)
- A I Göçer
- Department of Neurosurgery, Cukurova University, School of Medicine, Balcali, Adana, Turkey
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Abstract
We present a five-year-old girl with congenital insensitivity to pain with anhidrosis. A skeletal radiographic survey revealed several old fractures. Application of pilocarpine showed anhidrosis and nerve biopsy revealed a significant decrease in the number of myelinated and unmyelinated nerve fibres.
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Affiliation(s)
- M Herdem
- Department of Orthopaedics and Traumatology, Faculty of Medicine, University of Cukurova, Adana, Turkey
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Iidan F, Tuna M, Göçer I, Bağdatoğlu H, Polat S, Zorludemir S, Haciyakupoğlu S, Kaya M, karadayi A. The effect of collagen, interleukin-1 and glycosaminoglycan on the neovascularization of the central nervous system. Clin Neurol Neurosurg 1997. [DOI: 10.1016/s0303-8467(97)81857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Haciyakupoğlu S, Polat S, Tuna M, Göcer AI, Bağdatoğlu H, Ozbilgin MK. The effect of thyrotropin releasing hormone on carbon dioxide laser induced lesion of the cerebral artery. Neurol Res 1997; 19:78-83. [PMID: 9090641 DOI: 10.1080/01616412.1997.11740776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Carbon dioxide laser which is used widely in neurosurgery has less traumatic effect on the tissue beside the lesion than other types of laser. There has been little study on the changes to the vascular tissue, following laser application. We performed a study on 4 groups of dogs; comprising craniectomy only, craniectomy and thyrotropin releasing hormone (TRH), craniectomy and laser, and craniectomy, laser and TRH. We applied CO2 laser on the angular artery of two groups of dogs. To one group we infused TRH for 15 days following the laser application and to the other group we did not. We investigated the ultrastructural and biochemical changes and the effect of TRH on the tissue 15 days following laser application. In our study, we observed an increase in superoxide dismutase activity and a decrease in ATP-ase activities in the degenerated tissue on which CO2 laser was applied. TRH partially prevented the vascular degeneration of CO2 laser but did not significantly change superoxide dismutase and Adenosine-5'-triphosphatase activities.
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MESH Headings
- Adenosine Triphosphatases/metabolism
- Angioplasty, Laser
- Animals
- Ca(2+) Mg(2+)-ATPase/metabolism
- Calcium-Transporting ATPases/metabolism
- Carbon Dioxide
- Cerebral Arteries/drug effects
- Cerebral Arteries/metabolism
- Cerebral Arteries/pathology
- Dogs
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/pathology
- Endothelium, Vascular/ultrastructure
- Female
- Lasers/adverse effects
- Male
- Microscopy, Electron
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/pathology
- Muscle, Smooth, Vascular/ultrastructure
- Sodium-Potassium-Exchanging ATPase/metabolism
- Superoxide Dismutase/metabolism
- Thyrotropin-Releasing Hormone/pharmacology
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Tap O, Solmaz S, Polat S, Mete UO, Ozbilgïn MK, Kaya M. The effect of toluene on the rat ovary: an ultrastructural study. J Submicrosc Cytol Pathol 1996; 28:553-8. [PMID: 8933738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this study, eighteen Wistar female albino rats were used to observe the ultrastructural effects of toluene on the rat ovaries. The animals were divided into experimental and control groups. The experimental group was exposed to 3,000 ppm toluene/m3 for 7 days and 8 h/day. At the end of the experiment the main ultrastructural findings related to the oocytes of the antral follicles of the experimental group were: abundant vacuoles, lytic areas, degenerative mitochondria in the ooplasm and blunt microvilli on the surface. Furthermore, the granulosa cells revealed prominent degenerative changes such as pyknotic nuclei, mitochondrial alterations and dilatation of the endoplasmic reticulum (ER) cisternae. It was interesting to note tht the ultrastructure of primordial follicles was almost similar in both experimental and control groups. All these findings suggested that, although toluene did not affect the primordial follicles, the growing follicles showed degenerative changes attributable to the inhalation of a toxic agent such as toluene.
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Affiliation(s)
- O Tap
- Department of Histology and Embryology, Faculty of Medicine, Cukurova University, Balcali, Adana, Turkey
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