13 research outputs found

    Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

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    Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

    Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

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    PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

    Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

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    PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

    Structure-Based In Silico Approaches Reveal IRESSA as a Multitargeted Breast Cancer Regulatory, Signalling, and Receptor Protein Inhibitor

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    Breast cancer begins in the breast cells, mainly impacting women. It starts in the cells that line the milk ducts or lobules responsible for producing milk and can spread to nearby tissues and other body parts. In 2020, around 2.3 million women across the globe received a diagnosis, with an estimated 685,000 deaths. Additionally, 7.8 million women were living with breast cancer, making it the fifth leading cause of cancer-related deaths among women. The mutational changes, overexpression of drug efflux pumps, activation of alternative signalling pathways, tumour microenvironment, and cancer stem cells are causing higher levels of drug resistance, and one of the major solutions is to identify multitargeted drugs. In our research, we conducted a comprehensive screening using HTVS, SP, and XP, followed by an MM/GBSA computation of human-approved drugs targeting HER2/neu, BRCA1, PIK3CA, and ESR1. Our analysis pinpointed IRESSA (Gefitinib-DB00317) as a multitargeted inhibitor for these proteins, revealing docking scores ranging from −4.527 to −8.809 Kcal/mol and MM/GBSA scores between −49.09 and −61.74 Kcal/mol. We selected interacting residues as fingerprints, pinpointing 8LEU, 6VAL, 6LYS, 6ASN, 5ILE, and 5GLU as the most prevalent in interactions. Subsequently, we analysed the ADMET properties and compared them with the standard values of QikProp. We extended our study for DFT computations with Jaguar and plotted the electrostatic potential, HOMO and LUMO regions, and electron density, followed by a molecular dynamics simulation for 100 ns in water, showing an utterly stable performance, making it a suitable drug candidate. IRESSA is FDA-approved for lung cancer, which shares some pathways with breast cancers, clearing the hurdles of multitargeted drugs against breast and lung cancer. This has the potential to be groundbreaking; however, more studies are needed to concreate IRESSA’s role

    The Saudi urological association guidelines on urolithiasis

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    Aims: The Saudi Urolithiasis Guidelines are a set of recommendations for diagnosing, evaluating, and treating urolithiasis in the Saudi population. These guidelines are based on the latest evidence and expert consensus to improve patient outcomes and optimize care delivery. They cover the various aspects of urolithiasis, including risk factors, diagnosis, medical and surgical treatments, and prevention strategies. By following these guidelines, health-care professionals can improve care quality for individuals with urolithiasis in Saudi Arabia. Panel: The Saudi Urolithiasis Guidelines Panel consists of urologists specialized in endourology with expertise in urolithiasis and consultation with a guideline methodologist. All panelists involved in this document have submitted statements disclosing any potential conflicts of interest. Methods: The Saudi Guidelines on Urolithiasis were developed by relying primarily on established international guidelines to adopt or adapt the most appropriate guidance for the Saudi context. When necessary, the panel modified the phrasing of recommendations from different sources to ensure consistency within the document. To address areas less well covered in existing guidelines, the panel conducted a directed literature search for high quality evidence published in English, including meta analyses, randomized controlled trials, and prospective nonrandomized comparative studies. The panel also searched for locally relevant studies containing information unique to the Saudi Arabian population. The recommendations are formulated with a direction and strength of recommendation based on GRADE terminology and interpretation while relying on existing summaries of evidence from the existing guidelines

    Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

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    Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

    Global multi-stakeholder endorsement of the MAFLD definition

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    none1055noneMendez-Sanchez N.; Bugianesi E.; Gish R.G.; Lammert F.; Tilg H.; Nguyen M.H.; Sarin S.K.; Fabrellas N.; Zelber-Sagi S.; Fan J.-G.; Shiha G.; Targher G.; Zheng M.-H.; Chan W.-K.; Vinker S.; Kawaguchi T.; Castera L.; Yilmaz Y.; Korenjak M.; Spearman C.W.; Ungan M.; Palmer M.; El-Shabrawi M.; Gruss H.-J.; Dufour J.-F.; Dhawan A.; Wedemeyer H.; George J.; Valenti L.; Fouad Y.; Romero-Gomez M.; Eslam M.; Abate M.L.; Abbas B.; Abbassy A.A.; Abd El Ghany W.; Abd Elkhalek A.; Abd ElMajeed E.; Abdalgaber M.; AbdAllah M.; Abdallah M.; Abdallah N.; Abdelaleem S.; Abdelghani Y.; Abdelghany W.; Abdelhalim S.M.; Abdelhamid W.; Abdelhamid N.; Abdelkader N.A.; Abdelkreem E.; Abdelmohsen A.M.; Abdelrahman A.A.; Abd-elsalam S.M.; Abdeltawab D.; Abduh A.; Abdulhakam N.; Abdulla M.; Abedpoor N.; Abenavoli L.; Aberg F.; Ablack O.; Abo elftouh M.; Abo-Amer Y.E.-E.; Aboubkr A.; Aboud A.; Abouelnaga A.M.; Aboufarrag G.A.; Aboutaleb A.; Abundis L.; Adali G.; Adames E.; Adams L.; Adda D.; Adel N.; Adel N.; Adel Sayed M.; Afaa T.J.; Afredj N.; Aghayeva G.; Aghemo A.; Aguilar-Salinas C.A.; Ahlenstiel G.; Ahmady W.; Ahmed W.; Ahmed A.; Ahmed S.N.; Ahmed H.M.; Ahmed R.; Aigner E.; Akarsu M.; Akroush M.; Akyuz U.; Al Mahtab M.; Al Qadiri T.; Al Rawahi Y.; AL rubaee R.; Al Saffar M.; Alam S.; Al-Ani Z.; Albillos A.; Alboraie M.; Al-Busafi S.; Al-Emam M.; Alharthi J.; Ali K.; Ali B.A.; Ali M.; Ali R.A.R.; Alisi A.; AL-Khafaji A.R.; Alkhatry M.; Aller R.; Almansoury Y.; Al-Naamani K.; Alnakeeb A.; Alonso A.; Alqahtani S.A.; Alrabadi L.; Alswat K.; Altaher M.; Altamimi T.; Altamirano J.; Alvares-da-Silva M.R.; Aly E.A.M.; Alzahaby A.; Alzamzamy A.; Amano K.; Amer M.A.; Amin M.A.; Amin S.A.; Amir A.A.; Ampuero J.; Anas N.; Andreone P.; Andriamandimby S.F.; Anees M.; Angela P.; Antonios M.; Arafat W.; Araya J.M.; Armendariz-Borunda J.; Armstrong M.J.; Ashktorab H.; Aspichueta P.; Assal F.; Atef M.; Attia D.; Atwa H.; Awad R.; Awad M.A.E.; Awny S.; Awolowo O.; Awuku Y.A.; Ayada I.; Aye T.T.; Ayman S.; Ayman H.; Ayoub H.; Azmy H.M.; Babaran R.P.; Badreldin O.; Badry A.; Bahcecioglu I.H.; Bahour A.; Bai J.; Balaban Y.; Balasubramanyam M.; Bamakhrama K.; Banales J.M.; Bangaru B.; Bao J.; Barahona J.S.; Barakat S.; Barbalho S.M.; Barbra B.; Barranco B.; Barrera F.; Baumann U.; Bazeed S.; Bech E.; Benayad A.; Benesic A.; Bernstein D.; Bessone F.; Birney S.; Bisseye C.; Blake M.; Bobat B.; Bonfrate L.; Bordin D.S.; Bosques-Padilla F.; Boursier J.; Boushab B.M.; Bowen D.; Bravo P.M.; Brennan P.N.; Bright B.; Broekaert I.; Buque X.; Burgos-Santamaria D.; Burman J.; Busetto L.; Byrne C.D.; Cabral-Prodigalidad P.A.I.; Cabrera-Alvarez G.; Cai W.; Cainelli F.; Caliskan A.R.; Canbay A.; Cano-Contreras A.; Cao H.-X.; Cao Z.; Carrion A.; Carubbi F.; Casanovas T.; Castellanos Fernandez M.I.; Chai J.; Chan S.P.; Charatcharoenwitthaya P.; Chavez-Tapia N.; Chayama K.; Chen J.; Chen L.; Chen Z.-W.; Chen H.; Chen S.-D.; Chen Q.; Chen Y.; Chen G.; Chen E.-Q.; Chen F.; Chen P.-J.; Cheng R.; Cheng W.; Chieh J.T.W.; Chokr I.; Cholongitas E.; Choudhury A.; Chowdhury A.; Chukwudike E.S.; Ciardullo S.; Clayton M.; Clement K.; Cloa M.M.; Coccia C.; Collazos C.; Colombo M.; Cosar A.M.; Cotrim H.P.; Couillerot J.; Coulibaly A.; Crespo G.; Crespo J.; Cruells M.; Cua I.H.Y.; Dabbous H.K.; Dalekos G.N.; D'Alia P.; Dan L.; Dao V.H.; Darwish M.; Datz C.; Davalos-Moscol M.B.; Dawoud H.; de Careaga B.O.; de Knegt R.; de Ledinghen V.; de Silva J.; Debzi N.; Decraecker M.; Del Pozo E.; Delgado T.C.; Delgado-Blanco M.; Dembinski L.; Depina A.; Derbala M.; Desalegn H.; Desbois-Mouthon C.; Desoky M.; Dev A.; Di Ciaula A.; Diago M.; Diallo I.; Diaz L.A.; Dirchwolf M.; Dongiovanni P.; Dorofeyev A.; Dou X.; Douglas M.W.; Doulberis M.; Dovia C.K.; Doyle A.; Dragojevic I.; Drenth J.P.; Duan X.; Dulskas A.; Dumitrascu D.L.; Duncan O.; Dusabejambo V.; Dwawhi R.S.N.A.; Eiketsu S.; El Amrousy D.; El Deeb A.; El Deriny G.; El Din H.S.; El Kamshishy S.; El Kassas M.; El Raziky M.; Elagamy O.A.; Elakel W.; Elalfy D.; Elaraby H.; ElAwady H.; Elbadawy R.; Eldash H.H.; Eldefrawy M.S.; Elecharri C.L.; Elfaramawy A.; Elfatih M.; Elfiky M.; Elgamsy M.; Elgendy M.; El-Guindi M.A.; Elhussieny N.; Eliwa A.M.; Elkabbany Z.; El-Khayat H.; El-Koofy N.M.; Elmetwalli A.; Elrabat A.; El-Raey F.; Elrashdy F.; Elsahhar M.; Elsaid E.M.; Elsayed S.; Elsayed H.; Elsayed A.; Elsayed A.M.; Elsayed H.; El-Serafy M.; Elsharkawy A.M.; Elsheemy R.Y.; Elshemy E.E.; Elsherbini S.; Eltoukhy N.; Elwakil R.; Emad O.; Emad S.; Embabi M.; Ergenc I.; Ermolova T.; Esmat G.; Esmat D.M.; Estupinan E.C.; Ettair S.; Eugen T.; Ezz-Eldin M.; Falcon L.P.V.; Fan Y.-C.; Fandari S.; Farag M.; Farahat T.M.; Fares E.M.; Fares M.; Fassio E.; Fathy H.; Fathy D.; Fathy W.; Fayed S.; Feng D.; Feng G.; Fernandez-Bermejo M.; Ferreira C.T.; Ferrer J.D.; Forbes A.; Fouad R.; Fouad H.M.; Frisch T.; Fujii H.; Fukunaga S.; Fukunishi S.; Fulya H.; Furuhashi M.; Gaber Y.; Galang A.J.G.; Gallardo J.C.; Galloso R.; Gamal M.; Gamal R.; Gamal H.; Gan J.; Ganbold A.; Gao X.; Garas G.; Garba T.; Garcia-Cortes M.; Garcia-Monzon C.; Garcia-Samaniego J.; Gastaldelli A.; Gatica M.; Gatley E.; Gegeshidze T.; Geng B.; Ghazinyan H.; Ghoneem S.; Giacomelli L.; Giannelli G.; Giannini E.G.; Giefer M.; Gines P.; Girala M.; Giraudi P.J.; Goh G.B.-B.; Gomaa A.A.; Gong B.; Gonzales D.H.C.; Gonzalez H.C.; Gonzalez-Huezo M.S.; Graupera I.; Grgurevic I.; Gronbaek H.; Gu X.; Guan L.; Gueye I.; Guingane A.N.; Gul O.O.; Gul C.B.; Guo Q.; Gupta P.P.; Gurakar A.; Gutierrez J.C.R.; Habib G.; Hafez A.; Hagman E.; Halawa E.; Hamdy O.; Hamed A.E.; Hamed D.H.; Hamid S.; Hamoudi W.; Han Y.; Haridy J.; Haridy H.; Harris D.C.H.H.; Hart M.; Hasan F.; Hashim A.; Hassan I.; Hassan A.; Hassan E.A.; Hassan A.A.; Hassan M.S.; Hassanin F.; Hassnine A.; Haukeland J.W.; Hawal A.I.M.; He J.; He Q.; He Y.; He F.-P.; Hegazy M.; Hegazy A.; Henegil O.; Hernandez N.; Hernandez-Guerra M.; Higuera-de-la-Tijera F.; Hindy I.; Hirota K.; Ho L.C.; Hodge A.; Hosny M.; Hou X.; Huang J.-F.; Huang Y.; Huang Z.; Huang Y.; Huang A.; Huang X.-P.; Hui-ping S.; Hunyady B.; Hussein M.A.; Hussein O.; Hussien S.M.; Ibanez-Samaniego L.; Ibdah J.; Ibrahim L.; Ibrahim M.; Ibrahim I.; Icaza-Chavez M.E.; Idelbi S.; Idilman R.I.; Ikeda M.; Indolfi G.; Invernizzi F.; Irshad I.; Isa H.M.A.; Iskandar N.J.; Ismaiel A.; Ismail M.; Ismail Z.; Ismail F.; Iwamoto H.; Jack K.; Jacob R.; Jafarov F.; Jafri W.; Jahshan H.; Jalal P.K.; Jancoriene L.; Janicko M.; Jayasena H.; Jefferies M.; Jha V.; Ji F.; Ji Y.; Jia J.; Jiang C.; Jiang N.; Jiang Z.-Z.; Jin X.; Jin Y.; Jing X.; Jingyu Q.; Jinjolava M.; Jong F.H.H.; Jucov A.; Julius I.; Kaddah M.; Kamada Y.; kamal A.; Kamal E.M.; Kamel A.S.; Kao J.-H.; Karin M.; Karlas T.; Kashwaa M.; Katsidzira L.; Kaya E.; Kayasseh M.A.; Keenan B.; Keklikkiran C.; Keml W.; Khalaf D.K.; Khalefa R.; Khamis S.; Khater D.; khattab H.; Khavkin A.; Khlynova O.; Khmis N.; Kobyliak N.; Koffas A.; Koike K.; Kok K.Y.Y.; Koller T.; Komas N.P.; Korochanskaya N.V.; Koulla Y.; Koya S.; Kraft C.; Kraja B.; Krawczyk M.; Kuchay M.S.; Kulkarni A.V.; Kumar A.; Kumar M.; Lakoh S.; Lam P.; Lan L.; Lange N.F.; Lankarani K.B.; Lanthier N.; Lapshyna K.; Lashen S.A.; Laure K.N.J.; Lazebnik L.; Lebrec D.; Lee S.S.; Lee W.S.; Lee Y.Y.; Leeming D.J.; Leite N.C.; Leon R.; Lesmana C.R.A.; Li J.; Li Q.; Li J.; Li Y.-Y.; Li Y.; Li L.; Li M.; li Y.; Liang H.; Lijuan T.; Lim S.G.; Lim L.-L.; Lin S.; Lin H.-C.; Lin R.; Lithy R.; Liu Y.; Liu Y.; Liu X.; Liu W.-Y.; Liu S.; Liu K.; Liu T.; Lonardo A.; Lopez M.B.; Lopez-Benages E.; Lopez-Jaramillo P.; Lu H.; Lu L.G.; Lu Y.; Lubel J.; Lui R.; Lupasco I.; Luzina E.; Lv X.-H.; Lynch K.; Ma H.-L.; Machado M.V.; Maduka N.; Madzharova K.; Magdaong R.; Mahadeva S.; Mahfouz A.; Mahmood N.R.K.N.; Mahmoud E.; Mahrous M.; Maiwall R.; Majeed A.; Majumdar A.; Mak L.; Maklouf M.M.; Malekzadeh R.; Mandato C.; Mangia A.; Mann J.; Mansour H.H.; Mansouri A.; Mantovani A.; Mao J.Q.; Maramag F.; Marchesini G.; Marcus C.; Marinho R.A.R.T.; Martinez-Chantar M.L.; Martins A.A.S.; Marwan R.; Mason K.F.; Masoud G.; Massoud M.N.; Matamoros M.A.; Mateos R.M.; Mawed A.; Mbanya J.C.; Mbendi C.; McColaugh L.; McLeod D.; Medina J.F.R.; Megahed A.; Mehrez M.; Memon I.; Merat S.; Mercado R.; Mesbah A.; Meskini T.; Metwally M.; Metwaly R.; Miao L.; Micah E.; Miele L.; Milivojevic V.; Milovanovic T.; Mina Y.L.; Mishkovik M.; Mishriki A.; Mitchell T.; Mohamed A.; Mohamed M.; Mohamed S.; Mohammed S.; Mohammed A.; Mohan V.; Mohie S.; Mokhtar A.; Moniem R.; Montilla M.S.; Morales J.A.O.; Morata M.M.S.; Moreno-Planas J.M.; Morise S.; Mosaad S.; Moselhy M.; Mostafa A.M.; Mostafa E.; Mouane N.; Mousa N.; Moustafa H.M.; Msherif A.; Muller K.; Munoz C.; Munoz-Urribarri A.B.; Murillo O.A.; Mustapha F.I.; Muzurovic E.; Nabil Y.; Nafady S.; Nagamatsu A.; Nakajima A.; Nakano D.; Nan Y.; Nascimbeni F.; Naseef M.S.; Nashat N.; Natalia T.; Negro F.; Nersesov A.V.; Neuman M.; Ng'wanasayi M.; Ni Y.; Nicoll A.; Niizeki T.; Nikolova D.; Ningning W.; Niriella M.; Nogoibaeva K.A.; Nordien R.; O Sullivan C.; O'Beirne J.; Obekpa S.; Ocama P.; Ochwoto M.; Ogolodom M.P.; Ojo O.; Okrostsvaridze N.; Oliveira C.P.; Omana R.C.; Omar O.M.; Omar H.; Omar M.; Omran S.; Omran R.; Osman M.M.; Owise N.; Owusu-Ansah T.; Padilla- Machaca P.M.; Palle S.; Pan Z.; Pan X.-Y.; Pan Q.; Papaefthymiou A.; Paquissi F.C.; Par G.; Parkash A.; Payawal D.; Peltekian K.M.; Peng X.; Peng L.; Peng Y.; Pengoria R.; Perez M.; Perez J.L.; Perez N.M.; Persico M.; Pessoa M.G.; Petta S.; Philip M.; Plaz Torres M.C.; Polavarapu N.; Poniachik J.; Portincasa P.; Pu C.; Purnak T.; Purwanto E.; Qi X.; Qi X.; Qian Z.; Qiang Z.; Qiao Z.; Qiao L.; Queiroz A.; Rabiee A.; Radwan M.; Rahetilahy A.M.; Ramadan Y.; Ramadan D.; Ramli A.S.; Ramm G.A.; Ran A.; Rankovic I.; RAO H.; Raouf S.; Ray S.; Reau N.; Refaat A.; Reiberger T.; Remes-Troche J.M.; Reyes E.C.; Richardson B.; Ridruejo E.; Riestra Jimenez S.; Rizk I.; Roberts S.; Roblero J.P.; Robles J.A.P.; Rockey D.; Rodriguez M.; Rodriguez Hernandez H.; Roman E.; Romeiro F.G.; Romeo S.; Rosales-Zabal J.M.; Roshdi G.R.; Rosso N.; Ruf A.; Ruiz P.C.; Runes N.R.; Ruzzenente A.; Ryan M.; Saad A.; Sabbagh E.B.; Sabbah M.; Saber S.; Sabrey R.; Sabry R.; Saeed M.A.; Said D.; Said E.M.; Sakr M.A.; Salah Y.; Salama R.M.; Salama A.; Saleh H.; Saleh A.; Salem A.; Salem A.T.; Salifou A.; Salih A.F.; Salman A.; Samouda H.; Sanai F.; Sanchez-Avila J.F.; Sanker L.; Sano T.; Sanz M.; Saparbu T.; Sawhney R.; Sayed F.; Sayed S.A.; Sayed A.O.; Sayed M.; Sebastiani G.; Secadas L.; Sediqi K.Q.; Seif S.; Semida N.; Senates E.; Serban E.D.; Serfaty L.; Seto W.-K.; Sghaier I.; Sha M.; Shabaan H.M.; Shalaby L.; Shaltout I.; Sharara A.I.; Sharma V.; Shawa I.T.; Shawkat A.; Shawky N.; Shehata O.; Sheils S.; Shewaye A.B.; Shi G.; Shi J.; Shimose S.; Shirono T.; Shou L.; Shrestha A.; Shui G.; Sievert W.; Sigurdardottir S.; Sira M.M.; Siradj R.; Sison C.; Smyth L.; Soliman R.; Sollano J.D.; Sombie R.; Sonderup M.; Sood S.; Soriano G.; Stedman C.A.M.; Stefanyuk O.; Stimac D.; Strasser S.; Strnad P.; Stuart K.; Su W.; Su M.; Sumida Y.; Sumie S.; Sun D.-Q.; Sun J.; Suzuki H.; Svegliati-Baroni G.; Swar M.O.; TAHARBOUCHT S.; Taher Z.; Takamura S.; Tan L.; Tan S.-S.; Tanwandee T.; Tarek S.; Tatiana G.; Tavaglione F.; Tecson G.Y.; Tee H.-P.; Teschke R.; Tharwat M.; Thong V.D.; Thursz M.; Tine T.; Tiribelli C.; Tolmane I.; Tong J.; Tongo M.; Torkie M.; Torre A.; Torres E.A.; Trajkovska M.; Treeprasertsuk S.; Tsutsumi T.; Tu T.; Tur J.A.; Turan D.; Turcan S.; Turkina S.; Tutar E.; Tzeuton C.; Ugiagbe R.; Uygun A.; Vacca M.; Vajro P.; Van der Poorten D.; Van Kleef L.A.; Vashakidze E.; Velazquez C.M.; Velazquez M.I.; Vento S.; Verhoeven V.; Vespasiani-Gentilucci U.; Vethakkan S.R.; Vilaseca J.; Vitek L.; Volkanovska A.; Wallace M.; Wan W.; Wang Y.; Wang Y.; Wang X.; Wang X.; Wang C.; Wang C.; Wang M.; Wangchuk P.; Weltman M.; White M.; Wiegand J.; Wifi M.-N.; Wigg A.; Wilhelmi M.; William R.; Wittenburg H.; Wu S.; Wubeneh A.M.; Xia H.; Xiao J.; Xiao X.; Xiaofeng W.; Xiong W.; Xu L.; Xu J.; Xu W.; Xu J.-H.; Xu K.; Xu Y.; Xu S.-H.; Xu M.; Xu A.; Xu C.; Yan H.; Yang J.; Yang R.-X.; Yang Y.; Yang Q.; Yang N.; Yao J.; Yara J.; Yaras S.; Yilmaz N.; Younes R.; younes H.; Young S.; Youssef F.; Yu Y.; Yu M.-L.; Yuan J.; Yue Z.; Yuen M.-F.; Yun W.; Yurukova N.; Zakaria S.; Zaky S.; Zaldastanishvili M.; Zapata R.; Zare N.; Zerem E.; Zeriban N.; Zeshuai X.; Zhang H.; Zhang X.; Zhang Y.; Zhang W.-H.; Zhang X.; Zhang Y.-P.; Zhang Y.; Zhang Z.-Q.; Zhao J.; Zhao R.-R.; Zhao H.; Zheng C.; Zheng Y.; Zheng R.; Zheng T.-L.; Zheng K.; Zhou X.Q.; Zhou Y.; Zhou Y.-J.; Zhou H.; Zhou L.; Zhou Y.; Zhu L.D.; Zhu Y.F.; Zhu Y.; Zhu P.-W.; Ziada E.; Ziring D.; Ziyi L.; Zou S.; Zou Z.; Zou H.; Zuart Ruiz R.Mendez-Sanchez, N.; Bugianesi, E.; Gish, R. G.; Lammert, F.; Tilg, H.; Nguyen, M. H.; Sarin, S. K.; Fabrellas, N.; Zelber-Sagi, S.; Fan, J. -G.; Shiha, G.; Targher, G.; Zheng, M. -H.; Chan, W. -K.; Vinker, S.; Kawaguchi, T.; Castera, L.; Yilmaz, Y.; Korenjak, M.; Spearman, C. W.; Ungan, M.; Palmer, M.; El-Shabrawi, M.; Gruss, H. -J.; Dufour, J. -F.; Dhawan, A.; Wedemeyer, H.; George, J.; Valenti, L.; Fouad, Y.; Romero-Gomez, M.; Eslam, M.; Abate, M. L.; Abbas, B.; Abbassy, A. A.; Abd El Ghany, W.; Abd Elkhalek, A.; Abd ElMajeed, E.; Abdalgaber, M.; Abdallah, M.; Abdallah, M.; Abdallah, N.; Abdelaleem, S.; Abdelghani, Y.; Abdelghany, W.; Abdelhalim, S. M.; Abdelhamid, W.; Abdelhamid, N.; Abdelkader, N. A.; Abdelkreem, E.; Abdelmohsen, A. M.; Abdelrahman, A. A.; Abd-elsalam, S. M.; Abdeltawab, D.; Abduh, A.; Abdulhakam, N.; Abdulla, M.; Abedpoor, N.; Abenavoli, L.; Aberg, F.; Ablack, O.; Abo elftouh, M.; Abo-Amer, Y. E. -E.; Aboubkr, A.; Aboud, A.; Abouelnaga, A. M.; Aboufarrag, G. 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M.; Elsayed, H.; El-Serafy, M.; Elsharkawy, A. M.; Elsheemy, R. Y.; Elshemy, E. E.; Elsherbini, S.; Eltoukhy, N.; Elwakil, R.; Emad, O.; Emad, S.; Embabi, M.; Ergenc, I.; Ermolova, T.; Esmat, G.; Esmat, D. M.; Estupinan, E. C.; Ettair, S.; Eugen, T.; Ezz-Eldin, M.; Falcon, L. P. V.; Fan, Y. -C.; Fandari, S.; Farag, M.; Farahat, T. M.; Fares, E. M.; Fares, M.; Fassio, E.; Fathy, H.; Fathy, D.; Fathy, W.; Fayed, S.; Feng, D.; Feng, G.; Fernandez-Bermejo, M.; Ferreira, C. T.; Ferrer, J. D.; Forbes, A.; Fouad, R.; Fouad, H. M.; Frisch, T.; Fujii, H.; Fukunaga, S.; Fukunishi, S.; Fulya, H.; Furuhashi, M.; Gaber, Y.; Galang, A. J. G.; Gallardo, J. C.; Galloso, R.; Gamal, M.; Gamal, R.; Gamal, H.; Gan, J.; Ganbold, A.; Gao, X.; Garas, G.; Garba, T.; Garcia-Cortes, M.; Garcia-Monzon, C.; Garcia-Samaniego, J.; Gastaldelli, A.; Gatica, M.; Gatley, E.; Gegeshidze, T.; Geng, B.; Ghazinyan, H.; Ghoneem, S.; Giacomelli, L.; Giannelli, G.; Giannini, E. 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V.; Koulla, Y.; Koya, S.; Kraft, C.; Kraja, B.; Krawczyk, M.; Kuchay, M. S.; Kulkarni, A. V.; Kumar, A.; Kumar, M.; Lakoh, S.; Lam, P.; Lan, L.; Lange, N. F.; Lankarani, K. B.; Lanthier, N.; Lapshyna, K.; Lashen, S. A.; Laure, K. N. J.; Lazebnik, L.; Lebrec, D.; Lee, S. S.; Lee, W. S.; Lee, Y. Y.; Leeming, D. J.; Leite, N. C.; Leon, R.; Lesmana, C. R. A.; Li, J.; Li, Q.; Li, J.; Li, Y. -Y.; Li, Y.; Li, L.; Li, M.; Li, Y.; Liang, H.; Lijuan, T.; Lim, S. G.; Lim, L. -L.; Lin, S.; Lin, H. -C.; Lin, R.; Lithy, R.; Liu, Y.; Liu, Y.; Liu, X.; Liu, W. -Y.; Liu, S.; Liu, K.; Liu, T.; Lonardo, A.; Lopez, M. B.; Lopez-Benages, E.; Lopez-Jaramillo, P.; Lu, H.; Lu, L. G.; Lu, Y.; Lubel, J.; Lui, R.; Lupasco, I.; Luzina, E.; Lv, X. -H.; Lynch, K.; Ma, H. -L.; Machado, M. V.; Maduka, N.; Madzharova, K.; Magdaong, R.; Mahadeva, S.; Mahfouz, A.; Mahmood, N. R. K. N.; Mahmoud, E.; Mahrous, M.; Maiwall, R.; Majeed, A.; Majumdar, A.; Mak, L.; Maklouf, M. M.; Malekzadeh, R.; Mandato, C.; Mangia, A.; Mann, J.; Mansour, H. H.; Mansouri, A.; Mantovani, A.; Mao, J. Q.; Maramag, F.; Marchesini, G.; Marcus, C.; Marinho, R. A. R. T.; Martinez-Chantar, M. L.; Martins, A. A. S.; Marwan, R.; Mason, K. F.; Masoud, G.; Massoud, M. N.; Matamoros, M. A.; Mateos, R. M.; Mawed, A.; Mbanya, J. C.; Mbendi, C.; Mccolaugh, L.; Mcleod, D.; Medina, J. F. R.; Megahed, A.; Mehrez, M.; Memon, I.; Merat, S.; Mercado, R.; Mesbah,

    Global multi-stakeholder endorsement of the MAFLD definition

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    none1055noneMendez-Sanchez N.; Bugianesi E.; Gish R.G.; Lammert F.; Tilg H.; Nguyen M.H.; Sarin S.K.; Fabrellas N.; Zelber-Sagi S.; Fan J.-G.; Shiha G.; Targher G.; Zheng M.-H.; Chan W.-K.; Vinker S.; Kawaguchi T.; Castera L.; Yilmaz Y.; Korenjak M.; Spearman C.W.; Ungan M.; Palmer M.; El-Shabrawi M.; Gruss H.-J.; Dufour J.-F.; Dhawan A.; Wedemeyer H.; George J.; Valenti L.; Fouad Y.; Romero-Gomez M.; Eslam M.; Abate M.L.; Abbas B.; Abbassy A.A.; Abd El Ghany W.; Abd Elkhalek A.; Abd ElMajeed E.; Abdalgaber M.; AbdAllah M.; Abdallah M.; Abdallah N.; Abdelaleem S.; Abdelghani Y.; Abdelghany W.; Abdelhalim S.M.; Abdelhamid W.; Abdelhamid N.; Abdelkader N.A.; Abdelkreem E.; Abdelmohsen A.M.; Abdelrahman A.A.; Abd-elsalam S.M.; Abdeltawab D.; Abduh A.; Abdulhakam N.; Abdulla M.; Abedpoor N.; Abenavoli L.; Aberg F.; Ablack O.; Abo elftouh M.; Abo-Amer Y.E.-E.; Aboubkr A.; Aboud A.; Abouelnaga A.M.; Aboufarrag G.A.; Aboutaleb A.; Abundis L.; Adali G.; Adames E.; Adams L.; Adda D.; Adel N.; Adel N.; Adel Sayed M.; Afaa T.J.; Afredj N.; Aghayeva G.; Aghemo A.; Aguilar-Salinas C.A.; Ahlenstiel G.; Ahmady W.; Ahmed W.; Ahmed A.; Ahmed S.N.; Ahmed H.M.; Ahmed R.; Aigner E.; Akarsu M.; Akroush M.; Akyuz U.; Al Mahtab M.; Al Qadiri T.; Al Rawahi Y.; AL rubaee R.; Al Saffar M.; Alam S.; Al-Ani Z.; Albillos A.; Alboraie M.; Al-Busafi S.; Al-Emam M.; Alharthi J.; Ali K.; Ali B.A.; Ali M.; Ali R.A.R.; Alisi A.; AL-Khafaji A.R.; Alkhatry M.; Aller R.; Almansoury Y.; Al-Naamani K.; Alnakeeb A.; Alonso A.; Alqahtani S.A.; Alrabadi L.; Alswat K.; Altaher M.; Altamimi T.; Altamirano J.; Alvares-da-Silva M.R.; Aly E.A.M.; Alzahaby A.; Alzamzamy A.; Amano K.; Amer M.A.; Amin M.A.; Amin S.A.; Amir A.A.; Ampuero J.; Anas N.; Andreone P.; Andriamandimby S.F.; Anees M.; Angela P.; Antonios M.; Arafat W.; Araya J.M.; Armendariz-Borunda J.; Armstrong M.J.; Ashktorab H.; Aspichueta P.; Assal F.; Atef M.; Attia D.; Atwa H.; Awad R.; Awad M.A.E.; Awny S.; Awolowo O.; Awuku Y.A.; Ayada I.; Aye T.T.; 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Chieh J.T.W.; Chokr I.; Cholongitas E.; Choudhury A.; Chowdhury A.; Chukwudike E.S.; Ciardullo S.; Clayton M.; Clement K.; Cloa M.M.; Coccia C.; Collazos C.; Colombo M.; Cosar A.M.; Cotrim H.P.; Couillerot J.; Coulibaly A.; Crespo G.; Crespo J.; Cruells M.; Cua I.H.Y.; Dabbous H.K.; Dalekos G.N.; D'Alia P.; Dan L.; Dao V.H.; Darwish M.; Datz C.; Davalos-Moscol M.B.; Dawoud H.; de Careaga B.O.; de Knegt R.; de Ledinghen V.; de Silva J.; Debzi N.; Decraecker M.; Del Pozo E.; Delgado T.C.; Delgado-Blanco M.; Dembinski L.; Depina A.; Derbala M.; Desalegn H.; Desbois-Mouthon C.; Desoky M.; Dev A.; Di Ciaula A.; Diago M.; Diallo I.; Diaz L.A.; Dirchwolf M.; Dongiovanni P.; Dorofeyev A.; Dou X.; Douglas M.W.; Doulberis M.; Dovia C.K.; Doyle A.; Dragojevic I.; Drenth J.P.; Duan X.; Dulskas A.; Dumitrascu D.L.; Duncan O.; Dusabejambo V.; Dwawhi R.S.N.A.; Eiketsu S.; El Amrousy D.; El Deeb A.; El Deriny G.; El Din H.S.; El Kamshishy S.; El Kassas M.; El Raziky M.; Elagamy O.A.; Elakel W.; Elalfy D.; 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Gao X.; Garas G.; Garba T.; Garcia-Cortes M.; Garcia-Monzon C.; Garcia-Samaniego J.; Gastaldelli A.; Gatica M.; Gatley E.; Gegeshidze T.; Geng B.; Ghazinyan H.; Ghoneem S.; Giacomelli L.; Giannelli G.; Giannini E.G.; Giefer M.; Gines P.; Girala M.; Giraudi P.J.; Goh G.B.-B.; Gomaa A.A.; Gong B.; Gonzales D.H.C.; Gonzalez H.C.; Gonzalez-Huezo M.S.; Graupera I.; Grgurevic I.; Gronbaek H.; Gu X.; Guan L.; Gueye I.; Guingane A.N.; Gul O.O.; Gul C.B.; Guo Q.; Gupta P.P.; Gurakar A.; Gutierrez J.C.R.; Habib G.; Hafez A.; Hagman E.; Halawa E.; Hamdy O.; Hamed A.E.; Hamed D.H.; Hamid S.; Hamoudi W.; Han Y.; Haridy J.; Haridy H.; Harris D.C.H.H.; Hart M.; Hasan F.; Hashim A.; Hassan I.; Hassan A.; Hassan E.A.; Hassan A.A.; Hassan M.S.; Hassanin F.; Hassnine A.; Haukeland J.W.; Hawal A.I.M.; He J.; He Q.; He Y.; He F.-P.; Hegazy M.; Hegazy A.; Henegil O.; Hernandez N.; Hernandez-Guerra M.; Higuera-de-la-Tijera F.; Hindy I.; Hirota K.; Ho L.C.; Hodge A.; Hosny M.; Hou X.; Huang J.-F.; Huang Y.; Huang Z.; Huang Y.; Huang A.; Huang X.-P.; Hui-ping S.; Hunyady B.; Hussein M.A.; Hussein O.; Hussien S.M.; Ibanez-Samaniego L.; Ibdah J.; Ibrahim L.; Ibrahim M.; Ibrahim I.; Icaza-Chavez M.E.; Idelbi S.; Idilman R.I.; Ikeda M.; Indolfi G.; Invernizzi F.; Irshad I.; Isa H.M.A.; Iskandar N.J.; Ismaiel A.; Ismail M.; Ismail Z.; Ismail F.; Iwamoto H.; Jack K.; Jacob R.; Jafarov F.; Jafri W.; Jahshan H.; Jalal P.K.; Jancoriene L.; Janicko M.; Jayasena H.; Jefferies M.; Jha V.; Ji F.; Ji Y.; Jia J.; Jiang C.; Jiang N.; Jiang Z.-Z.; Jin X.; Jin Y.; Jing X.; Jingyu Q.; Jinjolava M.; Jong F.H.H.; Jucov A.; Julius I.; Kaddah M.; Kamada Y.; kamal A.; Kamal E.M.; Kamel A.S.; Kao J.-H.; Karin M.; Karlas T.; Kashwaa M.; Katsidzira L.; Kaya E.; Kayasseh M.A.; Keenan B.; Keklikkiran C.; Keml W.; Khalaf D.K.; Khalefa R.; Khamis S.; Khater D.; khattab H.; Khavkin A.; Khlynova O.; Khmis N.; Kobyliak N.; Koffas A.; Koike K.; Kok K.Y.Y.; Koller T.; Komas N.P.; Korochanskaya N.V.; Koulla Y.; Koya S.; Kraft C.; Kraja B.; 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    Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

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    Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)
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