The use of indocyanine green in bariatric surgery: A systematic review

Fluorescence-guided surgery is a recently developed technique in minimally invasive surgery in which a fluorescent dye is used to complement the surgeon’s judgment in making real-time intraoperative assessment of organ vascularization and proper tissue perfusion. This technique has been adopted in several different surgical subspecialties with positive results, particularly in hepatobiliary and colorectal surgery. More recently, it has also been applied in bariatric surgery, with the aim of reducing the incidence of leaks. This paper reviews the relevant literature on the topic

Actinomadura graeca sp. nov.: A novel producer of the macrocyclic antibiotic zelkovamycin

As part of a screening programme for antibiotic-producing bacteria, a novel Actinomadura species was discovered from a soil sample collected in Santorini, Greece. Preliminary 16S rRNA gene sequence comparisons highlighted Actinomadura macra as the most similar characterised species. However, whole-genome sequencing revealed an average nucleotide identity (ANI) value of 89% with A. macra, the highest among related species. Further phenotypic and chemotaxonomic analyses confirmed that the isolate represents a previously uncharacterised species in the genus Actinomadura, for which the name Actinomadura graeca sp. nov. is proposed (type strain 32-07T). The G+C content of A. graeca 32-07 is 72.36%. The cell wall contains DL-diaminopimelic acid, intracellular sugars are glucose, ribose and galactose, the predominant menaquinone is MK-9(H6), the major cellular lipid is phosphatidylinositol and fatty acids consist mainly of hexadecanoic acid. No mycolic acid was detected. Furthermore, A. graeca 32-07 has been confirmed as a novel producer of the non-ribosomal peptide antibiotic zelkovamycin and we report herein a provisional description of the unique biosynthetic gene cluster

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

La vita in un “cantiere” a Monte Stallonara

Questo contributo, all’interno della ricerca sui territori Post Metropolitani, nasce dall’analisi dello sviluppo di pezzi di città sorti in maniera disarticolata, prevalentemente fuori dal GRA e in discontinuità rispetto al tessuto urbano di riferimento, come esito di una combinazione tra insediamenti abusivi e piani di zona, ovvero piani di edilizia residenziale pubblica con componenti di edilizia agevolata, mediante i quali si vorrebbero recuperare le aree abusive e che invece portano ad effetti tutt’altro che desiderati. Ciò determina un modello di sviluppo insediativo, e quindi dell’abitare, che costituisce la declinazione romana della “Postmetropoli”, la cui rappresentazione, proprio in virtù delle complesse dinamiche che l’hanno generato, diventa meno immediata. L’attenzione, durante la ricerca, rivolta a Monte Stallonara è dovuta al fatto che esso è emblematico di questo modello di sviluppo ed, in particolare, di quei numerosi piani di zona che sono stati progettati nell'Agro romano con l’intento di “produrre città” e che avrebbero dovuto riqualificare interi quartieri ma che, di fatto, hanno costituito un altro modo di incentivare la speculazione edilizia: i recenti scandali che hanno coinvolto l’ambigua gestione di questi piani, tra cui quello di Monte Stallonara, attraverso le vendite o gli affitti in libero mercato degli immobili di edilizia agevolata, contrariamente alle convenzioni stipulate tra imprese costruttrici e Amministrazione pubblica, ne sono un chiaro esempio

Updates in bariatric surgery guidelines. What's new?

No abstract

Un libro, una storia, una voce. Corso di formazione per la gestione di una biblioteca per ragazzi

OBIETTIVO GENERALE: formare i volontari alla gestione di una biblioteca per bambini 0-12 anni ed all'approccio alla lettura ad alta voce. ampliare la rete dei lettori volontari per permettere un potenziamento dei servizi offerti al territoro ; aumentare la consapevolezza fra la popolazione del significato e dell'importanza della lettura. importanza della valenza delle iniziative dell'associazione sulla popolazione infantile del territorio. OBIETTIVI SPECIFICI: -aumentare il livello di formazione fra i volontari gi\ue0 operanti; - formare nuovi volontari per ampliare la rete; offrire questa occasione formativa a volontari di altre associazioni ed ad operatori della scuola , per creare le premesse di un lavoro in rete; familiarizzarsi con alcune modalit\ue0 di lettura efficacia ai fini della promozione della lettura in famiglia

Diagnosis and Treatment of Obstetric Anal Sphincter Injuries: New Evidence and Perspectives

Perineal injury during childbirth is a common event with important morbidity associated in particular with third-and-fourth degree perineal tears (also referred to as obstetric anal sphincter injuries—OASIS). Early diagnosis of these damages is mandatory to define a prompt therapeutic strategy and thus avoid the development of late-onset consequences, such as faecal incontinence. For this purpose, various diagnostic exams can be performed after a thorough clinical examination. The management of OASIS includes several measures and should be individualized according to the timing and features of the clinical presentation

Blockchain technology in healthcare: do we really need it?

Overview of blockchain in the healthcare sector

Portomesenteric Vein Thrombosis after Bariatric Surgery: An Online Survey

Portomesenteric vein thrombosis (PMVT) is a rare post-operative complication of bariatric procedures, occurring in between 0.3% and 1% of cases. A structured questionnaire consisting of 27 items was available online to members of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) to investigate the occurrence of PMVT. A total of 89 bariatric surgeons from 61 countries participated. Twenty-six (29.21%) reported at least one case of PMVT (46.15% males; 53.84% females). The surgery most associated with PMVT occurrence was sleeve gastrectomy (84.6%), followed by Roux-en-Y gastric bypass (RYGB) (7.69%), and laparoscopic adjustable gastric banding (LAGB) (7.69%). The time gap between surgery and PMVT was 19.28 ± 8.72 days. The predominant symptom was abdominal pain in 96.15% of patients, followed by fever in 26.9%. Complete occlusion of the portal vein was reported in 34.6% of cases, with involvement of the portal system in 69%, extension to the superior mesenteric district in 23%, and extension to the splenic vein in two patients (7.7%). Our survey, which is the largest regarding PMVT to date, revealed a diffuse lack of standardization in the choice, duration, and dosing of prophylaxis regimens as well as treatment modalities, reflecting the literature gap on the topic