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  1. Article ; Online: Is there a standard reaction of surgeons to surgical complications? Study on an interesting historical case.

    Tebala, Giovanni D

    Medical hypotheses

    2020  Volume 144, Page(s) 110006

    Abstract: The surgeon has been recognised as the "second victim" of a surgical complication and the long term psychological impact of a surgical adverse event has been demonstrated. However, the immediate and early psychological response to a surgical complication ...

    Abstract The surgeon has been recognised as the "second victim" of a surgical complication and the long term psychological impact of a surgical adverse event has been demonstrated. However, the immediate and early psychological response to a surgical complication has not been properly investigated. In this manuscript we analyse a well-known historical case of a surgical complication and discuss the early reaction of the surgeon. Sir Anthony Eden, UK Prime Minister in the '50s, underwent a cholecystectomy for gallstones, but the operation complicated with a biliary fistula causing jaundice and sepsis. The reaction of the surgeon followed a precise three-stage pattern that can be identified in almost every case of surgical complication. Initially he denied the complication, with a simplistic attitude, but subsequently he felt overwhelmed by the environmental pressure and gave up. The early psychological response of a surgeon to a surgical complication usually follows the three phases of "denial", "desperation" and "action or get-away". In the denial phase the surgeon tries to reassure him or herself by diminishing the real burden of the complication and to demonstrate self-confidence. After few days, when it is evident that the complication is more severe than expected, the surgeon changes completely his or her attitude and becomes more and more depressed and anxious. The reaction to phase 2 will determine the subsequent phase 3, where the surgeon would choose between a positive and proactive attitude or getting-away, thus disengaging from the complicated patient. Acknowledging these three phases would help team leaders and colleagues to recognise the need for a supportive, friendly and blame-free environment and to act timely to help the surgeon to overcome the negative impact on his or her personality and career.
    MeSH term(s) Female ; Humans ; Male ; Surgeons
    Language English
    Publishing date 2020-06-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 193145-3
    ISSN 1532-2777 ; 0306-9877
    ISSN (online) 1532-2777
    ISSN 0306-9877
    DOI 10.1016/j.mehy.2020.110006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Calculation and internal validation of a new synthetic and autocorrelate index to combine the determinants of health of a population.

    Tebala, Domenico / Tebala, Giovanni Domenico

    Archives of public health = Archives belges de sante publique

    2021  Volume 79, Issue 1, Page(s) 65

    Abstract: Background: The status of health of an individual and - more broadly - of a community or population is defined by the status of their determinants of health. A "systemic" approach to define the health determinants is necessary in order to explore the ... ...

    Abstract Background: The status of health of an individual and - more broadly - of a community or population is defined by the status of their determinants of health. A "systemic" approach to define the health determinants is necessary in order to explore the complex relations existing among them. This study is aimed at identifying a 'composite systemic' index of health to measure the impact of socioeconomic factors on public health at local level and to analyze possible spatial autocorrelations between neighboring regions.
    Results: A Composite Index of Health (CIH) was constructed on the basis of known indicators of socio-economic well-being by using the COMIC (COMposite Indices Creator) Software and was validated on the Italian population and a nationwide comparison has been performed. Analysis of the determinants showed a significant direct correlation between health, environment, work and wealth and inverse correlation between health and social distress. The analysis of data from Italian provinces confirmed the South-North gradient of well-being.
    Conclusion: The CIH is a reliable and robust index to evaluate the health of a local population. Although it was validated on Italian data, the index can be easily adapted to any Country.
    Language English
    Publishing date 2021-04-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 1117688-x
    ISSN 2049-3258 ; 0778-7367 ; 0003-9578
    ISSN (online) 2049-3258
    ISSN 0778-7367 ; 0003-9578
    DOI 10.1186/s13690-021-00590-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Emperor's New Clothes: a Critical Appraisal of Evidence-based Medicine.

    Tebala, Giovanni D

    International journal of medical sciences

    2018  Volume 15, Issue 12, Page(s) 1397–1405

    Abstract: Evidence-Based Medicine (EBM) is the way we are expected to deliver our healthcare in the ... ...

    Abstract Evidence-Based Medicine (EBM) is the way we are expected to deliver our healthcare in the 21
    MeSH term(s) Decision Making ; Evidence-Based Medicine ; Humans ; Knowledge ; Physicians ; Reproducibility of Results
    Language English
    Publishing date 2018-09-07
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 2151424-0
    ISSN 1449-1907 ; 1449-1907
    ISSN (online) 1449-1907
    ISSN 1449-1907
    DOI 10.7150/ijms.25869
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Correction to: War trauma in Homer's Iliad: a trauma registry perspective.

    Chicco, Maria / Tebala, Giovanni D

    European journal of trauma and emergency surgery : official publication of the European Trauma Society

    2020  Volume 47, Issue 3, Page(s) 779–780

    Language English
    Publishing date 2020-05-29
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 2275480-5
    ISSN 1863-9941 ; 1863-9933
    ISSN (online) 1863-9941
    ISSN 1863-9933
    DOI 10.1007/s00068-020-01393-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: War trauma in Homer's Iliad: a trauma registry perspective.

    Chicco, Maria / Tebala, Giovanni D

    European journal of trauma and emergency surgery : official publication of the European Trauma Society

    2020  Volume 47, Issue 3, Page(s) 773–778

    Abstract: Purpose: Homer's Iliad reports detailed descriptions of war traumas, with precise anatomical references, so that the Iliad can be considered the first trauma registry. We aimed to analyse the Iliad from the perspective of a modern trauma registry: that ... ...

    Abstract Purpose: Homer's Iliad reports detailed descriptions of war traumas, with precise anatomical references, so that the Iliad can be considered the first trauma registry. We aimed to analyse the Iliad from the perspective of a modern trauma registry: that is, to find historical and local prognostic factors through the epidemiological study of the reported traumas.
    Methods: Two different editions of Homer's Iliad-one in English and one in Italian-were thoroughly studied and epidemiological data were statistically analysed.
    Results: 148 reports of human traumas were analysed. The majority of traumas (73.6%) involved Trojan warriors, with spears being the most frequent wounding agent (71%). Overall mortality was 84.5% and was higher in the Trojan field (90.8% vs 61.5%). Despite the high mortality, median New Injury Severity Score (NISS) was low, probably due to high prevalence of penetrating mono-systemic trauma. Median NISS was higher in the Trojan group. Compared to the Achaeans, the Trojans had more torso injuries, whereas Achaeans had more injuries to limbs and superficial tissues. However, in both fields, head and neck were more frequently injured.
    Conclusions: Homer's Iliad gives us an interesting insight into war traumas during the siege of Troy. The reported higher mortality within the Trojan army can be explained not only by poetic reasons but also by different military skills.
    MeSH term(s) Extremities ; History, Ancient ; Humans ; Medicine in Literature ; Registries ; Wounds, Penetrating
    Language English
    Publishing date 2020-04-18
    Publishing country Germany
    Document type Historical Article ; Journal Article
    ZDB-ID 2275480-5
    ISSN 1863-9941 ; 1863-9933
    ISSN (online) 1863-9941
    ISSN 1863-9933
    DOI 10.1007/s00068-020-01365-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The "Left Ureteral Triangle" as an Anatomic Landmark for the Identification of the Left Ureter in Laparoscopic Distal Colectomies.

    Tebala, Giovanni D

    Surgical laparoscopy, endoscopy & percutaneous techniques

    2016  Volume 26, Issue 5, Page(s) e100–e102

    Abstract: Ureteral injury is one of the possible complications of distal colectomies. It may be caused by misidentification of the anatomic landmarks during the left lateral dissection, due to factor pertaining to the patient, the disease, and the surgeon. The ... ...

    Abstract Ureteral injury is one of the possible complications of distal colectomies. It may be caused by misidentification of the anatomic landmarks during the left lateral dissection, due to factor pertaining to the patient, the disease, and the surgeon. The only way to reduce the risk of this avoidable complication is the perfect knowledge and identification of the anatomy of the left ureter. In this article, we describe an anatomic triangle that can be a valid help in the identification of the ureter in the area where higher is the risk of iatrogenic injury. The left ureteric triangle can be prepared after the dissection of the left Toldt plane, as soon as the dissection reaches the superior mesorectum. Sides of this triangle are (a) superiorly, the dissected mesosigmoid, (b) right side, upper mesorectum and sacral promontorium, and (c) inferiorly, the margin of the incised posterior parietal peritoneum. The left ureter runs within this triangle.
    MeSH term(s) Anatomic Landmarks ; Colectomy/methods ; Humans ; Intraoperative Complications/prevention & control ; Laparoscopy/methods ; Organ Sparing Treatments/methods ; Risk Factors ; Ureter/anatomy & histology ; Ureter/injuries
    Language English
    Publishing date 2016-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1475108-2
    ISSN 1534-4908 ; 1530-4515 ; 1051-7200
    ISSN (online) 1534-4908
    ISSN 1530-4515 ; 1051-7200
    DOI 10.1097/SLE.0000000000000311
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: De Garengeot's Hernia Treated With a Hybrid Approach: A Case Report.

    Alkashty, Mohamed / Dickinson, Ben / Tebala, Giovanni D

    Annals of coloproctology

    2021  Volume 37, Issue Suppl 1, Page(s) S55–S57

    Abstract: De Garengeot's hernia happens when an inflamed or ischemic appendix is located within an incarcerated femoral hernia. We hereby report a case of De Garengeot's hernia treated with a combined open and laparoscopic approach. An 80-year-old male presented ... ...

    Abstract De Garengeot's hernia happens when an inflamed or ischemic appendix is located within an incarcerated femoral hernia. We hereby report a case of De Garengeot's hernia treated with a combined open and laparoscopic approach. An 80-year-old male presented to the emergency department with a 1-day history of a tender right inguinal mass. A computed tomography scan revealed a direct right inguinal hernia containing an incarcerated appendix. At surgery, the diagnosis of a strangulated appendix within a femoral hernia was made. To avoid a wide disruption of the right groin region, the ischemic appendix was reduced into the abdomen and removed laparoscopically. The femoral defect was treated by open plug repair. De Garengeot's hernia may represent a surgical challenge. A combined open and laparoscopic approach is a good option in these cases.
    Language English
    Publishing date 2021-05-28
    Publishing country Korea (South)
    Document type Case Reports
    ZDB-ID 2711906-3
    ISSN 2287-9722 ; 2287-9714
    ISSN (online) 2287-9722
    ISSN 2287-9714
    DOI 10.3393/ac.2020.09.21.2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Multidisciplinary treatment of cancer.

    Tebala, Giovanni D / Bond-Smith, Giles

    Updates in surgery

    2020  Volume 73, Issue 1, Page(s) 349–350

    MeSH term(s) Humans ; Neoplasms/therapy ; Patient Care Team
    Language English
    Publishing date 2020-05-15
    Publishing country Italy
    Document type Letter ; Comment
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-020-00794-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Platelet-Rich Fibrin-Mesh Technique for Inguinal Hernia Repair: Results of a Feasibility Pilot Study.

    Di Nicola, Valerio / Tebala, Giovanni D

    Surgical technology international

    2021  Volume 38, Page(s) 175–177

    Abstract: Background: Open mesh repair is one of the most frequently performed general surgery operations worldwide. Unfortunately, the classic technique using stitches to fix the mesh is still associated with a high risk of chronic pain. We propose a new ... ...

    Abstract Background: Open mesh repair is one of the most frequently performed general surgery operations worldwide. Unfortunately, the classic technique using stitches to fix the mesh is still associated with a high risk of chronic pain. We propose a new technique that uses autologous Platelet-Rich Fibrin (PRF) to fix the mesh.
    Methods: PRF is prepared in theatre by centrifugation of the patient's own blood and immediately applied to fix the mesh. In this feasibility pilot study, five patients were operated upon with the PRF-mesh repair technique. Postoperative pain was evaluated with a visual analogue scale (VAS) up to 6 months after surgery. Time to recovery was also recorded for all patients. VAS in this small group of patients was grossly compared with that in a historical cohort of patients who underwent Lichtenstein repair; due to the small sample size, no statistical comparison was performed.
    Results: Postoperative pain remained at low levels and no patient experienced chronic pain, recurrence or any other complication within 6 months. All patients returned to their usual activities within 3 days after surgery. The VAS scores confirmed that PRF-mesh repair may be associated with less pain than the Lichtenstein technique.
    Conclusions: PRF-mesh repair is a safe and effective option in the treatment of inguinal hernias as it couples the safety of physiologically enhanced healing with the efficacy of prompt fixation of the mesh.
    MeSH term(s) Feasibility Studies ; Hernia, Inguinal/surgery ; Herniorrhaphy ; Humans ; Pain, Postoperative/epidemiology ; Pilot Projects ; Platelet-Rich Fibrin ; Postoperative Complications ; Recurrence ; Surgical Mesh ; Treatment Outcome
    Language English
    Publishing date 2021-01-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1225512-9
    ISSN 1090-3941
    ISSN 1090-3941
    DOI 10.52198/21.STI.38.HR1354
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Laparoscopic tubularized gastrostomy: a valid alternative to percutaneous endoscopic gastrostomy.

    Tebala, Giovanni D / Bond-Smith, Giles

    Updates in surgery

    2020  Volume 73, Issue 2, Page(s) 779–780

    MeSH term(s) Enteral Nutrition ; Gastrostomy ; Humans ; Laparoscopy ; Surgical Stomas
    Language English
    Publishing date 2020-07-08
    Publishing country Italy
    Document type Letter
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-020-00849-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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