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Article ; Online: Functioning within the dysfunction: practical approaches to reducing surgeon burnout.

Cellini, Christina

2022 Volume 109, Issue 6, Page(s) 478–479

MeSH term(s)	Burnout, Professional/prevention & control ; Burnout, Psychological ; Humans ; Surgeons ; Surveys and Questionnaires
Language	English
Publishing date	2022-05-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znac068
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Article ; Online: Novel Approach for Laparoscopically Placed Chronic Amniotic Fluid Catheters in Sheep.

Cellini, Christina / Labuz, Daniel F / Buchmiller, Terry L

Fetal diagnosis and therapy

2021 Volume 48, Issue 5, Page(s) 400–406

Abstract: Introduction: Several fetal therapies involve repeated amniotic fluid intervention. We hypothesize that a minimally invasive approach can be used to safely implant an intrauterine catheter infusion system in a fetal ovine model for chronic use during ... ...

Abstract	Introduction: Several fetal therapies involve repeated amniotic fluid intervention. We hypothesize that a minimally invasive approach can be used to safely implant an intrauterine catheter infusion system in a fetal ovine model for chronic use during pregnancy. Method: Five pregnant sheep underwent operation between gestational days 110 and 115 (term 145 days). A Codman® implantable infusion pump was adapted for intrauterine use. The chamber was placed in the maternal flank and the tunneled catheter laparoscopically inserted into the amniotic cavity, secured with a pursestring. Three had an additional uterine anchoring suture. Ewes were sacrificed after natural delivery, and the uterus underwent gross and microscopic analyses. Results: There were no maternal mortalities, abortions, or preterm labor. Pumps were accessed and remained functional throughout gestation. Four ewes delivered healthy term lambs; the other delivered twins with failure to progress and demise. On necropsy, catheters secured with an anchoring suture remained in place, while the other 2 dislodged during labor. There was no chorioamnionitis by culture or histology. Conclusion: Laparoscopically placed intra-amniotic infusion catheters were implanted safely and remained functional until delivery in an ovine model. This novel approach has promise in providing safe, durable amniotic fluid access for the potential treatment of fetal disease.
MeSH term(s)	Amniotic Fluid ; Animals ; Catheters ; Chorioamnionitis ; Female ; Obstetric Labor, Premature ; Pregnancy ; Sheep ; Uterus
Language	English
Publishing date	2021-05-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1066460-9
ISSN	1421-9964 ; 1015-3837
ISSN (online)	1421-9964
ISSN	1015-3837
DOI	10.1159/000515695
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Article ; Online: Distinct epilepsy phenotypes and response to drugs in KCNA1 gain- and loss-of function variants.

Miceli, Francesco / Guerrini, Renzo / Nappi, Mario / Soldovieri, Maria Virginia / Cellini, Elena / Gurnett, Christina A / Parmeggiani, Lucio / Mei, Davide / Taglialatela, Maurizio

Epilepsia

2021 Volume 63, Issue 1, Page(s) e7–e14

Abstract: A wide phenotypic spectrum of neurological diseases is associated with KCNA1 (Kv1.1) variants. To investigate the molecular basis of such a heterogeneous clinical presentation and identify the possible correlation with in vitro phenotypes, we compared ... ...

Abstract	A wide phenotypic spectrum of neurological diseases is associated with KCNA1 (Kv1.1) variants. To investigate the molecular basis of such a heterogeneous clinical presentation and identify the possible correlation with in vitro phenotypes, we compared the functional consequences of three heterozygous de novo variants (p.P403S, p.P405L, and p.P405S) in Kv1.1 pore region found in four patients with severe developmental and epileptic encephalopathy (DEE), with those of a de novo variant in the voltage sensor (p.A261T) identified in two patients with mild, carbamazepine-responsive, focal epilepsy. Patch-clamp electrophysiology was used to investigate the functional properties of mutant Kv1.1 subunits, both expressed as homomers and heteromers with wild-type Kv1.1 subunits. KCNA1 pore mutations markedly decreased (p. P405S) or fully suppressed (p. P403S, p. P405L) Kv1.1-mediated currents, exerting loss-of-function (LoF) effects. By contrast, channels carrying the p.A261T variant exhibited a hyperpolarizing shift of the activation process, consistent with a gain-of-function (GoF) effect. The present results unveil a novel correlation between in vitro phenotype (GoF vs LoF) and clinical course (mild vs severe) in KCNA1-related phenotypes. The excellent clinical response to carbamazepine observed in the patients carrying the A261T variant suggests an exquisite sensitivity of KCNA1 GoF to sodium channel inhibition that should be further explored.
MeSH term(s)	Carbamazepine/therapeutic use ; Epilepsy/drug therapy ; Epilepsy/genetics ; Humans ; Kv1.1 Potassium Channel/genetics ; Mutation/genetics ; Phenotype
Chemical Substances	KCNA1 protein, human ; Kv1.1 Potassium Channel (147173-20-4) ; Carbamazepine (33CM23913M)
Language	English
Publishing date	2021-11-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17118
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Article ; Online: Acute kidney injury is a common and significant complication following ileostomy formation.

Loria, Anthony / Melucci, Alexa / Speranza, Jenny / Cellini, Christina / Salloum, Rabih / Temple, Larissa K / Fleming, Fergal J / Justiniano, Carla F

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2021 Volume 24, Issue 1, Page(s) 102–110

Abstract: Aim: The aim was to characterize the incidence and short-term prognostic value of an acute kidney injury (AKI) during the admission where an ileostomy is formed.: Methods: Adults with a baseline serum creatinine measurement discharged alive after ... ...

Abstract	Aim: The aim was to characterize the incidence and short-term prognostic value of an acute kidney injury (AKI) during the admission where an ileostomy is formed. Methods: Adults with a baseline serum creatinine measurement discharged alive after ileostomy formation from 2014 to 2016 were included. All patients had daily basic metabolic panels and the Kidney Diseases Improving Global Outcomes criteria were used to determine the presence and severity of any AKI. Dehydration was defined by a single urine abnormality or clinical criteria combined with an objective abnormality in vitals or basic metabolic panels. Results: Of 262 patients, 19.4% sustained an AKI (74.5% Stage I, 15.7% Stage II, 9.8% Stage III) during the index admission. Predictors of incident AKI were increasing age, male sex, higher baseline creatinine and open surgery. Patients with AKI had significantly longer length of stay and 45% had creatinine <1.0 mg/dl at discharge. Of the total cohort, 11% were readmitted with dehydration and the independent predictors were AKI during the index admission, high ileostomy output, age >65 years, male sex and prior ileostomy. Of those readmitted with dehydration, 79% had AKI at readmission. Conclusions: Nearly 20% of patients with ileostomies develop an AKI during the index admission with almost half resolving by discharge. Patients with AKIs are at high risk for 30-day dehydration-related readmission and AKI is present in nearly 80% of those readmitted with dehydration. Since AKI is objective, based on routine laboratory measures, and has known prognostic value it is probably a more robust outcome than dehydration for researchers, surgeons and patients.
MeSH term(s)	Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Adult ; Aged ; Humans ; Ileostomy/adverse effects ; Male ; Patient Readmission ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2021-10-07
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15917
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Article ; Online: Florid Vascular Proliferation of the Small Bowel and Colon, a Potential Masquerader of Malignancy: Report of Three Cases.

Agostini-Vulaj, Diana / Whitney-Miller, Christa L / Cellini, Christina / Huber, Aaron R

International journal of surgical pathology

2019 Volume 27, Issue 6, Page(s) 609–612

Abstract: Vascular abnormalities and lesions of the small bowel and colon are rare. A florid vascular proliferation (FVP) associated with colon obstruction and intussusception has been described and can mimic malignant vascular tumors such as angiosarcoma. In this ...

Abstract	Vascular abnormalities and lesions of the small bowel and colon are rare. A florid vascular proliferation (FVP) associated with colon obstruction and intussusception has been described and can mimic malignant vascular tumors such as angiosarcoma. In this article, we report a case of colonic FVP associated with colon obstruction, a case of small bowel FVP associated with a Meckel's diverticulum, and a case of small bowel FVP with intussusception. All cases occurred in older adults (mean 73 years of age, range 62-80 years of age). FVP grossly appeared as a mass-like lesion in one small bowel case, while the other cases did not demonstrate a grossly identifiable mass. Histologically, all cases demonstrated a transmural vascular proliferation with plump endothelial cells. No significant cytologic atypia was seen, and mitotic figures were rare. No recurrence was seen in all cases with an average follow-up of 22 months. It is important to be aware of this entity as it appears to be a nonneoplastic reactive process, unlike some of its histologic mimics.
MeSH term(s)	Aged ; Aged, 80 and over ; Cell Proliferation ; Colectomy ; Colon/blood supply ; Colon/pathology ; Colon/surgery ; Colonic Neoplasms/complications ; Colonic Neoplasms/diagnosis ; Colonic Neoplasms/surgery ; Diagnosis, Differential ; Endothelial Cells/pathology ; Endothelium, Vascular/cytology ; Endothelium, Vascular/pathology ; Female ; Hemangiosarcoma/complications ; Hemangiosarcoma/diagnosis ; Humans ; Ileum/blood supply ; Ileum/pathology ; Ileum/surgery ; Intestinal Mucosa/blood supply ; Intestinal Mucosa/pathology ; Intestinal Mucosa/surgery ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery ; Intussusception/etiology ; Intussusception/pathology ; Intussusception/surgery ; Male ; Meckel Diverticulum/complications ; Meckel Diverticulum/diagnosis ; Meckel Diverticulum/surgery ; Middle Aged
Language	English
Publishing date	2019-04-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1336393-1
ISSN	1940-2465 ; 1066-8969
ISSN (online)	1940-2465
ISSN	1066-8969
DOI	10.1177/1066896919837665
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Article: Postoperative pain control.

Garimella, Veerabhadram / Cellini, Christina

Clinics in colon and rectal surgery

2011 Volume 26, Issue 3, Page(s) 191–196

Abstract: The effective relief of pain is of the utmost importance to anyone treating patients undergoing surgery. Pain relief has significant physiological benefits; hence, monitoring of pain relief is increasingly becoming an important postoperative quality ... ...

Abstract	The effective relief of pain is of the utmost importance to anyone treating patients undergoing surgery. Pain relief has significant physiological benefits; hence, monitoring of pain relief is increasingly becoming an important postoperative quality measure. The goal for postoperative pain management is to reduce or eliminate pain and discomfort with a minimum of side effects. Various agents (opioid vs. nonopioid), routes (oral, intravenous, neuraxial, regional) and modes (patient controlled vs. "as needed") for the treatment of postoperative pain exist. Although traditionally the mainstay of postoperative analgesia is opioid based, increasingly more evidence exists to support a multimodal approach with the intent to reduce opioid side effects (such as nausea and ileus) and improve pain scores. Enhanced recovery protocols to reduce length of stay in colorectal surgery are becoming more prevalent and include multimodal opioid sparing regimens as a critical component. Familiarity with the efficacy of available agents and routes of administration is important to tailor the postoperative regimen to the needs of the individual patient.
Language	English
Publishing date	2011-05-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2048635-2
ISSN	1531-0043
ISSN	1531-0043
DOI	10.1055/s-0033-1351138
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Article: Postoperative Pain Control

Garimella, Veerabhadram / Cellini, Christina

Clinics in Colon and Rectal Surgery

(Perioperative Management)

2013 Volume 26, Issue 03, Page(s) 191–196

Series title	Perioperative Management
Abstract	The effective relief of pain is of the utmost importance to anyone treating patients undergoing surgery. Pain relief has significant physiological benefits; hence, monitoring of pain relief is increasingly becoming an important postoperative quality measure. The goal for postoperative pain management is to reduce or eliminate pain and discomfort with a minimum of side effects. Various agents (opioid vs. nonopioid), routes (oral, intravenous, neuraxial, regional) and modes (patient controlled vs. “as needed”) for the treatment of postoperative pain exist. Although traditionally the mainstay of postoperative analgesia is opioid based, increasingly more evidence exists to support a multimodal approach with the intent to reduce opioid side effects (such as nausea and ileus) and improve pain scores. Enhanced recovery protocols to reduce length of stay in colorectal surgery are becoming more prevalent and include multimodal opioid sparing regimens as a critical component. Familiarity with the efficacy of available agents and routes of administration is important to tailor the postoperative regimen to the needs of the individual patient.
Keywords	postoperative ; analgesia ; opioids ; nonsteroidal ; transversus abdominis
Language	English
Publishing date	2013-08-19
Publisher	Thieme Medical Publishers
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2072321-0
ISSN	1530-9681 ; 1531-0043
ISSN (online)	1530-9681
ISSN	1531-0043
DOI	10.1055/s-0033-1351138
Database	Thieme publisher's database

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Article ; Online: De novo KCNA1 variants in the PVP motif cause infantile epileptic encephalopathy and cognitive impairment similar to recurrent KCNA2 variants.

Rogers, Amanda / Golumbek, Paul / Cellini, Elena / Doccini, Viola / Guerrini, Renzo / Wallgren-Pettersson, Carina / Thuresson, Ann-Charlotte / Gurnett, Christina A

American journal of medical genetics. Part A

2018 Volume 176, Issue 8, Page(s) 1748–1752

Abstract: Derangements in voltage-gated potassium channel function are responsible for a range of paroxysmal neurologic disorders. Pathogenic variants in the KCNA1 gene, which encodes the voltage-gated potassium channel Kv1.1, are responsible for Episodic Ataxia ... ...

Abstract	Derangements in voltage-gated potassium channel function are responsible for a range of paroxysmal neurologic disorders. Pathogenic variants in the KCNA1 gene, which encodes the voltage-gated potassium channel Kv1.1, are responsible for Episodic Ataxia Type 1 (EA1). Patients with EA1 have an increased incidence of epilepsy, but KCNA1 variants have not been described in epileptic encephalopathy. Here, we describe four patients with infantile-onset epilepsy and cognitive impairment who harbor de novo KCNA1 variants located within the Kv-specific Pro-Val-Pro (PVP) motif which is essential for channel gating. The first two patients have KCNA1 variants resulting in (p.Pro405Ser) and (p.Pro405Leu), respectively, and a set of identical twins has a variant affecting a nearby residue (p.Pro403Ser). Notably, recurrent de novo variants in the paralogous PVP motif of KCNA2 have previously been shown to abolish channel function and also cause early-onset epileptic encephalopathy. Importantly, this report extends the range of phenotypes associated with KCNA1 variants to include epileptic encephalopathy when the PVP motif is involved.
MeSH term(s)	Amino Acid Motifs/genetics ; Ataxia/genetics ; Child ; Child, Preschool ; Cognitive Dysfunction/genetics ; Cognitive Dysfunction/physiopathology ; Epilepsy/genetics ; Epilepsy/physiopathology ; Female ; Genetic Predisposition to Disease ; Humans ; Infant, Newborn ; Kv1.1 Potassium Channel/genetics ; Kv1.2 Potassium Channel/genetics ; Male ; Mutation ; Myokymia/genetics ; Phenotype
Chemical Substances	KCNA1 protein, human ; KCNA2 protein, human ; Kv1.2 Potassium Channel ; Kv1.1 Potassium Channel (147173-20-4)
Language	English
Publishing date	2018-07-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1493479-6
ISSN	1552-4833 ; 1552-4825
ISSN (online)	1552-4833
ISSN	1552-4825
DOI	10.1002/ajmg.a.38840
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Article ; Online: Who gets a pouch after colectomy in New York state and why?

Aquina, Christopher T / Fleming, Fergal J / Becerra, Adan Z / Hensley, Bradley J / Noyes, Katia / Monson, John R T / Temple, Larissa K / Cellini, Christina

Surgery

2018 Volume 163, Issue 2, Page(s) 305–310

Abstract: Background: This study identified variation and factors associated with ileal pouch-anal anastomosis after total colectomy for ulcerative colitis.: Methods: The Statewide Planning & Research Cooperative System was used to identify patients with ... ...

Abstract	Background: This study identified variation and factors associated with ileal pouch-anal anastomosis after total colectomy for ulcerative colitis. Methods: The Statewide Planning & Research Cooperative System was used to identify patients with ulcerative colitis who underwent total colectomy in New York state from 2000-2013. Bivariate and mixed-effects multivariable analyses were performed to assess patient, surgeon, and hospital-level factors as well as surgeon and hospital-level variation associated with ileal pouch-anal anastomosis after total colectomy. Results: Across 2,203 patients, the rate of ileal pouch-anal anastomosis was 34%. Overall, 465 surgeons and 148 hospitals performed at least one total colectomy for ulcerative colitis from 2000-2013, and 178 surgeons and 80 hospitals performed at least one ileal pouch-anal anastomosis for ulcerative colitis during the study period. The median rate of ileal pouch-anal anastomosis creation was 14% (range = 6% to 69%) across surgeons and 14% (range = 7% to 63%) across hospitals. Patient-level factors independently associated with ileal pouch-anal anastomosis were younger age, lower comorbidity burden, and elective total colectomy. Surgeon and hospital-level factors independently associated with ileal pouch-anal anastomosis were colorectal surgery board-certification, surgeon ileal pouch-anal anastomosis volume, and hospital ileal pouch-anal anastomosis volume. Patient-level factors explained 43% of the surgeon and 47% of the hospital variation in ileal pouch-anal anastomosis creation while surgeon-level factors explained 26% of the surgeon and 21% of the hospital variation. Conclusion: These findings suggest that variation in ileal pouch-anal anastomosis creation for ulcerative colitis is influenced largely by provider practices/preferences or lack of referral of patients after colectomy to surgeons and centers that perform ileal pouch-anal anastomosis. Providers and hospitals that do not routinely perform ileal pouch-anal anastomosis should refer patients to centers with ileal pouch-anal anastomosis expertise after total colectomy.
MeSH term(s)	Adult ; Aged ; Female ; Hospitals ; Humans ; Male ; Middle Aged ; New York ; Proctocolectomy, Restorative/statistics & numerical data ; Surgeons
Language	English
Publishing date	2018
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2017.07.024
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Article ; Online: Changes in sleep timing and subjective sleep quality during the COVID-19 lockdown in Italy and Belgium: age, gender and working status as modulating factors.

Cellini, Nicola / Conte, Francesca / De Rosa, Oreste / Giganti, Fiorenza / Malloggi, Serena / Reyt, Mathilde / Guillemin, Camille / Schmidt, Christina / Muto, Vincenzo / Ficca, Gianluca

Sleep medicine

2020 Volume 77, Page(s) 112–119

Abstract: Italy and Belgium have been among the first western countries to face the Coronavirus disease 2019 (COVID-19) emergency, imposing a total lockdown over the entire national territories. These limitations have proven effective in slowing down the spread of ...

Abstract	Italy and Belgium have been among the first western countries to face the Coronavirus disease 2019 (COVID-19) emergency, imposing a total lockdown over the entire national territories. These limitations have proven effective in slowing down the spread of the infection. However, the benefits obtained in public health have come with huge costs in terms of social, economic, and psychological well-being. In the current study, we aimed to investigate how the period of home confinement affected self-reported sleep characteristics in Italians and Belgians, with special regard to sleep timing and subjective quality. Using an online survey we collected data from 2272 participants, 1622 Italians (Mage = 34.1 ± 13.6 years, 1171 F), and 650 Belgian (Mage = 43.0 ± 16.8 years, 509 F). Participants reported their sleep pattern (eg, bedtime, risetime) and perceived sleep quality during and, retrospectively, before the lockdown. During the lockdown, sleep timing was significantly delayed, time spent in bed increased, and sleep quality was markedly impaired in both Italians and Belgians. The most vulnerable individuals appeared to be women, subjects experiencing a more negative mood, and those perceiving the pandemic situation as highly stressful. However, the two samples differed in the subgroups most affected by the changes, possibly because of the different welfare systems of the two countries. In fact, in the Italian sample sleep quality and timing underwent significant modifications especially in unemployed participants, whereas in the Belgian sample this category was the one who suffered less from the restrictions. Considering that the novel coronavirus has spread across the whole globe, involving countries with different types of health and welfare systems, understanding which policy measures have the most effective protective role on physical and mental health is of primary importance.
MeSH term(s)	Adult ; Belgium ; COVID-19/epidemiology ; COVID-19/psychology ; Female ; Humans ; Italy ; Male ; Mental Health/statistics & numerical data ; Middle Aged ; Retrospective Studies ; Self Report ; Sleep Initiation and Maintenance Disorders/epidemiology ; Sleep Initiation and Maintenance Disorders/psychology ; Social Isolation/psychology ; Surveys and Questionnaires ; Time Factors ; Young Adult
Language	English
Publishing date	2020-12-03
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2012041-2
ISSN	1878-5506 ; 1389-9457
ISSN (online)	1878-5506
ISSN	1389-9457
DOI	10.1016/j.sleep.2020.11.027
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