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Article ; Online: Minimally invasive approach to incisional hernia in elective and emergency surgery: a SICE (Italian Society of Endoscopic Surgery and new technologies) and ISHAWS (Italian Society of Hernia and Abdominal Wall Surgery) online survey.

Crepaz, Lorenzo / Sartori, Alberto / Podda, Mauro / Ortenzi, Monica / Di Leo, Alberto / Stabilini, Cesare / Carlucci, Michele / Olmi, Stefano

Updates in surgery

2023 Volume 75, Issue 6, Page(s) 1671–1680

Abstract: Minimally invasive abdominal wall surgery is growing worldwide, with a constant and fast improvement of surgical techniques and surgeons' confidence in treating both primary and incisional hernias (IH). The Italian Society of Endoscopic Surgery and new ... ...

Abstract	Minimally invasive abdominal wall surgery is growing worldwide, with a constant and fast improvement of surgical techniques and surgeons' confidence in treating both primary and incisional hernias (IH). The Italian Society of Endoscopic Surgery and new technologies (SICE) and the ISHAWS (Italian Society of Hernia and Abdominal Wall Surgery) worked together to investigate state of the art in IH treatment in elective and emergency settings in Italy. An online open survey was designed, and Italian surgeons interested in abdominal wall surgery were invited to fill out a 20-point questionnaire on IH surgical procedures performed in their departments. Surgeons were asked to express their points of view on specific questions about technical and clinical variables in IH treatment. Preferred approach in elective IH surgery was minimally invasive (59.7%). Open surgery was the preferred approach in 40.3% of the responses. In emergency settings, open surgery was the preferred approach (65.4%); however, 34.5% of the involved surgeons declare to prefer the laparoscopic/endoscopic approach. Most respondents opted for conversion to open surgery in case of relevant surgical field contamination, with a non-mesh repair of abdominal wall defects. Among those that used the laparoscopic approach in the emergent setting, the majority (74%) used the size of the defect of 5 cm as a decisional cut-off. The spread of minimally invasive approaches to IH repair in emergency surgery in Italy is gaining relevance. Code-sharing through scientific societies can improve clinical practice in different departments and promote a tailored approach to IH surgery.
MeSH term(s)	Humans ; Incisional Hernia/surgery ; Abdominal Wall/surgery ; Hernia, Ventral/surgery ; Herniorrhaphy/methods ; Laparoscopy/methods ; Surgical Mesh
Language	English
Publishing date	2023-04-18
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-023-01505-8
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Article: Clinicopathological Factors Influencing Lymph Node Yield in Colorectal Cancer: A Retrospective Study.

Orsenigo, Elena / Gasparini, Giulia / Carlucci, Michele

Gastroenterology research and practice

2019 Volume 2019, Page(s) 5197914

Abstract: Many colorectal resections do not meet the minimum of 12 lymph nodes (LNs) recommended by the American Joint Committee on Cancer for accurate staging of colorectal cancer. The aim of this study was to investigate factors affecting the number of the ... ...

Abstract	Many colorectal resections do not meet the minimum of 12 lymph nodes (LNs) recommended by the American Joint Committee on Cancer for accurate staging of colorectal cancer. The aim of this study was to investigate factors affecting the number of the adequate nodal yield in colorectal specimens subject to routine pathological assessment. We have retrospectively analysed the data of 2319 curatively resected colorectal cancer patients in San Raffaele Scientific Institute, Milan, between 1993 and 2017 (1259 colon cancer patients and 675 rectal cancer patients plus 385 rectal cancer patients who underwent neoadjuvant therapy). The factors influencing lymph node retrieval were subjected to uni- and multivariate analyses. Moreover, a survival analysis was carried out to verify the prognostic implications of nodal counts. The mean number of evaluated nodes was 24.08 ± 11.4, 20.34 ± 11.8, and 15.33 ± 9.64 in surgically treated right-sided colon cancer, left-sided colon cancer, and rectal tumors, respectively. More than 12 lymph nodes were reported in surgical specimens in 1094 (86.9%) cases in the colon cohort and in 425 (63%) cases in the rectal cohort, and patients who underwent neoadjuvant chemoradiation were analysed separately. On univariate analysis of the colon cancer group, higher LNs counts were associated with female sex, right colon cancer, emergency surgery, pT3-T4 diseases, higher tumor size, and resected specimen length. On multivariate analysis right colon tumors, larger mean size of tumor, length of specimen, pT3-T4 disease, and female sex were found to significantly affect lymph node retrieval. Colon cancer patients with 12 or more lymph nodes removed had a significantly better long-term survival than those with 11 or fewer nodes (
Language	English
Publishing date	2019-01-22
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2435460-0
ISSN	1687-630X ; 1687-6121
ISSN (online)	1687-630X
ISSN	1687-6121
DOI	10.1155/2019/5197914
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Article ; Online: Assessing Hospital Adaptive Resource Allocation Strategies in Responding to Mass Casualty Incidents.

Trucco, Paolo / Nocetti, Claudio / Sannicandro, Riccardo / Carlucci, Michele / Weinstein, Eric S / Faccincani, Roberto

Disaster medicine and public health preparedness

2021 Volume 16, Issue 3, Page(s) 1105–1115

Abstract: Objectives: Hospitals are expected to operate at a high-performance level even under exceptional conditions of peak demand and resource disruptions. This understanding is not mature yet, and there are wide areas of possible improvement. In particular, ... ...

Abstract	Objectives: Hospitals are expected to operate at a high-performance level even under exceptional conditions of peak demand and resource disruptions. This understanding is not mature yet, and there are wide areas of possible improvement. In particular, the fast mobilization and reconfiguration of resources frequently result into the severe disruption of elective activities, worsening the quality of care. More resilient resource allocation strategies, ie, which adapt to the dynamics of the prevailing circumstance, are needed to maximize the effectiveness of health-care delivery. In this study, a simulation approach was adopted to assess and compare different hospital's adaptive resource allocation strategies in responding to a mass casualty incident (MCI). Methods: A specific set of performance metrics was developed to take into consideration multiple objectives and priorities and holistically assess the effectiveness of health-care delivery when coping with an MCI event. Discrete event simulation (DES) and system dynamics (SD) were used to model the key hospital processes and the MCI plan. Results: In the daytime scenario, during the recovery phase of the emergency, a gradual disengagement of resources from the emergency department (ED) to restart ordinary activities in operating rooms and wards, returned the best performance. In the night scenario, the absorption capacity of the ED was evaluated by identifying the current bottleneck and assessment of the benefit of different resource mobilization strategies. Conclusions: The present study offers a robust approach, effective strategies, and new insights to design more resilient plans to cope with MCIs. Future research is needed to widen the scope of the analysis and take into consideration additional resilience capacities, such as operational coordination mechanisms, among multiple hospitals in the same geographic area.
MeSH term(s)	Humans ; Mass Casualty Incidents ; Disaster Planning ; Hospitals ; Resource Allocation ; Benchmarking ; Emergency Service, Hospital
Language	English
Publishing date	2021-05-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375268-3
ISSN	1938-744X ; 1935-7893
ISSN (online)	1938-744X
ISSN	1935-7893
DOI	10.1017/dmp.2021.62
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Article ; Online: Assessing Hospital Adaptive Resource Allocation Strategies in Responding to Mass Casualty Incidents.

Faccincani, Roberto / Trucco, Paolo / Nocetti, Claudio / Carlucci, Michele / Weinstein, Eric S

Disaster medicine and public health preparedness

2021 , Page(s) 1–9

Abstract: Background: Hospitals are expected to operate at a high performance level even under exceptional conditions of peak demand and resource disruptions. This understanding is not mature yet and there are wide areas of possible improvement. In particular, ... ...

Abstract	Background: Hospitals are expected to operate at a high performance level even under exceptional conditions of peak demand and resource disruptions. This understanding is not mature yet and there are wide areas of possible improvement. In particular, the fast mobilization and reconfiguration of resources frequently result into the severe disruption of elective activities, worsening the quality of care. This becomes particularly evident during the on-going coronavirus disease 2019 (COVID-19) pandemic. More resilient resource allocation strategies, that is, which adapt to the dynamics of the prevailing circumstance, are needed to maximize the effectiveness of health-care delivery. In this study, a simulation approach was adopted to assess and compare different hospital's adaptive resource allocation strategies in responding to a sudden onset disaster mass casualty incident (MCI). Methods: A specific set of performance metrics was developed to take into consideration multiple objectives and priorities and holistically assess the effectiveness of health-care delivery when coping with an MCI event. Discrete event simulation (DES) and system dynamics (SD) were used to model the key hospital processes and the MCI plan. Results: In the daytime scenario, during the recovery phase of the disaster, a gradual disengagement of resources from the emergency department (ED) to restart ordinary activities in operating rooms and wards returned the best performance. In the night scenario, the absorption capacity of the ED was evaluated by identifying the current bottleneck and assessment of the benefit of different resource mobilization strategies. Conclusions: The present study offers a robust approach, effective strategies and new insights to design more resilient plans to cope with MCIs. It becomes particularly relevant when considering the risk of indirect damage of emergencies, where all the available resources are shifted from the care of the ordinary to the "disaster" patients, like during the on-going COVID-19 pandemic. Future research is needed to widen the scope of the analysis and take into consideration additional resilience capacities such as operational coordination mechanisms among multiple hospitals in the same geographic area.
Language	English
Publishing date	2021-06-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375268-3
ISSN	1938-744X ; 1935-7893
ISSN (online)	1938-744X
ISSN	1935-7893
DOI	10.1017/dmp.2021.113
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Article ; Online: Mass Casualty Incident (MCI) training in a metropolitan university hospital: short-term experience with MAss Casualty SIMulation system MACSIM

Castoldi, Laura / Greco, Massimiliano / Carlucci, Michele / Lennquist Montán, Kristina / Faccincani, Roberto

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

2020 Volume 48, Issue 1, Page(s) 283–291

Abstract: Aim: The aim of this study was to test and validate a new hospital Mass Casualty Incident (MCI) training using MACSIM: Methods: The original MCI training format called MACSIM-PEMAF (Piano di Emergenza per il Massiccio Afflusso di Feriti, i.e., ... ...

Abstract	Aim: The aim of this study was to test and validate a new hospital Mass Casualty Incident (MCI) training using MACSIM Methods: The original MCI training format called MACSIM-PEMAF (Piano di Emergenza per il Massiccio Afflusso di Feriti, i.e., hospital disaster plan for massive influx of casualties) was developed for the Italian Society for Trauma and Emergency Surgery (SICUT) in 2016. It uses MACSIM Results: MACSIM-PEMAF was tested over 7 courses, with a total of 258 participants. Pre- and post-course questionnaires showed a significant improvement for hospital staff in self-reported perceptions of knowledge and skills in MCI management. In total, on a 1-10 scale, all the staff increased their competencies from a value of 4.4 ± 2.5 to 7.5 ± 1.9 (p < 0.001). Conclusion: MACSIM-PEMAF demonstrated efficacy in fulfilling the requirements of Italian law for PEMAF implementation, testing local resources and resilience, as well as increasing the self-reported perception of the hospital staff ability to respond to a MCI.
MeSH term(s)	Computer Simulation ; Disaster Planning ; Emergency Service, Hospital ; Hospitals ; Humans ; Mass Casualty Incidents ; Personnel, Hospital ; Triage
Language	English
Publishing date	2020-11-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-020-01541-8
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Article ; Online: SIRS or qSOFA? Is that the question? Clinical and methodological observations from a meta-analysis and critical review on the prognostication of patients with suspected sepsis outside the ICU.

Franchini, Stefano / Scarallo, Luca / Carlucci, Michele / Cabrini, Luca / Tresoldi, Moreno

Internal and emergency medicine

2018 Volume 14, Issue 4, Page(s) 593–602

Abstract: The purpose of the study was to assess the prognostic performances, in terms of in-hospital mortality, of the quick sequential organ failure assessment (qSOFA) score and the systemic inflammatory response syndrome (SIRS) criteria applied to patients with ...

Abstract	The purpose of the study was to assess the prognostic performances, in terms of in-hospital mortality, of the quick sequential organ failure assessment (qSOFA) score and the systemic inflammatory response syndrome (SIRS) criteria applied to patients with suspected infection outside the ICU, and to critically reappraise the results and the clinical impact of the SEPSIS-3 study and of the subsequent trials. We performed bivariate meta-analysis, evaluation of the Bayesian post-test probabilities of death, and computation of the unidentified deaths for every 1000 screened cases (UDS
MeSH term(s)	Bayes Theorem ; Chi-Square Distribution ; Humans ; Organ Dysfunction Scores ; Prognosis ; Reproducibility of Results ; Sepsis/diagnosis ; Sepsis/physiopathology ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/physiopathology
Language	English
Publishing date	2018-10-15
Publishing country	Italy
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-018-1965-0
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Article ; Online: Hypocalcemia is highly prevalent and predicts hospitalization in patients with COVID-19.

Di Filippo, Luigi / Formenti, Anna Maria / Rovere-Querini, Patrizia / Carlucci, Michele / Conte, Caterina / Ciceri, Fabio / Zangrillo, Alberto / Giustina, Andrea

Endocrine

2020 Volume 68, Issue 3, Page(s) 475–478

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Hospitalization ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-06-12
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1194484-5
ISSN	1559-0100 ; 1355-008X ; 0969-711X
ISSN (online)	1559-0100
ISSN	1355-008X ; 0969-711X
DOI	10.1007/s12020-020-02383-5
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Article ; Online: Hypocalcemia is a distinctive biochemical feature of hospitalized COVID-19 patients.

di Filippo, Luigi / Formenti, Anna Maria / Doga, Mauro / Frara, Stefano / Rovere-Querini, Patrizia / Bosi, Emanuele / Carlucci, Michele / Giustina, Andrea

Endocrine

2020 Volume 71, Issue 1, Page(s) 9–13

MeSH term(s)	Acute Disease ; Aged ; Aged, 80 and over ; Biomarkers/analysis ; Biomarkers/blood ; COVID-19/blood ; COVID-19/complications ; COVID-19/epidemiology ; Calcium/analysis ; Calcium/blood ; Case-Control Studies ; Cohort Studies ; Female ; Hospitalization/statistics & numerical data ; Humans ; Hypocalcemia/blood ; Hypocalcemia/complications ; Hypocalcemia/diagnosis ; Hypocalcemia/epidemiology ; Italy/epidemiology ; Male ; Prognosis ; Respiratory Tract Infections/blood ; Respiratory Tract Infections/diagnosis ; Respiratory Tract Infections/epidemiology ; Retrospective Studies ; SARS-CoV-2/physiology
Chemical Substances	Biomarkers ; Calcium (SY7Q814VUP)
Keywords	covid19
Language	English
Publishing date	2020-11-09
Publishing country	United States
Document type	Letter
ZDB-ID	1194484-5
ISSN	1559-0100 ; 1355-008X ; 0969-711X
ISSN (online)	1559-0100
ISSN	1355-008X ; 0969-711X
DOI	10.1007/s12020-020-02541-9
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Article: High sensitivity of ROSE-supported ERCP-guided brushing for biliary strictures.

Archibugi, Livia / Mariani, Alberto / Ciambriello, Biagio / Petrone, Maria Chiara / Rossi, Gemma / Testoni, Sabrina Gloria Giulia / Carlucci, Michele / Aldrighetti, Luca / Falconi, Massimo / Balzano, Gianpaolo / Doglioni, Claudio / Capurso, Gabriele / Arcidiacono, Paolo Giorgio

Endoscopy international open

2021 Volume 9, Issue 3, Page(s) E363–E370

Abstract: Background and study ... ...

Abstract	Background and study aims
Language	English
Publishing date	2021-02-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722
ISSN (online)	2196-9736
ISSN	2364-3722
DOI	10.1055/a-1322-2638
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Article ; Online: Evaluation of Interaction Between Emergency Medical System and Hospital Network During a Train Derailment in Milano.

Faccincani, Roberto / Stucchi, Riccardo / Carlucci, Michele / Sannicandro, Riccardo / Formenti-Ujlaki, George / Pascucci, Federico / Montan, Carl / Zoli, Alberto / Picco, Carlo / Fumagalli, Roberto

Disaster medicine and public health preparedness

2021 Volume 16, Issue 2, Page(s) 829–834

Abstract: On January 25, 2018 a 5-car train derailed in Pioltello, 10 kilometers North-East of Milano City. A standardized post-hoc form was distributed to the hospitals involved in the management of the victims and allowed for an evaluation of the response to the ...

Abstract	On January 25, 2018 a 5-car train derailed in Pioltello, 10 kilometers North-East of Milano City. A standardized post-hoc form was distributed to the hospitals involved in the management of the victims and allowed for an evaluation of the response to the incident.The management of the incident by EMS (Emergency Medical System) was effective in terms of organization of the scene and distribution of the patients, although the time for the first severe patient to reach the closest appropriate hospital was very long (2 hours). This can be partially explained by the extrication time.None of the alerted hospitals exceeded their capacity, as patients were distributed carefully among the hospitals. The overall outcome was quite satisfactory; no deaths were reported except for those on scene. Some responding hospitals reported that there was an over-activation based on the services ultimately needed. However this is common in MCIs, as an over-activation is preferable to an under-estimation. To address this concern, as more data are available, activation should be scaled down based on a plan established prior to it; this mechanism of scaling down seems to have failed in this event.It is of note that the highest performing hospitals underwent recently to an educational program on MCI management.
MeSH term(s)	Disaster Planning ; Emergency Medical Services ; Emergency Service, Hospital ; Hospitals ; Humans ; Mass Casualty Incidents ; Triage
Language	English
Publishing date	2021-02-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375268-3
ISSN	1938-744X ; 1935-7893
ISSN (online)	1938-744X
ISSN	1935-7893
DOI	10.1017/dmp.2020.410
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