Medical degree at Federal University of Pará
Sugery Residence at Federal University of São Paulo
Plastic Surgery Residence at Federal University of São Paulo
PhD student at Federal University of São Paulo
RESEARCH, TEACHING, or OTHER INTERESTS
Medicine, Surgery
4
Scopus Publications
Scopus Publications
Assessing Risks in Intramuscular Fat Grafting: A Systematic Review and Meta-Analysis of Complications Gabriel de Almeida Arruda Felix, Felipe Contoli Isoldi, Marcelo Oliveira Mourão Filho, Lydia Masako Ferreira Plastic and Reconstructive Surgery, 2025 Background: Intramuscular fat grafting has gained popularity in plastic surgery to enhance muscle volume and definition. However, the safety and standardization of this technique remain controversial. This systematic review and meta-analysis aimed to evaluate the complications, safety, and outcomes of intramuscular fat grafting. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO). A comprehensive literature search was performed across multiple databases including EMBASE/Elsevier, Cochrane, Scopus, PubMed/Medline, BVS, SciELO, and Lilacs. This search covered all years and languages. The included studies were assessed for risk of bias using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool to ensure methodological rigor. A total of 36 studies were selected for qualitative synthesis. Results: The meta-analysis included 27 studies with 208,692 observations and 857 events. Among those specifying the target muscle, 25% injected the gluteus, 8.3% targeted the rectus abdominis, and 5.6% targeted the gastrocnemius and soleus. The pooled complication rate was 6.2% (95% CI: 3.06%-12.13%), with substantial heterogeneity among the studies (I² = 98.3%). The most common complications included fat embolism, infection, seroma, hematoma, fat necrosis, asymmetry, and revision surgery. Fat embolism was the most serious complication, with a mortality rate of 1:3,000 cases of gluteal intramuscular fat grafting. Conclusion: Intramuscular fat grafting offers aesthetic benefits but poses risks, notably, fat embolism. Advancements like ultrasound guidance enhance safety, but further research is needed to refine techniques and establish evidence-based guidelines.
Extended pharmacological thromboprophylaxis and clinically relevant venous thromboembolism after major abdominal and pelvic surgery: International, prospective, propensity score-weighted cohort study , A Sgrò, R Blanco-Colino, N Brindl, D Chaudhry, K Gressmann, R R Gujjuri, A Hilder, E Matey, I S Pereira, A Turňa, C Varghese, W Xu, K A McLean, R Blanco-Colino, N Brindl, S Brown, W A Cambridge, D Chaudhry, K Gressmann, R R Gujjuri, A Hilder, A Jaffer, I Jakaityte, S K Kamarajah, M Kawka, O Kouli, E Matey, K A McLean, A Mergo, E C Mills, V Murray, Szy Ooi, I S Pereira, A M Riad, A Sgrò, S Q Shafi, I Trout, A Turňa, C Varghese, W Xu, B M Biccard, A Docherty, J Martin, K El-Boghdadly, M Phull, R Mouton, A Bhangu, J C Glasbey, E M Harrison, K A McLean, N Smart, S Moug, T Pinkney, T Richards, I Dajti, M de Cillia, G Van Ramshorst, S Delibegovic, H Mughal, J Mihanovic, N Gouvas, P Kocian, V Levesen, J Kaupilla, N Brindl, D Merz, M Joos, A Ioannidis, G Nnaji, F Pata, G Pellino, A Gori, M Podda, C Riboni, E Moggia, E Fekaj, S Oliver Senica, A Dauksa, J Psaila, F de Ruitjer, P Major, I Santos, M Sampaio Alves, J Simões, E A Bonci, A Pașca, A Novikova, B Kovačević, V Milosavljevic, B Tadic, J Kosir, R Blanco-Colino, S Pérez Ajates, M E Ossola Revilla, A Papadia, C Riboni, M L Gasparri, M K Aktas, B E Baki, M D Tepe, A U Mutlu, A Singal, J Osei-Bonsu, H Lacey, S W Chan, M Allison, K Duah-Asante, D Chen, N Ahmed, A Ejiz, C Takyi, M Mujeeb, N Ravikumar, M Khan, J Hayes, J Mckenna, J Wang, N Essa, H Xianghan, L Ko, Y Aldabbagh, J Plascevic, N Zia, R Ismail, Y Kamel, I Epanomeritakis, R Tan, N Chiu, A Naeem, M Kakwani, R Mehra, K Feeney, C L Yan Naing, A Qureshi, A Richens, H Li, R Ahmed, L Wilson, S Abraha, I Dajti, S Mikalauskas, J Kahn, D Kniepeiss, M Kušar, A Belarmino, J Frenk, I Mikalauskiene, A Angelis, J E Waha, S Al-Sharafy, M Sandano, P Schemmer, C Reiterer, K Horvath, A Taschner, S Riss, F Harpain, C Dawoud, N Hantáková, N Adamowitsch, S Schallmeiner, T Christian, V Xu, M M Kuhrn, K M Widmann, B Capek, B Kama, S Turgut, L Hauptmann, M de Cillia, M Grünbart, H Hoi, A Binder, T Gürtler, P Riedl, D Mayer, K Van Belle, O Wautelet, E Dekkers, E Van Daele, T Apers, G Van Ramshorst, F Berrevoet, N Rennie, P Dries, P Panta, A Denys, W Pype, T Bauwens, N Renard, S Violon, J Stijns, T Van De Winkel, E Van Eetvelde, M Salibasic, S Delibegovic, S Pusina, E Hodžić, M Kruščica, S Žilić, E Bicakcic, A Rovcanin, E Kulovic, E Halilovic, A Vinčević Hodžić, E Kalbić, S Delibegovic, A Mujić, M Mešan, E Matović, S Delibegovic, A Kesetovic, D Dardanov, E Arabadzhieva, B Markov, К Спасова, C Biji, N Oliveira, V Miroslavov, G Korukov, K Ravendran, N Shah, Y Mitkov, K Arivanandan, R Gaikwad, S Gotru, R Saraff, N Sain, D Stanchev, L Gaydarski, U Ali, L J Kandathil, A Krishnaveni, I Ivanov, I Ganev, Т Krapeshki, M Miza, Msk Mumu, I Bashliev, A Sajjad, L Chandel, D Yordanov, E Hristova, K Spassov, T Tsankov, T Ivanov, E Filipov, D Georgiev, V Neykov, E Daleva, I Ilieva, D Krasimirova, H Hristov, М Арсова, O Soladoye, A Biswakarma, R Raj, A Negi, A Dey, J K Adidela, U G Alionye, A Ndukwe, R Dimov, V Ivanov, S Sulcheva, S Mitrev, V Nikolov, M Karamanliev, D Dimitrov, A Yordanov, P Vladova, M Shoshkova, K Karakadieva, A Gabarski, A Shanker, H Ehtisham, S Parambi, L Tranchev, A Vasileva, J Kareem, J Ezeabasili, O L Madueke-Ediae, T Muradia, A Saini, I Rana, R Kanagaratnam, L S Thomas, M Galasyuk, J J Costa, N Majid, P Reddy, M Abdullahi, S Koshy Thomas, A Mehta, A Biswakarma, R Raj, S Shittu, J Theophilus, J Theophilus, R Ilyas-Uddin, I Ogunleye, E Naghavi, A Kiran, A Sundar, A Joy, F Ali, I Angelova, M Slavchev, N Belev, B Atanasov, P Krastev, T Yotsov, D Dimitrov, P Kamenova, I Mihaylov, A Stavrov, A Vricheva, G Šantak, L Penezić, Z Kastelan, Z Zimak, H Saić, N Knezevic, B Cikic, T Zekulić, T Hudolin, I Juric, J Anđelić, T Kulis, M Maric, J Mihanovic, T Soric, D Surić Grčić, L Blagus, P Kovačević, I Vidić, A Miočić Juran, C Ergatidou, S Gravas, A Yiallourou, S Achilleos, M Vardas, G Kokkinos, C Panagiotou, M Kyprianou, K Kyriacou, P Papatheodorou, K Konstantinou, D Onisiforou, F Tsoutsouki, A Kasapi, E Demetriou, A Stylianou, E Xenophontos, P Georgiou, P Makrides, I Pozotou, M Constantinou, T Evangelou, A Varavina, S Charitonos, M Lampi, M Attaalla, T Dušek, M Ndukwe, L Kuzmane, E Moorlata, H Sillah, J Kotek, J Fazal, E Ssali, V Steingauer, K Vinklerova, O Ahmad, Á Rodríguez Martínez, E Hiebert, M Srivastava, A S Ramesh Babu, O Dobra, A Akiba, M F Kalou, T Sokolová, N Nepeřená, P Novotný, J Sedlackova, F Philips, H Al Atassi, P Jose, A Sunil Nair, L Ntashamaje, A Kaddah, M A Antabi, P Kocián, R Fiala, T Harustiak, S Vesely, A Haluza, A Štekrtová, V Král, K Zdichová, J Pastor, A Gorchakov, H Novák, V Novák, J Hornak, M Havova, M Marková, T Fořtová, D Lérias Bento, R Novysedlák, J F Smetana, T Novák, T Zdobinska, M Švarc, E Hejduková, K Havlová, A Vaishevich, J Čorňáková, P Zajíc, P Francúz, O Příman, Š Havlíková, B Zemlickova, A Whitley, R Gurlich, P Balaz, I Tomyak, M Kútik, O Molva, D Šturc, M Belbl, T Vinklarkova, V Villefranque, A Police, E Mikhael, A Mabilia, L Charre, E Volpin, H Braham, R Montero Macías, D Krief, A Boyer De Latour, M A Angeles, A Martinez, A Navarro, G Ferron, M Del, M Ghiani, F Migliorelli, M Danguy Des Déserts, S Johan, B Olivier, C Andro, D Von Wedel, C Kamphues, M Thiele, J Felber, J Neudecker, C Schineis, J C Lauscher, R Stephan, L P Meyer, C Wolff, B Bombera, J Rolinger, A Kirschniak, P Wilhelm, S Göller, L Van Den Hil, D Reim, M Kießler, C Buschhaus, S Naisar, N Zahlmann, R L Walter, M Weber, K Müller, A Schweden, M Berlet, N A Jorek, S Seyfried, N Rahbari, E Birgin, C Reissfelder, A Reeg, P Téoule, E Rasbach, N Pyrgidis, G Hatzichristodoulou, I Sokolakis, J J Strotmann, T Fahlbusch, P Höhn, J Hinrichs, J Horn, S Jollet, J Binder, T Förtsch, M Winterstein, D Hackner, A Girard, M Wittmann, T O Vilz, F Recker, M Velten, G Massoth, A Delis, M I Brugués Villalba, M Willis, S Soltau, S Kudaliyanage, R L Eymael, I Syring, R Neubauer, N Dahmen, A Zimmermann, N Straßberger-Nerschbach, A Puskarevic, X Wang, L Peyman, R A Philippi, K Schmidt, U Bork, F Schepp, S Korn, O Radulova-Mauersberger, J Von Dem Bussche, F Von Bechtolsheim, C Praetorius, N Knobloch, F Oehme, J Weitz, M Mansfeld, M Distler, F Klingler, G Fluegen, S Dávid, M Schneider, K A Baba, U Ronellenfitsch, J Kleeff, J Ukkat, J Klose, O Bayram, M Sommerer, A Rebelo, I Gockel, E Gentsch, N Rayes, R Thieme, N Kreuser, B Aktas, D Branzan, D Seehofer, M R Mallmann, C Mallmann, S Woldu, F Balci, C Domröse, M Diekhöner, G Micha, K Stroumpoulis, L Dritsoulas, K Kalopita, G Bitzi, P Thessalonikefs, E Fradelos, D Korkolis, A Sarafi, D K Manatakis, N Tasis, A Prountzopoulou, E Tziava, K Pikoulas, D Paramythiotis, M Tishukov, K Papadopoulos, G Chatziantoniou, G Tzikos, S Papamichail, S Bareka, A Sarafis, D Haidopoulos, K Angelou, A Prodromidou, E Stamatakis, N Alexakis, V Pergialiotis, A Rodolakis, N Thomakos, N Memos, N Vlahos, I Koutalas, T Kotsis, E Kalampokas, L Chardalias, C Kontopoulou, C Lignou, P Lykourgioti, A Bagiasta, A Petrolekas, O Savranakis, T Kozonis, V Themelidi, M Mccormac-Prekeze, C Nikolaou, E Bletsa, N Melissaridou, K Flamourakis, P Rammos, T Hadjizacharias, N Provata, D Politis, A P Gkioulekas, D Massaras, I Vakos, A Antonoglou, P Dimitra, A Kotzadimitriou, C Evangelou, D Psychogios, M K Konstantinidis, K Apostolou, K Konstantinidis, N Patelis, S Konstantinidou, P Kokoropoulos, N Michalopoulos, Z Kratiras, P Drakakis, T Sidiropoulos, M Papadoliopoulou, P Vassiliu, N Arkadopoulos, C Koratzanis, N Vrachnis, E Dylja, I Chatzialis, D Sampanis, N Danias, A Fotiou, S Stavros, Z Petropoulou, V Tsaousis, D Papakonstantinou, P Lykoudis, C Nastos, A Charalampopoulos, I E Papiri, I Hatzaras, K I Paraskevas, G Petrakis, E Polenta, E Kaparounaki, M Sotiropoulou, S Kapiris, E Mavrodimitraki, A Paraskeva, A Kolinioti, M Psarologos, D Stergiou, P Metaxas, K Stamatis, C Kyzeridis, E Kefalou, G Z Vrakopoulou, A Larentzakis, E Menenakos, V R Maravgaki, C Georgiadou, M Koutrouli, A Papageorgiou, A Skandali, G Tzovaras, I Baloyiannis, V Tzortzis, G Christodoulidis, K Perivoliotis, E Arnaoutoglou, M P Ntalouka, A Chatzis, A Daponte, A Samara, C Donoudis, D Zacharoulis, F Mulita, K Bouchagier, G Verras, L Tchabashvili, O Ioannidis, A Koltsida, A Malliora, D Paparouni, S Bitsianis, L Loutzidou, E Anestiadou, Χ Χατζηανεστιάδου, S Simeonidis, A Tekelidis, K Zapsalis, S Skalidou, N Ouzounidis, G Ntampakis, A Kelepouri, F Kontidis, V Foutsitzis, O Kontaxi, G Barakakis, O M Valaroutsou, C Athanasiou, E Kotidis, M Pramateftakis, I Mantzoros, K Toutouzas, M Frountzas, T Triantafyllou, A Triantafyllou, T Dagklis, G Katsanos, S Petousis, A Athanasiadis, G Tsoulfas, K Dinas, I Tsakiridis, A Mamopoulos, I Kalogiannidis, F Rao, C Christou, S Vasileiadou, G Kapetanios, N Tsakiridis, S Kopatsaris, E Papanikolaou, K E Karakasi, T A Tataridou, N Antoniadis, F Zachomitros, A Arvanitaki, K Tsakiridis, M Anemoulis, S Neiros, K Ouranos, E C Tampaki, C Maltezos, K Maltezos, C Anastasiadou, A Chaveles, A Pachi, P Tsiantoula, K Roditis, A Antoniou, N Bessias, T Papas, S Tzamtzidou, D Maras, V Papaioannou, G Koukoulis, K Bouliaris, K Skriapas, G Kontopoulos, C Doudakmanis, C Kolla, M Efthimiou, C Kalfountzos, D Mitsakou, C Kardasi, S Zourntou, L I Fountarlis, A Bakalis, M Samarinas, P L Chatzilamprou, A Migdanis, K Karvouni, K Katsiafliaka, C Arvaniti, A R Papazisi, V Markatou, K Zervas, K Marsitopoulos, N Machairas, P Dorovinis, E Kotsifa, M D Keramida, D Schizas, M Vailas, A Syllaios, E Mela, N Hasemaki, A Skotsimara, A Katsargyris, S Kykalos, N Tomara, I Palios, I Karniadakis, A Charalabopoulos, P Sakarellos, S Davakis, N Kydonakis, G Tsourouflis, P Stamopoulos, K Laios, A Kozadinos, I Katsaros, E Kontis, C Iavazzo, L Katsiaras, E Kaouras, P Manikis, K Kokkali, G Theodorou, A Dragi, G Vorgias, L Tzelves, A Skolarikos, I Manolitsis, M Spartalis, I Tzima, A Anastasiou, P Pantelidis, G Schismenou, E Spartalis, G E Zakynthinos, K Lasithiotakis, G Petra, M Lampou, D Toth, Z Varga, J Pósán, L Illésy, C Váradi, M Santarelli, L Puca, L Brignone, R Lisa Marie, L Silvia, P Silvia, A Ferguglia, C Piceni, M Improta, F Assanti, E Montanari, G Ettore, F Cannone, L Cormaci, V Nicastro, R De Carlis, G Ferrari, A Giani, S Grimaldi, L Gregorio, M Mazzola, L Ripamonti, L Lorusso, G A Tartufari, C Magistro, A Benedetti, A Gonta, J Maesano, C L Bertoglio, I Giusti, O Quagli, F Brucchi, E Bevilacqua, L De Carlis, A Lauterio, R Cerchione, M Migliorini, N Incarbone, L Centonze, S S Darwish, I Vella, V Buscemi, A Podestà, M Desio, M Berselli, S Megna, E Cocozza, L Livraghi, V Quintodei, V Marchionini, G Borroni, C Peverelli, M Corbella, F Ferrari, F Odicino, E Gozzini, F Cisotto, G Baronio, R Del Giudice, G Sala, A Iacomino, G Vennarecci, D Ferraro, M Di Martino, D Pisaniello, F Falaschi, L Petagna, A Giuliani, P Di Lascio, M Coluzzi, G Pascale, P Gallicchio, G Frezza, G Dinatale, G Cerino, A Bottari, J Martellucci, G Maltinti, M Scheiterle, L Fortuna, F Staderini, F Coratti, M Veroux, A Giaquinta, G Roscitano, A Volpicelli, P Veroux, M Palumbo, G Riccioli, L Stella, C Distefano, R Gioco, G Lomeo, E Lomeo, M Cavallo, C Virgilio, C Molino, M M Giambra, D Zerbo, R Santini, S Costa, G G Incognito, D C Centonze, G Currò, M Ammendola, R Filippo, G Ammerata, R Balestri, L Morelli, D Tartaglia, M Puccini, V F Asta, V Conte, P Buccianti, B Sargenti, G Boni, S Signori, D Pezzati, L Urbani, G Casale, G Taddei, G Di Franco, M Bianchini, C Carpenito, N Furbetta, A Comandatore, F Tarasco, S Guadagni, M Mastrangelo, C Gianfaldoni, M Palmeri, L M Fatucchi, A B Boato, D Gianardi, M Stingone, L Sacco, S Giaquinto, L Lami, M Iuliano, E A Annunziata, M Chiarugi, S Strambi, F Coccolini, G Anania, M Chiozza, A Campagnaro, V Nevoso, L Carbone, L Marano, G Micheletti, A Fontani, S Malerba, M Gambelli, A Bombino, G Grassi, V D Mandato, L Aguzzoli, V Mastrofilippo, N Fabbri, C V Feo, M Ginestri, D Oppici, M Torchiaro, A Pesce, F Catena, C Vallicelli, V Murzi, M Podda, A Pisanu, F Campus, T Pilia, A Saba, C Piras, M Pisano, E Locci, P Marongiu, E Gessa, Mario D’Oria, A Biloslavo, S Lepidi, P Germani, C J Nappi, B Grando, A Lauretta, S Pollesel, P P Brollo, G Gallo, M Trompetto, A Realis Luc, V Tiesi, A Porcu, T Perra, M Madonia, A Tedde, F Scognamillo, P L Tilocca, D Delogu, G Mucci, G Drocchi, M Tedde, A M Scanu, G Rizzo, A Fancellu, C F Feo, G Farina, R Casu, M L Cossu, G C Ginesu, M Anania, S Dessole, G Capobianco, M Petrillo, F Dessole, I Angelone, A Barberis, A Azzinnaro, A Petrungaro, E Palli, E Mina, N S Pipitone Federico, A Muratore, M Calabrò, M De Zuanni, E Herranz Van Nood, L Licari, C Callari, D Di Miceli, S Viola, M Manigrasso, C Caricato, M Milone, P Anoldo, S Vertaldi, A D’amore, G D De Palma, A Marello, C G Cantore, A Chini, F Maione, G Luglio, G Pagano, F P Tropeano, M Cricrì, G Aprea, G Palomba, M Capuano, R Basile, U Bracale, R Peltrini, M Visconti, G Magno, A G Di Santo Albini, P Fransvea, G Sganga, G Tropeano, C Puccioni, G Altieri, V Fico, P Mirco, V Bianchi, V Cozza, G Pepe, S Alfieri, F Rosa, C A Schena, V Laterza, M M Pascale, S Agnes, G Bianco, F Frongillo, F Ferracci, F Santullo, A Balla, P Lepiane, F Saraceno, R Mastroianni, G Simone, G Tuderti, F Marino, G Lantone, G Lantone, R Isernia, F Pezzolla, F Aquilino, D Raimondo, A Gori, R Seracchioli, M Rottoli, A Belvedere, L Maurino, I S Russo, B Orsini, M Maletta, A Romano, P Bernante, T Violante, D Morezzi, E Degli Esposti, A Raffone, G Poggioli, A Canavese, G Dajti, S Cardelli, P Casadio, A Arena, G Sanna, D Cuicchi, L F Angelicchio, C Catalioto, B Torre, P De Iaco, M Tesei, E De Crescenzo, C Larotonda, F Greco, M Minghetti, L Sissa, A M Perrone, G Dondi, M Di Stanislao, L Gaetani, L Serafini, E Prosperi, D Perone, C Isopi, F Bruno, I D Alexa, P Milito, A Lovece, G Chiappini, C Froiio, T Panici Tonucci, G Saletta, A Scardino, A Belli, F Izzo, R Patrone, C Cutolo, R Palaia, V Granata, V Albino, M Leongito, M Piccirillo, G Pasta, P Delrio, D Rega, M Rho, A Aversano, I A Angelone, M D’amico, M Di Marzo, S De Franciscis, P Cianci, E Restini, I Conversano, G Scialandrone, S Di Saverio, L Cardinali, G Travaglini, E Sebastiani, I Marziali, A B Bellocchia, I Raimondo, D Di Giorgio, G Garganese, V Tondolo, A Dore, G Pacini, L C Turco, P Campennì, M A Amara, A Rubattu, D Verri, G Sole, S Bove, F Inzaina, F Franceschi, G Grande, D P Pili, F Campus, G Delogu, V Sula, O Ez Zinabi, M Congiu, E Pira, G Ercolani, F D’acapito, D Annunziata, L Solaini, A Giordano, S Cantafio, S Novello, M Romano, C Armellin, G Zanus, F Milardi, U Grossi, R Baldan, M Brizzolari, F Scolari, A Brun-Peressut, A Broglia, M Martorana, N Fazzini, C Marafante, M Garino, E Moggia, S C Agosti, A Battaglia, A Borello, S L Birolo, R Barone, C Mosca, K Shakhova, A L Apostu, S Giaccari, M Pavanello, E Migliori, D Sambucci, C Corbellini, G M Sampietro, G Germiniasi, M Bischeri, F Colombo, P Danelli, F Cammarata, R S Zingale, I Pezzoli, M Carbonaro, F Albanesi, F Cozzani, M Rossini, F De Gennaro, M Giuffrida, P Del Rio, M Inama, G Moretto, L Iudici, A Vitali, M Creciun, H Impellizzeri, M Piazza, A Biancafarina, M De Prizio, R Malatesti, R Sulce, G A Pellicano’, A D’ignazio, V Mariottini, G Mura, M Angelini, M Scricciolo, F Barbara, F Tofani, L Nenci, V Borgogni, C Vece, A Sagnotta, L Solinas, M Rossi, S Mancini, R Fruscio, C Ciulli, M Braga, F Romano, M Garancini, F Carissimi, E Vico, Cdg Delle Grazie, S Negri, J Corti, N Tamini, L Cigagna, R Giordano, A Davolio, G Trezzi, T Grassi, C Procaccianti, L C Nespoli, L Pitoni, A Fogliati, G Cordaro, P Passoni, M Fantauzzi, S Villa, M A Scotti, G M Di Lucca, F Benedetti, P Masseria, M Frigerio, M Barba, I Re, M Ceresoli, F Ferraina, S K Adjei Antwi, C Fumagalli, G Di Martino, M L Di Meo, L Bazzano, T Nelli, F Masciello, G Canonico, E Chisci, E Adinolfi, R Borreca, A Damigella, C Di Martino, Gil Mottola, G Fontani, S Michelagnoli, M Fedi, F Leo, R De Vincenti, C Cecchi, L Piombetti, S Giannessi, B Benedetta, M Pagani, L Epis, A Percivale, M Malerba, V Tonini, M Cervellera, J Shahu, L Sartarelli, A Luzzi, E Romairone, S Carrabetta, F Tuminello, F Floris, F Ré, S Marzorati, F Ballari, C Meola, A Filippelli, U G Ribeca, A Viacava, V Lizzi, M Montagna, A Giuliani, N Tartaglia, F Vovola, F Maffei, A Cotoia, M Pacilli, G Pavone, G Berardi, N Depalma, M Maruccio, M G Spampinato, S D’ugo, T Marchese, F Basurto, C De Giorgi, S Garritano, F Manoochehri, F Perrone, I Botrugno, A Rizzi, W Sergi, G I Russo, A Cappellani, S Cimino, M G Asmundo, M G Matarazzo, M Di Vita, P Venturelli, G Cocorullo, F Zarcone, D M Dominici, G Salamone, R Tutino, A Corigliano, R Guercio, C Giuseppe, F D’arpa, G Melfa, M P Proclamà, G Scerrino, I Canfora, M Marcianò, G Guercio, S Barbera, C Amato, A V Agostara, G Pantuso, G Orlando, N Finocchiaro, A Picciariello, D F Altomare, L Vincenti, G Tomasicchio, N Paradiso, A Dezi, E Pinotti, M Montuori, L Siragusa, 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Sinha, J Blenkinsop, K Rawlings, T Chaudri, G Westland, H Umar, S Lee, J Cherian, Z Gurhan, T Chaudri, M S Sheraz, Dmi Khan, A Kucukmetin, D Malone, C Betts, M Ali, M Giblin, L Nowicki, P Korompelis, O Farley, M Fouweather, C Ioannides, H Yilmaz, R Landais, E X Ngeyu, C Erinjeri, D Badran, P Glen, J Aamir, A Aziz, P L Su, I Choong, M Reece, A Kulasekaran, Tns Tengku Saifudin, J Luckhurst, R O’hare, R Smith, Y T Siu, P H Kwok, V Sood, A Imran, K Fatima, Z Munir, T Kisova, N Rajendran, F Islam, E Teehan, H Sadik, U Patterson, N Rahman, H Harrisrhaj, D Govardhan, S Rajesh, Z Mumtaz, O S Ghori, H Nawaz, A Lysomirski, V Pikoula, Rmab Qadir, A Jones, Y Chiang, H Morsy, C Pazaiti, A N Asardag, I Ali, J Althonayan, A Badri, J Evans, E Chung, L Harriss, L Sinan, C Maxwell-Armstrong, A De, R Altman, F Varghese, W Chua, S Ahmed, M Javed, R Aljubure, A Bradley, S Moug, Oeh Kemmett, I Underwood, I Fitzpatrick, L S Wong, B Vakeesan, K Potter, T Varghese, S Daren, A Hazrin Fazail, S Farajzadeh Asl, H 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G Loy, E Roberts, S Baker, A Davies, Z Khan, M Leonidou, J K Chow, R Murugan, A Baker, R Burns, Y C Foo, F Sikora, L Chong, C Chan Ah Song, C Cosgrove, O Reeve-Chen, J Ma, L Mccolm, M K Zhang, F Hussain, X Y Ng, B Ingabire, B Wagner, T Bain, R Kovacs, E Small, S Lam, L Yao, L Ho, H Paremes Sivam, K Dahal, A Stanley, M White, L Hayois, M Thillai, T Tay, E Davies, N Kamaruzaman, L Robinson, R Sherrington, Z Abid Sohail, S Lawrence, A Sohail, D Brown, S Parker, M Ohr, D Jasniak, B Crowther, F Jadoon, L J Melo, H Amin, Rqh Lim, M A Thaha, M Bath, S A Saadqain, Y Benallal, Z Jin, A Jackson, A Kuri, M Malik, H Jos, E T Goh, M E Paraskevopoulou, A Kythreotis, Y Naim Ahmed, S P Glynou, H Rehan, A Pereira Pai, A Georgiannakis, N Dworschak, S Cho, B J Chow, Y Khan, T Enthoven, A Malik, I Latif, A H Lakhani, N Rahman, K Morgan, S Gkolia, N Khalessi, Plz May, A Lwin, P Kanesaratnam, M Tudgee, R English, K Hu, N Pathanchaly, Dcs Chien, M Holloway, K Gao, G Lekka, R Srinivasan, S Zafar, M R Peris, K Keiarash, H Kanesan, B Chong, M Kobus, D Dominic, D A Do, D Dennis, S Frankland, V Shah, B Youssef, U Sadia, A Hassouneh, A Jaipersad, T Chen, M Fulford, A Dawson, K Kapur, T Jha, P Zope, M Wilkinson, V Bhatnagar, J Knight, T K Madhuri, T Katsiari, N Pasternak-Albert, E Moussa, L Emms, M Lamah, Z Batool, A Sabesan, S Islam, M Baig, M Dave, X Liu, L Stuart, S Harvey, V Dam, P Ezuma, J Lee, S Suntharalingam, S Singh, P Preston, F Rickard, T Gupta, S Madden, C Jones, R Gidwani, X Wang, M Mcconnell, S Hanna, A Mcgettigan, K Brown, A Cios, C Ward-Bradley, O Hurrell, V Paice, N Mutsonziwa, S Pogoson, R Coulter, J Corry, L Mcclean, F Keenan, S O’dolan, A Plonkowski, R Brady, R Ooi, D Iles, L S Guillemot, C Low, S El-Barraj, J Epstein, M Pressler, I Ioannou, N Soliman, A Ktayen, A Macconnachie, J Menendez Lorenzo, J Tooke, K Noman, L Wilkins, J J Warner-Levy, R Evans, A Torrance, C Fear, H Vidis Humphries, G Velayudham, Z Jefferson-Pillai, J Brady, R Oza, D Singh, A Hamid, P Hartop, P Shojaie, J Mano, T Rajah, Ymc Cabdi, A Singal, M Afzali, J M Lee, D Bandyopadhyay, J Bennett, P Mendenhall, A Millett, S Davidson, R Kallam, M Pishia, H Butler, S Isidore, D Boutsias, K Bryce, T De Rancourt, J Barry, H Henry, A Aspinall, L Smith, C Conway, H Shanmugathas, C Huang, M Doherty, K Ahmed, T Chung, T Benson, A Habiba, J Singh Bhangu, B Bingor, L Fice, H Premanandhan, J Mckenna, I Jimenez-Reid, M Hoque, E Griffiths, J Loughran, M Laskowski, A Mehmood, R O’kane, M Mullan, R Mcclenaghan, G Kettyle, F Hosty-Blaney, Xhf Chan, S Sunny, M Kaur, S Vose, V George, D Killoran, R Doherty, Z Zagorac, A Pullyblank, R Ismail, N Anderton, L Dwyer-Joyce, R Morgan, N Zhang, B French, H Cox, J Tetro, A Clarke, K Shaw, R Iau, E King, S Patel, M Ovakimian, A Zahid, G Rowley, R Tanner, K Davoudi, B Shear, M Xu, K Karan, A O’reilly, S Ahmed, T Iskrenova Kirilova, A Ezekiel, M Shapland, M Mitra, T Krum, G Higginbotham, R Winayak, J Mustow, L Yorke, C Gibb, A Ilyas, M Pound, A Abouharb, D Burke, A Khan, K Aimar, J Bennett, E Kerman-Fiore, S Rao, A Dayal, S Chawla, L Wadey, C Smith, K Desor, R Surti, Z Gul, V Gourgiotis, L M Kaselampao, C Nguik, R Agrawal, Q Y Liaw, E Mckeown, A Hassan, K Krishnan, H O Glover, M Devassy, D Ogunyanwo, G Dickenson, G Elder, G Valdez, B White, I Hamilton, S Shah, S Sinha, K Punwani, I Peat, M Hayat, N Khalid, E Frankel, H Macgowan, A Braka, A Byfield, J Brooks, A Kashif, R Archer, S Akkaya, M Sood, S Akther, O Birkett, T Kadri, S Abdulmula, P Psefteli, S Chadha, G Reese, C Mark, M Asunramu, T Hess, S Mehta, C Tsang, K Syed, A Alocious, M Steinruecke, M Ashley, R Newton, J Wainwright, J Ayathamattam, H Wong, Z Elahi, M Fleming, T Ali, D Lloyd, K Brooks, C Kwon, A Mckerrell, T Jamadar, M D Barcelona, D Polluk, J Kwon, F Henry, S Ayirookuzhi, M Mwipatayi, M Cheruiyot, S Adam, T Cruickshank, K Gollub, M Revell, S Taiwo, A Atchade, A Harewood, A Niina, D Bosanquet, O Mckeon-Williams, T Szakmany, E Badhams, N Christensen, J Sammut, N Tay, J M Pollok, D Raptis, M Varcada, S Ganesananthan, R Chandrasekar, A Deshpande, L P Ghoora, G Hogg, S Staubli, M Banerjee, S Sunil Menon, A Sanz Pena, R Rana, A Mohamed, P Crabtree, A Flower, A Banerjee, Y Talabi, N Bishop, N Kupfuwa, D Ilangovan, H Qureshi, I Minty, R Baron, L Greasley, P Birkenhead, R Baron, M Shahid, N Rajasivam, W L Chu, N Punnoose, V Sundaresan, M El-Galley, K Prasansapakit, S Mitra, M Garlick, M Prakash, H Gao, C Parmar, F Lee, A Aich, A Ismail, M Kirupaharan, S Khan, K Patel, D Mclaverty, G Hammerton, H Walford, H Roberts, P Cautivo, H Abdel Kader, A Kimble, K Manaf, R Mackonochie, V Mitchell, S Ghaznavi, A Taheem, E Firth, H Chandler, K Eldessouki, J Fyfe, M Bhat, J Cavlin, E Pearce, S Patterson, C Johnson, K El-Badawi, M Gariballa, E Hale, H Younis, E Brackenbury, A Chappell, T Poulton, E Dawson, A Murray, I Mcallister, A Hassan, B Cunningham, T Chan-A-Sue, N Rajpal, P Keane, K Walsh, L Mcgeoghan, M Neeson, H Brown, S M Adams, S Ladha, A Walsh, M Alradhawi, R Tarighi, M I Miah, K Dawas, A Mojadady, A Priestman-Degano, S K Vellore Sasikumar, B Suresh, M Fornasiero, D Csvila, A Kumar, S T Adil, H S Adil, U Kataria, R Jaibaji, N Patel, A Goch, P Quaye, A Gupte, H Mustafa, V Otti, D Dewantoro, M Ali, M Sood, H Wright, L Abusheba, L Wong, M Docksey, A Abdinasir, M O Karim, V Kolaityte, M Vasileiadou Pelling, A Abdel Basit, E Pearson, E Hughes, A S Millington, L Taylor, C Borg, K Jagic, A Waheed, K Singh, V James, T Chowdhury, A Saxena, A Georgiou, T Jones, C Carpenter, I Hughes, Z Aloul, C Hanna-Davies, A Jacob, A Puthiyakunnel Saji, A Qureshi, Z Ulfin, M Dunlop, R Woods, N Hill, N Mohamed, A Vora, H Asharaf, E Maye, U Arif, S Srinivasan, S Prasad, B John, V Shivanand, A Singh, A Zahid, E Stewart, M Raketla, O Kokoricha, D Karwa, J Crisp, R Shehadeh, J Lee, B Webb, S Lepping, F Yusuf, E Pak, B Soo, P Pemmasani, S Goyal, A B Binti Azad Bashir, S Komolafe, A Naeem, H R Anbananthan, L K Au Yong, S Mookerjee, N Ward, M Aniq, J Davis, A Al-Sukaini, J Anthony, J Boyle, A Laird, D Speake, C Beagan, S Stewart, O El-Koubani, R Chan, M Viswanath, S Janssens, I Shah, V Nguyen, E Mckee, C W Ng, M Balać, D I Suresh Kumar, S Seeva Balan, R Kirk, B Miles, L A Kovacic, V G Collins, J Low, W Sim, S J Chua, N Narayanan, T Y Lee, Cmn Lo, M Chauhan, J Elkafsi, S Rasul, R Yammine, Z Sattar, D Dixit, N Rahman, J Davies, S Dindyal, L Osborne, L Nip, N Wilding de Miranda, A Stevens, B Al-Diri, A Lim, G Kallikas, Y Kim, M Anjum, P Jeyapahan, M Hakim, S Singh, E Jamileh, C Sohrabi, S H Baek, N Sadik, A Mohammed, D Aje, R Clifford, C O’halloran, K Mahajan, N Darke, S Lloyd, M Mlotshwa, K Melhuish, J Derex-Briggs, M Bell, P Varma, K Fray, Y Garg, K Datta, T Mantel-Cooper, M Goodfellow, B Kazi, N Sievers, K Telford, Z R Almansoor, K Craddock, J L Tan, L St John, A Singhania, S Dosani, S Mughal, N Bokhari, L Brooks, I Laid, A Lala, C S Ong, S Wakefield, S Phillips, H Unwin British Journal of Surgery, 2025 Background There is low-certainty evidence on the impact of extended pharmacological prophylaxis on venous thromboembolism-associated morbidity and mortality. The aim of this study was to determine the efficacy and safety of extended prophylaxis after major abdominopelvic surgery for the prevention of clinically relevant venous thromboembolism after hospital discharge. Methods CArdiovaSCulAr outcomes after major abDominal surgEry (CASCADE) was a prospective, international, cohort study into which consecutive adult patients undergoing major abdominopelvic surgery were enrolled (January–May 2022). Extended prophylaxis was considered at least 28 days of anticoagulant prescription after surgery. The primary efficacy outcome was clinically relevant venous thromboembolism and the primary safety outcome was clinically relevant bleeding within 30 days after surgery (European Medicines Agency definitions). The independent association of these outcomes with extended prophylaxis was explored using mixed-effects logistic regression and propensity score weighting. Results A total of 11 571 patients (median age of 58.0 years; 6399 (55.3%) women) from 29 countries were included. The extended prophylaxis prescription rate was 31.7% (3670 patients). The post-discharge venous thromboembolism and bleeding rates were 0.1% (12 patients) and 0.7% (85 patients) respectively. After weighting, extended prophylaxis was not significantly associated with increased bleeding risk (OR 1.07 (95% c.i. 0.64 to 1.81); P = 0.792) or decreased venous thromboembolism incidence, both in the overall cohort (OR 1.13 (95% c.i. 0.33 to 3.90); P = 0.848) and in a subgroup analysis of patients undergoing complex major surgery and with active cancer (OR: 1.36 (95% c.i. 0.33 to 5.57); P = 0.669). Conclusion In modern practice, the incidence of postoperative venous thromboembolism is low. Extended prophylaxis appears safe, yet the clinical efficacy remains uncertain. Further work is required to define patients who stand to benefit.
Healthcare-Associated Infections in a Burn Treatment Unit MARCELO MOURÃO, MARÍLIA BAENINGER, THAYSA SOBRAL ANTONELLI, DANIELA VIEIRA DA SILVA ESCUDERO, MARIA CLAUDIA STOCKLER DE ALMEIDA, ALFREDO GRAGNANI Revista do Colegio Brasileiro De Cirurgioes, 2025 Introduction: Severe burns significantly weaken the immune system and disrupt the skin’s natural barrier, which increases the likelihood of healthcare-associated infections (HAIs) and raises the risk of mortality. Methods: Based on CDC criteria, this study retrospectively examines the incidence of HAIs in burn patients hospitalized at a university hospital in São Paulo, Brazil, over five years from 2018 to 2022. Results: 536 patients were treated during this time, with 130 HAIs recorded in 88 individuals. The average age of the patients was 41 years, and the mean total body surface area (TBSA) affected by burns was 20.4%. The primary causes of burns were flammable liquids (39.7%), electrical injuries (25%), and scalds from heated liquids (14.8%). Burn wound infections were the most frequent HAI (51.5%), followed by bloodstream infections (13.8%), urinary tract infections (13.1%), and ventilator-associated pneumonia (10.7%). Regarding microbiological findings, 141 microorganisms were isolated, with gram-negative bacteria making up 71.6% of the total, gram-positive bacteria accounting for 21.2%, and fungi representing 7.1%. In three cases, no microorganism was identified. The mortality rate among these patients was 13,6%. Conclusion: Notably, the predominance of gram-negative bacteria in this population, responsible for more than 70% of infections, contrasts with findings from other studies. The findings highlight the importance of infection control to reduce morbidity and mortality in this vulnerable population.
Ultrasound-Guided Percutaneous Ethanol Injection Protocol to Treat Solid and Mixed Thyroid Nodules João Soares Felício, Antônio Maria Silva Conceição, Flávia Marques Santos, Michelle Masuyo Minami Sato, Fabíola de Arruda Bastos, Ana Carolina Contente Braga de Souza, Camila Cavalcante Koury, João Felício Abrahão Neto, Franciane Trindade Cunha de Melo, Carolina Tavares Carvalho, Thaís Pontes Arbage, Antonio Bentes de Figueiredo Junior, Hana Andrade de Rider Brito, Marcelo Oliveira Mourão Júnior, Fabricio de Souza Resende, Amanda Soares Peixoto, Karem Miléo Felício Frontiers in Endocrinology, 2016 Context Ultrasound (US)-guided percutaneous ethanol injection (PEI) has been proposed for treatment of benign thyroid nodules (TNs). However, there is no consensus for the optimal amount of ethanol injection, number of applications, and time to re-evaluation in order to achieve maximum volume reduction with minimum adverse effects. Objective The purpose of the present study was to analyze the effectiveness of an US-guided PEI protocol to treat solid and mixed TNs based on a new target outcome. Patients and methods We performed a prospective study evaluating the results of PEI in 52 patients with benign solid and mixed TNs. The ethanol dose was fixed in 30% of the nodular volume per session. Patients returned 1 month after each session for US re-evaluation. Therapeutic success was defined as volume reduction of at least 30% associated with disappearance of clinical symptoms and a complete esthetic satisfaction reported by the patient. Results We performed a mean of 2.8 ± 1.9 PEI sessions, with an average total volume of ethanol injected of 9.1 ± 10.3 ml, and a follow-up time of 10.0 ± 8.7 months. There was a reduction of at least 50% of the initial nodular volume in 33 patients (63.5%). In 11 patients (21.2%), the reduction did not reach 50% (mean reduction of 31 ± 11%), but 6 of them reported esthetically satisfactory results and treatment was stopped. Our therapeutic success rate considering the patients with esthetic improvement was 75%. There were no severe complications. Conclusion Our protocol is effective and safe to treat solid and mixed benign TNs based on our established outcome.
