To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.
Introduction:Bioactive-glass (B-G) has become a valuable adjunct to promote hard-tissue healing in many clinical situations and is of particular interest for endodontic care because of its biocompatibility, regenerative and antimicrobial properties as well as chemical composition that closely resembles the mineral make-up of human bone and dentine. Therapy:Initial studies suggested that bacteria-tight sealing within the entire root canal system can be achieved and successfully maintained after orthograde treatment. Promising results have also been obtained in conjunction with microsurgical techniques, with the aim of enhancing wound healing and positively influencing bone regeneration. Conclusion:Here, relevant literature was explored to present a comprehensive review of the rationale, development, and current applications of B-G in Endodontology illustrating them with case reports.
From 2002 to 2008, 86 patients have undergone surgical treatment of malignant upper maxillary tumors at the Maxillo-Facial Surgery Department, Tor Vergata University, Rome. All the N-positive patients at the time of the T therapy have undergone lymph node surgical emptying. In 6 patients, a laterocervical emptying was performed when laterocervical metastases were found. In the remaining 68 patients, with no evidence of N, we did not perform laterocervical emptying. We found in our patients a high percentage of cervical metastasis in T2 squamous cell carcinoma of the maxilla (32.1%). In this article, the authors present the results of their experience in treating N in upper maxillary tumors. This research study highlights some important aspects that have to be considered. Squamous cell carcinoma of the maxilla extending to the oral cavity (T1-T2) shows a higher laterocervical lymphophily than the superoposterior ones (T3-T4). Presence or appearance of lymph node metastases is a high-malignancy index, with a subsequently very negative prognosis. Considering the large percentage of cervical recurrences in T1-T2 squamous cell carcinoma of the maxilla that spread up in the hard palate mucosa and upper gum and the consequently high morbidity, performing a prophylactic laterocervical emptying in these patients could be advisable. Even in the recent literature, we found opinion in favor of this behavior.
Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.
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