Surgical Practice in the Current COVID-19 Pandemic: A Rapid Systematic Review

The coronavirus disease (COVID-19) outbreak started in Wuhan, China, in December 2019, and evolved into a global problem in a short period. The pandemic has led to many social and health-care challenges. In this context, surgery is an area that is facing the need for many adaptations. In this systematic literature review, we analyzed different perspectives concerning this situation, aiming to provide recommendations that could guide surgeons and entities toward screening, elective and emergency surgeries, decision making, and operating room management. A computerized search in PubMed, Scopus, and Scientific Electronic Library Online (SciELO) for relevant literature up to April 4, 2020, was performed. Articles were included if they were related to surgery dynamics in the context of the COVID-19 pandemic. Of the 281 articles found in our initial search and 15 articles from alternative sources, 39 were included in our review after a systematic evaluation. Concerning preoperative testing for severe acute respiratory syndrome coronavirus 2 infection, 29 (74.4%) articles recommended some kind of screening. Another major suggestion was postponing all (or at least selected) elective operations (29 articles, 74.4%). Several additional recommendations with respect to surgical practice or surgical staff were also assessed and discussed, such as performing laparoscopic surgeries and avoiding the use of electrocauterization. On the basis of the current literature, we concluded that any surgery that can be delayed should be postponed. COVID-19 screening is strongly recommended for all surgical cases. Moreover, surgical staff should be reduced to the essential members and provided with institutional psychological support

Corona Mortis: A Systematic Review of Literature

Our systematic review evaluates surgically relevant information about corona mortis (CM), such as anatomical structure, size, laterality, incidence, and anthropometric correlations. This study aimed to provide data about anastomosis in an attempt to avoid iatrogenic damage during surgery. Articles were searched online using the descriptor ‘‘Corona Mortis’’ in PubMed, Biblioteca Virtual em Sau´ de (BVS) (Literatura Latino-Americana e do Caribe em Sau´ de [LILACS], MEDLINE, indice bibliografico espan˜ ol en ciencias de la salud [IBECS]), and SciELO database. The time range was set between 1995 and 2020. The articles were selected according to their titles and later the abstracts’ relation to our research purpose. All the selected articles were read entirely. A manual search based of the references cited in these articles was also conducted to identify other articles or books of interest. Forty references fulfilled the criteria for this review. The mean incidence of CM was 63% (the majority venous) among 3,107 hemipelvises. The incidence of bilateral CM was lower than that of unilateral variations based on the analysis of 831 pelvises. The mean caliber of the anastomosis was 2.8 mm among 1,608 hemipelvises. There is no consensus concerning the anthropometric influences in CM. Finally, we concluded that CM is not an unusual anatomical variation and that we must not underestimate the risk of encountering the anastomosis during surgery. Anatomical knowledge of CM is, therefore, essential in preventing accidents for surgeons who approach the inguinal and retropubic regions

Dental practice in the context of the pandemic caused by COVID-19

COVID-19 was first described in Wuhan, China in December 2019, since then it has spread to all continents and was declared a pandemic by WHO. It is transmitted from person to person or by direct contact with contaminated surfaces. Its symptoms are nonspecific and can trigger severe pneumonia and even death. As it is a recently identified event, there is no specific treatment and its management focuses on symptom control. The dental profession is shown to be one of the most affected by this disease, due to close contact with patients and continuous exposure to aerosols with a high microbial load, produced by working instruments. So far there are no standardized protocols for clinical practice in the context of this pandemic and the information that circulates through social networks and the media is constantly changing and erroneous most of the time. The main objective of this work is to provide the dental professional with relevant information on COVID-19, based on the available evidence, to help mitigate and prevent the spread of the virus during dental practice.El COVID-19 fue descrito por primera vez en Wuhan, China en diciembre de 2019, desde entonces se ha extendido a todos los continentes y la OMS lo declaró como pandemia. Se transmite de persona a persona o por contacto directo con superficies contaminadas y su sintomatología es inespecífica, pudiendo desencadenar neumonía grave e incluso la muerte. Por ser un evento recientemente identificado, no existe un tratamiento específico y su manejo se centra en el control de los síntomas. La profesión odontológica se muestra como una de las más afectadas por esta enfermedad, debido al contacto próximo con los pacientes y a la exposición continua a aerosoles con carga microbiana alta, producidos por los instrumentos de trabajo. Hasta el momento no existen protocolos estandarizados para la práctica clínica en el marco de esta pandemia y las informaciones que circulan por redes sociales y medios de comunicación son cambiantes y erróneas la mayoría de las veces. El objetivo principal de este trabajo, es brindar al profesional informaciones relevantes sobre el COVID-19, basadas en la evidencia disponible, que ayuden a la mitigación y prevención de la propagación del virus durante la práctica odontológica