40 years of surgical advances

Changes in surgery over the last 40 years have been extraordinary. We want to reflect the progress of this period in the District Hospital of Alcoy, Spain. Technology and staffing have improved in an extraordinary way and allows a basic hospital to offer citizens the quality of the most sophisticated centers

Efficacy of a nasal spray containing Iota-carrageenan in the costexposure crophylaxis of COVID-19 in hospital personnel dedicated to patients care with COVID-19 disease

Background: Iota-Carrageenan (I-C) is a sulfate polysaccharide synthesized by red algae, with demonstrated antiviral activity and clinical efficacy as nasal spray in the treatment of common cold. In vitro, I-C inhibits SARS-CoV-2 infection in cell culture. Research Question: Can a nasal spray with Iota-Carrageenan be useful in the prophylaxis of COVID-19 in health care workers managing patients with COVID-19 disease? Study Design and Methods: This is a pilot pragmatic multicenter, randomized, double-blind, placebo-controlled study assessing the use of a nasal spray containing I-C in the prophylaxis of COVID-19 in hospital personnel dedicated to care of COVID-19 patients. Clinically healthy physicians, nurses, kinesiologists and other health care providers managing patients hospitalized for COVID-19 were assigned in a 1:1 ratio to receive four daily doses of I-C spray or placebo for 21 days. The primary end point was clinical COVID-19, as confirmed by reverse transcriptase polymerase chain reaction testing, over a period of 21 days. The trial is registered at ClinicalTrials.gov (NCT04521322). Results: A total of 394 individuals were randomly assigned to receive I-C or placebo. Both treatment groups had similar baseline characteristics. The incidence of COVID-19 differs significantly between subjects receiving the nasal spray with I-C (2 of 196 [1.0%]) and those receiving placebo (10 of 198 [5.0%]). Relative risk reduction: 79.8% (95% CI 5.3 to 95.4; p=0.03). Absolute risk reduction: 4% (95% CI 0.6 to 7.4). Interpretation: In this pilot study a nasal spray with I-C showed significant efficacy in preventing COVID-19 in health care workers managing patients with COVID-19 disease. Clinical Trials Registration: NCT04521322.Fil: Figueroa, Juan Manuel. Instituto de Ciencia y Tecnología Dr. César Milstein; ArgentinaFil: Lombardo, Mónica Edith. Nobeltri S.r.l; Argentina. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Dogliotti, Ariel. Instituto Cardiovascular de Rosario; ArgentinaFil: Flynn, Luis Pedro. Sanatorio de Niños de Rosario; ArgentinaFil: Giugliano, Robert. Harvard Medical School; Estados UnidosFil: Simonelli, Guido. McGill University. Montreal Neurological Institute and Hospital; CanadáFil: Valentini, Ricardo. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Ramos, Agñel. Sanatorio Parque de Rosario; ArgentinaFil: Romano, Pablo. Clínica y Maternidad Santa Isabel; ArgentinaFil: Marcote, Marcelo. Gobierno de la Provincia de Buenos Aires. Hospital Interzonal General de Agudos Presidente Peron; ArgentinaFil: Michelini, Alicia. Hospital Pediátrico Avelino Castelán; ArgentinaFil: Salvado, Alejandro. Hospital Británico de Buenos Aires; ArgentinaFil: Sykora, Emilio. Clínica Privada Monte Grande; ArgentinaFil: Kniz, Cecilia. Gobierno de la Provincia de Chaco. Hospital 4 de Junio Ramón Carrillo; ArgentinaFil: Kobelinsky, Marcelo. Clínica Modelo de Morón; ArgentinaFil: Salzberg, David Manuel. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Dr. Teodoro Álvarez"; ArgentinaFil: Jerusalinsky, Diana Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Uchitel, Osvaldo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; Argentin