Clinical presentation at the onset of COVID-19 and allergic rhinoconjunctivitis

Coronavirus disease 2019 may present with nasal and ocular manifestations that could be confused with allergic rhinoconjunctivits at the onset. The 2 clinical scenarios present some differences that allow one to clearly distinguish the 2 diseases even during the allergic seasonal period

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract 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

Sperm morphology in the black coral Cirrhipathes sp. (Anthozoa, Antipatharia)

Male polyps of the antipatharian Cirrhipathes sp., collected along the coral reef of Siladen Island (Sulawesi, Indonesia), were studied in order to gain an insight into the reproductive biology. Spermatocysts (maximum size 120 mm) are located within the primary gametogenic mesenteries and are separated by mesenteric cell cytoplasmic extensions. Sperm, maturing along radial rows, have a fairly round shape and contain a series of electron-dense vesicles in the apical nuclear region. A single mitochondrion flanks the nucleus. A peculiar cup-like electron-dense body, edged with regularly spaced electron-dense granules, is interposed between the nucleus and the tail, and delimits a central region that includes two centrioles. Cross-sections of the cup-like body reveal that the distal centriole has a pericentriolar system, consisting of nine arms arranged in a radial pattern. Each arm branches into three processes that are connected to the electron-dense granules. Indirect evidence of spawning is derived fromthe accumulation of sperm in the gastric cavity. This process takes place through the lysis of the cells bordering the mesenteries. Intact cells of this bordering layer appear to be involved in the phagocytosis of non-expelled gametes

Some spermatogenic steps in Distichopora sp. (Cnidaria, Hydrozoa, Stylasteridae): ultrastructural aspects

none6Elda Gaino; Francesca Scoccia; Daisy Monica Makapedua; Daniela Pica; Giorgio Bavestrello; Stefania PuceElda, Gaino; Francesca, Scoccia; Daisy Monica, Makapedua; Daniela, Pica; Bavestrello, Giorgio; Stefania, Puc

Visual acquisition system for georeferenced monitoring and reconstruction of the sea bottom using audio for data synchronisation

This work describes a Smart Dive Scooter (SDS) to be used as a support tool for monitoring application of different marine species. Professional divers of Environmental Protection Agencies are periodically involved in monitoring activities. Ligurian Regional Agency for the Environmental Protection (ARPAL) and the University of Pisa (UNIPI) are collaborating towards the integration of classical methodologies with ICT tools to support the work of divers in terms of safety, cost effectiveness and time effectiveness. The SDS is the first step in this direction. It is a classical Dive Scooter, used for rapid movements underwater, that is integrated with sensors for environment monitoring (a set of cameras) and for data georeferencing (acoustic localisation system). The SDS will be used by ARPAL divers to quickly acquire images of the bottom of a target area. Processing of optical and positioning data will allow to build a virtual model on which perform all the analysis and measurement activities. This approach results in limiting the time underwater for operators increasing the area mapper per each dive. The paper focuses on the technique used for the synchronization of optical data among the various cameras and of them with the acoustic position measurements. This goal is obtained exploiting the audio tracks acquired by the cameras avoiding the necessity of bulky and energy expensive dedicated computers. Results of the validation based on experimental data collected at sea are reported

An approach to evaluate the quality of radiological reports in Head and Neck cancer loco-regional staging: experience of two Academic Hospitals

none24Objectives: To evaluate the quality of the reports of loco-regional staging computed tomography (CT) or magnetic resonance imaging (MRI) in head and neck (H&N) cancer. Methods: Consecutive reports of staging CT and MRI of all H&N cancer cases from 2018 to 2020 were collected. We created lists of quality indicators for tumor (T) for each district and for node (N). We marked these as 0 or 1 in the report calculating a report score (RS) and a maximum sum (MS) of each list. Two radiologists and two otolaryngologists in consensus classified reports as low quality (LQ) if the RS fell in the percentage range 0-59% of MS and as high quality (HQ) if it fell in the range 60-100%, annotating technique and district. We evaluated the distribution of reports in these categories. Results: Two hundred thirty-seven reports (97 CT and 140 MRI) of 95 oral cavity, 52 laryngeal, 47 oropharyngeal, 19 hypo-pharyngeal, 14 parotid, and 10 nasopharyngeal cancers were included. Sixty-six percent of all the reports were LQ for T, 66% out of all the MRI reports, and 65% out of all CT reports were LQ. Eight-five percent of reports were HQ for N, 85% out of all the MRI reports, and 82% out of all CT reports were HQ. Reports of oral cavity, oro-nasopharynx, and parotid were LQ, respectively, in 76%, 73%, 100% and 92 out of cases. Conclusion: Reports of staging CT/MRI in H&N cancer were LQ for T description and HQ for N description.noneGiannitto, Caterina; Esposito, Andrea Alessandro; Spriano, Giuseppe; De Virgilio, Armando; Avola, Emanuele; Beltramini, Giada; Carrafiello, Gianpaolo; Casiraghi, Elena; Coppola, Alessandra; Cristofaro, Valentina; Farina, Davide; Gaino, Francesca; Lastella, Giulia; Lofino, Ludovica; Maroldi, Roberto; Piccoli, Francesca; Pignataro, Lorenzo; Preda, Lorenzo; Russo, Elena; Solimeno, Lorenzo; Vatteroni, Giulia; Vidiri, Antonello; Balzarini, Luca; Mercante, GiuseppeGiannitto, Caterina; Esposito, Andrea Alessandro; Spriano, Giuseppe; De Virgilio, Armando; Avola, Emanuele; Beltramini, Giada; Carrafiello, Gianpaolo; Casiraghi, Elena; Coppola, Alessandra; Cristofaro, Valentina; Farina, Davide; Gaino, Francesca; Lastella, Giulia; Lofino, Ludovica; Maroldi, Roberto; Piccoli, Francesca; Pignataro, Lorenzo; Preda, Lorenzo; Russo, Elena; Solimeno, Lorenzo; Vatteroni, Giulia; Vidiri, Antonello; Balzarini, Luca; Mercante, Giusepp