Impact of COVID-19 on maxillofacial surgery practice: a worldwide survey

The outbreak of coronavirus disease 2019 (COVID-19) is rapidly changing our habits. To date, April 12, 2020, the virus has reached 209 nations, affecting 1.8 million people and causing more than 110,000 deaths. Maxillofacial surgery represents an example of a specialty that has had to adapt to this outbreak, because of the subspecialties of oncology and traumatology. The aim of this study was to examine the effect of this outbreak on the specialty of maxillofacial surgery and how the current situation is being managed on a worldwide scale. To achieve this goal, the authors developed an anonymous questionnaire which was posted on the internet and also sent to maxillofacial surgeons around the globe using membership lists from various subspecialty associations. The questionnaire asked for information about the COVID-19 situation in the respondent's country and in their workplace, and what changes they were facing in their practices in light of the outbreak. The objective was not only to collect and analyse data, but also to highlight what the specialty is facing and how it is handling the situation, in the hope that this information will be useful as a reference in the future, not only for this specialty, but also for others, should COVID-19 or a similar global threat arise again

Neuronavigational approach for orbital neurofibroma excision: a case report

Orbital neurofibromas are uncommon in adults, accounting for approximately 1%-3% of all space occupying lesions of the orbit. The complex anatomy of the orbital region, with the pronounced vulnerability of its neurovascular structures, requires particular surgical precautions. Neuronavigation, as a high-tech device for intraoperative safety, represents a valuable option for the confined orbital space. However, the application of neuronavigation in orbital surgery has been rarely reported. The authors present a case report of a 32-year-old female with an isolated localized neurofibroma surgically approached by intraoperative navigation and a review of the literature

Reconstruction of the adult hemifacial microsomia patient with temporomandibular joint total joint prosthesis and orthognathic surgery

HFM patients' reconstruction has always been a challenge for maxillofacial surgeons, and numerous reconstructive techniques have been described. Surgical treatment depends on the patient's age and contemplates Temporomandibular Joint (TMJ) reconstruction in conjunction with orthognathic surgery, usually necessary following completion of growth to maximize the functional and esthetic results. Distraction osteogenesis had gained popularity as valid alternative in growing patients, but the two primary methods to reconstruct the TMJs involve the use of autogenous, using free or microvascular bone grafts, or alloplastic graft, but there is no widely accepted method

Patterns of self-care in adults with heart failure and their associations with sociodemographic and clinical characteristics, quality of life, and hospitalizations: A cluster analysis

Background: Self-care is important in heart failure (HF) treatment, but patients may have difficulties and be inconsistent in its performance. Inconsistencies in self-care behaviors may mirror patterns of self-care in HF patients that are worth identifying to provide interventions tailored to patients. Objectives: The aims of this study are to identify clusters of HF patients in relation to self-care behaviors and to examine and compare the profile of each HF patient cluster considering the patient's sociodemographics, clinical variables, quality of life, and hospitalizations. Methods: This was a secondary analysis of data from a cross-sectional study in which we enrolled 1192 HF patients across Italy. A cluster analysis was used to identify clusters of patients based on the European Heart Failure Self-care Behaviour Scale factor scores. Analysis of variance and [chi]2 test were used to examine the characteristics of each cluster. Results: Patients were 72.4 years old on average, and 58% were men. Four clusters of patients were identified: (1) high consistent adherence with high consulting behaviors, characterized by younger patients, with higher formal education and higher income, less clinically compromised, with the best physical and mental quality of life (QOL) and lowest hospitalization rates; (2) low consistent adherence with low consulting behaviors, characterized mainly by male patients, with lower formal education and lowest income, more clinically compromised, and worse mental QOL; (3) inconsistent adherence with low consulting behaviors, characterized by patients who were less likely to have a caregiver, with the longest illness duration, the highest number of prescribed medications, and the best mental QOL; (4) and inconsistent adherence with high consulting behaviors, characterized by patients who were mostly female, with lower formal education, worst cognitive impairment, worst physical and mental QOL, and higher hospitalization rates. Conclusion: The 4 clusters identified in this study and their associated characteristics could be used to tailor interventions aimed at improving self-care behaviors in HF patients

Covid-2019 pandemic: growing wave of cancelled meetings in oral and maxillofacial surgery and its impact on specialty

We are at war. All our energy should be on one aim: to slow the progress of the virus. 1 —Emmanuel Macron French President (March 16, 2020) The official cause of the coronavirus disease 2019 (Covid-19) 2 became a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3 which was officially identified on January 9, 2020. 4 Generally described four transmission routes for the Covid-19: 1) aerosol transmission, 2) contact transmission, 3) droplets transmission, and even through 4) digestive system. 3 The most commonly reported symptoms in patients are cough, fever, myalgia/fatigue, pneumonia, and complicated dyspnea. 3,5 According to Li et al cases resulting in death were primarily in elderly and middle-aged patients with pre-existing co-morbidities. 6 The statistically proved number of death worldwide continues permanently to increase. On March 26 that number of death reached 21,297 people, 7 on April 1 – 42,341 people, 8 on April 7 – 74,820 people, 9 on May 29 – 362,091 10 , and on August 11 – 739,342 1

General Report - Session 5

This General Report summarizes the papers submitted to Session 5 titled “Case Histories and Failure of Geological, Rock and Mining Engineering, including Underground Structures and Excavations, and Subsidence of Deltas, Anticipation, Characterization, Design and Construction in the Geological Complexity of Mélanges, Fault Rocks, Weathered Rocks, Boulder Colluvium, Lahars, and Similar Bimrocks (Block-in-Matrix Rocks) and Rock/Soil Mixtures.” A total of eleven papers covering the broad session themes described above were submitted. The geographic distribution of the case histories is listed in Table 1. Overall, five papers were submitted from Asia, two from Africa, two from North America, and two from Europe

A Middle-Range Theory of Social Isolation in Chronic Illness

: Chronic illnesses and social isolation are major public phenomena that drive health and social policy worldwide. This article describes a middle-range theory of social isolation as experienced by chronically ill individuals. Key concepts include social disconnectedness, loneliness, and chronic illness. Antecedents of social isolation include predisposing factors (e.g., ageism and immigration) and precipitating factors (e.g., stigma and grief). Outcomes of social isolation include psychosocial responses (e.g., depression and quality of life), health-related behaviors (i.e., self-care), and clinical responses (e.g., cognitive function and health service use). Possible patterns of social isolation in chronic illness are described

Unilateral condylar hyperplasia recurrence after orthognathic surgery: a case report

Introduction: Unilateral Condylar Hyperplasia (UCH) is an uncommon condition resulting in facial asymmetry and malocclusion. At the time of diagnosis, an accurate evaluation of condylar activity through bone SPECT is necessary to determine the most appropriate surgical treatment. The Authors present a case of a UCH recurrence after orthognathic surgery in order to discuss about the clinical role of condylar SPECT in UCH therapeutic management. Case report: A 60-years old female patient was referred to the Department of Maxillo-Facial Surgery of Sapienza University of Rome for a relapse of mandibular laterodeviation. At the age of 24, she underwent orthognathic surgery after a diagnosis of UCH without condylar SPECT evaluation. As part of our clinical routine, condylar SPECT was performed and a significant difference in radiotracer uptake (20%) was found between the left condylar region and the contralateral one. She underwent high condilectomy and Bilateral Mandibular Sagittal Osteotomy. She had no evidence of recurrence till today. Discussion: Optimal surgical management of UCH is still controversial. In the diagnostic phase of UCH, a functional evaluation of condylar growth status by bone SPECT is an essential step to avoid long-term recurrence of mandibular asymmetry. On the basis of condylar metabolic activity, UCH can be classified in an active phase or a stationary phase. Clinical and functional evaluation of patients with mandibular asymmetry should be standardized in order to plan the most appropriate surgical and orthodontic treatment

Measures of Self-Care in Heart Failure: Issues with Factorial Structure and Reliability

Dear Editor We read with great interest the recently published paper by Dr Lambrinou and colleagues1 entitled “The Greek version of the 9-item European heart failure self-care behaviour scale: A multidimensional or an uni-dimensional scale?” The paper is one of several papers published on the psychometric properties of the European Heart Failure Self-care Behaviour Scale (EHFScBS) and continues to raise the important questions: (1) Is self-care of heart failure (HF) a multidimensional or an uni-dimensional construct? (2) Is self-care of HF a generalizable construct across countries? (3) Is Cronbach\u27s alpha the best approach to estimate reliability of instruments