Human Papillomavirus in Head and Neck Cancer

Throughout the last three decades, there has been a notable shift in the epidemiology of head and neck cancer (HNC) worldwide. A rapidly spreading subtype of HNCs is caused by human papillomavirus (HPV) infection. HPV-related cancers are now considered to constitute 30–65% of all HNC cases and 50–80% of oropharyngeal cancers. HPV-positive oropharyngeal cancers have a unique demographic profile and tumor biology characteristics. HPV-associated patients predominantly consist of younger men with better performance status and fewer comorbid diseases. They have better dentition, higher numbers of oral sex partners, and use less amount of tobacco or alcohol, higher amount of marijuana compared with HPV-negative patients. In addition, patients with HPV-positive tumors have a 60–80% reduced mortality rates, a finding that was confirmed by multiple trials and led to several ongoing deintensification studies. This chapter describes epidemiologic features of HPV-positive HNC, risk factors for HPV infection and HPV-associated oropharyngeal cancer, HPV detection methods, mechanisms of carcinogenesis and improved treatment response, and the impact of HPV status on clinical outcome as well as deintensification approaches and potential of vaccination

Determinación de algunos metales inorgánicos en aceites vegetales comestibles mediante espectroscopia de emisión atómicacon fuente de plasma acoplado inductivamente (ICP-AES)

Seventeen edible vegetable oils were analyzed spectrometrically for their metal (Cu, Fe, Mn, Co, Cr, Pb, Cd, Ni, and Zn) contents. Toxic metals in edible vegetable oils were determined by Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES). The highest metal concentrations were measured as 0.0850, 0.0352, 0.0220, 0.0040, 0.0010, 0.0074, 0.0045, 0.0254 and 0.2870 mg/kg for copper in almond oil, for iron in corn oil-(c), for manganese in soybean oil, for cobalt in sunflower oil-(b) and almond oil, for chromium in almond oil, for lead in virgin olive oil, for cadmium in sunflower oil-(e), for nickel almond oil and for zinc in almond oil respectively. The method for determining toxic metals in edible vegetable oils by using ICP-AES is discussed. The metals were extracted from low quantities of oil (2-3 g) with a 10% nitric acid solution. The extracted metal in acid solution can be injected into the ICPAES. The proposed method is simple and allows the metals to be determined in edible vegetable oils with a precision estimated below 10% relative standard deviation (RSD) for Cu, 5% for Fe, 15% for Mn, 8% for Co, 10% for Cr, 20% for Pb, 5% for Cd, 16% for Ni and 11% for Zn.En este estudio se analizó espectrométricamente el contenido en metales (Cu, Fe, Mn, Co, Cr, Pb, Cd, Ni, and Zn) de 17 aceites vegetales comestibles mediante ICP-AES. Las concentaciones más elevadas se encontraron para el cobre en el aceite de almendra (0.0850 mg/kg), para el hierro en el aceite de maiz(c),(0.0352 mg/kg), para el manganeso en el aceite de soja (0.0220 mg/kg), para el cobalto en el aceite de girasol (b) (0.0040 mg/kg), para el cromo en el aceite de almendra (0.0010 mg/kg), para el plomo en el aceite de oliva virgen (0.0074 mg/kg), para el cadmio en el aceite de girasol (e) (0.0045 mg/kg), para el niquel en el aceite de almendra (0.0254 mg/kg) y para el zincen el aceite de almendra (0.2870 mg/kg). Los metales se extrajeron a partir de bajas cantidades de aceite (2-3 g), con una solución de ácido nítrico al 10%. Se discute el método y se conclluye que el método propuesto es simple y permite la determinación en aceites vegetales comestibles con una precisión estimada inferior al 10% para Cu, 5% para Fe, 15% para Mn. 8% para Co, 20% para Pb, 5% para Cd, 16% para Ni y 11% para Zn

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