Breast surgeons updating on the thresholds of COVID-19 era: results of a multicenter collaborative study evaluating the role of online videos and multimedia sources on breast surgeons education and training.

OBJECTIVE: Current trends show a rise of attention given to breast cancer patients' quality of life and the surgical reconstructive result. Along with this trend, surgical training quality and efficacy are gaining importance and innovative training methods such as online videos shared on social media portals, are becoming main updating tools. In hazardous times like COVID-19 pandemic nowadays, online communication becomes of vital importance and adaptation and innovation are fundamental to keep research and education alive. The authors aimed to investigate the role of video and multimedia sources on the daily activity and surgical training of a representative group of surgeons specifically dedicated to oncologic, oncoplastic and reconstructive breast surgeries. MATERIALS AND METHODS: A survey was produced and administered to 20 major Italian Breast Centers. Collected data were analyzed with Fisher's Exact Test. RESULTS: From October 2019 to March 2020, a total of 320 surveys were collected. Among the responders, there were 188 trainees (intern medical doctors and residents) and 110 faculty, 72% of them belonged to a plastic surgery environment, while 28% to general surgery environment. Almost all respondents have ever watched videos concerning breast surgery. CONCLUSIONS: The results of the study show how breast surgeons rely on videos and web platforms, mostly YouTube, when searching for training info about surgical procedures. Social media offer great opportunities for sharing knowledge and diffusion of new ideas but greater attention to their reliability is mandatory.

HPLC/fluorescence determination of anti-BPDE-DNA adducts in mononuclear white blood cells from PAH-exposed humans.

The aim of this study was to compare (+/-)-r-7,t-8-dihydroxy-t-9,10-oxy-7,8,9,10-tetrahydrobenzo[a]pyrene (anti-BPDE)-DNA adduct levels in groups of humans subjected to various levels of polycyclic aromatic hydrocarbon (PAH) (benzo[a]pyrene) exposure. An HPLC/fluorescence method was applied to detect specifically anti-BPDE-DNA adducts in mononuclear white blood cells [lymphocyte plus monocyte fraction (LMF)] from humans exposed to PAHs. A total of 130 subjects comprised the sample population: 26 psoriatic patients (3 days after clinical coal tar treatment of the skin), 15 coke oven workers, 19 chimney sweeps, 36 aluminium anode plant workers and 34 non-occupationally PAH-exposed subjects (controls). PAH exposure was assessed in each group by means of the urinary excretion of 1-pyrenol (mean group levels: 1.2, 0.7, 0.3, 65.0 and 0.1 micromol/mol creatinine in coke oven workers, chimney sweeps, aluminium plant anode workers, psoriatic patients and non-occupationally PAH-exposed subjects, respectively). HPLC/fluorescence analysis of BPDE-DNA adducts showed that the percentage of subjects with adduct levels exceeding the 95 percentile control subject value (8.9 adducts/10(8) nucleotides) was significantly high in coke oven workers (46.7%) and chimney sweeps (21.0%) (chi2 test, P < 0.01 and P < 0.05, respectively) but not in aluminium plant workers (11.1%) and psoriatic patients (0%). The increase in BPDE-DNA adduct levels in LMF (Ln values) was significantly related to chronic inhalatory and high PAH exposure (linear multiple regression analysis, F = 6.37, P < 0.01; t = 4.2, P < 0.001). Skin acute (or short-term) and high PAH exposure, charcoal-grilled meat consumption and smoking habit did not seem to influence BPDE-DNA adduct formation in LMF.

Pectus excavatum in adults: destructive surgery or simple correction of an aesthetic defect?

Pectus excavatum, a congenital depressive malformation of the sternum, is described since 1594 by Johannes Schenk and has successively been the subject of many studies because of its various inherent problems. The repercussions on the respiratory and cardiac dynamics caused by the compression on the mediastinal structures and by the reduction of the respiratory volume have only recently been valuated completely with the application of the latest techniques to diagnosis, cardiology and radiology. The aesthetic defect, often the first aspect to attract the attention of patient and doctor, has serious psychological implications, especially for what concerns the affective life and relationships in general. The surgical therapy consists in radical interventions with large sternocostal resections and repositioning of the sternum (turnover), or in interventions with a less invasive technique to correct only the aesthetic defect. In this study have been examined 7 cases of patients affected by pectus excavatum who were operated at the Institute of General Surgery IV and the Department of Plastic surgery of the University of Rome "La Sapienza" between 1983 and 1993. The patients were divided in two groups: a first group of 4 patients who underwent a sternal turnover, and a second group of 3 patients who were operated with conservative methods to correct the aesthetic defect. In both groups the results were good without any post-operatory complications. The experience gained during these years consents us to propose radical interventions for patients who have a severe malformation with evident physiopathological implications; this intervention is especially indicated if the patient is young, to prevent further disabling complications. Less invasive methods, on the other hand, should be applied to all other cases, considering the higher degree of tolerance of the intervention, the absence of postoperatory complications and the minor cost, thanks to a shorter hospital stay.

Antagonistic effects of caffeine and alcohol on mental performance parameters.

Scientific experiments done so far allow no clear conclusions about the popular belief that freshly brewed coffee can offset the debilitating effects of alcoholic intoxication. This question was addressed using a computer-controlled and subject-paced rapid information processing task (RIP) which was shown earlier to be sensitive to psychoactive substances. Nine male students were tested in a Latin square design before and after the intake of 3.3 mg/kg caffeine (or placebo) followed by 0.7 g/kg alcohol (or placebo). Whereas the mean RIP-task processing rate and the mean reaction time were impaired by alcohol and improved by caffeine, no changes were observed after the combination of alcohol and caffeine. Thus, it was concluded that under the tested conditions, caffeine was able to offset the debilitating effects of alcohol.