Manejo de pacientes en cirugía oral y maxilofacial durante el periodo de crisis y de control posterior de la pandemia de COVID-19 / Management of patients in oral and maxillofacial surgery during the stage of crisis and subsequent control of COVID-19 pandemic

La pandemia por la nueva infección respiratoria conocida como enfermedad coronavirus 2019 (COVID-19), causada por el virus SARS-CoV-2, ha desencadenado una perturbación sin precedentes en la actividad habitual de los servicios de cirugía oral y maxilofacial en España, retrasando la atención rutinaria de pacientes e intervenciones quirúrgicas programadas. Los cirujanos orales y maxilofaciales son uno de los colectivos sanitarios con mayor riesgo de infección nosocomial por el estrecho contacto que se produce con los pacientes asintomáticos y sintomáticos con infección por SARS-CoV-2 a través de la cavidad oral y orofaringe. El propósito del presente documento ha sido actualizar la evidencia disponible para el manejo y tratamiento seguro y efectivo en consulta, cirugías ambulatorias, programadas y urgentes y hospitalización, minimizando al mismo tiempo, tanto como sea posible, el riesgo de contagio para el cirujano oral y maxilofacial, personal sanitario y pacientes. Este documento pretende esclarecer los aspectos más significativos y crear un protocolo común de manejo de pacientes con COVID-19 en cirugía oral y maxilofacial durante la fase aguda de propagación y de control posterior de la pandemia en nuestro país

The pandemic due to the new respiratory infection known as coronavirus 2019 disease (COVID-19), caused by the SARS-CoV-2 virus, has triggered an unprecedented disruption in the normal activity of oral and maxillofacial surgery departments in Spain, delaying routine patient care and elective surgical interventions. Oral and maxillofacial surgeons are one of the healthcare groups with the highest risk of nosocomial infection because of the close contact that occurs with asymptomatic and symptomatic patients with SARS-CoV-2 infection through the oral cavity and oropharynx. The purpose of this document has been to update the available evidence for the safe and effective management and treatment in outpatient clinic, ambulatory, elective and emergency surgeries, and hospitalization, while minimizing as much as possible the risk of infection for the oral and maxillofacial surgeon, health workers and patients. This document aims to clarify the most significant aspects and create a common protocol for the management of patients with COVID-19 in oral and maxillofacial surgery during the acute stage of spread and subsequent control of the pandemic in our country

[Usefulness of the determination of lipids parameters in pleural effusions]. / Utilidad de la determinación de parámetros grasos en los derrames pleurales.

In 160 patients with pleural effusion, consecutively studied in our section, cholesterol and triglyceride concentrations and lipidogram were prospectively measured in the pleural fluid and the blood to rule out the possible occurrence of chylothorax. For the diagnosis of chylothorax the presence of chylomicrons in the pleural fluid was required. The macroscopic appearance of the fluid was a poor indicator of the presence of chylothorax, as in three of the seven patients in which the latter was discovered the characteristically reported milky appearance of the pleural fluid was not found. The mean value of triglycerides in the chylous effusions (162.3 +/- 34.8 mg/dl) was significantly higher (p less than 0.001) than in nonchylous effusions (45.8 +/- 26.3 mg/dl). All patients with chylothorax had triglyceride values higher than 110 mg/dl; using this figure as the cut-off value, 7.5% of the patients with pleural effusion were selected as those in whom, irrespectively of the macroscopic appearance of their effusions, the performance of lipidogram would be indicated to rule out chylothorax.