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1.
BMC Med Res Methodol ; 20(1): 209, 2020 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787822

RESUMO

BACKGROUND: As the whole world is experiencing the cascading effect of a new pandemic, almost every aspect of modern life has been disrupted. Because of health emergencies during this period, widespread fear has resulted in compromised patient safety, especially for patients with cancer. It is very challenging to treat such cancer patients because of the complexity of providing care and treatment, along with COVID-19. Hence, an effective treatment comparison strategy is needed. We need to have a handy tool to understand cancer progression in this unprecedented scenario. Linking different events of cancer progression is the need of the hour. It is a huge challenge for the development of new methodology. METHODS: This article explores the time lag effect and makes a statistical inference about the best experimental arm using Accelerated Failure Time (AFT) model and regression methods. The work is presented as the occurrence of other events as a hazard rate after the first event (relapse). The time lag effect between the events is linked and analysed. RESULTS: The results were presented as a comprehensive analytical strategy by joining all disease progression. An AFT model applied with the transition states, and the dependency structure between the gap times was used by the auto-regression model. The effects of arms were compared using the coefficient of auto-regression and accelerated failure time (AFT) models. CONCLUSIONS: We provide the solutions to overcome the issue with intervals between two consecutive events in motivating head and neck cancer (HNC) data. COVID-19 is not going to leave us soon. We have to conduct several cancer clinical trials in the presence of COVID-19. A comprehensive analytical strategy to analyse cancer clinical trial data during COVID-19 pandemic is presented.


Assuntos
Algoritmos , Infecções por Coronavirus/prevenção & controle , Neoplasias de Cabeça e Pescoço/terapia , Oncologia/métodos , Modelos Teóricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Teorema de Bayes , Betacoronavirus/fisiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/virologia , Progressão da Doença , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Estimativa de Kaplan-Meier , Cadeias de Markov , Método de Monte Carlo , Recidiva Local de Neoplasia , Pneumonia Viral/complicações , Pneumonia Viral/virologia
2.
Anticancer Res ; 40(8): 4207-4214, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32727746

RESUMO

BACKGROUND/AIM: To assess factors that predict detection of tumors and oncologic outcomes in head and neck squamous cell carcinoma of unknown primary (SCCUP). PATIENTS AND METHODS: This was a retrospective cohort study at a single tertiary care institution. RESULTS: The primary site was detected at examination under anesthesia (EUA) in 92 (51.1%) patients. The primary site was detected by directed biopsies in 60 (65%), palatine tonsillectomy in 28 (30.4%), and lingual tonsillectomy in 4 patients (4.3%). Four of eight lingual tonsillectomies were positive (50%). Primary locations included: palatine tonsils (51, 28.3%), base of tongue (37, 20.6%), larynx (4, 2.2%), oral cavity (3, 1.67%) and nasopharynx (1, 0.6%). Human papillomavirus (HPV) positive status (HR=0.26, p=0.004) and treatment with chemoradiation (CRT) (HR=0.38, p=0.004) were associated with better disease free survival (DFS). CONCLUSION: A primary site was located after aggressive investigation in approximately half of the patients. More research is warranted towards the use of lingual tonsillectomy. Predictors of favorable prognosis included HPV positive status and treatment with CRT.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/secundário , Neoplasias Primárias Desconhecidas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/secundário , Idoso , Intervalo Livre de Doença , Feminino , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia
3.
Eur Rev Med Pharmacol Sci ; 24(13): 7516-7518, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32706093

RESUMO

OBJECTIVE: The ongoing pandemic of coronavirus disease 2019 is having a dramatic effect on most medical disciplines. Otolaryngology Head and Neck Surgery is one of the most engaged disciplines, and otolaryngology specialists are facing a radical change of their role and daily activities that will have severe impact on the return to the ordinary. In this paper, the COVID-19 Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology comment on the changes that occurred for otolaryngology in Italy during the pandemic. Changes include organizational rearrangement of Otolaryngology Units, with merges and closures that affected a significant portion of them; reallocation of otolaryngology personnel, mainly to COVID-19 wards; reduction of elective clinical and surgical activity, that was mainly limited to oncology and emergency procedures; and execution of screening procedures for SARS-CoV-2 among healthcare providers and patients in otolaryngology units in Italy.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Otorrinolaringologistas/organização & administração , Otolaringologia/organização & administração , Pneumonia Viral/cirurgia , Infecções por Coronavirus/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Itália , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico
4.
Head Neck ; 42(7): 1507-1515, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32584447

RESUMO

INTRODUCTION: The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has altered the health care environment for the management of head and neck cancers. The purpose of these guidelines is to provide direction during the pandemic for rational Head and Neck Cancer management in order to achieve a medically and ethically appropriate balance of risks and benefits. METHODS: Creation of consensus document. RESULTS: The process yielded a consensus statement among a wide range of practitioners involved in the management of patients with head and neck cancer in a multihospital tertiary care health system. CONCLUSIONS: These guidelines support an ethical approach for the management of head and neck cancers during the COVID-19 epidemic consistent with both the local standard of care as well as the head and neck oncological literature.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Neoplasias de Cabeça e Pescoço/terapia , Controle de Infecções/normas , Oncologia/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Assistência Ambulatorial/normas , Terapia Combinada , Continuidade da Assistência ao Paciente/normas , Infecções por Coronavirus/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Sistemas Multi-Institucionais , Procedimentos Cirúrgicos Otorrinolaringológicos/normas , Cuidados Paliativos/normas , Segurança do Paciente , Pennsylvania , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Assistência Terminal/normas , Centros de Atenção Terciária
5.
Otolaryngol Head Neck Surg ; 163(3): 447-454, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32484380

RESUMO

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has caused physicians and surgeons to consider restructuring traditional cancer management paradigms. We aim to review the current evidence regarding the diagnosis and management of head and neck cancer, with an emphasis on the role of the multidisciplinary team (MDT) during a pandemic. DATA SOURCES: COVID-19 resources from PubMed, Google Scholar, the American Academy of Otolaryngology-Head and Neck Surgery, and the American Head and Neck Society were examined. REVIEW METHODS: Studies and guidelines related to the multidisciplinary management of head and neck cancer in the COVID-19 setting were reviewed. A total of 54 studies were included. Given the continuously evolving body of literature, the sources cited include the latest statements from medical and dental societies. RESULTS: The unpredictable fluctuation of hospital resources and the risk of the nosocomial spread of SARS-CoV-2 have direct effects on head and neck cancer management. Using an MDT approach to help define "essential surgery" for immediately life- or function-threatening disease processes in the context of available hospital resources will help to maximize outcomes. Early enrollment in an MDT is often critical for considering nonsurgical options to protect patients and health care workers. The role of the MDT continues after cancer treatment, if delivered, and the MDT plays an essential role in surveillance and survivorship programs in these challenging times. CONCLUSION: Head and neck cancer management during the COVID-19 pandemic poses a unique challenge for all specialists involved. Early MDT involvement is important to maximize patient outcomes and satisfaction in the context of public and community safety.


Assuntos
Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/terapia , Pneumonia Viral/epidemiologia , Betacoronavirus , Humanos , Pandemias , Guias de Prática Clínica como Assunto
6.
Lancet Oncol ; 21(7): e350-e359, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32534633

RESUMO

The speed and scale of the global COVID-19 pandemic has resulted in unprecedented pressures on health services worldwide, requiring new methods of service delivery during the health crisis. In the setting of severe resource constraint and high risk of infection to patients and clinicians, there is an urgent need to identify consensus statements on head and neck surgical oncology practice. We completed a modified Delphi consensus process of three rounds with 40 international experts in head and neck cancer surgical, radiation, and medical oncology, representing 35 international professional societies and national clinical trial groups. Endorsed by 39 societies and professional bodies, these consensus practice recommendations aim to decrease inconsistency of practice, reduce uncertainty in care, and provide reassurance for clinicians worldwide for head and neck surgical oncology in the context of the COVID-19 pandemic and in the setting of acute severe resource constraint and high risk of infection to patients and staff.


Assuntos
Infecções por Coronavirus/epidemiologia , Neoplasias de Cabeça e Pescoço/cirurgia , Alocação de Recursos para a Atenção à Saúde , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Oncologia Cirúrgica/normas , Betacoronavirus , Consenso , Infecções por Coronavirus/prevenção & controle , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Cooperação Internacional , Saúde do Trabalhador , Pandemias/prevenção & controle , Segurança do Paciente , Pneumonia Viral/prevenção & controle , Oncologia Cirúrgica/organização & administração
7.
Head Neck ; 42(7): 1423-1447, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32357378

RESUMO

BACKGROUND: Coronavirus has serially overtaken our metropolitan hospitals. At peak, patients with acute respiratory distress syndrome may outnumber mechanical ventilators. In our Miami Hospital System, COVID-19 cases have multiplied for 4 weeks and elective surgery has been suspended. METHODS: An Otolaryngologic Triage Committee was created to appropriately allocate resources to patients. Hospital ethicists provided support. Our tumor conference screened patients for nonsurgical options. Patients were tested twice for coronavirus before performing urgent contaminated operations. N95 masks and protective equipment were conserved when possible. Patients with low-grade cancers were advised to delay surgery, and other difficult decisions were made. RESULTS: Hundreds of surgeries were canceled. Sixty-five cases screened over 3 weeks are tabulated. Physicians and patients expressed discomfort regarding perceived deviations from standards, but risk of COVID-19 exposure tempered these discussions. CONCLUSIONS: We describe the use of actively managed surgical triage to fairly balance our patient's health with public health concerns.


Assuntos
Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/ética , Neoplasias de Cabeça e Pescoço/cirurgia , Pandemias/estatística & dados numéricos , Seleção de Pacientes/ética , Pneumonia Viral/epidemiologia , Triagem/ética , Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/epidemiologia , Hospitais Urbanos , Humanos , Controle de Infecções/métodos , Masculino , Saúde do Trabalhador , Otolaringologia/organização & administração , Pandemias/prevenção & controle , Segurança do Paciente , Pneumonia Viral/prevenção & controle , Medição de Risco , Estados Unidos
8.
Head Neck ; 42(7): 1674-1680, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32374942

RESUMO

BACKGROUND: Outpatient telemedicine consultations are being adopted to triage patients for head and neck cancer. However, there is currently no established structure to frame this consultation. METHODS: For suspected referrals with cancer, we adapted the Head and Neck Cancer Risk Calculator (HaNC-RC)-V.2, generated from 10 244 referrals with the following diagnostic efficacy metrics: 85% sensitivity, 98.6% negative predictive value, and area under the curve of 0.89. For follow-up patients, a symptom inventory generated from 5123 follow-up consultations was used. A customized Excel Data Tool was created, trialed across professional groups and made freely available for download at www.entintegrate.co.uk/entuk2wwtt, alongside a user guide, protocol, and registration link for the project. Stakeholder support was obtained from national bodies. RESULTS: No remote consultations were refused by patients. Preliminary data from 511 triaging episodes at 13 centers show that 77.1% of patients were discharged directly or have had their appointments deferred. DISCUSSION: Significant reduction in footfall can be achieved using a structured triaging system. Further refinement of HaNC-RC-V.2 is feasible and the authors welcome international collaboration.


Assuntos
Continuidade da Assistência ao Paciente , Infecções por Coronavirus/epidemiologia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/epidemiologia , Pneumonia Viral/epidemiologia , Encaminhamento e Consulta , Medição de Risco/métodos , Triagem/organização & administração , Betacoronavirus , Tomada de Decisão Clínica , Prática Clínica Baseada em Evidências , Humanos , Oncologia/métodos , Pandemias , Valor Preditivo dos Testes , Consulta Remota , Avaliação de Sintomas , Reino Unido/epidemiologia
9.
Head Neck ; 42(6): 1153-1158, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-48032

RESUMO

Since December 2019, a number of patients with novel coronavirus pneumonia (NCP) have been identified in Wuhan, Hubei Province, China. NCP has rapidly spread to other provinces and cities in China and other countries in the world. Due to the rapid increase in reported cases in China and around the world, on January 30, 2020, the World Health Organization (WHO) Emergency Committee announced that NCP is a Public Health Emergency of International Concern (PHEIC). However, there are relatively few suggestions and measures for tumor patients, especially patients with head and neck tumors. This article summarizes the prevention and control of disease in our medical institution to provide a reference for front-line head and neck surgeons.


Assuntos
Institutos de Câncer/organização & administração , Doenças Transmissíveis/transmissão , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Neoplasias de Cabeça e Pescoço/terapia , Pneumonia Viral/epidemiologia , Betacoronavirus , China , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Emergências/epidemiologia , Serviço Hospitalar de Emergência/organização & administração , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/epidemiologia , Hospitais Especializados/organização & administração , Humanos , Masculino , Pandemias/prevenção & controle , Segurança do Paciente , Pneumonia Viral/prevenção & controle , Triagem
10.
Head Neck ; 42(6): 1218-1226, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-171134

RESUMO

BACKGROUND: Pulmonary complications and infections frequently affect patients with head and neck squamous cell carcinoma (HNSCC). Common characteristics can predispose these patients to the development of severe respiratory illness, which may be particularly relevant during the 2019 coronavirus disease (COVID-19) pandemic. METHODS: A scoping review was performed to assess the impact of pulmonary comorbidities and adverse respiratory outcomes in HNSCC patients. RESULTS: Advanced age, history of tobacco and alcohol abuse, and cardiopulmonary comorbidities are significant risk factors for the development of adverse respiratory outcomes. Treatment toxicities from radiation or chemoradiation therapy significantly increase these risks. CONCLUSION: Respiratory complications are a frequent cause of morbidity and mortality among HNSCC patients, and the COVID-19 pandemic may disproportionately affect this population. Interventions designed to decrease smoking and alcohol use, improve oral hygiene, and aggressively manage medical comorbidities are important to the long-term management and health of these patients.


Assuntos
Infecções por Coronavirus/epidemiologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Pneumopatias/epidemiologia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Doenças Respiratórias/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Adulto , Fatores Etários , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Comorbidade , Intervalo Livre de Doença , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Pneumopatias/diagnóstico , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Doenças Respiratórias/diagnóstico , Medição de Risco , Fatores Sexuais , Fumar/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Análise de Sobrevida , Estados Unidos
11.
Head Neck ; 42(6): 1194-1201, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-133336

RESUMO

BACKGROUND: COVID-19 pandemic has strained human and material resources around the world. Practices in surgical oncology had to change in response to these resource limitations, triaging based on acuity, expected oncologic outcomes, availability of supportive resources, and safety of health care personnel. METHODS: The MD Anderson Head and Neck Surgery Treatment Guidelines Consortium devised the following to provide guidance on triaging head and neck cancer (HNC) surgeries based on multidisciplinary consensus. HNC subsites considered included aerodigestive tract mucosa, sinonasal, salivary, endocrine, cutaneous, and ocular. RECOMMENDATIONS: Each subsite is presented separately with disease-specific recommendations. Options for alternative treatment modalities are provided if surgical treatment needs to be deferred. CONCLUSION: These guidelines are intended to help clinicians caring for patients with HNC appropriately allocate resources during a health care crisis, such as the COVID-19 pandemic. We continue to advocate for individual consideration of cases in a multidisciplinary fashion based on individual patient circumstances and resource availability.


Assuntos
Infecções por Coronavirus/epidemiologia , Neoplasias de Cabeça e Pescoço/cirurgia , Avaliação de Resultados em Cuidados de Saúde , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto/normas , Oncologia Cirúrgica/normas , Betacoronavirus , Institutos de Câncer , Controle de Doenças Transmissíveis/normas , Consenso , Infecções por Coronavirus/prevenção & controle , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Saúde do Trabalhador , Pandemias/prevenção & controle , Segurança do Paciente , Seleção de Pacientes , Pneumonia Viral/prevenção & controle , Triagem/normas , Estados Unidos
12.
Eur Arch Otorhinolaryngol ; 277(7): 2141-2145, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: covidwho-125306

RESUMO

The coronavirus disease 2019 pandemic has resulted in new challenges for clinicians, head and neck cancer (HNC) patients and carers. There is evidence that the current crisis is affecting the management of HNC patients. Most healthcare systems have introduced remote consultations to decrease the risk of coronavirus infection to patients, carers and clinicians. At present, HNC patients may be anxious and due to logistical issues, may not be adequately prepared for their treatment. To ensure that patients have a thorough understanding of their treatment and expected outcome during the current COVID-19 crisis there may be merit in the use of the HaNC-AD PCI.


Assuntos
Infecções por Coronavirus/prevenção & controle , Coronavirus , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/terapia , Necessidades e Demandas de Serviços de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Lista de Checagem , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Qualidade de Vida
13.
Head Neck ; 42(6): 1240-1242, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-125246

RESUMO

Health crises have become a popular topic of discussion. In the wave of the ongoing pandemic, experts have suggested the role of vaping and other tobacco product use exemplifying the vulnerability of the population to contract the COVID-19. We discuss some of the events that led up to these conclusions and also offer a unique insight into another form of tobacco use that is potentially propagating its spread especially in the South Asian region-chewed tobacco. Both of these have been a perennial issue that head and neck cancer surgeons have been dealing with. Governments and head and neck cancer care providers now have an opportunity to deal with a common enemy in the midst of this pandemic.


Assuntos
Neoplasias de Cabeça e Pescoço/epidemiologia , Pandemias/prevenção & controle , Fumar/epidemiologia , Uso de Tabaco/epidemiologia , Vaping/epidemiologia , Ásia , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Feminino , Saúde Global , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Pandemias/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Medição de Risco , Fumar/efeitos adversos , Vaping/efeitos adversos , Populações Vulneráveis/estatística & dados numéricos
14.
Head Neck ; 42(6): 1144-1146, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-125245

RESUMO

Health care services are being confronted by a daily dilemma of who can receive critical care and who cannot. In a palliative care clinic, this apprehension gets exemplified, as these patients have limited life expectancy. The head and neck region further makes things critical, as it comprises of all the sites through which the SARS-CoV-2 can be transmitted. This document strives to define the ways in which the head and neck cancer services can contribute to better patient care in a triage context. Practical steps suggested are protective equipment use, ensuring access to critical drugs (such as opioids), greater use of telemedicine consultations, discussing advance care plans, and embracing the role of a wider community support.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Neoplasias de Cabeça e Pescoço/terapia , Cuidados Paliativos/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Segurança do Paciente/estatística & dados numéricos , Seleção de Pacientes , Pneumonia Viral/prevenção & controle , Medição de Risco , Telemedicina/organização & administração , Fatores de Tempo
15.
Head Neck ; 42(6): 1202-1208, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-125244

RESUMO

The practices of head and neck surgical oncologists must evolve to meet the unprecedented needs placed on our health care system by the Coronavirus disease 2019 (COVID-19) pandemic. Guidelines are emerging to help guide the provision of head and neck cancer care, though in practice, it can be challenging to operationalize such recommendations. Head and neck surgeons at Wuhan University faced significant challenges in providing care for their patients. Similar challenges were faced by the University of Toronto during the severe acute respiratory syndrome (SARS) pandemic in 2003. Herein, we outline our combined experience and key practical considerations for maintaining an oncology service in the midst of a pandemic.


Assuntos
Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/prevenção & controle , Neoplasias de Cabeça e Pescoço/cirurgia , Pandemias/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Oncologia Cirúrgica/normas , Canadá , China , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/normas , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Monitorização Intraoperatória/métodos , Saúde do Trabalhador , Avaliação de Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Segurança do Paciente , Pneumonia Viral/epidemiologia , Padrões de Prática Médica/normas
17.
Head Neck ; 42(6): 1214-1217, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-116364

RESUMO

The COVID-19 pandemic has upended head and neck cancer care delivery in ways unforeseen and unprecedented. The impact of these changes parallels other fields in oncology, but is disproportionate due to protective measures and limitations on potentially aerosolizing procedures and related interventions specific to the upper aerodigestive tract. The moral and professional dimensions of providing ethically appropriate and consistent care for our patients in the COVID-19 crisis are considered herein for head and neck oncology providers.


Assuntos
Infecções por Coronavirus/epidemiologia , Neoplasias de Cabeça e Pescoço/terapia , Oncologia/ética , Pandemias/estatística & dados numéricos , Planejamento de Assistência ao Paciente/ética , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/prevenção & controle , Gerenciamento Clínico , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Medição de Risco , Estados Unidos
19.
Otolaryngol Head Neck Surg ; 162(6): 795-796, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-38313

RESUMO

The recent Italian outbreak of coronavirus disease 2019 led to an unprecedented burden on our health care system. Despite head and neck-otolaryngology not being a front-line specialty in dealing with this disease, our department had to face several specific issues. Despite a massive reallocation of resources in the hospital, we managed to keep the service active, improving safety measures for our personnel, specifically during common otolaryngologic maneuvers known to produce aerosols. Furthermore, we strived to maintain our teaching role, giving residents an inclusive role in managing the response to the emergency state, and we progressively integrated our inactive specialists into other service rotations to relieve front-line colleagues' burden. Specific issues and management decisions are discussed in detail in the article.


Assuntos
Infecções por Coronavirus/epidemiologia , Efeitos Psicossociais da Doença , Surtos de Doenças/economia , Gastos em Saúde , Otolaringologia/economia , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/patologia , Surtos de Doenças/estatística & dados numéricos , Feminino , Cabeça/fisiopatologia , Cabeça/cirurgia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/cirurgia , Recursos em Saúde/economia , Departamentos Hospitalares/economia , Humanos , Itália , Masculino , Pescoço/fisiopatologia , Pescoço/cirurgia , Otolaringologia/estatística & dados numéricos , Pandemias , Pneumonia Viral/patologia , Medição de Risco , Papel (figurativo)
20.
Anticancer Res ; 40(4): 2393-2403, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234943

RESUMO

BACKGROUND/AIM: Hepatitis B core (HBc) antibody positivity indicates a history of hepatitis B virus (HBV) infection and latent infection. PATIENTS AND METHODS: We conducted a retrospective case-control study of 512 and 495 head and neck cancer (HNC) and non-HNC patients treated at the Okayama University Hospital, Head and Neck Cancer Center from 2008-2017. Demographic data and risk factors that might affect HNC diagnosis were analyzed to assess their effects. RESULTS: Cancer diagnosis was found to correlate with HBc antibody positivity [odds ratio (OR)=1.50, 95% confidence interval (CI)=1.09-2.08], smoking (OR=3.03, 95%CI=2.16-4.25), and a previous history of cancer (OR=4.12, 95%CI=2.79-6.09). The HBs antigen positivity rate in both groups was very close to that observed in the general Japanese population. The HBc antibody positivity rate was very high only in the HNC group. CONCLUSION: HBc antibody positivity and HNC are epidemiologically correlated.


Assuntos
Neoplasias de Cabeça e Pescoço/epidemiologia , Anticorpos Anti-Hepatite B/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Idoso , Estudos de Casos e Controles , Comorbidade , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Hepatite B/virologia , Vírus da Hepatite B/fisiologia , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
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