Objectives The aim of this study was to evaluate the differences in surgical capacity for head and neck cancer in the UK between the first wave (March‐June 2020) and the current wave (Jan‐Feb 2021) of the COVID‐19 pandemic. Design REDcap online‐based survey of hospital capacity. Setting UK secondary and tertiary hospitals providing head and neck cancer surgery. Participants One representative per hospital was asked to report the capacity for head and neck cancer surgery in that institution. Main outcome measures The principal measures of interests were new patient referrals, capacity in outpatients, theatres and critical care; therapeutic compromises constituting delay to surgery, de‐escalated surgery and therapeutic migration to non‐surgical primary modality. Results Data were returned from approximately 95% of UK hospitals with a head and neck cancer surgery specialist service. 50% of UK head and neck cancer patients requiring surgery have significantly compromised treatments during the second wave: 28% delayed, 10% have received radiotherapy‐based treatment instead of surgery, and 12% have received de‐escalated surgery. Surgical capacity has been more severely constrained in the second wave (58% of pre‐pandemic level) compared with the first wave (62%) despite the time to prepare. Conclusions Some hospitals are overwhelmed by COVID‐19 and unable to offer essential cancer surgery, but all have neighbouring hospitals in their region retaining good (or even normal) capacity. It is noteworthy that very few patients have been appropriately redirected away from the hospitals most constrained by their burden of COVID‐19. The paucity of an effective central or regional strategic response to this evident mismatch between demand and surgical capacity is to the detriment of our head and neck cancer patients.
This observational and retrospective cohort study, carried out in two medical centers, Centro Medico Bournigal (CMBO) in Puerto Plata and Centro Medico Punta Cana (CMPC) in Punta Cana, Dominican Republic, sought to determine whether Ivermectin, at a weekly oral (PO) dose of 0.2 mg/kg, is an effective pre-exposure prophylaxis (PrEP) method for the spread of Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), in the healthcare workers. The study began on June 29, 2020 and ended on July 26, 2020, where 713 active healthcare personnel were included for the analysis, of which 326 adhered to a weekly prophylactic program with Ivermectin for Coronavirus Disease-19 (COVID-19), designed by Grupo Rescue task force, that runs both medical centers, and 387 healthcare personnel who did not adhere to the program were assigned to the control group. A SPSS Propensity Score Matching procedure was applied in a 1:1 ratio to homogeneously evaluate the groups that were made up of 271 participants each. In 28 days of follow-up, a significant protection of Ivermectin as a PrEP method of infection from SARS-CoV-2 was observed 1.8% compared to those who did not take it 6.6%, (p-value = 0.006) and a reduction of the risk of a positive Chain Reaction of Real-Time Polymerase Transcription (RT-PCR) COVID-19 test by 74% (HR 0.26, 95% CI [0.10,0.71]). These results support the use of weekly Ivermectin as a compassionate preventive method in the healthcare personnel.
Resumen La introducción de las redes sociales como una herramienta en la práctica clínica es cada vez una realidad más patente. El coste de oportunidad que ha supuesto la pandemia SARS-CoV2 ha dado un importante impulso a la telemedicina como un recurso eficaz, especialmente en el ámbito de la Cirugía Mayor Ambulatoria.
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