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Covid-19 pandemic and head and neck cancers, what should we expect?
Full text linkTo the Editor,
One year after the first case of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) in Italy, the COVID-19 emergency has been
affecting our country; however, it is early to really understand the social
implications of the pandemic. Instead, what we can try to predict is what
has already happened in the field of head and neck (HN) oncology and,
above all, what we should expect in the coming months. Since February
21, 2020, when the first case of COVID-19 was reported in Italy [1,2],
the Italian Health System’s ability to respond to the COVID-19 emergency
has been severely tested in terms of human and economic resources
[3]. It is neither known nor foreseeable what effects the
pandemic has had on the diagnosis and treatment of these patients [4].
The lockdown has caused a blockage of outpatient visits to general
practitioners, dentists, and specialists such as maxillofacial or ENT
surgeons, thus significantly limiting access to screening visits for oral
cancer patients. The effects of COVID-19 on the population of patients
potentially suffering from HN cancer are manifold. Patients suffering
from this pathology are often socially marginalized – smokers, alcohol
abusers – and unlikely to access private care facilities. Onset symptoms,
such as dental or mucous membrane pain and neck swelling, can be
confused with the symptoms of an infection of the oral cavity or dental
abscess. If these patients are not visited, it is easy to underestimate these
symptoms and treat them with antibiotic or corticosteroid therapy. The
difficulties in treating patients with HN cancer during this pandemic
[5,6] have been faced and overcome by putting into practice the prevention
strategies suggested by the international literature [7]. What has
recently been highlighted, both in literature and our clinical practice, is
how the diagnostic and therapeutic delay affects the patients’ outcomes
[8,9]. This delay is partly due to patient-related factors (social
distancing and travel restrictions during the pandemic makes it challenging
to attend the hospital for treatment) and partly to healthcarerelated
factors. The pandemic is affecting both treatment-naive patients,
as it worsens survival and quality of life and aggravates psychological
impact, and follow-up patients, as it delays their visits [10]. What
caught our attention in these months is the number of outpatient biopsies
and new cancer diagnoses, compared to the same period of the
previous year. A comparison between the outpatient biopsies performed
in our Department from March to December 2019 and those performed
in 2020 shows a significant reduction in their number (Table 1). In 2019,
268 biopsies were performed, while only 93 in 2020 –a difference of 175
procedures. The decrement is due to the lockdown in the first place, but
also to the limited number of procedures that can be performed daily in
the clinic to comply with the preventive measures, i.e., by rigorously
scheduling appointments. The percentage of malignant tumors diagnosed
in 2019 is 34.4% on 268 procedures (92 patients) and 34.5% (32
patients) in 2020; considering this data, the question is: out of all the
patients who did not undergo the biopsy, how many are affected by a
malignant tumor?
Furthermore, patients treated in recent months were frequently at
very advanced stages, but further studies are needed to confirm this
suggestion. Considering that the incidence of HN cancer cannot be
decreased, how many diagnostic delays will be caused by the pandemic?
How many patients will undergo less thorough treatments or, even
worse, will not be treated surgically and will be referred to palliative
care for the extreme stage of the disease?
Two admonishments we must learn from the lesson that COVID19
taught us. First, prevention and screening services must always be
guaranteed, especially for the weaker social classes. Second, the healthcare
systems’ capacity and financing need to be increased in order to
face this new reality, wherein we must live with the virus and all the
maneuvers essential to its confinement. To date, we have suffered the
short-term effects of this pandemic, but the long-term repercussions are
foreseeable and cannot be underestimated
Paediatric vascular malformations of head and neck: From diagnosis to treatment
No full textOBJECTIVES Vascular anomalies frequently involve the face are a pathological entity, consisting of different types of tumors and malformations that can affect the head and neck in paediatric patients and these may have a very variable clinical presentation. To reach a correct diagnosis and treatment it is actually necessary to have a thorough knowledge of these disorders. Classification and treatment options have significantly changed over the years, from Mulliken and Glowacki in 1982 to the international guidelines of the ISSVA in 2018 (International Society for the Study of Vascular Anomalies). The purpose of this review is that of deepening the knowledge of the vascular anomalies concerning the head and neck district in paediatric age, providing the indispensable knowledge for the correct diagnosis and for the subsequent corrects therapeutic procedure. MATERIALS AND METHODS This is a non-systematic review of the literature using as research terms: “vascular anomalies”, “vascular malformations”, “venous arterial malformations (VM)", “capillary malformations”, “lymphatic malformations”, “primary lymphedema”, “primary lymphatic dysplasia” or “combination” of the head and neck in paediatric patients. The articles that were not written in english have been excluded. The most recent studies, that best described etiopathogenesis, clinical- radiological characteristics and therapeutic course of patients suffering from vascular malformations of the craniofacial district in childhood, were included. RESULTS Vascular anomalies represent a rather frequent clinical entity in the general population, although still remain understood. Their clinical course is poorly predictable, because they can remain asymptomatic as whereas they can worsen with acute or subclinical onset. Intraosseous vascular malformations can often occur in the mandible. They represent a pathological entity which can be dangerous in paediatric patients: they can have a presentation with an acute important uncontrolled bleeding, especially during ambulatorial surgical procedures such as the extraction of deciduous or permanent teeth. Treatment can often combine different kind of interventional procedure (embolization or sclerotization procedures) with or without surgical procedures. CONCLUSIONS The correct classification, diagnosis and treatment indications of vascular anomalies is really important, in consideration of the morbidity and complications that may occur (uncontrollable and severe bleeding). The paediatric dentist, who is often the first figure to visit these patients, plays a fundamental role for the diagnosis. The correct diagnosis and therapeutic choice of vascular anomalies is mandatory, in consideration of the important complications that can be associated with them (even severe bleeding, often uncontrollable). The purpose of this review is to underline the need for a multidisciplinary approach involving dentists, paediatricians, surgeons and interventional radiologists, which leads to a correct diagnostic classification and allows its correct treatment. Different therapeutic approaches can be applied in combination or individually to achieve the patient’s quality of life as the sole purpose. Often the indication for treatment is the result of a compromise between surgical radicality and possible complications. The paediatric dentist, who is often the first figure to whom these patients turn, must play a fundamental role in timely diagnosis. CLINICAL SIGNIFICANCE The diagnosis in the paediatric population is mandatory to reduce the risk related to spontaneous bleeding due also to small surgical procedures
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Effetti dei fenomeni di cavitazione sul comportamento di cassoni a suzione sollecitati da carichi verticali
No full textNella presente nota si descrivono brevemente i risultati di una prova in centrifuga eseguita presso la University of Western Australia. Questa prova si inserisce all'interno di una sperimentazione più ampia finalizzata allo studio della risposta di cassoni a suzione installati in terreni stratificati e sollecitati da carichi verticali. Successivamente si analizzano i risultati delle simulazioni numeriche eseguite con il software FLAC 2D adottando per lo strato di sabbia il legame Severn Trent (Gajo & Wood, 1999a, 1999b) precedentemente implementato nella libreria del codice di calcolo (Rotisciani, 2010). I risultati presentati dimostrano la marcata influenza della rigidezza del cuscinetto d'acqua che separa il coperchio del cassone dal terreno sulla risposta del complesso fondazione-terreno
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Head and neck cancer cannot wait for this pandemic to end: Risks, challenges and perspectives of oral-maxillofacial surgeon during COVID-19
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