ABSTRACT
The current climate is one of uncertainty and immeasurable tragedy for people afflicted by the pandemic of SARS-CoV-2 virus infection. As professionals, we have a duty of care towards all patients especially the vulnerable and those suffering with life-threatening illnesses such as oral cancer. We present a safe & objective triaging method for afflicted with this disease in the prevailing morbid situation.
Subject(s)
Algorithms , COVID-19/complications , Head and Neck Neoplasms/surgery , Infection Control/methods , Medical Oncology/methods , Triage/methods , Follow-Up Studies , Humans , Neoplasm Recurrence, Local , Pandemics , Risk Assessment , Risk Factors , SARS-CoV-2ABSTRACT
The Odyssey and the Iliad are the most prominent works of ancient Greek epic poetry, and we have retrieved injuries to the head and neck mentioned in the Odyssey. We studied the texts both in ancient Greek and the translations in modern Greek and English and searched for references to trauma to the head and neck. We recorded the injuries, the attacker and defender, the weapons used, the site, and the result. There were 11 injuries of the head and neck, nine of which were fatal.
Subject(s)
Craniocerebral Trauma , Greek World , Medicine in Literature , Neck Injuries , Humans , WarfareABSTRACT
UNLABELLED: á : The purpose of the current study was to determine the accuracy of the clinical diagnosis in non-melanoma skin malignancy as confirmed by histopathological examination of the specimen. Positive predictive value (PPV) was selected as a reliable measure of diagnostic accuracy. METHODS: Clinical diagnosis was made in the outpatient clinic by a consultant oral and maxillofacial surgeon. We reviewed the electronic charts of 210 patients with non-melanoma skin malignant tumours and calculated the positive predictive value of the initial clinical diagnosis. Histological confirmation for each lesion was compared with the provisional clinical diagnosis made in the clinic. RESULTS: Of the 147 lesions provisionally diagnosed as basal cell carcinomas, 133 lesions were histologically confirmed to be basal cell carcinomas (BCC) (PPV 90.4 %). Of the 63 lesions provisionally thought to be squamous cell carcinomas, 47 lesions were histologically confirmed as squamous cell carcinomas (SCC) (PPV 74.6 %). The difference between the PPVs for the two types of malignancy in our study was not significant (p = 0.39). Statistics between our results for BCC and SCC and those reported from two other cancer institutes revealed no significant difference (p = 0.58 and 0.07). CONCLUSIONS: The present study supports that relying on clinical diagnosis with the purpose to formalise a treatment plan for head and neck non-melanoma skin cancer is safe and efficient. This is more reliable in cases of basal cell carcinoma in comparison to suspected squamous cell carcinomas. Although positive predictive value represents a reliable measure of diagnostic accuracy, it is increased when populations with higher prevalence of the disease are studied.
Subject(s)
Skin Neoplasms/diagnosis , Carcinoma, Basal Cell/diagnosis , Carcinoma, Squamous Cell/diagnosis , Humans , Predictive Value of TestsABSTRACT
In the formulation of polymer microspheres (MSs) loaded with verapamil hydrochloride (VRP), a low molecular weight ionizable drug, by W/O/W emulsification, the pH of the external aqueous phase proved to be a primary determinant of both IE and drug release behavior. Increasing the pH of the external aqueous phase enhanced IE (approximately 100% at pH 8.4). This was associated with a considerable increase in initial release rate at pH 1.2. Two multivariate methods, factorial analysis (FA) and artificial neural network (ANN), were used to investigate the impact of the combined effect of the external phase pH and other parameters (polymer concentration and initial drug load) on MS characteristics; IE, initial drug release, MS size and yield. FA indicated that the external aqueous phase pH affected all responses, with a particularly strong correlation with IE in addition to a combined synergistic effect with polymer concentration on MS size. ANN showed better internal and external predictive ability of responses compared to FA. The ANN model developed in the study can be successfully used for multivariate modeling of the encapsulation and release of VRP and similar drug salts from hydrophobic polymer MSs prepared by multiple emulsification in addition to other MS characteristics.
Subject(s)
Drug Compounding/methods , Pharmaceutical Preparations/administration & dosage , Pharmaceutical Preparations/metabolism , Polymers/chemistry , Acrylic Resins , Calorimetry, Differential Scanning , Chemistry, Pharmaceutical , Delayed-Action Preparations , Drug Carriers , Drug Design , Emulsions , Factor Analysis, Statistical , Hydrogen-Ion Concentration , Microscopy, Electron, Scanning , Microspheres , Models, Theoretical , Neural Networks, Computer , Particle Size , SolventsABSTRACT
In this study, chlorpheniramine maleate spheres were prepared by the extruder/marumerizer. A new waxy material, Gelucire 50/02 at three levels (10 per cent , 30 per cent and 50 per cent ) was added and Avicel PH-101 was used as spheronizing material. The drug was incorporated into the waxy material by two methods. The first was the direct method, in which the drug (10 per cent ), wax and Avicel PH-101 were mixed together. The second was the fusion method, in which the drug was dispersed in the melted wax and the solidified mass was milled and mixed with Avicel PH-101. The data obtained indicated that simple addition of waxy material into chlorpheniramine maleate-Avicel PH-101 spheres interrupted matrix formation and increased drug release. Also in this study, a multiparticulate delivery system was prepared successfully by compaction of spheres into tablets. Tablets compacted from spheres prepared by fusion method gave less drug release than those compacted from spheres of the same composition but prepared with direct method. As the level of wax was increased in tablet formulation, drug release was decreased
