THE IMPACT OF COVID-19 ON HEAD AND NECK CANCER TREATMENT DELAY.

The aim of this study was to demonstrate the impact of COVID-19 pandemic on the number and characteristics of head and neck cancer patients in two consecutive periods, pre-pandemic and pandemic. For this purpose, we performed a retrospective analysis of patients with primary carcinomas of head and neck mucosal sites, salivary gland tumors, as well as neck metastases. Two pre-COVID-19 years (2018-2019) and two pandemic years (2020-2021) were compared. Demographic data, overall number of patients, TNM classification of the two most affected sites (oral cavity and larynx), time from symptom onset to first outpatient admission to our department, and time from first admission to treatment initiation were noted. Study results revealed a higher number of patients during the pandemic period and difference in the distribution of tumor sites (χ2=33.68, df=9, p<0.001). Oral cavity cancer prevailed over laryngeal cancer during the pandemic period. A statistically significant difference was observed in delay of initial presentation to head and neck surgeon for oral cavity cancer during the pandemic period (p=0.019). Furthermore, significant delay was found for both sites concerning time from initial presentation to the beginning of treatment (larynx: p=0.001 and oral cavity: p=0.006). Despite these facts, there were no differences in TNM stages comparing two observed periods. Study results indicated that there was a statistically significant delay of surgical treatment for both cancer sites observed (oral cavity and larynx) during the COVID-19 pandemic. A survival study is necessary in the future to definitely reveal the true consequences of COVID-19 pandemic on treatment outcomes.

Hypocalcemia After Completion Thyroidectomy for Papillary Thyroid Carcinoma.

Surgical management of papillary thyroid carcinoma (PTC) includes total thyroidectomy and lobectomy. After lobectomy, a reoperation called completion thyroidectomy is occasionally required. Postoperative hypocalcemia is the most common complication associated with thyroid surgery. Our main goal was to determine if there is a significant difference between the incidence rate of postoperative hypocalcemia in patients who underwent total thyroidectomy for PTC compared with patients who underwent completion thyroidectomy for PTC. Apart from that, we analyzed the following potential predictive factors for the occurrence of hypocalcemia: sex, age, size of tumor, side of tumor, maximum diameter of individual lobe, occult metastasis, and operating surgeon. The study involved 340 patients who underwent surgery for PTC at the Department of ENT and Head and Neck Surgery, Zagreb University Hospital Centre, between February 25, 2013 and January 3, 2016. Postoperative hypocalcemia incidence rates were higher in the total thyroidectomy group than in the completion thyroidectomy group (37.8% and 29.0%, respectively). However, these differences were not statistically significant. Every analyzed potential predictive factor was proven not to have any correlation with postoperative hypocalcemia. This study demonstrated that there was no significant difference between postoperative hypocalcemia rates in patients who underwent completion thyroidectomy compared with patients who underwent total thyroidectomy for PTC.

International study of the incidence of particular types of septal deformities in chronic rhinosinusitis patients: the outcomes from five countries.

BACKGROUND: Chronic rhinosinusitis (CRS) may be more frequent in patients with particular types of septal deformities. The aim of this article was to investigate the incidence of particular types of septal deformities in adult CRS patients and healthy volunteers in various countries to determine whether some of them are more frequent in those groups. METHODS: This international multicentric study involved 505 subjects from five countries: Croatia, Romania, Italy, Russia, and Turkey. The types of septal deformities were observed and grouped according to the Mladina classification. Subjects were examined by means of native anterior rhinoscopy, anterior rhinoscopy after decongestion, and fiber endoscopy with topical anesthesia. CRS patients have been diagnostically proved by computed tomography scanning of the paranasal sinuses. RESULTS: Considering the CRS patients, the prevalence of so-called vertical deformities (types 2, 3, and 4) was seen. Among them, type 3 deformity was found most frequently in Turkey, Croatia, Italy, and Romania. CONCLUSION: Type 3 deformity has been found frequently in CRS patients in all five of the countries. Russian subjects exhibited a high frequency of type 4 deformity. Because this type consists of types 2 and 3, the later, again, has been proven to be prevalent in CRS patients also in this group of patients.

Mosses and some mushroom species as bioindicators of radiocaesium contamination and risk assessment.

Mosses, lichens, mushrooms are able to efficiently accumulate different radioactive elements from their environment to a much higher degree than other vegetation. They are sensitive bioindicators of radioactive contamination for various ecosystems, particularly in the event of a nuclear accident and uncontrolled emission oh fission products. Results of systematic, long-term measurements of 137Cs activities in mosses and in some edible mushroom species in North Croatia for the post-Chernobyl period (1986-2007) are summarized. The study was conducted in the Radiation Protection Unit of the Institute for Medical Research and Occupational Health in Zagreb, as a part of an extensive monitoring program of the Croatian environment. In the overall observed period the highest activity concentration of 137Cs deposited by fallout has been recorded in 1986, which is the year of Chernobyl accident, causing peak S7Cs activity concentration in moss of 8800 Bq/kg in May 1986. In the same period mean 137Cs activity concentration in grass was 390 Bq/kg. The highest value of 137Cs activity concentration in Cortinarius caperatus mushrooms of 1351 Bq/kg has been recorded in 1989. Fitting the measured 137Cs activity concentrations to the theoretical curve the ecological half-life of 137Cs in moss was found to be around 978 days, in grass around 126 days in the period 1986-1990, in Cortinarius caperatus mushroom around 5865 days (16.1 years). Regarding the risk assessment to Croatian population, due to consumption of mushrooms, the collective effective dose for Croatian population, estimated to be about 35 mSv per year, was found to be quite low. Therefore, it can be concluded that mushroom consumption was not a critical pathway for the transfer of radiocaesium from fallout to humans after the Chernobyl accident.