UltraViolet SANitizing System for Sterilization of Ambulances Fleets and for Real-Time Monitoring of Their Sterilization Level.

BACKGROUND: The contamination of ambulances with pathogenic agents represents a potential threat for the public health, not only for common pathogens but also for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this project was to exploits the germicidal effect of the UVC radiation at 254 nm to sanitize the patient's compartment of ambulances with an advanced UltraViolet SANitizing System (UV-SAN) and assess its relevance for avoiding the spread of COVID-19 and other drug resistant pathogens. METHODS: The system is equipped with UVC lamps that are activated when the ambulance compartment is empty and sanitize the environment in less than 15 min. An Ozone sensor continuously monitors the gas concentration, ensuring it does not exceed threshold value harmful for patients and operators' health. The system is relying on GNSS data and a satellite communication link, which allow to monitor and record traceability (when, where and what) of all the sanitation operations performed. This information is real-time monitored from a dedicated web-application. RESULTS: UVC irradiation efficiently reduced SARS-CoV-2 virus titer (>99.99%), on inanimate surfaces such as plastic, stainless steel or rubber, with doses ranging from 5.5 to 24.8 mJ/cm2 and the UV-SAN system is effective against multi drug resistant (MDR) bacteria up to >99.99%, after 10 to 30 min of irradiation. CONCLUSIONS: UV-SAN can provide rapid, efficient and sustainable sanitization procedures of ambulances.

Management of clinically negative neck in maxillary carcinoma.

Maxillary cancers include neoplasms arising in both maxillary sinus and oral cavity (upper alveolar ridge, hard palate) according to the American Joint Committee on Cancer. Although it is universally accepted that the combination of surgery and radiotherapy seems to be the treatment of choice, there is no accordance about the treatment of clinically negative neck. We retrospectively analyzed 20 patients with maxillary sinus cancer and 37 with an upper alveolar ridge or hard palate cancer, evaluating the incidence of N-disease and the recurrence at local site. On the basis of our findings, we can affirm that elective treatment of the neck in maxillary carcinoma is not recommended. Considering only squamous cell carcinoma, cervical node metastases are most frequent in case of tumors staged as T1 o T2. High-grade squamous cell carcinomas seem to be related to a higher incidence of nodal involvement. T recurrence has demonstrated to be the most frequent neoplastic event, so that radical surgery is considered one of the most important prognostic factors. Nevertheless, other prospective studies are necessary.