Search

Introduction: Intraoperative imaging and stereotactic navigation in spinal surgery to guide instrumentation placement and tumour resection is well documented. However, image depiction is restricted to high attenuation structures such as osseous tissue and metal objects. Vascular anatomy like major arteries or vascular neoplasm cannot be depicted. We reported angiographically enhancing intraoperative cone-beam imaging (O-arm) to facilitate resection of a craniocervical junction neoplasm that distorted the course of vertebral artery, and discussed the feasibility of this technique. Methods: We performed intraoperative angiography employing the O-arm for image acquisition, and applied the images in S7 Stealth Station to guide tumour resection in an occipitocervical osseous tumour in which the course of the vertebral artery was heavily distorted. Results: Intraoperative findings matched the 3D navigation images demonstrating the V3 and upper V2 segments of the vertebral artery in close proximity to the tumour. Complete en bloc tumour removal was achieved without injury to the adjacent vertebral artery. No intra- or postoperative complications occurred. Conclusion: It is feasible intraoperatively to acquire angiographically enhancing cone-beam imaging of spinal tumour in close proximity to the V3 and upper V2 segments of vertebral artery. It appears to facilitate safe tumour resection by mapping critical vascular structures in the surgical field that is initially occult to direct vision. Such novel use of technique warrants further validation.

Objectives: To estimate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity among healthcare workers (HCWs) in Greece and to identify high-risk groups in healthcare facilities., Study Design: The study design used in this study is a nationwide cross-sectional study., Methods: Data were collected from 1 June to 9 July 2020. HCWs in the Greek National Health System were offered a free SARS-CoV-2 IgG antibody test, regardless of symptoms., Results: Overall, 379 of 57,418 HCWs (0.66%, 95% confidence interval [CI]: 0.59-0.73) were positive for SARS-CoV-2 antibodies. The adjusted overall seroprevalence was 0.43% (95% CI: 0.35-0.51). We found that HCWs in non-reference hospitals for COVID-19 (odds ratio [OR]: 1.81, 95% CI: 1.23-2.64; P = 0.002) and reference hospitals for COVID-19 (OR: 1.66, 95% CI: 1.06-2.58; P = 0.03) were more likely to be seropositive than HCWs in primary care centres. Regarding professions, nurses (OR: 1.45, 95% CI: 1.07-1.98; P = 0.02), physicians (OR: 1.43, 95% CI: 1.06-1.93; P = 0.02), and administrative, cleaning and security staff (OR: 1.50, 95% CI: 1.09-2.06; P = 0.01) had a statistically higher chance of having a positive serology than laboratory employees., Conclusions: The adjusted overall seroprevalence found in this study indicates a very low prevalence of SARS-CoV-2 among HCWs in Greece. This result is in line with the low incidence of COVID-19 during the first wave of the pandemic and is a direct benefit from the early implementation of lockdown., (Copyright © 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)