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Claytor B. Commentary on: Evaluating Postoperative Outcomes of Patients Undergoing Elective Procedures in an Ambulatory Surgery Center During the COVID-19 Pandemic. Aesthet Surg J 2021; 41:258-261. [PMID: 33094823 PMCID: PMC7665329 DOI: 10.1093/asj/sjaa243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Brannon Claytor
- Chief of Plastic Surgery, Main Line Health, and a Clinical Associate Professor, Lankenau Institute for Medical Research, Philadelphia, PA
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A prospective study on the feasibility of cochlear implantation during the coronavirus disease 2019 crisis and trends of assessment: experience in a UK centre. J Laryngol Otol 2021; 135:21-27. [PMID: 33436111 PMCID: PMC7844212 DOI: 10.1017/s0022215121000190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives To demonstrate the feasibility of continuing cochlear implantation during the coronavirus disease 2019 crisis and to report on trends of referrals via the neonatal hearing screening programme. Methods A prospective case series was conducted on children who underwent cochlear implantation during the coronavirus disease 2019 crisis in the UK and a sample of referrals via the neonatal hearing screening programme. A step-by-step description of peri-operative management is included. Results Regionally, between February and May 2020, 106 babies were referred via the neonatal hearing screening programme to paediatric audiology. Eleven children were operated on during the coronavirus disease 2019 study period. None of the 11 children developed coronavirus symptoms. Discussion It is widely recognised that the demands of managing the current pandemic may compromise screening, clinical assessment and elective surgery. Time-sensitive issues such as cancer management have gained prominence, but a similar need exists for timely paediatric cochlear implantation. Conclusion Implantation in the paediatric population during the coronavirus disease 2019 pandemic is feasible with careful planning.
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Review of Clinical and Operative Recommendations for Ophthalmology Practices During the COVID-19 Pandemic. ACTA ACUST UNITED AC 2021; 3:3-8. [PMID: 33437928 PMCID: PMC7790025 DOI: 10.1007/s42399-020-00633-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 01/08/2023]
Abstract
In response to climbing global case and fatality rates of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease, COVID-19, ophthalmology practices have modified their clinical and operative approach to patient care in an attempt to reduce spread of the virus. The presence of SARS-CoV-2 viral RNA in the preocular tear film raises speculation that the ocular surface can act as an initial site of infection as well as a potential source of person-to-person viral transmission. More recently, conjunctival specimens and immunohistochemical analyses have identified the presence of cellular surface factors necessary for SARS-CoV-2 infection on the ocular surface. Together, these results highlight the importance of safety measures in ophthalmology practices to prevent transmission of SARS-CoV-2. As ophthalmic exams typically require close proximity between a patient's respiratory tract and the provider, clinical and surgical recommendations are aimed at reducing unnecessary patient-provider interactions. Subspecialty professional guidelines can be used to instruct ophthalmologists on the necessity of various procedures and best practice measures. Ophthalmology practice during the COVID-19 pandemic has been dramatically curtailed in an effort to reduce the risk of transmission and converse valuable personal protective equipment (PPE), and the impacts of the ongoing pandemic on ophthalmology practices will be felt for the foreseeable future.
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Teitelbaum S, Diaz J, Singer R. Can Outpatient Plastic Surgery Be Done Safely During a COVID-19 Surge? Results of a July 2020 Los Angeles Survey and Literature Review. Aesthet Surg J 2021; 41:98-108. [PMID: 33026419 PMCID: PMC7665343 DOI: 10.1093/asj/sjaa287] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background A moratorium was placed on nonurgent surgery throughout much of the United States in mid-March 2020 due to surging numbers of COVID-19 cases. Several months later, and with new safety precautions in place, elective surgery gradually resumed. However, no data exist on the safety of plastic surgery during the pandemic. Objectives This aim of this survey was to assess the safety of plastic surgery during the pandemic by quantifying: (1) the preoperative prevalence of SARS-CoV-2; (2) the risk of postoperative COVID-19; (3) outcomes and precious resource utilization for such cases; and (4) the risks to office staff. Methods Los Angeles plastic surgeons certified by the American Board of Plastic Surgery (ABPS) were sent an online survey in July 2020, during a local COVID-19 surge, querying about the number of procedures performed in the 8- to 10-week period since reopening, testing policies, surgical complications, and cases among staff. Results In total, 112 surgeons reported 5633 surgeries since resuming elective surgery. Of these, 103 (91.96%) surgeons obtained a preoperative SARS-CoV-2 polymerase chain reaction (PCR) test for every patient. The preoperative PCR test was positive in 41/5881 (0.69%). Positive tests within 2 weeks postoperation occurred in 7/5380 (0.13%) of surgical patients, 3/8506 (0.04%) of injection patients, and 6/2519 (0.24%) of energy therapy patients. Nine offices reported at least 1 staff member who developed COVID-19. All cases were mild, with no hospitalizations or deaths. Conclusions These data demonstrate that plastic surgery can be performed safely during a COVID-19 surge by ABPS diplomates. This has profound impact for patients, plastic surgeons, and health policy regulators.
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Affiliation(s)
- Steven Teitelbaum
- Associate Clinical Professor (Voluntary) of Plastic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - John Diaz
- private practice in Beverly Hills, CA
| | - Robert Singer
- Clinical Professor (Voluntary) of Plastic Surgery, University of California, San Diego, La Jolla, CA
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Chan JJ, Chen KK, Choi P, Rojas EO, Schipper ON, Aiyer A, de Cesar Netto C, Haleem AM, Kadakia AR, Vulcano E. Impact of COVID-19 Pandemic on Patients’ Perceptions of Safety and Need for Elective Foot and Ankle Surgery in the United States. FOOT & ANKLE ORTHOPAEDICS 2021; 6:24730114211013788. [PMID: 35097451 PMCID: PMC8702750 DOI: 10.1177/24730114211013788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: With the development of the COVID-19 pandemic, elective foot and ankle surgeries were delayed throughout the United States to divert health care resources and limit exposure. Little is known about the impact of COVID-19 on patient’s willingness to proceed with elective procedures once restrictions are lifted and factors contributing to such decision. Methods: Patients across 6 US orthopedic institutions who had their elective foot and ankle surgeries cancelled secondary to the pandemic were given a questionnaire. Specifically, patients were asked about their willingness to move forward with surgery once restrictions were lifted and if not why. Pain-level and pain medication use were also assessed. Univariate analysis was used to identify factors that contribute to patient’s decisions. Results: A total of 150 patients participated in this study. Twenty-one (14%) opted not to proceed with surgery once restrictions were lifted. Forty-three percent (n = 9) listed concern for COVID infection as the reason; however, 14% of them would proceed if procedures were performed in surgery center. Twenty-nine (19% of the total cohort) patients had increased pain and 11% of patients were taking more pain meds because of the delay to their procedure. Patients who decided not to proceed with surgery reported pain reduction (3% vs 14%) and lower increase in pain medication used (5% vs 12%). Conclusion: COVID-19 has made a significant impact on the health care system. Delay of elective foot and ankle procedures impact patient quality of life and outcomes. Access to surgery centers may provide a partial solution during the pandemic Level of Evidence: Level III.
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Affiliation(s)
| | | | - Peter Choi
- University of Massachusetts, Worcester, MA, USA
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Farasani A. Genetic analysis of the 2019 coronavirus pandemic with from real-time reverse transcriptase polymerase chain reaction. Saudi J Biol Sci 2021; 28:911-916. [PMID: 33199970 PMCID: PMC7658593 DOI: 10.1016/j.sjbs.2020.11.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 12/17/2022] Open
Abstract
Corona viruses (CoV) are known to cause extreme pandemics in the globe. The year 2020 will be a pandemic with the spread of the novel coronavirus (SARS-CoV-2) across the globe. Coronavirus 2019 (COVID-19) has been a part of our scary life for more than a quarter of a year in 2020. The Wuhan market and China have been the most commonly used terms in the world for at least a quarter of 2020. A zoonotic coronavirus has entered organisms to affect organisms for the third season in several centuries. CoV is a global pandemic prompted a drastic and rapid reconfiguration of society. CoV have extraordinary broad genomes of about 30 kilobases of RNA. There is no genetic relationship between the SARS-CoV, MERS and SARS-CoV-2. For health care strategies and for anticipating and preventing potential outbreaks, adequate description of the international spread of COVID-19 virus is imperative. The WHO has declared COVID-19 as endemic to pandemic in the first trimester of 2020. The biggest issues for diagnosis COVID-19 is not established apart from Real-time reverse transcriptase polymerase chain reaction (RT-PCR). In order to monitor the COVID-19 pandemic, testing of active SARS-CoV-2 infections is a fundamental public health method. The vast use of SARS-CoV-2 RT-PCR tests around the world has led to increased availability of test kits, which is also a major bottleneck. The technique RT-PCR was generally agreed in the present scenario to detect SARS-CoV-2 in the human body. This review discusses about the importance of molecular technique for diagnosing the pandemic disease of 2019. In conclusion, RT-PCR was found to be an apt technique for identification of SARS-CoV-2.
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Affiliation(s)
- Abdullah Farasani
- Address: Biomedical Research Unit, Medical Research Center, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia.
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Muhammad R, Bisiriyu O. Prevalence of COVID-19 infection among asymptomatic ophthalmic surgical patients undergoing ophthalmic procedures at University of Abuja Teaching Hospital, Gwagwalada, Abuja. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2021; 11:14-18. [PMID: 35983260 PMCID: PMC9380790 DOI: 10.4103/jwas.jwas_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/23/2022] [Indexed: 11/04/2022]
Abstract
Purpose: Materials and Methods: Results: Conclusion:
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Take-Home Messages from the COVID-19 Pandemic: Strengths and Pitfalls of the Italian National Health Service from a Medico-Legal Point of View. Healthcare (Basel) 2020; 9:healthcare9010017. [PMID: 33375544 PMCID: PMC7824087 DOI: 10.3390/healthcare9010017] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 01/28/2023] Open
Abstract
The World Health Organization (WHO) declared the outbreak of the Coronavirus disease-2019 (COVID-19) infection a pandemic on 11 March 2020. As of the end of October 2020, there were 50 million cases of infection and over one million deaths recorded worldwide, over 45,000 of which occurred in Italy. In Italy, the demand for intensive care over the course of this pandemic crisis has been exceptionally high, resulting in a severe imbalance between the demand for and availability of the necessary resources. This paper focuses on elements of preventive medicine and medical treatments in emergency and non-emergency situations which, based on the international scientific literature, may prove to be useful to physicians on a behavioral level and avert professional liability problems. In order to achieve this objective, we have performed a search on MEDLINE to find published articles related to the risks associated with the pandemic that contain useful suggestions and strategies for mitigating risks and protecting the safety of the population. The results have been collocated in line with these specific study areas.
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Wang VTJ, Odani T, Ito M. Considerations and Strategies for Restarting Elective Spine Surgery in the Midst of a Pandemic of COVID-19. Spine Surg Relat Res 2020; 5:52-60. [PMID: 33842710 PMCID: PMC8026206 DOI: 10.22603/ssrr.2020-0154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/01/2020] [Indexed: 02/06/2023] Open
Abstract
The 2019 coronavirus disease (COVID-19) pandemic outbreak has rapidly spread to the globe, causing severe global socioeconomic disruption on an unprecedented scale. As the first wave of COVID-19 pandemic is now going to settle down, many medical organizations are in the process of reopening surgical services. This paper describes a few key factors that spine surgeons should consider prior to resuming elective spine services namely, local outbreak situations, availability of hospital resources, manpower and personal protective equipment (PPE). Spine surgeons should prioritize their operating list based on clinical indications and likely benefits from surgical intervention so as to make optimum use of hospital resources and operating room listings. International organizations have published on general principles and recommendations on how to restart elective surgery. However, with different regions at varying phases of the outbreak and unpredictable nature of the COVID-19 pandemic, a general set of practice guidelines may not be applicable. This paper also proposes, on top of peri-operative precautionary measures already in place, clearly-defined risk stratification algorithms for hospital visitors, as well as a disease-testing protocol for patients planned for elective surgery. It is of critical importance for surgeons to define key areas of concern and assimilate these principles into clearly-defined algorithms which can be applied to the field of spine surgery so as to help re-establish continuity of care for patients.
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Affiliation(s)
- Victor Tzong-Jing Wang
- Department of Orthopaedic Surgery, the National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Toshio Odani
- Department of Rheumatology, the National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Manabu Ito
- Department of Orthopaedic Surgery, the National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
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Operation mode of plastic surgery during COVID-19 epidemic: The experience of the department of plastic surgery in Zibo Central Hospital. J Plast Reconstr Aesthet Surg 2020; 74:890-930. [PMID: 33341384 PMCID: PMC7832478 DOI: 10.1016/j.bjps.2020.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022]
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Some Thoughts on the Impact of COVID-19 on Plastic Surgery. Aesthetic Plast Surg 2020; 44:2342-2343. [PMID: 32978656 PMCID: PMC7518651 DOI: 10.1007/s00266-020-01979-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 09/13/2020] [Indexed: 10/24/2022]
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62
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Raper SE, Clapp JT, Fleisher LA. Let's Be Reasonable: Surgical Informed Consent in the COVID-19 Era. ANNALS OF SURGERY OPEN 2020; 1:e016. [PMID: 37637442 PMCID: PMC10455294 DOI: 10.1097/as9.0000000000000016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/07/2020] [Indexed: 11/25/2022] Open
Abstract
Mini-Abstract Our perspective on informed consent is that expanding the duty to disclose novel uncertainties (eg, the covid-19 pandemic) stretches the doctrine to almost limitless proportions. Instead, we argue for a more conventional view in which the informed consent process should remain focused on the proposed operation and its ramifications.
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Affiliation(s)
- Steven E. Raper
- From the Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Justin T. Clapp
- From the Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lee A. Fleisher
- From the Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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63
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Kamal A, Widodo W, Kuncoro M, Karda I, Prabowo Y, Singh G, Liastuti L, Trimartani, Hutagalung E, Saleh I, Tobing S, Gunawan B, Dilogo I, Lubis A, Kurniawan A, Rahyussalim A, Oesman I, Ifran N, Latief W, Wijaya M, Ivansyah M, Primaputra M, Reksoprodjo A, Hendriarto A, Novriandi K, Alaztha Z, Canintika A, Sitanggang A. Does elective orthopaedic surgery in pandemic era increase risk of developing COVID-19? A combined analysis of retrospective and prospective study at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Ann Med Surg (Lond) 2020; 60:87-91. [PMID: 33078074 PMCID: PMC7557301 DOI: 10.1016/j.amsu.2020.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To date, no recommendations have been published on when and how to start again carrying out elective, non-urgent surgery on COVID-19-negative patients after the epidemic peak has been reached in a given country or region and the pressure on healthcare facilities, healthcare workers and resources has been released by so far that elective surgery procedures can be safely and ethically programmed again. This study aims to investigate whether elective orthopaedic surgery will increase the risk of developing COVID-19. MATERIALS AND METHODS This was a combined retrospective and prospective studies performed at a national tertiary hospital in Jakarta, Indonesia. Subjects were patients who underwent elective orthopaedic surgeries at our institution from April to May 2020. Those who were previously infected with COVID-19 from polymerase chain reaction (PCR) reverse transcriptase (RT) examination obtained via nasopharynx and oropharynx swab, as well as those who were reluctant to participate were excluded from the study. RESULTS A total of 35 subjects (mean age 32.89 ± 17.42) were recruited. Fifteen (42.9%) subjects were male, and 20 subjects (57.1%) were female. Mean duration of surgery was 240 min with the longest and shortest duration of 690 and 40 min, respectively. General anaesthesia was performed in the majority of cases in 18 surgeries (51.4%) with local anaesthesia as the least in 2 surgeries (5.7%). Length of stay of our study was 6 days of average. None of the patients developed symptoms suggestive of COVID-19 infection. CONCLUSION We found that elective orthopaedic surgery may not be associated with increased cases of COVID-19 cases. However, our study was limited by short duration of follow-up. Further studies are required in order to investigate the affect of undergoing elective surgery and the number of COVID-19 cases.
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Affiliation(s)
- A.F. Kamal
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - W. Widodo
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - M.W. Kuncoro
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - I.W.A.M. Karda
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Y. Prabowo
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - G. Singh
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Trimartani
- Department of Ear, Nose, and Throat, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - E.U. Hutagalung
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - I. Saleh
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - S.D.A.L. Tobing
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - B. Gunawan
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - I.H. Dilogo
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A.M.T. Lubis
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A. Kurniawan
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A.J. Rahyussalim
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - I. Oesman
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - N.N.P.P.S. Ifran
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - W. Latief
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - M.T. Wijaya
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - M.D. Ivansyah
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - M.R.A. Primaputra
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A.Y. Reksoprodjo
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A. Hendriarto
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - K.M.A. Novriandi
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Z. Alaztha
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A.F. Canintika
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A.H.R. Sitanggang
- Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Pisapia P, Malapelle U, Salatiello M, Rosell R, Troncone G. A narrative review of lung cancer cytology in the times of coronavirus: what physicians should know. Transl Lung Cancer Res 2020; 9:2074-2081. [PMID: 33209627 PMCID: PMC7653120 DOI: 10.21037/tlcr-20-795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In the modern era of personalized and precision medicine, lung cancer management needs to be carried out in a multidisciplinary manner. Among other disciplines, also cytopathology is key in diagnosis and treatment management of these patients. Indeed, cytopathology specimens are often the only source of available tissue material for morphological diagnosis and molecular purposes in order to guarantee an adequate treatment decision making, since surgical resection specimens are not available when lung cancer is diagnosed at advanced disease stages. Today, as an effect of the current severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic, cytopathology is reorganizing and reshaping many of its procedures and workflows, in order to ensure the safety of cytopathologists and laboratory personnel. In particular, careful attention should be paid on biosafety procedures when pulmonary cytological specimens are handled. In addition, also molecular cytopathology, that provides relevant information on the molecular status and on the potential sensitivity to target treatments, is undergoing major changes. In this setting, fully automated technologies, requiring minimal hands-on work, may be a valid option. The aim of this narrative review is to keep updated all the different professional figures involved in lung cancer management and treatment on how SARS-CoV-2 is modifying lung cancer cytopathology.
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Affiliation(s)
- Pasquale Pisapia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Maria Salatiello
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program Catalan Institute of Oncology; Germans Trias i Pujol Health Sciences Institute and Hospital Badalona, Barcelona, Spain
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
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Hamidian Jahromi A, Arnautovic A, Konofaos P. Impact of the COVID-19 Pandemic on the Education of Plastic Surgery Trainees in the United States. JMIR MEDICAL EDUCATION 2020; 6:e22045. [PMID: 33119537 PMCID: PMC7674135 DOI: 10.2196/22045] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 06/02/2023]
Abstract
The current COVID-19 pandemic has vastly impacted the health care system in the United States, and it is continuing to dictate its unprecedented influence on the education systems, especially the residency and fellowship training programs. The impact of COVID-19 on these training programs has not been uniform across the board, with plastic surgery residency and fellowship programs among the hardest hit specialties. Implementation of social distancing regulations has affected departmental educational activities, including preoperative, morbidity and mortality conferences and journal clubs; operating room educational activities; as well as the overall education of plastic surgery trainees in the United States. Almost all elective and semielective surgeries across the United States were suspended for a few months during the COVID-19 pandemic; this constitutes a significant portion of plastic surgery cases. Considering the current staged reopening policies, it may be a long time, if ever, before restrictions are completely lifted. In this paper, we review the multidimensional impact of the current COVID-19 pandemic on the training programs of plastic surgery residents and fellows in the United States and worldwide, along with some potential solutions on how to address existing challenges.
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Affiliation(s)
- Alireza Hamidian Jahromi
- Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis, TN, United States
- Department of Plastic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Alisa Arnautovic
- The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Petros Konofaos
- Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis, TN, United States
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Kannan NB, Sen S, Reddy H, Kumar K, Rajan RP, Ramasamy K. Preoperative COVID-19 testing for elective vitreoretinal surgeries: Experience from a major tertiary care institute in South India. Indian J Ophthalmol 2020; 68:2373-2377. [PMID: 33120621 PMCID: PMC7774179 DOI: 10.4103/ijo.ijo_2870_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/10/2020] [Accepted: 09/28/2020] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To study the prevalence of asymptomatic SARS-CoV-2 virus infection (COVID-19) among patients undergoing elective vitreoretinal surgeries at a tertiary care eye hospital. METHODS This cross-sectional, observational study was performed between July 16, 2020 and August 31, 2020, in the retina clinic of a tertiary care eye hospital in south India. All patients undergoing elective retinal surgical procedures underwent RT-PCR testing for SARS-CoV-2 before being posted for surgery and after obtaining informed consent. Patients planned for surgery under general anesthesia underwent additional computed tomography of the chest. Testing strategies and outcomes were documented. RESULTS Out of a total of 413 patients who were given appointments for surgery during this period, nine patients (2.2%) were found to have positive RT-PCR for SARS-CoV-2, and their surgeries were postponed. The test positivity (prevalence) rate of asymptomatic COVID-19 infection among all elective vitreoretinal surgical patients in our hospital was 2.2%. None of the patients were symptomatic for COVID-19. CONCLUSION Our results showed that among patients visiting high volume ophthalmic centers in the near future, approximately 1 in 45 patients may be asymptomatic, SARS-CoV-2 RT-PCR positive. Asymptomatic COVID-19 patients may lead to chances of transmission of the virus inside healthcare facilities among other visiting patients and healthcare workers.
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Affiliation(s)
- Naresh Babu Kannan
- Department of Retina-Vitreous Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Sagnik Sen
- Department of Retina-Vitreous Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Harshavardhan Reddy
- Department of Retina-Vitreous Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Karthik Kumar
- Department of Retina-Vitreous Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Renu P Rajan
- Department of Retina-Vitreous Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Kim Ramasamy
- Department of Retina-Vitreous Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
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Timeline and Procedures on Restarting Non-Emergent Arthroplasty Care in the US Epicenter of the COVID-19 Pandemic. HSS J 2020; 16:146-152. [PMID: 33013245 PMCID: PMC7524030 DOI: 10.1007/s11420-020-09801-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/07/2020] [Indexed: 02/07/2023]
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Abstract
BACKGROUND AND AIMS COVID-19 pandemic has caused significant disruption in training which is even more pronounced in the surgical specialties. We aim to assess the impact of COVID-19 pandemic on core surgical training. METHODS All core surgical and improving surgical trainees in West of Scotland region were invited to participate in an online voluntary anonymous survey via SurveyMonkey. RESULTS 28 of 44 (63.6%) trainees responded, 15 (53.6%) were CT1/ST1. 14 (50.0%) working in teaching hospital and 15 (53.6%) working in general surgery. 20 (71.4%) felt that due to the pandemic they have less opportunity to operate as the primary surgeon. 21 (75.0%) have not attended any outpatient clinics. 8 (28.6%) did not have any form of access to the laparoscopic box-trainer. 20 (71.4%) felt their level of confidence in preforming surgical skills has been negatively impacted. 18 (64.3%) found it difficult to demonstrate progress in portfolio. 21 (75.0%) trainees have not attended any teaching. 10 (35.7%) trainees have been off-sick. 8 (28.6%) trainees have felt slightly or significantly more stressed. CONCLUSION COVID-19 pandemic has an unprecedented negative impact on all aspects of core surgical training. The long term impact on the current cohort of trainees is yet to be seen.
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Affiliation(s)
- Khurram Shahzad Khan
- ST6 in General Surgery, University Hospital Hairmyres, East Kilbride, Scotland, UK
| | - Rona Keay
- Clinical Development Fellow in Emergency Medicine, University Hospital Hairmyres, East Kilbride, Scotland, UK
| | - Morag McLellan
- ST6 in General Surgery, University Hospital Hairmyres, East Kilbride, Scotland, UK
| | - Sajid Mahmud
- ST6 in General Surgery, University Hospital Hairmyres, East Kilbride, Scotland, UK
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Early Changes to Neurosurgery Resident Training During the COVID-19 Pandemic at a Large U.S. Academic Medical Center. World Neurosurg 2020; 144:e926-e933. [PMID: 32992058 PMCID: PMC7521299 DOI: 10.1016/j.wneu.2020.09.125] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has led to sweeping changes in residency programs across the world, including cancellation of elective cases. The effects of safety measures on neurosurgical training remain unclear. To understand how neurosurgical residents have been affected, we analyzed the operative experience in the months leading up to and during the pandemic. METHODS The resident and institutional case totals were tallied for a single residency program in Miami-Dade County from January 1, 2019 to June 30, 2020. A matched cohort analysis was performed before and during the pandemic to assess the effects on resident surgical training. RESULTS The case totals for all levels of training were lower when restrictions were placed on elective surgeries. An average of 11 cases was logged in April 2020, a decrease from 26 cases in April 2019 (95% confidence interval, 8.7-22; P < 0.01). An average of 20 cases was logged in May 2020, a decrease from 25 cases in May 2019 (95% confidence interval, 1.2-8.8; P = 0.01). In April and May 2020, 299 (66%) and 148 (50%) fewer cases had been performed at our institution compared with April and May 2109. CONCLUSIONS Operative experience was reduced for residents during the months when the performance of elective cases was restricted. Our data suggest experience in some areas of neurosurgery were more affected than were others, and residents at different levels of training were also affected differently. However, the extent of the coronavirus disease 2019 pandemic on neurosurgical training is unlikely to be understood in the short term.
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Long R, Martin S, Hill C. Cosmetic tourism amidst the Covid-19 global pandemic. J Plast Reconstr Aesthet Surg 2020; 74:223-243. [PMID: 32978112 PMCID: PMC7502226 DOI: 10.1016/j.bjps.2020.08.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/01/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Rebekah Long
- Plastic Surgery Department, Ulster Hospital, Dundonald, BT16 1RH, United Kingdom.
| | - Serena Martin
- Plastic Surgery Department, Ulster Hospital, Dundonald, BT16 1RH, United Kingdom
| | - Chris Hill
- Plastic Surgery Department, Ulster Hospital, Dundonald, BT16 1RH, United Kingdom
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Sethi N, Singh S, Kaur J, Raghukumar S, Ramchandani C, Dharmana S, Balani K, Jain H, Khoja M, Singhal S. Consensus Guidelines on Opening Up of Aesthetic Practices in India During the COVID-19 Era. Clin Cosmet Investig Dermatol 2020; 13:661-669. [PMID: 32982359 PMCID: PMC7490074 DOI: 10.2147/ccid.s267528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/12/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The COVID-19 is a pandemic which has affected most people directly or indirectly. It being a communicable disease, the best way to control the disease is to prevent its spread. Lockdown in India has resulted in aesthetic practices all over the country being shut down indefinitely. As things return to normal, most aesthetic practitioners are looking forward to opening practices. Hence, there was a definite need for a consensus on how to safely open up practices in India and at the same time reassure patients coming into these clinics that their safety is paramount. METHODS This consensus guidelines use the PICO model in its structure. Five critical areas for opening up clinical establishments were identified and approached independently. A questionnaire was prepared using the modified Likert scale, and all the stakeholders were asked to answer the same. Any differences were then resolved with discussion among the stakeholders. The entire study was divided into five subgroups which were then analyzed in detail. RESULTS Key recommendations and consensus guidelines were made after detailed analysis. Handy flow diagram reviews of these key areas have been provided. A thorough review of literature was also done on each of the critical areas and recommendations incorporated wherever feasible. CONCLUSION These recommendations have considered the difficulties and cultural issues faced by aesthetic practices in India. They are user friendly, easy to understand and implement. These guidelines would help in reassuring practices to open up safely and continue serving patients with utmost care. LEVEL OF EVIDENCE Level V, Consensus guidelines.
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Affiliation(s)
- Nitin Sethi
- Plastic & Cosmetic Surgery, Fortis Hospital, Ludhiana, Punjab141001, India
| | - Sukhbir Singh
- Resplendent the Cosmetic Studio, New Delhi110048, India
| | - Jasleen Kaur
- Department of Dermatology, SGRDIMS & R, Amritsar, India
| | | | | | | | | | - Hema Jain
- Health and Harmony Clinic, Pune, India
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Malapelle U, Pisapia P, Iaccarino A, Barberis M, Bellevicine C, Brunnström H, de Biase D, De Maglio G, Ericson Lindquist K, Fassan M, Fontanini G, Gruppioni E, Hofman P, Merkelbach-Bruse S, Molina Vila MA, Pujals A, Rapa I, Righi L, Rosell R, Schildgen O, Schildgen V, Schmitt FC, Tallini G, Vander Borght S, Vigliar E, Volante M, Wagener-Ryczek S, Weynand B, Troncone G. Predictive molecular pathology in the time of coronavirus disease (COVID-19) in Europe. J Clin Pathol 2020; 74:jclinpath-2020-206957. [PMID: 32737190 PMCID: PMC7397978 DOI: 10.1136/jclinpath-2020-206957] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023]
Abstract
AIMS Lung cancer predictive biomarker testing is essential to select advanced-stage patients for targeted treatments and should be carried out without delays even during health emergencies, such as the coronavirus (COVID-19) outbreak. METHODS Fifteen molecular laboratories from seven different European countries compared 4 weeks of national lockdown to a corresponding period in 2019, in terms of tissue and/or plasma-based molecular test workload, analytical platforms adopted, number of cases undergoing programmed death-ligand1 (PD-L1) expression assessment and DNA-based molecular tests turnaround time. RESULTS In most laboratories (80.0%), tissue-based molecular test workload was reduced. In 40.0% of laboratories (6/15), the decrease was >25%, and in one, reduction was as high as 80.0%. In this instance, a concomitant increase in liquid biopsy was reported (60.0%). Remarkably, in 33.3% of the laboratories, real-time PCR (RT-PCR)-based methodologies increased, whereas highly multiplexing assays approaches decreased. Most laboratories (88.9%) did not report significant variations in PD-L1 volume testing. CONCLUSIONS The workload of molecular testing for patients with advanced-stage lung cancer during the lockdown showed little variations. Local strategies to overcome health emergency-related issues included the preference for RT-PCR tissue-based testing methodologies and, occasionally, for liquid biopsy.
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Affiliation(s)
- Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Pasquale Pisapia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Antonino Iaccarino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Massimo Barberis
- Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Hans Brunnström
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Dario de Biase
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | | | - Kajsa Ericson Lindquist
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Matteo Fassan
- Surgical Pathology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Gabriella Fontanini
- Department of Surgical, Medical, and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Elisa Gruppioni
- Department of Pathology, University of Bologna Medical Center, Bologna, Italy
| | | | | | | | - Anaïs Pujals
- Department of Pathology, CHU Henri Mondor, Creteil, France
| | - Ida Rapa
- Pathology Unit, Department of Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Luisella Righi
- Pathology Unit, Department of Oncology, University of Turin, Turin, Italy
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology; Germans Trias i Pujol Health Sciences Institute and Hospital Badalona, Barcelona, Spain
| | - Oliver Schildgen
- Institute of Pathology, Hospital of the Private University Witten/Herdecke, Cologne, Germany
| | - Verena Schildgen
- Institute of Pathology, Hospital of the Private University Witten/Herdecke, Cologne, Germany
| | | | - Giovanni Tallini
- Department of Pathology, University of Bologna Medical Center, Bologna, Italy
| | | | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Marco Volante
- Pathology Unit, Department of Oncology, University of Turin, Turin, Italy
| | | | - Birgit Weynand
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
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Abdalkader M, Sathya A, Malek AM, Fifi JT, Norbash AM, Wakhloo AK, Nguyen TN. Roadmap for Resuming Elective Neuroendovascular Procedures Following the First COVID-19 Surge. J Stroke Cerebrovasc Dis 2020; 29:105177. [PMID: 32891495 PMCID: PMC7383144 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/08/2020] [Accepted: 07/16/2020] [Indexed: 01/05/2023] Open
Affiliation(s)
- Mohamad Abdalkader
- Departments of Radiology, Boston Medical Center, Boston University-School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA.
| | - Anvitha Sathya
- School of Medicine, Boston Medical Center, Boston University-School of Medicine, Boston, MA, USA
| | - Adel M Malek
- Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Johanna T Fifi
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Ajay K Wakhloo
- Department of Radiology, Beth Israel Lahey Health, MA, USA
| | - Thanh N Nguyen
- Departments of Radiology, Boston Medical Center, Boston University-School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA; Neurology, Boston Medical Center, Boston University-School of Medicine, Boston, MA, USA; Neurosurgery, Boston Medical Center, Boston University-School of Medicine, Boston, MA, USA
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Khashaba H, Ng L, Osmani O, Chalmers R. COVID-19 and plastic surgery: a UK plastic surgery unit experience. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020; 43:867-870. [PMID: 32836892 PMCID: PMC7369535 DOI: 10.1007/s00238-020-01703-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Haitham Khashaba
- Plastic Surgery Department, University Hospital of North Durham, Durham, UK
| | - Lisa Ng
- Plastic Surgery Department, University Hospital of North Durham, Durham, UK
| | - Omer Osmani
- Plastic Surgery Department, University Hospital of North Durham, Durham, UK
| | - Richard Chalmers
- Plastic Surgery Department, University Hospital of North Durham, Durham, UK
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Verma V, Nagar M, Jain V, Santoshi JA, Dwivedi M, Behera P, Selvanayagam R, Pal D, Singh K. Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital. Cureus 2020; 12:e9147. [PMID: 32789084 PMCID: PMC7417187 DOI: 10.7759/cureus.9147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction The recent novel coronavirus disease 2019 (COVID-19) pandemic has brought the world to a standstill. This outbreak not only affected healthcare systems but the resultant economic losses were also enormous. COVID-19 has demanded that the health care systems globally evolve, develop new strategies, identify new models of functioning, and at times, fall back on the old conservative methods of orthopedic care to decrease the risk of disease transmission. Although, the majority of hospitals are refraining from performing elective surgeries, emergent and urgent procedures cannot be delayed. Various strategies have been developed at the institute level to reduce the risk of infection transmission among the theatre team from an unsuspected patient (asymptomatic and presymptomatic) during the perioperative period. Material and methods The present study is a part of an ongoing project which is being conducted in a tertiary level hospital after obtaining research review board approval. All patients admitted either for vertebral fracture or spinal cord compression from February 2020 to May 2020 were included. The present study included 13 patients (nine males and four females) with an average age of 35.4 years The oldest patient was of 63 years which is considered a risk factor for developing severe COVID-19 infection. Results Eight patients (61.5%) presented with spinal cord injury (SCI) due to vertebral fracture with fall from height (87.5%) as the most common etiology. Among the traumatic SCI patients, six (75%) were managed surgically with posterior decompression and instrumented fusion with pedicle screws while two patients (25%) were managed conservatively. There were four patients (30.8%) of tuberculosis of the spine of whom two (50%) were managed with posterior decompression, debridement, and stabilization with pedicle screws, samples for culture, biopsy, and cartridge-based nucleic acid amplification test (CBNAAT) were collected during the procedure; for the remaining two patients (50%), a trans-pedicular biopsy was performed to confirm the diagnosis for initiation of anti-tubercular therapy. Prolapsed intervertebral disc causing cauda equina syndrome was the reason for emergency surgery in one patient (7.7%). COVID-19 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test was performed in four patients (30.8%), in whom the most common symptom was fever (two patients (50%)). These patients were residents of high prevalence area for COVID-19 infection. Sore throat (25%), fatigue (25%), and low oxygen saturation (25%) were present in one patient which prompted us to get the COVID-19 test. All patients were reported negative for COVID-19. Conclusion The structural organization and the management protocol we describe allowed us to reduce infection risk and ultimately hospital stay, thereby maximizing the already stretched available medical resources. These precautions helped us to reduce transmission and exposure to COVID-19 in health care workers (HCW) and patients in our institute. The aim of this article is that our early experience can be of value to the medical communities that will soon be in a similar situation.
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Affiliation(s)
- Virendra Verma
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Manoj Nagar
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Vaibhav Jain
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - John A Santoshi
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Manish Dwivedi
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Prateek Behera
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | | | - Dharm Pal
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Kuldeep Singh
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
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Hardie JA, Brennan PA. Are you surgically current? Lessons from aviation for returning to non-urgent surgery following COVID-19. Br J Oral Maxillofac Surg 2020; 58:843-847. [PMID: 32576468 PMCID: PMC7303632 DOI: 10.1016/j.bjoms.2020.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 12/27/2022]
Abstract
The COVID-19 crisis has caused many issues across healthcare. In surgery, many operations have been cancelled with some surgeons losing their regular operating lists. During this time, technical expertise and decision making can deteriorate. In aviation after a prolonged period of absence from flying, this deficit in keeping skills and thinking up to date is known as being “out of currency” or “not current”. Although aviation and healthcare cannot be compared, numerous human factors concepts are applicable to both. In this article, we explore the likely impact of potentially prolonged absences in operating on surgical skills and psyche, and introduce the concept of a Surgical Skills Currency Barometer. We also discuss a “task-o-meter” thought experiment, and suggest practices which could be adopted to help protect surgeon workload from exceeding surgical capability when returning to operating following a period of prolonged absence.
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Affiliation(s)
- J A Hardie
- Trauma & Orthopaedic Department, Frimley Park Hospital, Camberley GU16 7UJ, UK.
| | - P A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
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Singh K, Nooreyezdan S, Mehta P, Shastry A, Kumar G, Agarwal K, Krishna U, Arora P. Aesthetic practice in covid times-evolving guidelines at the cosmetic clinic, indraprastha apollo hospital, New Delhi. APOLLO MEDICINE 2020. [DOI: 10.4103/am.am_83_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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