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Jeong WS, Hong DW, Ahn TJ, Han HH. The Volumetric Effect of Botulinum Toxin Type A Injection on the Parotid Gland: A Randomized Controlled Trial. Plast Reconstr Surg 2024; 153:337-343. [PMID: 37010458 DOI: 10.1097/prs.0000000000010528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
BACKGROUND Botulinum neurotoxin type A (BTX-A) to the masseter muscle is a useful tool for the aesthetic narrowing of the width of the lower face. The administration of BTX-A to visible parotid glands is also effective to reduce lower facial width. However, no studies have quantitatively analyzed the effect of BTX-A on the parotid glands. METHODS The purpose of this study was to confirm the impact of BTX-A injection on the parotid gland and to suggest the effective dosage of BTX-A in facial slimming. This study was conducted by selecting patients who desired facial slimming from among patients who required surgery for a facial bone fracture. Patients undergoing BTX-A injection were randomized to high-dose, low-dose, and placebo groups, and different doses of BTX-A for each group were injected into both parotid glands during facial bone surgery. RESULTS A total of 30 patients were enrolled in this study. Ten patients in the high-dose group, eight in the low-dose group, and nine in the control group completed the clinical trial. There were significant changes in both the high- and low-dose groups compared with the control group ( P < 0.001, P < 0.001), and in interaction of time and group ( P < 0.001). Volume recovery after 3 months was found in 7.6% in the high-dose group and in 4.8% in the low-dose group. CONCLUSION BTX-A injection into parotid glands can be an effective treatment option in managing salivary gland enlargement for lower face contouring. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, II.
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Affiliation(s)
- Woo Shik Jeong
- From the Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center
| | - Dae Won Hong
- From the Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center
| | | | - Hyun Ho Han
- From the Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center
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2
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Cizmic A, Eichel VM, Weidner NM, Wise PA, Müller F, Rompen IF, Bartenschlager R, Schnitzler P, Nickel F, Müller-Stich BP. Viral load of SARS-CoV-2 in surgical smoke in minimally invasive and open surgery: a single-center prospective clinical trial. Sci Rep 2023; 13:20299. [PMID: 37985848 PMCID: PMC10662446 DOI: 10.1038/s41598-023-47058-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
At the beginning of the COVID-19 pandemic, it was assumed that SARS-CoV-2 could be transmitted through surgical smoke generated by electrocauterization. Minimally invasive surgery (MIS) was targeted due to potentially higher concentrations of the SARS-CoV-2 particles in the pneumoperitoneum. Some surgical societies even recommended open surgery instead of MIS to prevent the potential spread of SARS-CoV-2 from the pneumoperitoneum. This study aimed to detect SARS-CoV-2 in surgical smoke during open and MIS. Patients with SARS-CoV-2 infection who underwent open surgery or MIS at Heidelberg University Hospital were included in the study. A control group of patients without SARS-CoV-2 infection undergoing MIS or open surgery was included for comparison. The trial was approved by the Ethics Committee of Heidelberg University Medical School (S-098/2021). The following samples were collected: nasopharyngeal and intraabdominal swabs, blood, urine, surgical smoke, and air samples from the operating room. An SKC BioSampler was used to sample the surgical smoke from the pneumoperitoneum during MIS and the approximate surgical field during open surgery in 15 ml of sterilized phosphate-buffered saline. An RT-PCR test was performed on all collected samples to detect SARS-CoV-2 viral particles. Twelve patients with proven SARS-CoV-2 infection underwent open abdominal surgery. Two SARS-CoV-2-positive patients underwent an MIS procedure. The control group included 24 patients: 12 underwent open surgery and 12 MIS. One intraabdominal swab in a patient with SARS-CoV-2 infection was positive for SARS-CoV-2. However, during both open surgery and MIS, none of the surgical smoke samples showed any detectable viral particles of SARS-CoV-2. The air samples collected at the end of the surgical procedure showed no viral particles of SARS-CoV-2. Major complications (CD ≥ IIIa) were more often observed in SARS-CoV-2 positive patients (10 vs. 4, p = 0.001). This study showed no detectable viral particles of SARS-CoV-2 in surgical smoke sampled during MIS and open surgery. Thus, the discussed risk of transmission of SARS-CoV-2 via surgical smoke could not be confirmed in the present study.
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Affiliation(s)
- Amila Cizmic
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vanessa M Eichel
- Department of Infectious Diseases, Section Infection Control University Hospital Heidelberg, Heidelberg, Germany
| | - Niklas M Weidner
- Department of Infectious Diseases, Virology, Heidelberg University, Heidelberg, Germany
- Department of Infectious Diseases, Medical Microbiology and Hygiene, University Hospital Heidelberg, Heidelberg, Germany
| | - Philipp A Wise
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Müller
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Ingmar F Rompen
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Ralf Bartenschlager
- Department of Infectious Diseases, Molecular Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Paul Schnitzler
- Department of Infectious Diseases, Virology, Heidelberg University, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Beat P Müller-Stich
- Department of Digestive Surgery, University Digestive Healthcare Center Basel, Kleinriehenstrasse 30, 4058, Basel, Switzerland.
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Liu KQ, Dallas J, Wenger TA, Ristianto Z, Ding L, Chow F, Zada G, Mack WJ, Attenello FJ. Increased time to surgery and worse perioperative outcome in benign brain tumor patients with COVID-19. J Clin Neurosci 2023; 117:20-26. [PMID: 37740998 PMCID: PMC10686786 DOI: 10.1016/j.jocn.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/23/2023] [Accepted: 09/14/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic caused significant disruptions to healthcare systems around the world, due to both high resource utilization and concern for disease spread. Delays in non-emergent surgeries have also affected chronic disease management, including that of benign brain tumors such as meningiomas and pituitary adenomas. To evaluate the effect of COVID-19 infection on benign brain tumor resection rates and subsequent perioperative and inpatient outcomes, this study utilized the 2020 National Inpatient Sample (NIS) to investigate rates of surgical resection, time to surgery, and mortality among benign brain tumor patients with and without COVID-19. METHODS Patient data from April 2020 to December 2020 was extracted from the NIS. Confirmed COVID-19 diagnosis was identified using the ICD-10 diagnosis code U07.1. Patients with benign neoplasms of the cerebral meninges, cranial nerves, pituitary gland, craniopharyngeal duct, and brain were included in the study. Patient socio-demographics, hospital characteristics, and clinical comorbidities were obtained. Outcome variables included rates of surgical resection, time to surgery, in-hospital mortality, length of stay, and discharge disposition. RESULTS The study analysis consisted of 13,053 patients with benign intracranial neoplasms who met inclusion criteria; 597 (4.6%) patients were COVID-19 positive. Patients with COVID-19 were more likely to be older and male than COVID-19 negative patients. Patients with COVID-19 had increased overall likelihood of mortality (OR 2.36, 95% CI 1.72-3.25, p < 0.0001). Even when controlling for sociodemographic/hospital factors and comorbidities, COVID-19 positive patients had a significantly longer time to surgery (8.7 days vs. 0.9 days, p < 0.0001) than COVID negative patients, and were associated with a decreased likelihood of undergoing surgery on index admission overall (OR 0.17, 95% CI 0.10-0.29, p < 0.0001). CONCLUSIONS As expected, COVID-19 infection was associated with worse inpatient outcomes in effectively all measured categories, including longer time to surgery, decreased likelihood of receiving surgery on index admission, and increased likelihood of in-hospital mortality. These findings emphasize the effect that COVID-19 has on other aspects of patient care and highlight the importance of appropriate avenues of care for patients who are COVID-19 positive. Although the COVID-19 pandemic is no longer a public health emergency, understanding the pandemic's impact on outcome for these patients is essential in efficient triage and optimizing treatment for these patients in the future. Further study is needed to elucidate causal relationships on the outcomes of benign brain tumor patients.
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Affiliation(s)
- Kristie Q Liu
- Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA.
| | - Jonathan Dallas
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street Suite 3300, Los Angeles, CA 90033, USA
| | - Talia A Wenger
- Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA
| | - Zasca Ristianto
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street Suite 3300, Los Angeles, CA 90033, USA
| | - Li Ding
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA 90032, USA
| | - Frances Chow
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street Suite 3300, Los Angeles, CA 90033, USA
| | - Gabriel Zada
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street Suite 3300, Los Angeles, CA 90033, USA
| | - William J Mack
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street Suite 3300, Los Angeles, CA 90033, USA
| | - Frank J Attenello
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street Suite 3300, Los Angeles, CA 90033, USA
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Zanin L, Ius T, Panciani PP, Esposito F, Gori A, Fontanella MM, Tropeano MP, Raco A, Angileri FF, Sabatino G, Olivi A, Esposito V, Pessina F. The impact of COVID-19 pandemic on surgical neuro-oncology: A survey from the Italian society of neurosurgery (SINch). World Neurosurg X 2023; 20:100233. [PMID: 37456685 PMCID: PMC10289824 DOI: 10.1016/j.wnsx.2023.100233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/14/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Background The COVID-19 pandemic and its impact on hospitals' activity and organization has imposed a vast change in standard neurosurgical oncology practice to accommodate for shifting resources. Aims This investigation aims to analyse the nationwide capability in reorganizing the surgical neuro-oncological activity during the COVID-19 pandemic to evaluate whether COVID-19-pandemic influenced the surgical management in these patients. Method A web-based dataset model organized by the Italian Neurosurgical Society (SINCh) was sent to all the Italian neurosurgical departments in May 2021, requesting to report the types and numbers of surgical procedures performed in the pre-pandemic period (from March 9th 2019 to March 9th 2020) compared to the pandemic period (from March 10th 2020 to March 10th 2021). Results This multicentre investigation included the surgical activity of 35 Italian Neurosurgical Departments in a pre-pandemic year versus a pandemic year. During the COVID period, 699 fewer neuro-oncological patients were operated on than in the pre-COVID period. We noted a slight increase in urgency and a more severe decrease in elective and benign pathology. None of these differences was statistically significant. Surgically treated patients who tested positive for SARS-CoV-2 were 36, of which 11 died. Death was found to be COVID-related only in 2 cases. Conclusion The reorganization of the Italian Neurosurgical Departments was able to guarantee a redistribution of the CNS tumors during the inter-pandemic periods, demonstrating that patients even in the pandemic era could be treated without compromising the efficacy and safety of the surgical procedure.
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Affiliation(s)
- Luca Zanin
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Tamara Ius
- Neurosurgery Unit, Department of Neurosciences, Santa Maria Della Misericordia University Hospital, Udine, Italy
| | - Pier Paolo Panciani
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Felice Esposito
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Marco Maria Fontanella
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Maria Pia Tropeano
- Neurosurgical Department-Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Mi, Italy
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Antonino Raco
- Division of Neurosurgery, AOU Sant’Andrea, Department of NESMOS, Sapienza University, Rome, Italy
| | | | - Giovanni Sabatino
- Institute of Neurosurgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy
- Division of Neurosurgery, Mater Olbia Hospital, Olbia, Italy
| | - Alessandro Olivi
- Institute of Neurosurgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy
| | - Vincenzo Esposito
- Department of Neurosurgery "Giampaolo Cantore"-IRCSS Neuromed, Pozzilli, Italy
- Department of Human Neurosciences-"Sapienza" University of Rome, Italy
| | - Federico Pessina
- Neurosurgical Department-Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Mi, Italy
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
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Crawford AM, Lightsey Iv HM, Xiong GX, Ye J, Call CM, Pomer A, Cooper Z, Simpson AK, Koehlmoos TP, Weissman JS, Schoenfeld AJ. Changes in Elective and Urgent Surgery Among TRICARE Beneficiaries During the COVID-19 Pandemic. Mil Med 2023; 188:e2397-e2404. [PMID: 36519498 DOI: 10.1093/milmed/usac391] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND COVID-19 is known to have altered the capacity to perform surgical procedures in numerous health care settings. The impact of this change within the direct and private-sector settings of the Military Health System has not been effectively explored, particularly as it pertains to disparities in surgical access and shifting of services between sectors. We sought to characterize how the COVID-19 pandemic influenced access to care for surgical procedures within the direct and private-sector settings of the Military Health System. METHODS We retrospectively evaluated claims for patients receiving urgent and elective surgical procedures in March-September 2017, 2019, and 2020. The pre-COVID period consisted of 2017 and 2019 and was compared to 2020. We adjusted for sociodemographic characteristics, medical comorbidities, and region of care using multivariable Poisson regression. Subanalyses considered the impact of race and sponsor rank as a proxy for socioeconomic status. RESULTS During the period of the COVID-19 pandemic, there was no significant difference in the adjusted rate of urgent surgical procedures in direct (risk ratio, 1.00; 95% CI, 0.97-1.03) or private-sector (risk ratio, 0.99; 95% CI, 0.97-1.02) care. This was also true for elective surgeries in both settings. No significant disparities were identified in any of the racial subgroups or proxies for socioeconomic status we considered in direct or private-sector care. CONCLUSIONS We found a similar performance of elective and urgent surgeries in both the private sector and direct care during the first 6 months of the COVID-19 pandemic. Importantly, no racial disparities were identified in either care setting.
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Affiliation(s)
- Alexander M Crawford
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Harry M Lightsey Iv
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Grace X Xiong
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jamie Ye
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | | | - Alysa Pomer
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Zara Cooper
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Andrew K Simpson
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Tracey P Koehlmoos
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Joel S Weissman
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Andrew J Schoenfeld
- Center for Surgery and Public Health, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Stojičić M, Jurišić M, Marinković M, Jovanović M, Igić A, Nikolić Živanović M. Necrotizing Skin and Soft Tissue Infection after Gluteal Augmentation in a Perioperatively Asymptomatic COVID-19 Patient-Complications of the Post-Lockdown Era? A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050914. [PMID: 37241146 DOI: 10.3390/medicina59050914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/10/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Introduction: Aesthetic surgery procedures are generally done in a relatively healthy population and carry a rather low risk compared to other surgical specialties. The incidence of complications in aesthetic surgery varies greatly depending on the type, wound cleanliness regarding the anatomical site, complexity of the surgery, patient's age, and comorbidities but is generally considered low. The overall incidence of surgical site infections (SSIs) in all aesthetic surgical procedures is around 1% in most of the literature while cases of necrotizing soft tissue infections are mostly found as individual reports. In contrast, treating COVID-19 patients is still challenging with many diverse outcomes. Surgical stress and general anesthesia are known mediators of cellular immunity impairment while studies regarding COVID-19 infection unquestionably have shown the deterioration of adaptive immunity by SARS-CoV-2. Adding COVID-19 to the modern surgical equation raises the question of immunocompetence in surgical patients. The main question of the modern post-lockdown world is: what could be expected in the postoperative period of perioperatively asymptomatic COVID-19 patients after aesthetic surgery? Case report: Here, we present a purulent, complicated, necrotizing skin and soft tissue infection (NSTI) after gluteal augmentation most likely triggered by SARS-CoV-2-induced immunosuppression followed by progressive COVID-19 pneumonia in an otherwise healthy, young patient. To the best of our knowledge, this is the first report of such adverse events in aesthetic surgery related to COVID-19. Conclusion: Aesthetic surgery in patients during the incubation period of COVID-19 or in asymptomatic patients could pose a significant risk for surgical complications, including severe systemic infections and implant loss as well as severe pulmonary and other COVID-19-associated complications.
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Affiliation(s)
- Milan Stojičić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milana Jurišić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milana Marinković
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milan Jovanović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleksa Igić
- Center for Radiology and Magnetic Resonance Imaging, Department of Interventional Radiology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Maja Nikolić Živanović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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Albuainain A, Alkharashi M. Preoperative universal screening of coronavirus disease 2019 during Omicron outbreak in patients undergoing ophthalmic surgeries: Experience from a tertiary eye care center in Saudi Arabia. Saudi J Ophthalmol 2023; 37:131-136. [PMID: 37492210 PMCID: PMC10365250 DOI: 10.4103/sjopt.sjopt_94_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/22/2022] [Accepted: 07/31/2022] [Indexed: 07/27/2023] Open
Abstract
PURPOSE This study aims to determine the frequency of coronavirus disease 2019 (COVID-19) during Omicron outbreak among patients scheduled for elective and emergency ophthalmic surgeries in a tertiary eye care center in Saudi Arabia. METHODS This observational retrospective study was performed between December 1, 2021, and February 28, 2022, in a single tertiary eye care center in Riyadh, Saudi Arabia. All patients who were given appointments for elective or emergency surgeries were included. All patients underwent preoperative nasopharyngeal and oropharyngeal reverse transcription-polymerase chain reaction testing for the severe acute respiratory syndrome coronavirus 2. A retrospective chart review of all patients who tested positive for COVID-19 during Omicron outbreak was performed for the demographic and clinical information, presence of symptoms upon presentation, nature and urgency of the scheduled surgical intervention, and the overall outcomes. RESULTS A total of 851 patients were scheduled for elective and emergency ophthalmic surgeries during the study period. The mean age of all patients was 58.2 years; 451 were males (52.9%) and 400 were females (47%). Of 851 patients tested for the COVID-19 during Omicron outbreak, the test was positive in 65 (7.6%) patients. All patients who tested positive for the COVID-19 during Omicron outbreak were asymptomatic at the time of swabbing. No patient-related perioperative complications or health-care workers' affection secondary to exposure to positive cases was documented. CONCLUSION The study showed that almost 1 in 13 patients scheduled for elective or emergency ophthalmic surgeries may test positive for the COVID-19 during Omicron outbreak. All positive cases were asymptomatic at the time of swabbing, highlighting the importance of routine preoperative screening for COVID-19.
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Affiliation(s)
- Abdulrahman Albuainain
- Eye and Laser Center, Bahrain Defence Force Hospital, Royal Medical Services, Military Hospital, Riffa, Bahrain
| | - Majed Alkharashi
- Department of Ophthalmology, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
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Al Abyad OS, Annan B, Melhem A, Chahine EM, Ramly EP, Vyas RM, Hamdan US. Application of Safety Protocols for International Cleft Outreach Programs During the COVID-19 Pandemic: Global Smile Foundation Precaution Guidelines and Implications. Cleft Palate Craniofac J 2023; 60:344-351. [PMID: 34919450 PMCID: PMC9902902 DOI: 10.1177/10556656211066435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Since COVID-19 was declared a worldwide pandemic by the World Health Organization (WHO) in March of 2020, foundation-based cleft outreach programs to Low- and Middle-Income Countries (LMICs) were halted considering global public health challenges, scarcity of capacity and resources, and travel restrictions. This led to an increase in the backlog of untreated patients with cleft lip and/or palate, with new challenges to providing comprehensive care in those regions. Resumption of international outreach programs requires an updated course of action to incorporate necessary safety measures in the face of the ongoing pandemic. In this manuscript, the authors outline safety protocols, guidelines, and recommendations implemented in Global Smile Foundation's (GSF) most recent outreach trip to Beirut, Lebanon. METHODS COVID-19 safety protocols for outreach cleft care and an Action Response Plan were developed by the GSF team based on the published literature and recommendations from leading international organizations. RESULTS GSF conducted a 1-week surgical outreach program in Beirut, Lebanon, performing 13 primary cleft lip repairs, 7 cleft palate repairs, and 1 alveolar bone grafting procedure. Safety protocols were implemented at all stages of the outreach program, including patient preselection and education, hospital admission and screening, intraoperative care, and postoperative monitoring and follow-up. CONCLUSIONS Organizing outreach programs in the setting of infectious diseases outbreaks should prioritize the safety and welfare of patients and team members within the program's local community. The COVID-19 protocols and guidelines described may represent a reproducible framework for planning future similar outreach initiatives in high-risk conditions.
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Affiliation(s)
| | | | | | | | - Elie P Ramly
- 6684Oregon Health & Science University, Portland, OR, USA
| | - Raj M Vyas
- 8788University of California Irvine, Irvine, CA, USA
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Leite IB, Moterani NJW, Moterani VC, Moterani LBBG, dos Reis FJC. A propensity score-matched retrospective cohort study of hysterectomies for benign disease during the COVID-19 pandemic. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:458-462. [PMID: 36820776 PMCID: PMC10004295 DOI: 10.1590/1806-9282.20221564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/15/2022] [Indexed: 02/22/2023]
Abstract
OBJECTIVE This study aimed to evaluate how the pandemic might have affected the number of elective and urgent hysterectomies for benign gynecological pathologies in a single-care tertiary center in the State of São Paulo, Brazil, and to identify if there were any changes in the need for blood transfusions. METHODS This is a single-center retrospective cohort study. It involved all non-puerperal and non-oncological hysterectomies from October 2018 to July 2021. Patients were divided into two groups, namely, the pandemic group (46 patients) and the control group (92 patients). Data were collected by reviewing the physical and electronic patient records. We carried out the statistical analysis using the RStudio software. RESULTS The number of planned hysterectomies was 82 in the pre-pandemic group and 23 in the analysis group, representing a 71.9% decrease. When considering only urgent surgeries, 10 of them happened in the pre-pandemic group, while 23 occurred in the pandemic group, representing an increase of 130%. CONCLUSION Elective hysterectomies may improve the quality of life of women, reducing abnormal bleeding and pelvic pain. Treatment delay can worsen patients' physiological and biological conditions, such as lower labor production, humor, and social aspects, increasing costs to the healthcare system.
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Affiliation(s)
| | - Nino Jose Wilson Moterani
- Faculdade de Medicina de Marília, Department of Gynecology and Obstetrics – Marília (SP), Brazil
- Universidade de São Paulo, Ribeirão Preto Medical School, Department of Gynecology and Obstetrics – Ribeirão Preto (SP), Brazil
| | - Vinicius Cesar Moterani
- Faculdade de Medicina de Marília, Department of Gynecology and Obstetrics – Marília (SP), Brazil
| | | | - Francisco José Candido dos Reis
- Universidade de São Paulo, Ribeirão Preto Medical School, Department of Gynecology and Obstetrics – Ribeirão Preto (SP), Brazil
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10
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An Investigation for Future Practice of Elective Hip and Knee Arthroplasties during COVID-19 in Romania. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020314. [PMID: 36837514 PMCID: PMC9961101 DOI: 10.3390/medicina59020314] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
Background and Objectives: Elective arthroplasty in Romania has been severely affected by the COVID-19 pandemic, and its effects are not quantified so far. The aim of this paper is to determine the impact of COVID-19 on arthroplasty interventions and how they varied in Romania. Materials and Methods: We performed a national retrospective analysis of patients who underwent primary and revision elective hip and knee interventions at the 120 orthopedic-traumatology hospitals in Romania that are registered in the National Endoprosthesis Registry from 1 January 2019 to 1 September 2022. First, we examined the monthly trend in the number of surgeries for seven categories of arthroplasties. We calculated the percentage change in the average number of cases per month and compared them with other types of interventions. We then examined the percentage change in the average monthly number of arthroplasty cases, relative to the number of COVID-19 cases reported nationwide, the influence of the pandemic on length of hospital stay, and the percentage of patients discharged at home who no longer follow recovery protocols. Finally, we calculated the impact of the pandemic on hospital revenues. Results: There was an abrupt decrease in the volume of primary interventions in hip and knee patients by up to 69.14% with a low degree of patient care, while the average duration of scheduled hospitalizations increased. We found a 1-2-day decrease in length of hospital stays for explored arthroplasties. We saw an increasing trend of home discharge, which was higher for primary interventions compared to revision interventions. The total hospital revenues were 50.96% lower in 2020 compared to 2019, and are currently increasing, with the 2022 estimate being 81.46%. Conclusions: The conclusion of this study is that the COVID-19 pandemic severely affected the volume of arthroplasty of the 120 hospitals in Romania, which also had unfavorable financial implications. We proposed the development of new procedures and alternative clinical solutions, as well as personalized home recovery programs, to be activated if necessary, for possible future outbreaks.
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11
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Qiao Z, Deng Y, Wang X, Sun Y, Xiong X, Meng X, Li W, Yi Z, Li X, Fang B. The impact of COVID-19 on plastic and reconstructive surgery in China: A single-centre retrospective study. J Plast Reconstr Aesthet Surg 2023; 76:160-168. [PMID: 36516508 PMCID: PMC9576908 DOI: 10.1016/j.bjps.2022.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/25/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study aimed to investigate the volume of plastic surgery operations in a large public hospital and figure out the changes in the related factors associated with Coronavirus Disease 2019 (COVID-19) and identify the potential problems. METHODS We created a survey and collected clinical data from 1 January 2018 to 31 December 2020. Information on procedure time, patient gender, patient age, and procedure type was collected from the database. The data were analysed using IBM SPSS Statistics for Windows, version 25.0. RESULTS A total of 10,827 patients were admitted to our department. The total number of patients decreased by 21.53% in 2020 (3057 cases) than the same period in 2019 (3896 cases). The total number of aesthetic procedures decreased by 34.17% in 2020 than that in 2019. However, restorative procedures in 2020 (2013 cases) only decreased by 12.86% than that in 2019 (2310 cases). The percentages of women amongst patients who underwent aesthetic procedures were 91.75%, 92.18%, and 90.71% in 2018, 2019, and 2020, respectively. Most of the patients in these three years were aged 20-29 years. CONCLUSIONS The plastic surgery industry is experiencing the effects of the unprecedented COVID-19 pandemic worldwide. COVID-19 was quickly brought under control, and the plastic surgery industry developed rapidly in China because of the active, timely, and accurate implementation of epidemic prevention strategies.
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Affiliation(s)
- Zhihua Qiao
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Yiwen Deng
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiancheng Wang
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China.
| | - Yang Sun
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiang Xiong
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Xianxi Meng
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbo Li
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhongjie Yi
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaofang Li
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Borong Fang
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University, Changsha, China
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12
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Beleva N. Change in hospital admissions in dental diseases before and during the COVID-19 pandemic. APPLIED NANOSCIENCE 2023; 13:2179-2185. [PMID: 35155059 PMCID: PMC8820364 DOI: 10.1007/s13204-021-02106-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022]
Abstract
In this retrospective cross-sectional study, it was aimed to evaluate the negative effects of the pandemic process in the field of oral health by revealing the characteristics of applications made to a hospital related to oral health before and during the pandemic. Patient records who applied to Cyprus Science University Dentistry Hospital between October 2019 and March 2021 were included in the study. Gender, age, applied unit, applying frequency and procedure records were evaluated. Ethical approval was taken from Cyprus Science University. Patient records were divided into two groups as before pandemic (n = 338) and during pandemic (n = 1517). Results of the study showed that gender, age and applied unit distributions were not significantly different between before and during pandemic (p > 0.05). Female and prosthesis applied patients were more common before and after COVID-19 pandemic. Detertrage, tooth extraction, night plaque, temporary cron, metal supported porcelain crown on implant, compomer filler and orthodontic diagnosis rates were decreased during pandemic, compared to before pandemic. Panaromic X-ray was the most common process before and during the pandemic. The differences between before and during pandemic were statistically significant (p < 0.05). The results of the research show that the pandemic process in terms of oral health caused significant differences in the reasons for application, even in the population aged 34-36, the majority of whom are women.
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Affiliation(s)
- Nadejda Beleva
- Health and Social Sciences, University of Cyprus, Nicosia, Cyprus
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13
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Yin F, Feng Z. The Effect of COVID-19 Safety Protocols on Hospital Workers' Mental Health: A Moderated-Mediation Model of COVID-19 Anxiety and Psychological Resilience. Behav Sci (Basel) 2022; 12:bs12120477. [PMID: 36546960 PMCID: PMC9774179 DOI: 10.3390/bs12120477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
Social distancing measures can create psychological issues, especially among hospital staff who constantly deal with emergency patients. To explore the mediating role of COVID-19 anxiety on the association between COVID-19 safety protocols and mental health, and to test the moderating role of resilience between COVID-19 safety protocols and COVID-19 anxiety, this work collected data on hospital staff in terms of COVID-19 safety protocols, psychological resilience, COVID-19 anxiety, and improving staff mental health. The effects of the use of COVID-19 safety protocols on COVID-19 anxiety and the mental health of hospital workers in China were also analyzed. The experimental results showed that resilience remarkably moderated COVID-19 safety protocols and COVID-19 anxiety among Chinese hospital staff.
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14
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Aryanian Z, Ehsani A, Razavi Z, Hamzelou S, Mohseni Afshar Z, Hatami P. The COVID-19 pandemic and its impact on esthetic dermatology. J Cosmet Dermatol 2022; 21:6557-6561. [PMID: 36106524 PMCID: PMC9538429 DOI: 10.1111/jocd.15386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023]
Abstract
In general, the world population interest has increased for maintaining youthfulness and having better appearance since this leads to a better mental wellbeing and self-estimate. The coronavirus disease 2019 (COVID-19) pandemic has revolutionized every field of medicine. As every specialty has been affected by limitations caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this branch of medicine has also needed certain precautions for safer practice in the COVID era. With the global vaccination program against COVID-19, reports of some cutaneous reactions in patients have been undergone various esthetic procedures including filler or botox injection would be increasingly demonstrated. Although the end of pandemic was announced, the necessity of continuing COVID vaccination in future mandates gathering data regarding safety of vaccines. Herein, we presented a comprehensive review on various aspects of association between esthetic medicine or cosmetic dermatology and COVID-19.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Amirhooshang Ehsani
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zahra Razavi
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Shahin Hamzelou
- Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran
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15
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Martins MS, Lourenção DCDA, Pimentel RRDS, de Oliveira JM, Manganoti LTDCN, Modesto RC, Silva MSDS, Dos Santos MJ. Recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic: a scoping review. BMJ Open 2022; 12:e060182. [PMID: 36123068 PMCID: PMC9485646 DOI: 10.1136/bmjopen-2021-060182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To map the recommendations for hospitalised patient safety in the context of the COVID-19 pandemic. DESIGN Scoping review using the method recommended by the Joanna Briggs Institute. DATA SOURCES Databases: Medline, SCOPUS, EMBASE, ScienceDirect, LILACS, CINAHL and IBECS; grey literature platform: Google Scholar; and 11 official websites of leading healthcare institutions were searched on 27 April 2021 and updated on 11 April 2022. ELIGIBILITY CRITERIA We included documents that present recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic, published in any language, from 2020 onwards. DATA EXTRACTION AND SYNTHESIS Data extraction was performed in pairs with consensus rounds. A descriptive analysis was carried out to present the main characteristics of the articles. Qualitative data from the extraction of recommendations were analysed through content analysis. RESULTS One hundred and twenty-five documents were included. Most papers were identified as expert consensus (n=56, 44.8%). Forty-six recommendations were identified for the safety of hospitalised patients: 17 relating to the reorganisation of health services related to the flow of patients, the management of human and material resources and the reorganisation of the hospital environment; 11 on the approach to the airways and the prevention of the spread of aerosols; 11 related to sanitary and hygiene issues; 4 about proper use of personal protective equipment and 3 for effective communication. CONCLUSIONS The recommendations mapped in this scoping review present the best practices produced so far and serve as a basis for planning and implementing good practices to ensure safe hospital care, during and after COVID-19. The engagement of everyone involved in the care of hospitalised patients is essential to consolidate the mapped recommendations and provide dignified, safe and quality care.
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Affiliation(s)
| | | | | | - Janine Melo de Oliveira
- Escola de Enfermagem, Universidade Federal de Alagoas, Maceio, Brazil
- Curso de Enfermagem, Universidade Estadual de Ciências da Saúde de Alagoas, Maceio, Brazil
| | | | | | | | - Marcelo José Dos Santos
- Career Guidance Department, Universidade de São Paulo Escola de Enfermagem, Sao Paulo, Brazil
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16
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Yoon JS, Khoo KH, Akhavan AA, Lagziel T, Ha M, Cox CA, Blanding R, Werthman EH, Caffrey J, Hultman CS. Changes in Burn Surgery Operative Volume and Metrics due to COVID-19. J Burn Care Res 2022; 43:1233-1240. [PMID: 35986489 PMCID: PMC9384663 DOI: 10.1093/jbcr/irac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Due to COVID-19, hospitals underwent drastic changes to operating room policy to mitigate the spread of the disease. Given these unprecedented measures, we aimed to look at the changes in operative volume and metrics of the burn surgery service at our institution. A retrospective review was conducted for operative cases and metrics for the months of March to May for 2019, 2020, and 2021, which correspond with pre-COVID, early COVID (period without elective cases), and late COVID (period with resumed elective cases). Inclusion criteria were cases related to burns. Case types and operative metrics were compared amongst the three time periods. Compared to the hospital, the burn service had a smaller decrease in volume during early COVID (28.7% vs. 50.1%) and exceeded pre-pandemic volumes during late COVID (+21.8% vs. -4.6%). There was a significant increase in excision and grafting cases in early and late COVID periods (p < .0001 and p < .002). There was a significant decrease in laser scar procedures that persisted even during late COVID (p < .0001). The projected and actual lengths of cases significantly increased and persisted into late COVID (p < .01). COVID-19 related operating room closures led to an expected decrease in the number of operative cases. However, there was no significant decline in the number of burn specific cases. The elective cases were largely replaced with excision and grafting cases and this shift has persisted even after elective cases have resumed. This change is also reflected in increased operative times.
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Affiliation(s)
- Joshua S Yoon
- Division of Plastic, Reconstructive & Maxillofacial Surgery, R Adams Cowley Shock Trauma Center , Baltimore, MD USA
- Department of Surgery, George Washington University Hospital , Washington, DC USA
| | - Kimberly H Khoo
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
| | - Arya A Akhavan
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - Tomer Lagziel
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
| | - Michael Ha
- Division of Plastic Surgery, University of Maryland School of Medicine , Baltimore, MD USA
| | - Carrie A Cox
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - Renee Blanding
- Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - Emily H Werthman
- Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing , Baltimore, MD USA
| | - Julie Caffrey
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - C Scott Hultman
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
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17
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Al-Essa RS, Alkharashi MS. Preoperative universal screening for COVID-19 in patients undergoing ophthalmic surgeries: Experience from a tertiary eye care center in Saudi Arabia. Saudi J Ophthalmol 2022; 35:316-319. [PMID: 35814999 PMCID: PMC9266476 DOI: 10.4103/sjopt.sjopt_8_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to determine the frequency of coronavirus disease-2019 (COVID-19) among patients scheduled for elective and emergency ophthalmic surgeries in a tertiary eye care center in Saudi Arabia. METHODS This observational retrospective study was performed between June 1, 2020, and October 31, 2020, in a single tertiary eye care center in Riyadh, Saudi Arabia. All patients who were given appointments for elective or emergency surgeries were included in the study. All patients underwent preoperative nasopharyngeal and oropharyngeal reverse transcription-polymerase chain reaction testing for severe acute respiratory syndrome coronavirus-2 virus. Retrospective chart review of all patients who tested positive for COVID-19 was performed for the demographic and clinical information; presence of symptoms upon presentation, nature, and urgency of the scheduled surgical intervention; and the overall outcomes. RESULTS A total of 727 patients were scheduled for elective or emergency ophthalmic surgeries during the study period. The mean age of all patients was 61.3 years, 407 were males (55.9%) and 320 were females (44.1%). Of 727 patients tested for COVID-19, the test was positive in 17 (2.3%) patients. All patients who tested positive for COVID-19 were asymptomatic at the time of swabbing. No patient-related perioperative complications or health-care workers' affection secondary to exposure to positive cases were documented. CONCLUSION The study showed that almost 1 in 43 patients scheduled for elective or emergency ophthalmic surgeries may be positive for COVID-19. All positive cases were asymptomatic at the time of swabbing, underscoring the importance of the routine preoperative screening for COVID-19.
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Affiliation(s)
- Rakan S. Al-Essa
- Department of Ophthalmology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia,Address for correspondence: Dr. Rakan S. Al-Essa, Department of Ophthalmology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia. E-mail:
| | - Majed S. Alkharashi
- Department of Ophthalmology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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18
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Zhussupov B, Suleimenova Z, Amanova G, Saliev T, Tanabayeva S, Sarybayeva G, Iskakova G, Fakhradiyev I, Aukenov N. The Study of the Outbreak of Coronavirus Infection in a General Hospital in Almaty. Hosp Top 2022; 101:326-335. [PMID: 35435796 DOI: 10.1080/00185868.2022.2063774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The study aimed to identify the possible causes of COVID-19 outbreak and its development in a general hospital in Almaty (from April 11 to May 6, 2020), where 682 persons were identified with a COVID-19. 546 were hospital employees (48.9%), including doctors (57.8%), nurses (53.4%), junior medical personnel (54.4%) and other personnel (23.3%), and also among 136 patients. The attack rate among women was 50.0%, and incidence rate was higher amongst young employees < 30 years old (57.0%). The analysis showed that there was a failure of the management of the medical personnel in such critical situation.
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Affiliation(s)
- Baurzhan Zhussupov
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Zhanar Suleimenova
- National Scientific and Practical Centre for Sanitary and Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Gulzhan Amanova
- National Scientific and Practical Centre for Sanitary and Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Timur Saliev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Shynar Tanabayeva
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | - Ildar Fakhradiyev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Nurlan Aukenov
- Ministry of Healthcare of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
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19
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Joji N, Patel N, Nugent N, Patel N, Mair M, Vadodaria S, Waterhouse N, Ramakrishnan V, Sankar TK. Aesthetic Surgery Practice Resumption in the United Kingdom During the COVID-19 Pandemic. Aesthet Surg J 2022; 42:435-443. [PMID: 34633039 PMCID: PMC8549290 DOI: 10.1093/asj/sjab364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The global COVID-19 pandemic has significantly impacted all aspects of healthcare, including the delivery of elective aesthetic surgery practice. We carried out a national, prospective data collection of the first aesthetic plastic surgery procedures carried out during the COVID-19 pandemic in the United Kingdom. Objectives Our aim was to explore the challenges aesthetic practice is facing and to identify if any problems or complications arose from carrying out aesthetic procedures during the COVID-19 pandemic. Methods Over a 6-week period from June 15 th-August 2 nd, 2020, data was collected using a proforma for aesthetic plastic surgery cases. All patients had outcomes recorded for the audit period of 14 days post-surgery. Results Our results demonstrated that none of the 371 patients audited whom underwent aesthetic surgical procedures developed any symptoms of COVID-19-related illness and none required treatment for any subsequent respiratory illness. Conclusions We found no COVID-19–related cases or complications in a cohort of patients who underwent elective aesthetic procedures under strict screening and infection control protocols in the early resumption of elective service.
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Affiliation(s)
| | - Nakul Patel
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | | | - Manish Mair
- University Hospitals of Leicester NHS Trust, Leicester, UK
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20
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Bhaskaran D, Chandran A, T.M SR. Plastic Surgery Practice during COVID Times. Indian J Plast Surg 2022; 55:54-57. [PMID: 35444754 PMCID: PMC9015828 DOI: 10.1055/s-0041-1740079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction
COVID-19 has affected plastic surgeons like never before. We conducted an all-India survey to find how the practice was affected among public/private sector, reconstructive/aesthetic practice, and consultants/residents. We have proposed some solutions to the identified problems, which are supported by previous literature.
Methods
A survey framed in Google forms was circulated through WhatsApp and emails in August 2020. Closed and semiopen questions regarding changes in personal and professional lives, coping strategies adopted, and open questions for suggestions in improving practice, academics and measures to tackle the pandemic were included. Responses were collected in an Excel sheet and analysis done using SPSS software.
Results
A total of 220 consented responses were obtained. Public hospital practitioners had to bear the COVID-related administrative as well as executive works, especially residents, which led to anxiety, family concern, burnout, and concern about the loss of skills and academics. Patient interaction was also reduced. Aesthetic surgeons bore more financial loss.
Conclusions
Plastic surgeons in India faced decrease in caseload, financial loss, COVID-related duties, workload for residents, reduced academics, family and mental health problems, difficulty with personal protection equipment (PPE) during surgeries, and queries from patients. These can be solved by doing cases within the limits of protocols and safety, pooling public and private sector for COVID duties, rotating residents' groups to reduce workload, using telemedicine for academics and patient consultations, and providing social support groups to surgeons.
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Affiliation(s)
- Deepak Bhaskaran
- Department of Plastic and Reconstructive Surgery, Government Medical College, Kozhikode, Kerala, India
| | - Aswathy Chandran
- Department of Plastic and Reconstructive Surgery, Government Medical College, Kozhikode, Kerala, India
| | - Sheeja Rajan T.M
- Department of Plastic and Reconstructive Surgery, Government Medical College, Kozhikode, Kerala, India
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21
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Fiala T, Fernau J, Singer R. Evaluation of the Post-COVID Patient Prior to Elective Plastic Surgery: Developing an Evidence-Based Framework. Aesthet Surg J 2022; 42:314-324. [PMID: 34516612 PMCID: PMC8499962 DOI: 10.1093/asj/sjab340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Preoperative assessment of a potential surgical patient has long been a cornerstone of patient safety. As more patients get, and recover from, COVID-19, plastic surgeons will be faced with the challenge of evaluating the health status and operative risk of convalescent COVID patients who now desire elective surgery. A significant fraction of these patients, however, can have new or persistent health issues as a result of COVID-19, which can affect surgical safety. This paper briefly examines the current relevant literature regarding the post-COVID patient, reviews the waiting period for adequate recovery, and suggests an evidence-based framework for preoperative assessment, based on the severity of the prior COVID-19 episode, ongoing symptoms, and basic screening tests.
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Affiliation(s)
- Thomas Fiala
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - James Fernau
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Robert Singer
- The University of California, San Diego, San Diego, CA, USA
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22
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The Effect of the COVID-19 Pandemic on Patient Selection, Surgical Procedures, and Postoperative Complications in a Specialized Dental Implant Clinic. J Clin Med 2022; 11:jcm11030855. [PMID: 35160306 PMCID: PMC8837166 DOI: 10.3390/jcm11030855] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 11/27/2022] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, aerosol-generating procedures, including dental implant treatments, are considered high-risk. With dental implant treatment mostly an elective procedure, we aimed to assess whether the pandemic influenced patient selection, surgical procedures, and postoperative complications. We compared dental implant treatments during (March to December 2020) and before (December 2018 to February 2020) the COVID-19 pandemic based on patient and implant parameters, as well as postoperative complications. For analysis, we used the Chi-squared test with the Holm–Sidak correction for multiple comparisons. The number of implants placed during the COVID-19 pandemic (696 implants in 406 patients, 70 implants per month) was comparable to pre-pandemic levels (1204 implants in 616 patients, 80 implants per month). Regarding patient parameters, there were no significant differences in respiratory (p = 0.69) and cardiovascular conditions (p = 0.06), diabetes (p = 0.69), and smoking (p = 0.68). Regarding implant parameters, there was a significant difference in the distribution of augmentative procedures (no augmentation, guided bone regeneration, and sinus floor elevation, p = 0.01), but no significant differences in the types of edentulous spaces (p = 0.19) and the timing of implant placement (p = 0.52). Regarding complications, there were significantly fewer minor complications (p < 0.001) and early (i.e., before loading) implant failures (p = 0.02) compared with pre-pandemic levels. Our results suggest that the COVID-19 pandemic had no effect on patient selection and only a slight effect on the surgical procedures. However, postoperative complications, including early failures, were significantly less prevalent during the pandemic.
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23
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Neufeld MY, Jang H, Caron E, Golz R, Brahmbhatt TS, Sanchez SE. Social Vulnerability and COVID-19: Changes in Trauma Activations at a Safety-Net Hospital. J Surg Res 2022; 276:100-109. [PMID: 35339778 PMCID: PMC8860669 DOI: 10.1016/j.jss.2022.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/05/2022] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Abstract
Introduction Following the declaration of the COVID-19 pandemic, there were reports of decreased trauma hospitalizations, although violent crime persisted. COVID-19 has had the greatest impact on minoritized and vulnerable communities. Decreases in traumatic events may not extend to these communities, given pandemic-related socioeconomic and psychological burdens that increase the risk of exposure to trauma and violence. Materials and methods This was a retrospective cohort study (n = 1634) of all trauma activations presenting to our institution January 1, 2020 to May 31, 2020, and same time periods in 2018 and 2019. Census tracts and associated Social Vulnerability Index quartiles were determined from patient addresses. Changes in trauma activations pre and post Massachusetts’ state-of-emergency declaration compared to a historical control were analyzed using a difference-in-differences methodology. Results Weekly all-cause trauma activations fell from 26.44 to 8.25 (rate ratio = 0.36 [0.26, 0.50]) postdeclaration, with significant difference-in-differences compared to a historical control (P < 0.0001). Nonviolent trauma activations significantly decreased from 21.11 to 5.17 after the declaration (rate ratio = 0.27 [0.37, 0.91]; P < 0.0001), whereas there was no significant decrease in violent injury (5.33 to 3.08 rate ratio = 0.69 [0.39, 1.22]; P = 0.20). Stratified by vulnerability, the most vulnerable quartile had an increased proportion of all-cause trauma postdeclaration and had no decrease in violent trauma activations following the declaration compared to the historical control (rate ratio = 0.84 [0.38-1.86]; P = 0.67). Conclusions The state-of-emergency declaration was associated with significant decreases in overall trauma, to a greater extent in nonviolent injuries. Among those living in the most socially vulnerable communities, there was no decrease in violent trauma. These findings highlight the need for violence and injury prevention programs in vulnerable communities, particularly in times of crisis.
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Affiliation(s)
- Miriam Y Neufeld
- Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston, Massachusetts.
| | - Hyerim Jang
- Boston University School of Medicine, Boston, Massachusetts
| | - Elisa Caron
- Boston University School of Medicine, Boston, Massachusetts
| | - Reece Golz
- Department of Surgery, Boston Medical Center, Boston, Massachusetts
| | - Tejal S Brahmbhatt
- Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston, Massachusetts
| | - Sabrina E Sanchez
- Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston, Massachusetts
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Evolving perceptions regarding receiving orthopaedic care during the Coronavirus 2019 (COVID-19) pandemic. CURRENT ORTHOPAEDIC PRACTICE 2022; 33:141-146. [PMID: 35222788 PMCID: PMC8862675 DOI: 10.1097/bco.0000000000001081] [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: 12/02/2022]
Abstract
As the Coronavirus 2019 (COVID-19) pandemic evolves, it is critical to understand how patients’ feelings and perceptions have changed. The aim of this study was to understand current feelings and concerns about seeking and receiving orthopaedic care 9 mo into the global pandemic.
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Jungwirth-Weinberger A, Boettner F, Kapadia M, Diane A, Chiu YF, Lyman S, Fontana MA, Miller AO. History of COVID-19 Was Not Associated with Length of Stay or In-Hospital Complications After Elective Lower Extremity Joint Replacement. Arthroplast Today 2021; 13:109-115. [PMID: 34909457 PMCID: PMC8660178 DOI: 10.1016/j.artd.2021.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/11/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022] Open
Abstract
Background The impact of previous SARS-CoV-2 infection on the morbidity of elective total joint arthroplasty (TJA) is not fully understood. This study reports on the association between previous COVID-19 disease, hospital length of stay (LOS), and in-hospital complications after elective primary TJA. Methods Demographics, comorbidities, LOS, and in-hospital complications of consecutive 340 patients with a history of COVID-19 were compared with those of 5014 patients without a history of COVID-19 undergoing TJA. History of COVID-19 was defined as a positive IgG antibody test for SARS-CoV-2 before surgery. All patients were given both antibody and polymerase chain reaction tests before surgery. Results Patients with a history of COVID-19 were more likely to be obese (43.8% vs 32.4%, P < .001), Black (15.6% vs 6.8%, P < .001), or Hispanic (8.5% vs 5.4%, P = .028) than patients without a history of COVID-19. COVID-19 treatment was reported by 6.8% of patients with a history of COVID-19. Patients with a history of COVID-19 did not have a significantly longer median LOS after controlling for other factors (for hip replacements, median 2.9 h longer, 95% confidence interval = −2.0 to 7.8, P = .240; for knee replacements, median 4.1 h longer, 95% confidence interval = −2.4 to 10.5, P = .214), but a higher percentage were discharged to a post–acute care facility (4.7% vs 1.9%, P = .001). There was no significant difference in in-hospital complication rates between the 2 groups (0/340 = 0.0% vs 22/5014 = 0.44%, P = .221). Conclusions We do not find differences in LOS or in-hospital complications between the 2 groups. However, more work is needed to confirm these findings, particularly for patients with a history of more severe COVID-19. Level of evidence II.
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Affiliation(s)
- Anna Jungwirth-Weinberger
- Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.,Cantonal Hospital Baden, Im Ergel 1, CH-5404 Baden, Switzerland
| | - Friedrich Boettner
- Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Milan Kapadia
- Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Alioune Diane
- Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Yu-Fen Chiu
- Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Stephen Lyman
- Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Mark Alan Fontana
- Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.,Weill Cornell Medical College, Department of Population Health Sciences, 1300 York Ave, New York, NY, 10065, USA
| | - Andy O Miller
- Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
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Palumbo P, Massimi F, Biondi A, Cirocchi R, De Luca GM, Giraudo G, Intini SG, Monzani R, Sozio G, Usai S. Recommendations for outpatient activity in COVID-19 pandemic. Open Med (Wars) 2021; 16:1696-1704. [PMID: 34805532 PMCID: PMC8578809 DOI: 10.1515/med-2021-0378] [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: 06/17/2021] [Revised: 08/23/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022] Open
Abstract
The spread of the COVID-19 disease substantially influenced the International Healthcare system, and the national governments worldwide had before long to decide how to manage the available resources, giving priority to the treatment of the COVID-infected patients. Then, in many countries, it was decided to limit the elective procedures to surgical oncology and emergency procedures. In fact, most of the routine, middle-low complexity surgical interventions were reduced, and the day surgery (DS) activities were almost totally interrupted. As a result of this approach, the waiting list of these patients has significantly increased. In the current phase, with a significant decrease in the incidence of COVID-19 cases, the surgical daily activity can be safely and effectively restarted. Adjustments are mandatory to resume the DS activity. The whole separation of pathways with respect to the long-stay and emergency surgery, an accurate preoperative protocol of patient management, with a proper selection and screening of all-day cases, careful scheduling of surgical organization in the operating room, and planning of the postoperative pathway are the goals for a feasible, safe, and effective resumption of DS activity.
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Affiliation(s)
- Piergaspare Palumbo
- Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Fanny Massimi
- Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Antonio Biondi
- Department of General Surgery and Surgical Specialities, University of Catania, Catania, Italy
| | - Roberto Cirocchi
- Deparment of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | | | - Giorgio Giraudo
- Department of Surgery, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | - Roberta Monzani
- Department of Anesthesia and Intensive Care, Humanitas Research Hospital, Rozzano (MI), Italy
| | - Giampaolo Sozio
- Department of General Surgery and Emergency, Alta Val D’Elsa Hospital, Poggibonsi (SI), Italy
| | - Sofia Usai
- Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
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Response to "cosmetic tourism amidst the Covid-19 global pandemic". J Plast Reconstr Aesthet Surg 2021; 75:893-939. [PMID: 34887221 PMCID: PMC8598252 DOI: 10.1016/j.bjps.2021.11.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/10/2021] [Indexed: 11/22/2022]
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28
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Adverse Events Following COVID-19 Vaccine in Patients Previously Injected with Facial Filler: Scoping Review and Case Report. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112210888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The “Vaccines and Related Biological Products Advisory Committee 17 December 2020 Meeting Briefing Document”, formulated by the FDA, reported three cases of swelling in areas previously injected with HA filler, introducing the possible relationship between a COVID-19 vaccine and adverse events in areas previously injected with HA fillers. The aim of this research is to report a case of an adverse event following a COVID-19 vaccine in a patient previously injected with facial filler. Furthermore, a scoping review on the same topic was performed. The research was carried out on the electronic databases PubMed, Cochrane Library, Web of Science, Google Scholar and Scopus. The selection process identified four articles as eligible for inclusion in the review. Nineteen patients, including the described case report, who experienced an adverse event following a COVID-19 vaccine in areas previously injected with facial filler were identified. Adverse events following a COVID-19 vaccine in patients previously injected with facial filler appear to be rare. A high BDDE cross-linking rate and/or a low-molecular-weight hyaluronic acid filler may have a higher tardive adverse event rate when triggered.
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29
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Reddy RS, Gautam AP, Tedla JS, Ferreira AS, Reis LFF, Bairapareddy KC, Kakaraparthi VN, Gular K. The Aftermath of the COVID-19 Crisis in Saudi Arabia: Respiratory Rehabilitation Recommendations by Physical Therapists. Healthcare (Basel) 2021; 9:1560. [PMID: 34828606 PMCID: PMC8619334 DOI: 10.3390/healthcare9111560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022] Open
Abstract
Since late 2019, the number of COVID-19 patients has gradually increased in certain regions as consecutive waves of infections hit countries. Whenever this wave hits the corresponding areas, the entire healthcare system must respond quickly to curb the diseases, morbidities, and mortalities in intensive care settings. The healthcare team involved in COVID-19 patients' care must work tirelessly without having breaks. Our understanding of COVID-19 is limited as new challenges emerge with new COVID-19 variants appearing in different world regions. Though medical therapies are finding solutions to deal with the disease, there are few recommendations for respiratory rehabilitation therapies. A group of respiratory rehabilitation care professionals in Saudi Arabia and international experts have agreed with the World Health bodies such as the World Health Organization (WHO) on the treatment and rehabilitation of patients with COVID-19. Professionals participating in COVID-19 patient treatment, rehabilitation, and recovery formulated respiratory rehabilitation guidelines based on the DELPHI Method, combining scientific research and personal practical experience. As a result, it is envisaged that the number of individuals in the region suffering from respiratory ailments due to post-COVID-19 will decrease. This narrative review and clinical expertise guidelines may give physiotherapists acceptable and standard clinical guideline protocols for treating COVID-19 patients.
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Affiliation(s)
- Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, King Khalid University, Abha 61413, Saudi Arabia; (R.S.R.); (J.S.T.); (V.N.K.); (K.G.)
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, King Khalid University, Abha 61413, Saudi Arabia; (R.S.R.); (J.S.T.); (V.N.K.); (K.G.)
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, King Khalid University, Abha 61413, Saudi Arabia; (R.S.R.); (J.S.T.); (V.N.K.); (K.G.)
| | - Arthur Sá Ferreira
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro 21032-060, Brazil; (A.S.F.); (L.F.F.R.)
| | - Luis Felipe Fonseca Reis
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro 21032-060, Brazil; (A.S.F.); (L.F.F.R.)
| | | | - Venkata Nagaraj Kakaraparthi
- Department of Medical Rehabilitation Sciences, King Khalid University, Abha 61413, Saudi Arabia; (R.S.R.); (J.S.T.); (V.N.K.); (K.G.)
| | - Kumar Gular
- Department of Medical Rehabilitation Sciences, King Khalid University, Abha 61413, Saudi Arabia; (R.S.R.); (J.S.T.); (V.N.K.); (K.G.)
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30
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Martin S, Khatib M, Reissis D, Srinivasan JR. Bridging the gap for aesthetic training amidst the Covid-19 pandemic. J Plast Reconstr Aesthet Surg 2021; 75:439-488. [PMID: 34774445 PMCID: PMC8801923 DOI: 10.1016/j.bjps.2021.09.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 04/26/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Serena Martin
- ST7 Plastic Surgery, Regional Plastic Surgery Unit, Ulster Hospital, Upper Newtownards Road, BT16 1RH, United Kingdom.
| | - Manaf Khatib
- ST7 Plastic Surgery, Regional Plastic Surgery Unit, Ulster Hospital, Upper Newtownards Road, BT16 1RH, United Kingdom
| | - Dimitris Reissis
- ST7 Plastic Surgery, Regional Plastic Surgery Unit, Ulster Hospital, Upper Newtownards Road, BT16 1RH, United Kingdom
| | - Jeyaram R Srinivasan
- ST7 Plastic Surgery, Regional Plastic Surgery Unit, Ulster Hospital, Upper Newtownards Road, BT16 1RH, United Kingdom
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31
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Brown M, Eardley S, Ahmad J, Lista F, Barr S, Mulholland S, Khanna J, Knapp C, Saheb-Al-Zamani M, Austin R, Levine R. The Safe Resumption of Elective Plastic Surgery in Accredited Ambulatory Surgery Facilities During the COVID-19 Pandemic. Aesthet Surg J 2021; 41:NP1427-NP1433. [PMID: 33367485 PMCID: PMC7799347 DOI: 10.1093/asj/sjaa311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background On March 11, 2020 the World Health Organization declared COVID-19 a worldwide pandemic resulting in an unprecedented shift in the Canadian health care system, where protection of an already overloaded health care system became a priority; all elective surgeries and non-essential activities were ceased. With the impact being less than predicted, on May 26, 2020, elective surgeries and non-essential activities were permitted to resume. Objectives To examine outcomes following elective aesthetic surgery and the impact on the Canadian health care system with the resumption of these services during the COVID-19 worldwide pandemic. Methods Data was collected in a prospective manner on consecutive patients undergoing elective plastic surgery procedures in six accredited ambulatory surgery facilities. Data included patient demographics, procedural characteristics, COVID-19 PCR test status, airway management and postoperative outcomes. Results 368 patients underwent elective surgical procedures requiring a general anesthetic. All 368 patients that underwent surgery were negative on pre visit screening. A COVID-19 PCR test was completed by 352 patients (95.7%) and all were negative. In the postoperative period, seven patients (1.9%) had complications, three patients (0.8%) required a hospital visit, and one patient (0.3%) required hospital admission. No patients or health care providers developed COVID-19 symptoms or had a positive test for COVID-19 within 30 days of surgery. Conclusions With appropriate screening and safety precautions, elective aesthetic plastic surgery can be performed in a manner that is safe for patients and health care providers and with a very low risk for accelerating virus transmission within the community.
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Affiliation(s)
- Mitchell Brown
- Department of Surgery, University of Toronto, Toronto, Canada
| | | | - Jamil Ahmad
- Department of Surgery, University of Toronto, Toronto, Canada
| | - Frank Lista
- Department of Surgery, University of Toronto, Toronto, Canada
| | - Scott Barr
- Plastic and Reconstructive Surgeon in private practice in Sudbury, Canada
| | - Stephen Mulholland
- plastic and reconstructive surgeon in private practice in Toronto, Canada
| | | | - Charles Knapp
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
| | | | | | - Ronald Levine
- Department of Surgery, University of Toronto, Toronto, Canada
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32
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The grey zone in plastic surgery: priorities amidst the COVID 19 pandemic. Arch Plast Surg 2021; 48:572-574. [PMID: 34583450 PMCID: PMC8490103 DOI: 10.5999/aps.2021.00493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/27/2021] [Indexed: 11/23/2022] Open
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Mohty KM, Lashkari N, Gittings DJ, Bell JA, Stevanovic M, Nicholson LT. Utilizing Google Trends to Track Online Interest in Elective Hand Surgery During the COVID-19 Pandemic. Cureus 2021; 13:e17313. [PMID: 34567866 PMCID: PMC8451539 DOI: 10.7759/cureus.17313] [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] [Accepted: 08/19/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction Elective hand surgery encompasses a large volume of orthopaedic cases annually. Carpal tunnel syndrome, ganglion cysts, and trigger digits are some of the most common pathologies treated by hand surgeons. In the midst of the COVID-19 pandemic, patient's interest in elective hand surgery for these conditions is uncertain. The objective of this study is to use Google Trends to track online interest in elective hand surgery in the United States during the COVID-19 pandemic. Methods Online search trends regarding elective orthopaedic hand surgery were obtained via Google Trends from November 2019 to November 2020. Three common hand pathologies in lay terms ("carpal tunnel," "‘ganglion cyst’ + ‘wrist cyst,’" and "trigger finger") and three hand surgery-specific keywords ("hand surgery," "carpal tunnel surgery," and "trigger finger surgery") were used as search terms. The search volume index (SVI) graphs for the United States for both sets of search terms were then generated from the Google Trends data and compared to the seven-day average of new COVID-19 cases per day as reported by the CDC. A separate SVI graph was then created for the search term "coronavirus” and was compared against both sets of search terms as above. Results Search trends for all elective hand pathologies and surgery-specific keywords remained constant from November 2019 to the beginning of March 2020 and then decreased significantly within a one-month period following the peak in COVID-19 cases the week of March 15, 2020. Search trends for these keywords increased to baseline levels over the next few months. The search trend for "coronavirus" demonstrated a small search volume index peak of 13 during January 2020 followed by the maximum peak of 100 during the week of March 15, 2020, corresponding to the decrease in search trends of elective hand surgery at that time. Conclusions Online interest in elective hand surgery remained constant prior to the COVID-19 pandemic; however, there was a marked decrease in search trends of elective hand surgery with the rise in daily reported COVID-19 cases, suggesting that patient's interest in elective hand surgery decreased with the onset of the pandemic.
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Affiliation(s)
- Kurt M Mohty
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, USA
| | - Nassim Lashkari
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, USA
| | - Daniel J Gittings
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, USA
| | - Jennifer A Bell
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, USA
| | - Milan Stevanovic
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, USA
| | - Luke T Nicholson
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, USA
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Singh M, Sethi HS, Gupta S, Duvesh RK, Naik M. Preoperative COVID-19 Testing for Elective Ophthalmological Procedure in a Tertiary Health Care Centre: Our Experience During the Pandemic. Clin Ophthalmol 2021; 15:3841-3845. [PMID: 34548780 PMCID: PMC8449681 DOI: 10.2147/opth.s319173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/11/2021] [Indexed: 12/13/2022] Open
Abstract
Background To study the prevalence of coronavirus infection among asymptomatic patients requiring eye surgery and the role of screening in prevention of spread of infection among the healthcare workers. Design The prospective observational study was conducted in the Ophthalmology department of a tertiary care center in Delhi from September 2020 to December 2020. Setting Patients requiring elective ophthalmological procedures in a tertiary care hospital were screened for coronavirus using the RT-PCR method. Testing methods and results were documented. Results Among the 218 asymptomatic patients posted for elective surgery in that period, 16 (7.3%) were found to be positive for COVID-19. Those who tested positive were advised home isolation and surgery was postponed for the next 14 days. No complications were reported in these patients. One health-care worker also tested positive for COVID-19 during our study period. Conclusion In our study, 1 out of 14 asymptomatic patients were found to be carriers for the novel virus. Asymptomatic COVID-infected patients may lead to transmission of the virus inside the hospital among the visiting patients and hospital staff while they have no adverse effect on the surgery and its outcome.
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Affiliation(s)
- Mrityunjay Singh
- Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
| | | | - Sukriti Gupta
- Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Ram Kishan Duvesh
- Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Mayuresh Naik
- Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
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Joji N, Nugent N, Vadodaria S, Sankar TK. Impact of COVID-19 on Aesthetic Plastic Surgery Practice in the United Kingdom. J Plast Reconstr Aesthet Surg 2021; 74:2311-2318. [PMID: 34257034 PMCID: PMC8179720 DOI: 10.1016/j.bjps.2021.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/07/2021] [Accepted: 05/24/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The COVID-19 pandemic has transformed the delivery of medical and surgical services globally. Subsequently, all elective and aesthetic procedures have been cancelled or deferred in accordance with government-mandated quarantine measures. The Cosmetic Surgery Governance Forum (CSGF) is a network of aesthetic plastic surgery consultants which has enabled a sharing of expertise during challenging times. We conducted a cross-sectional survey to assess the impact of the COVID-19 pandemic on aesthetic plastic surgeons and their practice in the UK. METHODS On 15 June 2020, 131 respondents from the CSGF and wider aesthetic plastic surgeons in the UK were invited to respond to an online survey. An anonymised questionnaire was created using SmartSurveyTM and distributed at the end of the quarantine period. Questions regarding their current scope of practice, willingness to recommence face-to-face consultations, financial loss and psychological impact were asked. RESULTS A total of 101 Consultant Plastic surgeons (76%) completed the questionnaire. If strict protocols and adequate personal protective equipment were available, 50-55% of respondents would consider offering non-surgical treatments as soon as the private clinic was open. Furthermore, 51% would consider procedures under general anaesthetic, whilst 89% of respondents would offer local anaesthetic only in the initial phase. Moreover, 66% reported experiencing a psychological impact and 100% of respondents reported a significant financial impact. CONCLUSIONS This survey aims to give an account of the current state (May-July 2020) of aesthetic plastic surgery in the UK. There is ongoing uncertainty and deliberation regarding the timing and organisational changes required for aesthetic practice to restart.
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Affiliation(s)
- Nikita Joji
- Plastic Surgery Registrar, Cosmetic Surgery Governance forum (CSGF), UK
| | - Nora Nugent
- Consultant Plastic Surgeon, Cosmetic Surgery Governance forum (CSGF), UK
| | - Shailesh Vadodaria
- Consultant Plastic Surgeon, Cosmetic Surgery Governance forum (CSGF), UK; Consortium of Aesthetic Plastic Surgery Clinic Owners (CAPSCO) UK
| | - Thangasamy K Sankar
- Consultant Plastic Surgeon, Cosmetic Surgery Governance forum (CSGF), UK; Consortium of Aesthetic Plastic Surgery Clinic Owners (CAPSCO) UK.
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Farasani A. Biochemical role of serum ferratin and d-dimer parameters in COVID 19 diagnosis. Saudi J Biol Sci 2021; 28:7486-7490. [PMID: 34429685 PMCID: PMC8378068 DOI: 10.1016/j.sjbs.2021.08.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/14/2021] [Accepted: 08/15/2021] [Indexed: 12/15/2022] Open
Abstract
One and one only most unforgettable pandemic is coronavirus 2019 (COVID 19) which is the most memorable pandemic of the twenty-first century. The diagnosis of COVID19 is based on purely clinical symptoms and real time reverse transcription polymerase chain reaction (RT-PCR) test. The role of COVID19 during this pandemic was horrible in diagnosing the disease with RT-PCR as this disease was documented to be a symptomatic disease. Serum ferratin and D-dimer tests plays a major role in identifying the infections in the human body specifically, patients diagnosed with COVID19. Serum ferritin levels are important for an immune response mediator that rises in severe COVID-19 instances, and elevated ferritin levels may trigger a cytokine storm by exerting direct immunosuppressive and pro-inflammatory effects. d-dimer is used to identify the clots in the blood. COVID-19 patients were found to be clotting of blood and d-dimer is recommended. The blood of the COVID-19 patients were found to clotted than the patients were prescribed the anticoagulant Injections are prescribed. d-dimer can be used as a biomarker in the COVID-19 patients by measuring the d-dimer levels and analyse the mortality and severity. Pulmonary complication risk can also be identified. d-dimer is a mandatory and an essential test in the COVID-19. Numerous COVID-19 vaccines have been shown to have great efficacy levels through clinical trials. COVID-19 vaccines are not 100% effective, although the condition is mild or moderate and can be controlled if COVID-19 is affected. In this review, I have only included serum ferritin and d-dimer; however, C-reactive protein, vitamin D levels, and prolactin were also attributed to COVID-19. This review concludes the importance of RT-PCR, serum ferratin, and d-dimer testing in identifying COVID-19 infection in humans.
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Affiliation(s)
- Abdullah Farasani
- Biomedical Research Unit, Medical Research Center, Jazan University, Jazan-45142, Saudi Arabia.,Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan-45142, Saudi Arabia
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Jiang T, Osadchiy V, Weinberger JM, Zheng MH, Owen MH, Leonard SA, Mills JN, Kachroo N, Eleswarapu SV. Impact of the COVID-19 Pandemic on Patient Preferences and Decision Making for Symptomatic Urolithiasis. J Endourol 2021; 35:1250-1256. [PMID: 33478351 PMCID: PMC8390773 DOI: 10.1089/end.2020.1141] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Pandemic restrictions have changed how patients approach symptomatic kidney stones. We used a mixed-methods digital ethnographic approach to evaluate social media discussions about patient concerns and preferences for urolithiasis care during the COVID-19 pandemic. Materials and Methods: We retrospectively analyzed kidney stone-related discussions on a large social media platform using qualitative analysis and natural language processing-based sentiment analysis. Posts were mined for demographic details, treatments pursued, and health care encounters. Pre-COVID-19 (January 1, 2020-February 29, 2020) and COVID-19 (March 1, 2020-June 1, 2020) posts were extracted from the popular online Reddit discussion board, "r/KidneyStones," which is dedicated to discussions related to urolithiasis. Results: We extracted n = 649 posts (250 pre-COVID-19, 399 COVID-19); 150 from each cohort underwent thematic analysis and data extraction. Quantitative sentiment analysis was performed on 418 posts (179 pre-COVID-19, 239 COVID-19) that described stone-related decision making before intervention. Notable discussion themes during COVID-19 focused on barriers to care and concerns about stone management. Discussants exhibited more negative and anxious tones during COVID-19, based on sentiment analysis (p < 0.01). Patient preferences shifted away from in-person visits and procedures (p < 0.001). Mean reported stone size among those visiting emergency room (ER) increased from 5.1 to 10.5 mm (p < 0.001). The proportion of discussants preferring conservative management with stones ≥10 mm increased (12.5% pre-COVID-19 vs 26% during COVID-19, p = 0.002). Opioid mentions increased from 9% to 27% of posts (p < 0.001) and were most associated with conservative management discussions. Conclusions: Online discussion forums provide contemporaneous insight into patients' experiences during a time when traditional patient-centered research methodologies are limited due to social distancing. During the pandemic, patients with symptomatic kidney stones expressed anxiety regarding outpatient encounters and reluctance toward procedural intervention. Patients opted instead for at-home conservative treatment beyond clinical guidelines and reserved ER visits for larger stones, potentially causing self-harm. Opioid discussions proliferated, an alarming consequence of the pandemic.
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Affiliation(s)
- Tommy Jiang
- Division of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Consortium for Health Activity on Social Media, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Vadim Osadchiy
- Division of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Consortium for Health Activity on Social Media, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - James M. Weinberger
- Division of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Michael H. Zheng
- Department of Statistics, University of California, Berkeley, California, USA
| | - Michael H. Owen
- Department of Computer Science, College of Liberal Arts, University of Iowa, Iowa City, Iowa, USA
| | - Sarah A. Leonard
- College of Letters and Sciences, Carleton College, Northfield, Minnesota, USA
| | - Jesse N. Mills
- Division of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Naveen Kachroo
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Urology, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
| | - Sriram V. Eleswarapu
- Division of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Consortium for Health Activity on Social Media, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Paprottka FJ, Rolfes SB, Richter DF, Kaye KO. COVID-19 Pandemic: Evaluation of Socio-Economic Impact on Aesthetic Plastic Surgery Providers. Aesthetic Plast Surg 2021; 45:1877-1887. [PMID: 33830307 PMCID: PMC8029606 DOI: 10.1007/s00266-021-02130-9] [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: 10/19/2020] [Accepted: 01/04/2021] [Indexed: 11/14/2022]
Abstract
Background In many countries, the worldwide spread of COVID-19 has led to a near total stop of non-urgent, elective surgeries across all specialties during the first wave’s peak of the pandemic. For providers of aesthetic surgery procedures or minimal invasive cosmetic treatments, this led to a huge socio-economic impact worldwide. In order to evaluate valid clinical management strategies for future pandemic events and to overcome the challenges imposed by the current pandemic, it is paramount to analyse the socio-economic effects caused by the COVID-19 crisis. Methods An online survey comprising 18 questions was sent out five times by e-mail to all members of the International Society of Aesthetic Plastic Surgery (ISAPS) between June and August 2020. The data set was statistically analyzed and grouped into an overall group and into subgroups of countries with high (n = 251) vs. low (n = 440) gross domestic product per capita (GDP p.c.) and five defined world regions (Europe (n = 214); North America (NA; n = 97); South America (SA; n = 206); Asia and Oceania (Asia + OC; n = 99); Africa and Middle East (Africa + ME; n = 75)). Results A total of 691 recipients completed the survey. The majority of the participants experienced severe operating restrictions resulting in a major drop of income from surgical patients. Low GDP p.c. countries experienced a bigger negative economic impact with less aesthetic (non-) surgical procedures, whereas the high GDP p.c. subgroup was less affected by the COVID-19 crisis. Most of the survey participants had already adopted the ISAPS guidelines for patient (pre-) appointment screening and clinical/patient-flow management. For surgical and non-surgical aesthetic procedures, in the high GDP p.c. subgroup more basic-level PPE (surgical mask) was used, whereas the low GDP p.c. subgroup relied more on advanced-level PPE (N-95 respirator mask or higher). Comparing the different world regions, Europe and Africa used more basic-level PPE. Conclusions Measurable differences in the socio-economic impact and in the adaptation of safety protocols between high and low GDP p.c. subgroups and between different world regions were present. Since the COVID-19 pandemic is an international crisis, aligned, expedient and universal actions should be taken. Level of evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266. Supplementary Information The online version of this article (10.1007/s00266-021-02130-9) contains supplementary material, which is available to authorized users.
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O'Connor K, McGee M, Gibson M, Sullivan MJ, Pennelli M, Alvis S, Lajoie D. Developing an Outpatient Pediatric Pre-Procedure COVID-19 Testing Model. J Perianesth Nurs 2021; 36:367-371. [PMID: 34419219 PMCID: PMC8053238 DOI: 10.1016/j.jopan.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE The purpose of this project was to design, develop, implement, and manage a sustainable process for pediatric preoperative COVD-19 testing and use the test results to determine the level of personal protective equipment and infection control required for each patient for optimal surgical scheduling and preservation of resources. DESIGN This quality improvement project used the Plan-Do-Study-Act methodology. Multiple cycles of re-evaluation refined this process which was standardized across the enterprise. METHODS A process for preoperative testing for all patients undergoing procedures requiring anesthesia was developed and implemented. FINDINGS A safe, feasible, timely process was developed and piloted to obtain COVID-19 test results to guide individualized interventions. During the pilot, 1,707 patients were screened, and five tested positive for COVID-19, eliminating the need to manage 1702 patients as COVID-19 positive. CONCLUSION To continue to safely re-open, knowledge of the patient's COVID-19 status is imperative to ensure a safe journey through the perioperative area.
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Affiliation(s)
- Katherine O'Connor
- Perioperative Care Coordination Clinic, Boston Children's Hospital, Boston, MA.
| | - Morgan McGee
- Perioperative Care Coordination Clinic, Boston Children's Hospital, Boston, MA
| | - Mary Gibson
- Perioperative Care Coordination Clinic, Boston Children's Hospital, Boston, MA
| | - Mary Jean Sullivan
- Perioperative Care Coordination Clinic, Boston Children's Hospital, Boston, MA
| | - Mary Pennelli
- Perioperative Care Coordination Clinic, Boston Children's Hospital, Boston, MA
| | - Sarah Alvis
- Perioperative Care Coordination Clinic, Boston Children's Hospital, Boston, MA
| | - Debra Lajoie
- Perioperative Care Coordination Clinic, Boston Children's Hospital, Boston, MA
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The Role of Portable Incisional Negative Pressure Wound Therapy (piNPWT) in Reducing Local Complications of Post-bariatric Brachioplasty: A Case-Control Study. Aesthetic Plast Surg 2021; 45:1653-1659. [PMID: 33481062 PMCID: PMC7821840 DOI: 10.1007/s00266-020-02122-1] [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] [Accepted: 12/28/2020] [Indexed: 12/12/2022]
Abstract
Background Due to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide. The portable incisional negative pressure wound therapy (piNPWT) is a promising medical device for accelerating wounds closure and controlling post-operative complication, which have been shown promising results in post-bariatric population. We aimed to evaluate the role of piNPWT in optimizing wound healing and controlling post-operative complications after a post-bariatric brachioplasty. Patients and Methods 26 post-bariatric female patients who underwent a brachioplasty followed by either a piNPWT (14 cases) or a standard wound treatment (12 controls) were analyzed. The number of post-operative dressing changes, the rate of local post-operative complications (re-operation, hematoma and serosa development, dehiscence and necrosis), the time to dry as well as the scar quality and hospitalization length were evaluated. Results None of the patients prematurely stopped treatment with piNPWT due to intolerance. The piNPWT patient group showed a significant lower healing time as well as a significant reduction of the number of post-operative dressing changes and hospital stay. Despite the scarring process was excellent from the functional point of view in the long term, we noticed a higher rate of hyperchromic scarring at 90 days after surgery. Conclusion The piNPWT is a cost-effective and user-friendly medical tool that increase and promote wound healing. We suggest the use of this device in post-bariatric patients who undergo a brachioplasty, especially if there is the need to minimize the number of post-operative dressing changes. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Sankar TK, Nugent N, Patel N, Vadodaria S, Joji N, Ramakrishnan V, Waterhouse N. Preliminary Report of a National Audit of Aesthetic Surgery Practice in the United Kingdom During the COVID-19 Pandemic. Aesthet Surg J 2021; 41:NP1134-NP1136. [PMID: 34008843 PMCID: PMC8194542 DOI: 10.1093/asj/sjab069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
| | | | - Nakul Patel
- Cosmetic Surgery Governance Forum (CSGF), Leicester, United Kingdom
| | - Shailesh Vadodaria
- Consortium of Aesthetic Plastic Surgery Clinic Owners (CAPSCO), Watford, United Kingdom
| | - Nikita Joji
- Cosmetic Surgery Governance Forum (CSGF), East Grinstead, United Kingdom
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Piteira AR, Bofill-Ródenas AM, Fariñas O, Tabera J, Vilarrodona A. Lessons Learned From SARS-CoV-2 Pandemic in Donation and Tissue Banking Activities: Key Takeaways. Transplantation 2021; 105:1398-1402. [PMID: 34019361 DOI: 10.1097/tp.0000000000003716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- A Rita Piteira
- Barcelona Tissue Bank (BTB), Banc de Sang i Teixits (BST), Barcelona, Spain
- Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain
| | - Ana Maria Bofill-Ródenas
- Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain
- Hospital Clínic de Barcelona, Barcelona, Spain
| | - Oscar Fariñas
- Barcelona Tissue Bank (BTB), Banc de Sang i Teixits (BST), Barcelona, Spain
- Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain
| | - Jaime Tabera
- Barcelona Tissue Bank (BTB), Banc de Sang i Teixits (BST), Barcelona, Spain
- Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain
| | - Anna Vilarrodona
- Barcelona Tissue Bank (BTB), Banc de Sang i Teixits (BST), Barcelona, Spain
- Biomedical Research Institute (IIB-Sant Pau; SGR1113), Barcelona, Spain
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Perception of Cosmetic Procedures among Saudis during COVID-19 Pandemic. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3710. [PMID: 34235043 PMCID: PMC8245110 DOI: 10.1097/gox.0000000000003710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/27/2021] [Indexed: 11/25/2022]
Abstract
Background: A novel coronavirus disease (COVID-19) was first reported in December 2019 in Wuhan, China. The fast spread of the virus has led to a significant reduction in the numbers of elective procedures especially cosmetic interventions. Although many measures have been carried out to offload the health care system, it is unclear whether these changes had an effect on general population perception toward undergoing cosmetic procedures. The aim of this study was to assess the perception of Saudis toward undergoing a cosmetic surgery during the COVID-19 pandemic. Method: An online survey consisting of two parts was used, with a series of questions about cosmetic procedures, in general, and cosmetic procedures during the COVID-19 pandemic, in particular. The survey included Saudis (age 18 to 60 years) with access to social media. Results: A total of 563 respondents participated in this survey. The vast majority were women (86.9%) and were between 18 and 24 years old (38.7%). Some 27.4% considered a cosmetic procedure during the COVID-19 pandemic; however, only 11.9% underwent any. In the majority of the participants (86%), the pandemic did not change their minds about having a cosmetic procedure. About 49.7% agreed that fear of contracting the virus would be a factor for not undergoing a cosmetic procedure during the pandemic. Conclusions: Clear differences in the engagement and perception of cosmetic procedures during the COVID-19 pandemic exist among Saudis. More studies are needed to explore the effects of pandemics on aesthetic practice and to find ways to perform elective procedures in a safe way.
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Heo H, Lee K, Jung E, Lee H. Developing the First Telenursing Service for COVID-19 Patients: The Experience of South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136885. [PMID: 34206977 PMCID: PMC8296892 DOI: 10.3390/ijerph18136885] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 06/23/2021] [Indexed: 01/10/2023]
Abstract
This study aimed to examine the process of establishing a telenursing service for COVID-19 patients with mild or no symptoms admitted to a community treatment center (CTC). The process of establishing the service was reviewed, and the degree of satisfaction with the provided service was investigated based on the medical records the patients submitted at their discharge from the CTC. A total of 113 patients were admitted; the patients themselves entered the self-measured vital signs and symptoms of COVID-19 infection to the electronic questionnaires and mobile application. The nurses implemented remote nursing based on the patients’ input data. The educational materials, including the video for self-measuring vital signs and the living guidelines, were prepared and arranged in advance. The telenursing protocol regarding the whole process from the patients’ admission to their discharge was used and applied to five other CTCs. The non-contact counseling service’s satisfaction and convenience scores were 4.65 points and 4.62 points, respectively, out of 5 points. The non-contact nursing counseling service played an important role in monitoring patients’ medical conditions during the spread of COVID-19. This experience of establishing telenursing services to the CTC provides a clear direction to innovate healthcare services in future disasters.
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Affiliation(s)
- Hyunsook Heo
- Comprehensive Community Care Center, Seoul National University Hospital, Seoul 03080, Korea;
| | - Kyungyi Lee
- Nursing Service Department, Seoul National University Hospital, Seoul 03080, Korea; (K.L.); (E.J.)
| | - Eunhee Jung
- Nursing Service Department, Seoul National University Hospital, Seoul 03080, Korea; (K.L.); (E.J.)
| | - Hyangyuol Lee
- College of Nursing, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: ; Tel.: +82-2-2258-7406
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Tawfik AM, Silver JM, Katt BM, Patankar A, Rivlin M, Beredjiklian PK. Patient Perceptions of COVID-19 Precautions and Their Effects on Experiences With Hand Surgery. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2021; 3:167-171. [PMID: 33997725 PMCID: PMC8113162 DOI: 10.1016/j.jhsg.2021.04.003] [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] [Received: 02/18/2021] [Accepted: 04/07/2021] [Indexed: 02/06/2023] Open
Abstract
Purpose The purpose of this study is to evaluate patient perceptions of COVID-19 precautions and how these precautions have affected their hand and upper extremity surgery experience. Methods We sent an 18-item survey to 1,213 patients who underwent elective hand and upper extremity surgery at 1 academic institution from October 2020 to January 2021. The survey consisted of questions related to patient demographics, treatment delays due to COVID-19, and patient perceptions of COVID-19 precautions. Descriptive statistics were performed to analyze the survey responses. Responses for patients aged 18–50 and 51+ were compared using a chi-square analysis for categorical variables and a Student t-test for continuous variables. Results Out of 1,213 invitations, 384 survey respondents completed the survey (31.6%). Of the respondents, 16.8% reported delaying medical treatment for an average of 123.2 days because of COVID-19. The preventative measures were found to be adequate by 95% of patients. Only 2.6% of patients reported experiencing surgical delays due to preoperative COVID-19 testing or other COVID-19-related precautions. COVID-19 testing was seen as necessary by 88% of patients, and 74% did not find COVID-19 testing to be a barrier to their surgery. Patients aged 51+ were more likely to delay seeking medical treatment than younger patients (19.3% vs 9.1%, respectively). Furthermore, those that did delay seeking treatment waited longer on average than their younger counterparts (136.1 vs 72.9 days, respectively). Conclusions In conclusion, patients undergoing hand and upper extremity surgery typically do not find COVID-19 precautions to be a significant barrier to care and understand their importance. Despite this, many patients, particularly older ones, are delaying medical care for extended periods of time. It is important for hand surgeons to acknowledge their patients’ perspectives and work to educate patients on evolving surgical safety guidelines. Clinical relevance Patient perspectives of current COVID-19 precautions can help inform hand surgeons on areas for continued patient education.
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Affiliation(s)
- Amr M Tawfik
- Rothman Orthopaedic Institute, Philadelphia, PA.,Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jeremy M Silver
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Brian M Katt
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Aneesh Patankar
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
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Choi JY, Park IJ, Lee HG, Cho E, Kim YI, Kim CW, Yoon YS, Lim SB, Yu CS, Kim JC. Impact of the COVID-19 Pandemic on Surgical Treatment Patterns for Colorectal Cancer in a Tertiary Medical Facility in Korea. Cancers (Basel) 2021; 13:cancers13092221. [PMID: 34066390 PMCID: PMC8125443 DOI: 10.3390/cancers13092221] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/02/2021] [Accepted: 05/03/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary The COVID-19 pandemic is threatening to public health, including malignant disease. Fear of viral infection has influenced the diagnosis and treatment of colorectal cancer and may result in impairment of surgical and oncologic outcomes. Therefore, we need to analyze the influence of COVID-19 on surgical outcomes of colorectal cancer and provide guidance on proper diagnosis and treatment, including public messaging regarding appropriate healthcare. Abstract Because of their reluctance to visit the hospital due to concerns about contracting coronavirus disease 2019 (COVID-19), patients with colorectal cancer have been affected by delays in care during the pandemic. This study assessed the effects of the pandemic on the clinical characteristics and surgical treatment patterns of colorectal cancer patients at a tertiary medical facility in Korea. Patients who underwent colorectal cancer surgery at our institution between March and September 2020 were analyzed. Clinicopathological and treatment characteristics were compared with those of patients who underwent surgery in 2018 and 2019. The patients who did not undergo tumor resection (4.1% vs. 1.8%, p < 0.001) and who received neoadjuvant treatment (16.7% vs. 14.7%, p = 0.039) were significantly higher during the COVID period. The minimally invasive approach was performed less during the COVID period (81.2% vs. 88%, p < 0.001). More patients in the COVID period required combined resection of organs adjacent to the tumor (4.8% vs. 2.8%, p = 0.017). Surgical aggressiveness, as shown by the proportion of patients undergoing minimally invasive surgery and adjacent organ resection, was significantly influenced by the pandemic. In addition, resectability decreased during the COVID period. These characteristics will likely influence long-term oncological outcomes, indicating the need for long-term monitoring of this cohort.
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Affiliation(s)
- Ju Yeon Choi
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - In Ja Park
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
- Correspondence: ; Tel.: +82-2-3010-3937
| | - Hyun Gu Lee
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Eunhae Cho
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Young Il Kim
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Chan Wook Kim
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Yong Sik Yoon
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Seok-Byung Lim
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Chang Sik Yu
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
| | - Jin Cheon Kim
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.G.L.); (E.C.); (Y.I.K.); (C.W.K.); (Y.S.Y.); (S.-B.L.); (C.S.Y.); (J.C.K.)
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Patients’ perceptions of receiving orthopaedic care during a pandemic: a patient survey. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000000988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Brown NJ, Wilson B, Szabadi S, Quon C, Ong V, Himstead A, Shlobin NA, Yang CY, Lien BV, Shahrestani S, Tran K, Tafreshi AR, Birkenbeuel J, Ransom SC, Choi EH, Sahyouni R, Chan AY, Kheriaty A, Yang I. Ethical considerations and patient safety concerns for cancelling non-urgent surgeries during the COVID-19 pandemic: a review. Patient Saf Surg 2021; 15:19. [PMID: 33926498 PMCID: PMC8082741 DOI: 10.1186/s13037-021-00293-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/20/2021] [Indexed: 12/19/2022] Open
Abstract
At the time of writing of this article, there have been over 110 million cases and 2.4 million deaths worldwide since the start of the Coronavirus Disease 2019 (COVID-19) pandemic, postponing millions of non-urgent surgeries. Existing literature explores the complexities of rationing medical care. However, implications of non-urgent surgery postponement during the COVID-19 pandemic have not yet been analyzed within the context of the four pillars of medical ethics. The objective of this review is to discuss the ethics of elective surgery cancellation during the COVID-19 pandemic in relation to beneficence, non-maleficence, justice, and autonomy. This review hypothesizes that a more equitable decision-making algorithm can be formulated by analyzing the ethical dilemmas of elective surgical care during the pandemic through the lens of these four pillars. This paper’s analysis shows that non-urgent surgeries treat conditions that can become urgent if left untreated. Postponement of these surgeries can cause cumulative harm downstream. An improved algorithm can address these issues of beneficence by weighing local pandemic stressors within predictive algorithms to appropriately increase surgeries. Additionally, the potential harms of performing non-urgent surgeries extend beyond the patient. Non-maleficence is maintained through using enhanced screening protocols and modifying surgical techniques to reduce risks to patients and clinicians. This model proposes a system to transfer patients from areas of high to low burden, addressing the challenge of justice by considering facility burden rather than value judgments concerning the nature of a particular surgery, such as cosmetic surgeries. Autonomy can be respected by giving patients the option to cancel or postpone non-urgent surgeries. However, in the context of limited resources in a global pandemic, autonomy is not absolute. Non-urgent surgeries can ethically be postponed in opposition to the patient’s preference. The proposed algorithm attempts to uphold the four principles of medical ethics in rationing non-urgent surgical care by building upon existing decision models, using additional measures of resource burden and surgical safety to increase health care access and decrease long-term harm as much as possible. The next global health crisis will undoubtedly present its own unique challenges. This model may serve as a comprehensive starting point in determining future guidelines for non-urgent surgical care.
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Affiliation(s)
- Nolan J Brown
- Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA.
| | - Bayard Wilson
- Department of Neurological Surgery, University of California, Los Angeles, CA, USA
| | - Stephen Szabadi
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Cameron Quon
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Vera Ong
- John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Alexander Himstead
- Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Chen Yi Yang
- Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA
| | - Brian V Lien
- Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA
| | | | - Katelynn Tran
- Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Ali R Tafreshi
- Department of Neurological Surgery, Geisinger Commonwealth School of Medicine, Danville, PA, USA
| | - Jack Birkenbeuel
- Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA
| | - Seth C Ransom
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Elliot H Choi
- Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA
| | - Ronald Sahyouni
- Department of Neurological Surgery, University of California, San Diego, San Diego, CA, USA
| | - Alvin Y Chan
- Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA
| | - Aaron Kheriaty
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Isaac Yang
- University of California, Los Angeles, CA, USA.,Departments of Neurosurgery, Los Angeles, CA, USA.,Departments of Departments of Head and Neck Surgery, Los Angeles, CA, USA.,Departments of Radiation Oncology, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Los Angeles Biomedical Research Institute, Los Angeles, CA, USA.,Harbor-UCLA Medical Center, Los Angeles, CA, USA.,David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Santos PJF, Arowojolu OA, Vyas RM. Interdisciplinary Considerations for Nasolabial Repair During a Global Pandemic. Cleft Palate Craniofac J 2021; 58:1341-1347. [PMID: 33648383 DOI: 10.1177/1055665621993970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND At the declaration of the global pandemic on March 11, 2020, many hospitals and institutions developed a tiered framework for the stratification and prioritization of elective surgery. Cleft lip and palate repair was classified as low acuity, and nasoalveolar molding (NAM) clinics were closed. Anticipating the consequences of delayed cleft care and the additional burden this would cause families, we reassessed our risk-stratification and perioperative algorithms. We hypothesized we could safely optimize nasolabial repair without burdening our care systems and without increasing COVID-19-related morbidity/mortality. METHODS Our multidisciplinary cleft team reevaluated patient selection to maximize surgical impact. Perioperative protocols were adjusted, and COVID-19 preoperative testing was utilized before nasolabial repair and prior to suture removal under anesthesia. RESULTS Early in the pandemic, unilateral cleft repair was prioritized and successfully completed on 9 patients. There were no complications related to COVID-19. Nasoalveolar molding clinic was reopened after total patient volume was significantly decreased. CONCLUSIONS We offer an approach for surgical management of nasolabial clefts during a global pandemic. Although guidelines have suggested postponing all cleft care, we found that at our dedicated pediatric hospital with low burden of COVID-19 and adequate resources, we could follow a strategy to safely resume cleft care while decreasing burden on our patients' families and care delivery systems.
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Affiliation(s)
- Pauline Joy F Santos
- Department of Plastic Surgery, University of California Irvine, Orange, CA, the United States
| | - Omotayo A Arowojolu
- Department of Plastic Surgery, University of California Irvine, Orange, CA, the United States
| | - Raj M Vyas
- Department of Plastic Surgery, University of California Irvine, Orange, CA, the United States
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Palumbo P, Massimi F, Usai S, Biondi A, Monzani R. Resumption of Day Surgery Activity in the Acute Phase of COVID-19 Pandemic. Surg Innov 2021; 28:247-248. [PMID: 33522436 PMCID: PMC8685590 DOI: 10.1177/1553350620987788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Fanny Massimi
- Department of Surgical Sciences, 9311Sapienza University of Rome, Italy
| | - Sofia Usai
- Department of Surgical Sciences, 9311Sapienza University of Rome, Italy
| | - Antonio Biondi
- Department of General Surgery and Surgical Specialities, University of Catania, Sicilia, Italy
| | - Roberta Monzani
- Department of Anesthesia and Intensive Care, 9268Humanitas Research Hospital, Italy
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