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Brument M, Defortescu G, Bugel H, Sibert L, Duflot T, Dupuis H, Surlemont L, Pfister C, Cornu JN. Differential impact of COVID-19 on urological surgeries in public and private institutions between 2019 and 2021 in France. Prog Urol 2023:S1166-7087(23)00109-4. [PMID: 37328317 PMCID: PMC10239898 DOI: 10.1016/j.purol.2023.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/10/2023] [Accepted: 05/31/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The COVID-19 pandemic disrupted all routine health care services in 2020. To date, data regarding adjustment and coverage of surgical backlog in the post-COVID era actually remains scarce. The aim of this study was to compare the number of urological procedures coded between 2019 and 2021 in public and private institutions to (i) quantify the variation in surgical activity linked to the shutdown in 2020 and (ii) study the adjustment of procedures over the year 2021. MATERIALS AND METHODS This is a comprehensive retrospective analysis of all urological surgeries coded between January 1, 2019 and December 31, 2021 in France. Data were extracted from the open access dataset of the national Technical Agency for Information on Hospital Care (ATIH) website. In total, 453 urological procedures were retained and allocated in 8 categories. Primary outcome was the impact of COVID-19 analyzed by the 2020/2019 variation. The secondary outcome was the post-COVID catch-up analyzed by the 2021/2019 variation. RESULTS Surgical activity in public hospitals dropped by 13.2% in 2020 compared to 7.6% in the private sector. The most impacted areas were functional urology, stones and BPH. Incontinence surgery did not recover at all in 2021. BPH and stone surgeries were far less impacted in the private sector, with even explosive activity in 2021, post-COVID period. Onco-urology procedures were roughly maintained with a compensation in 2021 in both sectors. CONCLUSION The recovery of surgical backlog was much more efficient in the private sector in 2021. The pressure on the health system associated to the multiple COVID-19 waves may generate a gap between public and private surgical activity in the future. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- M Brument
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France.
| | - G Defortescu
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - H Bugel
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - L Sibert
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - T Duflot
- Service d'urologie, centre hospitalier de Tourcoing, 115, rue du Président-Coty, 59200 Tourcoing, France
| | - H Dupuis
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - L Surlemont
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - C Pfister
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - J-N Cornu
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France
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Benmeziani R, Royer M, Aubert C, Rolley C, Le Corre V, Culty T, Nedelcu C, Zidane M, Lebdai S, Bigot P. [Impact of delay before partial nephrectomy of a localized kidney tumor]. Bull Cancer 2023; 110:160-167. [PMID: 36379731 DOI: 10.1016/j.bulcan.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Partial nephrectomy is the treatment of choice for small localized renal tumors. In case of doubt, a biopsy can confirm the diagnosis. The aim of this study was to evaluate the impact of a delayed time to partial nephrectomy on cancer development. MATERIALS AND METHODS Our single center study enrolled localized renal tumor patients who underwent a partial nephrectomy between 2015 and 2020; the collected data were included in the uroCCR prospective database. The histopathological stage of the tumors and the recurrence rate in patients treated with surgery >90 days after diagnosis were investigated. The impact a preoperative biopsy on was also explored. Statistical significance was tested using Student's t-test and Chi-squared test (SPSS software). RESULTS The cohort consisted of 179 patients, among which 41 (23 %) received a preoperative biopsy. 89 patients (50 %) were treated surgically >3 months after diagnosis. The median time to nephrectomy was 86 days (13-1 037). A delayed time to surgery did not lead to significantly higher recurrence rates (P=0.66). Preoperative biopsy led to a doubling time to surgery (P<0.001) but was neither correlated to a more severe tumor stage (P=0.944) nor to a higher recurrence rate (P=0.08). Tumor growth was not significantly different with or without the presence of a biopsy (P=0.122). CONCLUSION Our data evidence that a substantial delayed time to partial nephrectomy does not result in a negative impact on cancer prognosis in localized renal tumor patients.
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Affiliation(s)
- Racha Benmeziani
- CH Angoulême, service d'urologie, rond-point de Girac, 16959 Angoulême, France.
| | - Matthias Royer
- CHU de Angers, service d'urologie, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Cécile Aubert
- CHU de Angers, service d'urologie, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Cyrielle Rolley
- CHU de Angers, service d'urologie, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Vincent Le Corre
- CHU de Angers, service d'urologie, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Thibaut Culty
- CHU de Angers, service d'urologie, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Cosmina Nedelcu
- CHU de Angers, service de radiologie, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Merzouka Zidane
- CHU de Angers; service d'anatomopathologie, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Souhil Lebdai
- CHU de Angers, service d'urologie, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Pierre Bigot
- CHU de Angers, service d'urologie, 4, rue Larrey, 49933 Angers cedex 9, France
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Zapała P, Ślusarczyk A, Rajwa P, Przydacz M, Krajewski W, Dybowski B, Kubik P, Kuffel B, Przudzik M, Osiecki R, Stamirowski R, Zapała Ł, Kozikowski M, Chorągwicki D, Szymańska M, Kiełb P, Małkiewicz B, Zostawa J, Roslan M, Zajączkowska J, Jarzemski M, Brzoszczyk B, Petrasz P, Jarzemski P, Zdrojowy R, Dobruch J, Paradysz A, Drewa T, Chłosta P, Radziszewski P. Not as black as it is painted? The impact of the first wave of COVID-19 pandemic on surgical treatment of urological cancer patients in Poland - a cross-country experience. Arch Med Sci 2023; 19:107-115. [PMID: 36817674 PMCID: PMC9897107 DOI: 10.5114/aoms/130927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/27/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In the majority of Western European countries, the coronavirus disease (COVID-19) pandemic has led to a dramatic reduction in urooncological surgeries. Our objective was to evaluate the impact of the pandemic on volume and patterns of urooncological surgery in Poland. MATERIAL AND METHODS This is a retrospective analysis of 10 urologic centres in Poland. Data regarding major oncological procedures performed after the COVID-19 pandemic outbreak (March 15, 2020 - May 31, 2020) were evaluated and compared with data from the respective period in 2019. RESULTS Between March 15, 2020 and May 31, 2020, a total of 968 oncological procedures were performed in participating centres. When compared to the respective period in 2019 (1063 procedures) the overall number of surgeries declined by 8.9%. The reduction was observed for transurethral resection of bladder tumour (TURBT) (20.1%) and partial nephrectomies (PN) (16.5%). Surgical activity considering radical nephrectomy (RN), nephroureterectomy (NU), and radical prostatectomy (RP) remained relatively unchanged, whereas radical cystectomy (RC) burden showed a significant increase (90.9%). Characteristics of patients treated with TURBT, RC, NU, PN, and RN did not differ significantly between the compared periods, whereas RP in the COVID-19 period was performed more frequently in patients with a higher grade group (p = 0.028) and positive digital rectal examination (p = 0.007). CONCLUSIONS Surgical activity for urological cancers in Poland has been maintained during the first wave of the COVID-19 pandemic. The Polish strategy in the initial period of the COVID-19 crisis mirrors the scenario of hard initial lockdown followed by adaptive lockdown, during which oncological care remained undisrupted and did not require particular priority triage.
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Affiliation(s)
- Piotr Zapała
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Warsaw, Poland
| | - Aleksander Ślusarczyk
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Rajwa
- Department of Urology, Medical University of Silesia, Katowice, Poland
| | - Mikołaj Przydacz
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Wojciech Krajewski
- Department of Urology and Oncologic Urology, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Dybowski
- Department of Urology, Roefler Memorial Hospital, Pruszkow, Poland
| | - Przemysław Kubik
- Department of General and Oncologic Urology, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Błażej Kuffel
- Department of General and Oncologic Urology, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Maciej Przudzik
- Department of Urology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Rafał Osiecki
- Department of Urology, Centre of Postgraduate Medical Education, Professor W. Orłowski Independent Public Teaching Hospital, Warsaw, Poland
| | - Remigiusz Stamirowski
- Department of Urology and Urooncology, Multispecialty Regional Hospital, Gorzow Wielkopolski, Poland
| | - Łukasz Zapała
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Warsaw, Poland
| | - Mieszko Kozikowski
- Department of Urology, Centre of Postgraduate Medical Education, Professor W. Orłowski Independent Public Teaching Hospital, Warsaw, Poland
| | - Dominik Chorągwicki
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Szymańska
- Department of General and Oncologic Urology, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Paweł Kiełb
- Department of Urology and Oncologic Urology, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Małkiewicz
- Department of Urology and Oncologic Urology, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek Zostawa
- Department of Urology, Medical University of Silesia, Katowice, Poland
| | - Marek Roslan
- Department of Urology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Joanna Zajączkowska
- Department of Urology and Urooncology, Multispecialty Regional Hospital, Gorzow Wielkopolski, Poland
| | - Marcin Jarzemski
- Department of Urology, Jan Biziel University Hospital, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Bartosz Brzoszczyk
- Department of Urology, Jan Biziel University Hospital, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Piotr Petrasz
- Department of Urology and Urooncology, Multispecialty Regional Hospital, Gorzow Wielkopolski, Poland
| | - Piotr Jarzemski
- Department of Urology, Jan Biziel University Hospital, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Romuald Zdrojowy
- Department of Urology and Oncologic Urology, Wroclaw Medical University, Wroclaw, Poland
| | - Jakub Dobruch
- Department of Urology, Centre of Postgraduate Medical Education, Professor W. Orłowski Independent Public Teaching Hospital, Warsaw, Poland
| | - Andrzej Paradysz
- Department of Urology, Medical University of Silesia, Katowice, Poland
| | - Tomasz Drewa
- Department of General and Oncologic Urology, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Piotr Chłosta
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Radziszewski
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Warsaw, Poland
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Robert G, Bernhard JC, Capon G, Alezra E, Estrade V, Blanc P, Bladou F, Bensadoun H. Consequences of SARS-CoV-2 pandemic on urological surgery in France: a nationwide analysis of the healthcare system database. BMJ Open 2022; 12:e066220. [PMID: 36375970 PMCID: PMC9664026 DOI: 10.1136/bmjopen-2022-066220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The SARS-CoV-2 outbreak overwhelmed the healthcare systems worldwide. Saturation of hospitals and the risk of contagion led to a reduction in the care of other diseases. OBJECTIVE To determine the impact of SARS-CoV-2 pandemic on urological surgery in France during the year 2020. DESIGN, SETTING AND PARTICIPANTS An observational descriptive study was conducted on anonymised data collected from the national healthcare database established each year as part of the Program for the Medicalization of Information Systems in Medicine, Surgery, Obstetrics and Odontology. INTERVENTION None. PRIMARY AND SECONDARY OUTCOME MEASURES We gathered the number of urology surgical procedures carried out between 2010 and 2019, and we observed the difference between the forecast and actual number of urological surgeries performed in 2020. RESULTS Urological surgeries decreased by 11.4%, non-oncological surgeries being more affected (-13.1%) than oncological ones (-4.1%). Among the most relevant surgeries, female urinary incontinence (-44.7%) and benign prostatic hyperplasia (-20.8%) were the most impacted ones, followed by kidney cancer (-9%), urolithiasis (-8.7%), radical cystectomy for bladder cancer (-6.1%), prostate cancer (-3.6%) and transurethral resection of bladder tumour (-2%). Public hospitals had a more reduced activity (-17.7%) than private ones (-9.1%). Finally, the distribution of the reduction in urological activities by region did not correspond to the regional burden of SARS-CoV-2. CONCLUSIONS Urological care was severely affected during SARS-CoV-2 pandemic. Even if oncological surgeries were prioritised, the longer it takes to receive appropriate care, the greater the risk on survival impact. TRIAL REGISTRATION The data collection and analysis was authorised by the French Data Protection Authority (CNIL) under the number1 861 282v2.
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Affiliation(s)
- Gregoire Robert
- Department of Urology, CHU de Bordeaux, Bordeaux, France
- Université de Bordeaux, Talence, France
| | | | - Grégoire Capon
- Department of Urology, CHU de Bordeaux, Bordeaux, France
| | - Eric Alezra
- Department of Urology, CHU de Bordeaux, Bordeaux, France
| | | | - Peggy Blanc
- Department of Urology, CHU de Bordeaux, Bordeaux, France
| | - Franck Bladou
- Department of Urology, CHU de Bordeaux, Bordeaux, France
- Université de Bordeaux, Talence, France
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Seydou A, Hachelaf M, Thiébaud D, Barondeau-Leuret A. Évolution du nombre de passages aux urgences pour intoxications aiguës lors des périodes de confinement de Covid-19 en Bourgogne-Franche-Comté. ANNALES FRANCAISES DE MEDECINE D URGENCE 2022. [DOI: 10.3166/afmu-2022-0414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectif : Estimer l’évolution du nombre de passages aux urgences pour intoxications aiguës (IA) lors des périodes de confinement en 2020 par rapport à l’année précédente.
Matériels et méthode : Une étude rétrospective multicentrique de type transversale a été menée en utilisant les données des résumés de passages aux urgences. Deux périodes ont été étudiées en 2020 : période 1 = 1er confinement et période 2 = 2e confinement et ont été comparées aux mêmes périodes en 2019. Les diagnostics pour IA volontaires ou accidentelles toutes causes ont été définis à partir du code CIM-10. Le critère de jugement principal a été la variation du nombre de passages aux urgences pour IA entre les périodes de confinement en 2020 et les périodes de référence en 2019.
Résultats : Comparé à la même période en 2019, le nombre de passages aux urgences pour IA a baissé de 31 % (p = 0,001) pendant le premier confinement et de 18 % (p = 0,07) pendant le deuxième confinement. Le nombre de passages pour IA médicamenteuse a baissé de 3 % (p = 0,035) pendant le deuxième confinement en comparaison à 2019. Les caractéristiques des patients consultant pour IA étaient comparables dans chacune des périodes.
Conclusion : Dans cette étude, une diminution du nombre de passages aux urgences pour IA a été observée pendant les périodes de confinement en 2020 par rapport aux mêmes périodes l’année précédente.
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de Souza Maciel Ferreira JE, Rocha de Oliveira L, Galvão Pereira K, Marques Frota N, Frota Cavalcante T, Santos Monte A, Lopes Chaves AF. Estratégias organizacionais no centro cirúrgico diante da pandemia de COVID 19: uma revisão integrativa. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Introdução: os sistemas de saúde foram desafiados a desenvolver estratégias organizacionais para a prestação de cuidados cirúrgicos. Objetivo: apresentar as estratégias dos serviços de saúde no que se refere às práticas de cuidados cirúrgicos em tempos de pandemia de COVID-19. Materiais e métodos: revisão integrativa, desenvolvida em seis etapas, cuja busca dos artigos ocorreu na Biblioteca Virtual de Saúde, SciELO, PubMed e ScienceDirect. Os descritores controlados em saúde adotados foram “Centros Cirúrgicos” e “Infecções por Coronavírus”, de acordo com os sistemas DeCS e MeSH Terms. Foram selecionados 60 artigos de 405 estudos encontrados. Resultados: as principais estratégias utilizadas pelos serviços de saúde foram: a suspensão e adiamento de cirurgias eletivas durante as ondas de contágio da doença; e a triagem cuidadosa dos pacientes para COVID-19 antes e após intervenções cirúrgicas. Discussão: a suspensão e o adiamento de cirurgias eletivas devem ser avaliados com cautela pela equipe de saúde, de forma individualizada, para cada paciente, visto que situações clínicas não urgentes podem agravar ao longo do tempo, aumentando as chances de morbimortalidade desses pacientes. Conclusão: a triagem dos pacientes e dos profissionais da saúde para COVID-19 são estratégias importantes para evitar a contaminação desses sujeitos. A suspensão e o adiamento de cirurgias eletivas, durante as ondas de contágio por COVID-19, são recomendados para aumentar a capacidade de leitos disponíveis para pacientes graves hospitalizados por essa doença. Essa recomendação também auxilia no remanejamento de profissionais desse setor para as unidades com a demanda de cuidados de saúde mais elevada.
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Goldman C, Pradere B, Mete M, Talso M, Bernardino R, Campi R, Marchalik D. A MULTINATIONAL STUDY OF THE IMPACT OF COVID-19 ON UROLOGIC SURGERY RESIDENCY AND WELLBEING. Urology 2022; 166:87-94. [PMID: 35461917 PMCID: PMC9023370 DOI: 10.1016/j.urology.2022.01.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/06/2021] [Accepted: 01/02/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess changes to the experiences and wellbeing of urology trainees in the United States(US) and European Union (EU) during the COVID-19 pandemic. METHODS A 72-item anonymous online survey was distributed September 2020 to urology residents of Italy, France, Portugal, and the US. The survey assessed burnout, professional fulfillment, loneliness, depression and anxiety as well as 38 COVID specific questions. RESULTS Two hundred twenty-three urology residents responded to the survey. Surgical exposure was the main educational concern for 81% of US and 48% of EU residents. E-learning was utilized by 100% of US and 57% of EU residents with two-thirds finding it equally or more useful than traditional didactics. No significant differences were seen comparing burnout, professional fulfillment, depression, anxiety, or loneliness among US or EU residents, 73% of US and 71% of EU residents reported good to excellent quality of life during the pandemic. In the US and EU, significantly less time was spent in the hospital, clinic, and operating room (p<0.001) and residents spent more time using telehealth and working from home during the pandemic and on research projects, didactic lectures, non-medical hobbies and reading. The majority of residents reported benefit from more schedule flexibility, improved work life balance, and increased time for family, hobbies, education, and research. CONCLUSIONS The COVID-19 pandemic has resulted in significant restructuring of residents' educational experience around the globe. Preservation of beneficial changes such as reduction of work hours and online learning should be pursued within this pandemic and beyond it.
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Affiliation(s)
- Charlotte Goldman
- MedStar Georgetown University Hospital, Department of Urology, 3800 Reservoir Rd NW, Washington, DC, 20007
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Mihriye Mete
- MedStar Health, Office of Physician Wellbeing, 10980 Grantchester Way, Columbia, MD, 21044; MedStar Health Research Institute, Depart of Behavioral Health Research; Georgetown University Medical Center, Department of Psychiatry
| | - Michele Talso
- Department of Urology ASST Fatebenefratelli-Sacco Luigi Sacco University Hospital, Milan, Italy
| | - Rui Bernardino
- Central Lisbon University Hospital Centre, Urology Department, Lisbon
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniel Marchalik
- MedStar Georgetown University Hospital, Department of Urology, 3800 Reservoir Rd NW, Washington, DC, 20007; MedStar Health, Office of Physician Wellbeing, 10980 Grantchester Way, Columbia, MD, 21044.
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Loaiza-Aldeán Y, de Miguel M, Morales-Ariza V, González-Tallada A, Manrique S, Domínguez González JM, de Nadal M. “Evaluación de la efectividad del nuevo modelo perioperatorio para recuperar la actividad quirúrgica durante la pandemia de COVID-19”. J Healthc Qual Res 2022; 37:408-414. [PMID: 35764494 PMCID: PMC8898673 DOI: 10.1016/j.jhqr.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Y Loaiza-Aldeán
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d́Hebron, Barcelona, España.
| | - M de Miguel
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d́Hebron, Barcelona, España
| | - V Morales-Ariza
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d́Hebron, Barcelona, España
| | - A González-Tallada
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d́Hebron, Barcelona, España
| | - S Manrique
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d́Hebron, Barcelona, España
| | | | - M de Nadal
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d́Hebron, Barcelona, España
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Noureldin YA, Elmohamady B, El-Dakhakhny AS, Omar M, Desoky EE, Ghazwani Y, Hamri SB, Alkhayal A, Alrabeeah K, Kamal W, Farag F, Farahat Y. How did the first year of the COVID-19 pandemic affect urology practice in Arab countries? A cross-sectional study by the Arab Association of Urology research group. Ther Adv Urol 2022; 14:17562872221079492. [PMID: 35251310 PMCID: PMC8891825 DOI: 10.1177/17562872221079492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/21/2022] [Indexed: 11/28/2022] Open
Abstract
Objective: The aim of this study was to assess of the effect of coronavirus disease 2019 (COVID-19) pandemic on urology practice in the Arab world during the first year of the crisis. Methods: An Internet-based questionnaire was created and sent out via email to members of the Arab Association of Urology (AAU) using ‘Google Forms’. The survey assessed participants’ demographics in terms of age, gender, country of origin, type of practice and position. Impacts of COVID-19 on urological practice were assessed in terms of the changes in hospital policies regarding consultations, and elective and emergency surgical cases. Moreover, impacts of COVID-19 on urologists were assessed. Results: A total of 255 AAU members across 14 Arab countries (Emirates, Egypt, Saudi Arabia, Iraq, Jordan, Algeria, Kuwait, Yemen, Qatar, Lebanon, Libya, Oman, Sudan and Syria) completed the survey; 4% were female urologists. Consultations at outpatient clinics were closed or restricted to emergency cases or replaced by telemedicine in almost 15%, 40% and 25% of hospitals, respectively. Elective surgeries were stopped or reduced to under 25% of surgical capacity in >10% and about 25% of hospitals, respectively. Almost 90% (228) reported changes in the policy for emergency theatres. Nearly 65% of hospitals offered preoperative COVID-19 testing to patients and 50% of hospitals provided personal protective equipment (PPE) to their urologists. Of 99% (253) who reported a change in urological education, 95% relied on online webinars. About 56% of respondents had their own private practice, of whom 91% continued private practice during the crisis. About 38% of participants reported exposure to intimidation (75% emotional, 20% verbal and 5% physical). Conclusion: The COVID-19 pandemic resulted in major changes in hospitals’ policies regarding outpatient consultations, elective and emergency operative cases, and the shift to telemedicine. Arab urologists have been facing major challenges either in both the governmental or the private sectors, and some of them were exposed to emotional, verbal and even physical intimidation.
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Affiliation(s)
- Yasser A. Noureldin
- Department of Urology, Benha Faculty of Medicine, Benha University, Benha 13511, Egypt
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, Saudi Arabia
| | - Basheer Elmohamady
- Department of Urology, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Amr S. El-Dakhakhny
- Department of Urology, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Mohamed Omar
- Department of Urology, Menoufiya University Hospital, Menoufiya, Egypt
| | - Esam E.A. Desoky
- Department of Urology, Zagazig University Hospital, Zagazig, Egypt
| | - Yahia Ghazwani
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saeed Bin Hamri
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, Saudi Arabia
| | - Abdullah Alkhayal
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid Alrabeeah
- Division of Urology, King Abdulaziz Medical City, MNGHA, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Wissam Kamal
- Department of Urology, King Fahd Hospital, Jeddah, Saudi Arabia
| | - Fawzy Farag
- Department of Urology, Sohag University Hospital, Sohag, Egypt
| | - Yasser Farahat
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
- Urology Department, Sheikh Khalifa General Hospital, Umm Al Quwain, United Arab Emirates
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Bheenick D, Young MJ, Elmussareh M, Ali A. The impact of COVID-19 pandemic on acute urology admissions in a busy district general hospital in the United Kingdom. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158211073435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the United Kingdom. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the United Kingdom. Patient and methods: Retrospective data of patients presenting acutely to the urology department were collected between 13 January to 22 March 2020 (pre-lockdown period) and 23 March to 31 May 2020 (lockdown period). The nature of referrals, types of admission encountered and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Results: Overall, 1092 patients were included in the study. An overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. Conclusion: The admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.
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Affiliation(s)
- Divya Bheenick
- Department of Urology, Pinderfields General Hospital, Mid Yorkshire Hospitals NHS Trust, UK
| | - Matthew J Young
- Department of Urology, Pinderfields General Hospital, Mid Yorkshire Hospitals NHS Trust, UK
| | - Muhammad Elmussareh
- Department of Urology, Pinderfields General Hospital, Mid Yorkshire Hospitals NHS Trust, UK
| | - Ased Ali
- Department of Urology, Pinderfields General Hospital, Mid Yorkshire Hospitals NHS Trust, UK
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Carré F, Leboulanger N, Thierry B, Simon F, Couloigner V, Denoyelle F, Luscan R. Impact of COVID-19 lockdown on a tertiary center pediatric otolaryngology emergency department. Eur J Pediatr 2022; 181:647-652. [PMID: 34498170 PMCID: PMC8425462 DOI: 10.1007/s00431-021-04236-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/22/2021] [Accepted: 08/08/2021] [Indexed: 11/26/2022]
Abstract
To assess the quantitative and qualitative impact of the COVID-19 lockdown on pediatric otolaryngology emergency activity. A retrospective study was conducted in a pediatric otolaryngology tertiary care center. Emergency activity during the lockdown period from March 17 to May 11, 2020, was compared to the 2019 and 2018 averages for the same period. Study data included a number of emergency consultations and the number and type of surgical procedures: infection management, endoscopic airway procedure, and post-tonsillectomy hemorrhage. Only 350 children were referred to the pediatric otolaryngology emergencies in our center during the lockdown, compared to 761 on the same period the year before (- 54%); 62 emergency surgeries were performed, compared to 93 (- 33%). The ratio between emergency surgeries and consultations was 18% in 2020, versus 12% previously (p = 0.014). The number of surgical procedures for infectious diseases decreased (- 68%), at 16% of surgical emergencies in 2020 compared to 33% previously (p = 0.017). In 2020, 52 emergency endoscopies were performed, versus 59 previously (- 12%), 27% being performed for suspected tracheobronchial or esophageal foreign bodies, compared to 66% in previous years (p < 0.0001). No post-tonsillectomy hemorrhages were managed in 2020.Conclusion: The COVID-19 lockdown changed pediatric ENT emergency activity quantitatively and also qualitatively. What is Known: • SARS-CoV-2 pandemic impacted pediatric ENT emergency activity quantitatively and qualitatively. What is New: • here was a 54% decrease in pediatric ENT emergency consultation and 33% decrease in emergency ENT surgeries. • Rates of surgery for infection of whatever type decreased by 68%.
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Affiliation(s)
- Fabienne Carré
- Pediatric Otolaryngology Department, Hôpital Necker-Enfants-Malades, APHP.Centre, Université de Paris, 75015, Paris, France.
- UFR Médecine Paris Centre, Université de Paris, 75006, Paris, France.
| | - Nicolas Leboulanger
- Pediatric Otolaryngology Department, Hôpital Necker-Enfants-Malades, APHP.Centre, Université de Paris, 75015, Paris, France
- UFR Médecine Paris Centre, Université de Paris, 75006, Paris, France
| | - Briac Thierry
- Pediatric Otolaryngology Department, Hôpital Necker-Enfants-Malades, APHP.Centre, Université de Paris, 75015, Paris, France
- UFR Médecine Paris Centre, Université de Paris, 75006, Paris, France
| | - François Simon
- Pediatric Otolaryngology Department, Hôpital Necker-Enfants-Malades, APHP.Centre, Université de Paris, 75015, Paris, France
- UFR Médecine Paris Centre, Université de Paris, 75006, Paris, France
| | - Vincent Couloigner
- Pediatric Otolaryngology Department, Hôpital Necker-Enfants-Malades, APHP.Centre, Université de Paris, 75015, Paris, France
- UFR Médecine Paris Centre, Université de Paris, 75006, Paris, France
| | - Françoise Denoyelle
- Pediatric Otolaryngology Department, Hôpital Necker-Enfants-Malades, APHP.Centre, Université de Paris, 75015, Paris, France
- UFR Médecine Paris Centre, Université de Paris, 75006, Paris, France
| | - Romain Luscan
- Pediatric Otolaryngology Department, Hôpital Necker-Enfants-Malades, APHP.Centre, Université de Paris, 75015, Paris, France
- UFR Médecine Paris Centre, Université de Paris, 75006, Paris, France
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12
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Masselin-Dubois A, Enert-Barbero N, Gazagne A. Adaptation des pratiques psychologiques en clinique de la douleur durant la pandémie de la COVID-19. PRAT PSYCHOL 2022. [PMCID: PMC8784648 DOI: 10.1016/j.prps.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction La pratique clinique auprès de patients douloureux chroniques, ébranlée par la réorganisation du champ sanitaire, a nécessité de repenser la prise en charge psychologique de la douleur. Afin de poursuivre l’accompagnement psychologique des patients, des consultations individuelles ou des ateliers de groupes à distance se sont développés. Un groupe d’échange de pratiques rassemblant des psychologues et psychothérapeutes a partagé ses expériences cliniques et son vécu de la crise. Objectifs Les objectifs de cette étude sont d’explorer l’adaptation des pratiques cliniques pour les sujets douloureux chroniques, le vécu des professionnels, et de proposer des recommandations issues des réflexions collectives. Méthode La méthodologie de recherche clinique a suivi celle d’un focus group. Trois réunions en visioconférence de deux heures ont eu lieu de septembre 2020 à mai 2021. Une analyse thématique des retranscriptions a été réalisée avec le logiciel d’analyse qualitative NVivo. Résultats Au total, 9 psychologues et psychothérapeutes ont participé au focus group. L’analyse thématique a révélé trois grands thèmes, à savoir : (1) impact de la crise sanitaire liée à la COVID-19 ; (2) adaptation des pratiques ; (3) processus de changement des pratiques cliniques. Conclusion Les professionnels rapportent que l’usage des outils numériques a permis de limiter l’impact psychologique de la crise sanitaire sur les patients et de maintenir le lien. Des recommandations issues des réflexions collectives suggèrent de maintenir les soins en distanciel et de s’appuyer sur le soutien des équipes, de la hiérarchie, et des groupes d’échanges entre pairs.
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13
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Collateral damage of COVID-19 pandemic: The impact on a gynecologic surgery department. J Gynecol Obstet Hum Reprod 2021; 51:102255. [PMID: 34757223 PMCID: PMC8555111 DOI: 10.1016/j.jogoh.2021.102255] [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] [Received: 03/11/2021] [Revised: 10/03/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022]
Abstract
Objective This study focuses on changes in gynecologic surgical activity at Hospital Foch, Paris, France during the first French COVID lockdown in 2020. Additional goals include the evaluation the extent of the postponement suffered for each type of surgery and estimate the possible negative impact for patients. Study design Single-center, retrospective, chart-review cohort study in the gynecology department of Hospital Foch. Comparison of all patients scheduled, postponed and operated during the first COVID lockdown (March 14, to May 11, 2020) versus the same period in 2019. Postponed surgeries were classified into 4 scheduling interval categories according to the Society of Gynecology Oncology (SGO) recommendations: urgent (without delay), semi-urgent (1–4 weeks), non-urgent (>4–12 weeks) and elective (>3 months) and evaluated to determine whether COVID-19-related delays of surgeries fell within guidelines. The potential “loss of chance” or medical risk associated with postponed surgeries was estimated according to a composite criterion including death, aggravation of expected tumor stages/grades in cancers, increase in surgical complexity compared to that initially planned, need for preoperative transfusions, start of morphine consumption during preoperative treatment for opiate-naive patients, additional hospitalization or consultations in emergency room and delay in treatment when surgery was urgent. Results During the 2020 French COVID lockdown, 61 patients had a surgical procedure and 114 were postponed; in the comparator 2019 group, 232 patients underwent surgical procedures, indicating an overall decrease of 65% of activity. Analysis of differences between the two years revealed a reduction of 64% in emergency procedures, 90% of functional pathologies, and 13% of cancers. According to SGO guidelines, the only type of surgical procedures that had excessive delay was the semi-urgent group, where time to surgery was 6.7 weeks [range 5.4–10 weeks] instead of the recommended interval of 1–4 weeks. Among postponed surgeries there were 10 patients (8.7%) with a potential “loss of chance” according to the composite criteria, all included in the semi-urgent group. Conclusion The COVID 19 pandemic was responsible for a significant decrease of activity in the surgical department of Hospital Foch. Difficulty of rescheduling surgeries was responsible for an increased delay in semi-urgent operations. In almost 9% of postponed surgeries, there was a potential “loss of chance”, which likely represents only the tip of iceberg of collateral damages due to COVID 19 pandemic in this surgical unit. These data show the importance of continuing to treat pathologies requiring urgent or semi-urgent surgery during pandemics.
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14
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Micoogullari U, Kisa E, Yucel C, Ozbilen MH, Karaca E, Cakici MC, Ozcift B, Ilbey YO. The effect of the first wave of COVID-19 pandemic on urology practice and anxiety scores of patients awaiting surgery. Int J Clin Pract 2021; 75:e14201. [PMID: 33794032 PMCID: PMC8250375 DOI: 10.1111/ijcp.14201] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/22/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE We aimed to determine the effect COVID-19 pandemic on the daily urology practice of the level 3 centre located in one of the most affected regions in Turkey. We also aimed to assess anxiety and depression levels of patients whose procedures and surgeries had to be postponed due to COVID-19-related restrictions. METHODS The number of patients admitted to the outpatient clinic, outpatient procedures, emergency consultation requests, hospitalised patients and the total number of surgeries between March 10, 2020 and June 15, 2020 were evaluated. These numbers were compared with the same period of 2019. Subsequently, patients who could not be operated or whose elective surgeries were postponed between March 10, 2020 and June 15, 2020 were determined(n:96). These patients were asked to fill out Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI). The presence of difference between the baseline anxiety levels and the anxiety levels during the COVID-19 pandemic was investigated. Afterwards, these patients were divided into two groups based on planned procedures as oncological group (group1) and non-oncological group (group2). The presence of a difference between the anxiety and depression levels between the groups was investigated. RESULTS There was a drastic decline in number of patients in all assessed parameters. The least amount of change was seen in the number of emergency consultations. The evaluation of anxiety and depression scores of the patients showed a significant difference between their STAI-S and STAI-T scores (51.8 ± 9.3, 38.2 ± 7.5, respectively)(P < .001). STAI-S scores of the patients were found to be compatible with severe anxiety. The patients' mean BDI score was found to be 15 ± 8.9, which indicated mild depression. However, the age and STAI-S values were significantly higher in group1. CONCLUSION We noted that anxiety and depression levels increased in patients whose operations were delayed because of pandemic-related restrictions, especially in oncological patients. We believe that an important contribution can be made to the protection of public health by planning advance psychosocial interventions for high-risk groups during pandemics.
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Affiliation(s)
| | - Erdem Kisa
- Department of UrologyTepecik Training and Research HospitalIzmirTurkey
| | - Cem Yucel
- Department of UrologyTepecik Training and Research HospitalIzmirTurkey
| | | | - Erkin Karaca
- Department of UrologyTepecik Training and Research HospitalIzmirTurkey
| | - Mehmet Caglar Cakici
- Department of UrologySchool of MedicineIstanbul Medeniyet UniversityIstanbulTurkey
| | - Burak Ozcift
- Department of Pediatric UrologyDr. Behcet Uz Children HospitalIzmirTurkey
| | - Yusuf Ozlem Ilbey
- Department of UrologyTepecik Training and Research HospitalIzmirTurkey
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15
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Bozkurt O, Sen V, Irer B, Sagnak L, Onal B, Tanidir Y, Karabay E, Kaya C, Ceyhan E, Baser A, Duran MB, Suer E, Celen I, Selvi I, Ucer O, Karakoc S, Sarikaya E, Ozden E, Deger D, Egriboyun S, Ongun S, Gurboga O, Asutay MK, Kazaz IO, Yilmaz IO, Kisa E, Demirkiran ED, Horsanali O, Akarken I, Kizer O, Eren H, Ucar M, Cebeci OO, Kizilay F, Comez K, Mercimek MN, Ozkent MS, Izol V, Gudeloglu A, Ozturk B, Akbaba KT, Polat S, Gucuk A, Ziyan A, Selcuk B, Akdeniz F, Turgut H, Sabuncu K, Kaygisiz O, Ersahin V, Kahraman HI, Guzelsoy M, Demir O. Nation-wide analysis of the impact of Covid-19 pandemic on daily urology practice in Turkey. Int J Clin Pract 2021; 75:e13735. [PMID: 32996259 PMCID: PMC7536952 DOI: 10.1111/ijcp.13735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/23/2020] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. METHODOLOGY The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. RESULTS A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life. CONCLUSIONS Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.
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16
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Panthier F, Traxer O, Yonneau L, Lebret T, Berthe L, Illoul L, Timsit MO, Mejean A, Doizi S, Audenet F. Evaluation of a free 3D software for kidney stones' surgical planning: "kidney stone calculator" a pilot study. World J Urol 2021; 39:3607-3614. [PMID: 33779821 PMCID: PMC8006641 DOI: 10.1007/s00345-021-03671-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/13/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction Kidney Stone Calculator (KSC) is a free, three-dimensional (3D) planning software for flexible ureteroscopy(fURS) with Holmium:YAG(Ho:YAG) endocorporeal lithotripsy (EL). KSC provides the stone volume (SV) and expected duration of lithotripsy (ExDL) estimations based on non-enhanced-CT scan (NECT) DICOM series. We aimed to provide a preclinical and clinical evaluation of KSC. Patients and methods A preclinical evaluation measured the SV by three operators (resident, endourology expert and research engineer) among 17 NECT cases. Between January and March 2020, a multicentric, prospective, observational double-blind clinical evaluation was conducted in patients presenting with renal stones treated with Ho:YAG-EL during fURS and preoperative NECT. Demographic and surgical data were collected. The primary endpoint was a significant median difference between ExDL and EffectiveDL (EfDL). Second, efficiency (J/mm3) and efficacy (mm3/min) ratios were calculated. Results The preclinical evaluation showed no significant difference in the SV measurements among operators (p > 0.05). Pearson and Kendall coefficients of 0.99 and 0.98, respectively, were found. Twenty-six patients were included in the clinical evaluation, with a median age of 55 years. In 66% of cases, there was a single stone located in the lower pole, with a density > 1000 Hounsfield Unit observed in 42% and 85% of cases. A 14% [Q1–Q3 (5.4–24.8); p = 0.36] median difference between ExDL and EfDL was noted, which was greater in the case of lower pole stones with no possible relocation (p = 0.008). Median values of 17.6 J/mm3 and 0.4 (0.32–0.56) mm3/s EL were also noted. Conclusions Kidney Stone Calculator is a reproducible and accurate software that allows for an estimation of the stone burden and provides an ExDL for URSf. Defining the influencing factors of EL will improve its ExDL. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-021-03671-z.
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Affiliation(s)
- Frédéric Panthier
- Service D'Urologie, Hôpital Européen Georges Pompidou, AP-HP, Centre-Université de Paris, 20 rue Leblanc, 75015, Paris, France. .,GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.
| | - Olivier Traxer
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.,Service D'Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.,PIMMUMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
| | - Laurent Yonneau
- Service D'Urologie, Hôpital Foch-Université Paris Saclay-UVSQ, 40 rue Worth, 92150, Suresnes, France
| | - Thierry Lebret
- Service D'Urologie, Hôpital Foch-Université Paris Saclay-UVSQ, 40 rue Worth, 92150, Suresnes, France
| | - Laurent Berthe
- PIMMUMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
| | - Lounès Illoul
- PIMMUMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
| | - Marc-Olivier Timsit
- Service D'Urologie, Hôpital Européen Georges Pompidou, AP-HP, Centre-Université de Paris, 20 rue Leblanc, 75015, Paris, France
| | - Arnaud Mejean
- Service D'Urologie, Hôpital Européen Georges Pompidou, AP-HP, Centre-Université de Paris, 20 rue Leblanc, 75015, Paris, France
| | - Steeve Doizi
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.,Service D'Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.,PIMMUMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l'Hôpital, 75013, Paris, France
| | - François Audenet
- Service D'Urologie, Hôpital Européen Georges Pompidou, AP-HP, Centre-Université de Paris, 20 rue Leblanc, 75015, Paris, France
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17
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Riera R, Bagattini ÂM, Pacheco RL, Pachito DV, Roitberg F, Ilbawi A. Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review. JCO Glob Oncol 2021; 7:311-323. [PMID: 33617304 PMCID: PMC8081532 DOI: 10.1200/go.20.00639] [Citation(s) in RCA: 256] [Impact Index Per Article: 85.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally. METHODS This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented. RESULTS Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the reduction in service availability. The studies identified 38 different categories of delays and disruptions with impact on treatment, diagnosis, or general health service. Delays or disruptions most investigated included reduction in routine activity of cancer services and number of cancer surgeries; delay in radiotherapy; and delay, reschedule, or cancellation of outpatient visits. Interruptions and disruptions largely affected facilities (up to 77.5%), supply chain (up to 79%), and personnel availability (up to 60%). CONCLUSION The remarkable frequency of delays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.
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Affiliation(s)
- Rachel Riera
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil.,Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.,Oxford-Brazil EBM Alliance, Petrópolis, Brazil
| | | | - Rafael Leite Pacheco
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil.,Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.,Oxford-Brazil EBM Alliance, Petrópolis, Brazil.,Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Felipe Roitberg
- Instituto do Câncer do Estado de São Paulo/HCFMUSP, São Paulo, Brazil.,Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland.,European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - Andre Ilbawi
- Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland
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18
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Blanc T, Pinar U, Anract J, Assouad J, Audenet F, Borghese B, De La Taille A, El Ghoneimi A, Mongiat-Artus P, Mordant P, Penna C, Roupret M. Impact of the COVID-19 pandemic on oncological and functional robotic-assisted surgical procedures. J Robot Surg 2021; 15:937-944. [PMID: 33511526 PMCID: PMC7843004 DOI: 10.1007/s11701-021-01201-y] [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: 12/25/2020] [Accepted: 01/17/2021] [Indexed: 12/20/2022]
Abstract
The COVID-19 pandemic led to a decrease in surgical activity to avoid nosocomial contamination. Robotic-assisted surgery safety is uncertain, since viral dissemination could be facilitated by gas environment. We assessed the impact and safety of the COVID-19 pandemic on robotic-assisted surgery. Data were collected prospectively during lockdown (March 16th–April 30th 2020) in 10 academic centres with robotic surgical activity and was compared to a reference period of similar length. After surgery, patients with suspected COVID-19 were tested by RT-PCR. During the COVID-19 lockdown we evidenced a 60% decrease in activity and a 49% decrease in oncological procedures. However, the overall proportion of oncological surgeries was significantly higher during the pandemic (p < 0.001). Thirteen (7.2%) patients had suspected COVID-19 contamination, but only three (1.6%) were confirmed by RT-PCR. The COVID-19 pandemic resulted in a significant decrease in robotic-assisted surgery. Robotic approach was safe with a low rate of postoperative COVID-19 contamination.
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Affiliation(s)
- Thomas Blanc
- Department of Paediatric Surgery and Urology, AP-HP, Necker-Enfants Malades Hospital, Université de Paris, Paris, France
| | - Ugo Pinar
- Urology, Predictive Onco-Urology, GRC 5, APHP, Pitié-Salpêtrière, Sorbonne University, 75013, Paris, France
| | - Julien Anract
- Urology, Predictive Onco-Urology, GRC 5, APHP, Pitié-Salpêtrière, Sorbonne University, 75013, Paris, France
| | - Jalal Assouad
- Departement of Thoracic and Vascular Surgery, AP-HP, Hôpital Tenon, Sorbonne University, 75020, Paris, France
| | - François Audenet
- Department of Urology, AP-HP Centre, Hôpital Européen Georges Pompidou, Université de Paris, 75015, Paris, France
| | - Bruno Borghese
- Department of Gynaecologic Surgery, AP-HP. Centre, Hôpital Cochin, Université de Paris, 75014, Paris, France
| | - Alexandre De La Taille
- Department of Urology, APHP, Hôpital Henri Mondor, Hôpitaux Universitaires Henri Mondor, 94010, Creteil, France
| | - Alaa El Ghoneimi
- Department of Paediatric Surgery and Urology, AP-HP. Nord, Hôpital Robert Debré, Université de Paris, 75019, Paris, France
| | - Pierre Mongiat-Artus
- Department of Urology, AP-HP. Nord, Hôpital Saint Louis, Université de Paris, 75010, Paris, France
| | - Pierre Mordant
- Department of Thoracic and Vascular Surgery, AP-HP. Nord, Hôpital Bichat, Université de Paris, 75010, Paris, France
| | - Christophe Penna
- Department of Digestive Surgery, APHP, Hôpital Bicêtre, Université Paris Saclay, 94270, Le Kremlin-Bicetre, France
| | - Morgan Roupret
- Urology, Predictive Onco-Urology, GRC 5, APHP, Pitié-Salpêtrière, Sorbonne University, 75013, Paris, France.
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19
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Ganaraja B, Prasanth YM, Kumar PP, Rao SM. Did the fear of contagion deter patients from reporting serious conditions during the COVID-19 pandemic lockdown? A report from South India. MULLER JOURNAL OF MEDICAL SCIENCES AND RESEARCH 2021. [DOI: 10.4103/mjmsr.mjmsr_48_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Watschinger B, Watschinger C, Reindl-Schwaighofer R, Meyer EL, Deak AT, Hammer T, Eigner M, Sprenger-Mähr H, Schneeberger S, Cejka D, Mayer G, Oberbauer R, Rosenkranz AR, Kerschbaum J. Impact of Timely Public Health Measures on Kidney Transplantation in Austria during the SARS-CoV-2 Outbreak-A Nationwide Analysis. J Clin Med 2020; 9:jcm9113465. [PMID: 33126481 PMCID: PMC7693584 DOI: 10.3390/jcm9113465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/21/2020] [Accepted: 10/24/2020] [Indexed: 02/06/2023] Open
Abstract
SARS-CoV-2 led to considerable morbidity/mortality worldwide and tremendously impacted on daily life. Strict lockdown measures were implemented early to contain the viral outbreak in Austria. Massive changes in organizational structures of healthcare facilities followed with unclear implications on the care of non-COVID-19-affected patients. We studied the nationwide impact of COVID-19 on kidney transplantation in Austria during the first six months of 2020. Concurrent with general lockdown measures, all kidney transplant activity was suspended from 13 March to 9 April. Nevertheless, between January and June, total transplant (p = 0.48) and procured donor organ numbers (p = 0.6) did not differ significantly from earlier years. Ten (0.18%) of 5512 prevalent Austrian kidney transplant recipients were diagnosed with SARS-CoV-2. The case fatality rate (one death; 10%) in renal transplant patients was less than in other countries but higher than in Austria's general population (2.4%). We conclude that early and strict general lockdown measures imposed by the government allowed an early, however cautious, re-opening of Austrian transplant programs and played a crucial role for the favorable outcomes of SARS-CoV-2 in Austrian kidney transplant patients. Even though it may be uncertain whether similar results may be obtainable in other countries, the findings may support early intervention strategies during similar episodes in the future.
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Affiliation(s)
- Bruno Watschinger
- Department of Nephrology, Medical University of Vienna, 1090 Vienna, Austria; (C.W.); (R.R.-S.); (R.O.)
- Correspondence: ; Tel.: +43-1-40400-43910
| | - Clara Watschinger
- Department of Nephrology, Medical University of Vienna, 1090 Vienna, Austria; (C.W.); (R.R.-S.); (R.O.)
| | - Roman Reindl-Schwaighofer
- Department of Nephrology, Medical University of Vienna, 1090 Vienna, Austria; (C.W.); (R.R.-S.); (R.O.)
| | - Elias L. Meyer
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, 1090 Vienna, Austria;
| | - Andras T. Deak
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (A.T.D.); (A.R.R.)
| | - Tamara Hammer
- Department of Medicine III: Nephrology, Transplantation Medicine, Rheumatology, Geriatrics, Ordensklinikum Linz Elisabethinen, 4010 Linz, Austria; (T.H.); (D.C.)
| | - Manfred Eigner
- Department of Medicine I, Klinik Favoriten, 1100 Vienna, Austria;
| | - Hannelore Sprenger-Mähr
- Landeskrankenhaus Feldkirch Abteilung für Innere Medizin III, Nephrologie und Dialyse, 6807 Feldkirch, Austria;
| | - Stefan Schneeberger
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Daniel Cejka
- Department of Medicine III: Nephrology, Transplantation Medicine, Rheumatology, Geriatrics, Ordensklinikum Linz Elisabethinen, 4010 Linz, Austria; (T.H.); (D.C.)
| | - Gert Mayer
- Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, 6020 Innsbruck, Austria; (G.M.); (J.K.)
- Austrian Dialysis and Transplant Registry, Department of Internal Medicine IV, Nephrology and Hypertension, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Rainer Oberbauer
- Department of Nephrology, Medical University of Vienna, 1090 Vienna, Austria; (C.W.); (R.R.-S.); (R.O.)
| | - Alexander R. Rosenkranz
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (A.T.D.); (A.R.R.)
| | - Julia Kerschbaum
- Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, 6020 Innsbruck, Austria; (G.M.); (J.K.)
- Austrian Dialysis and Transplant Registry, Department of Internal Medicine IV, Nephrology and Hypertension, Medical University of Innsbruck, 6020 Innsbruck, Austria
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