1
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Zancana G, Armocida D, Capobianco M, Corvino S, Cofano F, Garbossa D, Santoro A, Frati A. Clinical, Radiologic, and Surgical Features of Brain Metastases in Colorectal Cancer. A Strong Correlation Between Surgical Patterns and Outcome. World Neurosurg 2024:S1878-8750(24)01213-0. [PMID: 39013497 DOI: 10.1016/j.wneu.2024.07.073] [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: 06/13/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Brain metastases (BMs) from colorectal cancer (CRC) are a small percentage of metastatic patients and surgery is considered the best choice to improve survival. While most research has focused on the risk of CRC spreading to the brain, no studies have examined the characteristics of BMs in relation to surgery and outcome. In this study, we evaluate the clinical and radiologic features of BMs from CRC patients who underwent surgery and analyze their outcomes. METHODS The study is a retrospective observational analysis that included a cohort of 31 patients affected by CRC surgically-treated for their related BMs. For all patients, clinical and surgical data (number, site, side, tumor and edema volume, and morphology) were recorded. RESULTS Analysis found that synchronous diagnosis and lesion morphology, particularly cystic versus solid, had the most significant impact on survival (6 vs. 22 months, P = 0.04). To compare BMs with cystic morphology to those with solid morphology, a multivariate analysis was conducted. No significant differences were observed between the 2 groups in terms of age, sex, clinical onset, or performance status. The analysis revealed no significant differences in localization with regard to site, tumor and edema volume, biology, or complications rate. CONCLUSIONS BMs derived from CRC have a significantly different prognosis depending on whether they present as a solid or cystic pattern. Although solid pattern is more common, cystic BMs in this tumor type are less frequent and are associated with a poorer prognosis, regardless of molecular expression, location, size, and adjuvant treatment.
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Affiliation(s)
- Giuseppa Zancana
- Human Neurosciences Department Neurosurgery Division, Sapienza University Rome, Rome, Italy
| | - Daniele Armocida
- Neuroscience Department "Rita Levi Montalcini", Neurosurgery Unit, Università degli studi di Torino, Turin, Italy; Experimental Neurosurgery Unit, IRCCS "Neuromed", Pozzilli, Italy.
| | - Mattia Capobianco
- Human Neurosciences Department Neurosurgery Division, Sapienza University Rome, Rome, Italy
| | - Sergio Corvino
- Program in Neuroscience, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università di Napoli "Federico II", Naples, Italy
| | - Fabio Cofano
- Neuroscience Department "Rita Levi Montalcini", Neurosurgery Unit, Università degli studi di Torino, Turin, Italy
| | - Diego Garbossa
- Neuroscience Department "Rita Levi Montalcini", Neurosurgery Unit, Università degli studi di Torino, Turin, Italy
| | - Antonio Santoro
- Human Neurosciences Department Neurosurgery Division, Sapienza University Rome, Rome, Italy
| | - Alessandro Frati
- Experimental Neurosurgery Unit, IRCCS "Neuromed", Pozzilli, Italy
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2
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Armocida D, D'Angelo L, Pietro RD, Chiarello G, Jiang T, Rizzo F, Garbossa D, Frati A, Marampon F, Santoro A. The Impact of the COVID-19 Pandemic and Lockdown on the Outcome of Glioblastoma. J Neurol Surg A Cent Eur Neurosurg 2024. [PMID: 38959941 DOI: 10.1055/s-0044-1779262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
BACKGROUND Rapid spread of the SARS-CoV-2 pandemic in 2020 led to an indirect effect on non-COVID patients. Since neuro-oncology cases are unique and brain tumors need a specific therapeutic protocol at proper doses and at the right times, the effects of the pandemic on health care services for patients with glioblastomas (GBs) and their impact on overall survival (OS) and quality of life are not yet known. METHODS We conducted a retrospective study of 142 GB patients who underwent surgery, radiation, and chemotherapy before and after the lockdown period, aiming to determine the differences in access to care, treatment modality, and adjuvant therapies, and how the lockdown changed the prognosis. RESULTS The number of procedures performed for GB during the pandemic was comparable to that of the prepandemic period, and patients received standard care. There was a significant difference in the volume of lesions measured at diagnosis with a decreased number of "accidental" diagnoses and expression of a reduced use by the patient for a checkup or follow-up examinations. Patients expressed a significantly lower performance index in the lockdown period with longer progression-free survival (PFS) in the face of a comparable mean time to OS. CONCLUSION Patients treated surgically for GB during the pandemic period had a more pronounced and earlier reduction in performance status than patients treated during the same period the year before. This appears to be primarily due to lower levels of care in the rehabilitation centers and more frequent discontinuation of adjuvant care.
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Affiliation(s)
- Daniele Armocida
- Neurosurgery Division, Human Neurosciences Department, "Sapienza" University
- IRCCS "Neuromed" Pozzilli (IS), Italy
| | - Luca D'Angelo
- Neurosurgery Division, Human Neurosciences Department, "Sapienza" University
| | - Raffaella De Pietro
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Giuseppina Chiarello
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Tingting Jiang
- Neurosurgery Division, Human Neurosciences Department, "Sapienza" University
| | - Francesca Rizzo
- Unit of Neurosurgery, AOU Città della Salute e della Scienza, Torino, Italy
| | - Diego Garbossa
- Unit of Neurosurgery, AOU Città della Salute e della Scienza, Torino, Italy
| | | | - Francesco Marampon
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Antonio Santoro
- Neurosurgery Division, Human Neurosciences Department, "Sapienza" University
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3
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Armocida D, Santoro A, Frati A. Letter to the Editor Regarding "Case Series and Systematic Review of Electronic Scooter Crashes and Severe Traumatic Brain Injury". World Neurosurg 2023; 173:301-302. [PMID: 37189321 DOI: 10.1016/j.wneu.2023.02.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 05/17/2023]
Affiliation(s)
- Daniele Armocida
- Human Neurosciences Department, Neurosurgery Division "Sapienza" University, AOU Policlinico Umberto I, Rome, Italy; IRCCS "Neuromed" Pozzilli (IS), Molise, Italy.
| | - Antonio Santoro
- Human Neurosciences Department, Neurosurgery Division "Sapienza" University, AOU Policlinico Umberto I, Rome, Italy
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4
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Lee CH, Kim YH, Oh BK, Lee CH, Kim CH, Sung SK, Lee SW, Song GS. Does the COVID-19 Screening Test Affect the Postoperative Prognosis of Patients Who Undergo Emergency Surgery for Cerebral Hemorrhage? Korean J Neurotrauma 2022; 18:198-207. [PMID: 36381433 PMCID: PMC9634325 DOI: 10.13004/kjnt.2022.18.e48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/26/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022] Open
Abstract
Objective The coronavirus disease 2019 (COVID-19) pandemic has affected all medical fields, including neurosurgery. Particularly, performing preoperative screening tests has become mandatory, potentially extending the time from admission to the emergency room and operating room, thus possibly affecting patients' prognosis. This study aimed to determine the influence of COVID-19 screening time on patients' postoperative prognosis. Methods From September 10, 2020, to May 31, 2021, we retrospectively evaluated 54 patients with cerebral hemorrhage who underwent emergency surgery in the emergency room after the screening test. The control group included 89 patients with cerebral hemorrhage who underwent emergency surgery between January 2019 and March 2020, i.e., the period before the COVID-19 pandemic. Prognosis was measured using the Glasgow Coma Scale scores, which were obtained preoperatively, postoperatively, and at discharge, and the modified Rankin Scale (mRS). Additionally, unfavorable outcomes (mRS score 3-6) and in-hospital mortality rates were investigated for postoperative prognostic assessments. Results No remarkable differences were observed in the time to surgical intervention and prognostic evaluation scores between patients with cerebral hemorrhage who underwent COVID-19 screening tests and subjects in the control group. Conclusion This study confirmed that patient treatment and prognosis were not significantly affected by additional preoperative screening testing times during the pandemic. We believe that our results are informative for the evaluation and performance of emergency neurosurgery during the pandemic.
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Affiliation(s)
- Chang Ho Lee
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan, Korea
| | - Young Ha Kim
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan, Korea
| | - Bu Kwang Oh
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan, Korea
| | - Chi Hyung Lee
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan, Korea
| | - Chang Hyeun Kim
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan, Korea
| | - Soon Ki Sung
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan, Korea
| | - Sang Weon Lee
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan, Korea
| | - Geun Sung Song
- Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan, Korea
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Tomasi SO, Umana GE, Raudino G, Scalia G, Ganau M, Winkler PA. In Reply: Neurosurgery and Coronavirus (COVID-19) Epidemic: Doing Our Part. NEUROSURGERY OPEN 2021; 1:okaa011. [PMID: 34632390 PMCID: PMC7499736 DOI: 10.1093/neuopn/okaa011] [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: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- S Ottavio Tomasi
- Department of Neurological Surgery Christian Doppler Klinik Paracelsus Medical University Salzburg, Austria
| | | | - Giuseppe Raudino
- Department of Neurosurgery Istituto di Ricovero e Cura ad alta specializzazione Policlinico di Monza Monza, Italy
| | - Gianluca Scalia
- Neurosurgery Unit Highly Specialized Hospital and of National Importance "Garibaldi" Catania, Italy
| | - Mario Ganau
- Division of Neurosciences Oxford University Hospitals NHS Foundation Trust Oxford, United Kingdom
| | - Peter A Winkler
- Department of Neurological Surgery Christian Doppler Klinik Paracelsus Medical University Salzburg, Austria
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6
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Maragkos GA, McNeill IT, Kessler R, Xie M, Schaefer S, Patel G, Bederson JB, Shrivastava RK. Letter: Comprehensive Neurosurgery Infection Prevention and Control Practice in the COVID-19 “Return to Operate” Era. JOURNAL OF SCIENTIFIC INNOVATION IN MEDICINE 2021. [DOI: 10.29024/jsim.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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7
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Luther E, Burks J, Eichberg DG, Basil G, Berry K, Lu V, Shah A, Kaur G, Ivan M, Komotar R. Neuro-oncology practice guidelines from a high-volume surgeon at the COVID-19 epicenter. J Clin Neurosci 2020; 85:1-5. [PMID: 33581778 PMCID: PMC7834482 DOI: 10.1016/j.jocn.2020.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/27/2020] [Accepted: 12/07/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND During the coronavirus 19 (COVID-19) pandemic, physicians have begun adapting their daily practices to prevent transmissions. In this study we aimed to provide surgical neuro-oncologists with practice guidelines during the COVID-19 pandemic based on objective data from a high-volume brain tumor surgeon at the current COVID-19 epicenter. METHODS All outpatient visits and surgeries performed by the senior author during the COVID-19 pandemic were compared between the initial quarantine (3/23/20-5/4/20), the plateau period following quarantine (5/5/20-6/27/20), and the second peak (6/28/20-7/20/20). In-person and telemedicine visits were evaluated for crossovers. Surgeries were subdivided based on lesion type and evaluated across the same time period. RESULTS From 3/23/20-7/20/20, 469 clinic visits and 196 surgeries were identified. After quarantine was lifted, face-to-face visits increased (P < 0.01) yet no change in telehealth visits occurred. Of 327 telehealth visits, only 5.8% converted to in-person during the 4-month period with the most cited reason being patient preference (68.4%). Of the 196 surgeries performed during the pandemic, 29.1% occurred during quarantine, 49.0% during the plateau, and 21.9% occurred in the second peak. No COVID negative patients developed symptoms at follow-up. 55.6% were performed on malignant tumors and 31.6% were benign with no difference in case volumes throughout the pandemic. CONCLUSIONS Despite exceptional challenges, we have maintained a high-volume surgical neuro-oncology practice at the epicenter of the COVID-19 pandemic. We provide the protocols implemented at our institution in order to maximize neuro-oncology care while mitigating risk of COVID-19 exposure to both patients and providers.
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Affiliation(s)
- Evan Luther
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Joshua Burks
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel G Eichberg
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gregory Basil
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Katherine Berry
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Victor Lu
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ashish Shah
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gurvinder Kaur
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael Ivan
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ricardo Komotar
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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8
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Pelargos PE, Chakraborty AR, Adogwa O, Swartz K, Zhao YD, Smith ZA, Dunn IF, Bauer AM. An Evaluation of Neurosurgical Practices During the Coronavirus Disease 2019 Pandemic. World Neurosurg 2020; 146:e91-e99. [PMID: 33065352 PMCID: PMC7550862 DOI: 10.1016/j.wneu.2020.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022]
Abstract
Objective We sought to understand how the coronavirus disease 2019 pandemic has affected the neurosurgical workforce. Methods We created a survey consisting of 22 questions to assess the respondent's operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began. The survey was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. Results Of the 724 who opened the survey link, 457 completed the survey. The respondents were from throughout the United States and Puerto Rico and represented all practices types and subspecialties. Nearly all respondents reported hospital restrictions on elective surgeries. Most reported a decline in clinic and operative volume. Nearly 70% of respondents saw a decrease in the work hours of their ancillary providers, and almost one half (49.1%) of the respondents had had to downsize their practice staff, office assistants, nurses, schedulers, and other personnel. Overall, 43.6% of survey respondents had experienced a decline in income, and 27.4% expected a decline in income in the upcoming billing cycle. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic compared with their colleagues. Conclusion The coronavirus disease 2019 pandemic will likely have a lasting effect on the practice of medicine. Our survey results have described the early effects on the neurosurgical workforce. Nearly all neurosurgeons experienced a significant decline in clinical volume, which led to many downstream effects. Ultimately, analysis of the effects of such a pervasive pandemic will allow the neurosurgical workforce to be better prepared for similar events in the future.
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Affiliation(s)
- Panayiotis E Pelargos
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Arpan R Chakraborty
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Owoicho Adogwa
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Karin Swartz
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Yan D Zhao
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Zachary A Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ian F Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Andrew M Bauer
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
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Ozoner B, Gungor A, Hasanov T, Toktas ZO, Kilic T. Neurosurgical Practice During Coronavirus Disease 2019 (COVID-19) Pandemic. World Neurosurg 2020; 140:198-207. [PMID: 32474101 PMCID: PMC7255756 DOI: 10.1016/j.wneu.2020.05.195] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly contagious life-threatening condition with unprecedented impacts for worldwide societies and health care systems. Since the first detection in China, it has spread rapidly worldwide. The increased burden has substantially affected neurosurgical practice and intensive modifications have been required in surgical scheduling, inpatient and outpatient clinics, management of emergency cases, and even in academic activities. In some systems, nonoverlapping teams have been created to minimize transmission among health care workers. In cases of a massive burden, neurosurgeons may need to be reassigned to COVID-19 wards, or teams from other regions may need to be sent to severely affected areas. Recommendations are as following. In outpatient practice, if possible, appointments should be undertaken via telemedicine. All staff assigned to the non-COVID treatment unit should be clothed in level 1 personal protective equipment. If possible, postponement is recommended for operations that do not require urgent or emergent intervention. All patients indicated for surgery must receive COVID-19 screening, including a nasopharyngeal swab and thorax computed tomography. Level 2 protection measures are appropriate during COVID-19-negative patients' operations. Operations of COVID-19-positive patients and emergency operations, in which screening cannot be obtained, should be performed after level 3 protective measures. During surgery, the use of high-speed drills and electrocautery should be reduced to minimize aerosol production. Screening is crucial in all patients because the surgical outcome is highly mortal in patients with COVID-19. All educational and academic conferences can be undertaken as virtual webinars.
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Affiliation(s)
- Baris Ozoner
- Department of Neurosurgery, School of Medicine, Bahcesehir University, Istanbul, Turkey.
| | - Abuzer Gungor
- Department of Neurosurgery, Umraniye Research and Education Hospital, University of Medical Sciences, Istanbul, Turkey
| | - Teyyup Hasanov
- Department of Neurosurgery, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Zafer Orkun Toktas
- Department of Neurosurgery, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Turker Kilic
- Department of Neurosurgery, School of Medicine, Bahcesehir University, Istanbul, Turkey
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10
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Lakhdar F, Benzagmout M. Letter: Neurosurgery at war with the COVID-19 pandemic: patient's management from an African neurosurgical center. Acta Neurochir (Wien) 2020; 162:1787-1788. [PMID: 32474640 PMCID: PMC7261040 DOI: 10.1007/s00701-020-04406-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/10/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Fayçal Lakhdar
- Department of neurosurgery, University Hassan II Hospital, Fez, Morocco.
- Clinical Neurosciences Laboratory Faculty of Medicine, University Sidi Mohammed BenAbdellah, Fes, Morocco.
| | - Mohammed Benzagmout
- Department of neurosurgery, University Hassan II Hospital, Fez, Morocco
- Clinical Neurosciences Laboratory Faculty of Medicine, University Sidi Mohammed BenAbdellah, Fes, Morocco
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11
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Mazzatenta D, Zoli M, Cavallo MA, Ferro S, Giombelli E, Pavesi G, Sturiale C, Tosatto L, Zucchelli M. Remodulation of neurosurgical activities in an Italian region (Emilia-Romagna) under COVID- 19 emergency: maintaining the standard of care during the crisis. J Neurosurg Sci 2020; 66:234-239. [PMID: 32525290 DOI: 10.23736/s0390-5616.20.05018-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The impact of COVID-19 outbreak in the neurosurgical practice has been dramatic, imposing several limitations. The aim of this study is to present how the neurosurgical departments of Emilia-Romagna, a northern Italian region, have re-set their organization to maintain the higher standard of care as possible. METHODS All OR and out-patients activities performed during the COVID-19 emergency in the neurosurgical department of Emilia-Romagna have been collected and compared to the means of the same timeframe in 2018 and 2019. RESULTS In 2020, 205 surgical procedures and 466 out-patients consultations have been performed, representing respectively 28.8% and 26.4% of the previous biennium. The most of OR procedures had been emergencies/urgencies and oncological patients (respectively 113 and 66 vs 164.5 and 84.5 of the previous biennium), while elective surgeries decrease up to -97.1%, as for spinal nerves and endoscopic skull base procedures. The patients phone contacts and telemedicine evaluations of their examinations have permitted to reduce the hospital access for outpatients of 75.6%, but these modalities have, also, permitted to follow-up a large number of cases. CONCLUSIONS The outbreak of COVID-19 has imposed several limits to our current practice, however this should not represent an excuse to reduce the standard of care. In our experience, the net integration of different local centers has permitted for each of them to effectively cope the crisis, managing the local cases requiring a prompt surgery and keeping the care continuity with already discharged patients.
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Affiliation(s)
- Diego Mazzatenta
- Center for the Diagnosis and Treatment of Hypothalamic-Pituitary Diseases, Pituitary Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Matteo Zoli
- Center for the Diagnosis and Treatment of Hypothalamic-Pituitary Diseases, Pituitary Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy - .,Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Michele A Cavallo
- Neurosurgery Division, Department of Morphology, Surgery, and Experimental Medicine, Hospital S. Anna, Ferrara University, Ferrara, Italy
| | - Salvatore Ferro
- Department of Hospital Services, Emilia-Romagna Regional Health Authority, Bologna, Italy
| | - Ermanno Giombelli
- Department of Neurosurgery, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Giacomo Pavesi
- Unit of Neurosurgery, Department of Neurosciences, NOCSAE Modena Hospital, Modena, Italy
| | - Carmelo Sturiale
- Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Luigino Tosatto
- Neurosurgery Department, "Maurizio Bufalini" Hospital, Cesena, Italy
| | - Mino Zucchelli
- Center of Pediatric Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Thomas JG, Gandhi S, White TG, Jocelyn C, Soo TM, Eisenberg M, Schulder M, Narayan RK. Letter: A Guide to the Prioritization of Neurosurgical Cases After the COVID-19 Pandemic. Neurosurgery 2020; 87:E411-E416. [PMID: 32504465 PMCID: PMC7313802 DOI: 10.1093/neuros/nyaa251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Justin G Thomas
- Division of Neurosurgery Michigan State University College of Human Medicine Ascension Providence Hospital Southfield, Michigan
| | - Shashank Gandhi
- Department of Neurosurgery The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell North Shore University Hospital Manhasset, New York
| | - Timothy G White
- Department of Neurosurgery The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell North Shore University Hospital Manhasset, New York
| | - Christian Jocelyn
- Department of Neurosurgery The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell North Shore University Hospital Manhasset, New York
| | - Teck M Soo
- Division of Neurosurgery Michigan State University College of Human Medicine Ascension Providence Hospital Southfield, Michigan
| | - Mark Eisenberg
- Department of Neurosurgery The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell North Shore University Hospital Manhasset, New York
| | - Michael Schulder
- Department of Neurosurgery The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell North Shore University Hospital Manhasset, New York
| | - Raj K Narayan
- Department of Neurosurgery The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell North Shore University Hospital Manhasset, New York
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