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Yun G, Oh HJ. Letter to the Editor: Commentary on 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). Korean J Neurotrauma 2023; 19:122-123. [PMID: 37051036 PMCID: PMC10083444 DOI: 10.13004/kjnt.2023.19.e10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/25/2023] [Indexed: 03/29/2023] Open
Affiliation(s)
- Giyong Yun
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyuk Jin Oh
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
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Airth A, Whittle JR, Dimou J. How has the COVID-19 pandemic impacted clinical care and research in Neuro-Oncology? J Clin Neurosci 2022; 105:91-102. [PMID: 36122487 PMCID: PMC9452416 DOI: 10.1016/j.jocn.2022.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/08/2022] [Accepted: 09/03/2022] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic has challenged the continued delivery of healthcare globally. Due to disease risk, clinicians were forced to re-evaluate the safety and priorities of pre-pandemic care. Neuro-oncology presents unique challenges, as patients can deteriorate rapidly without intervention. These challenges were also observed in countries with reduced COVID-19 burden with centres required to rapidly develop strategies to maintain efficient and equitable care. This review aims to summarise the impact of the pandemic on clinical care and research within the practice of Neuro-oncology. A narrative review of the literature was performed using MEDLINE and EMBASS and results screened using PRISMA guidelines with relevant inclusion and exclusion criteria. Search strategies included variations of ‘Neuro-oncology’ combined with COVID-19 and other clinical-related terms. Most adult and paediatric neurosurgical centres experienced reductions in new referrals and operations for brain malignancies, and those who did present for treatment frequently had operations cancelled or delayed. Many radiation therapy and medical oncology centres altered treatment plans to mitigate COVID-19 risk for patients and staff. New protocols were developed that aimed to reduce in-person visits and reduce the risk of developing severe complications from COVID-19. The COVID-19 pandemic has presented many challenges to the provision of safe and accessible healthcare. Despite these challenges, some benefits to healthcare provision such as the use of telemedicine are likely to remain in future practice. Neuro-oncology staff must remain vigilant to ensure patient and staff safety.
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Affiliation(s)
- Angus Airth
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
| | - James R Whittle
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia; Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - James Dimou
- Department of Neurosurgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.
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Fernández Fernández E, Fernández-Ordoñez E, García-Gamez M, Guerra-Marmolejo C, Iglesias-Parra R, García-Agua Soler N, González-Cano-Caballero M. Indicators and predictors modifiable by the nursing department during the preoperative period: A scoping review. J Clin Nurs 2022; 32:2339-2360. [PMID: 35293058 DOI: 10.1111/jocn.16287] [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: 10/05/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVES The aim of this study is to identify preoperative indicators and/or predictors of complications or inefficiencies in the surgical process that can be modified within nursing practice. BACKGROUND Due to rapid sociodemographic and technological change, the global demand for surgical attention is rising exponentially, requiring new strategies for optimisation and sustainability in perioperative care. DESIGN We conduced the scoping review using the methodology recommended by the Joanna Briggs Institute supported with The PAGER framework and guided by the PRISMA-ScR Checklist. METHODS Four databases (CINAHL, MEDLINE, SCOPUS and PUBMED) were examined to extract relevant published results for elective surgery on adult patients during the period 2011-2021. This process identified 609 records. Exclusion criteria were applied, and the sample was then evaluated with the Quality Assessment Tool for Studies with Diverse Designs (QATSDD), after which 15 studies remained. RESULTS The following preoperative indicators and/or predictors were considered: (1) Anxiety; (2) Pain; (3) Health education, knowledge and training; (4) Satisfaction; (5) Management/organisation (including costs, resources used/available, organisational issues, hospital stay (preoperative), standardisation and protocolisation. CONCLUSION The identification of five indicators and/or predictors of complications or inefficiencies in the surgical process, which can be modified by nursing, allows the effective application of interventions in the preoperative phase, optimising care and improving health outcomes. RELEVANCE TO CLINICAL PRACTICE The development and implementation of specific nursing skills in the preoperative phase are essential to optimise the surgical process.
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Affiliation(s)
| | | | - Marina García-Gamez
- Department of Nursing, Faculty of Health Sciences, University of Málaga, Málaga, Spain
| | | | - Rosa Iglesias-Parra
- Department of Nursing, Faculty of Health Sciences, University of Málaga, Málaga, Spain
| | - Nuria García-Agua Soler
- Department of Pharmacology and Pediatrics, Faculty of Medicine, University of Málaga, Málaga, Spain
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Analysis of the Efficacy of Universal Screening of Coronavirus Disease with Antigen-Detecting Rapid Diagnostic Tests at Point-or-Care Settings and Sharing the Experience of Admission Protocol—A Pilot Study. J Pers Med 2022; 12:jpm12020319. [PMID: 35207807 PMCID: PMC8876277 DOI: 10.3390/jpm12020319] [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] [Received: 01/06/2022] [Revised: 02/01/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
Aims: To introduce the admission protocol of a COVID-19 specialized hospital outlined by the government, including the assessment of reverse transcription polymerase chain reaction (RT-PCR), low dose chest computed tomography (CT) and antigen-detecting rapid diagnostic test (Ag-RDT) for patient screening. Materials and Methods: This was a retrospective cohort study of 646 patients who were admitted between December 2020, and February 2021, during the third wave of COVID-19 in Korea. Ag-RDT and RT-PCR were routinely performed on all patients who required admission, and low-dose chest CT was performed on high-risk patients with associated symptoms. Any patients with high-risk COVID-19 infection according to the Ag-RDT test were quarantined alone in a negative pressured room, and those with low-risk COVID-19 infection remained in the preemptive quarantine room with or without negative pressure. The diagnostic values of the Ag-RDT test and associated cycle threshold (Ct) values of the RT-PCR test were subsequently evaluated. Results: In terms of the diagnostic value, the Ag-RDT for COVID-19 had a sensitivity of 68.3%, specificity of 99.5%, positive predictive value (PPV) of 90.3%, and negative predictive value (NPV) of 97.9%. For the 355 symptomatic patients with low-dose chest CT, the diagnostic values of combined evaluations had a sensitivity of 90.2%, specificity of 99.0%, PPV of 86.1%, and NPV of 99.3%. The cut-off Ct value for positive Ag-RDT was ≤25.67 for the N gene (sensitivity: 89.3%, specificity: 100%), which was regarded as a high viable virus in cell culture. There were no patients or medical staff who had COVID-19 in the hospital. Conclusion: Appropriate patient care was possible by definitive triage of the area, according to the symptoms and using diagnostic tests. Screening protocols, including the Ag-RDT test and low-dose chest CT, could be helpful in emergency point-of-care settings.
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Yun JH. Lessons From Experience of Surgical Treatment for Severe Traumatic Brain Injury Patient Infected With COVID-19. Korean J Neurotrauma 2022; 18:31-33. [PMID: 35557650 PMCID: PMC9064742 DOI: 10.13004/kjnt.2022.18.e23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jung-Ho Yun
- Department of Neurological Surgery, Dankook University Hospital, Cheonan, Korea
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Tan Q, Liu QJ, Fan WH, Du XY, Wu L, Gong HM, Wei J, Zhao R, Lei M, Zhao LB. Impact of COVID-19 on Acute Stroke Presentation in a Designated COVID-19 Hospital. Front Neurol 2021; 12:673703. [PMID: 34566833 PMCID: PMC8456084 DOI: 10.3389/fneur.2021.673703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/16/2021] [Indexed: 02/03/2023] Open
Abstract
Objectives: Thousands of designated COVID-19 hospitals have been set up in China to fight the ongoing COVID-19 pandemic. Anecdotal reports indicate a falling rate of acute stroke diagnoses in these hospitals during the COVID-19 period. We conducted an exploratory single-center analysis to estimate the change in acute stroke presentation at the designated COVID-19 hospitals. Methods: This retrospective observational study included all patients admitted to Yongchuan Hospital Affiliated to Chongqing Medical University with acute stroke between January 24 and March 10, 2020. Patient demographics, characteristics of the stroke, treatment details, and clinical outcomes were compared with those of patients admitted in the corresponding period in the year before (2019, “the pre-COVID-19 period”). Subgroup analysis was performed in the ischemic and hemorrhagic stroke groups. Results: A total of 110 patients presented with acute stroke symptoms during the COVID-19 pandemic, compared with 173 patients in the pre-COVID-19 period. A higher proportion of stroke patients presented to the hospital via emergency medical services during the pandemic (48.2 vs. 31.8%, p = 0.006). There was a lower proportion of ischemic stroke patients (50.9 vs. 65.3%, p = 0.016) than in the preceding year. There were significantly fewer patients with 90-day modified Rankin Scale score ≥3 in the COVID-19 period compared with the pre-COVID-19 period (17.3 vs. 30.6%, p = 0.012). Among patients with ischemic stroke, the mean time from patient arrival to vessel puncture for emergency endovascular therapy in the COVID-19 period was shorter than that in the pre-COVID-19 period (109.18 ± 71.39 vs. 270.50 ± 161.51 min, p = 0.002). Among patients with hemorrhagic stroke, the rate of emergency surgical operation in the COVID-19 period was higher than that in the pre-COVID-19 period (48.1 vs. 30.0%, p = 0.047). The mean time from patient arrival to emergency surgical operation (15.31 ± 22.89 vs. 51.72 ± 40.47 min, p = 0.002) was shorter in the COVID-19 period than in the pre-COVID-19 period. Conclusions: Although fewer acute stroke patients sought medical care in this designated COVID-19 hospital during the COVID-19 pandemic, this type of hospital was more efficient for timely treatment of acute stroke. Recognizing how acute strokes presented in designated COVID-19 hospitals will contribute to appropriate adjustments in strategy for dealing with acute stroke during COVID-19 and future pandemics.
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Affiliation(s)
- Qing Tan
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
| | - Qing-Jun Liu
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
| | - Wen-Hui Fan
- Department of Neurology, Chongqing Ninth People's Hospital, Chongqing, China
| | - Xiao-Yan Du
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
| | - Lin Wu
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
| | - Hong-Min Gong
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
| | - Jing Wei
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
| | - Rui Zhao
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
| | - Ming Lei
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
| | - Li-Bo Zhao
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, China
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