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Garofil ND, Bratucu MN, Zurzu M, Paic V, Tigora A, Prunoiu V, Rogobete A, Balan A, Vladescu C, Strambu VDE, Radu PA. Groin Hernia Repair during the COVID-19 Pandemic-A Romanian Nationwide Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050970. [PMID: 37241202 DOI: 10.3390/medicina59050970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Groin hernia repair surgery (GHRS) is among the most common elective interventions. The aim of this three-year nationwide study on GHRS is to provide a thorough analysis of the impact that the COVID-19 pandemic had on the Romanian Health System in regard to elective procedures. Materials and Methods: 46,795 groin hernia cases obtained between 2019 and 2021 from the DRG database using ICD-10 diagnostic codes. The data were collected from all 261 GHRS performing hospitals nationwide, including 227 public hospitals (PbH) and 34 private hospitals (PvH). The 42 variables taken into account were processed using Microsoft Excel 2021, applying Chi square, F-Test Two-Sample for variances, and Two Sample t-Test. The significance threshold considered was p < 0.001. Results: Of the grand total of cases, 96.2% were inguinal hernias, 86.8% were performed on men, 15.2% were laparoscopic procedures, and 6.88% were in PvH. Overall, due to the pandemic, the total number of GHRS decreased with 44.45% in 2020 and with 29.72% in 2021 compared to pre-pandemic year 2019. April 2020 shows the steepest decrease in GHRS (91 procedures nationwide). In the private sector, there was an opposite trend with increases in the number of cases by 12.21% and a 70.22% in both pandemic years. The mean admission period (MAP) for all procedures was 5.5 days. There was a significant difference between PbH and PvH (5.75 vs. 2.8 days, p < 0.0001). During the pandemic, the MAP in PbH decreased (6.02 in 2019, 5.82 in 2020 and 5.3 in 2021), remaining stable for PvH (2.9 days in 2019, 2.85 days in 2020 and 2.74 days in 2021). Conclusions: The COVID-19 pandemic significantly reduced the overall number of GHRS performed in Romania in 2020 and 2021, compared to 2019. However, the private sector thrived with an actual increase in the number of cases. There was a significant lower MAP in the PvH compared to PbH throughout the three-year period.
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Affiliation(s)
- Nicolae Dragos Garofil
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mircea Nicolae Bratucu
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihai Zurzu
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Vlad Paic
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Anca Tigora
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Virgiliu Prunoiu
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Alexandru Rogobete
- Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Ana Balan
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Vladescu
- National Institute of Health Services Management, 030167 Bucharest, Romania
| | - Victor Dan Eugen Strambu
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Petru Adrian Radu
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Wilson AD, Forse LB. Potential for Early Noninvasive COVID-19 Detection Using Electronic-Nose Technologies and Disease-Specific VOC Metabolic Biomarkers. SENSORS (BASEL, SWITZERLAND) 2023; 23:2887. [PMID: 36991597 PMCID: PMC10054641 DOI: 10.3390/s23062887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/19/2023] [Accepted: 03/03/2023] [Indexed: 06/12/2023]
Abstract
The established efficacy of electronic volatile organic compound (VOC) detection technologies as diagnostic tools for noninvasive early detection of COVID-19 and related coronaviruses has been demonstrated from multiple studies using a variety of experimental and commercial electronic devices capable of detecting precise mixtures of VOC emissions in human breath. The activities of numerous global research teams, developing novel electronic-nose (e-nose) devices and diagnostic methods, have generated empirical laboratory and clinical trial test results based on the detection of different types of host VOC-biomarker metabolites from specific chemical classes. COVID-19-specific volatile biomarkers are derived from disease-induced changes in host metabolic pathways by SARS-CoV-2 viral pathogenesis. The unique mechanisms proposed from recent researchers to explain how COVID-19 causes damage to multiple organ systems throughout the body are associated with unique symptom combinations, cytokine storms and physiological cascades that disrupt normal biochemical processes through gene dysregulation to generate disease-specific VOC metabolites targeted for e-nose detection. This paper reviewed recent methods and applications of e-nose and related VOC-detection devices for early, noninvasive diagnosis of SARS-CoV-2 infections. In addition, metabolomic (quantitative) COVID-19 disease-specific chemical biomarkers, consisting of host-derived VOCs identified from exhaled breath of patients, were summarized as possible sources of volatile metabolic biomarkers useful for confirming and supporting e-nose diagnoses.
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Affiliation(s)
- Alphus Dan Wilson
- Pathology Department, Center for Forest Health & Disturbance, Forest Genetics and Ecosystems Biology, Southern Research Station, USDA Forest Service, Stoneville, MS 38776, USA
| | - Lisa Beth Forse
- Southern Hardwoods Laboratory, Southern Research Station, USDA Forest Service, Stoneville, MS 38776, USA
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Yokoyama R, Inokuchi R, Shimada K, Ueda H, Tanaka M, Tamiya N. Impact of COVID-19 on pediatric surgery cancellations: A retrospective study. Pediatr Int 2023; 65:e15662. [PMID: 38108148 DOI: 10.1111/ped.15662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Prevalence trends and reasons for pediatric surgery cancellation in Japan during the coronavirus disease 2019 (COVID-19) pandemic have not previously been reported. This study aimed to compare the prevalence and reasons for cancellation of pediatric surgeries in Japan before and during the COVID-19 pandemic. METHODS This single-center retrospective cohort study reviewed the reasons for surgery cancellations scheduled for patients aged <18 years between the prepandemic period (September 2017-December 2019) and the COVID-19 pandemic period (January 2020-April 2022). The cancellation reasons were classified into four major categories: medical, surgical, patient-related, and administrative. RESULTS Of the 3395 and 3455 surgeries scheduled before and during the COVID-19 pandemic, 305 (9.0%) and 319 (9.2%) surgeries were canceled (p = 0.737), respectively. The proportion of cancellations due to infections or fever in medical reasons decreased from 67.9% to 56.1% (p = 0.003) and that due to patient-related reasons increased from 6.6% to 15.1% (p = 0.001). Further, the proportion of cancellations due to staff shortages in staff administrative reasons increased from 0.3% to 3.1% (p = 0.011). There was no significant difference in the proportion of surgeries canceled due to surgical reasons between the two periods. CONCLUSIONS The proportion of cancellations due to infections or fever decreased during the COVID-19 pandemic, while that due to staff shortages increased. Infection prevention is an important measure to address the staff shortages. Implementation of national or regional policies and additional strategic interventions may be required to prepare for disasters like the COVID-19 pandemic.
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Affiliation(s)
- Ryota Yokoyama
- Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
- Department of Anesthesiology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Ryota Inokuchi
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kensuke Shimada
- Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Hiroshi Ueda
- Department of Anesthesiology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Makoto Tanaka
- Department of Anesthesiology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
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Zhou Z, Qiu C, Liu S, Wang S, Wang D, Xu H. Secondary preventing effect of lung cancer in non-high-risk population: A retrospective investigation of opportunistic screening with low-dose computed tomography in Wuhan. Front Oncol 2022; 12:991485. [DOI: 10.3389/fonc.2022.991485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/02/2022] [Indexed: 11/23/2022] Open
Abstract
BackgroundGiven the mortality benefit of low-dose computed tomography (LDCT) screening on high-risk populations, the retrospective investigation intended to identify the benefits of LDCT on lung cancer screening among the general demographic cohorts.MethodsWe used an opportunistic screening with LDCT implemented during the pandemic in Wuhan to study the impact on subsequent thoracic surgeries, especially surgeries for lung cancer. Patients who received LDCT from October 1, 2019, to July 31, 2020, in three Triple-A accredited hospitals in Wuhan were included in the study. Relative week volumes of both surgeries before and after the chest LDCT screening were compared pairwise. The counts of surgeries for pulmonary nodules or masses, and corresponding pathological results among different gender and age groups were also compared.ResultThe relative weekly volumes of thoracic surgery were significantly greater than those of stomach surgery after the opportunistic screening with LDCT. They were 33% (95% CI, 0.20-0.46; p<0. 001) higher than those of stomach surgery. For every 1,000 chest LDCT scans conducted in a given week, on average, 3.52(95% CI,0.56-6.49, p =0.03) thoracic surgeries were performed in the following week. After the implementation of opportunistic screening with LDCT, there was a higher percentage of young females with pulmonary nodule or mass (64.4% vs. 45.8%, p = 0.032). The fraction of lung cancer surgery in the treatment period was significantly greater than that in the control period (74.09% vs. 68.79%, p=0.007). There was a higher percentage of stage I lung cancer surgery in young and mid-age females than in the senior age group (64% vs. 53%, p= 0.05).InterpretationOpportunistic screening with LDCT can advance the early diagnosis window of lung cancer in non-high-risk populations, especially young women who are easy to be ignored.
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Demissie WR, Mulatu B, Siraj A, Hajikassim A, Kejela E, Muluken Z, Mekonin GT, Biratu M, Birhanu M, Dadi N, Kelbesa M, Belay A, Dukessa A. Pattern of Perioperative Surgical Patient Care, Equipment Handling and Operating Room Management During COVID-19 Pandemic at Jimma Medical Center. J Multidiscip Healthc 2022; 15:2527-2537. [PMID: 36352855 PMCID: PMC9639398 DOI: 10.2147/jmdh.s372428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/07/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The nature of COVID-19 transmission creates significant risks in surgical departments owing to the close contact of medical staff with patients, the limited physical environment of the operating room and recovery room, the possibility of shared surgical equipment and challenges in the delivery of surgical care in all surgical departments. Globally, studies have reported that the effects of the pandemic on surgical departments are profound, potentially long-lasting and extensive. To manage these effects, different local guidelines and recommendations have been developed, with potential differences in their effectiveness and implementation. Therefore, harmonized and effective national/international guidelines for specific surgical departments during perioperative periods are pertinent to curtail the infection, and will inevitably need to be adapted for consistent and sustainable implementation by all medical staff. The pattern of surgical patient care during the COVID-19 pandemic at Jimma Medical Center (JMC), Ethiopia, has not been explored yet. The present study aimed to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC. METHODS A cross-sectional study was conducted to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC, using five-point Likert scales (0, not at all; 1, rarely; 2, sometimes; 3, most of the time; 4, frequently). A total of 90 respondents [35 patients (five patients from each of seven surgical departments) and 55 healthcare providers (six professionals from each of nine units, including the center of sterility room and anesthesia)] who were available during the study period, selected by a convenience sampling technique with multistage clustering, participated in the study. Data were collected using a structured questionnaire via direct observation and face-to-face interviews with patients undergoing surgery, healthcare providers and hospital administrators, against the standard surgical patient care guidelines. The collected data were manually checked for missing values and outliers, cleared, entered into EpiData (v4.3.1) and exported to SPSS (v22) for analysis. The mean score of practice was compared among different disciplines by applying the unpaired t-test. The findings of the study were reported using tables and narration. A p-value of less than 0.05 was declared as statistically significant. RESULTS Despite the surgical care practice having changed during the COVID-19 pandemic in all service domains, it is not implemented consistently among different surgical departments owing to different barriers (lack of training on the updated guidelines and financial constraints). The majority of surgical staff were implementing the use of preventive measures against COVID-19, while they were practiced less among patients. The guidelines for surgical practice during the preoperative phase were well applied, especially screening patients by different methods and the application of telemedicine to reduce physical contacts. But, against guidelines, elective patients were planned and underwent surgery, especially in the general surgery department. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. The extent of practice for anesthesia care, operating room management and postoperative care in the recovery room also changed, and the guidelines were sometimes applied. CONCLUSION AND RECOMMENDATIONS Although perioperative surgical care practice differed before and during the pandemic, the standard guidelines were inconsistently implemented among surgical departments. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. Thus, the authors developed safe surgical care guidelines throughout the different domains (infection prevention and PPE use; preoperative care, intraoperative care, operating room management, anesthesia care, equipment handling process and postoperative care) for all disciplines and shared them with all staff. We recommend that all surgical staff should access these guidelines and strictly adhere to them for surgical service during the pandemic.
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Affiliation(s)
- Wondu Reta Demissie
- Department of Biomedical Sciences, Jimma University, Jimma, Oromia, Ethiopia,Correspondence: Wondu Reta Demissie, Jimma University, Jimma, Oromia, Ethiopia, Email ;
| | - Bilisuma Mulatu
- School of Medicine, Jimma University, Jimma, Oromia, Ethiopia
| | - Ahmed Siraj
- School of Medicine, Jimma University, Jimma, Oromia, Ethiopia
| | | | - Edosa Kejela
- Department of Anesthesia, Jimma University, Jimma, Oromia, Ethiopia
| | - Zemenu Muluken
- Department of Anesthesia, Jimma University, Jimma, Oromia, Ethiopia
| | | | - Melka Biratu
- Department of Anesthesia, Jimma University, Jimma, Oromia, Ethiopia
| | - Mitiku Birhanu
- Department of Anesthesia, Jimma University, Jimma, Oromia, Ethiopia
| | - Negashu Dadi
- Department of Anesthesia, Jimma University, Jimma, Oromia, Ethiopia
| | - Megersa Kelbesa
- Department of Anesthesia, Jimma University, Jimma, Oromia, Ethiopia
| | - Admasu Belay
- School of Nursing, Jimma University, Jimma, Oromia, Ethiopia
| | - Abebe Dukessa
- Department of Biomedical Sciences, Jimma University, Jimma, Oromia, Ethiopia
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6
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Rodrigues DDOW, Magalhães NNS, Silva-Malta MCF, Chaves DG, Freire de Carvalho RV, Ribeiro MA, Cioffi JGM, Martins ML. Impact of COVID-19 on the efficacy of meeting the transfusion demand by a Brazilian blood banks network. Transfus Apher Sci 2022; 61:103439. [PMID: 35431115 PMCID: PMC8972979 DOI: 10.1016/j.transci.2022.103439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 01/28/2023]
Abstract
One of the effects of the pandemic in the hemotherapy services was the reduction in the attendance of blood donors and production of blood components. It is relevant to investigate how the capacity to meet the demand for blood components was affected, especially in blood centers located in the regions most affected by the pandemic, such as Brazil. This study aimed to describe the impact of the pandemic on the capacity to meet the demand for different types of blood components by a Brazilian blood center in 2020, compared to the historical series of 2016-2019 and to discuss the measures adopted to mitigate the effects of the pandemic. Retrospective cross-sectional study was carried out with comparative analysis of the blood components requested and attended in the period from 2016 to 2020. Data analysis was performed by Graphpad Prism 5. The spread of COVID-19 cases since March 2020 had impact on the blood components production and transfusions. The reduction in the production of blood components was observed prior to the restriction measures, in March 2020. In comparison to 2016-2019, there was a reduction in the number of transfusions performed in all months of 2020. The results suggest that the measures adopted in a Brazilian blood center to face the COVID-19 pandemic resulted in reasonable regularity in the supply of blood components. The sharing of experiences between blood banks in different regions, social and epidemiological contexts can contribute to the improvement of strategies to reduce the impact of COVID-19 in transfusion medicine.
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Affiliation(s)
| | | | | | - Daniel Gonçalves Chaves
- Fundação Hemominas, Alameda Ezequiel Dias, 321 - Santa Efigênia, Belo Horizonte 30130-110, Minas Gerais, Brazil.
| | | | - Maisa Aparecida Ribeiro
- Fundação Hemominas, Alameda Ezequiel Dias, 321 - Santa Efigênia, Belo Horizonte 30130-110, Minas Gerais, Brazil.
| | | | - Marina Lobato Martins
- Fundação Hemominas, Alameda Ezequiel Dias, 321 - Santa Efigênia, Belo Horizonte 30130-110, Minas Gerais, Brazil.
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Mehta A, Awuah WA, Ng JC, Kundu M, Yarlagadda R, Sen M, Nansubuga EP, Abdul-Rahman T, Hasan MM. Elective surgeries during and after the COVID-19 pandemic: Case burden and physician shortage concerns. Ann Med Surg (Lond) 2022; 81:104395. [PMID: 35999832 PMCID: PMC9388274 DOI: 10.1016/j.amsu.2022.104395] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/01/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
The COVID-19 pandemic had a significant impact on several aspects of global healthcare systems, particularly surgical services. New guidelines, resource scarcity, and an ever-increasing demand for care have posed challenges to healthcare professionals, resulting in the cancellation of many surgeries, with short and long-term consequences for surgical care and patient outcomes. As the pandemic subsides and the healthcare system attempts to reestablish a sense of normalcy, surgical recommendations and advisories will shift. These changes, combined with a growing case backlog (postponed surgeries + regularly scheduled surgeries) and a physician shortage, can have serious consequences for physician health and, as a result, surgical care. Several initiatives are already being implemented by governments to ensure a smooth transition as surgeries resume. Newer and more efficient steps aimed at providing adequate surgical care while preventing physician burnout, on the other hand, necessitate a collaborative effort from governments, national medical boards, institutions, and healthcare professionals. This perspective aims to highlight alterations in surgical recommendations over the course of the pandemic and how these changes continue to influence surgical care and patient outcomes as the pandemic begins to soften its grip. The COVID-19 pandemic had a significant impact on several aspects of surgical care. New surgical recommendations amidst an ever-increasing demand for care pose, short and long-term consequences for surgical care and patient outcomes. As the pandemic subsides, these changes, combined with a growing case backlog and a physician shortage, can have serious consequences for physician health and, as a result, surgical care.
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Wintjens AGWE, Hintzen KFH, Engelen SME, Lubbers T, Savelkoul PHM, Wesseling G, van der Palen JAM, Bouvy ND. Applying the electronic nose for pre-operative SARS-CoV-2 screening. Surg Endosc 2021; 35:6671-6678. [PMID: 33269428 PMCID: PMC7709806 DOI: 10.1007/s00464-020-08169-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/15/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infection with SARS-CoV-2 causes corona virus disease (COVID-19). The most standard diagnostic method is reverse transcription-polymerase chain reaction (RT-PCR) on a nasopharyngeal and/or an oropharyngeal swab. The high occurrence of false-negative results due to the non-presence of SARS-CoV-2 in the oropharyngeal environment renders this sampling method not ideal. Therefore, a new sampling device is desirable. This proof-of-principle study investigated the possibility to train machine-learning classifiers with an electronic nose (Aeonose) to differentiate between COVID-19-positive and negative persons based on volatile organic compounds (VOCs) analysis. METHODS Between April and June 2020, participants were invited for breath analysis when a swab for RT-PCR was collected. If the RT-PCR resulted negative, the presence of SARS-CoV-2-specific antibodies was checked to confirm the negative result. All participants breathed through the Aeonose for five minutes. This device contains metal-oxide sensors that change in conductivity upon reaction with VOCs in exhaled breath. These conductivity changes are input data for machine learning and used for pattern recognition. The result is a value between - 1 and + 1, indicating the infection probability. RESULTS 219 participants were included, 57 of which COVID-19 positive. A sensitivity of 0.86 and a negative predictive value (NPV) of 0.92 were found. Adding clinical variables to machine-learning classifier via multivariate logistic regression analysis, the NPV improved to 0.96. CONCLUSIONS The Aeonose can distinguish COVID-19 positive from negative participants based on VOC patterns in exhaled breath with a high NPV. The Aeonose might be a promising, non-invasive, and low-cost triage tool for excluding SARS-CoV-2 infection in patients elected for surgery.
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Affiliation(s)
- Anne G W E Wintjens
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Kim F H Hintzen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Sanne M E Engelen
- Department of Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Tim Lubbers
- Department of Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Paul H M Savelkoul
- Department of Medical Microbiology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Geertjan Wesseling
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Job A M van der Palen
- Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede, The Netherlands
- Department of Epidemiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Nicole D Bouvy
- Department of Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
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Okereke IC, Ramadan O, Sampalli SR. The Management of Wrist Fractures During COVID-19: A Preliminary Report. Cureus 2021; 13:e19982. [PMID: 34987887 PMCID: PMC8716115 DOI: 10.7759/cureus.19982] [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] [Accepted: 11/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background Due to the current COVID-19 pandemic, there has been an increase in the need for the virtual follow-up of patients. These innovations in clinical care have helped to reduce hospital attendance of patients and the spread of the virus. Injuries such as wrist fractures that are non-obligatory are increasingly being followed up virtually. This paper compares the early experience of management of wrist fractures in a District General Hospital in the United Kingdom during the COVID-19 pandemic lockdown with a similar period before. Methods A retrospective study of the management and clinical follow-up of all skeletally mature patients seen in the Accident and Emergency (A&E) department with a radiologically confirmed distal radius fracture after imposition of COVID-19 lockdown measures in the United Kingdom (between March 23, 2020 and May 24, 2020), and comparison with a control group of patients with distal radius fractures seen within a similar time frame the previous year (March 23, 2019 to May 24, 2019). Results During the COVID-19 lockdown, a total of 39 skeletally mature patients (85% females; average age of 70.4 years [SD: 14.6]) who had suffered a wrist fracture were seen. A total of 23% of the patients had surgical fixation. The others were managed conservatively and followed up regularly in the fracture clinic and by virtual telephone consultation in 15% (p > 0.05) compared to the previous year. Three patients who had an AO/OTA Type-C fracture were not keen on surgery, citing the COVID-19 pandemic. Patients had their operations at 5.2 days post-injury on average compared to the pre-COVID average of 6.4 days post-injury. Conclusion This preliminary study showed that patients considered "high risk" (as per the UK government guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19) with low functional demands who had suffered fractures of the distal radius were followed up mostly virtually after their first A&E attendance, thereby eliminating unnecessary hospital attendances. There was no difference in the epidemiology of wrist fractures pre- and post-COVID-19 lockdown. No COVID-positive patients were treated. The limitations of this study are the fact that it is cross-sectional with a lack of patient-reported outcome measures (PROM). As this was only a preliminary study to assess initial results, it will be followed up by a full report assessing outcomes at defined intervals.
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Favaro E, Fernandes DR, Vieira LG, Margatho AS, Mendes KDS, Silveira RCDCP. Postoperative complications in adult patients undergoing surgery with confirmed infection by SARS-CoV-2: An integrative review. Rev Lat Am Enfermagem 2021; 29:e3496. [PMID: 34755777 PMCID: PMC8584806 DOI: 10.1590/1518-8345.5346.3496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/20/2021] [Indexed: 01/08/2023] Open
Abstract
Objective: to analyze the evidence available in the literature about postoperative
complications in adult patients undergoing surgical procedures with
confirmed infection by SARS-CoV-2. Method: an integrative literature review conducted in the CINAHL, EMBASE, LILACS,
PubMed, Scopus and Web of Science databases, as well as in the gray
literature. The references identified were exported to the EndNote manager
and, subsequently, to the Rayyan web application for study selection. The
stages of sampling, categorization of studies, evaluation of the studies
included, interpretation of the results and knowledge synthesis were
performed by two reviewers independently and in a masked manner. The data
were analyzed descriptively. Results: of the 247 articles identified, 15 were selected to comprise this review. The
prevalent postoperative complications in patients infected with SARS-CoV-2
were the following: cough, dyspnea and hypoxia, need for invasive mechanical
ventilation or not, admission to the intensive care unit and death. Conclusion: the most reported postoperative complications in the studies evaluated were
respiratory-related, followed by cardiovascular complications. The
importance of preoperative screening for COVID-19 is highlighted, as well as
of the monitoring and tracking of confirmed cases in the postoperative
period, as these actions exert an impact on reducing the occurrence of
complications related to SARS-CoV-2.
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Affiliation(s)
- Erica Favaro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Daiane Rubinato Fernandes
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - (CAPES), Brazil
| | - Leticia Genova Vieira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico/Ministério da Ciência, Tecnologia e Inovações, Brazil
| | - Amanda Salles Margatho
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Karina Dal Sasso Mendes
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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11
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Does the COVID-19 Pandemic Affect Morbidity and Mortality Rates of Emergency General Surgery? A Retrospective Study from a Single-Center Tertiary Greek Hospital. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111185. [PMID: 34833403 PMCID: PMC8624623 DOI: 10.3390/medicina57111185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 12/29/2022]
Abstract
Background and Objectives: The outbreak of the COVID-19 pandemic had a major impact on all aspects of health care. Few up-to-date studies have actually assessed the impact of COVID-19 on emergency surgeries. The aim of this study was to provide an overview of the impact of the pandemic relating to the emergency surgery performed, as well as morbidity and mortality rates during the first year of the pandemic (March 2020–February 2021) and during the control period. In this period, the first propaedeutic surgery department and the third surgery department of the University General Hospital of Thessaloniki “AHEPA” in Greece provided continuous emergency general surgery services. Material and Methods: The study is in a retrospective cohort and included patients who were admitted to the Emergency Department and underwent emergency general surgery during the control period (n = 456), March 2019–February 2020 and during the first year of the pandemic (n = 223), March 2020–February 2021. Gender, age, type of surgical operation (morbidity), ICU need, the patient’s outcome, and days of hospitalization were compared. Results: A total of 679 emergency surgeries were included. Statistically significant differences emerged between the two time periods in the total number of emergency surgeries performed (p < 0.001). The most common type of surgery in the control period was associated with soft tissue infection while, during the pandemic period, the most common type of surgery was associated with the hepatobiliary system. In addition, the mortality rates nearly doubled during the pandemic period (2.2% vs. 4%). Finally, the mean age of our sample was 50.6 ± 17.5 and the majority of the participants in both time periods were males. Conclusions: The COVID-19 pandemic changed significantly the total number of emergency general surgeries performed. Mortality rates doubled and morbidity rates were affected between the control and pandemic periods. Finally, age, gender, length of hospitalization, intensive care unit hospitalization, and laparoscopy use in patients undergoing emergency surgery during the pandemic were stable.
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12
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Guillot-Tantay C, Robert G, Ruffion A, Gamé X, Balanca A, Cousin T, Campello PV, Simon J, Baron M, Fleury R, Dequirez PL, Davidson S, Joussain C, Vangheluwe L, Anastay V, Léon P, Perrouin-Verbe MA, Peyronnet B, Biardeau X, Cornu JN, Karsenty G, Phé V. Impact of COVID-19 pandemic on functional urology procedures in France: a prospective study. World J Urol 2021; 40:277-282. [PMID: 34476595 PMCID: PMC8412852 DOI: 10.1007/s00345-021-03821-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/19/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate the impact of COVID-19 pandemic on functional urology procedures in France. Methods A prospective study was conducted within 11 secondary and tertiary referral centers in France. Patients aged > 18 years who were diagnosed with a functional urology disease before the national lockdown (March 17th, 2020) and who required a surgery were included. Study period went from March 17th to September 30th 2020. The included interventions were listed according to the guidelines for functional urology enacted by the French Association of Urology and delay of reoperation was compared to the guidelines’ delay. The primary outcome was the number of procedures left unscheduled at the end of the study period. Descriptive statistics were performed. Results From March 17th 2020 to September 3 rd 2020, 1246 patients with a previous diagnosis of a functional urological disease requiring a surgery were included. The mean follow-up was 140.4 days (± 53.4). Overall, 316 interventions (25.4%) were maintained whereas 74 (5.9%) were canceled, 848 (68.1%) postponed and 8 patients (0.6%) died. At the end of the follow-up, 184 patients (21.7%) were still not rescheduled. If the intervention was postponed, the mean delay between the initial and final date was 85.7 days (± 64.4). Conclusion Overall, more than two thirds of interventions had to be postponed and the mean delay between the initial and final date was about three months.
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Affiliation(s)
- Cyrille Guillot-Tantay
- Department of Urology, Sorbonne Université, Assistance Publique - Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Academic Hospital, 47-83 boulevard de l'hôpital, 75013, Paris, France
| | - Grégoire Robert
- Department of Urology, Centre Hospitalier Universitaire de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Alain Ruffion
- Department of Urology, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | - Xavier Gamé
- Department of Urology, Centre Hospitalier Universitaire de Rangueil, Toulouse, France
| | - Astrid Balanca
- Department of Neuro-Urology, Assistance-Publique-Hôpitaux de Paris (AP-HP), Raymond Poincaré Academic Hospital, Garches, France
| | - Tiffany Cousin
- Department of Urology, Centre Hospitalier Universitaire de Bordeaux, Université de Bordeaux, Bordeaux, France
| | | | - Jeanne Simon
- Department of Urology, Centre Hospitalier Universitaire de Rangueil, Toulouse, France
| | - Maximilien Baron
- Department of Urology, Nantes Academic Hospital, Hôtel Dieu, Nantes, France
| | - Raphael Fleury
- Centre Hospitalier Universitaire de Rennes, Service d'urologie, Rennes, France
| | - Pierre-Luc Dequirez
- Department of Urology, Lille Academic Hospital, Claude Huriez Hospital, Lille, France
| | - Sypre Davidson
- Department of Urology, Lille Academic Hospital, Claude Huriez Hospital, Lille, France
| | - Charles Joussain
- Department of Neuro-Urology, Assistance-Publique-Hôpitaux de Paris (AP-HP), Raymond Poincaré Academic Hospital, Garches, France
| | - Lucie Vangheluwe
- Department of Urology, Centre Hospitalier Universitaire Rouen, Rouen, France
| | - Vassily Anastay
- Department of Urology, Assistance-Publique-Hôpitaux de Marseille (AP-HM), La Conception Hospital, Marseille, France
| | | | | | - Benoit Peyronnet
- Centre Hospitalier Universitaire de Rennes, Service d'urologie, Rennes, France
| | - Xavier Biardeau
- Department of Urology, Lille Academic Hospital, Claude Huriez Hospital, Lille, France
| | - Jean-Nicolas Cornu
- Department of Urology, Centre Hospitalier Universitaire Rouen, Rouen, France
| | - Gilles Karsenty
- Department of Urology, Assistance-Publique-Hôpitaux de Marseille (AP-HM), La Conception Hospital, Marseille, France
| | - Véronique Phé
- Department of urology, Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Tenon Academic Hospital, Paris, France.
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13
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Kovoor JG, Tivey DR, Ovenden CD, Babidge WJ, Maddern GJ. Evidence, not eminence, for surgical management during COVID-19: a multifaceted systematic review and a model for rapid clinical change. BJS Open 2021; 5:6342605. [PMID: 34355242 PMCID: PMC8342932 DOI: 10.1093/bjsopen/zrab048] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronavirus (COVID-19) forced surgical evolution worldwide. The extent to which national evidence-based recommendations, produced by the current authors early in 2020, remain valid, is unclear. To inform global surgical management and a model for rapid clinical change, this study aimed to characterize surgical evolution following COVID-19 through a multifaceted systematic review. METHODS Rapid reviews were conducted targeting intraoperative safety, personal protective equipment and triage, alongside a conventional systematic review identifying evidence-based guidance for surgical management. Targeted searches of PubMed and Embase from 31 December 2019 were repeated weekly until 7 August 2020, and systematic searches repeated monthly until 30 June 2020. Literature was stratified using Evans' hierarchy of evidence. Narrative data were analysed for consistency with earlier recommendations. The systematic review rated quality using the AGREE II and AMSTAR tools, was registered with PROSPERO, CRD42020205845. Meta-analysis was not conducted. RESULTS From 174 targeted searches and six systematic searches, 1256 studies were identified for the rapid reviews and 21 for the conventional systematic review. Of studies within the rapid reviews, 903 (71.9 per cent) had lower-quality design, with 402 (32.0 per cent) being opinion-based. Quality of studies in the systematic review ranged from low to moderate. Consistency with recommendations made previously by the present authors was observed despite 1017 relevant subsequent publications. CONCLUSION The evidence-based recommendations produced early in 2020 remained valid despite many subsequent publications. Weaker studies predominated and few guidelines were evidence-based. Extracted clinical solutions were globally implementable. An evidence-based model for rapid clinical change is provided that may benefit surgical management during this pandemic and future times of urgency.
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Affiliation(s)
- J G Kovoor
- University of Adelaide, Adelaide, South Australia, Australia.,Australian Safety and Efficacy Register of New Interventional Procedures-Surgical, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
| | - D R Tivey
- Research, Audit and Academic Surgery, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.,Discipline of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - C D Ovenden
- University of Adelaide, Adelaide, South Australia, Australia
| | - W J Babidge
- Research, Audit and Academic Surgery, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.,Discipline of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - G J Maddern
- Research, Audit and Academic Surgery, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.,Discipline of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
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14
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Sim JH, Jo JY, Kim H, Lim JS, Choi SS, Nam S, Ku S, Choi IC. Implementation of a comprehensive preoperative screening process for elective and emergency surgery during the peak of the COVID-19 outbreak. Br J Surg 2021; 108:e175-e176. [PMID: 33793748 PMCID: PMC7929334 DOI: 10.1093/bjs/znab030] [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: 11/23/2020] [Revised: 12/08/2020] [Accepted: 01/11/2021] [Indexed: 11/20/2022]
Affiliation(s)
- J H Sim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - J-Y Jo
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - H Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - J S Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - S-S Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - S Nam
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - S Ku
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - I-C Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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15
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Master SR, Neide B, Kollu S, Mulchandani S, Harris RM, Obstfeld AE. Facilitating Test Status Information Communication in the Time of COVID-19. Acad Pathol 2021; 8:23742895211006822. [PMID: 33884294 PMCID: PMC8040609 DOI: 10.1177/23742895211006822] [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: 02/08/2021] [Revised: 02/08/2021] [Accepted: 03/06/2021] [Indexed: 11/17/2022] Open
Abstract
The Coronavirus 2019 pandemic has strained nearly every aspect of pathology practice, including preanalytic, analytic, and postanalytic processes. Much of the challenges result from high demand for limited severe acute respiratory syndrome coronavirus 2 testing capacity, a resource required to facilitate patient flow throughout the hospital system and society at large. At our institution, this led to unprecedented increases in inquiries from providers to laboratory staff relating to the expected time to result for their patients. The demand was great enough to require redeployment of staff to handle the laboratory call volume. Although these data are available in our laboratory information system, the data do not interface to our electronic health record system. We developed systems using the R statistical programming language that abstract the necessary data regarding severe acute respiratory syndrome coronavirus 2 polymerase chain reaction testing from our lab system in real time, store it, and present it to clinicians for on demand querying. These data have been accessed over 2500 times by over 100 distinct users. Median length of each user session is approximately 4.9 minutes. Because our lab information system does not persistently store tracking information while our system does, we have been able to iteratively recalculate time to result values for each tracking stop as workflows have changed over time. Facility with informatics and programming concepts coupled with clinical understanding have allowed us to swiftly develop and iterate on applications which provide efficiency gains, allowing laboratory resources to focus on generating test results for our patients.
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Affiliation(s)
- Stephen R Master
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Brandy Neide
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA
| | - Sunaina Kollu
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA
| | | | - Rebecca M Harris
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Amrom E Obstfeld
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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16
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Santoro GA, Grossi U, Murad-Regadas S, Nunoo-Mensah JW, Mellgren A, Di Tanna GL, Gallo G, Tsang C, Wexner SD. DElayed COloRectal cancer care during COVID-19 Pandemic (DECOR-19): Global perspective from an international survey. Surgery 2021; 169:796-807. [PMID: 33353731 PMCID: PMC7670903 DOI: 10.1016/j.surg.2020.11.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer care during the pandemic. METHODS The impact of coronavirus disease 2019 on preoperative assessment, elective surgery, and postoperative management of colorectal cancer patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in colorectal cancer care. Respondents were divided into 2 comparator groups: (1) "delay" group: colorectal cancer care affected by the pandemic and (2) "no delay" group: unaltered colorectal cancer practice. RESULTS A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the delay (745, 70.9%) and no delay (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to coronavirus disease 2019 units, units fully dedicated to coronavirus disease 2019 care, and personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology, and prolonged chemoradiation therapy-to-surgery intervals. In the delay group, 48.9% of respondents reported a change in the initial surgical plan, and 26.3% reported a shift from elective to urgent operations. Recovery of colorectal cancer care was associated with the status of the outbreak. Practicing in coronavirus disease-free units, no change in operative slots and staff members not relocated to coronavirus disease 2019 units were statistically associated with unaltered colorectal cancer care in the no delay group, while the geographic distribution was not. CONCLUSION Global changes in diagnostic and therapeutic colorectal cancer practices were evident. Changes were associated with differences in health care delivery systems, hospital's preparedness, resource availability, and local coronavirus disease 2019 prevalence rather than geographic factors. Strategic planning is required to optimize colorectal cancer care.
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Affiliation(s)
- Giulio A Santoro
- Tertiary Referral Colorectal and Pelvic Floor Center, 4th Surgery Unit, Treviso Regional Hospital, DISCOG, University of Padua, Italy.
| | - Ugo Grossi
- Tertiary Referral Colorectal and Pelvic Floor Center, 4th Surgery Unit, Treviso Regional Hospital, DISCOG, University of Padua, Italy
| | | | - Joseph W Nunoo-Mensah
- Department of Colorectal Surgery, King's College Hospital Foundation NHS Trust, Department of Colorectal Surgery, Cleveland Clinic London, United Kingdom
| | - Anders Mellgren
- Division of Colon and Rectal Surgery, University of Illinois, Chicago, IL
| | - Gian Luca Di Tanna
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Gaetano Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Italy
| | - Charles Tsang
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Steven D Wexner
- Digestive Disease Institute, Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale, FL
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17
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Al-Ghunaim TA, Johnson J, Biyani CS, O'Connor D. Psychological and occupational impact of the COVID-19 pandemic on UK surgeons: a qualitative investigation. BMJ Open 2021; 11:e045699. [PMID: 33795311 PMCID: PMC8024056 DOI: 10.1136/bmjopen-2020-045699] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic represents the greatest biopsychosocial emergency the world has faced for a century. The pandemic has changed how individuals live and work, and in particular, frontline healthcare professionals have been exposed to alarming levels of stress. OBJECTIVE The aim of this study was to understand the professional and personal effects of COVID-19 pandemic on surgeons working in the UK National Health Service (NHS). SETTING Surgical departments in the NHS. DESIGN Between May and July 2020, as part of an ongoing study, we asked surgeons two open-ended questions: 'What challenges are the COVID-19 crisis currently presenting to you in your work and home life?' and 'How is this stress affecting you personally?' Thematic analysis was used for the qualitative data. Responses to the second question were also categorised into four groups reflecting valence: positive, neutral, mildly negative and strongly negative. RESULTS A total of 141 surgeons responded to the survey and the results indicated that 85.8% reported that they were generally negatively affected by the COVID-19 pandemic, of which 7.8% were strongly affected in a negative way. Qualitative thematic analysis identified four key themes from responses relating to the impact of the pandemic: (1) changing and challenging work environment as a result of COVID-19; (2) challenges to professional life and development; (3) management of change and loss in the respondents' personal lives; (4) emotional and psychological impacts. CONCLUSION The results highlighted the substantial emotional and psychological effects of the COVID-19 pandemic on surgeons' mental health, particularly in relation to fear and anxiety, loss of motivation, low mood, stress and burnout. There is an urgent need for workplace support and mental health interventions to help surgeons cope with the difficulties they face during the ongoing COVID-19 pandemic.
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18
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Kim JW, Huh CH, Mun JH. Transparent film as an alternative to face mask for decreasing the risk of coronavirus disease transmission during head and neck surgery. Dermatol Ther 2021; 34:e14945. [PMID: 33719105 PMCID: PMC8250234 DOI: 10.1111/dth.14945] [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: 12/29/2020] [Revised: 02/16/2021] [Accepted: 03/11/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Jee-Woo Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University Hospital, Seoul, South Korea
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19
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Importance of Preoperative Screening Strategies for Coronavirus Disease 2019 in Patients Undergoing Cesarean Sections: A Retrospective, Large Single-Center, Observational Cohort Study. J Clin Med 2021; 10:jcm10040885. [PMID: 33671681 PMCID: PMC7926628 DOI: 10.3390/jcm10040885] [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: 01/08/2021] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 12/28/2022] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, many guidelines have recommended postponing non-emergency operations. However, cesarean sections cannot be indefinitely delayed. Our institution has established a COVID-19 screening strategy for patients undergoing cesarean section. We evaluated the usefulness of this screening strategy. Parturients undergoing cesarean section at our center during the first peak of the COVID-19 outbreak were retrospectively analyzed. Each parturient underwent a questionnaire survey evaluating epidemiological correlation and symptoms at admission. Reverse transcriptase–polymerase chain reaction (RT–PCR) testing and/or chest radiography were performed. In total, 296 parturients underwent cesarean section. All elective and 37 emergency cesarean sections were performed in general operating rooms because they were considered to have a low risk of COVID-19 infection through the screening process. However, 42 emergency cases were performed in negative-pressure operating rooms with full personal protective equipment (PPE) because the RT–PCR results could not be confirmed in a timely manner. None of them were positive for RT–PCR, and there were no cases of nosocomial infection. A comprehensive preoperative screening strategy, including symptomatic and epidemiological correlation, PCR, and/or imaging test, should be performed in patients undergoing cesarian section. Further, cesarean sections in parturients with unconfirmed COVID-19 status should be performed in a negative-pressure operating room with appropriate PPE.
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20
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Shoff HW, Huecker M, Davis H, Smith JW. Very Low Rate of Positive COVID Infections (<.5%) on Preoperative Screening in the Elective Procedure Population. Am Surg 2021:3134820983206. [PMID: 33502223 DOI: 10.1177/0003134820983206] [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]
Affiliation(s)
- Hugh W Shoff
- Department of Emergency Medicine, 12254University of Louisville School of Medicine, Louisville, KY, USA
| | - Martin Huecker
- Department of Emergency Medicine, 12254University of Louisville School of Medicine, Louisville, KY, USA
| | - Hailey Davis
- 399365University of Louisville Physicians, Louisville, KY, USA
| | - Jason W Smith
- Department of Surgery, 12254University of Louisville School of Medicine, Louisville, KY, USA
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21
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Larsen CG, Bub CD, Schaffler BC, Walden T, Intravia JM. The impact of confirmed coronavirus disease 2019 (COVID-19) infection on ambulatory procedures and associated delays in care for asymptomatic patients. Surgery 2021; 169:1340-1345. [PMID: 33593601 PMCID: PMC7817437 DOI: 10.1016/j.surg.2021.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/18/2020] [Accepted: 01/08/2021] [Indexed: 12/25/2022]
Abstract
Background Since the reopening of ambulatory centers, minimal data has been reported regarding positive tests among patients undergoing ambulatory procedures, associated delays in care, and outcomes of patients previously positive for coronavirus disease 2019. Methods A retrospective observational case series of ambulatory procedures was performed. Records since the reopening of ambulatory centers in New York were searched for patients with positive coronavirus disease 2019 nasal swab results who underwent ambulatory procedures. Chart reviews were conducted to determine coronavirus disease history and hospitalizations, demographic information, procedure details, and 30-day admissions. Results A total of 3,762 patients underwent ambulatory procedures. Of those, 53 were previously diagnosed with coronavirus disease 2019 but recovered and tested negative at preprocedural testing. Of the 3,709 asymptomatic patients, 37 (1.00%) tested positive during preprocedural testing; 21 patients had their procedures delayed on average 28.6 days until testing negative, while 16 had their procedures performed before testing negative owing to the time sensitivity of the procedure. There were no major complications or 30-day admissions in any of these asymptomatic patients. Three patients tested positive for coronavirus disease after having an ambulatory procedure. Conclusion Positive tests in asymptomatic patients led to procedure delays of 28.6 days. No patients who underwent ambulatory procedures after a positive coronavirus disease 2019 test had any coronavirus disease-related complications, regardless of whether or not the procedure was delayed until testing negative. Three patients tested positive for coronavirus disease 2019 after having an ambulatory procedure; however, at an average of 19.7 days after, these cases were likely community acquired making the rate of nosocomial infection negligible.
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Affiliation(s)
- Christopher G Larsen
- Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
| | - Christine D Bub
- Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Benjamin C Schaffler
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Timothy Walden
- Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Jessica M Intravia
- Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
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22
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Nortje N, Jones-Bonofiglio K, Haque S, Rathi N. Operational framework for rural hospitals during a pandemic. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2021. [DOI: 10.1080/20479700.2020.1870369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Nico Nortje
- Department of Critical care and Respiratory Care, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Dietetics, University of the Western Cape, Bellville, South Africa
- Lakehead University Centre for Health Care Ethics, Thunder Bay, Ontario, Canada
| | - Kristen Jones-Bonofiglio
- Lakehead University Centre for Health Care Ethics, Thunder Bay, Ontario, Canada
- International Network of the UNESCO Chair in Bioethics, Haifa, Israel
| | - Sajid Haque
- Department of Critical care and Respiratory Care, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Nisha Rathi
- Department of Critical care and Respiratory Care, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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23
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Omer AAA. Directives of general surgical practice during the COVID-19 pandemic: A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:395. [PMID: 34912931 PMCID: PMC8641720 DOI: 10.4103/jehp.jehp_233_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/02/2021] [Indexed: 05/09/2023]
Abstract
The coronavirus disease 2019 (COVID-19) is a serious global pandemic that has extremely affected health-care systems. This article aimed to review the perspectives of general surgical practice during the COVID-19 pandemic. A systematic review of the literature addressing modification to general surgical practice during the COVID-19 pandemic indexed in PubMed, Scopus, Google, and Google scholar was carried out on June 19-20, 2020. The literature review yielded 577 articles. The exclusion of duplication, articles not in English, and specialized ones in various surgical disciplines precluded 398 articles. Finally, following checking for relevance and publication status, 114 papers were included. Recommendations for surgical practice during the COVID-19 pandemic revolved around mitigation of the risk of virus transmission to patients and health-care workers. The emerging themes of safety precautions were related to patient prioritization and testing, mindful consideration of the operative strategy, optimum use of personal protective equipment, operative room setup, and departmental organization. However, those recommendations were often diverging and bore on a dearth of evidence and personal opinions. Multidisciplinary work and cooperation among surgical specialties are required to establish and validate the protocols for safe surgical practice during the pandemic and perhaps similar crises in future. The COVID-19 pandemic has brought several challenges to the field of medicine, including the surgical specialty. The centrality of safety precautions emerging in this crisis requires surgeons to adopt the new roles and work standards and translate them into practice during the pandemic and perhaps longer.
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Affiliation(s)
- Ahmad AbdulAzeem Abdullah Omer
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdul Aziz University, Al-Kharj, 11942, Saudi Arabia
- Address for correspondence: Dr. Ahmad AbdulAzeem Abdullah Omer, Department of Surgery, College of Medicine, Prince Sattam Bin Abdul Aziz University, P.O. Box: 1040, Al-Kharj 11942, Saudi Arabia. E-mail:
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Cimen C, Keske Ş, Ergönül Ö. What is the 'new normal' in surgical procedures in the era of COVID-19? Clin Microbiol Infect 2021; 27:16-18. [PMID: 33007477 PMCID: PMC7525368 DOI: 10.1016/j.cmi.2020.09.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/07/2020] [Accepted: 09/18/2020] [Indexed: 01/12/2023]
Affiliation(s)
- Cansu Cimen
- Department of Infectious Diseases and Clinical Microbiology, American Hospital, Istanbul, Turkey.
| | - Şiran Keske
- Department of Infectious Diseases and Clinical Microbiology, American Hospital, Istanbul, Turkey
| | - Önder Ergönül
- Department of Infectious Diseases and Clinical Microbiology, Koc University School of Medicine, Istanbul, Turkey; Koç University Research Center for Infectious Diseases, Istanbul, Turkey
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Okunlola AI. Awake craniotomy in a Covid-19 positive patient: The challenges and outcome. INTERDISCIPLINARY NEUROSURGERY-ADVANCED TECHNIQUES AND CASE MANAGEMENT 2020; 24:101064. [PMID: 33520666 PMCID: PMC7834066 DOI: 10.1016/j.inat.2020.101064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/29/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022]
Abstract
Background The SARS-COV-2 is a novel coronavirus which is the etiological agent of the COVID-19 infection. The neurosurgical practice is not exempted from the impact of the COVID-19 pandemic. Awake craniotomy in a COVID-19 positive patient pose a significant risk for theatre staff but intubation of a COVID-19 positive patient for surgery under general anesthesia also pose similar risk. Method Federal Teaching Hospital Ido Ekiti is a tertiary hospital in suburban community in Southwest Nigeria with 300-bed capacity. The hospital is a designated COVID-19 treatment centre. A 69-year-old female patient was referred from a nearby COVID-19 treatment hospital on account of left parieto-occipital high grade glioma. She had awake craniotomy and gross total tumor excision. Result There was no need to convert to general anesthesia and she had immediate post-operative neurological improvement. Repeat COVID-19 test on post-operative day 4 was negative and she was discharged home. Thirty-day post-operative review confirmed progressive motor gain. Conclusion Awake craniotomy in COVID-19 positive patient with appropriate use of necessary PPEs is achievable.
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Affiliation(s)
- Abiodun Idowu Okunlola
- Department of Surgery, Federal Teaching Hospital, Ido-Ekiti/Afe Babalola University, Ado-Ekiti, Nigeria
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Handaya AY, Andrew J, Hanif AS, Fauzi AR. Covid-19 mimicking symptoms in emergency gastrointestinal surgery cases during pandemic: A case series. Int J Surg Case Rep 2020; 77:22-27. [PMID: 33137666 PMCID: PMC7585363 DOI: 10.1016/j.ijscr.2020.10.064] [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: 08/26/2020] [Accepted: 10/17/2020] [Indexed: 01/01/2023] Open
Abstract
Digestive surgery emergency cases can present with COVID-19 mimicking symptoms. Indications of emergency surgery are the same in during pandemic compared to non-pandemic settings. Strict screening, examination, and protocol are necessary during pandemic.
Background The COVID-19 pandemic has changed patient management in all sectors. All patients need to be examined for COVID-19, including in digestive surgery emergency cases. In this paper, we report four digestive surgery emergency cases with clinical and radiological findings similar to COVID-19. Case presentation We report four digestive surgery emergency cases admitted with fever and cough symptoms. Case 1 is a 75-year-old male with gastric perforation and pneumonia, case 2 is a 32-year-old female with intestinal and pulmonal tuberculosis, case 3 is a 30-year-old female with acute pancreatitis with pleuritis and pleural effusion, and the last case is a 56-year-old female with rectosigmoid cancer with pulmonal metastases. All the patients underwent emergency laparotomy, were hospitalized for therapy, and discharged from the hospital. After 1-month follow-up after surgery, 1 patient had no complaints, 2 patients had surgical site infection, and 1 patient died because of ARDS due to lung metastases. Discussion For all four cases, the surgeries were done with strict COVID-19 protocol which included patient screening, examination, laboratory assessment, rapid test screening, and RT-PCR testing. There were no intrahospital mortalities and all the patients were discharged from the hospital. Three patients were followed-up and recovered well with 2 patients having surgical site infection which recovered within a week. However, 1 patient did not show up for the scheduled follow-up and was reported dead 2 weeks after surgery because of ARDS due to lung metastases. Conclusions Emergency surgery, especially digestive surgery cases, can be done in the COVID-19 pandemic era with strict prior screening and examination, and safety protocol.
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Affiliation(s)
- Adeodatus Yuda Handaya
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
| | - Joshua Andrew
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
| | - Ahmad Shafa Hanif
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
| | - Aditya Rifqi Fauzi
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
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Hojaij FC, Chinelatto LA, Boog GHP, Kasmirski JA, Lopes JVZ, Medeiros VMB. Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review. Int Arch Otorhinolaryngol 2020; 24:e518-e526. [PMID: 33101521 PMCID: PMC7575400 DOI: 10.1055/s-0040-1715506] [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: 06/03/2020] [Accepted: 06/25/2020] [Indexed: 01/20/2023] Open
Abstract
Introduction Head and neck specialists and otorhinolaryngologists are greatly exposed to coronavirus disease 2019 (COVID-19) transmission in their everyday praxis. Many articles are being published regarding medical staff protection and patient management during the pandemic. Objective To provide an easy access to and a trustful review of the main aspects that have changed in the head and neck surgery and otorhinolaryngology practice due to the COVID-19 pandemic. Data Synthesis The search terms used were: ( head and neck or otorhinolaryngology or ORL or thyroid ) AND ( severe acute respiratory syndrome coronavirus 2 [ SARS-COV-2] or COVID-19 or CORONAVIRUS ). The results were limited to the year of 2020. Articles were read in English, Portuguese, French, German, and Spanish or translated from Chinese. All included articles were read by at least two authors. Thirty-five articles were included. Most articles suggest postponing elective surgeries, with exception to cancer surgeries, which should be evaluated separately. Twenty-five articles recommended some kind of screening prior to surgery, using polymerase chain reaction (PCR) tests and epidemiological data. Extra precautions, such as use of personal protective equipment (PPE), are suggested for both tracheostomies and endoscopies. Fifteen articles give recommendation on how to use telemedicine. Conclusion The use of PPE (N95 or powered air-purifying respirator [PAPR]) during procedures should be mandatory. Patients should be evaluated about their COVID-19 status before hospital admission. Cancer should be treated. Tracheostomy tube cuff should be inflated inside the tracheal incision. All COVID-19 precautions should be kept until there is a validated antiviral treatment or an available vaccine.
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Affiliation(s)
- Flavio Carneiro Hojaij
- Department of Surgery, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
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Gallegos M, Cervigni M, Consoli AJ, Caycho-Rodríguez T, Polanco FA, Martino P, de Castro Pecanha V, Burgos Videla C, Polanco-Carrasco R, Cusinato AM. COVID-19 in Latin America: A Bibliometric Analysis of Scientific Publications in Health. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2020. [DOI: 10.29333/ejgm/8460] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Schlosser M, Signorelli H, Gregg W, Korwek K, Sands K. COVID-19 testing processes and patient protections for resumption of elective surgery. Am J Surg 2020; 221:49-52. [PMID: 32736801 PMCID: PMC7367801 DOI: 10.1016/j.amjsurg.2020.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 10/31/2022]
Affiliation(s)
| | | | - William Gregg
- HCA Healthcare, One Park Plaza, Nashville TN, 37203, United States
| | - Kimberly Korwek
- HCA Healthcare, One Park Plaza, Nashville TN, 37203, United States.
| | - Kenneth Sands
- HCA Healthcare, One Park Plaza, Nashville TN, 37203, United States
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Spinal surgery in COVID-19 pandemic era: One trauma hub center experience in central-southern Italy. J Orthop 2020; 22:291-293. [PMID: 32616990 PMCID: PMC7322226 DOI: 10.1016/j.jor.2020.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of the study is to analyze and report the results of the surgical activity in a spinal unit of a trauma hub in central Italy during COVID-19 pandemic. Surgical activity was compared between COVID 19 pandemic and the same period of time in 2019 at our institution. A 50% reduction of surgical procedures during the last three months was observed compared with the same period of time in 2019. The compliance with the containment rules for the spread of the infection, were sufficient to allow safe surgical activity for the medical teams and patients.
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Will the guidelines and recommendations for surgery during COVID-19 pandemic still be valid if it becomes endemic? Int J Surg 2020; 79:250-251. [PMID: 32531306 PMCID: PMC7280821 DOI: 10.1016/j.ijsu.2020.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 01/22/2023]
Abstract
The current COVID-19 pandemic has impacted all the healthcare sectors all over the world. The WHO and various other health organizations have been issuing recommendations and guidelines for surgical practice and patient management during the current pandemic. Some of these guidelines include triaging of the patients, prioritizing emergency surgery and delaying the elective surgical procedures till the COVID-19 pandemic is over. However, it seems that COVID-19 might become endemic in the community and current guidelines might not hold true. Surgical practices cannot remain suspended forever as it will have a deleterious effect on surgeons and patients. Therefore we need novel guidelines so that the surgeons can resume their general surgical practice as soon as possible.
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