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Matsinhe C, Kagodora SB, Mukheli T, Mokoena TP, Malebati WK, Moeng MS, Luvhengo TE. Machine Learning Algorithm-Aided Determination of Predictors of Mortality from Diabetic Foot Sepsis at a Regional Hospital in South Africa During the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1718. [PMID: 39459505 PMCID: PMC11509229 DOI: 10.3390/medicina60101718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2024] [Revised: 09/26/2024] [Accepted: 10/15/2024] [Indexed: 10/28/2024]
Abstract
Background and Objectives: Diabetic foot sepsis (DFS) accounts for approximately 60% of hospital admissions in patients with diabetes mellitus (DM). Individuals with DM are at risk of severe COVID-19. This study investigated factors associated with major amputation and mortality in patients admitted with DFS during the COVID-19 pandemic. Materials and Methods: Demographic information, COVID-19 and HIV status, clinical findings, laboratory results, treatment and outcome from records of patients with diabetic foot sepsis, were collected and analysed. Supervised machine learning algorithms were used to compare their ability to predict mortality due to diabetic foot sepsis. Results: Overall, 114 records were found and 57.9% (66/114) were of male patients. The mean age of the patients was 55.7 (14) years and 47.4% (54/114) and 36% (41/114) tested positive for COVID-19 and HIV, respectively. The median c-reactive protein was 168 mg/dl, urea 7.8 mmol/L and creatinine 92 µmol/L. The mean potassium level was 4.8 ± 0.9 mmol, and glycosylated haemoglobin 11.2 ± 3%. The main outcomes included major amputation in 69.3% (79/114) and mortality of 37.7% (43/114) died. AI. The levels of potassium, urea, creatinine and HbA1c were significantly higher in the deceased. Conclusions: The COVID-19 pandemic led to an increase in the rate of major amputation and mortality in patients with DFS. The in-hospital mortality was higher in patients above 60 years of age who tested positive for COVID-19. The Random Forest algorithm of ML can be highly effective in predicting major amputation and death in patients with DFS.
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Affiliation(s)
- Carlos Matsinhe
- Department of Surgery, Thelle Mogoerane Hospital, University of the Witwatersrand, Johannesburg 2017, South Africa;
| | | | - Tshifhiwa Mukheli
- Directorate of Oral Health and Therapeutic Services, Gauteng Province Department of Health, Johannesburg 2001, South Africa;
| | - Tshepo Polly Mokoena
- Department of Podiatry, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg 2193, South Africa;
| | - William Khabe Malebati
- Nursing Department, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg 2193, South Africa;
| | - Maeyane Stephens Moeng
- Department of Surgery, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg 2193, South Africa;
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Derda E, Szymańska E, Sokolek M, Kierkuś J. Inflammatory bowel diseases during the COVID-19 pandemic. PRZEGLAD GASTROENTEROLOGICZNY 2024; 19:231-235. [PMID: 39802974 PMCID: PMC11718498 DOI: 10.5114/pg.2024.143143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 01/08/2023] [Indexed: 01/16/2025]
Abstract
Since the beginning of the COVID-19 pandemic in 2020, the safety of those with compromised immune systems and chronic disease has been of particular concern for health care providers. Inflammatory bowel diseases (IBD) are chronic, incurable conditions of digestive system with unknown aetiology, but one of the causes is disordered immune response. Medical therapies most frequently used in IBD are immune suppressing or modifying with the rising use of biologic treatment. All these aspects make patients with Crohn's disease and ulcerative colitis a group of particular risk. Therefore, the aim of this review is to discuss potential mechanisms, risks, and management of patients with IBD during COVID-19 pandemic.
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Affiliation(s)
- Edyta Derda
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Edyta Szymańska
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Magda Sokolek
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Jarosław Kierkuś
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children’s Memorial Health Institute, Warsaw, Poland
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Jain S, Mahajan A, Patil PM, Bhandarkar P, Khajanchi M, IndSurg Collaboration. Trends of surgical-care delivery during the COVID-19 pandemic: A multi-centre study in India (IndSurg Collaboration). J Postgrad Med 2023; 69:198-204. [PMID: 37449588 PMCID: PMC10846812 DOI: 10.4103/jpgm.jpgm_485_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/18/2022] [Accepted: 11/24/2022] [Indexed: 07/18/2023] Open
Abstract
Context The COVID-19 pandemic and subsequent lockdowns adversely affected global healthcare services to varying extents. To accommodate its added burden, emergency services were affected along-with elective surgeries. Aims To quantify and analyze the trends of essential surgeries and bellwether procedures during the waxing and waning of the pandemic, across various hospitals in India. Settings and Design Multi-centric retrospective study. Methods and Material A research consortium led by World Health Organization (WHO) Collaboration Center (WHOCC) for Research in Surgical Care Delivery in Low-and Middle-Income countries, India, conducted this study with 5 centers. All surgeries performed during April 2020 (Wave I), November 2020 (Recovery I), and April 2021 (Wave II) were compared with those performed in April 2019 (pre-pandemic period). Statistical Analysis Used Microsoft Excel 2019 and SPSS Version 20. Results The total number of surgeries reduced by 77% during Wave I, which improved to a 52% reduction in Recovery I compared to the pre-pandemic period. However, surgeries were reduced again during Wave II to 68%, but the reduction was less compared to Wave I. Emergency and essential surgeries were affected along with the elective ones but to a lesser extent. Conclusions The present study has quantified the effects of the pandemic on surgical-care delivery across a timeline and documented a reduction in overall surgical volumes during the peaks of the pandemic (Wave I and II) with minimal improvement as the surge of COVID-19 cases declined (Recovery II). The surgical volumes improved during the second wave compared to the first one which may be attributable to better preparedness. Cesarean sections were affected the least.
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Affiliation(s)
- S Jain
- Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - A Mahajan
- Government Medical College, Amritsar, Punjab, India
| | - PM Patil
- Department of Biostatistics, BARC Hospital, Mumbai, Maharashtra, India
| | - P Bhandarkar
- Department of Biostatistics, BARC Hospital, Mumbai, Maharashtra, India
| | - M Khajanchi
- Department of Surgery, Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra, India
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Munda M, Bosnjak R, Velnar T. Problematics of neurosurgical service during the COVID-19 pandemic in Slovenia. World J Clin Cases 2022; 10:12462-12469. [PMID: 36579102 PMCID: PMC9791516 DOI: 10.12998/wjcc.v10.i34.12462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/17/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) is an ongoing disease caused by severe acute respiratory syndrome coronavirus-2 that still poses an important and urgent threat to global health. In Slovenia, the epidemic was declared on March 12th, 2020, and since then COVID-19 has had a great impact on our health system. The field of neurosurgery in particular has been experiencing difficulties in both elective and emergency service. In this article, we described epidemiologic protocols and the effect that the COVID-19 pandemic had on the surgical practice and workflow of the Department of Neurosurgery at the University Medical Centre Ljubljana. We analyzed and compared the number of elective and emergency neurosurgical procedures in a 2-year period before and during the pandemic. We recorded a drop in cases mostly on account of elective procedures whilst emergency service remained relatively unaffected.
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Affiliation(s)
- Matic Munda
- Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Roman Bosnjak
- Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Tomaz Velnar
- Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
- Alma Mater Europaea, AMEU-ECM, Maribor 2000, Slovenia
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Through-Knee Amputation-Time to Recall the Neglected Technique. Indian J Surg 2022; 84:1366. [PMID: 35125749 PMCID: PMC8802987 DOI: 10.1007/s12262-022-03310-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 12/27/2022] Open
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Tarta C, Marian M, Capitanio M, Faur FI, Duta C, Diaconescu R, Oprescu-Macovei AM, Totolici B, Dobrescu A. The Challenges of Colorectal Cancer Surgery during the COVID-19 Pandemic in Romania: A Three-Year Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14320. [PMID: 36361200 PMCID: PMC9658781 DOI: 10.3390/ijerph192114320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
The predictions on the influence of the SARS-CoV-2 pandemic on access to medical services in Romania predicted a 35% drop in oncological hospitalizations in 2020 compared to the previous decade, raising the hypothesis that patients with colorectal cancer can become indirect victims of the ongoing pandemic. Therefore, the aim of the current research was to observe how the COVID-19 pandemic influenced colorectal cancer surgery in Romania, to determine the level of addressability towards specialized care, to compare the cancer staging between the pandemic and pre-pandemic periods, and to observe the risk factors for disease progression. This retrospective study was spread over three years, respectively, from March 2019 to March 2022, and included a total of 198 patients with a history of colorectal cancer surgery. It was decided to perform a parallel comparison of 2019, 2020, and 2021 to observe any significant changes during the pandemic. Our clinic encountered a significant decrease in all interventions during the pandemic; although the number of CRC surgeries remained constant, the cases were more difficult, with significantly more patients presenting in emergency situations, from 31.3% in 2019 to 50.0% in 2020 and 57.1% in 2021. Thus, the number of elective surgeries decreased significantly. The proportion of TNM (tumor-node-metastasis) staging was, however, statistically significant between the pre-pandemic and pandemic period. In 2019, 13.3% of patients had stage IIa, compared with 28.8% in 2020 and 13.1% in 2021. Similarly, the proportion of very advanced colorectal cancer was higher during the pandemic period of 2020 and 2021 (12.0% in 2019 vs. 12.5% in 2020 and 25.0% in 2021), which was represented by a significantly higher proportion of patients with bowel perforation. Patients with an advanced TNM stage had a 6.28-fold increased risk of disease progression, followed by lymphovascular invasion (HR = 5.19). However, the COVID-19 pandemic, represented by admission years 2020 and 2021, did not pose a significant risk for disease progression and mortality. In-hospital mortality during the pandemic also did not change significantly. After the pandemic restrictions have been lifted, it would be advisable to conduct a widespread colorectal cancer screening campaign in order to identify any instances of the disease that went undetected during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Cristi Tarta
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marco Marian
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marco Capitanio
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Flaviu Ionut Faur
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ciprian Duta
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Razvan Diaconescu
- Department of Gastroenterology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of General Surgery, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania
| | - Anca Monica Oprescu-Macovei
- Department of Gastroenterology, Emergency Hospital “Prof. Dr. Agripa Ionescu”, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Bogdan Totolici
- Department of General Surgery, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania
| | - Amadeus Dobrescu
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Akbulut S, Hargura AS, Garzali IU, Aloun A, Colak C. Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic. World J Clin Cases 2022; 10:9228-9240. [PMID: 36159422 PMCID: PMC9477669 DOI: 10.12998/wjcc.v10.i26.9228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/29/2022] [Accepted: 08/06/2022] [Indexed: 02/05/2023] Open
Abstract
Management of colorectal cancer (CRC) was severely affected by the changes implemented during the pandemic, and this resulted in delayed elective presentation, increased emergency presentation, reduced screening and delayed definitive therapy. This review was conducted to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on management of CRC and to identify the changes made in order to adapt to the pandemic. We performed a literature search in PubMed, Medline, Index Medicus, EMBASE, SCOPUS, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Google Scholar using the following keywords in various combinations: Colorectal cancer, elective surgery, emergency surgery, stage upgrading, screening, surveillance and the COVID-19 pandemic. Only studies published in English were included. To curtail the spread of COVID-19 infection, there were modifications made in the management of CRC. Screening was limited to high risk individuals, and the screening tests of choice during the pandemic were fecal occult blood test, fecal immunochemical test and stool DNA testing. The use of capsule colonoscopy and open access colonoscopy was also encouraged. Blood-based tests like serum methylated septin 9 were also encouraged for screening of CRC during the pandemic. The presentation of CRC was also affected by the pandemic with more patients presenting with emergencies like obstruction and perforation. Stage migration was also observed during the pandemic with more patients presenting with more advanced tumors. The operative therapy of CRC was altered by the pandemic as more emergencies surgeries were done, which may require exteriorization by stoma. This was to reduce the morbidity associated with anastomosis and encourage early discharge from the hospital. There was also an initial reduction in laparoscopic surgical procedures due to the fear of aerosols and COVID-19 infection. As we gradually come out of the pandemic, we should remember the lessons learned and continue to apply them even after the pandemic passes.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Abdirahman Sakulen Hargura
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Department of Surgery, Kenyatta University Teaching, Referral and Research Hospital, Nairobi 00100, Kenya
| | - Ibrahim Umar Garzali
- Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Department of Surgery, Aminu Kano Teaching Hospital, Kano 700101, Nigeria
| | - Ali Aloun
- Department of Surgery, King Hussein Medical Center, Amman 11855, Jordan
| | - Cemil Colak
- Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
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Laguardia GCDA, Püschel VADA, de Oliveira PP, de Faria LR, Cavalcante RB, Coelho ADCO, dos Santos KB, Carbogim FDC. Control of airborne particles in surgical procedures during the Covid-19 pandemic: scoping review. Rev Esc Enferm USP 2022; 56:e20210579. [PMID: 35899926 PMCID: PMC10111397 DOI: 10.1590/1980-220x-reeusp-2021-0579en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/09/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To map the technical and managerial strategies for the management and reduction of airborne particles production in surgical procedures settings during the Covid-19 pandemic. METHOD Scoping review, according to the Joana Briggs Institute methodology, based on documents indexed in MEDLINE, VHL, CINAHL Cochrane, Embase, Scopus, Web of Science, and gray literature, published in Portuguese, English, or Spanish. All studies from indexed scientific journals and recommendations published by international agencies or academic associations from 2019 to January 2022 were considered. Findings were summarized and analyzed using descriptive statistics and narrative synthesis. RESULTS Twenty-two studies were selected, 19 of which were published in English, two in Spanish, one in Portuguese, with a predominance of literature reviews. Findings were categorized into recommendations for the environment, the team, and the surgical technique. CONCLUSION The review mapped the technical and managerial strategies for the management and reduction of the airborne particles production in surgical procedures settings. They involve from the use of personal protective equipment, training, anesthetic modality, airway manipulation, to the execution of the surgical technique.
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Affiliation(s)
| | - Vilanice Alves de Araújo Püschel
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil
- Centro Brasileiro para o Cuidado à Saúde Baseado em Evidências: Centro de Excelência do JBI (JBI Brasil), São Paulo, SP, Brazil
| | | | | | | | | | - Kelli Borges dos Santos
- Universidade Federal de Juiz de Fora, Faculdade de Enfermagem, Juiz de Fora, MG, Brazil
- Centro Brasileiro para o Cuidado à Saúde Baseado em Evidências: Centro de Excelência do JBI (JBI Brasil), São Paulo, SP, Brazil
| | - Fábio da Costa Carbogim
- Universidade Federal de Juiz de Fora, Faculdade de Enfermagem, Juiz de Fora, MG, Brazil
- Centro Brasileiro para o Cuidado à Saúde Baseado em Evidências: Centro de Excelência do JBI (JBI Brasil), São Paulo, SP, Brazil
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The Impact of SARS-CoV-2 Pandemic on Patients with Malignant Melanoma at a Romanian Academic Center: A Four-Year Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148499. [PMID: 35886351 PMCID: PMC9317187 DOI: 10.3390/ijerph19148499] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
Abstract
Considering cancer patients may be at an increased risk of severe COVID-19 disease, their oncologic treatment cannot be delayed without risking their oncologic outcomes. Considering this, a comprehensive evaluation is required for the management of malignant diseases such as melanoma. The current study aimed to assess the impact of the COVID-19 pandemic on the delivery of cancer care services for patients diagnosed with malignant melanoma in Romania; to document the difference in patients’ addressability and melanoma staging between the pandemic and pre-pandemic periods; as well as to determine the risk factors responsible for disease progression during the pandemic. We developed a retrospective analysis using a monocentric hospital database to compare the final 24 months of the pre-pandemic era to the first 24 months of the COVID-19 pandemic. All outpatients and inpatients with a diagnosis of malignant melanoma were screened during the study period and included in the analysis if matching the inclusion criteria. A total of 301 patients were included in the study, with 163 cases identified in the 24 months before the COVID-19 pandemic and 138 patients during the first 24 months of the pandemic. It was observed during the first two lockdown periods from March to May 2020, and, respectively, from October to December 2020, that significantly fewer patients with malignant melanoma presented for specialized medical care, while there was a statistically significantly lower proportion of outpatients due to COVID-19 restrictions (18.1% vs. 42.9%). The average Breslow depth was 1.1 mm before the pandemic, compared with 1.8 mm during the pandemic (p-value < 0.001). Third-stage patients were the most prevalent during both study periods, although with a statistically significant difference during the pandemic, with an increase from 90 (55.2%) patients to 94 (68.1%) (p-value < 0.001). The significant risk factors for disease progression were advanced AJCC stage (HR = 3.48), high Breslow index (HR = 3.19), postponed treatment (HR = 2.46), missed appointments (HR = 2.31), anemia at presentation (HR = 1.60), and patient’s age (HR = 1.57). After the pandemic limitations are brought to an end, a broad skin-cancer-screening campaign is warranted to detect the missed cases during COVID-19.
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Ramanathan M, Ravichandran SK, Parameswaran A. COVID-19 and Cleft and Craniofacial Surgery in Indian Scenario. J Maxillofac Oral Surg 2022; 21:460-465. [PMID: 33897127 PMCID: PMC8054694 DOI: 10.1007/s12663-020-01487-9] [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: 07/18/2020] [Accepted: 11/27/2020] [Indexed: 12/05/2022] Open
Abstract
The coronavirus disease (COVID-19) had created the new normal approach towards the management of all maxillofacial problems as it is highly contagious and causing a threat to the health care professionals. The surgical management of patients with cleft and craniofacial deformities has caused lots of anxiety among patients and doctors in the recent COVID era as some essential treatment will be required for cleft babies from day one. Safety and protection for cleft children and parents must be the priority while dealing with this non-emergency disease. This article will highlight the important steps of management of the cleft and craniofacial cases during this pandemic by adhering to the protocols. It also throws light towards the strategies in revoking the cleft surgical management at least till this infection subsides.
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Affiliation(s)
- Manikandhan Ramanathan
- Meenakshi Cleft and Craniofacial Centre, Meenakshi General Hospital, Alapakkam Main Road, Maduravoyal, Chennai, Tamil Nadu 600 095 India
| | - Sailesh Kumar Ravichandran
- Meenakshi Cleft and Craniofacial Centre, Meenakshi General Hospital, Alapakkam Main Road, Maduravoyal, Chennai, Tamil Nadu 600 095 India
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Abdelkader H, El-Kassas M. Tailored treatment strategies for cancer patients during COVID-19 pandemic. Rep Pract Oncol Radiother 2022; 27:318-330. [PMID: 36299379 PMCID: PMC9591031 DOI: 10.5603/rpor.a2022.0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/11/2022] [Indexed: 11/25/2022] Open
Abstract
The global pandemic of respiratory disease caused by the novel human coronavirus (SARS-CoV-2) has caused indefinite global distress, uncertainty, and disturbance. This pandemic has had direct and indirect impacts for the healthcare systems across the world, but certain subgroups of patients have been particularly affected. Among these groups are patients with cancer, who as a result of their immunosuppressed status either from the disease itself or as a consequence of treatment, are at increased risk of severe COVID-19 infection and complications. The pandemic has also led to limited resources as medical services have been primarily directed to emergency care. In this context, physicians and healthcare providers have had to balance the importance of continuing treatment of cancer patients with the risk of virus infection. In this review, we outline the treatment strategies for cancer patients during this pandemic, focusing on tailored treatment in this challenging situation of varying risks and benefits.
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Affiliation(s)
- Haytham Abdelkader
- Clinical Oncology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
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Ortenzi M, Balla A, Botteri E, Lepiane P, Guerrieri M, Arezzo A, Sartori A. COVID-19 pandemic: is it time for shared surgical guidelines? A systematic review of the literature. Minerva Surg 2022; 77:171-179. [PMID: 35416005 DOI: 10.23736/s2724-5691.21.09166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The recent COrona Virus Disease 2019 (COVID-19) pandemic caused a massive disruption of surgical activity and after a year from its first outbreak surgeons still struggle to keep their regular activity coexisting with the virus exhausting requests of healthcare resources. The aim of this paper is to offer a comprehensive overview of the most important recommendations by the International Guidelines about general surgery, and possibly to invite building common shared guidelines to preserve the potential to provide surgical assistance despite the pandemic. EVIDENCE ACQUISITION This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. PubMed, Embase, Cochrane and Web of Science databases were searched. EVIDENCE SYNTHESIS The searches revealed a total of 18579 articles published up to the end of February 2021. Five articles published between March and May 2020, were included in the present study: Guidelines from The European Society of Trauma and Emergency Surgery (ESTES), The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and The European Association for Endoscopic Surgeons (EAES), The Endoscopic and Laparoscopic Surgeons of Asia (ELSA), The European Hernia Society (EHS) and The International Organization for the Study of Inflammatory Bowel Disease (IOS-IBD). CONCLUSIONS In the likely scenario that the SARS-CoV-2 pandemic will become an endemic chronic problem, we should not be forced to choose between COVID-19 or surgery in the future and find a way to make both coexisting.
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Affiliation(s)
- Monica Ortenzi
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy -
| | - Andrea Balla
- General Surgery Unit, San Paolo Hospital, Civitavecchia, Rome, Italy
| | - Emanuele Botteri
- General Surgery Unit, ASST Spedali Civili, Montichiari Hospital, Montichiari, Brescia, Italy
| | - Pasquale Lepiane
- General Surgery Unit, San Paolo Hospital, Civitavecchia, Rome, Italy
| | - Mario Guerrieri
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Alberto Arezzo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alberto Sartori
- Department of General Surgery, Montebelluna Hospital, Montebelluna, Treviso, Italy
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Vatsya P, Garika SS, Mittal S, Trikha V, Sharma V, Malhotra R. Lockdown imposition due to COVID-19 and its effect on orthopedic emergency department in level 1 trauma center in South Asia. J Clin Orthop Trauma 2022; 28:101826. [PMID: 35345869 PMCID: PMC8942879 DOI: 10.1016/j.jcot.2022.101826] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The coronavirus pandemic brought the entire world to a standstill. One of the most stringent lockdowns in the world was implemented in India. With the entire healthcare system being stretched, emergency orthopaedic services also take a hit. We studied the trends in patient presentation, testing, management, and restructuring of doctors at a tertiary care orthopaedic centre and compared them with the data from the same time period the previous year (2019). METHOD Data was collected separately for all the 5 different phases of lockdown and unlock, as well as for the same duration of months in 2019, and was analysed for epidemiological trends. RESULTS A rapid fall in the total number of cases was seen during the lockdown, followed by a skewed rise during the unlock. Forearm, wrist, and hip fractures were the most common fractures. Once nucleic acid testing of all patients intended to be admitted was started, a steep rise in coronavirus positivity was seen. There was a reduction in the total number of cases compared to 2019, but it was not as significant as would have been expected due to the complete standstill of activity during the lockdown. CONCLUSION During a pandemic, with the healthcare system under a crisis of workforce and infrastructure, there needs to be a separate task force for catering to orthopaedic emergencies since all fractures cannot be managed conservatively and the numbers of trauma-related patients did not show a stark fall as compared to normal months of last year. LEVEL OF EVIDENCE Level 3 Retrospective Case Series.
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14
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Guo Y, Liu Y. Sustainable poverty alleviation and green development in China’s underdeveloped areas. JOURNAL OF GEOGRAPHICAL SCIENCES 2022; 32:23-43. [PMCID: PMC8732968 DOI: 10.1007/s11442-021-1932-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/21/2021] [Indexed: 05/21/2023]
Abstract
In 2020, the decisive victory of building a moderately well-off society in all aspects means that absolute poverty in rural China has been completely eliminated. Consolidating and expanding the achievements of poverty alleviation and establishing a long-term mechanism to solve relative poverty have become key issues in high-quality development of underdeveloped areas. In this study, human-earth system is employed to analyze the element composition, structural organization and functional state of underdeveloped areas. The results show that poverty in underdeveloped areas stems from the lack of the coupling and coordinating mechanism among human, economic, resource and environmental elements, which is not conducive to transforming the ecological advantages into the advantages of regional development. In the antipoverty stage, underdeveloped areas innovate the human-earth coupling and coordinating mechanism through a series of targeted measures, promote the organic combination of poverty alleviation, ecological conservation and sustainable development, and boost the transformation of regional development and the increase of farmers’ incomes. Focusing on the 14th Five-year Plan (2021-2025) and the long-term goal of 2035, governments in underdeveloped areas should make full use of the policy support to explore scientific methods of modern governance and sustainable development. In particular, it is necessary to practice the concept that “clear waters and lush mountains are invaluable assets” and take the road of the ecologicalization of industry and the industrialization of ecology by establishing a policy system of “green land”, “green people”, “green industry” and “green right”, thus building an endogenous growth mechanism of sustainable poverty alleviation and green development in China’s underdeveloped areas.
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Affiliation(s)
- Yuanzhi Guo
- Key Laboratory of Regional Sustainable Development Modeling, Institute of Geographic Sciences and Natural Resources Research, CAS, Beijing, 100101 China
| | - Yansui Liu
- Key Laboratory of Regional Sustainable Development Modeling, Institute of Geographic Sciences and Natural Resources Research, CAS, Beijing, 100101 China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100190 China
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Laguardia GCDA, Püschel VADA, Oliveira PPD, Faria LRD, Cavalcante RB, Coelho ADCO, Santos KBD, Carbogim FDC. Controle de partículas aéreas nos procedimentos cirúrgicos durante a pandemia da Covid-19: revisão de escopo. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0579pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Mapear as estratégias técnicas e gerenciais para o manejo e a redução da produção de partículas aéreas em ambientes de procedimentos cirúrgicos durante a pandemia da Covid-19. Método: Revisão de escopo, de acordo com metodologia do Joana Briggs Institute, a partir de documentos indexados nas bases MEDLINE, BVS, CINAHL Cochrane, Embase, Scopus, Web of Science e literatura cinza, publicados em português, inglês ou espanhol. Foram considerados todos os estudos provenientes de periódicos científicos indexados e recomendações publicadas por órgãos internacionais ou associações acadêmicas, de 2019 a janeiro de 2022. Os achados foram sumarizados e analisados por estatística descritiva e síntese narrativa. Resultados: Foram selecionados 22 estudos, sendo 19 publicados em inglês, dois em espanhol, um em português, com predominância de revisões da literatura. Os achados foram categorizados em recomendações para o ambiente, a equipe e a técnica cirúrgica. Conclusão: a revisão mapeou as estratégias técnicas e gerenciais para o manejo e a redução da produção de partículas aéreas nos ambientes de procedimentos cirúrgicos. Envolvem desde o uso de equipamentos de proteção individual, treinamentos, modalidade anestésica, manipulação de vias aéreas, até a execução da técnica cirúrgica.
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Affiliation(s)
| | - Vilanice Alves de Araújo Püschel
- Universidade de São Paulo, Brazil; Centro Brasileiro para o Cuidado à Saúde Baseado em Evidências: Centro de Excelência do JBI (JBI Brasil), Brazil
| | | | | | | | | | - Kelli Borges dos Santos
- Universidade Federal de Juiz de Fora, Brazil; Centro Brasileiro para o Cuidado à Saúde Baseado em Evidências: Centro de Excelência do JBI (JBI Brasil), Brazil
| | - Fábio da Costa Carbogim
- Universidade Federal de Juiz de Fora, Brazil; Centro Brasileiro para o Cuidado à Saúde Baseado em Evidências: Centro de Excelência do JBI (JBI Brasil), Brazil
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Kshirsagar MM, Dodamani AS, Deokar RN, Garg Y, Khobragade VR, Garg K. Impact of COVID-19 on Dentistry. Int J Clin Pediatr Dent 2021; 14:711-714. [PMID: 34934288 PMCID: PMC8645626 DOI: 10.5005/jp-journals-10005-2025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Pandemic situations always impose devastating aftereffects on communities and cause chronic damaging effects on the healthcare system. Novel coronavirus disese-2019 (COVID-19) which has originated in China (Wuhan) is nowadays an emerging threat to public health across the world. It is spreading worldwide so rapidly and has started infecting people in all possible ways. Several dental care facilities in affected countries are completely closed or have been only providing minimal treatment for emergency cases since the whole lockdown has been announced. However, in some affected countries, they are still providing regular dental treatment. This discrepancy could be because of the dearth of proper awareness, knowledge, protocol, or guidelines. How to cite this article Kshirsagar MM, Dodamani AS, Deokar RN, et al. Impact of COVID-19 on Dentistry. Int J Clin Pediatr Dent 2021;14(5):711-714.
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Affiliation(s)
- Minal M Kshirsagar
- Department of Public Health Dentistry, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Arun S Dodamani
- Department of Public Health Dentistry, ACPM Dental College, Dhule, Maharashtra, India
| | - Rahul N Deokar
- Department of Public Health Dentistry, SMBT Dental College and Hospital, Igatpuri, Maharashtra, India
| | - Yogesh Garg
- Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sriganganagar, Rajasthan, India
| | | | - Kamal Garg
- Department of Periodontics, Surendera Dental College and Research Institute, Sriganganagar, Rajasthan, India
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17
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Jayadev C, Mochi Basavaraj T, Pandey K, Pinto R, Pandey SP, Basu S, Roy AS, Shetty R. Risk Assessment of Aerosol Generation During Vitreoretinal Surgery Using High Speed Imaging Amidst the COVID-19 Pandemic. Transl Vis Sci Technol 2021; 10:17. [PMID: 34647963 PMCID: PMC8525865 DOI: 10.1167/tvst.10.12.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to discuss the propensity of aerosol and droplet generation during vitreoretinal surgery using high speed imaging amidst the coronavirus disease 2019 (COVID-19) pandemic. Methods In an experimental set up, various steps of vitreoretinal surgery were performed on enucleated goat eyes. The main outcome measures were visualization, quantification of size, and calculation of aerosol spread. Results During intravitreal injection, insertion of cannulas, lensectomy, and vitrectomy with both 23 and 25-gauge instruments, with either valved or nonvalved cannulas, aerosols were not visualized which was confirmed on imaging. Although there was no aerosol generation during active fluid air exchange (FAE), there was bubbling and aerosol generation at the exit port of the handle during passive FAE. Under higher air pressure, with reused valved and fresh nonvalved cannulas, aerosol generation showed a trajectory 0.4 to 0.67 m with droplet size of 200 microns. Whereas removing cannulas or suturing under active air infusion (35 mm Hg and above) aerosols were noted. Conclusions Based on the above experiments, we can formulate guidelines for safe vitrectomy during COVID-19. Some recommendations include the use of valved cannulas, avoiding passive FAE or to direct the exit port away from the surgeon and assistant, and to maintain the air pressure less than or equal to 30 mm Hg. Translational Relevance In the setting of the COVID-19 pandemic, the risk from virus laden aerosols, as determined using an experimental setup, appears to be low for commonly performed vitreoretinal surgical procedures.
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Affiliation(s)
- Chaitra Jayadev
- Vitreoretina Department, Narayana Nethralaya Eye Institute, Bangalore, India
| | | | - Khushboo Pandey
- Department of Mechanical Engineering, Indian Institute of Science, Bangalore, India
| | - Roven Pinto
- Department of Mechanical Engineering, Indian Institute of Science, Bangalore, India
| | - Shashi Prabha Pandey
- Department of Mechanical Engineering, Indian Institute of Science, Bangalore, India
| | - Saptarshi Basu
- Department of Mechanical Engineering, Indian Institute of Science, Bangalore, India
| | - Abhijit Sinha Roy
- Imaging, Biomechanics and Mathematical Modeling solutions, Narayana Nethralaya Foundation, Bangalore, India
| | - Rohit Shetty
- Vitreoretina Department, Narayana Nethralaya Eye Institute, Bangalore, India
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Singh SK, Gupta A, Sandhu H, Mani R, Sharma J, Kumar P, Rajput D, Kumar N, Huda F, Basu SP, Ravi B, Kant R. Surgical Diseases Management during COVID-19 Crisis at a Tertiary Care Hospital of India: Our Institutional Strategy. Surg J (N Y) 2021; 7:e366-e373. [PMID: 34977359 PMCID: PMC8714410 DOI: 10.1055/s-0041-1740452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/20/2021] [Indexed: 11/03/2022] Open
Abstract
Introduction In response to the national coronavirus disease 2019 (COVID-19) pandemic, all hospitals and medical institutes gave priority to COVID-19 screening and to the management of patients who required hospitalization for COVID-19 infection. Surgical departments postponed all elective operative procedures and provided only essential surgical care to patients who presented with acute surgical conditions or suspected malignancy. Ample literature has emerged during this pandemic regarding the guidelines for safe surgical care. We report our experience during the lockdown period including the surgical procedures performed, the perioperative care provided, and the specific precautions implemented in response to the COVID-19 crisis. Materials and Methods We extracted patient clinical data from the medical records of all surgical patients admitted to our tertiary care hospital between the March 24th, 2020 and May 31st, 2020. Data collected included: patient demographics, surgical diagnoses, surgical procedures, nonoperative management, and patient outcomes. Results Seventy-seven patients were included in this report: 23 patients were managed medically, 28 patients underwent a radiologic intervention, and 23 patients required an operative procedure. In total eight of the 77 patients died due to ongoing sepsis, multiorgan failure, or advanced malignancy. Conclusion During the COVID-19 lockdown period, our surgical team performed many lifesaving surgical procedures and appropriately selected cancer operations. We implemented and standardized essential perioperative measures to reduce the spread of COVID-19 infection. When the lockdown measures were phased out a large number of patients remained in need of delayed elective and semi-elective operative treatment. Hospitals, medical institutes, and surgical leadership must adjust their priorities, foster stewardship of limited surgical care resources, and rapidly implement effective strategies to assure perioperative safety for both patients and operating room staff during periods of crisis.
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Affiliation(s)
- Sudhir Kumar Singh
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Harindra Sandhu
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rishit Mani
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Jyoti Sharma
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Praveen Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Navin Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Farhanul Huda
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Som Prakas Basu
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bina Ravi
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Tolani MA, Fidelis L, Oyelowo N, Mustapha A, Adebayo WO, Okeke CJ, Alioke II, Abdulsalam KI, Aruna AA, Okonji NO, Okeke UA. Impact of the COVID-19 pandemic on surgical practice, training, and research in Nigeria. Pan Afr Med J 2021; 39:59. [PMID: 34422182 PMCID: PMC8363979 DOI: 10.11604/pamj.2021.39.59.23678] [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: 05/22/2020] [Accepted: 03/14/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction the rising rate of SARS-CoV-2 infections has caused perceptible strain on the global health system. Indeed, this disease is also a litmus test for the resilience of the structures in the African health system including surgery. Therefore, this study aimed to determine the impact of the COVID-19 pandemic on surgical practice, training and research in Nigeria. Methods it was a cross-sectional study conducted over three weeks in Nigeria among doctors in 12 surgery-related specialties. Consenting participants filled a pre-tested online form consisting of 35 questions in 5 sections which assessed demographics, infection control measures, clinical practice, academic training, research program, and future trends. Data were analyzed using Statistical Package for Social Sciences Version 20. Results a total of 384 respondents completed the form. Their mean age was 38.3 years. Lockdown measures were imposed in the state of practice of 89.0% of respondents. Most participants reported a decrease in patient volume in outpatient clinics (95.5%) and elective operations (95.8%) compared to reports for emergency operations (50.2%). They also noted a decrease in academic training [Bedside teaching (92.1%), seminar presentation (91.1%) and journal presentation (91.8%)] and research (80.5%). Except in bedside teaching, those who had other virtual academic programmes were thrice the number of those who used in-person mode for the events. Conclusion COVID-19 pandemic has caused a significant change in pattern and a decrease in the volume of patients seen by surgeons in their practice as well as a decrease in the frequency of academic programs and research activities in Nigeria.
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Affiliation(s)
- Musliu Adetola Tolani
- Department of Surgery, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Lovely Fidelis
- Department of Surgery, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Nasir Oyelowo
- Department of Surgery, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Aisha Mustapha
- Department of Obstetrics and Gynaecology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Wasiu Olusola Adebayo
- Department of Surgery, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Chike John Okeke
- Department of Surgery, Lagos University Teaching Hospital, Idi-Araba, Surulere, Lagos State, Nigeria
| | | | | | - Afeez Ajibade Aruna
- Department of Surgery, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Nkemdilim Oyetola Okonji
- Department of Surgery, Central Hospital Benin, Edo State Hospital Management Board, Benin City, Edo State, Nigeria
| | - Uche Albert Okeke
- Department of Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
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20
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Health facilities' readiness for safe surgical care provision in Uganda and the Eastern Democratic Republic of Congo during Ebola and COVID-19 era. BMC Health Serv Res 2021; 21:831. [PMID: 34404419 PMCID: PMC8370832 DOI: 10.1186/s12913-021-06870-x] [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: 04/29/2021] [Accepted: 08/02/2021] [Indexed: 12/22/2022] Open
Abstract
Objective This study aimed to assess health facilities’ readiness to provide safe surgical care during Ebola and COVID-19 era in Uganda and in the Eastern DR Congo. Methods A cross-sectional study was conducted in selected national, regional referral and general hospital facilities in Uganda and in the eastern part of DR Congo from 1st August 2020 to 30th October 2020. Data was analysed using Stata version 15. Results The participation rate was of 37.5 % (72/192) for both countries. None of the hospitals fulfilled the readiness criteria for safe surgical care provision in both countries. The mean bed capacity of participating health facilities (HF) was 184 in Eastern DR Congo and 274 in Uganda with an average surgical ward bed capacity of 22.3 % (41/184) and 20.4 % (56/274) respectively. The mean number of operating rooms was 2 and 3 in Eastern DR Congo and Uganda respectively. Nine hospitals (12.5 %) reported being able to test for Ebola and 25 (34.7 %) being able to test for COVID-19. Postponing of elective surgeries was reported by 10 (13.9) participating hospitals. Only 7 (9.7 %) hospitals reported having a specific operating room for suspect or confirmed cases of Ebola or COVID-19. Appropriate Personal Protection Equipment (PPE) was reported to be available in 60 (83.3 %) hospitals. Most of the staff had appropriate training on donning and doffing of PPE 40 (55.6 %). Specific teams and protocols for safe surgical care provision were reported to be present in 61 (84.7 %) and 56 (77.8 %) respectively in Uganda and Eastern DR Congo participating hospitals. Conclusions The lack of readiness to provide safe surgical care during Ebola and COVID-19 era across the participating hospitals in both countries indicate a need for strategies to enhance health facility supplies and readiness for safe surgical provision in resource-limited settings.
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Nagarkar R, Roy S, Dhondge R, Adhav A, Manke A, Banswal L, Upwanshi M, Kulkarni N, Tandale R, Bang Y, Pasumarthi LS, Subramaniam A, Rajpari KN, Yajurvedi P, Ansari S, Wankhede B, Ramesh YV. Elective Surgical Experience During COVID Pandemic at a Tertiary Cancer Care Centre in India: A Retrospective Analysis. Indian J Surg Oncol 2021; 12:257-264. [PMID: 34421277 PMCID: PMC8365133 DOI: 10.1007/s13193-021-01403-8] [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: 08/28/2020] [Accepted: 07/27/2021] [Indexed: 11/26/2022] Open
Abstract
To analyse and identify possible outcomes of elective cancer surgeries performed at a tertiary cancer centre during COVID19 pandemic. This is a retrospective study including patients that underwent surgery at HCG Manavata cancer centre, Nashik, Maharashtra, India, from 15 March 2020 to 15 June 2020. Among the 458 patients that underwent elective surgeries, 54% were male and 46% were female, with a median age of 50.57 years. The most common sites of cancer distribution were head and neck (24.67%), colorectal (11.57%), gynaecological (11.35%), and breast (10.26%). Of the included patients, 92% were of American Society of Anaesthesiologists (ASA) II with comorbidities such as hypertension, and 64% underwent major surgeries with a mortality rate of 1.52% (n = 7). Average duration of surgery and hospital stay was observed to be 168.43 min and 4.4 days, respectively. Post-operatively, 7 patients were tested COVID positive and their recovery was uneventful. Despite the difficulty that set in because of COVID19 pandemic, it was proven from our study that elective cancer care surgeries can be successfully performed by following all the set guidelines.
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Affiliation(s)
- Raj Nagarkar
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Sirshendu Roy
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Rajendra Dhondge
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Aditya Adhav
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Aditya Manke
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Lalit Banswal
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Manish Upwanshi
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Nayana Kulkarni
- Department of Anaesthesiology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Ravindra Tandale
- Department of Anaesthesiology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Yogesh Bang
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | | | - Anuraag Subramaniam
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Kamil N. Rajpari
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Pranay Yajurvedi
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Shoeb Ansari
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Bhushan Wankhede
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
| | - Yasam Venkata Ramesh
- Department of Academics, HCG Manavata Cancer Centre, Nashik, 422011 Maharashtra India
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22
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Rural Healthcare Enterprises in the Vortex of COVID-19: The Impact of Public Policies on the Internal and External Environment. ADMINISTRATIVE SCIENCES 2021. [DOI: 10.3390/admsci11030082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The public policies implemented in order to contain the spread of COVID-19 in the community have created issues both in the internal and the external environments of the Greek rural healthcare enterprises. This study aimed to investigate the full extent of the issues (internal and external) caused by the public policies. Regarding the external factors, we examined the state, the local authorities, the financial institutions, the social stakeholders and the citizens. Regarding the internal factors, we focused on turnover, liquidity, working conditions, internal changes related to patient care and the implementation of protective measures. A qualitative research was conducted among twelve rural healthcare business owners in the form of semi-structured interviews. The research was conducted in the fall of 2020 during the second phase of COVID-19. The research showed that these enterprises were severely impacted by the government’s public policies. Local authorities were not involved due to lack of competence. The business owners were unwilling to support their enterprises via bank lending. During the first phase of COVID-19, citizens postponed nonessential medical examinations, causing a reduction in these enterprises’ turnover. As a result, in the following periods, these enterprises faced liquidity problems. However, they developed social objectives and implemented protective measures for their employees and patients. The present study contributes to the mapping of the factors affecting the internal and external environments of rural healthcare enterprises along with the public policies developed in times of prolonged crisis. These kinds of data are crucial to the business world and government officials voting on social policies. One cannot rule out the possibility of a new financial or health crisis; the findings of this study can prove to be a useful tool in the process of decision making.
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Subtotal colectomy for refractory ulcerative colitis with COVID-19 infection; a first case report in Japan. Clin J Gastroenterol 2021; 14:1437-1442. [PMID: 34213760 PMCID: PMC8250545 DOI: 10.1007/s12328-021-01472-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/23/2021] [Indexed: 10/29/2022]
Abstract
We report a 60-year-old male who was transferred to our hospital for the operation because of refractory ulcerative colitis (UC). He was diagnosed to be infected with COVID-19 for SARS-CoV-2 PCR test positive at the time of transfer. We determined emergency operation because his general condition was poor such as malnutrition and ADL decline due to exacerbation of UC and air embolization by central venous catheter removal. He underwent subtotal colectomy with a sigmoid mucous fistula and ileostomy. He was well postoperatively. This is a first case report in Japan who underwent an operation for UC with COVID-19 infection.
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Management of Obsessive-Compulsive Disorder before Bariatric Surgery with Cognitive Behavioral Therapy During COVID-19. Obes Surg 2021; 31:4213-4215. [PMID: 34156665 PMCID: PMC8217972 DOI: 10.1007/s11695-021-05516-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 05/31/2021] [Accepted: 06/09/2021] [Indexed: 11/28/2022]
Abstract
This is a report about a 44-year-old woman, with morbid obesity (BMI = 43) who was a candidate for bariatric surgery (BS) in Mother and Child Hospital in Shiraz, Iran. She had obsessive-compulsive disorder (OCD), so she refused surgery because she was afraid of getting the coronavirus. Psychiatric diagnostic interview and EyleBrown questionnaire that consists of 10 items were performed by a psychiatrist for the patient. After diagnosis of OCD, the patient underwent cognitive behavioral therapy (CBT) for 8 sessions. Results show that CBT is effective in reducing symptoms of OCD during COVID-19. Therefore, preoperative psychological interventions help increase patients’ readiness for BS during COVID-19.
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Rashdan M, Al-Taher R, Al-Qaisi M, Khrais I, Salameh M, Obaidat I, Abbad M, Alsaadi T, Hani AB. The impact of the Covid-19 pandemic on emergency surgery in a tertiary hospital in Jordan. A cross sectional study. Ann Med Surg (Lond) 2021; 66:102339. [PMID: 33968400 PMCID: PMC8087663 DOI: 10.1016/j.amsu.2021.102339] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Since the emergence of COVID-19 pandemic, governments around the world reacted by implementing curfews and sometimes nation-wide lockdowns intended to control the spread of the disease and help the already overwhelmed healthcare systems from imminent collapse. The Jordanian government was one of those countries that implemented a complete nation-wide lockdown which lasted for 3 months during the peak months of 2020. The aim of this study is to shed the light on the impact of this lockdown on the surgical emergency practice at a tertiary referral center in Amman, the capital of Jordan. METHODS A retrospective review of the medical records of the patients who were admitted to the hospital through the emergency department over the lock-down months in 2020 and compare them to the records of the patients admitted within the same period in 2019. RESULTS A total of 143 patients were admitted in the 2020 group, compared to 201 patients in the 2019 group, marking a 28% reduction in admission rate. The average duration of symptoms before the ER visit was significantly longer in the 2020 period compared to 2019 (95.32 ± 148.62 min, 57 ± 64.4 min respectively, p = 0.01) which resulted in a Significant increase in the ICU admission in the same period (P=.00001). As for the type of management, there was no difference between the two groups with similar percentage of surgeries performed in the two periods (p = 0.333). Additionally, the average length of stay did not also differ (p = 0.141). CONCLUSION The COVID-19 pandemic has negatively affected the health care systems around the world to the point of collapse in some countries. This study has demonstrated its effects on the emergency surgery practice at our institution which was mainly related to the delay in getting medical care caused by the strict lock-down laws implemented in the country. Thus, we recommend that special measures should be taken to improve the access to medical care during future events that may require limiting the movement of people and vehicles in the country.
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Affiliation(s)
- Mohammad Rashdan
- Department of General Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | - Raed Al-Taher
- Department of General Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | - Mohammad Al-Qaisi
- Department of General Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | - Ibrahim Khrais
- Department of General Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | - Mohammad Salameh
- Department of General Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Mutaz Abbad
- Department of General Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | - Tabarak Alsaadi
- Department of General Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | - Amjad Bani Hani
- Department of General Surgery, School of Medicine, The University of Jordan, Amman, Jordan
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Jacob S, Hameed A, Lam V, Pang TC. Consistency of global recommendations regarding open versus laparoscopic surgery during the COVID-19 pandemic: a systematic review. ANZ J Surg 2021; 91:1358-1363. [PMID: 33792122 PMCID: PMC8250243 DOI: 10.1111/ans.16761] [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: 12/30/2020] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022]
Abstract
Background Throughout the COVID‐19 pandemic, there has been worldwide debate regarding whether open surgery should be performed in preference to laparoscopic surgery due to the theoretical higher risk of viral aerosolization by the release of pneumoperitoneum. We aimed to assess the consistency of national and international surgical society recommendations regarding the choice of surgical approach; assess the quality of evidence of viral emission in surgical aerosol; and assess the quality of evidence comparing aerosol generation by different surgical energy devices. Methods A systematic review of PubMed, Medline, Embase and Cochrane databases was performed. Three search strategies were employed. Twenty‐eight studies were included in the final analysis and quality appraised. Confidence in review findings was assessed using the GRADE‐CERQual (Confidence in Evidence from Reviews of Qualitative research) tool. Results Worldwide recommendations regarding open versus laparoscopic surgery are consistent, with a majority recommending that surgical approach is decided on a case‐by‐case, risk minimization approach. There is limited, low‐quality evidence that viral particles can be emitted in surgical aerosol. There is a paucity of literature on the quantity of aerosol produced by different surgical energy devices, and no evidence to support the use of certain surgical instruments to minimize aerosol production. Conclusions There is considerable consistency among worldwide recommendations regarding the choice of surgical approach, although the evidence base is lacking. To inform clinical recommendations, further research examining viral emission, transmission, infectivity and amount of surgical aerosol produced is required.
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Affiliation(s)
- Susan Jacob
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Ahmer Hameed
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Clinical School, Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Surgical Innovations Unit, Westmead Hospital, Sydney, New South Wales, Australia
| | - Vincent Lam
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Clinical School, Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Tony Cy Pang
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Clinical School, Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Surgical Innovations Unit, Westmead Hospital, Sydney, New South Wales, Australia
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Du Q, Zhang D, Hu W, Li X, Xia Q, Wen T, Jia H. Nosocomial infection of COVID‑19: A new challenge for healthcare professionals (Review). Int J Mol Med 2021; 47:31. [PMID: 33537803 PMCID: PMC7891837 DOI: 10.3892/ijmm.2021.4864] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/19/2021] [Indexed: 12/28/2022] Open
Abstract
Nosocomial infections, also known as hospital-acquired infections, pose a serious challenge to healthcare professionals globally during the Coronavirus disease 2019 (COVID‑19) pandemic. Nosocomial infection of COVID‑19 directly impacts the quality of life of patients, as well as results in extra expenditure to hospitals. It has been shown that COVID‑19 is more likely to transmit via close, unprotected contact with infected patients. Additionally, current preventative and containment measures tend to overlook asymptomatic individuals and superspreading events. Since the mode of transmission and real origin of COVID‑19 in hospitals has not been fully elucidated yet, minimizing nosocomial infection in hospitals remains a difficult but urgent task for healthcare professionals. Healthcare professionals globally should form an alliance against nosocomial COVID‑19 infections. The fight against COVID‑19 may provide valuable lessons for the future prevention and control of nosocomial infections. The present review will discuss some of the key strategies to prevent and control hospital‑based nosocomial COVID‑19 infections.
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Affiliation(s)
- Qiu Du
- Department of Immunology, College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
| | - Dingding Zhang
- Department of Immunology, College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
- Department of Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, P.R. China
- Department of Microbiology and Immunology, North Sichuan Medical College, Nanchong, Sichuan 637100, P.R. China
| | - Weimin Hu
- Department of Microbiology and Immunology, North Sichuan Medical College, Nanchong, Sichuan 637100, P.R. China
| | - Xuefei Li
- Department of Immunology, College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
| | - Qiongrong Xia
- Department of Immunology, College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
| | - Taishen Wen
- Department of Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, P.R. China
| | - Haiping Jia
- Department of Microbiology and Immunology, North Sichuan Medical College, Nanchong, Sichuan 637100, P.R. China
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De Simone B, Chouillard E, Sartelli M, Biffl WL, Di Saverio S, Moore EE, Kluger Y, Abu-Zidan FM, Ansaloni L, Coccolini F, Leppänemi A, Peitzmann AB, Pagani L, Fraga GP, Paolillo C, Picetti E, Valentino M, Pikoulis E, Baiocchi GL, Catena F. The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper. World J Emerg Surg 2021; 16:14. [PMID: 33752721 PMCID: PMC7983964 DOI: 10.1186/s13017-021-00349-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Since the COVID-19 pandemic has occurred, nations showed their unpreparedness to deal with a mass casualty incident of this proportion and severity, which resulted in a tremendous number of deaths even among healthcare workers. The World Society of Emergency Surgery conceived this position paper with the purpose of providing evidence-based recommendations for the management of emergency surgical patients under COVID-19 pandemic for the safety of the patient and healthcare workers. METHOD A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) through the MEDLINE (PubMed), Embase and SCOPUS databases. Synthesis of evidence, statements and recommendations were developed in accordance with the GRADE methodology. RESULTS Given the limitation of the evidence, the current document represents an effort to join selected high-quality articles and experts' opinion. CONCLUSIONS The aim of this position paper is to provide an exhaustive guidelines to perform emergency surgery in a safe and protected environment for surgical patients and for healthcare workers under COVID-19 and to offer the best management of COVID-19 patients needing for an emergency surgical treatment. We recommend screening for COVID-19 infection at the emergency department all acute surgical patients who are waiting for hospital admission and urgent surgery. The screening work-up provides a RT-PCR nasopharyngeal swab test and a baseline (non-contrast) chest CT or a chest X-ray or a lungs US, depending on skills and availability. If the COVID-19 screening is not completed we recommend keeping the patient in isolation until RT-PCR swab test result is not available, and to manage him/she such as an overt COVID patient. The management of COVID-19 surgical patients is multidisciplinary. If an immediate surgical procedure is mandatory, whether laparoscopic or via open approach, we recommend doing every effort to protect the operating room staff for the safety of the patient.
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Affiliation(s)
- Belinda De Simone
- Service de Chirurgie Générale, Digestive, Metabolique, Centre Hospitalier de Poissy/Saint Germain en Laye, Poissy, France
| | - Elie Chouillard
- Service de Chirurgie Générale, Digestive, Metabolique, Centre Hospitalier de Poissy/Saint Germain en Laye, Poissy, France
| | - Massimo Sartelli
- Department of General Surgery, Macerata’s Hospital, Macerata, Italy
| | - Walter L. Biffl
- Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital, La Jolla, CA USA
| | - Salomone Di Saverio
- Department of General Surgery, University Hospital of Varese, University of Insubria, Varese, Italy
| | | | - Yoram Kluger
- Department of Emergency and Trauma Surgery, Rambam Health Campus, Haifa, Israel
| | - Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Luca Ansaloni
- Department of Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | | | - Ari Leppänemi
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | - Andrew B. Peitzmann
- University of Pittsburgh School of Medicine, F-1281, UPMC-Presbyterian, Pittsburgh, PA 15213 USA
| | - Leonardo Pagani
- Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy
| | - Gustavo P. Fraga
- Departamento de Cirurgia, Faculdade de Ciências Médicas (FCM) –Unicamp, Campinas, SP Brazil
| | - Ciro Paolillo
- Spedali Civili di Brescia, ASST degli Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Edoardo Picetti
- Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy
| | | | - Emmanouil Pikoulis
- Department of Surgery, Attikon General Hospital, National & Kapodistrian University of Athens (NKUA), Athens, Greece
| | | | - Fausto Catena
- Department of Emergency and Trauma Surgery, Parma University Hospital, Parma, Italy
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29
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Burden EG, Walker RW, Ferguson DJ, Goubran A, Howell JR, John JB, Khan F, McGrath JS, Evans JP. The provision of a time-critical elective surgical service during the COVID-19 Crisis: a UK experience. Ann R Coll Surg Engl 2021; 103:173-179. [PMID: 33557703 DOI: 10.1308/rcsann.2020.7023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION With the emergence of the COVID-19 pandemic, all elective surgery was temporarily suspended in the UK, allowing for diversion of resource to manage the anticipated surge of critically unwell patients. Continuing to deliver time-critical surgical care is important to avoid excess morbidity and mortality from pathologies unrelated to COVID-19. We describe the implementation and short-term surgical outcomes from a system to deliver time-critical elective surgical care to patients during the COVID-19 pandemic. MATERIALS AND METHODS A protocol for the prioritisation and safe delivery of time-critical surgery at a COVID-19 'clean' site was implemented at the Nuffield Health Exeter Hospital, an independent sector hospital in the southwest of England. Outcomes to 30 days postoperatively were recorded, including unplanned admissions after daycase surgery, readmissions and complications, as well as the incidence of perioperative COVID-19 infection in patients and staff. RESULTS A total of 128 surgical procedures were performed during a 31-day period by a range of specialties including breast, plastics, urology, gynaecology, vascular and cardiology. There was one unplanned admission and and two readmissions. Six complications were identified, and all were Clavien-Dindo grade 1 or 2. All 128 patients had preoperative COVID-19 swabs, one of which was positive and the patient had their surgery delayed. Ten patients were tested for COVID-19 postoperatively, with none testing positive. CONCLUSION This study has demonstrated the implementation of a safe system for delivery of time-critical elective surgical care at a COVID-19 clean site. Other healthcare providers may benefit from implementation of similar methodology as hospitals plan to restart elective surgery.
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Affiliation(s)
- E G Burden
- Royal Devon and Exeter Foundation Trust, Exeter, UK
| | - R W Walker
- Royal Devon and Exeter Foundation Trust, Exeter, UK
| | - D J Ferguson
- Royal Devon and Exeter Foundation Trust, Exeter, UK.,University of Exeter Medical School, St Luke's Campus, Exeter, UK
| | - Amf Goubran
- Royal Devon and Exeter Foundation Trust, Exeter, UK
| | - J R Howell
- Royal Devon and Exeter Foundation Trust, Exeter, UK
| | - J B John
- Royal Devon and Exeter Foundation Trust, Exeter, UK
| | - F Khan
- Royal Devon and Exeter Foundation Trust, Exeter, UK
| | - J S McGrath
- Royal Devon and Exeter Foundation Trust, Exeter, UK.,University of Exeter Medical School, St Luke's Campus, Exeter, UK
| | - J P Evans
- Royal Devon and Exeter Foundation Trust, Exeter, UK.,Health Services and Policy Research Unit, University of Exeter Medical School, Exeter, UK
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30
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Gunadi, Makkadafi M, Fauzi AR, Praja A, Athollah K, Marcellus. Emergency high ligation in a suspected COVID-19 pediatric patient with incarcerated inguinal hernia: A case report. Ann Med Surg (Lond) 2021; 62:261-264. [PMID: 33520222 PMCID: PMC7830290 DOI: 10.1016/j.amsu.2021.01.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND SARS-Cov-2 infects not only adults, but also children, including pediatric surgery patients with acute abdomen. Here, we report a pediatric surgery case with incarcerated inguinal hernia and suspected COVID-19. CASE PRESENTATION A 11-month-old male was brought to our emergency department with the main complaint of recurrent yellowish-green vomiting that was experienced from one day before admission. High fever and shortness of breath were also reported. This patient was also suffering from moderate dehydration. Neither history of contact with a confirmed case of COVID-19 nor traveling from any local transmission area were found. However, a SARS-CoV-2 rapid antibody test revealed a positive result. A lump in the left scrotum that persisted during admission was found. Fluid resuscitation and nasogastric tube placement for decompression was performed. Manual reduction was attempted but failed to reduce the lump. Accordingly, we decided to perform an emergency high ligation using tertiary protection regulations, i.e., full personal protective equipment (PPE) for COVID-19. Intraoperatively, we found a small intestine loop trapped in the scrotum and stuck in the inguinal canal. Postoperatively, the baby was continued to be managed as a patient with COVID-19 while waiting for the real-time reverse transcription polymerase chain reaction (RT-PCR) results. DISCUSSION Manual reduction is standard treatment for incarcerated inguinal hernia in children. The successful rate of manual reduction is about 70%, therefore, if the manual reduction fails, an emergency surgery is mandatory.During the COVID-19 pandemic, all medical procedures require clarity of the patient's status including whether infected with COVID-19. Along with proper precautions, great care must be taken during surgery to minimize the risk of cross infection to health workers. CONCLUSIONS During the COVID-19 pandemic, surgeons should always be aware of the possibility of cross-transmission from the patient, since children are also susceptible to SARS-CoV-2 infection. When and wherever possible, surgeons should perform the procedure in the quickest and most effective manner to shorten exposure time with patient and anesthetic aerosols as well as using appropriate PPE.
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Affiliation(s)
- Gunadi
- Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Munawir Makkadafi
- Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
- Department of Surgery, Faculty of Medicine, Hasanudin University, Makassar, 90241, Indonesia
- Undata Distric Hospital, Palu, 94116, Indonesia
| | - Aditya Rifqi Fauzi
- Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | | | - Kemala Athollah
- Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Marcellus
- Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
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31
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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: 0.5] [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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32
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Aggarwal S, Mahawar K, Khaitan M, Raj P, Wadhawan R, Dukkipati N, Kular KS, Prasad A, Bhasker AG, Soni V, Madhok B, Baig S, Palaniappan R, Shivaram HV, Goel D, Bindal V, Saggu S, Shrivastava R, Shah S, Dhorepatil S, Khullar R. Obesity and Metabolic Surgery Society of India (OSSI) Recommendations for Bariatric and Metabolic Surgery Practice During the COVID-19 Pandemic. Obes Surg 2020; 30:5101-5107. [PMID: 32829450 PMCID: PMC7443150 DOI: 10.1007/s11695-020-04940-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/01/2022]
Abstract
Bariatric and metabolic surgery (BMS), the only effective option for patients with obesity with or without comorbidities, has been stopped temporarily due to the ongoing novel corona virus disease (COVID-19) pandemic. However, there has been a recent change in the governmental strategy of dealing with this virus from 'Stay at Home' to 'Stay Alert' in many countries including India. A host of health services including elective surgeries are being resumed. In view of the possibility of resumption of BMS in near future, Obesity and Metabolic Surgery Society of India (OSSI) constituted a committee of experienced surgeons to give recommendations about the requirements as well as precautions to be taken to restart BMS with emphasis on safe delivery and high-quality care.
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Affiliation(s)
- Sandeep Aggarwal
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Praveen Raj
- Gem Hospital & Research Centre, Coimbatore, India
| | | | | | | | | | | | - Vandana Soni
- Max Institute of Laparoscopic, Endoscopic and Bariatric Surgery Max Super Specialty hospital, New Delhi, India
| | - Brijesh Madhok
- University Hospitals of Derby & Burton NHS Foundation Trust, University of Nottingham (School of Medicine), Nottingham, UK
| | | | | | | | - Deep Goel
- BLK Super-Speciality Hospital, New Delhi, India
| | - Vivek Bindal
- Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS), Sir Ganga Ram Hospital, New Delhi, India
| | | | | | - Sumeet Shah
- Max Smart Super Speciality Hospital, New Delhi, India
| | | | - Rajesh Khullar
- Max Institute of Laparoscopic, Endoscopic and Bariatric Surgery Max Super Specialty hospital, New Delhi, India
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33
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Mehanathan PB, Edwards AA, Athisayamani, Robinson T. Experience of a surgeon at the emergency department during COVID-19 pandemic. Ann Med Surg (Lond) 2020; 60:245-248. [PMID: 33163177 PMCID: PMC7598423 DOI: 10.1016/j.amsu.2020.10.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/16/2020] [Accepted: 10/18/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction The COVID pandemic, which started on 11th March as per the World Health Organization, has resulted in a drastic change in health care delivery, including emergency services. Most health workers have deviated towards COVID care delivery; only a few were available for non-COVID conditions. All elective and non-essential services were postponed resulting in the increased burden of the emergency department. The emergency department had to provide essential emergency care with available staff without exposing them to the virus. Triaging of the patients was modified according to the needs. Methods The statistics of the emergency department of this period (April and May 2020) are compared with the same period of previous years (2018-2019) with the number of patients, indications, and complications. The methods of triaging and preparation were discussed. Discussion The number of patients admitted to the emergency department (ED) was low during the COVID pandemic. Nevertheless, they got admitted with complications due to delay in accessing the health care facility. Patients with diabetic foot ulcers were also presenting late, leading to an increased number of the forefoot and below knee amputations. In trauma, the emergency department has maintained the same death rate as previous years by giving great care. The indications for tracheostomy were worrisome because it would have been prevented if the patients presented early. Pediatric patients were also presented late, resulting in increased mortality. Some cancer patients also presented with a complication in the emergency department because of the postponement of elective surgeries. Conclusion There is a delay in accessing the health care delivery for non-COVID conditions resulting in more amputations of limbs and resections of the bowel. So the type of care in the emergency department was changed due to atypical presentation and complicated cases. It is necessary to ensure the provision of high quality health care delivery to non-COVID patients also.
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Affiliation(s)
| | - Alex Arthur Edwards
- Department of Surgery, Tirunelveli Medical College Tirunelveli, 627011, India
| | - Athisayamani
- Department of Surgery, Tirunelveli Medical College Tirunelveli, 627011, India
| | - Theodar Robinson
- Department of Surgery, Tirunelveli Medical College Tirunelveli, 627011, India
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34
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Shah S, Gadiya A, Patel MS, Shafafy M. Coronavirus Disease 2019 Transmission: Blood Viremia and Aerosol Generation from Spinal Surgery. Is There an Increased Risk to the Surgical Team? Asian Spine J 2020; 14:702-709. [PMID: 33108836 PMCID: PMC7595826 DOI: 10.31616/asj.2020.0378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
As a respiratory pathogen, the novel coronavirus is commonly associated with aerosol-generating procedures. However, it is currently unclear whether spinal surgical procedures pose an additional risk of viral transmission to the surgical team. We reviewed the available evidence to ascertain the presence of coronavirus disease 2019 (COVID-19) blood viremia and the virus' blood transmissibility, as well as evidence of blood-aerosol generation and operating room contamination from spinal surgical procedures. There is established evidence of COVID-19 blood viremia, a viral pathogenic cycle via angiotensin-converting enzyme 2 (ACE-2) receptors and similar blood transmission risk data from the SARS (severe acute respiratory syndrome)/MERS (Middle East respiratory syndrome) era. Spinal surgical practices demonstrate significant blood-aerosol generation from the operative wound due to the use of common surgical instruments, such as electrocautery, as well as high-speed and high-impact devices. Based on the evidence, there is an established additional risk of viral transmission faced by surgical teams from blood-aerosols generated from the operative wound of COVID-19- infected patients via the inhalation of virus-laden aerosols and the subsequent initiation of the viral pathogenic cycle through binding with pulmonary ACE-2 receptors. Recognizing this additional risk amidst the ongoing pandemic serves as a caution to front-line surgical personnel to strictly adhere to personal protective equipment usage in operating rooms, to modify surgical techniques to reduce the hazard of surgical aerosol generation and COVID-19 viral exposure, and to consider it as an integral aspect of planning and adapting to the "new normal" operating practices.
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Affiliation(s)
- Siddharth Shah
- The Centre for Spinal Studies and Surgery, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Akshay Gadiya
- The Centre for Spinal Studies and Surgery, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Mohammed Shakil Patel
- The Centre for Spinal Studies and Surgery, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Masood Shafafy
- The Centre for Spinal Studies and Surgery, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Bresadola V, Biddau C, Puggioni A, Tel A, Robiony M, Hodgkinson J, Leo CA. General surgery and COVID-19: review of practical recommendations in the first pandemic phase. Surg Today 2020; 50:1159-1167. [PMID: 32720009 PMCID: PMC7383064 DOI: 10.1007/s00595-020-02086-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/18/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND In March, 2020, the World Health Organization declared COVID-19 a pandemic. The absence of previous knowledge of COVID-19 has made decision-making difficult for all in health care, including surgical departments. We reviewed the management recommendations for surgical activity and changes to surgical practice, identifying concordances and discrepancies, based on the literature published in the early phase of the pandemic. METHOD We searched the electronic datasets, PubMed Database, Google, and Google Scholar, using the keywords "SARS-CoV-2", "COVID-19", "surgery", "recommendations", "guideline", and "triage". The search was limited to the first 2 months after the pandemic began and was closed on May 6, 2020. RESULTS Twenty papers were included in the analysis and their recommendations are divided into the following categories: 1. general aspects, such as maintaining the safety of health personnel and indications for surgery. 2. The preoperative phase, with recommendations about activating different care pathways for COVID-19 positive patients. 3. The operative phase, with recommendations about activating safety measures for aerosol-generating procedures. 4. The postoperative phase, with recommendations for managing operating theatres and patient transfers. CONCLUSION The recommendations proposed in the revised documents are considered good practices aimed at keeping patients and healthcare professionals safe. However, these recommendations must be contextualized in each individual hospital.
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Affiliation(s)
- Vittorio Bresadola
- General Surgery Department and Simulation Center, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy.
| | - Carlo Biddau
- General Surgery Department and Simulation Center, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Puggioni
- General Surgery Department and Simulation Center, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Tel
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Massimo Robiony
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | | | - Cosimo Alex Leo
- Department of General and Emergency Surgery, Northwick Park and St Mark's Hospital, London North West University Healthcare NHS Trust, Harrow, UK
- Department of Surgery & Cancer, Imperial College London, London, UK
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Propensity and quantification of aerosol and droplet creation during phacoemulsification with high-speed shadowgraphy amid COVID-19 pandemic. J Cataract Refract Surg 2020; 46:1297-1301. [PMID: 32649436 DOI: 10.1097/j.jcrs.0000000000000289] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To study propensity of aerosol and droplet generation during phacoemulsification using high-speed shadowgraphy and quantify its spread amid COVID-19 pandemic. SETTING Aerosol and droplet quantification laboratory. DESIGN Laboratory study. METHODS In an experimental set-up, phacoemulsification was performed on enucleated goat eyes and cadaveric human corneoscleral rims mounted on an artificial anterior chamber. Standard settings for sculpt and quadrant removal mode were used on Visalis 100 (Carl Zeiss Meditec AG). Microincision and standard phacoemulsification were performed using titanium straight tips (2.2 mm and 2.8 mm in diameter). The main wound incisions were titrated equal to and larger than the sleeve size. High-speed shadowgraphy technique was used to detect the possible generation of any droplets and aerosols. The visualization and quantification of size of the aerosols and droplets along with calculation of their spread were the main outcome measures. RESULTS In longitudinal phacoemulsification using a peristaltic pump device with a straight tip, no aerosol generation was seen in a closed chamber. In larger wounds, there was a slow leak at the main wound. The atomization of balanced salt solution was observed only when the phacoemulsification tip was completely exposed next to the ocular surface. Under this condition, the nominal size of the droplet was approximately 50 µm, and the maximum calculated spread was 1.3 m. CONCLUSIONS There was no visible aerosol generation during microincision or standard phacoemulsification. Phacoemulsification is safe to perform in the COVID-19 era by taking adequate precautions against other modes of transmission.
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Tasa D, Eslami P, Dashti H, Nassiri Toosi M, Zarghami SY, Zarghami SY, Jafarian A. The successful management of Thirty-six hepatopancreatobiliary surgeries under the intensive protective arrangements during the COVID-19 pandemic. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020005. [PMID: 32921703 PMCID: PMC7717014 DOI: 10.23750/abm.v91i3.9997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/06/2020] [Indexed: 12/13/2022]
Abstract
ackground: During the pandemic of COVID-19, the overwhelm of infected patients created an exponential surge for ICU and ward beds. As a result, a major proportion of elective surgeries was postponed. However, various emergency and urgent procedures were allowed. Due to the mortality complications of hepatopancreatobiliary issues, we decided to afford urgent procedures under intensive protective arrangements. Method and results: In our ward (liver transplant), 4 ICU beds and 16 ward beds were allocated to non-COVID-19 patients. A total of 36 hepatopancreatobiliary procedures were managed for one month. All the surgeries were afforded under personal protective equipment and other intensive protective arrangements for personnel and patients. During 6 weeks following the surgery, all patients were followed up through telemedicine and no new case of COVID-19 was detected. Conclusion: In general, it appears that intensive protections could significantly reduce the number of COVID-19 incidence among patients with co-morbidities who undergo invasive procedures.
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Affiliation(s)
- Davood Tasa
- Liver transplantation research center, imam Khomeini hospital complex, Tehran University of Medical sciences, Tehran, Iran..
| | - Pegah Eslami
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Habibollah Dashti
- Liver transplantation research center, imam Khomeini hospital complex, Tehran University of Medical sciences, Tehran, Iran..
| | - Mohsen Nassiri Toosi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .
| | - Seyed Yahya Zarghami
- Liver transplantation research center, imam Khomeini hospital complex, Tehran University of Medical sciences, Tehran, Iran..
| | - Seyed Yahya Zarghami
- Liver transplantation research center, imam Khomeini hospital complex, Tehran University of Medical sciences, Tehran, Iran..
| | - Ali Jafarian
- Liver transplantation research center, imam Khomeini hospital complex, Tehran University of Medical sciences, Tehran, Iran..
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Wielogórska NL, Ekwobi CC. COVID-19: What are the challenges for NHS surgery? Curr Probl Surg 2020; 57:100856. [PMID: 32948255 PMCID: PMC7329670 DOI: 10.1016/j.cpsurg.2020.100856] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/29/2020] [Indexed: 12/15/2022]
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Ghidinelli F, De Pascale S, Romario UF. COVID-19: Effect on patients with gastrointestinal cancer and surgery. Int J Surg 2020; 82:32-33. [PMID: 32858211 PMCID: PMC7446650 DOI: 10.1016/j.ijsu.2020.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 02/09/2023]
Affiliation(s)
- Federico Ghidinelli
- Spedali Civili di Brescia, Brescia, Piazzale Spedali Civili, 1, 25123, Brescia BS, Italy.
| | - Stefano De Pascale
- Department of Surgery, European Institute of Oncology, IRCCS, Milan, Italy.
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Zaniboni A, Ghidini M, Grossi F, Indini A, Trevisan F, Iaculli A, Dottorini L, Moleri G, Russo A, Vavassori I, Brevi A, Rausa E, Boni L, Dondossola D, Valeri N, Ghidini A, Tomasello G, Petrelli F. A Review of Clinical Practice Guidelines and Treatment Recommendations for Cancer Care in the COVID-19 Pandemic. Cancers (Basel) 2020; 12:E2452. [PMID: 32872421 PMCID: PMC7565383 DOI: 10.3390/cancers12092452] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic has inevitably caused those involved in cancer care to change clinical practice in order to minimize the risk of infection while maintaining cancer treatment as a priority. General advice during the pandemic suggests that most patients continue with ongoing therapies or planned surgeries, while follow-up visits may instead be delayed until the resolution of the outbreak. We conducted a literature search using PubMed to identify articles published in English language that reported on care recommendations for cancer patients during the COVID-19 pandemic from its inception up to 1st June 2020, using the terms "(cancer or tumor) AND (COVID 19)". Articles were selected for relevance and split into five categories: (1) personal recommendations of single or multiple authors, (2) recommendations of single authoritative centers, (3) recommendations of panels of experts or of multiple regional comprehensive centers, (4) recommendations of multicenter cooperative groups, (5) official guidelines or recommendations of health authorities. Of the 97 included studies, 10 were personal recommendations of single or multiple independent authors, 16 were practice recommendations of single authoritative cancer centers, 35 were recommendations provided by panel of experts or of multiple regional comprehensive centers, 19 were cooperative group position papers, and finally, 17 were official guidelines statements. The COVID-19 pandemic is a global emergency, and has rapidly modified our clinical practice. Delaying unnecessary treatment, minimizing toxicity, and identifying care priorities for surgery, radiotherapy, and systemic therapies must be viewed as basic priorities in the COVID-19 era.
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Affiliation(s)
| | - Michele Ghidini
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Francesco Grossi
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Alice Indini
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | | | - Alessandro Iaculli
- Oncology Unit, ASST Bergamo Est, 24068 Seriate (BG), Italy; (A.I.); (L.D.)
| | - Lorenzo Dottorini
- Oncology Unit, ASST Bergamo Est, 24068 Seriate (BG), Italy; (A.I.); (L.D.)
| | - Giovanna Moleri
- Centro Servizi, Direzione Socio-Sanitaria, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Alessandro Russo
- Surgical Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Ivano Vavassori
- Urology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Alessandra Brevi
- Otorhinolaryngology-Head and Neck Surgery Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Emanuele Rausa
- General Surgery 1 Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy;
| | - Luigi Boni
- Department of Surgery, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
| | - Daniele Dondossola
- General and Liver Transplant Surgery Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, Università degli Studi of Milan, 20122 Milan, Italy
| | - Nicola Valeri
- Division of Molecular Pathology and Centre for Evolution and Cancer, The Institute of Cancer Research, London SW7 3RP, UK;
- Department of Medicine, The Royal Marsden Hospital, London SW3 6JJ, UK
| | | | - Gianluca Tomasello
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Fausto Petrelli
- Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy
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Abstract
Since its initial outbreak in China, in December, 2019, COVID-19 has spread rapidly across the globe. At the time of writing, on April 29, 2020, infections had been confirmed in more than 200 countries and regions and 3,018,681 infections and 207,973 deaths had been recorded. In Japan, the first confirmed case of SARS-CoV-2 infection was reported on January 16, 2020, since when, the number of domestic infections and the death toll have reached 13,852 and 389, respectively, representing exponential increases. Moreover, both domestically and internationally, the shortage of medical resources and the spread of infection among medical personnel, caused by nosocomial transmissions have become problematic. The pathology of COVID-19, including the exact infection route, remains largely unknown. Given the unavailability of an effective cure and vaccine, people are required to respond to this adversity without becoming complacent. The global efforts against the COVID-19 pandemic are ongoing endeavors, far from over. New epidemiological data and clinical findings are emerging on a daily basis, making it critical to always refer to the latest information.
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Affiliation(s)
- Manabu Watanabe
- Department of Surgery, Toho University Ohashi Medical Center Manabu Watanabe, 2-22-36 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
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Patient safety associated with the surgical treatment of bone and soft tissue tumours during the COVID-19 pandemic-results from an observational study at the Oxford Sarcoma Service. INTERNATIONAL ORTHOPAEDICS 2020; 44:1853-1858. [PMID: 32728926 PMCID: PMC7387417 DOI: 10.1007/s00264-020-04736-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022]
Abstract
Purpose Deferring cancer surgery can have profound adverse effects including patient mortality. During the COVID-19 pandemic, departmental reorganisation and adherence to evolving guidelines enabled provision of uninterrupted surgical care to patients with bone and soft tissue tumours (BST) in need of surgery. We reviewed the outcomes of surgeries on BST during the first two months of the pandemic at one of the tertiary BST centres in the UK. Materials and methods Between 12 March 2020 and 12 May 2020, 56 patients of a median age of 57 years (18–87) underwent surgery across two sites: index hospital (n = 27) and COVID-free facility (n = 29). Twenty-five (44.6%) patients were above the age of 60 years and 20 (35.7%) patients were in ASA III and ASA IV category. The decision to offer surgery was made in adherence with the guidelines issued by the NHS, BOOS and BSG. Results At a minimum follow-up of 30 days post-surgery, 54 (96.4%) patients were recovering well. Thirteen patients (23.2%) had post-operative complications which included four (7.1%) patients developing pulmonary embolism. The majority of complications (12/13 = 92.7%) occurred in ASA III and IV category patients. Four (7.1%) patients contracted COVID-19, of which three required escalation of care due to pulmonary complications and two (3.6%) died. Patients < 60 years of age had significantly less complications than those > 60 years (p < 0.001). Patients operated on in the COVID-free facility had fewer complications compared with those operated on at the index hospital (p < 0.027). Conclusion In spite of the favourable results in majority of our patients, our study shows that patients with sarcoma operated at the height of the pandemic are at a risk of contracting COVID-19 and also having associated with mortality. The use of a COVID-free facility, surgery in patients < 60 60 years and in ASA I & II category are associated with better outcomes. If a second wave occurs, a serious consideration should be given to ways of minimising the risk of contracting COVID-19 in these vulnerable patients either by using COVID-free facilities or delaying treatment until peak of infection has passed.
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Magro F, Rahier JF, Abeu C, MacMahon E, Hart A, van der Woude CJ, Gordon H, Adamina M, Viget N, Vavricka S, Kucharzik T, Leone S, Siegmund B, Danese S, Peyrin-Biroulet L. Inflammatory Bowel Disease Management During the COVID-19 Outbreak: The Ten Do's and Don'ts from the ECCO-COVID Taskforce. J Crohns Colitis 2020; 14:S798-S806. [PMID: 32722754 PMCID: PMC7454472 DOI: 10.1093/ecco-jcc/jjaa160] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Our knowledge of COVID-19 is changing and evolving rapidly, with novel insights and recommendations, almost on a daily basis. It behooves the medical community to provide updated information on a regular basis, on best practice to facilitate optimal care of infected patients and on appropriate advice for the general population. This is particularly important in the case of patients with chronic conditions, such as inflammatory bowel disease [IBD]. In this review, we have compiled existing evidence on the impact of COVID-19 in IBD patients and provide guidance on the most appropriate care to adopt during the pandemic. Our review highlights that IBD, per se, is not a risk factor for COVID-19. However, all IBD patients with symptoms should be tested for SARS-CoV-2 and the procedures for disease management should be carefully adapted: [i] in SARS-CoV-2-positive IBD patients, medical treatments should be re-evaluated [with a particular focus on corticosteroids] always with the purpose of treating active disease and maintaining remission; [ii] non-urgent surgeries and endoscopic procedures should be postponed for all patients; [iii] online consultancy should be implemented; and [iv] hospitalization and surgery should be limited to life-threatening situations.
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Affiliation(s)
- F Magro
- Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Gastroenterology, Centro Hospitalar de São João, Porto, Portugal;Department of Clinical Pharmacology Centro Hospitalar de São João, Porto, Portugal
| | - J-F Rahier
- CHU UCL Namur, Université catholique de Louvain, service de Hépato-gastroentérologie, Yvoir, Belgium
| | - C Abeu
- Infectious Diseases Service, Centro Hospitalar Universitário São João, Porto, Portugal. Instituto de Inovação e Investigação em Saúde (I3s), Faculty of Medicine, Department of Medicine, University of Porto,Portugal
| | - E MacMahon
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - A Hart
- IBD Unit, St Mark’s Hospital, London, UK
| | - C J van der Woude
- Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlnads
| | - H Gordon
- Department of Gastroenterology Royal London Hospital, Barts Health NHS Trust, London, England. Centre for Immunobiology, The Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, England
| | - M Adamina
- Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - N Viget
- Department of Infectious Diseases, Tourcoing Hospital, Tourcoing
| | - S Vavricka
- Center for Gastroenterology and Hepatology, Zürich, Switzerland
| | - T Kucharzik
- Lüneburg Hospital, University of Hamburg, Department of Gastroenterology, Lüneburg, Germany
| | - S Leone
- EFCCA, European Federation of Crohn’s and Ulcerative Colitis Associations, Brussels, Belgium
| | - B Siegmund
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin, Germany
| | - S Danese
- Division of Gastroenterology, IBD Center, Humanitas University, Rozzano, Milan, Italy
| | - L Peyrin-Biroulet
- Department of Gastroenterology Nancy University Hospital, Vandoeuvre-Les-Nancy, France,Inserm NGERE U1256, Lorraine University, Vandoeuvre-Les-Nancy, France,Correspondence author: Laurent Peyrin-Biroulet, MD, PhD Inserm NGERE and Department of Gastroenterology Nancy University Hospital, University of Lorraine 1 Allée du Morvan, 54511 Vandoeuvre-lès-Nancy, France Tel: (+33) 383153661 Fax: (+33) 383153633
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O'Connell DA, Seikaly H, Isaac A, Pyne J, Hart RD, Goldstein D, Yoo J. Recommendations from the Canadian Association of Head and Neck Surgical Oncology for the Management of Head and Neck Cancers during the COVID-19 pandemic. J Otolaryngol Head Neck Surg 2020; 49:53. [PMID: 32727583 PMCID: PMC7387877 DOI: 10.1186/s40463-020-00448-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The SARS-CoV-2 virus (COVID19) pandemic has placed extreme pressures on the Canadian Healthcare system. Many health care regions in Canada have cancelled or limited surgical and non-surgical interventions on patients to preserve healthcare resources for a predicted increase in COVID19 related hospital admissions. Also reduced health interventions may limit the risk of possible transmission of COVID19 to other patients and health care workers during this pandemic. The majority of institutions in Canada have developed their own operational mandates regarding access to surgical resources for patients suffering from Head and Neck Cancers during this pandemic. There is a large degree of individual practitioner judgement in deciding access to care as well as resource allocation during these challenging times. The Canadian Association of Head and Neck Surgical Oncology (CAHNSO) convened a task force to develop a set of guidelines based on the best current available evidence to help Head and Neck Surgical Oncologists and all practitioners involved in the care of these patients to help guide individual practice decisions. MAIN BODY The majority of head and neck surgical oncology from initial diagnosis and work up to surgical treatment and then follow-up involves aerosol generating medical procedures (AGMPs) which inherently put head and neck surgeons and practitioners at high risk for transmission of COVID19. The aggressive nature of the majority of head and neck cancer negates the ability for deferring surgical treatment for a prolonged period of time. The included guidelines provide recommendations for resource allocation for patients, use of personal protective equipment for practitioners as well as recommendations for modification of practice during the current pandemic. CONCLUSION 1. Enhanced triaging should be used to identify patients with aggressive malignancies. These patients should be prioritized to reduce risk of significant disease progression in the reduced resource environment of COVID19 era. 2. Enhanced triaging including aggressive pre-treatment COVID19 testing should be used to identify patients with high risk of COVID19 transmission. 3. Enhanced personal protective equipment (PPE) including N95 masks and full eye protection should be used for any AGMPs performed even in asymptomatic patients. 4. Enhanced PPE including full eye protection, N95 masks and/or powered air purifying respirators (PAPRs) should be used for any AGMPs in symptomatic or presumptive positive COVID 19 patients.
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Affiliation(s)
- Daniel A O'Connell
- Canadian Association of Head and Neck Surgical Oncology (CAHNSO), 1E4 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada.
- Division of Otolaryngology - Head & Neck Surgery, University of Alberta, Edmonton, AB, Canada.
| | - Hadi Seikaly
- Canadian Association of Head and Neck Surgical Oncology (CAHNSO), 1E4 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada.
- Division of Otolaryngology - Head & Neck Surgery, University of Alberta, Edmonton, AB, Canada.
| | - Andre Isaac
- Division of Otolaryngology - Head & Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Justin Pyne
- Division of Otolaryngology - Head & Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Robert D Hart
- Canadian Association of Head and Neck Surgical Oncology (CAHNSO), 1E4 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada
- Division of Otolaryngology, University of Calgary, Calgary, AB, Canada
| | - David Goldstein
- Canadian Association of Head and Neck Surgical Oncology (CAHNSO), 1E4 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - John Yoo
- Canadian Association of Head and Neck Surgical Oncology (CAHNSO), 1E4 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada
- Department of Otolaryngology - Head & Neck Surgery, University of Western Ontario, London, ON, Canada
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Alizadeh Ghavidel A, Mirzaaghayan M, Yousefnia MA, Asdaghpour E, Baghaei Tehrani R, Jalilifar N, Radmehr H, Shirzad M, Austine N, Ahmadi H, Ahmadi ZH, Afrasiabi Rad A, Amirghofran A, Amin A, Ansari Aval Z, Babazadeh K, Bakhshandeh A, Baharestani B, Parvizi R, Jadbabaei A, Jahangirifard A, Hoseini S, Hekmat M, Heidari A, Shabani M, Sadeghipour P, Salehi M, Ziabakhsh Tabari S, Abbasi M, Gholampour Dahaki M, Firouzi A, Laali M, Mandegar MH, Mirmohammadsadeghi M, Navvabi Shirazi M, Nikpajooh A. Iranian Society of Cardiac Surgeons COVID-19 task force version II, restarting elective surgeries. J Cardiovasc Thorac Res 2020; 12:158-164. [PMID: 33123320 PMCID: PMC7581843 DOI: 10.34172/jcvtr.2020.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/10/2020] [Indexed: 12/16/2022] Open
Abstract
Given the nature of heart disease and the importance of continuing heart surgery during the pandemic and its aftermath and in order to provide adequate safety for the surgical team and achieve the desired result for patients, as well as the optimal use of ICU beds, the medical team, blood, blood products, and personal protective equipment, it is essential to change the usual approach during the pandemic. There are still a lot of evidences and experiences needed to produce the perfect protocol. Some centers may have a special program for their centers during this period of epidemics that can be respected and performed. Generally, in pandemic conditions, the use of non-surgical approaches is preferred if similar outcomes can be obtained.
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Affiliation(s)
- Alireza Alizadeh Ghavidel
- Heart Valve Disease Research Center, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Mohammadreza Mirzaaghayan
- Department of Cardiac Surgery, Tehran Children Hospital, Tehran University of Medical Science, Tehran Iran
| | | | | | - Ramin Baghaei Tehrani
- Department of Cardiac Surgery, Shahid Moddares Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Naser Jalilifar
- Department of Cardiac Surgery, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Hasan Radmehr
- Department of Cardiac Surgery, Tehran Children Hospital, Tehran University of Medical Science, Tehran Iran
| | - Mahmoud Shirzad
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Science, Tehran Iran
| | - Nicholas Austine
- Editoral Office, Iranian Society of Cardiac Surgeons, Tehran, Iran
| | - Hosein Ahmadi
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Science, Tehran Iran
| | - Zargham Hossein Ahmadi
- Department of Cardiac Surgery, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Abbas Afrasiabi Rad
- Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Ahmadali Amirghofran
- Department of Cardiac Surgery, Shahid Faghihi Hospital, shiraz University of Medical Science, Shiraz, Iran
| | - Ahmad Amin
- Department of Cardiology, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Zahra Ansari Aval
- Department of Cardiac Surgery, Shahid Moddares Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Kamran Babazadeh
- Department of Cardiac Surgery, Milad General Hospital, Tehran, Iran
| | - Alireza Bakhshandeh
- Department of Cardiac Surgery, Imam Khomeini Medical Center, Tehran University of Medical Science, Tehran Iran
| | - Bahador Baharestani
- Department of Cardiac Surgery, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Amirnaser Jadbabaei
- Department of Cardiac Surgery, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Alireza Jahangirifard
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Hoseini
- Heart Valve Disease Research Center, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Manouchehr Hekmat
- Department of Cardiac Surgery, Shahid Moddares Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Amanollah Heidari
- Department of Cardiac Surgery, Golestan Hospital, Ahvaz University of Medical Science, Ahvaz Iran
| | - Minoosh Shabani
- Department of Infectious Disease, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Salehi
- Department of Cardiac Surgery, Imam Khomeini Medical Center, Tehran University of Medical Science, Tehran Iran
| | - Shervin Ziabakhsh Tabari
- Department of Cardiac Surgery, Fatemeh Zahra Hospital, Mazandaran University of Medical Science, Sari Iran
| | - Mohammad Abbasi
- Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Science, Mashhad Iran
| | - Maziar Gholampour Dahaki
- Department of Cardiac Surgery, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mojgan Laali
- Department of Cardiac Surgery, La pitié-salpetrier Hospital, Paris, France
| | - Mohammad Hosein Mandegar
- Department of Cardiac Surgery, Shariati hospital, Tehran University of Medical Science, Tehran Iran
| | - Mohsen Mirmohammadsadeghi
- Department of Cardiac Surgery, Shahid Chamran Hospital, Isfahan University of Medical Science, Isfahan Iran
| | | | - Akbar Nikpajooh
- Department of Social Medicine, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
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Spina A, Boari N, Gagliardi F, Bailo M, Calvanese F, Mortini P. Letter to the Editor Management of Neurosurgical Patients During the COVID-19 Pandemic. World Neurosurg 2020; 139:715-717. [PMID: 32360732 PMCID: PMC7192077 DOI: 10.1016/j.wneu.2020.04.161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Alfio Spina
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
| | - Nicola Boari
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Filippo Gagliardi
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Michele Bailo
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Francesco Calvanese
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Pietro Mortini
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
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Reed LK, Wen J, Liang B, Wang X, Feng D, Huang JH. Safely performing neurosurgical procedures during COVID-19 pandemic. Neurol Res 2020; 42:811-817. [DOI: 10.1080/01616412.2020.1781455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Laura K. Reed
- Department of Neurosurgery, Baylor Scott & White Medical Center, Temple, TX, USA
- Department of Surgery, Texas A&M University College of Medicine, Temple, TX, USA
| | - Jun Wen
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Buqing Liang
- Department of Neurosurgery, Baylor Scott & White Medical Center, Temple, TX, USA
- Department of Surgery, Texas A&M University College of Medicine, Temple, TX, USA
| | - Xiangyu Wang
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Dongxia Feng
- Department of Neurosurgery, Baylor Scott & White Medical Center, Temple, TX, USA
- Department of Surgery, Texas A&M University College of Medicine, Temple, TX, USA
| | - Jason H. Huang
- Department of Neurosurgery, Baylor Scott & White Medical Center, Temple, TX, USA
- Department of Surgery, Texas A&M University College of Medicine, Temple, TX, USA
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48
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Abbasi-Oshaghi E, Mirzaei F, Farahani F, Khodadadi I, Tayebinia H. Diagnosis and treatment of coronavirus disease 2019 (COVID-19): Laboratory, PCR, and chest CT imaging findings. Int J Surg 2020; 79:143-153. [PMID: 32422384 PMCID: PMC7227548 DOI: 10.1016/j.ijsu.2020.05.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/24/2022]
Abstract
Since December 2019, more than 3 million cases of coronavirus disease 2019 (COVID-19) and about 200,000 deaths have been reported worldwide. The outbreak of this novel disease has become a global health emergency and continues to rapidly spread around the world. Based on the clinical data, approved cases are divided into four classes including mild, moderate, severe, and critical. About 5% of cases were considered critically ill and 14% were considered to have the severe classification of the disease. In China, the fatality rate of this infection was about 4%. This review focuses on currently available information on the etiology, clinical symptoms, diagnosis, and mechanism of action of COVID-19. Furthermore, we present an overview of diagnostic approaches and treatment of this disease according to available findings. This review paper will help the physician to diagnose and successfully treat COVID-19.
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Affiliation(s)
- Ebrahim Abbasi-Oshaghi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Fatemeh Mirzaei
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; Department of Anatomical Sciences, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farhad Farahani
- Hearing Impairment Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Iraj Khodadadi
- Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Heidar Tayebinia
- Department of Clinical Biochemistry, Hamadan University of Medical Sciences, Hamadan, Iran
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49
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Celayir MF, Aygun N, Tanal M, Koksal HM, Besler E, Uludag M. How should be the Surgical Treatment Approach during the COVID-19 Pandemic in Patients with Gastrointestinal Cancer? SISLI ETFAL HASTANESI TIP BULTENI 2020; 54:136-141. [PMID: 32617050 PMCID: PMC7326676 DOI: 10.14744/semb.2020.93709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/16/2020] [Indexed: 12/23/2022]
Abstract
COVID-19 was first seen in China at the end of December 2019. COVID-19 is a novel type of coronavirus that is defined as SARS-CoV-2, which can be mild or severe in the lungs, causing acute respiratory infection. The disease was first presented in the literature as Coronavirus Disease 2019 (COVID-19) in February 2020. The disease spread rapidly and was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. There have been approximately 7734185 reported cases, and 412369 reported deaths to date (09/June/2020). As COVID-19 spread in the world and our country, hospitals struggling with this disease have also become risky areas for transmitting the disease. Health workers also have a high risk of viral contamination from direct contact of droplets and surfaces. Personal protective equipment (PPE), such as masks, coveralls, gloves, face shields and/or goggles, are mandatory. The aim is to spread the flow of cases requiring hospitalization over time, thereby preventing possible accumulation in hospitals. All non-urgent procedures, such as elective surgeries and diagnostic interventions, were significantly affected. The hospitalization procedures were mostly allocated to patients with COVID-19 infection, and surgical operations were postponed. Only urgent surgical cases and oncological surgeries that cannot be postponed were performed during this pandemic process. Patients followed by oncology are immunosuppressed both because of the disease itself and the side effects of chemotherapy and/or radiotherapy taken. This makes patients more susceptible to infections, and the prognosis of infections in these patients is worse and more destructive. Cancer patients are almost twice as likely to catch COVID-19 compared to the general population. The choice of surgical procedures and perioperative management of the patients with malignancy has become even more important in the COVID-19 pandemic. In this study, we analyzed the treatment processes of our patients with malignancy that underwent a surgical oncological procedure during this pandemic.
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Affiliation(s)
- Mustafa Fevzi Celayir
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Nurcihan Aygun
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mert Tanal
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Hakan Mustafa Koksal
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Evren Besler
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Uludag
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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50
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Kumar J, Raina R. Recommendations for Surgery During the COVID-19 Pandemic. Indian J Surg 2020; 82:297-298. [PMID: 32837073 PMCID: PMC7289626 DOI: 10.1007/s12262-020-02467-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Jitendra Kumar
- Department of Surgery, Dr B. S. A. Medical College & Hospital, Sector – 6, Rohini, New Delhi, 110085 India
| | - Rajni Raina
- Department of Anaesthesia, Dr B.S.A. Medical College & Hospital, Rohini, New Delhi, 110085 India
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