text stringlengths 120 6.48k | conversation_id int64 77.3k 898k | embedding list | cluster int64 44 44 |
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Please summerize the given abstract to a title
Impact of the first COVID-19 shutdown on patient volumes and surgical procedures of a Level I trauma center
PURPOSE: In Dec 2019, COVID-19 was first recognized and led to a worldwide pandemic. The German government implemented a shutdown in Mar 2020, affecting outpatient and hospital care. The aim of the present article was to evaluate the impact of the COVID-19 shutdown on patient volumes and surgical procedures of a Level I trauma center in Germany. METHODS: All emergency patients were recorded retrospectively during the shutdown and compared to a calendar-matched control period (CTRL). Total emergency patient contacts including trauma mechanisms, injury patterns and operation numbers were recorded including absolute numbers, incidence proportions and risk ratios. RESULTS: During the shutdown period, we observed a decrease of emergency patient cases (417) compared to CTRL (575), a decrease of elective cases (42 vs. 13) and of the total number of operations (397 vs. 325). Incidence proportions of emergency operations increased from 8.2 to 12.2% (shutdown) and elective surgical cases decreased (11.1 vs. 4.3%). As we observed a decrease for most trauma mechanisms and injury patterns, we found an increasing incidence proportion for severe open fractures. Household-related injuries were reported with an increasing incidence proportion from 26.8 to 47.5% (shutdown). We found an increasing tendency of trauma and injuries related to psychological disorders. CONCLUSION: This analysis shows a decrease of total patient numbers in an emergency department of a Level I trauma center and a decrease of the total number of operations during the shutdown period. Concurrently, we observed an increase of severe open fractures and emergency operations. Furthermore, trauma mechanism changed with less traffic, work and sports-related accidents.
| 77,323 | [
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... | 44 |
Please summerize the given abstract to a title
Recommendations for head and neck surgical oncology practice in a setting of acute severe resource constraint during the COVID-19 pandemic: an international consensus
The speed and scale of the global COVID-19 pandemic has resulted in unprecedented pressures on health services worldwide, requiring new methods of service delivery during the health crisis. In the setting of severe resource constraint and high risk of infection to patients and clinicians, there is an urgent need to identify consensus statements on head and neck surgical oncology practice. We completed a modified Delphi consensus process of three rounds with 40 international experts in head and neck cancer surgical, radiation, and medical oncology, representing 35 international professional societies and national clinical trial groups. Endorsed by 39 societies and professional bodies, these consensus practice recommendations aim to decrease inconsistency of practice, reduce uncertainty in care, and provide reassurance for clinicians worldwide for head and neck surgical oncology in the context of the COVID-19 pandemic and in the setting of acute severe resource constraint and high risk of infection to patients and staff.
| 77,373 | [
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... | 44 |
Please summerize the given abstract to a title
Performing gynecologic cancer surgery during the COVID-19 pandemic in Turkey: A multicenter retrospective observational study
OBJECTIVE: To report the perioperative outcomes of 200 patients with gynecologic cancer who underwent surgery during the Novel Coronavirus Disease (COVID-19) pandemic and the safety of surgical approach. METHODS: Data of patients operated between March 10 and May 20, 2020, were collected retrospectively. Data were statistically analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows v. SP21.0. RESULTS: Data of 200 patients were included. Their mean age was 56 years. Of the patients, 54% (n=108), 27.5% (n=55), 12.5% (n=25), and 2% (n=4) were diagnosed as having endometrial, ovarian, cervical, and vulvar cancer, respectively. Of them, 98% underwent non-emergent surgery. A minimally invasive surgical approach was used in 18%. Stage 1 cancer was found in 68% of patients. Surgeons reported COVID-related changes in 10% of the cases. The rate of postoperative complications was 12%. Only two patients had cough and suspected pneumonic lesions on thoracic computed tomography postoperatively, but neither was positive for COVID-19 on polymerase chain reaction testing. CONCLUSION: Based on the present findings, it is thought that gynecologic cancer surgery should continue during the COVID-19 pandemic while adhering to the measures. Postponement or non-surgical management should only be considered in patients with documented infection. Gynecologic cancer surgery should continue during the COVID-19 pandemic while adhering to measures. Only 1% of patients developed COVID-19-related symptoms during the postoperative follow-up period.
| 77,683 | [
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... | 44 |
Please summerize the given abstract to a title
Rationing Urology Care During a Pandemic: A Primer
In March 2020, edicts from many states required offices and hospitals to cancel all non-emergent surgeries and office visits to prevent hospitals from being overloaded, preserve personal protective equipment, and prevent the spread of COVID-19 with the goal to flatten the curve of novel corona virus infections on the community Beneficence demands health care providers develop and maintain skills and knowledge, continually update training, consider individual circumstances of all patients, and strive for net benefit [ ]justice discusses fairness in decisions, which can burden or benefit, are equally considered [ ]Jus Post Bellum considers how the war is ended and how the restoration of the community is completed
| 77,720 | [
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... | 44 |
Please summerize the given abstract to a title
A Worldwide Survey On Proctological Practice During Covid-19 Lockdown (Proctolock 2020): A Cross-Sectional Analysis
BACKGROUND: Proctology is one of the surgical specialties that suffered the most during COVID-19 pandemic Using a cross-sectional non-incentivized worldwide web-survey we aimed to snapshot the current status of proctological practice in 6 world regions METHODS: Surgeons affiliated to renowned scientific societies with an interest in coloproctology were invited to join the survey Members of the ProctoLock Working Group enhanced recruitment by direct invitation Predictive power of respondents' and hospitals' demographics on the change of status of surgical and outpatient activities was calculated RESULTS: Respondents (N=1,050) were mostly men (79%), with a mean age of 46 9 years, at consultant level (79%), practicing in academic hospitals (53%), offering a dedicated proctology service (68%) A total of 119 (11%) tested COVID-19 positive The majority (54%) came from Europe Participants from Asia reported a higher proportion of unaltered practice (17%), while those from Europe had the highest proportion of fully stopped practice (20%) The likelihood of ongoing surgical practice was higher in males (OR 1 54, 95%CI 1 13;2 09;P=0 006), in those reporting readily availability of personal protective equipment (PPE) (OR 1 40, 1 08;1 42;P=0 012) and in centers that were partially or not at all involved in COVID-19 care (OR 2 95, 2 14;4 09;P<0 001) This chance decreased by 2% per year of respondents' age (P=0 001) CONCLUSION: Several factors including different screening policies and resource capacity impacted the current status of proctological practice This may inform health authorities to formulate effective preventive strategies to limit curtailment of care of these patients during the pandemic
| 77,738 | [
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Please summerize the given abstract to a title
New adaptation of neurosurgical practice and residency programs during the Covid-19 pandemic and their effects on neurosurgery resident satisfaction and welfare at the National General Hospital, Jakarta, Indonesia
INTRODUCTION: Many institutions in numerous countries have made changes in their health care services during the COVID-19 pandemic. One change has been to reduce elective neurosurgery cases, which has impacted neurosurgery education. Published literature is lacking about the healthcare services, education, and residents’ well-being during adaptation to the pandemic, especially in national referral hospitals in developing countries. METHODS: We conducted a cross-sectional study on current neurosurgical services during 2020. We evaluated 34 neurosurgery residents in Cipto Mangunkusumo National General Hospital using a self-made questionnaire to determine the effects of the COVID-19 pandemic on their surroundings, education process, and satisfaction with the currently adapted education program. We used the modified Maslach Burnout Inventory to assess burnout in the residents before and during the pandemic. RESULTS: Neurosurgical residents spent more time studying neurosurgical theory (Mode 1–1.5h/day, p < 0.05) but spent less time learning neurosurgical skills (Mode 30 min–1 h/day, p < 0.05) compared to before the pandemic. The resident satisfaction mean score (scale 0–10) was 7.58 for live surgery and 8.53 for the microsurgical skills lab training program. On a scale of 1–10, the residents’ stress level increased after the pandemic but the change was not statistically significant (6.61 ± 1.87, p > 0.05). The Modified Maslach Burnout inventory score was 3.02 ± 3.74 during the pandemic, and increased from before the pandemic (2.41 ± 3.18), but the difference was not statistically significant. CONCLUSION: The COVID-19 pandemics have reduced the working hours and the clinical exposure of neurosurgical residents. Fortunately, this pandemic has led to a new opportunity to find many suitable learning methods which may decrease the risk of burnout. The psychological burden of residents is still worrisome, and planned management is necessary to sustain resident performance.
| 77,843 | [
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Please summerize the given abstract to a title
The First 60 Days: Physical Therapy in a Neurosurgical Center Converted Into a COVID-19 Center in Brazil
OBJECTIVE: The purpose of this case report was to describe the role of physical therapists in a neurosurgical center that was converted into a COVID-19 center for critically ill patients. METHODS (CASE DESCRIPTION): On March 16, 2020, the state government of Rio de Janeiro, Brazil, determined that a neurosurgical center with 44 ICU beds equipped with mechanical ventilators should immediately transfer all patients with neurological conditions to other institutions and prepare for patients who were critically ill with COVID-19. The staff, including physical therapists, were trained to handle patients with COVID-19, many of whom were developing acute respiratory distress syndrome (ARDS) with complex and multifactorial ventilatory support needs. Adjustments were made to the physical therapy routine and protocols. Following the stabilization of patients' respiratory condition, physical therapist interventions focused on restoring physical function. RESULTS: A total of 116 confirmed COVID-19 cases were treated from March 17 to May 17, 2020. Sixty percent were men (70) and 40% were women (46), with a median age of 59 years. Eighty-nine percent (103) underwent mechanical ventilation during hospitalization, of which 11% (11) were successfully extubated. Thirty percent (31) of patients underwent tracheostomy, and 26% of those (8) were successfully decannulated. Of the total patients, 57 patients died (mortality rate of 49%), 4 (3%) were transferred to another institution, 23 (20%) were discharged home, and 32 (28%) continued to be hospitalized. CONCLUSION: Physical therapists in the ICU can facilitate care for critical events such as intubation, patient positioning, ventilatory adjustments, extubation, and functional training. IMPACT: The coronavirus pandemic has highlighted the importance of physical therapists, specifically in the care of patients who are critically ill with COVID-19. The availability and expertise of physical therapists in the ICU are important for managing critical events such as intubation, patient positioning, ventilatory adjustments, extubation, and functional training.
| 77,894 | [
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... | 44 |
Please summerize the given abstract to a title
Effect of COVID-19 on Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers
BACKGROUND: The coronavirus disease of 2019 (COVID-19) pandemic led to the suspension and shortening of the 2020 Major League Baseball (MLB) season from 162 to 60 regular season games. The effect of this disruption on injury rates, specifically injury to the ulnar collateral ligament (UCL), has not been quantified. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the rate of UCL reconstruction (UCLR), surgery timing, and pitching workload in MLB pitchers from before and after the COVID-19 pandemic lockdown. We hypothesized that UCLR rates relative to games played would be increased and pitching workload would be decreased in 2020 compared with previous seasons. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: An extensive online search using publicly available data was conducted to identify all MLB pitchers who underwent UCLR between January 1, 2017, and December 31, 2020. Only pitchers who were competing at the MLB level when undergoing reconstruction were included. Player characteristics and surgery date, as well as career and season of surgery pitching workload, were collected for all included pitchers. All data were compared as a pooled sample (2017-2019 vs 2020). RESULTS: A similar number of pitchers underwent UCLR during or after the 2020 regular season (n = 18) compared with the 2017-2019 seasons (n = 16, 20, and 16, respectively). However, after accounting for the decrease in games played during the 2020 regular season, an MLB pitcher was 2.9 times more likely to undergo surgery per game after the COVID-19 lockdown compared with the previous years (P < .001). MLB pitchers who underwent surgery in 2020 threw fewer preseason innings than did pitchers who underwent surgery between 2017 and 2019 (5.98 vs 9.39; P = .001). CONCLUSION: MLB pitchers were almost 3 times more likely to undergo UCLR per game after the COVID-19 lockdown. A decreased preseason pitching workload because of the COVID-19 lockdown may have had an effect on per game UCLR rates.
| 77,988 | [
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... | 44 |
Please summerize the given abstract to a title
Investigating the real impact of covid-19 pandemic on the daily neurosurgical practice?
Objective: The objective of this study was to relate the neurosurgical activity during a time of sanitary crisis such as experienced during the SARS-Cov-2 pandemic. Methods: A monocentric retrospective analysis was made based on a prospectively gathered cohort of all patients requiring neurosurgical care between March 15th and May 12th, 2020. Local impact of SARS-CoV-2 was analysed regarding number of patients admitted in ICU. Results: 160 patients could benefit from neurosurgical care with a wide-ranging profile of clinical and surgical activities performed during the study that seemed similar to last year profile activity. Surgical indications were restricted to nondeferrable surgeries, leading to a drop in operative volume of 50%. Only 1,3% of patients required transfer to other units due to the impossibility of providing gold standard neurosurgical care in our centre. Conclusion: Despite the challenges represented by the SARS-CoV-2 pandemic, it was proven possible to assure the routine neurosurgical continuity and provide high standards of neurosurgical care without compromising patients’ access to the required treatments.
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Please summerize the given abstract to a title
The impact of national lockdown due to COVID-19 pandemic on frequency of occurrence of secretory otitis media in children - our experience
Objective: To present the impact of national lockdown due to COVID-19 pandemic on the incidence of persistent secretory otitis media in children. Patients: Children aged from four to 13 years who were surgically treated from 1st January 2017 to 31th December 2020 at the University Department of Otolaryngology, Head and Neck Surgery, University Hospital Center Osijek. Methods: Patients underwent otomicroscopy, tympanometry, tone audiometry and fiberendoscopy of the epipharynx. After confirmation of the existence of secretory otitis the children were treated surgically, using adenotomy and myringotomy by inserting ventilation tubes in the equilateral ear. Results: This study included 107 children who were surgically treated with adenotomy and myringotomy by inserting ventilation tubes. The results showed a significant decline in the number of operations in 2020 compared to the previous three years, presumably due to national lockdown closures. We recorded the largest difference comparing 2018 and 2020, when the number of operations decreased by 87%. Conclusions: Drastic reduction of activities during the national lockdown closure, schooling from home and emphasizing the proper and regular implementation of personal hygiene have contributed to reducing the incidence of one of the most common infections in children. Lower frequency of acute otitis media has a positive effect on reducing the frequency of development of secretory otitis in children. Compared to the previous three years, there has been a significant decline in the number of children requiring surgical treatment. This is the first retrospective study on the impact of national lockdown on reducing the need for surgical treatment of persistent secretory otitis in children. © 2022 Hrvatski Lijecnicki Zbor. All rights reserved.
| 78,405 | [
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... | 44 |
Please summerize the given abstract to a title
[Do COVID-19 restrictions lead to a decrease in severely injured patients at a level 1 trauma center in Germany?]
BACKGROUND: Intensive care and ventilator capacities are essential for treatment of COVID-19 patients Severely injured patients are often in continuous need of intensive care and ventilator treatment The question arises, whether restrictions related to COVID-19 have led to a decrease in severely injured patients and thus to an increase in intensive care unit (ICU) capacity MATERIAL AND METHODS: A retrospective analysis of all seriously injured patients with an injury severity score (ISS) >=16 was performed between 17 March and 30 April 2020 at a level 1 trauma center in Germany The mechanism of injury and the ISS were recorded Further data were collected as to whether it was a work-related accident, a documented suicide attempt and if surgery was necessary in the first 24h after arrival in hospital Data from 2018 and 2019 served as a control group RESULTS: There was no substantial difference in the total number of seriously injured patients (2018 n= 30, 2019 n= 23, 2020 n= 27) Furthermore, there was no relevant difference in the number of patients needing intensive care or ventilator treatment when leaving the shock room The number of patients needing an operative intervention within the first 24h after arriving at hospital was slightly higher in 2020 The mean ISS was at a constant level during all 3 years In 2020 there was no polytraumatized motorbike rider, who did not have a work-related accident (2018 n= 5, 2019 n= 4, 2020 n= 0) A noticeable increase in work-related accidents was observed (2018: 10%, 2019: 26 1%, 2020 44 4%) DISCUSSION: Restrictions related to COVID-19 did not lead to a reduction in seriously injured patients needing ICU care Due to the monocentric data analysis there is room for misinterpretation In general, intensive care and operating capacities should be managed with adequate consideration for seriously injured patients even in times of crisis, such as the COVID-19 pandemic Confirmation through the German Trauma Register is pending
| 78,408 | [
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Please summerize the given abstract to a title
Impact of COVID-19 on Timing of Hip-Fracture Surgeries: An Interrupted Time-Series Analysis of the Pre/Post-Quarantine Period in Northern Italy.
BACKGROUND To assess whether the imposition of the coronavirus disease 2019 (COVID-19) national quarantine (March 10, 2020) resulted in a shift in the proportion of patients operated for hip fracture on the day of admission, the following day and two days after admission in the region of Piedmont, northern Italy. METHODS Interrupted time-series analysis (ITSA) comparing hospitalization rate and timing of hip-fracture surgeries between pre- and post-quarantine period. The same data observed in Piedmont the year before were included as a control time series with no "intervention" (quarantine) in the middle of the observation period. RESULTS We found that 70.3% and 69.4% of hip-fracture patients received surgery within 2 days of hospital admission in the 16 weeks before and after the national quarantine, respectively. One-day surgery went from 46.0% to 46.5%, and same-day surgery from 13.3% to 12.4%. Unchanged trends were confirmed by ITSA after controlling for the 32-week time-series observed the year before. In the second week of March 2020, there was a borderline significant decrease in weekly hospital admissions for hip fractures as compared with that of the same week of March 2019 (-1.95 per 100 000, 95% CI = -4.10 to 0.21, P value = .075), followed by a weekly significant increase in the hospitalization rate (+0.14 per 100 000, 95% CI = 0.01 to 0.27, P value = .039), although the difference-in-differences of slopes failed to achieve statistical significance (0.19 per 100 000, 95% CI = -0.03 to 0.41, P value = .090). CONCLUSION Our study shows that the timing of hip-fracture surgery was unchanged during the lockdown period. This suggests that the healthcare systems can be resilient and able to guarantee a high-quality and safe healthcare to hip-fracture patients, even in the most challenging working conditions.
| 78,424 | [
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0.0... | 44 |
Please summerize the given abstract to a title
Impact of COVID19 pandemic on treatment outcome of locallyadvanced head and neck squamous cell carcinoma (LAHNSCC): IMPACCT study
Background: Treatment (ttm) of cancer patients (pts) was compromised during the first wave of COVID19 pandemic due to collapse of healthcare systems. Standard of care (SOC) for LA-HNSCC pts had to be adapted as operating rooms were temporarily unavailable, and to reduce risk of COVID19 exposure. The IMPACCT study evaluated the outcome of LA-HNSCC pts treated at the Catalan Institute of Oncology during the first semester of 2020 and compared it to a control cohort previously treated in the same institution. Methods: Retrospective single institution analysis of two consecutively-treated cohorts of newly-diagnosed HNSCC pts: from January to June of 2020 (CT20) and same period of 2018 and 2019 (CT18-19). Pt demographics and disease characteristics were obtained from our in-site prospective database. Ttm modifications from SOC as per COVID19- contingency protocol in CT20 for LA-HNSCC were collected. Chi-squared was used to compare variables and ttm response between cohorts. One-year recurrence-free survival (1yRFS) and overall survival (1yOS) of LA-HNSCC pts were estimated by Kaplan-Meier method and compared by Log-rank test. Results: A total of 306 pts were included: CT20=99;CT18- 19=207. Baseline characteristics were balanced between cohorts (Table1). In pts treated with conservative ttm (non-surgical approach), persistence disease was higher in CT20 vs CT18- 19 (26 vs. 10% p=0.02). Median follow-up of CT20 and CT18-19 was 6.8 months (IQR 5.1-7.9) and 12.3 (6.7-18.4), respectively. A trend towards lower 1yRFS and 1yOS was observed in CT20 vs CT18-19 (72 vs 83% p=0.06;80 vs 84% p=0.07), respectively. Within CT20, 37 pts (37%) had one or more ttm modifications: switch from surgery to conservative ttm (n=13);altered radiotherapy fractionation (n=14);reduced cisplatin cumulative dose to 200mg/m2 (n=19);no adjuvant ttm (n=1). Pts who received modified ttm had no differences in 1yRFS vs those who did not (80 vs 66% p=0.31), but higher 1yOS was observed (97 vs 67% p<0.01). When stratified by stage, 1yOS difference remained significant in stage III/IVA (100 vs 61% p<0.01) but not in I/II (100 vs 77% p=0.28) or IVB (67 vs 50% p=0.54). Conclusions: COVID19 pandemic had a negative impact on ttm outcomes and survival in LA-HNSCC pts when compared to our historical cohort. Ttm modifications based on COVID19-contingency protocol did not compromise ttm efficacy in terms of RFS and was associated with better OS in Stage III/IVA.
| 78,489 | [
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Please summerize the given abstract to a title
Drastic reduction of orthopaedic services at an urban tertiary hospital in South Africa during COVID-19: Lessons for the future response to the pandemic.
BACKGROUND The COVID-19 pandemic has impacted on the global surgery landscape. OBJECTIVES To analyse and describe the initial impact of the COVID-19 pandemic on orthopaedic surgery at Groote Schuur Hospital, a tertiary academic hospital in South Africa. METHODS The number of orthopaedic surgical cases, emergency theatre patient waiting times, and numbers of outpatient clinic visits, ward admissions, bed occupancies and total inpatient days for January - April 2019 (pre-COVID-19) were compared with the same time frame in 2020 (COVID-19). The COVID-19 timeframe included initiation of a national 'hard lockdown' from 26 March 2020, in preparation for an increasing volume of COVID-19 cases. RESULTS April 2020, the time of the imposed hard lockdown, was the most affected month, although the number of surgical cases had started to decrease slowly during the 3 preceding months. The total number of surgeries, outpatient visits and ward admissions decreased significantly during April 2020 (55.2%, 69.1% and 60.6%, respectively) compared with April 2019 (p<0.05). Trauma cases were reduced by 40% in April 2020. Overall emergency theatre patient waiting time was 30% lower for April 2020 compared with 2019. CONCLUSIONS COVID-19 and the associated lockdown has heavily impacted on both orthopaedic inpatient and outpatient services. Lockdown led to a larger reduction in the orthopaedic trauma burden than in international centres, but the overall reduction in surgeries, outpatient visits and hospital admissions was less. This lesser reduction was probably due to local factors, but also to a conscious decision to avoid total collapse of our surgical services.
| 78,583 | [
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0.75732421875,
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-0.5380859375,
-0.223388671875,
0.333740234375,
0.307861328125,
0.64306640625,
0.464599609375,
-0.412841796875,
-0.08843994140625,
-0.4638671875,
-0.383056640625,
0.5927734375,
-0.355712890625,
-0.498046... | 44 |
Please summerize the given abstract to a title
St Andrew's COVID-19 surgery safety (StACS) study: Elective plastic surgery, trauma & burns
INTRODUCTION: This study evaluates COVID-19 related patient risk, when undergoing management within one of the largest specialist centres in Europe, which rapidly implemented national COVID-19 safety guidelines METHOD: A prospective cohort study was undertaken in all patients who underwent surgical (n = 1429) or non-operative (n = 191) management during the UK COVID-19 pandemic peak (April-May 2020);all were evaluated for 30-day COVID-19 related death A representative sample of elective/trauma/burns patients (surgery group, n = 729) were selected and also sub-analysed within a controlled cohort study design Comparison was made to a random selection of non-operatively managed (non-operative group, n = 100) or waiting list (control group, n = 250) patients These groups were prospectively followed-up and telephoned from the end of June (control group) or at 30 days post-first assessment (non-operative group)/post-operatively (surgery group) RESULTS: Complex general (9 2%, 136/1483) or regional (5 0%, 74/1483) anaesthesia cases represented 14 2% (210/1483) of operations undertaken There were no 30-day post-operative (0/1429)/first assessment (0/191) COVID-19 related deaths Neither the three sub-speciality plastic surgery, or non-operative groups, displayed increases in post-operative/first assessment symptoms in comparison to each other, or to control The proportion of COVID-19 positive tests were: 7 1% (1/14) (non-operative), 5 9% (2/34) (burns) and 3 0% (3/99) (trauma);there were however no significant differences between these groups, the elective (0%, 0/54) and control (0%, 0/24) groups (p = 0 236) CONCLUSION: We demonstrate that even heterogeneous sub-speciality patient groups, who required operative/non-operative management, did not incur an increased COVID-19 risk compared to each other or to control These highly encouraging results were achieved with described, rapidly implemented service changes that were tailored to protect each patient group and staff
| 78,922 | [
0.32861328125,
0.285400390625,
-0.78076171875,
0.350830078125,
-0.50390625,
-0.69140625,
-0.016754150390625,
0.41943359375,
0.382568359375,
0.451171875,
0.54541015625,
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-0.7568359375,
-0.361328125,
0.381591796875,
-0.21337890625,
-0.5595703125,
-0.2... | 44 |
Please summerize the given abstract to a title
The impact of COVID-19 pandemic on bariatric patients' self-management post-surgery
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had far reaching consequences on the health and well-being of the general public. Evidence from previous pandemics suggest that bariatric patients may experience increased emotional distress and difficulty adhering to healthy lifestyle changes post-surgery. OBJECTIVE: We aimed to examine the impact of the novel COVID-19 public health crisis on bariatric patients' self-management post-surgery. METHOD: In a nested-qualitative study, semi-structured telephone interviews were conducted with 23 post-operative bariatric patients who had undergone Roux-en-Y gastric bypass (RYGB) at a Canadian Bariatric Surgery Program between 2014 and 2020. A constant comparative approach was used to systematically analyze the data and identify the overarching themes. RESULTS: Participants (n = 23) had a mean age of (48.82 ± 10.03) years and most were female (n = 19). The median time post-surgery was 2 years (range: 6 months-7 years). Themes describing the impact of COVID-19 pandemic on patients' post-bariatric surgery self-management included: coping with COVID-19; vulnerability factors and physical isolation; resiliency factors during pandemic; and valuing access to support by virtual care. The need for patients to access post-operative bariatric care during COVID-19 differed based on gender and socioeconomic status. CONCLUSION: This study showed that the COVID-19 pandemic has impacted patients' ability to self-manage obesity and their mental health in a variety of ways. These findings suggest that patients may experience unique psychological distress and challenges requiring personalized care strategies to improve obesity self-care and overall well-being.
| 78,932 | [
0.37451171875,
-0.0306396484375,
-0.469970703125,
0.892578125,
-0.58056640625,
-0.7197265625,
-0.329833984375,
0.51318359375,
0.48388671875,
0.60546875,
0.44287109375,
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-0.87109375,
-0.291259765625,
0.248291015625,
-0.501953125,
-0.58349609375,
-0... | 44 |
Please summerize the given abstract to a title
The COVID CLAVICLE Study: A predictor of future trauma trends
BACKGROUND: Clavicle fractures are a common presentation to the Emergency Department following falls and sporting injuries. During 2020, the COVID-19 pandemic brought with it a long period of social isolation resulting in a change of behavior patterns and in return, the presentation of fractures to our local hospitals. The effects of this global pandemic on the presentation and management of clavicles were noted with particular interest to the change in mechanism and its future implications. METHODS: We performed a longitudinal observational study in 10 hospitals in the North West of England, reviewing all patients presenting with a clavicle fracture during six weeks in the first peak of COVID-19 pandemic and compared these with the same time period in 2019. Collection points included the patient demographics, fracture characteristics, mechanism of injury and management. RESULTS: A total of 427 clavicle fractures were assessed with lower numbers of patients presenting with a clavicle fracture during the COVID-2020 period (n=177) compared with 2019 (n=250). Cycling related clavicle fractures increased three fold during the pandemic compared to the 2019 control group. We also noted an overall increase in clavicle fractures resulting from higher energy trauma as opposed to low energy or fragility fracture. We also found a faster time to surgery in the COVID cohort by 2.7 days on average when compared to 2019. CONCLUSIONS: Government restrictions and the encouragement of social distancing led to behavioral changes with a vast increase in cyclists on the road. This created a significant rise in clavicle fractures related to this activity. This is likely to be further driven by the Government pledge to double cyclists on the road by 2025 in the United Kingdom.(5) We forecast that this increase in cyclists, a behavior change accelerated by the pandemic, is a reliable predictor for future trauma trends.
| 78,942 | [
-0.28125,
-0.14599609375,
-0.193359375,
1.0517578125,
-0.52880859375,
-0.495361328125,
-0.5185546875,
0.734375,
0.442626953125,
0.346435546875,
0.0243377685546875,
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0.147705078125,
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-0.630859375,
0.5478515625,
-0.6650390625,
-0.60791015625,
-0.2261962... | 44 |
Please summerize the given abstract to a title
Spinal surgery in COVID-19 pandemic era: One trauma hub center experience in central-southern Italy
The aim of the study is to analyze and report the results of the surgical activity in a spinal unit of a trauma hub in central Italy during COVID-19 pandemic. Surgical activity was compared between COVID 19 pandemic and the same period of time in 2019 at our institution. A 50% reduction of surgical procedures during the last three months was observed compared with the same period of time in 2019. The compliance with the containment rules for the spread of the infection, were sufficient to allow safe surgical activity for the medical teams and patients.
| 79,063 | [
0.406494140625,
0.1312255859375,
-0.37646484375,
0.955078125,
-0.394287109375,
-0.5234375,
-0.8935546875,
0.360595703125,
0.53369140625,
0.457275390625,
0.47900390625,
-0.156494140625,
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-0.5703125,
-0.95263671875,
0.1639404296875,
-0.207763671875,
-0.164306640625,
... | 44 |
Please summerize the given abstract to a title
The impact of COVID‐19 on thoracic surgery residency programs in the US: A program director survey
OBJECTIVE: The coronavirus disease 2019 (COVID‐19) has altered how the current generation of thoracic surgery residents are being trained. The aim of this survey was to determine how thoracic surgery program directors (PDs) are adapting to educating residents during the COVID‐19 pandemic. METHODS: Thoracic surgery PDs of integrated, traditional (2 or 3 year), and combined 4 + 3 general/thoracic surgery training programs in the United States were surveyed between 17th April and 1st May 2020 during the peak of the COVID‐19 pandemic in much of the United States. The 15‐question electronic survey queried program status, changes to the baseline surgical practice, changes to didactic education, deployment/scheduling of residents, and effect of the pandemic on case logs and preparedness for resident graduation. RESULTS: All 23 institutions responding had ceased elective procedures, and most had switched to telemedicine clinic visits. Online virtual didactic sessions were implemented by 91% of programs, with most (69.6%) observing same or increased attendance. PDs reported that 82.7% of residents were on a non‐standard schedule, with most being deployed in a 1 to 2 week on, 1 to 2 week off block schedule. Case volumes were affected for both junior and graduating trainees, but a majority of PDs report that graduating residents will graduate on time without perceived negative effect on first career/fellowship position. CONCLUSIONS: The COVID‐19 pandemic has radically changed the educational approach of thoracic surgery programs. PDs are adapting educational delivery to optimize training and safety during the pandemic. Long‐term effects remain uncertain and require additional study.
| 79,089 | [
0.306884765625,
-0.0200653076171875,
-0.48583984375,
0.488525390625,
-0.1922607421875,
-0.68994140625,
-0.80908203125,
0.7216796875,
0.0985107421875,
0.58984375,
0.1319580078125,
-0.3115234375,
0.273681640625,
-0.442626953125,
-0.5390625,
0.0489501953125,
-0.290283203125,
-0.150146... | 44 |
Please summerize the given abstract to a title
Effects of COVID-19 lockdown on a bariatric surgery waiting list cohort and its influence in surgical risk perception
PURPOSE: The COVID-19 outbreak has forced a 2-month lockdown (LD) in Spain We aimed to assess how that had affected our cohort of bariatric patients waiting for surgery METHODS: A review of electronic records and a structured phone interview with each patient were conducted Changes in severity of obesity were analyzed using the Obesity Surgery Score (OSS) and changes in health-related quality of life (HRQoL) using the validated EQ-5D questionnaire Other miscellaneous questions about behavior modifications and surgical risk perception were also analyzed RESULTS: All 51 patients fully answered the questionnaires Mean age was 47 years and mean time on waiting list 91 days Mean BMI increased during LD (42 7 vs 43 2;p < 0 001) Both OSS (2 84 vs 3;p = 0 011) and EQ-5D (69 vs 64;p < 0 001) mildly worsened during LD, mainly due to psychosocial issues Twenty-seven patients (53%) thought that perioperative risks were higher under the current circumstances but they were as willing to undergo surgery as those who believed that the risks had not increased (74% vs 87%, p = 0 2) CONCLUSIONS: COVID-19 LD had a significant but mild effect on our cohort of bariatric surgery waiting list patients Although perioperative risk perception had increased, patients were still willing to undergo their planned surgeries
| 79,377 | [
0.1861572265625,
0.065185546875,
-0.4619140625,
0.9130859375,
-0.92529296875,
-0.84326171875,
-0.045013427734375,
0.73046875,
0.035400390625,
0.955078125,
0.65771484375,
-0.5908203125,
0.3134765625,
-0.6748046875,
-0.67236328125,
0.64404296875,
-0.447998046875,
-0.73583984375,
-0... | 44 |
Please summerize the given abstract to a title
COVID-19 Pandemic and Elective Spinal Surgery Cancelations – What Happens to the Patients?
BACKGROUND CONTEXT: The COVID-19 pandemic caused nationwide suspensions of elective surgeries due to reallocation of resources to the care of COVID-19 patients. Following resumption of elective cases, a significant proportion of patients continued to delay surgery, with many yet to reschedule, potentially prolonging their pain and impairment of function and causing detrimental long-term effects. PURPOSE: The aim of this study was to examine differences between patients who have and have not rescheduled their spine surgery procedures originally cancelled due to the COVID-19 pandemic, and to evaluate the reasons for continued deferment of spine surgeries even after the lifting of the mandated suspension of elective surgeries. STUDY DESIGN/SETTING: Retrospective case series at a single institution PATIENT SAMPLE: Included were 133 patients seen at a single institution where spine surgery was canceled due to a state-mandated suspension of elective surgeries from March to June, 2020. OUTCOME MEASURES: The measures assessed included preoperative diagnoses and neurological dysfunction, surgical characteristics, reasons for surgery deferment, and PROMIS scores of pain intensity, pain interference, and physical function. METHODS: Patient electronic medical records were reviewed. Patients who had not rescheduled their canceled surgery as of January 31, 2021, and did not have a reason noted in their charts were called to determine the reason for continued surgery deferment. Patients were divided into three groups: early rescheduled (ER), late rescheduled (LR), and not rescheduled (NR). ER patients had a date of surgery (DOS) prior to the city's Phase 4 reopening on July 20, 2020; LR patients had a DOS on or after that date. Statistical analysis of the group findings included analysis of variance with Tukey's honestly significant difference (HSD) post-hoc test, independent samples T-test, and chi-square analysis with significance set at p≤0.05. RESULTS: Out of 133 patients, 47.4% (63) were in the ER, 15.8% (21) in the LR, and 36.8% (49) in the NR groups. Demographics and baseline PROMIS scores were similar between groups. LR had more levels fused (3.6) than ER (1.6), p= 0.018 on Tukey HSD. NR (2.1) did not have different mean levels fused than LR or ER, both p= >0.05 on Tukey HSD. LR had more three column osteotomies (14.3%) than ER and (1.6%) and NR (2.0%) p=0.022, and fewer lumbar microdiscectomies (0%) compared to ER (20.6%) and NR (10.2%), p=0.039. Other surgical characteristics were similar between groups. LR had a longer length of stay than ER (4.2 vs 2.4, p=.036). No patients in ER or LR had a nosocomial COVID-19 infection. Of NR, 2.0% have a future surgery date scheduled and 8.2% (4) are acquiring updated exams before rescheduling. 40.8% (20; 15.0% total cohort) continue to defer surgery over concern for COVID-19 exposure and 16.3% (8) for medical comorbidities. 6.1% (3) permanently canceled for symptom improvement. 8.2% (4) had follow-up recommendations for non-surgical management. 4.1% (2) are since deceased. CONCLUSION: Over 1/3 of elective spine surgeries canceled due to COVID-19 have not been performed in the 8 months from when elective surgeries resumed in our institution to the end of the study. ER patients had less complex surgeries planned than LR. NR patients continue to defer surgery primarily over concern for COVID-19 exposure. The toll on the health of these patients as a result of the delay in treatment and on their lives due to their inability to return to normal function remains to be seen.
| 79,425 | [
0.405517578125,
0.0594482421875,
-0.7724609375,
0.98779296875,
-0.6005859375,
-0.56396484375,
-0.332763671875,
0.1724853515625,
0.403076171875,
0.890625,
0.42626953125,
-0.57421875,
-0.206787109375,
-0.49560546875,
-0.54150390625,
0.54736328125,
-0.5205078125,
-0.5107421875,
-0.3... | 44 |
Please summerize the given abstract to a title
[Urologic cancer care during the first wave of the COVID-19 pandemic : Role of federal cancer registration in Germany]
Urologic cancer care needs to be prioritized despite multiple health care restrictions during the coronavirus disease 2019 (COVID-19) pandemic However, therapies and procedures may be delayed and complicated In Germany, analysis of the multiple cancer registries provides insights into the actual numbers of treated patients We provide a review on the registration of urologic cancer care during the first wave of the COVID-19 pandemic in Germany and on potential surgical complications of urologic interventions We found that during the year 2020 there were generally fewer registrations of newly diagnosed patients with major urologic neoplasms in a representative federal database The number of surgical interventions in patients with renal cell carcinoma and urothelial bladder cancer decreased, whereas equal numbers of radical prostatectomies were performed when compared to the year 2019 COVID-19 may increase non-urological postoperative complications following surgical treatment of urologic malignancies;however, available data are still very limited
| 79,488 | [
0.182373046875,
-0.260009765625,
-0.466552734375,
0.68798828125,
-0.57666015625,
-0.52685546875,
-0.2481689453125,
0.396484375,
0.25390625,
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1.126953125,
-0.537109375,
0.036834716796875,
-0.184814453125,
-0.412841796875,
0.334716796875,
-0.417236328125,
-0.8837890625... | 44 |
Please summerize the given abstract to a title
Management of non-invasive tumours, benign tumours and breast cancer during the COVID-19 pandemic: recommendations based on a Latin American survey
Introduction: The COVID-19 pandemic has changed health systems across the world, both in general hospitals and in oncology institutes or centres For cancer specialists, particularly breast cancer (BC), the COVID-19 pandemic represents a combination of challenges since the hospital resources and staff have become more limited;this has obliged oncology specialists to seek a consensus and establish which patients with BC require more urgent attention and which patients can wait until there is a better control of this pandemic The health system in Latin America has some special characteristics;in some of the countries, there are shortages which limit access to several specialities (surgery, clinical oncology and radiotherapy) in some regions Objective: After a systematic review of the most recent literature regarding the management of BC during the COVID-19 pandemic, the main objective is to understand the position of the different Latin American Societies of Mastology in terms of available alternatives for the treatment of BC Methods: After carrying out a comprehensive and exhaustive search of the most recent guides on the management of BC during the COVID-19 pandemic, the board members of the Latin American Federation of Mastology invited, via email, different specialists, all experts in BC care, to complete an anonymous survey online The survey was distributed between 30 and 10 May 2020 The survey included 27 questions on four topics: demographic information, consultations, imaging and treatment of BC The questionnaire was sent and then distributed to various health specialists including breast surgeons, clinical oncologists, radiation oncologists and radiologists via the Presidents of the different Latin American Societies of Mastology in 18 countries The results are summarised as tallies based on the number of responses to each question Results: A total of 499 responses were received The majority of the respondents were males (275 (55 11%));290 participants were over 45 years (58 11%) The questionnaire presented those surveyed with three possible answers (agree, disagree and neither agree nor disagree) The results reflect that there was consensus in the majority of situations presented Only seven questions revealed disagreement among those responding The results are presented as recommendations Conclusion: The management of patients with BC presents unique challenges during the current world health situation produced by COVID-19 pandemic Breast care specialists (surgical oncologists, breast care clinicians, clinical oncologists, radiation oncologists and radiologists) from 18 countries in Central and South America submitted through their responses and recommendations for the treatment of BC during the COVID-19 pandemic
| 79,645 | [
0.51025390625,
-0.0911865234375,
-0.58251953125,
0.3681640625,
0.0020503997802734375,
-0.51513671875,
-0.14697265625,
0.5380859375,
0.467529296875,
0.57275390625,
0.83251953125,
-0.525390625,
-0.200439453125,
-0.486328125,
-0.492431640625,
0.383056640625,
-0.30419921875,
-0.9624023... | 44 |
Please summerize the given abstract to a title
Coronavirus disease 2019 pandemic, restriction, and orthopedic trauma: Retrospective observational study
In 2019, the Coronavirus disease 2019 (Covid-19) was reported in Wuhan, China. Governments in various countries had taken many safeguards. This study investigated the incidence of orthopedic trauma in a rural region epidemiologically and guided source distribution and medical professionals to sustain healthcare systems. Between December 2019 and August 2020, 1651 patients admitted to orthopedics and traumatology clinics with trauma were evaluated in this study. Patients were grouped into 3 groups: pre-covid, restriction, and permitted groups. Age, sex, and fracture types of patients were recorded. The number of patients in the pre-covid period was 629 (38.1%), those were 334 (20.2%) in the restriction period, and 688 (41.7%) patients were admitted in the permitted period. A total of 1203 (72.9%) patients with upper extremity fractures, 383 (23.2%) patients with lower extremity fractures, and 65 (3.9%) patients with axial skeleton and pelvic ring fractures were included in the study. The lowest rates were found in the restriction period when all fractures were evaluated according to the admission periods. There were significant differences between admission dates and the fractures (P < .001). In this study, a decrease in orthopedic trauma rates was observed by half in the restriction period compared with the other 2 periods. Public health precautions had led to a reduction in the incidence of orthopedic trauma in all age groups.
| 79,647 | [
-0.198486328125,
-0.12890625,
-0.32861328125,
0.57470703125,
-0.76171875,
-0.4501953125,
-0.5205078125,
0.74169921875,
0.5830078125,
0.60498046875,
0.56298828125,
-0.5908203125,
0.10369873046875,
-0.67333984375,
-0.53564453125,
0.658203125,
-0.2203369140625,
-0.424560546875,
-0.0... | 44 |
Please summerize the given abstract to a title
Morbidity and Mortality in Patients with Perioperative COVID-19 Infection: Prospective Cohort in General, Gastroesophagic, Hepatobiliary, and Colorectal Surgery
BACKGROUND: Severe acute respiratory syndrome due to coronavirus 2 has rapidly spread worldwide in an unprecedented pandemic. Patients with an ongoing COVID-19 infection requiring surgery have higher risk of mortality and complications. This study describes the mortality and morbidity in patients with perioperative COVID-19 infection undergoing elective and emergency surgeries. METHODS: Prospective cohort of consecutive patients who required a general, gastroesophageal, hepatobiliary, colorectal, or emergency surgery during COVID-19 pandemic at an academic teaching hospital. The primary outcome was 30-day mortality and major complications. Secondary outcomes were specific respiratory mortality and complications. RESULTS: A total of 701 patients underwent surgery, 39 (5.6%) with a perioperative COVID-19 infection. 30-day mortality was 12.8% and 1.4% in patients with and without COVID-19 infection, respectively (p < 0.001). Major surgical complications occurred in 25.6% and 6.8% in patients with and without COVID-19 infection, respectively (p < 0.001). Respiratory complications occurred in 30.8% and 1.4% in patients with and without COVID-19 infection, respectively (p < 0.001). Mortality due to a respiratory complication was 100% and 11.1% in patients with and without COVID-19 infection, respectively (p < 0.006). CONCLUSIONS: 30-day mortality and surgical complications are higher in patients with perioperative COVID-19 infection. Indications for elective surgery need to be reserved for non-deferrable procedures in order to avoid unnecessary risks of non-urgent procedures.
| 79,670 | [
0.58642578125,
0.1285400390625,
-0.880859375,
0.2462158203125,
-0.0180816650390625,
-0.52734375,
-0.283203125,
0.408203125,
0.44140625,
0.583984375,
0.5048828125,
-1.076171875,
-0.188232421875,
-0.72607421875,
-0.462646484375,
0.1273193359375,
-0.55224609375,
-0.6533203125,
-0.10... | 44 |
Please summerize the given abstract to a title
The effect of COVID-19 lockdown on acute type A aortic dissection: insights from Bologna
This document is intended to provide an overview of the incidence and characteristics of acute type A aortic dissection in Bologna during the month of severe restrictions imposed by the National Italian government due to COVID-19 pandemic. Aspects on management and time to intervention are outlined.
| 80,250 | [
-0.08612060546875,
-0.1533203125,
-0.212890625,
0.483642578125,
-0.6396484375,
-0.2198486328125,
-0.48046875,
0.52880859375,
0.41015625,
0.970703125,
0.337646484375,
-0.66015625,
-0.38134765625,
-0.27490234375,
-0.473388671875,
0.55126953125,
-0.6201171875,
-0.6474609375,
-0.3447... | 44 |
Please summerize the given abstract to a title
Practical Guidance for Managing EMG Requests and Testing during the COVID‐19 Pandemic
The COVID‐19 pandemic has necessitated cancelation of elective or non‐urgent contact with the healthcare system, including non‐urgent nerve conduction studies and electromyography (electrodiagnostic [EDX] studies). The definitions of elective and non‐urgent are physician judgments, and often are not straightforward. Clinical care must be provided to help our patients in a timely manner, while keeping them, health care personnel and the community safe. Benefit/risk stratification is an important part of this process. We have stratified EDX studies into 3 categories: Urgent, Non‐urgent and Possibly Urgent, in an effort to help clinicians triage these referrals. For each category, we provide a rationale and some examples. However, each referral must be reviewed on a case‐by‐case basis, and the clinical situation will evolve over time, necessitating flexibility in managing EDX triaging. Engaging the referring clinician and, at times, the patient, may be useful in the triage process. This article is protected by copyright. All rights reserved.
| 80,509 | [
0.0771484375,
0.445556640625,
-0.43603515625,
0.438720703125,
-0.806640625,
-0.496826171875,
0.1005859375,
0.61328125,
0.1915283203125,
0.54638671875,
0.354248046875,
-0.433837890625,
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-0.7041015625,
-0.50830078125,
0.345947265625,
-0.304443359375,
-0.8798828125,
... | 44 |
Please summerize the given abstract to a title
Review of orthopaedic trauma surgery during the peak of COVID-19 pandemic - An observational cohort study in the UK
Aim: This study aims to estimate the risk of acquiring medical complication or death from COVID-19 infection in patients who were admitted for orthopaedic trauma surgery during the peak and plateau of pandemic. Unlike other recently published studies, where patient-cohort included a more morbid group and cancer surgeries, we report on a group of patients who had limb surgery and were more akin to elective orthopaedic surgery. Methods: The study included 214 patients who underwent orthopaedic trauma surgeries in the hospital between 12th March and 12th May-2020 when the pandemic was on the rise in the United Kingdom. Data was collected on demographic profile including comorbidities, ASA grade, COVID-19 testing, type of procedures and any readmissions, complications or mortality due to COVID-19. Results: There were 7.9% readmissions and 52.9% of it was for respiratory complications. Only one patient had positive COVID-19 test during readmission. 30-day mortality for trauma surgeries was 0% if hip fractures were excluded and 2.8% in all patients. All the mortalities were for proximal femur fracture surgeries and between ASA Grade 3 and 4 or in patients above the age of 70 years. Conclusion: This study suggests that presence of COVID-19 virus in the community and hospital did not adversely affect the outcome of orthopaedic trauma surgeries or lead to excess mortality or readmissions in patients undergoing limb trauma surgery. The findings also support resumption of elective orthopaedic surgeries with appropriate risk stratification, patient optimization and with adequate infrastructural support amidst the recovery phase of the pandemic.
| 80,573 | [
0.515625,
-0.123779296875,
-0.59228515625,
0.86279296875,
-0.7333984375,
-0.72265625,
-0.209228515625,
0.54736328125,
0.509765625,
0.55029296875,
0.1998291015625,
-0.765625,
0.26220703125,
-0.73974609375,
-0.250732421875,
0.60400390625,
-0.2218017578125,
-0.82080078125,
-0.010025... | 44 |
Please summerize the given abstract to a title
Compliance and perception about personal protective equipment among health care workers involved in the surgery of COVID-19 negative cancer patients during the pandemic
BACKGROUND: Health care workers (HCWs) are at risk of getting infected while at work, for example, operating room (OR), hence it is pertinent that they don all the appropriate personal protective equipment (PPE) to minimize the chance of getting infected. METHODS: A COVID-19 specific briefing and debriefing form was created and used in the OR along with the World Health Organization surgical safety checklist to reinforce the use of appropriate PPE. An audit was subsequently done to understand the compliance to PPE use, followed by a survey based on the findings of the audit to understand the issues related to noncompliance. RESULTS: The form was used in 183 out of the 238 (77%) surgeries performed during a months' time. The overall compliance for PPE usage was 96.3%. Noncompliance was seen most often for eye protection (45/567) (P = .01). The survey revealed that this was mostly among surgeons mainly due to discomfort, poor visibility, and frequent fogging. CONCLUSIONS: Our HCW were adapting well to the new normal of donning appropriate PPE in the OR, except for the eye protection due to discomfort and visibility related issues. This is important to know so that necessary changes could be introduced to better the compliance.
| 80,760 | [
0.27490234375,
-0.2958984375,
-0.5390625,
0.783203125,
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0.1607666015625,
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-0.28076171875,
... | 44 |
Please summerize the given abstract to a title
COVID-19 and Management of Orthopedic Emergencies. Producing a Consensus of Experts
OBJECTIVE: Report the results of a participatory approach in Tunisian orthopedic surgery, for the development of a consensus of experts, on the identification of the list of pathologies to always be considered as non-postponable emergencies, during the COVID-19 pandemic. MATERIAL AND METHODS: This descriptive study of the opinions of Tunisian experts covered all orthopedic morbidities classified into three homogeneous groups: trauma, infections and tumors of the musculoskeletal system. The attitudes of the interviewees were collected using the "Delphi" method, using a "Google-Form" questionnaire, sent by email to all of the Tunisian university orthopedic surgeons in practice, and registered at the SOTCOT. Consensus has been established for an item, if validated by at least 80% of the experts. The analysis of the results focused on the first 30 responses to this "online" form. RESULTS: Tunisian experts agreed on the continuity of the urgency of taking in charge all the items of orthopedic morbidity during the COVID-19 pandemic, apart from the following affections: aseptic nonunions in the upper and lower limbs, aggressive giant cell tumors, and hyperalgesic disc herniations, where agreement rates were only at 8%, 12%, 58% and 77%. CONCLUSION: Relative to its disciplinary and professional specificities, the majority the of orthopedic conditions were still considered as emergencies, during the COVID-19 pandemic, which did not lend to postponement of the surgery. However, their management should obey to the recommendations of "Sorting" and the " COVID-19 Patient Pathway ", established by national authorities.
| 80,906 | [
0.10443115234375,
-0.05828857421875,
-0.5654296875,
0.7255859375,
-0.432861328125,
-0.42431640625,
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0.235595703125,
0.7978515625,
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0.6328125,
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-0.80615234375,
-0.6025390625,
0.6376953125,
-0.355224609375,
-0.74755859375,
-... | 44 |
Please summerize the given abstract to a title
Setting up and maximising the usage of an Urgent Dental Care Centre in Blackpool. Sharing our experiences
An integrated Urgent Dental Care Centre with Tier 2 Oral Surgery support was set up in Blackpool starting 24th March 2020. This was in reaction to the COVID-19 pandemic. In the first month 1433 patients had telephone consultations and 713 extractions were performed. The challenges surrounding set up and continuity of care are discussed.
| 80,968 | [
0.25048828125,
0.2548828125,
-0.77294921875,
0.5087890625,
-0.63671875,
-0.480224609375,
0.2205810546875,
0.51171875,
0.5048828125,
0.413818359375,
0.438232421875,
-0.2457275390625,
0.044830322265625,
-0.425048828125,
-0.1529541015625,
0.28564453125,
-0.88330078125,
-0.50830078125,... | 44 |
Please summerize the given abstract to a title
Fracture Surgery in Known COVID-19 Infected Patients: What Are the Challenges?
Background: Surgery in the time of COVID-19 pandemic is a challenging issue while treatment of affected fracture patients is inevitable. The present study summarizes the challenges that an orthopedic surgeon is confronting during the surgical treatment of fracture patients with concomitant COVID-19 infection. Methods: Demographic and fracture related data of 13 fracture patients with concomitant COVID-19 infection who were treated with surgery was collected from three trauma centers in Tehran and Kermanshah cities from 21, February 2020 to April 3, 2020. Results: All patients were male with mean age of 38.6±19.5 years. Eight patients had high energy fracture and seven patients had multiple fractures and trauma. Wrist and hand were the common sites of fracture following hip and pelvis. The mean interval time period between the diagnosis of COVID-19 infection and surgery was 2.3±1.5 days. Before surgery, all patients except one had been admitted to the corona dedicated wards, while two patients were admitted to the intensive care unit (ICU). One of the ICU admitted patients died. All the 12 alive patients remained in home isolation after discharge. Conclusion: Fracture surgery in COVID-19 patients has many challenges such as lack of medical resources, delay of surgery, medial staff fear, and patient isolation. However, a multidisciplinary approach using all potential hospital resources would lead to successful operation and acceptable outcome.
| 81,050 | [
0.1832275390625,
-0.385986328125,
-0.7958984375,
0.8115234375,
-0.349365234375,
-0.17578125,
-0.1492919921875,
0.40478515625,
0.5322265625,
0.51416015625,
0.1854248046875,
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0.2890625,
-1.2451171875,
-0.1868896484375,
0.448974609375,
-0.433837890625,
-0.46533203125,
... | 44 |
Please summerize the given abstract to a title
The impact of SARS-CoV-2 (COVID-19) pandemic on trauma bay management and guideline adherence in a European level-one-trauma centre
PURPOSE: SARS CoV-2 (COVID-19) represents a pandemic that has led to adjustments of routine clinical practices. The initial management in the trauma bay follows detailed international valid algorithms. This study aims to work out potential adjustments of trauma bay algorithms during a global pandemic in order to reduce contamination and to increase safety for patients and medical personnel. METHODS: This retrospective cohort study compared patients admitted to the trauma bay of one academic level-one trauma centre in March and April 2019 with patients admitted in March and April 2020. Based on these datasets, possible adjustments of the current international guidelines of trauma bay management were discussed. RESULTS: Group Pan (2020, n = 30) included two-thirds the number of patients compared with Group Ref (2019, n = 44). The number of severely injured patients comparable amongst these groups: mean injury severity score (ISS) was significantly lower in Group Pan (10.5 ± 4.4 points) compared with Group Ref (15.3 ± 9.2 points, p = 0.035). Duration from admission to whole-body CT was significantly higher in Group Pan (23.8 ± 9.4 min) compared with Group Ref (17.3 ± 10.7 min, p = 0.046). Number of trauma bay admissions decreased, as did the injury severity for patients admitted in March and April 2020. In order to contain spreading of SARS Cov-2, the suggested recommendations of adjusting trauma bay protocols for severely injured patients include (1) minimizing trauma bay team members with direct contact to the patient; (2) reducing repeated examination as much as possible, with rationalized use of protective equipment; and (3) preventing potential secondary inflammatory insults. CONCLUSION: Appropriate adjustments of trauma bay protocols during pandemics should improve safety for both patients and medical personnel while guaranteeing the optimal treatment quality. The above-mentioned proposals have the potential to improve safety during trauma bay management in a time of a global pandemic.
| 81,242 | [
0.48046875,
0.44287109375,
-0.16162109375,
0.544921875,
-0.888671875,
-0.4599609375,
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0.2054443359375,
0.336181640625,
0.59228515625,
0.2088623046875,
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-0.302734375,
-0.461181640625,
0.256103515625,
-0.27978515625,
-0.25390625,
-0.2174... | 44 |
Please summerize the given abstract to a title
EMERGENCY HAND & RECONSTRUCTIVE MICROSURGERY IN THE COVID-19 POSITIVE PATIENT
Abstract The case spectrum in hand surgery is one of extremes – purely elective day surgery cases under local anesthesia to mangling limb injuries that require immediate, and frequently, lengthy, surgery. Despite the cancellation of most elective orthopedic and plastic surgical procedures, hand surgeons around the world continue to see a steady stream of limb-threatening cases such as severe trauma and infections that require emergent surgical care. With the increase in community-spread, an increasing number of COVID-19 infected patients may be asymptomatic or have mild, non-specific or atypical symptoms. Some of them may already have an ongoing, severe infection. The time-sensitive nature of some of these cases means that hand surgeons may need to operate urgently on patients who may be suspected of COVID-19 infections, often before confirmatory test results are available. General guidelines for peri-operative care of the COVID-19 positive patient have been published. However, our practices differ from general orthopedic and plastic surgery, primarily because of the focus on trauma. This article discusses the peri-operative and technical considerations that are essential to manage the COVID-19 patient requiring emergency care, without compromising clinical outcomes and while ensuring safety of the attending staff.
| 81,421 | [
0.3203125,
0.3525390625,
-0.84423828125,
0.440185546875,
-0.401611328125,
-0.55859375,
0.01397705078125,
0.5693359375,
0.25439453125,
0.77001953125,
0.471923828125,
-0.673828125,
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-0.994140625,
-0.19921875,
0.5458984375,
-0.5224609375,
-0.6259765625,
-0.130859375... | 44 |
Please summerize the given abstract to a title
Laparoscopic Gastrointestinal Surgery During COVID-19 Pandemic: Single-Center Experience
Background: COVID-19 era has put laparoscopic surgery a risk procedure because of theoretical risk of viral transmission of COVID-19. However, safe evacuation of stagnant air during laparoscopic surgery is also necessary to safeguard health care warriors. Methods: We are reporting experience of 24 laparoscopic surgeries using a closed smoke evacuation/filtration system using a ultra low-particulate air (ULPA) filtration capability (ConMed AirSeal® System) at a single center between March 22, 2020, and May 30, 2020. All surgeries were either urgent or emergency in nature. Results: Totally, 17 males and 7 females who required urgent surgery. Most common indication for laparoscopic intervention was acute cholecystitis and complications related to acute cholecystitis. Owing to the closed smoke evacuation system, low intra-abdominal pressure was maintained during all surgeries. Of all procedures, only 0.8 time per procedure, the laparoscope taken out for cleaning. Mean time for completion of surgery was 58 minutes. Compliance of surgical staff was high due to the deemed safe smoke evacuation system. Mean of postoperative pain score was low. Mean hospital stay was 4.9 days. Conclusions: We propose to use a closed smoke evacuation/filtration system with ULPA filtration capability or similar devices in each minimally invasive surgery to reduce risks of transmission as minute as possible until we have enough knowledge about the pattern of disease transmission.
| 81,470 | [
0.467529296875,
0.27978515625,
-0.3701171875,
0.98583984375,
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-0.26220703125,
-0.310302734375,
0.57080078125,
0.366943359375,
0.6337890625,
0.64599609375,
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-0.81298828125,
-0.904296875,
0.6474609375,
-0.58642578125,
-0.52490234375,
... | 44 |
Please summerize the given abstract to a title
Preliminary evaluation of a new initiative to centralize colorectal cancer care during the COVID-19 epidemic in Shanghai, China: a retrospective study
Background: A novel colorectal cancer center (CCC) was developed in the Shanghai Tenth People’s hospital of Tongji University during the COVID-19 epidemic. In this study, we aimed to evaluate the CCC model in terms of three aspects. Methods: This retrospective study used data from the Shanghai Tenth People’s hospital patient databases. The research hypothesis was that the CCC reduces preoperative waiting time (PWT), length of hospital stay (LOS), and costs of hospitalization, without reducing the quality of surgery. Thus, we compared the time, cost, and quality between March 1 to December 31, 2019, and March 1 to December 31, 2020. Descriptive and inferential analyses of patient demographic characteristics, time, postoperative outcomes, and inpatient costs were conducted. Results: A total of 965 hospitalizations for colorectal cancer (CRC) were identified—415 in 2019 and 550 in 2020. In the CCC, PWT declined by 26.2 hours (P<0.01). Patients in the CCC express group only needed to wait for 24.5 hours before undergoing surgery, with a shorter LOS than the normal group (P<0.01). None of the patients had any symptoms of COVID-19 or were high-risk COVID-19 contacts, and the incidence of immediate postoperative complications was low. The mean total inpatient cost (TIC) for all patients with CRC was 78,309.824 Chinese Yuan in 2020, which was slightly lower than that in 2019. Conclusions: This study found that the centralized management model for CRC care could help patients save the PWT, LOS and costs of hospitalization during the COVID-19 epidemic.
| 81,498 | [
0.17919921875,
-0.130126953125,
-0.7041015625,
0.09197998046875,
-0.0565185546875,
-0.381103515625,
-0.0589599609375,
0.08233642578125,
0.66796875,
0.57666015625,
0.97412109375,
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0.2115478515625,
-0.89404296875,
-0.427001953125,
0.1263427734375,
-0.340087890625,
-0... | 44 |
Please summerize the given abstract to a title
Impact de la pandémie de COVID-19 sur l’activité chirurgicale au sein des services d’urologie de l’Assistance Publique -Hôpitaux de Paris
ABSTRACT Introduction: As a result of the COVID-19 pandemic in France, all non-emergency surgical activity has been cancelled since March 12, 2020. In order to anticipate the reinstatement of delayed interventions, surgical activity reduction analysis is essential. The objective of this study was to evaluate the reduction of urological surgery in adult during the COVID-19 pandemic compared to 2019. Material: The data regarding urological procedures realized in the 8 academic urological departments of Parisians centres (AP-HP) were compared over two similar periods (14-29 March 2019 and 12-27 March 2020) using the centralized surgical planning software shared by these centres. Procedure title, type of surgery and outpatient ratio were collected. The interventions were sorted into 16 major families of urological interventions. Results: Overall, a 55% decrease was observed concerning urological procedures over the same period between 2019 and 2020 (995 and 444 procedures respectively). Oncology activity and emergencies decreased by 31% and 44%. The number of kidney transplantations decreased from 39 to 3 (-92%). Functional, andrological and genital surgical procedures were the most impacted among the non-oncological procedures (-85%, -81% and -71% respectively). Approximatively 1033 hours of surgery have been delayed during this 16-day period. Conclusion: Lockdown and postponement of non-urgent scheduled urological procedures decisions has led to a drastic decrease in surgical activity in AP-HP. Isolated Kidney transplantation has been stopped (national statement). Urologists must anticipate for lockdown exit in order to catch-up delayed surgeries.
| 81,607 | [
0.10003662109375,
0.2408447265625,
-0.81884765625,
0.6962890625,
-0.364501953125,
-0.2159423828125,
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0.3212890625,
0.70361328125,
0.57470703125,
0.446533203125,
-0.230224609375,
-0.00685882568359375,
-0.228271484375,
-0.9384765625,
0.1865234375,
-0.404052734375,
-0.... | 44 |
Please summerize the given abstract to a title
Fragility hip fractures in the COVID-19 pandemic – a local experience in the United Kingdom
BACKGROUND: Fragility hip fractures are a major cause of morbidity and mortality in the UK. The 2019 novel coronavirus disease (COVID-19) pandemic led to restrictions on trauma services in several hospitals with potential operating delays and unintended negative outcomes. This local study describes the impact of operative pathway changes on clinical outcomes of patients undergoing fragility hip fracture fixation during the COVID-19 pandemic. METHODS: A single centre, retrospective analysis was performed for all patients who presented with fragility hip fractures for operative management between the 23(rd) March and 29(th) April 2020. RESULTS: 34 patients met the inclusion criteria for analysis. The median patient age was 88 years old, with a median inpatient stay of 8 days. Three patients died prior to being operated on. 48% of patients were operated on within 36 hours. The 30 day all-cause mortality from the date of presentation of injury was 20%. DISCUSSION: Our study demonstrates that the pandemic and changes to operating pathways has had a sizeable impact on the hip fracture service with delays in surgery and an increase in the 30 day mortality. These disruptions to surgical operating systems are likely to continue, with potential ongoing unintended negative consequences as demonstrated in this study. We believe that a focus on solving logistical issues including availability of sufficient operating theatre capacity, redeployment of staff, early multidisciplinary input and counselling patients on the increased outcome risks will help to mitigate risks posed to this vulnerable patient population during these periods.
| 82,116 | [
0.27197265625,
-0.0416259765625,
-0.576171875,
0.84814453125,
-0.7158203125,
-0.5712890625,
-0.362060546875,
0.32666015625,
0.379150390625,
0.47314453125,
0.52685546875,
-0.6611328125,
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-0.90771484375,
-0.417724609375,
0.23583984375,
-0.4580078125,
-0.378662109375... | 44 |
Please summerize the given abstract to a title
Admission avoidance in acute epistaxis: A prospective national audit during the initial peak of the COVID-19 pandemic
OBJECTIVES: To report changes in practice brought about by COVID-19 and the implementation of new guidelines, and to explore factors relating to unscheduled re-presentations for patients discharged from the emergency department (ED). DESIGN: Prospective multicentre national audit over 12 weeks from 6th April 2020. SETTING: UK secondary care ENT departments. PARTICIPANTS: Adult patients with acute epistaxis. MAIN OUTCOME MEASURES: Re-presentation within 10 days for patients discharged from the ED. RESULTS: Eighty three centres from all four UK nations submitted 2631 valid cases. The majority of cases were ED referrals (89.7%, n = 2358/2631). 54.6% were discharged from the ED following ENT review (n = 1267/2322), of whom 19.5% re-presented within 10 days (n = 245/1259) and 6.8% were ultimately admitted (n = 86/1259). 46.7% of patients had a non-dissolvable pack inserted by ED prior to referral to ENT (n = 1099/2355). The discharge rates for ED patients and their subsequent re-presentation rates were as follows: non-dissolvable packs, 29.5% discharged (n = 332/1125), 18.2% re-presented (n = 60/330); dissolvable products, 71.1% discharged (n = 488/686), 21.8% re-presented (n = 106/486); cautery only, 89.2% discharged (n = 247/277), 20.0% re-presented (n = 49/245); and no intranasal intervention, 85.5% discharged (n = 200/234), 15.2% re-presented (n = 30/198). Univariable logistic regression showed that not being packed by ED, antiplatelet medications, failed cautery and recent epistaxis treatment were significant predictors of re-presentation within 10 days. CONCLUSIONS: Management of acute epistaxis was notably affected during the initial peak of the pandemic, with a shift towards reduced admissions. This national audit highlights that many patients who may previously have been admitted to hospital may be safely discharged from the ED following acute epistaxis.
| 82,176 | [
0.1834716796875,
-0.01503753662109375,
-0.6572265625,
0.5986328125,
-0.7744140625,
-0.98193359375,
-0.461669921875,
0.266845703125,
0.3701171875,
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0.34912109375,
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0.394775390625,
-0.53564453125,
-0.546875,
0.5703125,
-0.98828125,
-0.92724609375,
-0.21... | 44 |
Please summerize the given abstract to a title
The impact of a dedicated coronavirus disease 2019 primary angioplasty protocol on time components related to ST-segment elevation myocardial infarction management in a 24/7 primary percutaneous coronary intervention-capable hospital
BACKGROUND: Primary per-cutaneous coronary intervention (PPCI) as treatment of choice for ST-Elevation Myocardial Infarction (STEMI) should be performed rapidly Applying preventive strategies during coronavirus disease 2019 (COVID-19) outbreak as an ongoing major global concern is necessary However, critical times in STEMI management may be influenced by infection control protocols implementation AIMS: To investigate the impact of our dedicated COVID-19 PPCI protocol on time intervals related to STEMI care and catheterization laboratory personnel safety and to determine a median of 70-day outcome during this outbreak compared with the same duration in previous year as a sub-endpoint METHODS: The patients with STEMI who underwent PPCI were included Chest Computed tomography (CT) imaging and real time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) were performed for COVID-19 suspected patients One hundred and seventy-eight patients from February 29th to April 30th, 2020 were compared with 146 patients from March 1st to April 30th, 2019 RESULTS: COVID-19 infection was confirmed by rRT-PCR in 7 cases CT imaging in 6 out of 7 patients was in favor of COVID-19 There are no statistically significant differences between the groups according to critical time intervals for reperfusion in STEMI Seventy-day mortality before and during outbreak was 2 73% and 4 49%, respectively (P = 0 40) CONCLUSIONS: Implementation of the dedicated COVID-19 primary PCI protocol for patients with STEMI allowed to achieve similar target times for reperfusion and short-term clinical outcome in comparison to pre-pandemic era and staff safety
| 82,408 | [
0.353759765625,
0.061004638671875,
-0.42333984375,
0.3603515625,
-0.546875,
-0.38134765625,
-0.60498046875,
0.19189453125,
0.2091064453125,
0.8056640625,
0.4111328125,
-0.2166748046875,
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-0.7705078125,
-0.487060546875,
0.39697265625,
-0.55078125,
-0.515625,
-0.532... | 44 |
Please summerize the given abstract to a title
Informed Consent for Emergency Obstetric Care During COVID-19 Pandemic
Informed consent process has become a challenging issue before surgery for any emergency obstetric care during this COVID pandemic. There is an increased risk of morbidity if there is a need of intensive care unit postoperatively and a risk of high mortality if patient has symptoms of COVID-19. Admission to intensive care unit adds on to the financial burden to the patient. Also, there is an increased risk of perinatal anxiety and depression during the COVID pandemic. When an asymptomatic carrier develops symptoms of COVID after delivery or caesarean section, the morbidity increases. So we have designed an informed consent form for patients undergoing emergency obstetric surgeries incorporating some points specific for COVID-19.
| 82,561 | [
0.487060546875,
0.251220703125,
-0.6513671875,
0.662109375,
-0.196044921875,
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-0.35205078125,
0.402587890625,
0.291259765625,
0.7763671875,
1.08984375,
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-0.0262451171875,
-0.810546875,
-0.385009765625,
0.50439453125,
-0.6650390625,
-0.9013671875,
-0.... | 44 |
Please summerize the given abstract to a title
Impact of the Strategies Adopted to Face the COVID-19 Pandemic in a Brazilian Reference Institute for High Complexity Surgery in Orthopedics and Traumatology
COVID-19 pandemics required substantial reorganization and adaptation of healthcare services all over the world This study aims to analyze the effect of operational strategies implemented in Brazil to manage the extra strain placed on healthcare services by the COVID-19 pandemic of 2020 In particular, this investigation examines the strategy to convert an institute specialized in elective orthopedic procedures of high complexity into a trauma unit for all musculoskeletal trauma patients of an entire federative unit A retrospective study was conducted comparing hospital variables at the peak period of the pandemic (from March 16, 2020 to June 30, 2020) with the same period in 2019 as a comparative baseline The variables analyzed included number of professionals away from work, surgeries performed, outpatient care, transfers, length of stay, number of patients diagnosed with COVID-19 and patient mortality During the COVID-19 peak period, there was a 48 5% reduction in surgical productivity and 72 4% reduction in outpatient care compared with the same period in 2019 The number of transfers increased substantially (124 5%), while 94 confirmed cases and 77 suspected cases of COVID-19 were reported The mortality rate increased by 245% The present study highlighted the effect of COVID-19 on a tertiary orthopedic hospital Despite the dramatic changes in hospital operations, due to the implementation of protocols to manage the pandemic, the results demonstrated the feasibility and efficiency of such protocols in prioritizing quality and safety for patients and the healthcare workforce
| 82,623 | [
0.281982421875,
-0.238037109375,
-0.5703125,
0.73583984375,
-0.490234375,
-0.6142578125,
-0.318115234375,
0.444091796875,
0.390625,
0.521484375,
0.564453125,
-0.335693359375,
-0.05755615234375,
-0.364990234375,
-0.5,
0.4072265625,
-0.1881103515625,
-0.5400390625,
-0.185791015625,... | 44 |
Please summerize the given abstract to a title
Early Response of the Orthopaedic Trauma Community to the COVID-19 Pandemic
Background With the rise of the COVID-19 pandemic, medical systems and providers have been forced to undertake substantial changes to staffing structure, hospital policy, and surgical indications to remain able to care for patients and protect the providers Here, we present a survey of orthopaedic trauma fellowship directors to assess when and what changes these individual units have made in order to cope with this global pandemic Methods The survey was distributed via email to all 62 programs listed in the Orthopaedic Trauma Association web site Results Twenty four responses were received The majority of programs implemented changes between March 1st and 14th, with nearly all splitting teams into individual units, incorporating virtual sign out, and reducing the number of available, i e exposed, staff, fellows, and residents at any particular time Conclusions These changes have been implemented in order to proactively maintain the functionality of these vital teams to patient care with no definite end point to this pandemic in sight We hope this study provides other trauma centers and orthopaedic practices insight into possible precautions that can be taken in response to the COVID-19 pandemic
| 82,643 | [
0.45947265625,
-0.07464599609375,
-0.66064453125,
0.85693359375,
-0.378173828125,
-0.45654296875,
-0.47314453125,
0.398681640625,
0.51416015625,
0.39453125,
0.499755859375,
-0.364990234375,
-0.1778564453125,
-0.638671875,
-0.70263671875,
0.6435546875,
-0.247314453125,
-0.5087890625... | 44 |
Please summerize the given abstract to a title
Cirugía electiva durante la pandemia por SARS-CoV-2 (COVID-19): análisis de morbimortalidad y recomendaciones sobre priorización de los pacientes y medidas de seguridad./ [Elective surgery during the SARS-CoV-2 pandemic (COVID-19): a morbimortality analysis and recommendations on patient prioritisation and security measures]
Introduction: The spread of the SARS-CoV-2 infection (COVID-19) has required adaptation by hospitals affected by the pandemic, which has caused a reduction in elective surgical activity. Methods: Retrospective study of patients operated on in the previous month and during the peak of the pandemic. We analysed the COVID-19 infection rate, the severity of respiratory infection according to the Brescia respiratory COVID-19 severity scale, the adopted therapeutic measures and the overall postoperative complications. Results: From 17th February to 31st March 2020, there was a progressive decrease in surgical activity, with only 213 patients operated on. This comprised 59 (27.8%) elective operations for oncological diseases, 97 (45.5%) elective operations for benign diseases and 57 (26.7%) as urgent procedures.There was a progressive increase in the rate of infection by COVID-19, with a total of 15 cases (7%). This included 10 patients (16.9%) in the elective group for oncological disease, 1 (1%) in the elective surgery group for benign disease and 4 (7%) in the urgent surgery group (p < 0.001). Five patients presented with a severe respiratory infection, of which 4 were affected by oncological disease. There were 3 deaths (1.4%), which were all due to the worsening of a respiratory infection. Conclusions: The patients undergoing the surgical procedures showed high rates of COVID-19 infection and postoperative complications, especially the patients with oncological diseases. Local resumption of surgical activity must be based on the prioritisation of the cases to be operated on, respecting certain premises of security and optimisation of the available resources.
| 83,002 | [
0.35302734375,
0.343994140625,
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Please summerize the given abstract to a title
EP.WE.470 Emergency General Surgery during the first COVID peak, a single centre experience
AIMS: The COVID-19 pandemic brought significant changes on all aspects of health care. We aimed to conduct a retrospective review of the trends in general surgical and vascular procedures during the first peak following the cessation of all elective activity. METHODS: All general and vascular procedures performed during April 2020 were included in the study. Peri-operative data were extracted from electronic patient records. We looked into operation notes, COVID status and post-operative complications. Descriptive analysis was performed using Microsoft Excel software. RESULTS: Table 1 shows a breakdown of the 54 operations performed. There were 47 patients, with a male to female ratio at 1:1. Mean age was 46.9 years. There were 6 expedited cases but none elective. Mean duration of symptoms prior to presentation was 8.3 days. Laparoscopic work was kept to a minimum. A consultant was present for 63% of the cases. There were only 2 COVID positive patients, but the majority (74%) were not tested. 20% of patients suffered a complication requiring an intervention. 6/54 had an unplanned return to theatre and there were 5 deaths in total. CONCLUSION: The number of procedures during the first peak was significantly reduced following the uncertainty around the novel coronavirus. In accordance with the initial intercollegiate guidance, patients were managed conservatively where possible. The high complication rate is indicative of the often-late presentation due to hospital fear following the outbreak of SARS‐CoV‐2.
| 83,042 | [
0.156005859375,
0.1319580078125,
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0.58154296875,
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-0... | 44 |
Please summerize the given abstract to a title
Impact of COVID-19 Pandemic in a Brazilian High-Volume Aortic Center
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic brought an unprecedented lack of control of what was to come. The intent of this document is to provide a balance of how much was ceased to be done for patients with aortic disease, to assess the mortality of these patients, and to show what happened to those who became COVID-19 positive during their hospitalization. METHODS: From April 1st to July 31st 2020, the worst period of the pandemic in São Paulo, Brazil, the Institute's aortic surgical patients operated on were evaluated and those were compared with patients operated during the same period in 2019. RESULTS: In 2019, 88 surgeries were performed; most of them were elective (66 [75%]), 10 were urgent, and 12 were emergency surgeries. In 2020, during the COVID-19 pandemic, we operated on only 31 patients, being 74.2% non-elective surgeries (P<0,001). There was a higher mortality for patients operated on during the pandemic surge of COVID-19 (P<0,001), but it was not specifically related to infected patients. CONCLUSION: The COVID-19 pandemic had an impact on surgical volume and outcome of patients with aortic disease, although it did not directly increase mortality.
| 83,047 | [
0.264404296875,
0.291015625,
-0.509765625,
0.7822265625,
-0.3408203125,
-0.61669921875,
-0.4140625,
0.41162109375,
0.53125,
0.294189453125,
0.65234375,
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0.29345703125,
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-0.29345703125,
-0.72802734375... | 44 |
Please summerize the given abstract to a title
Unexpected Decrease in Shunt Surgeries Performed during the Shelter-in-Place Period of the COVID-19 Pandemic
BACKGROUND: It is expected that the incidence of cerebrospinal fluid (CSF) shunt malfunctions would remain unchanged during the shelter-in-place period related to the COVID-19 pandemic. OBJECTIVE: To examine the number of shunt surgeries performed in a single institution during this time interval in comparison to equivalent periods in past years. METHODS: The numbers of elective and emergent/urgent shunt surgeries performed at a single institution were queried for a 28-d period starting on the third Monday of March, between years 2015 and 2020. These were further stratified by how they presented as well as the type of surgery performed. RESULTS: During the 28-d period of interest, in the years between 2015 and 2020, there was a steady increase in the number of shunt surgeries performed, with a maximum of 64 shunt surgeries performed in 2019. Of these, approximately 50% presented in urgent fashion in any given year. In the 4-wk period starting March 16, 2020, a total of 32 shunt surgeries were performed, with 15 of those cases presenting from the outpatient setting in emergent/urgent fashion. For the surgeries performed, there was a statistically significant decrease in the number of revision shunt surgeries performed. CONCLUSION: During the 2020 COVID-19 pandemic, there was an unexpected decrease in the number of shunt surgeries performed, and particularly in the number of revision surgeries performed. This suggests that an environmental factor related to the pandemic is altering the presentation rate of shunt malfunctions.
| 83,172 | [
0.08282470703125,
0.2384033203125,
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0.576171875,
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0.42626953125,
0.2130126953125,
0.5986328125,
0.962890625,
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-0.904296875,
0.335693359375,
-0.53564453125,
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-0.33227... | 44 |
Please summerize the given abstract to a title
SHOULD I BE CONCERNED? SURGICAL TRAINING IN THE TIME OF COVID19
As the US healthcare system restructured to deal with the COVID-19 pandemic, medical training was significantly disrupted. During the peak of the crisis, three surgical trainees in different stages of their residency shared their experiences and concerns on how this pandemic affected their training. The article is intended to generate discussion on the concerns of derailment and stagnation of surgical training and difficulties faced at all levels of surgical training to perform clinical duties and fulfill academic responsibilities during the early months of the COVID pandemic.
| 83,218 | [
0.84326171875,
0.04376220703125,
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0.64599609375,
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... | 44 |
Please summerize the given abstract to a title
The number of patients "worse than death" while waiting for a hip or knee arthroplasty has nearly doubled during the COVID-19 pandemic
AIMS: The aim of this study was to assess the quality of life of patients on the waiting list for a total hip (THA) or knee arthroplasty (KA) during the COVID-19 pandemic. Secondary aims were to assess whether length of time on the waiting list influenced quality of life and rate of deferral of surgery. METHODS: During the study period (August and September 2020) 843 patients (THA n = 394, KA n = 449) from ten centres in the UK reported their EuroQol five dimension (EQ-5D) scores and completed a waiting list questionnaire (2020 group). Patient demographic details, procedure, and date when listed were recorded. Patients scoring less than zero for their EQ-5D score were defined to be in a health state "worse than death" (WTD). Data from a retrospective cohort (January 2014 to September 2017) were used as the control group. RESULTS: The 2020 group had a significantly worse EQ-5D score compared to the control group for both THA (p < 0.001) and KA (p < 0.001). Over one-third (35.0%, n = 138/394) of patients waiting for a THA and nearly a quarter (22.3%, n = 100/449) for KA were in a health state WTD, which was significantly greater than the control group (odds ratio 2.30 (95% confidence interval (CI) 1.83 to 2.93) and 2.08 (95% CI 1.61 to 2.70), respectively; p < 0.001). Over 80% (n = 680/843) of the 2020 group felt that their quality of life had deteriorated while waiting. Each additional month spent on the waiting list was independently associated with a decrease in quality of life (EQ-5D: -0.0135, p = 0.004). There were 117 (13.9%) patients who wished to defer their surgery and the main reason for this was health concerns for themselves and or their family (99.1%, n = 116/117). CONCLUSION: Over one-third of patients waiting for THA and nearly one-quarter waiting for a KA were in a state WTD, which was approaching double that observed prior to the pandemic. Increasing length of time on the waiting list was associated with decreasing quality of life. Level of evidence: Level III retrospective case control study Cite this article: Bone Joint J 2021;103-B(4):672-680.
| 83,228 | [
0.218505859375,
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1.126953125,
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0.01806640625,
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0.0859375,
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0.69140625,
-0.401611328125,
-0.70849609375,
-0.354248046... | 44 |
Please summerize the given abstract to a title
Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
INTRODUCTION: The coronavirus 2019 (COVID-19) pandemic disease has imposed an unprecedented degree of stress on healthcare systems. This study aimed to understand whether COVID-19 positivity is associated with an increased risk of adverse outcomes after geriatric hip fracture surgery. METHODS: From a national administrative claims data set, patients who underwent hip fracture surgery from April 1, 2020, to December 1, 2020 were selected for analysis. COVID-19–positive status was assessed by the emergency International Classification of Diagnoses, 10th Revision, COVID-19 code within 2 weeks before the surgery. Demographic, comorbidity, and 30-day postoperative adverse event information were extracted. Logistic regression before and after 10:1 propensity matching was performed to identify patient risk factors associated with the occurrence of postoperative adverse events. RESULTS: Of 42,002 patients who underwent hip fracture surgery, 678 (1.61%) were identified to be positive for COVID-19 infection. No significant differences in age, sex, and procedure type were found between COVID-19–positive and COVID-19–negative groups, but the COVID-19–positive patients demonstrated a higher incidence of several comorbidities. These differences were no longer significant after matching. After matching, the COVID-19–positive group had a higher incidence of any, serious, and minor adverse events (P < 0.001 for all). Controlling for preoperative variables, COVID-19 positivity was associated with an increased risk of experiencing any adverse events (odds ratio [OR] = 1.62, 95% confidence interval [95% CI] = [1.37 to 1.92], P < 0.001), serious adverse events (OR = 1.66, 95% CI = [1.31 to 2.07], P < 0.001), and minor adverse events (OR = 1.59, 95% CI = [1.34 to 1.89], P < 0.001). DISCUSSION: After matching and controlling for confounding variables, COVID-19–positive hip fracture patients had increased odds of multiple postoperative events. Clinicians caring for this vulnerable geriatric population should be mindful of this risk to improve the care for these patients during the ongoing global pandemic.
| 83,465 | [
0.186279296875,
-0.1241455078125,
-0.53271484375,
1.08203125,
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-0.59619140625,
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0.4814453125,
0.53173828125,
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0.169677734375,
-0.4921875,
-0.48828125,
-0.08862304687... | 44 |
Please summerize the given abstract to a title
Management of Neurosurgical Cases in a Tertiary Care Referral Hospital During the COVID-19 Pandemic: Lessons From a Middle-Income Country
Background/Introduction COVID-19 pandemic has been at its peak for the past 6months and has affected more than 215 countries around the world. India is now the 2nd most-affected nation with more than 48,00,000 cases and 79,000 deaths. Despite this, and the fact that it is a lower-middle-income nation the number of deaths is almost 1/3rd of the USA and ½ of Brazil. There has, however, been no experience published from non-COVID designated hospitals where the aim is to manage non-infected cases with neurosurgical ailments while keeping the number of infected cases to a minimum. Methods We analyzed the number of neurosurgical cases (non-trauma) done in the past 5 months (March- July 2020) in our institute which is the largest neurosurgical center by volume in southern India and compared the same to the concurrent 5 months in 2019 and 5 months preceding the pandemic. We also reviewed the total number of cases infected with COVID-19 managed during this time. Results We operated a total of 630 cases(non-trauma) in these 5 months and had 9 COVID-19 infected cases operated during this time. There was a 57% (p=0.002) reduction in the number of cases operated as compared to the same 5 months in the preceding year. We employed a dual strategy of Rapid Antigen testing and surgery for cases needing emergency intervention and Reverse Transcriptase-Polymerase chain reaction test for elective cases. The hospital was divided into three zones (red, orange, and green) depending on infectivity level with minimal interaction. Separate teams were designated for each zone and thus we were able to effectively manage even infected cases despite the absence of pulmonology/medical specialists. Conclusion We present a patient management protocol for non-COVID designated hospitals in high volume centers with the constraints of a lower-middle-income nation and demonstrate its effectiveness. Strict zoning targeted testing and effective triage can help in management during the pandemic.
| 83,565 | [
0.042694091796875,
0.33740234375,
-0.7177734375,
0.60595703125,
-0.80419921875,
-0.73876953125,
-0.031036376953125,
0.326171875,
0.223876953125,
0.405029296875,
0.2364501953125,
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-0.40966796875,
-0.62744140625,
-0.004230499267578125,
-0.377197265625,
-... | 44 |
Please summerize the given abstract to a title
Sample times for surveillance of S. aureus transmission to monitor effectiveness and provide feedback on intraoperative infection control
Background : Reductions in perioperative surgical site infections are obtained by a multifaceted approach including patient decolonization, vascular care, hand hygiene, and environmental cleaning Associated surveillance of S aureus transmission quantifies the effectiveness of these basic measures to prevent transmission of pathogenic bacteria and viruses to patients and clinicians, including Coronavirus Disease 2019 (COVID-19) To measure transmission, the observational units are pairs of successive surgical cases in the same operating room on the same day We measured sampling times for inexperienced and experienced personnel Methods : OR PathTrac kits included 6 samples collected before the start of surgery and 7 after surgery The time for consent also was recorded We obtained 1677 measurements of time among 132 cases Results : Sampling times were not significantly affected by technician's experience, type of anesthetic, or patient's American Society of Anesthesiologists’ Physical Status Sampling times before the start of surgery averaged less than 5 minutes (3 39 minutes [SE 0 23], P < 0 0001) Sampling times after surgery took approximately 5 minutes (4 39 [SE 0 25], P = 0 015) Total sampling times averaged less than 10 minutes without consent (7 79 [SE 0 50], P < 0 0001), and approximately 10 minutes with consent (10 22 [0 56], P = 0 70) Conclusions : For routine use of monitoring S aureus transmission, when done by personnel already present in the operating rooms of the cases, the personnel time budget can be 10 minutes per case
| 83,647 | [
0.0777587890625,
0.5771484375,
-0.082275390625,
0.76123046875,
-0.375244140625,
-0.39599609375,
-0.7578125,
0.415771484375,
0.1412353515625,
0.70849609375,
0.5947265625,
-0.40234375,
0.1619873046875,
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-0.419921875,
0.3916015625,
-0.2496337890625,
-0.62548828125,
-0.... | 44 |
Please summerize the given abstract to a title
Emergency surgical strategies for patients with acute abdomen during the COVID-19 outbreak
Objective: To investigate the emergency surgical strategies for patients with acute abdomen during the Corona Virus Disease 2019 (COVID-19) outbreak Methods: The retrospective and descriptive study was conducted The clinical data of 20 patients with acute abdomen who were admitted to the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology between January 18, 2020 and February 10, 2020 were collected There were 13 males and 7 females, aged from 25 to 82 years, with an average age of 57 years All the patients with emergency surgeries received pulmonary computed tomography (CT) examination before surgery, and completed nucleic acid detection in throat swab if necessary Patients excluded from COVID-19 underwent regular anesthesia, suspected and confirmed cases were selected a proper anesthesia based on their medical condition and surgical procedure Patients excluded from COVID-19 underwent emergency surgeries following the regular procedure, suspected and confirmed cases underwent emergency surgeries following the three-grade protection Observation indicators: (1) surgical situations;(2) postoperative situations Measurement data with normal distribution were represented as average (range) Count data were described as absolute numbers Results: (1) Surgical situations: of the 20 patients with acute abdomen, 16 patients were excluded from COVID-19, and 4 were not excluded All the 20 patients underwent emergency abdominal surgeries successfully, of whom 2 received surgeries under epidural anesthesia (including 1 with open appendectomy, 1 with open repair of duodenal bulbar perforation), 18 received surgeries under general anesthesia (including 9 with laparoscopic repair of duodenal bulbar perforation, 3 with open partial enterectomy, 3 with laparoscopic appendectomy, 1 with laparoscopic left hemicolectomy, 1 with laparoscopic right hemicolectomy, 1 with cholecystostomy) The operation time of patients was 32-194 minutes, with an average time of 85 minutes The volume of intraoperative blood loss was 50-400 mL, with an average volume of 68 mL (2) Postoperative situations: 16 patients excluded from COVID-19 preopratively were treated in the private general ward postoperatively One of the 16 patients had fever at the postoperative 5th day and was highly suspected of COVID-19 after an emergency follow-up of pulmonary CT showing multiple ground-glass changes in the lungs The patient was promptly transferred to the isolation ward for treatment, and results of nucleic acid detection in throat swab showed double positive Medical history described by the patient showed that the patient and family members were residents of Wuhan who were not isolated at home during the epidemic There was no way to confirm whether they had a history of exposure to patients with COVID-19 Medical staffs involved in this case did not show COVID-19 related symptoms during 14 days of medical observation The other 15 patients recovered well postoperatively The 4 patients who were not excluded from COVID-19 preoperatively based on medical history and results of pulmonary CT examination were directly transferred to the isolation ward for treatment postoperatively They were excluded from COVID-19 for two consecutive negative results of nucleic acid detection in the throat swab and recovered well Two of the 20 patients with acute abdomen had postoperative complications One had surgical incision infection and recovered after secondary closure following opening incision, sterilizing and dressing, the other one had intestinal leakage and was improved after conservative treatment by abdominal drainage There was no death in the 20 patients with acute abdomen Conclusions: Patients with acute abdomen need to be screened through emergency forward Patients excluded from COVID-19 undergo emergency surgeries following the regular procedure, and patients not excluded from COVID-19 undergo emergency surgeries following the three-grade protection The temperature, blood routine test and other laborat ry examinations are performed to monitor patients after operation, and the pulmonary CT and throat nucleic acid tests should be conducted if necessary Patients excluded from COVID-19 preopratively are treated in the private general ward postoperatively, and they should be promptly transferred to the isolation ward for treatment after being confirmed Patients who are not excluded from COVID-19 preoperatively based on medical history should be directly transferred to the isolation ward for treatment postoperatively Copyright © 2020 by the Chinese Medical Association
| 83,657 | [
-0.077880859375,
-0.036346435546875,
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0.44970703125,
-0.8798828125,
-0.278076171875,
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0.67138671875,
0.57080078125,
0.66650390625,
0.87646484375,
-0.50927734375,
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0.386962890625,
-0.587890625,
-0.6674... | 44 |
Please summerize the given abstract to a title
Clinical Pathway for Emergency Brain Surgery during COVID-19 Pandemic and Its Impact on Clinical Outcomes
BACKGROUND: One of the challenges neurosurgeons are facing in the global public health crisis caused by the coronavirus disease 2019 (COVID-19) pandemic is to balance COVID-19 screening with timely surgery. We described a clinical pathway for patients who needed emergency brain surgery and determined whether differences in the surgery preparation process caused by COVID-19 screening affected clinical outcomes. METHODS: During the COVID-19 period, patients in need of emergency brain surgery in our institution were managed using a novel standardized pathway designed for COVID-19 screening. We conducted a retrospective review of patients who were hospitalized through the emergency room and underwent emergency brain surgery. A total of 32 patients who underwent emergency brain surgery from February 1 to June 30, 2020 were included in the COVID-19 group, and 65 patients who underwent surgery from February 1 to June 30, 2019 were included in the pre-COVID-19 group. The baseline characteristics, disease severity indicators, time intervals of emergency processes, and clinical outcomes of the two groups were compared. Subgroup analysis was performed between the immediate surgery group and the semi-elective surgery group during the COVID-19 period. RESULTS: There were no significant differences in baseline characteristics and severity indicators between the pre-COVID-19 group and COVID-19 group. The time interval to skin incision was significantly increased in the COVID-19 group (P = 0.027). However, there were no significant differences in the clinical outcomes between the two groups. In subgroup comparison, the time interval to skin incision was shorter in the immediate surgery group during the COVID-19 period compared with the pre-COVID-19 group (P = 0.040). The screening process did not significantly increase the time interval to classification and admission for immediate surgery. The time interval to surgery initiation was longer in the COVID-19 period due to the increased time interval in the semi-elective surgery group (P < 0.001). CONCLUSION: We proposed a clinical pathway for the preoperative screening of COVID-19 in patients requiring emergency brain surgery. No significant differences were observed in the clinical outcomes before and after the COVID-19 pandemic. The protocol we described showed acceptable results during this pandemic.
| 83,844 | [
0.0134429931640625,
0.251708984375,
-0.73193359375,
0.82177734375,
-0.85400390625,
-0.5048828125,
-0.28955078125,
0.21826171875,
0.39404296875,
0.85009765625,
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-1.0595703125,
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0.3271484375,
-0.64990234375,
-0.515625,
... | 44 |
Please summerize the given abstract to a title
694 The Impact Of COVID-19 On Trauma Referrals to a National Neurosurgical Centre
OBJECTIVE: To investigate the impact of COVID-19 on trauma referrals to a National Neurosurgical Centre. METHOD: Retrospective analysis of a prospectively maintained database of all trauma referrals to the National Neurosurgical Centre at Beaumont Hospital, during the period March 1(st) – May 31(st), 2019 and 2020. Patient characteristics including age, sex, alcohol use, anticoagulant/antiplatelet use and initial Glasgow Coma Scale were recorded. Patients were grouped by trauma aetiology and diagnosis. RESULTS: There were 527 and 437 trauma referrals in 2019 and 2020, respectively. Overall, there was a 17.1% reduction in trauma referrals between years. Traumatic brain injury, spinal injury and cranial fractures referrals reduced 25% (375 vs 283), 59% (32 vs 13) and 18% (39 vs 32) respectively from 2019 to 2020. Low energy falls below 2 metres were the most common mechanism of injury and accounted for 60 and 61% of referrals in 2019 and 2020. No reduction in road traffic collision (33 vs 34) and assault (40 vs 40) referrals were observed between years. CONCLUSIONS: COVID-19 has had a significant impact on the volume and mechanism of trauma referrals to the National Neurosurgical Centre in Ireland, with falls below 2 metres the most common mechanism of trauma referral across both years.
| 84,074 | [
0.10986328125,
0.14501953125,
-0.369384765625,
0.87451171875,
-1.0419921875,
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-0.0694580078125,
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-0.032440185546875,
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0.611328125,
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-0.2773... | 44 |
Please summerize the given abstract to a title
SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri‐operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England
The scale of the COVID‐19 pandemic means that a significant number of patients who have previously been infected with SARS‐CoV‐2 will require surgery. Given the potential for multisystem involvement, timing of surgery needs to be carefully considered to plan for safe surgery. This consensus statement uses evidence from a systematic review and expert opinion to highlight key principles in the timing of surgery. Shared decision‐making regarding timing of surgery after SARS‐CoV‐2 infection must account for severity of the initial infection; ongoing symptoms of COVID‐19; comorbid and functional status; clinical priority and risk of disease progression; and complexity of surgery. For the protection of staff, other patients and the public, planned surgery should not be considered during the period that a patient may be infectious. Precautions should be undertaken to prevent pre‐ and peri‐operative infection, especially in higher risk patients. Elective surgery should not be scheduled within 7 weeks of a diagnosis of SARS‐CoV‐2 infection unless the risks of deferring surgery outweigh the risk of postoperative morbidity or mortality associated with COVID‐19. SARS‐CoV‐2 causes either transient or asymptomatic disease for most patients, who require no additional precautions beyond a 7‐week delay, but those who have persistent symptoms or have been hospitalised require special attention. Patients with persistent symptoms of COVID‐19 are at increased risk of postoperative morbidity and mortality even after 7 weeks. The time before surgery should be used for functional assessment, prehabilitation and multidisciplinary optimisation. Vaccination several weeks before surgery will reduce risk to patients and might lessen the risk of nosocomial SARS‐CoV‐2 infection of other patients and staff. National vaccine committees should consider whether such patients can be prioritised for vaccination. As further data emerge, these recommendations may need to be revised, but the principles presented should be considered to ensure safety of patients, the public and staff.
| 84,372 | [
0.274169921875,
0.462890625,
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0.69091796875,
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-0.4296875,
-0.259765625,
0.57373046875,
0.14794921875,
0.787109375,
0.2005615234375,
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-0.4462890625,
0.7060546875,
-0.35400390625,
-0.62744140625,
-0.045... | 44 |
Please summerize the given abstract to a title
[Current status for urpper tract transitional cell carcinoma during COVID-19 pandemia.]
INTRODUCTION: First cases of COVID-19 were reported in China on December 2019 and rapidly spread globally The explosive increase in number of cases requiring hospitalization has led to a delay in a big number of surgical interventions, including oncologic surgeries Collateral effects of this increase means a challenge for urologists, who have been forced to redistribute their resources Due to its poor pronostic, patients suffering from by upper tract urinary tumours will be negatively affected by this pandemic METHODS: A non sistematic review was performed using literature published until May 23, 2020, using "Uppertract urothelial tumours", "COVID-19" and "nephroureterectomy" as keywords The resulting manuscript was critically revised by national authors in order to establish common criteria about treatment and follow up EVIDENCE SYNTHESIS: Four studies were identified that assessed the impact of delaying radical nephrouretrectomy as curative treatment These studies showed that surgery delays decrease overall survival and cancer specific survival rates in high-risk groups On the other hand, delaying radical nephrouretrectomy due to ureteroscopy did not affect survival in cohorts of patients with predominately low-grade disease CONCLUSIONS: A delay in curative treatment of upper tract urothelial tumours for more than three months results in adverse outcomes as overal survival and cancer specific survival Hence, it is important to prioritize the timely care of this group of patients as far as COVID-19 pandemic allows it
| 84,490 | [
0.294677734375,
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-0.89208984... | 44 |
Please summerize the given abstract to a title
"P(3)": an adaptive modeling tool for post-COVID-19 restart of surgical services
OBJECTIVE: To develop a predictive analytics tool that would help evaluate different scenarios and multiple variables for clearance of surgical patient backlog during the COVID-19 pandemic. MATERIALS AND METHODS: Using data from 27 866 cases (May 1 2018-May 1 2020) stored in the Johns Hopkins All Children's data warehouse and inputs from 30 operations-based variables, we built mathematical models for (1) time to clear the case backlog (2), utilization of personal protective equipment (PPE), and (3) assessment of overtime needs. RESULTS: The tool enabled us to predict desired variables, including number of days to clear the patient backlog, PPE needed, staff/overtime needed, and cost for different backlog reduction scenarios. CONCLUSIONS: Predictive analytics, machine learning, and multiple variable inputs coupled with nimble scenario-creation and a user-friendly visualization helped us to determine the most effective deployment of operating room personnel. Operating rooms worldwide can use this tool to overcome patient backlog safely.
| 84,671 | [
0.45361328125,
0.2135009765625,
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0.384765625,
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0.0574035... | 44 |
Please summerize the given abstract to a title
Case Volumes and Perioperative Coronavirus Disease 2019 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC
OBJECTIVE: The true incidence of perioperative coronavirus disease 2019 (COVID-19) has not been well elucidated in neurosurgical studies. We reviewed the effects of the pandemic on the neurosurgical case volume to study the incidence of COVID-19 in patients undergoing these procedures during the perioperative period and compared the characteristics and outcomes of this group to those of patients without COVID-19. METHODS: The neurosurgical and neurointerventional procedures at 2 tertiary care centers during the pandemic were reviewed. The case volume, type, and acuity were compared to those during the same period in 2019. The perioperative COVID-19 tests and results were evaluated to obtain the incidence. The baseline characteristics, including a modified Medically Necessary Time Sensitive (mMeNTS) score, and outcome measures were compared between those with and without COVID-19. RESULTS: A total of 405 cases were reviewed, and a significant decrease was found in total spine, cervical spine, lumbar spine, and functional/pain cases. No significant differences were found in the number of cranial or neurointerventional cases. Of the 334 patients tested, 18 (5.4%) had tested positive for COVID-19. Five of these patients were diagnosed postoperatively. The mMeNTS score, complications, and case acuity were significantly different between the patients with and without COVID-19. CONCLUSION: A small, but real, risk exists of perioperative COVID-19 in neurosurgical patients, and those patients have tended to have a greater complication rate. Use of the mMeNTS score might play a role in decision making for scheduling elective cases. Further studies are warranted to develop risk stratification and validate the incidence.
| 84,730 | [
-0.0352783203125,
0.146728515625,
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0.1982421875,
-0.60107421875,
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-0.108... | 44 |
Please summerize the given abstract to a title
Preliminary model assessing the cost-effectiveness of preoperative chlorhexidine mouthwash at reducing postoperative pneumonia among abdominal surgery patients in South Africa
BACKGROUND: Pneumonia is a common and severe complication of abdominal surgery, it is associated with increased length of hospital stay, healthcare costs, and mortality. Further, pulmonary complication rates have risen during the SARS-CoV-2 pandemic. This study explored the potential cost-effectiveness of administering preoperative chlorhexidine mouthwash versus no-mouthwash at reducing postoperative pneumonia among abdominal surgery patients. METHODS: A decision analytic model taking the South African healthcare provider perspective was constructed to compare costs and benefits of mouthwash versus no-mouthwash-surgery at 30 days after abdominal surgery. We assumed two scenarios: (i) the absence of COVID-19; (ii) the presence of COVID-19. Input parameters were collected from published literature including prospective cohort studies and expert opinion. Effectiveness was measured as proportion of pneumonia patients. Deterministic and probabilistic sensitivity analyses were performed to assess the impact of parameter uncertainties. The results of the probabilistic sensitivity analysis were presented using cost-effectiveness planes and cost-effectiveness acceptability curves. RESULTS: In the absence of COVID-19, mouthwash had lower average costs compared to no-mouthwash-surgery, $3,675 (R 63,770) versus $3,958 (R 68,683), and lower proportion of pneumonia patients, 0.029 versus 0.042 (dominance of mouthwash intervention). In the presence of COVID-19, the increase in pneumonia rate due to COVID-19, made mouthwash more dominant as it was more beneficial to reduce pneumonia patients through administering mouthwash. The cost-effectiveness acceptability curves shown that mouthwash surgery is likely to be cost-effective between $0 (R0) and $15,000 (R 260,220) willingness to pay thresholds. CONCLUSIONS: Both the absence and presence of SARS-CoV-2, mouthwash is likely to be cost saving intervention for reducing pneumonia after abdominal surgery. However, the available evidence for the effectiveness of mouthwash was extrapolated from cardiac surgery; there is now an urgent need for a robust clinical trial on the intervention on non-cardiac surgery.
| 84,946 | [
0.25341796875,
0.36376953125,
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0.52685546875,
-0.72265625,
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0.51025390625,
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0.703125,
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0.46044921875,
-0.2548828125,
-0.80810546875,
0.14428710... | 44 |
Please summerize the given abstract to a title
Mortality Rates of Patients with Proximal Femoral Fracture in a Worldwide Pandemic: Preliminary Results of the Spanish HIP-COVID Observational Study
BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), in December 2019 in Wuhan, People's Republic of China, has developed into an unprecedented pandemic with enormous pressure on health-care providers around the world. A higher mortality rate has been described in older infected individuals. Patients with hip fracture are a particularly vulnerable population during this pandemic because older age is associated with a higher mortality rate. Our aim was to describe the early mortality rate and demographic variables in a hip fracture sample population in Spain during the coronavirus pandemic. METHODS: This is a multicenter, observational, retrospective, descriptive study. We collected data from 13 major hospitals in Spain from the beginning of the national state of alarm (declared on March 14, 2020, by the Spanish government) until the end of our study period on April 4, 2020. All patients who were ≥65 years of age, presented to the Emergency Department of the participating hospitals during this period with a diagnosis of proximal femoral fracture, and had a minimum follow-up of 10 days were included in the cohort. In addition to mortality, demographic and other potential prognostic variables were also collected. RESULTS: In this study, 136 patients with a hip fracture were included. Of these patients, 124 underwent a surgical procedure and 12 were managed nonoperatively. The total mortality rate was 9.6%. Sixty-two patients were tested for COVID-19, with 23 patients being positive. The mortality rate for these 23 patients was 30.4% (7 of 23 patients) at a mean follow-up of 14 days. The mortality rate was 10.3% (4 of 39) for patients who had been tested and had a negative result and 2.7% (2 of 74) for patients who had not been tested. Of the 12 patients who were managed nonoperatively, 8 (67%) died, whereas, of the 124 patients who were surgically treated, 5 (4%) died. Results differed among centers. CONCLUSIONS: There is a higher mortality rate in patients with a hip fracture and an associated positive test for COVID-19. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
| 85,147 | [
0.10308837890625,
0.045074462890625,
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0.8427734375,
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-0.7265625,
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-0.564453125,
-0... | 44 |
Please summerize the given abstract to a title
Neuro-oncology practice guidelines from a high-volume surgeon at the COVID-19 epicenter
BACKGROUND: During the coronavirus 19 (COVID-19) pandemic, physicians have begun adapting their daily practices to prevent transmissions. In this study we aimed to provide surgical neuro-oncologists with practice guidelines during the COVID-19 pandemic based on objective data from a high-volume brain tumor surgeon at the current COVID-19 epicenter. METHODS: All outpatient visits and surgeries performed by the senior author during the COVID-19 pandemic were compared between the initial quarantine (3/23/20-5/4/20), the plateau period following quarantine (5/5/20-6/27/20), and the second peak (6/28/20-7/20/20). In-person and telemedicine visits were evaluated for crossovers. Surgeries were subdivided based on lesion type and evaluated across the same time period. RESULTS: From 3/23/20-7/20/20, 469 clinic visits and 196 surgeries were identified. After quarantine was lifted, face-to-face visits increased (P < 0.01) yet no change in telehealth visits occurred. Of 327 telehealth visits, only 5.8% converted to in-person during the 4-month period with the most cited reason being patient preference (68.4%). Of the 196 surgeries performed during the pandemic, 29.1% occurred during quarantine, 49.0% during the plateau, and 21.9% occurred in the second peak. No COVID negative patients developed symptoms at follow-up. 55.6% were performed on malignant tumors and 31.6% were benign with no difference in case volumes throughout the pandemic. CONCLUSIONS: Despite exceptional challenges, we have maintained a high-volume surgical neuro-oncology practice at the epicenter of the COVID-19 pandemic. We provide the protocols implemented at our institution in order to maximize neuro-oncology care while mitigating risk of COVID-19 exposure to both patients and providers.
| 85,151 | [
0.1898193359375,
0.167724609375,
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-0.52587890625,
0.08026123046875,
-0.5595703125,
-0.81640625,
-0.3... | 44 |
Please summerize the given abstract to a title
Challenges post-COVID-19: planning strategies to resume elective dentistry and allied surgical specialities
The effect of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on the NHS in the UK has been profound and unprecedented Many surgical specialities, including dentistry, throughout the country have not been exempt from this effect As there are many aerosol-generating procedures and aerosol-generating exposures in surgical specialities, there has been a substantial cancellation of elective treatment This has been in part because of the limited availability of personal protective equipment for surgeons as this is being use elsewhere by clinicians to aid the reduction of viral spread in the community As the UK is preparing to emerge from the 'lockdown' during the pandemic, restarting elective surgical and dental treatment is an expected challenge This article looks at the possible roadmap to recovery of elective surgical management and dentistry, taking into consideration possible predicted further peaks and troughs of COVID-19 infections
| 85,234 | [
0.2470703125,
0.1383056640625,
-0.456298828125,
0.80126953125,
-0.92041015625,
-0.76904296875,
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0.65087890625,
0.1671142578125,
0.63916015625,
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0.2220458984375,
-0.425537109375,
-0.389404296875,
0.2578125,
-0.45654296875,
-0.2236328125,... | 44 |
Please summerize the given abstract to a title
Junior doctors as leaders in development and live management of a contingency rota during the COVID-19 pandemic: our experience at the general surgery department in queen elizabeth hospital, London
Clinical Fellow, Queen Elizabeth Hospital, London, UKConsultant Colorectal Surgeon and Clinical Director, Queen Elizabeth Hospital, London, UKThe COVID-19 pandemic has affected millions of patients around the world. Hospital departments had to adapt their services and expand their bed capacity. Our aim was to lead a team that will create a contingency rota in order to anticipate possible COVID-19 related sickness and support front-line specialities, such as Acute Medicine and Intensive Care.The team involved in the creation of this rota was led by one junior doctor from every grade. Data from the surgical take showed that the average number of daily surgical inpatients dropped from 47 in February, to 22 by the first week of April. This reduction, together with cancellation of elective operations, allowed us to create a contingency plan with a ward cover, an on-call and a stand-by team at all times. We managed to release doctors to support other departments, ensuring that surgical inpatients were receiving the pre-COVID-19 standards of care. We, also, created a ‘buddy system’, predicting possible COVID-19 sickness in the on-call or the ward-cover team. On this contingency rota, there was a ward cover team with one SHO, three FY1s and two registrars, including the team for ITU support and a ‘standby’ ward-cover team. Two of the FY1 doctors were redeployed to reinforce Acute Medicine. There was constant feedback via a ‘WhatsApp’ group from the on-call and the ward-cover team to recruit help from the standby teamAll doctors who were part of this rota were invited to provide feedback via a satisfaction survey. Out of 13 responses, 61.54% replied that they were satisfied or very satisfied with the contingency rota, and 76.92% replied that the rota was fair to very fair. The rota was designed by Junior doctors proving that well-thought planning measures can make all the difference when facing extremely difficult and unprecedented situations like the COVID-19 pandemic.
| 85,281 | [
0.279541015625,
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-0.58740234375,
0.43212890625,
-0.2978515625,
-1.001953125,
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0.1495361328125,
0.740234375,
0.52392578125,
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-0.407958984375,
0.284912109375,
-0.61474609375,
-0.151855468... | 44 |
Please summerize the given abstract to a title
Impact of SARS-CoV-2 pandemic on emergency department activity at the pediatric surgery unit of a third-level hospital
INTRODUCTION: As a result of the emergence of the SARS-CoV-2 respiratory virus in Wuhan in December 2019, the Spanish Government declared the state of emergency with restrictions such as stay-at-home lockdown The objective of this study was to analyze emergency activity at a referral pediatric surgery unit in its territory and determine whether surgical pathologies had decreased or not METHODS: A retrospective study of pediatric patients presenting at the emergency department and referred to the pediatric surgery unit from March 14, 2020 to April 20, 2020 was carried out The results were compared with those from the same dates of the previous year Demographic variables, pathologies, and management strategies were studied for each case The number of patients with abdominal pain requiring surgical assessment was also analyzed RESULTS: 161 patients were included - 91 from 2019 and 70 from 2020 Of the 2020 patients, 62 (88 6%) underwent surgery and 8 (11 4%) were admitted, whereas in 2019, patient distribution was 67 (73 6%) and 24 (26 4%), which means there were fewer admissions in 2020 (p=0 018) There were no differences in terms of hours to emergency department consultation - just an increase in the case of appendicular pathologies in the 2020 period, with 24 [23-48] hours vs 24 [12-30] hours (p = 0 045) CONCLUSION: The current pandemic has not caused emergency surgeries to decrease It has only increased time to consultation in patients with appendicular pathologies
| 85,349 | [
0.11431884765625,
0.71240234375,
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0.61474609375,
-0.305419921875,
-0.44873046875,
-0.443603515625,
0.321533203125,
0.400634765625,
0.70556640625,
0.54248046875,
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-0.67919921875,
-0.3369140625,
0.1551513671875,
-0.1279296875,
-0.4768066... | 44 |
Please summerize the given abstract to a title
Public Interest in Sports Medicine and Surgery (Anterior Cruciate Ligament, Meniscus, Rotator Cuff) Topics Declined Following the COVID-19 Outbreak
Purpose To quantify the coronavirus disease 2019 (COVID-19) pandemic’s impact on public interest in sports medicine and surgery topics. Methods The Google Trends analysis tool (Google Search Volume Indices (GSVI)) was utilized to collect search information regarding orthopaedic sports medicine terms (“ACL”), “meniscus”, “rotator cuff”), and sports surgery terms (“ACL surgery”, “meniscus surgery”, and “rotator cuff surgery”) from May 2015 to May 2020. A time series analysis was performed for these GSVI’s and compared to the timing of the pandemic. Results Interest in both sports medicine and surgery declined following the COVID-19 outbreak. Following the World Health Organization’s statement on COVID-19’s pandemic status on March 11, 2020, searches for “ACL”, “meniscus”, “rotator cuff” declined by 34.78%, 43.95%, and 31.37% and search for “ACL surgery”, “meniscus surgery”, and “rotator cuff surgery” declined by 42.70%, 51.88%, and 53.32%. Conclusion The COVID-19 outbreak correlated with a decline in public interest in sports medicine and sports surgery topics as measured by Google searches.
| 85,361 | [
0.00453948974609375,
0.2105712890625,
-0.4609375,
0.7275390625,
-0.5791015625,
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-0.337890625,
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0.64599609375,
0.7470703125,
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0.787109375,
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... | 44 |
Please summerize the given abstract to a title
The management of emergency spinal surgery during the COVID-19 pandemic in Italy: a preliminary report
AIMS: The current pandemic caused by COVID-19 is the biggest challenge for national health systems for a century. While most medical resources are allocated to treat COVID-19 patients, several non-COVID-19 medical emergencies still need to be treated, including vertebral fractures and spinal cord compression. The aim of this paper is to report the early experience and an organizational protocol for emergency spinal surgery currently being used in a large metropolitan area by an integrated team of orthopaedic surgeons and neurosurgeons. METHODS: An organizational model is presented based on case centralization in hub hospitals and early management of surgical cases to reduce hospital stay. Data from all the patients admitted for emergency spinal surgery from the beginning of the outbreak were prospectively collected and compared to data from patients admitted for the same reason in the same time span in the previous year, and treated by the same integrated team. RESULTS: A total of 19 patients (11 males and eight females, with a mean age of 49.9 years (14 to 83)) were admitted either for vertebral fracture or spinal cord compression in a 19-day period, compared to the ten admitted in the previous year. No COVID-19 patients were treated. The mean time between admission and surgery was 1.7 days, significantly lower than 6.8 days the previous year (p < 0.001). CONCLUSION: The structural organization and the management protocol we describe allowed us to reduce the time to surgery and ultimately hospital stay, thereby maximizing the already stretched medical resources available. We hope that our early experience can be of value to the medical communities that will soon be in the same emergency situation. Cite this article: Bone Joint J 2020;102-B(6):671–676.
| 85,411 | [
0.254150390625,
0.004489898681640625,
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0.8974609375,
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-0.427001953125,
-0.41015625,
0.319580078125,
0.56201171875,
0.94140625,
0.5810546875,
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-0.5986328125,
-0.420654296875,
0.6513671875,
-0.464599609375,
-0.5849609375,
... | 44 |
Please summerize the given abstract to a title
Implementation of Clean Hospital Strategy and Prioritizing Covid-19 Prevention Factors Using Best-Worst Method
Many nations have suffered the catastrophe of COVID-19, and one of the first countries affected by the pandemic was Iran; all industries and individuals have been adversely affected by the pandemic. Health care systems and patients' conditions, in particular, were disrupted due to canceling elective surgery. To put it more sharply, a delay in performing elective surgery may potentially impact patients' survival and the quality of their lives. To cope with the new situation, in the first stage, the Clean Hospital strategy was proposed in order to minimize the effects of this pandemic on elective surgical services. The mentioned strategy is a try to provide a solution and resume elective surgeries in the pandemic period. In the second stage, panel discussion, Delphi method, and the best-worst method (BWM) were employed to prioritize the factors that inhibit Coronavirus transmission. The proposed strategy and the results of this study could be used by policymakers and health departments to resume elective surgeries and control the infection to maintain a hospital or a section of it clear. The overall result of the study showed that the most important Covid-19 prevention factors in Clean Hospitals were personal protection (w = 0.212), screening checklist (w = 0.182), and check body temperature (w = 0.126), respectively (C1 > C2 > C3). According to the financial, time, and human resource limitations, first, resources were allocated to higher priority criteria, and in order of priority, all items (C1, C2, ., C9) were used in the Clean hospital strategy.
| 85,509 | [
-0.068603515625,
0.1416015625,
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0.7802734375,
-0.587890625,
-0.464599609375,
-0.05126953125,
0.328369140625,
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-0.97265625,
-0.02886962890625,
-0.415283203125,
-0.85742187... | 44 |
Please summerize the given abstract to a title
Starting the first robotic lobectomy program in the Eastern Europe during Coronavirus disease-2019 pandemic
BACKGROUND: We report our experience in starting RATS (robotic-assisted thoracic surgery) lobectomy program during COVID-19 pandemic. METHODS: Data from 20 consecutive cases undergoing RATS lobectomy between August 2020 and April 2021 were prospectively accumulated into our database. RESULTS: The mean operational time was 235±69 minutes (median 210, range 175 to 370). Conversion-to-open rate was 5 %. One patient was converted to an open procedure during surgery due to surgical bleeding. One patient (5 %), with sever chronic obstructive pulmonary disease (COPD), had prolonged air leak with chest drainage 11 days and conservative treatment. Morbidity rate was 10 % (2 patients). Estimated costs of RATS lobectomy in our department were $9,590 (range $8,250-$12,730). 30-days mortality was 0%. CONCLUSIONS: Safe robotic surgery is based not only on improved robotic equipment, but also on good technical skills and medical knowledge. It requires training of the entire operating room team. The learning curve is steep, involving port placement, use of the correct robotic arms, availability of the proper instrumentation, and proper patient positioning (Tab. 2, Ref. 28).
| 85,526 | [
0.6533203125,
0.210205078125,
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-0.336181640625,
-0.398193359375,
-0.338134765625,
0.302001953125,
0.477783203125,
0.1258544921875,
0.8779296875,
-0.439453125,
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-0.6357421875,
-0.455810546875,
0.642578125,
-0.116455078125,
-0.3918... | 44 |
Please summerize the given abstract to a title
Emergency surgery in COVID-19 outbreak: Has anything changed? Single center experience
BACKGROUND: The current coronavirus disease 19 (COVID-19) pandemic is changing the organization of health care and has had a direct impact on the management of surgical patients.At the General Surgery Department of Sant’Anna University Hospital in Ferrara, Italy, surgical activities were progressively reduced during the peak of the COVID-19 outbreak in Italy. During this period, only one operating room was available for elective cancer surgeries and another for emergency surgeries. Moreover, the number of beds for surgical patients had to be reduced to provide beds and personnel for the new COVID-19 wards. AIM: To compare 2 different period (from March 9 to April 9 2019 and from March 9 to April 9 2020), searching differences in terms of number and type of interventions in emergency surgery of a main University Hospital in Ferrara, a city in Emilia Romagna region, North of Italy. METHODS: This retrospective study was carried out at the General Surgery Department of Sant’Anna University Hospital in Ferrara, Italy. We examined the number of emergency surgeries performed and patient outcomes during the peak of the COVID-19 outbreak in Italy and subsequent total lockdown. We then drew a comparison with the number of surgeries performed and their outcomes during the same period in 2019. The study examined all adult patients who underwent emergency surgery from March 9 to April 9, 2019 (n = 46), and those who underwent surgery during the first month of the lockdown, from March 9 to April 9, 2020 (n = 27). Analyses were adjusted for age, gender, American Society of Anesthesiologists classification scores and types of surgery. RESULTS: A total of 27 patients underwent emergency surgery at Sant’Anna University Hospital in Ferrara during the first month of the lockdown. This represents a 41.3% reduction in the number of patients who were hospitalized and underwent emergency surgery compared to the same period in 2019. The complication rate during the pandemic period was substantially higher than it was during the analogous period in 2019: 15 out of 27 cases from March 9 to April 9, 2020 (55) vs 17 out of 46 cases from March 9 to April 9, 2019 (36.9). Of the 27 patients who underwent emergency surgery during the pandemic, 10 were screened for COVID-19 using both thorax high resolution computerized tomography and a naso-pharyngeal swab, while 9 only underwent thorax high resolution computerized tomography. Only 1 patient tested positive for SARS-CoV-2 and died following surgery. CONCLUSION: There was a significant reduction in emergency surgeries at our center during the COVID-19 pandemic, and it is plausible that there were analogous reductions at other centers across Italy.
| 85,702 | [
0.0288238525390625,
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0.1583251953125,
-0.56884765625,
-0.609375,
0... | 44 |
Please summerize the given abstract to a title
Impact of the Novel Coronavirus 2019 (COVID-19) Pandemic on Head and Neck Cancer Care
OBJECTIVE: The study aimed to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on head and neck oncologic care at a tertiary care facility. STUDY DESIGN: This was a cross-sectional study conducted between March 18, 2020, and May 20, 2020. The primary planned outcome was the rate of treatment modifications during the study period. Secondary outcome measures were tumor conference volume, operative volume, and outpatient patient procedure and clinic volumes. SETTING: This single-center study was conducted at a tertiary care academic hospital in a large metropolitan area. METHODS: The study included a consecutive sample of adult subjects who were presented at a head and neck interdepartmental tumor conference during the study period. Patients were compared to historical controls based on review of operative data, outpatient procedures, and clinic volumes. RESULTS: In total, 117 patients were presented during the review period in 2020, compared to 69 in 2019. There was an 8.4% treatment modification rate among cases presented at the tumor conference. There was a 61.3% (347 from 898) reduction in outpatient clinic visits and a 63.4% (84 from 230) reduction in procedural volume compared to the prior year. Similarly, the operative volume decreased by 27.0% (224 from 307) compared to the previous year. CONCLUSION: Restrictions related to the COVID-19 pandemic resulted in limited treatment modifications. Transition to virtual tumor board format observed an increase in case presentations. While there were reductions in operative volume, there was a larger proportion of surgical cases for malignancy, reflecting the prioritization of oncologic care during the pandemic.
| 85,854 | [
0.331298828125,
-0.2340087890625,
-0.57763671875,
0.568359375,
-0.374755859375,
-1.0751953125,
-0.223388671875,
0.424072265625,
0.62744140625,
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0.830078125,
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... | 44 |
Please summerize the given abstract to a title
EAES Recommendations for Recovery Plan in Minimally Invasive Surgery Amid COVID-19 Pandemic
BACKGROUND: COVID-19 pandemic presented an unexpected challenge for the surgical community in general and Minimally Invasive Surgery (MIS) specialists in particular. This document aims to summarize recent evidence and experts' opinion and formulate recommendations to guide the surgical community on how to best organize the recovery plan for surgical activity across different sub-specialities after the COVID-19 pandemic. METHODS: Recommendations were developed through a Delphi process for establishment of expert consensus. Domain topics were formulated and subsequently subdivided into questions pertinent to different surgical specialities following the COVID-19 crisis. Sixty-five experts from 24 countries, representing the entire EAES board, were invited. Fifty clinicians and six engineers accepted the invitation and drafted statements based on specific key questions. Anonymous voting on the statements was performed until consensus was achieved, defined by at least 70% agreement. RESULTS: A total of 92 consensus statements were formulated with regard to safe resumption of surgery across eight domains, addressing general surgery, upper GI, lower GI, bariatrics, endocrine, HPB, abdominal wall and technology/research. The statements addressed elective and emergency services across all subspecialties with specific attention to the role of MIS during the recovery plan. Eighty-four of the statements were approved during the first round of Delphi voting (91.3%) and another 8 during the following round after substantial modification, resulting in a 100% consensus. CONCLUSION: The recommendations formulated by the EAES board establish a framework for resumption of surgery following COVID-19 pandemic with particular focus on the role of MIS across surgical specialities. The statements have the potential for wide application in the clinical setting, education activities and research work across different healthcare systems.
| 85,981 | [
0.26953125,
-0.110595703125,
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0.54345703125,
-0.82470703125,
-0.429931640625,
-0.267333984375,
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0.24951171875,
0.826171875,
0.4384765625,
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-0.5107421875,
-0.78857421875,
0.407470703125,
-0.323486328125,
-0.86572265625... | 44 |
Please summerize the given abstract to a title
Assessing the Early Impact of the COVID-19 Pandemic on Spine Surgery Fellowship Education
This was a cross-sectional study. OBJECTIVE: The objective of this study is to report the impact of COVID-19 on spine surgery fellow education and readiness for practice. SUMMARY OF BACKGROUND DATA: COVID-19 has emerged as one of the most devastating global health crises of our time. To minimize transmission risk and to ensure availability of health resources, many hospitals have cancelled elective surgeries. There may be unintended consequences of this decision on the education and preparedness of current surgical trainees. MATERIALS AND METHODS: A multidimensional survey was created and distributed to all current AO Spine fellows and fellowship directors across the United States and Canada. RESULTS: Forty-five spine surgery fellows and 25 fellowship directors completed the survey. 62.2% of fellows reported >50% decrease in overall case volume since cancellation of elective surgeries. Mean hours worked per week decreased by 56.2%. Fellows reported completing a mean of 188.4±64.8 cases before the COVID-19 crisis and 84.1% expect at least an 11%–25% reduction in case volume compared with previous spine fellows. In all, 95.5% of fellows did not expect COVID-19 to impact their ability to complete fellowship. Only 2 directors were concerned about their fellows successfully completing fellowship; however, 32% of directors reported hearing concerns regarding preparedness from their fellows and 25% of fellows were concerned about job opportunities. CONCLUSIONS: COVID-19 has universally impacted work hours and case volume for spine surgery fellows set to complete fellowship in the middle of 2020. Nevertheless, spine surgery fellows generally feel ready to enter practice and are supported by the confidence of their fellowship directors. The survey highlights a number of opportunities for improvement and innovation in the future training of spine surgeons. LEVEL OF EVIDENCE: Level III.
| 86,138 | [
0.51513671875,
0.17919921875,
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0.6396484375,
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0.6279296875,
0.51318359375,
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0.493408203125,
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-0.267333984375,
0.529296875,
-0.202392578125,
-0.1859130859375,
-... | 44 |
Please summerize the given abstract to a title
Year 2020 in review – Anaesthesiology in obstetrics
The article highlights and discusses several current topics that have been published in the field of anaesthesiology in obstetrics in the Czech Republic and abroad last year It summarizes the influence of COVID-19 pandemic on anaesthesiological praxis in obstetrics It also presents new developments in systemic and neuroaxial obstetric analgesia, Caesarean Section anaesthesia and emergencies in peripartum period
| 86,218 | [
0.386962890625,
0.07501220703125,
-0.3544921875,
0.53564453125,
-0.353271484375,
-0.421630859375,
0.1943359375,
0.3681640625,
0.320556640625,
0.72265625,
0.818359375,
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-0.59375,
-0.251953125,
0.6533203125,
-0.168701171875,
-0.705078125,
-0.27246093... | 44 |
Please summerize the given abstract to a title
Percutaneous Cholecystostomy for Acute Cholecystitis: A Three-Year Single-Centre Experience Including During COVID-19
Introduction Percutaneous cholecystostomy is a recognised treatment modality for acute cholecystitis. Traditionally, its use was reserved for patients deemed unfit for surgery. However, the coronavirus disease 2019 (COVID-19) pandemic had a detrimental effect on both elective and emergency surgery. The utilisation of cholecystostomy thus increased. Unanswered questions remain over timing with respect to interval cholecystectomy. We evaluated our local practice over the preceding three years. Methods A retrospective analysis was performed of all patients who had a percutaneous cholecystostomy inserted over a three-year period (1 January 2018-1 January 2021). The primary outcome was time to cholecystectomy. Secondary outcomes were cholecystostomy-related complications, 30-day mortality, cholecystectomy-related complications and length of postoperative hospital stay. Results A total of 31 patients were identified during the period. Thirteen (42%) patients went on to have a laparoscopic cholecystectomy. The median time interval from cholecystostomy to cholecystectomy was 97 days (interquartile range [IQR]: 81-140, minimum: 47 and maximum: 791). One case was complicated by small bowel perforation; this occurred after an interval of 106 days. The median length of postoperative stay was one day (IQR: 1-1, minimum: 0 and maximum: 4). Cholecystostomy-related complications were observed in four (13%) patients, whereby three became displaced and one developed blockage. Thirty-day mortality following cholecystostomy insertion was zero. Conclusions Percutaneous cholecystostomy is a safe and effective intervention for the management of acute cholecystitis. Interval cholecystectomy should be carefully considered; it may be safer to perform prior to 90 days.
| 86,406 | [
0.002307891845703125,
0.1650390625,
-0.52001953125,
0.84033203125,
-1.103515625,
-0.34814453125,
-0.294677734375,
0.267578125,
0.52880859375,
0.5517578125,
0.330078125,
-0.59326171875,
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-0.994140625,
-0.6611328125,
0.5146484375,
-0.44873046875,
-0.6806640625,
-0.4... | 44 |
Please summerize the given abstract to a title
Patient and Resource Management of Emergency Walk-In Clinic During a COVID-19 Pandemic State Lockdown
OBJECTIVE: To gather data on the most common chief complaints, diagnoses, in-office procedures, and surgeries that presented to the Kresge Eye Institute’s Emergency Clinic in Detroit, Michigan during the COVID-19 state lockdown period to provide data for staff and resource allocation in future waves. DESIGN: Retrospective study. PARTICIPANTS: All patients 18 years or older presenting for ophthalmic consultation to the Kresge Eye Institute Emergency Walk-in Clinic between March 23rd and April 17th, 2020 were included in the study. METHODS: All patients who met the inclusion criteria were indexed based on their initial encounter date and patients were stratified by urgent and non-urgent ophthalmic reasons for evaluation. Patient demographics, medical history, chief complaint, diagnosis, and need for surgical intervention and procedures were obtained from the electronic medical records. RESULTS: The most common diagnoses were corneal disease (31.4%), followed by vitreoretinal disease (25.3%), orbit-eyelid pathology (8.8%), and glaucoma-related issues (8.8%). The most common office procedure was intravitreal injections (37.5%) followed by foreign body removal (21.9%), and pan-retinal photocoagulation laser (21.9%). Retina surgery was the most common emergency surgery representing 73.3% of the total, the second most common was keratoplasty (13%). CONCLUSION: Future implementation of protocols for triaging based on chief complaints can aid in protecting patients and expanding the role of distanced assessment with telemedicine. Suggested management of an emergent clinic requires availability of retina and cornea specialists given the majority of visits, procedures, and surgeries were related to their area of expertise.
| 86,408 | [
0.081298828125,
0.10943603515625,
-0.62255859375,
0.376708984375,
-0.78515625,
-0.6298828125,
-0.505859375,
0.1956787109375,
0.24365234375,
0.85986328125,
0.64501953125,
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0.060394287109375,
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0.74365234375,
-0.64501953125,
-0.52783203125,
0.... | 44 |
Please summerize the given abstract to a title
Orthopaedic trauma during COVID-19: Is patient care compromised during a pandemic?()
BACKGROUND: The Coronavirus disease-2019 (COVID-19) placed unprecedented pressure on the healthcare system. Many institutions implemented a government-mandated restructured set of safety and administrative protocols to treat urgent orthopaedic trauma patients. The objective of this study was to compare two cohorts of patients, a COVID group and non-COVID control group, and to evaluate the effectiveness of safety measures outlined in the Rutgers Orthopaedic Trauma Patient Safety Protocol (ROTPSP). Secondary outcomes were to elucidate risk factors for complications associated with fractures and COVID-19. METHODS: Patients treated for orthopaedic traumatic injuries were retrospectively identified between March and May 2020, and compared to a series of patients from the same time period in 2018. Main outcome measures included surgical site infections (SSI), length of stay (LOS), post-operative LOS (poLOS), presentation to OR time (PORT), and length of surgery. RESULTS: After review, 349 patients (201 non-COVID, 148 COVID) undergoing 426 surgeries were included. Average LOS (11.91 days vs. 9.27 days, p = 0.04), poLOS (9.68 days vs. 7.39 days, p = 0.03), and PORT (30.56 vs. 25.59 h, p < 0.01) was significantly shorter in the COVID cohort. There were less SSI in the COVID group (5) compared to the non-COVID group (14) (p = 0.03). Overall complications were significantly lower in the COVID group. Patients receiving Cepheid tests had significantly shorter LOS and poLOS compared to patients receiving the RNA and DiaSorin tests (p < 0.01 and p < 0.01, respectively). The Cepheid test carried the best benefit-to-cost ratio, 0.10, p < 0.05. CONCLUSION: The restructuring of care protocols caused by COVID-19 did not negatively impact perioperative complication rates, PORT or LOS. Cepheid COVID test type administered upon admission plays an integral role in a patient's hospital course by reducing both length of stay and hospital costs. This information demonstrates we can continue to treat orthopaedic trauma patients safely during the COVID-19 pandemic by utilizing strict safety protocols.
| 86,412 | [
0.2044677734375,
-0.1456298828125,
-0.353271484375,
1.03515625,
-0.87890625,
-0.477783203125,
-0.490478515625,
0.31494140625,
0.493896484375,
0.66357421875,
0.246337890625,
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0.09918212890625,
-0.71875,
-0.375,
0.5361328125,
-0.17578125,
-0.32421875,
-0.091796875,
... | 44 |
Please summerize the given abstract to a title
Characteristics and operation outcomes of neuro-oncology patients after COVID-19 pandemic — A case series
BACKGROUND: COVID-19 has been spreading worldwide at hitherto unknown speed, and the treatment of neuro-oncology patients without COVID-19 has been greatly affected. METHODS: To compare the medical records and surgical results of surgical patients before and after the pandemic. We collected a total of 80 patients form April 2020 to May 2020 after pandemic and from April 2019 to May 2019 before pandemic. The patient's demographics, past medical history, comorbidities, imaging, pathology, laboratory teat, and Karnofsky Performance Score (KPS) were analyzed. RESULTS: The most common presenting symptom was intracranial hypertension and neurological deficit. Hypertension and diabetes were the most common comorbid diseases. The pre-operation KPS were 83.21 ± 15.60, 80 ± 14.77, 78.57 ± 12.83 and 74.14 ± 12.72, respectively. The post-operation KPS were 94.64 ± 8.65, 95.45 ± 6.56, 91.43 ± 10.82 and 84.21 ± 22.55, respectively. The tumor volume was larger and the midline shift distance was greater after the pandemic than before. For pathological grade, meningiomas were mostly grade I, while gliomas were mainly grade III and IV. CONCLUSION: Although affected by the COVID-19 pandemic, patients with glioma should be operated as soon as possible to obtain better surgical results, however, for patients with meningiomas, their operation can be postponed slightly when the patients are tolerable.
| 86,551 | [
0.39599609375,
0.0921630859375,
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0.8271484375,
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0.53564453125,
0.446533203125,
0.35009765625,
0.66455078125,
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0.53173828125,
-0.68115234375,
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... | 44 |
Please summerize the given abstract to a title
A systematic review and meta-analysis of surgery delays and survival in breast, lung and colon cancers: Implication for surgical triage during the COVID-19 pandemic
BACKGROUND: Thousands of cancer surgeries were delayed during the peak of the COVID-19 pandemic. This study examines if surgical delays impact survival for breast, lung and colon cancers. METHODS: PubMed/MEDLINE, EMBASE, Cochrane Library and Web of Science were searched. Articles evaluating the relationship between delays in surgery and overall survival (OS), disease-free survival (DFS) or cancer-specific survival (CSS) were included. RESULTS: Of the 14,422 articles screened, 25 were included in the review and 18 (totaling 2,533,355 patients) were pooled for meta-analyses. Delaying surgery for 12 weeks may decrease OS in breast (HR 1.46, 95%CI 1.28–1.65), lung (HR 1.04, 95%CI 1.02–1.06) and colon (HR 1.24, 95%CI 1.12–1.38) cancers. When breast cancers were analyzed by stage, OS was decreased in stages I (HR 1.27, 95%CI 1.16–1.40) and II (HR 1.13, 95%CI 1.02–1.24) but not in stage III (HR 1.20, 95%CI 0.94–1.53). CONCLUSION: Delaying breast, lung and colon cancer surgeries during the COVID-19 pandemic may decrease survival.
| 86,757 | [
0.53369140625,
0.05914306640625,
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0.072265625,
-0.09295654296875,
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-0.1231689453125,
0.7421875,
0.830078125,
1.0107421875,
0.9541015625,
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0.314697265625,
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0.1134033203125,
0.2734375,
-0.038604736328125,
-0.70458984375,
-0.... | 44 |
Please summerize the given abstract to a title
Impact of the COVID-19 Pandemic on Surgical Oncology in Europe: Results of a European Survey
BACKGROUND: The first COVID-19 pandemic wave hit most of the health-care systems worldwide. The present survey aimed to provide a European overview on the COVID-19 impact on surgical oncology. METHODS: This anonymous online survey was accessible from April 24 to May 11, 2020, for surgeons (n = 298) who were contacted by the surgical society European Digestive Surgery. The survey was completed by 88 surgeons (29.2%) from 69 different departments. The responses per department were evaluated. RESULTS: Of the departments, 88.4% (n = 61/69) reported a lower volume of patients in the outpatient clinic; 69.1% (n = 47/68) and 75.0% (n = 51/68) reported a reduction in hospital bed and the operating room capacity, respectively. As a result, the participants reported an average reduction of 29.3% for all types of oncological resections surveyed in this questionnaire. The strongest reduction was observed for oncological resections of hepato-pancreatico-biliary (HPB) cancers. Of the interviewed surgeons, 68.7% (n = 46/67) agreed that survival outcomes will be negatively impacted by the pandemic. CONCLUSION: The first COVID-19 pandemic wave had a significant impact on surgical oncology in Europe. The surveyed surgeons expect an increase in the number of unresectable cancers as well as poorer survival outcomes due to cancellations of follow-ups and postponements of surgeries.
| 86,783 | [
0.630859375,
-0.19482421875,
-0.9814453125,
0.347412109375,
-0.40185546875,
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0.568359375,
0.6103515625,
0.322509765625,
0.53271484375,
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0.1180419921875,
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0.27685546875,
-0.363037109375,
-0.56591796875,
-0... | 44 |
Please summerize the given abstract to a title
Impact of COVID-19 Pandemic on Orthopedics and Traumatology Service
Medical records, including in-patient hospitalizations, outpatient clinic attendances, surgical operations performed, and accident and emergency department attendances, were retrieved from the territory-wide clinical data repository. Of the patients who presented at ED with orthopaedic complaints in Period 1, 892 were male, and 782 were female, with an average age of 43 years, and of these, 256 patients were hospitalized in DISCUSSION The results of this comparative study showed a significant increase in the number of patients who presented at ED in Period 2 compared to Period 1, which could be attributed to the difficulties experienced by patients in reaching outpatient clinics during the pandemic. At this stage, primary healthcare centers have a greater duty, as at such times, this intensity can be eliminated by directing non-emergency patients to primary health care facilities or outpatient clinics with triage established outside the ED. According to a study conducted in Turkey, domestic violence has been shown to increase by 27.8% during the pandemic8.
| 87,038 | [
-0.045379638671875,
-0.018341064453125,
-0.5126953125,
0.845703125,
-0.6923828125,
-0.68701171875,
-0.476318359375,
0.7646484375,
0.63037109375,
0.52197265625,
0.447265625,
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-0.311279296875,
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0.37939453125,
-0.480224609375,
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... | 44 |
Please summerize the given abstract to a title
Management and early outcomes of children with appendicitis in the UK and Ireland during the COVID-19 pandemic: a survey of surgeons and observational study
OBJECTIVES: Acute appendicitis is the most common surgical condition in children. In the UK, appendicectomy is the most common treatment with non-operative management unusual. Due to concerns about the risk of SARS-CoV-2 transmission during surgical procedures, surgeons were advised to consider non-operative treatment and avoid laparoscopy where possible. This study aims to report management and outcomes, to date, of children with appendicitis in the UK and Ireland during the COVID-19 pandemic. DESIGN: Survey of consultant surgeons who treat children with appendicitis that informed a prospective multicentre observational cohort study. SETTING: Data were collected from centres in the UK and Ireland for cases admitted between 1 April and 31 May 2020 (first 2 months of the COVID-19 pandemic) at both general surgical and specialist paediatric surgical centres. PARTICIPANTS: The study cohort includes 838 children with a clinical and/or radiological diagnosis of acute appendicitis of which 527 (63%) were male. MAIN OUTCOMES MEASURED: Primary outcome was treatment strategy used for acute appendicitis. Other outcomes reported include change in treatment strategy over time, use of diagnostic imaging and important patient outcomes to 30 days following hospital admission. RESULTS: From very early in the pandemic surgeons experienced a change in their management of children with appendicitis and almost all surgeons who responded to the survey anticipated further changes during the pandemic. Overall, 326/838 (39%) were initially treated non-operatively of whom 81/326 (25%) proceeded to appendicectomy within the initial hospital admission. Of cases treated initially surgically 243/512 (48%) were performed laparoscopically. Diagnostic imaging was used in 445/838 (53%) children. Cases treated non-operatively had a shorter hospital stay than those treated surgically but hospital readmissions within 30 days were similar between groups. In cases treated surgically the negative appendicectomy rate was 4.5%. There was a trend towards increased use of surgical treatment and from open to laparoscopic appendicectomy as the pandemic progressed. CONCLUSION: Non-operative treatment of appendicitis has been widely used for the first time in children in the UK and Ireland and is safe and effective in selected patients. Overall patient outcomes do not appear to have been adversely impacted by change in management during the pandemic thus far.
| 87,147 | [
0.10943603515625,
0.160888671875,
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0.56005859375,
-0.57080078125,
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0.439453125,
0.412841796875,
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0.3662109375,
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0.377197265625,
-0.5,
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... | 44 |
Please summerize the given abstract to a title
Recommendations to Safeguard Reconstructive Microsurgeons Performing High-risk Operations during the COVID-19 Pandemic
An unprecedented number of health care providers have been infected and many have died during the COVID-19 pandemic. Reconstructive microsurgeons from different surgical backgrounds often are involved in the care of known COVID-19 and high-risk patients. The need for a magnification loupe/microscope makes it difficult for them to wear recommended personal protection equipment, increasing the risk of exposure. Although advanced technologies are available, they have not been exploited effectively. To date, no safety guidelines are available for safe reconstructive microsurgical procedures in high-risk operations/known COVID-19 patients—particularly, to address operations risk and COVID-19 status of the patients, who would operate, how many should be involved, how to equip the surgeons for the procedure, when to operate as the procedure unfolds, how to adapt surgical techniques to reduce exposure risk, and can advanced technology be used to minimize exposure. A set of safety recommendations were thus developed based on literature review and firsthand knowledge of safety procedures during the COVID-19 pandemic. Current understanding of COVID-19 virology can optimize surgical team buildup and dynamics. Operating smaller teams (in a sequential style), minimizing the use of aerosols-generating devices, and modifying surgical plan and flap selection could aid in diminishing the risk of exposure and in conserving resources. Modifications in loupes design, and the combined wear of surgical mask and N95 respirators, and efficient use of “buddy system” could aid in protecting surgeons during donning and doffing. “Remote operating” is a novel concept of using a surgical robot to maximize surgeons’ safety during COVID-19 pandemic.
| 87,377 | [
0.427490234375,
-0.10931396484375,
-0.44677734375,
0.7646484375,
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-0.4140625,
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0.330322265625,
0.533203125,
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-0.53369140625,
0.38623046875,
-0.442626953125,
-0.77734375,
-... | 44 |
Please summerize the given abstract to a title
Impact of the COVID-19 pandemic on emergency and elective hip surgeries in Norway
Background and purpose - Many countries implemented strict lockdown policies to control the COVID-19 pandemic during March 2020. The impacts of lockdown policies on joint surgeries are unknown. Therefore, we assessed the effects of COVID-19 pandemic lockdown restrictions on the number of emergency and elective hip joint surgeries, and explored whether these procedures are more/less affected by lockdown restrictions than other hospital care.Patients and methods - In 1,344,355 persons aged ≥ 35 years in the Norwegian emergency preparedness (BEREDT C19) register, we studied the daily number of persons having (1) emergency surgeries due to hip fractures, and (2) electively planned surgeries due to hip osteoarthritis before and after COVID-19 lockdown restrictions were implemented nationally on March 13, 2020, for different age and sex groups. Incidence rate ratios (IRR) reflect the after-lockdown number of surgeries divided by the before-lockdown number of surgeries.Results - After-lockdown elective hip surgeries comprised one-third the number of before-lockdown (IRR â¼0.3), which is a greater drop than that seen in all-cause elective hospital care (IRR â¼0.6). Men aged 35-69 had half the number of emergency hip fracture surgeries (IRR â¼0.6), whereas women aged ≥ 70 had the same number of emergency hip fracture surgeries after lockdown (IRR â¼1). Only women aged 35-69 and men aged ≥ 70 had emergency hip fracture surgery rates after lockdown comparable to what may be expected based on analyses of all-cause acute care (IRR â¼0.80)Interpretation - It is important to note for future pandemics management that lockdown restrictions may impact more on scheduled joint surgery than other scheduled hospital care. Lockdown may also impact the number of emergency joint surgeries for men aged ≥ 35 but not those for women aged ≥ 70.
| 87,402 | [
0.1688232421875,
0.339111328125,
-0.7333984375,
0.63671875,
-1.0419921875,
-0.483154296875,
-0.08270263671875,
0.81982421875,
0.291259765625,
0.8623046875,
0.7470703125,
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-0.83154296875,
-0.294921875,
0.54248046875,
-0.376220703125,
-0.603515625,
0.36... | 44 |
Please summerize the given abstract to a title
International surgical guidance for COVID-19: Validation using an international Delphi process - Cross-sectional study
BACKGROUND: International professional bodies have been quick to disseminate initial guidance documents during the COVID-19 pandemic. In the absence of firm evidence, these have been developed by expert committees, limited in participant number. This study aimed to validate international COVID-19 surgical guidance using a rapid Delphi consensus exercise. METHODS: Delphi statements were directly mapped to guidance from surgical professional bodies in the US and Europe (SAGES/EAES), the UK (Joint RCS), and Australasia (RACS), to validate content against international consensus. Agreement from ≥70% participants was determined as consensus agreement. RESULTS: The Delphi exercise was completed by 339 individuals from 41 countries and 52 statements were mapped to the guidance, 47 (90.4%) reaching consensus agreement. Of these, 27 statements were mapped to SAGES/EAES guidance, 21 to the Joint RCS document, and 33 to the RACS document. Within the SAGES/EAES document, 92.9% of items reached consensus agreement (median 89.0%, range 60.5-99.2%), 90.4% within the Joint RCS document (87.6%, 63.4-97.9%), and 90.9% within the RACS document (85.5%, 18.7-98.8%). Statements lacking consensus related to the surgical approach (open vs. laparoscopic), dual consultant operating, separate instrument decontamination, and stoma formation rather than anastomosis. CONCLUSION: Initial surgical COVID-19 guidance from the US, Europe and Australasia was widely supported by an international expert community, although a small number of contentious areas emerged. These findings should be addressed in future guidance iterations, and should stimulate urgent investigation of non-consensus areas.
| 87,871 | [
0.08453369140625,
0.10137939453125,
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-0.76025390625,
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0.12353515625,
-0.111083984375,
... | 44 |
Please summerize the given abstract to a title
CSF rhinorrhoea after endonasal intervention to the skull base (CRANIAL).: Part 2: Impact of COVID-19
BACKGROUND: During the pandemic, there has been a concern about the increased risk of perioperative mortality for patients with COVID-19, and the transmission risk to healthcare workers, particularly during endonasal neurosurgical operations. The Pituitary Society produced recommendations to guide management during this era. We sought to assess contemporary neurosurgical practice and the impact of COVID-19. METHODS: A multicentre, prospective, observational cohort study was conducted at twelve tertiary neurosurgical units (UK and Ireland). Data were collected from March 23rd-July 31st, 2020 inclusive. Data points collected were patient demographics, pre-operative COVID-19 testing, intra-operative operative modifications, and 30-day COVID infection rates. RESULTS: 124 patients were included. 116 patients (n=116/124, 94%) underwent COVID-19 testing pre-operatively (TSA: 97/105, 92%; EEA: 19/19, 100%). One patient (n=1/115, 1%) tested positively for COVID-19 pre-operatively, requiring a delay of operation until the infection was confirmed as resolved. Asides from transient diabetes insipidus; no other complications were reported for this case. All theatre staff wore at least level 2 PPE. Adaptations to surgical techniques included minimising drilling, draping modifications, and using nasal iodine wash. At 30 days postoperatively, there was no evidence of COVID infection (symptoms or on formal testing) in our cohort, and no mortality. CONCLUSIONS: Preoperative screening protocols and operative modifications have facilitated endonasal neurosurgery during the COVID-19 pandemic, with Pituitary Society guidelines followed for the majority of these operations. There was no evidence of COVID infection in our cohort, and no mortality, supporting the use of risk mitigation strategies to continue endonasal neurosurgery in subsequent pandemic waves.
| 89,386 | [
0.31591796875,
0.1470947265625,
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0.414306640625,
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0.3935546875,
0.5712890625,
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-0.54833984375,
0.31103515625,
-0.45068359375,
-0.37841796875,
-0.2... | 44 |
Please summerize the given abstract to a title
The Impact of the COVID-19 Pandemic on an Israeli Acute Care Surgery Unit: Fewer Patients, More Disease
BACKGROUND: The COVID-19 pandemic has transformed and affected every aspect of health care. Like any catastrophic event, the stress on hospitals to maintain a certain level of function is immense. Acute surgical pathologies cannot be prevented or curtailed; therefore, it is important to understand patterns and outcomes during catastrophes in order to optimize care and organize the health care system. METHODS: In a single urban tertiary care center, a retrospective study examined the first complete lockdown period of Israel during the COVID-19 pandemic. This was compared to the same time period the previous year. RESULTS: During the pandemic, time to hospitalization was significantly decreased. There was also an overall reduction in surgical admissions yet with a higher percentage being hospitalized for further treatment (69.2% vs 23.5%). The patients admitted during this time had a higher APACHE-II score and Charlson comorbidity index score. During the pandemic, time to surgery was decreased, there were less laparoscopic procedures, and more RBC units were used per patient. There were no differences in overall complications, except when sub-analyzed for major complications (9.7% vs 6.3%). There was no significant difference in overall in-house mortality or morbidity. Length of hospitalization was significantly decreased in the elderly population during the pandemic. CONCLUSION: During the COVID-19 pandemic, despite a significantly less number of patients presenting to the hospital, there was a higher percentage of those admitted needing surgical intervention, and they were overall sicker than the previous year.
| 89,420 | [
0.56298828125,
0.337646484375,
-0.623046875,
0.72705078125,
-0.434814453125,
-0.35693359375,
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0.224853515625,
0.5712890625,
0.414794921875,
0.7451171875,
-0.6357421875,
-0.232666015625,
-0.671875,
-0.56591796875,
0.392578125,
-0.3603515625,
-0.48681640625,
-0.3610839... | 44 |
Please summerize the given abstract to a title
Laparoscopic Appendectomy in the Days of COVID-19
BACKGROUND: Acute appendicitis is one of the most common emergencies treated by general surgeons. The treatment of choice in the majority of cases is laparoscopic appendectomy. In the era of the COVID-19 pandemic, there is a concern for a delayed referral of patients and thus a more advanced presentation of the disease leading to a prolonged and complicated course. METHODS: Retrospective review of a computerized database of patients who were admitted with acute appendicitis and underwent laparoscopic appendectomy during the COVID pandemic in a single tertiary center in Israel. Patients were compared with those who were admitted and operated for appendicitis in the same period in the previous year. RESULTS: One hundred twenty-three patients underwent laparoscopic appendectomy in the study period in 2020, compared with 109 who had surgery in 2019. During the COVID pandemic 41 patients presented with complicated appendicitis versus 22 patients in 2019 (P=0.0174). The placement of peritoneal drains was more prevalent during the pandemic, 5.5% versus 11.4%, and the use of stapler device for appendicular stump closure (P=0.0105). CONCLUSIONS: During the first stage of the COVID-19 pandemic, there was a significant increase in the rate of complicated appendicitis. Patients should be strongly encouraged not to refrain from medical treatment and go to the emergency room with the persistence of symptoms.
| 89,480 | [
0.410888671875,
0.129150390625,
-0.466064453125,
0.6962890625,
-0.7001953125,
-0.349609375,
-0.322265625,
0.421142578125,
0.763671875,
0.2408447265625,
0.7880859375,
-0.9365234375,
-0.261474609375,
-0.6044921875,
-0.80615234375,
0.321533203125,
-0.47509765625,
-1.189453125,
-0.51... | 44 |
Please summerize the given abstract to a title
Transcatheter aortic valve implantation versus surgical aortic valve replacement during the COVID-19 pandemic-Current practice and concerns.
COVID-19 has had a dramatic impact on the provision of healthcare. COVID-19 can manifest with cardiac and thrombotic presentations. Additionally, patients with cardiovascular comorbidities are at an increased risk of adverse outcomes related to COVID-19 infection. This in turn has led to a significant reduction in the provision of cardiac surgery with alternative management options utilized to address patients with significant disease. In terms of aortic valve disease, transcatheter aortic valve implantation (TAVI) provides advantages over surgical aortic valve replacement in with a lower burden on healthcare resources. COVID-19 also resulted in changes in management strategies and as such TAVI is now being considered in younger- and low-risk patients. However, long term data with regard to TAVI is still unknown, and the use in patient groups that have been excluded in the large pivotal studies that established TAVI as an alternative to surgery has raised specific concerns in the use of TAVI as the preferred treatment choice. With the long term ramification unknown, it is essential that decisions are made with caution.
| 89,495 | [
0.407958984375,
0.04864501953125,
-0.363037109375,
0.69482421875,
-0.96875,
-0.48486328125,
-0.25830078125,
0.43408203125,
0.397216796875,
0.1673583984375,
0.529296875,
-0.41259765625,
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-0.7802734375,
-0.5908203125,
0.434326171875,
-0.48583984375,
-0.7236328125,
... | 44 |
Please summerize the given abstract to a title
Resumption of Elective Surgery Following COVID-19 Outbreak, Guideline for Female Pelvic Medicine and Surgery
Division of Female Pelvic Medicine and Surgery, Department of Obstetrics and Gynecology, Emam Khomeini Hospital, Tehran University of medical sciences proposed a clinically relevant algorithm to guide appropriate decision making based on underlying risk stratification and resource utilization in order to resume elective surgeries, following COVID-19 pandemic crisis. The consequence of standardized decision-making factors and transparency of the principles will provide more assurance, consistency, and reliability on both sides, care providers and the patient. It also will decrease ethical dilemmas and moral criticism for surgeons. Eventually, this approach is applicable in any other disaster preparedness as a logical stratification of surgical indications for the female pelvic floor surgical procedures.
| 89,513 | [
0.27783203125,
-0.2313232421875,
-0.48193359375,
0.59228515625,
-0.79638671875,
-0.293212890625,
-0.7138671875,
0.4775390625,
-0.002216339111328125,
0.472900390625,
0.85302734375,
-0.8408203125,
-0.476318359375,
-0.74951171875,
-0.78466796875,
0.50634765625,
-0.5947265625,
-0.90771... | 44 |
Please summerize the given abstract to a title
Surgical Prioritization: The Northwell Neurosurgical Prioritization Initiative
INTRODUCTION: Beginning in March, 2020, hospitals across the majority of the United States were required to cancel all elective surgery in preparation for a surge of patients with the coronavirus disease of 2019 (COVID-19). A large number of neurosurgical patients with less than emergency conditions had their surgery postponed indefinitely. METHODS: The Delphi method was used to obtain consensus. Twenty-two neurosurgeons actively practicing in two separate geographic regions of the United States where “black level” COVID-19 surges occurred (New York Metropolitan Area and Detroit, Michigan) participated. A total of 86 neurosurgical case scenarios were categorized into six tiers of priority: emergent or within 24 hours, within 48 hours, within 1 week, within 2 weeks, within one month, or post hospital crisis/more than 4 weeks. Consensus was defined as 75% of participants reaching an agreement. Majority opinion (>50% agreement) was also reported. RESULTS: 67 of the 86 surgical scenarios (78%) reached a consensus agreement with 85 out of 86 scenarios reaching at least a majority opinion. Only one scenario (central cord syndrome) did not reach any agreement. CONCLUSION: The NNPI developed in this study can assist neurosurgical departments in prioritizing the timing of surgery, whether it be due to a pandemic, or any other scenario where the normal work flow has been severely disrupted and resources are limited.
| 89,553 | [
0.08355712890625,
0.185302734375,
-0.80029296875,
0.67626953125,
-0.83837890625,
-0.5546875,
-0.1529541015625,
0.1058349609375,
0.3828125,
0.87451171875,
0.5966796875,
-0.50439453125,
-0.0299224853515625,
-0.54296875,
-0.51171875,
0.5966796875,
-0.64208984375,
-0.83349609375,
-0.... | 44 |
Please summerize the given abstract to a title
The impact of SARS-CoV-2 (COVID-19) pandemic on trauma bay management and guideline adherence in a European level-one-trauma centre
PURPOSE: SARS CoV-2 (COVID-19) represents a pandemic that has led to adjustments of routine clinical practices. The initial management in the trauma bay follows detailed international valid algorithms. This study aims to work out potential adjustments of trauma bay algorithms during a global pandemic in order to reduce contamination and to increase safety for patients and medical personnel. METHODS: This retrospective cohort study compared patients admitted to the trauma bay of one academic level-one trauma centre in March and April 2019 with patients admitted in March and April 2020. Based on these datasets, possible adjustments of the current international guidelines of trauma bay management were discussed. RESULTS: Group Pan (2020, n = 30) included two-thirds the number of patients compared with Group Ref (2019, n = 44). The number of severely injured patients comparable amongst these groups: mean injury severity score (ISS) was significantly lower in Group Pan (10.5 ± 4.4 points) compared with Group Ref (15.3 ± 9.2 points, p = 0.035). Duration from admission to whole-body CT was significantly higher in Group Pan (23.8 ± 9.4 min) compared with Group Ref (17.3 ± 10.7 min, p = 0.046). Number of trauma bay admissions decreased, as did the injury severity for patients admitted in March and April 2020. In order to contain spreading of SARS Cov-2, the suggested recommendations of adjusting trauma bay protocols for severely injured patients include (1) minimizing trauma bay team members with direct contact to the patient; (2) reducing repeated examination as much as possible, with rationalized use of protective equipment; and (3) preventing potential secondary inflammatory insults. CONCLUSION: Appropriate adjustments of trauma bay protocols during pandemics should improve safety for both patients and medical personnel while guaranteeing the optimal treatment quality. The above-mentioned proposals have the potential to improve safety during trauma bay management in a time of a global pandemic.
| 89,603 | [
0.48046875,
0.44287109375,
-0.16162109375,
0.544921875,
-0.888671875,
-0.4599609375,
-0.56982421875,
0.2054443359375,
0.336181640625,
0.59228515625,
0.2088623046875,
-0.556640625,
-0.196533203125,
-0.302734375,
-0.461181640625,
0.256103515625,
-0.27978515625,
-0.25390625,
-0.2174... | 44 |
Please summerize the given abstract to a title
Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multi-Center Study
Abstract: Objective Quantitative documentation of the effects of outbreaks, including the COVID-19 pandemic, is limited in the field of neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality. Methods A multicenter case-control study was conducted, involving patients who underwent neurosurgical intervention in the Kingdom of Saudi Arabia during two periods: pre-COVID-19, and during the COVID-19 pandemic. The surgical intervention data evaluated included diagnostic category, case priority, complications, length of hospital stay, and 30-day mortality. Results A total of 850 procedures were included, 36% during COVID-19. The median number of procedures per day was significantly lower during the COVID-19 period (5.5 cases) than the pre-COVID-19 period (12 cases, P-value<0.0001). Complications, length of hospital stay, and 30-day mortality rates did not differ during the pandemic. In a multivariate analysis comparing both periods, case priority levels 1 (immediate) (OR 1.82, 95%CI 1.24–2.67), 1 (1–24 h) (OR 1.63, 95%CI 1.10–2.41), and 4 (OR 0.28, 95%CI 0.19–0.42) showed significant differences. Conclusions During the early phase of the COVID-19 pandemic, the overall number of neurosurgical procedures declined, but the load of emergency procedures remained the same, thus highlighting the need to allocate sufficient resources for emergencies. More importantly, performing neurosurgical procedures during the pandemic in regions with limited effects of the outbreak on the health care system was safe. Our findings may aid in developing guidelines for acute and long-term care during pandemics in surgical sub-specialties.
| 89,959 | [
0.16845703125,
0.5771484375,
-0.406494140625,
0.71728515625,
-0.60693359375,
-0.6767578125,
-0.44921875,
0.3671875,
0.2470703125,
0.5185546875,
0.92529296875,
-0.90283203125,
-0.537109375,
-0.8095703125,
-0.54150390625,
0.4189453125,
-0.53662109375,
-0.53515625,
-0.2430419921875,... | 44 |
Please summerize the given abstract to a title
Impact of diabetes in patients waiting for invasive cardiac procedures during COVID-19 pandemic
BACKGROUND: During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. OBJECTIVES: The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. METHODS: We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. RESULTS: Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p < 0.001] and cardiovascular mortality 4.9% vs 0.9% [p = 0.002] in patients with and without diabetes, respectively). In the multivariable analysis, diabetes remained as an independent risk factor both for overall and cardiovascular mortality. No significant interaction was found with other clinical variables. CONCLUSION: Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.
| 90,571 | [
0.1324462890625,
0.16845703125,
-0.420654296875,
0.43359375,
-0.69189453125,
-0.66650390625,
-0.356201171875,
0.50439453125,
0.217529296875,
0.560546875,
0.62109375,
-0.6875,
-0.0675048828125,
-0.70556640625,
-0.5986328125,
0.43212890625,
-0.343017578125,
-0.64013671875,
-0.51757... | 44 |
Please summerize the given abstract to a title
Safety and operational efficiency of restructuring and redeploying a transcatheter aortic valve replacement service during the COVID-19 pandemic: The Oxford experience
BACKGROUND: The risk of nosocomial COVID-19 infection for vulnerable aortic stenosis patients and intensive care resource utilization has led to cardiac surgery deferral. Untreated severe symptomatic aortic stenosis has a dismal prognosis. TAVR offers an attractive alternative to surgery as it is not reliant on intensive care resources. We set out to explore the safety and operational efficiency of restructuring a TAVR service and redeploying it to a new non-surgical site during the COVID-19 pandemic. METHODS: The institutional prospective service database was retrospectively interrogated for the first 50 consecutive elective TAVR cases prior to and after our institution's operational adaptations for the COVID-19 pandemic. Our endpoints were VARC-2 defined procedural complications, 30-day mortality or re-admission and service efficiency metrics. RESULTS: The profile of patients undergoing TAVR during the pandemic was similar to patients undergoing TAVR prior to the pandemic with the exception of a lower mean age (79 vs 82 years, p < 0.01) and median EuroScore II (3.1% vs 4.6%, p = 0.01). The service restructuring and redeployment contributed to the pandemic-mandated operational efficiency with a reduction in the distribution of pre-admission hospital visits (3 vs 3 visits, p < 0.001) and the time taken from TAVR clinic to procedure (26 vs 77 days, p < 0.0001) when compared to the pre-COVID-19 service. No statistically significant difference was noted in peri-procedural complications and 30-day outcomes, while post-operative length of stay was significantly reduced (2 vs 3 days, p < 0.0001) when compared to pre-COVID-19 practice. CONCLUSIONS: TAVR service restructuring and redeployment to align with pandemic-mandated healthcare resource rationalization is safe and feasible.
| 90,663 | [
0.31298828125,
0.004619598388671875,
-0.4150390625,
0.63134765625,
-0.30322265625,
-0.95751953125,
-0.75439453125,
0.4873046875,
0.1666259765625,
0.4521484375,
0.857421875,
-0.58642578125,
-0.4091796875,
-0.642578125,
-0.6181640625,
0.435302734375,
-0.71728515625,
-0.69140625,
-0... | 44 |
Please summerize the given abstract to a title
[Update in surgery].
The occurrence of the COVID-19 pandemic had a major impact on global society with major repercussions on surgical activity. As the pandemic has evolved, the hospital resources available to perform surgeries have been reallocated to COVID-19 patients with a reduction in surgical capacity. The impact has spread from urgent surgery to cancer surgery, and the long-term effects remain to be established. Protocols allowing cost-saving care, such as enhanced recovery after surgery, are tools that can partially offset the rationing of available resources in order to optimize the surgical outcome.
| 90,847 | [
0.483154296875,
0.0014324188232421875,
-0.84375,
0.7568359375,
-0.368896484375,
-0.4189453125,
-0.361572265625,
0.1988525390625,
0.671875,
0.62109375,
0.974609375,
-0.90625,
-0.1240234375,
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-0.5166015625,
0.311279296875,
-0.0302886962890625,
-0.8037109375,
0.051635742... | 44 |
Please summerize the given abstract to a title
Outcomes of orthopaedic trauma patients undergoing surgery during the peak period of COVID-19 infection at a UK major trauma centre
BACKGROUND: To review the clinical outcomes of all patients undergoing emergency orthopaedic trauma surgery at a UK major trauma centre during the first 6 weeks of the COVID-19 related lockdown. METHODS: A retrospective review was performed of all patients who underwent emergency orthopaedic trauma surgery at a single urban major trauma centre over the first six-week period of national lockdown. Demographics, co-morbidities, injuries, injury severity scores, surgery, COVID-19 status, complications and mortalities were analysed. RESULTS: A total of 76 patients were included for review who underwent multiple procedures. Significant co-morbidity was present in 72%. The overall COVID-19 infection rate of the study population at any time was 22%. Sub-group analysis indicated 13% had active COVID-19 at the time of surgery. Only 4% of patients developed COVID-19 post surgery with no mortalities in this sub-group. The overall mortality rate was 4%. The overall complication rate was 14%. However mortality and complications rates were higher if the patients had active COVID-19 at surgery, if they were over 70 years and had sustained life-threatening injuries. CONCLUSION: The overall survival rate for patients undergoing emergency orthopaedic trauma surgery during the COVID-19 peak was 96%. The rate of any complication was more significant in those presenting with active COVID-19 infections who had sustained potentially life threatening injuries and were over 70 years of age. Conversely those without active COVID-19 infection and who lacked significant co-morbidities experienced a lower complication and mortality rate.
| 91,187 | [
0.4365234375,
-0.076904296875,
-0.87353515625,
0.68408203125,
-0.57177734375,
-0.53076171875,
-0.1270751953125,
0.3330078125,
0.77783203125,
0.66357421875,
0.058441162109375,
-0.415771484375,
0.09234619140625,
-0.814453125,
0.0166778564453125,
0.52685546875,
-0.44921875,
-0.7070312... | 44 |
Please summerize the given abstract to a title
Can machine learning optimize the efficiency of the operating room in the era of COVID-19?
SUMMARY: The cancellation of large numbers of surgical procedures because of the coronavirus disease 2019 (COVID-19) pandemic has drastically extended wait lists and negatively affected patient care and experience. As many facilities resume clinical work owing to the currently low burden of disease in our community, we are faced with operative booking protocols and procedures that are not mathematically designed to optimize efficiency. Using a subset of artificial intelligence called "machine learning," we have shown how the use of operating time can be optimized with a custom Python (a high-level programming language) script and an open source machine-learning algorithm, the ORTools software suite from the Google AI division of Alphabet Inc. This allowed the creation of customized models to optimize the efficiency of operating room booking times, which resulted in a reduction in nursing overtime of 21% - a theoretical cost savings of $469 000 over 3 years.
| 91,505 | [
0.52978515625,
0.215087890625,
-0.755859375,
0.493896484375,
-0.2061767578125,
-0.78271484375,
-0.2666015625,
0.389404296875,
-0.02606201171875,
0.300537109375,
0.8310546875,
-0.360107421875,
-0.443115234375,
-0.79736328125,
-0.330322265625,
0.53955078125,
-0.30859375,
-0.306884765... | 44 |
Please summerize the given abstract to a title
Pattern of Maxillofacial Injuries during Covid-19 Pandemic at Birat Medical College Teaching Hospital of Eastern Nepal
Introduction: Maxillofacial injuries are one of the most common injuries seen in trauma patients Road traffic accidents (RTA) are the most common cause of maxillofacial injuries all over the world RTA are supposed to decrease due to lockdown which has become a usual phenomenon during the COVID- 19 pandemic Changes in the etiology of maxillofacial injuries are supposed to dictate their pattern as well 
Objectives: The objective of this study was to assess the pattern of maxillofacial injuries during the COVID-19 Pandemic at Birat Medical College and Teaching Hospital 
Methodology: A cross-sectional study was conducted among the patients attending Birat Medical College and Teaching Hospital for the treatment of maxillofacial injuries from 1 May to 31 July 2020 Consecutive sampling was used to collect data from 52 study participants 
Results: A total of 52 patients with maxillofacial injuries were studied The age of patients ranged from 1 year to 73 years with a median age of 26 years There were 69 2% (n=36) males with a male to female ratio of 2 25:1 The most common etiology was Road Traffic Accidents (50%, n=26) Laceration (70 7%, n=29) was the most common soft tissue injury Parasymphysis fracture (23 8%, n=5) was the most common site of mandible fracture The most common midface fracture was the zygomaticomaxillary complex (ZMC) fracture (40 9%, n=9) 
Conclusion: RTA still remains the most common etiology of maxillofacial injuries in spite of COVID-19 and the pattern of maxillofacial injuries has not changed much either
| 91,757 | [
-0.22705078125,
0.184814453125,
-0.234375,
0.662109375,
-0.9375,
-0.751953125,
0.003704071044921875,
0.3056640625,
0.283203125,
0.68994140625,
0.42333984375,
-0.6142578125,
0.65234375,
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-0.6962890625,
0.486572265625,
-0.15185546875,
-0.6787109375,
0.0772705078125,
... | 44 |
Please summerize the given abstract to a title
Osteomyelitis, diabetic foot ulcers and the role of the community nurse.
Community nurses face numerous challenges in both diagnosing and effectively treating their patients. The diabetic patient has complex needs requiring a holistic approach. With a reported increase in diabetic patients, and a possible decline in some routine screening following Covid-19 pandemic, complications in diabetic patients are likely to rise. It is estimated that 25% of diabetic patients will develop a diabetic foot ulcer (DFU), with a reported 43% of DFU already infected at first presentation to a health professional. NICE categorise the level of infection in DFU based on standardised assessments such as SINBAD. A high categorised DFU has the possibility of osteomyelitis. It is imperative that osteomyelitis is treated immediately to achieve positive outcomes, benefitting the patients' health and wellbeing in addition to reducing the financial implications to the NHS.
| 91,877 | [
0.36572265625,
-0.12646484375,
-0.321044921875,
0.369384765625,
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-0.2421875,
0.3603515625,
0.46337890625,
0.46923828125,
0.5234375,
0.52783203125,
-0.361572265625,
0.64404296875,
-0.400390625,
-0.6396484375,
0.42431640625,
-0.25732421875,
-0.64404296875,
-0.20947265625... | 44 |
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