A critical appraisal on the treatment of acute appendicitis in pediatric population during the COVID-19 pandemic.

Acute appendicitis is one of the most common causes of abdominal pain in children. During the coronavirus disease 2019 (COVID-19) pandemic, a delay in presentation to the emergency department and a higher rate of complicated appendicitis were observed. Traditionally, operative management (laparoscopic or open appendectomy) was thought to be the best treatment strategy for acute appendicitis. However, nonoperative management with antibiotics has gained popularity in managing pediatric appendicitis during the COVID-19 era. The pandemic has posed significant challenges in the management of acute appendicitis. Cancellation of elective appendectomies, delay in seeking care due to fear of contracting COVID-19 infection, and impact of COVID-19 infection in the pediatric population have resulted in higher rates of complications. Furthermore, multiple studies have reported multisystem inflammatory syndrome in children mimicking acute appendicitis, subjecting patients to unnecessary surgery. Therefore, it is imperative to update the treatment guidelines for the management of acute appendicitis in the pediatric population during and after COVID-19 times.

NeuroVerse: neurosurgery in the era of Metaverse and other technological breakthroughs.

The tremendous evolution in modern technology has led to a paradigm shift in neurosurgery. The latest advancements such as augmented reality, virtual reality, and mobile applications have been incorporated into neurosurgical practice. NeuroVerse, representing the application of the metaverse in neurosurgery, brings enormous potential to neurology and neurosurgery. Implementation of NeuroVerse could potentially elevate neurosurgical and interventional procedures, enhance medical visits and patient care, and reshape neurosurgical training. However, it is also vital to consider the challenges that may be associated with its implementation, such as privacy issues, cybersecurity breaches, ethical concerns, and widening of existing healthcare inequalities. NeuroVerse adds phenomenal dimensions to the neurosurgical environment for patients, doctors, and trainees, and represents an incomparable advancement in the delivery of medicine. Therefore, more research is needed to encourage widespread use of the metaverse in healthcare, particularly focusing on the areas of morality and credibility. Although the metaverse is expected to expand rapidly during and after the COVID-19 pandemic, it remains to be seen whether it represents an emerging technology that will revolutionize our society and healthcare or simply an immature condition of the future.

Increased rhinovirus/enterovirus infections including Ev-D68 in the United States, a challenge for healthcare providers amidst influenza virus infection and the COVID-19 pandemic.

In March 2020, WHO declared SARS-CoV-2 a global pandemic and lockdowns were enforced in most of the United States. Self-protective measures and travel restrictions were implemented, and schools/universities initiated online learning. Consequently, the global incidence and hospitalization rates of seasonal respiratory infections decreased significantly up to early 2021. Despite the decrease in hospitalization rates due to respiratory illnesses other than Covid-19, hospitals and healthcare providers faced huge stressors regarding workload dueto the pandemic. Furthermore, higher vaccination rates across the United States decreased non pharmaceutical interventions (NPI) implementation increasing the risk of major seasonal viral outbreaks. This editorial discusses the increased Rhinovirus/Enterovirus infections in the United States, challenges faced by healthcare providers and provides recommendations to address the issue.

Approaching COVID-19 with epidemiological genomic surveillance and the sustainability of biodiversity informatics in Africa.

COVID-19 is an acute respiratory illness caused by Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). The first case was reported in Africa on February 14, 2020 and has surged to 11 million as of July 2022, with 43% and 30% of cases in Southern and Northern Africa. Current epidemiological data demonstrate heterogeneity in transmission and patient outcomes in Africa. However, the burden of infectious diseases such as malaria creates a significant burden on public health resources that are dedicated to COVID-19 surveillance, testing, and vaccination access. Several control measures, such as the SHEF2 model, encompassed Africa's most effective preventive measure. With the help of international collaborations and partnerships, Africa's pandemic preparedness employs effective risk-management strategies to monitor patients at home and build the financial capacity and human resources needed to combat COVID-19 transmission. However, the lack of safe sanitation and inaccessible drinking water, coupled with the financial consequences of lockdowns, makes it challenging to prevent the transmission and contraction of COVID-19. The overwhelming burden on contact tracers due to an already strained healthcare system will hurt epidemiological tracing and swift counter-measures. With the rise in variants, African countries must adopt genomic surveillance and prioritize funding for biodiversity informatics.

Elective surgeries during and after the COVID-19 pandemic: Case burden and physician shortage concerns.

The COVID-19 pandemic had a significant impact on several aspects of global healthcare systems, particularly surgical services. New guidelines, resource scarcity, and an ever-increasing demand for care have posed challenges to healthcare professionals, resulting in the cancellation of many surgeries, with short and long-term consequences for surgical care and patient outcomes. As the pandemic subsides and the healthcare system attempts to reestablish a sense of normalcy, surgical recommendations and advisories will shift. These changes, combined with a growing case backlog (postponed surgeries + regularly scheduled surgeries) and a physician shortage, can have serious consequences for physician health and, as a result, surgical care. Several initiatives are already being implemented by governments to ensure a smooth transition as surgeries resume. Newer and more efficient steps aimed at providing adequate surgical care while preventing physician burnout, on the other hand, necessitate a collaborative effort from governments, national medical boards, institutions, and healthcare professionals. This perspective aims to highlight alterations in surgical recommendations over the course of the pandemic and how these changes continue to influence surgical care and patient outcomes as the pandemic begins to soften its grip.

Investigating discrepancies in demand and access for bariatric surgery across different demographics in the COVID-19 era.

Obesity affects over 650 million adults worldwide and increases the risk of cardiovascular events, diabetes, and hypertension. While lifestyle recommendations are popular management options, bariatric surgery has emerged as a standard of care in refractory cases, reported to cause at least a 30% reduction in mortality. In addition, it mitigates obesity-related complications leading to a significant improvement in the quality of life for morbidly obese patients (BMI >40). Despite the numerous benefits, demand and access to bariatric surgery vary across different demographics such as age, gender, and socioeconomic status. This demand and access were further reduced due to the COVID-19 pandemic. This has resulted in cancellations of elective surgeries such as weight loss procedures and promotes a sedentary lifestyle which has short-term and long-term detrimental consequences on the health of obese patients. In the context of the prevalent epidemiological trends, this reduction in bariatric services will disproportionately affect the elderly, males, low SES, and African Americans. This editorial highlights the prevalent discrepancies in demand and access to bariatric surgery amidst the COVID-19 pandemic, and possible recommendations to improve overall access and utilization of bariatric services in morbidly obese patients belonging to all demographics.