No Detectable Association between Virtual Setting for Vasectomy Consultation and Vasectomy Completion Rate

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic has fueled widespread incorporation of telehealth into Urology practices. Vasectomy consultation via telehealth is convenient and improves access to care for male contraception. However, it does not allow for physical examination, inherently leading to possible day-ofprocedure cancellations due to unforeseen anatomic concerns. This study aimed to compare vasectomy completion rates between patients undergoing virtual versus in-person consultation. METHOD(S): All patients seen by a single provider at NYU Langone Health for vasectomy consultation between October 2016 and June 2022 were included in the study. Most patients seen before March 2020 had in-person consultations, whereas the majority of patients seen afterwards had virtual consultations due to the emergence of COVID- 19. All patients seen virtually were examined in a consult room prior to being prepped for the vasectomy in the procedure room. Visit type, demographic information, and clinical outcomes data were collected for all patients. A chi-squared test was used to compare the rate of vasectomy completion between those with in-person and virtual consultation. Analysis was performed using R, version 4.0.5. RESULT(S): 491 patients were seen by a single provider for vasectomy consultation between October 2016 and June 2022. 197 (40.1%) consultations were performed virtually and 294 (59.9%) consultations were performed in-person. 370 (75.4%) of all patients seen for consultation (both virtual and in-person) ultimately underwent vasectomy. There was no evidence of difference in rate of completing vasectomy after virtual (75.6%) and in-person (75.2%) consultation (p=.91). Two of the 197 (1%) patients who consulted virtually had their vasectomy procedures cancelled on the day of the procedure based on their pre-operative exam;one because of abnormal epididymal sensitivity after prior scrotal infection, the other because of a history of orchiopexy that the patient was not aware of until the surgeon started inquiring about scrotal scars present. CONCLUSION(S): Despite the lack of physical examination, virtual vasectomy consultation is both feasible and effective, with rates of vasectomy completion comparable to traditional in-person consultation.

Implications of physiological changes in pregnancy in COVID-19

Pregnant women generally constitute a group at high risk of infectious diseases due to gestational immunological and physiological changes in their system. That is why the objective of this work is to analyze the implications of the physiological changes of pregnancy in SARS-CoV-2 disease. Physiological changes in pregnant women not only increase their susceptibility to the virus, but also increase the severity of the disease. Changes in the respiratory and immune systems, the role of the placenta in coagulation, and the function of endothelial cells are the physiological changes that most influence the disease. The decrease in lung capacity and the variations that occur in the immune system represent new treatment challenges for pregnant women with COVID-19 disease and therefore new areas of research limited so far.

The social solidarity economy as agent of economic activation in times of the COVID-19 pandemic

The purpose of emerging economies such as social solidarity and collaborative, seek through entrepreneurship, to achieve a social focus, providing different sources of employment, marketing of goods and services at a fair price, eliminating intermediation in the chain of production;allowing to generate value and competitive advantages of which were not counted in the past. The models of the economies of the countries are in constant change and adaptation to the new needs of the different populations, it is here where a series of economies emerge, whose aim pursues a spirit of solidarity in favor of the benefit first of the people and later of the profit. The collaborative economy initiatives and the social solidarity economy are two of the new and emerging models of economies that countries are adopting, with the aim of reaching vulnerable populations and sometimes confined to oblivion by government agents. The rebound in poverty and unemployment rates in countries around the world, aggravated by COVID-19, will translate into an increase in the crime rate, as well as business closures. It is here where the incentive by the government authorities through financing and the participating actors play an important role in the generation of new business models that lead to new ventures associated with reinvention and linkages in national economies that serve as agents. of economic activation.

Progression of COVID-19 in workers of a cuban health institution, vaccinated with the heterologous scheme of SOBERANA

Severe acute respiratory syndrome coronavirus 2 is the causative agent of COVID-19. In the week of March 21 to 27, 2021 an increase of 8% in cases was confirmed in Cuba. The Cuban Ministry of Public Health decided to approve the health intervention with the SOBERANA vaccine candidates to be administered to the staff working in health institutions. The objectives were to describe the vaccination coverage achieved with the SOBERANA heterologous scheme and the progression of the disease in the vaccinated subjects. This is a descriptive, prospective study. We perceived 884 subjects that fulfilled the criteria to be included. The subjects were followed up by the researchers of the sentinel site during the application of the scheme and 5 months after its conclusion. Adequate vaccination coverage was achieved for the heterologous scheme of three doses of SOBERANA. The most frequent comorbidities inside the group of workers who fell ill of COVID-19, 14 days after of completing the heterologous scheme were: high blood pressure, asthma, type 2 diabetes mellitus and ischemic heart disease. The bigger proportion of sick persons corresponded to those who worked in the high-risk red zone, followed by those who worked in the green zone and in the professional group, and lastly non-professional non-technical workers. Disease progression to severe and critical forms was not described in vaccinated workers. Symptoms and more frequent signs in the sick persons were fever, cough, asthenia and anorexia. Adequate vaccination coverage was achieved;the progression of the disease to severe or critical forms was aborted despite the high occupational exposure of the staff and chronic comorbidities. Copyright © 2022, Finlay Ediciones. All rights reserved.

Advances in the Constitutionalization of the Colombian Contentious-Administrative Procedure in Times of COVID-19

This article aims to show the progress in the constitutionalization of the contentious-administrative procedure, on the occasion of the reform of Law 1437 of 2011, which materialized with Law 2080 of January 2021, amid the COVID-19 pandemic. Progress was made through this reform in the realization of the constitutional principles of transparency, legal security, good faith, respect for due process, effective access to material justice, and immediacy and orality, which allow the Social State of law to be concretized. © 2022, Universidad Santo Tomas. All rights reserved.

Advanced atrio-ventricular block in patients with active covid-19 infection

Introduction: Cardiac arrhythmia is a frequent complication of COVID-19, However, there are currently only a few case reports of advanced atrioventricular block (AVB). Hypothesis: We sought to describe a case series of AVB as a complication of COVID-19. Methods: We included a series of ten (10) consecutive patients with confirmed COVID-19, who developed advanced AVB in a prospective observational multi-center study. Patients underwent clinical, laboratory evaluation, Holter, telemetry, Echocardiogram, Chest X-Ray, chest CT scan and cardiac MRI. Results: Of the ten (10) patients, 5 were female (50%) with a mean age of 62,7 +-11,5 years. Eight (8) developed complete AVB, one a 3:1 AVB and one 2:1 AVB. None of the patients had a history of cardiac arrhythmia AVB was not related to medication or intubation. Six patients developed AVB during their hospitalization for COVID-19 and 4 after the first month as a late sequela. Four patients were asymptomatic, one presented syncope, two dyspnea and two dizziness. Six patients presented reverse AVB early by a high dose of corticosteroid in six and colchicine in 3 cases, with no recurrent episodes.Four patients required a permanent pacemaker for persistent conduction defect. Conclusions: Advanced AVB could be a complication of COVID-19. The conduction disturbance was reversed by corticosteroids with or without colchicine in six of ten cases The resolution with corticosteroids of the advanced AVB in these patients could reflect the transient nature of the viral infection and the inflammatory response associated with it in some patients. Four patients required a pacemaker. Physicians should be aware of this complication.

MEDIIK: Design and Manufacturing of an Emergency Ventilator against COVID-19 Pandemic

Herein we describe the modular design and manufacturing of an emergency ventilator based on cyclical compression of a resuscitation bag to face the COVID-19 pandemic. This was done to mitigate the staggering conditions to supply these medical devices under challenging scenarios of need and logistics. The design is based on international standards and commissions for medical electrical equipment, particular requirements for basic safety, electromagnetic compatibility, and essential performance of critical care and emergency ventilators. The modular design is capable of providing four ventilation modes: volume/pressure mandatory ventilation and volume/pressure assisted ventilation. After testing with artificial lungs, calibration, and validation instruments it was found that the main ventilation parameters achieved are: maximum tidal volume of 700 mL, maximum pressure of 50 cmH2O, inspiration/expiration ratio up to 1:4 at 30 breaths per minute. The MEDIIK designation is derived from the mayan word ik' which means wind. © 2021 ACM.

Delayed colonoscopies in the COVID-era: The effects of the COVID-19 pandemic on the endoscopic evaluation patterns of a busy colorectal surgery practice in a major urban setting

Purpose/Background: Due to the COVID-19 pandemic, health-care systems around the world postponed elective and non-emergent procedures to help decrease the burden on hospitals and healthcare workers. As a result, cancer screening programs in the US have seen serious delays and a resultant decrease in the number of cancer diagnoses compared to before the pandemic. During the COVID-era, the number of newly diagnosed colorectal cancers has seen a dramatic drop compared to baseline;likely due in large part to postponed colonoscopies. The aim of this study is to identify the effects of the COVID-era on the endoscopic evaluation patterns of a busy colorectal surgery practice in a large metropolitan city. Methods/Interventions: We performed a retrospective chart review of our practice of thirteen colorectal surgeons working in a large metropolitan city. We included all patients with a colonoscopy postponed from 3/16/2020-5/18/2020 due to COVID-19 regulations or patient request to delay due to the pandemic. We evaluated the average length of delay from time of the original appointment to time the evaluation was completed. We also recorded the number of procedures where a polyp was removed or biopsied and if that biopsy showed high-risk pathology and/or cancer. Results/Outcome(s): During the COVID-era 344 patients had a colonoscopy cancelled. Of these, 158 colonoscopies have been performed with an average delay of 54.75 days;the average delay varied per provider from 36-70 days. 186 endoscopies have yet to be performed. For comparison, 799 colonoscopies were performed during the same time period last year. The total number of cases with biopsy/polypectomy performed was 102/158 (64.5%). High-risk pathology and/or cancer was identified in 26/158 (16.5%). Conclusions/Discussion: The COVID-19 pandemic forced healthcare systems to enforce restrictions on elective and non-emergent procedures. An unfortunate result of those changes may be a delay in diagnosis of colorectal cancer leading to a delay in treatment and worse patient outcomes. This study summarizes the effects on practice patterns of one busy colorectal surgery practice but also serves as a clue to the challenges now facing providers across the country both in compensating for the delays and in planning for future potential disruptions as COVID outbreaks force frequent and ongoing changes to healthcare in the US.

Thoracostomy with placement of the thoracic tube in prone decubit during COVID-19 pandemic

The severe acute respiratory syndrome caused by the SARS-CoV-2 coronavirus, leads to respiratory failure and severe hypoxemia, and requires the implementation of invasive mechanical ventilation in addition to strategies such as prone position to improve arterial oxygenation. Extrapulmonary complications such as spontaneous pneumothorax, pneumomediastinum, pleural effusion complicate its management, especially in the prone position. Chest tube thoracostomy is the first treatment line. This procedure leads to a high risk of contagion by the generation of aerosols, in addition to the risk of lung injury during insertion of the pleural drain due to the prone position. We report a case of SARS-CoV-2 infection with mechanical ventilatory assistance complicated by spontaneous pneumothorax that required placement of pleural drainage when the patient was in the prone position. We describe the technique that is not described in the literature.

Factors associated to inadequate practices of social distancing during the COVID-19 pandemic in Peru

Objetive: To determine the factors associated with inappropriate practices of social distancing during the COVID-19 pandemic in Peru. Material and methods. It was conducted an online survey that included an scale for measuring practices of social distancing, the use of information and emotional coping with coronavirus and socio-demographic characteristics. A bivariate and multivariate analysis was performed using crude (RP) and adjusted (RPs) prevalence ratios with 95% confidence intervals using generalized linear models. Results. There were included 377 people, 35% of whom had inadequate practices of social distancing, which was associated with having incomplete primary or secondary education (RPa 1.41 95% CI: 1.11 to 1.81) inadequate use of information (RPa 2.82 95% CI: 1.98 to 4.05) and inadequate emotional coping (RPa 1.76 95% CI 1.27 to 2.42). Conclusion. Inappropriate practices of social distancing are more likely in people with less education, inadequate use of information and for emotional coping with the pandemic. © 2021 Medical Body of the Almanzor Aguinaga Asenjo National Hospital.