ABSTRACT
Background: In response to the coronavirus disease 2019 (COVID-19) pandemic, the use of Telemedicine has skyrocketed. This study aimed to assess the relationship between the changes in Google relative search volume (RSV) of telehealth and COVID-19 worldwide and in different Italian regions over 18 months during the pandemic. Methods: Data about the Google searches Telemedicine and COVID-19 were analysed (01/12/2019– 31/08/2021). The number of Google searches was measured in RSV (range, 0–100). Results: Mean worldwide RSV was 52.2±17.6 for the Telemedicine and 57.7±19.5 for COVID-19;mean Italian RSV was 17.5±21.6 for the Telemedicine and 42.0±20.0 for COVID-19. The maximum interest for Telemedicine was observed on 16/02/2020, while the maximum interest for COVID-19 was registered on 25/10/2020. The RSV curve of COVID-19 presented two nadirs during the summer periods. On the other hand, the RSV curve of Telemedicine presented a single peak in May 2020. After the peak, interest in Telemedicine continued declining (mean RSV =18). Conclusions: COVID-19 has expanded the use of all telemedicine modalities. Future research is required to improve the understanding of user needs and the effects of Telemedicine on providers at various levels of experience to guide efforts to encourage telemedicine adoption and usage after the COVID-19 pandemic. © Journal of Medical Artificial Intelligence. All rights reserved.
ABSTRACT
Objective: New approaches incorporating artificial intelligence solutions have proven successful and valuable support for decision-making. The purpose of this review is to describe the emerging artificial intelligence applications to the prognostic stratification and profiling of patients suffering from COVID-19. Background: COVID-19 has become a public health emergency, alarming social and economic impact on healthcare systems worldwide. It is paramount to identify patients at the highest risk of developing severe COVID-19, thus improving resource allocation. Methods: A systematic literature search for articles published in English between the date of database inception and January 31, 2021, was performed in EMBASE (via Ovid), MEDLINE (via PubMed) and Cochrane CENTRAL. Conclusions: Several artificial intelligence-based approaches have been conceived to ease the pressure on the overloaded health system and assist clinicians in the prognostic profiling of COVID-19 patients. Risk assessment and categorisation are essential: By identifying the more likely subjects to suffer from an acute disease, it might be possible to plan a closer monitoring and/or earlier therapeutic intervention. Hence, artificial intelligence (AI) may support physicians in adjusting their management strategy according to the prognostic estimation, resulting in improved quality of care. This would also facilitate resource allocation in a time when careless supply distribution is not allowed. Artificial intelligence may support physicians in adjusting their management strategy according to the prognostic estimation, resulting in improved quality of care. © 2022 Quantum. All rights reserved.
ABSTRACT
TYPE: TOPIC: Disorders of the Mediastinum PURPOSE: Infiltration of superior vena cava (SVC) is not uncommon in stage III–IVa thymic epithelial tumours (TETs). SVC extent of resection is proportional to width of neoplastic invasion region. Aim: to assess the safety and long-term results of prolonged thymectomy for TETs with and without SVC resection. METHODS: Retrospective review of patients who underwent extended thymectomy for TETs during the preceding two decades, using STROBE method. Kaplan–Meier technique was used to calculate progression-free survival (PFS) and overall survival (OS). To evaluate the factors related to long-term outcomes, a backward stepwise Cox regression multivariate analysis was done. RESULTS: Between January 1998 and April 2019, 78 individuals received surgery for advanced-stage TETs (Masaoka-Koga stages III–IVa). 14 (17.9%) received thymectomy with SVC resection. At multivariate analysis, presence of thymic cancer (HR=2.26;95%CI=1.82–6.18;p=0.038) and SVC resection (HR=1.89;95%CI=1.11–3.96;p=0.041) were found to be unfavourable prognostic variables. All SVC resected patients had median OS=50 months (range: 5–207) and median PFS=31 months (range: 5–151). There was no statistically significant difference in OS (p=0.28) or PFS (p=0.32) between patients with and without SVC resection. CONCLUSIONS: SVC resection is a safe and successful surgery for re-establishing the continuity of the venous system that appears not to influence survival or disease recurrence. CLINICAL IMPLICATIONS: Surgical approaches vary considerably according to extent of SVC infiltration, and issues associated with SVC resection for TETs remain unresolved. SVC resection is a safe and effective operation that appears not to affect survival or recurrence. This surgical technique enables complete resection of locally progressed TETs, even following neoadjuvant treatment. DISCLOSURE: No conflict of interest to declare. This was submitted (ad accepted) in Chest 2020 Bologna withdrawn due to the COVID pandemic. KEYWORD: thymic epithelial neoplasm