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World Neurosurg ; 2021 Nov 11.
Article in English | MEDLINE | ID: covidwho-1574951

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic necessitated the use of telemedicine for most medical specialties, including neurosurgery, although before the pandemic, neurosurgeons infrequently used telemedicine for outpatient visits. We conducted a patient-centric evaluation of telemedicine in our endovascular neurosurgery practice, covering a 4-month period early in the pandemic. METHODS: Survey e-mails after telemedicine visits were sent to all patients who underwent an outpatient telemedicine visit between March 11, 2020, and June 22, 2020, at an endovascular neurosurgery clinic affiliated with a tertiary care center. RESULTS: Of 140 patients, 65 (46%) completed the e-mail survey. Of the 65 respondents, 35 (54%) agreed or strongly agreed with the statement that even before their telemedicine experience, they thought telemedicine would be a convenient way to receive a neurological consultation. After their telemedicine visit, 47 (72%) agreed or strongly agreed with this statement, and 28 (43%) agreed or strongly agreed that they would prefer telemedicine for future visits. Of the 65 respondents, 61 (94%) rated their telemedicine visit as average or better: 34 (52%) rated it excellent, 12 (18%) rated it above average, and 15 (23%) rated it average. When patients compared their telemedicine visit with a prior in-person clinic visit, only 10 of 44 patients (23%) thought the telemedicine visit was more complicated than an in-person visit, and 21 of 44 (48%) said they would prefer telemedicine for future visits. CONCLUSIONS: Our patients expressed satisfaction with their telemedicine visits, and telemedicine will likely play an important role in future outpatient endovascular neurosurgery consultations.

4.
Case Studies in Chemical and Environmental Engineering ; : 100082, 2021.
Article in English | ScienceDirect | ID: covidwho-1039329

ABSTRACT

Face masks became a part of our daily life amid the global COVID-19 (SARS-CoV-2) pandemic. Most of the face masks are made for single-use and primarily disposed of in garbage bins with other non-recyclable wastes. To date, little is known about how disposable face masks in municipal solid waste (MSW) would interfere with high-solids anaerobic digestion (HSAD) in waste management facilities. Here, we first report preliminary results from a lab experiment conducted with the organic fraction of municipal solid waste (OFMSW) amended with used disposable face masks. The lab-scale HSAD systems were operated with percolate recirculation comparable to commercial HSAD systems typically used for full-scale processing of OFMSW. The results suggested that the presence of face masks in OFMSW could negatively affect methane productivity and kinetics. In the digesters amended with face masks, total cumulative methane production decreased by up to 18%, along with a 12-29% decrease in maximum methane production rates than the control digester (without face masks). Moreover, lag phases increased by 7-14%. The results also suggested that the type of polymeric materials used in face masks would be more critical than their total number/loading in the digester, which warrants further investigation. The visual inspection of digestate showed that the face masks were mostly undegraded after 40 days of operation. Much remains unknown about how the undegraded face masks will affect the digestate management practices, such as composting, land application, and landfilling. However, the review of existing literature suggested that they can be a potential source of plastic and microplastic pollution and amplify transmission of antibiotic resistance genes to the ecosystem. In summary, this study underscores the importance of developing safe and reliable disposal guidelines and management plans for single-use face masks.

5.
J Neurointerv Surg ; 13(1): 1, 2021 01.
Article in English | MEDLINE | ID: covidwho-978823
7.
Cardiovasc Revasc Med ; 28S: 57-60, 2021 07.
Article in English | MEDLINE | ID: covidwho-841087

ABSTRACT

Coronavirus Disease-2019 (COVID-19) has been associated with potentially life threatening cardiovascular complications, including fulminant myocarditis and cardiac tamponade. Optimal management strategies are still unclear, including the role of immunomodulatory therapies and extracorporeal membrane oxygenation (ECMO) in the context of cardiogenic shock. We report a case of a middle-aged female with COVID-19 who developed respiratory distress and hemodynamic deterioration with elevated troponin levels on the seventh day of symptoms. Echocardiography demonstrated pericardial effusion with diastolic restriction of the right ventricle. Cardiac arrest developed during pericardiocentesis, resulting in emergency thoracotomy and pericardial drainage. Venoarterial ECMO was subsequently initiated due to refractory cardiogenic shock. Tocilizumab, immunoglobulin, methylprednisolone and convalescent plasma were added to supportive care, with progressive recovery of cardiac function and successful weaning from mechanical ventilation. This case highlights the potential role of ECMO, convalescent plasma and immunomodulatory therapies in the management of cardiogenic shock associated with COVID-19 myopericarditis.


Subject(s)
COVID-19 , Extracorporeal Membrane Oxygenation , Heart Arrest , Myocarditis , COVID-19/therapy , Female , Heart Arrest/diagnosis , Heart Arrest/etiology , Heart Arrest/therapy , Humans , Immunization, Passive , Middle Aged , Myocarditis/complications , Myocarditis/diagnosis , Myocarditis/therapy , SARS-CoV-2 , Shock, Cardiogenic/diagnosis , Shock, Cardiogenic/etiology , Shock, Cardiogenic/therapy
8.
J Neurointerv Surg ; 12(11): 1049-1052, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-809207

ABSTRACT

BACKGROUND: Academic physicians aim to provide clinical and surgical care to their patients while actively contributing to a growing body of scientific literature. The coronavirus disease 2019 (COVID-19) pandemic has resulted in procedural-based specialties across the United States witnessing a sharp decline in their clinical volume and surgical cases. OBJECTIVE: To assess the impact of COVID-19 on neurosurgical, stroke neurology, and neurointerventional academic productivity. METHODS: The study compared the neurosurgical, stroke neurology, and neurointerventional academic output during the pandemic lockdown with the same time period in previous years. Editors from a sample of neurosurgical, stroke neurology, and neurointerventional journals provided the total number of original manuscript submissions, broken down by months, from the year 2016 to 2020. Manuscript submission was used as a surrogate metric for academic productivity. RESULTS: 8 journals were represented. The aggregated data from all eight journals as a whole showed that a combined average increase of 42.3% was observed on original submissions for 2020. As the average yearly percent increase using the 2016-2019 data for each journal exhibited a combined average increase of 11.2%, the rise in the yearly increase for 2020 in comparison was nearly fourfold. For the same journals in the same time period, the average percent of COVID-19 related publications from January to June of 2020 was 6.87%. CONCLUSION: There was a momentous increase in the number of original submissions for the year 2020, and its effects were uniformly experienced across all of our represented journals.


Subject(s)
Coronavirus Infections , Efficiency , Neurology/statistics & numerical data , Neurosurgery/statistics & numerical data , Pandemics , Pneumonia, Viral , Research/statistics & numerical data , Stroke/physiopathology , Stroke/surgery , Universities/statistics & numerical data , COVID-19 , Humans , Neurosurgery/trends , Periodicals as Topic , Publishing , Quarantine/statistics & numerical data , Research/trends , Universities/trends
9.
J Neurointerv Surg ; 12(8): 725, 2020 08.
Article in English | MEDLINE | ID: covidwho-646093
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