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Background: Lichen planus (LP) is an inflammatory disorder believed to result from CD8+ cytotoxic T-cell (CTL) mediated autoimmune reactions against basal keratinocytes. We present a review of LP following COVID-19 infection and vaccination. Method(s): Literature searches were conducted on PubMed and Google Scholar from 2019 to 7/2022. 35 articles were selected based on subject relevance, and references within articles were also screened. Result(s): 39 cases of post-vaccination LP and 6 cases of post-infection LP were found among case reports and case series. 150 cases of postvaccination LP and 12 cases of post-infection LP were found in retrospective and prospective studies. Conclusion(s): LP is a rare complication of COVID-19 infection and vaccination that may be mediated by overstimulation of T-cell responses and proinflammatory cytokine production. However, it does not represent a limitation against COVID-19 vaccination, and the benefits of vaccination considerably outweigh the risks.
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SARS-CoV-2 has infected more than 600 million people worldwide over the last 2.5 years. So far, there efficacy of many antiviral drugs against COVID-19 has been evaluated only in small studies conducted in different countries. Objective. To assess the efficacy of umifenovir in patients with COVID-19. Materials and methods. We performed systematic search of publications in the PubMed and Google Scholar databases. Sixteen studies with a total of 1,843 patients were included in the analysis. The following endpoints were evaluated: frequencies of negative PCR test on days 7 and 14;mortality in patients with mild, moderate, and severe disease;and frequency of fever resolution on day 7. Results. We found that patients receiving umifenovir demonstrated a significantly higher frequency of negative PCR test on day 7 than patients who received no causal therapy or other antiviral drugs (odds ratio (OR) 1.69, 95% confidence interval (CI): 1.09-2.62, p = 0.02, I2 = 13%). This difference was even more significant among patients with mild to moderate COVID-19 (OR: 2.03, 95% CI: 1.24-3.32, p = 0.005, I2 = 0%), as well as on day 14 (OR: 2.02, 95% CI: 1.35-3.94, p = 0.0007, I2 = 50%). We also observed a reduced risk of death in the studies that included only patients with mild and moderate disease (JR: 0.53, 95% CI: 0.33-0.83, p = 0.006, I2 = 0). Umifenovir therapy did not affect the frequency of fever resolution by day 7 (OR: 0.87, 95% CI: 0.49-1.56, p = 0.64, I2 = 0%). Conclusion. Umifenovir significantly accelerated virus elimination by days 7 and 14 among patients with mild to moderate COVID-19. Umifenovir also reduced the risk of death compared to other antiviral drugs.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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Objectives: This scoping review aimed to determine whether the COVID-19 pandemic influenced any modifications to patient selection methods or prioritisation and services provided by proton therapy centres. Method(s): This review was conducted based on the PRISMA methodology and Joanna Briggs Institute scoping review guidelines.1,2 A literature search was performed in Medline, Embase, Web Of Science and Scopus as well as grey literature. Keywords including "COVID-19" and "Proton Therapy" were used. Articles published from 1 January 2020 in English were included. In total, 138 studies were identified of which 14 articles met the inclusion criteria. A scoping review design was chosen to capture the full extent of information published relating to the aim. Result(s): Six of 14 articles included statements regarding treatment of COVID-19 patients. Three publications recommended deferred or alternative treatment, two indicated to treat urgent/emergency patients and one reported continuous treatment for infectious patients. Recurring impacts on PT provision included more frequent use of alternative therapies, reduced referrals, delayed treatment starts and CT simulation, change in treatment volume and staffing limitations due to pandemic restrictions. Consequently, telehealth consults, remote work, reduction in patient visitors, screening procedures and rigorous cleaning protocols were recommended. Discussion/Conclusion: Few publications detailed patient selection or workflow methods used during the pandemic. Further research is needed to obtain more detailed information regarding current global patient selection methods in proton therapy, collecting this data could aid in future planning for proton therapy in Australia.
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Introduction: The COVID-19 pandemic has negatively impacted clinical experience and case volumes. Surgical simulation is now an even more powerful training tool and, to maximize potential, we must ensure learner engagement. Our aim was to identify barriers to surgical simulation engagement and strategies to mitigate these. Method(s): Scoping search was performed with a trained librarian of PubMed, EMBASE and Web of Science. Title and screening were completed with inclusion criteria: articles describing barriers to engagement with surgical simulation. After full text screening, data was extracted from included articles: type of study, MERSQI score, type/number of participants, barriers to engagement and strategies to mitigate these. Result(s): Twenty-nine manuscripts were included with 951 faculty and 2,467 residents. The majority (86%) were in high income countries (HIC) and four in LMICs. Most were surveys (22/29), and five involved semi-structured interviews/focus groups. Mean adjusted MERSQI score was 8. Commonest barriers to HIC engagement were learner clinical duties (9/25), lack of learner time (13/25), lack of learner interest/motivation (9/25) and lack of faculty time or interest to participate (12/25). In LMIC, commonest barriers were lack of simulation lab/equipment (4/4), cost (3/4) and inadequate supervision (3/4). Strategies to improve HIC engagement were mandatory/protected resident simulation training (9/25) and, in LMIC, low cost simulators (4/4) and sharing resources (2/4). Conclusion(s): Identification of barriers to simulation engagement is crucial for successful learning. Given the increased importance of simulation education due to the COVID-19 pandemic, surgical educators should strategize to maximize engagement.
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Background and Objectives: The decline in GDP caused by the global economic recession of 2008 and that caused by the COVID-19 pandemic has resulted in the poor economy of countries around the globe with increased rates of unemployment and adverse job conditions. This systematic review aims to identify the impact of a Financial crisis on Psychological well-being, Life satisfaction, Health Satisfaction, and Financial Incapability. Methodology: The literature included in the review was searched from Feb 1, 2023, to March 26, 2023, by using the PUBMED database as the search engine. Studies discussing the impact of the financial or economic crisis on psychological well-being, Health, Life satisfaction, and Financial Incapabilities published in the English Language were included in this review whereas systematic reviews and metanalysis, case reports, articles published in languages other than English and articles with limited access were excluded. Result(s): Of the 26 articles found eligible for the study, there were 22 Quantitative studies, 2 qualitative studies, and 2 Mixed Method Studies. Most of the articles included in this study discussed the Global Economic crisis caused by COVID-19 and the Global Financial Crisis of 2008. Almost 80% of the studies included in this review discussed psychological well-being and the prevalence of psychological disorders including Depression, Anxiety, Stress, Fear, Loneliness, Burnout, and Suicide whereas the rest of the articles discussed mortality regarding mental disorders. Conclusion(s): Financial crisis or economic recession results in an increased prevalence of common mental disorders affecting psychological well-being by increasing rates of unemployment and adverse job conditions. Policymakers with competitive financial behavior and knowledge are essential elements for psychological well-being and life satisfaction.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Introduction: Loop diuretics are the first-line treatment for volume overload in acute decompensation of congestive heart failure (AHF). Loop diuretic resistance is common due to pharmacologic tachyphylaxis. Therefore, thiazide and thiazide-like diuretics are often used as add-on therapy to combine two different pharmacologic mechanisms. This systemic review and meta-analysis aimed to synthesize the current evidence on the efficacy and safety of metolazone and other thiazide-like diuretics in AHF. Method(s): PRISMA guidelines were followed in conducting this systematic review. PubMed, Scopus, PubMed Central, and Embase databases were searched using relevant keywords for studies published before 5 Jan 2022. and title screening was performed, followed by full-text screening using the Covidence software. Data were extracted, and analysis was done using Cochrane Review Manager (RevMan v5.1). The results were reported in odds ratio and mean difference with 95% confidence intervals. Result(s): Out of 2999 studies identified by database search, eight studies met the inclusion criteria (2 RCTs and 6 cohort studies). Pooled analysis using a random-effects model showed no difference in mean difference among the metolazone group and control group for 24 hours total urine output (MD 69.32, 95% CI -638.29 to 776.94;n = 551;I2 = 84%), change in urine output in 24 hours (MD -284.09, 95% CI -583.99 to 15.81;n = 345;I2 = 0%), 48 hours total urine output (MD -465.62, 95% CI -1302.22 to 370.99;n = 242;I2 = 0%) and urine output at 72 hours (MD -13.24, 95% CI -90.88 to 64.40;n = 205;I2 = 0%). However, studies with furosemide only in the comparator arm, 24 hours of total urine outcome favored metolazone (MD 692.70, 95% CI 386.59 to 998.82;n = 334;I2 = 0%). There was no difference between the two groups in the rate of adverse events, loss of weight, mortality, or readmission rates. Conclusion(s): Metolazone therapy in diuretic resistant AHF may improves urine output and facilitates achieving a net negative balance. Thus, metolazone and thiazide-like diuretics can be used as add-on therapy in acute decompensation of heart failure, especially in diuretic resistance.Copyright © 2023 The Author(s)
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Introduction: The COVID-19 pandemic and duty hour restrictions have illuminated a role for surgical simulation in trainees that permits meaningful technical experience outside the operating room. There is a need for the implementation of surgical simulation infrastructure adjacent to clinical training with practical considerations for complexity and cost. This systematic review analyzes surgical simulations that train hand surgical techniques and procedures with subjective or objective competency assessment. Method(s): A systematic review was conducted according to PRISMA- P guidelines using the PubMed, Medline, Scopus, Embase, Web of Science, and Cochrane databases. Selected search terms included procedures relevant to the field of hand surgery and various types of simulation training. Data, including skills and techniques taught and assessed, model type, equipment, cost, and emphasis placed in training for each article, were extracted. Result(s): Of 2,519 articles, 40 met inclusion criteria. Models were described as: synthetic benchtop/3D-printed (40.0%), animal (22.5%), cadaveric (20.0%), augmented and virtual reality (AR/ VR;12.5%), and other computer simulation (12.5%). Three models incorporated both a physical benchtop component and an AR/ VR component. The procedures most represented included tendon repair (30.0%), fracture fixation (27.5%), wrist arthroscopy (15.0%), and carpal tunnel release (15.0%). Sixty-five percent of articles emphasized the importance of surgical simulation in a surgeon's training. Conclusion(s): A diversity of surgical simulation models exist for the practice of various aspects of hand surgery. The existing literature demonstrates their utility for increasing expertise with surgical techniques and procedures in a low-risk setting.
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Objective This S2k guideline of the German Society for Gynecology and Obstetrics (DGGG) and the German Society of Perinatal Medicine (DGPM) contains consensus-based recommendations for the care and treatment of pregnant women, parturient women, women who have recently given birth, and breastfeeding women with SARS-CoV-2 infection and their newborn infants. The aim of the guideline is to provide recommendations for action in the time of the COVID-19 pandemic for professionals caring for the above-listed groups of people. Methods The PICO format was used to develop specific questions. A systematic targeted search of the literature was carried out using PubMed, and previously formulated statements and recommendations issued by the DGGG and the DGPM were used to summarize the evidence. This guideline also drew on research data from the CRONOS registry. As the data basis was insufficient for a purely evidence-based guideline, the guideline was compiled using an S2k-level consensus-based process. After summarizing and presenting the available data, the guideline authors drafted recommendations in response to the formulated PICO questions, which were then discussed and voted on. Recommendations Recommendations on hygiene measures, prevention measures and care during pregnancy, delivery, the puerperium and while breastfeeding were prepared. They also included aspects relating to the monitoring of mother and child during and after infection with COVID-19, indications for thrombosis prophylaxis, caring for women with COVID-19 while they are giving birth, the presence of birth companions, postnatal care, and testing and monitoring the neonate during rooming-in or on the pediatric ward.Copyright © 2023. Thieme. All rights reserved.
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Objectives: A LSR is a systematic review that is continually updated, incorporating new evidence as it becomes available. They are conducted in research areas where new evidence is constantly emerging on diagnostic methods, treatments, and outcomes. The objective of this study was to understand the current application of LSRs across research areas. Method(s): Embase, MEDLINE, and the Cochrane Database of Systematic Reviews were searched to identify LSRs. Only the most recent update of a LSR was included. Data regarding the indication, intervention, methods, frequency of updates, and funding were extracted. Result(s): Of the 1,243 records identified, 126 LSRs were included for analysis. The first LSR was published in 2015, with a significant increase in the number of LSRs published starting in 2020, coinciding with the COVID-19 pandemic. The most common indication represented by LSRs was COVID-19 (72%), followed by oncology (10%). Other indications with LSRs included chronic pain, traumatic brain injury, and skin disorders, among others. While most oncology LSRs identified interventional randomized-controlled trials (RCTs) (85%), only 54% of COVID-19 LSRs were restricted to interventional studies, including a combination of RCTS and real-world observational studies. Oncology LSRs included common cancers such as prostate, renal, or multiple myeloma. Of the reviews that reported update frequency, 28% planned monthly, 12% yearly, and 12% weekly updates. Only 46% of LSRs were registered. The majority of LSRs were funded by government or research organizations. Objectives of LSRs varied, with most stating the need to maintain up-to-date databases;however, several studies used LSRs to facilitate network meta-analysis or mixed treatment comparisons. Conclusion(s): While LSRs were introduced over five years ago, their frequency increased during the COVID-19 pandemic. Apart from COVID-19, LSRs are commonly used in oncology settings. LSRs provide high-level, relevant, and up-to-date evidence, making them a useful tool for clinical and real-world research.Copyright © 2023
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Objective: Representing diverse perspectives in medical publications is of great importance. We assessed diversity among investigators, study participants, authors and tweeters of recent publications on COVID-19 vaccine trials, a topic likely to have significant global implications. Research design and methods: Primary publications reporting on COVID vaccine randomized controlled trials (RCTs) were identified via PubMed (n=302 hits, 23 September 2022). The 100 articles with the greatest impact (Altmetric score) were selected for evaluation. National affiliation of authors and investigators, and demographics of participants were collected. Geographic locations of Tweets mentioning the publications were collected via Altmetric. Result(s): In our preliminary analysis, as expected, selected publications most frequently appeared in top-tier journals, e.g. New England Journal of Medicine (n=24) and Lancet (n=19), and had high Altmetric scores (median 886, range 30-29,153). Articles included authors from mean 2.2 countries, most frequently the USA (n=43 articles), the UK (n=31) and China (n=23). Investigators' locations were often not reported, but most frequent were the UK (n=2711 investigators), USA (n=1029) and South Africa (n=269). There was a gender balance among participants across the studies (mean 49.4% female). The most frequent ethnic groups were white, Hispanic and Asian. Tweets mentioning the publications most commonly came from the USA (8.1%), the UK (3.1%) and Japan (2.9%). Conclusion(s): Despite COVID-19 being a global health emergency, most authors, investigators and readers of high impact COVID-19 vaccine RCT publications were from a small group of countries, with some notable exceptions. Numerous studies did not report the geographic location of investigators or participant ethnicity. Consistent and transparent reporting would support the drive towards greater diversity and representation in medical research.
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This rapid review provides an overview of recent literature on the nature of digital interventions for young people in terms of technologies used, substances and populations targeted, and theoretical or therapeutic models employed. A keyword search was conducted using MEDLINE and other databases for 2015-2021. Following a title/ and full-text screening of articles and consensus decision on study inclusion, data extraction proceeded using an extraction grid. Data synthesis relied on an adapted conceptual framework (Stockings et al., 2016) that involved a three-level treatment spectrum for youth substance use (prevention, early intervention, and treatment). The review identified 43 articles describing 39 digital interventions. Most were early interventions (n = 28), followed by prevention (n = 6) and treatment (n = 5). Of the five technologies identified, web-based interventions (n = 14) were most common. Digital interventions have mainly focused on alcohol use (n = 20), reflecting limited concern for other substance use and co-occurring use. Yet the rise in substance use and related harms during the Covid-19 pandemic highlights a critical need for more innovative substance use interventions. Technologies with more immersive and interactive features, such as VR and game-based interventions, call for further exploration. Only one intervention was culturally tailored and purposefully designed for gender minority youth, and another was geared to young men. As well, most interventions used a personalized or normative feedback approach, while a harm reduction approach guided only one intervention. The incorporation of culturally tailored interventions and harm reduction approaches may promote uptake and stronger engagement with digital interventions amongst youth.
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Objectives: To provide an overview of trends in the current evidence landscape of products and services in development that support remote patient monitoring (RPM) and remote therapeutic monitoring (RTM), given the release of new billing codes for RPM and RTM by Centers for Medicare and Medicaid Services (CMS) in 2019. Method(s): A focused literature review was conducted in PubMed. Articles published between January 1, 2013 and January 1, 2023 were eligible for inclusion if reported technologies were classified as RPM (defined as the collection and interpretation of physiologic data digitally stored and/or transmitted by patients and/or caregivers to qualified health care professionals) or RTM (defined as the use of medical devices to monitor a patient's health or response to treatment using non-physiological data), following CMS definitions. RPM and RTM technologies included hardware, software, telehealth, and blockchain applications. Articles were then categorized using a semi-automated software platform (AutoLit, Nested Knowledge, St. Paul, MN) based on disease area, study design, intervention, and outcomes studied. Result(s): Of the 673 records screened, 245 articles were included. Observational studies (19.6%) were the most common study design, followed by systematic or focused literature reviews (11.0%) and narrative reviews (10.6%). The most common disease areas included cardiology (25.7%), coronavirus disease of 2019 (COVID-19;13.9%), and diabetes (9.4%). The most frequent clinical, non-clinical, and patient-reported outcomes were symptom monitoring (20.8%), all cause readmission and hospitalization rates (both 7.3%), and patient experience (7.8%), respectively. Conclusion(s): CMS policy and coding practices for RPM and RTM are evolving, and this trend is likely to continue into the future. This review provides details on the current evidence trends associated with RPM/RTM technologies. Evidence development of RPM and RTM should be assessed as evidence needs for coverage and reimbursement may receive increased payer management.Copyright © 2023
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Objectives: Several attributes may be important in flu vaccine and since Covid-19, the role of health care professionals (HCPs) may have become more important in increasing flu vaccine uptake. We conducted a literature review to assess if previous preference research could inform future flu vaccination policies. Method(s): We conducted a literature review to assess the most common attributes used in stated-preference studies to determine seasonal flu vaccination preferences. PubMed with key terms such as "discrete choice", "stated preference" and "flu/vaccin*" was used to retrieve relevant research. Result(s): In total, twelve studies investigating consumer and HCP preferences for flu vaccines using a discrete-choice experiment were included. Six studies were conducted in vaccine-eligible populations, three were conducted with parents (specifically, two focused on older adults and one elicited preferences directly from HCPs in Hong Kong). Three studies were conducted in the Netherlands, two in Japan and four in China. Vaccine efficacy was most often framed in terms of percentage (n=7). Out of pocket cost and duration of immunity were common attributes. Source of recommendation for vaccination (i.e., regulatory or public health body) was assessed in 25% of the studies. In studies assessing parental preferences for their children influenza vaccination, risks of fewer side effects were, unsurprisingly, preferred. Finally, among HCPs, vaccine effectiveness and vaccination location (staff clinic/mobile vaccination center) were most important and could increase the probability of vaccination. Conclusion(s): Information incompleteness and asymmetry could play a role in vaccine hesitation and/or aversion. To increase vaccination rates, evidence on the attributes perceived to be important to both HCPs and the general population may help the design and delivery of vaccines that match consumers' preferences. Currently, there is a critical need for more stated-preference studies among HCPs to better understand the attributes likely to increase vaccination rates against seasonal influenza.Copyright © 2023
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Objectives: To systematically review longitudinal studies to determine the prevalence and time-course of fatigue after stroke (post-stroke fatigue, PSF). Material(s) and Method(s): A study protocol was registered on PROSPERO. Five databases (PUBMED, MEDLINE, EMBASE, PSYCHINFO and CINAHL) were searched (10th to 13th June 2022). Citations were imported into Covidence software, s screened by one author, full texts of potentially eligible studies retrieved, and one author applied inclusion criteria (longitudinal cohort studies of patients with acute stroke). Quality assessment of included studies was performed using the Joanna Briggs institute tool for observational studies. A meta-analysis was performed for the prevalence of PSF at different time-points after stroke onset, and changes over time. Subgroup analyses were performed by type of stroke and study location. Result(s): A total of 13,991 records were returned from the searches. Nine studies were eligible and were included. Five studies were of strong and four of moderate quality. Of the studies suitable for meta-analysis, the prevalence of PSF was 42% (95% CI - 39-44%) at six months after ischaemic stroke;and 34% (95% CI - 28-40%) at one year in stroke survivors excluding subarachnoid haemorrhage. Subgroups analyses found no differences in PSF prevalence between Asian countries and others. Of those with PSF at first assessment, 66% (95% CI - 61-71%) remained fatigued at follow-up;of those without PSF initially, 15% (95% CI - 11-20%) developed PSF at follow-up. Conclusion(s): PSF is common and around two-thirds with fatigue remain fatigued. This justifies the development of new interventions for PSF treatment.Copyright © 2023 The Author(s)
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Objectives: Assessment of the literature on the ProtekDuo cannula when used as venopulmonary (V-P) extracorporeal membrane oxygenation (ECMO) in ARDS secondary to COVID-19. Method(s): Systematic literature search in EMBASE, Medline (Pubmed) and NHS library using appropriate keywords as well as PICOS and PRISMA approach. Result(s): We found 285 publications, of which 5 publications met the search criteria and were included in this review. A total of 194 patients with COVID-19 related ARDS had a ProtekDuo placed to establish venovenous (V-V) ECMO and right ventricular (RV) support. Patients treated with the ProtekDuo cannula had survival rates between between the studies of 59 and 89%, with a significant survival compared to an invasive ventilation group or when compared to dual site V-V ECMO or other double lumen ECMO cannulas. One of the studies focused on extubation and early discontinuation of ventilator support, which the authors achieved in 100% of ProtekDuo patients. The incidence of acute kidney injury (AKI) and use of continuous renal replacement therapy (CRRT) was significantly reduced in the ProtekDuo versus other groups. Conclusion(s): The ProtekDuo displayed lower mortality rates, AKI occurrence and CRRT need as compared to other respiratory support modalities and has shown to be a game changer for ECMO support in patients suffering from COVID-19 ARDS. Many authors suggested the ProtekDuo for first line use in these patients.
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Objectives: The COVID19 pandemic caused over six million deaths worldwide as of 2022 and made necessary the rapid development of vaccines. The objective of this Systematic Literature Review is to summarise the main evidence from economic evaluations of vaccines against COVID19. Method(s): Searches were conducted on PubMed on July 13th 2022. The selected papers considered COVID19 vaccination scenarios without population limits. The types of study design examined were cost-benefit and cost-effectiveness analyses. Result(s): Overall, 16 articles from an initial list of 1842 were included in this review. Out of the 16 models, there were five Markov cohort models (three of them were combined with a decision tree model), four dynamic transmission models, three microsimulation models, three epidemiological models (without further information on the model structure) and one decision tree model. Model characteristics were considerably consistent between high-, middle- or low-income countries. Five studies considered both the healthcare and societal perspective, while seven studies reported only the former, and one only the latter. Two studied did not specify the study perspective. Ten of the studies did not consider any level of herd immunity, and no study considered cross-protection. Although eight studies used "naive" comparisons between vaccines, none of the studies conducted thorough indirect treatment comparison. All the models suggest that vaccines are cost-effective as they prevent death and transmission, and reduce the severity of cases. Although the sources of effectiveness estimates were always stated, the details of those studies were rarely reported. Nevertheless, the outcome measures and the key parameters used in the models were generally clearly stated and justified. Conclusion(s): This SLR highlights several challenges for conducting Health Economic evaluations of COVID19 vaccines. The quality of the models and their estimates suffered from the very fast pace of COVID19 research. Therefore, economic evidence on vaccination programs requires additional rigorous research.Copyright © 2023
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Introduction: The COVID-19 pandemic necessitated proliferation of telesimulation. This pedagogy may be useful in rural areas to increase procedural adoption and reduce healthcare disparities. Our aim was to determine the current status of surgical simulation education to retool rural practicing Urologists. Method(s): Literature search was performed with a trained librarian for PubMed, EMBASE and Web of Science. Title/ screening were performed to include all studies of surgical simulation involving rural surgical learners to identify simulation education opportunities for practicing rural Urologists. Data was then extracted: simulation event, skills focus, MERSQI score, type/number of learners, learner assessment and event evaluation. Result(s): Seven manuscripts met inclusion criteria. Most were published 2019-2020 and were cross sectional (5/7, 71%). Mean adjusted MERSQI score was 13 (range 6-15.5). A wide range of surgical skills were taught (incl. laparoscopy, cricothyroidotomy, chest tube insertion, damage control laparotomy), but no Urological surgical skills. Two articles described mobile simulation units for rural areas. A total of 232 learners were identified including 69 medical students. One fifth of rural learners were non-medical or non-physicians. Only one study involved faculty, who were general surgeons. Conclusion(s): Telesimulation education for practicing Urologists in rural areas is lacking. Current in-operating room telementoring for rural Urologists requires surgeons to travel and perform their first cases utilizing this new technique on patients. Telesimulation to teach Urological skills in rural areas of the US may increase dissemination of techniques with no patient risk and has significant potential to redress current healthcare disparities.
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Introduction: The incidence of arterial thrombosis among critically ill patients with COVID-19 is 4.4%, acute aortic obstruction alone having a mortality rate of 31%. We present a review of the literature regarding isolated abdominal aortic thrombosis (IAAT) in the setting of COVID-19 infection, as well as a case presentation. Method(s): A literature review was performed using Pubmed with the keywords, aorta, aortic, thrombus, and Covid-19. Within these articles, the scope was narrowed to articles that related to IAAT in the setting of Covid-19 infection. Result(s): Our literature review found 9 articles detailing a total of 11 cases of IAAT in the setting of COVID-19 infection. IAAT had a mortality 22% (2 out of 9 patients). Approximately, 55% (6 out of 11) of the patients were treated with surgery and 27% (3 out of 11) received anticoagulation. 73%, (8 out of 11) of the patients in our literature review presented with symptoms of acute limb ischemia. Ages ranged from neonate to 85 years old, though 82% (9 out of 11) were over the age of 50. Conclusion(s): Our literature review suggests that IAAT is a serious complication of COVID-19 infection. IAAT is more common in males and people over the age of 50, which aligns with the 52 year- old male patient who presented to our clinic with lower extremity claudication and bilateral 1st & 5th toe cyanosis after COVID-19 infection. To prevent devastating limb ischemia, we emphasize early evaluation of claudication symptoms in patients with COVID-19 or recent COVID-19 infection.
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This paper examines the relevance of the use of a single irradiation of lungs in treatment of pneumonia caused by a new coronavirus infection. Clinical observations are presented that demonstrate perspectives in the treatment of this disease. Patients with severe pneumonia who were prescribed LD-RT (low-dose radiation therapy) at a dose of 0.5-1.5 Gy showed shorter recovery times and no complications. This method of treatment has shown its effectiveness in a number of studies from different countries, predicting success and economic benefits in its further use and study. A literature search containing information on relevant studies was carried out in PubMed, EMBASE, Web of Science and Google Scholar systems. Attention was focused on full-text articles given their general availability in a pandemic.Copyright © 2021 VIDAR Publishing House. All right reserved.
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Background: The recent pandemic prompted a number of clinical trials to assess the efficacy and safety of medication use for the treatment for COVID-19. As pregnant women are excluded or vastly underrepresented in clinical research, there is a paucity of data on how pregnancy and perinatal outcomes are impacted by such medications. Considering that pregnant women are at increased risk for COVID-19 infection and that pregnancy is also associated with an increased risk of developing severe COVID-19, it is of utmost importance to assess the effect of gestational medications use for COVID-19 on pregnancy outcomes. Objective(s): The aims of this systematic review were to (1) determine and quantify COVID-19-specific and repurposed medication use during pregnancy, and (2) provide an overview of the pregnancy and neonatal outcomes that have occurred in COVID-19-positive pregnant women exposed to COVID-19-specific or repurposed medications compared to use in pregnant women without COVID-19;neonatal outcomes compared between COVID-19 positive pregnant women treated and untreated with these medications. Method(s): A systematic literature search was conducted in Ovid and executed in the following databases: MEDLINE, Embase, and Global Health. Search strategies applied combined database-specific subject headings and keywords relevant to the topic. Some subject headings used in databases were pregnancy outcome, COVID-19, SARS-CoV-2, pharmaceutical preparations, drugs, and prescription. Some keywords used for the searches were pregnancy outcome, neonatal outcome, coronavirus disease 2019, drug, medication, and treatment. For each database, keywords were searched within the , keyword heading word or heading words, and title fields. Restrictions were applied regarding the date of publication and searches were limited to English publications. Study selection was accomplished by two independent investigators (NSK, NAB). Only original research articles were considered for inclusion. Included studies investigated pregnancy or neonatal outcomes in women with COVID-19 receiving medication to treat COVID-19. A standardized extraction form was used to independently extract relevant information. Result(s): The literature search yielded a total of 344 records. After deduplication, 69 records were removed. The title and of 275 publications were screened.