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1.
J Clin Neurosci ; 99: 204-211, 2022 May.
Article in English | MEDLINE | ID: covidwho-1804600

ABSTRACT

OBJECTIVE: COVID-19 has caused a massive surge in telemedicine utilization as patients and physicians tried to minimize in-person contact to avoid the spread and impact of the pandemic. This study aims to expand on the knowledge of telemedicine during and beyond the COVID-19 era as it pertains to its use, efficacy, and patient and provider satisfaction through surveys. METHODS: This is a retrospective study involving 93 patients and 33 Neurosurgery physicians who anonymously participated in the survey about their experience with telemedicine visits. RESULTS: Most respondents indicated extreme satisfaction with their telemedicine encounters during the pandemic (77%). As for how comfortable physicians are in providing a diagnosis via telemedicine compared to clinic visits, 7 (21.9%) physicians felt extremely comfortable, 13 (40.6%) felt somewhat comfortable, 2 (6.4%) were neutral, 9 (28.1%) felt somewhat uncomfortable and 1 (3.1%) felt extremely uncomfortable. Physical examination was the main tool that telemedicine didn't provide (n = 21, 100%). CONCLUSION: Telemedicine has become a major force in the health care system under the circumstances the world is witnessing. Physicians and patients have displayed high levels of satisfaction with telemedicine which could be pivotal to improving healthcare access to underprivileged areas beyond the pandemic.


Subject(s)
COVID-19 , Neurosurgery , Physicians , Telemedicine , Humans , Patient Satisfaction , Retrospective Studies , SARS-CoV-2
4.
World Neurosurg ; 161: e376-e383, 2022 May.
Article in English | MEDLINE | ID: covidwho-1671301

ABSTRACT

BACKGROUND: The practice of neurosurgery has been profoundly affected by the coronavirus disease 2019 (COVID-19) pandemic in Kazakhstan. Many elective surgeries were postponed or canceled, which resulted in difficulties in hospitalization. In the present study, we aimed to describe the effects of COVID-19 on neurosurgical practice and to determine whether a discrepancy was present in the effects between metropolises and regional cities in Kazakhstan. METHODS: We performed an electronic internet-based survey among Kazakhstan's neurosurgeons using the virtual snowball sampling method. The invitation link to complete the questionnaire was sent to neurosurgeons through personal and corporate electronic mail and social networks. The data were analyzed using Excel and Stata. RESULTS: A total of 43 neurosurgeons completed the survey. The distribution of regional and urban respondents was almost equal. The male neurosurgeons outnumbered the female neurosurgeons (93.02% vs. 6.98%). A decrease in consultations (65.34% ± 28.24%) and surgeries (56.55% ± 26.34%) had been observed by all neurosurgeons, regardless of city type. However, the proportion of neurosurgeons who had attended online educational courses during the pandemic was significantly higher (P = 0.001) for the surgeons from major cities (68.18%) compared with the surgeons from smaller cities (19.05%). The regional neurosurgeons tended to perform urgent surgeries on COVID-19-positive patients 3 times more often than had the metropolitan neurosurgeons (P < 0.001). CONCLUSIONS: The true effect of the pandemic remains unknown for Kazakhstan. A discrepancy between the metropolitan and regional cities was found in the present study. Efforts are required and relevant guidelines must be developed to ensure that the neurosurgical treatment of various conditions continues to be available during health emergencies and that the disparities are addressed.


Subject(s)
COVID-19 , Neurosurgery , Female , Humans , Kazakhstan/epidemiology , Male , Neurosurgical Procedures , Pandemics
5.
Acta Neurochir (Wien) ; 164(4): 967-972, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1640858

ABSTRACT

BACKGROUND: Disruptions in global surgery educational routines by the COVID-19 pandemic have elicited demands for alternative formats for rendering qualitative neurosurgical education. This study presents application of a novel model of online neurosurgical course, the Lecture-Panel-Discussion Model (LPDM). METHODS: This is a cross-sectional survey of participants who attended the Swedish African Neurosurgery Collaboration (SANC)-100A course. Participants evaluated the course through an online self-administered questionnaire using a 5-point Likert scale ranging from very poor-1, poor-2, average (fair)-3, good-4, to excellent-5. SANC-100A comprises a tripod of Lectures, Panel review, and interactive case Discussion. This model (LPDM) was innovated by SANC and applied at the Enugu International Neurosurgery course in February 2021. RESULTS: There were 71 attendees, 19 were course faculty, while 52 were participants. Thirty-five attended from Nigeria, 11 from Sweden, 3 from Malawi, 2 from Senegal, and 1 from the UK. Among 44 participants who completed the questionnaire, there were 9 fellows and 35 residents. The overall median course Likert rating was 4.65 ± 0.1. The median overall rating for course events was similar between day 1 (Likert score = 4.45) and day 2 (Likert score = 4.55), U = 55, Z score = 1.10, P = 0.27. The median rating for lectures was 4.50 ± 0.2 and varied from 4.40 on day 1 to 4.55 on day 2. The median rating for panel review was 4.60 ± 0.1 and varied from 4.55 on day 1 to 4.65 on day 2. Interactive case discussions were rated 4.80 on both course days. There was a significant variability in the rating profiles of the course tripod: U = 24.5, P = 0.03. Fifty-one (98%) participants believe LPDM was COVID-19-compliant, while 90% believe the course was beneficial to training and practice. CONCLUSION: Initial application of LPDM is rewarded with both high acceptance and high rating among participants.


Subject(s)
COVID-19 , Internship and Residency , Neurosurgery , Cross-Sectional Studies , Humans , Neurosurgery/education , Nigeria , Pandemics , Sweden
10.
Adv Drug Deliv Rev ; 181: 114033, 2022 02.
Article in English | MEDLINE | ID: covidwho-1520626

ABSTRACT

Neurosurgery as one of the most technologically demanding medical fields rapidly adapts the newest developments from multiple scientific disciplines for treating brain tumors. Despite half a century of clinical trials, survival for brain primary tumors such as glioblastoma (GBM), the most common primary brain cancer, or rare ones including primary central nervous system lymphoma (PCNSL), is dismal. Cancer therapy and research have currently shifted toward targeted approaches, and personalized therapies. The orchestration of novel and effective blood-brain barrier (BBB) drug delivery approaches, targeting of cancer cells and regulating tumor microenvironment including the immune system are the key themes of this review. As the global pandemic due to SARS-CoV-2 virus continues, neurosurgery and neuro-oncology must wrestle with the issues related to treatment-related immune dysfunction. The selection of chemotherapeutic treatments, even rare cases of hypersensitivity reactions (HSRs) that occur among immunocompromised people, and number of vaccinations they have to get are emerging as a new chapter for modern Nano neurosurgery.


Subject(s)
Brain Neoplasms/surgery , COVID-19/surgery , Neurosurgery/methods , Animals , Blood-Brain Barrier/surgery , Glioblastoma/surgery , Humans , Nanotechnology/methods , Pandemics/statistics & numerical data , Tumor Microenvironment/physiology
11.
Int J Environ Res Public Health ; 18(22)2021 11 16.
Article in English | MEDLINE | ID: covidwho-1523965

ABSTRACT

The healthcare system has been placed under an enormous burden by the SARS-CoV-2 (COVID-19) pandemic. In addition to the challenge of providing sufficient care for COVID-19 patients, there is also a need to ensure adequate care for non-COVID-19 patients. We investigated neurosurgical care in a university hospital during the pandemic. We examined the second wave of the pandemic from 1 October 2020 to 15 March 2021 in this retrospective single-center study and compared it to a pre-pandemic period from 1 October 2019 to 15 March 2020. Any neurosurgical intervention, along with patient- and treatment-dependent factors, were recorded. We also examined perioperative complications and unplanned readmissions. A statistical comparison of the study groups was performed. We treated 535 patients with a total of 602 neurosurgical surgeries during the pandemic. This compares to 602 patients with 717 surgeries during the pre-pandemic period. There were 67 fewer patients (reduction to 88.87%) admitted and 115 fewer surgeries (reduction to 83.96%) performed, which were essentially highly elective procedures, such as cervical spinal stenosis, intracranial neurinomas, and peripheral nerve lesions. Regarding complication rates and unplanned readmissions, there was no significant difference between the COVID-19 pandemic and the non-pandemic patient group. Operative capacities were slightly reduced to 88% due to the pandemic. Nevertheless, comprehensive emergency and elective care was guaranteed in our university hospital. This speaks for the sufficient resources and high-quality processes that existed even before the pandemic.


Subject(s)
COVID-19 , Neurosurgery , Germany/epidemiology , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
15.
World Neurosurg ; 156: 96-102, 2021 12.
Article in English | MEDLINE | ID: covidwho-1475124

ABSTRACT

Connectivity is a driving force for productivity across a wide variety of sectors in the 21st century, with health care being no exception. Fifth generation cellular technology (5G) is frequently alluded to in the mainstream media but understanding of the technology and its potential impact is not widespread in clinical communities. It promises unprecedented improvement in speed, bandwidth, reliability, and latency, all of which have significant implications for the way we use wireless data. 5G can be subdivided into 3 parallel technological architectures: extended mobile broadband (eMBB), ultra-reliable low latency communication (URLLC), and massive machine type communication (mMTC). These domains each present different and exciting prospects for the future of health care. This narrative review aims to elucidate the nature of 5G, its context within the development of telecommunications, and describe some of the notable opportunities it presents to the neurosurgical community. In many cases the requisite hardware has already been developed, but use has been limited by the requirements of a fast, reliable, and omnipresent network connection. Examples include telesurgical robots, remote supervision of procedures, integrated smart operating rooms, and clinician telepresence. The events of 2020 and the COVID-19 pandemic have brought the world's attention to digital transformation. The mechanics of 5G connectivity creates the capacity for these changes to be applied practically. An understanding of this technology is essential to appreciate the development and opportunities which will be part of our professional future.


Subject(s)
Neurosurgery/trends , Wireless Technology/trends , COVID-19 , Humans , SARS-CoV-2
18.
Neurosurg Rev ; 45(2): 1101-1110, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1460346

ABSTRACT

The COVID-19 pandemic has disrupted neurosurgical training worldwide, with the shutdown of academic institutions and the reduction of elective surgical procedures. This impact has disproportionately affected LMICs (lower- and/or middle-income countries), already burdened by a lack of neurosurgical resources. Thus, a systematic review was conducted to examine these challenges and innovations developed to adapt effective teaching and learning for medical students and neurosurgical trainees. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and The Cochrane Handbook of Systematic Reviews of Interventions. MEDLINE, PubMed, Embase and Cochrane databases were accessed, searching and screening literature from December 2019 to 5th December 2020 with set inclusion and exclusion criteria. Screening identified 1254 articles of which 26 were included, providing data from 96 countries. Twenty-three studies reported transition to online learning, with 8 studies also mentioned redeployment into COVID wards with 2 studies mentioning missed surgical exposure as a consequence. Of 7 studies conducted in LMICs, 3 reported residents suffering financial insecurities from reduced surgical caseload and recession. Significant global disruption in neurosurgical teaching and training has arisen from the COVID-19 pandemic. Decreased surgical exposure has negatively impacted educational provision. However, advancements in virtual technology have allowed for more affordable, accessible training especially in LMICs. Using this, initiatives to reduce physical and mental stress experienced by trainees should be paramount.


Subject(s)
COVID-19 , Neurosurgery , Humans , Neurosurgery/education , Pandemics
19.
World Neurosurg ; 157: e198-e206, 2022 01.
Article in English | MEDLINE | ID: covidwho-1458616

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, disruption of surgical hands-on training has hampered the skills acquisition by budding neurosurgeons. Online and virtual classrooms have not been able to substitute the hands-on experience and learning via direct interaction with senior colleagues. To overcome these challenges, we organized a hybrid workshop where simulation-based learning modules, and direct and virtual interaction with surgeons during live surgeries or didactic lectures were utilized to help delegates in understanding the nuances of neurosurgery. METHODS: A 3-day hybrid workshop was held in March 2021, which was attended by 133 delegates. A structured questionnaire was utilized to record their feedback. RESULTS: An overwhelming majority of the respondents (94.1%, n = 64) found hybrid conferences to be better than an online conference. Most of the respondents (88.3%, n = 60) rated the utility of direct face-to-face interaction to be more satisfying as compared with online interaction with faculty during a webinar. Again, many the respondents (86.8%, n = 59) believed that similar hybrid events will be the new normal given the current situation of COVID-19 pandemic. A large majority (88.2%, n = 60) of the respondents reported that they will prefer a hybrid event over an online conference. CONCLUSIONS: In this era of the COVID-19 pandemic, "hybrid" microneurosurgery workshops offer unique opportunities to enhance surgical skills acquisition by hands-on simulation-based learning and observing live surgical demonstrations, apart from 2-way interactions with experts under one roof. This may be a stepping stone for what lies ahead in the future of neurosurgical training.


Subject(s)
COVID-19 , Education, Distance/methods , Education, Medical, Graduate/methods , Neurosurgery/education , Humans , Neurosurgical Procedures/education , SARS-CoV-2
20.
No Shinkei Geka ; 49(5): 1093-1104, 2021 Sep.
Article in Japanese | MEDLINE | ID: covidwho-1456522

ABSTRACT

Although surgical site infections(SSIs)are usually controllable, their occasional occurrence is unavoidable. SSIs in neurosurgery comprise surgical-wound infections and surgical-organ/space infections. Data from the Japan Nosocomial Infections Surveillance revealed an overall infection rate of 1.1% during the first half of 2020. Responses to two questionnaire-based surveys on SSI prevention and complications related to cranial implant/artificial bone revealed the real world situation in neurosurgery. In 2020, neurosurgical information was added to the practical guidelines concerning the proper use of prophylactic antibacterial drug for SSIs. COVID-19 hygiene control protocols may have reduced the incidence of SSIs. It may be prudent to continue this stringent hygiene control after the COVID-19 pandemic has abated. Information of medical material on SSI is presented in this article, including the Plus suture®, DuraGen®, DuraSeal®, Adherus®, ultra-high-molecular-weight polyethylene(SKULPIO®, CRANIOFIT-PE®), Bioglide® and Bactiseal® shunt systems, and olanexidine. Minimizing SSIs requires proper knowledge on infection control, taking care while performing neurosurgical procedures, and compassion for the patients. In addition, information and material must be updated over time.


Subject(s)
COVID-19 , Neurosurgery , Humans , Neurosurgical Procedures/adverse effects , Pandemics , SARS-CoV-2 , Surgical Wound Infection/epidemiology , Surgical Wound Infection/prevention & control
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