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1.
Pituitary ; 23(4): 327-337, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-603905

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the viral strain that has caused the coronavirus disease 2019 (COVID-19) pandemic, has presented healthcare systems around the world with an unprecedented challenge. In locations with significant rates of viral transmission, social distancing measures and enforced 'lockdowns' are the new 'norm' as governments try to prevent healthcare services from being overwhelmed. However, with these measures have come important challenges for the delivery of existing services for other diseases and conditions. The clinical care of patients with pituitary disorders typically involves a multidisciplinary team, working in concert to deliver timely, often complex, disease investigation and management, including pituitary surgery. COVID-19 has brought about major disruption to such services, limiting access to care and opportunities for testing (both laboratory and radiological), and dramatically reducing the ability to safely undertake transsphenoidal surgery. In the absence of clinical trials to guide management of patients with pituitary disease during the COVID-19 pandemic, herein the Professional Education Committee of the Pituitary Society proposes guidance for continued safe management and care of this population.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/therapy , Delivery of Health Care, Integrated/standards , Health Services Accessibility/standards , Pituitary Diseases/therapy , Pneumonia, Viral/therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Health Status , Host-Pathogen Interactions , Humans , Pandemics , Patient Care Team/standards , Pituitary Diseases/diagnosis , Pituitary Diseases/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Prognosis , Risk Factors
3.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(2): 209-214, 2020 May 25.
Article in Chinese | MEDLINE | ID: covidwho-241763

ABSTRACT

OBJECTIVE: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19). METHODS: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed. RESULTS: In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections. CONCLUSIONS: The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.


Subject(s)
Betacoronavirus , Coronavirus Infections , Interdisciplinary Communication , Pandemics , Patient Care Team , Pneumonia, Viral , Betacoronavirus/isolation & purification , China , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Humans , Patient Care Team/standards , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Retrospective Studies , Treatment Outcome
4.
Can J Surg ; 63(3): E229-E230, 2020 05 08.
Article in English | MEDLINE | ID: covidwho-226013

ABSTRACT

Summary: The coronavirus disease 2019 (COVID-19) pandemic has accentuated the importance of leadership training for health care professionals, particularly surgeons. Surgeons are expected to lead and thrive in multidisciplinary teams. There is, however, a critical gap in teaching residents about fundamental leadership principles, such as developing productive and vision-driven teams, conflict resolution and emotional intelligence. We discuss the merits of leadership training for surgical residents and future directions for implementing a leadership curriculum for Canadian residency programs in the competency by design era.


Subject(s)
Coronavirus Infections , General Surgery/education , Internship and Residency/organization & administration , Leadership , Pandemics , Patient Care Team/organization & administration , Pneumonia, Viral , Canada , Clinical Competence , Curriculum , General Surgery/standards , Internship and Residency/methods , Internship and Residency/standards , Patient Care Team/standards , Teaching
5.
J Laparoendosc Adv Surg Tech A ; 30(5): 481-484, 2020 May.
Article in English | MEDLINE | ID: covidwho-125506

ABSTRACT

The novel coronavirus SARS-CoV-2 (COVID-19) strain has caused a pandemic that affects everyday clinical practice. Care of patients with acute surgical problems is adjusted to minimize exposing health care providers to this highly contagious virus. Our goal is to describe a specific and reproducible perioperative protocol aiming to keep health care providers safe and, simultaneously, not compromise standard of care for surgical patients.


Subject(s)
Coronavirus Infections , General Surgery/standards , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , Perioperative Care/standards , Pneumonia, Viral , Surgical Procedures, Operative/standards , Algorithms , Clinical Protocols/standards , Emergencies , Humans , Massachusetts , Patient Care Team/standards , United States
7.
Oncologist ; 25(6): 463-467, 2020 06.
Article in English | MEDLINE | ID: covidwho-66231

ABSTRACT

Italy and the rest of the world are experiencing an outbreak of a novel beta-coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this context, in Italy, we reorganized the National Health System and prioritized the clinical cancer care scenario, balancing risk of SARS-CoV-2 transmission versus the magnitude of clinical benefit deriving from a specific therapeutic approach. As initial actions, we recommended that routine screening be suspended and that patients with early and advanced cancer be treated as outpatients as much as possible and at the nearest medical center. Patients who need to be hospitalized for cancer treatment were protected from potential SARS-CoV-2 infection by creating a dedicated diagnostic and therapeutic internal pathway for cancer treatment. We implemented reorganization of the hospital networks, based on a hub-and-spoke design. Stronger personal protection was made available for patients with cancer. Because of the extreme burden created by COVID-19, antitumor treatment was initiated only after considering patient performance status, comorbidities, biology of disease, and the likely impact of treatment on outcome. Treatment strategies were discussed in the context of a multidisciplinary tumor board. Treatment decision making balanced risk and benefits of treatment in the context of the specific pandemic level, on a case-by-case basis.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Medical Oncology/organization & administration , Neoplasms/therapy , Patient Care , Pneumonia, Viral/epidemiology , Clinical Decision-Making , Coronavirus Infections/transmission , Coronavirus Infections/virology , Hospitalization , Humans , Infection Control/organization & administration , Infection Control/standards , Infection Control/trends , Italy/epidemiology , Mass Screening/organization & administration , Mass Screening/standards , Mass Screening/trends , Medical Oncology/standards , Medical Oncology/trends , Pandemics , Patient Care Team/organization & administration , Patient Care Team/standards , Patient Care Team/trends , Patient Selection , Pneumonia, Viral/transmission , Pneumonia, Viral/virology
8.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(1): 0, 2020 May 25.
Article in Chinese | MEDLINE | ID: covidwho-51208

ABSTRACT

OBJECTIVE: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of corona virus disease 2019 (COVID-19). METHODS: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed. RESULTS: Of the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times per case. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged; there was no cross-infection occurred in suspected patients during the hospitalization; there were no deaths and no medical staff infections. CONCLUSIONS: The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved under MDT mode, particularly for complicated and refractory cases.


Subject(s)
Coronavirus Infections , Disease Management , Interdisciplinary Communication , Pandemics , Pneumonia, Viral , Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Humans , Patient Care Team/standards , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Retrospective Studies , Treatment Outcome
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