Evaluating the management timeline of tracheoesophageal fistulas secondary to button batteries: A systematic review.

INTRODUCTION: During the SARS-CoV-2 pandemic, the incidence of pediatric button battery (BB) ingestions has risen. Children have spent more time at home from school, while many parents try to balance working from home and childcare. Additionally, the amount of electronics powered by BB has increased. Tracheoesophageal fistula (TEF) secondary to a retained aerodigestive BB is a devastating development. Management is challenging, and the clinical timeline of watchful waiting versus surgical intervention for TEF is poorly defined in the literature. METHODS: In accordance with PRISMA guidelines, databases searched include PubMed, Scopus, and CINAHL from database date of inception through August 13, 2021. All study designs were included, and no language, publication date, or other restrictions were applied. Case series and reports of TEFs secondary to BBs were included. Clinical risk factors and outcomes were compared between the spontaneous closure and surgical repair groups. RESULTS: A total of 79 studies with 105 total patients were included. Mortality was 11.4%. There were 23 (21.9%) TEFs that spontaneously closed and 71 (67.6%) that underwent surgical repair. Median time to spontaneous closure compared to surgical repair was significantly different (8.0 weeks [IQR 4.0-18.4] vs. 2.0 weeks [IQR 0.1-3.3], p<0.001). Smaller TEFs were more likely to spontaneously close versus being surgically repaired (9.3 mm ± 3.5 vs. 14.9 mm ± 8.3, p=0.022). Duration of symptoms before BB discovery, BB size, time between BB removal and TEF discovery, and location of the TEF were not statistically different between the spontaneous closure and surgical repair groups. CONCLUSION: A TEF secondary to BB ingestion is a potentially deadly complication. Timing of reported TEF spontaneous closure varies significantly. While smaller TEFs may be amenable to healing without surgical repair, no other significant factors were identified that may be associated with spontaneous closure. If clinical status permits, these data suggest a period of observation of at least 8 weeks prior to surgical intervention may be practical for many BB-induced TEFs.

Covid-19 and Children's Social Development Changes in cognitive functioning after COVID-19: A systematic review and meta-analysis

Summary In this chapter, the authors focus on disruptions to children's lives at home and at school (including early childhood care and education programs [ECCE] and primary schooling) as critical settings for healthy development. The Covid-19 pandemic has upended children's lives in myriad ways, including disruptions in the family system due to illness or death, financial instability tied to job loss, and educational disruptions as a result of closures of child care facilities and schools. In considering how the Covid-19 pandemic is shaping children's social development, the authors attend to how interactions with others and socialization processes within families and schools may buffer or exacerbate the pandemic's negative impact. Developmental scientists are well positioned to research how macro-level shocks such as the coronavirus pandemic affect children's developmental trajectories, and the life-course perspective can guide and inform that investigation. Introduction We conducted a systematic review and meta-analysis of the cognitive effects of coronavirus disease 2019 (COVID-19) in adults with no prior history of cognitive impairment. Methods Searches in Medline/Web of Science/Embase from January 1, 2020, to December 13, 2021, were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.  A meta-analysis of the Montreal Cognitive Assessment (MoCA) total score comparing recovered COVID-19 and healthy controls was performed. Results Oof 6202 articles, 27 studies with 2049 individuals were included (mean age = 56.05 years, evaluation time ranged from the acute phase to 7 months post-infection). Impairment in executive functions, attention, and memory were found in post-COVID-19 patients.  The meta-analysis was performed with a subgroup of 290 individuals and showed a difference in MoCA score between post-COVID-19 patients versus controls (mean difference = ?0.94, 95% confidence interval [CI] ?1.59, ?0.29;P = .0049). Discussion Patients recovered from COVID-19 have lower general cognition compared to healthy controls up to 7 months post-infection.

Changes in cognitive functioning after COVID-19: A systematic review and meta-analysis.

INTRODUCTION: We conducted a systematic review and meta-analysis of the cognitive effects of coronavirus disease 2019 (COVID-19) in adults with no prior history of cognitive impairment. METHODS: Searches in Medline/Web of Science/Embase from January 1, 2020, to December 13, 2021, were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.  A meta-analysis of the Montreal Cognitive Assessment (MoCA) total score comparing recovered COVID-19 and healthy controls was performed. RESULTS: Oof 6202 articles, 27 studies with 2049 individuals were included (mean age = 56.05 years, evaluation time ranged from the acute phase to 7 months post-infection). Impairment in executive functions, attention, and memory were found in post-COVID-19 patients.  The meta-analysis was performed with a subgroup of 290 individuals and showed a difference in MoCA score between post-COVID-19 patients versus controls (mean difference = -0.94, 95% confidence interval [CI] -1.59, -0.29; P = .0049). DISCUSSION: Patients recovered from COVID-19 have lower general cognition compared to healthy controls up to 7 months post-infection.

Tracheotomy in the SARS-CoV-2 pandemic.

The severe acute respiratory syndrome (SARS)-CoV-2 pandemic continues to produce a large number of patients with chronic respiratory failure and ventilator dependence. As such, surgeons will be called upon to perform tracheotomy for a subset of these chronically intubated patients. As seen during the SARS and the SARS-CoV-2 outbreaks, aerosol-generating procedures (AGP) have been associated with higher rates of infection of medical personnel and potential acceleration of viral dissemination throughout the medical center. Therefore, a thoughtful approach to tracheotomy (and other AGPs) is imperative and maintaining traditional management norms may be unsuitable or even potentially harmful. We sought to review the existing evidence informing best practices and then develop straightforward guidelines for tracheotomy during the SARS-CoV-2 pandemic. This communication is the product of those efforts and is based on national and international experience with the current SARS-CoV-2 pandemic and the SARS epidemic of 2002/2003.

Characterization of COVID-19 disease in pediatric oncology patients: The New York-New Jersey regional experience.

PURPOSE: Pediatric oncology patients undergoing active chemotherapy are suspected to be at a high risk for severe disease secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection; however, data to support this are lacking. We aim to describe the characteristics of coronavirus disease 2019 (COVID-19) in this population and also its impact on pediatric cancer care in the New York region during the peak of the pandemic. PATIENTS AND METHODS: This multicenter, retrospective study included 13 institutions. Clinical and laboratory information on 98 patients ≤21 years of age receiving active anticancer therapy, who tested positive for SARS-CoV-2 by nasopharyngeal swab polymerase chain reaction (PCR), was collected. RESULTS: Of the 578 pediatric oncology patients tested for COVID-19, 98 were positive, of whom 73 were symptomatic. Most experienced mild disease, 28 required inpatient management, 25 needed oxygen support, and seven required mechanical ventilation. There is a slightly higher risk of severe disease in males and obese patients, though not statistically significant. Persistent lymphopenia was noted in severe cases. Delays in cancer therapy occurred in 67% of SARS-CoV-2-positive patients. Of four deaths, none were solely attributable to COVID-19. The impact of the pandemic on pediatric oncology care was significant, with 54% of institutions reporting delays in chemotherapy, 46% delays in surgery, and 30% delays in transplant. CONCLUSION: In this large multi-institutional cohort, we observed that mortality and morbidity from COVID-19 amongst pediatric oncology patients were low overall, but higher than reported in general pediatrics. Certain subgroups might be at higher risk of severe disease. Delays in cancer care due to SARS-CoV-2 remain a concern.

In an era of uncertainty: Impact of COVID-19 on dental education.

PURPOSE/OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic arguably represents the worst public health crisis of the 21st century. However, no empirical study currently exists in the literature that examines the impact of the COVID-19 pandemic on dental education. This study evaluated the impact of COVID-19 on dental education and dental students' experience. METHODS: An anonymous online survey was administrated to professional dental students that focused on their experiences related to COVID-19. The survey included questions about student demographics, protocols for school reopening and student perceptions of institutional responses, student concerns, and psychological impacts. RESULTS: Among the 145 respondents, 92.4% were pre-doctoral dental students and 7.6% were orthodontic residents; 48.2% were female and 12.6% students lived alone during the school closure due to the pandemic. Students' age ranged from 23 to 39 years. Younger students expressed more concerns about their emotional health (P = 0.01). In terms of the school's overall response to COVID-19, 73.1% students thought it was effective. The majority (83%) of students believed that social distancing in school can minimize the development of COVID-19. In general, students felt that clinical education suffered after transitioning to online but responded more positively about adjustments to other online curricular components. CONCLUSIONS: The COVID-19 pandemic significantly impacted dental education. Our findings indicate that students are experiencing increased levels of stress and feel their clinical education has suffered. Most students appear comfortable with technology adaptations for didactic curriculum and favor masks, social distancing, and liberal use of sanitizers.

Dental care and personal protective measures for dentists and non-dental health care workers.

As a pathogen spread primarily by the respiratory route COVID-19 infection not only poses significant risks to health care workers, but to dentists and dental health care workers, owing to the potential prolonged exposure and proximity to patients. This holds true for non-dentist health care workers who often in the setting of emergency departments and urgent care centers are tasked with addressing oral symptoms including abscesses, damaged teeth, jaw injuries and other dental urgencies. Infection control practice guidelines were evaluated for COVID-19 infection prevention in a dental setting. In this brief review, protective measures to reduce the risk of COVID-19 infection for dentists and non-dentist health care providers will be introduced. This includes patient evaluation, personal and patient protective equipment use, sterilization and disinfection protocols.