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Yu-xuan Li1† , Chang-zheng He1† , Yi-chen Liu1† , Peng-yue Zhao1 , Xiao-lei Xu1 , Yu-feng Wang2 , Shao-you Xia1* and Xiao-hui Du1
Abstract
Background:The coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization. Patients with cancer are more likely to incur poor clinical outcomes. Due to the prevailing pandemic, we propose some surgical strategies for gastric cancer patients.
Methods: The ‘COVID-19’ period was defined as occurring between 2020 and 01-20 and 2020-03-20. The enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study.
Results: The waiting time before admission increased by 4 days in the CG (PCG: 4.5 [IQR: 2, 7.8] vs. CG: 8.0 [IQR: 2, 20]; p = 0.006). More patients had performed chest CT scans besides abdominal CT before admission during the COVID-19 period (PCG: 22 [32%] vs. CG: 30 [73%], p = 0.001). After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. CG: 7[IQR: 5,9]; p < 0.001), more laparoscopic surgeries were performed (PCG: 51[75%] vs. CG: 38[92%], p = 0.021), and hospital stay period after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11]; p < 0.001). In addition, the total cost of hospitalization increased during this period, (PCG: 9.22[IQR: 7.82,10.97] vs. CG: 10.42[IQR:8.99,12.57]; p = 0.006).
Conclusion: This study provides an opportunity for our surgical colleagues to reflect on their own services and any contingency plans they may have to tackle the COVID-19 crisis.
Keywords: Gastric cancer, Coronavirus disease 2019, COVID-19, Retrospective analysis
Grace F. Chao, MD, MSc, Kathleen Y. Li, MD, MSc, [...], and Chad Ellimoottil, MD, MSc
Additional article information
Associated Data
- Supplementary Materials
Key Points
Question
What were telehealth use patterns across surgical specialties before and during the COVID-19 pandemic?
Findings
In this statewide cohort study that included 4405 surgeons, telehealth use grew substantially during the early pandemic period and declined during the later period; this use varied by surgical specialty. Compared with 2019 visit volume, telehealth salvaged only a small portion of 2020 surgical visits.
Meaning
Telehealth is being used in surgical fields at rates higher than before the pandemic, and its use varies across surgical specialties.
Chaitany Jayprakash Raorane †, Jin‐Hyung Lee † and Jintae Lee *
School of Chemical Engineering, Yeungnam University, Gyeongsan 38541, Korea; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (C.J.R.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (J.‐H.L.) * Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; Tel.: +82‐53‐810‐2533; Fax: +82‐53‐810‐4631 † These authors contributed equally to this work. Received: 23 June 2020; Accepted: 12 August 2020; Published: 14 August 2020
Abstract: Multi‐drug resistant Acinetobacter baumannii is well‐known for its rapid acclimatization in hospital environments. The ability of the bacterium to endure desiccation and starvation on dry surfaces for up to a month results in outbreaks of health care‐associated infections. Previously, indole and its derivatives were shown to inhibit other persistent bacteria. We found that among 16 halogenated indoles, 5‐iodoindole swiftly inhibited A. baumannii growth, constrained biofilm formation and motility, and killed the bacterium as effectively as commercial antibiotics such as ciprofloxacin, colistin, and gentamicin. 5‐Iodoindole treatment was found to induce reactive oxygen species, resulting in loss of plasma membrane integrity and cell shrinkage. In addition, 5‐iodoindole rapidly killed three Escherichia coli strains, Staphylococcus aureus, and the fungus Candida albicans, but did not inhibit the growth of Pseudomonas aeruginosa. This study indicates the mechanism responsible for the activities of 5‐iodoindole warrants additional study to further characterize its bactericidal effects on antibiotic‐resistant A. baumannii and other microbes.
Keywords: Acinetobacter baumannii; antibiotics; biofilm; 5‐iodoindole; membrane damage
Eyitayo Omolara Owolabi1 • Tamlyn Mac Quene1 • Johnelize Louw1 • Justine I. Davies1,2,3 • Kathryn M. Chu1,4
Accepted: 10 March 2022 The Author(s) under exclusive licence to Socie´te´ Internationale de Chirurgie 2022
1 Centre for Global Surgery, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
2 Institute of Applied Health Research, University of Birmingham, Birmingham, UK
3 Faculty of Health Sciences, Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, University of Witwatersrand, Johannesburg, South Africa
4 Department of Surgery, University of Botswana, Gaborone, Botswana
Abstract
Background Access to timely and quality surgical care is limited in low- and middle-income countries (LMICs). Telemedicine, defined as the remote provision of health care using information, communication and telecommunication platforms have the potential to address some of the barriers to surgical care. However, synthesis of evidence on telemedicine use in surgical care in LMICs is lacking.
Aim To describe the current state of evidence on the use and distribution of telemedicine for surgical care in LMICs. Methods This was a scoping review of published and relevant grey literature on telemedicine use for surgical care in LMICs, following the PRISMA extension for scoping reviews guideline. PubMed-Medline, Web of Science, Scopus and African Journals Online databases were searched using a comprehensive search strategy from 1 January 2010 to 28 February 2021. Results A total of 178 articles from 53 (38.7%) LMICs across 11 surgical specialties were included. The number of published articles increased from 2 in 2010 to 44 in 2020. The highest number of studies was from the World Health Organization Western Pacific region (n = 73; 41.0%) and of these, most were from China (n = 69; 94.5%). The most common telemedicine platforms used were telephone call (n = 71, 39.9%), video chat (n = 42, 23.6%) and WhatsApp/WeChat (n = 31, 17.4%). Telemedicine was mostly used for post-operative follow-up (n = 71, 39.9%), patient education (n = 32, 18.0%), provider training (n = 28, 15.7%) and provider-provider consultation (n = 16, 9.0%). Less than a third (n = 51, 29.1%) of the studies used a randomised controlled trial design, and only 23 (12.9%) reported effects on clinical outcomes.
Conclusion Telemedicine use for surgical care is emerging in LMICs, especially for post-operative visits. Basic platforms such as telephone calls and 2-way texting were successfully used for post-operative follow-up and education. In addition, file sharing and video chatting options were added when a physical assessment was required. Telephone calls and 2-way texting platforms should be leveraged to reduce loss to follow-up of surgical patients in LMICs and their use for pre-operative visits should be further explored. Despite these telemedicine potentials, there remains an uneven adoption across several LMICs. Also, up to two-thirds of the studies were of low-to-moderate quality with only a few focusing on clinical effectiveness. There is a need to further adopt, develop, and validate telemedicine use for surgical care in LMICs, particularly its impact on clinical outcomes.
