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Shim J, Lee JM. The Role of Interventional Radiology and Management of an Angiography Suite in the Treatment of COVID-19 Patients: Single-Center, 2-Year Experience. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020188. [PMID: 36837390 PMCID: PMC9960077 DOI: 10.3390/medicina59020188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 01/19/2023]
Abstract
Background and Objectives: Hospital angiography suites with negative-pressure ventilation facilities are challenging to equip. During the COVID-19 pandemic, we aimed to introduce interventional radiology procedures performed on COVID-19 patients and understand management of the angiography suite without a negative-pressure ventilation facility before and after the procedures to prevent the spread of infection. Materials and Methods: Between December 2020 and November 2022, 52 COVID-19 patients underwent interventional radiology procedures in an angiography suite, where no negative-pressure ventilation facility was installed. During the procedure, all staff members wore full personal protection equipment, and after the procedure for the COVID-19-positive patient was completed, the angiography suite was disinfected and entry to the angiography suite was prohibited for 1-3 h. In this angiography suite, procedures for COVID-19 patients and non-COVID-19 patients were performed. Results: A total of 61 interventional radiology procedures were performed in 52 patients with COVID-19. Of 52 patients, 21 underwent procedures under intubation and mechanical ventilation. All procedures were performed according to the guidelines set by the Infection Control Committee of our hospital. No major or minor complications were associated with the procedures. There were no cases of infection among staff members or other non-COVID-19 patients related to procedures on COVID-19 patients. Conclusions: Interventional radiology can play an important role in solving the complications of COVID-19 and the problems caused by patients' underlying diseases. In addition, if accurate guidelines are followed, both COVID-19 and non-COVID-19 patients can undergo procedures in an angiography room without negative-pressure ventilation while preventing infection.
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O' Doherty J, O' Doherty S, Abreu C, Aguiar A, Reilhac A, Robins E. Evolving operational guidance and experiences for radiology and nuclear medicine facilities in response to and beyond the COVID-19 pandemic. Br J Radiol 2022; 95:20200511. [PMID: 35930772 PMCID: PMC9815748 DOI: 10.1259/bjr.20200511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 01/13/2023] Open
Abstract
The resulting pandemic from the novel severe acute respiratory coronavirus 2, SARS-CoV-2 (COVID-19), continues to exert a strain on worldwide health services due to the incidence of hospitalization and mortality associated with infection. The aim of clinical services throughout the period of the pandemic and likely beyond to endemic infections as the situation stabilizes is to enhance safety aspects to mitigate transmission of COVID-19 while providing a high quality of service to all patients (COVID-19 positive and negative) while still upholding excellent medical standards. In order to achieve this, new strategies of clinical service operation are essential. Researchers have published peer-reviewed reference materials such as guidelines, experiences and advice to manage the resulting issues from the unpredictable challenges presented by the pandemic. There is a range of international guidance also from professional medical organizations, including best practice and advice in order to help imaging facilities adjust their standard operating procedures and workflows in line with infection control principles. This work provides a broad review of the main sources of advice and guidelines for radiology and nuclear medicine facilities during the pandemic, and also of rapidly emerging advice and local/national experiences as facilities begin to resume previously canceled non-urgent services as well as effects on imaging research.
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Affiliation(s)
- Jim O' Doherty
- Clinical Imaging Research Centre, National University of, Singapore 117599, Singapore
| | - Sophie O' Doherty
- Clinical Imaging Research Centre, National University of, Singapore 117599, Singapore
| | | | - Ana Aguiar
- Department of Nuclear Medicine and PET, Royal Marsden NHS Foundation Trust, SM2 5PT, Sutton, UK
| | - Anthonin Reilhac
- Clinical Imaging Research Centre, National University of, Singapore 117599, Singapore
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Howlett NC, Wood RM. Modeling the Recovery of Elective Waiting Lists Following COVID-19: Scenario Projections for England. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:S1098-3015(22)02071-X. [PMID: 35963839 PMCID: PMC9365524 DOI: 10.1016/j.jval.2022.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/22/2022] [Accepted: 06/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES A significant indirect impact of COVID-19 has been the increasing elective waiting times observed in many countries. In England's National Health Service, the waiting list has grown from 4.4 million in February 2020 to 5.7 million by August 2021. The objective of this study was to estimate the trajectory of future waiting list size and waiting times up to December 2025. METHODS A scenario analysis was performed using computer simulation and publicly available data as of November 2021. Future demand assumed a phased return of various proportions (0%, 25%, 50%, and 75%) of the estimated 7.1 million referrals "missed" during the pandemic. Future capacity assumed 90%, 100%, and 110% of that provided in the 12 months immediately before the pandemic. RESULTS As a worst-case scenario, the waiting list would reach 13.6 million (95% confidence interval 12.4-15.6 million) by Autumn 2022, if 75% of missed referrals returned and only 90% of prepandemic capacity could be achieved. The proportion of patients waiting under 18 weeks would reduce from 67.6% in August 2021 to 42.2% (37.4%-46.2%) with the number waiting over 52 weeks reaching 1.6 million (0.8-3.1 million) by Summer 2023. At this time, 29.0% (21.3%-36.8%) of patients would be leaving the waiting list before treatment. Waiting lists would remain pressured under even the most optimistic of scenarios considered, with 18-week performance struggling to maintain 60%. CONCLUSIONS This study reveals the long-term challenge for the National Health Service in recovering elective waiting lists and potential implications for patient outcomes and experience.
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Affiliation(s)
- Nicholas C Howlett
- Modelling and Analytics, Bristol, North Somerset and South Gloucestershire, Clinical Commissioning Group, National Health Service, Bristol, England, UK
| | - Richard M Wood
- Modelling and Analytics, Bristol, North Somerset and South Gloucestershire, Clinical Commissioning Group, National Health Service, Bristol, England, UK; Centre for Healthcare Innovation and Improvement, School of Management, University of Bath, Bath, England, UK.
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Moore MN, Leamy MB, England DA, O'Connor DOJ, McEntee MF. An Evaluation of the impact of the Coronavirus (COVID 19) pandemic on Interventional Radiographers well-being. J Med Imaging Radiat Sci 2022; 53:384-395. [PMID: 35660274 PMCID: PMC9114273 DOI: 10.1016/j.jmir.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 10/25/2022]
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Angcahan DZ, de Guzman AB. Palliative care and Interventional Radiology for older adults during the COVID-19 pandemic. J Med Imaging Radiat Sci 2022; 53:S18-S21. [PMID: 35346611 PMCID: PMC8901376 DOI: 10.1016/j.jmir.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/22/2022] [Accepted: 03/04/2022] [Indexed: 11/25/2022]
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Barón-Ródiz PA, Cifuentes-García I, Domínguez-Paillacho ID, Antezana F, Martín-Luque VS, Pérez CL. Un año completo de pandemia COVID-19 y su impacto en la Unidad de Radiología Intervencionista. RADIOLOGIA 2022; 64:3-10. [PMID: 35369573 PMCID: PMC8531256 DOI: 10.1016/j.rx.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022]
Abstract
Objetivos Describir el impacto que la pandemia de COVID-19 ha supuesto en la Unidad de Radiología Intervencionista de nuestro hospital a lo largo de un año. Materiales y métodos Se ha realizado un estudio observacional prospectivo en 83 pacientes consecutivos con infección confirmada por COVID-19 a los cuales se les realizó algún tipo de procedimiento de radiología intervencionista durante el periodo comprendido entre el 13 de marzo del 2020 y el 13 de marzo de 2021. Se describe la repercusión de la situación en la actividad total de la unidad, así como en las diferentes fases de la pandemia. Resultados Se alcanzó el éxito técnico y clínico en el 96,43% y 82,14% de los casos, respectivamente. Durante el seguimiento a lo largo de un año, 68 pacientes seguían vivos y 15 fallecieron a causa de su enfermedad de base. No se produjeron complicaciones relacionadas con los procedimientos intervencionistas y nuestra actividad decayó solo un 12% en comparación con el mismo período del año 2019-2020 (no-COVID). Asimismo, solo se produjo una reducción en unidades relativas de valor y unidades de actividad radiológica del 13% y del 12%, respectivamente. Conclusión La pandemia de COVID-19 ha supuesto un desafío en nuestro trabajo diario condicionando una reducción general en el número de procedimientos. No obstante, la radiología intervencionista ha participado activamente en la atención de los pacientes con COVID-19 mediante la realización de una amplia variedad de intervenciones necesarias. La atención de la radiología intervencionista pudo realizarse de forma segura durante la pandemia, siguiendo una serie de medidas y protocolos específicos.
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Affiliation(s)
- P A Barón-Ródiz
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - I Cifuentes-García
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - I D Domínguez-Paillacho
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - F Antezana
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - V San Martín-Luque
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - C Lanciego Pérez
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, España
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7
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Barón-Ródiz PA, Cifuentes-García I, Domínguez-Paillacho ID, Antezana F, San Martín-Luque V, Lanciego Pérez C. Impact of the first year of the COVID-19 pandemic on an interventional radiology unit. RADIOLOGIA 2022; 64:3-10. [PMID: 35180985 PMCID: PMC8801775 DOI: 10.1016/j.rxeng.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/28/2021] [Indexed: 11/19/2022]
Abstract
Objectives To describe the impact of the Covid-19 pandemic on the interventional radiology unit at our hospital in the first year of the pandemic. Material and methods This prospective observational study included 83 consecutive patients with confirmed SARS-CoV-2 infections who underwent an interventional radiology procedure in the period comprising March 13, 2020 through March 13, 2021. We describe the repercussions of the situation on the unit's total activity, as well as on its activity during the different phases of the pandemic. Results Technical and clinical success were achieved in 96.43% and 82.14% of cases, respectively. During follow-up throughout the year, 68 patients remained alive and 15 died from their underlying disease. No complications related with interventional procedures occurred, and activity declined by only 12% in comparison with the same period in the previous year (2019-2020, without COVID). Similarly, the decrease in relative value units and radiology activity units was only 13% and 12%, respectively. Conclusion The Covid-19 pandemic has been a challenge in our daily work, leading to an overall decrease in the number of procedures. Nevertheless, the interventional radiology unit has been actively involved in caring for Covid-19 patients, performing a wide variety of necessary procedures. Following a series of specific measures and protocols has enabled us to perform interventional radiology procedures safely during the pandemic.
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Affiliation(s)
- P A Barón-Ródiz
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - I Cifuentes-García
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - I D Domínguez-Paillacho
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - F Antezana
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - V San Martín-Luque
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - C Lanciego Pérez
- Unidad de Radiología Intervencionista, Servicio de Radiología, Complejo Hospitalario Universitario de Toledo, Toledo, Spain.
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8
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Anand SV, Shuy YK, Lee PSS, Lee ES. One Year on: An Overview of Singapore's Response to COVID-19-What We Did, How We Fared, How We Can Move Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179125. [PMID: 34501718 PMCID: PMC8431401 DOI: 10.3390/ijerph18179125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/30/2021] [Accepted: 08/20/2021] [Indexed: 01/28/2023]
Abstract
Background—One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods—This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results—The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion—Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.
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Affiliation(s)
- S Vivek Anand
- Ministry of Health Holdings, Singapore 099253, Singapore;
| | - Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
| | - Poay Sian Sabrina Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
- Correspondence:
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Tay YX, Kothan S, Kada S, Cai S, Lai CWK. Challenges and optimization strategies in medical imaging service delivery during COVID-19. World J Radiol 2021; 13:102-121. [PMID: 34141091 PMCID: PMC8188837 DOI: 10.4329/wjr.v13.i5.102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/10/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
In coronavirus disease 2019 (COVID-19), medical imaging plays an essential role in the diagnosis, management and disease progression surveillance. Chest radiography and computed tomography are commonly used imaging techniques globally during this pandemic. As the pandemic continues to unfold, many healthcare systems worldwide struggle to balance the heavy strain due to overwhelming demand for healthcare resources. Changes are required across the entire healthcare system and medical imaging departments are no exception. The COVID-19 pandemic had a devastating impact on medical imaging practices. It is now time to pay further attention to the profound challenges of COVID-19 on medical imaging services and develop effective strategies to get ahead of the crisis. Additionally, preparation for operations and survival in the post-pandemic future are necessary considerations. This review aims to comprehensively examine the challenges and optimization of delivering medical imaging services in relation to the current COVID-19 global pandemic, including the role of medical imaging during these challenging times and potential future directions post-COVID-19.
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Affiliation(s)
- Yi Xiang Tay
- Radiography Department, Singapore General Hospital, Singapore 169608, Singapore
| | - Suchart Kothan
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50000, Thailand
| | - Sundaran Kada
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen Postbox 7030, 5020 Bergen, Norway
| | - Sihui Cai
- Radiography Department, Singapore General Hospital, Singapore 169608, Singapore
| | - Christopher Wai Keung Lai
- Department of Health and Social Sciences, Singapore Institute of Technology, Singapore 138683, Singapore
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Liu H, Zhou H, Xu C. Real-time measurement method for the skin temperature of the human arm via large lateral shearing interferometry. APPLIED OPTICS 2021; 60:763-772. [PMID: 33690451 DOI: 10.1364/ao.411212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
This paper presents a real-time measurement method for the skin temperature of the human arm. In this method, the air temperature close to the arm skin is measured via large lateral shearing interferometry, thus avoiding the possible influences of the different physical characteristics of different people, while maintaining the advantages of optical measurement, including its noncontact, noninvasive, and rapid features. The method captures the real-time fringe patterns generated using a parallel-sided plate when a collimated laser light beam transfers through the air surrounding the arm to be measured. Additionally, the phase difference distribution caused by the temperature difference is calculated in combination with the background fringe patterns. The phase difference in the light close to the arm skin is then estimated via a linear fitting method. Accordingly, based on the size parameters of the arm cross section and the ambient temperature monitored in real time, the air temperature close to the arm skin, which is considered equal to the arm skin temperature, is determined while considering the heat conduction effect. Experimental measurements of the temperature of human arm skin were conducted using the proposed method, and the axillary temperatures of the same person before and after the experiments were also measured using an electronic thermometer and a mercury thermometer. Good agreements were found, verifying the reliability of the proposed method. Moreover, based on this method, the possibility for the construction of a real-time body temperature measurement system is also discussed.
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Cherian M, Mehta P, Barath S, Yadav M, Pandi M, Joshi S, Kareparambil Ranasingh R, Monga A, Muthugounder Athiyappan K, Handihal Reddy N. Impact of COVID-19 Pandemic on Interventional Radiology Practice—A Multicenter Observational Study. JOURNAL OF CLINICAL INTERVENTIONAL RADIOLOGY ISVIR 2020. [DOI: 10.1055/s-0040-1718790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Abstract
Background The COVID-19 pandemic has brought unprecedented challenges to health care services including interventional radiology (IR). Treating COVID-19 infected patients became a priority; furthermore, government policies of differing elective procedures and the public’s fear of contacting COVID-19 have impacted IR workload worldwide. The aim of this study was to evaluate the impact of the COVID-19 pandemic on the workflow in six vascular IR centers located across India.
Methods The data were collected retrospectively from April 1 to June 30, 2020. All the six centers were staffed by the alumni of a single parent center located in India. Data was also collected from the same time period in 2019 for comparison.
Results A total of 893 patients were treated from April 1 to June 30, 2019, and 419 were treated during the same period in 2020 during the pandemic, a 53% case volume reduction (95% CI:28. 56–129.44; p < 0.001). The month of April had the largest case volume reduction (66%, 95% CI: 13.57–50.43; p < 0.001). Elective procedures showed an 85% reduction (95% CI: 9.62–91.71; p < 0.001). Venous interventions showed the highest reduction of 76% (95% CI: 0.75–67.75; p < 0.001). Neurological emergencies, dialysis-related interventions, and nonvascular procedures did not show a significant change. No patient tested positive for COVID-19 prior to the procedure; however, one patient who was treated emergently was found to be positive later.
Conclusion COVID-19 pandemic has severely impacted IR practice across India. Workload reduction was more profound at the beginning of the COVID-19 pandemic with a gradual improvement over time.
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Affiliation(s)
- Mathew Cherian
- Department of Interventional Radiology, KMCH Hospital, Coimbatore, India
| | - Pankaj Mehta
- Department of Interventional Radiology, KMCH Hospital, Coimbatore, India
| | - Sitaram Barath
- Department of Interventional Radiology, Geetanjali Medical College and Hospital, Udaipur, India
| | - Manish Yadav
- Department of Interventional Radiology, KIMS Hospital, Trivandrum, India
| | - Muthurajan Pandi
- Department of Interventional Radiology, Ramakrishna Hospital, Coimbatore, India
| | - Saurabh Joshi
- Department of Interventional Radiology, Vein Center, Mumbai, India
| | | | - Akhil Monga
- Department of Interventional Radiology, KMCH Hospital, Coimbatore, India
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How GY, Pua U. Trends of interventional radiology procedures during the COVID-19 pandemic: the first 27 weeks in the eye of the storm. Insights Imaging 2020; 11:131. [PMID: 33296046 PMCID: PMC7724451 DOI: 10.1186/s13244-020-00938-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023] Open
Abstract
Objectives While the Novel Coronavirus (COVID-19) pandemic looks to persist, institutions promote delaying procedures. Understanding trends and demands of interventional radiology (IR) procedures in the infected and COVID-free populations are needed in long-term planning. We detail IR procedure trends in the first 27 weeks of the pandemic and compare with the pre-pandemic era. Methods In this IRB approved retrospective electronic case review, all IR patients in our institution from 1 January to 9 July 2020, the same period in 2019 pre-pandemic and the Severe Acute Respiratory Syndrome (SARS-CoV) outbreak were included. IR procedures were classified using Interventional Radiology—Procedure Acuity Scale (IR-PAS) and category of IR procedures. Along with descriptive frequencies, the Mann–Whitney U test and Chi-square test of independence were performed. Results During the pandemic, 3655 IR procedures were performed compared to 3851 procedures pre-pandemic. No statistically significant difference in weekly IR caseloads across IR-PAS tiers between both periods (p = .088) and category of procedure (p = .054) were noted. General intervention procedures remained the largest proportion and musculoskeletal procedures the minority, in both periods. More general intervention radiology and oncology procedures were performed during the COVID-19 pandemic compared to the SARS-CoV outbreak. Thirty-four (0.93%) IR procedures were performed on 30 COVID-19 patients. There was no IR procedure-related COVID-19 cross-transmission. Conclusions Demand for IR procedures among COVID-free patients remains high, and IR procedures involving COVID-19 represents a fraction of the IR caseload. A sustainable model in providing timely IR services to COVID-free patients needs to be considered.
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Affiliation(s)
- Guo Yuan How
- Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Uei Pua
- Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
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Tan THY, Toh MPHS, Vasoo S, Lye DCB, Ang BSP, Leo YS, Lee VJM, Puah SH, Kurup A. Coronavirus Disease 2019 (COVID-19): The Singapore Experience. A Review of the First Eight Months. ANNALS ACADEMY OF MEDICINE SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020306] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
As of 27 October 2020, there have been 57,980 confirmed cases of COVID-19 in Singapore, with 28 fatalities. To summarise the Singapore experience in managing and containing COVID-19 based on available published data and from relevant sources, a review of literature using research databases such as PubMed and OVID Medline, along with non-peer-reviewed articles and other sources, was conducted with the search terms ‘COVID-19’ and ‘Singapore’. Research conducted in Singapore has provided insight into the clinical manifestations and period of infectivity of COVID-19, demonstrated evidence of pre-symptomatic transmission, linked infection clusters using serological tools, and highlighted aspects of hospital-based environmental contamination. It has also provided guidance for diagnostic testing and has described immune and virologic correlates with disease severity. Evidence of effectiveness of containment measures such as early border control, rigorous contact training, and calibrated social distancing measures have also been demonstrated. Singapore’s multipronged strategy has been largely successful at containing COVID-19 and minimising fatalities, but the risk of re-emergence is high. Keywords: Epidemiology, management, prevention, transmission
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14
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Lee KS, Talenfeld AD, Browne WF, Holzwanger DJ, Harnain C, Kesselman A, Pua BB. Role of interventional radiology in the treatment of COVID-19 patients: Early experience from an epicenter. Clin Imaging 2020; 71:143-146. [PMID: 33259979 PMCID: PMC7642741 DOI: 10.1016/j.clinimag.2020.10.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To highlight the role of interventional radiology (IR) in the treatment of patients hospitalized with coronavirus disease 2019 (COVID-19). METHODS Retrospective review of hospitalized patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and had one or more IR procedures at a tertiary referral hospital in New York City during a 6-week period in April and May of 2020. RESULTS Of the 724 patients admitted with COVID-19, 92 (12.7%) underwent 124 interventional radiology procedures (79.8% in IR suite, 20.2% at bedside). The median age of IR patients was 63 years (range 24-86 years); 39.1% were female; 35.9% in the intensive care unit. The most commonly performed IR procedures were central venous catheter placement (31.5%), inferior vena cava filter placement (9.7%), angiography/embolization (4.8%), gastrostomy tube placement (9.7%), image-guided biopsy (10.5%), abscess drainage (9.7%), and cholecystostomy tube placement (6.5%). Thoracentesis/chest tube placement and nephrostomy tube placement were also performed as well as catheter-directed thrombolysis of massive pulmonary embolism and thrombectomy of deep vein thrombosis. General anesthesia (10.5%), monitored anesthesia care (18.5%), moderate sedation (29.8%), or local anesthetic (41.1%) was utilized. There were 3 (2.4%) minor complications (SIR adverse event class B), 1 (0.8%) major complication (class C), and no procedure-related death. With a median follow-up of 4.3 months, 1.1% of patients remain hospitalized, 16.3% died, and 82.6% were discharged. CONCLUSION Interventional radiology participated in the care of hospitalized COVID-19 patients by performing a wide variety of necessary procedures.
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Affiliation(s)
- Kyungmouk Steve Lee
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Box 141, New York, NY 10065, United States of America.
| | - Adam D Talenfeld
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Box 141, New York, NY 10065, United States of America.
| | - William F Browne
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Box 141, New York, NY 10065, United States of America.
| | - Daniel J Holzwanger
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Box 141, New York, NY 10065, United States of America.
| | - Christopher Harnain
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Box 141, New York, NY 10065, United States of America.
| | - Andrew Kesselman
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Box 141, New York, NY 10065, United States of America.
| | - Bradley B Pua
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Box 141, New York, NY 10065, United States of America.
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15
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Attia AK, Omar UF, Kaliya-Perumal AK. A Review of Guidelines to Resuming Elective Orthopaedic Surgeries Amid COVID-19 Pandemic: Deriving a Simple Traffic Light Model. Malays Orthop J 2020; 14:10-15. [PMID: 33403057 PMCID: PMC7752020 DOI: 10.5704/moj.2011.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic has affected most healthcare systems around the world. Routine care operations such as outpatient clinics and elective surgery remain badly hit. This situation cannot continue for long as it puts patients at a higher risk for complications due to delayed management. Hence, it is essential to resume routine, especially elective surgery. Regarding orthopaedic practice, various authors and organisations have come out with guidelines to resume elective surgeries. However, clear consensus and common strategies need be derived. With this motive, we conducted a review of the literature for guidelines to resume elective orthopaedic surgery amid COVID-19 pandemic and shortlisted scholarly publications and information from regional organisations. We have summarised the information and derived an organised algorithm considering the guidelines provided by various sources. In this extraordinary time, guidelines come in as a relief for every surgeon who is in a dilemma whether to resume electives or not. Putting safety first, these guidelines or suitable versions should be followed at all levels wherever possible to avoid the lack of trained manpower in the event of staff morbidity.
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Affiliation(s)
- A K Attia
- Department of Orthopaedic Surgery, Hamad Medical Corporation, Doha, Qatar
| | - U F Omar
- Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore
| | - A K Kaliya-Perumal
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
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16
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Jang B, Facchini D, Staib L, Fernandez A, Pye S, Goodman RT, Granucci C, Nardecchia N, Pahade JK. Creating a Radiology Call Center Hotline and "HOT" Sites: Centralizing Radiology Questions and Cohorting Out-patient Care During the COVID-19 Pandemic. Curr Probl Diagn Radiol 2020; 50:665-668. [PMID: 33036812 PMCID: PMC7519410 DOI: 10.1067/j.cpradiol.2020.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/25/2020] [Accepted: 09/15/2020] [Indexed: 12/15/2022]
Abstract
Introduction Amidst COVID-19 crisis, confusion exists over current radiology operations due to influx of new data and new protocols. In order to decrease confusion and reduce imaging facility related COVID-19 transmissions, we created a dedicated radiology COVID-19 call center and dedicated out-patient COVID-19 imaging sites (referred to “HOT” sites). Materials and Methods We created a central radiology call center hotline, staffed by our radiology technologists, to answer all radiology questions related to COVID-19 and help with scheduling exams. All out-patient x-ray exams became mandatory to schedule through the call center so proper COVID-19 screening could occur. If positive for COVID-19 symptoms, they are sent to “HOT” sites. Various statistical analyses were performed. Results A total of 2548 calls were received over 7 weeks with linear increase in calls during this period (R 2 = 0.17, P = 0.003). Most common reasons for calling were related to scheduling (n = 2336, 92%) and radiology operations (n = 145, 6%). At our main “HOT” site, from a total of 371 separate patient encounters by date of study, 72 patient encounters (19%) were COVID-19 positive at time of exam. Discussion This project provides efficient and reassuring radiology operations during an emergency situation by providing a single reliable point of contact and a source of truth for all facets of radiology. In doing so, we facilitate high quality patient centered care while protecting the health of our patients and staff.
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Affiliation(s)
- Benjamin Jang
- Yale University School of Medicine, Department of Radiology and Biomedical Imaging, 333 Cedar Street, New Haven, CT 06510.
| | - David Facchini
- Yale New Haven Hospital, Department of Radiology and Biomedical Imaging, 20 York Street, New Haven, CT 06510
| | - Lawrence Staib
- Yale University School of Medicine, Department of Radiology and Biomedical Imaging, 333 Cedar Street, New Haven, CT 06510
| | - Alison Fernandez
- Yale New Haven Hospital, Department of Radiology and Biomedical Imaging, 20 York Street, New Haven, CT 06510
| | - Shannon Pye
- Yale New Haven Hospital, Department of Radiology and Biomedical Imaging, 20 York Street, New Haven, CT 06510
| | - Rob T Goodman
- Yale University School of Medicine, Department of Radiology and Biomedical Imaging, 333 Cedar Street, New Haven, CT 06510
| | - Cheryl Granucci
- Yale New Haven Hospital, Department of Radiology and Biomedical Imaging, 20 York Street, New Haven, CT 06510
| | - Nicole Nardecchia
- Yale New Haven Hospital, Department of Radiology and Biomedical Imaging, 20 York Street, New Haven, CT 06510
| | - Jay K Pahade
- Yale University School of Medicine, Department of Radiology and Biomedical Imaging, 333 Cedar Street, New Haven, CT 06510
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17
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Regli A, Sommerfield A, von Ungern-Sternberg BS. The role of fit testing N95/FFP2/FFP3 masks: a narrative review. Anaesthesia 2020; 76:91-100. [PMID: 32932556 DOI: 10.1111/anae.15261] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
For healthcare workers performing aerosol-generating procedures during the COVID-19 pandemic, well fitted filtering facepiece respirators, for example, N95/FFP2 or N99/FFP3 masks, are recommended as part of personal protective equipment. In this review, we evaluate the role of fit checking and fit testing of respirators, in addition to airborne protection provided by respirators. Filtering facepiece respirators are made of material with sufficient high filter capacity to protect against airborne respiratory viruses. Adequate viral protection can only be provided by respirators that properly fit the wearer's facial characteristics. Initial fit pass rates vary between 40% and 90% and are especially low in female and in Asian healthcare workers. Fit testing is recommended to ensure a proper fit of respirators for the individual healthcare worker so that alternative respirators can be selected if required. Although fit testing is required to comply with respirator standards, it is not performed consistently within all healthcare settings. Fit checking (a self-test) is recommended every time a healthcare worker dons a respirator, but is unreliable in detecting proper fit or leak. Additionally, fit testing has a high educational value and as such is best performed as part of a hospital respiratory protection programme. Whether fit checking alone, as opposed to fit tested and fit checked respirators, provides adequate airborne protection against aerosols containing the SARS-CoV-2 virus and other respiratory viruses remains unknown. While fit testing undoubtedly incurs additional costs, it is still recommended, not only to protect healthcare workers but also as it may reduce overall healthcare cost when considering the potential costs of sickness leave and the associated legal costs of compensation.
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Affiliation(s)
- A Regli
- Intensive Care Medicine, Fiona Stanley Hospital, Perth, Western Australia, Australia.,School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - A Sommerfield
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Western Australia, Australia.,Peri-operative Medicine Team, Telethon Kids Institute, Perth, Western Australia, Australia
| | - B S von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Western Australia, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, University of Western Australia, Perth, Western Australia, Australia.,Peri-operative Medicine Team, Telethon Kids Institute, Perth, Western Australia, Australia
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18
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Benazzo F, Rossi SMP, Maniscalco P, Moretti B, Vaienti E, Ruggieri P, Massè A, Medici A, Formica A, Di Maggio B, Caiaffa V, Mosconi M, Murena L, D'Angelo F, Belluati A, Mazza EL, Rivera F, Castelli A, Ghiara M, Rosolani M, Cioffi R, Pezzella R, Scaravilli G, Bove G, Stissi P, Mazzacane M, Quattrini F, Ciatti C, Trovarelli G, Pala E, Angelini A, Sanna F, Nonne D, Colombelli A, Raggini F, Puzzo A, Canton G, Maritan G, Iuliano A, Randelli P, Solarino G, Moretti L, Vicenti G, Garofalo N, Nappi V, Ripanti S, Chinni C, Pogliacomi F, Visigalli A, Bini N, Aprato A, Perticarini L. The orthopaedic and traumatology scenario during Covid-19 outbreak in Italy: chronicles of a silent war. INTERNATIONAL ORTHOPAEDICS 2020; 44:1453-1459. [PMID: 32591960 PMCID: PMC7319215 DOI: 10.1007/s00264-020-04637-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND From February 21, the day of hospitalisation in ICU of the first diagnosed case of Covid-19, the social situation and the hospitals' organisation throughout Italy dramatically changed. METHODS The CIO (Club Italiano dell'Osteosintesi) is an Italian society devoted to the study of traumatology that counts members spread in public and private hospitals throughout the country. Fifteen members of the CIO, Chairmen of 15 Orthopaedic and Trauma Units of level 1 or 2 trauma centres in Italy, have been involved in the study. They were asked to record data about surgical, outpatients clinics and ER activity from the 23rd of February to the 4th of April 2020. The data collected were compared with the data of the same timeframe of the previous year (2019). RESULTS Comparing with last year, overall outpatient activity reduced up to 75%, overall Emergency Room (ER) trauma consultations up to 71%, elective surgical activity reduced up to 100% within two weeks and trauma surgery excluding femoral neck fractures up to 50%. The surgical treatment of femoral neck fractures showed a stable reduction from 15 to 20% without a significant variation during the timeframe. CONCLUSIONS Covid-19 outbreak showed a tremendous impact on all orthopaedic trauma activities throughout the country except for the surgical treatment of femoral neck fractures, which, although reduced, did not change in percentage within the analysed timeframe.
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Affiliation(s)
- Francesco Benazzo
- Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Università degli Studi di Pavia, Pavia, Italy
| | - Stefano Marco Paolo Rossi
- Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy.
| | - Pietro Maniscalco
- Orthopaedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Biagio Moretti
- UOC Ortopedia E Traumatologia- Azienda Ospedaliero-Universitaria, "Policlinico" Universita, Bari, Italy
| | - Enrico Vaienti
- Clinica Ortopedica, Azienda Ospedaliero - Universitaria di Parma, Parma, Italy
| | - Pietro Ruggieri
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padua, PD, Italy
| | - Alessandro Massè
- School of Medicine Clinica Ortopedica e Traumatologica I Città della Salute e della Scienza - C.T.O, University of Torino, Torino, Italy
| | | | - Alessandro Formica
- UOC Ortopedia e Traumatologia, Az. Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Bruno Di Maggio
- Orthopaedic and Traumatology Unit, A.S.L. Caserta, Piedimonte Matese Hospital, Piedimonte Matese, Italy
| | - Vincenzo Caiaffa
- Orthopedics and Trauma Department, Di Venere Hospital, Bari, Italy
| | - Mario Mosconi
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Università degli Studi di Pavia, Pavia, Italy
| | - Luigi Murena
- SC (UCO) Clinica Ortopedica e Traumatologica, Azienda sanitaria universitaria Giuliano Isontina (ASU GI), Trieste, Italy
| | - Fabio D'Angelo
- Division of Orthopaedics and Traumatology, ASST dei Sette Laghi, Department of Biotechnologies and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Alberto Belluati
- Orto-Trauma Dept., Ospedale Santa Maria delle Croci Ravenna, Ravenna, Italy
| | - Emilio Luigi Mazza
- Centro Specialistico Ortopedico Traumatologico Gaetano Pini - CTO (ASST Pini-CTO), Milan, MI, Italy
| | - Fabrizio Rivera
- Orthopaedics and Trauma Department, SS Annunziata Hospital, Savigliano, CN, Italy
| | - Alberto Castelli
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Matteo Ghiara
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Rosolani
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | - Gabriele Scaravilli
- Orthopaedic and Traumatology Unit, A.S.L. Caserta, Piedimonte Matese Hospital, Piedimonte Matese, Italy
| | - Giovanni Bove
- Department of Orthopaedic Surgery, "Federico II" University, Naples, Italy
| | - Placido Stissi
- Division of Orthopaedics and Traumatology, ASST dei Sette Laghi, Department of Biotechnologies and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Michael Mazzacane
- Division of Orthopaedics and Traumatology, ASST dei Sette Laghi, Department of Biotechnologies and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Fabrizio Quattrini
- Orthopaedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Corrado Ciatti
- Orthopaedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Giulia Trovarelli
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padua, PD, Italy
| | - Elisa Pala
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padua, PD, Italy
| | - Andrea Angelini
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padua, PD, Italy
| | - Francesco Sanna
- Orthopaedics and Trauma Department, SS Annunziata Hospital, Savigliano, CN, Italy
| | - Daniela Nonne
- Orthopaedics and Trauma Department, SS Annunziata Hospital, Savigliano, CN, Italy
| | - Andrea Colombelli
- Orto-Trauma Dept., Ospedale Santa Maria delle Croci Ravenna, Ravenna, Italy
| | - Filippo Raggini
- Orto-Trauma Dept., Ospedale Santa Maria delle Croci Ravenna, Ravenna, Italy
| | - Agnese Puzzo
- Orto-Trauma Dept., Ospedale Santa Maria delle Croci Ravenna, Ravenna, Italy
| | - Gianluca Canton
- SC (UCO) Clinica Ortopedica e Traumatologica, Azienda sanitaria universitaria Giuliano Isontina (ASU GI), Trieste, Italy
| | - Guido Maritan
- SC (UCO) Clinica Ortopedica e Traumatologica, Azienda sanitaria universitaria Giuliano Isontina (ASU GI), Trieste, Italy
| | - Angela Iuliano
- Centro Specialistico Ortopedico Traumatologico Gaetano Pini - CTO (ASST Pini-CTO), Milan, MI, Italy
| | - Pietro Randelli
- Centro Specialistico Ortopedico Traumatologico Gaetano Pini - CTO (ASST Pini-CTO), Milan, MI, Italy
| | - Giuseppe Solarino
- UOC Ortopedia E Traumatologia- Azienda Ospedaliero-Universitaria, "Policlinico" Universita, Bari, Italy
| | - Lorenzo Moretti
- UOC Ortopedia E Traumatologia- Azienda Ospedaliero-Universitaria, "Policlinico" Universita, Bari, Italy
| | - Giovanni Vicenti
- UOC Ortopedia E Traumatologia- Azienda Ospedaliero-Universitaria, "Policlinico" Universita, Bari, Italy
| | - Nunzia Garofalo
- Orthopedics and Trauma Department, Di Venere Hospital, Bari, Italy
| | - Vittorio Nappi
- Orthopedics and Trauma Department, Di Venere Hospital, Bari, Italy
| | - Simone Ripanti
- UOC Ortopedia e Traumatologia, Az. Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Carmela Chinni
- UOC Ortopedia e Traumatologia, Az. Ospedaliera San Giovanni Addolorata, Rome, Italy
| | | | - Alberto Visigalli
- Clinica Ortopedica, Azienda Ospedaliero - Universitaria di Parma, Parma, Italy
| | - Nathalie Bini
- School of Medicine Clinica Ortopedica e Traumatologica I Città della Salute e della Scienza - C.T.O, University of Torino, Torino, Italy
| | - Alessandro Aprato
- School of Medicine Clinica Ortopedica e Traumatologica I Città della Salute e della Scienza - C.T.O, University of Torino, Torino, Italy
| | - Loris Perticarini
- Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy
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19
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Iezzi R, Valente I, Cina A, Posa A, Contegiacomo A, Alexandre A, D'Argento F, Lozupone E, Barone M, Giubbolini F, Milonia L, Romi A, Scrofani AR, Pedicelli A, Manfredi R, Colosimo C. Longitudinal study of interventional radiology activity in a large metropolitan Italian tertiary care hospital: how the COVID-19 pandemic emergency has changed our activity. Eur Radiol 2020; 30:6940-6949. [PMID: 32607633 PMCID: PMC7326392 DOI: 10.1007/s00330-020-07041-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/02/2020] [Accepted: 06/17/2020] [Indexed: 12/13/2022]
Abstract
Objectives To retrospectively analyze interventional radiology (IR) activity changes in the COVID-19 era and to describe how to safely and effectively reorganize IR activity. Methods All IR procedures performed between January 30 and April 8, 2020 (COVID-era group) and the same 2019 period (non-COVID-era group) were retrospectively included and compared. A sub-analysis for the lockdown period (LDP: 11 March–8 April) was also conducted. Demographic, hospitalization, clinical, and procedural data were obtained for both groups and statistically compared with univariable analysis. Results A total of 1496 procedures (non-COVID era, 825; COVID era, 671) performed in 1226 patients (64.9 ± 15.1 years, 618 women) were included. The number of procedures decreased by 18.6% between 2019 and 2020 (825 vs 671, p < .001), with a reduction by 48.2% in LDP (188 vs 363, p < .0001). In the LDP COVID era, bedside procedures were preferred (p = .013), with an increase in procedures from the intensive care unit compared with the emergency department and outpatients (p = .048), and an increased activity for oncological patients (p = .003). No incidents of cross-infection of non-infected from infected patients and no evidence of COVID-19 infection of healthcare workers in the IR service was registered. Conclusions Coronavirus disease outbreak changed the interventional radiology activity with an overall reduction in the number of procedures. However, this study confirms that interventional radiology continuum of care can be safely performed also during the pandemic, following defined measures and protocols, taking care of all patients. Key Points • Coronavirus disease pandemic determined a reduction of interventional radiology activity as compared to the same period of the previous year. • Interventional radiology procedures for life-threatening conditions and non-deferrable oncologic treatments were prioritized as opposed to elective procedures. • Strict adoption of safe procedures allowed us to have until now no incidents of cross-infection of non-infected from infected patients and no evidence of COVID-19 infection of HCWs in the IR service.
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Affiliation(s)
- Roberto Iezzi
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy. .,Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy.
| | - Iacopo Valente
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Alessandro Cina
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Alessandro Posa
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Andrea Contegiacomo
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Andrea Alexandre
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Francesco D'Argento
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Emilio Lozupone
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Michele Barone
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Francesca Giubbolini
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Luca Milonia
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Andrea Romi
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Anna Rita Scrofani
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Alessandro Pedicelli
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy
| | - Riccardo Manfredi
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy.,Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
| | - Cesare Colosimo
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia - Area di Diagnostica per Immagini, UOC Radiologia Diagnostica e Interventistica Generale, L.go A. Gemelli 8, 00168, Rome, Italy.,Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
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20
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Wong ASK, Ooi CC, Leow MQH, Kiew YS, Yeo KCW, Tan SG, Tay KH. Adapting Lessons From SARS for the COVID-19 Pandemic-Perspectives From Radiology Nursing in Singapore. ACTA ACUST UNITED AC 2020; 39:164-167. [PMID: 32837391 PMCID: PMC7318957 DOI: 10.1016/j.jradnu.2020.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
When severe acute respiratory syndrome (SARS) hit Singapore in 2003, we began to formulate rigorous protocols and reconfigure our facilities to prevent in-hospital transmission. This became the foundation of our practices in COVID-19. However, some adaptations were made to suit the current needs of the department, and technology has been used for communication. This article describes the preparation and response of nursing in the radiology department in Singapore in SARS and coronavirus 2019 (COVID-19) outbreak. Protocols and measures taken during SARS and COVID-19 outbreak are described. Stringent infection control and prevention measures, detailed standard operating protocols for handling SARS and COVID-19 patients coming for radiological examinations and interventions, team segregation, safe distancing, efficient communication, and rigorous staff surveillance are paramount to ensure patient and staff safety. Our SARS experience has shaped our preparations and response toward the COVID-19 pandemic. To date, there have been zero health care worker transmissions in the department. The crisis has also enhanced the cohesiveness among staff because of the camaraderie and shared experience. The response and measures taken by the radiology department in a large acute care teaching hospital could be practiced in other similar health care settings. Regular infection control audits should be part of routine nursing care. In a pandemic, more stringent infection control protocols and audits are required. Team segregation help to prevent shutdown of services if a staff gets infected. Online platforms allow rapid communication, and reduce face-to-face discussions.
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Affiliation(s)
- Agnes Sau Kheng Wong
- Division of Radiological Sciences, Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore
| | - Chin Chin Ooi
- Radiography Unit, Division of Radiological Sciences, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Mabel Qi He Leow
- University of Western Australia, Faculty of Health and Medical Sciences, Perth, Australia
| | - Yen San Kiew
- Radiography Unit, Division of Radiological Sciences, Singapore General Hospital, Singapore
| | - Kenneth Chye Whatt Yeo
- Radiography Unit, Division of Radiological Sciences, Singapore General Hospital, Singapore
| | - Soong Geck Tan
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Kiang Hiong Tay
- Division of Radiological Sciences, Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
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21
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Diagnostic Ultrasound Services During the Coronavirus Disease (COVID-19) Pandemic. AJR Am J Roentgenol 2020; 215:1130-1135. [PMID: 32520580 DOI: 10.2214/ajr.20.23167] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE. Nosocomial transmission of coronavirus disease (COVID-19) to frontline health care workers is well known, and health care workers may inadvertently become vectors for onward transmission. Ultrasound (US) service providers are at significant risk because scanning usually requires prolonged close patient contact. The bulky US equipment may also facilitate fomite transmission of disease. With increasing use of point-of-care and portable diagnostic US services, the risk is substantial. CONCLUSION. Our experience and protocols may help service providers with their own effective response against COVID-19.
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22
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Interventional Radiology Preparedness in the Time of the COVID-19 Pandemic: Is there a Gold Standard? Cardiovasc Intervent Radiol 2020; 43:1420-1422. [PMID: 32435832 PMCID: PMC7239503 DOI: 10.1007/s00270-020-02510-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/28/2020] [Indexed: 01/07/2023]
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