scholarly journals Telemedicine in Spine Surgery: Global Perspectives and Practices

2021 ◽  
pp. 219256822110223
Author(s):  
Grant Riew ◽  
Francis Lovecchio ◽  
Dino Samartzis ◽  
Philip K. Louie ◽  
Niccole Germscheid ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Descriptive Statistics ◽  
South American ◽  
Geographical Differences ◽  
Cross Sectional ◽  
Global Perspectives ◽  
Phone Calls ◽  
Initial Appointment ◽  
Almost All

Study Design: Cross-sectional, anonymous, international survey. Objectives: The COVID-19 pandemic has resulted in the rapid adoption of telemedicine in spine surgery. This study sought to determine the extent of adoption and global perspectives on telemedicine in spine surgery. Methods: All members of AO Spine International were emailed an anonymous survey covering the participant’s experiences with and perceptions of telemedicine. Descriptive statistics were used to depict responses. Responses were compared among regions. Results: 485 spine surgeons participated in the survey. Telemedicine usage rose from <10.0% to >39.0% of all visits. A majority of providers (60.5%) performed at least one telemedicine visit. The format of “telemedicine” varied widely by region: European (50.0%) and African (45.2%) surgeons were more likely to use phone calls, whereas North (66.7%) and South American (77.0%) surgeons more commonly used video ( P < 0.001). North American providers used telemedicine the most during COVID-19 (>60.0% of all visits). 81.9% of all providers “agreed/strongly agreed” telemedicine was easy to use. Respondents tended to “agree” that imaging review, the initial appointment, and postoperative care could be performed using telemedicine. Almost all (95.4%) surgeons preferred at least one in-person visit prior to the day of surgery. Conclusion: Our study noted significant geographical differences in the rate of telemedicine adoption and the platform of telemedicine utilized. The results suggest a significant increase in telemedicine utilization, particularly in North America. Spine surgeons found telemedicine feasible for imaging review, initial visits, and follow-up visits although the vast majority still preferred at least one in-person preoperative visit.

scholarly journals Utility of telemedicine in COVID-19 pandemic: our experience at a tertiary cancer center in North East India

2020 ◽  
Vol 8 (11) ◽  
pp. 4027
Author(s):  
Ashok Kumar Das ◽  
Sumanjit S. Boro ◽  
Anupam Das ◽  
Partha Pratim Medhi ◽  
Kaberi Kakati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Task Force ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Cross Sectional ◽  
Ongoing Treatment ◽  
North East ◽  
Phone Calls

Background: Telemedicine is a very useful tool of communication between the doctor and the patient. The aim of this study was to find out the utility of telemedicine during the lockdown period of COVID-19 pandemic in North East India.Methods: It is a cross sectional study among the cancer patients at our center on follow up or ongoing treatment and analysis of all the data acquired from telephonic conversation with our patients from 30th March, 2020 to 3rd May, 2020. Have contacted 4181 patients during this period over phone. All phone calls were done by respective department doctors.Results: From the demographic data, we get that 35.4% of patients were at good physical condition, 3.5% with poor general condition, 11.6% patients having ongoing treatment in our institute, 21.1% patients expired, 0.9% patients have nonmalignant diagnosis, 1.4% patients left the institute due to various reasons. Analyzed this data with brain storming sessions amongst the COVID-19 task force doctors and tried to find out solutions of each problem.Conclusions: Telemedicine cannot replace conventional method of in person treatment, but it proved to be a useful tool during the COVID-19 pandemic for patient follow up and treatment of cancer patients.

scholarly journals Statin Utilization among Patients with Acute Coronary Syndrome: Systematic Review

2021 ◽  
Vol 9 (T4) ◽  
pp. 267-278
Author(s):  
Pramitha Esha Nirmala Dewi ◽  
Montarat Thavorncharoensap
Keyword(s):  
Acute Coronary Syndrome ◽  
Current Practice ◽  
Utilization Rate ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Early Use ◽  
Risk Patients ◽  
Almost All ◽  
Intensive Regimen

BACKGROUND: The early use of statin with intensive regimen has been recommended by the recent guidelines as the prevention of acute coronary syndrome (ACS) related events among the high-risk patients. Meanwhile, the inconsistent statin utilization for targeted patient in current practice is still an issue. AIM: This study aims to review the utilization rate of statin among patients with ACS. METHODS: A systematic search of relevant studies published between inceptions to June 2020 was conducted in PubMed. Patients and intervention domains were used to build up the searching formula. A study was eligible for inclusion if it was an original study of patients with ACS and it examined the utilization of statin. The risk of bias was assessed using Axis and NOS checklist. RESULTS: Among the 49 eligible studies, 38 were cohort studies while the others were cross-sectional studies. The utilization rate of statin at hospital admission ranged from 16% to 61% while 25% to 75% during the hospitalization. Of the total studies, 35 studies reported the statin rate at discharge ranging from 58% to 99%. Almost all studies revealed the reduction of statin utilization rate along the follow-up period. The number of statins prescribed was found to be lower among female and elderly patients. CONCLUSION: Despite the established benefits of statin among patients with ACS, our study revealed that statin was underutilized for secondary prevention after ACS. To improve patients’ clinical outcomes with ACS, efforts should be made to increase optimal treatment and compliance with a statin.

FP1-2 Implementation of duty of candor regulation within neurosurgery: a national cross-sectional survey

2019 ◽  
Vol 90 (3) ◽  
pp. e22.3-e22
Author(s):  
HJ Marcus ◽  
P Sayal ◽  
N Kitchen ◽  
B Surajit ◽  
L Thorne
Keyword(s):  
Adverse Events ◽  
Online Survey ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Statutory Duty ◽  
Safety Incident ◽  
Patient Safety Incident ◽  
Survey Responses ◽  
Almost All

ObjectivesStatutory Duty of Candor was introduced in 2014 for NHS bodies in England. Contained within the regulation were definitions regarding the threshold for what constitutes a notifiable patient safety incident. The aim of this survey was to evaluate the interpretation of these definitions by British neurosurgeons.MethodsFull members of the SBNS were electronically invited to participate in an online survey. Surgeons were presented with 15 cases and asked to decide in each one whether they would trigger the process of Duty of Candor. Cases were stratified according to their likelihood and severity.ResultsIn all, 106/357 (29.7%) members participated in the survey. Responses varied widely with almost no members triggering the process of Duty of Candor in cases where adverse events were likely (>10% likelihood) and required only outpatient follow up (7/106; 6.6%), and almost all members doing so in cases where adverse events were rare (<0.1% likelihood) and resulted in death (102/106; 96.2%). However, there was clear equipoise in triggering the process of Duty of Candor in cases where adverse events were unlikely (0.1%–10% likelihood) and resulted in moderate harm (38/106; 35.8%), severe harm (57/106; 53.8%), or death (49/106; 46.2%).ConclusionsThere is considerable nationwide variation in the interpretation of definitions regarding the threshold for Duty of Candor; this has important implications with some providers at risk of penalties, and others unduly burdened by the associated administrative processes.

scholarly journals Mother Baby's Knowledge About Post-Immunization Follow-up Events (KIPI) Pentabio Immunization

2020 ◽  
Vol 9 (2) ◽  
pp. 11-17
Author(s):  
Ni ketut ayu sugiartini
Keyword(s):  
Sampling Technique ◽  
Cross Sectional ◽  
Post Immunization ◽  
Descriptive Research ◽  
Sufficient Knowledge ◽  
Knowledge Based ◽  
Processing Data ◽  
Using Data ◽  
Almost All

Abstract: Mother Baby's Knowledge About Post-Immunization Follow-up Events (KIPI) Pentabio Immunization. The purpose of the study was to find out the knowledge of mothers of infants about post-immunization follow-up events (KIPI) Pentabio immunization based on age, education and parity. The research method used descriptive research with a cross-sectional approach. The number of samples in this study was 77 people. The method of collecting data using a questionnaire and the sampling technique used is a consecutive sampling. Processing data using data tabulation. This study found that the knowledge of mothers of infants about post-immunization follow-up (KIPI) immunization was almost half, namely 20 people (26%) had good knowledge, most of which were 48 people (62.3%) had sufficient knowledge and a small number of nine people (11.7%). ) have less knowledge. Based on almost all age characteristics, 41 (85.4%) of respondents aged 20-35 years had sufficient knowledge. Based on the educational characteristics of almost half, 19 (39.6%) of respondents with secondary education had sufficient knowledge. Based on the characteristics of parity, most of which 30 (62.5%) respondents of multiparas have sufficient knowledge.   Key Words: Knowledge, Immunization, KIPI Pentabio

scholarly journals Study of Hypercoagulability in Patients with Acute Leukaemia in the Hematology Department of Teaching Hospital of Yopougon (Abidjan)

2020 ◽  
Vol 3 (4) ◽  
pp. 1-6
Author(s):  
Mahawa Sangaré-Bamba ◽  
Mahawa Sangaré-Bamba ◽  
Valère Tchako ◽  
Hermance Kassi-Kablan ◽  
Hermance Kassi-Kablan ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Vascular Endothelium ◽  
Acute Leukaemia ◽  
Cross Sectional Study ◽  
Severe Anaemia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Predominance ◽  
Almost All

Introduction Acute leukaemia are the clonal and malignant proliferation of immature hematopoietic cells (blast), blocked in their differentiation process. There is an interaction between cancer cells and the clotting process. This could be the expression of Tissue Factor (TF) on the surface of tumor cells; or a lesion of the vascular endothelium and platelet activation. The result is an activation of clotting that can lead to disseminated Intravascular Coagulation (DIC). The objective of this study was to assess the risk of DIC occurring in patients with acute leukaemia. Methods This was a cross-sectional study for analytical purposes that took place on 40 frozen samples from the biobank of the haematology laboratory of Teaching Hospital Yopougon for which the diagnosis of acute leukaemia had been taken from myelogram. The myelogram results were accompanied by hemogram data. PTTa, QT, fibrinogen and D-Dimers were performed on these samples. The risk assessment of DIC occurred was determined on the recommendations of the International Society of Thrombosis and Hemostasis (ISTH). Results We noted a female predominance with a Sex Ratio (M / F) of 0.90. The average age of the patients was 38 years (± 23 years) with extremes ranging from 2 to 84 years. ALL represented 20 % of cases against 80 % for AMLs. Hemogram parameters were characterized by severe anaemia (Tx Hb < 6 g / dL) in 52.5 % of cases; hyperleukocytosis > 100.103 / mm3 in 35 % of cases; thrombocytopenia < 25.103 / mm3 in 40 % of case; and significant blood and spinal cord blastosis (> 80 %). The lengthening of the PTTa was observed in 50 % of cases, compared to 40% for the QT. Similarly, hyperfibrinemia was present in 65% of cases. D-Dimers were high in almost all subject (95 % of cases). According to the ISTH criteria, 17.5 % of subjects were at risk of developing a DIC. Conclusion The risk of occurrence of DIC is indeed present during acute leukaemia. The parameters of haemostasis are thus found to be crucial data in the follow-up assessment during the diagnosis of acute leukaemia.

scholarly journals 424. The Impact of COVID-19 Response on Infection Prevention Programs and Practices in Southeastern United States

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S312-S312
Author(s):  
Sonali D Advani ◽  
Sonali D Advani ◽  
Andrea Cromer ◽  
Brittain A Wood ◽  
Esther Baker ◽  
...  
Keyword(s):  
Resource Availability ◽  
Infection Prevention ◽  
Cross Sectional ◽  
Elective Surgical Procedures ◽  
Symptom Screening ◽  
Initial Survey ◽  
One Year ◽  
Almost All ◽  
The Impact

Abstract Background Early assessments of COVID19 preparedness reported resource shortages, use of crisis capacity strategies, variations in testing, personal protective equipment (PPE), and policies in US hospitals. One year later, we performed a follow-up survey to assess changes in infection prevention practice and policies in our diverse network of community and academic hospitals. Methods This was a cross-sectional electronic survey of infection preventionists in 58 hospitals within the Duke Infection Control Outreach Network (community) and Duke/UNC Health systems (academic) in April-May 2021 to follow-up our initial survey from April 2020. The follow-up survey included 26 questions related to resource availability, crisis capacity strategies, procedures, changes to PPE and testing, and staffing challenges. Results We received 54 responses (response rate, 93%). Facilities reported significantly fewer PPE and resource shortages in the follow-up survey compared to our initial survey (Figure 1, P&lt; 0.05). Only 32% of respondents were still reprocessing N95 respirators (compared to 73% in initial survey, P&lt; 0.05). All hospitals performed universal masking, universal symptom screening on entry, and 30% required eye protection. In 2020, most hospitals suspended elective surgical procedures in March-April, and restarted in May-June. Approximately 92% reported in-house testing for SARS-COV-2 by April 2020, at least a third of which had a weekly capacity of &gt;100 tests. Almost 80% performed universal pre-operative testing, while 61% performed universal preadmission testing for SARS-COV-2. Almost all hospitals switched from test-based to time-based strategy for discontinuing isolation precautions, majority in August-September 2020. Twenty-five percent hospitals reported infection prevention furloughs, staffing cuts, and or reassignments, while 81% reported increased use of agency nursing during the pandemic. Conclusion Our follow-up survey reveals improvement in resource availability, evolution of PPE guidance, increase in testing capacity, and burdensome staffing changes. Our serial surveys suggest increasing uniformity in infection prevention policies, but also highlight the increase in staff turnover and infection prevention staffing shortages. Disclosures Sonali D. Advani, MBBS, MPH, Nothing to disclose David J. Weber, MD, MPH, PDI (Consultant)

Cardiac rhabdomyoma in childhood tuberous sclerosis

1995 ◽  
Vol 5 (2) ◽  
pp. 166-171 ◽  
Author(s):  
Jung Yun Choi ◽  
Eun Jung Bae ◽  
Chung Il Noh ◽  
Yong-Soo Yoon ◽  
Yong Seung Hwang
Keyword(s):  
Tuberous Sclerosis ◽  
Spontaneous Regression ◽  
High Rate ◽  
Cardiac Tumors ◽  
Complete Regression ◽  
Cardiac Rhabdomyoma ◽  
Cross Sectional ◽  
One Year ◽  
Almost All

AbstractWe studied 52 children in order to assess the prevalence, natural history, and electrophysiologic effects of cardiac rhabdomyoma in tuberous sclerosis. Their ages ranged from one day to 12 years (median age 1.33 year). The tumors in the heart were found in 22 patients through cross-sectional echocardiography. The overall prevalence of cardiac rhabdomyoma was 42%. The prevalence of cardiac tumors in patients first seen in infancy was 77%, and that in patients over one year of age was 31%. Those with cardiac tumors diagnosed in infancy had more tumors per person than did the patients diagnosed after infancy, and the tumors were smaller in the patients diagnosed over one year of age. Follow-up cross-sectional echocardiography showed that almost all tumors showed spontaneous regression. Complete regression occurred more commonly in younger patients, and in those with smaller tumors. About 70% of patients with cardiac tumors had either normal findings or infrequent premature contractions on 24hour Holter monitorings. The rest of the patients with cardiac tumors showed either frequent premature contractions, atrioventricular block, or atrial tachycardia, but antiarrhythmic medication was rarely required. Cross-sectional echocardiography, therefore, seems to be the best diagnostic tool for screening cardiac rhabdomyomas in patients with tuberous sclerosis. The tumors may be managed more conservatively in view of their high rate of spontaneous regression and rather rare association with symptomatic arrhythmias.

Title: Remote monitoring program for patients with COVID-19 after hospital discharge: Exploring user's experience and perspectives on two telehealth platforms. (Preprint)

2021 ◽  
Author(s):  
Marie-Pascale Pomey ◽  
Khayreddine Bouabida ◽  
Bertrand Lebouché ◽  
Kathy Malas ◽  
Annie Talbot ◽  
...  
Keyword(s):  
Content Analysis ◽  
Remote Monitoring ◽  
Healthcare Providers ◽  
Monitoring Program ◽  
Healthcare Services ◽  
Descriptive Statistics ◽  
Research Approach ◽  
Quality And Safety ◽  
Cross Sectional ◽  
Phone Calls

BACKGROUND As Covid-19 pandemic circumstances created the need to act to reduce the spread of the virus and alleviate healthcare services from congestions, protect healthcare providers and support them in maintaining a satisfactory quality and safety of care, Covid19 patient remote monitoring platforms quickly emerged. OBJECTIVE This study aimed to evaluate the capacity and contribution of two different platforms' services to monitor remotely patients with Covid-19. The first is a platform of telecare calls (Telecare-Covid), and the second platform is a telemonitoring app (Tactio-Covid). The study sought to examine the differences in acceptability, usefulness, and conviviality of those two different platforms services from users' perspectives and evaluate their contribution in maintaining the quality and safety of care, and engaging patients in their care. METHODS We performed a retrospective cross-sectional study using a survey. The data were collected through phone calls between May and August 2020. The data were analyzed using descriptive statistics, and t-test analysis. The participants' responses and comments on open-ended questions were analyzed using content analysis. The research approach through descriptive statistics allowed us to examine the differences in acceptability, usefulness, and conviviality of those two different platforms services from users' perspectives and determine their contributions to maintaining the quality and safety of care and promoting patient engagement. Whereas the content analysis of the general comments enabled the identification of certain stakes and challenges and improvements paths of the platforms. RESULTS In total, 51 patients participated in the study. 18 participants have used the Tactio-Covid platform and 33 participants have used the Telecare-Covid platform. Overall, the satisfaction rate regarding the quality and safety of the care services provided through the two platforms was 80%. Over 88% of users on each platform considered the services offered by the two platforms as engaging, useful, convivial, and meet their needs. The survey identified very few significant differences in users' perceptions regarding certain aspects on each platform. The survey identified four well-appreciated domains by the platforms’ users: (1) the ease of access and the proximity of care teams, and (2) the conviviality of the platform features (3) the continuity of care, and (4) the multitude of services. Certain stakes and limits such as the importance of maintaining human contact and confidentiality have been also identified and suggestions for improvement have been formulated. CONCLUSIONS This study provided preliminary evidence suggesting that the two remote monitoring platforms were well-received by users by users with very few significant differences between users' experience and perspectives over the two platforms. This type of program can be considered in a post-pandemic era and for other post-hospitalization clienteles. To maximize efficiency, the areas for improvement and the issues identified should be considered in a patient-centered manner. CLINICALTRIAL NA

scholarly journals Orthopedic Master’s in Business Administration: A career path analysis

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Kush S. Mody ◽  
Pankti P. Acharya ◽  
Kyle Brougham ◽  
Selene G. Parekh
Keyword(s):  
Formal Education ◽  
Fellowship Training ◽  
Cross Sectional Study ◽  
Business Administration ◽  
Cross Sectional ◽  
Career Trajectories ◽  
Orthopedic Surgeons ◽  
Phone Calls ◽  
The Many ◽  
Almost All

In recent years, it has become increasingly important for physicians to understand the healthcare system holistically. Thus, some physicians have sought formal education in business through a Master’s in Business Administration (MBA). In this study, we looked specifically at orthopedic MD-MBAs and their career trajectories. We conducted a cross-sectional study of 127 orthopedic surgeons who have both MD and MBA degrees. Through online searches and phone calls, we compiled information regarding years in practice, fellowship training, practice type, non-clinical roles, and business school education. Almost all (96.85%) orthopedic MD-MBAs identified are still practicing clinically. The most common nonclinical roles are administration (38.58%), industry consulting (20.47%), and entrepreneurship (11.02%). Most (65.35%) pursued MBAs after medical school, but dual-degree programs are increasing in popularity. Almost all (88.57%) graduates of such programs have been practicing for less than 15 years. Orthopedic surgeons participate in a variety of nonclinical roles including administration, consulting, and entrepreneurship. For those currently in training, it is important to recognize the many opportunities that exist and the potential paths to pursuing them.

scholarly journals Perioperative Anticoagulation Management in Spine Surgery: Initial Findings From the AO Spine Anticoagulation Global Survey

2020 ◽  
Vol 10 (5) ◽  
pp. 512-527 ◽  
Author(s):  
Philip Louie ◽  
Garrett Harada ◽  
James Harrop ◽  
Thomas Mroz ◽  
Khalid Al-Saleh ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Geographic Location ◽  
Anticoagulation Management ◽  
Cross Sectional ◽  
Global Perspectives ◽  
Geographical Variations ◽  
Medical Clearance ◽  
Perioperative Anticoagulation ◽  
Spine Care ◽  
Spine Surgeon

Study Design: Cross-sectional, international survey. Objectives: This study addressed the global perspectives concerning perioperative use of pharmacologic thromboprophylaxis during spine surgery along with its risks and benefits. Methods: A questionnaire was designed and implemented by expert members in the AO Spine community. The survey was distributed to AO Spine’s spine surgeon members (N = 3805). Data included surgeon demographic information, type and region of practice, anticoagulation principles, different patient scenarios, and comorbidities. Results: A total of 316 (8.3% response rate) spine surgeons completed the survey, representing 64 different countries. Completed surveys were primarily from Europe (31.7%), South/Latin America (19.9%), and Asia (18.4%). Surgeons tended to be 35 to 44 years old (42.1%), fellowship-trained (74.7%), and orthopedic surgeons (65.5%) from academic institutions (39.6%). Most surgeons (70.3%) used routine anticoagulation risk stratification, irrespective of geographic location. However, significant differences were seen between continents with anticoagulation initiation and cessation methodology. Specifically, the length of a procedure ( P = .036) and patient body mass index ( P = .008) were perceived differently when deciding to begin anticoagulation, while the importance of medical clearance ( P < .001) and reference to literature ( P = .035) differed during cessation. For specific techniques, most providers noted use of mobilization, low-molecular-weight heparin, and mechanical prophylaxis beginning on postoperative 0 to 1 days. Conversely, bridging regimens were bimodal in distribution, with providers electing anticoagulant initiation on postoperative 0 to 1 days or days 5-6. Conclusion: This survey highlights the heterogeneity of spine care and accentuates geographical variations. Furthermore, it identifies the difficulty in providing consistent perioperative anticoagulation recommendations to patients, as there remains no widely accepted, definitive literature of evidence or guidelines.

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