IMPACT OF THE COVID-19 PANDEMIC ON SURGICAL PROCEDURES IN BRAZIL: A DESCRIPTIVE STUDY

COVID-19 pandemic has deeply affected medical practice, and conducts o minimize the overload of healthcare services were necessary. The objective of this study is to evaluate the impact of the pandemic in the practice of surgical procedures in Brazil. This is a descriptive study with data about hospitalizations for surgical procedures in Brazil from 2016 to 2020, collected from the Department of Informatics of Brazil’s Unified Health System (DATASUS). Primary analysis describes the variations in the number of elective, urgent and other types of surgical procedures performed during this period, by comparing the mean number of hospitalizations from 2016 to 2019 with the absolute number from 2020. Secondary analysis describe the variations in hospitalizations for surgical procedures during this period in each of Brazil’s geographical regions, and variations in different surgical procedure subgroups. There was a decrease of 14.88% [95% CI: 14,82-14,93] in hospitalizations for surgical procedures in 2020, when comparing to the mean between 2016-2019. Decrease rates were 34.82% [95% CI: 34,73-34,90] for elective procedures and 1.11% [95% CI: 1.07-1.13] for urgent procedures. Surgical procedure subgroups with highest decrease rates were endocrine gland surgery, breast surgery, oral-maxillofacial surgery and surgery of upper airways, face, head and neck. The overload of healthcare facilities demanded reductions in non-urgent activities to prevent services’ collapse. Further studies are needed to evaluate the social and clinical impact of such reductions and support the development of precise criteria defining which procedures should be prioritized.

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Impact of the COVID-19 pandemic on surgical procedures in Brazil: a descriptive study

10.21203/rs.3.rs-337266/v1 ◽

2021 ◽

Author(s):

Bárbara Okabaiasse Luizeti ◽

Victor Augusto Santos Perli ◽

Gabriel Gonçalves da Costa ◽

Igor da Conceição Eckert ◽

Aluisio Marino Roma ◽

...

Keyword(s):

Health System ◽

Surgical Procedures ◽

Subcutaneous Tissue ◽

Maxillofacial Surgery ◽

Descriptive Study ◽

Healthcare Systems ◽

Oral And Maxillofacial Surgery ◽

Endocrine Gland ◽

Upper Airways ◽

The Impact

Abstract Background: The COVID-19 pandemic has deeply affected medical practice, and changes in healthcare activities were needed to minimize the overload and avoid healthcare systems collapse. The aim of this study was to evaluate the impact of the pandemic on surgical procedures in Brazil. Materials and Methods: We conducted a descriptive study of the number of hospitalizations for surgical procedures in Brazil from 2016 to 2020. Data were collected from the Brazilian Department of Informatics of the Unified Health System (DATASUS). Analyzes were performed according to the type of procedure, geographical region, subgroups of surgical procedures, and the number of surgeries from 2020 were compared with the average from 2016 to 2019. Results: There were 4,009,116 hospitalizations for surgical procedures in the Brazilian Public Health System in 2020. When comparing it to the average of hospitalizations from 2016-2019, there was a decrease of 14.88% [95%IC (14.82-14.93)]. Decrease rates were 34.82% [95%IC (34.73-34.90)] for elective procedures and 1.11% [95%IC (1.07-1.13)] for urgent procedures. Decrease rates were similar in all the five regions of the country (average 14.17%). Surgical procedure subgroups with the highest decrease rates were endocrine gland surgery (48.03%), breast surgery (40.68%), oral and maxillofacial surgery (37.03%), surgery of the upper airways, face, head and neck (36.06%), and minor surgeries and surgeries of skin, subcutaneous tissue and mucosa (33.16%). Conclusion: The overload of healthcare facilities has demanded a reduction of non-urgent activities to prevent a collapse of healthcare systems, resulting in a decrease in elective surgeries. Recommendations about the performance of surgical procedures were made, and continuous refinements of these recommendations are encouraged.

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Impact of the COVID-19 pandemic on surgical procedures in Brazil: a descriptive study

10.1101/2021.03.17.21253801 ◽

2021 ◽

Author(s):

Barbara Okabaiasse Luizeti ◽

Victor Augusto Santos Perli ◽

Gabriel da Costa ◽

Igor Eckert ◽

Aluisio Marino Roma ◽

...

Keyword(s):

Health System ◽

Surgical Procedures ◽

Subcutaneous Tissue ◽

Maxillofacial Surgery ◽

Descriptive Study ◽

Healthcare Systems ◽

Oral And Maxillofacial Surgery ◽

Endocrine Gland ◽

Upper Airways ◽

The Impact

Background: The COVID-19 pandemic has deeply affected medical practice, and changes in healthcare activities were needed to minimize the overload and avoid healthcare systems collapse. The aim of this study was to evaluate the impact of the pandemic on surgical procedures in Brazil. Materials and Methods: We conducted a descriptive study of the number of hospitalizations for surgical procedures in Brazil from 2016 to 2020. Data were collected from the Brazilian Department of Informatics of the Unified Health System (DATASUS). Analyzes were performed according to the type of procedure, geographical region, subgroups of surgical procedures, and the number of surgeries from 2020 were compared with the average from 2016 to 2019. Results: There were 4,009,116 hospitalizations for surgical procedures in the Brazilian Public Health System in 2020. When comparing it to the average of hospitalizations from 2016-2019, there was a decrease of 14.88% [95%IC (14.82-14.93)]. Decrease rates were 34.82% [95%IC (34.73-34.90)] for elective procedures and 1.11% [95%IC (1.07-1.13)] for urgent procedures. Decrease rates were similar in all the five regions of the country (average 14.17%). Surgical procedure subgroups with the highest decrease rates were endocrine gland surgery (48.03%), breast surgery (40.68%), oral and maxillofacial surgery (37.03%), surgery of the upper airways, face, head and neck (36.06%), and minor surgeries and surgeries of skin, subcutaneous tissue and mucosa (33.16%). Conclusion: The overload of healthcare facilities has demanded a reduction of non-urgent activities to prevent a collapse of healthcare systems, resulting in a decrease in elective surgeries. Recommendations about the performance of surgical procedures were made, and continuous refinements of these recommendations are encouraged.

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Positive patient experience of wide awake local anaesthesia no tourniquet (WALANT) hand surgery in the government setting: a prospective descriptive study

SA Orthopaedic Journal ◽

10.17159/2309-8309/2021/v20n3a1 ◽

2021 ◽

Vol 20 (3) ◽

Author(s):

Jaco J Naude ◽

Odette Koch ◽

Ludwig W Schmidt ◽

Theo LB le Roux

Keyword(s):

Patient Experience ◽

Carpal Tunnel ◽

Local Anaesthesia ◽

Surgical Procedure ◽

Hand Surgery ◽

Descriptive Study ◽

Trigger Finger ◽

The Mean ◽

Wide Awake ◽

No Tourniquet

ABSTRACT BACKGROUND: The purpose of this study was to establish a subjective patient experience with wide awake local anaesthesia no tourniquet (WALANT) procedures performed in the institution from May 2019 to March 2020. WALANT surgery was initiated to improve standard operating procedure and to decrease theatre burden METHODS: This prospective, descriptive study included 100 patients with a mean age of 59 years who required either a carpal tunnel or trigger finger release. The patients' pain experience was documented on the visual analogue scale (VAS) for the local anaesthetic injection and the surgical procedure. Overall experience was assessed on the patient's preference to have the procedure performed by the WALANT method or the conventional method RESULTS: One hundred patients were included, of which 67 had medical comorbidities. The mean VAS score was 1.5 (SD±1.6) with pain on injection. The mean VAS pain score during the surgical procedure was 0.2 (SD±0.7). One hundred per cent of patients (100/100) felt they would do the WALANT outpatient procedure again instead of admission to hospital and surgery in the theatre. Two complications occurred related to wound care problems, and were successfully managed. None of the patients required reoperations for incomplete release of the carpal tunnel or trigger finger surgery CONCLUSION: The results of this study suggest that minor hand surgery using the WALANT protocol can be performed effectively and with high patient satisfaction rates in the orthopaedic outpatient clinic, and is a useful tool in the skillset of a hand surgeon Level of evidence: Level 4 Keywords: WALANT, hand surgery, trigger finger, carpal tunnel release

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Comparison of earthworm populations in arable and grassland fields in the Outer Western Carpathians, South Poland

Biologia ◽

10.1515/biolog-2016-0035 ◽

2016 ◽

Vol 71 (3) ◽

Cited By ~ 4

Author(s):

Agnieszka Józefowska ◽

Anna Miechówka ◽

Jan Frouz

Keyword(s):

Chemical Properties ◽

Biological Properties ◽

Outer Western Carpathians ◽

Geographical Regions ◽

Type Of Land Use ◽

Earthworm Biomass ◽

The Mean ◽

Physical And Chemical ◽

The Impact ◽

Earthworm Populations

AbstractThe impact of different geographical regions (Silesian Foothills, region 1 and Maly Beskids, region 2), and method of soil use (arable field and grassland) on the main soil properties and biological activity was studied. Earthworm biomass, density and diversity, as well as dehydrogenase activity, were analysed. Significant soil physical and chemical properties were more affected by regions, whereas the type of land use had a greater impact on the biological properties. The mean earthworm density was 213 ind. m

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The Impact of STRICTA and CONSORT on Reporting of Randomised Control Trials of Acupuncture: A Systematic Methodological Evaluation

Acupuncture in Medicine ◽

10.1136/acupmed-2017-011519 ◽

2018 ◽

Vol 36 (6) ◽

pp. 349-357 ◽

Cited By ~ 13

Author(s):

Simen Svenkerud ◽

Hugh MacPherson

Keyword(s):

Positive Impact ◽

Meta Analysis ◽

Reporting Quality ◽

Primary Analysis ◽

Quality Of Reporting ◽

The Mean ◽

Time Periods ◽

The Impact ◽

Over Time

Background Clear and unambiguous reporting is essential for researchers and clinicians to be able to assess the quality of research. To enhance the quality of reporting, consensus-based reporting guidelines are commonly used. Objectives To update and extend previous research by evaluating the more recent impact of STRICTA (STandards for Reporting Interventions in Controlled Trials of Acupuncture) and CONSORT (CONsolidated Standards Of Reporting Trials) guidelines on the quality of reporting of acupuncture trials. Methods By random sampling, approximately 45 trials from each of five 2-year time periods between 1994 and 2015 were included in the study. Using scoring sheets based on the STRICTA and CONSORT checklist items (range 0 to 7 and 0 to 5, respectively), the distribution of items reported over time was investigated, with changes shown using scatterplots. The primary analysis used a before-and-after t-test to compare time periods. A meta-analysis investigated whether or not trials published in journals that endorsed STRICTA were associated with better reporting. Results The study included 207 trials. Improved reporting of items over time was observed, as represented by changes in the scatterplot slope and intercept. The mean STRICTA score increased from 4.27 in the 1994–1995 period to 5.53 in 2014–2015, an 18% improvement. The mean CONSORT score rose from 1.01 in the 1994–1995 period to 3.32 in 2014–2015, an increment of 46%. There was proportionately lower reporting for items related to practitioner background (STRICTA) and for randomisation implementation and allocation concealment (CONSORT). Trials published in journals that endorsed STRICTA had statistically significantly superior reporting of both STRICTA and CONSORT items overall. Conclusion This study has provided evidence of an improvement in reporting of STRICTA and CONSORT items over the time period from 1994 to 2015. Journals that endorse STRICTA have a better record in terms of reporting quality. Some evidence suggests that the publication of STRICTA has had a positive impact on reporting quality.

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Multicentric descriptive study of the lung cancer treatment

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.20109 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 20109-20109

Author(s):

M. Quintana ◽

C. Pallares ◽

I. Martinez ◽

I. Gich ◽

X. Bonfill

Keyword(s):

Lung Cancer ◽

Cancer Treatment ◽

Clinical Characteristics ◽

Descriptive Study ◽

Small Cell ◽

Lung Cancer Treatment ◽

The Mean ◽

Clinical Records ◽

The Cost ◽

The Impact

20109 Background: Given the insufficient available information on the clinical characteristics and the results of the lung cancer treatment at a population level, we performed a large multicentric descriptive study in the main hospitals in our city. Methods: We analyzed the patients diagnosed and treated for lung cancer during 1999 in five University Hospitals in Barcelona (Spain). We performed a retrospective analysis of the individual data obtained from the clinical records using a specifically validated questionnaire. A descriptive analysis was performed, stratifying for type of tumor, stage, and institution. The follow-up for the complete population was 5 years. Results: We included 836 patients (94.6% male, 5.4% female) with an average age of 64 years. Karnofsky was ≥ 70% in 85% of patients. Histologic distribution was non-small cell (NSCLC) 85.5%, small-cell (SCLC) 14.5%. 42% of cases were stage IV (38% NSCLC, 67.8% SCLC). First treatment was performed in 82% of cases with therapeutic intention (52% was chemotherapy). Pulmonary resection with lobectomy and platinum-based chemotherapy were the more frequent treatments. Complete remission was obtained in 25% of cases. Survival was 42.0, 17.9 and 12.6% at 1, 3 and 5 years respectively (NSCLC: 43.8, 19.4, 13.1%; SCLC: 31.9, 9.5, 9.5%). The mean interval first visit - treatment start was 2 months. The mean of direct costs per patient was 9000 €. The cost per life-year gained was 5200 € for NSCLC and 7600 € for SCLC patients. Conclusions: The obtained results allow to describe the clinical characteristics of a wide cohort of patients diagnosed of lung cancer and their survival to 5 years. Globally, these results are similar to those who have been published in our country and others, and constitute a very thorough referent for assessing the impact of future therapeutic advances. The comparison among hospitals can also be the matter of further analysis for identifying the causes of the observed differences. Equally, specific strategies for some patients’ subgroups could be designed in order to improve the cost-effectiveness of their treatment. No significant financial relationships to disclose.

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Teledermatology in paediatrics: Health-care impact on the early treatment of infantile haemangiomas

Journal of Telemedicine and Telecare ◽

10.1177/1357633x20904901 ◽

2020 ◽

pp. 1357633X2090490 ◽

Cited By ~ 1

Author(s):

Isabel Betlloch-Mas ◽

María-Teresa Martínez-Miravete ◽

Laura Berbegal-DeGracia ◽

Laura Sánchez-Vázquez ◽

José Sánchez-Payá

Keyword(s):

Health Care ◽

Response Time ◽

Early Treatment ◽

Descriptive Study ◽

Sex Diagnosis ◽

Health Area ◽

Propranolol Treatment ◽

The Mean ◽

The Impact ◽

Infantile Haemangiomas

Introduction Teledermatology can solve diagnostic and therapeutic problems in paediatrics, for example in infantile haemangiomas (IHs) requiring early treatment with propranolol. This study aims to assess the impact of teledermatology following its implementation in a health area of Spain, specifically analysing its effectiveness in reducing the age of first propranolol treatment for IH. Methods This was a descriptive study of paediatric teledermatology from 2015 to 2018, studying age, sex, diagnosis, time and mode of resolution. All IHs referred via teledermatology were analysed, and age at propranolol initiation was compared to the period prior to implementation (2008–2014). We also analysed IHs according to referral pathways (teledermatology vs. conventional pathways). Results We included 432 consultations (47.7% boys). The main diagnoses were IH, erythematous-desquamative diseases and infections. Concordance in diagnosis between paediatricians and dermatologists was good, and 48.12% of cases consulted via teledermatology were resolved remotely. Response time was 2.81 days on average. Children younger than two months of age showed the highest proportion of in-person visits. In 2015–2018, children with IHs began treatment with propranolol at a mean age of 4.5 months (1.9 months in those referred via teledermatology vs. 5.6 months in those using conventional referral pathways). In 2008–2014, the mean age at referral was 7.1 months. These differences were significant. Discussion Teledermatology is a fast and effective tool to resolve paediatric cases, enabling a significant decrease in the age of treatment in infants with IH.

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Anesthetic recovery assisted by rope at three points in horses

Ciência Rural ◽

10.1590/0103-8478cr20180154 ◽

2018 ◽

Vol 48 (11) ◽

Author(s):

Diego Rafael Palma da Silva ◽

Gabriele Biavaschi Silva ◽

Flávio Desessards De La Corte ◽

Karin Erica Brass ◽

Ricardo Pozzobon ◽

...

Keyword(s):

General Anesthesia ◽

Surgical Procedures ◽

Surgical Procedure ◽

Recovery Time ◽

Safe Procedure ◽

Quality Of Recovery ◽

Anesthetic Drugs ◽

Time Test ◽

The Mean

ABSTRACT: This study evaluated the quality of anesthesyc recovery of horses using a three-point assisted method. Sixty-eight horses (37 females and 31 males) of different breeds, age and weight submitted to general anesthesia for abdominal - ABD (n=15), arthroscopy - ART (n=17), other orthopedic - ORT (n=18) and miscellaneous - MIX (n=18) surgical procedures. Isoflurane resulted in shorter recovery time (67.4±25.7min) compared to halothane (88.0±37.8min). The mean duration (±SD) of anesthesia for ABD, ORT, ART and MIXgroups was 166.7 (±14), 54.9 (±5.9), 86.5 (±7.3) and 76.4 (±32.5) minutes (min) respectively. Quality of recovery wasn’t influenced by duration of anesthesia or by use of analgesic, sedative and/or anesthetic drugs or not (p>0.05). Mean standing time (TEst) during anesthetic recovery was 67.5 (±29.9) min in ABD, 44.4 (±27) min in ORT, 42.2 (±23.2) min in ART and 39 (±14.7) min in MIX group. Average number of attempts (Ast) to stand was 1.8 (±0.8) in ABD group, 3.1 (±4.7) in ORT, 1.8 (±1.2) in ART and 1.8 (±1.2) in MIX. Recovery time (TRec) in ABD group was 102.2 (±36.5) min, ORT 70.1 (±36.5) min, ART 72.2 (±24.8) min and MIX group 66.6 (±19.1) min. TRec differed (p<0.05) between ABDand other groups. Three-point assisted recoveryfrom anesthesia showed to be a safe procedure during horses’ recovery. This method is easy to apply and well tolerated by horses regardless of the surgical procedure.

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The Impact of Surgical Procedures During Septorhinoplasty on the Intraoperative Pain Response

Aesthetic Surgery Journal ◽

10.1093/asj/sjab234 ◽

2021 ◽

Author(s):

Bilsev Ince ◽

Moath Zuhour ◽

Merve Yusifov ◽

Atilla Erol ◽

Mehmet Dadaci

Keyword(s):

Surgical Procedures ◽

Pain Response ◽

Depth Of Anesthesia ◽

State Entropy ◽

Average Value ◽

Lateral Osteotomy ◽

The Central Nervous System ◽

Intraoperative Pain ◽

The Mean ◽

The Impact

Abstract Background During septorhinoplasty, many different surgical procedures are used to bring the nose to the desired shape and to solve the breathing complaints. As a matter of course, intraoperative pain response occurs due to these procedures. Objectives This study aims to evaluate the intraoperative pain formed during septorhinoplasty surgery with numerical values, and to determine which stage of surgery is more painful. Methods Between April 2019 and March 2020, a total of 30 female patients who were planned to undergo septorhinoplasty were included in this prospective study. Standard anesthesia and analgesia were applied to all patients. During surgery, State Entropy (SE) measure was used to evaluate the depth of anesthesia, and Surgical Pleth Index (SPI) was used to evaluate the response of the central nervous system to pain "Nociception". Results The age of the patients ranged from 18-42-years-old (average, 25.3 ± 6.1 years). The average value of State Entropy (SE) recorded during the surgery for all patients was found to be 45.43 ± 5.37. The mean beginning SPI value recoded from all of the patients was found to be 23.4 ± 8.84, when compared with the beginning value; the values recorded during periost dissection, lateral osteotomy and lower turbinate lateralization were statistically significantly higher (P <0.005). Conclusions Although sufficient depth of anesthesia and standard protocol of analgesia were applied, pain response was found to be significantly higher at some procedures during septorhinoplasty. We think that increasing the depth of anesthesia during these procedures will increase the comfort of this operation by inhibiting pain response.

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Haptic-Assisted Virtual Osteotomy As a Training Tool

Volume 3: Biomedical and Biotechnology Engineering ◽

10.1115/imece2017-72211 ◽

2017 ◽

Author(s):

Eder H. Govea-Valladares ◽

Hugo I. Medellín-Castillo ◽

Pedro J. García-Zugasti ◽

Pablo A. Limon-Leyva

Keyword(s):

Clinical Practice ◽

Surgical Procedures ◽

Surgical Procedure ◽

Surgical Planning ◽

Planning Process ◽

Maxillofacial Surgery ◽

Free Form ◽

Virtual Training ◽

Training Tool ◽

Virtual Osteotomy

The maxillofacial surgery is a complex surgical procedure to correct facial malformations located in the head of the patient. A precise and reliable surgical planning is necessary for a successful maxillofacial surgical procedure. The experience and clinical practice of surgeons play a very important role during the surgical procedures. Modern Computer Aided Systems (CAS) have been developed in order to speed up the surgical planning process and to increase the accuracy and reliability of the surgical procedure. However, CAS systems have not been focused on their ability to train and to provide experience and clinical practice to novice surgeons or medical student. In this way CAS systems could be a potential tool to improve the skill of surgeons in order to decrease human errors in the maxillofacial treatment and surgical procedures. This paper presents an investigation to evaluate the use of virtual reality and haptic systems as a training tool for maxillofacial surgeries, in particular osteotomies procedures. The aim is to evaluate the effect of virtual training on surgeon skills. Thus, a virtual osteotomy system has been developed and is presented. The system is based on an open source computer and programming resources, and makes use of haptic technologies to provide the users with the sense of touch. The virtual osteotomy procedures implemented are based on current surgical orthognathic surgery procedures. Free-form 3D manual cutting of bone is available in the system by means of the haptic device and the force feedback provided to the user, which increases the level of realism of the virtual procedure. The evaluation results show that the haptic-enabled virtual training of osteotomies increases the psychomotor skills of the practitioner, leading to an improved accuracy when carrying out the actual bone cut.

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