scholarly journals The impact of COVID-19 epidemiological restriction guidelines measures in a Croatian tertiary colorectal cancer center

2020 ◽  
Vol 48 (2-3) ◽  
pp. 43-46
Author(s):  
Iva Kirac ◽  
◽  
Zvonimir Misir ◽  
Vesna Vorih ◽  
Loris Ćurt ◽  
...  

Background: In the past six months, Croatia faced a short lockdown and a slow return to most hospitals’ everyday activities. During the lockdown, our center, as a part of the University Hospital Centre specialized for solid cancer, was enabled to maintain most of the routine practices with the one-month colonoscopy exception. Aim: To determine the oscillation in the number of endoscopies and colorectal surgery for 13 months (six months pre and post COVID-19 lockdown). Materials and methods: From August 1st, 2019, until August 31st 2020, the hospital analytics determine the number of colonoscopies, screening colonoscopies, and surgeries. Results: During the given period number of detected and operated colorectal cancers was stable, except for April, when we mostly did not perform colonoscopies. Conclusion: We maintained a pre-COVID-19 pace in colorectal cancer treatment, colonoscopies, and colorectal surgery after epidemiological guidelines for colonoscopies and colorectal surgery were applied, owing to the relatively stable overall epidemiological situation.

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199607 ◽  
Author(s):  
Chia-Lung Shih ◽  
Peng-Ju Huang ◽  
Hsuan-Ti Huang ◽  
Chung-Hwan Chen ◽  
Tien-Ching Lee ◽  
...  

Aim: Taiwan’s response to the coronavirus disease 2019 (COVID-19) differed in that it successfully prevented the spread without having to shutdown or overburden medical services. Patients’ fear regarding the pandemic would be the only reason to reduce surgeries, so Taiwan could be the most suitable place for research on the influence of psychological factors. This study aimed to assess the impact of patients’ fear on orthopedic surgeries in Taiwan amid the peak period of the COVID-19 pandemic. Patients and Methods: The investigation period included the COVID-19 pandemic (March 2020 to April 2020) and the corresponding period in the previous year. The following data on patients with orthopedic diseases were collected: outpatient visits, hospital admission, and surgical modalities. Results: The COVID-19 pandemic led to a 22%–29% and 20%–26% reduction in outpatients, 22%–27% and 25%–37% reduction in admissions, and 26%–35% and 18%–34% reduction in surgeries, respectively, at both hospitals. The weekly mean number of patients was significantly smaller during the COVID-19 pandemic for all types of surgery and elective surgeries at the university hospital, and for all types of surgery, elective surgeries, and total knee arthroplasties at the community hospital. Further, patients visiting the community hospital during the pandemic were significantly younger, for all types of surgery, elective surgeries, and total knee arthroplasties. Conclusions: The reduction in orthopedic surgeries in Taiwan’s hospitals during COVID-19 could be attributed to patients’ fear. Even without restriction, the pandemic inevitably led to a reduction of about 20%–30% of the operation volume.


2020 ◽  
pp. 205715852097518
Author(s):  
Leila Saud Abdulkadir ◽  
Morten Sodemann ◽  
Claire Gudex ◽  
Sören Möller ◽  
Dorthe Susanne Nielsen

The aim was to examine the impact on interpreters’ health knowledge, attitudes and self-evaluated skills after they participated in a pilot health introduction course at a university hospital in Denmark. The study was conducted as an intervention study using a questionnaire with both closed and open-ended questions. The questionnaire was distributed to interpreters one week before the six-week course started, and again at one week and at three months after course completion. Level of knowledge was calculated based on the number of answers to 18 multiple-choice questions on common health issues, diagnoses and treatments. Of the 100 interpreters who registered for the course, 86 completed the course, and 61 of these participants (70%) completed both the baseline and the one-week questionnaire. The mean knowledge score increased from 48 ( SD 6.9) at baseline to 52 ( SD 3.4; p < 0.001) one week after the course and was 51 ( SD 7.3; p < 0.001) three months after the course ( n = 55). Participants who increased their knowledge score the most were those with the least interpreter experience ( p = 0.001). One week after the course, most participants (83–95%) agreed that the individual lessons had been useful in their subsequent interpreting activities and that they had gained useful information. The health introduction course appeared to be beneficial for interpreters. This study highlights the need for greater focus on education for interpreters working in the healthcare sector.


2017 ◽  
Vol 8 (1) ◽  
pp. 100
Author(s):  
Ghrissi Larbi

:it would seem that the University Hospital Centre of Oran suffers from an insufficiency in the control ¶existing human resources and of an inadequacy enters the needs and the profiles ¶existing on the one hand, and that it would not have a true policy of management of ¶human resources which would enable him to benefit best from the resources ¶human available to take up the challenges of management and the development of ¶services provided to the patients.¶


2020 ◽  
Vol 2020 (1) ◽  
pp. 4-10
Author(s):  
Andrey Kirichek ◽  
Sergey Barinov ◽  
Aleksandr Yashin ◽  
Aleksey Zaycev ◽  
Aleksandr Konstantinov

The article raises the problem of the need to take into account real dimensions when they are strengthened by wave deformation. The fact is that in carrying out initial calculations the overall dimensions of the models under study are quite often neglected. On the one hand, this makes it possible to significantly simplify the calculation of the flat model, and on the other - to exclude consideration of the influence of geometric dimensions of the sample on the process to be followed. This is especially relevant in the study of shock systems in which wave processes lie. The effect of the final samples on the hardening process should not be excluded. This is because the elastic-stic deformation pattern has its own features. Hardening is carried out due to transmission of energy in the form of deformation wave, which is transformed on all gras with variable acoustic rigidity, including on boundaries, which are final dimensions of the analysed sample. Preliminary studies have developed a significant effect on the process of wave deformation hardening of geometrical dimensions of the material to be treated, since at equal volumes of strengthened materials and processing modes different distribution of microassay in the surface layer is observed. The established algorithm of further research of the given direction will allow not only to reveal the regularities of through strengthening of samples of different shapes and sizes, but also to establish the possibility of contactless de-formation strengthening of the sides of the sample opposite to the impact of the HRD, which have a complex profile shape, as well as the possibility of contactless deformation strengthening of internal hard-to-reach surfaces.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Haipeng Chen ◽  
Sicheng Zhou ◽  
Jianjun Bi ◽  
Qiang Feng ◽  
Zheng Jiang ◽  
...  

Abstract Background The impact of primary tumour location on the prognosis of patients with peritoneal metastasis (PM) arising from colorectal cancer (CRC) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is rarely discussed, and the evidence is still limited. Methods Patients with PM arising from CRC treated with CRS and HIPEC at the China National Cancer Center and Huanxing Cancer Hospital between June 2017 and June 2019 were systematically reviewed. Clinical characteristics, pathological features, perioperative parameters, and prognostic data were collected and analysed. Results A total of 70 patients were divided into two groups according to either colonic or rectal origin (18 patients in the rectum group and 52 patients in the colon group). Patients with PM of a colonic origin were more likely to develop grade 3–4 postoperative complications after CRS+HIPEC (38.9% vs 19.2%, P = 0.094), but this difference was not statistically significant. Patients with colon cancer had a longer median overall survival (OS) than patients with rectal cancer (27.0 vs 15.0 months, P = 0.011). In the multivariate analysis, the independent prognostic factors of reduced OS were a rectal origin (HR 2.15, 95% CI 1.15–4.93, P = 0.035) and incomplete cytoreduction (HR 1.99, 95% CI 1.06–4.17, P = 0.047). Conclusion CRS is a complex and potentially life-threatening procedure, and we suggest that the indications for CRS+HIPEC in patients with PM of rectal origin be more restrictive and that clinicians approach these cases with caution.


2020 ◽  
Author(s):  
Rosi Sicuro ◽  
Emanuele Tumino ◽  
Christian Lambiase ◽  
Domenica Mamone

Abstract BackgroundAmong the various causes of death, colorectal carcinoma represents the second highest cause in frequency both in men and in women. A colorectal cancer is diagnosed every 3.5 minutes and a person dies of colorectal cancer every 9 minutes. In 2018, in Italy were recorded around 51.000 new cases, with a mortality rate of over 18.000 deaths. There is clear evidence demonstrating that the identification and treatment of cancer at an early stage positively influence the reduction in mortality. Colonoscopy is the most effective technique used to identify and remove polyps, thus avoiding the costs related to surgical treatment and hospitalization.The purpose of this study is to evaluate the costs of the system Endotics for robotic colonoscopy as an alternative to conventional diagnostic colonoscopy performed under anaesthesia at the University Hospital of Pisa.MethodsThe cost analysis was developed according to the Budget Impact Analysis method application, an essential and complementary part of the Health Technology Assessment evaluation, which has the main purpose of assessing the financial sustainability of new health technology, estimating the consequences of its use and diffusion in a specific context characterized by the limited availability of resources. The observation period covered a time interval of 3 months, during which an average of 43 colonoscopic procedures per day was performed and mapped and a total of 23 colonoscopes were used. ResultsOverall, the work done has allowed identifying the cost of a conventional painless diagnostic colonoscopy performed in our institution which amounts to € 426.25. The valuation of the costs of the robotic colonoscopy amounted overall to € 441.25.ConclusionsThe ideal procedure to diagnose a colon disease should be safe, well-tolerated, possibly non-invasive, with high diagnostic accuracy and, not least, cost-effectiveness. The results of this study suggest that in the University Hospital of Pisa the costs related to robotic colonoscopy performed with the Endotics system are superimposable to those of conventional painless colonoscopy, reducing the overall risk associated with the colonoscopic procedure maintaining a high diagnostic accuracy with a greater tolerability by the patient, thus pushing the colonoscopy towards “the ideal procedure”.


2007 ◽  
Vol 25 (33) ◽  
pp. 5267-5274 ◽  
Author(s):  
Sung-Gyeong Kim ◽  
Eun-Cheol Park ◽  
Jae-Hyun Park ◽  
Myung-Il Hahm ◽  
Jin-Hwa Lim ◽  
...  

PurposeTo identify the initiation or discontinuation of complementary therapy (CT) and determine the impact of sociodemographic and clinical factors on CT use among cancer patients.Patients and MethodsEligible patients were age 20 or older; newly diagnosed with stomach, liver, or colorectal cancer; and started their initial treatment at the National Cancer Center, Korea, between April 1, 2001, and April 30, 2003. In total, 541 cancer patients were surveyed in face-to-face interviews at baseline, and telephone follow-up interviews were performed every 3 months for 3 years.ResultsA total of 281 patients commenced CT after diagnosis; 164 patients stopped using CT during the follow-up period. The overall cumulative probability of starting CT at 1, 2, and 3 years was 50%, 54%, and 55%, respectively. In a Cox multivariate analysis, stomach and liver cancer were associated with an increased probability of initiating CT compared with colorectal cancer. Patients who were classified as stage I, II, or III at diagnosis were associated with a decreased probability of discontinuing CT compared with stage IV.ConclusionMost cancer patients started to use CT during the initial treatment period. Thus, physicians should communicate with cancer patients about CT at this phase. In particular, more attention should be paid to women and individuals with higher household incomes because these groups are more likely to start CT.


2020 ◽  
Vol 405 (7) ◽  
pp. 959-966
Author(s):  
Pénélope St-Amour ◽  
Pascal St-Amour ◽  
Gaëtan-Romain Joliat ◽  
Aude Eckert ◽  
Ismail Labgaa ◽  
...  

Abstract Background Multidisciplinary approach with adjuvant chemotherapy is the key element to provide optimal outcomes in pancreas and liver malignancies. However, post-operative complications may increase the interval between surgery and chemotherapy with negative oncologic effects. Hypothesis and study aim The aim of the study was to analyse whether compliance to Enhanced Recovery After Surgery (ERAS) pathway was associated with decreased interval to adjuvant chemotherapy. Methods Retrospective analysis of all consecutive ERAS patients with surgery for hepatobiliary or pancreatic malignancies at the University Hospital of Lausanne between 2012 and 2016. Multivariate analysis was performed to assess the impact of ERAS compliance on time to chemotherapy. Results A total of 133 patients with adjuvant chemotherapy were included (n = 44 liver and n = 89 pancreatic cancer). Median compliance to ERAS was 61% (IQR 55–67) for the study population, and median delay to chemotherapy was 49 days (IQR 39-61). Overall, compliance ≥ 67% to ERAS induced a significant reduction in the interval between surgery and chemotherapy for young patients (< 65 years old) with or without severe comorbidities (reduction of 22 and 10 days, respectively). High compliance in young ASA3 patients with liver colorectal metastases was associated with an increase of 481 days of DFS. Conclusions ERAS compliance ≥ 67% tends to be associated with a reduction in the delay to adjuvant chemotherapy for young patients with hepatobiliary and pancreatic malignancies. More prospective studies with strict adhesion to the ERAS protocol are needed to confirm these results.


2020 ◽  
Vol 77 (Supplement_1) ◽  
pp. S2-S7
Author(s):  
Devlin V Smith ◽  
Stefani Gautreaux ◽  
Alison M Gulbis ◽  
Jeffrey J Bruno ◽  
Kevin Garey ◽  
...  

Abstract Purpose To describe the development, design, and implementation of a pilot preceptor development bootcamp and feedback related to its feasibility and impact on operational pharmacy preceptors. Summary The University of Texas MD Anderson Cancer Center designed and implemented a pilot preceptor development bootcamp for operational staff pharmacists serving as residency preceptors for longitudinal weekend staffing experiences. A systematic, multipronged approach was taken to identify preceptor development gaps and design a full-day bootcamp curriculum. The resultant curriculum was comprised of content in major functional areas including using the 4 preceptor roles, documenting performance, giving and receiving feedback, and dealing with difficult situations or learners. The impact of the pilot preceptor development bootcamp was assessed using survey methodology and qualitative feedback from debrief discussions. Conclusion Implementation of a pilot preceptor bootcamp program addressing major areas of precepting skill was well received, resulted in positive feedback from operational pharmacy preceptors, and was feasible to implement at a large academic medical center.


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