Alveolar air leak and paraseptal emphysema in severe COVID-19 disease

Background Corona virus 2019 (COVID-19) pandemic spread in the world as a great medical crisis. Its pathophysiology, manifestations, complications, and management are not completely defined, yet. In this study frequency of alveolar air leak in critically ill COVID-19 subjects is explored. Methods A total of 820 critically ill COVID-19 subjects who admitted with respiratory insufficiency to ICUs of Sina University Hospital from March 2020 to June 2021 were included. All their chest x ray (CXR) and Computed tomography (CT) of chest were reviewed. All alveolar air leak episodes (pneumothorax, pneumomediastinum, pneumopericardium, subcutaneous emphysema) suspected films reviewed by attending intensivist and radiologist. Results Of the 820 ill COVID-19 subjects in ICUs, 492(60%) were male, and 328 (40%) were female. The Mean age of 820 subjects was 60.84 + 16.82. 584 (71.22%) of subjects were non-intubated, and 236 (28.78%) were intubated. Alveolar air leak occurred in 98 (11.95%) of subjects. Alveolar air leak episodes include pneumothorax in 26 (3.17%), subcutaneous emphysema in 72 (8.78%), pneumomediastinum in 9 (1.10%), and pneumopericardium in 1 (0.12%) of subjects. The mean age in non-intubated subjects was 59.65 + 16.84, and for intubated subjects was 63 + 16.42. There was a significant difference in age between the groups who get intubated, versus not intubated P 0.001. Of the 584 non-intubated subjects, 31 (5.31%) had subcutaneous emphysema, of the 236 intubated subjects, 41 (17.37%) had subcutaneous emphysema. Difference between groups was statistically significant, P <0.001. When we compared intubated and non-intubated patients in case of total numbers of alveolar air leak episodes, the difference was statistically significant P <0.001. Conclusion According to this study, intubation was implemented more in older patients. Also, invasive ventilation was significantly associated with subcutaneous emphysema and total number of alveolar air leak episodes. In every patient with exaggeration of hypoxia, dyspnea or chest pain, pneumothorax should be kept in mind as a differential diagnosis. Keywords: COVID-19; Respiratory failure; Alveolar air leak; Paraseptal emphysema

Medical crisis during pandemic: Career preferences change in medical student

<span>The COVID-19 pandemic is a major threat to global education. Incidental emotions of fear and anxiety during pandemic have unconsciously influenced preference and outcome about their future career. This study aimed to assess the effect of the COVID-19 pandemic towards career preference change in medical students. A total of 1,027 responses from all over the medical students in Indonesia were collected from an online questionnaire which was broadcasted through social media from 14th July 2020–21st July 2020. This study was using Fear of COVID-19 Scale (FCV-19S) and Depression Anxiety Stress-Scale-21 (DASS-21) to assess fear of COVID-19, stress, anxiety, and depression. Out of 1,027 respondents, 44.6% had stressed, 47.8% had anxiety, and 18.5% had depression with an average FCV-19S score was 17.1. The result showed that the fear and anxiety of COVID-19 during the pandemic had associated significantly with the career decisions in medical students (p=&lt;0.05). Indonesian policymakers had to keep in mind that the fear of the COVID-19 pandemic in medical students is due to the high mortality COVID-19 cases of health workers in Indonesia. Health workers need adequate working conditions and specific protection, this requires prompt attention from stakeholders.</span>

Human Rights during the COVID-19 Pandemic in Hungary with Special Regard to the Right to Have Contact

In Hungary, the government declared a state of danger in March 2020 as a consequence of the COVID-19 pandemic. The state of danger was lifted in June, but epidemological preparedness and state of medical crisis were declared by a government decree. In November 2020, the state of danger was declared for the second time, while epidemological preparedness was maintained. In February 2021, the state of danger was declared again. The list of the legal rules which changed and have been continuously changing because of the COVID-19 pandemic since March 2020 is extremly long and the new provision or the modifications have been heavily influencing the population's everyday life. The aim of this paper is to overview primarily the restrictions affecting human rights with special regard to the right to have contact as one of the patients' rights. Important issues of the parent-child contact affected by the COVID-19 pandemic is discussed, as well.

On Learning from Natural Language to Develop Intelligent System to Identify Potential Medical Condition

With the rise in human population and emergence of the medical crisis across the whole globe, it has become essential to develop smart systems to automate the process of identification of medical conditions and therefore provide timely aid to the patient. As the first step to develop such a system in this paper we aim to create a natural language based medical condition identification system. The user would provide a text review of how they feel with few other categorical features, based upon that our model would identify the potential medical condition the user is suffering from. We employed three different machine-learning algorithms and mitigated class imbalance in our dataset. Empirical results indicate that Random Forest is the best machine-learning algorithm among all the investigated models with an accuracy of 80.39%, whereas the accuracy of the AdaBoost model improved the highest with an absolute value of 7.77% after mitigating class imbalance

Pandemagogy and Online Teaching: A Case for Online Teaching

The Coronavirus pandemic (COVID-19) is not merely a medical crisis; it is also a social one. It has paralyzed all aspects of public life, leading to closures of all “non-essential” public spaces, chief among them, schools. Universities across Canada have shut down and moved online in an attempt to halt the transmission of the deadly virus. What many initially thought would be remote learning for just a few weeks, turned into months. Now, for the foreseeable future, remote learning will be the new normal. However, this poses unique challenges for educators and students, because there is no universal access to high-speed internet in Canada, which means that those who have access to it can transition online with ease; while those who do not have access are left behind. In an effort to work through these challenges, this reflection paper offers an autoethnographic account of online learning and its associated challenges during COVID-19. It makes the case for public internet and pandemagogy.

Media coverage of COVID-19 state surveillance in Israel: the securitization and militarization of a civil-medical crisis

Israel, traditionally known as a nation-in-arms, has been undergoing processes of securitization and militarization from its inception to the present day. While several countries have employed surveillance technologies to tackle the spread of coronavirus, Israel was the only country in the world to authorize its internal security agency to track citizens’ cellphones to deal with this civil-medical crisis. Employing a reflexive thematic analysis to news media outlets, this study examined coverage of Israel Security Agency (ISA) surveillance by four leading Israeli news sites, inquiring into the socio-cultural imageries, and motifs that informed their reports. While two of the sites were mostly supportive and the other two were critical, the coverage as a whole was informed by national security imageries reminiscent of Israel’s nation-in-arms tradition. Our discussion contextualizes these findings within a three-decade tension that has prevailed in Israeli society and culture between securitization/militarization and democratization/demilitarization.

Mitigating the Impact of Reemergence From a Pandemic on Healthcare

ABSTRACT Healthcare workers have never faced a medical crisis that compares to the coronavirus disease-2019 pandemic. This modern-day pandemic fight draws parallels to a war. Because of these similarities, it would make sense that the experiences frontline providers have when transitioning to a normal healthcare routine would emulate experiences service members voice when reintegrating home from a battlefield. These common experiences include a unified mission, an exhausting, adrenaline-packed responsibility, and a celebrity-like status to the public. The pandemic response consumed healthcare with one united mission, but as we reemerge from the pandemic and restore other aspects of our healthcare system, multiple missions develop and compete. Returning to a common routine and regular status can manifest feelings of disappointment in healthcare workers’ everyday lives and career choices and lead to a reexamination of priorities and professions. As an organization with a focus on high reliability, mitigating the harm to staff and delivery system may be our new priority. The risk of not facing this situation head on is a potential exodus of seasoned professionals contemplating their future and selecting other career paths, thus draining the current institutional knowledge and potentially deterring future generations from healthcare. Leaders in the healthcare industry need to take a proactive stance in addressing this reemergence. Integrated, proactive programming is needed utilizing evidence-based resiliency training from professional organizations such as the National Alliance on Mental Illness, the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, as well as the existing Department of Defense programs. The Veterans Affairs has the backbone to develop and offer these programs and make a positive difference with Employee Whole Health efforts. Organized, evidence-based programming such as second victim education, mindfulness, and other personal skill building could be key to improving the lifelong well-being of our caregivers.

Spatiotemporality in the Anthropocene: Deleuzoguattarian Philosophy, Quantum Physics, and the German Netflix Series Dark

Crises alter our perception of time. For medical personnel faced with treating unprecedented numbers of critically ill patients under conditions of personal threat, COVID-19 has most recently accelerated the subjective perception of time. For millions of others, social isolation has decelerated our lives. For all of us, at least in the short term, the future has become more uncertain. Theoretical physicists tell us, however, that under any conditions, the human perception of the flowing of time is only a result of our blurred, limited, macroscopic vision. As the quantum physicist Carlo Rovelli writes, therefore, “[t]o understand ourselves is to reflect on time” (2018: 179). Potentially caused by humans’ failed interactions with wild animals, the contemporary global pandemic, as well as previous outbreaks such as SARS (Severe Acute Respiratory Syndrome-related coronavirus) or the bird flu, has led to calls to reevaluate humans’ relationships with nonhuman life, with the natural environment that includes us, in the epoch that may soon be named for our very failure – the Anthropocene. In an era in which our usual, day-to-day certainties and desire for human control have been upended, not only by the current medical crisis but also by the continuing existential threat to terrestrial life that is climate change, a rethinking of the category of the human, a new conceptualization of the entangled (human and nonhuman) material relationships on our planet and beyond, requires reflecting on time. This article engages in such reflection through a conversation with the philosophical writings of Gilles Deleuze and Félix Guattari.

‘Fake news’ or trust in authorities? The problems of uncertainty at a time of medical crisis

This article examines the complex boundaries between ‘fake news’, speculation, hypothesis, gossip and whistleblowing during the COVID-19 pandemic. It shows that apparently authoritative sources and experts gave information or policy recommendations that have turned out to be wrong, sometimes dangerously so, and explores the kinds of bias that enter medical advice and planning decisions. The article then diagnoses a WhatsApp voice-note from a young South African doctor that went viral and was denounced as ‘fake news’ because of obvious errors. This note, however, revealed behind the scenes medical thinking about subjects that professional bodies and authorities usually avoid discussing publicly. In highlighting what apparently authoritative sources omit and distort, the article suggests that journalists should report medical advice, even from authoritative sources, with caution and shows that apparently ‘fake’ news may reveal issues other news sources neglect.

Knee Surgery during the COVID-19 Lockdown—Experiences of a Level-One Trauma Center in Germany

Background. Almost every sector in the health care is affected by the COVID-19 pandemic. Many studies already investigated the effect on different aspects in orthopedic and trauma care. However, the current literature lacks data regarding the consequence on daily surgical business. Thus, the aim of the present study was to analyze the development of knee-related pathologies and surgical procedures in a German university level-one trauma center during the lockdown phase and early lockdown phase to investigate the impact of the COVID-19 lockdown on orthopedic and trauma knee surgery. Material and Methods. The amount of knee joint surgeries performed during the high-peak COVID-19 crisis in the period of January to May 2020 was evaluated retrospectively and compared to the corresponding time periods of the previous years (2017-2019). Results. The COVID-19 lockdown led to a significant decrease in the number of knee injuries in March and April 2020 by 83.3%. Surgical procedures were reduced by 84.8% during the same period. In May 2020, the number of knee joint procedures returned to an almost prepandemic level. The distribution of urgent and elective knee surgery changed to predominantly acute trauma care at the beginning of the COVID-19 lockdown and persisted through to May 2020. Conclusion. The COVID-19 pandemic had a high impact on emergency and elective knee surgery in a level-one trauma center in Germany during the lockdown phase. It also showed that a level-one trauma center in the German healthcare system is able to handle urgent trauma and orthopedic operations during a worldwide medical crisis and to return to a prepandemic level within a short phase.