SUMMARY OF CONTACT WITH DR. MARIK. PULMONARY MEDICINE AND CRITICAL CARE. EASTERN VIRGINIA MEDICAL SCHOOL - USA.

This brief note introduces the reproduction of medical content, authored by Doctor Paul E. Marik. Dr. Marik is Professor of Medicine and Chief of Pulmonary Medicine and Critical Care at Eastern Virginia Medical School in Norfolk, Virginia (USA). Dr. Marik is an extremely qualified and experienced professional. The reprinting of the material was authorized by Dr. Marik himself on 12/02/2020. This material is relevant in the Brazilian scenario due to standardized procedures for patients infected with the coronavirus. Only 1 of the 5 files kindly provided by the author, in PDF format, was selected and reproduced as received, without any editing. Due to the pandemic's long duration, the Journal editors (who are not medical doctors) have already had the opportunity to monitor the development of the disease in more than one infected person. The type of treatment offered to patients seems to influence the course, duration, and severity of the disease. The treatments described in the materials below appear to be effective and have good results. The editors will refrain from making additional comments on the proposed methods not to influence anyone, restricting themselves to suggesting that they be discussed with the reader's trusted doctor in case of need or doubts. Complete, updated information and also translated into Portuguese are available at . We are grateful to Dr. Marik for his kindness in giving us his time in this troubled period.

Partnerships Connecting Healthcare and Community-Based Organizations in Virginia

The Virginia Geriatric Education Center (VGEC)’s Geriatrics Workforce Enhancement Program (GWEP) partners with two programs, Senior Strong at Eastern Virginia Medical School in Norfolk, VA and the Richmond Health and Wellness Program at Virginia Commonwealth University in Richmond VA to support their age-friendly initiatives. These programs enhance primary care for an older population experiencing adverse social determinants of health by providing screening around the 4Ms pillars of age-friendly healthcare and connecting participants with healthcare and community-based organizations. These programs offer a rich learning environment for interprofessional students. The VGEC GWEP strengthens these programs by developing faculty and student training in collaboration with the programs and facilitating program participation in the GWEP-CC Age-Friendly Action Community to develop and refine age-friendly practice workflows, referral pathways and documentation.

Moderate Sedation or Monitored Anesthesia Care for Colonoscopies: Is There a Difference?

To determine whether monitored anesthesia care (MAC) results in shorter colonoscopy time. A retrospective chart review from electronic medical records at Sentara Norfolk General Hospital was performed of all patients seen by the Eastern Virginia Medical School Department of Surgery who underwent a screening or diagnostic colonoscopy from December 2015 to July 2017. The primary end point is procedure time, with secondary end point of sedation time. There is a statistically significant difference in time to cecum between moderate sedation (MOD) and MAC (P = 0.002). Operator perceived difficulty is statistically associated with increased time to cecum (P < 0.0001). Time to cecum between MOD and MAC over the levels of difficulty was not significant (P = 0.403). A subanalysis looking at time to cecum between MOD and MAC for each level of difficulty showed a significant effect when difficulty was described as no difficulty. There is a statistically significant difference in time to scope insertion between MOD and MAC (P < 0.0001). Our data show that, taken as a conglomerate, the procedure and sedation time is shorter in MAC than in MOD. The use of MAC is associated with decrease time to scope insertion and overall time to cecum.