Articles: pandemics.
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Arch Orthop Trauma Surg · Jun 2024
Managing an epidemic within a pandemic: orthopedic opioid prescribing trends during COVID-19.
In response to the opioid epidemic, a multitude of policy and clinical-guideline based interventions were launched to combat physician overprescribing. However, the sudden rise of the Covid-19 pandemic disrupted all aspects of healthcare delivery. The purpose of this study was to evaluate how opioid prescribing patterns changed during the Covid-19 pandemic within a large multispecialty orthopedic practice. ⋯ During the Covid-19 pandemic opioid prescribing levels remained below historical averages. While continued efforts are needed to minimize opioid overprescribing, it appears that the significant progress made toward this goal was not lost during the pandemic era.
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As the coronavirus disease 2019 (COVID-19) pandemic spread to the United States in 2020, there was an impetus toward postponing or ceasing nonurgent transsphenoidal pituitary surgeries to prevent the spread of the virus. Some centers encouraged transcranial approaches for patients with declining neurologic function. However, no large-scale data exist evaluating the effects that this situation had on national pituitary practice patterns. ⋯ In 2020, transsphenoidal surgery remained the preferred approach for pituitary tumor resection despite initial recommendations against the approach to prevent COVID-19 spread. Pituitary surgeries had a higher risk of periprocedural complications despite accounting for preoperative comorbidities, COVID-19 infection status, and surgical approach, suggesting that an overwhelmed hospital system can negatively influence surgical outcomes in noninfected patients.
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The coronavirus disease 2019 pandemic forced a wide range of medical practices to virtual formats, including the preoperative informed consent practice. However, virtual informed consent persists despite the pandemic being largely considered resolved. ⋯ We suggest a "trust-building" model of consent as a better conceptualization of what is occurring during the consent process. Highlighting how virtual formats might fail to fulfill this fuller understanding of consent on both interpersonal and systemic levels, we offer an ethical structure for physicians to navigate this novel virtual space.
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Background & objectives We aimed to assess the impact of COVID-19-related disruptions on ongoing and future projects related to neuroscience research and young researchers in India. Methods We conducted a countrywide online survey using a structured, self-administered questionnaire involving medical trainees, post-doctoral fellows, PhD students, early career faculty members and basic neuroscience researchers. The purpose was to assess the impact of the COVID-19 pandemic on the respondents' ongoing/planned research activities and capture their concerns related to future research. ⋯ Interpretation & conclusions In our survey, an overwhelming majority of the respondents reported that the pandemic adversely impacted their study. This trend was independent of sex, designation, and research output of individual subjects. The serious impact of the COVID-19 pandemic on neurosciences research warrants the attention and concerted efforts of the research supervisors, institutional heads, funding agencies and other stakeholders.