Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Centro de investigación y acción psicosocial comunitaria: un escenario para la construcción de paz. Volumen III

Since 2020, the social, political, and welfare conditions around the world have been violated due to the COVID-19 pandemic. As a result, according to World Health Organization (WHO) figures for December 2021, more than five million people’s lives have been taken, and millions more have fallen into poverty. And not to mention the sociopolitical issues emerging in Colombia in 2021, which caused social struggles that impacted lives, economy, and other areas in a country with a long way to go to build peace and transform the culture of war. However, this context has also created challenges that have led science, academia, and governments to be strategic, creative, and dynamic. Thus, the university has developed pedagogical, technological, and psychosocial plans and strategies to face and mitigate the impacts that barely start to emerge. Life will not be the same, but it has been moving towards a new way of living, capable of building solidarity, fraternity, accompaniment, and confrontation bonds. This new version of the book presents reflections and the theoretical and the research analyses based on the actions of change in times of crisis that researchers from the research center have been developing. It is organized in two sections; the first has reflections on research in education and alternative pedagogical strategies that are being developed by the research center. In the second section, there are the reflections on research praxis, that is, research, projection, or social extension in both community and organizational contexts.Desde 2020, las condiciones sociales, políticas y de bienestar en el mundo se han visto vulneradas dada la pandemia del COVID-19, que le ha costado la vida a más de cinco millones de personas, y millones más han caído en la pobreza, de acuerdo con las cifras de la Organización Mundial de la Salud (OMS) para diciembre de 2021, esto sin especificar las problemáticas sociopolíticas que se levantan en Colombia en el 2021 y que desencadenaron luchas sociales que impactaron vidas, economía, y otros ámbitos en un país que tiene un largo camino para construir paz y transformar la cultura de la guerra. Sin embargo, también ha creado los retos que ha llevado a la ciencia, la academia y los gobiernos a ser estratégicos, creativos y dinámicos. Estas acciones han hecho que en la universidad se generen planes y estrategias pedagógicas, tecnológicas, psicosociales, para enfrentar y mitigar los impactos que apenas se asoman. La vida no será la misma, pero se ha venido transitando a una nueva forma de vivir, capaz de tender lazos de solidaridad, fraternidad, acompañamiento y enfrentamiento. Esta nueva versión del libro presenta las reflexiones, los análisis teóricos e investigativos desde las acciones de cambio en tiempos de crisis que vienen desarrollando investigadoras e investigadores del centro de investigación. Está estructurado en dos secciones, en la primera sección se encuentran reflexiones sobre investigación en educación y estrategias pedagógicas alternativas en las que avanza el centro de investigación a través de sus investigadores. En la segunda sección se encuentran las reflexiones sobre las praxis de las investigaciones, es decir, la investigación, la proyección o extensión social en tanto en contextos comunitarias como en las organizaciones.  Desde 2020, as condições sociais, políticas e de bem-estar no mundo foram violadas devido à pandemia da COVID-19, que custou a vida de mais de cinco milhões de pessoas, e mais milhões caíram na pobreza, de acordo com os números da Organização Mundial da Saúde (OMS) para dezembro de 2021, Isto sem especificar as questões sócio-políticas que surgem na Colômbia em 2021 e que desencadearam lutas sociais que impactaram vidas, a economia e outras áreas em um país que tem um longo caminho a percorrer para construir a paz e transformar a cultura da guerra. No entanto, também criou desafios que levaram a ciência, a academia e os governos a serem estratégicos, criativos e dinâmicos. Estas ações levaram a universidade a gerar planos e estratégias pedagógicas, tecnológicas e psicossociais para enfrentar e mitigar os impactos que estão apenas começando a surgir. A vida não será a mesma, mas estamos caminhando para um novo modo de vida, capaz de construir laços de solidariedade, fraternidade, acompanhamento e confronto. Esta nova versão do livro apresenta as reflexões, análises teóricas e de pesquisa a partir das ações de mudança em tempos de crise que os pesquisadores do centro de pesquisa vêm desenvolvendo. Ela está estruturada em duas seções: a primeira seção contém reflexões sobre pesquisa em educação e estratégias pedagógicas alternativas nas quais o centro de pesquisa está avançando através de seus pesquisadores. A segunda seção contém reflexões sobre práticas de pesquisa, ou seja, pesquisa, projeção ou extensão social, tanto em contextos comunitários quanto em organizações

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study (vol 46, pg 2021, 2022)

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Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2