Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services

Background The ongoing pandemic is having a collateral health effect on delivery of surgical care to millions of patients. Very little is known about pandemic management and effects on other services, including delivery of surgery. Methods This was a scoping review of all available literature pertaining to COVID‐19 and surgery, using electronic databases, society websites, webinars and preprint repositories. Results Several perioperative guidelines have been issued within a short time. Many suggestions are contradictory and based on anecdotal data at best. As regions with the highest volume of operations per capita are being hit, an unprecedented number of operations are being cancelled or deferred. No major stakeholder seems to have considered how a pandemic deprives patients with a surgical condition of resources, with patients disproportionally affected owing to the nature of treatment (use of anaesthesia, operating rooms, protective equipment, physical invasion and need for perioperative care). No recommendations exist regarding how to reopen surgical delivery. The postpandemic evaluation and future planning should involve surgical services as an essential part to maintain appropriate surgical care for the population during an outbreak. Surgical delivery, owing to its cross‐cutting nature and synergistic effects on health systems at large, needs to be built into the WHO agenda for national health planning. Conclusion Patients are being deprived of surgical access, with uncertain loss of function and risk of adverse prognosis as a collateral effect of the pandemic. Surgical services need a contingency plan for maintaining surgical care in an ongoing or postpandemic phase.publishedVersio

Research priorities for global food security under extreme events

International audienc

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd

Introduction to mathematical modeling of crop growth

xix, 256 hal; 21,5 c

Role of radiation therapy in the management of renal cell cancer

10.3390/cancers3044010Cancers344010-402

Prostate immobilization using a rectal balloon.

10.1120/jacmp.v3i1.2590Journal of applied clinical medical physics / American College of Medical Physics316-No

Utilizing a neural logic expert system in currency option trading

Expert Systems With Applications92213-222ESAP

Is there a role for endorectal balloons in prostate radiotherapy? A systematic review.

Contains fulltext : 87917.pdf (publisher's version ) (Closed access)BACKGROUND AND PURPOSE: Endorectal balloons (ERBs) are being used in prostate radiotherapy for prostate immobilization and rectal wall (Rwall) sparing. Some of their aspects, however, have been questioned, like patient's tolerance and their value in modern high-precision radiotherapy. This paper gives an overview of published data concerning ERB application in prostate radiotherapy. MATERIALS AND METHODS: Systematic literature review based on PubMed/MEDLINE database searches. RESULTS: Overall, ERBs are tolerated well, although patients with pre-existing anorectal disease have an increased risk of developing ERB-related toxicity. Planning studies show reduced Rwall and anal wall (Awall) doses with ERB application. Clinical data, however, are scarce, as only one study shows reduced late rectal damage. There is no consensus about the immobilizing properties of ERBs and it is recommended to use additional set-up and correction protocols, especially because there are potential pitfalls. CONCLUSION: ERBs seem well-tolerated and in planning studies reduce anorectal wall doses. This may lead to reduced anorectal toxicity, although clinical studies are warranted to confirm this hypothesis and to further investigate the immobilizing properties of ERBs, preferably in combination with advanced techniques for position verification.1 juni 201