• Adjunctive nutraceutical therapies for COVID-19

      Subedi, Lalita; Tchen, Stephanie; Gaire, Bhakta Prasad; Hu, Bingren; Hu, Kurt (MDPI AG, 2021-02-16)
      The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2/COVID-19), is a worldwide pandemic, as declared by the World Health Organization (WHO). It is a respiratory virus that infects people of all ages. Although it may present with mild to no symptoms in most patients, those who are older, immunocompromised, or with multiple comorbidities may present with severe and life-threatening infections. Throughout history, nutraceuticals, such as a variety of phytochemicals from medicinal plants and dietary supplements, have been used as adjunct therapies for many disease conditions, including viral infections. Appropriate use of these adjunct therapies with antiviral proprieties may be beneficial in the treatment and/or prophylaxis of COVID-19. In this review, we provide a comprehensive summary of nutraceuticals, such as vitamins C, D, E, zinc, melatonin, and other phytochemicals and function foods. These nutraceuticals may have potential therapeutic efficacies in fighting the threat of the SARS-CoV-2/COVID-19 pandemic. © 2021 by the authors.
    • A Brief Update on the Effect of the COVID-19 Pandemic on Hip and Knee Arthroplasty Patients in the United States: A Multicenter Update to a Previous Survey Study of Patients Postponed by the Pandemic

      Brown, Timothy S; Bedard, Nicholas A; Rojas, Edward O; Anthony, Christopher A; Schwarzkopf, Ran; Stambough, Jeffrey B; Nandi, Sumon; Prieto, Hernan; Parvizi, Javad; Bini, Stefano A; et al. (Elsevier Inc., 2020-12-03)
      Background: In March 2020, elective total hip and knee arthroplasty (THA and TKA) were suspended across the United States in response to the COVID-19 pandemic. We had previously published the results of a survey to the affected patients from 6 institutions. We now present the results of a larger distribution of this survey, through May and June 2020, to electively scheduled patients representing different regions of the United States. Methods: Fifteen centers identified through the American Association of Hip and Knee Surgeons Research Committee participated in a survey study of THA and TKA patients. Patients scheduled for primary elective THA or TKA but canceled due to the COVID-19 elective surgery stoppage (3/2020-5/2020) were included in the study. Descriptive statistics along with subgroup analysis with Wilcoxon rank were performed. Results: In total, surveys were distributed to 2135 patients and completed by 848 patients (40%) from 15 institutions. Most patients (728/848, 86%) had their surgery postponed or canceled by the surgeon or hospital. Unknown length of surgical delay remained the highest source of anxiety among survey participants. Male patients were more likely to be willing to proceed with surgery in spite of COVID-19. There were minimal regional differences in responses. Only 61 patients (7%) stated they will continue to delay surgery for fear of contracting COVID-19 while in the hospital. Conclusion: Similar to the previous study, the most anxiety-provoking thought was the uncertainty, over if and when the canceled joint replacement surgery could be rescheduled. Patients suffering from the daily pain of hip and knee arthritis who have been scheduled for elective arthroplasty remain eager to have their operation as soon as elective surgery is allowed to resume.
    • The Effect of the COVID-19 Pandemic on Hip and Knee Arthroplasty Patients in the United States: A Multicenter Update to the Previous Survey

      Brown, T.S.; Bedard, N.A.; Rojas, E.O.; Anthony, C.A.; Schwarzkopf, R.; Stambough, J.B.; Nandi, S.; Prieto, H.; Parvizi, J.; Bini, S.A.; et al. (Elsevier Inc., 2020-12-03)
      Background: In March 2020, elective total hip and knee arthroplasty (THA and TKA) were suspended across the United States in response to the COVID-19 pandemic. We had previously published the results of a survey to the affected patients from 6 institutions. We now present the results of a larger distribution of this survey, through May and June 2020, to electively scheduled patients representing different regions of the United States. Methods: Fifteen centers identified through the American Association of Hip and Knee Surgeons Research Committee participated in a survey study of THA and TKA patients. Patients scheduled for primary elective THA or TKA but canceled due to the COVID-19 elective surgery stoppage (3/2020-5/2020) were included in the study. Descriptive statistics along with subgroup analysis with Wilcoxon rank were performed. Results: In total, surveys were distributed to 2135 patients and completed by 848 patients (40%) from 15 institutions. Most patients (728/848, 86%) had their surgery postponed or canceled by the surgeon or hospital. Unknown length of surgical delay remained the highest source of anxiety among survey participants. Male patients were more likely to be willing to proceed with surgery in spite of COVID-19. There were minimal regional differences in responses. Only 61 patients (7%) stated they will continue to delay surgery for fear of contracting COVID-19 while in the hospital. Conclusion: Similar to the previous study, the most anxiety-provoking thought was the uncertainty, over if and when the canceled joint replacement surgery could be rescheduled. Patients suffering from the daily pain of hip and knee arthritis who have been scheduled for elective arthroplasty remain eager to have their operation as soon as elective surgery is allowed to resume. Copyright 2021
    • Getting Real: The Maryland Healthcare Ethics Committee Network's COVID-19 Working Group Debriefs Lessons Learned

      Elson, N.; Gwon, H.; Hoffmann, D.E.; Kelmenson, A.M.; Khan, A.; Kraus, J.F.; Onyegwara, C.C.; Povar, G.; Sheikh, F.; Tarzian, A.J. (Springer Science and Business Media B.V., 2021-02-13)
      Responding to a major pandemic and planning for allocation of scarce resources (ASR) under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland's response to COVID-19 and the role of the Maryland Healthcare Ethics Committee Network (MHECN) in bridging gaps in the state's response to prepare health care facilities for potential implementation of ASR plans. Identified "lessons learned" include: Deliberative Democracy Provided a Strong Foundation for Maryland's ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR ... And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies. Copyright 2021, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.
    • Prior pandemics. looking to the past for insight into the COVID-19 pandemic

      Mackowiak, Philip A (Taylor and Francis Inc., 2021-03-23)
      COVID-19 is not the world's first pandemic, not its worst, or likely to be its last. In fact, there have been many pandemics throughout history with lessons for the current one. The most destructive pandemic of all time, at least in terms of the number of people killed in the shortest time, was the "Spanish flu" pandemic of 1918/1919. Why did it happen? What lessons did it teach us? And could it happen again? These questions are addressed in the context of the current COVID-19 pandemic and several other nearly equally devastating pandemics of earlier times.
    • Radiology Education in the Time of COVID-19: A Novel Distance Learning Workstation Experience for Residents

      McRoy, Casey; Patel, Lakir; Gaddam, Durga Sivacharan; Rothenberg, Steven; Herring, Allison; Hamm, Jacob; Chelala, Lydia; Weinstein, Joseph; Smith, Elana; Awan, Omer (Elsevier USA, 2020-08-08)
      Rationale and Objectives: The coronavirus disease of 2019 (COVID-19) pandemic has challenged the educational missions of academic radiology departments nationwide. We describe a novel cloud-based HIPAA compliant and accessible education platform which simulates a live radiology workstation for continued education of first year radiology (R1) residents, with an emphasis on call preparation and peer to peer resident learning. Materials and Methods: Three tools were used in our education model: Pacsbin (Orion Medical Technologies, Baltimore, MD, pacsbin.com), Zoom (Zoom Video Communications, San Jose, CA, zoom.us), and Google Classroom (Google, Mountain View, CA, classroom.google.com). A senior radiology resident (R2-R4) (n = 7) driven workflow was established to provide scrollable Digital Imaging and Communications in Medicine (DICOM) based case collections to the R1 residents (n = 9) via Pacsbin. A centralized classroom was created using Google Classroom for assignments, reports, and discussion where attending radiologists could review content for accuracy. Daily case collections over an 8-week period from March to May were reviewed via Zoom video conference readout in small groups consisting of a R2-R4 teacher and R1 residents. Surveys were administered to R1 residents, R2-4 residents, and attending radiologist participants. Results: Hundred percent of R1 residents felt this model improved their confidence and knowledge to take independent call. Seventy-eight percent of the R1 residents (n = 7/9) demonstrated strong interest in continuing the project after pandemic related restrictions are lifted. Based on a Likert “helpfulness” scale of 1-5 with 5 being most helpful, the project earned an overall average rating of 4.9. Two R2-R4 teachers demonstrated increased interest in pursuing academic radiology. Conclusion: In response to unique pandemic circumstances, our institution implemented a novel cloud-based distance learning solution to simulate the radiology workstation. This platform helped continue the program's educational mission, offered first year residents increased call preparation, and promoted peer to peer learning. This approach to case-based learning could be used at other institutions to educate residents.