Teledentistry during COVID-19 pandemic

Background and aimsDentistry involves close face-to-face interaction with patients, hence during the COVID-19 pandemic, it has mostly been suspended. Teledentistry can offer an innovative solution to resume dental practice during this pandemic. In this review, we provide a brief overview of applications of teledentistry.MethodsArticles on teledentistry, relevant to this review, were searched and consulted from PubMed, Google Scholar, and Cochrane database.ResultsTeledentistry is the remote facilitating of dental treatment, guidance, and education via the use of information technology instead of direct face-to-face contact with patients. Teleconsultation, telediagnosis, teletriage, and telemonitoring are subunits of teledentistry that have important functions relevant to dental practice. There are many challenges for acceptance of teledentistry by the dentists as well as patients, which need to be addressed urgently.ConclusionTeledentistry can offer a novel solution to resume dental practice during the current pandemic, hence, the need of the hour is to incorporate teledentistry into routine dental practice. If not fully replace, at least teledentistry can complement the existing compromised dental system during the current pandemic.     

Acute bronchiolitis during the COVID-19 pandemic

IntroductionThe autumn and winter bronchiolitis epidemics have virtually disappeared in the first year of the COVID-19 pandemic.Our objectives were characterised bronchiolitis during fourth quarter of 2020 and the role played by SARS-CoV-2.MethodsProspective multi-centre study performed in Madrid (Spain) between October and December 2020 including all children admitted with acute bronchiolitis. Clinical data were collected and multiplex PCR for respiratory viruses were performed.ResultsThirty-three patients were hospitalised with bronchiolitis during the study period: 28 corresponded to rhinovirus (RV), 4 to SARS-CoV-2, and 1 had both types of infection. SAR-CoV-2 bronchiolitis were comparable to RV bronchiolitis except for a shorter hospital stay. A significant decrease in the admission rate for bronchiolitis was found and no RSV was isolated.ConclusionSARS-CoV-2 infection rarely causes acute bronchiolitis and it is not associated with a severe clinical course. During COVID-19 pandemic period there was a marked decrease in bronchiolitis cases.     

新型冠状病毒肺炎疫情防控期间ERCP 诊疗专家共识

为降低新型冠状病毒肺炎疫情防控期间经内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography,ERCP）诊疗工作中医患感染的风险,国家消化内镜专业质控中心联合中国医师协会内镜医师分会、中华医学会消化内镜学分会组织相关专家制定了《新型冠状病毒肺炎疫情防控期间ERCP诊疗专家共识》,旨在规范诊疗流程、防控与洗消措施,确保医患双方的诊疗安全。     

新型冠状病毒肺炎疫情防控期间胶囊内镜诊疗工作指导意见

依照《中华医学会消化内镜学分会在新型冠状病毒感染防控期间对消化内镜诊疗工作的指导意见》等相关标准及意见,中华医学会消化内镜学分会胶囊内镜协作组制定了新冠肺炎疫情期间胶囊内镜诊疗工作指导意见,旨在规范诊疗流程与防控、洗消措施,在确保医患双方诊疗安全基础上,最大限度的实现患者获益。     

Revisiting reactive arthritis during the COVID-19 pandemic

Clinical Rheumatology -     

Psychotropic medication prescribing during the COVID-19 pandemic

This study examined changes in psychotropic medication use associated with the early months of the coronavirus disease 2019 (COVID-19) pandemic. Using Kaiser Permanente Northern California electronic health records, the authors identified adult patients with fills for psychotropic medications and a non-psychotropic comparator (statins) in the 13 weeks before and after the first-known COVID-19-related death in California (March 4, 2020). Generalized estimating equations were used to derive relative risk ratios (RRR) for medication fills compared with the prior year. Analyses were stratified by new and continued fills and patient characteristics. Among 2,405,824 patients, the mean (SD) age was 49.8 (17.9) years; 52.9% were female; 47.9% identified as White; 8.0% and 7.9% had anxiety and depression disorder diagnoses, respectively. Accounting for secular trends, in the 13 weeks following March 4, 2020, there were increased fills for trazodone (RRR = 1.03, 95% CI = 1.02, 1.04), decreased fills for benzodiazepines (RRR = 0.95, 95% CI = 0.94, 0.96) and hypnotics (RRR = 0.97, 95% CI = 0.96, 0.99), and stable fills for antidepressants (RRR = 1.00, 95% CI = 0.99, 1.00). Relative rates of new fills decreased across most medication classes and continued fills either remained stable or demonstrated non-clinically significant decreases. Patients aged ≥65 years demonstrated decreased fills for most medication classes. In the first 13 weeks of the COVID-19 pandemic, fills for most psychotropic medications remained constant or showed small changes relative to the previous year. Continued (compared with new) fills accounted for observed increases in some medication classes. Older adults demonstrated decreased fills of most medications.     

应对新型冠状病毒肺炎疫情患者准入初筛调查表

(医护人员询问前请做好必要防护措施)1.您是否为武汉或湖北地区来诊人员?□否□是(按照医院应对感染相关管控规定执行)2.您是否近期去过武汉或湖北地区?□否□是(具体日期:___________________并按照医院应对感染相关管控规定执行).     

Model-driven mitigation measures for reopening schools during the COVID-19 pandemic

Reopening schools is an urgent priority as the COVID-19 pandemic drags on. To explore the risks associated with returning to in-person learning and the value of mitigation measures, we developed stochastic, network-based models of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in primary and secondary schools. We find that a number of mitigation measures, alone or in concert, may reduce risk to acceptable levels. Student cohorting, in which students are divided into two separate populations that attend in-person classes on alternating schedules, can reduce both the likelihood and the size of outbreaks. Proactive testing of teachers and staff can help catch introductions early, before they spread widely through the school. In secondary schools, where the students are more susceptible to infection and have different patterns of social interaction, control is more difficult. Especially in these settings, planners should also consider testing students once or twice weekly. Vaccinating teachers and staff protects these individuals and may have a protective effect on students as well. Other mitigations, including mask wearing, social distancing, and increased ventilation, remain a crucial component of any reopening plan.

As the COVID-19 pandemic accelerated in early 2020, schools around the world closed in an effort to preempt school-associated transmission and protect their students, teachers, and staff. By mid-April of that year, 195 countries had closed their schools in response to COVID-19, affecting more than 1.5 billion students (1). In the United States, schools were among the first organizations to close, and many remained closed or transitioned to remote learning through the end of the 2019–2020 school year. Some remain closed today. While remote learning affords students the opportunity to continue their education, it fails to provide many of the crucial benefits students typically receive through in-person schooling (2). There is an urgent need to evaluate the effectiveness of evidence-based strategies that would allow children, teachers, and staff to safely return to in-person learning.To date, widespread community transmission, conflicting public health guidance, and the emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants associated with higher transmissibility have compounded the challenges schools face when reopening (3–5). Numerous epidemiological models have been developed to forecast the spread of SARS-CoV-2 or compare the effectiveness of mitigation strategies in communities or large populations (6–12). However, only a few models have focused on the unique demographic and contact structures of primary and secondary school settings (13–15).Case studies suggest that primary schools have a lower risk of transmission compared to secondary schools (16–19). Two principal causes could be at play. First, younger children are less likely than adolescents or adults to become infected with SARS-CoV-2 (20), and less likely to experience symptomatic or severe disease (21, 22). Second, primary and secondary schools have different contact structures. Primary school students have fewer contacts and typically spend the full day with a single teacher and the same group of students. By contrast, secondary school students move between classrooms and encounter multiple teachers and groups of students each day.We have developed epidemiological models to simulate the spread of SARS-CoV-2 among students, teachers, and staff in both primary and secondary schools. Here, we use these models to better understand the risks of reopening schools and to explore the effectiveness of different mitigation strategies: cohorting students, proactive testing, quarantine protocols, and vaccinating teachers and staff.