The preoperative evaluation and risk assessment has always been a critical aspect of safe surgical practice, and in the midst of the SARS-CoV-2 pandemic, it has become even more crucial to patient safety. Emerging data show that surgical procedures in patients who test positive for coronavirus disease (COVID) are associated with worse clinical outcomes and increased postoperative complications and mortality. In addition to personal protective equipment (PPE) management, isolation protocols, preoperative SARS-CoV-2 screening, and steps to ensure clinician safety, determining how to deem patients who have recovered from COVID-19 safe to proceed is an added challenge. We present a preoperative protocol for evaluation of previously COVID-positive patients for elective surgery.

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Citations in news articlesMedia appearances (television, print, radio) Social mediaUse of social media during COVID-19 pandemic to address "infodemic" COVID-19-related podcasts or blog posts with no. of views/listens Platform (eg, Facebook, Twitter, Instagram accounts) and metrics for specific examples (Twitter threads or posts) Abbreviations: ED, emergency department; ICU, intensive care unit; NIH, National Institutes of Health; PPE, personal protective equipment; PUI, person under investigation.*Optional footnote may be included to describe personal disruptions that affected academic productivity during pandemic (eg, family medical leave, caregiving responsibilities).

BACKGROUND: The American Geriatrics Society (AGS) Beers Criteria is an explicit list of potentially inappropriate medications (PIMs) best avoided in adults ≥65 years of age. Cognitively impaired and frail surgical patients often experience poor outcomes after surgery, but the impacts of PIMs on these patients are unclear. Our objective was to assess whether perioperative PIM administration was associated with poor outcomes in geriatric surgical patients. We then evaluated the association between PIM administration and postoperative outcomes in subgroups of patients who were frail or cognitively impaired. METHODS: We performed a retrospective cohort study of patients ≥65 years of age who underwent elective inpatient surgery at a large academic medical center from February 2018 to January 2020. Edmonton Frail Scale and Mini-Cog screening tools were administered to all patients at their preoperative clinic visit. A Mini-Cog score of 0 to 2 was considered cognitive impairment, and frailty was defined by an Edmonton Frail Scale score of ≥8. Patients were divided into 2 groups depending on whether they received at least 1 PIM (PIM+), based on the 2019 AGS Beers Criteria, in the perioperative period or none (PIM−). We assessed the association of preoperative frailty, cognitive impairment, and perioperative PIM administration with the length of hospital stay and discharge disposition using multiple regression analyses adjusted for age, sex, ASA physical status, and intensive care unit (ICU) admission. RESULTS: Of the 1627 included patients (mean age, 73.7 years), 69.3% (n = 1128) received at least 1 PIM. A total of 12.7% of patients were frail, and 11.1% of patients were cognitively impaired; 64% of the frail patients and 58% of the cognitively impaired patients received at least 1 PIM. Perioperative PIM administration was associated with longer hospital stay after surgery (PIM−, 3.56 ± 5.2 vs PIM+, 4.93 ± 5.66 days; P < .001; 95% confidence interval [CI], 0.360–0.546). Frail patients who received PIMs had an average length of stay (LOS) that was nearly 2 days longer than frail patients who did not receive PIMs (PIM−, 4.48 ± 5.04 vs PIM+, 6.33 ± 5.89 days; P = .02). Multiple regression analysis revealed no significant association between PIM administration and proportion of patients discharged to a care facility (PIM+, 26.3% vs PIM−, 28.7%; P = .87; 95% CI, −0.046 to 0.054). CONCLUSIONS: Perioperative PIM administration was common in older surgical patients, including cognitively impaired and frail patients. PIM administration was associated with an increased hospital LOS, particularly in frail patients. There was no association found between PIM administration and discharge disposition.

Social media use across the health professions has significantly expanded in recent years. Specific attention has been paid to both the value of social media use in graduate medical education with residency program twitter accounts. More recently, social media has been examined for its role in supporting the rapid expansion of information exchange and connection across digital and virtual platforms during the COVID-19 pandemic. With the ongoing response to the pandemic, the 2020-2021 residency application cycle is anticipated to be a completely virtual interview process. Here, we draw from our collective experiences managing, maturing, and maximizing social media accounts for residency programs and GME to provide practical tips for using social media for the upcoming virtual interview season.

Non-HFE-related cardiac iron overload can occur in advanced liver disease We therefore recommend screening for cardiac iron prior to liver transplantation.

edical professionals and trainees 1,2 have adopted the use of Twitter 3 for medical education, 4,5 support, and advocacy, which has resulted in an online community often referred to as Medical Twitter (colloquially as #MedTwitter). The authors recognize an emerging utility of Medical Twitter in mentorship, coaching, and sponsorship, which has only become more necessary in the current climate of social distancing. We will discuss opportunities to use Twitter to enhance and promote mentoring relationships in medicine, particularly for those trainees from diverse and underrepresented backgrounds who might not otherwise find mentors in their institutions.