The worldwide pandemic caused by the novel acute respiratory syndrome coronavi-
Background: Vomeronasal organs (VNOs) are paired epithe-lial structures located adjacent to the nasal septum that form in the late first trimester of human fetal development. Although VNOs have long been known to exist in fetal and adult humans, some studies continue to suggest that these structures may be degenerative or functionless. Little is known of the growth of the VNO. Methods: The present study examined length and volume changes of the human VNO in 26 ''normal'' (10 female, 16 male) histologically prepared fetuses from the University of Pittsburgh and the University of Michigan across three trimesters (8-30 weeks postmenstrual age). A computer reconstruction technique was used to quantify lengths and volumes of right and left VNOs, and regression equations were generated to assess growth rates. Results: A linear increase in VNO length and a logarithmic increase in VNO volume with increasing postmenstrual age was found. Volume increase was noted for both the vomeronasal epithelium and the lumen of the VNO. A comparison with most estimates of adult human VNO length suggested that further prenatal or postnatal size increase occurs. The growth curves also suggested a more rapid growth in VNO length and volume for females than for males. Conclusions: The present study demonstrates that the fetal human VNO commences volumetric increase in the early second trimester but does not achieve maximum size during fetal development. Further investigation is needed to determine whether the human VNO is sexually dimorphic in size. Anat.
We aimed to examine factors impacting variability in cardiac procedural deferral during the COVID‐19 pandemic and assess cardiologists' perspectives regarding its implications. Unprecedented cardiac procedural deferral was implemented nationwide during the COVID‐19 pandemic. A web‐based survey was administered by Society for Cardiovascular Angiography and Interventions and the American College of Cardiology Interventional Council to cardiac catheterization laboratory (CCL) directors and interventional cardiologists across the United States during the COVID‐19 pandemic. Among 414 total responses, 48 states and 360 unique cardiac catheterization laboratories were represented, with mean inpatient COVID‐19 burden 16.4 ± 21.9%. There was a spectrum of deferral by procedure type, varying by both severity of COVID‐19 burden and procedural urgency (p < .001). Percutaneous coronary intervention volumes dropped by 55% (p < .0001) and transcatheter aortic valve replacement volumes dropped by 64% (p = .004), with cardiologists reporting an increase in late presenting ST‐elevation myocardial infarctions and deaths among patients waiting for transcatheter aortic valve replacement. Almost 1/3 of catheterization laboratories had at least one interventionalist testing positive for COVID‐19. Salary reductions did not influence procedural deferral or speed of reinstituting normal volumes. Pandemic preparedness improved significantly over time, with the most pressing current problems focused on inadequate testing and staff health risks. During the COVID‐19 pandemic, cardiac procedural deferrals were associated with procedural urgency and severity of hospital COVID‐19 burden. Yet patients did not appear to be similarly influenced, with cardiologists reporting increases in late presenting ST‐elevation myocardial infarctions independent of local COVID‐19 burden. The safety and importance of seeking healthcare during this pandemic deserves emphasis.
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