Background The ongoing COVID-19 pandemic has resulted in a sharp rise in demand for healthcare workers worldwide. This has been coupled with reduced numbers of available medical professionals due to confirmed or suspected infections with SARS-CoV-2. To counteract these shortages, governments of several countries have considered the enrolment of medical students into the workforce in order to help to tackle the ongoing crisis. Methods Questionnaire-based study assessing the perceived role of medical students in assisting in the COVID-19 pandemic. The primary aim was to determine factors contributing to the willingness of medical students to actively assist in the pandemic. The secondary aim was to evaluate their perspectives regarding the associated changes in medical education. Results Out of 760 responses, 71.18% of medical students were willing to assist the medical workforce during the pandemic. Clinical year students were more likely to help in a medical capacity than pre-clinical students (OR = 0.384, 95%CI [0.167, 0.883, P < 0.05)]. Respondents concerned about their own well-being were less likely to engage in clinical work (OR = 0.680, 95%CI [0.491, 0.941], P < 0.020). Students who agreed that online lectures will negatively impact their education were inclined to think that the academic year should be extended (95%CI [0.065, 0.271], P = 0.001). Conclusions Most students are willing to help in both a medical and non-medical capacity. Their primary concerns when working in a medical setting are the risk of infecting their relatives and patients, lack of protective equipment and necessary knowledge as well as legal uncertainty whilst working without a medical qualification.
In order to provide an efficient and safe service covering the broad spectrum of spinal pathology, a formal spine fellowship, ideally with a formal curriculum, should be considered.
The rise in Smartphone availability has brought about the development of multiple mobile applications and devices utilized in the clinical setting. Hardwicke et al. 1 have described the use of the FLIR ONE TM miniature thermal imaging camera (FLIR Systems, Wilsonville, Ore) in the evaluation of patients undergoing free tissue transfer. Thermal imaging captures the infrared radiation (IR) emitted from the skin surface and has been extensively used in plastic surgery as a means of determining burn depth, 2 detecting post-operative infection, 3 and postoperative free flap monitoring. 4 The smartphone-friendly product enables clinicians to utilize this technology at a fraction of the price of standard thermographic cameras. The device clips into the mobile phone charging port and requires the installation of the FLIR ONE mobile application to operate. It possesses both a thermal and digital camera that takes photographs simultaneously. The images are then merged by the software allowing for the addition of greater physical detail an otherwise raw thermal reading. Hardwicke et al. 1 argue that despite low image resolution and propensity for background thermal interference, it serves as an effective and inexpensive method of locating perforating vessels and evaluating overall tissue perfusion.We have used this in the peri-operative assessment of patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstructions. The device is portable and its software is similar to that of traditional Smartphone cameras which makes it easy to use and requires no additional training, however, factors such as vasoconstriction, warming blankets, or low ambient temperature significantly impact on accuracy. The heat signal identified by the camera strongly correlates with the position of the perforators as demonstrated by pre-operative radiological investigations and Doppler findings, even in the face of abundant overlying soft tissue (Fig. 1A). We propose that the perforators are best visualized following a 3-4 minute period of cooling of the skin as this will result in the faster warming of tissues immediately adjacent to the vessels allowing for more accurate localization ( Fig. 1B).We are currently investigating additional uses of this device including monitoring of digital replantation and pre-operative assessment of hand trauma patients. Our positive experience with the camera is in keeping with that described by Hardwicke et al. and there is currently a need for larger comparative studies in order to better evaluate the clinical applicability of the FLIR ONE TM thermal imaging system.
Management of soft tissue deficits resulting from congenital abnormalities, trauma, systemic disease, and tumors is a particularly challenging field of plastic and reconstructive surgery. Fat grafting, a technique traditionally used in the correction of facial asymmetry, is commonly seen in aesthetic procedures which use the grafted fat for soft tissue augmentation and recontouring. Despite its widespread use in reconstruction and aesthetic surgery, therapeutic modalities applied in fat grafting are crude and the results of this intervention are unpredictable. The aim of this review was to present the most recent evidence regarding experimental studies and designs which confirmed or disproved fat volume expansion or fat maintenance after autologous fat grafting.
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