Case Consultation Research Articles

Symptoms: Purple Ear Drum and Hearing Loss

Symptoms: Purple Ear Drum and Hearing Loss

1021. The post-sign-off events of Infectious Diseases (ID) consultation and the incidence of non-adherence to ID consultation during the post-sign-off period: A retrospective cohort study

Abstract Background Infectious Diseases (ID) consultation has contributed to improving the quality of care in inpatient settings. ID physicians traditionally examine patients and provide the final treatment recommendations (i.e., sign-off ID consultation). However, patients may acquire antimicrobial-associated adverse drug events (AAADE) and healthcare-associated infections (HAI) after the sign-off ID consultation. Moreover, it is unclear how these events that occurred during the post-sign-off period were managed. The study aims to scrutinize the post-sign-off events and the current epidemiology of non-adherence to ID recommendations during the post-sign-off period. Methods The retrospective cohort study was performed at a Japanese tertiary care center. Among all ID consultation cases from January to December 2019, those with general ID consultation with treatment recommendations given for the definitive or suspected infectious diseases were included for analysis. The instances of post-sign-off events included AAADE, HAI, and treatment failure of established infections. Non-adherence to ID consultation was defined as the failure of the primary care team to complete ID final recommendations. The incidence of the post-sign-off events and outcomes associated with nonadherence to ID consultations were investigated. Results Among 762 ID consultations that occurred, 367 cases were included for analysis. The incidence of the post-sign-off events was 10.9% (40/367), and AAADEs accounted for 62.5% (25/40) of cases. Non-adherence to ID consultation occurred in 105 (28.6%) cases, and prolonged antimicrobial therapy beyond ID consultation was the most common reason for non-adherence. The primary care team modified antimicrobial therapy in approximately two-thirds of cases (71/105) without ID re-consultation. The length of hospital stay was longer in patients with non-adherence to ID consultation than in those with adherence (36 versus 29 days; p=0.002). Conclusion The post-sign-off events of ID consultation commonly occur, leading to nonadherence to ID consultation during the post-sign-off period. Because nonadherence may be associated with worse clinical outcomes, attention after the sign-off ID consultation is needed to ensure patient safety. Disclosures All Authors: No reported disclosures.

The role of the specialist mental health probation officer

Individuals on probation have a high prevalence of health problems when compared to the general population. For them it is often difficult to access health treatment. Thus, improvement of mental health and access to mental health services could increasingly become a role of the probation officer. In Europe, there is less data about the use of specialty mental health probation (SMHP) than in the United States (US). In a survey for the Council of Europe, Brooker and Monteira (2021) summarized the practices of probation services and prisons among European countries. The authors alluded to useful initiatives in German states. One example is Baden-Wurttemberg, where some probation officers are trained to be mental health specialists ( Brooker and Monteira 2021 : 16). The main difference between the SMHP model in the US and the model in Baden-Wurttemberg is that the specialist in mental health in Baden-Wurttemberg does not necessarily care exclusively for individuals with mental illnesses, but rather serves as a source of expert knowledge to colleagues and assists with case consultations. Thus, the probation officer does not focus exclusively on one topic (mental health) and can take a holistic view of each individual case.

Dominant Discourse in Indigenous Consultations

Abstract In Canada, consulting with Indigenous communities over recourse projects, the Crown sometimes avoids critical engagement with them, holding to the same arguments and counterarguments through regulatory and hearing stages. Such hollow moves, produced under the Crown’s rules, become embedded in the dominant argumentative discourse and pass unnoticed. To detect them, I apply Argument Continuities (ac s) – a new category of argumentative discourse analysis. ac s are a set of the same arguments and counterarguments repeatedly produced/reproduced by the dominant arguer through an adversarial reasoning process to dismiss opposing arguments. ac s have a specific life cycle – a chain of reasoning dynamics developing in a path-dependent fashion and increasing the cost of adopting a certain argument/counterargument over time. I test ac s in two institutionally diverse cases of Indigenous consultations and argue for the contingency of ac s upon the rules of consultations in reasoning exchanges. Determining the evidence availability and allocating the burdens of proof in consultations, rules make it more or less likely for a dominant arguer to rebut opposing arguments with acs.

Exploring interprofessional collaboration during the implementation of a parent-infant mental health service: A qualitative study

ABSTRACT We examined interprofessional working in a newly implemented parent-infant mental health service team supporting families experiencing bonding and attachment difficulties. The aim was to identify forms of interprofessional work undertaken, barriers and facilitators of this work, and families’ and healthcare professionals’ perceptions of it. Semi-structured interviews were carried out with 21 stakeholders (5 parents, 4 team clinicians, 9 service referrers, 3 service commissioners) and were analyzed thematically. Interprofessional activities identified included building the service team’s cohesion and shared practice, building partner networks, interagency communication, coordination of roles, and raising awareness of infant mental health and parent-infant relationship needs. Enablers and barriers to interprofessional working were broadly consistent with findings from previous studies of related services, but with additional emphasis on consultative work as an enabler. Healthcare professionals reported benefiting from the case consultations and training on infant mental health provided by the service team. Parents reported that good interprofessional working enhanced satisfaction and engagement with the service. Findings indicate the centrality of interprofessional working for parent-infant mental health teams, with implications for future service implementation, service development, and understanding of mechanisms by which such services may influence family outcomes.

Infectious diseases consultations from general internal medicine physicians in Japan: A descriptive single-center study.

In Japan, general internal medicine (GIM) physicians must be aware of frequently encountered infections because of the shortage of infectious disease (ID) specialists. However, there are currently no epidemiological data on this subject. This study aimed to describe the frequency and pattern of ID consultations requested by GIM physicians in Japan. This is a 3-year retrospective review of the ID consultations requested by GIM physicians in Japan at a community-based acute tertiary care teaching hospital in Tokyo from April 2018 to March 2021. Demographic data, such as reasons for consultation, causative organism, and final diagnoses, were collected. During the study period, ID consultations were requested by GIM physicians 128 times. The incidence rates of bacteremia and 30-day mortality were 65.6% (n = 84) and 3.1% (n = 4), respectively. The most common diagnostic classifications after ID consultation were bone/joint (24.2%, n = 31), respiratory (17.7%, n = 22), and cardiovascular infections (12.5%, n = 16). The most common final diagnoses were bacteremia (11.7%, n = 15), infective endocarditis (9.4%, n = 12), and vertebral osteomyelitis (7.8%, n = 10). This is the first study to describe the ID consultation cases requested by GIM physicians in Japan in a community-based acute tertiary care teaching hospital. Despite the shortage of ID specialists, GIM physicians covered a wide range of IDs, including bone/joint infections and infectious endocarditis, which require long-term care. ID and GIM physicians, including hospitalists, should cooperate to promote the quality of care and clinical management. Future multi-center studies with large numbers of clinical cases are needed to determine the ID clinical knowledge required by GIM physicians in Japan.

Investigation the contents of employment consultation and support in a cancer center hospital

This study aimed to analyze and categorize the actual situation of employment consultation and support according to consultation times or employment status at the Consultation Support Center of the National Cancer Center Hospital of Japan. We retrospectively analyzed the patient backgrounds, consultation contents, and the number of employment consultation cases conducted at the Consultation Support Center of the National Cancer Center Hospital during a 6-month period from May to December 2018. During the study period, 117 patients (male: female = 46:71) visited the Consultation Support Center. The median age of patients was 48 years old. The most common primary cancer site was the breast in 28 patients followed by the lung in 16 patients, and then gynecologic cancer in 10 patients. The most common cancer treatment was chemotherapy in 53 patients (45.3%), and 12 patients (10.2%) were recurrent patients. Fifty-two patients were in regular employment, 24 were unemployed, 17 were of unknown employment status, 16 were in non-regular employment, and 8 were classified/categorized as other. In terms of working status, 40 were on leave, 35 were working, 15 were seeking work, 8 were unemployed, and 19 were categorized as other. The median number of consultations was 1 (1,11). The content of consultations was the social security system in 44 cases (37.6%) job seeking in 24 cases (20.5%), how to inform the workplace in 14 cases (12%), and workplace environment adjustment in 13 cases (11.1%). We conducted a survey on the actual status of employment consultation in a cancer center hospital. The majority of consultations were completed in one session. In terms of the content of consultations, there was a high need for consultations on the social security system and job seeking. Further study is needed on the characteristics of employment consultations according to employment status and other attributes.

Neuropathology Outreach in Ghana

Abstract Introduction/Objective Ghana has a population of over 31 million people and approximately 15 neurosurgeons but is currently without a dedicated neuropathologist. Here we present a month of neuropathology outreach performed at the Komfo Anokye Teaching Hospital (KATH) in Kumasi and the Korle-Bu Teaching Hospital (KBTH) in Accra. Methods/Case Report In February of 2022, a second-year neuropathology fellow and a board-certified neuropathologist traveled to Ghana to give 40 approximately 1.5 hour neuropathology didactic and interactive teaching sessions. A two-week format of outreach was developed for each site in Ghana and consisted of didactic lectures and interactive sessions covering the WHO 2021 brain tumor classification system, neuroautopsy, neuroinfectious disease, neurodegenerative disease, neuromuscular disease, forensic neuropathology, neurodevelopment, and unknown case conferences. Meanwhile, a pathology trainee worked remotely to organize 12 one-hour virtual general pathology lectures and develop continuing outreach. A survey of 16 questions including 12 multiple choice questions and four short answer questions was used to assess each component and the overall satisfaction of the outreach. Results (if a Case Study enter NA) Eight brains were examined at four neuroautopsy conferences and ten case consultations were performed upon request. Survey results showed no statistical differences amongst the 20 sessions. Comments were positive and included one respondent planning to redesign their PhD research to focus on neurodegenerative disease in Ghana and several others commenting on the utility of molecular updates. Suggestions for improvement included quizzes, including more morphology and IHC in lectures, sending digital slides before future visits, teaching spinal cord removal, and the need for continuing outreach in neuropathology, dermatopathology, cytopathology and gynecologic pathology. Conclusion This experience provides a useful and well-appreciated approach to delivering international neuropathology outreach. Opportunities in neuropathology on an international level range from educational to clinical practice and research.

Infection and the evaluation of biomarkers in obstetrics and gynecology patients with infectious disease: a retrospective observational study from clinical pharmacists’ consultation experience

BackgroundThe use of empirical anti-infective medication calls for the identification of common pathogens and accurate infectious biomarkers. However, clinical pharmacists’ anti-infective experience in the field of obstetrics and gynaecology is rare in the literature. This study aimed to retrospectively analyze the correlation between the anti-infective effectiveness after 7 days of antibiotic treatment and infectious biomarkers, according to clinical pharmacists’ consultation cases of gynecological and obstetric infections.MethodsIn this retrospective study, clinical pharmacists’ anti-infective consultation experiences applied by physicians from January 1, 2018, to December 31, 2020, were included. The exclusion criteria were as follows: (1) the patient died or left the hospital before undergoing an effectiveness evaluation after the consultation; (2) treatment was discontinued due to adverse reactions related to antibiotics; (3) the patient did not undergo an effectiveness evaluation within 3 or 7 days after application of the clinical pharmacist’s treatment plan; and (4) the physician did not adopt the clinical pharmacist’s suggestions. The registered information included patient characteristics, pathological bacteria, anti-infective medication and changes in infection indices before and after treatment. Statistical analysis of temperature, white blood cells (WBCs), C-reactive protein (CRP), procalcitonin (PCT) and WBCs in urine after 3 days and 7 days of anti-infective treatment, compared with before anti-infective treatment, was performed by the chi-square test. A t test was conducted to further study WBC count and CRP. A receiver operating characteristic curve verified the sensitivity and specificity of WBC count, CRP and PCT.ResultsA total of 265 cases were included. The CRP levels of patients 3 d and 7 d after antibiotic treatment were significantly lower than before antibiotic treatment (P < 0.05, P < 0.01), while the WBC count showed a downward trend after 3 days and a significant decrease after 7 days (P < 0.01). The areas under the curve (AUCs) for prognosis on the 7th day for WBC count, CRP and PCT were 0.90, 0.75 and 0.522, respectively. The AUC for WBC count combined with CRP was 0.90, which was higher than that for the biomarkers tested separately, especially compared to PCT. The most common gynecological infections were surgical site infection (SSI), urinary tract infection and fever of unknown origin, and the most common pathogens were E. coli and E. faecalis in Gram-negative and Gram-positive samples, respectively. Pharmacists’ recommended treatment plans included carbapenems and β-lactam antibiotics.ConclusionsOur dual-center study indicates that the combination of WBC count and CRP can improve diagnostic accuracy and treatment efficiency, and PCT alone is insensitive to gynecological infections, according to clinical pharmacists’ experience.

A critical evaluation of the EU-virtual consultation platform (CPMS) within the European Reference Network on Rare Endocrine Conditions.

In 2017, the European Commission installed 24 European Reference Networks (ERNs) for different categories of rare and complex conditions to facilitate cross-border health care via virtual case consultations in a secure Clinical Patient Management System (CPMS). The ERN for rare endocrine conditions (Endo-ERN) previously reviewed the CPMS, in which they detailed the difficulties physicians encountered with the system and proposed solutions to these that should enable the system to be used to a greater extent. This paper will further the endeavor of the first by performing a critical evaluation of the CPMS, assessing how these suggested improvements have been implemented, and if these have affected the usage of the system. The evaluation involves an assessment of CPMS usage statistics since its conception that takes into consideration the technical updates and the external factors that may have affected these, including data from a review survey following a training workshop for our new healthcare providers (HCPs) added in January 2022. It appears that the improvements made to the system since the first review, in particular the implementation of the Operational Helpdesk, have had a positive effect in increasing CPMS membership; however, the regular usage of the system continues to fluctuate. Several suggestions are made on how to further facilitate the use of CPMS by our members both individually and network-wide, by integrating CPMS activities with other network initiatives and further integrating these into national health care systems as well as looking for ways to measure patient satisfaction from the CPMS discussions outcomes.

Telefonische Sprechstunde am Institut und der Poliklinik für Arbeits-, Sozial- und Umweltmedizin der Friedrich-Alexander-Universität Erlangen-Nürnberg

Telephone consultation at the Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine at the Friedrich-Alexander-University of Erlangen-Nürnberg Objective: With the spread of the COVID-19 pandemic, the goal was to establish telephone consultations at the Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine at the Friedrich-Alexander-University of Erlangen-Nürnberg. Methods: After initial contact, the patient’s suitability for a telephone consultation is verified and an outpatient appointment can be explicitly requested. Prior to the consultation, written consent and a referral must be submitted; the submission of additional documents is optional. During the telephone appointment, the data are first compared. If there is any indication of a need for biomonitoring, the samples are usually taken by the referring physician and the analysis is performed in our laboratory. Finally, a doctor’s letter is written. Results: Since March 2020, 139 patients out of 253 referrals have been advised by telephone and 30 on an outpatient basis. Of all telephone consultation cases, 53.2 % (n = 74) were female. The mean age of patients advised by phone was 51.3 years, the mean duration of the call was 54.3 minutes, and the mean potential travel distance was 69.7 kilometres. A potential 9,688.8 kilometres of travel were thus avoided due to the availability of phone consultations. Biomonitoring was initiated in 23.7 % of cases, technical information was submitted in 88.5 %, further diagnostics were recommended in 37.4 %. A telephone consultation was deemed useful by physicians in 99.3 % of cases. Conclusion: Our model of a telephone consultation in the areas of occupational and environmental medicine enabled meaningful and effective patient care including both anamnesis and medical advice. Keywords: telephone consultation – consultation in occupational and environmental medicine – telemedicine

Symptom: Runny Nose Six Years After Acoustic Neuroma Surgery

Symptom: Runny Nose Six Years After Acoustic Neuroma Surgery

110 DEVELOPMENT AND DELIVERY OF A MULTI-DISCIPLINARY HYBRID EDUCATION PROGRAM IN SYNCOPE AND RELATED DISORDERS DURING THE COVID-19 PANDEMIC

Abstract Background Syncope and related disorders is an important area for training of all health professionals. During the COVID-19 pandemic, we adapted the delivery of our annual face-to-face certified program to a 9-month hybrid program. Here, we describe the development, delivery, and evaluation of such new program. Methods A pre-existing curriculum was modified to incorporate online content, online lecture delivery and interactive group learning, in addition to individual practical placements in a syncope management unit, in line with government and hospital infection control guidance at the time. Monthly content included video consultant case presentations, ECG analysis and interpretation, and instructional videos of diagnostic testing and relevant technologies. A comprehensive online week-long lecture program was developed. Results The lecture week included 30 clinical lectures, 10 clinical case presentations and 10 ‘how to’ practical videos for testing/monitoring procedures. Further learning over zoom incorporated learner case presentations in a small group format. At the completion of the course the leaners attended a final online half day of lectures and completed the multi choice question examination. Conclusion “Thank you so much for putting together such a fantastic week of training.” “The quality and expertise of the speakers was outstanding.” “I have taken a huge amount away to incorporate into my practice and local unit.” The above learner feedback is consistent with our aim to deliver a high-quality specialist program for those interested in advancing the management of syncope and related disorders. Over time, this specialist training will aid the development of regional syncope management units across Ireland. The benefits of a hybrid learning model include multiple options to cater for all categories of learners, thus suggesting it is the cornerstone of future learning modalities.

2.56 Understanding Pediatric Mental Health in Primary Care: Needs in a Rural State

2.56 Understanding Pediatric Mental Health in Primary Care: Needs in a Rural State

알코올 사용 장애 환자의 진전섬망 예측을 위한 의사 결정 모델 개발

Objectives: To identify predictive factors associated with the onset of delirium tremens (DT) and produce a ‘decision tree’ that clinicians could utilize when deciding which patient undergoing alcohol withdrawal symptoms is more likely to develop DT.&#x0D; Methods: Consultation answer notes, demographic, and laboratory data of 243 inpatient consultation cases regarding alcohol withdrawal symptoms were collected. Receiver operating characteristic analysis (ROC) was performed to identify predictors of DT development.&#x0D; Results: DT was developed in 26.75% of consulted cases. ROC revealed that delirium history was the most significant predictor of DT development (κ=0.342; χ2=29.415, p&lt;0.001). Subjects with a delirium history had a conversion rate of 59.5%. Those without such history had a conversion rate of 19.0%. The second most significant factor was body mass index (BMI), with a cutoff point of 23.8 kg/m2 (κ=0.224; χ2=9.043, p&lt;0.01). Among subjects without delirium history, those with BMI ≥23.8 kg/m2 had a conversion rate of 28.6% and those with BMI &lt;23.8 kg/m2 had a conversion rate of 9.0%.&#x0D; Conclusion: Assessing delirium history and BMI of non-psychiatric inpatient ward alcoholic patients can be useful for risk evaluation of DT development. For patients who have a high risk of DT, close monitoring of vital signs and alcohol withdrawal symptoms are needed with prompt administration of benzodiazepine drugs.

Training dementia care professionals to help caregivers improve the management of behavioral and psychological symptoms of dementia using the DICE Approach: A pilot study

Most persons living with dementia (PLWD) exhibit behavioral or psychological symptoms of dementia (BPSD) over the course of the illness. The DICE Approach (DICE) is a framework that enables caregivers to identify, evaluate, and manage BPSD. This pilot pre-post test study examined the effects of DICE training on dementia care professionals' self-efficacy, knowledge, and attitudes regarding care of patients with BPSD. Participants underwent either in-person DICE training or, during the pandemic, online training. Case consultations were offered as additional learning opportunities in challenging situations. Of 134 participants in the trainings, 122 (91.0%) provided survey data for one or more instruments before and after training. Participants experienced significant improvement in knowledge and attitudes with respect to BPSD and improvement in self-efficacy with respect to helping caregivers respond to BPSD. Training dementia care professionals in DICE can improve their capacity to support caregivers in the management of BPSD.

A retrospective analysis of the diagnostic accuracy and technical quality of frozen sections in detecting hepatobiliary lesions

IntroductionPathological consultation on intraoperative frozen sections plays a crucial role in the management of patients undergoing surgical therapy, and is also a key indicator for quality assurance in anatomical pathology. This study aimed to evaluate the diagnostic accuracy and technical quality of frozen sections in detecting hepatobiliary lesions with malignant potential. Patients and methodsA retrospective database review was performed for 1208 cases intraoperative pathology consultation who underwent hepatobiliary lesions resection at our institution from 2016 to 2020. The intraoperative consultation cases during a 5-year period were reviewed and analyzed, including the measurement of the diagnostic accuracy and turnaround time of frozen sections, the reasons for discrepancies, and the rates of discordance and deferral. ResultsIn this study, we confirmed that the overall accuracy, sensitivity and specificity were 95.3 %, 96.3 % and 96.6 %, respectively, in distinguishing benign from malignant lesions. The rates of deferred and discordant diagnoses were 2.57 % and 2.2 %, respectively. The overall frozen section turnaround time was 22.1 min. The most common cause of deferred and discordant was poor section quality, the lesion of bile duct margin on the frozen section, misinterpretation of difficult and complicated cases, etc. ConclusionsThis study confirms that the intraoperative frozen sections can serve as a rapid, accurate and robust method for the pathological diagnosis of suspected hepatobiliary lesions. However, it should be noted that some poor technical problems, pathological assessment of tumor margin and difficult cases are the most frequently causes of deferred and discordant interpretations.

Distractions in the operating room: a survey of the healthcare team.

BackgroundDistractions during surgical procedures are associated with team inefficiency and medical error. Little is published about the healthcare provider’s perception of distraction and its adverse impact in the operating room. We aim to explore the perception of the operating room team on multiple distractions during surgical procedures.MethodsA 26-question survey was administered to surgeons, anesthesia team members, nurses, and scrub technicians at our institution. Respondents were asked to identify and rank multiple distractions and indicate how each distraction might affect the flow of surgery.ResultsThere was 160 responders for a response rate of 19.18% (160/834), of which 71 (44.1%) male and 82 (50.9%) female, 48 (29.8%) surgeons, 59 (36.6%) anesthesiologists, Certified Registered Nurse Anesthetists (CRNA), and 53 (32.9%) OR nurses and scrub technicians. Responders were classified into a junior group (< 10 years of experience) and a senior group (≥ 10 years). Auditory distraction followed by equipment were the most distracting factors in the operating room. All potential auditory distractions in this survey were associated with higher percentage of certain level of negative impact on the flow of surgery except for music. The top 5 distractors belonged to equipment and environment categories. Phone calls/ pagers/ beepers and case relevant communications were consistently among the top 5 most common distractors. Case relevant communications, music, teaching, and consultation were the top 4 most perceived positive impact on the flow of surgery. Distractors with higher levels of “bothersome” rating appeared to associate with a higher level of perceived negative impact on the flow of surgery. Vision was the least distracting factor and appeared to cause minimal positive impact on the flow of surgery.ConclusionsTo our knowledge, this is the first survey studying perception of surgery, anesthesia, and OR staff on various distractions in the operating room. Fewer unnecessary distractions might improve the flow of surgery, improve OR teamwork, and potentially improve patient outcomes. Supplementary InformationThe online version contains supplementary material available at 10.1007/s00464-022-09553-8.

Report on the Establishment of the Consortium for Hospital Ethics Committees in Japan and the First Collaboration Conference of Hospital Ethics Committees.

Hospital ethics committees (HECs) are expected to play extremely broad and pivotal roles such as case consultation, education of staffs on healthcare ethics, and institutional policy formation. Despite the growing importance of HECs, there are no standards for setup and operation of HECs, and composition and activities of HECs at each institution are rarely disclosed in Japan. In addition, there is also a lack of information sharing and collaboration among HECs. Therefore, the authors established the Consortium of Hospital Ethics Committees (CHEC) in October 2020, which has been regularly hosting a couple of core activities. One is the Healthcare Ethics Forum, held monthly online for CHEC members to freely discuss HECs and healthcare ethics consultation. The other is the Collaboration Conference of Hospital Ethics Committees, intended to provide a place for HEC members and administrative officers from across Japan to exchange information of their HECs, learn from each other, and cooperate to operate HECs appropriately. In this paper, the authors introduced CHEC as well as reported the results of a questionnaire survey conducted at the first conference among participating facilities, suggesting the diverse structures and activities of HECs in Japan.

Telemedicine as a new platform of care: assessing quality of care for the endocrine surgical patient—a narrative review

Background and Objective: Expansion of reimbursement for telehealth under the Center for Medicare and Medicaid Services emergency COVID-19 pandemic waiver has allowed for wider implementation of telehealth as an accepted modality for delivering and receiving healthcare. In a specialty such as endocrine surgery, where complications are rare and recovery after surgery is usually uneventful, telemedicine is a viable option for postoperative visits and may be an acceptable alternative for in-person preoperative consultation in select cases. Therefore, our objective was to construct a narrative review describing the developing role of telemedicine in endocrine surgery, i.e., thyroidectomy and parathyroidectomy, and its current utilization and perception in the peri-COVID-19 pandemic era.