ABSTRACT
Background: Filtering Facepiece Particle (FFP) masks are the most common Personal Protective Equipment used by healthcare workers, particularly in relation to COVID-19 pandemic. With the aim of improving compliance and decreasing the discomfort caused by prolonged use of facemasks, a new type of FFP2 and FFP3 facemasks, defined as "high breathability", has been intro-duced to the market.Methods: We compared the commonly used FFP2/N95 facemasks with these new "high breathability" facemasks in terms of dis-comfort caused by prolonged use of the facemasks and an assessment of nasal cavity and nasal respiratory symptoms in healthcare workers.Results: We involved 36 healthcare workers employed in the operating room and outpatient activities at the Fondazione Policlin-ico Universitario Campus Bio-Medico of Rome. After seven days of wearing FFP2/BLS 502 facemasks, a statistically significant difference was found in the results to a discomfort questionnaire and the assessment of nasal cavity and the nasal respiratory symptoms, including nasal obstruction and rhinorrhea. Better results were obtained using the BLS 502 facemask in terms of the sneezing and nasal itchiness variables.Conclusions: Thanks to its design and low breathing resistance, the FFP2/BLS 502 facemask appears to be more comfortable to wear than common FFP2/N95 facemasks.
ABSTRACT
COVID-19 pandemic changed quickly world's clinical picture. Symptoms often are sneaky, hiding dramatic clinical scenarios. A 52-year-old man was sent to the Emergency Department with persistent chest pain, dyspnea and hypoxia. He also complained of cough and fever (38 degrees C) since four days without clinical improvements by paracetamol. Nasopharyngeal swab was positive for SARS-CoV-2. High resolution computer tomography (HRCT) showed typical CT pattern of bilateral COVID-19 pneumonia. During hospital stay clinical worsening occurred and a CT pulmonary angiography revealed a bilateral massive acute pulmonary embolism. The patient was treated with unfractionated heparin.
ABSTRACT
Background and Aims: Starting from February 2020 it was clear that early identification of SARS-CoV-2 infected patients and their isolation was the key to block the spread of the new disease. The aim of the study is to identify strengths and weaknesses of a telemedicine program. Methods: In order to avoid the hospitalization we enrolled 543 patient on telemedicine service. Monitored patients were required to submit twice a day to the dedicated platform their oximetry, HR, RR, body temperature, systolic blood pressure and their symptoms. Every set of data generated a color coded score viewed realtime by the HPs who performed a phone call and decided to run phone tests for a new color coded score that induced to apply corrective actions: new call, home examination or emergency intervention network activation. Results: On 453 patients 87% healed and 6.4% were hospitalized, 11,79% needed oxygen therapy. The mean time spent in the telemonitoring program was 24.21 days. Malaise was the most common and persistent symptom, followed by cough, lack of appetite and myalgia. Conclusions: Telemonitoring is a safe, low budget and patientfriendly alternative to hospitalization for mild CoViD-19 patients. Relying on elementary instrumentation entrusted to fragile patients, for an effective telemonitoring program, especially during an outbreak, is essential a sound training of health professionals who can train unskilled operators. It also needs a strong collaboration with the general practitioner and the emergency division team.
ABSTRACT
Recently, the use of barbed sutures (BS) for the treatment of retro-palatal collapse and vibration in patients affected by snoring and obstructive sleep apnea (OSA) has significantly increase and surgeons have become more familiar with advantages and disadvantages of using this new technology. However, in the common surgical practice, there are some problems related to the use of BS and few technical solutions have been described. One problem still unsolved is when the needle becomes unusable. Today, there is still no recognized procedure for this critical intraoperative problem that forces the surgeon to cut the thread and start the procedure all over again. We describe an easily repeatable technique called “barbed suture needle rescue procedure” to solve this critical problem and allow the surgeon to complete the procedure. © 2020, Springer Nature Switzerland AG.
ABSTRACT
Background: Data on SARS-CoV-2 infection in Hemoglobinopathies are still scarce and controversial. Since March 2020, we, as Italian Society for Thalassemia and Hemoglobinopathies (SITE), recommended close monitoring and set up an Italian survey to verify the impact of SARSCoV- 2 infection on patients with Hemoglobinopathies (EMO AER COVID-19 NCT04746066) among Italian Centers. Aims: To explore the hypothesis of an increased vulnerability of Hemoglobinopathies to SARS-COV2 infection. Methods: After SITE proposal and Ethics Committee approval, each participating Center entered data on a specific electronic Case Report Form (eCRF) (https://covid19.site-italia.org). Inclusion criteria included positive swab or serology and at least 15 days of follow-up from either the onset of symptoms or SARS-CoV2 positivity. This cut-off is updated to February 15, 2021. Results: Twenty-seven Centers that provide care to 6121 patients with Hemoglobinopathy (65% of the Italian population) recorded a total of 275 SARS-CoV2 infections (overall, prevalence 4.5%), in 191 transfusion- dependent thalassemia cases (TDT, prevalence 5.8%), 36 non-transfusion- dependent thalassemia (NTDT, prevalence 2.3%) and 48 sickle cell disease patients (SCD, prevalence 3.7%). Median age was 41 years (IQR: 30-48, range: 9 months-85 year). Twenty-eight patients (10 %) were pediatrics (median age: 6.5 years, IQR: 4-11). Most patients (72%) had comorbidities;134 (49%) had splenectomy or functional asplenia. We observed a broad spectrum of disease severity, ranging from no symptoms in 65 patients (24%) to multisystem organ failure and death in 5 patients: 2 TDT (age: 49 and 56 years), 1 NTDT (age: 45 years), 2 SCD (age: 57 years both). Overall, 56 (20%) patients required hospitalization, 12 in high-intensity care unit;10 required support by oxygen, 11 needed more intensive ventilation support with continuous positive airway pressure (CPAP), and 7 required intubation. Nine patients required ad hoc transfusion or more than scheduled. Two SCD patients of 9 and 20 months of age, respectively, recovered after a long and life-treating disease. One TDT patient experienced reinfection after 3 months from the first;one 30w-pregnant SCD woman developed COVID-19 without consequences for herself and the fetus. Overall clinical severity has been higher in SCD than in thalassemia patients. Summary/Conclusion: The prevalence of COVID-19 in Hemoglobinopathies apparently overlaps the general population (4.5% vs 4.6%), however, these patients are more strictly observed and we could postulate that the precautions suggested or self-applied by the patients were effective. The overall mortality is 1.8% vs 3.4% and the difference may be due to the younger age of patients with Hemoglobinopathies. Our data confirm the higher risk of severe disease and death in SCD.
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The recent COVID-19 carries potential risk factors for VTE and worse clinical course in some patients has an association with thrombosis. While low molecular weight heparins are under investigation for appropriate dosage, other elements could be useful. We share our experience about two patients with unexpected clinical course. © 2020 Czech Society of Cardiology Z.S. All rights reserved.