Dysphagia rehabilitation in post-COVID patients: Review of the literature

COVID-19 causes acute respiratory failure syndrome (SIRA), leading patients to require intubation in the intensive care unit (ICU). A common complication of this ventilatory support is dysphagia, which has a prevalence of up to 30%.This work aims to describe rehabilitation methods in patients with coronavirus infection based on levels of evidence according to the GRADE System, so a systematic review of the literature was carried out. The selected articles were divided into the following subtopics: diagnosis of dysphagia and rehabilitation in COVID patients. The gold standard for the diagnosis of dysphagia is the videofluoroscopic swallowing study (VFS). Fiberoptic Evaluation of Swallowing Assessment (FEES) has high sensitivity and specificity, although they have the disjunction of an aerosol-generating procedure (AGP);however, in a pandemic situation, the study of choice in the literature is VF. Once the diagnosis is made, it is necessary to initiate rehabilitation as soon as possible, even from hospitalization in patients who have hemodynamic stability to prevent long-term effects and promote normal swallowing even before discharge. In patients with COVID-19 infection dysphagia, the risk-benefit of assessment tools and therapy used for diagnosis should be decided to help to maintain social distancing. It becomes imperative to carry out clinical studies with high levels of evidence that allow us to generate Clinical Practice Guides for the benefit of our patients.Copyright © 2021 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.

Sources of water-soluble organic carbon in fine particles at a southern European urban background site

In this study, the temporal evolution and sources of water-soluble organic carbon (WSOC) in submicron particles at an urban background site in Elche (Spain) were investigated. Measurements of PM1 (N = 200) were carried out over one year (2021). Samples were analysed for organic carbon (OC), elemental carbon (EC), WSOC, levoglucosan, elements and major ions. A positive matrix factorization (PMF) analysis was performed in order to identify the sources of WSOC on an annual and a monthly basis. During the study period, traffic restrictions due to COVID-19 led to lower concentrations of PM1 and carbonaceous compounds than expected. The WSOC annual average mass concentration was 0.95 mugm-3, with maximum values during the colder months. The apportionment results indicate that the biomass burning (BB) source contributed 30.63% to WSOC levels, road traffic (RT) accounted for 23.90% of the WSOC, while the contribution of a source related to secondary organic aerosol formation (ammonium sulfate-AS) was 33.80%. Minor sources of WSOC were: soil dust (SD) and secondary nitrate (SN), which contributed 7.44% and 4.22%, respectively, to WSOC concentrations. The WSOC/OC ratio did not exhibit significant variations during the study period, since source contributions were similar for WSOC and OC. The highest values of this ratio were recorded in summer, due to the higher contribution from the AS source to WSOC concentrations.Copyright © 2023 The Authors

Acoustic contamination assessment during the transition between the COVID-19 restrictions and reactivation: A exploratory analysis in Guayaquil

Noise pollution is becoming a critical health risk for city life. In 2020, the COVID-19 pandemic forced many cities to implement several mobility restrictions. These restrictions changed human activity patterns and decreased the noise levels and noise pollution that often affect urban settings. As the number of infections decreased, so did the outdoor activities, influencing the population's perception of noise. This paper aims to evaluate the changes in noise levels associated with mobility restrictions between 2020 and 2021 in Guayaquil, Ecuador. This study used crowdsourcing with the help of smartphones and mobile applications to collect geo-referenced environmental noise data. The data was used to generate noise maps in different time frames. Finally, noise level maps were created using GIS-based tools to identify the urban areas that experienced the highest noise level variation during the study period. The results show that the most significant noise increase occurred at night. Furthermore, when analyzing noise level changes in different urban areas, the western area of Guayaquil was the one that experienced the most significant noise level variation. Findings inform the perception of noise pollution and could potentially serve as a reference for decision-makers during the proposal of public policies that ensure a better quality of life for its citizens. © 2023 The Authors

Acoustic contamination assessment during the transition between the COVID-19 restrictions and reactivation: A exploratory analysis in Guayaquil

Noise pollution is becoming a critical health risk for city life. In 2020, the COVID-19 pandemic forced many cities to implement several mobility restrictions. These restrictions changed human activity patterns and decreased the noise levels and noise pollution that often affect urban settings. As the number of infections decreased, so did the outdoor activities, influencing the population's perception of noise. This paper aims to evaluate the changes in noise levels associated with mobility restrictions between 2020 and 2021 in Guayaquil, Ecuador. This study used crowdsourcing with the help of smartphones and mobile applications to collect geo-referenced environmental noise data. The data was used to generate noise maps in different time frames. Finally, noise level maps were created using GIS-based tools to identify the urban areas that experienced the highest noise level variation during the study period. The results show that the most significant noise increase occurred at night. Furthermore, when analyzing noise level changes in different urban areas, the western area of Guayaquil was the one that experienced the most significant noise level variation. Findings inform the perception of noise pollution and could potentially serve as a reference for decision-makers during the proposal of public policies that ensure a better quality of life for its citizens. Graphical abstract Image, graphical abstract

Bilateral facial palsy with paresthesias, variant of Guillain-Barré syndrome following COVID-19 vaccine: A case series of 9 patients.

Several cases of Guillain-Barré Syndrome (GBS) associated with COVID-19 vaccination have been reported, including the rare subtype known as Bilateral Facial Palsy with paresthesias (BFP). To date, it is not known whether a causal relationship may exist between the two. We report 9 cases of BFP in patients vaccinated against COVID-19 in the previous month. Nerve conduction studies revealed demyelinating polyneuropathy in 4 patients, and 5 presented bilateral, focal facial nerve involvement, exclusively. Ganglioside antibody panel was positive in 4 patients (anti-GM1=2, anti-GD1a=1 and anti-sulfatide=1). Seven patients received intravenous immunoglobulin treatment, one plasma exchange, and one patient died from sudden cardiac arrest following arrhythmia before treatment could be administered. Rates of BFP following COVID-19 vaccination, did not differ from those reported in previous series. Epidemiological studies are essential to determine whether a causal relationship may exist between this rare form of GBS and COVID-19 vaccination.

PSYCHOPHYSIOLOGICAL CONDITION IN THE PERFORMANCE OF SANITARY-MILITARY TASKS WITH SURGICAL MASK

Using a quasi-experimental design with 19 health workers (33.7 ?? 5.1 years), the importance of physical and cognitive condition and performance when wearing protective equipment with a surgical mask during training situations in significant contexts of military intervention has been analysed. Heart rate and its variability, glucose levels, thermoregulation, explosive strength and perceived effort in specific motor performance tasks (tapping test, tourniquet, ammunition), and cognitive and decisional performance (triage) were measured. The results indicate significant differences (p < 05) depending on the physical condition (blood glucose and explosive strength), gender (explosive strength and tourniquet), smoking habit (perceived effort) and specialty (glucose level) in the study group. In conclusion, the importance of physical and psychological training is highlighted to improve the operational response in health-military situations that require the use of a surgical mask.

Quantification and mapping of domestic plastic waste using GIS/GPS approach at the city of Guayaquil

A significant contributor to the waste stream is the domestic single-use plastic used in households, being the final disposal in most cases the local landfill. There is a significant opportunity to promote resource recovery and efficiency through the introduction of circular economy strategies. However, the knowledge and management of post-consumer plastic waste in the country is poor, and there is a lack of an efficient collection and sorting system. In this context, spatial information on domestic plastic waste generation (DPWG) is essential for recycling decision-making. The integration of Geographic Information Systems (GIS) and the Global Positioning System (GPS) shows an opportunity to collect, mapping, and analyse spatial DPWG issues. Thus, this paper had a double objective. The first was to assess the evolution of eight different types of plastic waste in the city's households and their daily per capita generation between 2019 and 2021. The second objective was to provide a complete geo-referenced information on the quantities and typologies of domestic plastic waste (DPW) produced in Guayaquil and analyse how the flows have shifted throughout the years. The results showed that PET is the most generated, recording 97.76% and 100.00 % of the households who generate this type of plastic for 2019 and 2021, respectively, with an average of 13.08 and 15.13 g/day/c. Following, we had HDPE, PP and PVC occupying the second, third and fourth place for 2019 with 5.86, 3.05, 2.54 g/day/c, respectively. On the other hand, for 2021, PP (7.43 g/day/c), HDPE (5.92 g/day/c), and LDPE (3.99 g/day/c) occupied the second, third and fourth, respectively. According to the spatial maps, the DPW increment is in most of the popular zones. These popular zones are neighborhoods with a considerable quantity of population and limited basic services. Most of these people live in extreme poverty, being a possible relation between the COVID-19 lockdown and the increasement of DPW. © 2022 Elsevier B.V.. All rights reserved.

Resilience of health care workers in the covid-19 emergency: areas of intervention

Main objective: Analyze the level of resilience of health professionals during the Covid-19 pandemic in health centers. Methodology: A pre-experimental study of a single group without comparison level and quantitative methodology was designed, in which was applied the Wagnild and Young (1993) resilience scale. It was distributed using the snowball technique in digital format, respecting the ethics of the investigation. Main results: 101 health professionals participated, reporting a low level of resilience. No statistically significant differences were found in the level of resilience between sex, age or profession. Main conclusion: Being the level of resilience low, axes of a potential individual and group intervention plan are proposed for the development of resilience and the improvement of coping. The work marks the need to investigate the optimal process of resilient development and its transfer to the work environment. © 2021, Fundacion Index. All rights reserved.

Delayed local reactions to mRNA vaccines against COVID-19

Background: Vaccines represent an efficient means to control the pandemic of Coronavirus Disease 2019 (COVID-19). Two mRNA-based emergency vaccines have recently been licensed for mass administration: BNT162b2 and mRNA-1273 COVID-19 vaccine. Delayed hypersensitivity reactions these new vaccines can range widely from localized skin symptoms to disseminated exanthemas. Locally confined reactions can be caused by the active component or the excipients in the vaccine. Both mRNA vaccines contain polyethylene glycol (PEG) 2000 lipid conjugate as excipient. PEG and its derivatives with clinical cross-reactivity (polysorbates, laureth-9) are ubiquitous in many drugs. The mRNA-1273 COVID-19 vaccine also contains trometamol, an organic amine used extensively. Method: We reported a series of 14 patients referred to our Allergy Department with suspected delayed large local reactions (DLLR): erythematous and edematous plaques ≥10 cm in diameter accompanied by pain or pruritus, after the administration of BNT162b2 or mRNA-1273 COVID-19 vaccine between January to February 2021. We describe cutaneous manifestations,latency time, treatment and duration of the lesions. We performed patch test in the upper back with PEG 400 1% in petrolatum (pet), PEG 3350 10% pet, PEG 3350 in aqueous solution (aq), PEG 4000 10% pet, polysorbate 80 1% pet, polysorbate 80 10% pet, laureth-9/ sodium lauril sulphate 1%, trometamol 0.50% aq (only in mRNA-1273 vaccinated patients), with readings at day 2 and day 4. Results: We collected 14 patients: 13 received mRNA-1273 and only one BNT162b2 COVID-19 vaccine. Most patients (13/14) reacted to the first dose. 42.9% had detectable serum specific IgG antibodies against SARS-CoV-2 in the last 3 months. The mean size of DLLR was 11.9 ± 1.6 cm and the latency time was 4.4 ± 1.8 days. Ten patients (71.4%) not receive any treatment, and four (28.6%) received topical corticosteroids. The mean duration of the reactions was 4.75 ± 2.7 days when treated and 4.5 ± 0.60 days without treatment, with no significant differences (p = 0.79). All patients completed vaccination with the second dose and 69.2% developed DLLR again. PT were negative in the 100% cases Conclusion: We didn't found any sensitization to excipients in our 14 cases series. We thought that DLLR may occur due to a non-specific inflammatory response or represent the normal immune response to the vaccination, and in our experience, this should not be a contraindication to receive further doses of mRNA vaccines.