ABSTRACT
BACKGROUND AND AIMS: With the global epidemic of SARS-CoV-2, there has been a growing concern regarding the risk of aerosol exposure to healthcare workers and patients during medical/surgical interventions. The Schlieren device is capable of visualizing fine gas-flows by using refractive index differences in the medium. We aimed to reveal the existence of gas leakage from gastro-intestinal endoscopy system by utilizing Schlieren device and to clarify the factors which relates to the amount of gas leakage. METHODS: The experiments were performed on the excised swine stomach while maintaining a constant pressure environment in the stomach. The System Schlieren (SS100,KatoKoken) was used to visualize possible gas leakages from forceps plugs of endoscopy. We attempted to semi-quantify the leakage by referring to the image of the gas from the forceps plug and by measuring the initial velocity and diffusion area of the leakage. RESULTS: Regardless of the type of forceps plugs, a certain amount of leakage was detected during both insertion and removal of forceps. The initial velocity and the diffusion area of the leakage increased with the increase in intragastric pressure. Semi-quantitative comparison showed that there was a difference in the amount of gas leakage among various forceps plugs. Furthermore, the amount of gas leakage was significantly greater in the forceps plugs that were used repeatedly. CONCLUSION: It was possible to visualize gas leakages from the gastrointestinal endoscope system using the Schlieren optical device. Avoiding too high intragastric pressure and not using deteriorated plugs may reduce the risk of aerosol exposure.
ABSTRACT
The activities of nursing researchers have been constrained by the COVID-19 pandemic. Therefore, this study aimed to investigate the types of support and related factors that nursing researchers hope to receive from academic societies during the pandemic and to obtain suggestions for the role of academic societies in supporting nursing researchers and expanding research. An online survey was conducted with 1532 Japan Academy of Nursing Science members. The survey included 19 items of potential support from the society during the COVID-19 pandemic as well as open-ended questions. Data were analyzed statistically and qualitatively. For 9 of the 19 items, over 50% of respondents reported that they "needed" or "very much needed" support. Multivariate analysis results showed that younger respondents and those with family members requiring care were significantly more likely to report needs for some items. In the open-ended comments, there were several suggestions for activities, including "Lobbying for revision of regulations on research implementation." Nursing researchers expressed needs for support that reflect their demographic characteristics and situations, including collaboration across organizations and securing research-promotion and skill-development opportunities online.
ABSTRACT
During the COVID-19 pandemic, intravitreal injections are performed with patients wearing masks. The risk of endophthalmitis after intravitreal injection is reported to increase due to an influx of exhaled air containing oral bacteria from the upper part of the mask onto the ocular surface. We retrospectively investigated the incidence of endophthalmitis when intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections were performed using the same infection control measures before and during the pandemic. Vitreoretinal specialists performed intravitreal injections of anti-VEGF agents in the outpatient room of a university hospital. Infection control measures before and during the pandemic included covering the patient's eye with adhesive face drape and irrigating the ocular surface with 0.25% povidone-iodine before draping, and immediately before and after injection. Before the COVID-19 pandemic (February 2016 to December 2019), one case of endophthalmitis occurred among 31,173 injections performed (0.0032%; 95% confidence interval (CI), 0.000008-0.017872%). During the COVID-19 pandemic (January 2020 to August 2021), one case of endophthalmitis occurred among 14,725 injections performed (0.0068%; 95% CI, 0.000017-0.037832%). There was no significant difference between the two periods (Fisher's exact test: p = 0.5387). Even during the COVID-19 pandemic, very low incidence of endophthalmitis after intravitreal injection can be maintained by implementing basic infection prophylactic measures, including face draping and 0.25% povidone-iodine irrigation, established before COVID-19 pandemic.
ABSTRACT
Background: Coronavirus Disease 2019 (COVID-19) has spread worldwide with collateral damage and therefore might affect the behavior of stroke patients with mild symptoms seeking medical attention. Methods: Patients with ischemic stroke who were admitted to hospitals within 7 days of onset were retrospectively registered. The clinical characteristics, including onset-to-door time (ODT), of patients with a transient ischemic attack (TIA)/mild stroke (National Institutes of Health Stroke Scale [NIHSS] score of ≤ 3 on admission) or moderate/severe stroke were compared between those admitted from April 2019 to March 2020 (pre-COVID-19 period) and from April to September 2020 (COVID-19 period). Multivariable regression analysis was performed to identify factors associated with the ODT. Results: Of 1,100 patients (732 men, median age, 73 years), 754 were admitted during the pre-COVID-19 period, and 346 were admitted during the COVID-19 period. The number and proportion of patients with TIA/minor stroke were 464 (61.5%) in the pre-COVID-19 period and 216 (62.4%) during the COVID-19 period. Among patients with TIA/mild stroke, the ODT was longer in patients admitted during the COVID-19 period compared with that of the pre-COVID-19 period (median 864 min vs. 508 min, p = 0.003). Multivariable analysis revealed the COVID-19 period of admission was associated with longer ODT (standardized partial regression coefficient 0.09, p = 0.003) after adjustment for age, sex, route of arrival, NIHSS score on admission, and the presence of hypertension, diabetes mellitus, and wake-up stroke. No significant change in the ODT was seen in patients with moderate/severe stroke. Conclusions: The COVID-19 epidemic might increase the ODT of patients with TIA/mild stroke.