The importance of a comprehensive study in allergic reactions

Background: Polyethylene glycol (PEG) is a condensed polymer of ethylene glycol used as excipient in over 1000 commonly medicines, as well as for industrial products or cosmetics (shampoo, toothpaste.) where it can act as thickener, solvent, softener or humectant. In relation to the recently developed COVID-19 vaccines and their excipients some questions have arisen in our consultations. Method(s): A 48-year- old woman came to our clinic with doubts about the administration of COVID-19 vaccine. 8 years ago, after rectal administration of a healing suppository for an anal fissure she immediately presented a dry cough and a generalized urticaria which subsided spontaneously without attend to the emergency department. 5 years ago, with the application of an hemorrhoid cream se presented an immediate reaction consisting of cough, difficulty breathing and generalized urticaria. The symptoms subsided spontaneously after 30-45 minutes. The patient reported previous tolerance to both drugs. She has avoided them ever since. All these medicines have in common PEG as an excipient. We performed several studies to find out if PEG was the culprit. Result(s): *Prick test with Casenlax (which contains 10 grams of PEG 4000): negative. *Oral provocation test with Casenlax: we started with the intake of 2.5 grams of Casenlax and after 5 minutes she started with oropharyngeal pruritus, dry cough, feeling of shortness of breath and desaturation (since 98% to 92-90%). The patient was monitored and administered intramuscular adrenaline (0.3 ml), methylprednisolone 60 mg and dexchlorpheniramine 5 mg. The symptoms were controlled after 15-30 minutes. *COVID-19 AstraZeneca vaccine was administered without incident. Conclusion(s): Given the high incidence of reactions to the excipients accompanying the drugs, this should be taken into account when taking the patient's medical history and in the subsequent pharmacological study.

Contact allergy to Efudix cream: a reminder and review

5-Fluorouracil (Efudix) cream is established as a topical treatment for superficial malignant and premalignant skin lesions. Its method of action involves the irreversible binding of the pyrimidine analogue fluorouracil to thymidylate synthetase within a cell. This prevents the incorporation of uracil into nuclear RNA, which destroys abnormal cancer cells (https://dermnetnz.org/topics/5-fluorouracil-cream). The expected sequelae of its use involves the development of a marked inflammatory response. We present a case of a severe, disproportionate reaction to Efudix cream, secondary to contact allergy to the excipients. A 61-year-old man attended the cutaneous allergy clinic with a history of severe, florid, inflammatory and ulcerative skin reactions affecting the lower limbs at sites of application of Efudix cream. This had been used as directed, to treat areas of Bowen disease, at intervals between December 2019 and February 2021. Contact allergy to Efudix cream was suspected and patch testing was performed to the British Standard and Cosmetic series, as well as the excipients of Efudix cream, including stearyl alcohol, propylene glycol (PG), methylparahydroxybenzoate, propylparahydroxybenzoate and white soft paraffin. While the patch tests were applied in the department on day 0, subsequent appointments on days 2, 4 and 7 were performed virtually with photographs as the patient developed COVID-19 symptoms, with positive lateral flow and polymerase chain reaction tests. He was patch test positive on days 4 and 7 to stearyl alcohol and propylene glycol, both being excipients of Efudix cream. A review of our database over a period of 17 years revealed 53 other cases with positive patch test to PG (n = 53/8000;0.66%), none of which were attributable to the use of Efudix cream, and only six cases of a positive patch test to stearyl alcohol (n = 6/8000;0.075%), of which one was attributable to the use of Efudix cream. Allergic contact dermatitis to Efudix cream and its excipients stearyl alcohol and propylene glycol is rare, although it has previously been described in the literature with the earliest reports in 1992, and the most recent being 15 years ago [Meijer B, de Waardvan der Spek F. Allergic contact dermatitis because of topical use of 5-fluorouracil (Efudix cream). Contact Dermatitis 2007;57: 58-60]. This case adds to the existing literature and is a reminder to clinicians that, although inflammation is expected with the use of Efudix cream, severe or disproportionate reactions should raise suspicion of possible contact allergy. Furthermore, this case highlights the challenges of patch testing in the current COVID-19 climate and highlights the importance of teledermatology as a novel option for assessment in cutaneous allergy services facing these conditions.

Compound lidocaine/prilocaine cream combined with tetracaine prevents cough caused by extubation after general anaesthesia: a randomised controlled trial.

BACKGROUND: Coughing caused by tracheal extubation is common following general anaesthesia. Heavy aerosol production by coughing during recovery from general anaesthesia in patients with respiratory infections (especially COVID-19) may be one of the highest risk factors for infection in healthcare workers. The application of local anaesthetics to the endotracheal tube is an effective method to reduce coughing. The most commonly used anaesthetics are compound lidocaine/prilocaine cream and tetracaine spray. However, coughing still occurs when the two anaesthetics are used alone. We speculated that the application of compound lidocaine/prilocaine combined with tetracaine spray would better prevent coughing caused by tracheal extubation. METHODS: Patients scheduled for laparoscopic cholecystectomy or cholecystectomy combined with common bile duct exploration under general anaesthesia were randomly assigned to Group C (saline spray), Group L (2 g compound lidocaine/prilocaine cream contains 5 mg of lidocaine and 5 mg prilocaine)), Group T (tetracaine) and Group F (compound lidocaine/prilocaine cream combined with tetracaine). The incidence of coughing, the endotracheal tube tolerance assessment, the incidence of agitation, the active extubation rate, the incidence of postoperative pharyngeal pain and the incidence of postoperative cough were recorded and analysed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and the plasma concentrations of epinephrine and norepinephrine were measured immediately before extubation and 1 min after extubation. RESULTS: A total of 211 patients were randomly assigned to Group C (53 cases), Group L (52 cases), Group T (52 cases) and Group F (54 cases). The primary result is assessment of the incidence of cough. The patients emerged from general anaesthesia, 96% of Group C had cough, which was significantly reduced in Group L (61.5%, P < 0.001), Group T (75%, P < 0.05) and Group F (22.2%, P < 0.001). Group F had a significantly reduced incidence of cough compared to Group L and Group T (P < 0.05 or P < 0.01, respectively). The secondary results were assessed. The endotracheal tube tolerance score in Group C ((1, 3) 4, P < 0.001) was higher than Group L ((0, 1) 2), Group T ((0, 1.25) 3) and Group F ((0, 0) 1). Group F had a significantly lower score than Group L and Group T (P < 0.05, P < 0.01, respectively). The incidence of agitation and the active extubation rate were also higher in Group C (96.2% and 71.7%, respectively, P < 0.001) than Group L (48.1% and 15.4%, respectively), Group T (61.5% and 26.9%, respectively) and Group F (17.3% and 7.7%, respectively). Blood pressure, HR and plasma concentrations of epinephrine and norepinephrine were significantly higher in Group C than in all other groups at the time of extubation and 1 min after extubation (P < 0.001). Group F exhibited significantly reduced blood pressure, heart rate and plasma concentrations of epinephrine and norepinephrine compared to Group L and Group T (P < 0.05, P < 0.01 or P < 0.001, respectively). The incidence of postoperative pharyngeal pain and the incidence of postoperative cough were not significantly different among the groups. CONCLUSIONS: Compound lidocaine/prilocaine cream combined with tetracaine may be a more effective approach for preventing coughing and stabilising circulation during extubation following general anaesthesia. This may play an important role in preventing medical staff from contracting respiratory infectious diseases. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2200058429 (registration date: 09-04-2022) "retrospectively registered".

Less stress, better sleep

It is hardly surprising that the COVID-19 pandemic has impacted both stress levels and sleep patterns. According to a survey by the American Psychological Association, two out of three persons have admitted to feeling more stressed out during the pandemic, and four out of ten claim to have had sleep issues during the pandemic. Consumers are increasingly looking for ways to manage with stress and sleep problems, from mobile apps like Headspace and Sleep Cycle to food and beverage products that claim to offer comfort. Herbal teas, particularly those containing chamomile, valerian root, or lavender, have long been popular for aiding sleep and relieving stress, but recent product launches in this area go beyond more conventional offerings. For instance, Nightfood Holdings has introduced Nightfood sleep-friendly ice cream in hotels throughout more than 40 states in the nation. The frozen treat is designed to satisfy ice cream cravings at night while being more sleep-friendly. It comprises vitamins, minerals, and amino acids that may promote sleep in addition to having less sugar and fat. The variety of snacks and beverages that aid in improving sleep quality and lowering stress will keep expanding as studies delve deeper into more nutritional elements.

THE BEAST IN THE BEAUTY BOX

SESSION TITLE: Critical Care in Chest Infections Case Report Posters 2 SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: Enterobacter species are notorious for causing nosocomial infection. They were found to be the third most common pathogen in the respiratory tract amongst isolates in the ICU. What makes the situation grim is the growing antibiotic resistance with regards to treating these infections. Such is the extent of this problem that in certain parts of the world the antibiotic sensitivity of Pluralibacter gergoviae is used as an indicator for the spreading antibiotic resistance in the environment. CASE PRESENTATION: A 73 year old female with past medical history significant for hypertension, atrial fibrillation, and Coronary artery disease s/p stent placement in 2019 presented to our facility with a 4 day history of fever, cough and chest discomfort. She had tested positive for COVID-19 two days prior to presentation and was initiated on remdesivir, tocilizumab, and dexamethasone. She was initially managed on the floors but in view of her increasing oxygen requirement she was transferred to the critical care where she was intubated due to respiratory failure. She continued to spike fevers and was persistently hypoxic. Initially this was attributed to COVID pneumonia and a trial of convalescent plasma was also given. After 3 weeks, she tested negative for COVID-19 while still intubated and precautions were taken off. However, she continued to spike fevers. Repeat chest X-ray was done and it showed multifocal airspace disease with increasing opacification in the left upper lobe. Her endotracheal aspirate grew carbapenemase producing Pluralibacter gergoviae sensitive for ciprofloxacin. Subsequently, she was started on IV levofloxacin and received it for a total of 21 days. Her treatment course was complicated by prolonged intubation requiring tracheostomy and development of Pneumatocele. After stopping the antibiotics, she did not have fever and her white blood cell count was within normal limits. DISCUSSION: P. gergoviae is a known contaminant in intravenous fluids, invasive medical devices, eye cream, children's shampoo, skin cream, hand cleaning paste, and cleansing wipes. Over the decades due to selective pressure especially in the cosmetic industry from preservatives it has gained antibiotic resistance via overexpression of detoxifying enzymes, flagellin, modification of membrane structure/function. Improving patient's oral hygiene, implementing infection control protocols strictly in the ICU, minimizing invasive medical devices/catheters and educating the stakeholders shall help in curbing these incidents. Once identified, early Infectious disease specialist involvement can help choose an apt antibiotic regimen on the basis of existing antibiograms. CONCLUSIONS: This case highlighted the importance of close microbiological surveillance, minimizing occurrence of nosocomial infection and treating atypical organisms. Reference #1: Enterobacter gergoviae adaptation to preservatives commonly used in cosmetic industry M. Périamé,J.-M. Pagès,A. Davin-Regli 14 May 2014 DISCLOSURES: No relevant relationships by Abinesh Sekar

A cross-sectional study on the use of big data for the past H1N1 influenza epidemic in obesity after COVID-19: Focused on the body slimming cream and leptin via DTC gene test.

BACKGROUND: Based on the big data of 2010, 2011, and 2012, when H1N1 influenza was prevalent around the world in the past, this study investigated the obesity rate, weight change, and dietary methods of Korean dieters based on the historical situation of the past H1N1 influenza epidemic in Republic of Korea. This is intended to be the data for utilizing the prognostic evaluation of coronavirus disease-19 (COVID-19). OBJECTIVE: After COVID-19, research on obesity should be conducted systematically, and to prevent obesity, nutrition education, customized inner beauty & cosmetics, and the development of body slimming cream and leptin for proper diet should be done at the national level. This study was conducted to investigate the relationship between methods of weight control, generation, and gender, which have not yet been evaluated in the Korean adult population. METHODS: The cross-sectional study was comprised of 25 534 Korean who participated in the Fifth Korean National Health and Nutrition Examination Survey (KNHNES) conducted in 2010, 2011, and 2012. RESULTS: A 17 876 of the 19 375 respondents 20 years of age or older in the KNHNES answered about diet method. Two thousand and fifty-seven (15.63%) men and 4134 (25.77%) women thought of themselves as fat. However, 11 973 people (66.96%) did not change weight in the past year, 2536 people (14.19%) had increase in weight, and 3.164 (17.70%) reduced weight. A total of 7176 people (48.11%) indicated that they attempted to reduce weight through exercising, while 5553 people (37.23%) did so through reduced food intake. CONCLUSIONS: This study was based on big data at the time of the H1N1 influenza epidemic in Korean population. The results of the present study will be helpful in the development of the body slimming cream and leptin via direct to consumer (DTC) gene test (GT) due to the rapid increase in obesity due to COVID-19 pandemic.

I never leave the house and keep both phones in my pockets all day so that whichever phone you ring, I never miss your call

Introduction: I will never forget the tightness in my throat and the pressure rising in my chest when I heard those words spoken by the husband of an ICU survivor. How ashamed I felt that despite all we do to alleviate the suffering of our patients, sometimes we create new suffering for those left at home. Main Body: Restricted visiting during the pandemic has created unprecedented challenges for patients, staff, and families. Not able to rely on family visits to communicate news and to help families appreciate any change in the condition of their loved ones, we have had to develop new ways of working. The consultants enthusiastically rallying juniors into daily telephone updates, emailed messages read to patients by nursing staff, pictures on the walls of a hospital room, and wrestling with technology to bring families together in one room via video call. Despite all the energy and innovation, I am sure I'm not the only person who has found themselves thinking that perhaps the call to update the wife/father/daughter of our patient can wait. They had an update yesterday;maybe someone else can speak to them later. This phone call, one of several to ICU survivors and their families, was the first time I had fully understood the reality for the loved ones of so many of our patients. They are barred from the hospital due to covid restrictions, struggling to build a picture of their loved one from the snatches of information given down a phone, desperate for news. Since this conversation, I am incredibly mindful of the responsibility to care for families as well as our patients. Even if they aren't with their loved ones in person, we have an opportunity to include them in the journey. Maybe we remember to share the big things, but sometimes the small things are the ones that matter most: a shave, the music on the radio, ice cream with their lunch. Each member of the ICU team has a different story to share, and it's these human connections this patient's husband was waiting for by the phone. Conclusion: As we slowly arrive at “the new normal” we might be relieved to see the end of some of our pandemic practices. However, I will never forget the lesson this man taught me. I will use my privileged position to make painful times perhaps a little more bearable for the families and friends of those we treat.

Evaluation of human error in workers of an Iranian copper mine during the COVID-19 pandemic using the CREAM.

BACKGROUND: The outbreak of COVID-19 has adversely affected both global economy and public health around the world. These effects have also been observed in many workplaces, including mines. OBJECTIVE: This study aimed to examine the human error of copper miners during the pandemic. METHOD: This descriptive-analytical, cross-sectional study was performed on 192 workers of a copper mine in Iran.. For this, occupation tasks were firstly analyzed using the Hierarchical Task Analysis (HTA), and then the human error in different subunits was assessed using the basic Cognitive Reliability and Error Analysis Method (CREAM). The prevalence of COVID-19 among miners was determined by assessing positive PCR test records. RESULTS: The probability of human error in the operational subunits including mining, crushing, processing, and support subunits was estimated to be 0.0056, 0.056, 0.0315, and 0.0177, respectively. All three operational units were found to be in the scrambling control mode. The support unit was determined to be in the tactical control mode. Approximately 50% of all workers had been infected with COVID-19, with the highest prevalence in support units. CONCLUSION: The results suggest that during the COVID-19 pandemic, copper miners are at higher risk of human error induced by poor working conditions. Therefore, it is recommended to employ some management strategies such as promotion of safety, health monitoring, and adopting supportive measures to control occupational stresses and therefore the probability of human error in the mine's operational units.

Facial dermatoses due to increased use of masks in medical students during COVID-19 pandemic: A cross sectional study from JSMU

Objective To determine the frequency of skin manifestations associated with prolonged mask wearing during the course of ongoing COVID-19 pandemic. Methods A cross-sectional study was conducted at Jinnah Sindh Medical University (JSMU), Karachi. A total of 138 medical students, who gave history of wearing masks were enrolled. The demographic data including age, gender, and their year of education was collected. A total of 20 questions were asked related to the type of mask, duration of wearing mask, associated and underlying skin disorders, etc. All information was carefully recorded on Google forms. Results This study included 138 participants, 124 (89.9%) females and 14 (10.1%) males. The type of masks used by the medical students varied, however 84.8% used surgical masks. The average duration of mask wear was 4 hours for 72.4% of the participants. There was no significant relation between skin changes and the type and duration of mask wear. The common skin manifestations reported in this study were itching (24.6 %), redness (27.5%), rash (10.1%), burning sensation (12.3%), acne (24.6%), pimples (37.7%), pigmentation (8.7), cracked skin (1.4%), scaling of skin (2.9%), and 29.7% reported no changes. The most frequently affected locations were cheeks (41.3%), followed by chin (13.8%), nasal bridge (10.1%) and perioral area (8%). Participants with history of atopic dermatitis were affected slightly more by itching, redness, rash, burning sensation, acne than those without a history of atopic dermatitis however these manifestations had no significant relation (p>0.05). Pressure bruises were reported in 23.9% of the participants and there was no significant relation with the skin manifestations. About 33% of the females who use makeup under the mask found it inconvenient due to pimples and itching. (p<0.05). Relationship between different skin types and use of cleansers for maintaining skin hygiene generally (p=0.006) and after taking mask off is significant (p=0.034). Significant relation exists between people experiencing pimples after taking off masks and using oral/systemic drugs (p=0.003), and other products (ice cubes, day cream, steroids, skincare regime) for management (p=0.012). Significant relation exists between acne after taking off mask and use of topical drugs (p=0.034). Conclusion The increase in skin manifestations is associated with the increased use of face masks during the COVID 19 pandemic among medical students. As mask wearing can't be compromised due to the nature of the working environment, certain guidelines need to be established to prevent or reduce the occurrence of such manifestations.

“Dying of failure to thrive”: Caregiver Perspectives on the Impact of COVID-19 Isolation on Residents' Cognitive and Functional Status

Background: The COVID-19 pandemic has profoundly affected skilled nursing facilities (SNFs). Our objective was to understand SNF staff perspectives on the unintended effects of isolation protocols and suggestions for future outbreaks. Methods: Qualitative analysis of semi-structured interviews from caregivers (n=17) from seven SNFs. Interviews focused on the impact of isolation on caregiving, SNF residents' cognitive and physical health, and best practices. Virtual interviews were recorded and transcribed. Qualitative framework analysis using a modified care preparedness model was used to identify themes related to the impact of COVID-19 isolation. Results: Caregivers observed withdrawal, irritability, depression, and lack of motivation among residents. Staff noted increased confusion in cognitively impaired residents and observed that cognitively intact residents displayed more symptoms of depression. Most participants related residents' emotional changes to lack of family visitation and loneliness. SNFs connected residents with families using technology and modified visits. Staff also developed creative programming to engage residents while maintaining physical distancing, such as a mobile ice cream cart. Challenges included less hands-on caregiving due to fear of COVID-19 transmission, staff turnover, personal protective equipment (PPE) shortages, and COVID-19 outbreaks. Many participants also noted inadequate administrative support and hoped for more aid and flexibility. Staff reported that increasing family communication and physical and psychological therapy interventions worked well for residents. Staff who perceived early initiation of infection control measures (e.g., closing admittance, frequent testing, maintaining PPE supplies) and/or had highly involved administrators (e.g., open door policy, visible on the floor) felt better equipped to care for residents. Most also noted strong coworker camaraderie. Staff recommendations for quantifying the effects of isolation included tracking physical and cognitive measures longitudinally to identify changes in resident status. For future epidemics, staff emphasized the need for communication and preparation with ample supplies and staff. Conclusions: This analysis includes suggestions for preparation, communication, enforcement of infection control policies for future outbreaks.

Influence of Celebrity Endorsement on the Purchase of Ice Cream During Covid Pandemic

Covid 19 had a devasting effect on the Indian ice cream sector, resulting in a huge reduction in ice cream sales. The current study focuses on the possibility of the use of celebrity endorsement to revive sales by ice cream brands. The objectives of the study are to find whether celebrity endorsement influences the frequency of purchase of ice cream. The study further investigates the relationship of demographic variables like age, gender, and income on the influence of celebrity endorsement on consumers' purchase intention. 480 respondents of various age groups, genders, and income groups were a part of this study. The respondents were chosen from the South Indian states of Karnataka and Kerala. The results of the study indicate that celebrity endorsement influences the purchase frequency of ice cream by consumers. The study found that perception of celebrity endorsement influence on purchase intention varied among respondents of different gender and income groups respectively. However, no such difference in perception concerning celebrity influence was observed among respondents of various age groups.

Fathers' structure-related food parenting practices and child emotional overeating during pandemic

Background: Fathers play an important role in child development but are rarely included in research on the parental determinants of child eating behavior. This omission requires addressing, particularly in the context of the COVID-19 pandemic, during which families spent more time at home and thus more time together for meals and snacks. Previous research in mothers suggests providing structure around children's eating may be beneficial for child eating behavior. We aimed to investigate associations of fathers' reports of provision of structure around children's eating during the pandemic with child eating behavior and diet during the pandemic. Methods: Fathers (N = 112) of 2-12- year- old children completed an online survey in May/June 2020 including questions on structure-related food parenting practices (e.g. insist child eats at table, not allowing child to wander around during meal, father decides timing of meal), child eating behaviors (emotional overeating [EOE], food responsiveness [FR]), and child diet. Correlations and path models were used to examine individual and simultaneous relationships. Results: A third of the sample was more likely to eat meals together compared to before the pandemic. Structure-related food parenting practices were significantly negatively associated with EOE (β = -. 434, p = .004) but not FR (β = -. 227, p = .132). EOE was significantly positively correlated with children's sweet and savory snack intake (e.g. chocolate, cookies/cake, donuts, ice cream, low-fat chips, savory snacks;rho = .244 to .504) as well as fast food intake (rho = .432). Conclusions: Our results suggest that fathers' provision of structure around children's eating during the pandemic may be associated with lower levels of obesity-associated eating behaviors in their children, which could contribute to healthier profiles of food intake and body weight.

Granular Parakeratosis secondary to benzalkonium chloride exposure from laundry rinse aids

Introduction: Granular parakeratosis (GP) is a dermatosis characterised by a rash at intertriginous sites. The pathogenesis is uncertain although it is proposed to be an irritant contact reaction with cases related to benzalkonium chloride (BAC) reported. This study aims to review the clinical presentation and histopathological features of GP. Methods: This study is a retrospective case series of adult and paediatric patients seen at private and public dermatology clinics in Auckland, New Zealand between 2015 and 2020. Information is collected on patient demographics, presentation, investigation and management. Results: Twelve cases (seven adults, five children) are included. The typical presentation of GP was erythematous or brown, scaly papules and plaques with desquamation in a predominantly flexural distribution. The rash was also observed in the anterior neck, natal cleft and helices of the ears. All patients reported recent exposure to BAC in laundry rinse solution and creams commonly found on the consumer market. Ten biopsies were taken from four patients. Psoriasiform and eczematous findings were common on histopathology. The mainstay of treatment was cessation of BAC exposure. Conclusion: GP has a distinct clinical pattern although histopathological findings are varied. Our experience is that patients often have delayed diagnosis. Clinical diagnosis is usually possible and resolution of GP typically follows avoidance of BAC. Clinicians should have a high index of suspicion for GP in patients presenting with erythematous flexural eruptions and seek a history of exposure to BAC, especially in context of the COVID-19 pandemic and increased antiseptic use.

Microbiological analysis of frozen profiteroles and mini chocolate eclairs implicated in a national salmonellosis outbreak.

Between November 2018 and May 2019, Canada experienced a nationwide salmonellosis outbreak linked to the presence of Salmonella enterica ser. Enteritidis in frozen profiteroles. Analysis of the implicated food products revealed low levels of Salmonella ranging from 0.2 to 0.7 MPN/100g. Water activity and pH of the food samples ranged from 0.9479 to 0.9867 and 4.6-6.8 respectively indicating conditions conducive to bacterial growth. Higher levels of the hygiene indicators Enterobacteriaceae and coliforms were associated with Salmonella positive samples compared to Salmonella negative samples. Investigation of the relationship between storage conditions, temperature, and pathogen levels during thawing revealed that the profiteroles reached temperatures permissive to pathogen growth (≥5 °C) much sooner than pathogen growth was observed and that the composition of the food matrix can influence bacterial levels upon thawing. Collectively these data can be used to inform guidance to minimize the risk of infection from the consumption of contaminated cream-filled frozen desserts.

How does working in pandemic units affect the risk of occupational hand eczema in healthcare workers during the coronavirus disease-2019 (COVID-19) pandemic: A comparative analysis with nonpandemic units.

BACKGROUND: Hand eczema (HE) has increased among healthcare workers (HCWs) working in coronavirus disease-2019 (COVID-19) units, and was associated with increased hand hygiene practices. OBJECTIVES: To compare the prevalence and clinical characteristics of HE, and hand hygiene practices in HCWs working in COVID-19 and non-COVID-19 units. METHODS: A total of 244 HCWs working in COVID-19 (n = 118) and non-COVID-19 patient care units (n = 126) were examined by dermatologists with regard to demographic parameters and hand hygiene practices. The COVID-19 and non-COVID-19 groups were matched at a 1:1 ratio according to age, atopy, and generalized dry skin. RESULTS: HE was more frequent in the COVID-19 group (48.3% vs 12.7%, P < .001), whereas working years (P < .05) and additional housework at home (P < .001) were longer in the non-COVID-19 group. After the development of HE, moisturizing creams were reported to be more frequently used in the COVID group (P < .001). Topical corticosteroids were used in a minority (40% in the COVID group and 26.7% in the non-COVID group). CONCLUSIONS: HCWs in COVID-19 units developed HE more frequently. A majority increased the frequency of moisturizer use, instead of using topical corticosteroids, after the development of HE for the purpose of treating eczema. New approaches are needed for the prevention and management of HE in HCWs, especially by facilitating access to dermatologists.