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The structure of the presentation will be 1) Pandemic-Epidemiology 2) General Pandemic-Management 3) HRT and COVID 4) Different spectrum of menopausal symptoms (Europe/Asia) 5) Different risks lead to different HRT. 1) Pandemic-Epidemiology: SARS-COVID-19 has got to be a new disease, China was the first to suffer from the pandemic starting in December 2019 with spread all over the world. Diagnosis, treatment and protective measures have started in Europe in March 2020;up from autumn 2022 in Europe the pandemic changed to endemic, but protective measures still should be continued in risk patients like in hospitals and nursing homes. Rehabilitation will for long-time be an issue like treatment of "Post-" and "Long-COVID". China pursued a zero-COVID-policy until Dec 2022. The sudden stop of almost all measures led to a sharp increase in infections, which shows that the disease will remain a global risk. 2) General Pandemic-Management: Protective measures like vaccination, surgical masks, screening/testing, isolation management, travel/residence history in high-risk regions, education of patients and families had to be the first priority, ahead of other issues such as the management of menopause. 3) HRT and COVID: Already the first prelimary data assessed in Wuhan/China have shown that women with low estradiol-levels had more severe infections with COVID. An analysis of health records of 68,466 COVID-positive patients from 17 countries showed that the fatality risk for women > 50 years receiving HRT was reduced by more than 50% compared to those women not taking HRT (Seeland, 2020). Likewise from a case-control study analyzing the self-reported data of 1.6 million UK menopausal women through the COVID-Symptoms Study Smartphone application (control populations adjusted for age, body mass index, and smoking status) was concluded, that HRT not only can be used, but even can protect from COVID-infections and/or their sequelae (Costeira, 2021). 4) The different spectrum of menopausal symptoms (independent of COVID-infections) comparing data in Europe (showing more vasomotor symptoms) and China (more somatic symptoms) will be presented, including own data. 5) Different risks during HRT consequently lead to different use of HRT, especially more transdermal estrogen combined with progesterone in Europe due to much higher VTE-risk, but more management of the high bleeding-problems in China using individualized (mostly oral) estrogen/progestogen combinations. Copyright © 2023
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Although the effect of face masks on preventing airborne transmission of SARS-CoV-2 is well studied, no study has evaluated their effect on blood pressure (BP). Therefore, we investigated the effect of surgical masks on BP in 265 treated hypertensive patients. Following the routine mask-on office BP measurement, patients were left alone and randomized to automated office BP measurement, with measurements taken after first wearing a mask for 10 min, then without wearing the mask for 10 min, and vice versa. Among the participants, 115 were women (43.4%), the mean age was 62 +/- 12 years, and the mean office BP was 134 +/- 15/81 +/- 12 mmHg. There was no significant difference between mask-on unattended systolic BP (133 +/- 15 mmHg) and mask-off unattended systolic BP (132 +/- 15 mmHg) (P = 0.13) or between mask-on unattended diastolic BP (77 +/- 13 mmHg) and mask-off unattended diastolic BP (76 +/- 13 mmHg) (P = 0.32). Surgical masks had no effect on BP in treated hypertensive patients.Copyright © 2022 Krause und Pachernegg GmbH. All rights reserved.
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INTRODUCTION: Since the beginning of the COVID-19 pandemic, face masks have been among the cornerstones of COVID-19 prevention. Therefore, evaluating their preventive effects against COVID-19 is crucial. This review aimed to systematically search for the systematic review articles that explored the role of various types of face masks in preventing COVID-19. METHODS: We browsed the keywords of this study in the online databases of Scopus, Web of Science, PubMed, and Cochrane on 10th January 2023 and retrieved all the relevant systematic review articles. The records were downloaded into an Endnote file, and the duplicates were removed. A two-step screening process consisting of title/abstract and full-text screenings was conducted to select the most relevant articles. To ensure the validity and reliability of the results, this study adhered to the PRISMA protocol. RESULTS: A total of 28 systematic reviews were included in this review. Most studies found that face masks are beneficial against viral respiratory infections, such as COVID-19. Different types of masks were evaluated in included studies. It appeared that mask efficacy depends on the material, layers, fitting on the face and user compliance. N 95 respirator had maximum efficacy, especially when used continuously. CONCLUSION: Face masks have a beneficial effect against COVID-19. Home masks are less protective than surgical masks or N95 personal breathing masks. Besides, the use of masks may elicit a false sense of security in people, which may lead to poor hand hygiene and violation of social distancing. Therefore, the necessary training should be provided to the public to increase awareness and encourage the right practice of using the mask, emphasizing the preventive effects of washing hands, social distancing, and using a face mask against COVID-19.
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BACKGROUND: The studies on cardiovascular alterations when using an N95 respirator or surgical mask-covered N95 during dental treatments are limited. AIM: To investigate and compare the cardiovascular responses of dentists treating paediatric patients while wearing an N95 respirator or a surgical mask-covered N95. DESIGN: This was a crossover clinical trial in 18 healthy dentists wearing an N95 respirator or surgical mask-covered N95 during the dental treatment of paediatric patients. Oxygen saturation (SpO2 ), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were monitored at baseline, intraoperation, and postoperation. The data were analyzed using the generalized estimating equation. RESULTS: The mean SpO2 , HR, SBP, DBP, and MAP significantly changed from baseline up to the end of the procedures after wearing an N95 by 3.1%, 19.3%, 11.5%, 17.7%, and 13.8% and after wearing a surgical mask-covered N95 by 3.0%, 20.2%, 5.3%, 13.9%, and 8.8%, respectively (p < .05). No significant differences in these values were found between groups (p > .05). CONCLUSIONS: N95 respirators and surgical mask-covered N95s significantly impact the cardiovascular responses of dentists treating paediatric patients with no differences between the two types of masks.
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COVID-19 , Respiratory Protective Devices , Humans , Child , N95 Respirators , Masks/adverse effects , COVID-19/etiology , DentistsABSTRACT
During the coronavirus (COVID-19) pandemic, the UK government mandated the use of face masks in various public settings and recommended the use of reusable masks to combat shortages of medically graded single-use masks in healthcare. To assist decision-making on the choice of masks for future pandemics, where shortages may not be a contributing factor, the University College London (UCL) Plastic Waste Innovation Hub has carried out a multidisciplinary comparison between single-use and reusable masks based on their anatomy, standalone effectiveness, behavioural considerations, environmental impact and costs. Although current single-use masks have a higher standalone effectiveness against bacteria and viruses, studies show that reusable masks have adequate performance in slowing infection rates of respiratory viruses. Material flow analysis (MFA), life cycle assessment (LCA) and cost comparison show that reusable masks have a lower environmental and economic impact than single-use masks. If every person in the UK uses one single-use mask each day for a year, it will create a total of 124,000 tonnes of waste, 66,000 tonnes of which would be unrecyclable contaminated plastic waste (the masks), with the rest being the recyclable packaging typically used for transportation and distribution of masks. Using reusable masks creates >85% less waste, generates 3.5 times lower impact on climate change and incurs 3.7 times lower costs. Further behavioural research is necessary to understand the extent and current practices of mask use; and how these practices affect mask effectiveness in reducing infection rates. Wearing single-use masks may be preferred over reusable masks due to perceptions of increased hygiene and convenience. Understanding behaviour towards the regular machine-washing of reusable masks for their effective reuse is key to maximise their public health benefits and minimise environmental and economic costs.
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Eye discomfort is a major complaint reported in indoor spaces and has been suggested to be exacerbated by environmental conditions such as low humidity and high air velocity. Wearing face masks, which has become essential in our daily lives during the COVID-19 pandemic, can also cause eye discomfort by affecting the microclimate around the eyes. We conducted a pilot study to evaluate the effect of wearing masks on eye discomfort by measuring the physical environment around the eyes and short-term physiological and psychological responses and comparing them with and without surgical face masks. The results showed that when the participant wore a mask, exhaled air flowed out through the gap at the top edge of the mask, resulting in a higher air velocity and absolute humidity around the eyes than when the mask was not worn. No significant differences were found in subjective discomfort, tear-film stability, ocular surface temperature or blink frequency. However, the tear evaporation rate, estimated based on physical measurements, was greater when wearing a mask than when not wearing it. This study revealed that wearing face masks can negatively affect the environment around the eyes in terms of tear-film health.
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Plastic, in all its forms, always harms the environment, humans, and other living organisms. The coronavirus situation exacerbates the use of plastic products more than at any other time, of which surgical masks contribute to plastic pollution the most. These masks spread to terrestrial and aquatic environments, where they break down into even more noxious microplastics. These microplastics enter the human food chain through water and fish, causing severe damage to the lungs, kidneys, and intestines and even causing death. In this paper, a jute nose holder mask was prepared as an alternative to typical masks to reduce plastic pollution. The jute nose holder was produced with a modified jute flyer-spinning frame machine, where jute was used as the sheath and metal wire was applied as the core component. The nose holder was later coated with starch-based natural gum. Then, the non-woven fabric of 75 grams per square meter (GSM), and the jute nose holder were used to produce the alternative, environmentally friendly mask, which might reduce the 773 tons of plastic waste generated daily from the nose holder of the mask. This alternative mask was then distributed to 900 people for a survey to find out their opinion. From the results of the survey, it is seen that 82.6% of people felt no problem in the nose when they put on the given mask. 85.6% considered the mask more comfortable than the traditional mask, and it was rated above average by 79.8% of the surveyors. So, this study suggests that the given mask can be a sustainable alternative to traditional masks.
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The COVID-19 pandemic has created a new type of waste (surgical mask waste "WMs") that presents a major challenge now and in the future, given the strong possibilities of similar epidemics to reoccur. In order to find an effective industrial solution to the millions of WMs produced daily, this research aims to develop a new eco-friendly strategy to convert WMs into H-2-CH4-rich syngas, carbon nanoparticles (CNPs), and benzene-rich tar using an updraft gasifier system. The experiments started with the preparation of WM granules using shredding followed by granulation processes. Subsequently, the granules were processed in a lab-scale reactor with a capacity of 0.9-1 kg/h and consisted of a continuous WM feed system, a gasifier, a sampling system for syngas and tar, a ceramic filtration unit for separating the CNPs against the synthesis gas, and a burner. The gasification experiments were performed in ambient air with different air-fuel equivalence ratios (ER: 0.21, 0.25, and 0.29) and temperatures (700 degrees C, 800 degrees C, and 900 degrees C) to determine the optimal conditions that yield the maximum amount of H-2-CH4-rich syngas and CNPs with less impurities. The chemical composition and morphology of the obtained gasification products (syngas, tar, and CNPs) were observed using GC-FID, FTIR, and SEM. The results showed that the maximum production of syngas (4.29 +/- 0.16 kg/h with HHV of 3804 kJ/kg) and CNPs (0.14 +/- 0.011 kg/h) accompanied by a moderate tar rate (0.123 +/- 0.009 kg/h with HHV of 41,139.88 kJ/kg) could be obtained at 900 degrees C and ER = 0.29, while the highest H-2 (16.93 +/- 1.7 vol.%) and CH4 (10.44 +/- 0.85 vol.%) contents in syngas product were synthesized at 900 degrees C and ER = 0.19. Benzene and toluene were the major GC-FID compounds in the formulated tar product with abundance up to 25.6% and 11%, respectively. Meanwhile, gasification conditions of 900 degrees C and ER = 0.24 allowed the best morphology to be formulated for spherical-shaped CNPs with a diameter of less than 200 nm.
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Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. (SARS-CoV-2). It spreads mainly through saliva droplets or nasal discharge. Dentists are among the professionals with the greatest risk of contracting and transmitting COVID-19. We compared the efficacy of surgical masks versus N95 respirators in preventing COVID-19 infection in dental settings. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched. Search terms corresponded to a predefined PICOS (patient/population, intervention, comparison, and outcomes) question. The risk of bias was evaluated using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews-2), ROBIS (Risk of Bias in Systematic Reviews), and Health Evidence tools. A total of 191 articles were screened, and nine of them were further evaluated for eligibility, of which five articles (fulfilled the selection criteria) and were included in this study. Two studies concluded that surgical masks could provide equivalent protection to N95 respirators. Another study found that N95 respirators were superior to surgical masks. The fourth study found that better protection can be achieved when using surgical masks by the aerosol source than when the recipient uses an N95 respirator, while the last study concluded that surgical masks or N95 respirators alone do not provide full protection. Thus, according to this systematic review, N95 respirators provide better protection against COVID-19 infection compared to surgical masks.
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During the COVID-19 pandemic, more than 24 billion pieces of surgical mask waste (WM) were generated in the EU region, with an acute shortage of their management and recycling. Pyrolysis and gasification are among the most promising treatments that were proposed to dispose of WMs and convert them into pyrolysis oil and hydrogen-rich syngas. This work aimed to investigate the techno-economic analysis (TEA) of both treatments in order to assess the feasibility of scaling up. The TEA was carried out using a discounted cash flow model and its data were collected from practical experiments conducted using a fluidised bed pyrolysis reactor and bubbling fluidised bed gasifier system with a capacity of 0.2 kg/h and 1 kg/h, respectively, then upscaling to one tonne/h. The technological evaluation was made based on the optimal conditions that could produce the maximum amount of pyrolysis oil (42.3%) and hydrogen-rich syngas (89.7%). These treatments were also compared to the incineration of WMs as a commercial solution. The discounted payback, simple payback, net present value (NPV), production cost, and internal rate of return (IRR) were the main indicators used in the economic feasibility analysis. Sensitivity analysis was performed using SimLab software with the help of Monte Carlo simulations. The results showed that the production cost of the main variables was estimated at 45.4 EUR/t (gate fee), 71.7 EUR/MWh (electricity), 30.5 EUR/MWh (heat), 356 EUR/t (oil), 221 EUR/t (gaseous), 237 EUR/t (char), and 257 EUR/t (syngas). Meanwhile, the IRR results showed that gasification (12.51%) and incineration (7.56%) have better economic performance, while pyrolysis can produce less revenue (1.73%). Based on the TEA results, it is highly recommended to use the gasification process to treat WMs, yielding higher revenue. [ FROM AUTHOR] Copyright of Energies (19961073) is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Administration of aerolized drugs to patients diagnosed with COVID-19 leads to the risk of transmission of patient-generated infectious aerosols to healthcare providers.While the COVID-19 pandemic is ongoing, in order to provide the best treatment for patients and at the same time to protect healthcare providers at the highest level, it is necessary to increase access to information and pay maximum attention to preventive measures.Copyright © 2020 Bilimsel Tip Yayinevi. All rights reserved.
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Goats may suffer from rumen bloat for many reasons, e.g. improperly concentrated ratio or obstruction. The disease can be caused by eating undigested items, e.g. plastic rope or bags. Since the COVID-19 pandemic, it has often become mandatory for people to wear medical masks. People are generally unaware that masks left on the ground pose a risk to goats who may eat them. This case report describes the rumen bloat caused by medical masks in a male goat reared in an elementary school. After physical examination, the goat showed a bloated rumen, anorexia, depression, and weakness. The heart rate was normal, but respiratory patterns were fast and deep. Fewer defecated feces were noted by the owner. Furthermore, the owner's complaints and ultrasound images revealed that undigested items in the rumen were the cause. After performing a standard rumenotomy, we scooped out four medical masks, one plastic bag, and one high-density nylon rope from the rumen. We believe this was the first report describing the risk of medical masks in goats. Promoting life and animal welfare education is essential to inform others of the harm medical masks pose to animals.Copyright © 2023 World Scientific Publishing Co. Pte Ltd. All rights reserved.
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Disposable surgical face masks are designed to block the airborne transmission of infectious viruses between patients and healthcare personnel;however, there are limitations to a surgical mask's ability to prevent transmissions because the mask does not provide an airtight seal around the face. This study focuses on the design and development of a custom mask frame, using individuals' three-dimensional (3D) facial scans, to improve the seal of the existing surgical masks. Three participants' facial scans with a wide range of facial dimensions were collected using a 3D hand-held scanner. During design, the contact area between the custom frame and the wearer's skin was determined based on the individual's 3D facial shape. To evaluate the effectiveness of the airtight seal, a qualitative fit (smell/taste) test kit and thermal imaging camera were utilized. When the participants wore the surgical masks without the customized mask frames, the participants smelled the saccharine scent from the test kit. However, while wearing the surgical masks fitted with the custom mask frame that held the mask in place, none of the participants could smell the scent. In addition, thermal images showed ambient temperature changes in the surgical mask suggesting air leakage around the boundary of the mask while the subject was inhaling and exhaling. With the mask frame, thermal images confirmed the effectiveness of the custom frame to block the inflow/outflow of air potentially carrying the virus. The results indicate that the custom-built mask frames are effective in providing a proper and much improved seal compared to a surgical mask without the frame. The developed custom mask frame will be particularly beneficial for frontline medical staff members who treat patients with infectious viruses transmitted through aerosols as part of their PPE.
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Background During the coronavirus disease 2019 (COVID-19) pandemic, healthcare workers (HCWs) were required to use personal protective equipment (PPE) for unusually prolonged periods of time in order to protect themselves. This study was conducted to assess the prevalence of adverse skin reactions to PPE among HCWs from occupational and domestic exposure in Oman. Methods This was a cross-sectional study that used a self-administered questionnaire, modified based on the Nordic Occupational Skin Questionnaire, and was conducted in different categories of healthcare facilities in Oman from September to December 2020. This study involved 431 different categories of HCWs. Stata statistical software, version 12 (StataCorp, College Station, TX), was used to analyze the data, with a P value <0.05 indicating statistical significance. Results Findings indicated that 58.24% of HCWs reported new skin symptoms since the pandemic started, compared to 33.41% of HCWs who had skin symptoms before the pandemic (P<0.001). From the multivariate analysis, being female (odds ratio, or OR, 3.512; 95% confidence interval, or CI: 2.193-5.625), allergic rhinitis diagnosis (OR 2.420; 95% CI: 1.097-5.347), history of skin symptoms (OR 3.166; 95% CI: 1.856-5.400), and total glove use time (OR 1.160; 95% CI: 1.078-1.247) were associated with an increased risk of acquiring new skin symptoms. Conclusion This study demonstrates that there is some association between the prolonged use of PPE during an event such as a pandemic and a previous history of allergic rhinitis and skin symptoms. This study also emphasizes the importance of appropriate protective skin care before and after the use of PPE.
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Mask-wearing during the ongoing COVID-19 pandemic has been associated with an increased occurrence of a form of acne mechanica, popularly termed 'maskne. However, our understanding of this entity is limited. Hence we aimed to study the role of changes in the skin microbiome in mask induced acne and its response to standard acne treatment regimens. This was a prospective observational study. Adult patients having new-onset of lesions suggestive of acne within 6 weeks of regularly wearing mask or exacerbation of pre-existing acne were recruited. Disease severity was assessed using the 'Global Acne Severity Grading System (GAGS). Sample collection was done from pustules or comedones. Treatment was given according to American Academy of Dermatology Guidelines and follow up was done till 12 weeks. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) v.25. Total 50 patients were recruited in the study. 56% patients were female and 44% were male. 60% patients had a history of similar lesions in the past. 56% patients used surgical mask, 34 % used N-95 mask and 18 % used cloth mask. The average duration of use for mask per day was 6.78 +/- 2.65. Cheeks were the most commonly involved site and 62% of patients had mild GAGS. The severity of acne was significantly higher in patients using N-95 mask ( p<0.05) but not associated with duration of mask use, history of mask re-use and use of moisturizers. 70% cases did not require systemic treatment. KOH was negative in all cases. Gram stain showed gram positive cocci and rods in 22% and 14 % cases respectively. Aerobic culture showed Staphylococcus aureus growth in 30% cases and Anaerobic culture showed Cutibacterum acnes growth in 20% cases. In our study we found that maskne presented with a milder variant of acne which in majority of cases responded well to topical treatment standardized for acne vulgaris and had a microbiome profile similar to acne vulgaris.Copyright © 2023
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Italy is the second most affected by coronavirus epidemy country in the world. In this article, members of the Italian Society of Surgical Endoscopy analyze the work of endoscopic units during the COVID-19 pandemic. Authors explain how to stratify patients according to risk groups, how to put on and off personal protective equipment, list decontamination standards for endoscopic equipment and endoscopic room.Copyright © 2020, Media Sphera Publishing Group. All rights reserved.
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Case report Introduction: In the wake of the COVID-19 pandemic, occupational contact dermatitis related to the use of personal protective equipment (PPE) has become increasingly prevalent. While most cases are irritant in nature, allergic contact dermatitis (ACD) remains an important cause of occupational dermatitis. We report a case of ACD to rubber accelerators in the elastic bands of an N95 mask. Informed consent was obtained from the patient for this report. Case Report: A 27-year-old healthcare worker presented with a progressive pruritic eruption over her face and neck, 1 week after she began wearing N95 masks at work. She had only worn disposable surgical masks. She had no medical history apart from hand dermatitis, which was well controlled with topical medications. Examination revealed linear eczematous plaques along her lateral cheeks and posterior neck, corresponding to contact areas between the mask bands and her skin. Patch tests revealed a positive reaction to several rubber accelerators, including Thimerosal, 2-Mercaptobenzothiazole (MBT), and Methylisothiazolinone. We performed another patch test to several N95 mask straps, to which the patient developed an eczematous reaction to the elastic bands of 2 N95 mask types with elastic bands. Clarification with the manufacturer confirmed the use of rubber accelerators similar in properties to MBT in the production of these masks. A diagnosis of allergic contact dermatitis to rubber accelerator was made. The patient's dermatitis resolved with topical corticosteroids and the avoidance of N95 masks with elastic bands. Discussion and Conclusion(s): The use of facial PPE such as masks is a recognised cause of occupational dermatitis among healthcare workers. A variety of dermatoses are associated with the use of facial PPE, with contact dermatitis being the most common. However, while the majority of contact dermatitis are irritant in nature, ACD remains an important and preventable cause of occupational dermatitis. Commonly implicated allergens associated with mask use include preservatives and adhesives used in their production, as well as metals in the nose clip. Although less common, mask elastic bands have also been reported to be a potential source of ACD, with rubber accelerators being identified as potential allergens. However, there is often a lack of declaration of such chemicals used in the production of PPE. Given the need for continued use in the occupational setting, early identification and avoidance of allergens are key. Failure to do so may result in the progression of skin lesions, ultimately affecting the patients' quality of life and work performance. With the ubiquitous use of masks in the current climate, we wish to highlight the need for greater awareness of rubber accelerators as potential allergens, and their presence in the elastic bands of frequently used PPE.
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Community pharmacies play a significant role in providing medicines, vaccines, consultations, and other important health services to the public. Community pharmacies continued to provide their services during the COVID-19 pandemic in most countries around the world, and this was the case in Jordan. During the COVID-19 pandemic, the pharmacy staff needs to avoid the risk of exposure to the virus causing COVID-19 along with reducing the risk for customers. This paper summarizes the safety practices of most community pharmacies in Jordan during the COVID-19 pandemic, to protect staff and customers from the risk of exposure to COVID-19 infection. Data were collected in two folds. First, a survey was distributed online through social media targeting those pharmacists working in community pharmacies. Second, face-to-face interviews were conducted with the staff and owners of pharmacies in Jordan, asking about the procedures followed to enhance the safety practices of pharmacists. Analyzing responses revealed that since the start of the pandemic, about 94% of pharmacists were using personal protective equipment, 88% of pharmacies were frequently sterilizing the pharmacy and the main door handle, and 82% of pharmacies were providing medical masks, gloves, and alcohol at the entrance.Copyright © 2023 DSR Publishers/The University of Jordan. All Rights Reserved.