Biodegradable Bio-based Material for Wearable Air Filtering Skin

COVID-19, imagine having a temporary lip sticker that offers the protection of an n95 mask without the uncomfortable bulk. Using green electrospun nanofibers the lip sticker filters the virus and can communicate geospatial data to your phone using embedded NFC technology. Available in different designs and skins, some fiber formations can display temperature changes on your face. This paper investigates several prototypes of the described product. © 2022 Owner/Author.

Hepatitis C Virus Micro-Elimination Program in an Open Population

Introduction and Objectives: Among the WHO, goals for 2030 are to detect >90% of people with HCV and link >80% to treatment. Our institution serves an open population without social security. This study aimed to describe the detection strategy that was carried out in the open population, using two-step HCV detection tests at "Hospital General de Mexico" from January to December 2021. Material(s) and Method(s): The study was conducted in an open population that transits for our hospital for any reason and agreed to take the risk factor questionnaire and the rapid test for the detection of anti-HCV antibodies (RT);those who were reactive underwent viral load (PCR to detect HCV-RNA). Descriptive statistics and the statistical package STATA v.14 were used. Result(s): In 2021, 33,523 subjects were screened;71.5% were women, mean age of 47+/-10 years. Reported at least one risk factor for HCV 53.5%. The most frequent risk factors were: Multiple sexual partners (MSP)/sexually transmitted diseases (STDs) 36.2%, tattoos/piercings 26.7%, surgery before 1995 20.2%, transfusion before 1994 5.4%, health workers after accidental puncture 4.2%. Of the 33,523, 0.7% were reactive in the RT;of them, the PCR was positive in 57.9% (prevalence of viremia= 0.4%). Among the viremic, the risk factors identified were: blood transfusion before 1995 37%, MSP/STDs 35%, surgery before 1995 30%, tattoos/piercings 30%, and drugs 3.5%. Of all viremic, 134 (100%) were linked to attention at the Mexican health sector;114 (85.1%) without insurance treated at our hospital;89 (78%) received DAAs at our institution in 2021 and have completed the time to assess SVR12, per protocol the SVR12 rate was 97.7% (2 failures), by intention to treat SVR12 was 93.2% (2 failures, 1 missing, three deaths from COVID-19). The remaining 25 patients detected in 2021 (22%) and without eligibility continued the protocol for treatment with DAAs during the year 2022. Conclusion(s): The prevalence of HCV was similar to that previously reported. Traditional risk factors such as transfusion or surgery are still very prevalent. Timely diagnosis of HCV allows treatment to be linked to an optimal level of SVR12 in accordance with the WHO goals.Copyright © 2023

Late Onset Pseudolymphomatous Reaction to Blue Tattoo Pigment Precipitated by Covid Vaccination

Tattoos can lead to a variety of cutaneous conditions such as allergic or contact dermatitis, lichenoid dermatitis, pseudolymphomatous reactions and granulomatous responses such as foreign body granulomas that may have a sarcoidal histology simulating sarcoidosis. Pseudolymphomatous reactions are less common and may clinically and histologically resemble cutaneous lymphomas. Pseudolymphomatous reactions may develop in response to injections, Borrelia infections and arthropod bites. Diagnosis of cutaneous pseudolymphoma is usually based on clinicopathologic correlation coupled with skin biopsy and ancillary tests such as immunoperoxidase stains and genetic testing when necessary. Treatment is generally successful with application of topical corticosteroid preparation or injection of intralesional corticosteroids and in some cases, surgical excision. Here, we describe the case of a 61-year-old male who presented with 3-4 mm papules contained within the blue region of a multicolored tattoo on his upper right arm that had been present for several years. The reaction developed shortly following a Covid vaccination. © 2022 THE AUTHORS.

When Body Art Goes Awry-Severe Systemic Allergic Reaction to Red Ink Tattoo Requiring Surgical Treatment.

The aim of this report is to present a case of a patient who developed unusual systemic hypersensitivity reaction to a red-pigmented tattoo and to discuss diagnostic difficulties in case of systemic reactions to tattoo ink. The patient reported erythroderma on his arms and chest accompanied by plaque elevation of red parts of his most recently performed forearm tattoo as his primary symptoms. His health condition entailed a prolonged topical and intravenous immunosuppressive therapy, which proved ineffective. Over a year after emergence of initial symptoms, he presented to the Plastic Surgery Clinic with generalized erythroderma, systemic lymphadenopathy, elevation and granuloma formation in red tattoos on his forearm and complaints of fatigue and inability to participate fully in work-related and social activities. The patient underwent six staged excisions with direct closures, flap plasties and full-thickness skin grafts. Following completion of each surgical resection, the patient's symptoms gradually subsided. We find this case illustrative of a clinical challenge that delayed hypersensitivity reactions to red tattoos may pose. Furthermore, we provide insights on management of hypersensitivity reactions. This report underlines the importance of social awareness of and public health approach to tattoo complications as key to successful prevention, identification and treatment of adverse reactions to tattoos.

Implementation of a Surface Guide Radiotherapy (SGRT) system a Spain Multicenter Experience

Purpose or Objective The surface-guided radiotherapy (SGRT) VisionRT® system uses a combination of real-time optical and laserbased imaging to accurately position patients receiving radiotherapy. The aim of this study is to analyse the implementation efficiency of SGRT in four Genesis Care radiotherapy centers in Spain and to collect the RTT impressions regarding this system. Materials and Methods The system was implemented at GenesisCare facilities in Madrid, Barcelona, Alicante, and Málaga starting on August 15, 2020. Prior to this implementation, the centers were trained in a training program consisting of: A) An online course;B) A didactic weekend course;and C) Go live supervision during the first treatments for three days. The course was delivered by an expert VisionRT® trainer and a qualified radiotherapy technician. After two months of implementation, we collected the diagnostic and staging information of patients treated with the VisionRT system between the go live and October 16,2020. To evaluate the efficacy, we considered a goal of patients with SGRT in the practice: > 75% High, 75%- 50%: moderate, < 50%: low. Tattoo base method set up was allow for head and neck immobilization, skin cancer or clinician discretion. A questionnaire was carried out to the RTT working in these centers. The questionnaire contained a 1-5 satisfaction scale asking about the SGRT system: 1. very poor;2. poor;3. fair;4. good;or 5. very good regarding six points. These were safety (patient ID recognition), set up (precision increase, time reduction), management (no covid contact), confidence (technique), improvement (daily practice), and patient satisfaction (RTT point of view). Results 93.4 % of the patients in these four centers were positioned under SGRT conditions, and 6.6 % were positioned with a tattoo-based method. OF the total of 295 patients with SGRT, 212 of them were positioned without tattoos. The evaluated patients have breast cancer (43.0%), prostate cancer (18.6%), metastatic cancer (8.1 %) or lung cancer (5.4%). 21 RTT responded to the questionnaire. Results are as follows: 1. Safety: 61.9% very good and 38.1% good;2. Set-up: 61.9% very good, 28.6% good, and 9.5% moderate;3. Accuracy increase: 42.8% very good, 19% good, 28.6% fair, 4.8% poo,r and 4.8% very poor;4. Management (contactless COVID): 47.6% very good, 14.3% good, 23.8% fair, and 14.3% poor;5. Confidence (real time): 9.6% very good, 47.6% good, 33.2% fair, and 9.6% poor;5. Improvement: 52.4% very good, 23.8% good, 23.8% fair;6. Patient satisfaction with tattoo less from the technician point of view: 90.4% very good, 4.8% good, and 4.8% moderate. Conclusion The implementation of SGRT was carried out with high efficiency considering that 93,4% of care were delivered with this technique. RTT consider this technique very good for safety, accuracy, confidence, and improvement in the daily practice.

Implementation of marker less Surface Guided Radiotherapy in a complex multi-stakeholder environment

Purpose or Objective Surface guided Radiotherapy (SGRT) is more and more used in radiation therapy. With SGRT a marker less patient’s workflow can be implemented in a radiotherapy center and will give patients more comfort during their treatments, skin marks should no longer be placed. The implementation of SGRT in a Radiotherapy Network Centre with 4 radiotherapy sites and 9 linear accelerators can be quite challenging. This work demonstrates the steps adopted in our Network for the implementation of a SGRT system and the progressive transition to a marker less Radiotherapy with the use of a “Superusers” Team. Materials and Methods In October 2020 we have started the implementation of C-Rad Surface Guided Radiotherapy system in our Radiotherapy Network Center. We began with a “Superusers” Team - a selected group of 5 RTTS and 3 physicists with previous extended experience on SGRT/ tattoo less. The implementation of SGRT was progressive and included: I) Superusertraining by cRAD II) Training of the “Superusers” team at one linear accelerator in order to evaluate current used methods, identify bottlenecks and troubleshooting and create a new uniformized workflow III) Introduction of table parameters, since the Surface scanning system can only give accurate measurements with object within 5 cm of targeted position IV) Going Marker less meaning new patients had no tattoos workflow V) Create support materials, such as the positioning and procedure manuals. VI) Train the RTT’s. A SWOT analyze (see fig 1) was done by the superuserteam, our management and cRAD. (Figure Presented) Results From SWOT analyze, we see that the use of a Superuser team concept has helped with the fast implementation of marker less SGRT based positioning workflow and especially in a period of Covid-19. In one year, we have implemented SGRT in 3 radiotherapy sites totaling 7 linear accelerators and 25 trained RTTs. The more RTTs were trained and used to the new workflow, time of implementing in a new machine became shorter. At the time of writing, more than 75% of the treated population is in a tattoo less workflow. (See fig 2) (Figure Presented) Conclusion The use of the Superusers principe has allowed the implementation of marker less SGRT based positioning workflow in a one-year period at 3 radiotherapy sites totaling 7 linear accelerators and 25 trained RTTs.

Pulse oximeter as a home assessment tool: Knowledge and user experience among the community in Malaysia during the COVID-19 pandemic

Objective: To determine the degree of knowledge in the usage of pulse oximeter as a home assessment tool among the community in Malaysia. Methods: A cross-sectional survey was conducted in November 2021. The questionnaire assessed the knowledge in using pulse oximeters, user experience and opinions in using pulse oximeter as a home assessment tool during the pandemic. Results: A total of 504 respondents were included in the study, and the mean score in knowledge related to application of pulse oximetry was 73.00%, while the mean score in knowledge related to factors affecting pulse oximetry readings was only 38.51%. A total of 90.5% of the respondents recognised normal pulse rate and 88.5% knew the blood oxygen saturation levels of a healthy adult, while 69.4% recognised the definition of silent hypoxia. In addition, the majority of the respondents agreed that factors such as poor blood circulation (71.2%), excessive movements (69.8%), and hand position (60.7%) affected oximetry readings. However, 61.7%, 81.7%, 77.2% and 76.8% of the respondents could not identify nail polish, skin colour, skin thickness and tattoos as factors that may affect oximetry readings respectively. Conclusions: The respondents showed a satisfactory level of knowledge related to application of pulse oximetry, but a poor level of knowledge related to factors affecting pulse oximetry readings among the community in Malaysia. Continuous efforts in educating the community on the correct use of pulse oximeters are crucial for appropriate home assessment and avoiding unnecessary stress.

Axillary Lymph Node Core Biopsy Following SARS-CoV-2 Vaccination

Background: Atypical axillary lymph nodes identified on breast cancer screening often result in axillary lymph node core biopsy (ALNB). However, similar changes may occur after vaccination. Recent trends of mass vaccination for SARS-CoV-2 have resulted in new guidelines, specifically delay to biopsy following vaccination to avoid false positives and unnecessary biopsy, with notable exceptions in the context of breast cancer. We aimed to evaluate ALNB pathology, clinical and imaging features in patients who had received SARS-CoV-2 vaccination. Design: We evaluated ALNB specimens from patients who received SARS-CoV-2 vaccine before biopsy (1/2021 - 6/2021) at our enterprise (1 academic and 2 community hospital sites). Clinicopathologic features were assessed by chart and slide review, with pathology review by a dedicated hematopathologist and imaging review by dedicated breast radiologists. Results: Of 135 patients with ALNB, 48 (35.6%) had vaccination prior to biopsy. Patients were predominantly female (47/48;97.9%), with a mean age of 55.1 years (range 19.9-91.3). 34 of 48 (70.8%) were benign, 12 (25%) had metastatic carcinoma, 1 (2.1%) hematologic malignancy (CLL/SLL), and 1 (2.1%) metastatic melanoma. In non-vaccinated patients, the rate of malignancy was similar (24/87;27.6%) (p=0.73). All ALNB with metastatic carcinoma were from patients with concurrent breast carcinoma and the patient with metastatic melanoma had a history of melanoma. Of patients with benign ALNB, 10 (29.4%) had concurrent, 1 (2.9%) recent (within 2 years) and 3 (8.8%) remote (>2 years) history of breast cancer. Most (37/48;77.1%) ALNB specimens could be traced to abnormal breast imaging (Table 1). SARS-CoV-2 vaccine was ipsilateral in 18 (37.5%), contralateral in 14 (29.2%) and side was not documented in 16 (33.3%). Median time from 1st dose to ALNB was 10.6 weeks (range 1.9-23.9) and from 2nd dose to ALNB was 7.7 weeks (range 0-20.9). 16 (33.3%) had a dose within the prior 6 weeks. Benign ALNB in patients who underwent vaccination prior to biopsy comprised: 21 (61.8%) without specific features, 10 (29.4%) reactive follicular hyperplasia, 2 (5.9%) dermatopathic change and 1 (2.9%) tattoo pigment. Reactive follicular hyperplasia was significantly less frequent (4/63;6.3%) in patients who did not undergo vaccination prior to biopsy (p<.01). Conclusions: Some patients who underwent SARS-CoV-2 vaccination with reactive changes may have avoided ALNB if there were more time between imaging, vaccination and breast cancer diagnosis. (Table Presented).