CPAP therapy and the COVID pandemic

Introduction: Continuous positive airway pressure (CPAP) is an aerosol-generating procedure with increased potential to transmit COVID-19 during use. Our health service was located at the epicentre of the COVID-19 outbreak in Melbourne, Australia, placing our patients and staff at high risk of nosocomial COVID-19 infection. We describe our experience with a modified CPAP circuit utilising non vented masks and high efficiency microbial filters to reduce viral transmission in patients potentially infected with COVID-19. Method(s): Retrospective analysis of medical records and polysomnography (PSG) reports of 82 inpatients who used CPAP during admission, and 72 patients who underwent CPAP in-lab PSG with our modified circuit. This consisted of a non vented mask, 2 high efficiency microbial filters, an oxygen port (placed distal to a filter) for expiration, and ancillary equipment such as disposable tubing. Result(s): The mean age amongst inpatients (45 males/37 females) was 65.9 +/- 11.6 years. Equipment issues occurred in 28/82 patients. 9 patients (10.9%) chose not to use PAP therapy, 10 patients (12.2%) experienced excessive mask leak and 6 patients (7.3%) experienced discomfort. 7 patients (8.5%) were discharged before the circuit could be unmodified. The majority of issues occurred on non-respiratory wards. The mean age of in-lab PSG patients (48 males/24 females) was 51.3 +/- 13.6 years. 24 CPAP implementation, 31 CPAP treatment review and 17 split-night studies were included. Circuit modification did not impact the study conclusion in the majority (97.2%). Mask leak (13.9%) and patient discomfort (8.3%) were common. Conclusion(s): Our modified circuit was safe and well tolerated in the majority and did not significantly affect the outcome of in-lab CPAP studies.

Ophthalmology practice during the COVID-19 pandemic

OBJECTIVE: To present an established practice protocol for safe and effective hospital-setting ophthalmic practice during the coronavirus disease 2019 (COVID-19) pandemic. METHODS AND ANALYSIS: Literature was reviewed to identify articles relevant to COVID-19 pandemic and ophthalmology. The following keywords were used: COVID-19, SARS-CoV-2 and telemedicine, combined with eye, ophthalmology, conjunctivitis and tears. Data were extracted from the identified manuscripts and discussed among subspecialists to obtain consensus evidence-based practice. RESULT(S): A protocol for ophthalmic practice in the era of COVID-19 pandemic was established. The protocol covered patient screening, clinic flow, required personal protective equipment and modifications of ophthalmic equipment for improved safety. CONCLUSION(S): Important literature emerged with respect to the practice of ophthalmology in the era of COVID-19. An evidence-based ophthalmic practice protocol was established and should be modified in the future to accommodate new insights on the COVID-19 pandemic.Copyright © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Features of students mental health indicators during the academic year under pandemic conditions of COVID-19

The coronavirus disease 2019 (COVID-19) outbreak has rapidly transitioned into a worldwide pandemic. This development has had serious implications for public institutions and raises particular questions for medical universities. The article presented the results of original study the effect of distance learning during COVID-19 pandemic period in the psychological and physical indicators of students who study in medical university. Conducting survey in the pre-session period, which is characterized by the relative stability of the psychoemotional state of students and moderate mental and physical stress, established that the physical and psychological state of the studied group is satisfactory. The study showed that during the session period and quarantine, many students faced a number of negative factors affecting their normal mental health is an increase in the level of stress, anxiety, anxiety, which in turn led to the development of sleep problems in some of the students, which also contributed to decrease in attention, memory, general performance, strengthening, emotional lability. We can assume that distance learning during the COVID-19 pandemic period has led to an increase in the stress effect on the nervous system, which in the future may cause the development of diseases of various genesis. All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants.