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1.
Emerg Infect Dis ; 27(4): 1229-1231, 2021 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1147201

RESUMEN

Severe acute respiratory syndrome coronavirus 2 can persist on surfaces, suggesting possible surface-mediated transmission of this pathogen. We found that fomites might be a substantial source of transmission risk, particularly in schools and child daycares. Combining surface cleaning and decontamination with mask wearing can help mitigate this risk.


Asunto(s)
Transmisión de Enfermedad Infecciosa/prevención & control , Fómites/virología , Control de Infecciones , /aislamiento & purificación , Anciano , Número Básico de Reproducción , /prevención & control , /virología , Niño , Jardines Infantiles/normas , Descontaminación/métodos , Contaminación de Equipos/prevención & control , Desinfección de las Manos/métodos , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Máscaras , Casas de Salud/normas , Instituciones Académicas/normas , Estados Unidos/epidemiología
2.
Cytometry A ; 97(9): 882-886, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-790373

RESUMEN

Operating shared resource laboratories (SRLs) in times of pandemic is a challenge for research institutions. In a multiuser, high-turnover working space, the transmission of infectious agents is difficult to control. To address this challenge, imaging core facility managers being members of German BioImaging discussed how shared microscopes could be operated with minimal risk of spreading SARS-CoV-2 between users and staff. Here, we describe the resulting guidelines and explain their rationale, with a focus on separating users in space and time, protective face masks, and keeping surfaces virus-free. These recommendations may prove useful for other types of SRLs. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals LLC. on behalf of International Society for Advancement of Cytometry.


Asunto(s)
Betacoronavirus/patogenicidad , Investigación Biomédica/organización & administración , Infecciones por Coronavirus/prevención & control , Control de Infecciones , Laboratorios/organización & administración , Microscopía , Salud Laboral , Pandemias/prevención & control , Neumonía Viral/prevención & control , Conducta Cooperativa , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Descontaminación , Contaminación de Equipos/prevención & control , Alemania , Humanos , Exposición Profesional/prevención & control , Equipo de Protección Personal , Neumonía Viral/transmisión , Neumonía Viral/virología , Factores Protectores , Investigadores/organización & administración , Medición de Riesgo , Factores de Riesgo , Flujo de Trabajo
4.
Cir Cir ; 89(1): 4-11, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1077009

RESUMEN

Background: The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. Objective: To assess recommendations for care of patients and surgical team during the COVID-19 pandemic. Method: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (April 2020) were searched the key words "COVID-19", "PROTOCOL" and "SURGERY". Relevant recommendations, guidelines and cases series were checked for the most accurate information for apply to our center. Results: We found 379 papers that included the key words. A total of 25 papers were included in the manuscript based in the pertinence of the recommendations. Three major topics were selected: perioperative, intraoperative and postoperative. Conclusion: As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.


Asunto(s)
/prevención & control , Infección Hospitalaria/prevención & control , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Pandemias , Aerosoles , Contaminación del Aire Interior , Citas y Horarios , Desinfección/métodos , Contaminación de Equipos/prevención & control , Humanos , México , Exposición Profesional , Quirófanos , Aislamiento de Pacientes , Atención Perioperativa , Equipo de Protección Personal , Personal de Hospital , Sala de Recuperación , Esterilización/métodos , Equipo Quirúrgico
5.
Ann Ital Chir ; 91: 563-567, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1068445

RESUMEN

2019-nCoV currently named SARS-CoV-2 is a highly pathogenic Coronavirus identified in Wuhan China in December 2019. Turkey declared the first case relatively late compared to Asian and European countries on March 11, as the first SARS-CoV-2 infection in Turkey. In this study, we aimed to determine patients' outcomes in 50 surgeries done in the incubation period of SARS-CoV-2 in our hospital. METHODS: We retrospectively analyzed the clinical data of 50 patients who underwent surgeries during the incubation period of CoVid-19 at Istinye University Gaziosmanpasa Medical Park Hospital in Istanbul, from March 2 to April 11, 2020. RESULTS: The age of 50 patients range was 21 to 73, and the median age was 43.32 (64%) patients were women. The median length of hospital stay is 2.6 days (1-21). Operations at various difficulty levels were also performed on patients with co-morbidities. No complication or mortality was observed except for 1 patient, and the ICU requirement of that patient was also due to high energy trauma. CONCLUSION: Although contrary claims have been made in various studies; it is the primary duty of us surgeons to operate CoVid-19 positive/suspicious patients safely and without any contamination, and on the other hand, to continue their operations without victimizing negative patients. In this pilot study, we would like to emphasize with necessary and adequate measures these can be achieved. KEY WORDS: CoVid-19, SARS-CoV-2, Surgery.


Asunto(s)
/diagnóstico , Urgencias Médicas/epidemiología , Hospitales de Aislamiento/estadística & datos numéricos , Hospitales Universitarios/estadística & datos numéricos , Periodo de Incubación de Enfermedades Infecciosas , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias , Procedimientos Quirúrgicos Operativos/estadística & datos numéricos , Adulto , Anciano , /epidemiología , Comorbilidad , Procedimientos Quirúrgicos Electivos/mortalidad , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Contaminación de Equipos/prevención & control , Femenino , Mortalidad Hospitalaria , Humanos , Control de Infecciones/métodos , Masculino , Persona de Mediana Edad , Aislamiento de Pacientes , Proyectos Piloto , Estudios Retrospectivos , Procedimientos Quirúrgicos Operativos/mortalidad , Tomografía Computarizada por Rayos X , Turquia/epidemiología , Adulto Joven
6.
PLoS One ; 16(1): e0243554, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1067394

RESUMEN

With COVID-19 N95 shortages, frontline medical personnel are forced to reuse this disposable-but sophisticated-multilayer respirator. Widely used to decontaminate nonporous surfaces, UV-C light has demonstrated germicidal efficacy on porous, non-planar N95 respirators when all surfaces receive ≥1.0 J/cm2 dose. Of utmost importance across disciplines, translation of empirical evidence to implementation relies upon UV-C measurements frequently confounded by radiometer complexities. To enable rigorous on-respirator measurements, we introduce a photochromic indicator dose quantification technique for: (1) UV-C treatment design and (2) in-process UV-C dose validation. While addressing outstanding indicator limitations of qualitative readout and insufficient dynamic range, our methodology establishes that color-changing dosimetry can achieve the necessary accuracy (>90%), uncertainty (<10%), and UV-C specificity (>95%) required for UV-C dose measurements. In a measurement infeasible with radiometers, we observe a striking ~20× dose variation over N95s within one decontamination system. Furthermore, we adapt consumer electronics for accessible quantitative readout and use optical attenuators to extend indicator dynamic range >10× to quantify doses relevant for N95 decontamination. By transforming photochromic indicators into quantitative dosimeters, we illuminate critical considerations for both photochromic indicators themselves and UV-C decontamination processes.


Asunto(s)
Descontaminación/métodos , Dispositivos de Protección Respiratoria/microbiología , /prevención & control , Relación Dosis-Respuesta en la Radiación , Contaminación de Equipos/prevención & control , Contaminación de Equipos/estadística & datos numéricos , Equipo Reutilizado/estadística & datos numéricos , Humanos , Indicadores y Reactivos/efectos de la radiación , Radiometría/métodos , Sensibilidad y Especificidad , Rayos Ultravioleta , Ventiladores Mecánicos/microbiología
7.
Healthc Q ; 23(4): 35-38, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: covidwho-1040174

RESUMEN

With the global outbreak of the COVID-19 pandemic, hospitals in Canada and around the world have been forced to consider conservation strategies to ensure continued availability of personal protective equipment (PPE) for healthcare providers. To mitigate critical PPE shortages, Sinai Health System (Sinai Health), a large academic healthcare institution in Canada, has developed and operationalized a standard operating procedure for the collection, decontamination and reuse of N95 respirators and other single-use PPE using a vaporized hydrogen peroxide decontamination method. Sinai Health has incorporated stringent quality assurance steps to ensure that the N95 respirators are successfully decontaminated without deformation and are safe to use.


Asunto(s)
Descontaminación/métodos , Contaminación de Equipos/prevención & control , Equipo Reutilizado , Equipos y Suministros de Hospitales , /prevención & control , Infección Hospitalaria/prevención & control , Equipo Reutilizado/normas , Equipos y Suministros de Hospitales/efectos adversos , Equipos y Suministros de Hospitales/normas , Equipos y Suministros de Hospitales/virología , Humanos , /normas , /virología
8.
Adv Ther ; 37(11): 4538-4548, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-775209

RESUMEN

The coronavirus disease (COVID-19) pandemic has highlighted the importance of reducing occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The reprocessing procedure for reusable flexible bronchoscopes (RFBs) involves multiple episodes of handling of equipment that has been used during an aerosol-generating procedure and thus is a potential source of transmission. Single-use flexible bronchoscopes (SUFBs) eliminate this source. Additionally, RFBs pose a risk of nosocomial infection transmission between patients with the identification of human proteins, deoxyribonucleic acid (DNA) and pathogenic organisms on fully reprocessed bronchoscopes despite full adherence to the guidelines. Bronchoscopy units have been hugely impacted by the pandemic with restructuring of pre- and post-operative areas, altered patient protocols and the reassessment of air exchange and cleaning procedures. SUFBs can be incorporated into these protocols as a means of improving occupational safety. Most studies on the efficacy of SUFBs have occurred in an anaesthetic setting so it remains to be seen whether they will perform to an acceptable standard in complex respiratory procedures such as transbronchial biopsies and cryotherapy. Here, we outline their potential uses in a respiratory setting, both during and after the current pandemic.


Asunto(s)
Broncoscopios/tendencias , Broncoscopía/tendencias , Infecciones por Coronavirus/diagnóstico , Contaminación de Equipos/prevención & control , Neumonía Viral/diagnóstico , Betacoronavirus , Equipos Desechables , Humanos , Técnicas Microbiológicas/tendencias , Pandemias
9.
Int J Environ Res Public Health ; 17(21)2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: covidwho-908896

RESUMEN

Microbiological surveillance carried out in order to verify the effectiveness of endoscope reprocessing does not include the research of viruses, although endoscopes may be associated with the transmission of viral infections. This paper reports the experience of the University Hospital of Pisa in managing the risk from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during an endoscopy. A review of the reprocessing procedure was conducted to assess whether improvement actions were needed. To verify the reprocessing efficacy, a virological analysis was conducted both before and after the procedure. Five bronchoscopes and 11 digestive endoscopes (6 gastroscopes and 5 colonoscopes) were sampled. The liquid samples were subjected to concentration through the use of the Macrosep Advance Centrifugal Devices (PALL Life Sciences, Port Washington, NY, USA) and subsequently analyzed using the cobas® SARS-CoV-2 Test (Roche Diagnostics, Basel, Switzerland), together with eSwab 490 CE COPAN swabs (COPAN, Brescia, Italy), which were used to sample surfaces. In accordance with the first ordinance regarding the coronavirus disease 2019 (COVID-19) emergency issued by the Tuscany Region in March 2020, a procedure dedicated to the management of the COVID-19 emergency in endoscopic practices was prepared, including the reprocessing of endoscopes. The virological analysis carried out on samples collected from endoscopes after reprocessing gave negative results, as well as on samples collected on the endoscopy column surfaces and the two washer-disinfectors that were dedicated to COVID-19 patients. The improvement in endoscope reprocessing implemented during the COVID-19 emergency was effective in ensuring the absence of SARS-CoV-2, thus reducing the risk of infections after an endoscopy on COVID-19 patients.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Desinfección/normas , Endoscopía/instrumentación , Contaminación de Equipos/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus , Humanos , Italia
10.
BMJ Glob Health ; 5(10)2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-889896

RESUMEN

INTRODUCTION: During pandemics, such as the SARS-CoV-2, filtering facepiece respirators plays an essential role in protecting healthcare personnel. The recycling of respirators is possible in case of critical shortage, but it raises the question of the effectiveness of decontamination as well as the performance of the reused respirators. METHOD: Disposable respirators were subjected to ultraviolet germicidal irradiation (UVGI) treatment at single or successive doses of 60 mJ/cm2 after a short drying cycle (30 min, 70°C). The germicidal efficacy of this treatment was tested by spiking respirators with two staphylococcal bacteriophages (vB_HSa_2002 and P66 phages). The respirator performance was investigated by the following parameters: particle penetration (NaCl aerosol, 10-300 nm), scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), differential scanning calorimetry and mechanical tensile tests. RESULTS: No viable phage particles were recovered from any of the respirators after decontamination (log reduction in virus titre >3), and no reduction in chemical or physical properties (SEM, particle penetrations <5%-6%) were observed. Increasing the UVGI dose 10-fold led to chemical alterations of the respirator filtration media (FTIR) but did not affect the physical properties (particle penetration), which was unaltered even at 3000 mJ/cm2 (50 cycles). When respirators had been used by healthcare workers and undergone decontamination, they had particle penetration significantly greater than never donned respirators. CONCLUSION: This decontamination procedure is an attractive method for respirators in case of shortages during a SARS pandemic. A successful implementation requires a careful design and particle penetration performance control tests over the successive reuse cycles.


Asunto(s)
Descontaminación/métodos , Contaminación de Equipos/prevención & control , Equipo Reutilizado , Dispositivos de Protección Respiratoria , Rayos Ultravioleta , Betacoronavirus , Infecciones por Coronavirus/prevención & control , Análisis de Falla de Equipo , Humanos , Control de Infecciones/métodos , Ensayo de Materiales , Pandemias/prevención & control , Neumonía Viral/prevención & control
11.
Anesth Analg ; 131(5): 1342-1354, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-881133

RESUMEN

Many health care systems around the world continue to struggle with large numbers of SARS-CoV-2-infected patients, while others have diminishing numbers of cases following an initial surge. There will most likely be significant oscillations in numbers of cases for the foreseeable future, based on the regional epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Less affected hospitals and facilities will attempt to progressively resume elective procedures and surgery. Ramping up elective care in hospitals that deliberately curtailed elective care to focus on SARS-CoV-2-infected patients will present unique and serious challenges. Among the challenges will be protecting patients and providers from recurrent outbreaks of disease while increasing procedure throughput. Anesthesia providers will inevitably be exposed to SARS-CoV-2 by patients who have not been diagnosed with infection. This is particularly concerning in consideration that aerosols produced during airway management may be infective. In this article, we recommend an approach to routine anesthesia care in the setting of persistent but variable prevalence of SARS-CoV-2 infection. We make specific recommendations for personal protective equipment and for the conduct of anesthesia procedures and workflow based on evidence and expert opinion. We propose practical, relatively inexpensive precautions that can be applied to all patients undergoing anesthesia. Because the SARS-CoV-2 virus is spread primarily by respiratory droplets and aerosols, effective masking of anesthesia providers is of paramount importance. Hospitals should follow the recommendations of the Centers for Disease Control and Prevention for universal masking of all providers and patients within their facilities. Anesthesia providers should perform anesthetic care in respirator masks (such as N-95 and FFP-2) whenever possible, even when the SARS-CoV-2 test status of patients is negative. Attempting to screen patients for infection with SARS-CoV-2, while valuable, is not a substitute for respiratory protection of providers, as false-negative tests are possible and infected persons can be asymptomatic or presymptomatic. Provision of adequate supplies of respirator masks and other respiratory protection equipment such as powered air purifying respirators (PAPRs) should be a high priority for health care facilities and for government agencies. Eye protection is also necessary because of the possibility of infection from virus coming into contact with the conjunctiva. Because SARS-CoV-2 persists on surfaces and may cause infection by contact with fomites, hand hygiene and surface cleaning are also of paramount importance.


Asunto(s)
Anestesia , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Control de Infecciones , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Exposición por Inhalación/prevención & control , Intubación Intratraqueal , Exposición Profesional/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Aerosoles , Anestesia/efectos adversos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/transmisión , Infección Hospitalaria/virología , Contaminación de Equipos/prevención & control , Dispositivos de Protección de los Ojos , Higiene de las Manos , Interacciones Huésped-Patógeno , Humanos , Exposición por Inhalación/efectos adversos , Intubación Intratraqueal/efectos adversos , Exposición Profesional/efectos adversos , Salud Laboral , Seguridad del Paciente , Equipo de Protección Personal , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Neumonía Viral/virología , Factores Protectores , Dispositivos de Protección Respiratoria , Medición de Riesgo , Factores de Riesgo , Vestimenta Quirúrgica
12.
BMJ Open ; 10(9): e042045, 2020 09 28.
Artículo en Inglés | MEDLINE | ID: covidwho-807320

RESUMEN

BACKGROUND: In a previous randomised controlled trial (RCT) in hospital healthcare workers (HCWs), cloth masks resulted in a higher risk of respiratory infections compared with medical masks. This was the only published RCT of cloth masks at the time of the COVID-19 pandemic. OBJECTIVE: To do a post hoc analysis of unpublished data on mask washing and mask contamination from the original RCT to further understand poor performance of the two-layered cotton cloth mask used by HCWs in that RCT. SETTING: 14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam. PARTICIPANTS: A subgroup of 607 HCWs aged ≥18 years working full time in selected high-risk wards, who used a two-layered cloth mask and were part of a randomised controlled clinical trial comparing medical masks and cloth masks. INTERVENTION: Washing method for cloth masks (self-washing or hospital laundry). A substudy of contamination of a sample of 15 cloth and medical masks was also conducted. OUTCOME MEASURE: Infection rate over 4 weeks of follow up and viral contamination of masks tested by multiplex PCR. RESULTS: Viral contamination with rhinovirus was identified on both used medical and cloth masks. Most HCW (77% of daily washing) self-washed their masks by hand. The risk of infection was more than double among HCW self-washing their masks compared with the hospital laundry (HR 2.04 (95% CI 1.03 to 4.00); p=0.04). There was no significant difference in infection between HCW who wore cloth masks washed in the hospital laundry compared with medical masks (p=0.5). CONCLUSIONS: Using self-reported method of washing, we showed double the risk of infection with seasonal respiratory viruses if masks were self-washed by hand by HCWs. The majority of HCWs in the study reported hand-washing their mask themselves. This could explain the poor performance of two layered cloth masks, if the self-washing was inadequate. Cloth masks washed in the hospital laundry were as protective as medical masks. Both cloth and medical masks were contaminated, but only cloth masks were reused in the study, reiterating the importance of daily washing of reusable cloth masks using proper method. A well-washed cloth mask can be as protective as a medical mask. TRIAL RESGISTRATION NUMBER: ACTRN12610000887077.


Asunto(s)
Infecciones por Coronavirus , Desinfección , Contaminación de Equipos , Control de Infecciones , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Máscaras , Pandemias , Personal de Hospital/estadística & datos numéricos , Neumonía Viral , Adulto , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Desinfección/métodos , Desinfección/normas , Desinfección/estadística & datos numéricos , Contaminación de Equipos/prevención & control , Contaminación de Equipos/estadística & datos numéricos , Femenino , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Control de Infecciones/normas , Masculino , Máscaras/clasificación , Máscaras/normas , Máscaras/provisión & distribución , Exposición Profesional/análisis , Exposición Profesional/prevención & control , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Vietnam/epidemiología
13.
Dig Endosc ; 32(7): 1105-1110, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: covidwho-780816

RESUMEN

Endoscopy is widely used as a clinical diagnosis and treatment method for certain hepatobiliary and pancreatic diseases. However, due to the distinctive epidemiological characteristics of severe acute respiratory syndrome coronavirus 2, the virus causing coronavirus disease-2019 (COVID-19), healthcare providers are exposed to the patient's respiratory and gastrointestinal fluids, rendering endoscopy a high risk for transmitting a nosocomial infection. This article introduces preventive measures for endoscopic treatment enacted in our medical center during COVID-19, including the adjustment of indications, the application of endoscope protective equipment, the design and application of endoscopic masks and splash-proof films, and novel recommendations for bedside endoscope pre-sterilization.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Endoscopios/normas , Endoscopía Gastrointestinal/normas , Control de Infecciones/normas , Máscaras , Pandemias/prevención & control , Neumonía Viral/prevención & control , Microbiología del Aire , Betacoronavirus , China/epidemiología , Infecciones por Coronavirus/epidemiología , Contaminación de Equipos/prevención & control , Unidades Hospitalarias/normas , Humanos , Neumonía Viral/epidemiología , Esterilización
14.
Int J Pharm Compd ; 24(5): 358-364, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-743555

RESUMEN

When using ventilators in the management of the coronavirus disease 2019 patient, dense and abundant mucous secretions are formed, obstructing the endotracheal tube and making its aspiration difficult. This situation is worsened if in order to minimize the risk of infection of the medical personnel, the humidifier is disconnected. This circumstance forces the tube to be removed, cleaned, or changed, increasing the workload of the intensive care unit staff. Other therapies tested until now, like mesna, acetylcysteine, or hypertonic saline solution, are valid alternatives, although they have not shown great efficacy for this specific procedure in the past. The sanitary emergency forced the collaboration between a pharmacist and an otorhinolaryngologist to develop the cocamidopropyl betaine surfactant formula, after several tests with different concentrations of the surfactant. The objective of this compounding formula was to resolve a mechanical problem and avoid reintubation due to obstruction of the ventilator tube. The cocamidopropyl betaine surfactant solution 0.075% in saline 0.9% (physiological serum) solution demonstrated to be a well-tolerated formula, using inexpensive materials, was simple to prepare, and was easy to use in clinical practice.


Asunto(s)
Betaína/análogos & derivados , Infecciones por Coronavirus/terapia , Contaminación de Equipos/prevención & control , Intubación Intratraqueal , Neumonía Viral/terapia , Tensoactivos/farmacología , Betacoronavirus , Betaína/farmacología , Humanos , Higiene , Pandemias , Ventiladores Mecánicos
16.
Ann Surg ; 272(2): e125-e128, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-706789

RESUMEN

BACKGROUND: In the setting of the COVID-19 pandemic, the conduct of elective cancer surgery has become an issue because of the need to balance the requirement to treat patients with the possibility of transmission of the virus by asymptomatic carriers. A particular concern is the potential for viral transmission by way of aerosol which may be generated during perioperative care. There are currently no guidelines for the conduct of elective lung resection surgery in this context. METHODS: A working group composed of 1 thoracic surgeon, 2 anesthesiologists and 1 critical care specialist assessed the risk for aerosol during lung resection surgery and proposed steps for mitigation. After external review, a final draft was approved by the Committee for the Governance of Perioperative and Surgical Activities of the Hôpital Maisonneuve-Rosemont, in Montreal, Canada. RESULTS: The working group divided the risk for aerosol into 6 time-points: (1) intubation and extubation; (2) Lung isolation and patient positioning; (3) access to the chest; (4) conduct of the surgical procedure; (5) procedure termination and lung re-expansion; (6) chest drainage. Mitigating strategies were proposed for each time-point. CONCLUSIONS: The situation with COVID-19 is an opportunity to re-evaluate operating room protocols both for the purposes of this pandemic and similar situations in the future. In the context of lung resection surgery, specific time points during the procedure seem to pose specific risks for the genesis of aerosol and thus should be the focus of attention.


Asunto(s)
Aerosoles/efectos adversos , Infecciones por Coronavirus/epidemiología , Contaminación de Equipos/prevención & control , Control de Infecciones/normas , Neoplasias Pulmonares/cirugía , Quirófanos , Neumonía Viral/epidemiología , Procedimientos Quirúrgicos Pulmonares/normas , Betacoronavirus , Procedimientos Quirúrgicos Electivos , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias , Equipo de Protección Personal , Quebec/epidemiología
20.
Photodiagnosis Photodyn Ther ; 31: 101943, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-693299

RESUMEN

BACKGROUND: To review the effect of ultraviolet germicidal irradiation (UVGI) as a disinfection method for filtering facepiece respirators (FFRs) to facilitate reuse during COVID-19 pandemic. METHODS: Systematic review of the research concerning UVGI for FFRs disinfection to facilitate reuse (also termed limited reuse) during respiratory infectious diseases where aerosol transmission is considered possible. RESULTS: UVGI is one possible method for respiratory disinfection to facilitate the reuse of dwindling supplies. Appropriate dose UVGI exposition could provide enough energy to effectively decontaminate respiratory viral agents and maintain respirator's integrity for reuse. There was not currently sufficient research evidence on the effect of UVGI to inactivate coronaviruses SARS-CoV-2, and the practical application of UVGI is still unclear. . CONCLUSION: Appropriate dose UVGI exposition could provide enough energy to effectively decontaminate respiratory viral agents and maintain respirator's integrity for reuse. Further evidence concerning UVGI as a decontamination technique specifically for SARS-CoV-2 isneeded.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Descontaminación/métodos , Contaminación de Equipos/prevención & control , Pandemias/prevención & control , Fotoquimioterapia/métodos , Neumonía Viral/prevención & control , Terapia Ultravioleta/métodos , Ventiladores Mecánicos/virología , Infecciones por Coronavirus/epidemiología , Equipo Reutilizado/estadística & datos numéricos , Humanos , Control de Infecciones/métodos , Neumonía Viral/epidemiología
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