Decontamination of filtering facepiece respirators using a low-temperature-steam-2%-formaldehyde sterilization process during a pandemic: a safe alternative for re-use.

BACKGROUND: The coronavirus disease 2019 pandemic has caused problems with respirator supplies. Re-use may minimize the impact of the shortage, but requires the availability of an efficient and safe decontamination method. AIM: To determine whether low-temperature-steam-2%-formaldehyde (LTSF) sterilization is effective, preserves the properties of filtering facepiece (FFP) respirators and allows safe re-use. METHODS: Fourteen unused FFP2, FFP3 and N95 respirator models were subjected to two cycles of decontamination cycles. After the second cycle, each model was inspected visually and accumulated residual formaldehyde levels were analysed according to EN 14180. After one and two decontamination cycles, the fit factor (FF) of each model was tested, and penetration tests with sodium chloride aerosols were performed on five models. FINDINGS: Decontamination physically altered three of the 14 models. All of the residual formaldehyde values were below the permissible threshold. Irregular decreases and increases in FF were observed after each decontamination cycle. In the sodium chloride aerosol penetration test, three models obtained equivalent or superior results to those of the FFP classification with which they were marketed, both at baseline and after one and two cycles of decontamination, and two models had lower filtering capacity. CONCLUSION: One and two decontamination cycles using LTSF did not alter the structure of most (11/14) respirators tested, and did not degrade the fit or filtration capacity of any of the analysed respirators. The residual formaldehyde levels complied with EN 14180. This reprocessing method could be used in times of shortage of personal protective equipment.

Characterization of Microvascular Post Occlusive Hyperemia Using Laser Doppler Flowmetry Technique in Subjects With Cardiometabolic Disorders.

INTRODUCTION: Laser Doppler flowmetry (LDF) provides a noninvasive real-time quantification of relative changes in cutaneous perfusion. Assessment of the microvascular function can provide information on the development of various cardiometabolic disorders. In recent years, non-invasive measurements have gain attention, due to the potential complications associated to invasive procedures. OBJECTIVE: To differentiate the microvascular function between subjects with cardiometabolic disorders and healthy controls. METHODS: Evaluation through LDF during post-occlusive reactive hyperemia (PORH) in patients with or without history of cardiometabolic disorders. RESULTS: Peak values of microvascular flow during post-occlusive reactive hyperemia and both upload and recovery slopes were lesser in the pathological group. CONCLUSION: A novel approach to characterize LDF during PORH was useful to differentiate patients with cardiometabolic disorders from healthy subjects.

Iberian Cured-Ham Consumption Improves Endothelial Function in Healthy Subjects.

OBJECTIVES: Previous studies have shown that dietary components such as oleic acid or polyphenols exert beneficial effects on endothelium. We aimed to assess the impact of regular consumption of Iberian cured-ham (ICH) on endothelial function. DESIGN: An open-label, randomized controlled parallel study. SETTING: Volunteers recruited through advertisements at a hospital in Madrid, Spain. PARTICIPANTS: 102 Caucasian adults (76.8% females) aged 25-55 years, and free from cardiometabolic disease. INTERVENTION: Participants were randomized to an ICH-enriched ad libitum diet or an ad libitum diet without ICH for 6 weeks. Subjects in ICH group were randomly provided with either acorn- or mixed-fed ICH, and followed up for an additional 6-week period under their usual diet. MEASUREMENTS: Clinical parameters, biomarkers of endothelial function and oxidative stress, microvascular vasodilatory response to hyperemia and arterial stiffness were measured before and after the intervention. RESULTS: After 6 weeks, a larger decrease in PAI-1 was observed in subjects consuming ICH compared to the Control group (-6.2±17.7 vs. 0.3±1.4 ng/ml; p=0.020). Similarly, microvascular vasodilatory response to hyperemia showed a significant increase (112.4±391.7 vs. -56.0±327.9%; p=0.007). However, neither oxidative stress, hemodynamic nor clinical parameters differed significantly over the study. Additionally, after stopping ICH consumption, improvements in PAI-1 remained for 6 additional weeks with respect to baseline (p=0.006). CONCLUSION: The present study demonstrates, for the first time, that regular consumption of ICH improves endothelial function in healthy adults. Strategies aimed to preserve or improve the endothelial function may have implications in vascular aging beyond the prevention of the atherothrombotic disease.

Resultados a corto y medio plazo en el tratamiento de estenosis carotídea sintomática mediante «stenting» versus endarterectomía carotídea / Early and mid-term results after stenting and endarterectomy in the treatment of symptomatic carotid stenosis

INTRODUCCIÓN: La estenosis de la arteria carótida interna de origen aterosclerótico es una de las principales causas de los ictus isquémicos. La tromboendarterectomía (TEA) carotídea es el tratamiento clásico para disminuir el riesgo de recurrencia de un nuevo ictus. Las técnicas endovasculares, como el stenting carotídeo están en auge. OBJETIVO: Describir nuestra experiencia en el tratamiento de estenosis carotídea sintomática mediante TEA carotídea y el implante de stent carotídeo. Nuestros objetivos principales son comparar: eventos neurológicos, infarto de miocardio y muerte a los 30 días postintervención. El objetivo secundario es reportar la incidencia de reestenosis severa (≥70%), reintervencion carotídea y mortalidad durante el seguimiento. MÉTODOS: Realizamos un estudio descriptivo de pacientes tratados entre los años 2008 y 2012. Analizamos un total de 86 pacientes, 61,6% (n = 53) recibieron TEA carotídea y 38,4% (n = 33) stent carotídeo. El diagnóstico de estenosis carotídea fue con ecografía-doppler, confirmado mediante arteriografía en el grupo con stent. RESULTADOS: Se registraron 2 casos de ictus en el grupo TEA carotídea frente a 4 en el grupo con stent (3,2 versus 12,1%, respectivamente). Aconteció un solo caso de infarto agudo de miocardio, no letal, en el grupo de TEA carotídea. La mortalidad a los 30 días fue de 1,9% (n = 1) en el grupo TEA carotídea en comparación con 3,0% (n = 1) en el grupo stent. Se registraron 7 casos de reestenosis crítica en el grupo de stent carotídeo, ninguno en el de TEA (p = 0,006). La mediana de seguimiento fue de 38,5 meses en el grupo TEA y 37,5 meses en grupo endovascular. CONCLUSIONES: Nuestra experiencia reporta mejores resultados en el corto y medio plazo, a favor de la TEA carotídea. Así, pensamos que la TEA carotídea debería seguir siendo el tratamiento de elección en pacientes con estenosis carotídea sintomáticos

INTRODUCTION: Atherothrombotic stenosis of the internal carotid artery is a common cause of stroke. Carotid endarterectomy (CEA) is the most common treatment for secondary stroke prevention. Carotid artery stenting is an alternative treatment. OBJECTIVE: To describe our experience of treating symptomatic carotid artery stenosis with CEA or carotid artery stenting. The primary outcomes were: 30-day stroke, myocardial infarction, or death. The secondary outcomes were severe restenosis (>70%), re-intervention, and death during mid-term follow-up. METHODS: Retrospective cohort study including patients treated between 2008 and 2012. A total of 86 patients were included, of which 61.6% (n = 53) received CEA, and a CAS technique in the remaining 38.4% (n = 33). Diagnosis was established by echo-Doppler, and confirmed with selective arteriography in the carotid artery stenting group. RESULTS: Two strokes were recorded in the CEA group, and 4 cases in the carotid artery stenting group (3.21 vs. 12.12%). There was one case of non-lethal myocardial infarction in the CEA group. The 30-day mortality rate was 1.9% (n = 1) in the CEA group, and 3.0% (n = 1) in the carotid artery stenting group. There were 7 cases of severe restenosis in the carotid artery stenting group, with no cases being reported in the CEA group (p=.006). The median follow-up was 38.5 months in the CEA group and 37.5 months in the carotid artery stenting group. CONCLUSION: Our study reports better results in the early and mid-term after CEA. Thus, it is concluded that CEA should remain the reference-standard treatment in symptomatic patients