Pre-endoscopy SARS-CoV-2 testing strategy during COVID-19 pandemic: the care must go on.

BACKGROUND: In response to the COVID-19 pandemic, endoscopic societies initially recommended reduction of endoscopic procedures. In particular non-urgent endoscopies should be postponed. However, this might lead to unnecessary delay in diagnosing gastrointestinal conditions. METHODS: Retrospectively we analysed the gastrointestinal endoscopies performed at the Central Endoscopy Unit of Saarland University Medical Center during seven weeks from 23 March to 10 May 2020 and present our real-world single-centre experience with an individualized rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy. We also present our experience with this strategy in 2021. RESULTS: Altogether 359 gastrointestinal endoscopies were performed in the initial period. The testing strategy enabled us to conservatively handle endoscopy programme reduction (44% reduction as compared 2019) during the first wave of the COVID-19 pandemic. The results of COVID-19 rtPCR from nasopharyngeal swabs were available in 89% of patients prior to endoscopies. Apart from six patients with known COVID-19, all other tested patients were negative. The frequencies of endoscopic therapies and clinically significant findings did not differ between patients with or without SARS-CoV-2 tests. In 2021 we were able to unrestrictedly perform all requested endoscopic procedures (> 5000 procedures) by applying the rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy, regardless of next waves of COVID-19. Only two out-patients (1893 out-patient procedures) were tested positive in the year 2021. CONCLUSION: A structured pre-endoscopy SARS-CoV-2 testing strategy is feasible in the clinical routine of an endoscopy unit. rtPCR-based pre-endoscopy SARS-CoV-2 testing safely allowed unrestricted continuation of endoscopic procedures even in the presence of high incidence rates of COVID-19. Given the low frequency of positive tests, the absolute effect of pre-endoscopy testing on viral transmission may be low when FFP-2 masks are regularly used.

Prevention of AIDS and living together with an HIV-infected patient.

In Brazil, approximately 45 thousand cases had been reported until the end of 1993, with an estimated 50% underreport. According to the Ministry of Health, until the year 2,000 from 2 to 8 million Brazilians citizens will be infected with HIV. The basic aspect of the educational campaigns regarding AIDS does not refer only to information on forms of transmission and prevention measures, but also attempts to fight against the mystification and the enormous resistance of the public to definitely accept the fact that transmission does not occur by simple means such as having a drink from the same glass, independently of its socioeconomic and cultural level. In addition to the lack of information, prejudice and discrimination appear strongly rooted in the population to the point of a tendency of social and effective rejection of the HIV-infected patient. Fighting against prejudice, against which there is also no vaccine, is a task as gigantic as fighting against the virus. For both, investments in education of and information to the population in general, is very important. Development of a software which would fulfill the function of explaining, and providing the correct information about AIDS, would be extremely valuable for any part of the society and could also be used as a complementary element by health professionals. The objective was to develop an interactive software in order to demonstrate prevention measures and universal precaution in AIDS; to inform about the necessary care to people that are living together an HIV-infected patient. To develop this software with animation and elucidating text regarding AIDS for the general population, we are using the Storyboard live to be run in Windows environment.

Ethylene oxide environmental monitoring in a health care facility.

Adequate monitoring of ethylene oxide concentrations in the workplace is essential for employee safety. Three methods of monitoring EO levels--personnel monitoring, infrared spectrometry, and continuous gas monitoring--were evaluated for use in a hospital central sterile reprocessing department. The continuous gas monitor was found to be a cost-effective, comprehensive system for monitoring ambient EO levels.

Innovations in sterilization technology for instrument processing.

The past 5 years have seen the development of specialized devices to package, protect, and sterilize surgical instruments. The sterilization container system is one such innovative approach to operating room instrument processing. When compared with disposable and reusable systems, the sterilization container system was found to have the advantages of lower cost and improved efficiency.