COVID-19 Impact on Refugees Mask-Wearing Behaviors and Intentions.

COVID-19 challenged countries in addressing population and raising awareness about mask-wearing during pandemic; Lebanon is a refugee hotspot, with humanitarian responsibility for their protection. The goal of this study is to emphasize the need of raising awareness among vulnerable populations and studying their mask-wearing behavior and intentions. This research draws on findings from a survey characterized by refugees' representatives from NGO, focusing on the behaviors and implications of refugees' mask-wearing. To address the study question, a customized survey based on Theory of Interpersonal Behavior was undertaken, in which the behavior of refugees was impacted by their desire to engage in an activity. The findings show that refugees are influenced by other people's mask-wearing behavior; they view masks as providing protection and aim to use them in the future provided all enabling conditions are met. Artificial intelligence might be a better monitor for this behavior in the future.

Povidone-iodine functionalized nanofibers are prophylactic and protect against dissemination of SARS-CoV-2 infection.

The novel personal protection equipment based on a face mask equipped with a nanofiber filter functionalized with povidone iodine has been developed and tested in a clinical trial. This nanofiber filter was characterized with a low flow resistance and, thus, allowed comfortable breathing. The performed study proved that the novel nanofiber filter with incorporated povidone-iodine was characterized with a slow release of iodine which minimized side effects but kept disinfection efficiency. Our clinical study performed on 207 positively tested SARS-CoV-2 patients wearing the PPE for 4-8 hours daily for 1 to 4 days has shown that even the iodine amount as low as 0.00028 ppm was sufficient to significantly decrease the reproduction number and, very importantly, to protect against severe course of disease.

Design optimization and validation of UV-C illumination chamber for filtering facepiece respirators.

In this study, we constructed an UV-C illumination chamber using commercially available germicidal lamps and other locally available low-cost components for general-purpose biological decontamination purposes. The illumination chamber provides uniform illumination of around 1 J/cm2 in under 5 min across the chamber. The control mechanism was developed to automate the on/off process and make it more secure minimizing health and other electrical safety. To validate the decontamination efficacy of the UV-C Illumination Chamber we performed the Geobacillus spore strip culture assay. Additionally, we performed the viral load measurement by identifying the COVID-19-specific N-gene and ORF1 gene on surgical masks. The gold standard RT-qPCR measurement was performed to detect and quantify the COVID-19-specific gene on the mask sample. The biochemical assay was conducted on the control and test group to identify the presence of different types of bacteria, and fungi before and after exposure under the illumination chamber. The findings of our study revealed satisfactory decontamination efficacy test results. Therefore, it could be an excellent device in healthcare settings as a disinfection tool for biological decontamination such as SAR-CoV-2 virus, personal protection equipment (PPE), (including n95, k95 respirators, and surgical masks), and other common pathogens.

Evaluation of novel radiation protection devices during radiologically guided interventions.

BACKGROUND: In radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure. METHOD: An anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room. Thermoluminescent dosimeters (TLDs) were positioned at different depths in five slices in the phantom, measuring personal dose equivalent. Two different set up situations were evaluated: a head protector designed to reduce radiation in the upper section of the head; and a novel thyroid protector prototype extended in the front and on both sides, designed to reduce radiation in the lower and middle sections of the head. A standard thyroid collar prototype and a ceiling mounted lead glass shield were used as comparisons. Furthermore, the head protector was evaluated in a clinical study in which TLDs were positioned to measure scattered radiation exposure to the heads of operators during endovascular interventions. RESULTS: The extended thyroid protector reduced the scattered radiation in the throat, chin, and ear slices. Some shielding effect was seen in the brain and skull slices. The head protector showed a shielding effect in the skull slice up to two cm depth where it covered the phantom head. As expected, the ceiling mounted lead glass shield reduced the scattered radiation in all measuring points. CONCLUSIONS: A ceiling mounted lead glass shield is an effective radiation protection for the head, but in clinical practice, optimal positioning of a ceiling mounted lead shield may not always be possible, particularly during complex cases when radiation protection may be most relevant. Added protection using these novel guards may compliment the shielding effect of the ceiling mounted lead shield. The head protector stand-alone did not provide sufficient protection of the head. The extended thyroid protector stand-alone provided sufficient protection in the lower and middle sections of the head and neck.

Traqueostomía en pacientes con COVID-19: recomendaciones actuales / Traqueostomy in COVID-19 patients: current recomendations

Resumen El nuevo coronavirus (SARS-CoV-2), causante de la enfermedad COVID-19, es una pandemia con alta morbimortalidad mundial. Uno de los factores más importantes es su alta tasa de transmisibilidad por gotitas, aerosoles y fómites. La tendencia actual es el aumento progresivo de pacientes contagiados en nuestro país y, por consiguiente, de mayor cantidad de enfermos en unidades de cuidados intensivos (UCI) con uso de ventilación mecánica invasiva (VMI). La traqueostomía (TQT) se utiliza en pacientes críticos para facilitar la VMI a largo plazo y el destete de la ventilación. Una TQT temprana, definida como la realizada en los primeros 7 días después de la intubación orotraqueal (IOT), se asocia a una reducción en el tiempo de la VMI, mortalidad y permanencia en UCI. La TQT es una técnica quirúrgica con alta generación de aerosoles la cual implica medidas especiales frente a la realización de ésta en pacientes con COVID-19. Para limitar el contagio del SARS-CoV-2 en los trabajadores de salud es necesario el uso de elementos de protección personal (EPP) adecuados según la intervención a realizar. Es por esta razón que en el presente artículo se propone utilizar el acrónimo C-O-RO-NA para no olvidar elementos y pasos fundamentales al momento de realizar esta técnica, minimizando de esta manera el contagio en los trabajadores de salud.

The new coronavirus (SARS-CoV-2), which causes COVID-19 disease, is a high mortality pandemic illness. One of the most important factors is its high rate of transmissibility by respiratory droplets, aerosols and fomites. The reigning trend of this disease is progressively increasing infected patients in our country, therefore, more patients in intensive care units (ICU) with invasive mechanical ventilation (IMV). Tracheostomy (TQT) is used in critical patients to facilitate long-term IMV and ventilation weaning. An early TQT, defined as performed in the first 7 days after orotracheal intubation (IOT) is associated with a reduction IMV duration, mortality rate and length of stay in ICU. TQT is a surgical procedure which generates a huge amount of aerosols that need special measures to perform in COVID-19 patients. It is necessary to use appropriate personal protection elements (PPE) according to the intervention, limiting the spread of SARS-CoV-2 in health workers. It is for this reason that this article proposes to use the acronym C-O-RO-NA to remember fundamental elements and steps when performing this technique in order to minimize health workers infection.

Acciones del personal de salud del área estomatológica en relación a la COVID-19 / Actions taken by dental care providers in relation to COVID-19

Introducción: El brote de la enfermedad del coronavirus 2019 (COVID-19) ha sido declarado emergencia de salud pública de importancia internacional. Los estomatólogos, entre el personal sanitario, son los más expuestos a la enfermedad porque su área de trabajo es la boca, sitio que se reconoce como el lugar a partir del cual se contagia la enfermedad. Objetivo: Esclarecer elementos relacionados con la COVID-19 y las medidas a tener en cuenta para la prevención del contagio del personal de salud del área estomatológica. Comentarios principales: No se ha descubierto un método único que cumpla con todos los requisitos con respecto a las infecciones asociadas a la atención médica. En el enfrentamiento a la COVID-19 cumplen un papel importante las precauciones estándares, o sea, medidas que se aplican a todos los pacientes, independientemente del diagnóstico o de si se conoce si tiene una infección o está colonizado por un agente. El SARS-CoV-2 es un virus envuelto, y esta característica lo hace más sensible a la acción de las sustancias desinfectantes. Consideraciones globales: La COVID-19 manifiesta síntomas no específicos. Los más comunes son fiebre, anorexia y tos seca. La transmisión probablemente ocurre a través de la propagación del virus en el aire y por contacto. Con la implementación de precauciones estándares entre las que se encuentran la higiene de las manos, uso de equipos de protección personal y el cuidado del medio ambiente, se puede disminuir la posibilidad del contagio y contribuir a controlar la diseminación. Es importante que los proveedores de atención médica, dentro de los que se encuentra el personal de salud del área estomatológica, y el público conozcan este nuevo virus para que las acciones coordinadas, oportunas y efectivas puedan ayudar a prevenir casos adicionales o malos resultados ante el enfrentamiento a esta pandemia(AU)

ABSTRACT Introduction: The outbreak of coronavirus disease 2019 (COVID-19) has been declared a worldwide public health emergency. Dentists are the health care providers most directly exposed to this condition, since their area of activity is the mouth, a location recognized as the site through which the disease is transmitted. Objective: Clarify some notions about COVID-19 and the measures to be taken to prevent transmission to dental care providers. Main remarks: A single method has not been discovered which meets all the requirements concerning infections associated to medical care. In the struggle against COVID-19 an important role is played by standard precautions, i.e. measures applied to all patients, irrespective of their diagnosis or whether they are known to have an infection or be colonized by a given agent. SARS-CoV-2 is an enveloped virus, a characteristic that makes it more sensitive to the action of disinfectants. General considerations: COVID-19 presents non-specific symptoms, the most common of which are fever, anorexia and dry coughing. Transmission probably occurs by the spread of the virus in the air and by direct contact. Implementation of standard precautions, among which are hand hygiene, the use of personal protection equipment and care for the environment, will lead to a reduction in the chances of contagion and will contribute to control the spread of the disease. It is important for medical care providers, among them dental care professionals, and the public at large to know about this new virus, so that coordinated, timely and effective actions may be taken which will help prevent the occurrence of new cases or bad results in the struggle against this pandemic(AU)

Estudios de imagen cardiaca en la pandemia COVID-19 / Cardiac imaging studies in the COVID-19 pandemic

Resumen El COVID-19 es un síndrome respiratorio agudo ocasionado por el coronavirus-2 (SARS COV2). Los diferentes métodos de imagen cardiaca han dictado recomendaciones específicas de los diferentes métodos de imagen en esta pandemia, por lo que es indispensable recalcar las recomendaciones para la realización de estos estudios.

Abstract COVID-19 is an acute respiratory syndrome caused by coronavirus-2 (SARS COV2). The different cardiac imaging methods have issued specific recommendations for the different imaging methods in this pandemic, so it is essential to emphasize the recommendations for carrying out these studies.

impacto de la pandemia COVID-19 en el personal médico de los servicios de cirugía general del Hospital Dr. Miguel Pérez Carreño: estudio de cohorte / Impact of the COVID-19 Pandemic on the Medical Staff of General Surgery Services at Dr. Miguel Pérez Carreño Hospital. Cohort study

Las patologías quirúrgicas continúan siendo motivo de consulta habitual en los servicios de emergencia de nuestros hospitales, requiriendo una rápida evaluación y resolución oportuna aún en tiempos de pandemia, siendo muy probable que pacientes asintomáticos, con sospecha o confirmación de infección por COVID-19 ameriten una intervención quirúrgica.Objetivo : Analizar la incidencia de casos de COVID-19 y evaluar su correlación con el uso de equipos de protección personal en los médicos residentes y adjuntos de los servicios de cirugía general del Hospital Dr. Miguel Pérez Carreño.Métodos : Se realizó una investigación de tipo observacional, descriptiva y transversal. La muestra estuvo constituida por 32 médicos quienes respondieron anónimamente una encuesta electrónica realizada por el comité académico del Posgrado de Cirugía General.Resultados : El porcentaje global de participación fue 50,79%. Resultaron positivos para la prueba Reacción en Cadena de Polimerasa el 42% de los residentes y 9% de los médicos especialistas. El lugar más frecuente de probable contacto fue el hospital en 90% de los casos. El 50% de los médicos identificaron a un personal de salud como su fuente de contagio. Se reportó uso constante de equipo de protección personal y gel alcoholado en 47% y 72% de los casos respectivamente.Conclusión : El aumento de casos de COVID-19 en la población general y en el personal de salud debe alertarnos acerca de la necesidad de tomar medidas estrictas de protección en forma precoz orientadas a disminuir la incidencia de casos y por ende la morbilidad y la mortalidad asociada a la infección por el nuevo coronavirus(AU)

Surgical pathologies continue to be a common reason for consultation in the emergency services of our hospitals, requiring a rapid evaluation and timely resolution even in times of pandemic, and it is highly probable that asymptomatic patients, with suspected or confirmed COVID-19 infection, merit a surgical intervention.Objective : To analyze the incidence of COVID-19 cases and evaluate its correlation with the use of personal protective equipment (PPE) in resident and staff surgeons of General Surgery services at Dr. Miguel Pérez Carreño Hospital.Methods : An observational, descriptive and cross-sectional research was carried out. The sample consisted of 32 physicians who anonymously responded to an electronic survey conducted by the academic committee of the General Surgery residency program.Results : The overall percentage of participation was 50.79%. 42% of residents and 9% of specialist physicians were positive for the Polymerase Chain Reaction test. The most frequent place of probable contact was the hospital in 90% of the cases. 50% of the doctors identified a health personnel as their source of infection. Constant use of PPE and alcohol gel was reported in 47% and 72% of the cases, respectively.Conclusion : The increase in COVID-19 cases in the general population and in health personnel should alert us to the need to take stricter protection measures early in order to reduce the incidence of cases and, therefore, the morbidity and mortality associated with infection with the new coronavirus(AU)

Assessment of Primary Health Care for rural workers exposed to pesticides / Avaliação da atenção primária à saúde de trabalhadores rurais expostos a praguicidas

ABSTRACT OBJECTIVE To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.

ABSTRACT OBJETIVO Avaliar os atributos da atenção primária à saúde (APS) na assistência à saúde de trabalhadores rurais; analisar condições sociodemográficas, histórico de intoxicação e internações por agrotóxicos e uso de equipamentos de proteção individual; e verificar a exposição aos praguicidas pela determinação de bioindicadores. MÉTODOS Estudo transversal, descritivo-analítico, com amostra de 1.027 trabalhadores rurais residentes em municípios pertencentes a uma superintendência regional de saúde do sul de Minas Gerais, cuja APS é regida pelo modelo da Estratégia Saúde da Família. Utilizou-se o Instrumento de Avaliação da Atenção Primária (PCATool Brasil) versão adulto e um questionário estruturado para coleta de dados socioeconômicos, histórico de intoxicação e internação por agrotóxicos e uso de equipamentos de proteção individual. Foram coletadas amostras sanguíneas para dosagem de biomarcadores de exposição a praguicidas e de sinais de sequelas renais e hepáticas. RESULTADOS A baixa escolaridade foi prevalente, bem como o contato intenso dos trabalhadores com praguicidas. O uso frequente de equipamentos de proteção individual foi maior entre os homens, assim como o histórico de intoxicação e de internações por agrotóxicos. Detectaram-se índices de 20% de intoxicação, 15% de hepatopatia e 2% de nefropatia. Os sinais de hepatotoxicidade foram mais frequentes em homens. As diferenças entre sexos foram todas estatisticamente significantes. Com relação à APS, apenas o atributo "grau de afiliação" apresentou escore elevado. Nenhum dos casos de intoxicação detectados no estudo tinha diagnóstico prévio. CONCLUSÕES A despeito de uma alta cobertura da Estratégia Saúde da Família, o risco ocupacional e suas consequências não têm sido detectados pelos serviços de saúde, que se apresentam como não orientados à atenção primária, carecendo mesmo de seus atributos essenciais. Percebe-se a necessidade de adequação imediata e efetiva das políticas públicas no que concerne à saúde do trabalhador rural, com adequada capacitação das equipes e revisão da carteira de serviços da APS ofertados.