Analysis of aerosol production and aerosol dispersion during otologic surgery.

BACKGROUND: As a respiratory disease, the transmission of Coronavirus disease (COVID-19) is mainly caused by small droplets and aerosols. Healthcare personnel are particularly exposed during otologic surgery given the continuity with the nasopharynx, where the viral load is high, and the use of high-speed instruments. The purpose of the present study is to test a model of droplet dispersion produced in the performance of a drilling procedure on human bone to provide information about its distribution and size of the deposit in similar conditions to those of an operating theatre, to design different preventive measures. MATERIAL AND METHOD: A mastoidectomy and trans-labyrinthine approach were performed on an embalmed human corpse using for irrigation during drilling methylene blue dye in physiological saline solution (pss) at a concentration of 0.324 mg/mL. The distribution of the drops was stablished using semi-absorbent papers of size 52 cm × 42 cm covering the area around the dissection field to a radius of 150 cm and on the corpse at different heights to check vertical dispersion. The collected deposit material was analysed with the microscope at different magnification objectives. RESULTS: Droplets between 2 µm and 2.6 cm were obtained. The visualization of the coloured droplets in the horizontal plane at a magnification of 1.5 was detected at 150 cm from the focus of emission of milling particles. DISCUSSION: According to our study, bone drilling with high speed motors under continuous saline irrigation in a haemorrhagic surgical field increases the amount of aerosols exposing healthcare personnel to additional airbone particles. This risk does not end in the operating rooms as particles smaller than 2 µm can be suspended in the air for hours and could exit the operating theatre due to the use of positive pressure systems. Thus, the use of N95, FFP2, FFP3 or PAPRS should be considered and the development of hood systems to prevent the dispersion of aerosols during these procedures should be considered.

Immediate adverse reactions in the chemotherapy treatment of patients with cancer at an oncology day hospital.

A descriptive and cross-sectional study was performed to characterize the degree of immediate adverse reaction and the type of causative antineoplastic drug presented by 371 different patients treated for cancer at the oncology day hospital unit of the San Carlos Clinical Hospital (Madrid, Spain), during the period between January 2015 and December 2019. In the case series, 488 immediate adverse reactions secondary to chemotherapy toxicity were detected. The dominating factors were: Female sex, age from 51-70 years old, skin melanoma and the use of vinca alkaloids and analogs. Among the most frequent adverse reactions, the following stood out: Disorders of the nervous and musculoskeletal systems and of the connective tissue. There was a higher number of moderate adverse reactions (grade 2 according to the Common Terminology Criteria for Adverse Events Version 4.0) between the first and third chemotherapy cycles, with a latency period of between 6 and 15 min., generally lasting less than 30 min. Association with the degree of immediate adverse reaction (grade) has been observed in male subjects over 71 years of age, with soft tissue neoplasm type and monoclonal antibodies therapeutic group.

Observational Prospective Study to Determine the Efficacy of 'Non-Slip Socks' vs. 'Adequate Footwear' Regarding the Number of Falls Observed among Admitted Patients.

BACKGROUND: Fall prevention is an important indicator of the quality of patient care. Prevention includes the use of adequate footwear. Our objective is to determine the differences in the number of falls between patients with "adequate footwear" and "non slip socks", and their associated consequences, to support their use in the prevention of falls among hospitalized patients. METHODS: This is an observational prospective study on inpatient falls. Patient characteristics, fall circumstances, and injuries were collected through Clinical Report Forms, a review of fall reports, and medical records. Admitted patients over 18 years old were recruited from Geriatric and Internal Medicine Units over a brief period of 3 months. RESULTS: A total of 158 hospitalized patients were recruited. In total, 77 patients (48.73%) were assigned to the non-slip socks group, and 81 (51.27%) were assigned to the adequate footwear group. There were 21 falls during the study period, all of which were experienced by the adequate footwear group (p < 0.0001). The mean age of the patients who fell was 83.14 (range 60-100) years old. The most frequent reasons for admission among the patients who fell were COVID-19 infection (19%) and oncological complications (19%). Overall, 61.9% of patients had a high risk of falling. Most falls (76.1%) occurred in patient rooms, and most of these occurred while wandering around. The most frequent reason for falls was slipping (14/21). For 16 of 21 patients, falls did not have immediate consequences, while 5 had contusions and 1 suffered a wound. Nobody needed to be admitted to the ER or suffered external hemorrhages or loss of consciousness. CONCLUSIONS: Non-slip socks represent an adequate alternative to well-fitting rubber-soled footwear. It seems that non-slip socks could prevent falls among hospitalized patients; nevertheless, further studies are necessary to clarify their role in preventing hospital falls and reducing injury rates.

Descifrando narrativas contemporáneas sobre la salud y la enfermedad: el proyecto Madrasa / Deciphering Contemporary Narratives on Health and Disease: The Madrasa Project

OBJETIVO: describir el desarrollo del proyecto Madrasa y sus resultados tras dos años de implementación. METODOLOGÍA: proyecto de innovación docente llevado a cabo con metodología de Investigación-Acción Participativa y la participación de alumnos de los grados de Enfermería, Medicina y Antropología Social y Cultural de la Universidad de Granada. Resultados principales: se realizaron 10 círculos narrativos, 2 elucidarios y 2 visitas dialogadas, contando con 19 expertos invitados. Se registraron 1203 participantes (785 alumnos) en las actividades presenciales y los círculos narrativos experimentaron 8.400 visitas desde las plataformas digitales, con una satisfacción media del 84 %. Conclusión principal: el proyecto Madrasa ha logrado instaurar una pedagogía innovadora, apoyada en la transformación digital, con enfoque multidisciplinar, que contribuye a incorporar a la enseñanza reglada de los futuros profesionales de la salud y la antropología, de una forma transversal, competencias para el desarrollo del pensamiento crítico en el análisis de la diversidad de narrativas que se producen en torno a la salud y la enfermedad en el mundo contemporáneo

OBJECTIVE: to describe the development of the Madrasa project and its results after two years of implementation. METHODOLOGY: teaching innovation project carried out with Participatory Action Research methodology and the participation of students from the Nursing, Medicine and Social and Cultural Anthropology degrees at the University of Granada. MAIN RESULTS: 10 narrative circles, 2 elucidations and 2 dialogued visits were carried out, with 19 invited experts. 1203 participants (785 students) were registered in the face-to-face activities and the narrative circles experienced 8,400 visits from digital platforms, with an average satisfaction of 84%. Main conclusion: the Madrasa project has managed to establish an innovative pedagogy, supported by digital transformation, with a multidisciplinary approach, which contributes to incorporating into the regulated education of future health and anthropology professionals, in a transversal way, competences for the development of critical thinking in the analysis of the diversity of narratives that occur around health and disease in the contemporary world