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3.
J Prim Care Community Health ; 11: 2150132720936858, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32578477

RESUMO

Objective: Social distancing and hand washing with soap and water have been advocated as the main proactive measures against the spread of coronavirus. We sought to find out what other alternative materials and methods would be used among populations without running water and who may not afford alcohol-based sanitizers. Results: We reviewed studies that reported use of sand, soil, ash, soda ash, seawater, alkaline materials, and sunlight as possible alternatives to handwashing with soap and water. We identified the documented mechanism of actions of these alternative wash methods on both inanimate surfaces and at cellular levels. The consideration of use of these alternative locally available in situations of unavailability of soap and water and alcohol-based sanitizers is timely in the face of coronavirus pandemic. Further randomized studies need to be carried out to evaluate the effectiveness of these alternatives in management of SARS-Cov-2.


Assuntos
Infecções por Coronavirus/prevenção & controle , Desinfecção das Mãos/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Áreas de Pobreza , Infecções por Coronavirus/epidemiologia , Higienizadores de Mão/economia , Humanos , Quênia/epidemiologia , Metanálise como Assunto , Pneumonia Viral/epidemiologia , Revisões Sistemáticas como Assunto , Abastecimento de Água/estatística & dados numéricos
4.
Indian J Ophthalmol ; 68(6): 981-983, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32461409

RESUMO

Since the onset of the COVID-19 pandemic, there has been an advisory for regular and thorough cleaning of hands besides other measures such as social distancing and self-isolation. The rationale for the same is to prevent the transfer of the virus from hands that have come in contact with fomites. While both alcohol-based hand rubs (ABHR) or washing with soap and water are claimed to have been effective, hand sanitizers have gained more popularity due to the ease of use. The increased frequency of ABHR use and the aerosols generated pose a potential threat to the skin and exposed mucosal surfaces, especially that of the eye due to the proximity of use. The adverse effects of alcohol in these sanitizers can be manifold. An allergic or inflammatory response can occur depending on the predisposing or preexisting conditions. This article describes the risks, underlying mechanisms, and preventive measures for sanitizer aerosol-driven ocular surface disease.


Assuntos
Aerossóis/efeitos adversos , Betacoronavirus , Conjuntivite Alérgica/induzido quimicamente , Infecções por Coronavirus/epidemiologia , Higienizadores de Mão/efeitos adversos , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Conjuntivite Alérgica/diagnóstico , Infecção Hospitalar/prevenção & controle , Feminino , Humanos , Telemedicina
5.
Alcohol Alcohol ; 55(4): 354-356, 2020 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-32400852

RESUMO

AIM: In view of the increase in the use of ethanol-containing hand sanitizers throughout the world due to the current COVID-19 pandemic, we wished to review the possible risks to patients treated with disulfiram, following a case report in which an apparent DER (disulfiram-ethanol reaction) was attributed to the cutaneous absorption of alcohol from hand sanitizers as well as by inhalation of vapour. METHOD: Simple experiments to assess the levels of absorption by each route separately. RESULTS: Our results strongly suggest that while amounts of alcohol sufficient to cause a DER may be inhaled when hand sanitizers are used in confined spaces, absorption can be avoided by dispersal of the fumes, and absorption from the skin alone does not occur in pharmacologically significant quantities. CONCLUSION: Warnings about absorption of alcohol through the skin from hand sanitizers and products such as perfumes, deodorants and after-shave (whose use is often warned against when disulfiram is prescribed) should be modified accordingly.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Dissulfiram/efeitos adversos , Dissulfiram/química , Etanol/química , Etanol/farmacocinética , Higienizadores de Mão/efeitos adversos , Higienizadores de Mão/farmacocinética , Pneumonia Viral/complicações , Administração por Inalação , Testes Respiratórios/métodos , Dissulfiram/farmacocinética , Dissulfiram/uso terapêutico , Etanol/administração & dosagem , Etanol/efeitos adversos , Higienizadores de Mão/administração & dosagem , Higienizadores de Mão/química , Humanos , Pandemias , Absorção Cutânea/efeitos dos fármacos
6.
Sr Care Pharm ; 35(6): 243-246, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32456753

RESUMO

The COVID-19 pandemic is a rapidly evolving phenomenon that presents serious practical challenges and complex clinical considerations for health care workers, health care administrators, and policy formulators. The Senior Care Pharmacist carries periodic updates addressing matters relevant to pharmacotherapeutics and pharmacy practice as these relate to the care of older people in the time of the pandemic. The brief news items that are provided here are not intended to be substitutes for a careful and comprehensive consideration of the issues involved, but rather, they serve to provide initial awareness of concepts and to stimulate more complete situational analysis.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Higienizadores de Mão , Pandemias , Pneumonia Viral , Infecções por Coronavirus/terapia , Higienizadores de Mão/provisão & distribução , Humanos , Pneumonia Viral/terapia
7.
Contact Dermatitis ; 83(2): 108-114, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32452036

RESUMO

BACKGROUND: As a result of the COVID-19 outbreak, hygiene regulations have been revised and hand sanitation has been intensified. OBJECTIVE: To investigate the onset of hand eczema during the COVID-19 pandemic in healthcare workers (HCWs) directly involved in intensive care of COVID-19 patients and HCWs without direct contact with COVID-19 patients. Hereby, we aim at increasing awareness about occupational hand eczema and preventive measures that can be adopted. METHOD: A survey was distributed amongst 114 HCWs at a single surgical centre and at a COVID-19 intensive care unit of the university hospital Ludwig Maximilian University Munich, Germany. Participants were questioned about the daily frequency of hand hygiene prior to and during the pandemic. Participants self-reported the onset of hand eczema and associated symptoms. RESULTS: Our study revealed a significant increase in hand washing, disinfection, and use of hand cream across all participants (P-value <.001), regardless of having direct contact with COVID-19 patients. A high prevalence of symptoms associated with acute hand dermatitis of 90.4% was found across all HCWs, whereas hand eczema itself was underreported (14.9%). CONCLUSION: The increase in hand sanitation during the COVID-19 pandemic impairs the skin of the hands across all HCWs, independent of direct intensive care of affected patients.


Assuntos
Infecções por Coronavirus/prevenção & controle , Dermatite Ocupacional/epidemiologia , Eczema/epidemiologia , Dermatoses da Mão/epidemiologia , Desinfecção das Mãos/tendências , Higienizadores de Mão/uso terapêutico , Pessoal de Saúde/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Creme para a Pele/uso terapêutico , Adulto , Asma/epidemiologia , Betacoronavirus , Comorbidade , Infecções por Coronavirus/terapia , Dermatite Atópica/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Hipersensibilidade Tardia/epidemiologia , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Médicos/estatística & dados numéricos , Pneumonia Viral/terapia , Prevalência , Rinite Alérgica/epidemiologia
9.
PLoS One ; 15(4): e0230573, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32255783

RESUMO

Hand hygiene is the simplest and most effective measure for preventing healthcare-associated infections. Despite the simplicity of this procedure and advances made in infection control, hospital health care workers' compliance to hand hygiene recommendations is generally low. Nurses have the most frequent patient care interactions, and thus more opportunities to practice hand hygiene. As such, it is important to identify and understand determinants of nurses' reported compliance. Formative research was undertaken to assess the potential impact of several unexamined factors that could influence HH among nurses: professional role and status, social affiliation, social norms, and physical modifications to the work environment (as well as institutional factors like safety climate). A survey questionnaire was developed primarily to inform the creation of a behaviour change intervention. The survey looked at how these factors influence HH among nurses and sought to identify barriers and levers to reported hand hygiene. It was administered to a survey panel of acute care nurses, working in US hospitals, with a year or more of experience. Multivariate regression modelling suggested that reported hand hygiene compliance was most likely to be a function of a hospital management's communication openness, perceived performance by peers, increased interactions with patients and other staff members, and the reduction in stress, busyness, and cognitive load associated with role performance. A powerful, effective intervention on HH among nurses therefore could be directed at improving communication openness, consider the impact of perceived performance by peers, increase interactions with patients and staff, and determine how to reduce the stress and cognitive load associated with role performance.


Assuntos
Higiene das Mãos , Pessoal de Saúde/psicologia , Adulto , Idoso , Infecção Hospitalar/prevenção & controle , Feminino , Higienizadores de Mão/uso terapêutico , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
10.
Contact Dermatitis ; 82(1): 1-9, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31373027

RESUMO

BACKGROUND: Recent studies provide evidence for significant and previously underestimated barrier damaging effects of repeated exposure to 60% n-propanol in healthy skin in vivo. OBJECTIVES: To investigate further the cumulative effects of a range of n-propanol concentrations relevant at the workplace in healthy and atopic dermatitis (AD) individuals, and study the modulation of the outcomes by co-exposure and host-related factors. METHODS: Healthy adult and AD volunteers were exposed to n-propanol concentrations from 30% to 75% in occlusion-modified tandem repeated irritation test with measurements of erythema, transepidermal water loss, capacitance, and the natural moisturizing factor (NMF) levels at baseline and after 96 hours. RESULTS: n-Propanol exerted significant barrier damaging effects even at the lowest concentration in both groups. Exposure to all n-propanol concentrations significantly reduced the NMF levels. Preceding low-grade trauma by occlusion/water exposure reduced the skin irritation threshold in both groups. The differences in the severity of the barrier function impairment after exposure to the same concentrations under the same conditions between the AD and control groups were significant. CONCLUSIONS: The negative effects of cumulative exposure to n-propanol in healthy and atopic skin shown in the study suggest the need for critical re-evaluation of its irritant properties in vivo.


Assuntos
1-Propanol/efeitos adversos , Dermatite Atópica/induzido quimicamente , Dermatite Irritante/etiologia , Dermatite Ocupacional/etiologia , Higienizadores de Mão/efeitos adversos , Exposição Ocupacional/efeitos adversos , Perda Insensível de Água/efeitos dos fármacos , Adulto , Estudos de Casos e Controles , Dermatite Atópica/diagnóstico , Dermatite Irritante/diagnóstico , Dermatite Ocupacional/diagnóstico , Feminino , Humanos , Masculino , Fatores de Risco , Testes Cutâneos
12.
Am J Trop Med Hyg ; 101(6): 1446-1455, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31701861

RESUMO

Schoolchildren are commonly linked to influenza transmission. Handwashing with soap has been shown to decrease infections; however, improving handwashing practices using soap and water is difficult in low-resource settings. In these settings, alternative hygiene options, such as hand sanitizer, could improve handwashing promotion to reduce influenza virus infections. We conducted a cluster randomized control trial in 24 primary schools in Dhaka to assess the effectiveness of hand sanitizer and a respiratory hygiene education intervention in reducing influenza-like illness (ILI) and laboratory-confirmed influenza during June-September 2015. Twelve schools were randomly selected to receive hand sanitizer and respiratory hygiene education, and 12 schools received no intervention. Field staff actively followed children daily to monitor for new ILI episodes (cough with fever) through school visits and by phone if a child was absent. When an illness episode was identified, medical technologists collected nasal swabs to test for influenza viruses. During the 10-week follow-up period, the incidence of ILI per 1,000 student-weeks was 22 in the intervention group versus 27 in the control group (P-value = 0.4). The incidence of laboratory-confirmed influenza was 53% lower in the intervention schools (3/1,000 person-weeks) than in the control schools (6/1,000 person-weeks) (P-value = 0.01). Hand sanitizer and respiratory hygiene education can help to reduce the risk of influenza virus transmission in schools.


Assuntos
Desinfecção das Mãos , Comportamentos Relacionados com a Saúde , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Estudantes/estatística & dados numéricos , Bangladesh , Criança , Pré-Escolar , Feminino , Higienizadores de Mão/farmacologia , Humanos , Incidência , Influenza Humana/diagnóstico , Masculino , Instituições Acadêmicas , Sabões/farmacologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-31703325

RESUMO

Blood pressure cuffs (BP cuffs) have been implicated in some nosocomial outbreaks. We compared the efficacy of an ethanol-based hand sanitizer (EBHS) with a detergent/disinfectant for the disinfection of BP cuffs. The inner sides of 30 BP cuffs were sampled for bacterial culture. Then, the same area was divided into halves. One half was disinfected by a detergent/disinfectant and the other was disinfected by an EBHS. The bacterial count decreased significantly with both disinfectants (p < 0.0001 compared with before disinfection). The bacterial count decrease seemed greater with the EBHS compared with the detergent/disinfectant, but the difference was not significant. Therefore, within the limits of a single application, the EBHS was an efficacious means of BP cuff disinfection. However, the repeated exposure to emollients contained in EBHS may require further studies before validating these results.


Assuntos
Determinação da Pressão Arterial/instrumentação , Desinfetantes/farmacologia , Desinfecção/métodos , Etanol/farmacologia , Higienizadores de Mão/farmacologia , Bactérias/efeitos dos fármacos , Bactérias/crescimento & desenvolvimento , Carga Bacteriana , Pressão Sanguínea
14.
Anesth Analg ; 129(6): 1549-1556, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31743174

RESUMO

BACKGROUND: Frequent hand hygiene by anesthesia personnel may be an important factor in reducing contamination of IV lines and medication access ports and may reduce hospital-acquired infections. Measurement of hand hygiene frequency at the individual clinician level by direct observation or electronic devices is cumbersome and expensive. We developed and validated a simple method for estimating hand hygiene frequency by individual anesthesia providers and utilized it in a quality improvement initiative to increase hand hygiene use. METHODS: Pump-style, alcohol-based hand hygiene container weight at the anesthesia work station was measured before and after each surgical operation and converted to estimated number of accesses (pumps) per hour. Video observation was used to validate the estimated hand hygiene use. A quality improvement initiative utilized periodic measurement of hand hygiene frequency via the validated method, and incorporated individual provider feedback, email reminders, monthly departmental performance reports, and reminders in the electronic anesthesia record. Segmented linear regression was used to evaluate the effect of the intervention on hand hygiene use. RESULTS: Delivered product per pump was consistent for containers at least half-full and averaged (mean ± SD) 0.92 ± 0.13 g per pump. Video observation in 26 cases showed a strong correlation between observed hand hygiene episodes and estimated hand hygiene use frequency based on weight change of the container (linear regression, R = 0.97, P < .0001). Median hand hygiene frequency was near 0 at baseline but increased progressively throughout the intervention period (segmented linear regression, overall R = 0.76, P < .0001; change of intercept or mean hand hygiene after initiation of intervention [parameter estimate ± SE] [0.970 ± 0.29], P = .0008). CONCLUSIONS: A low-cost, simple method for measuring individual anesthesia clinician use of hand hygiene intraoperatively based on container weight change is feasible and sufficiently accurate to support a quality improvement initiative to increase its use.


Assuntos
Anestesiologistas , Atitude do Pessoal de Saúde , Desinfecção das Mãos , Higienizadores de Mão , Conhecimentos, Atitudes e Prática em Saúde , Controle de Infecções/métodos , Padrões de Prática Médica , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde , Humanos , Reprodutibilidade dos Testes , Fatores de Tempo , Gravação em Vídeo , Pesos e Medidas
15.
Anesth Analg ; 129(6): 1557-1560, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31743175

RESUMO

BACKGROUND: Anesthesia providers' hand hygiene practices in the operating room may contribute to the transmission of bacteria. There is a debate, however, over the best approaches for pathogen containment during task dense periods (induction and extubation) of anesthesia care. A novel approach to reducing pathogen spread during these task dense periods is the use of alcohol-based hand rub on gloves when it may be difficult to either change gloves or clean hands. METHODS: To evaluate the impact of alcohol-based hand rub on gloves, we estimated perforation rates of 50 gloves that were worn as pairs by volunteers for 2 hours at a time applying alcohol-based hand rub every 15 minutes (total of 8 alcohol-based hand rub applications per pair of gloves). We also identified perforation rates of 50 new, unused gloves. To evaluate the ability to perform routine anesthesia functions, volunteers were asked to pick up a coin from a table top and document whether the gloves felt normal or sticky at each 15-minute period. RESULTS: Fifty new gloves (not exposed to alcohol-based hand rub) were tested for integrity using the Food and Drug Administration-approved process, and one was found to have a microperforation. Of the 50 gloves that had been applied with alcohol-based hand rub 8 times, no microperforations were identified. All volunteers demonstrated tactile competence by picking up a coin from a table top after 8 alcohol-based hand rub applications; in addition, as the number of alcohol-based hand rub applications progressed, the volunteers reported increased stickiness. CONCLUSIONS: This study suggests that the use of alcohol-based hand rub on commonly used nitrile examination gloves does not compromise glove integrity or hamper the ability to safely perform routine anesthesia functions.


Assuntos
Anestesiologistas , Contaminação de Equipamentos/prevenção & controle , Etanol , Luvas Cirúrgicas , Desinfecção das Mãos/métodos , Higienizadores de Mão , Controle de Infecções/métodos , Salas Cirúrgicas , Atitude do Pessoal de Saúde , Falha de Equipamento , Etanol/efeitos adversos , Luvas Cirúrgicas/efeitos adversos , Higienizadores de Mão/efeitos adversos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Teste de Materiais , Padrões de Prática Médica , Percepção do Tato
16.
Anesth Analg ; 129(6): e182-e184, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31743176

RESUMO

Anesthesia providers have the burden of constant hand hygiene during task dense periods. The requirement for hand hygiene often demands frequent application of alcohol-based hand rub. To assess whether frequent alcohol-based hand rub use leads to skin changes or irritant contact dermatitis, volunteers cleaned their hands with alcohol-based hand rub every 15 minutes for 8 hours for 5 sequential days. They were examined by a dermatologist before and after and asked about subjective skin changes. Results suggest an increase in irritant contact dermatitis scores and subjective complaints.


Assuntos
Anestesiologistas/normas , Dermatite de Contato/etiologia , Dermatite Ocupacional/etiologia , Fidelidade a Diretrizes/normas , Desinfecção das Mãos/normas , Higienizadores de Mão/efeitos adversos , Controle de Infecções/métodos , Exposição Ocupacional/efeitos adversos , Guias de Prática Clínica como Assunto/normas , Padrões de Prática Médica/normas , Dermatite de Contato/diagnóstico , Dermatite Ocupacional/diagnóstico , Humanos , Salas Cirúrgicas/normas , Distribuição Aleatória , Medição de Risco , Fatores de Risco , Organização Mundial da Saúde
18.
J Orthop Surg Res ; 14(1): 166, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146763

RESUMO

BACKGROUND: Bone fractures are one of the most common injuries in the USA. Fiberglass tape is a commonly used casting material, and many medical professionals apply adjuvants including liquid hand soap, foam sanitizers, and ultrasound gel in the hopes of improving outcomes relating to ease of molding and eventual strength, lamination, and smoothness of cast material. However, the efficacy of these agents to improve fiberglass cast mechanics has not been scientifically evaluated. The purpose of this study was to assess the mechanical effects of commonly used adjuvants on fiberglass cast materials. METHODS: Studies compared regularly shaped samples of water-activated, untreated fiberglass tape (Ossur Techform Premium) to water-activated fiberglass tape treated with one of three commonly used adjuvants (liquid soap, foam hand sanitizer, or ultrasound gel) during lamination. Material stiffness, yield stress, and ultimate load were measured by 3-point bending. RESULTS: These studies demonstrated that that liquid soap and ultrasound gel did not affect fiberglass tape mechanical properties, but alcohol-based foam sanitizer significantly reduced stiffness (- 32.8%), yield stress (- 33.6%), and ultimate load (- 31.0%) of the cast material as compared to the control group. Regression slopes were not significantly different between groups, suggesting that no adjuvants improved material curing time. CONCLUSIONS: These data suggest that the application of adjuvants is not beneficial and potentially harmful to fiberglass cast behavior. Despite the widespread practice of adjuvant application by medical professionals during casting, results from the current study suggest that use of these agents for structural enhancement of fiberglass casts is not beneficial and should largely be discouraged.


Assuntos
Moldes Cirúrgicos , Géis/administração & dosagem , Vidro , Higienizadores de Mão/administração & dosagem , Teste de Materiais/métodos , Sabões/administração & dosagem , Moldes Cirúrgicos/normas , Fraturas Ósseas/terapia , Vidro/normas , Humanos
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