[Factors associated with the risk of COVID-19 in health-care workers]. / Factores asociados al riesgo de COVID-19 en el personal de salud.

BACKGROUND: Although healthcare personnel are considered a high-risk group for SARS-CoV-2 infection due to their exposure, research on the factors associated with their infection is limited. The objective was to identify factors associated with the acquisition of COVID-19 in healthcare personnel. METHODS: a multicenter, cross-sectional study with nested cases and controls was carried out in 23 hospitals in Argentina. A structured survey was used to collect demographic, institutional and behavioral variables from healthcare personnel with positive RT-PCR for SARS-CoV2 (cases) and healthcare personnel with negative test results (controls). Those variables significantly associated with the condition of having had COVID-19 in the bivariate analysis were included in a multivariate analysis. RESULTS: A total of 2088 workers participated in the study, with an incidence of 1.41 cases per 10 000 worker-hours (95%CI 1.35-1.48). Being male, (OR 1.60; 95%CI 1.32-1.95), working in social security, (OR 1.53; 95%CI 1.13-2.07), being nursing staff, (OR 1.46; 95%CI 1.22-1.74), having personal protective equipment, (OR 0.33; 95%CI 0.18-0.62), sharing unprotected common spaces with other workers, (OR 1.98; 95%CI 1. 60-2.44), living with people confirmed or suspected of COVID-19 (OR 1.69; 95%CI 1.37-2.09), sharing infusions or other drinks and/or food with people in the community (OR 1.31; 95%CI 1.02-1.70), feeling distressed (OR 1.85; 95%CI 1.55-2.21) and were independently associated with the risk of acquiring COVID-19. DISCUSSION: This study allowed us to identify different potentially modifiable factors on which action should be taken to reduce the risk of acquiring COVID-19 by the healthcare personnel.

Introducción: Aunque, el personal sanitario es considerado por su exposición un grupo de alto riesgo de infección por SARS-CoV-2, la investigación sobre los factores asociados a infección resulta limitada. El objetivo fue identificar los factores asociados a la adquisición de COVID-19 en el personal sanitario. Materiales y métodos: Estudio multicéntrico, de corte transversal con casos y controles anidados, en 23 hospitales de Argentina. A través de una encuesta estructurada se recolectaron variables demográficas, institucionales y conductuales del personal sanitario con RT-PCR positiva para SARS-CoV-2 (casos) y del personal sanitario con resultados negativos en el test (controles). Aquellas variables asociadas significativamente con la condición de haber padecido COVID-19 en el análisis bivariado fueron incluidas en un análisis multivariado. Resultados: Participaron del estudio 2088 trabajadores, con una incidencia de 1.41 casos c/10 000 horas-trabajador (IC95% 1.35-1.48). Pertenecer al sexo masculino (OR 1.60; IC95% 1.32-1.95), trabajar en la seguridad social (OR 1.53; IC95% 1.13-2.07), ser personal de enfermería (OR 1.46; IC95% 1.22-1.74), contar con elementos de protección personal (OR 0.33; IC95% 0.18-0.62), compartir con otros trabajadores espacios comunes sin protección (OR 1.98; IC95% 1.60-2.44), convivir con personas confirmadas o sospechadas de COVID-19 (OR 1.69; IC95% 1.37-2.09), compartir infusiones u otras bebidas y/o alimentos con personas de la comunidad (OR 1.31; IC95% 1.02-1.70), sentirse angustiado (OR 1.85; IC95% 1.55-2.21) se asociaron independientemente con el riesgo de adquirir COVID-19. Discusión: Este estudio permitió identificar distintos factores potencialmente modificables, sobre los cuales se debería actuar para reducir el riesgo de COVID-19 en el personal sanitario.

Factores asociados al riesgo de COVID-19 en el personal de salud / Factors associated with the risk of COVID-19 in health-care workers

Resumen Introducción: Aunque, el personal sanitario es considerado por su exposición un grupo de alto riesgo de infección por SARS-CoV-2, la investigación sobre los factores asociados a infección resulta limitada. El objetivo fue identificar los factores asociados a la adquisición de COVID-19 en el personal sanitario. Materiales y métodos: Estudio multicéntrico, de corte transversal con casos y controles anidados, en 23 hospitales de Argentina. A través de una encuesta estructurada se recolectaron variables demográficas, ins titucionales y conductuales del personal sanitario con RT-PCR positiva para SARS-CoV-2 (casos) y del personal sanitario con resultados negativos en el test (controles). Aquellas variables asociadas significativamente con la condición de haber padecido COVID-19 en el análisis bivariado fueron incluidas en un análisis multivariado. Re sultados: Participaron del estudio 2088 trabajadores, con una incidencia de 1.41 casos c/10 000 horas-trabajador (IC95% 1.35-1.48). Pertenecer al sexo masculino (OR 1.60; IC95% 1.32-1.95), trabajar en la seguridad social (OR 1.53; IC95% 1.13-2.07), ser personal de enfermería (OR 1.46; IC95% 1.22-1.74), contar con elementos de protección personal (OR 0.33; IC95% 0.18-0.62), compartir con otros trabajadores espacios comunes sin protección (OR 1.98; IC95% 1.60-2.44), convivir con personas confirmadas o sospechadas de COVID-19 (OR 1.69; IC95% 1.37-2.09), compartir infusiones u otras bebidas y/o alimentos con personas de la comunidad (OR 1.31; IC95% 1.02-1.70), sentirse angustiado (OR 1.85; IC95% 1.55-2.21) se asociaron independientemente con el riesgo de adquirir COVID-19. Discusión: Este estudio permitió identificar distintos factores potencialmente modificables, sobre los cuales se debería actuar para reducir el riesgo de COVID-19 en el personal sanitario.

Abstract Background: Although healthcare personnel are considered a high-risk group for SARS-CoV-2 infection due to their exposure, research on the factors associated with their infection is limited. The objec tive was to identify factors associated with the acquisition of COVID-19 in healthcare personnel. Methods: a multicenter, cross-sectional study with nested cases and controls was carried out in 23 hospitals in Argentina. A structured survey was used to collect demographic, institutional and behavioral variables from healthcare personnel with positive RT-PCR for SARS-CoV2 (cases) and healthcare personnel with negative test results (controls). Those variables significantly associated with the condition of having had COVID-19 in the bivariate analysis were included in a multivariate analysis. Results: A total of 2088 workers participated in the study, with an incidence of 1.41 cases per 10 000 worker-hours (95%CI 1.35-1.48). Being male, (OR 1.60; 95%CI 1.32-1.95), working in social security, (OR 1.53; 95%CI 1.13-2.07), being nursing staff, (OR 1.46; 95%CI 1.22- 1.74), having personal protective equipment, (OR 0.33; 95%CI 0.18-0.62), sharing unprotected common spaces with other workers, (OR 1.98; 95%CI 1. 60-2.44), living with people confirmed or suspected of COVID-19 (OR 1.69; 95%CI 1.37-2.09), sharing infusions or other drinks and/or food with people in the community (OR 1.31; 95%CI 1.02-1.70), feeling distressed (OR 1.85; 95%CI 1.55-2.21) and were independently associated with the risk of acquiring COVID-19. Discussion: This study allowed us to identify different potentially modifiable fac tors on which action should be taken to reduce the risk of acquiring COVID-19 by the healthcare personnel.

Training Habits of Eumenorrheic Active Women during the Different Phases of Their Menstrual Cycle: A Descriptive Study.

The purpose of this study was to examine the training habits of eumenorrheic active women during their menstrual cycle (MC), and its perceived influence on physical performance regarding their athletic level. A group of 1250 sportswomen filled in a questionnaire referring to demographic information, athletic performance and MC-related training habits. Of the participants, 81% reported having a stable duration of MC, with most of them (57%) lasting 26-30 days. Concerning MC-related training habits, 79% indicated that their MC affects athletic performance, although 71% did not consider their MC in their training program, with no differences or modifications in training volume or in training intensity for low-level athletes (LLA) and high-level athletes (HLA) with hormonal contraceptive (HC) use. However, LLA with a normal MC adapted their training habits more, compared with HLA, also stopping their training (47.1% vs. 16.1%, respectively). Thus, different training strategies should be designed for HLA and LLA with a normal MC, but this is not so necessary for HLA and LLA who use HC. To sum up, training adaptations should be individually designed according to the training level and use or non-use of HC, always taking into account the pain suffered during the menstrual phase in most of the athletes.

A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial.

ISSUE: Hand hygiene is a cost-effective measure to reduce microbial transmission (Teare EL, Cookson B, French GL, et al. UK handwashing initiative. J Hosp Infect. 1999;43:1-3.) and is considered to be the most important measure to prevent healthcare-associated infections (Pittet D, Allegranzi B, Sax H, Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641-52). Unfortunately, the compliance rate of healthcare workers (HCWs) with recommended hand hygiene procedures is less than expected. INITIAL ASSESSMENT: In order to estimate the effect of a multimodal intervention on improving healthcare workers' compliance with hand hygiene in eleven intensive care units (ICUs) from 11 hospitals of Buenos Aires, a randomized cluster-stepped wedge trial was designed. CHOICE OF SOLUTION AND IMPLEMENTATION: A multimodal intervention was designed based on practices characterized by being evidence-based, low cost and suggested by qualitative research: (i) leadership commitment, (ii) surveillance of materials needed to comply with hand hygiene and alcohol consumption, (iii) utilization of reminders, (iv) a storyboard of the project and (v) feedback (hand hygiene compliance rate). EVALUATION: The study enrolled 705 participants, comprising nurses (66.4%), physicians (25.8%) and other HCW (7.8%) along 9 months of observation. Compliance with hand hygiene in the control group was 66.0% (2354/3565) vs. 75.6% (5190/6864) in the intervention group. Univariate analysis showed an association between the intervention and hand hygiene compliance (odds ratio, OR 1.17; 95% confidence interval (CI), 1.13-1.22). The effect was still present after adjustment by calendar's time and providers' characteristics-age, gender and profession (OR 1.08; 95% CI, 1.03-1.14). LESSONS LEARNED: His study supports that a multimodal intervention was effective to improve compliance with hand hygiene in ICUs.

Effect of disclosing agents in oral hygiene

La caries dental y la enfermedad periodontal constituyen un problema de salud oral, cuyo factor común es la placa bacteriana. Se ha recomendado utilizar agentes detectores como auxiliares de la higiene oral. El propósito de esta investigación fue evaluar el efecto de las sustancias reveladoras en la higiene oral. Se llevó a cabo un estudio doble ciego, aleatorio y cruzado, utilizando una solución de verde malaquita al 2 por ciento y los criterios del índice de placa de Quigley & Hein (1962). En la primera etapa, se conformaron trece grupos, siete de ellos usaron la técnica A (cepillado habitual con detector de placa y sin crema dental), y los otros seis grupos usaron la técnica B (cepillado normal sin detector ni crema dental). En la segunda etapa, los escolares se intercambiaron en el uso de las técnicas. No se encontraron diferencias significativas entre las técnicas empleadas. Se observaron diferencias significativas entre ambos grupos al cambiar de la primera a la segunda etapa. Los resultados de este estudio señalan que las sustancias reveladoras no juegan un papel crucial en la higiene oral. Se discuten algunas hipótesis explicativas relacionadas con los efectos motivacionales en los sujetos del estudio.