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1.
Plast Reconstr Surg ; 147(5): 1087-1095, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33835086

RESUMEN

BACKGROUND: The coronavirus disease of 2019 (COVID-19) pandemic has widely affected rhinosurgery, given the high risk of contagion and the elective nature of the aesthetic procedure, generating many questions on how to ensure safety. The Science and Research Committee of the Rhinoplasty Society of Europe aimed at preparing consensus recommendations on safe rhinosurgery in general during the COVID-19 pandemic by appointing an international panel of experts also including delegates of The Rhinoplasty Society. METHODS: A Zoom meeting was performed with a panel of 14 international leading experts in rhinosurgery. During 3.5 hours, four categories of questions on preoperative safety measures in private practice and outpatient clinics, patient assessment before and during surgery, and legal issues were presented by four chairs and discussed by the expert group. Afterward, the panelists were requested to express an online, electronic vote on each category and question. The panel's recommendations were based on current evidence and expert opinions. The resulting report was circulated in an iterative open e-mail process until consensus was obtained. RESULTS: Consensus was obtained in several important points on how to safely restart performing rhinosurgery in general. Preliminary recommendations with different levels of agreement were prepared and condensed in a bundle of safety measures. CONCLUSION: The implementation of the panel's recommendations may improve safety of rhinoplasty by avoiding operating on nondetected COVID-19 patients and minimizing severe acute respiratory syndrome coronavirus 2 virus spread in outpatient clinics and operating rooms.


Asunto(s)
/prevención & control , Control de Infecciones/normas , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Cuidados Preoperatorios/normas , Rinoplastia/normas , Instituciones de Atención Ambulatoria/organización & administración , Instituciones de Atención Ambulatoria/normas , Procedimientos Quirúrgicos Ambulatorios/normas , /transmisión , Congresos como Asunto , Consenso , Procedimientos Quirúrgicos Electivos/normas , Humanos , Control de Infecciones/organización & administración , Pandemias/prevención & control , Cirujanos , Comunicación por Videocoferencia
2.
Int Nurs Rev ; 68(1): 9-11, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33891771

RESUMEN

Preparing the world to manage future pandemics must take priority. It is clear that we were not prepared for the COVID-19 pandemic which continues to cause great suffering around the world. Nurses and other health professionals everywhere must be involved in health policy planning and implementation of public health measures to combat this and future pandemics. Such preparation needs community policy involvement at grassroots levels and needs to be collaboratively instigated at international levels. The death so far of over 2000 nurses is unacceptable in this pandemic, and we need to better protect and sustain the workforce. The International Council of Nurses has been instrumental in data gathering of nurses' experiences during COVID-19. Key points from analysis of this data have been included in Second Progress Report of the World Health Organization's Independent Panel for Pandemic Preparedness and Response. This paper summarises the key messages from this report, as well as the nursing shortage. The International Council of Nurses resounds the call for massive investment in nursing education, leadership and jobs, as well as protection for our nurses on the frontlines of the pandemic.


Asunto(s)
/epidemiología , Rol de la Enfermera , Planificación en Desastres , Educación en Enfermería , Predicción , Humanos , Control de Infecciones/normas , Liderazgo , Pandemias , Sociedades de Enfermería , Organización Mundial de la Salud
3.
Radiol Technol ; 92(5): 487-502, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33903267

RESUMEN

In early 2020, the coronavirus disease 2019 (COVID-19) pandemic and its subsequent lockdown affected nearly the entire world. Imaging tests were found to be crucial for the diagnosis and evaluation of this new disease. Therefore, radiologic technologists began work on the frontlines, acquiring diagnostic images that helped determine the course of treatment for millions of patients. New infection control procedures were implemented, and technologists across the country provided high- quality care to patients with COVID-19 while learning ways to protect themselves from the virus in the process. This article discusses the basics of the disease, best infection control practices, and imaging findings associated with COVID-19.


Asunto(s)
/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Tecnología Radiológica , Humanos , Control de Infecciones/normas , Pandemias , Neumonía Viral/virología
4.
Medicine (Baltimore) ; 100(15): e25290, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847627

RESUMEN

ABSTRACT: Health care employees are the front liners whom are directly involved in the management of COVID-19 at high risk of developing psychological distress and other mental health illness. We aim to assess the burden of depression during this pandemic on health care employees treating COVID-19 in Saudi Arabia. We also will shed the light on the best solutions of how to encounter depression.A cross-sectional, hospital-based survey conducted via a region-stratified, 2-stage cluster sample was conducted for 554 participants in >15 hospitals from April 29, 2020, to June 30, 2020. Depression is measured using the established PHQ9 score system. We grade PHQ9 depression scores as: normal, 0 to 4, mild, 5 to 9, significant (moderate or severe), 10 to 27. χ2/Fisher exact test was used; significant association between level of depression and survey characteristics were made. P value <0.05 was considered statistically significant.A total of 554 participants completed the survey. A total of 18.9% (n = 105) were aged <29 years, 51.2% (n = 284) were between 30 to 39 years and female represent 70% of all participants. Of all participants, 53.7% (n = 298) were nurses, and 38.6% (n = 214) were physicians; 68.5% (n = 380) worked in central area hospitals in Saudi Arabia. No significant (P = .432, 95% confidence interval [CI]) association was observed between sex and depression classifications. However, female had high proportion of significant depression 75.0% (n = 76) was observed as compared to male 24.8% (n = 25). Depression was significant in Saudis 61.4% (n = 62) (P < .001, 95% CI) and medical staff who encountered corona patients 51.5% (n = 52) (P < .002, 95% CI). Hospital preparedness associated with more freedom of depression symptoms 69.1% (n = 199/288) (P < .001, 95% CI).Frontline young health care workers especially physician in Saudi Arabia reported a high rate of depression symptoms. Countermeasures for health care workers represent a key component for the mental and physical well-being as part of public health measures during this pandemic. Attention to hospital preparedness and adequacy of personal protective equipment contributed to milder depression symptoms. Further studies need to be conducted on crisis management and depression.


Asunto(s)
Ansiedad , Depresión , Personal de Salud , Control de Infecciones , Estrés Laboral , Adulto , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/prevención & control , /psicología , Estudios Transversales , Depresión/diagnóstico , Depresión/etiología , Depresión/prevención & control , Femenino , Personal de Salud/clasificación , Personal de Salud/psicología , Médicos Hospitalarios/psicología , Médicos Hospitalarios/estadística & datos numéricos , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Masculino , Salud Mental/estadística & datos numéricos , Salud Laboral/normas , Estrés Laboral/prevención & control , Estrés Laboral/psicología , Equipo de Protección Personal/provisión & distribución , Arabia Saudita/epidemiología
6.
Anticancer Res ; 41(4): 1903-1908, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33813395

RESUMEN

BACKGROUND/AIM: We employed a survey to the American Society of Plastic Surgeons (ASPS) to investigate the management of breast reconstruction across the US during the COVID-19 pandemic. PATIENTS AND METHODS: An electronic survey on breast reconstruction practice demographics, COVID-19-related restrictions on breast reconstruction, and pertinent dates of restrictions was employed. RESULTS: A total of 228 responses were obtained. Demographics were balanced for geography with most respondents located in either urban or suburban settings (91.2%). The majority proceeded with mastectomy/reconstruction as originally planned (39.0%), followed by hormonal/chemotherapy only (22.6%). The most common reconstructive option was tissue expander/implant-based reconstruction (47.7%). Most institutions implemented restrictions between March 11-20th (59%). Almost all respondents (91.8%) reported mandatory pre-operative SARS-Cov-2 testing once cases resumed. CONCLUSION: COVID-19 has forced the breast surgical team to adapt to new conditions to the detriment of women with breast cancer requiring reconstruction. Varying restrictions have limited access to breast reconstruction, carrying consequences yet to be determined.


Asunto(s)
/epidemiología , Mamoplastia/estadística & datos numéricos , Mastectomía/estadística & datos numéricos , Pandemias , Pautas de la Práctica en Medicina/estadística & datos numéricos , Implantes de Mama/estadística & datos numéricos , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Estudios Transversales , Femenino , Humanos , Control de Infecciones/normas , Cuarentena , Cirujanos/estadística & datos numéricos , Encuestas y Cuestionarios , Dispositivos de Expansión Tisular/estadística & datos numéricos , Estados Unidos/epidemiología
8.
Ann Palliat Med ; 10(3): 3452-3458, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33849129

RESUMEN

The novel coronavirus disease 2019 (COVID-19) epidemic broke out in 2019, it is highly contagious, and the infection rate among medical staff is high. The management of infection prevention and control during emergency surgery of COVID-19 patients has been outlined and the perioperative infection management checklist for emergency surgery of COVID-19 patients has been summarized and validated. There have been 13 emergency surgeries performed on COVID-19 patients at our hospital during this time. Two cases were cured and discharged, and the others were discharged after improvement and transferred to further rehabilitation, 30-day mortality of the emergency surgical is 0%. Once the emergency surgery protocol in the hospital is successfully established, emergency surgery can be performed as soon as the surgical planning decision is made, and the operating room can be prepared for use at any time. The incidence of surgical site infection (SSI) was largely higher than that of ordinary patients in the same time; however, the successful implementation of emergency surgery for COVID-19 had positive significance in reducing the incidence of death, risk of bleeding, and hypoxia. The current cumulative cure rate of COVID-19 in our hospital is 98%, patient mortality rate is 0%, and the incidence of COVID-19 infection in medical staff is 0%. The emergency surgical infection management checklist is feasible and effective in guiding the preoperative and intraoperative surgical procedures.


Asunto(s)
Lista de Verificación , Servicio de Urgencia en Hospital , Control de Infecciones/normas , Procedimientos Quirúrgicos Operativos/normas , China , Humanos
9.
Ann Palliat Med ; 10(2): 2331-2337, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33725779

RESUMEN

Currently, the epidemics situation of COVID-19 is still grim. As a high-risk department, it is necessary to take corresponding prevention and control measures in the ophthalmology department. To guide the ophthalmology department of medical institutions to recover from the post-pandemic period of COVID-19, we designed relevant prevention and control strategies formulated by the National Health Committee, combined with our practical work of hospital pandemic management. The prevention and control strategies contained ward settings, channel design, allocation of protective equipment, screening of hospitalized patients, supervision-guided improvement, ward disinfection, the management of patients and escorts. There are 64 doctors and nurses who had standardized training during the post-pandemic period in the ophthalmology department. A total of 185 patients were admitted to the ophthalmology department of our institution, and 107 operations were successfully performed during that period. We made a follow-up visit two weeks after discharge to ask whether the patients had fever and/or other symptoms and whether he had been diagnosed with a COVID-19 case. Ultimately the ophthalmic ward was free of infection with the novel coronavirus. These showed that our prevention strategies were effective for ophthalmology department to defending COVID-19 in the process of recovering medical services.


Asunto(s)
Departamentos de Hospitales/organización & administración , Control de Infecciones/normas , Oftalmología/organización & administración , Pandemias , Hospitalización , Humanos
10.
Artículo en Inglés | MEDLINE | ID: mdl-33652711

RESUMEN

Pharmacists in the community and the essential requirement to safeguard their own health have become fundamental since the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aims of this paper were (I) to analyze the directives provided to pharmacists in 2020 regarding preventative safety measures to be adopted; (II) to determine the number of pharmacists who came into contact with SARS-CoV-2 in North-West Italy and relate this to the adopted preventative measures. The first aim was pursued by conducting a bibliographic research, consulting the principal regulatory sources. The second one was achieved with an observational study by administering a questionnaire and performing a serological test. The various protection measures imposed by national and regional legislation were analyzed. Two hundred and eighty-six pharmacists (about 8% of the invited ones) responded to the survey. Ten pharmacists reported a positive result to the serological test. Of the subjects who presented a positive result, three declared that they had not used a hand sanitizer, while two stated that they had not scheduled the cleaning and decontamination of surfaces. Two interviewees had not set up a system of quota restrictions on admissions. In four cases, a certified cleaning company had decontaminated the premises. The results of our study show that during the coronavirus disease 2019 (COVID-19) pandemic, the most pressing challenge for community pharmacists has been the protection of staff and clients inside the pharmacy; the challenge to be faced in the near future will probably be the management of new responsibilities.


Asunto(s)
/diagnóstico , Servicios Comunitarios de Farmacia/tendencias , Control de Infecciones/normas , Servicios Comunitarios de Farmacia/legislación & jurisprudencia , Estudios Transversales , Humanos , Italia/epidemiología , Pandemias , Estudios Seroepidemiológicos
11.
Pediatr Transplant ; 25(3): e13991, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33704869

RESUMEN

Coronavirus disease 2019 is a global pandemic, and to deal with the unexpected, enormous burden on healthcare system, liver transplantation (LT) services have been suspended in many centers. Development of robust and successful protocols in preventing the disease among the recipients, donors and healthcare workers would help in re-starting the LT programs. We adapted a protocol at our center, which is predominantly a living donor liver transplant center based in north India, and continued the service as the pandemic unfolded and peaked in India with good results and shared the experience of the same. Between March 24 and June 7, 2020, during the government-enforced public curfew-"lockdown"-7 children received LT. The protocols of infection control were drafted in our team by local customization of published guidelines. The number of pediatric LT done during the lockdown period in 2020 was similar to that done in corresponding pre-COVID period in 2019. The outcomes were of 100% survival, and none of recipients developed COVID. One potential donor was asymptomatic positive for COVID, responded well to conservative treatment, and was later accepted as a donor. LT program during the COVID pandemic can successfully function after putting in place standard protocols for infection control. These can be implemented with minimal extra involvement of healthcare infrastructure, hence without diversion of resources from COVID management. In conclusion, pediatric liver transplantation services can be continued amid COVID-19 pandemic after establishing a properly observed protocol with minimum additional resources.


Asunto(s)
/prevención & control , Accesibilidad a los Servicios de Salud/organización & administración , Control de Infecciones/normas , Trasplante de Hígado/normas , Adolescente , Niño , Preescolar , Protocolos Clínicos , Femenino , Política de Salud , Humanos , India/epidemiología , Lactante , Control de Infecciones/métodos , Trasplante de Hígado/métodos , Masculino , Evaluación de Resultado en la Atención de Salud , Pandemias , Estudios Retrospectivos
12.
JBRA Assist Reprod ; 25(2): 293-302, 2021 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-33710841

RESUMEN

COVID-19 has caused radical effects on the daily lives of millions of people. The causal agent of the current pandemic is SARS-CoV-2, a virus that causes symptoms related to the respiratory system, leading to severe complications. In the in vitro fertilization (IVF) universe, there are several protocols for infection control and laboratory safety. Some professional associations have issued guidelines recommending measures involving patient flow and IVF practices. This study presents a review and considerations for the resumption of activities in IVF laboratories and clinics in Brazil during the COVID-19 pandemic, according to the guidelines and statements from professional organizations and societies in reproductive medicine.


Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , Fertilización In Vitro , Control de Infecciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , /prevención & control , Niño , Preescolar , Fertilización In Vitro/legislación & jurisprudencia , Fertilización In Vitro/métodos , Fertilización In Vitro/normas , Humanos , Lactante , Control de Infecciones/legislación & jurisprudencia , Control de Infecciones/métodos , Control de Infecciones/normas , Laboratorios/legislación & jurisprudencia , Laboratorios/normas , Persona de Mediana Edad , Pandemias , Adulto Joven
13.
Simul Healthc ; 16(2): 153-154, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33780966

RESUMEN

SUMMARY STATEMENT: In light of the COVID-19 pandemic, protocols to reduce risk of exposure to healthcare teams have been implemented. The use of an acrylic box during intubation and cardiopulmonary resuscitation has been adopted worldwide. A study was conducted to assess the effectiveness of an acrylic box in limiting contamination. The findings indicate that healthcare workers are still vulnerable to exposure despite the use of personal protective equipment (PPE) and an acrylic box. The causes of contamination were related to improper PPE donning and doffing and incomplete coverage by the acrylic box. Institutions should focus on ensuring proper donning and doffing of PPE and incorporating high-fidelity simulation training to prepare teams to resuscitate COVID-19 patients.


Asunto(s)
/epidemiología , Reanimación Cardiopulmonar/métodos , Enseñanza Mediante Simulación de Alta Fidelidad/organización & administración , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal/normas , Líquidos Corporales , Personal de Salud/educación , Humanos , Control de Infecciones/normas , Pandemias
14.
Epidemiol Infect ; 149: e77, 2021 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-33762038

RESUMEN

Control of the novel COronaVIrus Disease-2019 (COVID-19) in a hospital setting is a priority. A COVID-19-infected surgeon performed surgical activities before being tested. An exposure risk classification was applied to the identified exposed subjects and high- and medium-risk contacts underwent active symptom monitoring for 14 days at home. All healthcare professionals (HCPs) were tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) at the end of the quarantine and serological tests were performed. Three household contacts and 20 HCPs were identified as high- or medium-risk contacts and underwent a 14-day quarantine. Fourteen HCPs and 19 patients were instead classified as low risk. All the contacts remained asymptomatic and all HCPs tested negative for SARS-CoV-2. About 25-28 days after their last exposure, HCPs underwent serological testing and two of them had positive IgM but negative confirmatory swabs. In a low COVID-19 burden area, the in-hospital transmission of SARS-CoV-2 from an infectious doctor did not occur and, despite multiple and frequent contacts, a hospital outbreak was avoided. This may be linked to the adoption of specific recommendations and to the use of standard personal protective equipment by HCPs.


Asunto(s)
/diagnóstico , Cirujanos , /etiología , Trazado de Contacto/instrumentación , Trazado de Contacto/métodos , Epidemiología , Humanos , Control de Infecciones/normas , Pandemias/prevención & control , Equipo de Protección Personal/normas
15.
JAMA Surg ; 156(4): 372-378, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33704389

RESUMEN

Importance: During the COVID-19 pandemic, wearing masks has become necessary, especially within health care. However, to our knowledge, the consequences of mask wearing on communication between surgeons and patients have not been studied. Objective: To evaluate the effects of clear vs standard covered masks on communication during surgical clinic encounters. Design: This randomized clinical trial examined communication between surgeons and their patients when surgeons wore clear vs covered masks in surgical outpatient clinics at a single academic medical center. New patients were recruited from participating surgeons' clinic schedules. Interventions: Surgeons wore either clear masks or covered masks for each clinic visit with a new patient, based on a per-visit randomization plan. Main Outcomes and Measures: The primary outcome measures included patient perceptions of (1) surgeon communication and (2) trust in surgeons, as well as (3) quantitative assessments and (4) qualitative assessments regarding patient impressions of the surgeon's mask. After the clinic encounter, patients completed a verbal survey including validated Clinician and Group Consumer Assessment of Healthcare Providers and Systems questions. Additional questions involved surgeon empathy, trust, and the patient's impression of the surgeon's mask. Data were analyzed by comparing patient data in the clear vs covered groups using Cochran-Mantel-Haenszel tests, and comments were analyzed for themes. Results: Two hundred patients were enrolled from 15 surgeons' clinics spanning 7 subspecialties. When surgeons wore a clear mask, patients rated their surgeons higher for providing understandable explanations (clear, 95 of 100 [95%] vs covered, 78 of 100 [78%]; P < .001), demonstrating empathy (clear, 99 [99%] vs covered, 85 [85%]; P < .001), and building trust (clear, 94 [94%] vs covered, 72 [72%]; P < .001). Patients preferred clear masks (clear, 100 [100%] vs covered, 72 [72%]; P < .001), citing improved surgeon communication and appreciation for visualization of the face. Conversely, 8 of 15 surgeons (53%) were unlikely to choose the clear mask over their standard covered mask. Conclusions and Relevance: This randomized clinical trial demonstrates that patients prefer to see their surgeon's face. Surgeons who wore clear masks were perceived by patients to be better communicators, have more empathy, and elicit greater trust. Because masks will remain part of the health care landscape for some time, deliberate attention to preserving communication within the surgeon-patient relationship is warranted. Trial Registration: ClinicalTrials.gov Identifier: NCT04595695.


Asunto(s)
/prevención & control , Control de Infecciones/normas , Máscaras/normas , Relaciones Médico-Paciente , Cirujanos , Adulto , Femenino , Humanos , Masculino , Pandemias
16.
Fertil Steril ; 115(4): 831-839, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33750621

RESUMEN

The coronavirus disease 2019 pandemic has resulted in many changes in how we interact in society, requiring that we protect ourselves and others from an invisible, airborne enemy called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Until a vaccine is developed, and it reaches high levels of distribution, everyone must continue to be diligent to limit the viral spread. The practice of assisted reproduction during this pandemic presents unique challenges in addition to the risks identified in general clinical care. The established good tissue practices employed in laboratories are not designed to protect gametes and embryos from an airborne virus, particularly one that may be shed by an asymptomatic staff member. Armed with theoretical risks but lacking direct evidence, assisted-reproduction teams must examine every aspect of their practice, identify areas at a risk of exposure to SARS-CoV-2, and develop a mitigation plan. Several professional fertility societies have created guidelines for the best practices in patient care during the coronavirus disease 2019 pandemic. As we learn more about SARS-CoV-2, updates have been issued to help adapt infection-control and -prevention protocols. This review discusses what is currently known about SARS-CoV-2 infection risks in assisted reproductive centers and recommends the implementation of specific mitigation strategies.


Asunto(s)
/prevención & control , Personal de Salud/normas , Control de Infecciones/normas , Equipo de Protección Personal/normas , Guías de Práctica Clínica como Asunto/normas , Técnicas Reproductivas Asistidas/normas , /epidemiología , Humanos , Control de Infecciones/métodos , Medición de Riesgo/métodos , Medición de Riesgo/normas , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/prevención & control , Síndrome Respiratorio Agudo Grave/transmisión
17.
World J Emerg Surg ; 16(1): 14, 2021 03 22.
Artículo en Inglés | MEDLINE | ID: mdl-33752721

RESUMEN

BACKGROUND: Since the COVID-19 pandemic has occurred, nations showed their unpreparedness to deal with a mass casualty incident of this proportion and severity, which resulted in a tremendous number of deaths even among healthcare workers. The World Society of Emergency Surgery conceived this position paper with the purpose of providing evidence-based recommendations for the management of emergency surgical patients under COVID-19 pandemic for the safety of the patient and healthcare workers. METHOD: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) through the MEDLINE (PubMed), Embase and SCOPUS databases. Synthesis of evidence, statements and recommendations were developed in accordance with the GRADE methodology. RESULTS: Given the limitation of the evidence, the current document represents an effort to join selected high-quality articles and experts' opinion. CONCLUSIONS: The aim of this position paper is to provide an exhaustive guidelines to perform emergency surgery in a safe and protected environment for surgical patients and for healthcare workers under COVID-19 and to offer the best management of COVID-19 patients needing for an emergency surgical treatment. We recommend screening for COVID-19 infection at the emergency department all acute surgical patients who are waiting for hospital admission and urgent surgery. The screening work-up provides a RT-PCR nasopharyngeal swab test and a baseline (non-contrast) chest CT or a chest X-ray or a lungs US, depending on skills and availability. If the COVID-19 screening is not completed we recommend keeping the patient in isolation until RT-PCR swab test result is not available, and to manage him/she such as an overt COVID patient. The management of COVID-19 surgical patients is multidisciplinary. If an immediate surgical procedure is mandatory, whether laparoscopic or via open approach, we recommend doing every effort to protect the operating room staff for the safety of the patient.


Asunto(s)
/prevención & control , Control de Infecciones/normas , Atención Perioperativa/normas , Procedimientos Quirúrgicos Operativos/normas , /diagnóstico , /transmisión , /normas , Urgencias Médicas , Salud Global , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Laparoscopía/métodos , Laparoscopía/normas , Pandemias , Atención Perioperativa/métodos , Equipo de Protección Personal , Procedimientos Quirúrgicos Operativos/métodos
19.
Hastings Cent Rep ; 51(2): 10-16, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33755216

RESUMEN

Covid-19 has infected thousands and killed hundreds in prisons, jails, and immigration detention facilities across the United States. Responding to this crisis, leading medical researchers have called for expanding opportunities for people in prison to participate in vaccine trials. These calls, like current regulations, focus on individualized risk assessments around consent, coercion, and harm, while ignoring the unnaturalness of deprivation conditions in U.S. prisons. We need new frameworks of analysis that refocus on structural, rather than individual, risk assessments. Integrating structural perspectives-including skepticism of claims of scarcity, avoidance of representational distortions, and attention to institutional agency-into our existing, overly individualistic frameworks might permit the design of more ethical research projects involving people who are incarcerated. Still, the unnatural deprivations of incarceration might be so great that research subjects might need to be removed from prison entirely in order to ethically participate in research.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Prisioneros/estadística & datos numéricos , Vacunación/métodos , Investigación Biomédica/ética , Investigación Biomédica/métodos , /prevención & control , /normas , Humanos , Control de Infecciones/normas , Selección de Paciente/ética , Medición de Riesgo , Factores de Riesgo , Estados Unidos/epidemiología , Poblaciones Vulnerables
20.
Clin Exp Optom ; 104(3): 267-284, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33769228

RESUMEN

Optometry Australia's infection control guidelines 2020 deliver a revision of the paper: Infection control guidelines for optometrists 2016. A review of recent literature was undertaken, with information collected from peer-reviewed journal articles, guidelines from professional societies, government health departments and instructions from equipment manufacturers. This information was used to provide an update on current infection control best practice. The guidelines are presented in two sections: standard precautions and transmission-based precautions. The standard (routine) precautions section covers: hand hygiene; personal protective equipment; safe handling and disposal of sharps; routine environmental cleaning; reprocessing of reusable equipment, instruments and contact lenses; respiratory hygiene and cough etiquette; aseptic and clean technique; and waste management. The transmission-based precautions section covers considerations for optometry staff and/or patients when standard precautions alone may not be sufficient to prevent the spread of an infectious agent; particularly relevant during the COVID-19 pandemic. Finally, a comprehensive list of disinfection or sterilisation techniques to use on reusable devices, instruments or equipment in optometric practice is provided in an Appendix.


Asunto(s)
/epidemiología , Oftalmopatías/epidemiología , Guías como Asunto , Control de Infecciones/normas , Pandemias , Australia/epidemiología , Comorbilidad , Humanos , Optometría
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