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1.
Texto & contexto enferm ; 29: e20200262, Jan.-Dec. 2020. tab, graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1127496

RESUMEN

ABSTRACT Objective: to map the production of knowledge about the recommendations that can be applied in managing patients diagnosed or suspected with COVID-19 in cardiorespiratory arrest. Method: a scoping review, according to the Joanna Briggs Institute (2020) guidelines. Search was performed in ten data sources, and two electronic search engines were used; from 2001 to 2020. Results: of the 547 studies found, 14 met the inclusion and exclusion criteria. Most studies were published in 2020 (35.7%), and most studies were conducted in Canada (21.4%). It is observed the use of a systematized care to identify the possible means of care that should be provided to patients who suffer a cardiorespiratory arrest in hospitals, such as the monitoring of suspected cases by assessing the victim's breathing and pulse and identifying arrhythmias and shockable rhythms quickly. Personal protective equipment must be used to protect against droplets and aerosols and respiratory etiquette. Conclusion: managing patients in cardiorespiratory arrest suspected or diagnosis with COVID-19 requiring cardiopulmonary resuscitation should be performed in isolation areas and with the use of adequate protective equipment. There are gaps in scientific productions so that they address more clearly and instructively management when performing cardiopulmonary resuscitation in patients suspected or diagnosed with COVID-19.


RESUMEN Objetivo: mapear la producción de conocimiento sobre las recomendaciones que se pueden aplicar en el manejo de un paciente diagnosticado o sospechoso de tener COVID-19 en paro cardíaco. Método: se trata de una revisión de alcance, de acuerdo con las directrices del Instituto Joanna Briggs (2020). La búsqueda se realizó en diez fuentes de datos y se utilizaron dos buscadores electrónicos; período de tiempo de 2001 a 2020. Resultados: de las 547 publicaciones encontradas, 14 cumplieron los criterios de inclusión y exclusión. La mayoría de los estudios se publicaron en el año 2020 (35,7%) y la mayoría de los estudios se realizaron en Canadá (21,4%). Se observa el uso de una atención sistemática para identificar las posibles vías de asistencia que se deben brindar a los pacientes que sufren una parada cardiorrespiratoria en el ámbito hospitalario, como monitorear los casos sospechosos de la enfermedad mediante la evaluación de la respiración y el pulso de la víctima e identificar rápidamente arritmias y ritmos desfibrilables. Cabe mencionar el uso de equipo de protección personal para protegerse de gotitas y aerosoles y conductas respiratorias específicas para estos casos. Conclusión: el manejo de pacientes en parada cardiorrespiratoria con COVID-19 sospechado o diagnosticado que requieran reanimación cardiopulmonar debe realizarse en áreas de aislamiento y con el uso de equipo de protección adecuado. Se observó que existen lagunas en las producciones científicas, por lo que se abordan de forma más clara e instructiva sobre el manejo al realizar reanimación cardiopulmonar en pacientes con sospecha o diagnóstico de COVID-19.


RESUMO Objetivo: mapear a produção de conhecimento sobre as recomendações que podem ser aplicadas no manejo de paciente diagnosticado ou com suspeita de COVID-19 em Parada Cardiorrespiratória. Método: trata-se de uma revisão de escopo, de acordo com as orientações do Instituto Joanna Briggs (2020). Realizada busca em dez fontes de dados, e utilizados dois buscadores eletrônicos; recorte temporal de 2001 a 2020. Resultados: das 547 publicações encontradas, 14 atenderam aos critérios de inclusão e exclusão. A maior parte dos estudos foi publicada no ano de 2020 (35,7%), e a maioria dos estudos foi realizada no Canadá (21,4%). Observa-se o uso de um cuidado sistematizado para identificação das possíveis vias de assistência que deverão ser prestadas a pacientes que sofrem uma parada cardiorrespiratória no ambiente hospitalar, como o monitoramento de casos suspeitos da doença através da avaliação da respiração e pulso da vítima e identificação das arritmias e de ritmos chocáveis de forma rápida. Vale salientar o uso de equipamentos de proteção individual para proteção contra gotículas e aerossóis e condutas respiratórias específicas para estes casos. Conclusão: o manejo do paciente em parada cardiorrespiratória com suspeita ou diagnóstico de COVID-19 que necessita de reanimação cardiopulmonar deve ser realizado em áreas de isolamento e com a utilização de equipamentos de proteção adequados. Foi visto que existem lacunas nas produções científicas, para que abordem de maneira mais clara e instrutiva sobre o manejo ao realizar ressuscitação cardiopulmonar em pacientes com suspeita ou diagnóstico de COVID-19.


Asunto(s)
Humanos , Atención Individual de Salud , Equipos de Seguridad , Reanimación Cardiopulmonar , Coronavirus , Cuidados Críticos , Infecciones por Coronavirus , Pandemias
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 803-808, 2020 Oct 18.
Artículo en Chino | MEDLINE | ID: mdl-33047711

RESUMEN

OBJECTIVE: To determine the environmental contamination degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in corona virus disease 2019 (COVID-19) wards, to offer gui-dance for the infection control and to improve safety practices for medical staff, by sampling and detecting SARS-CoV-2 nucleic acid from the air of hospital wards, the high-frequency contact surfaces in the contaminated area and the surfaces of medical staff's protective equipment in a COVID-19 designated hospital in Wuhan, China. METHODS: From March 11 to March 19, 2020, we collected air samples from the clean area, the buffer room and the contaminated area respectively in the COVID-19 wards using a portable bioaerosol concentrator WA-15. And sterile premoistened swabs were used to sample the high-frequency contacted surfaces in the contaminated area and the surfaces of medical staff's protective equipment including outermost gloves, tracheotomy operator's positive pressure respiratory protective hood and isolation clothing. The SARS-CoV-2 nucleic acid of the samples were detected by real-time fluorescence quantitative PCR. During the isolation medical observation period, those medical staff who worked in the COVID-19 wards were detected for SARS-CoV-2 nucleic acid with oropharyngeal swabs, IgM and IgG antibody in the sera, and chest CT scans to confirm the infection status of COVID-19. RESULTS: No SARS-CoV-2 nucleic acid was detected in the tested samples, including the 90 air samples from the COVID-19 wards including clean area, buffer room and contaminated area, the 38 high-frequency contact surfaces samples of the contaminated area and 16 surface samples of medical staff's protective equipment including outermost gloves and isolation clothing. Moreover, detection of SARS-CoV-2 nucleic acid by oropharyngeal swabs and IgM, IgG antibodies in the sera of all the health-care workers who participated in the treatment for COVID-19 were all negative. Besides, no chest CT scan images of medical staff exhibited COVID-19 lung presentations. CONCLUSION: Good ventilation conditions, strict disinfection of environmental facilities in hospital wards, guidance for correct habits in patients, and strict hand hygiene during medical staff are important to reduce the formation of viral aerosols, cut down the aerosol load, and avoid cross-infection in isolation wards. In the face of infectious diseases that were not fully mastered but ma-naged as class A, it is safe for medical personnel to be equipped at a high level.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Neumonía Viral , Síndrome Respiratorio Agudo Grave , Betacoronavirus , China , Humanos , Cuerpo Médico , Equipos de Seguridad , Síndrome Respiratorio Agudo Grave/diagnóstico , Síndrome Respiratorio Agudo Grave/prevención & control
3.
Medicine (Baltimore) ; 99(44): e22910, 2020 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-33126347

RESUMEN

INTRODUCTION: Using mobile phones for communication in emergency departments is a common practice; however, several studies have demonstrated that they may act as vectors for bacteria and viruses. This study evaluated the effectiveness of plastic wrapping in decreasing bacterial contamination on mobile phone surfaces. METHOD: We used culture dishes and a luminometer to detect bacterial colonies and contamination on the phone surfaces. RESULT: Our experiment showed that bacterial colonies exist on mobile phones before and after work. We found that wiping with 75% alcohol sanitizers effectively reduces the number of colonies on either a mobile phone or a temporary plastic covering. In addition, we found that bacterial colonies do not contaminate or adhere to plastic wrap any easier than to mobile phones. CONCLUSION: These results demonstrated the effectiveness of plastic wrap for protecting mobile phone surfaces against bacterial colonization. In addition, applying a layer of plastic wrap protects the phone from potential damage due to the alcohol.


Asunto(s)
Bacterias , Teléfono Celular , Infección Hospitalaria , Desinfección/métodos , Servicio de Urgencia en Hospital , Contaminación de Equipos/prevención & control , Equipos y Suministros de Hospitales , Etanol/farmacología , Antiinfecciosos Locales/farmacología , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Infección Hospitalaria/microbiología , Infección Hospitalaria/prevención & control , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/normas , Equipos y Suministros de Hospitales/microbiología , Equipos y Suministros de Hospitales/normas , Humanos , Administración de Materiales de Hospital/métodos , Plásticos , Equipos de Seguridad/microbiología
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1448-1451, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-33018263

RESUMEN

In Electrical Impedance Tomography (EIT) the coaxial cables used to connect the electrodes to the electronics have long been a concern due to their impact on system performance. Driving the shield of the cable is useful, since it mitigates the shunt capacitance. However, this approach introduces complexity and, sometimes, stability issues. Using "active electrodes", i.e. placing the front end of the electronics at the electrode end of the cables, is also helpful but can introduce packaging and hygiene problems. In this paper, a new type of high-precision current source is described and its performance is studied when driving loads through a coaxial cable. This new current source adjusts its current output to compensate for current lost in any shunt impedance to ground, including the shunt losses in the cable. Experimental results for frequencies up to 1 MHz are provided, comparing performance with resistive and complex loads connected without a cable, with 1 m of RG-174 coaxial cable with a driven shield, and 1 m of RG-174 coaxial cable with a grounded shield. The results for all 3 cases are similar, demonstrating that the source can provide satisfactory performance with a grounded-shield cable.


Asunto(s)
Tomografía Computarizada por Rayos X , Tomografía , Impedancia Eléctrica , Electrodos , Equipos de Seguridad
5.
Indian J Ophthalmol ; 68(11): 2486-2489, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33120649

RESUMEN

Since the emergence of COVID pandemic, health workers have been facing major challenges every day. Ophthalmology practice has encountered countless modifications in the practice pattern not to jeopardize patient care and at the same time maintain all safety measures to reduce transmission. One such modification we made was the Safe Slit-Lamp Shield (SSS) which has been found to be extremely protective in differentiation to other available shield. Although SSS has a larger surface area when compared to already available shields, it won't compromise the comfort of the clinician at the same time gives satisfactory protection.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/transmisión , Seguridad de Equipos , Ergonomía , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Neumonía Viral/transmisión , Equipos de Seguridad , Microscopía con Lámpara de Hendidura/instrumentación , Resinas Acrílicas , Aerosoles , Diseño de Equipo , Humanos , Pandemias , Lámpara de Hendidura
6.
Cir. Esp. (Ed. impr.) ; 98(8): 433-441, oct. 2020. graf, tab
Artículo en Español | IBECS | ID: ibc-188970

RESUMEN

La infección por el nuevo coronavirus SARS-CoV-2 (enfermedad por coronavirus 2019 [COVID-19]) ha determinado la necesidad de la reorganización de muchos centros hospitalarios en el mundo. España, como uno de los epicentros de la enfermedad, ha debido asumir cambios en la práctica totalidad de su territorio. Sin embargo, y desde el inicio de la pandemia, en todos los centros que atienden urgencias quirúrgicas ha sido necesario el mantenimiento de su cobertura, aunque igualmente ha sido inevitable introducir directrices especiales de ajuste al nuevo escenario que permitan el mantenimiento de la excelencia en la calidad asistencial. Este documento desarrolla una serie de indicaciones generales para la cirugía de urgencias y la atención al politraumatizado desarrolladas desde la literatura disponible y consensuadas por un subgrupo de profesionales desde el grupo general Cirugía-AEC-COVID-19. Estas medidas van encaminadas a contemplar un riguroso control de la exposición en pacientes y profesionales, a tener en cuenta las implicaciones de la pandemia sobre diferentes escenarios perioperatorios relacionados con la urgencia y a una adaptación ajustada a la situación del centro en relación con la atención a pacientes infectados


New coronavirus SARS-CoV-2 infection (coronavirus disease 2019 [COVID-19]) has determined the necessity of reorganization in many centers all over the world. Spain, as an epicenter of the disease, has been forced to assume health policy changes in all the territory. However, and from the beginning of the pandemic, every center attending surgical urgencies had to guarantee the continuous coverage adopting correct measures to maintain the excellence of quality of care. This document resumes general guidelines for emergency surgery and trauma care, obtained from the available bibliography and evaluated by a subgroup of professionals designated from the general group of investigators Cirugía-AEC-COVID-19 from the Spanish Association of Surgeons, directed to minimize professional exposure, to contemplate pandemic implications over different urgent perioperative scenarios and to adjust decision making to the occupational pressure caused by COVID-19 patients


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Servicios Médicos de Urgencia/organización & administración , Equipos de Seguridad/normas , Administración de la Seguridad , Procedimientos Quirúrgicos Operativos/normas , Traumatismo Múltiple/cirugía , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control
7.
Adv Clin Exp Med ; 29(9): 1021-1028, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-33001589

RESUMEN

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted through respiratory droplets and contact routes, hence the demand for personal protective equipment (PPE) has increased during the outbreak of coronavirus disease 2019 (COVID-19). Among the most noticeable shortages was the lack of face shields. The urgent demand for PPE induced interdisciplinary cooperation to overcome the shortages, and additive manufacturing proved to be ideal for the crisis situation. OBJECTIVES: To investigate the possibilities of implementing additive manufacturing technologies in the interventional fabrication of protective face shields for medical staff. MATERIAL AND METHODS: An Ender 3 Pro 3D printer was used to print headbands and Cura 4.4 was chosen as the slicing software. Open source face shield designs were downloaded as standard tessellation language (STL) files and compared. Only models with scientific support were taken under consideration. RESULTS: The mean time for producing the headbands tested ranged from 59 min to almost 3 h, depending on the design. After setting up our low budget printer and choosing the Prusa RC 3 protective face shield as the main product, we were able to fabricate about 30 face shields per week at a cost of about €1 each. During 4 weeks, 126 face shields were produced and delivered to various hospital wards, which substantially eased the shortages. CONCLUSIONS: Additive manufacturing enables immediate responses to needs in emergency situations, and allows for mass production of personal protective equipment in a short time due the rapid exchange of data among printer users. Despite the unregulated legal situation and insufficient scientific evidence, such protective equipment has been approved by clinicians and is currently used by medical personnel around the world.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Infecciones por Coronavirus/prevención & control , Humanos , Máscaras , Pandemias/prevención & control , Neumonía Viral/prevención & control , Equipos de Seguridad
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 248-251, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-33017975

RESUMEN

Accurate and reliable detecting of driving fatigue using Electroencephalography (EEG) signals is a method to reduce traffic accidents. So far, it is natural to cut the part of operating the steering wheel data away for achieving the relatively high accuracy in detecting driving fatigue using EEG data. However, the data segment during operating the steering wheel also contains valuable information. Moreover, operating the steering wheel is a common practice during actual driving. In this study, we utilize the part of data operating the steering wheel to detecting fatigue. The feature used is the spectral band power calculates from the data. For each experiment and each experimental participant, the data and features are divided into sessions and subjects. Using the divided features, this work performs cross-session and cross-subject verification and comparison on the two classification methods of logistic regression and multi-layer perceptron. To compare the effect, the experiment is conducted on the data both operating the steering wheel and not operating the steering wheel. The result shows that the bias between the average accuracy of two types of data is only 2.27%, and the effect of using multi-layer perceptron is 10.37% better than using logistic regression. This proves that the data segment during operating the steering wheel also contains valid information and can be used for driving fatigue detection.


Asunto(s)
Conducción de Automóvil , Accidentes de Tránsito/prevención & control , Electroencefalografía , Técnicas Histológicas , Humanos , Equipos de Seguridad
9.
Acta Odontol Scand ; 78(8): 626-639, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32881590

RESUMEN

OBJECTIVE: The global pandemic of coronavirus disease-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is the latest hazard facing healthcare workers (HCW) including dental care workers (DCW). It is clear that the major mode of SARS-CoV-2 transmission is the airborne route, through inhalation of virus-infested aerosols and droplets. Several respiratory protection equipment (RPE), including masks, face shields/visors, and respirators, are available to obviate facial and conjunctival contamination by microbes. However, as their barrier value against microbial inhalation has not been evaluated, we systematically reviewed the data on the effectiveness and efficacy of facemasks and respirators, including protective eyewear, with particular emphasis on dental healthcare. MATERIAL AND METHODS: PubMed, MEDLINE, the Cochrane Library, and Embase databases were searched between 01January 1990 and 15 May 2020. RESULTS: Of 310 identified English language records, 21 were included as per eligibility criteria. In clinical terms, wearing layered, face-fitting masks/respirators and protective-eyewear can limit the spread of infection among HCWs. Specifically, combined interventions such as a face mask and a face shield, better resist bioaerosol inhalation than either alone. The prolonged and over-extended use of surgical masks compromise their effectiveness. CONCLUSIONS: In general, RPE is effective as a barrier protection against aerosolized microbes in healthcare settings. But their filtration efficacy is compromised by the (i) inhalant particle size, (ii) airflow dynamics, (iii) mask-fit factor, (iv) period of wear, (v) 'wetness' of the masks, and (vi) their fabrication quality. The macro-data presented here should inform policy formulation on RPE wear amongst HCWs.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Neumonía Viral , Equipos de Seguridad , Betacoronavirus , Odontología , Humanos
10.
Leg Med (Tokyo) ; 47: 101787, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32992157

RESUMEN

This study was aimed at investigating and comparing exposure dose of workers and the surrounding workers. In addition, worker's exposure was also measure about lens and finger. Four intraoral portable X-ray units were evaluated. The stray radiations were measured using Pitman 37D and ionization chamber (Pitman). MyDosemini (ALOKA) was used for measurement of the finger exposure dose. Without the shield became high in anterior 0.5 m. Comparing the air dose for the four models used in this study showed a high tendency for the two NOMAD models. And using the shields, the images could be taken 4.6 times of the baseline at a maximum and 3.6 times on average. The finger radiation exposure dose was low with both of the NOMAD models, with no significant difference found. By setting the baseline value without a shield, finger radiation exposure when using a shield was lower than the detection limit for the D3000, and was reduced by approximately 94-96% for other three models. All models can photograph around 100 bodies, so it is considered that it is not necessary to switch out the operator considering the operation limit. But even if it does not reach the operation limit, the stochastic effects of radiation exposure can be increased as well as the deterministic effects of the operation limit. The operator and the surrounding workers seek to protect themselves. It is important to perform exposure management that takes into account the stochastic effects to the operator and the surrounding workers.


Asunto(s)
Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Dosis de Radiación , Radiografía/efectos adversos , Radiografía/instrumentación , Dedos , Humanos , Cristalino , Exposición Profesional/prevención & control , Fantasmas de Imagen , Equipos de Seguridad , Radiografía Dental
12.
Artículo en Chino | MEDLINE | ID: mdl-32892583

RESUMEN

Objective: To investigate the situation of wearing protective equipment in the process of X-ray radiation examination (including DR and CT) in a 3A general hospital, so as to provide technical basis and solutions for better reducing the radiation dose of accompanying patients. Methods: From November 1, 2018 to June 30, 2019, the accompanying examinee 6 who had to stay in the examination room during the radiology examination (X-ray and CT examination) of a 3A general hospital from June 1, 2018 to June 30, 2019 was selected 535 people were divided into three groups according to whether they were reminded and instructed to wear protective equipment: group A was not reminded (group A) , group B was reminded to wear protective equipment, and group C was reminded and instructed to wear protective equipment (Group C) . Results: The wearing rates of protective equipment of the three groups were 35.0% (744/2126) , 85.2% (1858/2181) and 91.0% (2028/228) , and the complete wearing rates were 15.0% (319/2126) , 54.8% (1195/2181) and 88.0% (1960/228) , respectively. 4% (1450/3060) , 28.6% (876/3060) , 24.0% (734/3060) , respectively. 523 patients refused to wear protective equipment. The main reasons were emotion (33.8%, 177/523) and time (32.5%, 170/523) . Conclusion: The intervention of radiation workers can effectively improve the correct wearing rate of protective equipment and reduce the radiation exposure of accompanying people.


Asunto(s)
Equipos de Seguridad , Exposición a la Radiación , Protección Radiológica , Humanos , Radiografía , Rayos X
13.
S Afr Med J ; 110(7): 610-612, 2020 06 03.
Artículo en Inglés | MEDLINE | ID: mdl-32880332

RESUMEN

Indiscriminatory in its spread, COVID-19 has engulfed communities from all social backgrounds throughout the world. While healthcare professionals work tirelessly testing for the virus and caring for patients, they too have become casualties of the pandemic. Currently the best way to attempt to curb the spread of the virus, echoed by almost all nation leaders, is to distance ourselves from one another socially or physically. However ideal this may seem, social distancing is not always practical in densely populated lower-income countries with many citizens below the breadline. With the majority of South Africans living in poverty, communities in overcrowded households are unable to distance themselves from one another appropriately. In addition, as a nation we struggle with high HIV and tuberculosis rates, malnutrition and an already overburdened healthcare system, emphasising the extreme vulnerability of our people. These factors, coupled with the fact that many of our healthcare professionals lack the necessary personal protective equipment to prevent them from contracting the virus themselves, highlight the gravity of the damaging repercussions that we may face in the coming months, after the complete national lockdown in force at the time of writing is lifted and we move towards a partial lockdown state. Nationally, there needs to be a shift in mindset towards exploring alternative technology-based preventive measures that may empower the healthcare sector in the long term and enhance social distancing.


Asunto(s)
Inteligencia Artificial , Infecciones por Coronavirus/prevención & control , Sector de Atención de Salud/organización & administración , Control de Infecciones/organización & administración , Pandemias/prevención & control , Neumonía Viral/prevención & control , Equipos de Seguridad/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Empoderamiento , Femenino , Humanos , Masculino , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Pobreza , Rol , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/prevención & control , Aislamiento Social , Factores Socioeconómicos
15.
Nefrología (Madrid) ; 40(4): 395-402, jul.-ago. 2020. tab
Artículo en Español | IBECS | ID: ibc-191368

RESUMEN

La epidemia de COVID-19 representa un riesgo especial para los pacientes renales por sus comorbilidades y edad avanzada, y por la realización del tratamiento de hemodiálisis en salas colectivas, pero también supone un riesgo para los profesionales responsables de su atención. El presente manuscrito recoge una propuesta de actuación para prevenir la infección entre los profesionales en los Servicios de Nefrología


The COVID-19 epidemic represents a special risk for kidney patients due to their comorbidities and advanced age, and the need for hemodialysis treatment in group rooms. It also represents a risk for professionals responsible for their attention. This manuscript contains a proposal for action to prevent infection of professionals in the Nephrology Services, one of the most valuable assets at the present time


Asunto(s)
Humanos , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus , Pandemias , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipos de Seguridad/normas , Medidas de Seguridad/normas , Nefrología/normas , Factores de Riesgo
16.
Neurología (Barc., Ed. impr.) ; 35(6): 57, jul.-ago. 2020. graf
Artículo en Español | IBECS | ID: ibc-190278

RESUMEN

INTRODUCCIÓN: La pandemia por SARS-CoV-2 está condicionando los abordajes diagnósticos, terapéuticos y asistenciales establecidos en esclerosis múltiple (EM). Durante las fases inicial y pico de la epidemia, los fármacos modificadores del curso de la EM caracterizados por ser inmunosupresores administrados en pulsos (TIP), vieron pospuesta su administración debido a la incertidumbre sobre su influencia en la infección, principalmente en contagiados/contagiosos asintomáticos/presintomáticos. El objetivo de este trabajo es presentar un algoritmo basado en criterios de seguridad que permita reanudar los TIP durante la fase de desescalado. MÉTODOS: Se elabora un algoritmo, cuya estructura se sustenta en la experiencia clínica en EM de los autores y en una revisión bibliográfica del conocimiento acumulado, que facilita la detección de contagiosos asintomáticos, presintomáticos o con síntomas leves de SARS-CoV-2, con el objetivo de evitar la administración de TIP y contagios por contacto prolongado en hospital de día (HdD). RESULTADOS: Algoritmo con doble filtro clínico-microbiológico consistente en la aplicación telemática de un listado de comprobación de síntomas y después realización de PCR para SARS-CoV-2 en exudado nasofaríngeo, a las 48 y 24 h antes del TIP programado respectivamente. CONCLUSIÓN: Considerando el balance beneficio-riesgo, la aplicación del algoritmo resultaría ventajosa pese a que no se conoce la proporción real de asintomáticos/presintomáticos contagiosos. La realización sistemática de PCR, como test con mayor sensibilidad en la fase presintomática de la infección, en combinación con un sistema de detección precoz de síntomas, reduciría contagios y favorecería la identificación de pacientes con riesgo antes de su exposición a TIP


INTRODUCTION: The COVID-19 pandemic is changing approaches to diagnosis, treatment, and care provision in multiple sclerosis (MS). During both the initial and peak phases of the epidemic, the administration of disease-modifying drugs, typically immunosuppressants administered in pulses, was suspended due to the uncertainty about their impact on SARS-CoV-2 infection, mainly in contagious asymptomatic/presymptomatic patients. The purpose of this study is to present a safety algorithm enabling patients to resume pulse immunosuppressive therapy (PIT) during the easing of lockdown measures. METHODS: We developed a safety algorithm based on our clinical experience with MS and the available published evidence; the algorithm assists in the detection of contagious asymptomatic/presymptomatic cases and of patients with mild symptoms of SARS-CoV-2 infection with a view to withdrawing PIT in these patients and preventing new infections at day hospitals. RESULTS: We developed a clinical/microbiological screening algorithm consisting of a symptom checklist, applied during a teleconsultation 48hours before the scheduled session of PIT, and PCR testing for SARS-CoV-2 in nasopharyngeal exudate 24hours before the procedure. CONCLUSION: The application of our safety algorithm presents a favourable risk-benefit ratio despite the fact that the actual proportion of asymptomatic and presymptomatic individuals is unknown. Systematic PCR testing, which provides the highest sensitivity for detecting presymptomatic cases, combined with early detection of symptoms of SARS-CoV-2 infection may reduce infections and improve detection of high-risk patients before they receive PIT


Asunto(s)
Humanos , Medidas de Seguridad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Betacoronavirus , Pandemias , Esclerosis Múltiple/tratamiento farmacológico , Inmunosupresores/administración & dosificación , Quimioterapia por Pulso/normas , Medicina Basada en la Evidencia , Equipos de Seguridad/normas , Algoritmos
17.
Emergencias (Sant Vicenç dels Horts) ; 32(4): 227-232, ago. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-190939

RESUMEN

OBJETIVO: Evaluar la efectividad de un programa de prevención y control de infecciones (PCI) por COVID-19 en los trabajadores sanitarios (TS) del servicio de urgencias de un hospital terciario. MÉTODO: Se recogió el número de casos confirmados de COVID-19 en TS del 2 de marzo al 12 de abril de 2020. Los TS fueron evaluados si presentaban síntomas o en el marco de estudios de contactos. Se recogió: edad, sexo, estamento, área trabajo y motivo contacto. Se comparó si existían diferencias entre los TS del SU y los del resto del Departamento de Salud (DS). RESULTADOS: De los 3.900 TS del DS (279 adscritos al SU), se evaluaron 1.744 TS (92 del SU). Presentaron síntomas 736 (52 del SU); 151 fueron confirmados COVID-19 (9 del SU). Dos casos del SU (22,2%) se atribuyeron a la asistencia sanitaria, y 7 (77,8%) a relaciones sociales en el lugar de trabajo o fuera de este. La prevalencia de TS con COVID-19 en el SU fue de un 3,2% (9/279), y en el resto de TS del 3,9% (142/3621). Entre los TS del SU y del resto del DS no hubo diferencias significativas en la prevalencia de afectados, ni entre los motivos de contacto. CONCLUSIONES: Teniendo en cuenta la prevalencia de TS con COVID-19 del SU respecto al resto del DS, el motivo del contacto de riesgo y su distribución en el tiempo, se puede considerar que el PCI orientado al SU fue efectivo


OBJECTIVE: To evaluate the effectiveness of a coronavirus disease 2019 (COVID-19) prevention and control program for health care workers in a tertiary care hospital emergency department (ED). METHODS: We recorded the number of confirmed COVID-19 workers in the ED on March 2, 2020, and April 12, 2020. Workers were screened if they had symptoms or were traced as contacts. Variables recorded were age, sex, staff position, work area, and reason for contact. We used the χ2 test to compare ED workers to workers in other areas of the health care system. RESULTS: Of the 3900 health care workers (279 in the ED), 1744 cases (92 in the ED) were included for analysis. A total of 736 workers (52 in the ED) had symptoms, and 151 had positive test results (9 from the ED). Two of the infections in the ED workers (22.2%) were attributed to patient contact and 7 (77.8%) to nonwork-related contact either in the workplace or in the community. The prevalence of COVID-19 among ED workers was 3.2% (9/279). The prevalence among other health system workers was 3.9% (142/3621). The differences in COVID-19 prevalencebetween the 2 groups was not significant. Nor was there a significant difference in the reasons for contact with the virus between the 2 groups. CONCLUSION: Based on the prevalence of COVID-19 among ED workers and other health care workers, the reasons for risk of contact with the virus, and the time frame for gathering the data, we conclude that the prevention and control measures in the ED have been effective


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Pandemias/prevención & control , Infecciones por Coronavirus/prevención & control , Servicios Médicos de Urgencia/estadística & datos numéricos , Socorristas/estadística & datos numéricos , Resultado del Tratamiento , Neumonía Viral/prevención & control , Intervalos de Confianza , Equipos de Seguridad/normas
19.
Medicine (Baltimore) ; 99(34): e21831, 2020 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-32846829

RESUMEN

Adoption of interventional endoscopic procedures is increasing with increasing prevalence of diseases. However, medical radiation exposure is concerning; therefore, radiation protection for medical staff is important. However, there is limited information on the usefulness of an additional lead shielding device during interventional endoscopic procedures. Therefore, we aimed to determine whether an additional lead shielding device protects medical staff from radiation.An X-ray unit (CUREVISTA; Hitachi Medical Systems, Tokyo, Japan) with an over-couch X-ray system was used. Fluoroscopy-associated scattered radiation was measured using a water phantom placed at the locations of the endoscopist, assistant, nurse, and clinical engineer. For each location, measurements were performed at the gonad and thyroid gland/eye levels. Comparisons were performed between with and without the additional lead shielding device and with and without a gap in the shielding device. Additionally, a clinical study was performed with 27 endoscopic retrograde cholangiopancreatography procedures.The scattered radiation dose was lower with than without additional lead shielding at all medical staff locations and decreased by 84.7%, 82.8%, 78.2%, and 83.7%, respectively, at the gonad level and by 89.2%, 86.4%, 91.2%, and 87.0%, respectively, at the thyroid gland/eye level. Additionally, the scattered radiation dose was lower without than with a gap in the shielding device at all locations.An additional lead shielding device could protect medical staff from radiation during interventional endoscopic procedures. However, gaps in protective equipment reduce effectiveness and should be eliminated.


Asunto(s)
Exposición Profesional/prevención & control , Exposición a la Radiación/prevención & control , Protección Radiológica/instrumentación , Radiografía Intervencional/efectos adversos , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Colangiopancreatografia Retrógrada Endoscópica/estadística & datos numéricos , Fluoroscopía/efectos adversos , Gónadas/efectos de la radiación , Humanos , Traumatismos Ocupacionales/prevención & control , Fantasmas de Imagen/estadística & datos numéricos , Equipos de Seguridad/normas , Dosis de Radiación , Traumatismos por Radiación/prevención & control , Protección Radiológica/métodos , Glándula Tiroides/efectos de la radiación
20.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(4): 322-327, 2020 Apr 08.
Artículo en Chino | MEDLINE | ID: mdl-32762206

RESUMEN

This discussion attempts to organize and analyze the clinical purpose of various technologies developed by medical electron accelerators from the development history and clinical needs of radiotherapy products, so as to avoid the troubles caused by specific technical details and summarize the development of medical accelerators. Directly, the study provides differentiated development ideas for the development of domestic medical accelerators and ways and means to determine the dimensions of differentiated development.


Asunto(s)
Aceleradores de Partículas , Equipos de Seguridad
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