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1.
Arab J Gastroenterol ; 22(2): 170-173, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34090831

RESUMO

BACKGROUND AND STUDY AIMS: The COVID-19 outbreak has reorganized surgical team conditions regarding endoscopy. The number of interventions has been reduced, the number of healthcare professionals must be limited, and both the patients and physicians are more protected than ever. PATIENTS AND METHODS: In the highest peak of contagion in Colombia, endoscopy, colonoscopy, and esophagogastroduodenoscopy were performed using a low-cost disposable device. A total of 1388 procedures were performed. Every patient was assessed for symptoms via a telephone call, at the health center, and after the procedure, following specific attention routes. RESULTS: After procedure follow-up, no positive cases of COVID-19 were noted. CONCLUSION: The methodology reduced the risk of infection during the COVID-19 pandemic.


Assuntos
COVID-19 , Endoscopia , Telemedicina , COVID-19/prevenção & controle , Colômbia , Equipamentos Descartáveis , Endoscopia/instrumentação , Endoscopia/métodos , Humanos , Pandemias
2.
J Am Assoc Lab Anim Sci ; 60(4): 431-441, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34172106

RESUMO

Reuse of disposable personal protective equipment is traditionally discouraged, yet in times of heightened medical applications such as the SARS CoV-2 pandemic, it can be difficult to obtain. In this article we examine the reuse of disposable gowns with respect to still providing personnel protection. XR7, a fluorescent powder, was used to track contamination of gowns after manipulation of rodent cages. Mouse cages were treated with XR7 prior to manipulations. Disposable gowns were labeled for single person use and hung in common procedure spaces within the vivarium between usages. A simulated rack change of 140 cages was completed using XR7-treated cages. One individual changed all cages with a break occurring after the first 70 cages, requiring the gown to be removed and reused once. To simulate research activities, 5 individuals accessed 3 XR7-treated cages daily for 5 d. Each mouse in the XR7-treated cages was manipulated at least once before returning cages to the housing room. Disposable gowns were reused 5 times per individual. Gowns, gloves, clothing, bare arms, and hands were scanned for fluorescence before and after removing PPE. Fluorescence was localized to gloves and gown sleeves in closest contact with animals and caging. No fluorescence was detected on underlying clothing, or bare arms and hands after removing PPE. Fluorescence was not detected in procedure spaces where gowns were hung. The lack of fluorescence on personnel or surfaces indicate that gowns can be reused 1 time for routine husbandry tasks and up to 5 times for research personnel. A method for decontamination of used gowns using Vaporized Hydrogen Peroxide (VHP) was also validated for use in areas where animals are considered high risk such as quarantine, or for fragile immunocompromised rodent colonies.


Assuntos
Animais de Laboratório , Equipamentos Descartáveis , Pandemias , Roupa de Proteção , Técnicos em Manejo de Animais , Animais , Pessoal de Saúde , Abrigo para Animais , Humanos , Camundongos , Pandemias/prevenção & controle , Equipamento de Proteção Individual
3.
West J Emerg Med ; 22(3): 547-551, 2021 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-34125025

RESUMO

INTRODUCTION: The coronavirus 2019 pandemic caused a shortage of disposable N95 respirators, prompting healthcare entities to extend the use of these masks beyond their intended single-use manufacturer recommendation with a paucity of supporting research. METHODS: We performed a prospective cohort study of ED healthcare workers (HCW) ("subjects") required to use respirators at an academic, Level I trauma center. Subjects had been previously fit tested and assigned an appropriately sized N95 mask per hospital protocol. Per study protocol, subjects were fit tested periodically throughout their shifts and on multiple shifts over the eight-week study period. Data points collected included the age of the mask, subjective assessment of mask seal quality, and fit test results. We analyzed the data using Fisher's exact test, and calculated odds ratios (OR) to determine the failure rate of disposable N95 masks following reuse. RESULTS: A total of 130 HCWs underwent fit testing and 127 were included for analysis. Mask failure rate climbed after day 2 of use, with 33.3% of masks failing at day 3, 42.9% at day 4, and 50% at ≥ day 5. Categorizing the masks into those being used for two or fewer days vs those in use for three or more, failure was more common on day 3 of use or older compared to those in the first two days of use (41.8% vs 8.3%, P < 0.0001) with an OR of failure with an older mask of 7.9 (confidence interval [CI], 2.8-22.3). The healthcare workers' assessment of poor seal was 33.3% sensitive (CI, 18.6-51.9) and 95.7% specific (CI, 88.8-98.6) for fit test failure. CONCLUSION: Disposable N95 masks have significant failure rates following reuse in clinical practice. Healthcare personnel also performed poorly in assessing the integrity of the seal of their disposable respirators.


Assuntos
Falha de Equipamento/estatística & dados numéricos , Reutilização de Equipamento , Respiradores N95 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Equipamentos Descartáveis , Serviço Hospitalar de Emergência , Humanos , Pandemias , Estudos Prospectivos
4.
Infect Control Hosp Epidemiol ; 42(6): 740-742, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34009112

RESUMO

Healthcare-acquired infections are a tremendous challenge to the US medical system. Stethoscopes touch many patients, but current guidance from the Centers for Disease Control and Prevention does not support disinfection between each patient. Stethoscopes are rarely disinfected between patients by healthcare providers. When cultured, even after disinfection, stethoscopes have high rates of pathogen contamination, identical to that of unwashed hands. The consequence of these practices may bode poorly in the coronavirus 2019 disease (COVID-19) pandemic. Alternatively, the CDC recommends the use of disposable stethoscopes. However, these instruments have poor acoustic properties, and misdiagnoses have been documented. They may also serve as pathogen vectors among staff sharing them. Disposable aseptic stethoscope diaphragm barriers can provide increased safety without sacrificing stethoscope function. We recommend that the CDC consider the research regarding stethoscope hygiene and effective solutions to contemporize this guidance and elevate stethoscope hygiene to that of the hands, by requiring stethoscope disinfection or change of disposable barrier between every patient encounter.


Assuntos
Contaminação de Equipamentos/prevenção & controle , Estetoscópios/normas , COVID-19/prevenção & controle , COVID-19/transmissão , Centers for Disease Control and Prevention, U.S./normas , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/virologia , Desinfecção/métodos , Equipamentos Descartáveis , Desinfecção das Mãos , Humanos , Guias de Prática Clínica como Assunto , Estetoscópios/efeitos adversos , Estetoscópios/virologia , Estados Unidos
5.
Br Dent J ; 230(9): 555-556, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33990710
6.
J Vasc Interv Radiol ; 32(6): 907-915.e3, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33794372

RESUMO

PURPOSE: To calculate the volume of greenhouse gases (GHGs) generated by a hospital-based interventional radiology (IR) department. MATERIALS AND METHODS: Life cycle assessment (LCA) was used to calculate GHGs emitted by an IR department at a tertiary care academic medical center. The volume of waste generated, amount of disposable supplies and linens used, and the operating times of electrical equipment were recorded for procedures performed between 7:00 AM and 7:00 PM on 5 consecutive weekdays. LCA was then performed using purchasing data, plug loads for electrical hardware, data from temperature control units, and estimates of emissions related to travel in the area surrounding the medical center. RESULTS: Ninety-eight procedures were performed on 97 patients. The most commonly performed procedures were drainages (30), placement and removal of venous access (21), and computed tomography-guided biopsies (13). Approximately 23,500 kg CO2e were emitted during the study. Sources of CO2 emissions in descending order were related to indoor climate control (11,600 kg CO2e), production and transportation of disposable surgical items (9,640 kg CO2e), electricity plug load for equipment and lighting (1,060 kg CO2e), staff transportation (524 kg CO2e), waste disposal (426 kg CO2e), production, laundering, and disposal of linens (279 kg CO2e), and gas anesthetics (19.3 kg CO2e). CONCLUSIONS: The practice of IR generates substantial GHG volumes, a majority of which come from energy used to maintain climate control, followed by emissions related to single-use surgical supplies. Efforts to reduce the environmental impact of IR may be focused accordingly.


Assuntos
Poluentes Atmosféricos/análise , Dióxido de Carbono/análise , Monitoramento Ambiental , Gases de Efeito Estufa/análise , Radiografia Intervencionista , Centros Médicos Acadêmicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ar Condicionado , Poluentes Atmosféricos/efeitos adversos , Anestesia por Inalação , Dióxido de Carbono/efeitos adversos , Criança , Equipamentos Descartáveis , Eletricidade , Feminino , Gases de Efeito Estufa/efeitos adversos , Humanos , Serviço Hospitalar de Lavanderia , Masculino , Eliminação de Resíduos de Serviços de Saúde , Pessoa de Meia-Idade , Radiografia Intervencionista/efeitos adversos , Fatores de Risco , Fatores de Tempo , Emissões de Veículos/análise , Adulto Jovem
7.
J Orthop Surg Res ; 16(1): 188, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33722256

RESUMO

BACKGROUND: Total knee arthroplasty (TKA) is most frequently planned using conventional two-dimensional weight-bearing lower limb radiographs and is performed with conventional femoral and tibial cutting guides. Questions have been raised about the accuracy of conventional TKA instrumentation and planning for an anatomically standard or complex joint. Use of computed tomography (CT)-based three-dimensional (3D) templating and patient-specific cutting guides printed in 3D has shown improved postoperative lower limb alignment parameters. This case-control study compared costs and operative times of using CT-based, patient-specific, single-use instruments versus conventional metal instruments for TKA. METHODS: In this case-control, retrospective chart review, all TKAs were performed by one senior surgeon, using the F.I.R.S.T. posterior-stabilised knee prosthesis (Symbios, CH), with a similar protocol and identical operating room setup. Group A included 51 TKAs performed with patient-specific cutting guides and conventional metal instruments. Group B included 49 TKAs performed with patient-specific cutting guides and patient-specific, single-use instrumentation. Operation duration, number of instrumentation trays and sterilisation costs were evaluated. RESULTS: The groups were similar for age, body mass index, hip-knee-ankle angle and operation duration. The mean number of instrumentation trays was 8.0 ± 0.8 for group A (controls) and 5.1 ± 0.9 for group B (p<0.001). The mean sterilisation costs were 380 ± 47 Swiss Francs (CHF) for group A and 243 ± 55 CHF for group B (p<0.001), for a mean cost reduction of 130.50 CHF per intervention in group B. The time interval between two consecutive surgeries was 24 min for group A and 18 min for group B. There were no adverse events or complications, instrument-related or otherwise. CONCLUSION: Compared to conventional instrumentation, use of patient-specific, single-use instruments for TKA reduced the number of instrumentation trays by more than one-third and saved 36% in sterilisation costs. If fabrication costs of single-use instruments are included by the company, the total cost is significantly diminished. There was no operative time advantage for single-use instrumentation.


Assuntos
Artroplastia do Joelho/economia , Artroplastia do Joelho/instrumentação , Custos e Análise de Custo , Equipamentos Descartáveis , Esterilização/economia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Equipamentos Descartáveis/economia , Feminino , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Tomografia Computadorizada por Raios X
8.
J Stroke Cerebrovasc Dis ; 30(5): 105684, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33652346

RESUMO

Cervical carotid disease is typical atherosclerosis, which is responsible for ischemic stroke. The effectiveness of carotid endarterectomy (CEA) for advanced carotid stenosis has been established in many large studies, and CEA is the gold standard in surgical treatment. On the other hand, endovascular carotid artery stenting (CAS) has become increasingly popular recently. It is very important to avoid any complications to maintain the effectiveness of CEA. The retractor device is important for the exposure of carotid arteries and for the safe surgical manipulation. We have started to use lone star retractor system (LSRS) to deploy the surgical field. LSRS provides the usability to handle and a shallower surgical field without the disturbance of surgical manipulation. And it can facilitate exposure of the distal internal carotid artery because surgeon can retract freely in whole circumference by towing with moderate strength. LSRS may bring the smoother and easier surgical manipulations in CEA.


Assuntos
Artéria Carótida Interna/cirurgia , Estenose das Carótidas/cirurgia , Equipamentos Descartáveis , Endarterectomia das Carótidas/instrumentação , Instrumentos Cirúrgicos , Artéria Carótida Interna/diagnóstico por imagem , Estenose das Carótidas/diagnóstico por imagem , Endarterectomia das Carótidas/efeitos adversos , Desenho de Equipamento , Humanos , Resultado do Tratamento
9.
BMJ Open Respir Res ; 8(1)2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33771812

RESUMO

BACKGROUND: The COVID-19 pandemic has highlighted the need for alternative short-term, reliable means to aid in the treatment of patients requiring ventilatory support. Concurrent aerosol drug delivery is often prescribed to such patients. As such, this study examines one such short-term option, the disposable gas-powered transport ventilator to effectively deliver aerosol therapy. Factors such as aerosol generator type, patient breathing pattern, humidification and nebuliser position within the respiratory circuit were also examined. METHODS: Aerosol drug delivery characterisation was undertaken using two different disposable transport ventilators (DTVs). Two different nebuliser types, a closed circuit vibrating mesh nebuliser (VMN) and an open circuit jet nebuliser (JN), at different locations in a respiratory circuit, proximal and distal to an endotracheal tube (ETT), with and without passive humidification, were evaluated in simulated adult and paediatric patients. RESULTS: Placement of a nebuliser proximal to the ETT (VMN: 25.19%-34.15% and JN: 3.14%-8.92%), and the addition of a heat and moisture exchange filter (VMN: 32.37%-40.43% and JN: 5.60%-9.91%) resulted in the largest potential lung dose in the adult patient model. Irrespective of nebuliser position and humidification in the respiratory circuit, use of the VMN resulted in the largest potential lung dose (%). A similar trend was recorded in the paediatric model data, where the largest potential lung dose was recorded with both nebuliser types placed proximal to the ETT (VMN: 8.12%-10.89% and JN: 2.15%-3.82%). However, the addition of a heat and moisture exchange filter had no statistically significant effect on the potential lung dose (%) a paediatric patient would receive (p>>0.05). CONCLUSIONS: This study demonstrates that transport ventilators, such as DTVs, can be used concurrently with aerosol generators to effectively deliver aerosolised medication in both adult and paediatric patients.


Assuntos
COVID-19/terapia , Equipamentos Descartáveis , Nebulizadores e Vaporizadores , Respiração Artificial/instrumentação , Respiração Artificial/métodos , Administração por Inalação , Aerossóis , Albuterol/uso terapêutico , Sistemas de Liberação de Medicamentos , Desenho de Equipamento , Humanos , Técnicas In Vitro , SARS-CoV-2
10.
J Vasc Interv Radiol ; 32(5): 672-676, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33781687

RESUMO

PURPOSE: To analyze the impact of physician-specific equipment preference on cost variation for procedures typically performed by interventional radiologists at a tertiary care academic hospital. MATERIALS AND METHODS: From October 2017 to October 2019, data on all expendable items used by 9 interventional radiologists for 11 common interventional radiology procedure categories were compiled from the hospital analytics system. This search yielded a final dataset of 44,654 items used in 2,121 procedures of 11 different categories. The mean cost per case for each physician as well as the mean, standard deviation, and coefficient of variation (CV) of the mean cost per case across physicians were calculated. The proportion of spending by item type was compared across physicians for 2 high-variation, high-volume procedures. The relationship between the mean cost per case and case volume was examined using linear regression. RESULTS: There was a high variability within each procedure, with the highest and the lowest CV for radioembolization administration (56.6%) and transjugular liver biopsy (4.9%), respectively. Variation in transarterial chemoembolization cost was mainly driven by microcatheters/microwires, while for nephrostomy, the main drivers were catheters/wires and access sets. Mean spending by physician was not significantly correlated with case volume (P =.584). CONCLUSIONS: Physicians vary in their item selection even for standard procedures. While the financial impact of these differences vary across procedures, these findings suggest that standardization may offer an opportunity for cost savings.


Assuntos
Equipamentos Descartáveis/economia , Custos de Cuidados de Saúde , Disparidades em Assistência à Saúde/economia , Papel do Médico , Padrões de Prática Médica/economia , Radiografia Intervencionista/economia , Radiografia Intervencionista/instrumentação , Radiologistas/economia , Atitude do Pessoal de Saúde , Comportamento de Escolha , Tomada de Decisão Clínica , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estudos Retrospectivos
13.
JAMA Netw Open ; 4(3): e212574, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33704478

RESUMO

Importance: Face masks are recommended to prevent transmission of coronavirus disease 2019 (COVID-19); however, there is scarce evidence on their protection efficacy and ways to improve it. Objective: To determine the proportion of improper face mask use, the factors associated with face mask protection efficacy, and ways to improve efficacy. Design, Setting, and Participants: This population-based cross-sectional study was conducted in China from July to August 2020 in 5 kinds of public places. Participants included convenience samples of individuals wearing face masks and able to taste the check solution. Exposures: Demographic and socioeconomic characteristics, including sex, age, and education level; information on face mask model and the worn duration was recorded. Main Outcomes and Measures: The main outcome as airtightness, assessed by detecting face-to-face mask gaps, movement of cotton fiber placed at the face mask edges, and using a qualitative fit test with a bitter solution spray. Masks were further assessed for whether sealing the upper face mask edge with an adhesive tape strip was associated with improved face mask airtightness. Results: Among 6003 face mask wearers enrolled, the mean (SD) age of participants was 31.1 (13.7) years, and 3047 participants (50.8%) were female. The first qualitative fit test found air leakage in 2754 participants (45.9%; 95% CI, 44.6%-47.1%), which was mostly attributable to gaps at the upper face mask edge. After sealing the upper face mask edge with an adhesive tape strip, 69.7% (95% CI, 68.0%-71.5%) of masks that had exhibited leakage became airtight in the second qualitative fit test, and the rate of airtightness reached 96.2% (95% CI, 95.4%-96.8%) in a third qualitative fit test after new surgical face masks with tape on the upper edge were provided to those who had not converted initially. The tape was well tolerated; overall, 6 participants (1.2%) reported a rash and 24 participants (5.8%) reported significant discomfort. Conclusions and Relevance: In this study of face mask fit among participants in China, although most people used face masks in public places, compromised protection due to suboptimal airtightness was common. The simple approach of sealing the upper edge of the face mask with an adhesive tape strip was associated with substantially improved its airtightness.


Assuntos
COVID-19/prevenção & controle , Fibra de Algodão , Equipamentos Descartáveis , Máscaras , Respiradores N95 , Adulto , COVID-19/transmissão , China , Estudos Transversais , Feminino , Humanos , Masculino , SARS-CoV-2 , Adulto Jovem
14.
Cont Lens Anterior Eye ; 44(4): 101391, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33549474

RESUMO

PURPOSE: To report on the ocular health and safety of children fit with soft hydrogel daily-disposable contact lenses, and followed for 6-years in a double-masked clinical trial investigating the performance of a dual-focus contact lens designed to control myopia progression. METHODS: Children aged 8-12 years, naïve to contact lens wear, were enrolled across four international sites. During years 1-3, children were randomised to either MiSight® 1 day or Proclear® 1 day (both omafilcon A, CooperVision, Inc.). The lenses were identical in material and geometry except for the front optical zone design. At the end of year-3, all those wearing Proclear 1 day were switched to MiSight 1 day, therefore all wore MiSight 1 day in years 4-6. Subjects agreed to wear the lenses at least 10-hours/day, 6-days/week. After dispensing, study visits were at 1-week, 1-month, 6-months and every 6-months until 6-years. At each visit, ocular measurements and subjective responses were recorded. Biomicroscopy used 0-4 grading scales; grade 0 represented no findings. RESULTS: 144 children were enrolled: 69F:75M; mean age 10.1 years; mean cycloplegic spherical-equivalent refraction -2.11D; ethnicities included 34 East-Asian, 12 West-Asian, and 79 Caucasian. 92 completed the 6-years. Only three subjects discontinued due to an ocular adverse event (AE). No contact lens related AEs were classified as serious. The incidence rate of infiltrative AEs was 0.61% (6.1/1000 wearing-years; 95%CI: 0.24%-1.57%). The most common biomicroscopy findings were limbal, bulbar and tarsal hyperaemia and tarsal roughness. 99% of all biomicroscopy findings were grade-1 or lower. After 6-years of lens wear, ocular health by biomicroscopy was similar to pre-lens wear. CONCLUSIONS: Across the 6-years, there were no contact lens related serious AEs and biomicroscopy showed no significant changes. Results suggest that children this age can successfully wear daily-disposable hydrogel contact lenses with minimal impact on ocular physiology.


Assuntos
Lentes de Contato Hidrofílicas , Miopia , Criança , Equipamentos Descartáveis , Humanos , Miopia/terapia , Satisfação do Paciente , Refração Ocular , Visão Ocular
15.
Isr Med Assoc J ; 23(2): 76-81, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33595210

RESUMO

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic presented a major medical management challenge to ophthalmology departments throughout Israel. OBJECTIVES: To examine the managerial challenges, actions taken, and insights of directors of ophthalmology departments in Israel during the COVID-19 pandemic. METHODS: We conducted a cross sectional survey of directors of ophthalmology departments during the COVID-19 pandemic while the Israeli population was quarantined. RESULTS: All 21 directors answered the survey. The majority of the COVID-19 admissions were located in the center of Israel (53%) and Jerusalem (30%). E-communication took a central role in coping with the pandemic with 80% of the directors satisfied with this form of communication; 75% reported a reduction in clinical and surgery volume of at least 25%, and 40% reported reallocations of manpower. Most of the medical staff used gloves, a face shield, disposable robe, and a mask with no uniformity across departments. Cross satisfaction was noted regarding a hospital's ability to equip the departments. Lack of preparation for post-pandemic era was reported by all directors, but one (95%). Directors sought guidelines and uniformity regarding outpatient referral to the hospital (p = 0.035). CONCLUSIONS: Guidelines via safe digital platforms aid in management decisions and uniformity across departments. Advanced preparation is needed to prevent adverse clinical outcomes and to maintain treatment continuum. Our results can be used to guide and help improve the preparedness of ophthalmology departments during COVID-19 and for future pandemics.


Assuntos
COVID-19 , Departamentos Hospitalares/organização & administração , Oftalmologia/organização & administração , Equipamento de Proteção Individual/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Adulto , Comunicação , Estudos Transversais , Equipamentos Descartáveis/estatística & dados numéricos , Luvas Protetoras/estatística & dados numéricos , Departamentos Hospitalares/normas , Humanos , Israel , Máscaras/estatística & dados numéricos , Pessoa de Meia-Idade , Equipamento de Proteção Individual/provisão & distribuição , Quarentena , Encaminhamento e Consulta , Inquéritos e Questionários
16.
Acta Cytol ; 65(3): 235-241, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33631757

RESUMO

PURPOSE: For anaplastic lymphoma kinase (ALK) gene detection, the centrifugal sedimentation method (CSM) and cell block method (CBM) are commonly used to process samples of bloody pleural effusions (BPEs). However, in practice, the impurity content in the processed samples often affects the results and even leads to the detection failure. The purpose of this study was to establish a cell enrichment method (CEM) by using a disposable membrane cell collector to remove blood and inflammatory cells and enrich lung adenocarcinoma cells in BPE for more efficient RNA extraction and ALK gene detection. MATERIALS AND METHODS: CEM proposed in this study and the traditional CSM and CBM were used to treat BPE samples collected from 37 lung adenocarcinoma patients. A DeNovix DS-11 ultraviolet spectrophotometer was used to measure the concentration and purity of extracted RNA. Amplification refractory mutation systems (ARMS) and ABI 7500 fluorescence qPCR were used to detect ALK gene. Through statistical analysis, the CEM was compared with the CSM and CBM in RNA concentration, purity, and ALK gene detection results. RESULTS: The concentration of RNA extracted by using the CEM was significantly higher than that extracted by using the CBM and CSM (p < 0.001). The purity of RNA extracted by using the CEM was significantly higher than that by the other 2 methods (p = 0.011, p = 0.005). ALK gene testing with PCR was successful in all the samples using the CEM, but 2 cases by the CSM and 1 case by the CBM failed. CONCLUSIONS: Using the disposable membrane cell collector to process BPE of lung adenocarcinoma patients for RNA extraction and ALK gene detection is more effective and successful compared with the traditional methods, and it is suggested to be further applied and popularized in clinical practice.


Assuntos
Adenocarcinoma de Pulmão/genética , Quinase do Linfoma Anaplásico/genética , Biomarcadores Tumorais/genética , Separação Celular/instrumentação , Equipamentos Descartáveis , Fusão Gênica , Neoplasias Pulmonares/genética , Membranas Artificiais , Derrame Pleural Maligno/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adenocarcinoma de Pulmão/enzimologia , Adenocarcinoma de Pulmão/patologia , Centrifugação , Humanos , Neoplasias Pulmonares/enzimologia , Neoplasias Pulmonares/patologia , Inclusão em Parafina , Derrame Pleural Maligno/sangue , Derrame Pleural Maligno/enzimologia , Derrame Pleural Maligno/patologia , Valor Preditivo dos Testes , Fixação de Tecidos
17.
Am J Emerg Med ; 44: 124-127, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33607588

RESUMO

During the SARS-CoV-2 pandemic, many emergency departments (EDs) initiated continuous use of N95 disposable respirators (N95s) rather than discarding them after each use to conserve respirators. This study investigates the efficacy of wearing disposable N95s continuously during clinical work. METHODS: This is a prospective cohort study of ED staff required to wear N95s continuously throughout their shifts. Subjects were doctors, nurses, and technicians who were previously fitted for their assigned N95 by employee health. Subjects were fit tested periodically throughout their shifts. Investigators filled out a questionnaire for each subject noting the hours of continuous N95 wear. Data were analyzed using descriptive statistics. RESULTS: One hundred thirteen N95s were evaluated, with 23 failures at first testing. These were not retested. Twenty-seven N95s passed at the start of a shift and did not have repeat testing during the course of the shift. These were excluded from further analysis. Seventeen N95s passed testing after several hours of continuous wear, but only had a single fit test done partway or at the end of a shift. These were assumed to have passed if tested at shift start, and were assigned as "passes" for continuous use. Forty-six N95s had an initial pass and were evaluated for continuous use, of which 6 subsequently failed later in the shift, giving a fail rate with continuous use of 9.5%. CONCLUSION: Continuous use of disposable N95s throughout an ED shift is reasonable during a PPE shortage if wearers are assured of fit at the start of their shift.


Assuntos
COVID-19/prevenção & controle , Serviço Hospitalar de Emergência , Reutilização de Equipamento , Pessoal de Saúde , Respiradores N95 , Estudos Transversais , Equipamentos Descartáveis , Desenho de Equipamento , Humanos , Estudos Prospectivos
18.
Molecules ; 26(3)2021 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-33572552

RESUMO

Glycated albumin (GA) is an important glycemic control marker for diabetes mellitus. This study aimed to develop a highly sensitive disposable enzyme sensor strip for GA measurement by using an interdigitated electrode (IDE) as an electrode platform. The superior characteristics of IDE were demonstrated using one microelectrode of the IDE pair as the working electrode (WE) and the other as the counter electrode, and by measuring ferrocyanide/ferricyanide redox couple. The oxidation current was immediately reached at the steady state when the oxidation potential was applied to the WE. Then, an IDE enzyme sensor strip for GA measurement was prepared. The measurement of fructosyl lysine, the protease digestion product of GA, exhibited a high, steady current immediately after potential application, revealing the highly reproducible measurement. The sensitivity (2.8 nA µM-1) and the limit of detection (1.2 µM) obtained with IDE enzyme sensor strip were superior compared with our previously reported sensor using screen printed electrode. Two GA samples, 15 or 30% GA, corresponding to healthy and diabetic levels, respectively, were measured after protease digestion with high resolution. This study demonstrated that the application of an IDE will realize the development of highly sensitive disposable-type amperometric enzyme sensors with high reproducibility.


Assuntos
Técnicas Biossensoriais/instrumentação , Equipamentos Descartáveis , Enzimas/metabolismo , Albumina Sérica/análise , Eletrodos , Reprodutibilidade dos Testes
19.
Healthc Q ; 23(4): 39-45, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33475491

RESUMO

BACKGROUND: To date, the literature surrounding healthcare sustainability has focused largely on operating rooms, energy efficiency and biohazardous waste management. Few studies have looked at the sustainability within intensive care units (ICUs). OBJECTIVE: Our study sought to capture the array of sustainability initiatives undertaken by Canadian ICUs and gain a better understanding of current practices with regard to the management of single-use equipment waste. METHODS: We conducted a nationwide e-mail survey through the Canadian Critical Care Network. RESULTS: We received responses from a total of 81 hospital sites representing all 10 Canadian provinces and approximately 28.3% of all Canadian ICUs. The vast majority of responses came from ICU managers or nursing leadership. Our study identified variable waste management practices across the country and showcased successful initiatives undertaken by Canadian ICUs toward increased environmental sustainability.


Assuntos
Equipamentos Descartáveis/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Gerenciamento de Resíduos/métodos , Canadá , Equipamentos Descartáveis/provisão & distribuição , Hospitais , Humanos , Inquéritos e Questionários
20.
Nurs Health Sci ; 23(1): 245-254, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33438833

RESUMO

The purpose of this study of healthcare workers who cared for COVID-19 patients was to identify factors that affected the duration of wearing personal protective equipment (PPE). The results of this study will provide initial guidance to practicing clinicians and a foundation for further research on this topic. This cross-sectional study examined 139 frontline healthcare professionals who worked at a single hospital in Wuhan, China, from March 16 to April 1, 2020. General and demographic data, physical and mental status, use of personal protective equipment, type of hospital work, and duration of wearing personal protective equipment were recorded. The mean duration of wearing personal protective equipment was 194.17 min (standard deviation: 3.71). Multiple linear regression analysis indicated that the duration of wearing personal protective equipment was significantly associated with the presence of a chronic disease, working hours when feeling discomfort, lack of patient cooperation and subsequent psychological pressure, prolonged continuous wearing of personal protective equipment, feeling anxious about physical strength, and the presence of fatigue when wearing personal protective equipment. These factors should be considered by practicing healthcare professionals and in future studies that examine the optimal duration of wearing personal protective equipment.


Assuntos
COVID-19/terapia , Equipamentos Descartáveis/estatística & dados numéricos , Pessoal de Saúde/psicologia , Equipamento de Proteção Individual/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , China , Estudos Transversais , Estudos Epidemiológicos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pandemias , Equipamento de Proteção Individual/efeitos adversos , Equipamento de Proteção Individual/classificação , SARS-CoV-2 , Inquéritos e Questionários , Fatores de Tempo
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