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1.
MMWR Morb Mortal Wkly Rep ; 69(32): 1070-1073, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32790662

RESUMO

Alcohol-based hand sanitizer is a liquid, gel, or foam that contains ethanol or isopropanol used to disinfect hands. Hand hygiene is an important component of the U.S. response to the emergence of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). If soap and water are not readily available, CDC recommends the use of alcohol-based hand sanitizer products that contain at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol) in community settings (1); in health care settings, CDC recommendations specify that alcohol-based hand sanitizer products should contain 60%-95% alcohol (≥60% ethanol or ≥70% isopropanol) (2). According to the Food and Drug Administration (FDA), which regulates alcohol-based hand sanitizers as an over-the-counter drug, methanol (methyl alcohol) is not an acceptable ingredient. Cases of ethanol toxicity following ingestion of alcohol-based hand sanitizer products have been reported in persons with alcohol use disorder (3,4). On June 30, 2020, CDC received notification from public health partners in Arizona and New Mexico of cases of methanol poisoning associated with ingestion of alcohol-based hand sanitizers. The case reports followed an FDA consumer alert issued on June 19, 2020, warning about specific hand sanitizers that contain methanol. Whereas early clinical effects of methanol and ethanol poisoning are similar (e.g., headache, blurred vision, nausea, vomiting, abdominal pain, loss of coordination, and decreased level of consciousness), persons with methanol poisoning might develop severe anion-gap metabolic acidosis, seizures, and blindness. If left untreated methanol poisoning can be fatal (5). Survivors of methanol poisoning might have permanent visual impairment, including complete vision loss; data suggest that vision loss results from the direct toxic effect of formate, a toxic anion metabolite of methanol, on the optic nerve (6). CDC and state partners established a case definition of alcohol-based hand sanitizer-associated methanol poisoning and reviewed 62 poison center call records from May 1 through June 30, 2020, to characterize reported cases. Medical records were reviewed to abstract details missing from poison center call records. During this period, 15 adult patients met the case definition, including persons who were American Indian/Alaska Native (AI/AN). All had ingested an alcohol-based hand sanitizer and were subsequently admitted to a hospital. Four patients died and three were discharged with vision impairment. Persons should never ingest alcohol-based hand sanitizer, avoid use of specific imported products found to contain methanol, and continue to monitor FDA guidance (7). Clinicians should maintain a high index of suspicion for methanol poisoning when evaluating adult or pediatric patients with reported swallowing of an alcohol-based hand sanitizer product or with symptoms, signs, and laboratory findings (e.g., elevated anion-gap metabolic acidosis) compatible with methanol poisoning. Treatment of methanol poisoning includes supportive care, correction of acidosis, administration of an alcohol dehydrogenase inhibitor (e.g., fomepizole), and frequently, hemodialysis.


Assuntos
Higienizadores de Mão/envenenamento , Metanol/envenenamento , Adulto , Idoso , Arizona/epidemiologia , Ingestão de Alimentos , Feminino , Higienizadores de Mão/química , Humanos , Masculino , Metanol/análise , Pessoa de Meia-Idade , New Mexico/epidemiologia , Envenenamento/epidemiologia , Envenenamento/mortalidade , Adulto Jovem
2.
Sci Total Environ ; 742: 140561, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-32623176

RESUMO

Till date no medication or vaccine is available to cope with the COVID-19 infection and infection rate is increasing drastically across the globe. Only preventive measures and healthy life style with efficient immune system have been suggested by WHO to fight and stay safe from COVID-19. WHO recommended alcohol based hand sanitizers for frequent hand hygiene, which are mainly made up from ethanol, isopropyl alcohols, hydrogen peroxides in different combinations. These preparations may become toxic to human health and environment when misused. These chemicals have known toxic and hazardous impact on environment when released by evaporation. In early five months of 2020, American Association of Poison Control Center reported 9504 alcoholic hand sanitizer exposure cases in children under the age of 12 years and recognized that even a small amount of alcohol can cause alcohol poisoning in children that is responsible for confusion, vomiting and drowsiness, and in severe cases, respiratory arrest and death. Furthermore, frequent usage of said hand sanitizers has reported increased chance of antimicrobial resistance and chance of other viral diseases. Current review is designed with main objective to highlight the toxic and serious health risks to human health and environment by frequent using hand hygiene products with alcohols based formulations.


Assuntos
Infecções por Coronavirus , Higienizadores de Mão , Pandemias , Pneumonia Viral , Betacoronavirus , Criança , Desinfecção das Mãos , Humanos , Estados Unidos
4.
S Afr Med J ; 110(4): 291-295, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32657740

RESUMO

BACKGROUND: South Africa (SA) and other countries worldwide are experiencing extreme drought conditions. Since the start of the drought in SA, many ways of saving water have been proposed and innovative water-saving mechanisms have become part of the lives of communities. We investigated water use during surgical scrubbing procedures and possible interventions to reduce water consumption. OBJECTIVES: To compare water use during surgical hand preparation before and after the implementation of specific water-saving interventions. METHODS: This was a non-randomised controlled study, following a before-and-after design, of orthopaedic theatre personnel scrubbing for surgical cases at Tygerberg Hospital, Cape Town. A control (CON) group (n=32) was established to observe standard practice for baseline measurements including total amount of water used, wash time and water flow rate during surgical hand preparation. After this, three interventions were randomly assigned to a single theatre each, where the same variables were measured. Intervention AS entailed using an alcohol scrub (n=18), intervention SN (n=12) had a dedicated assistant to open and close taps during scrubbing, and intervention SW (n=12) made use of adjusted tap levers to allow the surgeon to open and close taps more easily. Analysis of variance was used to detect global differences between groups, and Tukey's post hoc test was performed to detect differences between groups. RESULTS: Significant differences in water use (p<0.001), wash time (p<0.001) and water flow rate (p<0.001) were observed between the four groups. On average, the AS group used the least water per scrub (mean (standard deviation) 0.82 (1.43) L), which was significantly less than the CON (5.56 (1.79) L; p<0.001) and SN (2.29 (0.37) L; p=0.002) groups. The amount of time spent per scrub was significantly less in the AS group than all the other groups (p<0.05 for all comparisons), with no significant differences observed between the CON, SN and SW groups independently. The SW group had the lowest mean water flow rate (0.73 (0.22) L/min), which was significantly lower than the CON group (2.19 (0.84) L/min; p<0.001). The flow rate of the SN group (1.36 (0.66) L/min) was also significantly lower than that of the CON group (p=0.005). CONCLUSIONS: Water use during surgical hand preparation can easily be reduced by implementing easy and effective interventions. The practicality of interventions may differ between institutions, and their acceptance by surgical staff is important to ensure compliance. However, ensuring that alternative scrubbing options are available to surgical staff would equate to substantial savings over time.


Assuntos
Conservação dos Recursos Hídricos/métodos , Secas , Desinfecção das Mãos/métodos , Higienizadores de Mão , Pessoal de Saúde , Estudos Controlados Antes e Depois , Humanos , Ortopedia , África do Sul , Fatores de Tempo , Água
7.
J Prim Care Community Health ; 11: 2150132720936858, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32578477

RESUMO

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


Assuntos
Infecções por Coronavirus/prevenção & controle , Desinfecção das Mãos/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Áreas de Pobreza , Infecções por Coronavirus/epidemiologia , Higienizadores de Mão/economia , Humanos , Quênia/epidemiologia , Metanálise como Assunto , Pneumonia Viral/epidemiologia , Revisões Sistemáticas como Assunto , Abastecimento de Água/estatística & dados numéricos
8.
Am J Infect Control ; 48(9): 1062-1067, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32565272

RESUMO

BACKGROUND: The emergence of the novel virus, SARS-CoV-2, has posed unprecedented challenges to public health around the world. Currently, strategies to deal with COVID-19 are purely supportive and preventative, aimed at reducing transmission. An effective and simple method for reducing transmission of infections in public or healthcare settings is hand hygiene. Unfortunately, little is known regarding the efficacy of hand sanitizers against SARS-CoV-2. METHODS: In this review, an extensive literature search was performed to succinctly summarize the primary active ingredients and mechanisms of action of hand sanitizers, compare the effectiveness and compliance of gel and foam sanitizers, and predict whether alcohol and non-alcohol hand sanitizers would be effective against SARS-CoV-2. RESULTS: Most alcohol-based hand sanitizers are effective at inactivating enveloped viruses, including coronaviruses. With what is currently known in the literature, one may not confidently suggest one mode of hand sanitizing delivery over the other. When hand washing with soap and water is unavailable, a sufficient volume of sanitizer is necessary to ensure complete hand coverage, and compliance is critical for appropriate hand hygiene. CONCLUSIONS: By extrapolating effectiveness of hand sanitizers on viruses of similar structure to SARS-CoV-2, this virus should be effectively inactivated with current hand hygiene products, though future research should attempt to determine this directly.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/métodos , Higienizadores de Mão/análise , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Etanol/análise , Humanos , Sabões/análise
9.
Indian J Ophthalmol ; 68(6): 981-983, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-401452

RESUMO

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


Assuntos
Aerossóis/efeitos adversos , Betacoronavirus , Conjuntivite Alérgica/induzido quimicamente , Infecções por Coronavirus/epidemiologia , Higienizadores de Mão/efeitos adversos , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Conjuntivite Alérgica/diagnóstico , Infecção Hospitalar/prevenção & controle , Feminino , Humanos , Telemedicina
10.
Sr Care Pharm ; 35(6): 243-246, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: covidwho-381847

RESUMO

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


Assuntos
Betacoronavirus , Infecções por Coronavirus , Higienizadores de Mão , Pandemias , Pneumonia Viral , Infecções por Coronavirus/terapia , Higienizadores de Mão/provisão & distribução , Humanos , Pneumonia Viral/terapia
11.
Contact Dermatitis ; 83(2): 108-114, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32452036

RESUMO

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


Assuntos
Infecções por Coronavirus/prevenção & controle , Dermatite Ocupacional/epidemiologia , Eczema/epidemiologia , Dermatoses da Mão/epidemiologia , Desinfecção das Mãos/tendências , Higienizadores de Mão/uso terapêutico , Pessoal de Saúde/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Creme para a Pele/uso terapêutico , Adulto , Asma/epidemiologia , Betacoronavirus , Comorbidade , Infecções por Coronavirus/terapia , Dermatite Atópica/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Hipersensibilidade Tardia/epidemiologia , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Médicos/estatística & dados numéricos , Pneumonia Viral/terapia , Prevalência , Rinite Alérgica/epidemiologia
12.
Emerg Infect Dis ; 26(9): 2064-2068, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32459621

RESUMO

As a result of the coronavirus disease pandemic, commercial hand hygiene products have become scarce and World Health Organization (WHO) alcohol-based hand rub formulations containing ethanol or isopropanol are being produced for hospitals worldwide. Neither WHO formulation meets European Norm 12791, the basis for approval as a surgical hand preparation, nor satisfies European Norm 1500, the basis for approval as a hygienic hand rub. We evaluated the efficacy of modified formulations with alcohol concentrations in mass instead of volume percentage and glycerol concentrations of 0.5% instead of 1.45%. Both modified formulations met standard requirements for a 3-minute surgical hand preparation, the usual duration of surgical hand treatment in most hospitals in Europe. Contrary to the originally proposed WHO hand rub formulations, both modified formulations are appropriate for surgical hand preparation after 3 minutes when alcohol concentrations of 80% wt/wt ethanol or 75% wt/wt isopropanol along with reduced glycerol concentration (0.5%) are used.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/normas , Higienizadores de Mão/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , 2-Propanol/análise , Etanol/análise , Europa (Continente) , Mãos/microbiologia , Higiene das Mãos/métodos , Higienizadores de Mão/análise , Humanos , Organização Mundial da Saúde
13.
Artigo em Inglês | MEDLINE | ID: mdl-32403261

RESUMO

Hand hygiene is of utmost importance as it may be contaminated easily from direct contact with airborne microorganism droplets from coughs and sneezes. Particularly in situations like pandemic outbreak, it is crucial to interrupt the transmission chain of the virus by the practice of proper hand sanitization. It can be achieved with contact isolation and strict infection control tool like maintaining good hand hygiene in hospital settings and in public. The success of the hand sanitization solely depends on the use of effective hand disinfecting agents formulated in various types and forms such as antimicrobial soaps, water-based or alcohol-based hand sanitizer, with the latter being widely used in hospital settings. To date, most of the effective hand sanitizer products are alcohol-based formulations containing 62%-95% of alcohol as it can denature the proteins of microbes and the ability to inactivate viruses. This systematic review correlated with the data available in Pubmed, and it will investigate the range of available hand sanitizers and their effectiveness as well as the formulation aspects, adverse effects, and recommendations to enhance the formulation efficiency and safety. Further, this article highlights the efficacy of alcohol-based hand sanitizer against the coronavirus.


Assuntos
Desinfecção das Mãos , Higienizadores de Mão , Surtos de Doenças , Desinfetantes , Etanol , Desinfecção das Mãos/normas , Higiene das Mãos , Higienizadores de Mão/toxicidade , Humanos , Controle de Infecções , Sabões , Vírus , Água
14.
Alcohol Alcohol ; 55(4): 354-356, 2020 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-32400852

RESUMO

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


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Dissulfiram/efeitos adversos , Dissulfiram/química , Etanol/química , Etanol/farmacocinética , Higienizadores de Mão/efeitos adversos , Higienizadores de Mão/farmacocinética , Pneumonia Viral/complicações , Administração por Inalação , Testes Respiratórios/métodos , Dissulfiram/farmacocinética , Dissulfiram/uso terapêutico , Etanol/administração & dosagem , Etanol/efeitos adversos , Higienizadores de Mão/administração & dosagem , Higienizadores de Mão/química , Humanos , Pandemias , Absorção Cutânea/efeitos dos fármacos
15.
J Hosp Infect ; 105(3): 424-427, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32360355

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has caused a huge demand for alcohol-based hand rubs, medical gloves, face masks, and gowns in healthcare and from the public. More and more hospitals face a serious shortage of these articles. We propose a risk-adapted approach to ensure adequate patient and healthcare worker safety for as long as possible.


Assuntos
Infecções por Coronavirus/prevenção & controle , Luvas Protetoras/provisão & distribução , Higienizadores de Mão/provisão & distribução , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Máscaras/provisão & distribução , Pandemias/prevenção & controle , Segurança do Paciente , Pneumonia Viral/prevenção & controle , Roupa de Proteção/provisão & distribução , Humanos , Equipamento de Proteção Individual , Comportamento de Redução do Risco
16.
Sr Care Pharm ; 35(6): 243-246, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32456753

RESUMO

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


Assuntos
Betacoronavirus , Infecções por Coronavirus , Higienizadores de Mão , Pandemias , Pneumonia Viral , Infecções por Coronavirus/terapia , Higienizadores de Mão/provisão & distribução , Humanos , Pneumonia Viral/terapia
17.
Indian J Ophthalmol ; 68(6): 981-983, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32461409

RESUMO

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


Assuntos
Aerossóis/efeitos adversos , Betacoronavirus , Conjuntivite Alérgica/induzido quimicamente , Infecções por Coronavirus/epidemiologia , Higienizadores de Mão/efeitos adversos , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Conjuntivite Alérgica/diagnóstico , Infecção Hospitalar/prevenção & controle , Feminino , Humanos , Telemedicina
18.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-fiocruz-SI | ID: lis-47131

RESUMO

Já discutimos em programas anteriores algumas preocupações em relação ao coronavírus em comunidades indígenas. À medida que o novo vírus se alastra pelo Brasil, crescem os temores de que comunidades indígenas sejam dramaticamente afetadas pela covid-19. Por isso, nesse Policast, Ana Lúcia Pontes, médica sanitarista, pesquisadora da Escola Nacional de Saúde Pública Sérgio Arouca (Ensp/Fiocruz) e coordenadora do Grupo de Trabalho de Saúde Indígena da Associação Brasileira de Saúde Coletiva (Abrasco), fala sobre o importante papel do Agente Indígena de Saúde (AIS) na prevenção e combate da Covid-19. Ana Lúcia destaca o papel de educação em saúde, busca ativa dos casos suspeitos e identificação e acompanhamento das pessoas com agravos.


Assuntos
Educação em Saúde , Promoção da Saúde , Acesso à Informação , Infecções Respiratórias , Higienizadores de Mão , Coronavirus
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