RESUMO
Esophagogastroduodenoscopies (EGD) are aerosol-generating procedures that may spread respiratory pathogens. We aim to investigate the production of airborne aerosols and droplets during Cytosponge procedures, which are being evaluated in large-scale research studies and National Health Service (NHS)implementation pilots to reduce endoscopy backlogs. We measured 18 Cytosponge and 37 EGD procedures using a particle counter (diameters = 0.3-25 µm), taking measurements 10 cm from the mouth. Two particle count analyses were performed: whole procedure and event-based. Direct comparison with duration-standardized EGD procedures shows that Cytosponge procedures produce 2.16× reduction (P < 0.001) for aerosols and no significant change for droplets (P = 0.332). Event-based analysis shows that particle production is driven by throat spray (aerosols: 138.1× reference, droplets: 16.2×), which is optional, and removal of Cytosponge (aerosols: 14.6×, droplets: 62.6×). Cytosponge burping produces less aerosols than EGD (2.82×, P < 0.05). Cytosponge procedures produce significantly less aerosols and droplets than EGD procedures and thus reduce two potential transmission routes for respiratory viruses.
Assuntos
Aerossóis e Gotículas Respiratórios , Medicina Estatal , Humanos , Boca , Endoscopia do Sistema Digestório , AerossóisRESUMO
At a solid boundary, the structural formation of bubbles is different from that in the bulk of a liquid foam. The presence of a solid boundary imposes additional constraints, resulting in a crystalline arrangement of the bubbles. For dry and monodisperse foam, the Kelvin and Fejes-Tóth structure is expected in the vicinity of the wall, while a random ordering should occur in the bulk. In this study, we investigate the transition from a crystalline to a random structure near a vertical wall located in the middle of a flat foam cell. The corresponding layering of the liquid was quantified by measuring the distribution of liquid fraction within the cell using neutron radiography. The amplitude of the liquid fraction distribution and its decay with distance from the solid boundary were correlated with the foam bubble size and polydispersity. Furthermore, by applying forced drainage, we measured the corresponding permeability and wetting front velocity near the vertical wall. We found that the crystalline sorting reduces the permeability and wetting front velocity compared to a randomly packed foam.