Endocavity Ultrasound Transducers: Why High-Level Disinfection Is Necessary

2020 ◽  
Author(s):  
Susan Campbell Westerway ◽  
Jocelyne M. Basseal
Keyword(s):  
Imaging Modality ◽  
Case Reports ◽  
Healthcare Providers ◽  
Pathogen Transmission ◽  
Ease Of Use ◽  
Transmission Risk ◽  
Ultrasound Transducers ◽  
Perceived Safety ◽  
Infection Transmission ◽  
High Level

AbstractAs a medical imaging modality, ultrasound is used by a wide cross-section of practitioners including radiologists, obstetricians, gynecologists, gastroenterologists, urologists and cardiologists. The increasing popularity of ultrasound as a diagnostic tool is due not only to the ease of use and portability of systems, but also to the perceived safety aspect of the examination. This latter point needs to be examined. As with any reusable medical device, the ultrasound transducer, also known as a probe, could potentially be a vector for the transmission of pathogenic viruses and fungi between patients if not correctly disinfected after each use. This transmission risk is magnified for an endocavity transducer that has come in contact with the vagina, anal canal or oral cavity, as it could be contaminated with organisms transmitted by blood or mucosal, genital or rectal secretions. Based on the Spaulding system, transducers that come in contact with mucous membranes are classified as semi-critical devices that require high-level disinfection (HLD) after each patient procedure. This HLD process should eliminate all microorganisms except high numbers of bacterial endospores. Only a small number of countries worldwide have implemented transducer reprocessing guidelines that adhere to the Spaulding classification and recommend HLD for endocavity transducers. Overall, there is a lack of conformity among global health agencies regarding the use of HLD for endocavity transducers. This is primarily due to the perception that the infection transmission risk is negligible and that if an endocavity transducer has been covered with a single-use sheath for the procedure, then low-level disinfection provides sufficient protection against pathogen transmission. The objective of this study was to review the published risk of infection transmission from endocavity transducers. By highlighting the outbreaks and case reports that implicate pathogen transmission from transducers, we posit that HLD should be a global standard of practice for the reprocessing of endocavity transducers. It requires substantial time for national health administrations to develop and legislate new recommendations, and for practice changes to be accepted and implemented by healthcare providers. We recommend that Joint Commission International (JCI) and other equivalent organizations enforce the use of HLD of endocavity ultrasound transducers during their accreditation reviews.

scholarly journals Sound Waves for Unsound Entities: An Electronic Search Study to Evaluate the Diagnostic Efficacy of Ultrasonography in Cysts and Tumors of Maxillofacial Region

2013 ◽  
Vol 14 (4) ◽  
pp. 586-589 ◽  
Author(s):  
GA Raviraj ◽  
DD Darshan ◽  
Girish Katti ◽  
NS Manikantan ◽  
AD Manoj Kumar ◽  
...  
Keyword(s):  
Preliminary Report ◽  
Imaging Modality ◽  
Case Reports ◽  
Low Cost ◽  
Sound Waves ◽  
Maxillofacial Region ◽  
Level Of Evidence ◽  
Diagnostic Efficacy ◽  
Electronic Search ◽  
High Level

ABSTRACT Objective The purpose of this electronic search study was to evaluate the diagnostic efficacy of ultrasonography in cysts and tumors of maxillofacial region. Materials and methods An electronic search was performed for articles published from January 1989 to august 2009. Results Only 30 publications were searched and 22 publications showed high level of evidence (4 review articles, 12 clinical studies, 2 case reports, 1 quantitative analysis, 2 research articles and 1 preliminary report) with total of more than 2000 patients. Conclusion Ultrasonography is a noninvasive, low cost procedure, and recommended as a complimentary imaging modality. How to cite this article Darshan DD, Katti G, Raviraj GA, Manikantan NS, Kumar ADM, Balakrishnan D. Sound Waves for Unsound Entities: An Electronic Search Study to Evaluate the Diagnostic Efficacy of Ultrasonography in Cysts and Tumors of Maxillofacial Region. J Contemp Dent Pract 2013; 14(4):586-589.

scholarly journals Two-Stage Isothermal Enzymatic Amplification for Concurrent Multiplex Molecular Detection

2017 ◽  
Vol 63 (3) ◽  
pp. 714-722 ◽  
Author(s):  
Jinzhao Song ◽  
Changchun Liu ◽  
Michael G Mauk ◽  
Shelley C Rankin ◽  
James B Lok ◽  
...  
Keyword(s):  
Point Of Care ◽  
Healthcare Providers ◽  
High Sensitivity ◽  
Ease Of Use ◽  
Isothermal Amplification ◽  
Healthcare Personnel ◽  
Highly Sensitive ◽  
Simple Implementation ◽  
Rapid Amplification ◽  
High Level

Abstract BACKGROUND The wide array of pathogens responsible for infectious diseases makes it difficult to identify causative pathogens with single-plex tests. Although multiplex PCR detects multiple targets, it is restricted to centralized laboratories, which delays test results or makes multiplexing unavailable, depriving healthcare providers of critical, real-time information. METHODS To address the need for point-of-care (POC) highly multiplexed tests, we propose the 2-stage, nested-like, rapid (<40 min) isothermal amplification assay, dubbed rapid amplification (RAMP). RAMP's first-stage uses outer loop-mediated isothermal amplification (LAMP) primers to amplify all targets with recombinase polymerase amplification (RPA). First-stage amplicons are aliquoted to second stage reactors, each specialized for a specific target, to undergo LAMP. The assay is implemented in a microfluidic chip. LAMP amplicons are detected in situ with colorimetric dye or with a fluorescent dye and a smartphone. RESULTS In experiments on a benchtop and in a microfluidic format, RAMP demonstrated high level of multiplexing (≥16); high sensitivity (i.e., 1 plaque-forming unit of Zika virus) and specificity (no false positives or negatives); speed (<40 min); ease of use; and ability to cope with minimally processed samples. CONCLUSIONS RAMP is a hybrid, 2-stage, rapid, and highly sensitive and specific assay with extensive multiplexing capabilities, combining the advantages of RPA and LAMP, while circumventing their respective shortcomings. RAMP can be used in the lab, but one of its distinct advantages is amenability to simple implementation in a microfluidic format for use at the POC, providing healthcare personnel with an inexpensive, highly sensitive tool to detect multiple pathogens in a single sample, on site.

Contaminated flexible endoscopes: Review of impact of channel sampling methods on culture results and recommendations for root-cause analysis

2021 ◽  
pp. 1-16
Author(s):  
Michelle J. Alfa ◽  
Harminder Singh
Keyword(s):  
Sampling Methods ◽  
Root Cause Analysis ◽  
Multidrug Resistant ◽  
Transmission Risk ◽  
Remedial Action ◽  
Sample Collection ◽  
Cause Analysis ◽  
Infection Transmission ◽  
Root Cause ◽  
Critical Aspects

Abstract Recently, infection transmission risk associated with contaminated, patient-ready flexible endoscopes has attracted attention. Outbreaks of multidrug-resistant organisms resulting in infection and/or colonization have been particularly concerning. Recent CDC and FDA recommendations focus on reducing “exogenous” infection transmission and specifically recommend that endoscopy sites have quality systems in place for endoscope reprocessing. Another key recommendation is the culture of patient-ready endoscopes to detect contamination with organisms of concern. Remaining gaps in the guidelines include ensuring that optimal endoscope-channel sample methods are used and ensuring effective root-cause analysis and remediation when contamination is detected. In this review, we summarize the critical aspects of endoscope sample collection and present a practical approach to root-cause analysis and remedial action plans.

scholarly journals 407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 123-123
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Anna Berall ◽  
Marsha Natadira ◽  
Anna Santiago
Keyword(s):  
Family Caregivers ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Well Being ◽  
Moderate Degree ◽  
Quick Response ◽  
Care Providers ◽  
High Level ◽  
Person With Dementia ◽  
The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

scholarly journals Metagenomics Analysis Reveals the Microbial Communities, Antimicrobial Resistance Gene Diversity and Potential Pathogen Transmission Risk of Two Different Landfills in China

Diversity ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 230
Author(s):  
Shan Wan ◽  
Min Xia ◽  
Jie Tao ◽  
Yanjun Pang ◽  
Fugen Yu ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Microbial Communities ◽  
Resistance Gene ◽  
Resistance Genes ◽  
Gene Diversity ◽  
Antibiotic Resistance Gene ◽  
Antibiotic Resistance Genes ◽  
Pathogen Transmission ◽  
Transmission Risk ◽  
Antimicrobial Resistance Gene

In this study, we used a metagenomic approach to analyze microbial communities, antibiotic resistance gene diversity, and human pathogenic bacterium composition in two typical landfills in China. Results showed that the phyla Proteobacteria, Bacteroidetes, and Actinobacteria were predominant in the two landfills, and archaea and fungi were also detected. The genera Methanoculleus, Lysobacter, and Pseudomonas were predominantly present in all samples. sul2, sul1, tetX, and adeF were the four most abundant antibiotic resistance genes. Sixty-nine bacterial pathogens were identified from the two landfills, with Klebsiella pneumoniae, Bordetella pertussis, Pseudomonas aeruginosa, and Bacillus cereus as the major pathogenic microorganisms, indicating the existence of potential environmental risk in landfills. In addition, KEGG pathway analysis indicated the presence of antibiotic resistance genes typically associated with human antibiotic resistance bacterial strains. These results provide insights into the risk of pathogens in landfills, which is important for controlling the potential secondary transmission of pathogens and reducing workers’ health risk during landfill excavation.

scholarly journals Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

2021 ◽  
Vol 18 (9) ◽  
pp. 5018
Author(s):  
Ik-Whan G. Kwon ◽  
Sung-Ho Kim ◽  
David Martin
Keyword(s):  
Precision Medicine ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Collaborative Tools ◽  
High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

scholarly journals Should COVID-19 Mother Breastfeed her Newborn Child? A Literature Review on the Safety of Breastfeeding for Pregnant Women with COVID-19

2021 ◽  
Author(s):  
Harshil Bhatt
Keyword(s):  
Direct Contact ◽  
Preventive Measures ◽  
Case Reports ◽  
Healthcare Providers ◽  
Case Series ◽  
Limited Evidence ◽  
Her Family ◽  
Viral Antibodies ◽  
Newborn Child ◽  
Droplet Transmission

Abstract Purpose of Review Breastfeeding is beneficial to both the newborn and the mother. During the COVID-19 pandemic, concerns have been raised on whether the SARS-CoV-2 virus could be transmitted from COVID-19 positive mother to the newborn through breastmilk. The purpose of this review is to examine the available evidence on the risks of transmission of infection from COVID-19 mothers to their newborns through breastfeeding. Recent Findings Data is very limited in this regard, with only a few smaller case series, and case reports have been published so far. In most of the studies, breastmilk samples from COVID-19 mothers tested negative for the virus. In the case reports where the virus was detected in breastmilk and the infants were diagnosed with COVID-19, it remained unclear whether the disease was transmitted through breastmilk or direct contact or through delivery. Another hypothesis is that the viral antibodies could pass to the newborn passively through breastmilk of COVID-19 positive mothers and give immunity to the child, but data is minimal. Summary Based on the currently available limited evidence and recognizing the benefits of breastfeeding, it may be concluded that if the health of the mother and her newborn allows, direct breastfeeding or extracted breastmilk should be encouraged by the healthcare providers after a careful discussion of the risks of vertical transmission to the mother and her family. Preventive measures should be taken by COVID-19 mothers to prevent droplet transmission of infection to the infants while breastfeeding.

scholarly journals Neurological manifestations and neuroimaging findings in patients with SARS-CoV2—a systematic review

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Nikita Mohan ◽  
Muhammad Ali Fayyaz ◽  
Christopher del Rio ◽  
Navpreet Kaur Rajinder Singh Khurana ◽  
Sampada Sandip Vaidya ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Case Reports ◽  
Healthcare Providers ◽  
Case Series ◽  
Altered Mental Status ◽  
Common Finding ◽  
Cochrane Library ◽  
Neurological Manifestations ◽  
The Cochrane Library ◽  
Ct And Mri

Abstract Background The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information. Objective To evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2. To identify neuro-invasive pathways of COVID infection. Methods Relevant studies were identified through four databases—the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords—“COVID-19,” “SARS-CoV2,” “neurological manifestations,” “neuroimaging,” “CT,” and “MRI.” Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020. Results Our review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases. Conclusion The information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.

scholarly journals Feasibility, usability and acceptability of paediatric lung ultrasound among healthcare providers and caregivers for the diagnosis of childhood pneumonia in resource-constrained settings: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042547
Author(s):  
Atif Riaz ◽  
Olga Cambaco ◽  
Laura Elizabeth Ellington ◽  
Jennifer L Lenahan ◽  
Khatia Munguambe ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Lung Ultrasound ◽  
New Technology ◽  
Healthcare Providers ◽  
Ease Of Use ◽  
Local Context ◽  
Future Research ◽  
Successful Implementation ◽  
Pneumonia Diagnosis

ObjectivesPaediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.DesignProspective qualitative study using semistructured interviewsSettingTwo referral hospitals in Mozambique and PakistanParticipantsA total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.ResultsHCPs highlighted themes of limited resource availability for the feasibility of LUS implementation, including perceived high cost of equipment, maintenance demands, time constraints and limited trained staff. HCPs emphasised the importance of policymaker support and caregiver acceptance for long-term success. HCP perspectives of usability highlighted ease of use and integration into existing workflow. HCPs and caregivers had positive attitudes towards LUS with few exceptions. Both HCPs and caregivers emphasised the potential for rapid, improved diagnosis of paediatric respiratory conditions using LUS.ConclusionsThis was the first study to evaluate HCP and caregiver perspectives of paediatric LUS through qualitative analysis. Critical components impacting feasibility, usability and acceptability of LUS for paediatric pneumonia diagnosis in LMIC were identified for initial deployment. Future research should explore LUS sustainability, with a particular focus on quality control, device maintenance and functionality and adoption of the new technology within the health system. This study highlights the need to engage both users and recipients of new technology early in order to adapt future interventions to the local context for successful implementation.Trial registration numberNCT03187067.

scholarly journals Carebots

2016 ◽  
Vol 138 (09) ◽  
pp. S8-S13 ◽  
Author(s):  
Thiago Marinho ◽  
Christopher Widdowson ◽  
Amy Oetting ◽  
Arun Lakshmanan ◽  
Hang Cui ◽  
...  
Keyword(s):  
Older Adults ◽  
Multidisciplinary Approach ◽  
Human Perception ◽  
The Elderly ◽  
Comfort Level ◽  
Robot System ◽  
Perceived Safety ◽  
High Level ◽  
Future Work ◽  
Flying Robots

This article demonstrates a multidisciplinary approach that proposes to augment future caregiving by prolonged independence of older adults. The human–robot system allows the elderly to cooperate with small flying robots through an appropriate interface. ASPIRE provides a platform where high-level controllers can be designed to provide a layer of abstraction between the high-level task requests, the perceptual needs of the users, and the physical demands of the robotic platforms. With a robust framework that has the capability to account for human perception and comfort level, one can provide perceived safety for older adults, and further, add expressively that facilitates communication and interaction continuously throughout the stimulation. The proposed framework relies on an iterative process of low-level controllers design through experimental data collected from psychological trials. Future work includes the exploration of multiple carebots to cooperatively assist in caregiving tasks based on human-centered design approach.

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