scholarly journals Infection prevention measures for orthopaedic departments during the COVID-2019 pandemic: a review of current evidence

2020 ◽  
Vol 1 (4) ◽  
pp. 74-79 ◽  
Author(s):  
Thomas E. Baldock ◽  
Scott M. Bolam ◽  
Ryan Gao ◽  
Mark F. Zhu ◽  
Michael P. J. Rosenfeldt ◽  
...  

Aim The coronavirus disease 2019 (COVID-19) pandemic presents significant challenges to healthcare systems globally. Orthopaedic surgeons are at risk of contracting COVID-19 due to their close contact with patients in both outpatient and theatre environments. The aim of this review was to perform a literature review, including articles of other coronaviruses, to formulate guidelines for orthopaedic healthcare staff. Methods A search of Medline, EMBASE, the Cochrane Library, World Health Organization (WHO), and Centers for Disease Control and Prevention (CDC) databases was performed encompassing a variety of terms including ‘coronavirus’, ‘covid-19’, ‘orthopaedic’, ‘personal protective environment’ and ‘PPE’. Online database searches identified 354 articles. Articles were included if they studied any of the other coronaviruses or if the basic science could potentially applied to COVID-19 (i.e. use of an inactivated virus with a similar diameter to COVID-19). Two reviewers independently identified and screened articles based on the titles and abstracts. 274 were subsequently excluded, with 80 full-text articles retrieved and assessed for eligibility. Of these, 66 were excluded as they compared personal protection equipment to no personal protection equipment or referred to prevention measures in the context of bacterial infections. Results There is a paucity of high quality evidence surrounding COVID-19. This review collates evidence from previous coronavirus outbreaks to put forward recommendations for orthopaedic surgeons during the COVID-19 pandemic. The key findings have been summarized and interpreted for application to the orthopaedic operative setting. Conclusion For COVID-19 positive patients, minimum suggested PPE includes N95 respirator, goggles, face shield, gown, double gloves, and surgical balaclava. Space suits not advised. Be trained in the correct technique of donning and doffing PPE. Use negative pressure theatres if available. Minimize aerosolization and its effects (smoke evacuation and no pulse lavage). Minimize further unnecessary patient-staff contact (dissolvable sutures, clear dressings, split casts).

2020 ◽  
Vol 1 (4) ◽  
pp. 74-79 ◽  
Author(s):  
Thomas E. Baldock ◽  
Scott M. Bolam ◽  
Ryan Gao ◽  
Mark F. Zhu ◽  
Michael P. J. Rosenfeldt ◽  
...  

Aim The coronavirus disease 2019 (COVID-19) pandemic presents significant challenges to healthcare systems globally. Orthopaedic surgeons are at risk of contracting COVID-19 due to their close contact with patients in both outpatient and theatre environments. The aim of this review was to perform a literature review, including articles of other coronaviruses, to formulate guidelines for orthopaedic healthcare staff. Methods A search of Medline, EMBASE, the Cochrane Library, World Health Organization (WHO), and Centers for Disease Control and Prevention (CDC) databases was performed encompassing a variety of terms including ‘coronavirus’, ‘covid-19’, ‘orthopaedic’, ‘personal protective environment’ and ‘PPE’. Online database searches identified 354 articles. Articles were included if they studied any of the other coronaviruses or if the basic science could potentially applied to COVID-19 (i.e. use of an inactivated virus with a similar diameter to COVID-19). Two reviewers independently identified and screened articles based on the titles and abstracts. 274 were subsequently excluded, with 80 full-text articles retrieved and assessed for eligibility. Of these, 66 were excluded as they compared personal protection equipment to no personal protection equipment or referred to prevention measures in the context of bacterial infections. Results There is a paucity of high quality evidence surrounding COVID-19. This review collates evidence from previous coronavirus outbreaks to put forward recommendations for orthopaedic surgeons during the COVID-19 pandemic. The key findings have been summarized and interpreted for application to the orthopaedic operative setting. Conclusion For COVID-19 positive patients, minimum suggested PPE includes N95 respirator, goggles, face shield, gown, double gloves, and surgical balaclava. Space suits not advised. Be trained in the correct technique of donning and doffing PPE. Use negative pressure theatres if available. Minimize aerosolization and its effects (smoke evacuation and no pulse lavage). Minimize further unnecessary patient-staff contact (dissolvable sutures, clear dressings, split casts).


2021 ◽  
Vol 5 (1) ◽  
pp. 214
Author(s):  
Heni Sumastri ◽  
Sari Wahyuni

ABSTRAKVirus Corona merupakan bagian dari keluarga virus yang menyebabkan penyakit mulai dari flu hingga penyakit yang lebih berat. World Health Organization (WHO) memberi nama virus ini Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) dan nama penyakitnya sebagai Corona Virus Disease 2019 (COVID-19). Infeksi SARS-CoV-2 pada manusia menimbulkan gejala gangguan pernapasan akut. Bukti saat ini mengindikasikan bahwa transmisi SARS-CoV-2 terjadi terutama dari orang ke orang melalui kontak langsung, tidak langsung, atau erat dengan orang yang terinfeksi melalui sekresi terinfeksi. Rekomendasi standar untuk mencegah penyebaran infeksi adalah melalui cuci tangan secara teratur, menerapkan etika batuk dan bersin, menghindari kontak secara langsung. Selain rekomendasi diatas, pemerintah juga mengajurkan untuk dapat menerapkan Slogan 4M untuk memutus mata rantai penyebaran COVID-19 yakni dengan Memakai Masker, Mencuci Tangan, Menjaga Jarak, Menghindari Kerumunan. Berdasarkan hasil observasi didapatkan bahwa pengetahuan masyarakat mengenai cara mencegah penyebaran COVID-19 masih rendah serta kurang disiplinnya masyarakat dalam menerapkan protokol kesehatan. Tujuan dari pengabdian masyarakat ini untuk meningkatkan pengetahuan dan keterampilan mengenai cara pencegahan penularan COVID-19 melalui penerapan protokol kesehatan 4M. Kegiatan dilakukan di Desa Pegayut Kabupaten Ogan Ilir pada Desember 2020 yang diikuti oleh 35 orang. Kegiatan diawali dengan persiapan, pembagian leaflet, penjelasan materi dengan metode ceramah tanya jawab, demonstrasi dan evaluasi. Hasil dalam pengabdian masyarakat ini terdapat peningkatan pengetahuan masyarakat desa mengenai cara pencegahan penularan COVID-19 melalui penerapan protokol kesehatan 4M. Luaran yang dicapai adalah peningkatan pengetahuan masyarakat mengenai cara pencegahan penularan COVID-19 dan keterampilan memakai masker dan mencuci tangan dengan benar. Kata Kunci : covid-19; pencegahan; penularan; protokol kesehatan. ABSTRACT Coronaviruses are part of a family of viruses that cause illnesses ranging from the flu to more severe diseases. The World Health Organization (WHO) named this virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and the name of the disease Corona Virus Disease 2019 (COVID-19). SARS-CoV-2 infection in humans causes symptoms of acute respiratory distress. Current evidence indicates that SARS-CoV-2 transmission occurs primarily from person to person through direct, indirect, or close contact with an infected person through infected secretions. Standard recommendations to prevent the spread of infection are through regular hand washing, practicing coughing and sneezing etiquette, avoiding direct contact. In addition to the suggestions above, the government also recommends implementing the 4M Slogan to break the chain of the spread of COVID-19, namely by wearing masks, washing hands, maintaining distance, and avoiding crowds. Based on the results of observations, it was found that public knowledge about how to prevent the spread of COVID-19 is still low and the community lacks discipline in implementing health protocols. This community service aims to increase knowledge and skills regarding how to prevent the transmission of COVID-19 through the application of the 4M health protocol. The activity was carried out in Pegayut Village, Ogan Ilir Regency, in December 2020, which was attended by 35 people. The training begins with preparation, distribution of leaflets, explanation of the material using the question and answers lecture method, demonstration, and evaluation. The results in this community service were an increase in the knowledge of the village community about how to prevent the transmission of COVID-19 through the application of the 4M health protocol. The output achieved was an increase in public knowledge about how to avoid the transmission of COVID-19 and skills to wear masks and wash hands properly. Keywords: covid-19: prevention; transmission; health protocol. 


Author(s):  
Takele S ◽  
◽  
Kedir M ◽  

The coronaviruses are a group of RNA-containing agents known to cause respiratory illnesses in humans and animals. This virus has caused two largescale pandemics in humans in the past two decades, SARS and Middle East Respiratory Syndrome (MERS). A novel coronavirus (SARS-CoV-2) that causes the disease Coronavirus Disease 2019 (COVID-19) has been isolated from in a seafood and poultry market in the Chinese city of Wuhan in 2019. Cases have been detected in most countries worldwide, and on March 11, 2020, the World Health Organization characterized the outbreak as a pandemic. The virus spreads from person-to-person via close contact, respiratory droplets, or surface contact. The disease is mild in most people, yet may progress to pneumonia, acute respiratory distress syndrome, multi-organ dysfunction, and even death. Treatment is essentially supportive as the role of antiviral agents is yet to be established. At the moment, is known relatively little about COVID-19, except that it is a highly pathogenic and possibly zoonotic agent. Therefore, the objective of this review paper is to summarize the current published evidence on the genomic structure, pathogenesis, epidemiology, clinical characteristics, diagnosis, and prevention of SARS-CoV-2 (COVID-19).


Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 835
Author(s):  
Mafalda N. S. Miranda ◽  
Marta Pingarilho ◽  
Victor Pimentel ◽  
Maria do Rosário O. Martins ◽  
Anne-Mieke Vandamme ◽  
...  

To control the Human Immunodeficiency Virus (HIV) pandemic, the World Health Organization (WHO) set the 90-90-90 target to be reached by 2020. One major threat to those goals is late presentation, which is defined as an individual presenting a TCD4+ count lower than 350 cells/mm3 or an AIDS-defining event. The present study aims to identify determinants of late presentation in Europe based on the EuResist database with HIV-1 infected patients followed-up between 1981 and 2019. Our study includes clinical and socio-demographic information from 89851 HIV-1 infected patients. Statistical analysis was performed using RStudio and SPSS and a Bayesian network was constructed with the WEKA software to analyze the association between all variables. Among 89,851 HIV-1 infected patients included in the analysis, the median age was 33 (IQR: 27.0–41.0) years and 74.4% were males. Of those, 28,889 patients (50.4%) were late presenters. Older patients (>56), heterosexuals, patients originated from Africa and patients presenting with log VL >4.1 had a higher probability of being late presenters (p < 0.001). Bayesian networks indicated VL, mode of transmission, age and recentness of infection as variables that were directly associated with LP. This study highlights the major determinants associated with late presentation in Europe. This study helps to direct prevention measures for this population.


Author(s):  
Mara Moreno-Gómez ◽  
Rubén Bueno-Marí ◽  
Andrea Drago ◽  
Miguel A Miranda

Abstract Vector-borne diseases are a worldwide threat to human health. Often, no vaccines or treatments exist. Thus, personal protection products play an essential role in limiting transmission. The World Health Organization (WHO) arm-in-cage (AIC) test is the most common method for evaluating the efficacy of topical repellents, but it remains unclear whether AIC testing conditions recreate the mosquito landing rates in the field. This study aimed to estimate the landing rate outdoors, in an area of Europe highly infested with the Asian tiger mosquito (Aedes albopictus (Skuse, 1894, Diptera: Culididae)), and to determine how to replicate this rate in the laboratory. To assess the landing rate in the field, 16 individuals were exposed to mosquitoes in a highly infested region of Italy. These field results were then compared to results obtained in the laboratory: 1) in a 30 m3 room where nine volunteers were exposed to different mosquito abundances (ranges: 15–20, 25–30, and 45–50) and 2) in a 0.064 m3 AIC test cage where 10 individuals exposed their arms to 200 mosquitoes (as per WHO requirements). The highest mosquito landing rate in the field was 26.8 landings/min. In the room test, a similar landing rate was achieved using 15–20 mosquitoes (density: 0.50–0.66 mosquitoes/m3) and an exposure time of 3 min. In the AIC test using 200 mosquitoes (density: 3,125 mosquitoes/m3), the landing rate was 229 ± 48 landings/min. This study provides useful reference values that can be employed to design new evaluation standards for topical repellents that better simulate field conditions.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Jackline L. Martin ◽  
Franklin W. Mosha ◽  
Eliud Lukole ◽  
Mark Rowland ◽  
Jim Todd ◽  
...  

Abstract Background The spread of pyrethroid resistance in malaria vectors threatens the effectiveness of standard long-lasting insecticidal nets (LLIN). Synergist nets combine pyrethroid (Py) and piperonyl-butoxide (PBO) to enhance potency against resistance mediated by mono-oxygenase mechanisms. Our project assessed personal protection of the World Health Organization first-in-class PBO-Py LLIN (Olyset Plus) versus the standard LLIN (Olyset net) against pyrethroid-resistant Anopheles gambiae sensu lato (s.l.) and An. funestus in North-West Tanzania after 20 months of household use. Methods From a household survey, 39 standard Olyset net and 39 Olyset Plus houses were selected. The physical integrity and hole index (HI) of the nets were assessed, and resting mosquitoes were collected from inside nets and from room walls. The indoor abundance was estimated using CDC light traps and species identified using PCR. The bioefficacy of PBO and standard LLINs against wild Anopheles was assessed using 30-minute cylinder bioassays. Results Of 2397 Anopheles collected, 8.9% (n = 213) were resting inside standard Olyset nets, while none were found inside Olyset Plus nets (PBO-Py LLINs) of any HI category. Resting density of blood-fed mosquitoes was higher on walls of sleeping rooms with Olyset nets compared to Olyset Plus (0.62 vs 0.10, density ratio [DR]: 0.03, 95% CI 0.01–0.13, p < 0.001). Mosquitoes were found inside Olyset nets of all WHO HI categories, but more were collected inside the more damaged nets (HI ≥ 643) than in less damaged (HI 0–64) nets (DR: 6.4, 95% CI 1.1–36.0, p = 0.037). In bioassay, mortality of An. gambiae s.l. was higher with Olyset Plus than with Olyset nets for new nets (76.8% vs 27.5%) and nets used for 20 months (56.8% vs 12.8%); similar trends were observed with An. funestus. Conclusion The PBO-Py LLINs provided improved protection after 20 months of household use, as demonstrated by the higher bioassay mortality and absence of pyrethroid-resistant An. gambiae sensu stricto (s.s.) and An. funestus collected from inside Olyset Plus nets, irrespective of HI category, as compared to Olyset nets.


2021 ◽  
pp. 112067212110186
Author(s):  
Arthur B Cummings ◽  
Cian Gildea ◽  
Antoine P Brézin ◽  
Boris E Malyugin ◽  
Ozlem Evren Kemer ◽  
...  

Since the World Health Organization declared COVID-19 to be a pandemic on 11th March 2020, changes to social and sanitary practices have included significant issues in access and management of eye care during the COVID-19 pandemic. Additionally, the fear of loss, coupled with social distancing, lockdown, economic instability, and uncertainty, have led to a significant psychosocial impact that will have to be addressed. In the current COVID-19 pandemic, personal protective equipment such as face masks or face coverings have become a daily necessity. While “mass masking” along with hand hygiene and social distancing became more widespread, new issues began to emerge – particularly in those who wore spectacles as a means of vision correction. As we began to see routine patients again after the first lockdown had been lifted, many patients visited our clinics for refractive surgery consultations with a primary motivating factor of wanting spectacle independence due to the fogging of their spectacles as a result of wearing a mask. In this article, we report on new emerging issues in eye care due to the widespread use of masks and on the new unmet need in the corneal and cataract refractive surgery fields.


Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1048
Author(s):  
Virginia Solitano ◽  
Maria Corina Plaz Torres ◽  
Nicola Pugliese ◽  
Alessio Aghemo

Direct-acting antivirals (DAA) have revolutionized the treatment of patients with chronic hepatitis C virus (HCV) infection, possibly leading to HCV elimination by 2030 as endorsed by the World Health Organization (WHO). However, some patients belonging to the so-called unique or special populations are referred to as difficult-to-treat due to unreached sustained virological response, potential drug side effects or interactions or co-morbidities. Several years after the DAA introduction and on the basis of excellent findings in terms of efficacy and safety, some doubts arise around the exact meaning of the special population designation and whether this group of patients actually exists. The aim of this review is to discuss and analyze current evidence on the management and treatment of the so-called “unique populations”. We placed particular emphasis on patients with decompensated cirrhosis, chronic kidney disease (CKD), coinfections, rare genotypes, and previous treatment failure, in order to provide physicians with an updated overview of the actual problems and needs in the current scenario.


2020 ◽  
Vol 134 (16) ◽  
pp. 2137-2160 ◽  
Author(s):  
Daniella S. Battagello ◽  
Guilherme Dragunas ◽  
Marianne O. Klein ◽  
Ana L.P. Ayub ◽  
Fernando J. Velloso ◽  
...  

Abstract The highly infective coronavirus disease 19 (COVID-19) is caused by a novel strain of coronaviruses – the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – discovered in December 2019 in the city of Wuhan (Hubei Province, China). Remarkably, COVID-19 has rapidly spread across all continents and turned into a public health emergency, which was ultimately declared as a pandemic by the World Health Organization (WHO) in early 2020. SARS-CoV-2 presents similar aspects to other members of the coronavirus family, mainly regarding its genome, protein structure and intracellular mechanisms, that may translate into mild (or even asymptomatic) to severe infectious conditions. Although the mechanistic features underlying the COVID-19 progression have not been fully clarified, current evidence have suggested that SARS-CoV-2 may primarily behave as other β-coronavirus members. To better understand the development and transmission of COVID-19, unveiling the signaling pathways that may be impacted by SARS-CoV-2 infection, at the molecular and cellular levels, is of crucial importance. In this review, we present the main aspects related to the origin, classification, etiology and clinical impact of SARS-CoV-2. Specifically, here we describe the potential mechanisms of cellular interaction and signaling pathways, elicited by functional receptors, in major targeted tissues/organs from the respiratory, gastrointestinal (GI), cardiovascular, renal, and nervous systems. Furthermore, the potential involvement of these signaling pathways in evoking the onset and progression of COVID-19 symptoms in these organ systems are presently discussed. A brief description of future perspectives related to potential COVID-19 treatments is also highlighted.


2021 ◽  
pp. 2979-2983
Author(s):  
Hamong Suharsono ◽  
Ali Ghufron Mukti ◽  
Ketut Suryana ◽  
I. Wayan Masa Tenaya ◽  
Dilasdita Kartika Pradana ◽  
...  

Background and Aim: Coronavirus disease 2019 (COVID-19) is an acute infectious respiratory disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has spread rapidly globally, resulting in a pandemic. In humans, the main routes of transmission are respiratory droplets and close contact with infected individuals or through contact with an object infected with the virus, followed by touching mouth, nose, or eyes. It is assumed that SARS-CoV-2 was originated in wild animals and was then transmitted to humans. Although some wildlife and domestic animals can be naturally or experimentally infected with the virus, the intermediate hosts that transmitted it to humans are still unknown. Understanding the dynamics of SARS-CoV-2 associated with possible zoonotic transmission of intermediate hosts is considered critical. Reportedly, cats or dogs living with COVID-19-positive humans tested positive for the disease, suggesting that the virus was transmitted to the animals from humans. Information regarding the epidemiological investigation and comprehensive studies is limited. Therefore, it is still unclear how high is the correlation of infection in humans and pet animals, especially those living together. The aim of this study was to investigate the possibility of SARS-CoV-2 infection in the pets of patients with COVID-19 who were hospitalized at the Wangaya hospital, Denpasar, Bali, Indonesia. Materials and Methods: A total of seven clinically asymptomatic pets (six dogs of different races and sexes and a cat [age, 360-2920 days]) were included in this study. These animals belonged to patients with confirmed SARS-CoV-2 infection from August to November 2020. Nasal swab and nasopharyngeal samples were collected from the pets individually under anesthetic condition and were collected 6-12 days after confirmed SARS-CoV-2 infection in owners and hospitalization at the Wangaya Hospital. The swab samples were then processed for RNA isolation and tested using reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2, in accordance with the World Health Organization manual 2020. Results: RT-PCR results for all seven RNA samples, prepared from the swab samples, were negative. For the samples, all PCR products were below the threshold limit, suggesting no genetic material belonging to the samples tested. Conclusion: This was the first preliminary study of COVID-19 on pets in pandemic using RT-PCR. The study tested a very limited quantity of samples, and all of them were negative. However, the way in which the samples were prepared was considered appropriate. Therefore, in further studies, testing of more samples of pets of more individuals with confirmed SARS-CoV-2 infection is required.


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